Locating the places people meet new sexual partners in a southern US city to inform HIV/STI prevention and testing efforts.

Places where people meet new sex partners can be venues for the delivery of individual and environmental interventions that aim to reduce transmission of HIV and other sexually transmitted infections (STI). Using the Priorities for Local AIDS Control Efforts (PLACE) methodology we identified and characterized venues where people in a southeastern US city with high prevalence of both HIV and STI go to meet new sexual partners. A total of 123 community informants identified 143 public, private and commercial venues where people meet sex partners. Condoms were available at 14% of the venues, although 48% of venue representatives expressed a willingness to host HIV prevention efforts. Interviews with 373 people (229 men, 144 women) socializing at a random sample of 54 venues found high rates of HIV risk behaviors including concurrent sexual partnerships, transactional sex and illicit substance abuse. Risk behaviors were more common among those at certain venue types including those that may be overlooked by public health outreach efforts. The systematic methodology used was successful in locating venues where risky encounters are established and reveal opportunities for targeted HIV prevention and testing programs as well as research.

Incarceration and risky sexual partnerships in a southern US city.

Incarceration is strongly associated with HIV infection and may contribute to viral transmission by disrupting stable partnerships and promoting high-risk partnerships. We investigated incarceration and STI/HIV-related partnerships among a community-based sample recruited for a sexual behavior interview while frequenting venues where people meet sexual partners in a North Carolina city (N = 373). Men reporting incarceration in the past 12 months were more likely than men without recent incarceration to experience multiple new sexual partnerships (unadjusted prevalence ratio [PR] 1.8, 95% confidence interval [CI]: 1.1-3.1) and transactional sex defined as trading sex for money, goods, or services (unadjusted PR: 4.0, 95% CI: 2.3-7.1) in the past 4 weeks. Likewise, women who were ever incarcerated were more likely than never-incarcerated women to experience recent multiple new partnerships (unadjusted PR: 3.1, 95% CI: 1.8-5.4) and transactional sex (unadjusted PR: 5.3, 95% CI: 2.6-10.9). Sexual partnership in the past 12 months with someone who had ever been incarcerated versus with partners with no known incarceration history was associated with recent multiple new partnerships (men: unadjusted PR 2.0, 95% CI 1.4-2.9, women: unadjusted PR 4.8, 95% CI 2.3-10.1) and transactional sex (men: unadjusted PR 3.3, 95% CI 1.7-6.6, women: unadjusted PR 6.1, 95% CI 2.4-15.4). Adjustment for demographic and socioeconomic variables had minimal effect on estimates. However, the strong overlap between incarceration, partner incarceration, and substance abuse had substantial effects in multivariable models. Correctional-facility and community-based HIV prevention, with substance abuse treatment, should reach currently and formerly incarcerated individuals and their sexual partners.