Longitudinal Trends in Sexual Behaviors with Advancing Age and Menopause Among Women With and Without HIV-1 Infection

Abstract

We assessed changes in self-reported sexual activity (SA) over 13 years among HIV-infected and uninfected women. The impact of aging and menopause on SA and unprotected anal or vaginal intercourse (UAVI) was examined among women in the Women's Interagency HIV Study (WIHS), stratifying by HIV status and detectable viral load among HIV-infected women. Generalized mixed linear models were fitted for each outcome, adjusted for relevant covariates. HIV-uninfected women evidenced higher levels of SA and UAVI than HIV-infected. The odds of SA declined by 62-64 % per decade of age. The odds of SA in a 6-month interval for women aged 40-57 declined by 18-22 % post-menopause (controlling for age). Among HIV+/detectable women only, the odds of any UAVI decreased by 17 % per decade of age; the odds of UAVI were unchanged pre-menopause, and then decreased by 28 % post-menopause. Elucidating the factors accounting for ongoing unprotected sex among older women should inform interventions.

Fig. 1

Linearity of relationship of age to log-odds of sexual behaviors: (a) Any sexual activity (SA). (b) Any unprotected sexual activity (UAVI) among those sexually active. Age is grouped in 5-year categories beginning with youngest subject in study. VL+ detectable plasma HIV-RNA, VL− non-detectable plasma HIV-RNA, HIV- HIV−uninfected

Fig. 2

Percent of any SA and UAVI at baseline and averaged across all visits. HIV+/detectable detectable plasma HIV-RNA, HIV+/undetectable non-detectable plasma HIV-RNA, HIV- HIV-uninfected