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P125 Heterosexual HIV Prevalence and High HIV-Risk Behaviors in a Mid-Atlantic, U.S. City

Tuesday, March 13, 2012
Hyatt Exhibit Hall
Jacky Jennings, PhD, MPH1, Jonathan Ellen, MD2, Caroline Fichtenberg, PhD3, Steve Huettner, BS4 and Sarah Polk, MD, ScM4, 1General Pediatrics and Adolescent Medicine, Johns Hopkins School of Medicine, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 2School of Medicine Ped Bay Bayview Pediatric Unit, The Johns Hopkins University, Baltimore, MD, 3Office of Epidemiology, Baltimore City Health Department, Baltimore, MD, 4Department of Pediatrics, Johns Hopkins University, Baltimore, MD

Background: In U.S. urban areas, HIV epidemics among IDU and heterosexuals are linked via personal and sex partner high HIV-risk behaviors. Objectives: To determine the prevalence of HIV and recent high HIV-risk behaviors among heterosexual adults to define epidemiologic patterns important for reducing HIV transmission.

Methods: A venue-based, cross-sectional study of heterosexual 18 to 35 year-olds was conducted in one city from 2008-2009.

Results: 1,461 heterosexuals (661 men, 800 women) were recruited at 87 venues. Participants were mostly Black and high school/GED graduates. The HIV prevalence was 3% overall, 3% males and 4% females. The HIV prevalence among male and female subgroups respectively was: 8% and 17% IDU past 6 months; 6% and 16% CSWs; 5% and 9% high HIV-risk sexual partnering (i.e. sex with an IDU or HIV +); and 2% and 2% no high-HIV behavioral risk. For males none of the subgroups were significantly (P<0.01) associated and for females each subgroup was significantly associated with an increased age-adjusted OR of HIV except no high-HIV behavioral risk females who were significantly associated with a 74% decrease. HIV infected (vs. non-infected) males (28 vs. 33 years) and females (27 vs. 33 years) were significantly older. For males, there were no differences by race, past 12 month high HIV-risk sexual behaviors including sexual partnering or CSW. HIV infected (vs. non-infected) males had significantly higher past 6 month parenteral risk behaviors (40% vs. 15%). HIV infected (vs. non-infected) females had significantly increased recent high HIV-risk sexual (53% vs. 16%) and parenteral risk behaviors (41% vs. 9%).

Conclusions: Venue-based screening is one method to identify HIV positives and drug-related transmission continues to be an important contributor to the heterosexual HIV epidemic in urban U.S. areas.

Implications for Programs, Policy, and Research: Understanding the HIV transmission dynamics in high-risk places is critical for heterosexual HIV prevention programs.

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