Cognitive and behavioral adaptations to HIV/AIDS among gay and bisexual adolescents

Purpose: To examine short-term changes in HIV knowledge, beliefs, and behaviors among gay and bisexual adolescents, 139 gay and bisexual male adolescents (13–21 years of age) completed interviews and self-administered surveys of HIV-related knowledge, attitudes, and behaviors during an initial assessment (Time 1) and 3–6 months after intervention (Time 2). Methods: The intervention included individualized HIV/ AIDS risk assessment and risk reduction counseling, peer education, and referrals to needed services. Crosssectional (group) and individual cognitive and behavioral changes were examined; adolescents who reported unprotected anal intercourse and/or injecting drug use after interventions were compared to those who did not. Results: Compared to Time 1,60% fewer subjects at Time 2 reported unprotected anal intercourse with recent partners. Subjects also reported less frequent anal intercourse and more consistent use of condoms during follow-up. Substance abuse severity scores and use of amphetamines and amyl nitrite declined. One-quarter of subjects reported ongoing high-risk behaviors associated with multiple partners, frequent anal intercourse, completion of education, and relative numbers of gay friends. Conclusions: Compliance with HIV risk reduction improved over time. Constructive change most often involved the practices of anal intercourse and, to a lesser extent, oral sex. Ongoing risk-taking behavior may reflect serious psychosocial problems.