SEXUAL ADVENTURISM, HIGH-RISK BEHAVIOR AND HUMAN IMMUNODEFICIENCY VIRUS-1 SEROCONVERSION AMONG THE CHICAGO MACS-CCS COHORT, 1984 TO 1992 - A CASE-CONTROL STUDY

Background and Objectives: To predict incident human immunodeficiency virus (HIV)-1 seroconversions among a cohort of gay and bisexual men b ased on recalled sexual behavior, drug use, partnership status, and an index of sexual adventurism/risk-seeking attitudes. Study Design: A n ested case-control design was used in a retrospective study spanning a 9-year period. Results: Sexual adventurism was an important predictor of HIV-1 infection. The partial risk ratio for our 100-point adventur ism scale indicated a marginal rate of increase in seroconversion risk of 4% (odds ratio = 1.04; 95% confidence interval = 1.02 to 1.06), wi th almost 79% of seroconverters scoring above the median on the index. As expected, partner status, drug use, and unprotected receptive anal (RA) intercourse were associated with seroconversion. However, multiv ariate results indicated that men using condoms consistently in RA sex were also at higher risk for infection (odds ratio = 2.68; 95% confid ence interval = 1.04 to 6.95) than men who abstained from RA intercour se. Conclusions: Results are discussed with respect to their implicati ons for HIV prevention intervention and research. Recommendations incl ude the development of new approaches and the adaptation of existing i ntervention techniques that recognize and treat persons with strong ri sk-taking predispositions.