976    

Background:  Measuring behavioral risk among persons infected with HIV provides valuable information for program planning to prevent secondary transmission or re-infection with another strain.

Methods:  Cross-sectional anonymous survey of HIV-infected patients receiving antiretroviral treatment at 4 hospital-based HIV primary care clinics in New York City. Information on sexual risk behaviors was collected through an audio-computer assisted self interview. Sexual activity was defined as ≥ 1 partner in the past 12 months. Sexual risk was defined as unprotected vaginal or anal sex with a partner.

Results:  Mean age of the 975 enrolled patients was 46 years (range 22 to 77), 43.6% were female, 38.6% black, and 38.8% Latino. Mean duration of HIV infection was 10.2 years (range 0 to 21; 95% CI 9.9 to 10.6). Of the 975 participants, 673 (69%) reported being sexually active. Of the 673 sexually active patients, 41% were females who reported having a male partner. Of 400 sexually active males, 31% reported having had sex with another man (MSM). Among persons who reported having a partner of the opposite sex, more females than males reported unprotected sex (40% vs 27%; p < 0.001). Of males reporting unprotected sex, 31% had a negative female partner. Of the MSM, 25% reported unprotected sex, of whom 35% had a negative partner. A low proportion of sexually active persons reported exchanging money or drugs for sex (7%), of which 6.5% reported unprotected sex. Among females, reasons for non-condom use during vaginal sex with the main partner included the partner did not want to use condoms (26%), partner was positive (14%), and condoms interfered with sexual pleasure (14%). Among males reporting non-condom use during vaginal sex with a main partner, reasons cited were:  partner was HIV positive (29%), condoms interfered with sexual pleasure (16%), and unavailability of condoms (16%). Among MSM reasons for non-condom use during insertive or receptive anal sex with a main or casual partner included:  partner did not want to use condoms (20%), condoms interfered with sexual pleasure (16%), and partner was positive (16%).

Conclusions:  In this sample of long-term HIV-infected patients in care a high proportion were sexually active. Self-reported unprotected sex was more frequent among females than males. Clinic-based intervention programs that address the variety of reasons for non-condom use, should be developed to prevent secondary transmission and re-infection.

Keywords: Risk Behaviors; Condom Use; HIV patients