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Identifying and Characterizing Places for the Targeted Control of Heterosexual HIV Transmission in Urban Areas

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Abstract

Places with active HIV transmission may serve as key locations for targeted control. In 2008–2009, heterosexual sex partner venues in Baltimore, MD were identified using a three-phase process and characterized by the presence or absence of HIV cases. 1,594 participants aged 18–35 years were enrolled at 87 venues. The study yielded an overall HIV prevalence of 3.7 %; 42 % of venues had ≥1 case of HIV (i.e., HIV positive venues). In final age-adjusted models, HIV positive venues had 10 % more high HIV-risk sexual partnering (95 % CI 1.01, 1.19) and more than twice as much drug market activity (95 % CI 1.04, 6.46) compared to HIV negative venues. Commercial sex work, parenteral risk behavior and venue-level sex market activity were not significantly associated with HIV status of the venues. This study highlights characteristics of venues, such as drug market activity, that may be important in identifying places with active HIV transmission.

Resumen

Los lugares con transmisión activa de infección por SIDA pueden servir como lugares claves para un control enfocado. De 2008 a 2009, utilizando un proceso de tres fases, fueron identificados lugares de interacción de parejas sexuales heterosexuales en Baltimore, MD y fueron caracterizados por la presencia o ausencia de casos de VIH. Se inscribieron 1,594 participantes en 87 lugares de interacción con edades comprendidas entre los 18 y los 35 años. El estudio mostró una prevalencia general de SIDA de 3.7 %; 42 % de los lugares tenía ≥1 caso de VIH (es decir, lugares con infección de VIH). En los últimos modelos ajustados por edad, los lugares con infección del VIH tenían 10 % más uniones sexuales de alto riesgo de VIH (95 % CI 1.01, 1.19) y más del doble de actividad de tráfico de drogas (95 % CI 1.04, 6.46) comparados con los lugares que no tienen infección de VIH. El trabajo sexual comercial, conducta de riesgo parenteral y actividad en el mercado del sexo en un determinado lugar no estaban asociados de una manera significativa con el estatus de VIH de los lugares. Este estudio destaca las características de los lugares de interacción, como el comercio de drogas, que podría ser importante para identificar los lugares con transmisión activa de infección por VIH.

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Acknowledgments

The authors thank the men and women who participated in this study and the staff who collected the data. This study was supported by funding from the National Institute of Child Health and Human Development (R21 HD052438) and the National Institute of Drug Abuse (KO1 DA022298-01A1). Meeting at which data were presented: National STD Prevention Conference, Centers for Disease Control and Prevention, Atlanta, GA, 2011.

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Authors and Affiliations

  1. Division of General Pediatrics and Adolescent Medicine, Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, USA

    Sarah Polk, Jonathan M. Ellen, Steven Huettner & Jacky M. Jennings

  2. Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, USA

    Jonathan M. Ellen, Caroline Fichtenberg & Jacky M. Jennings

  3. Department of Health, Behavior and Society, Johns Hopkins University Bloomberg School of Public Health, Baltimore, USA

    Meredith Reilly

  4. Department of Population, Family, and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, USA

    Jenita Parekh

  5. Department of Pediatrics, School of Medicine, The Johns Hopkins University Bayview Medical Center, Mason F. Lord Bldg, Center Tower, Suite 4200, 5200 Eastern Avenue, Baltimore, MD, 21224, USA

    Sarah Polk

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  1. Sarah Polk
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  2. Jonathan M. Ellen
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  3. Caroline Fichtenberg
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  4. Steven Huettner
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  7. Jacky M. Jennings
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Correspondence to Sarah Polk.

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Polk, S., Ellen, J.M., Fichtenberg, C. et al. Identifying and Characterizing Places for the Targeted Control of Heterosexual HIV Transmission in Urban Areas. AIDS Behav 18, 1476–1482 (2014). https://doi.org/10.1007/s10461-013-0691-x

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  • DOI: https://doi.org/10.1007/s10461-013-0691-x

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