HIV Treatments Optimism Among Gay Men: An International Perspective

OBJECTIVE: To examine HIV optimism (i.e., optimism in the light of highly active antiretroviral therapy [HAART]) among gay men in four industrialized countries using a standard scale. METHODS: Gay men were surveyed between January and December 2000 in Australia (Sydney and Melbourne, n = 3,120), Canada (Vancouver, n = 357), England (London, n = 690), and France (Paris, n = 1,715). Information was collected on HIV status, sexual behavior, and responses to a four-item HIV optimism scale. Possible responses to each item were as follows: strongly disagree, 1; disagree, 2; agree, 3; and strongly agree, 4. Agreement indicated optimism in the light of new HIV drug therapies. Total scores could range from a minimum of 4 (strongly disagree on all four items [i.e., not at all optimistic]) to a maximum of 16 (strongly agree on all four items [i.e., extremely optimistic]). RESULTS: In all cities, mean scores on the four-item scale were low (<7), indicating that for the most part men disagreed with the optimism statements. Mean scores were lowest in Paris (p <.001). There was no consistent relationship between mean optimism score and HIV status. In multivariate analysis, the association between mean optimism score and both city (p <.001) and HIV status (p =.05) was significant as was the interaction between city and HIV status (p =.02); the association between mean optimism score and age was not significant (p =.6). In London, Paris, and Sydney/Melbourne but not Vancouver, the mean optimism scores for men reporting high-risk sexual behavior were higher than scores for other men (p <.001). CONCLUSION: In the year 2000, only a few gay men in Australian, Canadian, and European cities were optimistic in the light of new HIV drug therapies. Although there was an association between HIV optimism and high-risk sexual behavior, causality could not be established. The lack of a consistent association between HIV optimism and HIV status across the cities suggests heterogeneity in gay men's response to HAART in different countries.