International AIDS Society

HIV Risk Behavior Stable for Years After Diagnosis in Seattle Group

Author: Mark Mascolini

26 January 2013

Sexual behavior that may lead to HIV transmission remained stable after the first year since HIV diagnosis in a 5-year study of HIV-positive men and women in Seattle, Washington. Compared with women and heterosexual men, men who have sex with men (MSM) took fewer sexual risks during the study period.

People diagnosed with HIV infection are strongly encouraged to have sex with condoms and take other steps to avoid transmitting their virus to sex partners. Studies of this issue yield varying results, with some showing safer sexual behavior after HIV diagnosis and the start of antiretroviral therapy, and other studies showing sustained or increased risk taking.

Researchers in Seattle addressed this question in annual anonymous cross-sectional surveys of randomly selected HIV-positive people attending a public hospital HIV clinic from 2005 to 2009. The two principal outcomes were unprotected anal or vaginal intercourse with partners of negative of unknown HIV status (nonconcordant UAVI) and number of anal or vaginal sex partners.

The analysis included 845 surveys collected over 5 years. MSM had been diagnosed with HIV for an average 12 years, while women and heterosexual men had been diagnosed for an average 11 years.

Among the 547 MSM studied, statistical analysis linked longer time since HIV diagnosis with lower age-adjusted odds of self-reported nonconcordant UAVI (odds ratio 0.96, 95% confidence interval [CI] 0.92 to 0.99) and with lower age-adjusted number of sex partners (β coefficient −0.03, P = 0.007).

Among 248 women and heterosexual men surveyed, time since HIV diagnosis was not associated with age-adjusted odds of self-reported nonconcordant UAVI (odds ratio 0.99, 95% CI 0.93 to 1.04) or with number of sex partners (β coefficient −0.01, P = 0.48). In other words, women and heterosexual men did not start having more unprotected sex or more sex partners as time since their HIV diagnosis increased.

The researchers believe their results “indicate that HIV transmission-associated behavior is relatively stable following the first year after HIV diagnosis” and that positive behavior change in the first year after HIV diagnosis is durable in this population.

Source: Julia C. Dombrowski, Robert D. Harrington, Matthew R. Golden. Evidence for the long-term stability of HIV transmission-associated sexual behavior after HIV diagnosis. Sexually Transmitted Diseases. 2013; 40: 41-45.

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