HIV Treatment Optimism Moderates the Relationship between Sexual Risk Behavior and HIV Risk Perception among Urban HIV-negative Gay, Bisexual, and Other Men who have Sex With Men

Using baseline data of the Engage Cohort Study, a Canadian study of sexually active gay, bisexual and other men who have sex with men (GBM), we evaluated the association between sexual behavior and risk perception among HIV-negative participants and whether HIV treatment optimism moderated this relationship. Participants were recruited by respondent-driven-sampling (RDS). We defined high-risk sexual behavior in the past six months as any condomless anal sex with a casual partner (i.e. not the participant's main partner) with either unknown HIV-status where neither used pre-exposure prophylaxis or with a partner living with HIV having detectable/unknown viral load. We assessed HIV treatment optimism-skepticism using a 12-item scale. RDS-II-weighted adjusted logistic regression models examined associations with risk perception measured by the question "How would you assess your current risk of getting HIV?" (response options were on a 6-point Likert-scale ranging from "very unlikely" to "very likely", dichotomized into "No Perceived Risk" (very unlikely/unlikely) and "Perceived Risk" (somewhat likely/likely/very likely/I think I already have HIV). Of 1961 participants, engagement in high-risk sexual behavior was reported by 155 (17.0%), 62 (12.4%), 128 (17.2%) of participants in Montr & eacute;al, Toronto, and Vancouver, respectively. High-risk sexual behavior increased the odds of perceived HIV risk (pooled adjusted odds ratio = 2.9, 95%CI = 2.2-3.8). HIV treatment optimism-skepticism scores moderated the relationship: for GBM engaging in high-risk sexual behavior, higher HIV treatment optimism-skepticism scores increased perceived HIV risk. Promoting awareness around advances related to HIV prevention and treatment is important for appropriate risk assessment and for increased engagement in prevention interventions. Evaluamos la asociaci & oacute;n entre el comportamiento sexual y la percepci & oacute;n de riesgo entre los participantes VIH negativos y si el optimismo sobre el tratamiento del VIH moder & oacute; esta asociaci & oacute;n. Definimos comportamiento sexual de alto riesgo en los & uacute;ltimos seis meses como cualquier sexo anal sin cond & oacute;n con una pareja casual con un estado de VIH desconocido donde ninguno utiliz & oacute; profilaxis previa a la exposici & oacute;n o con una pareja que vive con el VIH y que tiene una carga viral detectable/desconocida. Se evalu & oacute; el optimismo sobre el tratamiento del VIH mediante una escala de 12 & iacute;tems. Los modelos de regresi & oacute;n log & iacute;stica ajustados examinaron las asociaciones con la percepci & oacute;n del riesgo ("Riesgo no percibido" vs. "Riesgo percibido"). De 1961 participantes, 155 (17,0%), 62 (12,4%), 128 (17,2%) de los participantes en Montreal, Toronto y Vancouver, informaron comportamiento sexual de alto riesgo. El comportamiento sexual de alto riesgo se mostr & oacute; asociado con riesgo percibido. El optimismo sobre el tratamiento modero la asociaci & oacute;n. Promover la conciencia sobre los avances relacionados con la prevenci & oacute;n y el tratamiento del VIH es importante para una evaluaci & oacute;n adecuada de los riesgos y una mayor participaci & oacute;n en las intervenciones de prevenci & oacute;n.