Chapter 3: Correlates of Risk for HIV Infection Correlates  Unlike many viruses, which pass easily through air, water, food, and casual contact, HIV usually requires risky behaviors like sex and drug use for its transmission  People do not perform these risky behaviors in a vacuum. Instead, biological, psychological, demographic, and sociocultural factors affect both the likelihood and the consequences of these behaviors Module 1, Chapter 3

Overview of Risk Factors for HIV Infection Module 1, Chapter 3

Behaviors That Increase the Risk of HIV HIV is transmitted through bodily fluids. Behaviors that increase an uninfected person’s contact with infected body fluids will increase that person’s chances of contracting HIV. These behaviors include:  Unsafe sexual behaviors: The most common way of getting and giving HIV During sex HIV can be transmitted through cuts and tears on the penis, vagina, or anus Cuts and scrapes are more likely during anal sex, forced sex, dry sex, or when women are very young  Unsafe drug use Sharing injecting drug use (IDU) paraphernalia such as needles and syringes  Mixing Sex and Drugs/Alcohol When people use drugs and alcohol, their decision-making abilities, awareness of their surroundings, and memories are altered, making them less likely to choose or remember to practice safer sex  Not taking antiretroviral drugs properly When people do no take their antiretroviral drugs properly they have more HIV in their systems, and are therefore more likely to infect other people through sexual transmission or through sharing needles Module 1, Chapter 3

Overview of Risk Factors for HIV Infection As shown in this figure, all these factors combine and interact to both increase and decrease people’s chances of getting (contracting) or giving (transmitting) HIV Module 1, Chapter 3

Biological and Existing Health Risk Factors There are a number of biological risk factors (both one’s own, and one’s partners) that make it easier for HIV to enter the body. These include: the presence of other sexually transmitted diseases/infections structure of the vagina and of the anus viral load (often affected by a person’s antiretroviral medication history) immune system health (self or partner) tissue/membrane vulnerability (including tears, lesions, amount of coital lubrication, and mucous membrane health of self or partner) genetic character of the virus itself (different viral strains) Module 1, Chapter 3

Psychological Factors Individual psychological factors shape HIV risk behaviors. These include: personality (including impulsivity and sensation seeking, sexual and physical abuse history, sexual self-control, perceived self-efficacy to use condoms correctly and consistently, self-esteem, risk-taking (such as alcohol and other non-injection drug use, etc.) beliefs about HIV/AIDS risk perception coping styles communication styles with sexual partners mental health disorders depression and psychological distress Module 1, Chapter 3

Demographic and Population-based Factors HIV risk behaviors are shaped in the context of both demographic factors as well as population-based factors. These include: race/ethnicity age sexual orientation gender or transgender migration the number of HIV+ people in the population the frequency of risky behaviors, such as unsafe sex and intravenous drug use, in the population) Module 1, Chapter 3

Social and Cultural Factors HIV risk behaviors are shaped by a variety of social and cultural factors that occur at the level of face-to-face and small group interactions, as well as at the level of institutions, governments and organizations. These include: inequality discrimination stigma gender roles and constraints cultural rituals values norms political unrest economics individual and social poverty community transitions the availability and accessibility of medical and social services Module 1, Chapter 3