Behavioral and Demographic Risk Factors for Transmission of Human Immunodeficiency Virus Type 1 in Heterosexual Couples: Report from the Heterosexual HIV Transmission Study

Skurnick, Joan; Kennedy, Cheryl A.; Perez, George; Abrams, J; Vermund, Sten H.; Denny, Thomas N.; Wright, Thomas; Quinones, Mark A.; Louria, Donald B.

doi:10.1086/513929

Cited by 41 publications

(12 citation statements)

References 26 publications

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“…Close to one-third of patients (index cases) who transmitted HIV to their spouse between 6 and 12 months of care consumed alcohol on a regular basis, which was higher than patients in persistently discordant relationships. Alcohol use can lead to increased sexual risk-taking behaviour and decreased condom use [43]. Although a majority of patients reported monogamy, most patients reported not using condoms with their spouses at enrolment.…”

Section: Discussionmentioning

confidence: 99%

Risk factors for HIV transmission among heterosexual discordant couples in South India^*

et al. 2010

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ObjectiveTo assess the risk factors associated with heterosexual HIV transmission among South Indian discordant couples enrolled in clinical care. MethodsA nested matched case-control study of serodiscordant couples in which the HIV-infected partner (index case) was enrolled in care. Demographic and clinical characteristics, sexual behaviours, CD4 cell count and plasma HIV-1 RNA loads were measured at enrolment and longitudinally over 12 months of follow-up. The study included 70 cases who seroconverted during study follow-up and 167 matched controls who remained persistently serodiscordant. ResultsThe incidence of HIV infection among the initially seronegative partners was 6.52 per 100 personyears. Persistently discordant patients were more likely to have initiated highly active antiretroviral therapy (HAART) than patients in seroconverting relationships (62.9% vs. 42.9%) (P50.001). Patients in seroconverting relationships had significantly higher plasma viral loads (PVLs) than patients in discordant relationships at enrolment, at 6 months and at 12 months (Po0.05). Patients in seroconverting relationships were less likely to use condoms with their primary partners than patients in discordant relationships (Po0.05). Patients in relationships that seroconverted between 6 and 12 months were diagnosed more often with genital Herpes simplex than patients in discordant relationships (P50.001). In the univariate and multivariate logistic regression, the following variables were associated with seroconversion: PVL 4100 000 [odds ratio (OR): 1.82; 95% confidence interval (CI): 1.1-2.8], non-disclosure of HIV status (OR: 5.5; 95% CI: 4.3-6.2) and not using condoms (OR: 2.8; 95% CI: 2.4-3.6). ConclusionsCouples-based intervention models are crucial in preventing HIV transmission to seronegative spouses. Providing early treatment for sexually transmitted infections, HAART and enhancing condom use and disclosure could potentially decrease the risk of HIV transmission within Indian married couples. IntroductionAn increasing focus of HIV preventive strategies has been to move away from solely reducing the risk-taking behaviours of HIV-uninfected individuals to focusing on HIV-infected individuals who may continue to practice HIV risk-taking behaviours [1]. Studies from the developed and developing world have documented that a sizeable number of HIV-infected individuals continue to engage in unprotected sexual intercourse with HIV-serodiscordant partners [2][3][4][5][6]. Unprotected intercourse may be more common among HIV-infected individuals in steady or regular relationships than in casual or non-regular sexual *The first two authors contributed equally to this manuscript. [19]. The typical route of HIV transmission has been through unprotected heterosexual intercourse [20]; however, data about the incidence and risk factors associated with HIV transmission through heterosexual intercourse in India remains very limited [21]. The social construct of gender in India, which has evolved over many centuries, makes women highl...

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Section: Discussionmentioning

confidence: 99%

Risk factors for HIV transmission among heterosexual discordant couples in South India^*

et al. 2010

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“…1,2 Since the early 1990s, researchers have suggested that anal sex can also increase the risk of HIV and other sexually transmissible infections (STI). 1,[3][4][5][6][7][8][9] Empirical researches have subsequently demonstrated that anal intercourse carries a higher risk burden than vaginal intercourse even when practiced with a condom. 5,[10][11][12][13] Since condoms are generally manufactured for use in vaginal intercourse, the chances of condom breakage are higher if used in anal sex, thus resulting in an increased risk of exposure to HIV and other STIs.…”

Section: Introductionmentioning

confidence: 99%

Anal sex and associated HIV-related sexual risk factors among female sex workers in Andhra Pradesh, India

et al. 2012

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Abstract. Background: This study aims to understand the correlates of anal sex practices among female sex workers (FSWs) and examine the association of anal sex with HIV-related sexual risk factors in Andhra Pradesh, India. Methods: A cross-sectional behavioural survey was conducted in 2011 among 795 FSWs aged 18 years or older. Probability-based cluster sampling was used to select respondents from sex work hotspots. Results: One-quarter (23%) of FSWs had practiced anal sex in the last year. The odds of practicing anal sex were higher among FSWs aged 35 years or more than in those aged less than 25 years (adjusted odds ratio (AOR): 2.05, P < 0.05), in those formerly married compared to those currently married (AOR: 1.88, P < 0.01), in those having an income only from sex work compared to those having additional sources of income (AOR: 1.54, P < 0.05), those reporting heavy alcohol consumption compared to those who did not (AOR: 2.80, P < 0.01) and those who experienced violence compared to those who had not (AOR: 2.80, P < 0.01). FSWs practicing anal sex were more likely to experience sexually transmissible infection (STI) related symptoms than those practicing only vaginal sex. There was no association between anal sex practice and condom use. Conclusions: Anal sex is associated with STI symptoms, a factor for HIV risk. HIV intervention programmes need to educate FSWs about the risks associated with anal sex.

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“…Heterosexual anal intercourse is not uncommon; lifetime occurrence of anal intercourse has been reported to be 32% among college women (Flannery et al 2003), 30% in a national survey of 15-44 year olds ) and 16-22% among urban young adults (Lindberg 1999;Misegades et al 2001;Ompad et al 2006). Other studies found a prevalence of recent anal intercourse of 22% among women at clinics for sexually transmitted infections (Satterwhite et al 2007), 21% among HIV serodiscordant stable heterosexual couples (Skurnick et al 1998), 12-25% among HIV positive women (Chirgwin et al 1999;Kalichman 1999;Weinhardt et al 2004;Wilson et al 1999), 10-14% among HIV negative women (Chirgwin et al 1999;Wilson et al 1999), and 32% among high-risk HIV-negative women (Gross et al 2000). In the few studies reporting on condom use with anal intercourse among women, condom use was infrequent (Flannery et al 2003;Kalichman 1999;Lorvick et al 2006).…”

Section: Introductionmentioning

confidence: 99%

Correlates of Anal Intercourse Vary by Partner Type Among Substance-Using Women: Baseline Data from the UNITY Study

Koblin

Hoover

et al. 2008

AIDS Behav

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Data are limited about anal intercourse among women at risk of HIV infection. HIV-negative non-injection drug using women at sexual risk (N = 404) were recruited. At baseline, 41.7% reported anal intercourse in the prior 3 months; of these, 88.2% reported unprotected anal intercourse (UAI). Factors associated with UAI varied by partner type: UAI with a steady partner was associated with younger age, depressive symptoms, and experience of battering; UAI with casual partners was associated with younger age, cocaine use and negative outcome expectancies for condom use; UAI with exchange partners was associated with cocaine use, negative outcome expectancies for condom use and depressive symptoms. Younger women were more likely to report unprotected anal intercourse if they did not use birth control. Specific counseling messages are needed to identify and address this risk and associated factors, including partner relationships, substance use, birth control, mental health issues and domestic violence.

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Behavioral and Demographic Risk Factors for Transmission of Human Immunodeficiency Virus Type 1 in Heterosexual Couples: Report from the Heterosexual HIV Transmission Study

Cited by 41 publications

References 26 publications

Risk factors for HIV transmission among heterosexual discordant couples in South India^*

Risk factors for HIV transmission among heterosexual discordant couples in South India^*

Anal sex and associated HIV-related sexual risk factors among female sex workers in Andhra Pradesh, India

Correlates of Anal Intercourse Vary by Partner Type Among Substance-Using Women: Baseline Data from the UNITY Study

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Behavioral and Demographic Risk Factors for Transmission of Human Immunodeficiency Virus Type 1 in Heterosexual Couples: Report from the Heterosexual HIV Transmission Study

Cited by 41 publications

References 26 publications

Risk factors for HIV transmission among heterosexual discordant couples in South India*

Risk factors for HIV transmission among heterosexual discordant couples in South India*

Anal sex and associated HIV-related sexual risk factors among female sex workers in Andhra Pradesh, India

Correlates of Anal Intercourse Vary by Partner Type Among Substance-Using Women: Baseline Data from the UNITY Study

Contact Info

Product

Resources

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Risk factors for HIV transmission among heterosexual discordant couples in South India^*

Risk factors for HIV transmission among heterosexual discordant couples in South India^*