Psychosocial predictors of HIV/STI risk behaviours in a sample of homosexual men.

OBJECTIVES To determine the prevalence of STI/HIV risk behaviours in a sample of homosexual men and investigate the psychosocial and cognitive variables associated with these behaviours. METHOD A sample of 123 users of a homosexual men's sexual health clinic completed a questionnaire which included demographic information, psychometric measures, history of sexual risk behaviour, and history of non-consensual sex (NCS). RESULTS High rates of sexual risk were found in this sample behaviour (36% of men had risky sex in the previous month) despite using a narrower definition than other recent studies. Comparable rates of non-consensual sex were found in this sample (26% of the sample had experienced NCS); however, this variable was not directly linked to increased risk behaviour. Depression and cognitions associated with controllability or predictability of risk were associated with increased HIV/STI risk behaviour. CONCLUSIONS Clinical measures of depression are associated with risk behaviour in this sample as are cognitions about the uncontrollability of risk and reducing chances of exposure to HIV by insertive sexual practices and fidelity. Demographic variables, a history of non-consensual sex and depression are not predictors of risk behaviour when sexual risk cognitions are used to predict unsafe sexual practices indicating that cognitions are foremost in driving risk behaviours, demographic variables, and the NCS history of the subject. Given the considerable costs of providing medical care to patients with HIV it is likely that even modest reductions in rates of HIV infection through proactive psychological interventions to modify erroneous cognitions will prove highly cost effective.