Sexual Behavior and STDs in African American HIV Serodiscordant Couples
Sexual Behavior and STDs in African American HIV Serodiscordant Couples
This paper reports baseline behavioral and biological data collected from a cohort of 535 African American HIV serodiscordant couples enrolled in the Eban study across four urban metro areas. Data were collected on (1) the prevalence of risky sexual behaviors that occur within a couple and with concurrent sexual partners, (2) the STD prevalence for each member of the couple and (3) the correlates of STDs in the male partner as well as in the female partner. Presentation of the sociodemographic characterization and HIV risk behavior profiles of African American HIV serodiscordant couples represents an important initial description of a hidden, vulnerable population. Future research should be conducted with diverse samples of African American couples (i.e., younger couples, non-stable couples) to explore other potential correlates of STD prevalence.
Although the HIV/AIDS epidemic in the African American community continues to be a public health crisis, perhaps one subgroup that deserves special attention is African American HIV serodiscordant couples. In the US, HIV transmission risk reduction efforts for this population have been minimal. Although data indicate that condoms reduce the annual HIV transmission among HIV serodiscordant couples by 95% when used consistently, studies report 20–25% of serodiscordant couples engage in unprotected intercourse. Research also indicates that overall rates of unprotected intercourse are greater with regular partners than with nonregular partners. The rationale for these practices is unclear, but one study conducted by Wyatt et al., with African American and Caucasian HIV serodiscordant couples reported that couples in this study perceived being at a low risk for HIV transmission and avoided discussing safer sex so as not to remind the infected partner of their HIV status. The findings from these studies suggest significant risks for transmission of HIV in HIV serodiscordant couples. Furthermore, HIV acquisition and transmission in serodiscordant couples may be facilitated by sexually transmitted infections. While several articles have examined the prevalence of STDs in HIV-infected women and men who have sex with men, the prevalence of STDs and sexual risk behaviors is incompletely characterized among African American HIV serodiscordant couples. The present manuscript aims to address this gap by describing: (1) the prevalence of risky sexual behaviors that occur within a couple and that occur with concurrent sexual partners, (2) the STD prevalence for each member of the couple and (3) the correlates of STDs in the male partner as well as in the female partner. The provision of couples-based data, the opportunity to examine sexual behaviors from both the male and female partners' perspective is a unique scientific contribution of this manuscript.
Abstract and Introduction
Abstract
This paper reports baseline behavioral and biological data collected from a cohort of 535 African American HIV serodiscordant couples enrolled in the Eban study across four urban metro areas. Data were collected on (1) the prevalence of risky sexual behaviors that occur within a couple and with concurrent sexual partners, (2) the STD prevalence for each member of the couple and (3) the correlates of STDs in the male partner as well as in the female partner. Presentation of the sociodemographic characterization and HIV risk behavior profiles of African American HIV serodiscordant couples represents an important initial description of a hidden, vulnerable population. Future research should be conducted with diverse samples of African American couples (i.e., younger couples, non-stable couples) to explore other potential correlates of STD prevalence.
Introduction
Although the HIV/AIDS epidemic in the African American community continues to be a public health crisis, perhaps one subgroup that deserves special attention is African American HIV serodiscordant couples. In the US, HIV transmission risk reduction efforts for this population have been minimal. Although data indicate that condoms reduce the annual HIV transmission among HIV serodiscordant couples by 95% when used consistently, studies report 20–25% of serodiscordant couples engage in unprotected intercourse. Research also indicates that overall rates of unprotected intercourse are greater with regular partners than with nonregular partners. The rationale for these practices is unclear, but one study conducted by Wyatt et al., with African American and Caucasian HIV serodiscordant couples reported that couples in this study perceived being at a low risk for HIV transmission and avoided discussing safer sex so as not to remind the infected partner of their HIV status. The findings from these studies suggest significant risks for transmission of HIV in HIV serodiscordant couples. Furthermore, HIV acquisition and transmission in serodiscordant couples may be facilitated by sexually transmitted infections. While several articles have examined the prevalence of STDs in HIV-infected women and men who have sex with men, the prevalence of STDs and sexual risk behaviors is incompletely characterized among African American HIV serodiscordant couples. The present manuscript aims to address this gap by describing: (1) the prevalence of risky sexual behaviors that occur within a couple and that occur with concurrent sexual partners, (2) the STD prevalence for each member of the couple and (3) the correlates of STDs in the male partner as well as in the female partner. The provision of couples-based data, the opportunity to examine sexual behaviors from both the male and female partners' perspective is a unique scientific contribution of this manuscript.