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A Plausible Causal Model of HAART-Efficacy Beliefs, HIV/AIDS Complacency, and HIV-Acquisition Risk Behavior Among Young Men Who Have Sex with Men |
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| Authors: | Duncan A MacKellar Su-I Hou Christopher C Whalen Karen Samuelsen Linda A Valleroy Gina M Secura Stephanie Behel Trista Bingham David D Celentano Beryl A Koblin Marlene LaLota Douglas Shehan Hanne Thiede Lucia V Torian |
| Institution: | 1. Division of HIV/AIDS Prevention-Surveillance and Epidemiology, National Center for HIV, STD, and TB Prevention, Centers for Disease Control and Prevention, 1600 Clifton Road NE, MS E-46, Atlanta, GA, 30333, USA 2. College of Public Health, University of Georgia, Athens, GA, USA 3. Department of Educational Psychology and Instructional Technology, University of Georgia, Athens, GA, USA 4. Los Angeles County Department of Health Services, Los Angeles, CA, USA 5. Johns Hopkins University School of Hygiene and Public Health, Baltimore, MD, USA 6. The New York Blood Center, New York, NY, USA 7. Florida Department of Health, Tallahassee, FL, USA 8. University of Texas Southwestern Medical Center at Dallas, Dallas, TX, USA 9. Public Health??Seattle and King County, Seattle, WA, USA 10. New York City Department of Health, New York, NY, USA |
| Abstract: | Despite considerable research, the causal relationship remains unclear between HIV/AIDS complacency, measured as reduced HIV/AIDS concern because of highly active antiretroviral therapy (HAART), and HIV risk behavior. Understanding the directionality and underpinnings of this relationship is critical for programs that target HIV/AIDS complacency as a means to reduce HIV incidence among men who have sex with men (MSM). This report uses structural equation modeling to evaluate a theory-based, HIV/AIDS complacency model on 1,593 MSM who participated in a venue-based, cross-sectional survey in six U.S. cities, 1998?C2000. Demonstrating adequate fit and stability across geographic samples, the model explained 15.0% of the variance in HIV-acquisition behavior among young MSM. Analyses that evaluated alternative models and models stratified by perceived risk for HIV infection suggest that HIV/AIDS complacency increases acquisition behavior by mediating the effects of two underlying HAART-efficacy beliefs. New research is needed to assess model effects on current acquisition risk behavior, and thus help inform prevention programs designed to reduce HIV/AIDS complacency and HIV incidence among young MSM. |
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