Unprotected anal intercourse in HIV‐infected and non‐HIV‐infected gay men

Abstract

In 1990, gay men (N = 296) in Sydney, Australia, were asked to recall two sexual encounters from the preceding year: one in which they had unprotected anal intercourse (“unsafe” encounter) and one in which they had resisted a strong temptation to have unprotected intercourse (“safe” encounter). The aims were to record self‐justifications for unprotected intercourse used in the unsafe encounter and to identify situational factors distinguishing between the encounters. Among men who had been HIV infected at the time of the unsafe encounter (n = 88), the most common self‐justification had been the thought that they had nothing more to lose; among uninfected men (n = 207), it had been a resolution to have intercourse without ejaculation. The first factor emerging from a factor analysis of the infected group's self‐justifications involved reactions to a negative mood state; in the uninfected group it involved inferring from perceptible characteristics that the partner was unlikely to be infected. Some variables (e.g., closeness of the relationship to the partner, mood, communication, and use of “dirty talk”) distinguished between the unsafe and safe encounters equally among those who had been infected in both encounters (n = 76) and those who had been uninfected in both (n = 170). Other variables (knowledge that unprotected intercourse is a high risk activity, drug use, use of pornography, and condom availability) did not distinguish between the encounters in either group. Desire to seek adventure and excitement through sex distinguished between the encounters only in the infected group, and level of intoxication did so only in the uninfected group. Results are discussed in relation to those obtained in our earlier studies of gay men in Melbourne; we also discuss how such data might be put to use in AIDS education programs for gay men.