Sexual transmission-risk behaviour among HIV-positive persons: a multisite study using social action theory.
Kathleen M Sullivan, Carol Dawson Rose, J Craig Phillips and 16 others
PMID 27485796WHAT IT FOUND
Among HIV-positive adults, frequent substance use and lower confidence using condoms were linked to having sex with multiple partners without consistent condom use.
Being female and older age were linked to lower risk; college experience was linked to higher risk.
Key findings
01Frequent substance use was associated with having sex with multiple partners without consistent condom use.
02Lower confidence using condoms was associated with having sex with multiple partners without consistent condom use.
03College experience was associated with having sex with multiple partners without consistent condom use.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study was cross-sectional and used convenience samples, so it cannot show that any factor caused risk behaviour. All sexual and substance-use information was self-reported, and participants who did not report risk were counted as not engaging or not reporting, so some risk may have been missed. The number of people who had multiple partners without consistent condom use was small, so generalisation was limited, especially for women. Fewer male participants reported sex with a male (48.4%) than the rate of men who have sex with men transmission risk reported in larger U.S. samples (61.0%), so this group may be underrepresented. The design did not analyse partner serostatus or relationship details, which are important for HIV transmission. The model explained twenty-one percent of the variation, so many influences were unaccounted for.
The easy way to misread this
Do not read these associations as proof that counselling about condom confidence or substance use will reduce HIV transmission risk. This was a cross-sectional survey of self-reported behaviour, and it cannot show that changing any factor changes risk.