Testing Negative Means I’m Lucky, Making Good Choices, or Immune: Diverse Reactions to HIV Test Results are Associated with Risk Behaviors

Abstract

Background: HIV testing may lead to behavioral changes among some individuals, but no scale has been developed to assess potential mechanisms. Purpose: We aimed to develop and evaluate the psychometric properties of a scale to measure psychological reactions to the receipt of a negative HIV test and explore the scale’s associations with unprotected anal intercourse (UAI). Methods: Two focus groups were conducted to develop the Inventory of Reactions to Testing HIV Negative, which was subsequently tested on 725 men who have sex with men in the New York City area. Results: Factor analyses confirmed the presence of three subscales—Reinforced Safety, Invulnerability, and Luck. Regression analyses demonstrated that the subscales interacted with HIV testing behavior to influence UAI. Conclusions: These findings support the notion that there is heterogeneity in how individuals respond to a negative HIV test, with some individuals subsequently being influenced towards increased engagement in HIV risk behaviors.