Meta-Analysis of High-Risk Sexual Behavior in Persons Aware and Unaware They are Infected With HIV in the United States

Marks, Gary; Crepaz, Nicole; Jw, Senterfitt; Rs, Janssen

doi:10.1097/01.qai.0000151079.33935.79

Cited by 1,152 publications

(913 citation statements)

References 32 publications

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“…Those who self-reported as being HIV-positive were excluded because awareness of HIV status can influence risk behavior. 34 The analysis was conducted on 717 participants.…”

Section: Participants Analyzedmentioning

confidence: 99%

Reciprocal Sex Partner Concurrency and STDs among Heterosexuals at High-Risk of HIV Infection

et al. 2012

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Inconsistent findings on the relationship of sex partner concurrency to infection with HIV and other sexually transmitted diseases (STDs) may result from differences in how sex partner concurrency is conceptualized. We examine the relationship of reciprocal sex partner concurrency (RSPC) to diagnosed STDs among heterosexuals. Heterosexually active adults (N=717) were recruited for a cross-sectional study using respondent-driven sampling (RDS) from high-HIV-risk areas in New York City (NYC, 2006(NYC, -2007 and interviewed about their sexual risk behaviors, number of sex partners, last sex partners, and STD diagnoses (prior 12 months). RSPC was when both the participant and her/his last sex partner had sex with other people during their sexual relationship. Odds ratios (OR), adjusted odds ratios (aOR), and 95 % confidence intervals (95%CI) were estimated by logistic regression. The sample was 52.4 % female, 74.3 % Black; median age was 40 years. RSPC was reported by 40.7 % and any STD diagnoses by 23.4 %. Any STDs was reported by 31.5 % of those reporting RSPC vs. 17.9 % of those who did not (OR=2.11, 95%CI=1.49-3.0). Any STDs was independently associated with RSPC (aOR=1.54, 95%CI=1.02-2.32), female gender (aOR=2.15, 95%CI=1.43-3.23), having more than three sex partners (aOR=1.72, 95%CI=1.13-2.63), and unprotected anal sex (aOR=1.65, 95%CI=1.12-2.42). Heterosexuals in high-HIV-risk neighborhoods in sexual partnerships that involve RSPC are at greater risk of STDs and, potentially, HIV. RSPC, in addition to sexual risk behaviors and the number of sex partners, may facilitate the heterosexual spread of HIV through STD cofactors and linkage into larger STD/HIV sexual transmission networks.

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“…Those who self-reported as being HIV-positive were excluded because awareness of HIV status can influence risk behavior. 34 The analysis was conducted on 717 participants.…”

Section: Participants Analyzedmentioning

confidence: 99%

Reciprocal Sex Partner Concurrency and STDs among Heterosexuals at High-Risk of HIV Infection

et al. 2012

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“…A recent meta-analysis estimated that unprotected anal or vaginal intercourse with HIV-seronegative partners was reduced by 68% among HIVinfected persons who knew of their positive serostatus compared with those who were unaware. 18 In South Carolina, expanded routine opt-out HIV screening in health care settings should reduce the number of persons who are unaware of their HIV-infected status.…”

Section: Individuals With Dates Of Initial Hiv Diagnosis In Southmentioning

confidence: 99%

Risk-Based HIV Testing in South Carolina Health Care Settings Failed to Identify the Majority of Infected Individuals

Duffus

Weis

Kettinger

et al. 2009

AIDS Patient Care and STDs

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To provide evidence of large numbers of missed opportunities for early HIV diagnosis we designed a retrospective cohort study linking surveillance data from the South Carolina HIV=AIDS Reporting System to a statewide all payer health care database. We determined visits and diagnoses occurring before the date of the first positive HIV test and medical encounters were categorized to distinguish visits that were likely versus unlikely to have prompted an HIV test. Of the 4117 HIV-positive individuals newly diagnosed between 2001 and 2005, 3021 (73.4%) visited a South Carolina health care facility one or more times prior to testing HIV positive. Of these 3021, 1311 (43.4%) were late testers, and 1425 (47.2%) were early testers. Females were less likely than males to be late testers (odds ratio [OR] 0.55, 95% confidence interval [CI] 0.45-0.68), blacks were more likely than whites to be late testers (OR 1.37, 95% CI 1.10-1.71), and persons 50 years of age and older more likely to be late testers (OR 7.16,. A total of 78.8% of the 13,448 health care visits for both late and early testers were for health care diagnoses unlikely to prompt an HIV test. These findings underscore the need for more routine HIV testing of adults and adolescents visiting health care facilities in order to facilitate early diagnosis.

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“…2 Persons who are unaware of their HIV infection are less likely to reduce behaviors associated with HIV transmission than those who are aware of their status. 3 Emergency departments (EDs) not only provide health services for the acutely injured and ill, but also provide rapid access to health care for persons irregularly entering the health system, including the underserved and uninsured. Persons with undiagnosed HIV infection access the ED prior to their diagnosis, but are not often tested.…”

mentioning

confidence: 99%

Acceptance of Rapid HIV Screening in a Southeastern Emergency Department

Freeman

Sattin

Miller

et al. 2009

Academic Emergency Medicine

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Objectives: The objective was to assess the acceptance of an emergency department (ED) human immunodeficiency virus (HIV) screening program based on the Centers for Disease Control and Prevention (CDC) recommendations for routine HIV screening in health care settings.Methods: Rapid HIV screening was offered on an opt-out basis to patients aged 13 to 64 years presenting to the ED by trained HIV counselors. Patients were excluded if they had a history of HIV, were physically or mentally incapacitated, did not understand their right to opt-out, or did not speak English or Spanish. Statistical analyses, including logistic regression, were performed to assess the associations between the demographics of patients offered testing and their test acceptance or refusal.Results: From March 2008 to January 2009, a total of 5,080 (91%) of the 5,585 patients offered the HIV test accepted, and 506 (9%) refused. White and married patients were less likely to accept testing than those who were African American and unmarried (p < 0.001). Adult patients were almost twice as likely to accept testing as pediatric patients (odds ratio [OR] = 1.95; 95% confidence interval [CI] = 1.50 to 2.53). As age increased among pediatric patients, testing refusal decreased (OR = 0.71; 95% CI = 0.59 to 0.85), and as age increased among adult patients, testing refusal increased (OR = 1.17; 95% CI = 1.12 to 1.22). Two percent of persons accepting the test were considered high risk. Males were more likely to report high-risk behavior than females (OR = 1.83; 95% CI = 1.23 to 2.72).

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Meta-Analysis of High-Risk Sexual Behavior in Persons Aware and Unaware They are Infected With HIV in the United States

Cited by 1,152 publications

References 32 publications

Reciprocal Sex Partner Concurrency and STDs among Heterosexuals at High-Risk of HIV Infection

Reciprocal Sex Partner Concurrency and STDs among Heterosexuals at High-Risk of HIV Infection

Risk-Based HIV Testing in South Carolina Health Care Settings Failed to Identify the Majority of Infected Individuals

Acceptance of Rapid HIV Screening in a Southeastern Emergency Department

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