Maintenance of safe sex behavior by HIV-serodiscordant heterosexual couples.

We present findings from a prospective study of heterosexual HIV transmission in stable New Jersey couples who are serodiscordant for HIV and in which the uninfected partner is at risk solely from heterosexual contact. One hundred thirty-one couples were interviewed at enrollment and 6-month follow-up. This report describes couples' sexual behavior before and after knowledge of infective risk and examines associations of behavior with clinical and demographic characteristics. We observed that HIV serodiscordant couples' habitual sexual practices, drug and alcohol use, and measure of psychological distress may predict difficulty in adopting and maintaining safe sex. An understanding of common risk sexual behavior patterns and characteristic correlates of risk taking may prove useful for counseling individuals at risk and their infected partners and may contribute to the development of effective public health messages targeted to eliminate unsafe sexual contact.

PIP: Findings are presented from a prospective study of heterosexual HIV transmission in stable New Jersey couples serodiscordant for HIV infection and in which the uninfected partner is at risk solely from heterosexual contact. Between August 1990 and February 1992, 131 couples were interviewed at enrollment and 6-month follow-up, reporting their frequencies of vaginal, oral, and anal sex, with and without condoms, during the year before the negative partner learned of the positive partner's HIV infection, the month before baseline interview, and the interval between baseline and follow-up. A marked and significant decline was observed in couples' reported sexual activity and an increase in condom use after they first learned of their HIV serodiscordance. However, at the 6-month follow-up, the proportion who abstained from having sex declined from 33% to 21%, the proportion who practiced unsafe sex increased from 15% to 26%, and the proportion of couples who used condoms reliably was 53% at follow-up compared to 51% in the month before enrollment. Demographic characteristics, stage of disease in the HIV-infected partner, use of alcohol or drugs, and psychological state were correlates of unsafe sexual behavior after learning of HIV serodiscordance. The most important socioeconomic correlate of safe sex at baseline was employment of the female partner. People in stable partnerships may have greater difficulty changing well-established patterns of sexual behavior after one partner is found to be infected with HIV.

Recruitment of women into research studies: a nursing perspective.

RESEARCH TRIALS HAVE historically underrepresented women, especially women of ethnic minority and lower socioeconomic groups. Although these populations of women are disproportionately afflicted with human immunodeficiency virus (HIV), HIV studies have followed this pattern of underrepresentation. Nurses working in HIV research have developed a women-centered recruitment strategy that has been successful in enrolling women in clinical trials and epidemiological studies. Reasons for women's lack of inclusion and components of a strategy to remedy the situation are discussed.