478. How does changing sexual risk behaviors impact incident sexually transmitted infections (STIs) in a cohort of HIV+ Military beneficiaries?
Session: Poster Abstract Session: HIV and STI Prevention
Thursday, October 27, 2016
Room: Poster Hall

HIV+ individuals often continue to engage in behaviors that put them at risk for sexually transmitted infections (STIs). We were interested in identifying the short-term impact of sexual risk behavior changes on incident STIs.


All NHS participants are screened for STIs every six months. Since 9/2014, participants were administered a tablet-based computer-assisted self-interview on sexual risk behaviors at each follow-up. Incident STIs (chlamydia, gonorrhea, HBV, HSV2, and syphilis) were defined as a negative followed by a positive test (allowing for repeat bacterial infections) within one year of the survey. We limited our analysis to participants with at least 2 risk behavior surveys within 1 yr (+ 3 months). For each risk behavior, we identified whether their risk remained the same (low or high risk), or changed (low to high, high to low) and used conditional logistic regression to identify the impact of sexual risk behavior change on incident STIs.


789 NHS participants completed a baseline and follow-up risk survey within 1 yr 94% male, 40% white, 42% African-American, 18% Hispanic/other, 50% active duty, 70% single, 70% reported MSM at last sexual encounter. 148 (18.8%) had an incident STI. In univariate analyses, in addition to younger age, African-American race, being single and being on active duty, reporting new sex partners in the last 3 months, whether reported at both time points (OR 5.6 (95% CI 3.5-9.0) at follow up (i.e., increased risk, [OR 3.4, 95% CI 2.0-5.6]) or at baseline (i.e., decreased risk [OR 2.4, 95% CI 1.2-4.6]). In addition, MSM at last sex encounter at both time points was associated with an incident STI (OR 4.7, 95% CI 2.2-9.5). In an adjusted multivariate model, only younger age and consistent reporting of MSM at last sex encounter at both time points remained significantly associated with incident STIs (OR 3.5, 95% CI 1.7-7.4).


In our population, sexual risk behavior change did not provide additional information compared to baseline when looking at associations with incident STIs. This initial analysis provides support for the value of cross-sectional risk behavior reporting. Future studies will include identifying if sexual risk behavior change over longer follow-up time provides additional associations with STIs.

Grace Macalino, PhD1, Xun Wang, MS2, Anuradha Ganesan, MD, MPH1, Robert Deiss, MD3, Tahaniyat Lalani, MD3, Christina Schofield, MD FACP, FIDSA4, Jason Okulicz, MD5 and Brian Agan, MD3, (1)Infectious Disease Clinical Research Program, Uniformed Services University of the Health Sciences, Bethesda, MD, (2)The Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, (3)Infectious Disease Clinical Research Program, Uniformed Services University of the Health Sciences, Rockville, MD, (4)Madigan Army Medical Center, Tacoma, WA, (5)San Antonio Military Medical Center, Infectious Disease Service, Fort Sam Houston, TX


G. Macalino, None

X. Wang, None

A. Ganesan, None

R. Deiss, None

T. Lalani, None

C. Schofield, None

J. Okulicz, None

B. Agan, None

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