Behavior changes after notification of HIV infection.

Cleary, Paul D.; Devanter, Nancy Van; Rogers, Theresa F.; Singer, Eleanor; Shipton-Levy, R; Steilen, Melanie; Stuart, Ami; Avorn, J; Pindyck, Johanna

doi:10.2105/ajph.81.12.1586

Cited by 113 publications

(50 citation statements)

References 18 publications

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“…Many individuals, once aware of their HIV infection, reduce risky sexual behaviors with partners who are HIV-negative. [4][5][6] A recent metaanalysis found a 68% reduction in the prevalence of unprotected intercourse among HIV-positive persons aware of their status compared with HIV-infected persons unaware of their HIV status. 7 Persons who are unaware of their HIV serostatus may contribute disproportionately to the number of new transmissions.…”

Section: Introductionmentioning

confidence: 99%

HIV Testing Rates, Testing Locations, and Healthcare Utilization among Urban African-American Men

et al. 2008

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African-American men bear a disproportionate burden of HIV infection in the United States. HIV testing is essential to ensure that HIV-infected persons are aware of their HIV-positive serostatus, can benefit from early initiation of antiretroviral therapy, and can reduce their risk of transmitting the virus to sex partners. This cross-sectional study assessed HIV testing history and healthcare utilization among 352 young African-American men recruited in urban neighborhoods in a Midwestern city. The self-administered survey measured sexual risk behaviors, factors associated with HIV testing, and barriers to testing. The acceptability of community venues for HIV testing was also assessed. Of the respondents, 76% had been tested for HIV at some time in their lives, 52% during the prior 12 months. Of the participants, 70% had unprotected intercourse during the prior 12 months, 26% with two or more partners. Nearly three-quarters (72%) of participants had seen a healthcare provider during the prior year. In univariate analyses, those who had at least one healthcare provider visit during the prior 12 months and those who had a primary doctor were more likely to have been tested in the prior 12 months. In multivariate analyses, having a regular doctor who recommended HIV testing was the strongest predictor of having been tested [OR=7.38 (3.55, 15.34)]. Having been diagnosed or treated for a sexually transmitted disease also was associated with HIV testing [OR=1.83 (1.04, 3.21)]. The most commonly preferred testing locations were medical settings. However, community venues were acceptable alternatives. Having a primary doctor recommend testing was strongly associated with HIV testing and most HIV testing occurred at doctors' offices. But, a substantial proportion of persons were not tested for HIV, even if seen by a doctor. These results suggest that HIV testing could be increased within the healthcare system by increasing the number of recommendations made by physicians to patients. The use of community venues for HIV testing sites could further increase the number of persons tested for HIV.

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Section: Introductionmentioning

confidence: 99%

HIV Testing Rates, Testing Locations, and Healthcare Utilization among Urban African-American Men

et al. 2008

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“…Thus, it has become increasingly important to gather information about factors associated with high-risk sexual behavior among persons with HIV infection and to develop interventions to prevent the spread of HIV to their uninfected partners. Several studies have shown that HIV-infected persons who become aware of their infection tend to reduce or at least to temporarily refrain from activities that would cause risk to others (Cleary et al 1991;Higgins et al 1991;Weinhardt et al 1999). Later reports suggest that such behavioral changes are not maintained in a substantial proportion of HIV-infected persons (Crepaz and Marks 2002;Stall et al 2000).…”

Section: Introductionmentioning

confidence: 99%

Unsafe Sexual Behavior Among HIV-Infected Patients in Croatia, 2006: Prevalence and Associated Factors

Zekan

Novotny²,

Begovać

2008

AIDS Behav

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Information about risky sexual behavior among people living with HIV/AIDS is important to prevent the spread of the disease. Using an anonymous, self-administrated questionnaire, we surveyed 185 HIV-infected patients about risk behaviors at the University Hospital for Infectious Diseases in Croatia. Unprotected anal or vaginal sex in the preceding 6 months with partners of uninfected/ unknown HIV status was reported by 20% of men who have sex with men (MSM), about half of whom reported multiple casual partners of unknown HIV status; 6% of heterosexual men; and 3% of women. Heterosexual patients were potentially more likely to expose regular partners to HIV but reported no risk behaviors with casual, non-concordant partners. MSM reported more risk behaviors, which were strongly associated with having ≥2 sexual partners in the last 6 months and both insertive and receptive anal sex. Educational interventions in Croatia should target MSM to prevent high rates of HIV transmission KeywordsMen who have sex with men; Risk factors; Condom use; Croatia; HIV

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“…As a result, there has been a reduction of risk behaviors in certain high-risk populations Booth, Watters & Chitwood, 1993;Chitwood & Comerford, 1990;Des Jarlais et al, 2000;Fisher & Fisher, 1993;Liebman, Mulia, & McIlvaine, 1992;Longshore, Anglin, Annon, & Hsieh, 1993;Neaigus et al, 1994;Prendergast, Urada, & Podus, 2001;Stimson, 1995). Nevertheless, persons who are HIV seropositive still engage in highly risky behaviors (Centers for Disease Control and Prevention, 2004), especially HIV seropositive drug users (Celentano, Munoz, Cohn, & Vlahov, 2001;Cleary et al, 1991;Marks, Burris, & Peterman, 1999). This high level of continuing risk behaviors raises an important question of significant public health concern: to what extent do infected persons with high levels of ongoing risk behaviors threaten the uninfected population?…”

Section: Introductionmentioning

confidence: 99%

The HIV transmission gradient: relationship patterns of protection

et al. 2006

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We describe a gradient of potential HIV transmission from HIV-infected persons to their partners and thence to uninfected populations. The effect of this newly discovered transmission gradient is to limit the spread of HIV. We roughly estimate a 2% long-term transmission probability for sex and 14% for drug injection for two-step transmission. Then we test theories to account for this pattern on a network sample of 267 inner city drug users and nonusers. Although HIV positive persons engaged in a high level of risk with one another, they engaged in less risk with HIV negative partners, and these partners engaged in even lower levels of risk with other HIV negative persons. Analyses suggest that the primary motivation for sexual risk reduction is partner protection, while emotional closeness is the major barrier. Hypotheses accounting for risk in terms of self protection, social norms, gender power, and drug use were weakly supported or unsupported.

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Behavior changes after notification of HIV infection.

Cited by 113 publications

References 18 publications

HIV Testing Rates, Testing Locations, and Healthcare Utilization among Urban African-American Men

HIV Testing Rates, Testing Locations, and Healthcare Utilization among Urban African-American Men

Unsafe Sexual Behavior Among HIV-Infected Patients in Croatia, 2006: Prevalence and Associated Factors

The HIV transmission gradient: relationship patterns of protection

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