Sexual risk reduction strategies of HIV-positive adults in the U.S.: Substitution of less risky sexual activities

This study examined self-reported substitution of lower-risk for higher-risk sexual activities to reduce risk among sexually active HIV-positive adults in the US. Data are from interviews conducted in the fall of 1998 with participants in the HIV Cost and Services Utilization Study, a probability sample of adults receiving HIV care in the U.S. The analysis includes 932 respondents who reported having any oral, vaginal, or anal sex in the preceding 6 months. Respondents were classified in terms of whether they reported that since their HIV diagnosis, they had substituted a less risky sexual activity for a more risky one to reduce risk to themselves or their partner. Among those who were trying to reduce risk, the prevalence of substitution was 92% among gay/bisexual men, 56% among heterosexual men, and 57% among heterosexual women. These results were not attributable to differences in the number and type of sexual relationships for gay/bisexual men compared to heterosexual men and women.