A cautionary tale: risk reduction strategies among urban American Indian/Alaska Native men who have sex with men

AIDS Educ Prev. 2013 Feb;25(1):25-37. doi: 10.1521/aeap.2013.25.1.25.


American Indian and Alaska Native (AIAN) men who have sex with men (MSM) are considered particularly high risk for HIV transmission and acquisition. In a multi-site cross-sectional survey, 174 AIAN men reported having sex with a man in the past 12 months. We describe harm reduction strategies and sexual behavior by HIV serostatus and seroconcordant partnerships. About half (51.3%) of the respondents reported no anal sex or 100% condom use and 8% were in seroconcordant monogamous partnership. Of the 65 men who reported any sero-adaptive strategy (e.g., 100% seroconcordant partnership, strategic positioning or engaging in any strategy half or most of the time), only 35 (54.7%) disclosed their serostatus to their partners and 27 (41.5%) tested for HIV in the past 3 months. Public health messages directed towards AIAN MSM should continue to encourage risk reduction practices, including condom use and sero-adaptive behaviors. However, messages should emphasize the importance of HIV testing and HIV serostatus disclosure when relying solely on sero-adaptive practices.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Alaska
  • Condoms / statistics & numerical data
  • Cross-Sectional Studies
  • HIV Infections / ethnology
  • HIV Infections / prevention & control*
  • HIV Infections / psychology
  • HIV Infections / transmission
  • HIV Seronegativity
  • Health Knowledge, Attitudes, Practice
  • Homosexuality, Male / statistics & numerical data*
  • Humans
  • Indians, North American / psychology*
  • Indians, North American / statistics & numerical data
  • Male
  • Middle Aged
  • Risk Factors
  • Risk Reduction Behavior*
  • Risk-Taking
  • Sexual Partners*
  • Socioeconomic Factors
  • Surveys and Questionnaires
  • Truth Disclosure
  • Unsafe Sex / statistics & numerical data
  • Urban Population
  • Young Adult