Background. Monitoring the effects of HIV prevention efforts among persons who inject drugs (PWID) is key to informing prevention programs and policy.
Methods. Data for this study came from the 2012 National HIV Behavioral Surveillance interviews with PWID across 20 U.S. cities. The present analyses include those who identified as female, ever had sex with a man, and were at risk for HIV infection (did not report a previous positive HIV test result) (n = 2,624). We conducted latent class analysis (LCA) to identify sexual risk classes, and modeled associations with engagement in HIV prevention services and HIV test results.
Results. We identified six classes of sexual risk behavior: 1) low risk, 2) monogamous, 3) casual partner, 4) multiple partner, 5) exchange sex, and 6) exchange plus main partner. The class distribution was similar across the mainland regions. Bisexual orientation and homelessness were significant predictors of higher risk class. HIV prevalence and participation in behavioral interventions did not vary significantly by risk class, while obtaining and using free condoms did. Independent of risk class, women in cities in the South were significantly less likely to use free condoms, and HIV prevalence was higher among non-Hispanic black women and women aged 40-49.
Conclusions. Bisexual orientation and homelessness were predictors of higher risk. Condom distribution programs reached fewer women in cities in the South. Race and age disparities in HIV-positive rates persisted after adjusting for sexual risk class.
This research was supported by the Centers for Disease Control and Prevention under IPA agreement 15IPA1511782. The authors thank Chicago Department of Public Health for facilitating this data agreement. The NHBS Study Group includes the following individuals: Atlanta, GA: Jeff Todd, Greg Bautista; Baltimore, MD: Colin Flynn, Danielle German; Boston, MA: Maura Miminos, Rose Doherty, Chris Wittke; Chicago, IL: Nanette Benbow, Lawrence J. Ouellet, Antonio Jimenez; Dallas, TX: Sharon Melville, Shane Sheu, Alicia Novoa; Denver, CO: Mark Thrun, Alia Al-Tayyib, Ralph Wilmoth; Detroit, MI: Vivian Griffin, Emily Higgins, Karen MacMaster; Houston, TX: Marcia Wolverton, Hafeez Rehman, Paige Padgett; Los Angeles, CA: Trista Bingham, Ekow Kwa Sey; Miami, FL: Marlene LaLota, Lisa Metsch, David Forrest; Nassau-Suffolk, NY: Bridget Anderson, P. Tyler French, Lou Smith; New Orleans, LA: DeAnn Gruber, William T. Robinson, Narquis Barak; New York City, NY: Alan Neaigus, Kathleen H. Reilly, Travis Wendel; Newark, NJ: Barbara Bolden, Afework Wogayehu, Henry Godette; Philadelphia, PA: Kathleen A. Brady, Jennifer Shinefeld; San Diego, CA: Vanessa Miguelino-Keasling, Veronica Tovar; San Francisco, CA: H. Fisher Raymond; San Juan, PR: Sandra Miranda De León, Yadira Rolón-Colón; Seattle, WA: Tom Jaenicke, Hanne Thiede, Richard Burt; Washington, DC: , Manya Magnus, Irene Kuo, Tiffany West; CDC: Alexandra Balaji, Dita Broz, Laura Cooley, Melissa Cribbin, Paul Denning, Casey Eastman, Teresa Finlayson, Kathy Hageman, Wade Ivy, Nevin Krishna, Binh Le, Tricia Martin, Isa Miles, Alexandra Oster, Gabriela Paz-Bailey, Huong Pham, Brittani Robinson, Kathryn Salo, Catlainn Sionean, Amanda Smith, April Smith, Roy Smoot, Michael Spiller, Anissa Walker, Cyprian Wejnert, Wei Zhang.
Publisher StatementThis is a non-final version of an article published in final form in Mackesy-Amiti, M. E., Boodram, B., Handanagic, S., Paz-Bailey, G., Prachand, N. G., Broz, D., & Group, N. S. (2018). Latent Classes of Sexual Risk Behavior and Engagement in Outreach, Intervention and Prevention Services Among Women Who Inject Drugs Across 20 US Cities. Journal of acquired immune deficiency syndromes (1999), 79(3), 305-314. doi:10.1097/QAI.0000000000001816.
CitationMackesy-Amiti, M. E., Boodram, B., Handanagic, S., Paz-Bailey, G., Prachand, N. G., Broz, D., & Group, N. S. (2018). Latent Classes of Sexual Risk Behavior and Engagement in Outreach, Intervention and Prevention Services Among Women Who Inject Drugs Across 20 US Cities. Journal of acquired immune deficiency syndromes (1999), 79(3), 305-314. doi:10.1097/QAI.0000000000001816
PublisherLippincott, Williams & Wilkins