January 27, 2012

HIV Risk Behavior Declining, Family Survey Shows

By Michael Smith, North American Correspondent, MedPage Today
Published: January 26, 2012
Reviewed by Zalman S. Agus, MD; Emeritus Professor
University of Pennsylvania School of Medicine.

Americans appear to be taking fewer chances with HIV, according to the CDC.

Slightly more than 9% of the people surveyed from June 2006 to June 2010 reported behaviors thought to increase the risk of HIV, such as male-to-male sexual contact, illicit drug injection, and higher numbers of opposite-sex partners, according to Anjani Chandra, PhD, and colleagues at the CDC.

That's down from nearly 12% when the same survey was conducted in 2002, Chandra and colleagues said in a report issued by the agency's National Center for Health Statistics.

The year 2011 marked the 30th anniversary of the first diagnosed case of HIV, they noted.

The study found that the proportion reporting at least one of a series of HIV-risky behaviors was down for both men and women, the researchers reported -- a drop that appears to be related to a decline in sexually risky practices.

The findings come from the 2006-2010 National Survey of Family Growth, involving in-person interviews with a national sample of 22,682 men and women ages 15 through 44.

Data from the survey were compared to those obtained during the 2002 family growth survey.

The 2006 to 2010 survey was conducted by trained interviewers who read most questions to participants and entered the answers in a computer.

But, because of its sensitivity, most of the data for the current analysis was obtained through what is called audio computer-assisted self-interviewing, in which a participant listens to questions through headphones or reads them on the screen, or both, and responds directly and privately into the computer.

Participants were asked about sexual risk behavior, drug use, whether they had been treated for a sexually transmitted disease within the previous year, and if a condom was used during their most recent sexual encounter.

The researchers calculated summary statistics for sexual and drug risk behaviors and found that the proportion of participants who reported risky sexual behavior fell from 8.9% on 2002 to 5.6% from 2006 to 2010.

On the other hand, there was no difference in the proportion that reported risky drug behavior -- 1.5% in both surveys.

The proportion that reported any risky behavior fell from 11.9% in 2002 to 9.2% from 2006 to 2010.

Among statistically significant changes:

  • Fewer men and women reported exchanging sex for drugs or money. In 2002, 2.6% of men and 2.0% of women reported such behavior, but that fell to 1.3% and 0.7%, respectively, in the later survey.
  • Fewer reported having a sex partner who injected illicit drugs. In 2002, 2.3% of men and 2.9% of women reported such behavior, but that fell to 0.7% and 0.8%, respectively, from 2006 to 2010.
  • More women reported recent treatment for an STD, while the rate for men was stable at 2.6%. In 2002, the proportion of women reporting treatment was 3.4%, which rose to 4.1% from 2006 to 2010. The change was significant at P<0.05 both when comparing women in the two surveys and versus men from 2002 to 2010.
  • The proportion of men reporting crack cocaine use fell from 1.8% to 0.8%. The proportion of women reporting they used the drug also fell -- from 0.8% to 0.7% -- but the change was not significant.

The researchers cautioned that the study is a "useful snapshot" of the prevalence of risky behaviors, but does not account for factors that might increase or decrease individual risk.

As well, they noted, the study only included people living in a household, so the findings might not apply, for instance, to the homeless or those in institutions.

Finally, they cautioned, the study only included people ages 15 to 44 and the results do not apply to those older or younger, who also may be at risk.

The analysis was conducted by the CDC. Authors are employees of the agency.

Primary source: National Health Statistics Reports
Source reference:
Chandra A, et al "HIV risk-related behaviors in the United States household population aged 15–44 years: data from the National Survey of Family Growth, 2002 and 2006–2010" National Health Statistics Reports 2012; 46.

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