2. How much risky sex are people in Oregon with HIV having?

3. Oregon 1/26 cities and states participating Interviews + chart reviews with people with HIV seen by doctor This presentation: 541 Oregon interviews during 2007/2008 Random sample Statewide the methods in brief— Medical Monitoring Project

5. the population 541 participants 89% male 60% homosexual/10% bisexual 76% white

6. Male,472 Everyone,541 Female, 69

7. some data

8. + males—number of sex partners

9. Males: # Sex Partners Previous 12 mos. Most had ≤1 partner

10. Males: # Female Sex Partners Previous 12 mos. Most had 0 female partners

11. what constitutes risky sex?

12. Males: Anal Sex w/ another male with and w/o condom, previous 12 mos.

13. Males: Discussed HIV Status w/ all male sex partners previous 12 mos

15. Male,472 Unprotected anal intercourse,108 Discussed self and partner HIV status with all partners,past year Yes 66 No 42(10%)* *Weighted estimate of proportion of all men seen for HIV care risky sex, defn #1 >1 male partner, past year, 241

16. Male,472 >1 male partner, past year, 241 Unprotected anal intercourse,108 Most recent partner unknown HIV status or HIV-negative Yes 33(8%)* No 75 *Weighted estimate of proportion of all men seen for HIV care risky sex, defn #2

17. ‘Risky’ vs not § Overall health good/excellent 68%:45% Ever had opportunistic inf 17%:36%* Duration positive 9y:13y* Salary is primary income source 71%:39% Seen in metro-area facility 96%:71%* Aged <35 y 37%:09%* § Definition #1: Unprotected AI, failed to discuss with all partners * P<0.5

18. Conclusions Minority of HIV-positive men in care engage in high-risk sex This group is –Younger –more likely to be seen in metro area (live in metro area?) –More likely to be fully employed –Infected more recently Either: Prevention with Positives working great OR Prevention with Positives is 90% waste of time unless focused on the right people

19. Public health message Not everyone in care for HIV in urgent need of prevention-oriented behavior change Let’s find out more about who is in the risky minority and focus prevention with positive messages better