Analysis of Risk Behavior Change Following HIV Diagnosis

A study in a recent issue of Morbidity and Mortality Weekly Report (MMWR), published by the Centers for Disease Control and Prevention (CDC), examines the sexual practices of persons with newly diagnosed HIV infection.

From January 1997 through September 1998, researchers identified individuals in Alabama, New Jersey, and Tennessee who had recently acquired HIV infection as well as individuals who were between 13 and 24 years of age when diagnosed with HIV. Researchers then interviewed 180 of these eligible individuals.

Respondents were asked questions about their sexual behavior both before and after they learned of their HIV status. (Sexual behavior occurring before respondents learned of their HIV status was limited to events that occurred after 1977.)

Results

When asked about the leading reasons for being tested:

• 28% of male respondents reported a doctor or friend told them to be tested, and 22% reported being tested because they were worried they might be infected even though they were not sick.

• 33% of female respondents reported pregnancy care as the reason why they were tested, and 18% reported that a doctor or friend told them to be tested.

Sexual Behavior

• 90% of respondents reported changing their sexual behavior since learning of their HIV status. Of these respondents, 60% reported using condoms more often, 49% reported not having sexual intercourse as often, 36% reported not having sexual intercourse, 10% reported having sexual intercourse with persons they knew were infected, and 5% reported only having oral sex.

Condom Use

• Among female respondents who reported engaging in vaginal-penile intercourse and male respondents who reported having had anal intercourse with men, 25% reported never using condoms before diagnosis, 69% reported sometimes using condoms before diagnosis, and 6% reported always using condoms before diagnosis.

• After diagnosis, 30% of these respondents reported not engaging in sexual intercourse. Of those who continued to engage in sexual intercourse after diagnosis, 6% reported never using condoms, 11% reported sometimes using condoms, and 47% reported always using condoms.

Sexual Partners

• 79% of females who reported engaging in vaginal-penile intercourse after diagnosis had one partner since learning of their HIV infection.

• 50% of males who reported having anal intercourse with men after diagnosis reported having one partner since learning of their HIV infection.

• Among respondents interviewed within 6 months of diagnosis, 44% reported not having sexual intercourse compared with 18% of respondents interviewed more than 6 months after diagnosis.

The findings in this study suggest that a large proportion of young persons infected with HIV reduced their high-risk sexual behaviors and adopted safer sexual behaviors following diagnosis. For this reason, the authors suggest that HIV testing and counseling programs should encourage persons at high risk for HIV infection to seek knowledge of their status and facilitate referrals to ongoing care and prevention services for persons found to be infected.

The findings further show an increase in reported safer behaviors during the 6 months after HIV-related primary care is first sought. The authors note that persons who have not engaged in sexual intercourse since their diagnosis may become sexually active later and suggest that sustained interventions must be available for maintenance and adoption of safer behaviors.

Finally, the authors note that 84% of respondents reported receiving HIV-related medical care within one year of learning of their positive HIV status. They suggest that these encounters provide a good opportunity for behavioral risk-reduction counseling and intervention.

For more information: "Adoption of Protective Behaviors Among Persons With Recent HIV Infection and Diagnosis--Alabama, New Jersey, and Tennessee, 1997-1998," Morbidity and Mortality Weekly Report, June 16, 2000, vol. 49, no. 23, pp. 512-15.

See also "Benefits and Barriers of Early Detection of HIV Infection Among Adolescents."