Skip to main content
Log in

Gender differences in HIV risk behaviors in an adult emergency department in New York City

  • Original Article
  • Published:
Journal of Urban Health Aims and scope Submit manuscript

Abstract

Background

The human immunodeficiency virus (HIV) epidemic in the US increasingly involved urban heterosexual adults, particularly women, belonging to ethnic minority groups. An understanding of gender-based differences in HIV risk behaviors within these groups would be of value in the ongoing struggle to limit HIV transmission in metropolitan centers.

Methods

This was a prospective study of demographic and historical characteristics and HIV risk behaviors. The study utilized a structured interview format, which was administered to all patients treated by participating emergency department physicians.

Results

On univariate analysis of data obtained from 1,460 patients who had neither a known HIV infection nor a chief complaint or final emergency department diagnosis associated with HIV risk behaviors, men were more likely to be older, homeless, to have ever injected drugs, used crack, engaged in same-gender sex, paid for sex, been incarcerated, or had syphilis or gonorrhea. Women were more likely to report prior chlamydia infection or to report that their sole sex partners had other partners within the past year. On multivariate analysis, variables independently associated with male gender included homelessness, injection drug use, crack use, any prior sexually transmitted disease (in subjects 35 years of age or older), and sex with prostitutes. In a separate analysis of patients admitting to drug use, the male predominance of other risk behaviors was not observed; the only significant differences between genders were a higher rate of prostitution among women and a higher rate of sexual contact with a prostitute among men.

Conclusions

In patients visiting an inner-city emergency department in the Bronx, HIV risk behaviors are generally more common in men, but rates of risk behaviors among male and female drug users are comparable.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Centers for Disease Control and Prevention. Update: AIDS among women—United States, 1994.MMWR Morb Mortal Wkly Rep. 1995;44:81–84.

    Google Scholar 

  2. Centers for Disease Control and Prevention. Heterosexually acquired AIDS—United States, 1993.MMWR Morb Mortal Wkly Rep. 1994;155–160.

  3. Holmberg SD. The estimated prevalence and incidence of HIV in 96 large US metropolitan areas.Am J Public Health. 1996;86:642–654.

    CAS  PubMed  Google Scholar 

  4. Centers for Disease Control and Prevention. Community-level prevention of human immunodeficiency virus infection among high-risk populations: the AIDS community demonstration projects.MMWR Morb Mortal Wkly Rep. 1996;45(RR-6):1–24.

    Google Scholar 

  5. Centers for Disease Control and Prevention. Number of sex partners and potential risk of sexual exposure to human immunodeficiency virus.MMWR Morb Mortal Wkly Rep. 1983;37:565–568.

    Google Scholar 

  6. Catania JA, Coates TJ, Stall R, et al. Prevalence of AIDS-related risk factors and condom use in the United States.Science. 1992;258:1101–1106.

    CAS  PubMed  Google Scholar 

  7. Peterson JL, Grinstead OA, Golden E, Catania JA, Kegeles S, Coates TJ. Correlates of HIV risk behaviors in black and white San Francisco heterosexuals: the population-based AIDS in Multiethnic Neighborhoods (AMEN) study.Ethn Dis. 1992;2:361–370.

    CAS  PubMed  Google Scholar 

  8. Joe GW, Simpson DD. HIV risks, gender, and cocaine use among opiate users.Drug Alcohol Depend. 1995;37:23–28.

    CAS  PubMed  Google Scholar 

  9. Freeman RC, Rodriguez GM, French JF. A comparison of male and female intravenous drug users' risk behaviors for HIV infection.Am J Drug Alcohol Abuse. 1994;20:129–157.

    Google Scholar 

  10. Edlin BR, Irwin KL, Faruque S, et al. Intersecting epidemics—crack cocaine use and HIV infection among inner-city young adults.N Engl J Med. 1994;331:1422–1427.

    Google Scholar 

  11. Dwyer R, Richardson D, Ross MW, Wodak A, Miller ME, Gold J. A comparison of HIV risk between women and men who inject drugs.AIDS Educ Prev. 1994;6:379–389.

    Google Scholar 

  12. Centers for Disease Control and Prevention. Sexual risk behaviors of STD clinic patients before and after Earvin “Magic” Johnson's HIV-infection announcement—Maryland, 1991–1992.MMWR Morb Mortal Wkly Rep. 1993;42:45–58.

    Google Scholar 

  13. Chiasson MA, Stoneburner RL, Lifson AR, et al. Risk factors for human immunodeficiency virus type 1 (HIV-1) infection in patients at a sexually transmitted disease clinic in New York City.Am J Epidemiol. 1990;131:208–220.

    CAS  PubMed  Google Scholar 

  14. New York City Department of Health.AIDS Surveillance Update. October 1994.

  15. Alpert PL, Shuter J, DeShaw MG, Webber MP, Klein RS. Factors associated with unrecognized HIV-1 infection in an inner city emergency department in the Bronx, New York.Ann Emerg Med. 1996;28:159–164.

    Article  CAS  PubMed  Google Scholar 

  16. Shuter J, Alpert PL, DeShaw MG, Greenberg B, Klein RS. Rates of and factors associated with self-reported prior HIV testing among adult medical patients in an inner city emergency department in the Bronx, New York City.J Acquir Immune Defic Syndr Hum Retrovirol. 1997;14:61–66.

    CAS  PubMed  Google Scholar 

  17. Hosmer DW, Lemeshow S.Applied Logistic Regression. New York: John Wiley and Sons; 1989.

    Google Scholar 

  18. New York City Department of Health.Summary of Reportable Diseases and Conditions, 1994. New York: New York City Department of Health; 1995;14:12–13.

    Google Scholar 

  19. Warner LA, Kessler RC, Hughes M, Anthony JC, Nelson CB. Prevalence and correlates of drug use and dependence in the United States: results from the National Comorbidity Survey.Arch Gen Psychiatry. 1995;52:219–229.

    CAS  PubMed  Google Scholar 

  20. Neff JA, Burge SK. Alcohol use, liberal/conservative orientations, and ethnicity as predictors of sexual behaviors.J Acquir Immune Defic Syndr Hum Retrovirol. 1995;8: 302–311.

    CAS  PubMed  Google Scholar 

  21. Stamm WE. Toward control of sexually transmitted chlamydial infections.Ann Intern Med. 1993;119:432–434.

    CAS  PubMed  Google Scholar 

  22. Joe GW, Simpson DD. HIV risks, gender, and cocaine use among opiate users.Drug Alcohol Depend. 1995;37:23–28.

    CAS  PubMed  Google Scholar 

  23. Castro KG, Lifson AR, White CR, et al. Investigation of AIDS patients with no previously identified risk factors.JAMA. 1988;259:1338–1342.

    Article  CAS  PubMed  Google Scholar 

  24. Lindsay MK, Grant J, Peterson HB, Risby J, Williams H, Klein L. Human immunodeficiency virus infection among patients in a gynecology emergency department.Obstet Gynecol. 1993;81:1012–1015.

    CAS  PubMed  Google Scholar 

  25. McCoy CB, Khoury E. Drug use and the risk of AIDS.Am Behav Sci. 1990;33:419–431.

    Google Scholar 

  26. O'Brien TR, Busch MP, Donegan E, et al. Heterosexual transmission of human immunodeficiency virus type 1 from transfusion recipients to their sex partners.J Acquir Immune Defic Syndr Hum Retrovirol. 1994;7:705–710.

    Google Scholar 

  27. Michaels D, Levine C. Estimates of the number of motherless youth orphaned by AIDS in the United States.JAMA. 1992;268:3456–3461.

    Article  CAS  PubMed  Google Scholar 

  28. Wiebel WW, Jimenez A, Johnson W, et al. Risk behavior and HIV seroincidence among out-of-treatment injection drug users: a four-year prospective study.J Acquir Immune Defic Syndr Hum Retrovirol. 1996;12:282–289.

    CAS  PubMed  Google Scholar 

  29. Carne CA, Johnson AM, Pearce F, et al. Prevalence of antibodies to human immunodeficiency virus, gonorrhoea rates, and changed sexual behaviour in homosexual men in London.Lancet. 1987;1:656–658.

    CAS  PubMed  Google Scholar 

  30. du Guerny J, Sjoberg E. Inter-relationship between gender relations and the HIV/AIDS epidemic: some possible considerations for policies and programmes.AIDS. 1993;7:1027–1034.

    PubMed  Google Scholar 

  31. Kelen GD, Hexter DA, Hansen KN, Tang N, Pretorius S, Quinn TC. Trends in human immunodeficiency virus (HIV) infection among a patient population of an inner-city emergency department: implications for emergency department-based screening programs for HIV infection.Clin Infect Dis. 1995;21:867–875.

    CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Additional information

This work was supported in part by a collaborative agreement with the Centers for Disease Control and Prevention (U64/CCU200714). Drs. Shuter, Alpert, and DeShaw were supported in part by a training grant (5-T32-AI070183) from the National Institute of Allergy and Infectious Diseases. This study was presented in part at the 32nd Annual Meeting of the Infectious Diseases Society of America, October 1994, Orlando, Florida.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Shuter, J., Alpert, P.L., DeShaw, M.G. et al. Gender differences in HIV risk behaviors in an adult emergency department in New York City. J Urban Health 76, 237–246 (1999). https://doi.org/10.1007/BF02344679

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF02344679

Keywords

Navigation