Session 116Poster Presentations The HIV/STD Interface Session Day and Time: Tuesday 1:30 - 3:30 pm Room: Hall B
919 Potentially Transmitting Sexual Risk Behaviors and Urethral STD among Males Entering Care for HIV Infection E. Cachay*, M. Mar-Tang, C. Mathews Univ of California at San Diego Med Ctr
Background: The aims were: 1) To evaluate the prevalence and predictors of sexual risk behaviors and urethral STD among males entering care for HIV infection. 2) To examine if sildenafil prescriptions are associated with potentially transmitting sexual risk behavior (PTSRB).
Methods: 1) Self administered questionnaire of symptoms of STD, number of recent sex partners, unprotected sexual risk behaviors, use of drugs/alcohol during sex, and HIV disclosure. 2) Urine gonorrhea/chlamydia PCR. 3) Record review for sildenafil prescriptions. A PTSRB was defined as insertive anal, vaginal or oral sex without a condom.
Results: Between March 2001- 2002, 413 entrants were surveyed. Thirty-six percent (36%) were non-white. By HIV risk factor, 72% were MSM, 17% IDU, and 7.5% heterosexual transmission. Median age was 39. Median viral load and absolute CD4 were 3.8 logs and 342, respectively. Sex partners were exclusively male in 77%, exclusively female in 14%, and both in 9%. The prevalence of +urine PCR among those with and without urethral symptoms was 16.7% and 2.4%, respectively (p = 0.038). During the preceding month, among those reporting MSM behaviors, 31% reported at least 1 episode of unprotected anal receptive intercourse, 27% unprotected anal insertive intercourse. Of those reporting sex with female partners, 27% reported unprotected vaginal intercourse and 5% anal insertive intercourse. Disclosure of HIV status to new sex partners occurred "always" in 70%. The prevalence of drug or alcohol use during sex was 16%. Fifty-one percent (51%) met criteria for PTSRB during the preceding month. Those reporting PTSRB were more likely to report multiple partners (OR = 9.0, p < 0.0001). In a multiple logistic regression model, the following were identified as significant (p < 0.05) predictors of PTSRB: 1) drug or alcohol use during sex (OR = 5.8); 2) white race (OR = 2.2); 3) only male partners (OR = 2.1), and sildenafil use (OR = 3.0). Drug use during sex was associated with both more sex partners (3.5 vs 1, p < 0.00001) and more sexual risk behaviors (2.5 vs 1.2, p < 0.00001). Always disclosing HIV status was associated with fewer partners (1.6 vs 2.5, p = 0.037).
Conclusions: There was a high prevalence of PTSRB among HIV infected males entering care. MSM, white race, drug/alcohol use during sex, and sildenafil use were independent risk factors. PTSRB was associated with having multiple partners. Physicians should discuss risk behaviors before prescribing sildenafil.
