Perceived risk of different HIV risk management strategies among MSM in Germany: a measurement approach using short vignettes

Published: July 21, 2010

J. Drewes1, C. Kraschl1, P.C. Langer2, D. Kleiber1

1Free University Berlin, Public Health, Berlin, Germany, 2Bundeswehr Institute of Social Sciences, Strausberg, Germany

Background: Barrier-free methods of HIV risk management among MSM such as negotiated safety, sero-positioning and viral load method remain a challenge to prevention efforts. Questions arise regarding actual risks of these strategies and ways to integrate them in prevention . Though studies show that some MSM actually engage in these behaviors little is known about as how risky MSM perceive these strategies.
Methods: Five short vignettes were designed depicting people engaging in various strategies to minimize their risk, i.e. withdrawal, seropositioning, negotiated safety, viral load method and sero-guessing. Perceived risk of contracting HIV for these behaviors was measured on a numerical 10-point scale. Data from 5,252 HIV-negative MSM were collected who took part in a nationwide online-survey of MSM in Germany.
Results: Being the receptive part of seropositioning, viral load method and sero-guessing was rated with the highest risk of acquiring HIV. Negotiated safety was regarded as most safe practice. Significant relationships existed between actual risk behaviour and risk estimates: MSM reporting HIV risk behaviour rated strategies as less risky than MSM who reported no risk behaviour.
Conclusions: Measuring perceived risk of HIV risk management strategies using vignettes is a promising method to gain insight in the way these strategies are perceive. Results show that especially people at risk view strategies as less risky. Interventions to prevent HIV risk behavior should address these management strategies and help MSM who engage in these practices making informed choices.

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