AIDSImpact.com:: - Santa Fe, USA 2011

Abstract #87 - Couple agreement of HIV-related behaviors, communication, and knowledge: Heterosexual Partner Study, 16 U.S. cities, 2006-2007
Authors: Presenting Author: Dr. Kathy Hageman - U.S. Centers for Disease Control and Prevention
Additional Authors: Dr. Binh Le, Dr. Isa J Miles, Ms. Melissa Cribbin, Ms. Tricia Martin, Dr. Elizabeth DiNenno,
Aim: According to the Centers for Disease Control and Prevention (CDC), 31% of new infections in the United States are attributed to heterosexual contact and minority women are disproportionately affected. Many women may not know risk behaviors of their male sex partners. Investigating the extent to which sex partners agree on couple dynamics can improve partner-level HIV prevention, such as condom negotiation and communication. We assessed couple agreement of partner-level dynamics related to HIV risk.
Method / Issue: During 2006-2007, CDC conducted the Heterosexual Partner Study in conjunction with the National HIV Behavioral Surveillance System among black and Hispanic women 18-50 years old who had vaginal or anal sex with a man in the past 3 months. Women were recruited at venues and by peers, anonymously interviewed and tested for HIV, and asked to recruit up to two male sex partners. Agreement was assessed for relationship type, couple’s communication, whether the male had ever been HIV tested, his serostatus, and recent sexual behavior and consistent condom use (CCU). Descriptive statistics and bivariate associations are presented.
Results / Comments: 824 women (83.1% black, 17.0% Hispanic) recruited 1098 male partners, of which 78.2% of couples were black, 11.1% were Hispanic, and 10.7% were multi-race. One-third of women (n=272) recruited two partners. Approximately three-fourths of couples (73.4%) agreed they were main partners, 9.7% agreed being casual partners, and 16.9% were in disagreement. Agreement was also assessed for whether discussions had occurred related to the male’s current and past HIV risk behaviors. For each topic, more than forty percent of all couples disagreed on whether it had been discussed. Topics with most agreement included his drug use (discussed: 35.1%; not discussed: 21.7%), HIV status (discussed: 26.3%; not discussed: 32.1%), and past sex partners (discussed: 25.5%; not discussed: 33.1%). Lower agreement was found regarding discussions of his current sex partners (discussed: 22.1%; not discussed: 35.9%), and previous sexually transmitted infections (discussed: 19.3%; not discussed: 36.8%). High agreement was found regarding whether vaginal sex had occurred in the last 3 months (yes: 98.1%; no: 0.0%) and CCU during vaginal sex (yes: 7.6%; no: 75.7%). Three-quarters of couples agreed upon whether anal sex had occurred (yes: 11.1%; no: 65.9%), with high agreement regarding CCU during anal sex (use: 3.5%; no use: 83.6%). Regarding whether the male had ever been HIV tested, 60.5% agreed he had tested, 10.3% agreed he had not, and 29.2% were in disagreement. Agreement of the male’s HIV serostatus was high: 88.4% agreed he was negative, 1.9% agreed he was positive, and 9.7% were in disagreement.
Discussion: Couple agreement was high for relationship type, occurrence of vaginal sex, CCU for vaginal and anal sex, and partner’s serostatus. Agreement was fair to low regarding discussions of the male’s HIV risk behaviors, testing history, and occurrence of anal sex. Investigating couple agreement is an important step to understanding how partner-level dynamics impact HIV-related risk behavior and prevention efforts. Efforts to address HIV prevention at the couple-level have not been utilized as effectively as individual-level prevention efforts and may be a valuable untapped resource.
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