HIV Remains Threat To Urban Heterosexuals Interview with:
Dr. Catlainn Sionean
Epidemiologist, CDC’s Division of HIV/AID

Medical Research: What is the background for this study?

Dr. Sionean: Previous research has shown that heterosexuals in low socio-economic communities are disproportionately affected by HIV, so we analyzed data on low-SES heterosexuals in 21 metropolitan areas with a high AIDS burden from CDC’s National HIV Behavioral Surveillance system to better understand individual risk and HIV testing behaviors within this population.

Medical Research: What are the main findings?

Dr. Sionean: This analysis makes it clear that we must do a better job reaching heterosexuals in urban areas with prevention services. CDC recommends that everyone be tested at least once for HIV. However, we found that overall, 1 in 4 (25%) participants had never been tested for HIV.  HIV testing rates were notably low among Latinos, who, with African Americans, share a disproportionate burden of HIV in the U.S. Additionally, 1 in 3 participants (34%) received free condoms in the last year and only 11 percent of participants participated in a prevention intervention.

Medical Research: What should clinicians and patients take away from your report?

Dr. Sionean: HIV continues to threaten the lives of heterosexuals in urban areas hardest-hit by HIV, but they are not receiving critical HIV testing and prevention services they can use to protect themselves from HIV infection. With this analysis, we are reminded of a point we’ve learned from previous research, we can’t look at HIV in isolation from the environment in which people live. As we see with this analysis, many heterosexuals in high poverty urban communities are engaging in behaviors that put them at risk for HIV infection. These data are concerning because we know, from previous research that HIV prevalence among heterosexuals in low SES urban areas is high. As a result, heterosexuals residing in high-poverty, urban areas have a greater chance of becoming infected with HIV than would people engaging in the same behaviors elsewhere, because of the higher chance that any partner they have is HIV-positive.

Medical Research: What recommendations do you have for future research as a result of this study?

Dr. Sionean: Detailed data regarding HIV-related risk behaviors from the NHBS heterosexual cycle have not been reported previously. This analysis allows us to better understand the impact of HIV in this hard-hit population, and we will use these and future similar data to monitor trends within this population over time.

We must continue to address personal risk, but also work with other agencies to implement and scale up HIV prevention approaches that move beyond individual risk behaviors and address environmental factors (for example: to ensure stable housing and employment). This will require dedication from a range of public and private partners working together.


HIV Risk, Prevention, and Testing Behaviors Among Heterosexuals at Increased Risk for HIV Infection — National HIV Behavioral Surveillance System, 21 U.S. Cities, 2010

Morbidity and Mortality Weekly Report (MMWR)
Surveillance Summaries

December 19, 2014 / 63(SS14);1-39
Catlainn Sionean, PhD et al

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Last Updated on January 9, 2015 by Marie Benz MD FAAD