Sexual, contraceptive, and drug use behaviors of women with HIV and those at high risk for infection: results from the Women's Interagency HIV Study

Objective: To document the sexual and contraceptive practices of women with HIV infection or who are at risk for infection. Design: Data on the baseline behaviors of 561 HIV-negative and 2040 HIV-pos itive women were collected as part of the Women's Interagency HIV Study (WI HS). WIHS is a multisite, longitudinal study following the natural history of HIV infection among women in the United States. Methods: Each participant contributed an interviewer administered, sell-rep ort interview including questions on sexual and contraceptive behavior. Results: Women with HIV were less likely to report heterosexual activity in the previous 6 months (65% HIV-positive, 76% HIV-negative). Among sexually active women, there were no differences in the proportion of those reporti ng vaginal (97% HIV-positive, 98% HIV-negative) or anal sex (12% HIV-positi ve, 10% HIV-negative), although women with HIV were less likely to report c unnilingus (41% HIV-positive, 70% HIV-negative) and fellatio (48% HIV-posit ive, 57% HIV-negative). Of women with HIV, 63% always used condoms during v aginal sex (versus 28% HIV-negative), with lower rates reported during othe r sexual activities. Crack, cocaine, or injecting drug use, reported by 27% of HIV-positive and 35% of HIV-negative women, was associated with inconsi stent condom use, independent of serostatus. HIV-positive women who reporte d using condoms and another contraception method were less consistent condo m users (57% consistent versus 67%). Conclusions: The prevalence of sexual risk behavior in this sample suggests that, although women with HIV exhibit lower levels of sexual risk behavior than uninfected women, many have not been successfully reached with regard to implementing safer behaviors. These findings have implications for more widespread and effective behavioral intervention efforts. (C) 1999 Lippinc ott Williams & Wilkins.