Predictors of HIV risk behavior among Russian men who have sex with men: an emerging epidemic

Background: Russia is experiencing one of the sharpest increases in HIV inc idence in the world. Almost no research has examined patterns of risk behav ior among Russian men who have sex with men (MSM). Design and methods: A total of 434 MSM were surveyed in all of St. Petersbu rg's gay-identified clubs during lune 2000. Men completed questionnaires ab out their sexual practices, AIDS risk knowledge, safer sex attitudes, behav ior change intentions, perceived safer sex norms, and fatalism. Results: Most MSM were bisexual; 79% had female partners in their lives and 37% had female partners in the previous 3 months. Sexually transmitted dis ease treatment was reported by 32% of the men, 23% had sold sex to gain mon ey, and knowledge about critical HIV risk-reduction steps was low Of all me n surveyed, 38% had unprotected anal sex in the previous 3 months, consiste nt condom use was reported by only 30% of men, and most recent anal interco urse occasions 37% of particpants'. Regression analyses showed that high-ri sk behavior was predicted by poor safer sex attitudes, weak behavior change intentions, low knowledge about AIDS risk, perceived peer norms that did n ot support safer sex, and having a boyfriend. Conclusion: To avert a widespread epidemic, HIV prevention interventions fo r Russian MSM are critically needed. Factors predicting risk were consisten t with those found among MSM in other countries early in the HIV epidemic. However, unique cultural factors, including frequent bisexual behavior, the 'newness' of openly gay communities in Russia and lack of community experi ence in dealing with AIDS, require HIV prevention program tailoring. (C) 20 01 Lippincott Williams & Wilkins.