Changes in At-Risk Behavior for HIV Infection among HIV-Positive Persons in Italy

Abstract

Many HIV-positive persons reportedly continue to engage in at-risk behavior. We compared the sexual and drug-using practices of HIV-positive persons before and after the diagnosis of HIV infection to determine whether their behavior had changed. To this end, in 2006, we conducted a cross-sectional study involving clinical centers in five Italian cities. Each center was asked to enroll 100 persons aged 18 years or older who had a diagnosis of HIV infection that dated back at least 2 years. Data were collected with a specifically designed questionnaire, administered during a structured interview. The McNemar chi2 test was used to compare the data before and after the diagnosis. A total of 497 persons participated (65.5% males; median age of 40 years; age range, 34-45 years). The most common exposure categories were: heterosexual contact (43.4%), homosexual contact (27.2%), and injecting drug use (20.6%). Although the percentage of drug users significantly decreased after diagnosis, 32.4% of injectors continued to use drugs, and approximately half of them exchanged syringes. Regarding sexual behavior, after diagnosis there was a significant decrease in the number of sexual partners and in stable relationships and an increase in condom use, both for persons with stable partners and those with occasional partners, although the percentage varied according to the specific sexual practice. These results indicate that though at-risk behavior seems to decrease after the diagnosis of HIV infection, seropositive persons continue to engage in at-risk practices, indicating the need for interventions specifically geared toward HIV-positive persons.

Resisting Public Health Surveillance: Anonymous HIV Testing and the Imperative of Health

“…Indeed, as noted in previous research, after an HIV diagnosis, many persons forego practices that transmit HIV and become less infectious as a result of medication (Sasse et al 2006;Charlebois et al 2005;Fox et al 2009;Camoni et al 2009;Marks et al 2006). While the association between HIV-positive status awareness and decreased HIV transmission has led some authors to argue that HIV testing services should be as inclusive as possible, it is important to emphasize that the behaviour changes which occur after an HIV diagnosis are similar when HIV testing is done anonymously or with people's names (Marks et al 2005(Marks et al , 2006Sasse et al 2006;Charlebois et al 2005;Osmond et al 1999;Fox et al 2009;Camoni et al 2009). The group that Lyon (2007) called 'the watched' thus actively participates in their own surveillance by voluntarily seeking out, and subsequently undergoing, HIV testing, and then by reducing the possibility of onward HIV transmission through behaviour change and viral load suppression.…”

“…Indeed, in determining if an HIV diagnosis corresponds with changes in sexual and drug-using practices, Camoni and others (2009) found that their participants reported the following changes after their HIV diagnosis: a significant decrease in their number of different sexual partners; a significant decrease in commercial sex (as client or worker); and a significant increase in condom use with both casual and regular sexual partners. Additionally, the participants reported a significant decrease in the use of all drugs following their HIV diagnoses (Camoni et al 2009). …”

Epidemiology of Chlamydia trachomatis and Repeat Positivity Following Detection in New York State

“…This has been documented in studies analyzing the risk of STIs among HIV-positive individuals. 25,26 Thorough risk assessment and review of medical history are crucial to ensure that individuals with a previously diagnosed STI are identified by health care providers and prioritized for prevention.…”

Characteristics and behaviors in a sample of patients unaware of their infection until AIDS diagnosis in Italy: a cross-sectional study

“…Lastly, behavioral analysis made before and after HIV diagnosis has allowed for identifying late testers as tending to reduce sexual relations with steady or occasional partners while non-late testers only reduce sex with occasional partners but increase condom use in all sexual practices. However, the proportion of people who continue not using condoms is still high (Sudarshi et al, 2008;Camoni et al, 2009). It must be stressed that the importance of this result is limited by the low number of answers provided by the late testers in this part of the questionnaire.…”