Rural Center for AIDS/STD Prevention

RAP Time

(Volume 2, No. 10, October 2, 1998)

Issue Contents

Rural US Residents Report Least Reduction of HIV-Related Risky Sexual Behavior

An analysis of National Health and Social Life Survey data determined how United States adults have changed their sexual behaviors in response to the AIDS epidemic. The percentage of rural residents reporting a reduction of risky sexual behavior as a result of the AIDS epidemic was substantially lower than the percent of urban or suburban Americans reporting a reduction.

Nearly 3500 adults, 18-59 years of age, were surveyed. Respondents were asked, "Have you made any kind of changes in your sexual behavior because of AIDS?" and, if so, "What have you changed?". Responses were taken verbatim and sorted into categories. Demographic traits of the sample included gender, age, race/ethnicity, martial status, number of sex partners (lifetime and past five years), and place of residence (top/largest 100 central cities, suburban/other urban, or rural).

Nearly 30% of the sample reported at least one change in their sexual behavior because of the AIDS epidemic.

The most frequent change was a reduction of sex partners (12% reported this change). Nine percent reported using condoms more frequently and 7% reported increased attention to partner selection and familiarity. Three percent reported partial abstinence from sex. Males, younger adults, blacks, nonmarried adults, and those living in the largest 100 cities were the most likely to report at least one change in behavior.

  • Forty percent, 28%, and 18% of respondents from the largest 100 cities, suburban/other urban cities, and rural areas, respectively, reported at least one change in behavior.
  • Rural residents were about 40% and 70% less likely than suburban/other urban and respondents from the largest 100 cities, respectively, to report a behavior change.
  • Partner reduction was reported by 17%, 11%, and 7% of respondents from the largest 100 cities, suburban/other urban areas, and rural areas, respectively.
  • Condom use was reported by 15%, 8%, and 6% of the respondents from the largest 100 cities, suburban/other urban areas, and rural areas, respectively.
  • Increased attention to partner selection was reported by 10%, 7%, and 3% of the respondents from the largest 100 cities, suburban/other urban areas, and rural areas, respectively.
  • Abstinence was reported by 5%, 3%, and 2% of the respondents from the largest 100 cities, suburban/other urban areas, and rural areas, respectively. The number of rural adults that reduced risky sexual behavior is small and fewer than urban/suburban adults. Widespread denial of vulnerability to HIV infection is common among rural residents. Prevention education efforts should continue to focus on raising awareness of HIV risk among rural people.

SOURCE: Feinleib, J. A., & Michael, R. T. (1998). Reported changes in sexual behavior in response to AIDS in the United States. Preventive Medicine, 27, 400-411.

HIV Prevalence of U. S. Job Corps Youth Declined

The HIV prevalence of youth, aged 16-21, who entered the U.S. Job Corps from January 1990 through December 1996 were analyzed. The Job Corps is a federally funded jobs training program for socially and economically disadvantaged out-of-school youth. Of the 357,443 entrants, 822 were HIV-positive.

HIV prevalence was higher for women than for men (2.8 per 1000 versus 2.0 per 1000). Among racial/ethnic groups, prevalence was highest for Africian Americans (3.8 per 1000). Prevalence was higher for African American women (4.9 per 1000) than for any gender and racial/ethnic group.

From 1990 through 1996, standardized HIV prevalence declined for women and for men: for women, from 4.1 per 1000 in 1990 to 2.1 per 1000 in 1996; for men, from 2.8 per 1000 in 1990 to 1.4 per 1000.

SOURCE: Valleroy, L. A., et al. (1998). HIV infection in disadvantaged out-of-school youth: Prevalence for U.S. Job Corps Entrants, 1990 through 1996. Journal of Acquired Immune Deficiency Syndromes and Human Retrovirology, 19, 67-73.

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Many Adolescents Practice Risky Sexual Behaviors

Data from the CDC 1997 Youth Risk Behavior Survey shows that many high school students continue to practice behaviors that put them at risk for HIV/STD infection. Nationwide, nearly half (48.4%) of all students had sexual intercourse during their lifetime. Overall, black students (72.7%) were significantly more likely than Hispanic and white students (52.2% and 43.6%) to have had coitus.

The percentage of students who had initiated sexual intercourse before 13 years of age was 7.2%. The percentage who had had coitus during their lifetime with four or more sex partners was 16.0%. More than one third (34.8%) had had sexual intercourse during the 3 months preceding the survey.

Nationwide, among currently sexually active students, 56.8% reported that either they or their partner had used a condom during last sexual intercourse. One fourth had used alcohol or drugs at last coitus. About 2% (2.1%) had injected illegal drugs during their lifetime.

SOURCE: CDC. (1998). Youth risk behavior surveillance -- United States, 1997, MMWR, 47 (No. SS-3).

Gender Differences Found for At-Risk Sexual Behavior

Current sexual behavior was compared between heterosexuals who reported an STD in the 4 years prior and those reporting no STD (n = 2517). Reporting of STD was associated with past multiple partners for both sexes, but was associated with current at-risk behavior in men only.

SOURCE: Warszawski, J. Meyer, L., & ACSF-Investigators. (1998). Gender difference in persistent at-risk sexual behavior after a diagnosed sexually transmitted disease. Sexually Transmitted Diseases, 25, 437-447.

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STIs Found Among HIV-Infected Women

The incidence and predictors of sexually transmitted infections (STI) were assessed among HIV-infected women enrolled in a clinic setting. Sixty-five percent had at least one STI based on history and/or examination.

SOURCE: Capps, L., et al. (1998). Sexually transmitted infections in women infected with the human immunodeficiency syndrome. Sexually Transmitted Diseases, 25, 443-447.