Gay men who have poor communication skills and feel unable to protect themselves against HIV infection are more likely to engage in risky sexual behaviors, according to newly released data. The research, published in the June issue of the American Journal of Public Health, concludes that these are among many different combinations of behavioral factors that may be linked to risky sex among gay men.
The two behaviors that proved the most likely predictors of risky sexual behavior � noninjection drug use and enjoyment of unprotected receptive anal sex � accounted for risky sex in only one-third of the men, according to Margaret A. Chesney, Ph.D., who conducted the study while at the University of California, San Francisco.
The wide variety in risk-related behaviors suggests that one-on-one counseling, tailored to the particular behaviors practiced by each man, might be useful in preventing new HIV infections, the researchers say.
The data reported by Chesney and colleagues come from a study, still in progress, called EXPLORE, the first randomized clinical trial examining whether behavioral counseling might help reduce the rates of HIV infection in the United States.
Men participating in the trial are randomly assigned to receive either 10 one-on-one counseling sessions along with HIV testing every six months or only standard testing and counseling every six months.
The personalized counseling sessions begin by determining which of an individual's behaviors may be likely to lead to risky sexual behavior, followed by more tailored sessions that address these specific behaviors. For instance, men who report having poor communication skills may receiving coaching on how to discuss their HIV status with their partners.
The men enrolled in the study are at "high risk" of HIV infection, according to Beryl Koblin, Ph.D., of the New York Blood Center and colleagues. Koblin and colleagues report that alcohol and drug use, multiple partners or one primary partner are all associated with unprotected sex among the men
The results of the trial will be available in 2004.
