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Colleague's E-mail is Invalid. Your message has been successfully sent to your colleague. Save my selection. Hightow, Lisa B. Correspondence: Lisa B. E-mail: [ protected]. An investigation of young men newly diagnosed with HIV infection in North Carolina reveals that men who have sex with both men and women are a unique risk group that occupy a central position within sexual networks.

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In addition, interventions that are tailored to incorporate cultural constructs are more likely to be effective. Available evidence suggests that the epidemiology of HIV infection in the United States has shifted over the past decade. Seroepidemiologic studies have documented a change in the risk behaviors associated with new HIV infections. Few studies have assessed the validity of these self-reported risk behaviors. Network analysis can help explain transmission of HIV and other sexually transmitted infections STIs 12 and supports the use of the network perspective in understanding HIV risk behaviors.

In addition, we compared risk behaviors reported at the initial HIV voluntary counseling and testing VCT session with risk behaviors reported to the disease intervention specialists DIS during follow-up interviews of infected individuals. In North Carolina, HIV reporting is mandatory and DIS are ased to investigate and interview any positive HIV test result reported to the state or local health department by a medical provider or clinical laboratory.

This surveillance record review was considered part of an ongoing public health epidemiologic investigation sanctioned by the North Carolina Division of Health Services and therefore exempt from Institutional Review Board approval. Given the small sample size, exact methods were used to compare proportions. Backward elimination was used to simplify the models using the likelihood ratio test, and all pairwise comparisons were tested for interaction effect measure modification.

We constructed a sexual partner network through information obtained from DIS interview records of college males and their sexual contacts. This was achieved through manual review of all DIS interview records of index patients diagnosed with HIV infection and their contacts from January 1,through December 31, DIS are ased to investigate any positive HIV test result reported to the state health department.

They review medical records to obtain demographic and clinical information about the reported index patient and attempt to contact the patient to conduct a voluntary, confidential, in-depth interview. The case report form also includes an area for a narrative in which the DIS can record comments from the interview that are not captured elsewhere on the form e. We compared the self-reported sexual risk behaviors given by the male college case patients during their initial visits to the VCT sites with information about risk behaviors reported during the DIS interviews.

Male college case patients who reported sex with men during both the VCT and DIS interviews were compared with those men who had different risk behaviors recorded in both interviews. Between January 1,and December 31,men aged 18 to 30 years were reported with newly diagnosed HIV infection in North Carolina.

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Of We found ificant interactions in this model with age group and having college student sex partners and incarceration and ethnicity. Of the newly diagnosed HIV-infected males, 44 However, venues for meeting sex partners were not limited to college campuses. These students also reported meeting partners at either bars or clubs Only 2 4. Of note, 6 of the infected women were Hispanic, 3 were pregnant at the time of their diagnosis, and 2 were college students.

We examined potential sexual partner network links, as defined by HIV-infected college males self-reports to DIS of sexual partners at their college of enrollment or sexual partners at other colleges or with noncollege students. When only considering MSM and Woman and men sexs, 6 discrete networks consisting of 17 schools, 58 students, and 5 contacts of students are evident Fig.

As part of our attempts to characterize the reporting of risk behaviors, we compared the self-reported sexual risk behaviors given by the college case patients during their initial visits to the publicly funded VCT sites with information about risk behaviors reported during the DIS visits.

Compared with college case patients who changed the reports of their risk behaviors 16 individualsthose MSM that reported sex with men during both the VCT and DIS interviews 61 individuals were more likely to be coinfected with syphilis There have been mixed reports concerning the role that male bisexual behavior may play in the heterosexual transmission of HIV. First, the studies are largely cross-sectional and do not examine reported behavior over time. Second, these studies often use a wide window of time to define bisexual behavior.

Several recent reports have focused on a group of young black men who identify themselves as MSW but who also have undisclosed sexual encounters with other men. These descriptions in the popular media portray DL men as secretive and, because they do not perceive themselves to be at risk for HIV infection, unreceptive to standard HIV-prevention messages.

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The precise prevalence of the DL phenomenon among the HIV-infected black college students in our cohort is not known and was not addressed directly in our studies. Despite the small sample size, this finding underscores the point that identifying oneself as heterosexual and having sex with men is not unique to black men. Network analysis offers unique insight into the transmission of HIV and STIs among individuals and within communities. In addition, because we only reviewed the charts of HIV-infected males, we are unable to comment fully on the impact that this network may have in the heterosexual black community.

Nevertheless, this network demonstrates numerous interconnections and underscores the importance of HIV-prevention interventions directed toward individuals as well as social circles linked through different venues, both defined and through the Internet, where there may be an increased risk for sexual transmission.

Woman and men sexs findings in this study are subject to several limitations. Because all of the information on new HIV infections in this investigation related to new diagnoses, it is possible that case reporting could be influenced by changes in provision or uptake of HIV testing in specific populations e.

However, for the 5 years of case data, the proportion of cases diagnosed with early HIV infection defined as the presence of HIV ribonucleic acid [RNA] detected in plasma in the presence of a negative HIV antibody test or a documented negative HIV antibody test and a subsequent positive HIV antibody test within 6 months has increased from 4.

Moreover, the social and sexual networks may be incomplete and biased because HIV-infected men may occupy positions in the networks that are different from HIV-uninfected men, and contact tracing is unavoidably incomplete. To devise successful prevention messages and direct limited resources, we must recognize differences in HIV risk behaviors and transmission patterns within populations of MSM. Or are there essentially 2 loosely connected epidemics—one among MSM and one among heterosexuals? Providing answers to these questions are critical to successful prevention efforts.

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Thought you might appreciate this item s I saw at Sexually Transmitted Diseases. Some error has occurred while processing your request. Please try after some time. E-mail: [ protected] Received for publication June 9,and accepted January 31, Abstract In Brief. Stevenson HC, Davis G. Cited Here PubMed. Am J Community Psychol ; — Centers for Disease Control and Prevention. STD Surveillance Report. Cited Here. Laumann EO, Youm Y. Sex Transm Dis ; — Am J Public Health ; — Doll LS, Beeker C. Male bisexual behavior and HIV risk in the United States: Synthesis of research with implications for behavioral interventions.

Sociometric risk networks and risk for HIV infection. Randomised, controlled, community-level HIV prevention intervention for sexual-risk behaviour among homosexual men in US cities. Lancet ; — Network structural dynamics and infectious disease propagation.

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