The 130th Annual Meeting of APHA

Abstract #44239

Kimberly Mansfield, MS, OTR/L¹, Colin Flynn, ScM¹, Naomi Tomoyasu, PhD¹, Ellen Caldeira, MSc, MPH¹, Gary Risinger², and Liza Solomon, MHS, DrPH¹. (1) AIDS Administration, Maryland Department of Health and Mental Hygiene, 500 N. Calvert Street, 5th Floor, Baltimore, MD 21202, 410-767-5061, kmansfield@dhmh.state.md.us, (2) Chase Brexton Health Services, Inc., 1001 Cathedral Street, Baltimore, MD 21201

Methods: The Supplement to HIV and AIDS Surveillance (SHAS), a behavioral surveillance interview study, was conducted at an HIV clinic in Baltimore, MD. One hundred HIV positive patients were recruited for a one-hour structured interview that collected data on demographics, sexual activity, drug use, HIV testing and therapy, and medication compliance. Outcome measures were constructed to consider three levels of need for secondary prevention: ensuring that positives learn their serostatus, promoting behavior changes among known positives, and enrolling known positives in medical care. Results: At the time of their first HIV diagnosis, 25% of patients were already AIDS-defined, and 54% had been infected for an estimated 5 years or more. Patients with less education were more likely than others to have this delay in diagnosis. Measures of risky sexual behaviors were assessed and showed complex interactions of race, gender and sexual orientation. Non-whites were more likely than whites to report a sero-discordant (i.e., HIV negative) sex partner, but non-heterosexuals were more likely to report unprotected sero-discordant sex. Compliance with anti-retroviral medication regimens (ARV) was also assessed. Women and injecting drug users were less likely than others to be compliant with ARV. Conclusions: Both before and after their HIV diagnosis, many positives continue engaging in risky sexual activities and needle-sharing. A continued need exists for outreach efforts to promote HIV testing among at-risk groups and risk-behavior changes and medication compliance among known positives. Behavioral surveillance data provide detailed insight into the secondary prevention needs of different segments of the HIV-infected community.

Learning Objectives: At the conclusion of the session, participants will be able to

• Identify sub-populations in need of targeted HIV secondary prevention efforts (i.e., "prevention for positives").
• List 5 or more outcome measures of behavioral risk related to secondary HIV transmission.
• List 5 or more barriers to care for HIV positives.
• Articulate a methodology for using behavioral surveillance data in a needs assessment for secondary HIV prevention.

Keywords: HIV Risk Behavior, Prevention

Presenting author's disclosure statement:
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.