Using patient risk indicators to plan prevention strategies in the clinical care setting.
OBJECTIVE
Successful behavioral interventions to promote safe sex must be tailored to the sexual behaviors and relationships of individual patients. The aim of this study is to examine the distribution of unprotected anal and vaginal sex (UAV) and nondisclosure (ND) among categories of HIV-positive men and women based on relationship factors. These factors can be easily assessed and used as a basis for tailoring safer sex counseling in the clinic setting.


METHODS
Eight hundred forty HIV-positive persons who were sexually active and attending 1 of 6 clinics in California were surveyed. Participants were categorized on the basis of numbers of partners, sexual orientation, type of relationship, and partner serostatus. Self-reported UAV, ND, and duration of the relationship were reported for each category and were examined.


RESULTS
UAV was lower for those with 1 partner (26%) as compared with those with 2 or more partners (50%). ND was also lower for those with 1 partner (20%) as compared with those with 2 or more partners (60%). For those with 1 main partner, we found no significant differences in UAV by sexual orientation. UAV with seronegative main partners ranged from 16% to 20%, whereas UAV with seropositive partners ranged from 37% to 46%. Among men who have sex with men with 2 or more partners, relationships were more likely to be casual, of short duration, and to have higher levels of UAV and ND.


CONCLUSIONS
The number of sex partners, type of relationship, and perceived HIV serostatus of a partner influence sexual behaviors and may be an efficient and effective basis for tailoring prevention messages.
Richardson
Jean L
JL
Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA. jeanr@usc.edu
Milam
Joel
J
Stoyanoff
Susan
S
Kemper
Carol
C
Bolan
Robert
R
Larsen
Robert A
RA
Weiss
Jony M
JM
Hollander
Harry
H
Weismuller
Penny
P
McCutchan
Allen
A
D000328:Adult; D005260:Female; D015658:HIV Infections / Q000517:prevention & control* / Q000635:transmission; D006679:HIV Seropositivity / Q000635:transmission*; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D018579:Patient Selection; D012309:Risk-Taking; D012725:Sexual Behavior; D047568:Unsafe Sex