Molecular mechanism of limb muscle patterning

A national household survey of a representative sample of 9,984 individuals aged 15 years or over, carried out in 1996 using a combination of face-to-face interviews and self-completion questionnaires, was analyzed in order to describe the frequency of HIV sexual risk behaviours and condom use in Spain. Of a total of 8,101 persons (81%) who completed the questionnaire, 37% reported no sexual partner during the previous 12 months, 57% reported one partner and 6% reported more than one partner. Three per cent reported engaging in HIV sexual risk behaviour (i.e. more than one partner and failure to use a condom systematically), a pattern of behaviour which showed independent positive association with the male sex, an age of 20-59 years and being unmarried. Among those who had casual sexual partners during the preceding 12 months, 38% had always used condoms. In the multivariate analysis, failure to use a condom systematically with casual partners was associated with a higher age and being married. Of those who had regular partners during the previous 12 months, 26% had always used condoms, a finding associated with a lower age, higher educational level, unmarried status and non-cohabitation with the sexual partner. This survey has furnished some useful indicators for prevention purposes. Periodic repetition of this survey would enable possible changes in sexual risk behaviours to be detected.     

Risk of human immunodeficiency virus infection among pregnant crack cocaine users in a rural community

OBJECTIVE: To investigate why women who use crack cocaine are at increased risk of human immunodeficiency virus (HIV) infection. METHODS: One thousand one hundred fifty-two (99.7%) of 1155 consecutive prenatal patients attending a rural public health clinic were interviewed about drug use and sexual practices and tested for HIV infection and other sexually transmitted diseases. RESULTS: Fifty-one (4.7%) of 1096 pregnant women reported ever using crack cocaine, but only five (10%) of the crack cocaine users had ever injected drugs. Eighteen (35%) of the crack users were HIV infected compared with 22 (2%) of the 1045 women who reported never using crack (odds ratio 25, 95% confidence interval 12-52; P < .001). Crack users were more likely to have had a known HIV-infected sex partner, exchanged sex for money or drugs, and tested positive for syphilis than were non-crack users (for each comparison, P < .001). Before using crack, 18% of crack users had exchanged sex for money or drugs and 8% had averaged three or more sex partners per month; in contrast, after beginning to use crack, 76% of crack users exchanged sex for money or drugs and 63% averaged three or more sex partners per month (for both comparisons, P < .001). Crack users who were not HIV infected were more likely to have almost always used condoms and/or had fewer than three sex partners per month than were HIV-infected crack users (P < .01). CONCLUSION: Women who reported using crack cocaine were at an increased risk of HIV infection because crack use was associated with a significant increase in unprotected sexual contact.     

Sexual lifestyle of long distance lorry drivers in India: questionnaire survey

This article presents a study on the sexual lifestyle of long distance lorry drivers in India. Using a questionnaire survey method, a total of 5709 consecutive long distance lorry drivers were interviewed by three trained investigators between March 1994 and August 1994. Results showed that 87% (4949 men) of subjects were sexually promiscuous, of whom only 11% (563) used condoms during commercial sex. The percentage using condoms decreased with increasing age. In the 21-30 age group (n = 1766), 78% of unmarried sexually promiscuous men (331/425) reported having 31-60 sexual partners during the past 12 months. In addition, a significantly higher proportion of men over age 40, compared with men under age 21, were sexually promiscuous and abused alcohol and a lower proportion had AIDS knowledge (P 0.001). In the context of infection of sexually transmitted diseases (STDs), responses of long distance lorry drivers suggest that they are highly vulnerable and are crucial in spreading STDs and HIV infection throughout the country in a short time. Thus, research is urgently needed to find effective strategies to persuade lorry drivers to change their risky sexual behavior.     

Human immunodeficiency virus seroprevalence and condom use among female sex workers in Italy

BACKGROUND AND OBJECTIVES: In two different studies, we evaluated the human immunodeficiency virus (HIV) seroprevalence rate and the condom use in a group of female sex workers working in Italy. STUDY DESIGN: In the first study we collected data on HIV serologic testing of female sex workers; in the second study, we evaluated the use of condoms and high-risk sexual practices by sex workers with their clients and nonpaying partners. RESULTS: Overall, 131 of 802 (16%) were HIV positive: 36 of 558 (6%) professional sex workers and 95 of 244 (39%) sex workers who used intravenous drugs. There was a significant increase of seroprevalence among professional sex workers between 1988 to 1990 and 1991 to 1995 (2% versus 11%, P < or = 0.001), whereas among the sex workers who used intravenous drugs, the increase was not significant (37% versus 40%, P = 0.70). Similarly, the HIV seroprevalence in the Italian professional sex workers is constant in the two periods of time (2% versus 1%). In the second study, 97 of 102 (95%) sex workers reported regular condom use with clients, whereas 63% of sex workers reported they never used them with nonpaying partners. Fourteen sex workers reported having nonpaying partners who used intravenous drugs and 6 reported having nonpaying bisexual partners; 8 of these 20 partners were HIV positive. CONCLUSION: The results of the first study showed a significant increase of seroprevalence among professional sex workers, whereas the high seroprevalence among sex workers who used intravenous drugs was constant. The results of the second study showed that sex workers may be at higher risk for HIV infection through noncommercial sexual intercourses.     

Contact tracing as a part of HIV infection prevention. Current practice and attitudes of general practitioners and hospital physicians; preliminary results

All doctors that had reported a newly-identified HIV infected person to the national HIV surveillance unit during a nine months period were traced and interviewed for one year later. The results of the interviews that related to 102 out of 195 (52%) reports were compared between the 48 interviewed general practitioners (GPs) and the 33 interviewed hospital doctors (HDs). Both GPs and HDs found it difficult to give a positive HIV test result and wanted to co-work with trained counsellors for the partner notification (PN) process. It was neither a routine for all GPs nor for all HDs to ask the patients about sexual behaviour and to discuss safe sex, and screening for other STD's was rarely performed. The number of partners notified was low. HIV reporting doctors in Denmark seem motivated for PN. The outcome of PN can only be measured to a certain level as long as exposed partners are neither obliged to be tested nor to be counselled and as long as information about counselling and testing can not be shared between doctors in different settings.     

Impact of combination therapies on HIV risk perceptions and sexual risk among HIV-positive and HIV-negative gay and bisexual men.

The availability of improved HIV treatments may prompt reduced concern about HIV and sexual risk. Gay and bisexual men (N?=?554, 17% HIV-positive) completed measures of treatment attitudes, sexual risk, and assumptions regarding the infectiousness of sexual partners. A substantial minority reported reduced HIV concern related to treatment advances. Reduced HIV concern was an independent predictor of sexual risk, particularly among HIV-positive men. In response to hypothetical scenarios describing sex with an HIV-positive partner, participants rated the risk of unprotected sex to be lower if the partner was taking combination treatments and had an undetectable viral load, relative to scenarios with a seropositive partner not taking combination treatments. Prevention efforts must address attitudinal shifts prompted by recent treatment successes, stressing the continued importance of safer sex, and that an undetectable viral load does not eliminate infection risks. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

HIV serostatus disclosure among gay and bisexual men in four American cities: general patterns and relation to sexual practices

The present study examined patterns of serostatus disclosure among previously untested HIV-seropositive and HIV-seronegative gay and bisexual men recruited from four American cities (n = 701). Six months after learning their HIV serostatus, 97% of study participants had disclosed their test results to at least one other individual. Consistent with earlier studies, test results were most frequently shared with friends and the respondent's primary partner. HIV serostatus was disclosed less frequently to family members, co-workers, and non-primary sex partners. Compared with HIV-seronegative men, HIV-seropositive men were more likely to have disclosed their status to a health care provider and less likely to have shared this information with family members. Of seropositive men, 11% did not disclose their serostatus to their primary partner and 66% did not disclose to a non-primary sex partner. Of HIV-seropositive men with one or more non-primary partners, 16% of those who did not disclose their serostatus reported inconsistent condom use during anal intercourse with these partners. No significant differences in self-reported sexual practices were observed for HIV-seropositive disclosers versus non-disclosers. Compared with HIV-seronegative men who did not disclose, seronegative men who shared information about their serostatus were more likely to have had receptive anal intercourse with their primary partner (p < 0.05) and to have engaged in mutual masturbation (p < 0.005), receptive oral sex (p < 0.005) and insertive anal intercourse (p < 0.05) with non-primary partners. No significant differences were observed between disclosers and non-disclosers with regard to condom use. Implications of the findings for future research and HIV prevention programmes are discussed.     

Changes in attitude, sexual behaviour and the risk of HIV/AIDS transmission in southwest Nigeria

This pilot study was carried out in southwest Nigeria to determine the current trends in sexual behaviours known to be associated with HIV transmission in Nigeria. Knowledge of AIDS in general and as an incurable disease was high (91.4% and 79.4% respectively). Knowledge of the means of AIDS transmission was also very high among both men and women. Overall, condom use was consistent at 25%, inconsistent at 55% and non-existent at 20% for all sexually active respondents. Over 60 per cent of sexually active respondents had two or more sexual partners, with significantly more males than females having this number of sexual partners (p < 0.01). Eighteen per cent of sexually active respondents had a history of sex with commercial sex workers while 25% had a history of at least one sexually transmitted disease. Using multiple logistic regression, the significant determinants of condom use among the sexually active group were: being in a stable sexual relationship, history of sex with commercial sex workers, self-perception of testing positive for HIV and self-perception of HIV/AIDS risk in Nigeria. Prevalence of condom use in this study was much higher than those reported in previous studies, suggesting a probable decline in high risk sexual behaviours among inhabitants of urban Southwest Nigeria since the advent of AIDS. Most sexually active respondents aged 19 years or below (adolescents) who perceived themselves at a high risk of testing positive for HIV had never used condoms. The non usage of condoms among this group of adolescents is disturbing, since they are at greatest risk of spreading the disease. Health education and promotion of safe sex practices need to be extensively targeted at adolescents.     

Multiple sexual partners among U.S. adolescents and young adults

CONTEXT: Because many teenagers and young adults fail to use condoms correctly and consistently, the number of sexual partners they have is an important risk factor for sexually transmitted diseases, including HIV. Identifying factors that are associated with having multiple partners can help in the design of disease interventions. METHODS: Data on 8,450 males and females aged 14-22 who participated in the 1992 Youth Risk Behavior Survey were used to examine the prevalence of and factors associated with young people's having multiple partners. RESULTS: In all, 63% of female respondents and 64% of males were sexually experienced. Among those who had had sex during the three months before the survey, 15% and 35%, respectively, had had two or more partners during that period. At each age, the majority of sexually experienced respondents had had more than one lifetime partner; between ages 14 and 21, the proportion who had had six or more rose from 8% to 31% among females and from 14% to 45% among males. In logistic regression analyses, alcohol use, illicit drug use and young age at first coitus were associated with increased odds that females had had two or more partners in the previous three months, and being married lowered the odds; black or Hispanic race or ethnicity, alcohol use and young age at first coitus increased the odds for males, and being married reduced the odds. As the number of reported alcohol-related behaviors increased, the adjusted proportion of respondents who had recently had multiple partners rose from 8% to 48% among females and from 23% to 61% among men. CONCLUSIONS: The strong association between alcohol use and having multiple sexual partners underscores the need to educate young people about the effects of alcohol on partner choice and the risk of infection with sexually transmitted diseases.     

Sexual behaviour among London GUM clinic attenders: implications for HIV education

The aim of this study was to describe the sexual behaviour of a sample of genitourinary medicine (GUM) clinic attenders, 5 years after the launch of the UK government HIV media campaigns. A gender-specific and anonymous cross-sectional self-completion questionnaire was modified from the National Survey of Sexual Attitudes and Lifestyle and completed by 250 men and 250 women. The majority of the respondents were in their twenties, lived in London and were employed or students. Sixty-eight per cent of the men reported that one or more of their last 3 partners was not a regular partner. For those men whose last sexual encounter was with a new partner, 27% of heterosexuals and 33% of homosexuals reported using a condom. Fifty-one per cent of women reported one or more non-regular partners among their last 3 partners. For those women whose last sexual encounter was with a new partner, 43% of heterosexuals and 75% of bisexuals used a condom. Seventy-eight per cent of men and 75% of women had had a previous sexually transmitted disease (STD). These findings highlight the persistence of practices associated with the risk of contracting or transmitting HIV infection and which needs to be addressed in future educational campaigns. The GUM clinic population is an important population to monitor over time, either by longitudinal or serial cross-sectional studies. The results of this study provide a baseline against which to gauge the effects of future educational interventions.     

Transmission of acquired immunodeficiency syndrome among intravenous drug abusers in Belgrade

The prevalence of HIV infection among intravenous drug addicts (IVDAs) was 11% in Belgrade in 1997 (500 IVDAs). There are only two ways of transmission of HIV infection among IVDAs: the use of contaminated needles and syringes and sexual intercourse with an infected partner. We established in the counselling office for IVDAs that only 47.8% of them were injected with their own devices, 43% shared somebody's equipment, and 9.2% used other routes for drug taking. Condoms or safe sex were exceptional. Only 10.17% used condoms regularly; 12.5% from time to time and 77.32% never. Among 391 interviewed IVDAs 7% were not sexually active during the last year, 40% had one constant partner, 32% had intercourses with 2 to five partners, and 21% were promiscuous (more than 5 partners over one year). Fifty five were seropositive against HIV. Ten of them were promiscuous and used no condom. There is some evidence that the majority of IVDAs after twelve years of post seroconversion (average age between 35 and 45), stopped their sexual activity. The prostitution of female IVDAs in order to finance their own and their partners supply of drugs is found in 3% of cases. This study can be helpful in implementing a selective and individual approach to some IVDAs with risk behaviour, who accept treatment, to prevent the spreading of infection.     

Sexual HIV risk behaviour among men who have sex with both men and women

The aim of this study was to describe the sexual behaviour of men who had sex with both men and women in the preceding five years (behaviourally bisexual men), specifically to examine their needs in relation to HIV prevention. Anonymous telephone interviews were carried out with respondents recruited though advertisements in UK newspapers and magazines with (sexual) 'personal' or 'contact' sections. Data are reported from 745 respondents. Respondents report relatively high and approximately equal numbers of male and female sexual partners in the year preceding interview. There is a clear patterning of sexual activity by type of partner (regular or casual). A high proportion report anal intercourse with female and male partners. A third disclose their homosexual practices to regular female partners. Although self-reported HIV seroprevalence is low (less than 1%), the levels of unprotected sex with multiple sexual partners indicate substantial potential for transmission of sexually transmitted infections, including HIV. While low seroprevalence suggests that there is little overlap with existing core groups of HIV infection, the study provides information to judge the priority of targeting HIV prevention initiatives and suggests ways in which initiatives could be undertaken.     

Individual and situational markers of condom use and sex with nonprimary partners among alcoholic inpatients: Findings from the ATRISK Study.

Alcoholics in treatment have demonstrated increased rates of HIV risk behavior and infection. This study explored individual and situational variables associated with HIV risk behaviors such as condom nonuse and sex with nonprimary partners reported during structured interviews of 802 male and female alcoholic inpatients. Logistic regression analyses indicated that person variables, sexual history variables, and situation variables were independently associated with sexual risk behavior in the most recent episode. Results of paired t tests revealed that participants who had engaged in sex with both primary and nonprimary partners during the previous 6 months reported significantly more frequent alcohol and condom use in situations involving sex with nonprimary partners. Prevention efforts need to target alcoholic inpatients as a group and, within this group, to focus on both high-risk individuals and high-risk situations. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Trends in attitudes and behaviour relevant to AIDS in Ugandan community

Behaviour-related preventive measures are still the main weapon against the spread of AIDS. Intensive AIDS prevention and control activities conducted over the last ten years need to be evaluated on the basis of their impact on attitudes and behaviour relevant to AIDS. The main objective of this study was to document and evaluate trends in attitudes and behaviour relevant to AIDS in a Ugandan community over a seven year follow up period. The study was a longitudinal community-based closed cohort. Periodic surveys were conducted on the study group and data on condom use, attitudes about condoms, rates of sexual partner change and reported frequency of sexually transmitted diseases were collected in all surveys. Data reported are from surveys conducted during 1987, 1992 and 1994 in which similar questions were asked and emerging trends identified. Reported condom use ever, increased from 3.9% in 1987 to 10.1% in 1992 and to 27.2% in 1994. This is a 7.3 fold increase over seven years. In females, reported use of condoms increased from 1.2% in 1987 to 18.2% in 1994 while in males it increased from 6.9% to 35.3% over the same period. In this study group there are still more people opposed to the ongoing intensive condom campaign than there are those supporting it. The percentage supporting the campaign was 28% in 1987, 26% in 1992 and 40.8% in 1994. This is a rising trend. The rate of sexual partner change has declined. During the baseline survey, 26.5% of the respondents reported that they had intercourse with two or more sexual partners in the six months period before the interview. This proportion decreased to 6.8% in 1992 but then increased to 17.1% in 1994. During the baseline survey, 2.6% of the study group reported that they had sexual intercourse with six or more partners during the six months period before the interview but during the 1992 and 1994 surveys, no one reported sexual intercourse with more than five partners during a similar period. The reported frequency of sexually transmitted diseases during a twelve month recall period, reflecting STD incidence, decreased from 3.5% in 1992 to 1.9% in 1994. In conclusion during the seven year followup period of this community-based closed cohort, we have identified a sharp increase in condom use, a reduced rate of sexual partner change and a decline in the reported frequency of sexually transmitted disease. The percentage of people supporting the condom campaign is rising. These are some of the outstanding outcomes of the AIDS prevention activities conducted in the country over the last 10 years.     

Gender differences in risk behaviors among HIV+ persons with an IDU history. The link between partner characteristics and women's higher drug-sex risks. The Manif 2000 Study Group

BACKGROUND AND OBJECTIVES: Risk-taking behaviors differ among women and men injection drug users (IDU). GOAL: To specify the nature of sexual and drug risk-taking among women IDU and ex-IDU and how it relates to partner characteristics. DESIGN: A cross-sectional analysis of 324 HIV+ subjects enrolled into a prospective cohort study in Marseille, France. RESULTS: Women, as compared with men, were considerably more likely to report nonuse of condoms with a main partner (31% versus 12%). They were more likely to shoot with a partner at last injection (39% versus 12%), but far less likely to sterilize used needles (4% versus 16%). Two thirds of both men and women reported consistent condom use with a seronegative partner, but only 47% of men and 23% of women reported the same with a seropositive partner. Among the women only, needle and syringe sharing was associated with consistent use of a condom. CONCLUSIONS: Women reported behaviors which protect their partners from STD infection more frequently than behaviors which protect themselves. Greater attention must be paid to sexual risk-taking among HIV+ women.     

Prevalence of hepatitis B virus markers among intravenous drug abusers in Stockholm: impact of heterosexual transmission

In order to study the importance of sexual transmission of hepatitis B virus (HBV) among intravenous drug abusers (IVDAs), and from IVDAs to others, we consecutively interviewed 171 IVDAs detained at the Stockholm Remand Prison during 4 months in 1990. Sexual histories revealed that 77% reported > or = 3 sexual partners during the last 3 years, 64% had had a sexual partner who did not inject drugs, and 61% reported a prior STD. The prevalence of HBV markers was 75%. In a multiple logistic regression analysis, a high risk for HBV markers was associated with an increasing duration of drug abuse, a high prevalence of hepatitis A markers, and an increasing number of drug injecting sexual partners during the last 3 years, indicating that sexual transmission, along with sharing of needles, may contribute to the high prevalence of HBV markers within this group. It is suggested that an adequate sexual history must be obtained from IVDAs with acute viral hepatitis in order to identify sexual partners who should be offered postexposure prophylaxis, and that non-immune IVDAs should be vaccinated against viral hepatitis A and B.     

Close relationships and elevated HIV risk behavior: Evidence and possible underlying psychological processes.

A review of research on AIDS preventive behavior indicates that minority and nonminority heterosexual adolescents and adults, gay men, injection drug users, and commercial sex workers are all less likely to practice safer sex with close relationship partners, compared with partners they perceive to be "casual" sexual partners. Because many individuals in close relationships have engaged in HIV risk behavior over extended periods of time and are unaware of their actual HIV status, practicing unprotected sexual intercourse with a committed relationship partner who is not tested for HIV appears to be a major and unrecognized source of HIV risk. This article reviews the evidence for higher levels of HIV risk behavior in close relationships and then presents relevant conceptual and empirical work to explore the psychological processes that may underlie risky sexual behavior in close relationships, using as a framework the information-motivation-behavioral skills model of preventive behavior. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Risk factors and clinical presentation of acute primary HIV infection in India

CONTEXT: Most previous studies of clinical presentation and risk factors in early human immunodeficiency virus (HIV) infection have relied on retrospective analyses and referred seroconverters, and thus were subject to possible bias. OBJECTIVES: To apply a method based on measurement of prevalent HIV-1 p24 antigenemia for identification of risk factors for newly acquired HIV infection and to describe the signs and symptoms of acute HIV infection. DESIGN AND SETTING: Nested case-control study in Pune, India. PARTICIPANTS: HIV antibody-negative persons attending 2 sexually transmitted disease (STD) clinics between May 1993 and June 1996. OUTCOME MEASURES: Prevalent p24 antigenemia, risk factors for HIV infection, and clinical symptoms of acute primary HIV infection. RESULTS: Of 3874 HIV antibody-negative persons tested, 58 (1.5%) were p24 antigen positive at initial presentation to the clinics. Unprotected sexual contact with a commercial sex worker (CSW) was reported by 39 (77%) of the 51 p24 antigenemic men, compared with 131 (51 %) of 255 control men (adjusted odds ratio [AOR], 3.4; 95% confidence interval [CI], 1.2-9.6; P=.02). The presence of an active genital ulcer at the time of screening was found in 46 (79%) of the 58 p24 antigenemic men and women, compared with 137 (47%) of the 290 control subjects (AOR, 4.2; 95% CI, 2.0-9.0; P<.001). Signs and symptoms independently associated with p24 antigenemia in HIV antibody-seronegative persons included fever, which was reported by 28 (48%) of the 58 p24 antigenemic subjects, but only 52 (18%) of the 290 control subjects (AOR, 4.7; 95% CI, 2.4-9.0; P<.001). Joint pain was reported by 10% of subjects recently HIV infected, compared with 2% of the control subjects (AOR, 6.5; 95% CI, 1.7-24.8; P=.006). Night sweats were reported by 9% of the p24 antigenemic, but only 1% of the control subjects (AOR, 9.1; 95% CI, 1.7-47.6; P=.009). Overall, fever, joint pain, and/or night sweats were reported in 27 (47%) of the 58 subjects with recent HIV infection. CONCLUSIONS: This systematic case-control study of p24 antigen screening in HIV-seronegative patients attending STD clinics in India identified unprotected sex with a CSW and a genital ulcer as independent risk factors associated with newly acquired HIV infection. In addition, p24 antigen positivity identified recent fever, night sweats, and arthralgias as symptoms that may be predictive of recent HIV infection. In a study of patients attending STD clinics in India, screening for p24 antigen in HIV antibody-negative persons was found to be a reliable and effective research method for determining recent risk behavior and identifying clinical signs of acute primary HIV infection.     

Risk contexts and risk behaviors in the Euregion Maas-Rhein: the Boule de Neige intervention for AIDS prevention among drug users

Using targeted sampling, self-reported data of 1,767 drug users in the Euregion Maas-Rhein were collected over 3 years. Forty-two percent of the injection drug users shared syringes with sexual partners and 47.8% with friends. Eighty-one percent of the total sample had sexual contact in the last 6 months, half of whom with one person and half with two or more. Significant predictors of high-risk drug use were injecting in the presence of others, injection onset before the age of 20, female gender, and not living in The Netherlands. Participation in needle exchange or methadone programs and sufficient knowledge of risk factors was not significantly related to a reduction of high-risk drug use behavior. High-risk sexual behavior was found to be related to male gender, under the age of 30 and to multiple sexual partners. We conclude that in a social context where needle exchange, methadone programs, and sufficient knowledge of risk factors among the drug user population exist, AIDS prevention can be improved through behavioral skills training and developing specific interventions that target the peer group environments, rituals, partner relationships, and lifestyles of drug users.     

Women HIV sexual risk takers: related behaviors, interpersonal issues, and attitudes

HIV and AIDS is a growing health risk for heterosexual women, particularly women of color (Centers for Disease Control and Prevention, 1997). Our research identified 5 types of HIV sexual risk taking in 3 independent samples of adult women from a New England Community: Group A women were noted by low to moderate levels of the 4 risk markers (i.e., unprotected vaginal sex, perceived partner-related risk, number of sexual partners, and unprotected anal sex); Group B women reported very high frequency of unprotected vaginal sex; Group C women were characterized by unprotected anal sex; Group D women had high perceived partner risk; and Group E women reported extremely high levels on all 4 HIV risk markers. Sexual risk groups were validated by demonstrating significant differences among groups on relevant behaviors, interpersonal experiences, and attitudes. Compared to other women, higher risk types reported greater behavioral risk practices (substance use, prostitution, diverse sexual experience), interpersonal risk experiences (sexual abuse, violence), initiation sexual assertiveness, and attitudinal risks (psychosocial distress). They reported less interpersonal assurance (surety of own and partner's HIV status), sexual assertiveness (for condom use and partner communication), psychosocial strengths (sexual self-acceptance), and transtheoretical readiness for change (condom use efficacy, readiness to consider condoms). Results provide additional support for the multifaceted model of HIV risk and the transtheoretical model. Suggestions for specifically focused interventions are given, depending on the pattern of sexual risk taking.