Michael A. Janson, BA, Pamela C. Ogata, MPH, and Armida Ayala, PhD, MHA. Office of AIDS Programs and Policy, Los Angeles County Dept. of Health Services, 600 S. Commonwealth Avenue, 2nd Floor, Los Angeles, CA 90005, 213-351-8355, mjanson@ladhs.org

Objective: Recent findings in HIV prevention research demonstrate the need to target HIV-positive persons to reduce the number of new infections. Los Angeles County uses an annual Countywide Risk Assessment Survey (CRAS) to assess sexual risk and drug use behaviors of individuals receiving HIV prevention services including persons living with HIV/AIDS. The survey provides data for evidence-based prevention planning in Los Angeles County. Methods: In May, 2003, 238 staff representing 47 service providers completed 2,044 face-to-face interviews. This cross-sectional study used a two-tiered sampling methodology which included both stratified and systematic sampling. Results: Persons living with HIV/AIDS accounted for 11.4% of respondents. Of those who were HIV-positive, approximately three-fourths (74.7%,) were men who have sex with men (MSM). These findings with regard to MSM are consistent with AIDS epidemiology for the County. Approximately forty-six percent of HIV-positive MSM reported using drugs excluding marijuana, 22.0% reported crystal methamphetamine use, and 65.9% reported inconsistently using condoms for anal sex. MSM who were HIV-positive were almost twice as likely to use crystal methamphetamine than MSM who were HIV-negative (OR 1.80, CI 1.36, 2.39). HIV-positive MSM who used crystal methamphetamine were more than 3 times more likely to use condoms inconsistently than non-crystal methamphetamine users (OR 3.18, CI 1.72, 5.88). Conclusion: HIV-positive MSM continue to engage in a variety of risk behaviors. These findings demonstrate the need to target MSM living with HIV/AIDS who engage in sexual risk and drug use behaviors with effective prevention strategies including substance abuse treatment.

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