Changes in Sexual Behavior of HIV-Infected Older Adults Enrolled in a Clinical Trial of Standalone Group Psychotherapies Targeting Depression

Abstract

By 2015, one-half of all HIV-positive persons in the U.S. will be 50-plus years of age, and as many as 30% of older adults living with HIV/AIDS continue to engage in unprotected sexual intercourse. Contemporary positive prevention models often include mental health treatment as a key component of HIV prevention interventions. This secondary data analysis characterized longitudinal patterns of sexual behavior in HIV-positive older adults enrolled in a randomized controlled trial of group mental health interventions and assessed the efficacy of psychosocial treatments that targeted depression to reduce sexual risk behavior. Participants were 295 HIV-positive adults ≥ 50 years of age experiencing mild to severe depressive symptoms, randomized to one of three study conditions: a 12-session coping improvement group intervention, a 12-session interpersonal support group intervention, or individual therapy upon request. Approximately one-fifth of participants reported one or more occasions of unprotected anal or vaginal intercourse with HIV-negative sexual partners or persons of unknown HIV serostatus over the study period. Changes in sexual behavior did not vary by intervention condition, indicating that standalone treatments that target and reduce depression may be insufficient to reduce sexual risk behavior in depressed HIV-positive older adults.

Impact of length of injecting career on HIV incidence among people who inject drugs

“…In addition, secondary drug use variables included: syringe borrowing in the last 6 months (yes vs. no); daily use of each of crack smoking, cocaine injection and heroin injection in the last 6 months (yes vs. no); requiring help injecting drugs in the last 6 months (yes vs. no); and enrollment in methadone maintenance therapy (MMT) in the last 6 months (yes vs. no). It was hypothesized that being male [33], age (per 10 years older) [34] and enrollment in methadone maintenance therapy (MMT) in the last 6 months [35] were negatively associated with HIV seroconversion; while having Indigenous ancestry [36], being incarcerated in the last 6 months [37], and participating in sex work [38, 39], unprotected sex [40–42], syringe borrowing [43], requiring help injecting drugs [44], or daily use of cocaine, crack or heroin in the last 6 months [45] were positively associated with HIV seroconversion.…”

HIV infection among persons who inject drugs

“…Expansion of ART to all persons regardless of CD4+ cell count, leading to approximately 75% of HIV seropositive PWID receiving ART [30]. HIV prevalence among PWID is approximately 10% and HIV incidence is estimated at 0.1/100 PY [31].…”

The Association Between Alcohol Consumption and Condom Use: Considering Correlates of HIV Risk Among Black Men Who Have Sex with Men

“…In such circumstances, men may be willing to engage in risky sexual behaviors if doing so guarantees them access to needed provision. Additionally, the exchange sex interaction often has a power differential that impedes Black MSMW sex workers' ability for condom negotiation (96). In the study by Wheeler et al (71), exchanging sex for money, food, or drugs in the past 3 months was significantly associated with engaging in anal intercourse without a condom in the past 3 months.…”