Rural Center for AIDS/STD Prevention

RAP Time

(Volume 2, No. 3, March 6, 1998)

Issue Contents

Risky Sexual Practices and Douching May Increase Risk of STD Infection

New research showed that women who had sex during menses were more likely to be infected with Chlaymdia than those not engaging in this practice. Also, women who douched became infected with pelvic inflammatory disease more often than those not douching.

HIV prevention interventions to reduce sexual risk behaviors among injecting drug users (IDUs) typically are not specific to the various subgroups of IDUs. Substantial differences among IDUs have been reported. Changing sexual risk behaviors of IDUs has been difficult.

Data from recent interviews with IDUs showed that nearly 30 percent abuse alcohol to a greater degree than rest of the sample. Those most likely to abuse alcohol were also most likely to engaged in high-risk sexual behaviors for HIV infection.

Collection of Data
A purposeful sample of 238 low-income residents of Anchorage, Alaska was interviewed to assess behavioral and personality variables. The sample was 34 percent and 66 percent female and male, respectively.

Forty-four percent of the sample was white, with 26 percent and 24 percent being black and American Indian/Alaskan Native, respectively. The median age was 36 years and the median monthly income was $500-$999. Participants were out-of-treatment IDUs and/or cocaine smokes who reported at least one sex partner in the previous 30 days.

Study Outcomes
Alcohol use was initiated at a median age of 14 years. Seventy one percent of the sample reported drinking to intoxication at least once in the previous six months. Condoms were used by 32 percent and 27 reported having multiple partners and not always using condoms.

Twenty-five percent reported at least one IDU sex partner and not always using condoms. Forty percent of the females had exchanged sex to get money for drugs in the previous 30 days. Forty-one percent of the males had exchanged money or drugs to get sex in the past 30 days.

Subjects were classified as high-risk or low-risk alcohol users based on amount and frequency of alcohol use, frequency of intoxication and age of initiation to alcohol use. IDUs classified as high-risk alcohol users were compared to those classified as low-risk alcohol users on several dimensions of HIV sexual risk behavior. Subjects in the high-risk alcohol user group were more likely than those in the low-risk alcohol user group to:

  • report multiple sex partners,
  • have at least one IDU sex partner without the use of condoms,
  • report a low proportion of protected sexual acts in the past 30 days, and
  • report the exchange of sex to get money for drugs if female. These findings remained after controlling for the personality variables of risk proneness and sensation seeking behavior.

Findings suggest that patterns of alcohol use among IDUs can be used to identify persons at-risk of HIV/STD infection as a result of sexual behaviors. IDUs enrolled in alcohol treatment programs and out-of-treatment IDUs who fit the profile of high-risk alcohol users may be specifically targeted for HIV prevention interventions.

AIDS Cases among Persons over 50 Increase

A recent CDC report highlighted the need for HIV prevention for persons 50 years of age or older. In 1996, 11 percent of all new AIDS case in the U. S. were among persons of at least 50 years of age.

CDC stated that 84 percent of these cases were among males, in particular men having sex with men. Blacks accounted for the highest proportion of cases: 43 percent.

CDC suggested that persons 50 or older are less likely to be tested for HIV than those of younger ages. AIDS-related opportunistic illnesses such as encephalopathy and wasting syndrome may be mistaken for more common diseases among older persons.

Persons 50 or older may not perceive risk of HIV infection. Two studies indicated condom use among those 50 and over and at-risk for HIV is lower than condom use for those of equal risk of a younger age.

SOURCE: Centers for Disease Control and Prevention. (1998 ). AIDS among persons aged greater or equal to 50 Years - United States, 1991 -1996. Mortality and Weekly Morbidity Report, 47(2), January 23.

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Study Shows High Incidence of HPV among College Women

A recent three-year study of 608 women indicated that 43 percent of college women acquired human papillomavirus (HPV) infection. Twenty-six percent were already infected at the start of the study.

Increased risk of HPV infection was associated with younger age, black race, Hispanic ethnicity, high alcohol consumption, multiple sex partners, high frequency of vaginal sex, anal sex, primary sex partners having a high number of lifetime sex partners, and primary sex partners not being in school.

New HPV infections lasted a median of eight months. HPV types 16 and 18 were among those of longest duration - each has been strongly associated with cervical cancer. Older women had a lower risk of acquiring HPV than younger women.

About 60 percent of the women with infected with HPV at some time during the three-year study. Results suggest a high risk for HPV infection among heterosexual men and women in a college environment.

SOURCE: Ho, et al. (1998). Natural history of cervicovaginal papillmovirus infection in young women. New England Journal of Medicine, 338, 423-427.

Female AIDS Cases of Unknown Risk Reclassified

Two-thirds of the 9290 cases of AIDS among women originally classified as unknown risk have been reclassification provides a better estimate of the extent to which heterosexual risk behaviors contribute to AIDS in women.

SOURCE; Wortley, P. M. & Fleming, P. L. (1998). Increasing incidence of AIDS among women (letter). Journal of the American Medical Association, 279, 355-356.

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40% Concealed HIV Positive Status

A study of 203 HIV positive hospital patients found that four of every 10 patients did not tell their sex partner(s) about their HIV positive status. HIV patients with multiple sex partners were three times more likely to conceal this information. Two-thirds did not use condoms.

SOURCE: Stein, et al. (1998). Sexual ethics: Disclosure of HIV positive status to partners. Archives of Internat Medicine, 158, 253-257.