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HIV-Positive Men Sexually Active with Women: Sexual Behaviors and Sexual Risks

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Abstract

This study examines patterns of sexual behavior, sexual relating, and sexual risk among HIV-positive men sexually active with women. A total of 278 HIV-positive men were interviewed every 6–12 months between 1994 and 2002 and reported considerable variability in sexual behaviors over time. Many were not sexually active at all for months at a time; many continued to have multiple female and at times male partners. Over one-third of the cohort had one or more periods when they had engaged in unprotected sex with a female partner who was HIV-negative or status unknown (unsafe sex). Periods of unsafe sex alternated with periods of safer sex. Contextual factors such as partner relations, housing status, active drug use, and recently exchanging sex showed the strongest association with increased odds of unsafe sex. A number of predictors of unsafe sex among African American men were not significant among the Latino sub-population, suggesting race/ethnic differences in factors contributing to heterosexual transmission. Implications for prevention interventions are discussed.

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Acknowledgements

This research was made possible by grant number H89 HA 0015-15 from the U.S. Health Resources and Services Administration (HRSA) HIV/AIDS Bureau. The CHAIN study is supported by the HIV Health and Human Services Planning Council of New York under a Title I grant of the Ryan White Comprehensive AIDS Resource Emergency Act of 1990 through the New York City Department of Health.

A Technical Review Team (TRT) provides oversight for the Community Health Advisory & Information Network (CHAIN) Project. In addition to Peter Messeri, PhD, Angela Aidala, PhD, and David Abramson, PhD, of Columbia University's Mailman School of Public Health, TRT members include Mary Ann Chiasson, DrPH, MHRA (Chair); Grace Moon, New York City Department of Health and Mental Hygiene (NYCDOHMH) Office of AIDS Policy; Judy Sackoff, PhD, NYCDOHMH; JoAnn Hilger, NYCDOHMH; Julie Lehane, PhD, Westchester County DOH; Jennifer Nelson, MHRA, and a revolving member of the HIV Health and Human Services, PWA Advisory Group.

Contents of this report are solely the responsibility of the researchers and do not necessarily represent the official views of the U.S. Health Resources and Services Administration the City of New York or the Medical and Health Research Association of New York. This research has received approval for research on human subjects from the Institutional Review Boards of the health sciences campus of Columbia University, the New York City Department of Health and Mental Hygiene, and the Medical and Health Research Association of New York, Inc.

We are especially grateful to all the persons living with HIV who have shared their time and experiences with us as CHAIN Project participants.

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Correspondence to Angela A. Aidala PhD.

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Aidala, Lee, Howard, Caban, Abramson, and Messeri are with the Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, 722 W. 168th St, Suite 1119, New York, NY 10032, USA.

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Aidala, A.A., Lee, G., Howard, J.M. et al. HIV-Positive Men Sexually Active with Women: Sexual Behaviors and Sexual Risks. JURH 83, 637–655 (2006). https://doi.org/10.1007/s11524-006-9074-1

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