However, more years of education may reflect better understanding of find more the improved prognosis for HIV infection

treatment and hence greater treatment optimism. More years of education might also be associated with greater resources and better access to medical treatment. The other socio-demographic predictors in our model – younger age, substance use and engagement with care – have been previously demonstrated in the literature [4–9,11]. Two individual questions from the ACASI interview, along with Treatment Optimism scale scores, were statistically significant predictors of TRBs in our model. Thus we suggest that these questions, combined with socio-demographic variables that would already be known to a medical provider (younger age, greater educational attainment, greater engagement with care and substance use history), could be put together as an effective brief screener for patients who have recently engaged in TRBs and who may be at risk of continuing to do so. The most robust single item was a question regarding concern about having infected Linsitinib datasheet someone else in the past 6 months. Used in conjunction

with two other questions about risk of re-infection and treatment optimism, patients could effectively be identified as needing more intensive and focused prevention resources. The proposed TRB screener asks for level of agreement with the following statements: ‘I am concerned about the risk of being re-infected with HIV’, ‘The availability of combination HIV drug treatments makes me less worried about having unprotected sex’, and ‘I am worried that I could have infected someone else with HIV in the past 6 months.’ [We chose item 2 (see Table 2) from the Treatment Optimism scale because it had the highest corrected item-total correlation.] This brief screener could be easily Enzalutamide chemical structure implemented during the course of a medical clinic visit, helping the busy medical provider identify those HIV-infected patients in

need of more intensive prevention resources. In addition to its potential temporal advantage, the screener does not require an exhaustive set of questions about sexual TRBs that could generate denial, social-desirability biases, or defensiveness. Given that these initial development and validation data came from a convenience sample, the screener will benefit from additional validation in other samples of HIV-infected patients and in samples tracked across time. Seattle has a lower proportion of African-American and Hispanic persons compared with other large urban areas which may also limit the generalizability of the findings. That said, the proportion of African-American and Hispanic patients at the Madison Clinic is significantly higher than in Seattle generally, which reflects the demographic trends in HIV infection in the United States.