Risk behavior and correlates of risk for HIV infection in the Dallas County Household HIV Survey

Objectives. The Dallas County study of a proposed national household seroprevalence survey was designed to assess the feasibility of conducting a national survey and to estimate the prevalence of human immunodeficiency virus (HIV) and hepatitis B virus infection for Dallas County. Risk behavior data were collected and correlated with HIV infection. Methods. Participants in this survey represented a probability sample of the county. A self-administered questionnaire on demographic characteristics and HIV risk behavior was completed and a blood sample was obtained. Results. Of the 1724 adults eligible for the survey, 1446 completed the questionnaire and 1374 provided a blood sample. The prevalence estimates were 0.4% for HIV and 7.3% for hepatitis B virus. A strong relationship was observed between HIV and hepatitis B status and risk behavior. Conclusions. In this study population, receptive anal intercourse and increasing numbers of male partners had the strongest correlation with the prevalence of HIV and hepatitis B virus infection in men. The high level of risk reporting for individuals positive for HIV or hepatitis B suggests that survey participants who engage in risk behaviors were willing to report those behaviors. (Am J Public Health. 1994;84:747-753)
People who engage in behaviors that put them at risk for HIV infection appear willing to disclose this information during surveys. A total of 1,446 people between 18 and 54 years old completed a questionnaire about behaviors related to the risk of HIV infection for the Dallas County Household HIV Survey in 1989. Of these, 1,374 also provided a blood sample. Blood samples were analyzed for HIV and hepatitis B infections. Slightly more than 7% of those surveyed were infected with hepatitis B while 0.4% were HIV positive. Estimates of HIV and hepatitis B infection were significantly increased among those considered to be at high-risk for infection. Almost 5% of the men and 20% of the women reported participating in receptive anal intercourse. There was a strong association between HIV status and reports of high-risk behavior. Because these findings are consistent with known patterns of HIV transmission it appears that survey participants are willing to report high-risk behaviors. Responses obtained in this manner can be used to tailor HIV-prevention information to specific groups and areas.