Wednesday, June 1, 2011

Self-Perceived Risk of HIV Infection and Attitudes About PrEP Among STD Clinic Attendees

Via Liebert Online, by Y. Omar Whiteside, Tammy Harris, Christopher Scanlon, Stephen Clarkson, and Wayne Duffus


Despite the advances in the prevention of and treatment for HIV infection, the estimated rates of HIV infections remained constant from 2005 to 2008. More importantly, during this period the estimated number of newly diagnosed HIV/AIDS cases increased 8%. In 2008, blacks accounted for more than half (52%) of all new HIV cases diagnosed. The South, where the majority of black/African Americans live, continues to suffer disproportionately from the HIV/AIDS epidemic. The Centers for Disease Control and Prevention's (CDC) 2008 HIV Surveillance Report documented that the death rate among persons with AIDS increased in both the South and the Midwest and that the South has the highest number of AIDS diagnoses of any region in the country. Because of this region's epidemiology, the need to prevent new HIV infections is of paramount importance.

South Carolina, a southern state, has one of the highest AIDS rates in the United States (2008 AIDS rate: 15.5 per 100,000 population in South Carolina; 12.2 per 100,000 population in the United States) In 2008, Columbia, South Carolina, ranked seventh in its AIDS case rate (25.6 per 100,000 population) among metropolitan statistical areas. Of increasing concern to South Carolina public health officials is the high prevalence of HIV-infected residents and the potential for unabated transmission.


This was an exploratory study on self-perceived risk of HIV infection and attitudes about using PrEP among sexually transmitted diseases (STD) clinic attendees. It was designed as a cross-sectional study and was conducted from January 2009 to May 2009 and October 2010 to December 2010 in an STD clinic in South Carolina. An STD clinic was chosen as the location from which to draw participants because individuals with an STD have an increased risk for both HIV infection and transmission. The inclusion criteria were that participants be at least 16 years of age; have had oral, anal, or vaginal sex within the past 6 months; be seeking STD clinic services, self-report being HIV-negative, and not have previously completed the survey. Participants were given a 20-min, self-administered, paper-based, anonymous survey that measured demographic information; sexual exposure history; self-perceived risk perception for HIV infection; and attitudes about PrEP.


Compared to heterosexual participants, homosexual participants were significantly more likely to have knowledge of PrEP (odds ratio [OR]=6.7, 95% confidence interval [CI]: 1.70–26.1). Compared to those participants who had 1 sexual partner in the past 3 months, individuals who had 2 to 4 sexual partners in the past 3 months were approximately 2.35 times as likely to have a lower level of agreement with the statement “I believe I am at risk of getting HIV” (p=0.0003). Compared to female participants, respondents who were male were approximately 2.8 times as likely to have a lower level of agreement with the statement “If I had to it would be very difficult for me (or my partner) to both use condoms and take daily pills to prevent HIV infection” (p<0.0001). These results suggest the need for the creation of PrEP implementation programs that are tailored to self-perceived risk perception, age, and gender.

Read the full study here.

[If an item is not written by an IRMA member, it should not be construed that IRMA has taken a position on the article's content, whether in support or in opposition.]

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