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Transmission Risk Behaviors in HIV Patients
Attending an Inner-City HIV Primary Care Clinic
RL Wald & LR Temoshok, Institute of Human Virology,
University of Maryland, Baltimore, MD.
HIV prevention efforts continue to under-target the problem of continued transmission risk behaviors by HIV-infected individuals. To assess the extent of the problem, we surveyed 150 patients (90% African-American, 50% female, average years since diagnosis 9.4) attending an HIV clinic serving a disadvantaged inner-city population. The most common HIV risk factors were injecting drug use (54.9%), heterosexual sex (26.8%), and men having sex with men (12.2%). 57% reported at least one sexual partner in the past six months, and 83% had at least one partner in the past two years. 66% reported a recent partner who was HIV-negative or had unknown serostatus. 19% had hidden their HIV status from a partner. Respondents generally abstained from the riskiest activities (anal sex, needle sharing), but most engaged in vaginal and/or oral sex. Condoms were rarely used for oral sex, and only half of those having vaginal sex said they “always” used condoms. Unprotected sex was more common with HIV+ partners than with partners of negative or unknown status. Our data indicate that transmission risk behaviors remain a serious and largely unaddressed problem among HIV-infected patients in this population. These behaviors are particularly troubling in light of widespread drug resistance and incomplete viral suppression among the clinic’s patients, which combine to increase the likelihood that these behaviors will result in the transmission of drug-resistant HIV, and an increasing number of treatment-naive patients who are already resistant to one or more HIV drugs.
Attending an Inner-City HIV Primary Care Clinic
RL Wald & LR Temoshok, Institute of Human Virology,
University of Maryland, Baltimore, MD.
HIV prevention efforts continue to under-target the problem of continued transmission risk behaviors by HIV-infected individuals. To assess the extent of the problem, we surveyed 150 patients (90% African-American, 50% female, average years since diagnosis 9.4) attending an HIV clinic serving a disadvantaged inner-city population. The most common HIV risk factors were injecting drug use (54.9%), heterosexual sex (26.8%), and men having sex with men (12.2%). 57% reported at least one sexual partner in the past six months, and 83% had at least one partner in the past two years. 66% reported a recent partner who was HIV-negative or had unknown serostatus. 19% had hidden their HIV status from a partner. Respondents generally abstained from the riskiest activities (anal sex, needle sharing), but most engaged in vaginal and/or oral sex. Condoms were rarely used for oral sex, and only half of those having vaginal sex said they “always” used condoms. Unprotected sex was more common with HIV+ partners than with partners of negative or unknown status. Our data indicate that transmission risk behaviors remain a serious and largely unaddressed problem among HIV-infected patients in this population. These behaviors are particularly troubling in light of widespread drug resistance and incomplete viral suppression among the clinic’s patients, which combine to increase the likelihood that these behaviors will result in the transmission of drug-resistant HIV, and an increasing number of treatment-naive patients who are already resistant to one or more HIV drugs.
