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Patient Educ Couns. 2007 Jan;65(1):5-20. Epub 2006 Nov 13.

Sexual risk behavior among HIV-positive men who have sex with men: a literature review.

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  • 1Center for Research on HIV/AIDS Prevention and Education (Reshape), Department of Experimental Psychology, Maastricht University, The Netherlands.



To review research on sexual risk behavior among HIV-positive men who have sex with men (MSM) after the year 2000.


The review included 53 published studies that reported on unprotected anal intercourse (UAI) in cross-sectional and longitudinal surveys of HIV-positive MSM and MSM of mixed HIV status.


The findings indicate high levels of UAI among HIV-positive MSM, particularly with HIV-negative or HIV status unknown partners. In studies of MSM of mixed HIV status, we found that the rate of UAI among HIV-positive MSM was much higher than that of HIV-negative MSM. Furthermore, the prevalence of UAI among HIV-positive MSM has increased in recent years.


Although studies indicate that HIV-positive MSM have adopted risk reduction strategies, roughly two in five HIV-positive MSM continue to engage in UAI, which represents a risk for continued HIV and STI (sexually transmitted infection) transmission.


Prevention efforts targeting HIV-positive MSM to assist them in adopting and maintaining safer sexual behaviors need to be intensified.

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