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APHA Scientific Session and Event Listing

Kristin Dunkle, MPH PhD, Ralph DiClemente, PhD, Gina Wingood, MPH ScD, and Delia Lang, MPH PhD. Rollins School of Public Health and Center for AIDS Research, Emory Univeristy, 1518 Clifton Rd NE, Atlanta, GA 30322, +1 404 712-4702, kdunkle@sph.emory.edu

Background: African-American women are one of the fastest growing HIV+ populations in the US, yet understanding of the health and secondary prevention needs of this population remains limited. We examined risk factors for prevalent and incident bacterial STIs (Chlamydia trachomatis or Neisseria gonorrhoeae) among 308 African-American women from Georgia and Alabama participating in a behavioral intervention trial. Methods: Data were collected at baseline, 6, and 12 months via interviewer-administered questionnaires. Participants provided swabs for STI testing and urine specimens for drug toxicology. Multiple logistic regression was used to identify risk factors at baseline and to conduct preliminary analyses for incident infection.Results: At baseline17 women (5.5%) had a bacterial STI. Risk factors for prevalent infection were age under 30 (OR=10.3, 95%CI: 3.01, 35.4), sex with a partner of unknown HIV status in the past 6 months (OR=5.77, 95%CI: 1.61, 20.8), and being denied medical care because of inability to pay (OR=14.7, 95%CI: 2.84, 75.5), while higher condom use self-efficacy was protective (OR=0.27, 95%CI: 0.09, 0.83). Over the 12 month follow-up, 19 women (6.2%) experienced 28 incident infections (9.96 per 100 person-years). Age under 30 increased odds of incident infection (OR=8.13, 95%CI: 2.76, 24.0), while increasing spirituality was protective (OR=0.81, 95%CI: 0.67, 0.97 per unit increase). Conclusions: Younger age, risky sex, and financial barriers to care were associated with increased STI risk for HIV+ African-American women, while condom use efficacy and spirituality were protective. Interventions should focus on reducing societal and structural barriers and bolstering women's skills and social support networks.

Learning Objectives: At the conclusion of the session, the participant (learner) in this session will be able to

• Understand the importance and rationale for studying sexually transmitted infections among HIV+ women
• Describe multiple risk factors for bacterial STIs among HIV+ African-American women
• Describe several promising structual-level and individual-level intervention strategies that might be efficacious in reducing sexual risk-taking among HIV+ African-American women

Keywords: Chlamydia, HIV/AIDS

Presenting author's disclosure statement:

Not Answered