Differences Between HIV-Positive and HIV-Negative African American Men Who Have Sex with Men in Two Major U.S. Metropolitan Areas

Alarmingly high HIV prevalence rates among African American men who have sex with men (AAMSM) require the development of effective
prevention interventions. In this study of AAMSM conducted in two cities, we explored similarities and differences between
HIV-positive and HIV-negative AAMSM on sociodemographic variables, HIV-related risk behaviors, and attitudinal constructs.
Differences emerged in several major life areas: (1) poverty, employment, and use of mental health services, (2) sexual risk
behaviors, and (3) self-identification with gay identity and culture. With regard to sociodemographic indicators, HIV-positive
AAMSM were doing worse than HIV-negative AAMSM in that they were more likely to be disabled, to be living below the poverty
level, and accessing mental health services. With regard to risk behaviors and partner characteristics, HIV-positive AAMSM
were acting more responsibly than their HIV-negative counterparts, as they were more likely to have used a condom the last
time they had sex. In addition, when compared to their HIV-negative counterparts, HIV-positive AAMSM were more likely to have
either no casual partners at all or main or casual partners who were HIV-positive, thus preventing new HIV transmission by
partnering with other HIV-positive men. Attitudinally, HIV-positive men were more accepting of their sexual attractions to
men and were more likely to identify as gay than their HIV-negative peers. Although causality cannot be determined, the findings
of this study can be used to strengthen HIV prevention efforts by improving the selection of targeted behaviors and prevention
messages for HIV-positive and HIV-negative AAMSM.