Longitudinal study of condom use patterns among women with or at risk for HIV

The objectives of this paper are to compare the patterns of condom use at three times for sexually active HIV-infected women and a comparison group of uninfected women and to examine correlates of condom-use patterns. Data are reported from the first three visits (first year) of a longitudinal study of the biomedical and behavioral manifestations of HIV infection in women. Analyses were conducted on 386 HIV-infected and 203 uninfected sexually active women. Participants were interviewed at enrollment and at 6- and 12-month follow-up visits. HIV-infected and uninfected women received safer-sex counseling at each study visit and uninfected women were tested for HIV. Consistent condom use at all three times was reported by a higher percentage of HIV-infected than uninfected women (34% vs.13%;p <.01) whereas inconsistent or nonuse was more common among the uninfected than infected women (21% vs.7%;p <.01). Condom use differed by partner serostatus: 25% of the HIV-infected women with infected partners reported consistent condom use compared with 41% of those with partners whose serostatus was negative or unknown. For HIV-infected women with uninfected partners, injecting drugs and crack use were associated with inconsistent condom use. These findings suggest that HIV serostatus of women and their partners affects consistency of condom use. Despite greater condom use by HIV-infected women with partners of negative or unknown serostatus than by those with infected partners, the fact that condom use was far from universal suggests the need for interventions involving uninfected male partners of infected women.