The drug combinations that have revolutionized AIDS treatment in the United States have made some gay men more willing to engage in risky sex, researchers said Tuesday.
A study presented at the National HIV Prevention Conference showed gay men were less likely to use condoms or abstain from anal sex if they felt confident that AIDS drugs could prolong their lives or even prevent infections.
"Clearly many Americans equate improved treatments with a cure, which they are not," said Dr. Ronald Valdiserri, deputy director of the center for HIV and STD prevention at the Centers for Disease Control and Prevention.
Evidence has been mounting in the late 1990s of increases in risky sexual behavior among gay men -- who constitute an estimated 450,000 cases of HIV, or more than half the U.S. total.
But the University of Southern California study released Tuesday is among the first to link the success of AIDS drugs to increasingly cavalier attitudes about safe sex.
Researchers surveyed 410 gay men who were approached on the streets of West Hollywood, Calif., and said they were aware of the AIDS drugs called protease inhibitors, which can reduce the level of the virus in the blood so low that it can't be measured.
Of the 346 who did not have HIV, those who were more confident about the ability of drugs to control AIDS said they used condoms 74 percent of the time. Those who were less confident said they used condoms 85 percent of the time.
Of the 64 who were HIV-positive, those who were optimistic about the drugs used condoms 66 percent of the time, compared with 85 percent condom use for those who believed the drugs were less effective.
Valdiserri cautioned that the study was too limited to draw wide conclusions about how much advancements in AIDS treatment may have fueled risky behavior. And researchers said they remain confident that most gay men still are practicing safer sex, whether by using condoms or having sex with fewer people.
Still, scientists acknowledge that the protease inhibitors have dramatically changed the way people perceive AIDS.
Another study released Tuesday found that prison inmates are five to 10 times more likely than non-inmates to have AIDS or the virus that causes it, and recently released prisoners account for one-sixth of the nation's AIDS cases.
The first effort to estimate the prevalence of AIDS and HIV among the nation's nearly two million inmates found 8,900 inmates with AIDS in 1997.
The study estimated that 39,000 people, or approximately 17 percent of the 229,000 people with AIDS in 1996, had been released from a correctional facility that year. The percentages were even higher for HIV infection, hepatitis C and tuberculosis.
"Virtually all inmates return to the community and many of them return with HIV, AIDS and other infectious diseases," Hammett said.
"This means correctional facilities are critical settings for prevention and treatment interventions for infectious disease," he said.