Sexual behavior of individuals infected with the human immunodeficiency virus. The need for intervention

Abstract

Background: Public health efforts to stop the spread of the human immunodeficiency virus (HIV) emphasize behavior change among all persons at risk of infection. Yet efficient physician-based intervention might be targeted toward persons infected with HIV. To evaluate the need for intervention among HIV-infected persons attending a continuity clinic, we determined the prevalence of behaviors risky for new transmission of HIV and the characteristics of HIV-infected individuals participating in such behavior.

Methods: Cross-sectional structured survey of 227 HIV-infected patients attending an urban HIV continuity-of-care clinic.

Results: Nine percent of the subjects had vaginal, anal, or oral sex without a condom with an HIV-negative last sex partner (24% of whom were unaware that the subject was HIV infected) and an additional 13% with an HIV-status-unknown last sex partner (41% were unaware that the subject was HIV infected). Subjects used a condom for intercourse more often with a partner they knew to be HIV negative than HIV-status-unknown or HIV-positive (84% vs 59% vs 51%). Subjects with more lifetime male sexual partners were more likely to have had sex without a condom with an HIV-negative or HIV-status-unknown partner.

Conclusion: The HIV-infected individuals in this clinic setting participate in a substantial amount of sexual behavior placing others at risk of new HIV infection. Physicians must address such behaviors, and programs specifically aimed at reducing such behavior should be a public health priority.