title: Predicting HIV transmission risk among HIV-infected patients seen in clinical settings.
abstract: We assessed risk of transmission among 4,016 HIV-infected patients in primary care, including men who have sex with men (MSM, n = 2,109), women (n = 1,104) and men who had sex with women (MSW, n = 803) in clinics in 15 cities across the U.S. A transmission risk act, assessed by computer assisted interviews, was defined as unprotected vaginal or anal sex with a partner who was HIV-uninfected or of unknown HIV status. MSM were more than twice as likely to report transmission risk acts than MSW (Odds Ratio [OR] = 2.35; 95% Confidence Interval [CI] = 1.84, 3.00; P < or = .001). Women were also more likely to report transmission risk acts than MSW (OR = 1.56; 95% CI = 1.19, 2.05; P < or = .001). Stimulant use was associated with transmission risk in all three groups (P < or = .05). MSM were more likely to use methamphetamines (8% versus 2% and 3% respectively), while MSW (17%) and women (12%, compared to 11% for MSM) were more likely to use cocaine. Clinical settings offer opportunities for preventing HIV transmission, particularly if interventions are tailored to sub-populations of HIV-infected patients.
authors.affiliation: Center for AIDS Prevention Studies, University of California, San Francisco, 50 Beale St., Suite 1300, San Francisco, CA 94105, USA. steve.morin@ucsf.edu
authors.forename: Stephen F
authors.initials: SF
authors.lastname: Morin
authors.forename: Janet J
authors.initials: JJ
authors.lastname: Myers
authors.forename: Starley B
authors.initials: SB
authors.lastname: Shade
authors.forename: Kimberly
authors.initials: K
authors.lastname: Koester
authors.forename: Andre
authors.initials: A
authors.lastname: Maiorana
authors.forename: Carol Dawson
authors.initials: CD
authors.lastname: Rose
mesh_terms: D000328:Adult; D003710:Demography; D005260:Female; D015658:HIV Infections / Q000453:epidemiology* / Q000635:transmission*; D018451:Homosexuality, Male / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D011237:Predictive Value of Tests; D011320:Primary Health Care / Q000706:statistics & numerical data*; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012309:Risk-Taking; D012725:Sexual Behavior / Q000523:psychology; D015819:Substance Abuse, Intravenous / Q000453:epidemiology