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Sexual Behaviors of US Women at Risk of HIV Acquisition: A Longitudinal Analysis of Findings from HPTN 064

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Abstract

We describe the sexual behaviors of women at elevated risk of HIV acquisition who reside in areas of high HIV prevalence and poverty in the US. Participants in HPTN 064, a prospective HIV incidence study, provided information about individual sexual behaviors and male sexual partners in the past 6 months at baseline, 6- and 12-months. Independent predictors of consistent or increased temporal patterns for three high-risk sexual behaviors were assessed separately: exchange sex, unprotected anal intercourse (UAI) and concurrent partnerships. The baseline prevalence of each behavior was >30 % among the 2,099 participants, 88 % reported partner(s) with >1 HIV risk characteristic and both individual and partner risk characteristics decreased over time. Less than high school education and food insecurity predicted consistent/increased engagement in exchange sex and UAI, and partner’s concurrency predicted participant concurrency. Our results demonstrate how interpersonal and social factors may influence sustained high-risk behavior by individuals and suggest that further study of the economic issues related to HIV risk could inform future prevention interventions.

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Acknowledgments

The authors thank the study participants, community stakeholders, and staff from each study site. In addition, they acknowledge Lynda Emel, Jonathan Lucas, Nirupama Sista, Kathy Hinson, Elizabeth DiNenno, Ann O’Leary, Lisa Diane White, Waheedah Shabaaz-El, Quarraisha Abdool-Karim, and Sten Vermund., LeTanya Johnson-Lewis, Edward E. Telzak, Rita Sondengam, Cheryl Guity, Stephanie Lykes, Khadijah Abass, Eileen Rios, Manya Magnus, Christopher Chauncey Watson, Ilene Wiggins, Adongo Tia-Okwee, Joseph Eron, Cheryl Marcus, Valarie Hunter, and Christin Root.

Disclaimer

The views expressed herein are solely the responsibility of the authors and do not necessarily represent the official views of the National Institute of Allergy and Infectious Diseases, the National Institute of Mental Health, the National Institutes of Health, the HPTN, or its funders.

Grant Support

By the National Institute of Allergy and Infectious Diseases, National Institute on Drug Abuse, and National Institute of Mental Health (cooperative agreement no. UM1 AI068619, U01-AI068613, and UM1-AI068613); Centers for Innovative Research to Control AIDS, Mailman School of Public Health, Columbia University (5UM1Al069466); University of North Carolina Clinical Trials Unit (AI069423); University of North Carolina Clinical Trials Research Center of the Clinical and Translational Science Award (RR 025747); University of North Carolina Center for AIDS Research (AI050410); Emory University HIV/AIDS Clinical Trials Unit (5UO1AI069418), Center for AIDS Research (P30 AI050409), and Clinical and Translational Science Award (UL1 RR025008); Terry Beirn Community Programs for Clinical Research on AIDS Clinical Trials Unit; Johns Hopkins Adult AIDS Clinical Trial Unit (AI069465), Johns Hopkins Clinical and Translational Science Award (UL1 RR 25005); Robert W. Woodruff pre-doctoral fellowship of the Emory University Laney Graduate School; the National Institute of Mental Health (F31MH105238); and Columbia University Irving Institute Clinical and Translational Science Award TL1 TR000082-07.

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Correspondence to J. Justman.

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On behalf of the HPTN 064 Study Team.

www.ClinicalTrials.gov: NCT00995176.

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Justman, J., Befus, M., Hughes, J. et al. Sexual Behaviors of US Women at Risk of HIV Acquisition: A Longitudinal Analysis of Findings from HPTN 064. AIDS Behav 19, 1327–1337 (2015). https://doi.org/10.1007/s10461-014-0992-8

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