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AIDS and Behavior
Published in: AIDS and Behavior 6/2007

01-11-2007 | Original Paper

The HIV transmission gradient: relationship patterns of protection

Authors: David C. Bell, John S. Atkinson, Victoria Mosier, Micah Riley, Victoria L. Brown

Published in: AIDS and Behavior | Issue 6/2007

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Abstract

We describe a gradient of potential HIV transmission from HIV-infected persons to their partners and thence to uninfected populations. The effect of this newly discovered transmission gradient is to limit the spread of HIV. We roughly estimate a 2% long-term transmission probability for sex and 14% for drug injection for two-step transmission. Then we test theories to account for this pattern on a network sample of 267 inner city drug users and nonusers. Although HIV positive persons engaged in a high level of risk with one another, they engaged in less risk with HIV negative partners, and these partners engaged in even lower levels of risk with other HIV negative persons. Analyses suggest that the primary motivation for sexual risk reduction is partner protection, while emotional closeness is the major barrier. Hypotheses accounting for risk in terms of self protection, social norms, gender power, and drug use were weakly supported or unsupported.
Footnotes
1
“Index” is a term common in network studies to refer to the first recruited member of a social network. A “risk partner” is a person named by the index participant as a sex or drug injection partner in the previous 30 days.
 
2
We made the decision to include non-risk partners in the gatekeeper group because relationships are not static. Thus each gatekeeper may be a past or potential future risk partner. In analyses later in this paper where we examine predictors of sex risks, we exclude all non-sex relationships from analyses.
 
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Metadata
Title
The HIV transmission gradient: relationship patterns of protection
Authors
David C. Bell
John S. Atkinson
Victoria Mosier
Micah Riley
Victoria L. Brown
Publication date
01-11-2007
Publisher
Springer US
Published in
AIDS and Behavior / Issue 6/2007
Print ISSN: 1090-7165
Electronic ISSN: 1573-3254
DOI
https://doi.org/10.1007/s10461-006-9192-5

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