GENDER AND HIV CONSEQUENCES: HEALTH CARE AND RISK

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DESCRIPTION (provided by applicant): Although the Centers for Disease Control and Institute of Medicine's recently proposed public health prevention strategies are based on linking prevention to treatment of the HIV infected population, little is know about the relationships between health care utilization and sexual risk behavior. Women represent an increasing proportion of people living with HIV in the U.S. It is important to understand how social and health system factors contribute to gender disparities in treatment and outcomes and whether and how such disparities affect HIV+ men's and women's sexual risk behavior. Women are more likely than men who have sex with men to decide to be abstinent, a choice which eliminates the risk of sexual transmission of HIV. However, women are also more likely than men who do not have sex with men to have unprotected sex. The proposed study will examine (1) whether differences in resources, barriers to care, relationship violence, and knowledge about HIV risk help to explain differences between the health care utilization of HIV-infected men and women, and (2) whether differences in medical treatment and other social services, resources, barriers to care, relationship violence, and knowledge about HIV risk help to explain differences between the risk behavior of HIV-infected men and women. The proposed study will link follow-up data from a study of HIV risk behavior with core data from the 3 waves of HCSUS interviews. These linked data give us a unique opportunity to explore how HIV+ women and men differ in health care utilization, and to examine whether this is related to their risk behavior. Results from the proposed study will contribute to efforts to reduce the spread of HIV.