This study examined whether the Multifaceted Model of HIV Risk (MMOHR) would predict unprotected sex based on predictors including gender, childhood sexual abuse (CSA), sexual victimization (SV), depression, and sexual assertiveness for condom use. A community-based sample of 473 heterosexually active men and women, aged 18–46 years completed survey measures of model variables. Gender predicted several variables significantly. A separate model for women demonstrated excellent fit, while the model for men demonstrated reasonable fit. Multiple sample model testing supported the use of MMOHR in both men and women, while simultaneously highlighting areas of gender difference. Prevention interventions should focus on sexual assertiveness, especially for CSA and SV survivors, as well as targeting depression, especially among men.

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This paper identifies the recruitment strategies and human immunodeficiency virus (HIV) risk behaviors of at-risk women in an HIV vaccine preparedness study in New York City, assesses how these behaviors changed over time, and draws implications for women's involvement in HIV vaccine efficacy trials. Noninjecting HIV-1 negative women (N = 89) were recruited into an HIV vaccine preparedness study. An observational cohort study design was used. Women were recruited from clinics and community-based organizations (40%), through other study participants (24%), through newspaper advertisements (20%), and through street outreach (16%). Most women who refused (72%) also came from clinics and agencies. Retention after 12 months was 67%; after 18 months, it was 62%. The proportion of women reporting unprotected vaginal sex in the previous 3 months was 85% at baseline and declined to 70% after 12 months (P < .05). There have been no seroconversions detected. Recruitment efforts to include at-risk women in HIV vaccine efficacy trials must be diverse and actively involve community agencies. Successfully retaining these cohorts over time and detecting a high enough HIV seroincidence rate present ongoing challenges that will need to be addressed to ensure women's involvement in future trials in the US.

Project ACHIEVE, which conducts HIV prevention research studies, maintains a women's site in the South Bronx in NewYork City. Owing to a focused retention effort at the South Bronx site, high retention rates were achieved in a vaccine preparedness study for women at high risk of HIV infection. Comparable retention rates have been achieved in HIV vaccine trials with similar cohorts of women at this site. These results suggest that concerns about retaining hard-to-reach populations should not cause these populations to be excluded from HIV vaccine and prevention trials.

Recent douching was very common. The high prevalence of douching has implications for the design of microbicide trials and prevention interventions.