October 17, 2011
A recent study underscores the concern that there is still a large number of persons who possess knowledge of HIV transmission risks without recognizing their own risk for infection.
During the 51st Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC), an abstract presentation entitled "Human Immunodeficiency Virus Risk Perception and Interest in Pre-Exposure Prophylaxis Among Persons Visiting a Sexually-Transmitted Infection Clinic in Chicago" was presented by Thana Khawcharoenporn, M.D. Khawcharoenporn, along with Sabrina Kendrick, M.D., and Kimberly Smith, M.D., Ph.D., both physicians at Rush University Medical Center and the Ruth M. Rothstein CORE Center in Chicago, Ill., conducted an anonymous survey of 494 people at a sexually transmitted infection (STI) clinic in Chicago.
Client demographic information, substance use, risk behaviors, knowledge of HIV transmission risks and the interest in making use of pre-exposure prophylaxis (PrEP) were taken into account. Based on their response to the survey questions, the participants were categorized into one of three pre-defined HIV risk characteristic groups: high-risk, moderate-risk and low-risk behavior/environment. Additional statistical analyses were performed in the heterosexual high-risk participants to assess risk perception, condom use and PrEP interest.
The most surprising finding was that 84% (301) of the high-risk participants in this urban STI clinic perceived themselves as having no or low risk for HIV. Despite the participants having high levels of knowledge about HIV transmission risks, their rates of consistent barrier protection (condom) use for vaginal, oral and anal sex were extremely low (< 20%). Furthermore, in a multivariate analysis, a lack of interest in PrEP was associated with low education level (adjusted odds ratio [AOR] was 4.97, with a 95% confidence interval (CI) of 1.26-19.67; P = 0.02] and there was a trend toward an association with low-risk perception as well (AOR 2.85; 95% CI 0.93-8.16; P = 0.10).
The authors concluded that, despite having knowledge of HIV transmission risk, the majority of participants in this survey who exhibited high-risk behavior/environment did not recognize their own risks. Additionally, condoms were not consistently utilized with great frequency. Low education level and low-risk perception of HIV transmission risk may impact PrEP use, according to the study.
The presentation suggests that we in the health care field need enhanced interventions to improve HIV risk perception, safer sex practices and knowledge of PrEP among HIV-uninfected people.
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