Comparisons of sexual behaviors and STD prevalence among older and younger individuals with HIV infection

Abstract

Knowledge of an HIV-infected individual's sexual behaviors and routine sexually transmitted diseases (STDs) testing greatly facilitates HIV prevention efforts, but current data in older individuals are lacking. This study was developed to compare sexual behaviors and STD prevalence between older HIV-infected individuals and their younger counterparts. We conducted a cross-sectional cohort study of HIV-infected individuals ≥18 years who completed an annual behavioral assessment. A total of 541 individuals completed the assessment. Analyses were performed to examine differences in sexual behaviors and STD prevalence between age groups: younger (18–35 years) (30%), middle-aged (36–49 years) (46%), and older (≥50 years) (24%). Older individuals were most likely to be male and Caucasian with longest time since HIV diagnosis, greatest receipt of highly active antiretroviral therapy (HAART), and highest rates of HIV RNA <50 copies/mL (all p<0.001). Reports of recent sexual activity decreased with age, younger (56%) vs. middle-aged (43%) vs. older (27%) (p<0.001). The median number of recent sex partners was one (range 1–25) and 68% overall reported using condoms consistently; these parameters did not differ by age group. STD prevalence was 8% (gonorrhea [9], chlamydia [7], and syphilis [20]) and was highest among younger individuals (younger [11%] vs. middle-aged [7%] vs. older [3%]). Our results demonstrated that with older age, sexual activity declines but inconsistent condom use remains commonly reported. Furthermore, STDs were identified among all age groups. This latter finding reinforces the need for secondary prevention efforts among all individuals living with HIV/AIDS.

Keywords:

• HIV
• risk behaviors
• sexually transmitted disease
• older individuals

Acknowledgements

This publication was partially supported by Grant No. UL1RR024992 (PI: Dr. Kenneth Polonsky) from the National Center for Research Resources (NCRR), and KL2RR024994 to Dr. Shacham. Its contents are solely the responsibility of the authors and do not necessarily represent the official view of NCRR or NIH. Dr. Overton receives research grants from Merck, GlaxoSmithKline, Gilead, Abbott, Tibotec, and Boehinger Ingelheim through Washington University; has served as a consultant for Tibotec and GlaxoSmithKline; and served on speakers' bureau or received honoraria from Merck, Tibotec, GlaxoSmithKline, Bristol-Myers Squibb, GlaxoSmithKline, Monogram Sciences, and Gilead.