{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T09:57:29Z","timestamp":1753869449147,"version":"3.41.2"},"reference-count":27,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2021,8,27]],"date-time":"2021-08-27T00:00:00Z","timestamp":1630022400000},"content-version":"vor","delay-in-days":26,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Int AIDS Soc"],"published-print":{"date-parts":[[2021,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>As biomedical advances improved HIV treatment, the perceptions of severity and anticipated consequences of HIV could have changed accordingly. This study investigates the current perceptions of severity and anticipated consequences of HIV infection and its association with sexual risk behaviour among HIV\u2010negative and never\u2010tested men who have sex with men (MSM) living in the Netherlands.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In\u2010depth interviews with recently diagnosed HIV\u2010positive MSM were used to develop a questionnaire measuring the perceived severity and anticipated consequences of HIV infection. The questionnaire was distributed online between April and July 2019. A structural equation model was constructed to explore the anticipated consequences contributing to the perceived HIV severity and to assess the association between the perceived severity and sexual risk behaviour.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In total, 1,072 HIV\u2010negative and never\u2010tested MSM completed the questionnaire, of whom 28% reported recent sexual risk behaviour. Almost one\u2010quarter of participants (23%) had a low perceived HIV severity, which was associated with more prevalent sexual risk taking (\u03b2\u00a0=\u00a0\u22120.07, 95% CI\u00a0=\u00a0\u22120.12\/\u22120.01). In this model, the perceived severity of HIV was more strongly associated with anticipated psychological consequences of HIV (\u03b2\u00a0=\u00a00.34, 95% CI\u00a0=\u00a00.24 to 0.44) and to a lesser extent with anticipated negative consequences of HIV on sex\/relationships (\u03b2\u00a0=\u00a00.28, 95% CI\u00a0=\u00a00.19 to 0.38) and disclosure\u2010related consequences (\u03b2\u00a0=\u00a00.16, 95% CI\u00a0=\u00a00.07 to 0.26). Health\u2010related consequences of HIV were not significantly associated with the severity perceptions (\u03b2\u00a0=\u00a00.06, 95% CI\u00a0=\u00a0\u22120.03 to 0.14).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Anticipated negative social and psychological consequences of HIV mostly contribute to high HIV\u2010severity perceptions in MSM. A smaller subgroup of MSM does not perceive HIV as a serious disease, which is associated with increased sexual risk taking. Efforts to normalize living with HIV are essential but might present a challenge for HIV prevention as it could, for a minority of MSM, decrease the motivation to prevent HIV infection.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jia2.25715","type":"journal-article","created":{"date-parts":[[2021,8,27]],"date-time":"2021-08-27T13:45:01Z","timestamp":1630071901000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Prevention challenges with current perceptions of HIV burden among HIV\u2010negative and never\u2010tested men who have sex with men in the Netherlands: a mixed\u2010methods study"],"prefix":"10.1002","volume":"24","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1647-8485","authenticated-orcid":false,"given":"Hanne ML","family":"Zimmermann","sequence":"first","affiliation":[{"name":"Department of Infectious Diseases Public Health Service of Amsterdam Amsterdam The 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