title: Unprotected sexual behavior among heterosexual HIV-positive injection drug using men: associations by partner type and partner serostatus.
abstract: Few studies have examined sexual risk behaviors of HIV-positive, heterosexual, injection drug using (IDU) men. We investigated such behaviors and associations with risk among sexually active, HIV-positive IDU men who reported only female sex partners in the 3 months prior to baseline interview. We examined associations separately for four non-exclusive groups of men by crossing partner type (main or casual) and partner serostatus (HIV-positive or HIV-negative/unknown). Of 732 male participants, 469 (64%) were sexually active with only female partners. Of these 469 men, 155 (33%) reported sex with HIV-positive main partners, 127 (27%) with HIV-negative or unknown serostatus main partners, 145 (31%) with HIV-positive casual partners, and 192 (41%) with HIV-negative/unknown serostatus casual partners. Significant multivariate associations for unprotected sex with HIV-negative or unknown serostatus main partners were less self-efficacy to use condoms, weaker partner norms supporting condoms, and more negative condom beliefs. Similar correlates were found for unprotected sex with HIV-positive main and casual partners. In addition, alcohol or drug use during sex was a significant correlate of unprotected sex with HIV-positive main partners, while depression was significant for HIV-positive casual partners. For unprotected sex with HIV-negative/unknown status casual partners, self-efficacy for condom use, sex trade, and education were significant multivariate correlates. A combination of broad and tailored intervention strategies based on the relationship pattern of men's lives may provide the most benefit for reducing unprotected sex with female partners.
authors.affiliation: Centers for Disease Control and Prevention, NCHSTP/DHAP/PRB, 1600 Clifton Road, MS E-37, Atlanta, GA 30333, USA. dpurcell@cdc.gov
authors.forename: David W
authors.initials: DW
authors.lastname: Purcell
authors.forename: Yuko
authors.initials: Y
authors.lastname: Mizuno
authors.forename: Lisa R
authors.initials: LR
authors.lastname: Metsch
authors.forename: Richard
authors.initials: R
authors.lastname: Garfein
authors.forename: Karin
authors.initials: K
authors.lastname: Tobin
authors.forename: Kelly
authors.initials: K
authors.lastname: Knight
authors.forename: Mary H
authors.initials: MH
authors.lastname: Latka
mesh_terms: D000328:Adult; D006679:HIV Seropositivity; D020010:Heterosexuality; D006801:Humans; D008297:Male; D008875:Middle Aged; D012725:Sexual Behavior; D015819:Substance Abuse, Intravenous; D014481:United States; D047568:Unsafe Sex