244402 Unprotected anal intercourse among women in low-income areas United States, 2006-2007

Monday, October 31, 2011: 11:30 AM

Elizabeth DiNenno, PhD , Centers for Disease Control and Prevention, Atlanta, GA
Nevin Krishna, MS, MPH , Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, GA
Alexandra Oster, MD , Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, GA
Binh Le , Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, GA
Paul Denning, MD , Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, GA
Catlainn Sionean, PhD , Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, GA
James Heffelfinger, MD, MPH , Division of HIV/AIDS Prevention, CDC-NCHHSTP, Atlanta, GA
Background: The risk of women contracting HIV through unprotected anal intercourse (UAI) is estimated to be 18 times that of unprotected vaginal intercourse. We assessed the prevalence and correlates of UAI among women in low-income areas participating in the National HIV Behavioral Surveillance System (NHBS).

Methods: Interviews and HIV tests were conducted among heterosexuals in 24 U.S. cities during 2006-2007. Women residing in low income areas, aged 18-50 who reported ≥1 opposite sex partner in the past 12 months were recruited by peers or in venues. We restricted our analysis to those without other HIV risk factors such as injection drug use, sex work, or a previous positive HIV test, to assess factors associated with UAI.

Results: Of 7304 women who met our analysis criteria, 1573 (22%) reported AI with a male partner in the past 12 months and 1312 (18%) reported UAI (83% of those who had AI had UAI). AI was more prevalent among Hispanic (29%) and white (27%) women than black women (19%). In a multivariate logistic regression model, the odds of UAI were higher among Hispanic (adjusted odds ratio [aOR]=2.08, 95% confidence interval [CI]=1.79-2.42) or white (aOR=1.58, CI=1.23-2.05) than black women; women with 2-3 (aOR=1.87, CI=1.61-2.16) or ≥ 4 (aOR=3.91, CI=3.31-4.63) sex partners in the past 12 months than those with 1 sex partner; and those aged ≥ 25 (aOR=1.41, CI= 1.23- 1.62).

Conclusions: AI and UAI were common among heterosexual women in low-income areas and must be addressed through improved prevention messages to heterosexuals.

Learning Areas:
Epidemiology
Protection of the public in relation to communicable diseases including prevention or control
Public health or related research
Social and behavioral sciences

Learning Objectives:
Describe the patterns of anal intercourse among women as a risk factor for HIV. Discuss racial and ethnic disparities in unprotected anal intercourse in women across the United States using data from the National HIV Behavioral Surveillance System among heterosexuals at risk.

Keywords: HIV Risk Behavior, Women

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I oversee a behavioral surveillance system for HIV in the U.S. funded by the Centers for Disease Control.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.