Vol.:(0123456789) 1 3 AIDS Behav DOI 10.1007/s10461-017-1935-y ORIGINAL PAPER Accuracy of HIV Risk Perceptions Among Episodic Substance‑Using Men Who Have Sex with Men Grace (Chela) Hall 1  · Linda J. Koenig 1  · Simone C. Gray 1  · Jefrey H. Herbst 1,4  · Tim Matheson 2  · Phillip Cofn 3  · Jerris Raiford 1   © Springer Science+Business Media, LLC (outside the USA) 2017 Resumen Este estudio utilizó el índice de riesgo de inci- dentes de VIH para hombres que tienen sexo con hombres (HIRI-HSH)—una medida objetiva y validada de riesgo para la adquisición del VIH–y autopercepción de creencia y preocupación de contraer el VIH para identifcar individuos que subestimaron su riesgo substancial para el VIH. Se anal- izaron los datos de un cohorte de diversidad racial/étnica de 324 HSH, VIH-negativos usadores de sustancias de forma episódica (por sus siglas en inglés, SUMSM) inscritos en una intervención de reducción de riesgo del comportami- ento (2010-2012). Dos ciento catorce (66%) se identifcaron SUMSM con substancial riesgo de VIH, de los cuales 147 (69% o 45% de la muestra total) subestima el riesgo. En el análisis multivariado de regresión, en comparación con el resto del cohorte, los SUMSM más propensos fueron los que subestimaron su riesgo sustancial: una reciente trans- misión diagnóstico de infección, experimentando mayor aislamiento social y el intercambio de sexo por drogas, dinero ni otros cosas. La medida objetiva de riesgo para la adquisición de VIH, puede ser una herramienta valiosa para ayudar a los proveedores identifcar e iniciar conversaciones con SUMSM sobre los factores importantes asociados con riesgo de VIH, particularmente para aquellos que no pueden reconocer conductas de riesgo. Keywords MSM · Substance-using · Perceptions of risk · HIV Risk Introduction For gay, bisexual, and other men who have sex with men (MSM)—the population most severely affected by HIV—annual number of new HIV diagnoses in the United States has risen 6%, despite declines for other populations Abstract Using the HIV Incident Risk Index for men who have sex with men—an objective and validated measure of risk for HIV acquisition, and self-perceptions of belief and worry about acquiring HIV, we identifed individuals who underestimated substantial risk for HIV. Data from a racially/ethnically diverse cohort of 324 HIV-negative episodic substance-using men who have sex with men (SUMSM) enrolled in a behavioral risk reduction interven- tion (2010–2012) were analyzed. Two hundred and fourteen (66%) SUMSM at substantial risk for HIV were identifed, of whom 147 (69%, or 45% of the total sample) underestimated their risk. In multivariable regression analyses, compared to others in the cohort, SUMSM who underestimated their substantial risk were more likely to report: a recent sexually transmitted infection diagnosis, experiencing greater social isolation, and exchanging sex for drugs, money, or other goods. An objective risk screener can be valuable to pro- viders in identifying and discussing with SUMSM factors associated with substantial HIV risk, particularly those who may not recognize their risk. * Grace (Chela) Hall glh6@cdc.gov 1 Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention (CDC), 1600 Clifton Road, NE, Mailstop E-40, Atlanta, GA 30333, USA 2 Public Health Foundation Enterprises (San Francisco Department of Public Health AIDS Ofce), San Francisco, CA, USA 3 San Francisco Department of Public Health, Division of HIV/AIDS, University of California San Francisco, San Francisco, CA, USA 4 Present Address: Division of Violence Prevention, CDC, Atlanta, GA, USA