Michael Fendrich

Drawing on the social capital literature, we hypothesized that civic engagement, as measured by participation in lesbian, gay, bisexual, and transgender–related community activities, would be an important protective factor with respect to sexual risk behavior. Accordingly, we examined the association between participation and three measures of risky sexual behavior in a group of men who have sex with men (MSM) who were part of the four-city, 1996–1998 Urban Men's Health Study. In these analyses, we used the subsample of adult MSM who reported same-gender sex in the past year and were not HIV positive (N = 1857). Compared to those reporting no civic participation, those with the lowest and highest levels of participation were no more likely to engage in risky sexual behavior, but those with the second highest level had an increased likelihood of risky sexual behavior. Abstention from drugs, having a male primary partner, higher income, a college degree, and being older than 29 years of age all reduced the odds of risky sexual behavior among MSM.

Employing data from two Chicago-based household probability samples of men who have sex with men (MSM) implemented 5 years apart (the “UMHS 1997” and the “2002 MSM supplement” studies), we evaluated changes in risk behavior as well as the potential viability of two alternative perspectives for explaining these changes—risk management and safe-sex norm abandonment. We found significantly increased rates of unprotected insertive and receptive anal intercourse in the 2002 study. Sixty-eight percent of UMHS men reported having sex with partners having HIV positive or unknown status, compared with 38% of the MSM supplement men (p < .0001). Serosorting mediated and moderated the most extreme forms of risk behavior. Positive statistical associations between drug use and unprotected sex were stronger in the UMHS sample than in the MSM supplement. Findings suggesting that “risk management” strategies have shaped MSM behavior as it emerged in the early part of this decade have considerable implications for HIV prevention strategies.