Studies of HIV-infected people in Los Angeles
show disturbing trends in behavior that could lead to the rapid
spread of the virus, researchers said.
The sexual behavior alarmed scientists and outreach workers who
gathered Friday at an annual conference on AIDS research.
Researchers hope the studies will help explain January reports
of rising HIV infection rates in San Francisco as well as in
Sydney, Australia, and Vancouver, British Columbia.
One of the most disturbing studies involved 113 HIV-positive
bisexual men in Los Angeles. It found that 54.5 percent failed to
disclose their infection status to sex partners. Thirty-one percent
reported having unprotected sex.
"The importance is that a number of sexual partners may not
know they are at risk," said Matt Mutchler, a researcher with AIDS
Project Los Angeles.
In another study of 53 men in Los Angeles County, 50 percent
reported having had sex with an average of 28 partners in a public
place during the previous six months. And 41 percent said they had
unprotected sex in a public place.
A 1997-98 study of 305 black men with HIV or AIDS found that 31
percent identified themselves as heterosexual even though they
reported previously having sex with men.
In another control group of 305 black men who were not
HIV-infected, 16 percent said they were not homosexual but reported
having had sex with men.
The findings suggest that HIV prevention strategies should be
widened to include that segment of black men who have complex
sexual behaviors, said Amy Wohl, an HIV epidemiologist with the
county Department of Health Services.
Dr. George Lemp, director of the Universitywide AIDS Research
Program, said the Los Angeles sex behavior studies show that
prevention programs are not reaching HIV-infected people.
"Prevention is either not being delivered or it's not in high
quality," Lemp said. "They are getting the medication, but no one
is helping them with the psycho-social and relationship issues.
There are people in care who have a lot of issues other than
HIV. If you can address those issues, you may help them deal with
the risk behavior."
Researchers said that some of the factors effecting the sexual
behavior of HIV-positive people include alcohol and drug abuse,
childhood sexual abuse, and the abandonment of caution in certain
environments, such as bathhouses and all-night dance clubs.
Researchers cautioned against applying the Los Angeles findings
directly to other parts of the country, primarily because factors
that contribute to risky behavior often change with the
Lemp, however, noted that California often provides a look of
things to come for the rest of the United States.
"I think if you see something like this happening in Los
Angeles, you can expect to see it all over the country," he said.