A serological divide: men who have sex with men’s attitudes on HIV risk reduction strategies

C. Den Daas*, P. C.G. Adam, W. Zuilhof, J. B.F. de Wit

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

1 Citation (Scopus)


The expanding HIV risk reduction toolkit increases options for men who have sex men (MSM), but increasing options in combination with different preferences may complicate promoting risk reduction. To investigate what strategies MSM prefer, data of 3310 participants in the online survey “Men & Sexuality” (Median age = 37 years, 320 (9.7%) HIV positive) was analysed. Questions assessed attitudes towards HIV risk reduction strategies. Participants had the most positive attitudes regarding PrEP and HIV testing, while withdrawal and strategic positioning were least preferred (all p’s <.001). Condoms were seen as acceptable to partners and effective but scored low on sexual pleasure. HIV-positive participants were more negative about condoms and more positive about viral load sorting than HIV-negative participants (F(12,3297) = 5.09, p <.001, (Formula presented.) =.02). Findings highlight a preference for HIV risk reduction strategies (PrEP and HIV testing) that do not diminish sexual pleasure and can be applied independent of sexual partners. A serological divide was apparent: HIV-negative MSM were less negative about condoms than HIV-positive MSM, suggesting that condom promotion remains a viable strategy for HIV-negative MSM. Taken together, results indicate a need for personalized approaches to the promotion of HIV risk reduction strategies, accounting for individual preferences and strategy effectiveness.

Original languageEnglish
Pages (from-to)170-176
Number of pages7
JournalAIDS Care - Psychological and Socio-Medical Aspects of AIDS/HIV
Issue numbersup2
Early online date10 Mar 2020
Publication statusPublished - 2020


  • HIV
  • HIV risk reduction strategies
  • men who have sex with men (MSM)
  • sexual contexts
  • Unsafe Sex/prevention & control
  • Sexual Behavior
  • Risk Reduction Behavior
  • Humans
  • Male
  • Condoms/statistics & numerical data
  • Health Knowledge, Attitudes, Practice
  • Viral Load
  • HIV Infections/prevention & control
  • Homosexuality, Male/psychology
  • Adolescent
  • Adult
  • Surveys and Questionnaires
  • Safe Sex/statistics & numerical data
  • HIV Serosorting/statistics & numerical data
  • Sexual Partners


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