Risk behavior for transmission of human immunodeficiency virus (HIV) among HIV-seropositive individuals in an urban setting.

We conducted interviews with 256 human immunodeficiency virus (HIV)-infected patients who attended an HIV clinic in New York City to assess ongoing risk behaviors for HIV transmission. After learning that the result of an HIV test was positive, 106 subjects (41%) had unprotected sex, 63 (25%) had a new sexually transmitted disease diagnosis, and 38 (15%) used injection drugs. Unprotected sex was reported by 50% of women, 29% of heterosexual men (P=.006, compared with women), and 42% of men who have sex with men, and it was reported more often by persons with a history of trading sex for money or drugs (P<.001). In multivariate analysis, unprotected sex was associated with a history of trading sex for money or drugs (adjusted odds ratio [AOR], 4.0; 95% confidence interval [CI], 2.2-7.0) and use of highly active antiretroviral therapy (AOR, 1.8; 95% CI, 1.1-3.1). Ongoing risk-reduction counseling and substance abuse treatment for HIV-infected persons are needed to reduce behaviors associated with HIV transmission.