title: Psychosocial characteristics and sexual behaviors of people in care for HIV infection: an examination of men who have sex with men, heterosexual men and women.
abstract: Few studies have examined the psychosocial factors associated with sexual transmission behaviors among HIV-positive men who have sex with men (MSM), heterosexual men (MSW) and women. We enrolled 1,050 sexually active HIV-positive patients at seven HIV clinics in six US cities as part of a clinic-based behavioral intervention. We describe the sexual transmission behaviors and examine demographic, clinical, psychosocial, and clinic prevention variables associated with unprotected anal or vaginal intercourse (UAVI). Twenty-three percent of MSM, 12.3% of MSW and 27.8% of women engaged in UAVI with partners perceived to be HIV-negative or of unknown serostatus. Among MSM and MSW, having multiple partners and lower self-efficacy were associated with increased odds of UAVI. Self-rating one's health status as excellent/very good was a risk factor for UAVI among MSM. Among women, binge drinking and stressful life events were associated with UAVI. These findings identify variables that warrant attention in targeted interventions.
authors.affiliation: Department of Medicine, UNC School of Medicine, Chapel Hill, NC, USA. Carol_Golin@unc.edu
authors.forename: Carol
authors.initials: C
authors.lastname: Golin
authors.forename: Gary
authors.initials: G
authors.lastname: Marks
authors.forename: Julie
authors.initials: J
authors.lastname: Wright
authors.forename: Mary
authors.initials: M
authors.lastname: Gerkovich
authors.forename: Hsiao-Chuan
authors.initials: HC
authors.lastname: Tien
authors.forename: Shilpa N
authors.initials: SN
authors.lastname: Patel
authors.forename: Lytt
authors.initials: L
authors.lastname: Gardner
authors.forename: Christine
authors.initials: C
authors.lastname: O'Daniels
authors.forename: Tracey E
authors.initials: TE
authors.lastname: Wilson
authors.forename: Mark
authors.initials: M
authors.lastname: Thrun
authors.forename: Melanie
authors.initials: M
authors.lastname: Thompson
authors.forename: Stephen
authors.initials: S
authors.lastname: Raffanti
authors.forename: E Byrd
authors.initials: EB
authors.lastname: Quinlivan
mesh_terms: D000328:Adult; D003710:Demography; D005260:Female; D015658:HIV Infections / Q000453:epidemiology / Q000517:prevention & control* / Q000635:transmission; D007722:Health Knowledge, Attitudes, Practice; D020010:Heterosexuality / Q000523:psychology* / Q000706:statistics & numerical data; D018451:Homosexuality, Male / Q000523:psychology* / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012747:Sexual Partners / Q000523:psychology; D012944:Social Support; D011795:Surveys and Questionnaires; D014481:United States