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Longitudinal Trends in Sexual Behaviors with Advancing Age and Menopause Among Women With and Without HIV-1 Infection

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Abstract

We assessed changes in self-reported sexual activity (SA) over 13 years among HIV-infected and uninfected women. The impact of aging and menopause on SA and unprotected anal or vaginal intercourse (UAVI) was examined among women in the Women’s Interagency HIV Study (WIHS), stratifying by HIV status and detectable viral load among HIV-infected women. Generalized mixed linear models were fitted for each outcome, adjusted for relevant covariates. HIV-uninfected women evidenced higher levels of SA and UAVI than HIV-infected. The odds of SA declined by 62–64 % per decade of age. The odds of SA in a 6-month interval for women aged 40–57 declined by 18–22 % post-menopause (controlling for age). Among HIV+/detectable women only, the odds of any UAVI decreased by 17 % per decade of age; the odds of UAVI were unchanged pre-menopause, and then decreased by 28 % post-menopause. Elucidating the factors accounting for ongoing unprotected sex among older women should inform interventions.

Resumen

Evaluar los cambios en la actividad sexual (AS) auto reportada de más de 13 años entre mujeres infectadas y no infectadas por el VIH. El impacto del envejecimiento y la menopausia en la AS y el sexo anal y vaginal sin protección (SAVSP) fue examinado entre las mujeres del Estudio Interangencial del VIH en las Mujeres, estratificado por carga viral detectable entre las mujeres infectadas con VIH. Modelos lineales generalizados mixtos fueron equipados para cada resultado, ajustado por covariables relevantes. Las mujeres sin VIH demostraron niveles más altos de AS y SAVSP que las infectadas por el VIH. Las probabilidades de cualquier AS disminuyeron en un 62–64 % por década de edad. Las probabilidades de SA en un intervalo de 6 meses para las mujeres 40–57 años de edad se redujeron en 18–25 % después de la menopausia (controlando por edad). Entre las mujeres VIH detectables sólo, las probabilidades de cualquier UAVI disminuido en un 17 % por década de edad; las probabilidades de UAVI se mantuvieron sin cambios pre -menopausia, y luego disminuyeron un 28 % después de la menopausia. Analizar los factores que explican el sexo sin protección en curso entre las mujeres mayores, se debe informar las intervenciones.

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Acknowledgments

This work was supported by the National Institute of Mental Health (1 KO1 MH095670, Taylor, PI). Data in this manuscript were collected by the Women’s Interagency HIV Study (WIHS). The contents of this publication are solely the responsibility of the authors and do not represent the official views of the National Institutes of Health (NIH). WIHS (Principal Investigators): Bronx WIHS (Kathryn Anastos), U01-AI-035004; Brooklyn WIHS (Howard Minkoff and Deborah Gustafson), U01-AI-031834; Chicago WIHS (Mardge Cohen), U01-AI-034993; Metropolitan Washington WIHS (Mary Young), U01-AI-034994; Connie Wofsy Women’s HIV Study, Northern California (Ruth Greenblatt, Bradley Aouizerat, and Phyllis Tien), U01-AI-034989; WIHS Data Management and Analysis Center (Stephen Gange and Elizabeth Golub), U01-AI-042590; Southern California WIHS (Alexandra Levine and Marek Nowicki), U01-HD-032632 (WIHS I – WIHS IV). The WIHS is funded primarily by the National Institute of Allergy and Infectious Diseases (NIAID), with additional co-funding from the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), the National Cancer Institute (NCI), the National Institute on Drug Abuse (NIDA), and the National Institute on Mental Health (NIMH). Targeted supplemental funding for specific projects is also provided by the National Institute of Dental and Craniofacial Research (NIDCR), the National Institute on Alcohol Abuse and Alcoholism (NIAAA), the National Institute on Deafness and other Communication Disorders (NIDCD), and the NIH Office of Research on Women’s Health. WIHS data collection is also supported by UL1-TR000004 (UCSF CTSA). The contents of this publication are solely the responsibility of the authors and do not necessarily represent the official views of the National Institutes of Health.

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Authors and Affiliations

  1. Special Treatment and Research Program, SUNY Downstate Medical Center, Brooklyn, NY, USA

    Tonya N. Taylor & Susan Holman

  2. College of Medicine, SUNY Downstate Medical Center, 450 Clarkson Avenue, 1240, Brooklyn, NY, 11203, USA

    Tonya N. Taylor

  3. Statistical Design & Analysis Research Division, SUNY Downstate Medical Center, Brooklyn, NY, USA

    Jeremy Weedon

  4. Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA

    Elizabeth T. Golub

  5. School of Nursing, New York University, New York, NY, USA

    Stephen E. Karpiak

  6. AIDS Community Research Initiative of America (ACRIA), New York, NY, USA

    Stephen E. Karpiak

  7. School of Medicine, University of California, San Francisco (UCSF), San Francisco, CA, USA

    Monica Gandhi

  8. Department of Medicine, Cook County Health and Hospital System and Rush University, Chicago, IL, USA

    Mardge H. Cohen

  9. Department of Pathology, City of Hope National Medical Center, Duarte, CA, USA

    Alexandra M. Levine

  10. Department of Obstetrics and Gynecology, Maimonides Medical Center, Brooklyn, NY, USA

    Howard L. Minkoff

  11. Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA

    Adebola A. Adedimeji

  12. Department of Medicine, Georgetown University Medical Center, Washington, DC, USA

    Lakshmi Goparaju

  13. School of Public Health, SUNY Downstate Medical Center, Brooklyn, NY, USA

    Tracey E. Wilson

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  1. Tonya N. Taylor
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Correspondence to Tonya N. Taylor.

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Taylor, T.N., Weedon, J., Golub, E.T. et al. Longitudinal Trends in Sexual Behaviors with Advancing Age and Menopause Among Women With and Without HIV-1 Infection. AIDS Behav 19, 931–940 (2015). https://doi.org/10.1007/s10461-014-0901-1

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