TY - JOUR
T1 - Patterns and Trajectories of Anal Intercourse Practice Over the Life Course Among US Women at Risk of HIV
AU - Owen, Branwen Nia
AU - Baggaley, Rebecca F.
AU - Maheu-Giroux, Mathieu
AU - Elmes, Jocelyn
AU - Adimora, Adaora A.
AU - Ramirez, Catalina
AU - Edmonds, Andrew
AU - Sosanya, Kemi
AU - Taylor, Tonya
AU - Plankey, Michael
AU - Cederbaum, Julie
AU - Seidman, Dominika
AU - Weber, Kathleen M.
AU - Golub, Elizabeth T.
AU - Sheth, Anandi N.
AU - Bolivar, Hector
AU - Konkle-Parker, Deborah
AU - Boily, Marie Claude
N1 - Funding Information:
Funding: The WIHS is funded primarily by the National Institute of Allergy and Infectious Diseases (NIAID), with additional cofunding from the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), the National Cancer Institute (NCI), the National Institute on Drug Abuse (NIDA), and the NationalInstitute of Mental Health (NIMH). Targeted supplemental funding for specific projects is also provided by the National Institute of Dental and Craniofacial Research (NIDCR), the National Institute on Alcohol Abuse and Alcoholism (NIAAA), the National Institute on Deafness and Other Communication Disorders (NIDCD), and the NIH Office of Research on Women's Health. WIHS data collection is also supported by UL1-TR000004 (UCSF CTSA), P30-AI-050409 (Atlanta CFAR), P30-AI-050410 (UNC CFAR), and P30-AI-027767 (UAB CFAR). Rebecca F. Baggaley is supported by a Wellcome Trust Institutional Strategic Support Fund Fellowship (204801/Z/16/Z). Mathieu Maheu-Giroux's research program is funded by a career award from the Fonds de Recherche du Québec - Santé. Tonya Taylor's work is supported by HRSA-19-008 (Cohen and Reinhardt, mPI 7/1/19-6/30/24 and 1R21NR018348-01 (Wilson) 7/1/18-6/30/20. Dominika Seidman's work is supported by grant 5K12HD001262-18 from the National Institutes of Health. We acknowledge joint-centre funding from the UK Medical Research Council and Department for International Development (Grant reference MR/R015600/1). This award is jointly funded by the UK Medical Research Council (MRC) and the UK Department for International Development (DFID) under the MRC/DFID Concordat agreement and is also part of the EDCTP2 programme supported by the European Union. We thank the HIV Prevention Trials Network (HPTN) Modelling Centre (NIH UM1-AI-068617) and the HPTN Leadership and Operations Center (UM1AI068619) for support. Support for the HPTN is provided by the NIAID of the National Institutes of Health (ceNIH).
Funding Information:
Funding: The WIHS is funded primarily by the National Institute of Allergy and Infectious Diseases ( NIAID ), with additional cofunding from the Eunice Kennedy Shriver National Institute of Child Health and Human Development ( NICHD ), the National Cancer Institute ( NCI ), the National Institute on Drug Abuse ( NIDA ), and the National Institute of Mental Health ( NIMH ). Targeted supplemental funding for specific projects is also provided by the National Institute of Dental and Craniofacial Research ( NIDCR ), the National Institute on Alcohol Abuse and Alcoholism ( NIAAA ), the National Institute on Deafness and Other Communication Disorders ( NIDCD ), and the NIH Office of Research on Women's Health . WIHS data collection is also supported by UL1-TR000004 (UCSF CTSA), P30-AI-050409 (Atlanta CFAR), P30-AI-050410 (UNC CFAR), and P30-AI-027767 (UAB CFAR). Rebecca F. Baggaley is supported by a Wellcome Trust Institutional Strategic Support Fund Fellowship (204801/Z/16/Z). Mathieu Maheu-Giroux's research program is funded by a career award from the Fonds de Recherche du Québec - Santé . Tonya Taylor's work is supported by HRSA-19-008 (Cohen and Reinhardt, mPI 7/1/19-6/30/24 and 1R21NR018348-01 (Wilson) 7/1/18-6/30/20. Dominika Seidman's work is supported by grant 5K12HD001262-18 from the National Institutes of Health . We acknowledge joint-centre funding from the UK Medical Research Council and Department for International Development (Grant reference MR/R015600/1). This award is jointly funded by the UK Medical Research Council ( MRC ) and the UK Department for International Development (DFID) under the MRC/DFID Concordat agreement and is also part of the EDCTP2 programme supported by the European Union . We thank the HIV Prevention Trials Network (HPTN) Modelling Centre (NIH UM1-AI-068617) and the HPTN Leadership and Operations Center (UM1AI068619) for support. Support for the HPTN is provided by the NIAID of the National Institutes of Health (ceNIH).
Publisher Copyright:
© 2020 The Authors
PY - 2020/9
Y1 - 2020/9
N2 - Introduction: Condomless anal intercourse (AI) confers a far greater likelihood of HIV transmission than condomless vaginal intercourse (VI). However, little is known about AI practice over the life course of women, to what extent AI practice is condom-protected, and whether it is associated with other HIV risk behaviors. We aim to describe longitudinal AI practice among HIV-seronegative women and to identify subgroups with distinct trajectories of AI practice. Methods: Using data from the Women's Interagency HIV Study, an observational cohort of US women with or at risk for HIV, we described AI practice among HIV-seronegative participants. Group-based trajectory modeling was used to identify distinct AI trajectories. We used multinomial regression to examine associations between baseline characteristics and trajectory group membership. Results: A third of the 1,085 women in our sample reported any AI over follow-up (median follow-up = 14 years). AI decreased more sharply with age compared to VI. Consistent condom use during AI was low: twice the proportion of women never reported using condoms consistently during AI compared to during VI. 5 trajectory groups were identified: AI & VI persistors (N = 75) practiced AI and VI consistently over follow-up (AI & VI desistors (N = 169) tended to practice AI and VI when young only, while VI persistors (N = 549), VI desistors (N = 167), and AI & VI inactives (N = 125) reported varying levels of VI practice, but little AI. AI & VI persistors reported multiple male partners and exchange sex at more visits than other groups. Women who identified as bisexual/lesbian (vs heterosexual), who had ever experienced physical and sexual violence (vs never), and/or who reported above the median number of lifetime male sex partners (vs median or below) had approximately twice the odds of being AI & VI persistors than being VI persistors. Conclusions: We identified a small subgroup of women who practice AI and report inconsistent condom use along with other risk behaviors throughout the life course; they may therefore particularly benefit from ongoing access to HIV prevention services including pre-exposure prophylaxis. Owen BN, Baggaley RF, Maheu-Giroux M, et al. Patterns and Trajectories of Anal Intercourse Practice Over the Life Course Among US Women at Risk of HIV. J Sex Med 2020;17:1629–1642.
AB - Introduction: Condomless anal intercourse (AI) confers a far greater likelihood of HIV transmission than condomless vaginal intercourse (VI). However, little is known about AI practice over the life course of women, to what extent AI practice is condom-protected, and whether it is associated with other HIV risk behaviors. We aim to describe longitudinal AI practice among HIV-seronegative women and to identify subgroups with distinct trajectories of AI practice. Methods: Using data from the Women's Interagency HIV Study, an observational cohort of US women with or at risk for HIV, we described AI practice among HIV-seronegative participants. Group-based trajectory modeling was used to identify distinct AI trajectories. We used multinomial regression to examine associations between baseline characteristics and trajectory group membership. Results: A third of the 1,085 women in our sample reported any AI over follow-up (median follow-up = 14 years). AI decreased more sharply with age compared to VI. Consistent condom use during AI was low: twice the proportion of women never reported using condoms consistently during AI compared to during VI. 5 trajectory groups were identified: AI & VI persistors (N = 75) practiced AI and VI consistently over follow-up (AI & VI desistors (N = 169) tended to practice AI and VI when young only, while VI persistors (N = 549), VI desistors (N = 167), and AI & VI inactives (N = 125) reported varying levels of VI practice, but little AI. AI & VI persistors reported multiple male partners and exchange sex at more visits than other groups. Women who identified as bisexual/lesbian (vs heterosexual), who had ever experienced physical and sexual violence (vs never), and/or who reported above the median number of lifetime male sex partners (vs median or below) had approximately twice the odds of being AI & VI persistors than being VI persistors. Conclusions: We identified a small subgroup of women who practice AI and report inconsistent condom use along with other risk behaviors throughout the life course; they may therefore particularly benefit from ongoing access to HIV prevention services including pre-exposure prophylaxis. Owen BN, Baggaley RF, Maheu-Giroux M, et al. Patterns and Trajectories of Anal Intercourse Practice Over the Life Course Among US Women at Risk of HIV. J Sex Med 2020;17:1629–1642.
KW - Anal Sex
KW - Heterosexual
KW - Prevention
KW - Sexual Behavior
KW - Transmission
KW - Women
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U2 - 10.1016/j.jsxm.2020.06.007
DO - 10.1016/j.jsxm.2020.06.007
M3 - Article
C2 - 32703707
AN - SCOPUS:85088152075
SN - 1743-6095
VL - 17
SP - 1629
EP - 1642
JO - Journal of Sexual Medicine
JF - Journal of Sexual Medicine
IS - 9
ER -