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AIDS and Behavior

, Volume 11, Issue 6, pp 789–811 | Cite as

The HIV transmission gradient: relationship patterns of protection

  • David C. Bell
  • John S. Atkinson
  • Victoria Mosier
  • Micah Riley
  • Victoria L. Brown
Original Paper

Abstract

We describe a gradient of potential HIV transmission from HIV-infected persons to their partners and thence to uninfected populations. The effect of this newly discovered transmission gradient is to limit the spread of HIV. We roughly estimate a 2% long-term transmission probability for sex and 14% for drug injection for two-step transmission. Then we test theories to account for this pattern on a network sample of 267 inner city drug users and nonusers. Although HIV positive persons engaged in a high level of risk with one another, they engaged in less risk with HIV negative partners, and these partners engaged in even lower levels of risk with other HIV negative persons. Analyses suggest that the primary motivation for sexual risk reduction is partner protection, while emotional closeness is the major barrier. Hypotheses accounting for risk in terms of self protection, social norms, gender power, and drug use were weakly supported or unsupported.

Keywords

HIV/AIDS Social networks Risk reduction Power Social norms 

Notes

Acknowledgments

Work on this paper was supported in part by Grant DA08989 from the National Institute on Drug Abuse, principal investigators Isaac D. Montoya and David C. Bell. The analyses for this paper were completed while the authors were employed by Affiliated Systems Corporation, a think tank in Houston, Texas. The authors would like to thank Sam Friedman, Seth Kalichman, Martina Morris, Jon Potterat, and anonymous reviewers for their insightful critiques of an earlier version of this paper, and Swati Sheth and Travis Cal for assistance in the preparation of this paper. Opinions expressed herein are solely those of the authors.

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Copyright information

© Springer Science+Business Media, LLC 2006

Authors and Affiliations

  • David C. Bell
    • 1
  • John S. Atkinson
    • 2
  • Victoria Mosier
    • 3
  • Micah Riley
    • 4
  • Victoria L. Brown
    • 5
  1. 1.Department of SociologyIndiana University Purdue University IndianapolisIndianapolisUSA
  2. 2.Center for Health Promotion and Prevention ResearchUniversity of Texas School of Public HealthHoustonUSA
  3. 3.Department of ResearchDePelchin Children’s CenterHoustonUSA
  4. 4.Veterans AffairsHoustonUSA
  5. 5.Department of Behavioral ScienceUniversity of Texas—M. D. Anderson Cancer CenterHoustonUSA

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