title: Evidence for the long-term stability of HIV transmission-associated sexual behavior after HIV diagnosis.
abstract: BACKGROUND
  Most persons diagnosed as having HIV alter their sexual behavior in a way that reduces the risk of HIV transmission, but the durability of such behavior change is unknown.
  
  
  METHODS
  We conducted annual anonymous cross-sectional surveys in randomly selected patients with appointments at a large, public hospital HIV clinic in Seattle, Washington, from 2005 to 2009. We used logistic regression to assess the association between time since HIV diagnosis and self-report of unprotected anal or vaginal intercourse (UAVI) with partners of negative or unknown HIV status (nonconcordant UAVI), and quantile regression to evaluate the association between time since HIV diagnosis and number of anal or vaginal sex partners.
  
  
  RESULTS
  We analyzed 845 surveys collected for 5 years. Men who have sex with men (MSM) had been diagnosed as having HIV a mean (standard deviation) of 12 (7) years and non-MSM a mean of 11 (6) years. Among 597 MSM, longer time since HIV diagnosis was associated with lower age-adjusted odds of reporting nonconcordant UAVI (odds ratio, 0.96 [95% confidence interval, 0.92-0.99]) and a lower age-adjusted number of sex partners (β coefficient = -0.03, P = 0.007). Among 248 women and heterosexual men, time since HIV diagnosis was not significantly associated with age-adjusted odds of nonconcordant UAVI (odds ratio 0.99 [95% confidence interval, 0.93-1.04]) or number of sex partners (β coefficient = -0.01, P = 0.48).
  
  
  CONCLUSIONS
  These results indicate that HIV transmission-associated behavior is relatively stable following the first year after HIV diagnosis. Our findings suggest that behavior change in the first year after HIV diagnosis, reported in other studies, is durable.
authors.affiliation: Department of Medicine, University of Washington, Seattle, WA, USA. jdombrow@uw.edu
authors.forename: Julia C
authors.initials: JC
authors.lastname: Dombrowski
authors.forename: Robert D
authors.initials: RD
authors.lastname: Harrington
authors.forename: Matthew R
authors.initials: MR
authors.lastname: Golden
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000453:epidemiology / Q000517:prevention & control / Q000635:transmission*; D006679:HIV Seropositivity; D006306:Health Surveys; D020010:Heterosexuality; D018451:Homosexuality, Male; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D040242:Risk Reduction Behavior; D012309:Risk-Taking; D057566:Self Report; D012725:Sexual Behavior / Q000706:statistics & numerical data*; D012747:Sexual Partners; D013997:Time Factors; D014861:Washington / Q000453:epidemiology