Berlin Conference review. Men who have sex with men.

Fewer research presentations were made at the Berlin International AIDS Conference on men who have sex with men than in previous years. The most interesting reports included the ongoing success of Kellys community intervention study the consistent findings of the association of alcohol and other drug use unsafe behavior and the methodological innovations of Kelaher and Ross. Intoxication was commonly found to be a predictor of risk but it is nonetheless pointed out that one must consider factors which may interact with substance abuse such as educational status income and perceived community and peer norms instead of assuming that the consumption of drugs will always exacerbate risk. As for Kelaher and Ross they presented a nonstandard computer-based methodology for randomly generating risk situations to be rated in terms of the probability of unsafe behavior occurring. Evidence was also presented in Berlin of ethnic and geographical variation in risk behavior patterns and an increased emphasis on psychological variables as predictors of unsafe behavior. For example depressed men were less likely to have unsafe anal intercourse as were men who were HIV seropositive or who had multiple partners. Externalizers who were more distressed anxious eccentric isolated impulsive and with poor coping and behavioral controls were more likely to revert to unsafe sex patterns; escape-avoidance behavior patterns were also associated with higher risk. New insights will require more qualitative research into more specialized subsamples of men who have sex with men.