Abstract #3722  -  Aging and Longitudinal Trends in Sexual Behaviors Among Women With and Without HIV-1 Infection
Authors:   Presenting Author:   Dr. Tonya Taylor - SUNY Downstate Medical Center
Additional Authors:  Dr.  Stephen  Karpiak, Dr. Jeremy  Weedon, Dr. Adebola Adedimeji, Dr. Lakshmi Goparaju, Dr. Alexandra  Levine, Dr. Monica Gandhi, Dr. Mardge   Cohen, Dr. Elizabeth Golub, Dr. Howard  Minkoff, Dr. Tracey  Wilson ,
Aim: To assess changes in self-reported sexual activity over 13 years in HIV-infected and at-risk non-infected women
Method / Issue: The Women's Interagency HIV Study (WIHS) is a longitudinal cohort study of HIV-infected and at-risk women followed since 1994. We examined self-reported sexual activity (SA) over 13 years in the WIHS, including any unprotected anal or vaginal intercourse (UAVI) among women with and without HIV-1. We separately assessed the impact of aging and of menopause on SA and UAVI for all participants, and stratified by detectable viral load for those with HIV. Generalized mixed linear models were fitted for each outcome with relevant covariates included.
Results / Comments: The majority of women, regardless of HIV status, were sexually active with moderate to high levels of UAVI, especially among HIV- women. Sixty-five percent of the HIV+ women reported SA and 22% reported engaging in UAVI. Among the HIV- women, 79% reported SA and 54% reported engaging in UAVI. Regardless of serostatus/viral load, SA declined by 60% per each decade of age. Among women ages 40-57, SA declined by 40-50% after menopause. Among sexually active women, UAVI declined with age, but this decline differed with HIV status. After menopause, the odds of any UAVI declined in HIV-infected women, but not in HIV-uninfected women. The odds for UAVI by a 10-year age change for VL- was significantly lower from VL+ women (p=0.028), but not significantly different from HIV- women (p=0.065).
Discussion: Sexual activity (SA) and unprotected anal or vaginal intercourse (UAVI) among both HIV+ and HIV- women declined with age and menopause. However, HIV-women maintain higher levels of both SA and UAVI and HIV-infected women may participate in UAVI based on virologic suppression status. Further understanding of factors accounting for ongoing risk among midlife and older women can help inform interventions for this group.
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