Putting risk compensation to rest: Reframing the relationship between risk behavior and antiretroviral therapy among injection drug users

摘要

Risk compensation, or 'risk homeostasis', first gained attention in the early 1980s as a theory to explain unanticipated adverse consequences of government policies to improve road safety (e.g. seat belt laws, speed limits), and is understood to be behavior change in response to alterations in perceptions of risk [1]. Since the advent of efficacious HIV prevention interventions, including widespread condom distribution, male circumcision, preexposure prophylaxis (PrEP) and provision of HAART, concerns have been raised that risk compensation - increases in HIV risk behavior stemming from decreases in perceived risk of transmission - could significantly undermine their effectiveness [2].