HIV TRANSMISSION RISKS AMONG WOMEN IN ONE MID-ATLANTIC U.S. CITY

In 2012 in Baltimore City, more than one third of reported HIV diagnoses among women were associated with a high-risk heterosexual contact (HET) and approximately half were not associated with any reported exposure (NRR); the remaining diagnoses were associated with injection drug use (IDU) transmission risk. There is limited information on the differences between women who acquire HIV via known heterosexual exposure versus women who report no exposure risk. The objective of this study was to determine the extent to which women classified as having high-risk heterosexual contact (HET) or injection drug use (IDU) transmission risk were similar to or different from women without a defined exposure category (NRR). The study population included women newly diagnosed with HIV as reported to the Baltimore City Health Department (BCHD) between January 2009 and June 2014 with complete interview records and a valid address within Baltimore city (n=357). We examined the distribution of demographic characteristics, substance and sexual risk behaviors and neighborhood-level factors associated with classification of NRR versus HET/IDU/CSW using t-tests, Chi-square tests and Fisher’s exact tests, as appropriate. Reported addresses were geocoded, mapped and tested for hot spots in order to determine if there was geographic clustering of diagnoses by exposure category. Overall, both classification categories appeared to have similar distributions of demographic, risk behaviors and neighborhood characteristics. There did not appear to be different patterns of geographic distribution by exposure category. Women who are classified as NRR appear similar to those who report risk factors that lead to classification as HET/IDU/CSW. As exposure categories reveal salient information about epidemic characteristics, more research should be undertaken to understand heterosexual transmission in this population