Actual versus perceived HIV status, sexual behaviors and predictors of unprotected sex among young gay and bisexual men who identify as HIV-negative, HIV-positive and untested

AIDS. 1997 Oct;11(12):1495-502. doi: 10.1097/00002030-199712000-00014.


Objectives: To compare the prevalence and predictors of HIV sexual risk behavior among young gay and bisexual men who perceived themselves to be HIV-negative, HIV-positive, or who were untested.

Design: Population-based sample of young gay and bisexual men.

Methods: Using multi-stage probability sampling, 408 gay and bisexual men aged 18-29 years in San Francisco were recruited and interviewed, and blood samples for HIV-testing from 364 participants were obtained.

Results: HIV prevalence was 18.7%, although 25% of the men who were HIV-positive did not know it. Thirty-seven per cent reported engaging in unprotected anal intercourse during the past year, including 59% of the men who knew they were HIV-positive, 35% of the men who perceived themselves HIV-negative and 28% of the untested men. Logistic regressions found similar predictors of unprotected intercourse for HIV-negatives and HIV-positives, including sexual impulsivity, substance use, sexual enjoyment and communication problems.

Conclusions: The high rates of unprotected intercourse, particularly among the HIV-positive men, attest to the urgent need for HIV-prevention interventions for young gay and bisexual men. The findings suggest that many of the important variables to target in interventions are similar for both HIV-positive and HIV-negative men.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Adult
  • Bisexuality
  • HIV Infections / complications
  • HIV Infections / epidemiology
  • HIV Infections / psychology*
  • HIV Seronegativity*
  • HIV Seropositivity / psychology*
  • HIV-1*
  • Health Education
  • Health Knowledge, Attitudes, Practice
  • Homosexuality, Male / psychology*
  • Humans
  • Impulsive Behavior / psychology
  • Male
  • Prevalence
  • Risk-Taking
  • Sexual Behavior / psychology*
  • Substance-Related Disorders / complications
  • Surveys and Questionnaires
  • United States / epidemiology