Risk Factors for Human Immunodeficiency Virus Type 1 (Hiv-1) Infection in Patients at a Sexually Transmitted Disease Clinic in New York City

Abstract

Patients who attended a sexually transmitted disease clinic in New York City in 1987 were offered enrollment in a nonblinded study to estimate human immunodeficiency virus type 1 (HIV-1) seroprevalence in adults with multiple sexual partners and to determine risk factors associated with HIV-1 infection. In addition, a blinded serosurvey of a representative sample of patients was performed to obtain an unbiased estimate of seroprevalence in clinic attendees. The seroprevalence in the blinded serosurvey was 7.5% (26/348), while the seroprevalence of the 1,201 volunteers for the nonblinded study was 11.2%. For men in the nonblinded study, the risk behaviors most strongly associated with HIV-1 infection were intravenous drug use, sexual contact with another man, and sexual contact with a female intravenous drug user. For women, intravenous drug use and sexual contact with a man at risk for HIV-1 infection (an intravenous drug user or a bisexual) were most important. The seroprevalence among persons who denied all high-risk behavior was 1% (7/723). The results of this study, conducted in a city with one of the nation's highest reported cumulative incidences of acquired immunodeficiency syndrome, suggest that HIV-1 infection in clinic attendees was primarily limited to intravenous drug users, homosexual/bisexual men, and the sexual partners of these two groups.

Intimate Partner Violence and HIV Risks: A Longitudinal Study of Men on Methadone

“…Substantial research has found that drug-involved men are at disproportionately high risk of engaging in transmission risk behaviors for HIV and other sexually transmitted infections (STIs) [1][2][3][4] as well as of perpetrating intimate partner violence (IPV) against women. [5][6][7][8][9][10][11][12][13][14] Over the past decade, mounting evidence also has documented multifaceted relationships between experiencing IPV and HIV/STI transmission risks among drug-involved women.…”

Deconstructing the Relationship Between Intimate Partner Violence and Sexual HIV Risk Among Drug-Involved Men and Their Female Partners

“…A growing body of research has documented associations between drug and alcohol use and perpetration of IPV among men (Berenson et al, 1991;El-Bassel et al, 2001;Miller, 1995). Numerous studies have also linked drug and alcohol use with having unprotected sex, sex with a risky partner, sex with multiple partners, exchanging sex for money or drugs, as well as with HIV and other STDs (Chiasson et al, 1990;Edlin et al, 1992Edlin et al, , 1994El-Bassel et al, 1997).…”

Seroprevalence of Human Immunodeficiency Virus Type 1 and Sexual Behaviors in Bisexual African-American and Hispanic Men Visiting a Sexually Transmitted Disease Clinic in New York City

“…Depending on the definition of bisexuality used and the population studied, previous estimates of bisexuality among men who report having sex with men have ranged from 13 percent to 85 percent (6)(7)(8)(9). Estimates of HIV seroprevalence in bisexual men have ranged Lehner and Chiasson from 13 percent in a low seroprevalence area (6) to 35 percent in New York City (7).…”