Sexual risk behavior among HIV-positive men who have sex with men: a literature review

Patient Educ Couns. 2007 Jan;65(1):5-20. doi: 10.1016/j.pec.2006.09.003. Epub 2006 Nov 13.


Objective: To review research on sexual risk behavior among HIV-positive men who have sex with men (MSM) after the year 2000.

Method: The review included 53 published studies that reported on unprotected anal intercourse (UAI) in cross-sectional and longitudinal surveys of HIV-positive MSM and MSM of mixed HIV status.

Results: The findings indicate high levels of UAI among HIV-positive MSM, particularly with HIV-negative or HIV status unknown partners. In studies of MSM of mixed HIV status, we found that the rate of UAI among HIV-positive MSM was much higher than that of HIV-negative MSM. Furthermore, the prevalence of UAI among HIV-positive MSM has increased in recent years.

Conclusion: Although studies indicate that HIV-positive MSM have adopted risk reduction strategies, roughly two in five HIV-positive MSM continue to engage in UAI, which represents a risk for continued HIV and STI (sexually transmitted infection) transmission.

Practice implications: Prevention efforts targeting HIV-positive MSM to assist them in adopting and maintaining safer sexual behaviors need to be intensified.

Publication types

  • Review

MeSH terms

  • Antiretroviral Therapy, Highly Active / psychology
  • Attitude to Health
  • Cross-Sectional Studies
  • HIV Seropositivity / psychology*
  • HIV Seropositivity / transmission
  • Harm Reduction
  • Health Knowledge, Attitudes, Practice
  • Health Services Needs and Demand
  • Homosexuality, Male / psychology*
  • Humans
  • Longitudinal Studies
  • Male
  • Primary Prevention
  • Research Design
  • Risk Factors
  • Risk Reduction Behavior
  • Risk-Taking*
  • Sexual Partners
  • Unsafe Sex / prevention & control
  • Unsafe Sex / psychology*