The SafeGuards Men's Survey: Report of a Survey of Philadelphia Gay and Bisexual Men's Knowledge, Attitudes, Beliefs, and Behaviors Related to HIV Infection
Tóm tắt
Objective: To characterize HIV-related knowledge, attitudes, beliefs, and behaviors in a sample of gay and bisexual men in the greater Philadelphia area, to allow rational development of HIV prevention strategies. Design: Self-administered survey. Setting: Gay social groups, bars, service organizations, sex establishments, and street outreach in the greater Philadelphia area. Subjects: Gay and bisexual men who accepted $2–$4 for completing surveys in the above venues. Measurements: The survey booklet, available in English and Spanish, was completed by each subject in a multiple-choice and yes/no format. Questions were based on prior HIV prevention surveys, with new items added to sample dimensions identified from the literature as of interest. Data were analyzed using descriptive statistics, cross-tabulations, correspondence analysis, and logistic regression. Results: Overall knowledge of HIV transmission was high in the sample, but specific details were lacking for many subjects and overall knowledge was poorest in the least educated and poorest segment of the population. Attitudes including internal locus of control, level of fear, and peer support were important determinants of specific sexual behaviors. Sexual behaviors occurred in “clusters” or profiles that were partly determined by risk level and partly by sexual role preferences. Unprotected anal sex was more common among primary partners than nonprimary partners, regardless of the duration of the primary relationship. Conclusions: These results confirm that socio-economic status is an important determinant of HIV transmission risk, but that this is at least partly mediated by important differences in knowledge, attitudes, and beliefs. High-risk sexual behaviors do not occur in isolation, but form profiles or clusters that are related to various demographic and attitudinal factors. These findings can contribute to rationally designed prevention strategies.
Tài liệu tham khảo
Sullivan PS, Chu SY, Fleming PL, Ward JW. Changes in AIDS incidence for men who have sex with men, United States, 1990–1995. AIDS, 1997;11:1641-46.
Rotello G. Sexual Ecology: AIDS and the Destiny of Gay Men. New York: Dutton, 1997.
Hospers HJ, Kok G. Determinants of safe and risk-taking sexual behavior among gay men: A review. AIDS Educ Prev 1995;7:74-94.
Carlin E, Miller L, Fiona B. The hazards of oral sex. Sex Transm Dis 1994;21:241-42.
Lifson AR, O'Malley PM, Hessol NA, Buchbinder SP, Cannon L, Rutherford, GW. HIV seroconversion in two homosexual men after receptive oral intercourse with ejaculation: Implications for counseling concerning safe sexual practices. Am J Publ Health 1990;80:1509-11.
Rozenbaum W, Gharakhanian S, Cardon B, Duval E, Coulaud JP. HIV transmission by oral sex. Lancet. 1988;1:1395.
Ross MW, McLaws M-L. Subjective norms about condoms are better predictors of use and intention to use than attitudes. Health Educ Res 1992;7:335-39.
Kelly J, St. Lawrence JS, Brasfield TL, et al. Psychological factors that predict AIDS high-risk versus AIDS precautionary behavior. J Clin Consult Psychol. 1990;58:117-20.
Connell RW, Crawford J, Dowsett GW, Kippax S, Sinnott V, Rodden P, Berg R, Baxter D, Waston L. Danger and context: Unsafe anal sexual practice among homosexual and bisexual men in the AIDS crisis. Aust N Z J Sociol 1990;26:187-208.
Myers T, Locker D, Orr K, Jackson E. Men's Survey '90. In: AIDS: Knowledge, Attitudes, Behaviors. A Study of Gay and Bisexual Men in Toronto. Toronto. AIDS Committee of Toronto, 1991.
Grizzle JE, Starmer CF, Koch GG. Analysis of categorical data by means of linear models. Biometrics 1969;25:489-504.
Greenacre, MJ. Theory and Applications of Correspondence Analysis. New York, Academic Press, 1984.
Godin G, Savard, J, Kok G, Fortin C, Boyer R. HIV seropositive men: Understanding adoption of safe sexual practices. AIDS Educ Prev 1996;8:529-545.
Robins, AG, Dew MA, Kingsley LA, Becker JT. Do homosexual and bisexual men who place others at potential risk for HIV have unique psychosexual profiles? AIDS Educ Prev 1997;9:239-51.
Averill JR. The role of emotion and psychological defense in self-protective behavior. In: Weinstein ND, editor. Taking Care: Understanding and Encouraging Self-Protective Sexual Behavior. Cambridge, Cambridge University Press, 1987;54-78.
Hays RB, Kegeles SM, Coates TJ. Unprotected sex and HIV risk taking among young gay men within boyfriend relationships. AIDS Educ Prev 1997;9:314-29.
Stall RD, McKusick L, Wiley J, Coates TJ, Ostrow DG. Alcohol and drug use during sexual activity and compliance with safe sex guidelines for AIDS: The AIDS behavioral research project. Health Educ Q 1986;13:359-71.
Siegel K, Mesagno FP, Chen J-Y, Christ G. Factors distinguishing homosexual males practicing risky and safer sex. Soc Sci Med 1989;28:561-69.