title: Prevalence and correlates of sexual behavior and risk management among HIV-positive adults over 50.
abstract: BACKGROUND
  This study examined the prevalence and correlates of sexual behavior, sexual risk, and behavioral risk reduction strategies among a diverse sample of HIV-positive adults over age 50.
  
  
  METHODS
  Individual surveys were conducted with 914 HIV-positive adults age 50 and over (640 male, 264 female, 10 transgender) living in New York City.
  
  
  RESULTS
  Over half the sample reported sexual activity in the past 3 months, and one-third of sexually active participants reported unprotected anal or vaginal sex in that time period. Sexually active participants were more likely to be younger and male, but did not differ on physical health status. Participants reported a range of risk-management strategies, including 100% condom use (49% of sexually active participants), serosorting (17%), and strategic positioning (4%). The prevalence of strategies differed by gender/sexual identity subgroups. In multivariate modeling, unprotected sex was significantly associated with recent substance use and loneliness.
  
  
  CONCLUSIONS
  Older HIV-positive adults are sexually active, and engage in both high-risk and risk-management behaviors. Loneliness emerged as the dominant risk factor in this sample. Findings provide meaningful implications for HIV prevention interventions targeting this population.
authors.affiliation: Department of Psychology, Center for HIV Educational Studies and Training, Hunter College, City University of New York, 695 Park Avenue, Room 714N, New York, NY 10065. sarit.golub@hunter.cuny.edu
authors.forename: Sarit A
authors.initials: SA
authors.lastname: Golub
authors.forename: Julia C
authors.initials: JC
authors.lastname: Tomassilli
authors.forename: David W
authors.initials: DW
authors.lastname: Pantalone
authors.forename: Mark
authors.initials: M
authors.lastname: Brennan
authors.forename: Stephen E
authors.initials: SE
authors.lastname: Karpiak
authors.forename: Jeffrey T
authors.initials: JT
authors.lastname: Parsons
mesh_terms: D000368:Aged; D005260:Female; D006679:HIV Seropositivity / Q000453:epidemiology* / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009518:New York / Q000453:epidemiology; D015995:Prevalence; D012308:Risk Management; D012309:Risk-Taking; D012725:Sexual Behavior; D047568:Unsafe Sex