Objectives: To assess the impact on risk behaviors of knowing one's HIV serostatus, and to compare the relative impact for those who are HIV-positive versus HIV-negative.
Methods: Beginning in 1994, 794 street-recruited injection Drug Users (IDUs) in Chicago were interviewed, counseled and tested for HIV at baseline and two 6-month follow-ups. Generalized estimating equation models were used to test the interactions and to account for repeated measurement across waves.
Results: After controlling for age, gender, race, duration and frequency of injection, drug abuse treatment, syringe exchange use, and interview wave, we found significant interactions between awareness of HIV status and actual status for both injection and sexual risk behaviors. Among HIV-positive IDUs, those who knew their status were significantly less likely to pass needles to others (OR=0.53, 95% CI=0.28-0.99), share other injection equipment (OR=0.42, 95% CI=0.24-0.72), or engage in unprotected vaginal (OR=0.50, 95% CI=0.30-0.85), oral (OR=0.53, 95% CI=0.30-0.93) and anal sex (OR=0.29, 95% CI=0.12-0.69). Awareness of HIV-positive status did not affect receptive needle sharing, sexual abstinence, monogamy, and sex trading. Knowledge of being HIV-negative had no significant impact on injection or sex behaviors.
Discussion: Knowledge of HIV serostatus appears to motivate transmission-reducing behaviors among IDUs who are HIV-positive, but not among those who are HIV-negative. Efforts should be supported that increase the willingness and ability of IDUs to obtain counseling and testing, get their test results, and receive appropriate support. HIV test counselors and prevention case managers should explore behavioral motivations other than serostatus for those who are HIV-negative.
Learning Objectives: At the conclusion of the presentation, the participants can expect to have a better understanding of the effects of the effcts of knowing one's HIV status on risk behaviors among IDUs
Keywords: HIV Risk Behavior, HIV Interventions
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.