PREDICTORS OF SEXUAL-BEHAVIOR CHANGE AMONG MEN REQUESTING THEIR HIV-1ANTIBODY STATUS - THE CHICAGO MACS CCS COHORT OF HOMOSEXUAL BISEXUAL MEN, 1985-1986

It has been proposed that human immunodeficiency virus (HIV) antibody testing and counseling are effective means of altering sexual behavior among individuals at risk of HIV infection and transmission. However, the evidence supporting this hypothesis is inconclusive. This study e xamines the factors associated with sexual behavior change among a gro up of participants in the Chicago MACS/Coping and Change Study (CMACS/ CCS) who requested their HIV antibody status when they were first give n the opportunity, between 1985 and 1986. A set of demographic and psy chosocial predictors were tested in association with 4 possible outcom e patterns of sexual behavior change during the time of antibody statu s disclosure. For comparative purposes, a randomly selected sample of men who did not request disclosure of their HIV antibody status was an alyzed. The results revealed that, among the 177 individuals who reque sted disclosure, the group experiencing an adverse sexual behavior cha nge (i.e., from low risk before disclosure to high risk after disclosu re) reported, before disclosure, the highest level of mental distress and denial-fatalism coping strategies and had the lowest levels of soc ial support compared with other groups being analyzed. The psychosocia l predictor most strongly associated with adverse sexual behavior chan ge appears to be the use of denial-fatalism coping. Such an associatio n was not found among the nondisclosed comparison group. These results suggest that a subgroup of at-risk, well-educated, white men, with ov erall high knowledge of HIV transmission, may not benefit from current HIV counseling and testing. Such men at risk for adverse behavioral o utcomes might be identified in advance of HIV-I antibody testing by th eir psychosocial profile, and thus appropriate counseling resources co uld be targeted to them.