HIV risk, prevention, and testing behaviors among heterosexuals at increased risk for HIV infection - National HIV behavioral surveillance system, 21 U.S. cities, 2010

Catlainn Sionean, Binh C. Le, Kathy Hageman, Alexandra M. Oster, Cyprian Wejnert, Kristen L. Hess, Gabriela Paz-Bailey, Jianglan White, Laura Salazar, Jeff Todd, Colin Flynn, Danielle German, Maura Driscoll, Rose Doherty, Chris Wittke, Nikhil Prachand, Nanette Benbow, Sharon Melville, Shane Sheu, Alicia NovoaMark Thrun, Alia Al-Tayyib, Ralph Wilmoth, Vivian Griffin, Emily Higgins, Karen MacMaster, Jan Risser, Aaron Sayegh, Hafeez Rehman, Trista Bingham, Ekow Kwa Sey, Marlene LaLota, Lisa Metsch, David Forrest, Bridget J. Anderson, Carol Ann Watson, Lou Smith, DeAnn Gruber, William T. Robinson, Narquis Barak, Alan Neaigus, Samuel Jenness, Holly Hagan, Barbara Bolden, Sally D'Errico, Henry Godette, Kathleen A. Brady, Andrea Sifferman, Vanessa Miguelino-Keasling, Al Velasco, H. Fisher Raymond, Sandra Miranda de León, Yadira Rolón-Colón, Melissa Marzan, Hanne Thiede, Richard Burt, Michael Herbert, Yelena Friedberg, Dale Wrigley, Manya Magnus, Irene Kuo, Tiffany West

Research output: Contribution to journalArticlepeer-review


Problem/Condition: At the end of 2010, an estimated 872,990 persons in the United States were living with a diagnosis of human immunodeficiency virus (HIV) infection. Approximately one in four of the estimated HIV infections diagnosed in 2011 were attributed to heterosexual contact. Heterosexuals with a low socioeconomic status (SES) are disproportionately likely to be infected with HIV. Reporting Period: June-December 2010. Description of System: The National HIV Behavioral Surveillance System (NHBS) collects HIV prevalence and risk behavior data in selected metropolitan statistical areas (MSAs) from three populations at high risk for HIV infection: men who have sex with men, injecting drug users, and heterosexuals at increased risk for HIV infection. Data for NHBS are collected in rotating cycles in these three different populations. For the 2010 NHBS cycle among heterosexuals, men and women were eligible to participate if they were aged 18-60 years, lived in a participating MSA, were able to complete a behavioral survey in English or Spanish, and reported engaging in vaginal or anal sex with one or more opposite-sex partners in the 12 months before the interview. Persons who consented to participate completed an interviewer-administered, standardized questionnaire about HIVassociated behaviors and were offered anonymous HIV testing. Participants were sampled using respondent-driven sampling, a type of chain-referral sampling. Sampling focused on persons of low SES (i.e., income at the poverty level or no more than a high school education) because results of a pilot study indicated that heterosexual adults of low SES were more likely than those of high SES to be infected with HIV. To assess risk and testing experiences among persons at risk for acquiring HIV infection through heterosexual sex, analyses excluded participants who were not low SES, those who reported ever having tested positive for HIV, and those who reported recent (i.e., in the 12 months before the interview) male-male sex or injection drug use. This report summarizes unweighted data regarding HIV-associated risk, prevention, and testing behaviors from 9,278 heterosexual men and women interviewed in 2010 (the second cycle of NHBS data collection among heterosexuals). Results: The median age of participants was 35 years; 47% were men. The majority of participants were black or African American (hereafter referred to as black) (72%) or Hispanic/Latino (21%). Most participants (men: 88%; women: 90%) reported having vaginal sex without a condom with one or more opposite-sex partners in the past 12 months; approximately one third (men: 30%; women: 29%) reported anal sex without a condom with one or more opposite-sex partners. The majority of participants (59%) reported using noninjection drugs in the 12 months before the interview; nearly one in seven (15%) had used crack cocaine. Although most participants (men: 71%; women: 77%) had ever been tested for HIV, this percentage was lower among Hispanic/Latino participants (men: 52%; women: 62%). Approximately one third (34%) of participants reported receiving free condoms in the 12 months before the interview; 11% reported participating in a behavioral HIV prevention program. Interpretation: A substantial proportion of heterosexuals interviewed for the 2010 NHBS heterosexual cycle reported engaging in behaviors that increase the risk for HIV infection. However, HIV testing was suboptimal among the overall sample, including among groups disproportionately affected by HIV infection (i.e., blacks and Hispanics/Latinos). Public Health Action: Increasing coverage of HIV testing and other HIV prevention services among heterosexuals at increased risk is important, especially among groups disproportionately affected by HIV infection, such as blacks and Hispanics/Latinos. The National HIV/AIDS Strategy for the United States delineates a coordinated national response to reduce infections and HIVrelated health disparities among disproportionately affected groups. NHBS data can guide national and local planning efforts maximize the impact of HIV prevention programs.

Original languageEnglish (US)
Pages (from-to)1-39
Number of pages39
JournalMMWR Surveillance Summaries
Issue number1
StatePublished - 2014

ASJC Scopus subject areas

  • Epidemiology
  • Health(social science)
  • Health, Toxicology and Mutagenesis
  • Health Information Management


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