HIV risk perception plays a crucial role in the uptake of preventive strategies. We investigated how risk perception and its determinants changed between 1999 and 2018 in an open, prospective cohort of 1323 HIV-negative men who have sex with men (MSM). Risk perception, defined as the perceived likelihood of acquiring HIV in the past 6 months, changed over time: being relatively lower in 2008–2011, higher in 2012–2016, and again lower in 2017–2018. Irrespective of calendar year, condomless anal intercourse (AI) with casual partners and high numbers of partners were associated with higher risk perception. In 2017–2018, condomless receptive AI with a partner living with HIV was no longer associated with risk perception, while PrEP use and condomless AI with a steady partner were associated with lower risk perception. We showed that risk perception has fluctuated among MSM in the past 20 years. The Undetectable equals Untransmittable statement and PrEP coincided with lower perceived risk.

HIV风险感知在采取预防策略中起着至关重要的作用。我们在一个公开的，前瞻性队列研究中，对1323名与男性发生性关系的HIV阴性男性进行了调查，调查了1999年至2018年之间风险感知及其决定因素的变化。风险感知（定义为过去6个月中感染艾滋病毒的可能性）随时间而变化：在2008–2011年相对较低，在2012–2016年相对较高，在2017–2018年再次较低。不论历年如何，与休闲伴侣和大量伴侣的无避孕套肛交（AI）均与较高的风险感知有关。在2017-2018年，与艾滋病毒感染者伴侣一起使用安全套接受无避孕套不再与风险感知相关，而与稳定伴侣一起使用PrEP和无避孕套人工智能与较低的感测风险相关联。我们表明，过去20年间，风险感知在MSM中有所波动。不可检测等于不可传播的陈述，而PrEP与较低的感知风险相吻合。