Sexual Risk Behaviors by Relationship Type and Trauma History Among HIV-Positive Men Who Have Sex with Men

The association of trauma exposure and coping style to sexual risk behavior has yet to be fully examined in the context of
primary and casual sexual partnerships. The current study assessed a high risk sexual behavior—unprotected anal intercourse
(UAI)—in a high risk population of HIV-positive men who have sex with men (MSM) with a history of trauma. Using audio computer-assisted
self-interview technology, 132 HIV-positive MSM completed measures of trauma exposure, trauma symptoms, coping strategies,
and sexual risk behavior. Hierarchical logistic regression analyses indicated that completing more years of education and
having experienced sexual abuse were positively associated with UAI with casual partners. Additionally, use of active coping
was negatively associated with UAI with casual partners and the final model significantly predicted variance in UAI with casual
partners. However, no variables were significantly associated with UAI with primary partners, suggesting that sexual risk
behavior with primary partners may be associated with factors not commonly assessed in risk prediction or prevention research.
We discuss the results in the context of developing new or modifying existing interventions to address rates of sexual risk
in the relationships of HIV-positive MSM.