Social Anxiety and HIV Transmission Risk among HIV-Seropositive Male Patients

Abstract

The role of psychological factors in predicting HIV sexual transmission risk behavior is increasingly of interest in prevention research. Social anxiety, or anxiety about being evaluated in interpersonal situations, is associated with unprotected insertive anal intercourse among young men who have sex with men (MSM) and with other behavioral risk factors for unprotected intercourse, such as depression, smoking, alcohol use, and drug use. Social anxiety may be especially relevant in understanding HIV risk among HIV-seropositive men, given its stronger association with unprotected insertive than with receptive anal intercourse. In the present study, for which participants were recruited between October 2002 and May 2003, HIV-positive men attending regularly scheduled primary care medical appointments at a community HIV clinic were approached by research personnel and informed about the study topic and procedures. Ninety percent of patients approached agreed to participate, resulting in a sample of 206 patients. The sample was primarily African American, unemployed, of low educational level, and 95% of the sample had an AIDS diagnosis. The present study replicated and extended previous research from community samples by demonstrating an association between social anxiety and unprotected insertive anal intercourse with non-HIV-positive partners in a clinical sample of HIV-positive MSM and men who have sex with women (MSW). This association was maintained controlling for depression, smoking, and club drug use. Social anxiety is a relatively robust risk factor for unprotected insertive anal intercourse among MSM. Future work should examine the mechanisms by which social anxiety is associated with sexual risk among MSM. 879

Prevalence of Psychiatric and Substance Abuse Symptomatology Among HIV-Infected Gay and Bisexual Men in HIV Primary Care

“…37,38 There is also evidence to suggest that HIV is disproportionally present in people presenting for psychiatric treatment with PTSD. 39 …”

Sexual transmission‐risk behaviour among HIV‐positive persons: a multisite study using social action theory

“…2001). In a clinic sample ( n = 209) of mostly unemployed African American MSM, a strong association between social anxiety and unprotected insertive anal intercourse with sero-discordant partners was reported (Hart et al 2008). Further examination of mechanisms by which anxiety is associated with sexual risk among seropositive MSM was recommended.…”

HIV Symptom Distress and Anxiety Sensitivity in Relation to Panic, Social Anxiety, and Depression Symptoms Among HIV-Positive Adults

“…1,2,7,8 Here, there are statistically significant relations between these negative emotional states and nonadherence to HIV medications, [9][10][11][12][13] lesser quality of life, [14][15][16][17][18] greater health care utilization, 15,18,19 and greater sexual risk behaviors (i.e., unprotected insertive anal intercourse). 20 Although past research has focused on documenting relations between HIV/AIDS and negative affective symptoms and disorders, 1,7,8 empirical work has only begun to address explanatory processes that may underlie such associations. One emerging stream of research in this common symptoms include fatigue, nausea, chills/sweats, feeling dizzy/light-headed, pain/numbness in the hands and feet, trouble remembering, diarrhea, and sleep difficulties.…”