The Relationship Context for Risky Sex among HIV-Positive Adults in the United States

David Kanouse, RAND
Rebecca Collins, RAND
Frank Galvan, Charles R. Drew University of Medicine and Science
Daniela Golinelli, RAND
Philip Pantoja, RAND

Most research on correlates of sexual risk behavior among HIV-positive people has focused on individual rather than relationship characteristics. In this paper, we use data from a national probability sample of adults receiving HIV care to examine how sexual relationship patterns are related to high-risk sexual behavior that could transmit HIV infection. In a sample of 1,421 respondents representing a population of 197,100 adults receiving HIV care, 932 (66%) reported having sex in the previous six months, representing 133,700 adults with a total of 522,400 recent sexual partners. Eighty-four percent of sexually active respondents reported having a primary relationship partner or spouse (PRP). Twenty-two percent of sexually active respondents reported any high-risk sex, defined as unprotected anal or vaginal sex with a partner whose serostatus was HIV-negative or unknown. More than half (52%) of all partnerships in which high-risk sex occurred involved a person with multiple partners including a PRP.