Association Between "Safer Sex Fatigue" and Rectal Gonorrhea Is Mediated by Unsafe Sex With Casual Partners Among HIV-Positive Homosexual Men

The study authors investigated whether and what sexual risk behavior is a mediator of associations between rectal gonorrhea (RG) and beliefs about highly active antiretroviral therapy, safer sex fatigue, or sexual sensation-seeking among homosexual men.

From March 2002 to December 2003, a cross-section survey was conducted among homosexual men who visited an STD clinic in Amsterdam. A total of 1,568 men answered a written questionnaire. The researchers used logistic regression corrected for repeated measurements to determine associations.

Compared with homosexual men with negative or unknown HIV status, the RG infection rate was high among those who were HIV-positive (16 percent). Mediation could be confirmed among HIV-positive men only. Participants who experienced higher levels of safer sex fatigue were more likely to be positive for RG -- an association mediated by unprotected anal intercourse (UAI) with casual partners.

"Addressing safer sex fatigue might help prevent UAI with casual partners and possibly also RG among HIV-positive homosexual men," the authors concluded.

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