HIV Transmission Risk Behavior Among Men and Women Living With HIV in 4 Cities in the United States

Abstract

Determining rates of HIV transmission risk behavior among HIV-positive individuals is a public health priority, especially as infected persons live longer because of improved medical treatments. Few studies have assessed the potential for transmission to the partners of HIV-positive persons who engage in high-risk activities. A total of 3723 HIV-infected persons (1918 men who have sex with men [MSM], 978 women, and 827 heterosexual men) were interviewed in clinics and community-based agencies in Los Angeles, Milwaukee, New York City, and San Francisco from June 2000 to January 2002 regarding sexual and drug use behaviors that confer risk for transmitting HIV. Less than one quarter of women and heterosexual men had 2 or more sexual partners, whereas 59% of MSM reported having multiple partners. Most unprotected vaginal and anal sexual activity took place in the context of relationships with other HIV-positive individuals. Approximately 19% of women, 15.6% of MSM, and 13.1% of heterosexual men engaged in unprotected vaginal or anal intercourse with partners who were HIV-negative or whose serostatus was unknown. The majority of sexually active participants disclosed their serostatus to all partners with whom they engaged in unprotected intercourse. An estimated 30.4 new infections (79.7% as a result of sexual interactions with MSM) would be expected among the sex partners of study participants during the 3-month reporting period. Eighteen percent of 304 participants who injected drugs in the past 3 months reported lending their used injection equipment to others. In addition to the more traditional approaches of HIV test counseling and of focusing on persons not infected, intensive prevention programs for persons with HIV infection are needed to stem the future spread of the virus.

Is Injection Serosorting Occurring among HIV-Positive Injection Drug Users? Comparison by Injection Partner’s HIV Status

“…3 Many studies on sexual behaviors of HIV-positive persons suggest that the HIV status of an HIV-positive person's sex partner is one of the factors that might influence their sexual behavior. [4][5][6][7][8][9][10][11][12][13][14][15] The findings from these studies suggest that in some populations, HIV-positive persons may be adopting serosorting, in which unprotected sexual encounters are limited to partners who have the same HIV status.…”

Disparities in Reported Reasons for Not Initiating or Stopping Antiretroviral Treatment Among a Diverse Sample of Persons Living with HIV

“…Respondents received US$ 50 for completing the interview; additional details of study procedures are provided elsewhere 10,11 . The current analyses focus on the baseline screening data of the subsamples of those respondents who indicated that they had previously stopped ART or had never initiated ART.…”

Behavioral interventions to promote condom use among women living with HIV: a systematic review update

“…Among women, although the prevalence of sexual risk behavior generally declines after HIV diagnosis, a substantial group (30-40%) continues to engage in unprotected sexual intercourse 13,14 . Women are also less likely to use a condom when they have an HIV-infected partner than when the partners are HIV-negative or with unknown HIV status.…”

“…Women are also less likely to use a condom when they have an HIV-infected partner than when the partners are HIV-negative or with unknown HIV status. Findings from a cross-sectional study including 978 women showed that 51% of unprotected sexual intercourse among HIV-infected women in the previous three months involved an HIV-infected partner (30% of unprotected sexual intercourse occurred with an HIV-uninfected partner, and 26% with a partner of unknown status) 14 . Studies also reported higher levels of unprotected sex among women after ART initiation when compared to women before treatment initiation, independently of therapeutic response 15 , suggesting that beliefs regarding lower levels of infectivity under ART are also associated with less frequent condom use.…”