Recorded presentation

Matthew Hogben, PhD, Centers for Disease Control and Prevention (CDC), 1600 Clifton Road, Mailstop E-44, Atlanta, GA 30333, 404/639-1833, yzh5@cdc.gov

Risks for STD/HIV acquisition are discernable at individual, partnership, and group levels. The object of this talk is to present a selection of such factors with illustrative data and inferences to link various levels of data. At the individual level, one reliable correlate of STD acquisition is the number of sexual partners. Appropriate measurement of condom use, including correct use and measuring whether the partner is infected, also yields improved estimates of condoms’ protective value. Individual STD avoidance strategies may have some impact on disease acquisition, as may other individual mental processes. Modeling relationships among such cognitive and behavioral variables is often the simplest comprehensive presentation of data. Partners’ attitudes toward safer sexual behaviors not only influence behaviors such as condom use, but can even moderate the influence of one’s own attitudes. Other partnership level risk factors include post-diagnosis factors such as willingness to notify partners. Individual risk can be nested within partnership level data, for example, individual infection within dyadic infection. When one cannot capture such data, egocentric data remain a useful substitute. The same sexual behaviors among non/weakly interacting groups with different STD prevalences connote different levels of risk, for which population variables like age and race are markers. Prevailing group behavioral norms also influence behavior and therefore comprise risk factors for differential STD acquisition by group. Other group level risk factors include indirectly related factors such as health care access. Hierarchical modeling helps connect group-level data with those collected from individuals.

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