• DSHS HIV/STD Program

    Post Office Box 149347, MC 1873
    Austin, Texas 78714

    Phone: (512) 533-3000

    E-mail the HIV/STD Program

    E-mail data requests to HIV/STD Program - This email can be used to request data and statistics on HIV, TB, and STDs in Texas. It cannot be used to get treatment or infection history for individuals, or to request information on programs and services. Please do not include any personal, identifying health information in your email such as HIV status, Date of Birth, Social Security Number, etc.

    For treatment/testing history, please contact your local Health Department.

    For information on HIV testing and services available to Persons Living with HIV and AIDS, please contact your local HIV services organization.

Epi Profile Section 8 - Indicators of HIV Risk in HIV-negative Persons at High Risk for HIV

The National HIV Behavioral Surveillance Survey (NHBS) is funded by a grant from the Centers for Disease Control and Prevention (CDC). Its purpose is to conduct behavioral surveillance among those at high risk of HIV infection. The data collection is completed in rotating, annual cycles in three different populations at elevated risk for HIV: men who have sex with men (MSM), people who inject drugs (PWID), and heterosexual women at an increased risk of HIV (HET).

Data in this section comes from the Dallas data collection site of the NHBS. This information may not reflect the state as a whole. For more information, please see the section Data Sources and Notes.



Table 8-1. HIV Risk Behaviors in HIV-Negative MSM, Dallas, 2014, Unweighted

MSM

Average number
of male sex
partners in
past 12 months

Had condomless anal sex with a male partner in the past 12 months

Had condomless anal sex with a male partner whose HIV status was unknown in the past 12 months

Used injection or non-injection drugs in the past 12 months

Had condomless anal sex with an HIV-positive partner in the past 12 months

Self-reported syphilis infection in the past 12 months

N

N

N

%

N

%

N

%

N

%

N

%

Race/Ethnicity

White

141

8

89

63%

25

18%

83

59%

13

9%

52

37%

Black

111

5

60

54%

25

23%

59

53%

3

3%

30

27%

Hispanic

86

6

54

63%

21

24%

47

55%

3

3%

33

38%

Other

26

6

20

77%

8

31%

20

77%

0

0%

11

42%

Total*

368

7

227

62%

79

21%

211

57%

19

5%

129

35%

Age

15-24

65

8

41

63%

13

20%

41

63%

4

6%

25

38%

25-34

116

8

82

71%

34

29%

65

56%

10

9%

50

43%

35-44

89

5

53

60%

18

20%

50

56%

2

2%

33

37%

45+

98

5

51

52%

14

14%

55

56%

3

3%

21

21%

Total

368

7

227

62%

79

21%

211

57%

19

5%

129

35%

* Four participants whose race/ethnicity was missing were included in the total

  • Among the 368 HIV-negative MSM surveyed in 2014, 62% had condomless anal sex with a male partner, 57% used injection or non-injection drugs, and 21% had condomless anal sex with a male partner whose HIV status was unknown within the past 12 months. Only 5% reported having condomless anal sex with a partner living with HIV in the past 12 months. Thirty-five percent reported having syphilis in the past 12 months.

  • In Texas, young black MSM experience the highest rates of new HIV diagnoses (see Section 10 Men who have Sex with Men ). However, NHBS data indicates White MSM and Hispanic MSM in Dallas are more likely to engage in behaviors that increase the opportunities for acquiring HIV compared to Black MSM. Results show that 63% of White MSM and 63% of Hispanic MSM had condomless anal sex compared to 54% of Black MSM. Furthermore, 9% of White MSM had condomless anal sex with a partner living with HIV compared to 3% of Black MSM and 3% of Hispanic MSM.

  • In general, risk behavior among MSM decreases with age. A lower proportion of respondents 45 years of age or older had condomless anal sex (52%), had condomless anal sex with a male partner whose HIV status was unknown (14%), or had condomless anal sex with a partner living with HIV (3%) compared to those in the younger age groups.


Table 8-2. HIV Risk Behaviors in HIV-Negative Persons who Inject Drugs, Dallas, 2015, Unweighted

People who Inject Drugs

Average
number of
sex partners
in the past
12 months*

Shared needle in past 12 months

Sharing of drug paraphernalia in past 12 months

Exchanged money or drugs for sex in past 12 months

Had condomless sex in the past 12 months

N

N

N

%

N

%

N

%

N

%

Race/Ethnicity

White

86

4

46

53%

51

59%

13

15%

66

77%

Black

390

3

81

21%

203

52%

79

20%

253

65%

Hispanic

20

3

9

45%

13

65%

3

15%

16

80%

Other

13

3

6

46%

8

62%

2

15%

7

54%

Total

509

3

142

28%

275

54%

97

19%

342

67%

Age

15-24

12

6

6

50%

8

67%

4

33%

11

92%

25-34

60

5

27

45%

32

53%

8

13%

54

90%

35-44

71

7

24

34%

40

56%

14

20%

56

79%

45+

366

2

85

23%

195

53%

71

19%

221

60%

Total

509

3

142

28%

275

54%

97

19%

342

67%

* This analysis excludes females who inject drugs who reported sex exclusively with other females

  • Although persons who inject drugs (PWID) comprise only 6% of new HIV diagnoses in Texas, HIV-negative PWID remain at an elevated risk of HIV. Over 70% of HIV-negative PWID recruited for this survey were over the age of 45 and 77% were Black. This is in stark contrast to the race/ethnic and age breakdown of those newly diagnosed. Among those newly diagnosed in 2016, only 36% were Black and 21% were over the age of 45.

  • Injecting substances increase the risk of HIV transmission through the transfer of blood and body fluids through needles and injection equipment. Additionally, certain injectable drugs lower inhibition and can increase the likelihood of engaging in behaviors that increase the opportunities for acquiring HIV. Among people who inject drugs in Dallas, respondents reported (within the last 12 months) sharing needles (28%) or other injection equipment (54%), exchanging money or drugs for sex (19%), and having condomless sex (67%). These activities are also risk factors for contracting Hepatitis B and C infections. Both Hepatitis B and C can increase the chance of complications from HIV.

  • As mentioned previously, Blacks were the largest race/ethnic group sampled. Whites more frequently reported sharing needles compared to Hispanics (45%) and Blacks (21%). In addition, 65% of Hispanics shared drug paraphernalia compared to 59% of Whites and 52% of Blacks. Slightly more Blacks (20%) exchanged money or drugs for sex compared to all other race/ethnic groups (15% for each).

  • In general, risk behavior among PWID decreases with age. A lower proportion of respondents 45 years of age or older shared needles (23%) or drug paraphernalia (53%) compared to their 18 to 24-year-old counterparts (50% and 67%). Fewer older respondents exchanged money or drugs for sex (19%) compared to those 18 to 24-years-old (33%). Finally, fewer older respondents had condomless sex (60%) compared to those 18 to 24-years-old (92%).


  • Table 8-3. HIV Risk Behaviors in HIV-Negative in High Risk Heterosexuals, Dallas, 2013, Unweighted

    High Risk Heterosexuals*

    Average number
    of sex partners
    of the opposite sex
    in the past
    12 months

    Had condomless sex with a partner of the opposite sex in the past 12 months

    Exchanged money or drugs for sex in past 12 months

    Had condomless sex with an HIV-positive partner in the past 12 months

    N

    N

    N

    %

    N

    %

    N

    %

    Race/Ethnicity

    White

    22

    5

    12

    55%

    3

    14%

    83

    59%

    Black

    467

    4

    195

    42%

    103

    22%

    59

    53%

    Hispanic

    49

    2

    22

    45%

    3

    6%

    47

    55%

    Other

    7

    6

    4

    57%

    1

    14%

    20

    77%

    Total

    545

    3

    233

    43%

    110

    20%

    211

    57%

    Age

    15-24

    107

    3

    49

    46%

    11

    10%

    0

    0%

    25-34

    164

    3

    57

    35%

    25

    15%

    0

    0%

    35-44

    93

    4

    43

    46%

    27

    29%

    0

    0%

    45+

    181

    3

    84

    46%

    47

    26%

    1

    1%

    Total

    545

    3

    233

    43%

    110

    20%

    1

    0%

    * For HIV surveillance purposes, a high risk heterosexual is a male or female whose sexual partners are known to be HIV-infected or at high risk for HIV (partner has a history of sexual contact with bi-sexual male for females, exchanging money or drugs for sex, IDU, hemophiliacs, HIV+ transfusion recipients, or other HIV+ persons of unknown risk).

    • Persons who acquired HIV through heterosexual contact comprise 22% of new HIV diagnoses in Texas. Forty-three percent heterosexual study participants reported having condomless sex with a partner of the opposite sex. Twenty percent exchanged money or drugs for sex in the past 12 months. Only one respondent reported having condomless sex with a person living with HIV within the last 12 months.

    • In the HRH cycle of data collection, 85% percent of survey respondents were Black, compared to 56% of heterosexuals newly diagnosed with HIV in Texas. Given the high proportion of Black persons in the study population, these data may not be reflective of all risk behaviors among heterosexuals in Texas.

    • Age appears unrelated to patterns in condomless sex as it was reported by 46% of those 18-24 years of age and by 46% of those 45 years of age or older. Furthermore, older respondents were more likely to report exchanging sex for money or drugs.


    Epi Profile

    Table of Contents | 1. Executive Summary | 2. New HIV Diagnoses | 3. Persons Living with HIV | 4. Co-Morbidities | 5. HIV/AIDS Deaths | 6. HIV Incidence | 7. Focused and Routine HIV Testing | 8. Indicators of HIV Risk in HIV-negative Persons at High Risk for HIV | 9. Indicators of HIV Risk in PLWH Currently in Care | 10. Men Who Have Sex With Men (MSM) | 11. HIV Treatment Cascade | Data Sources and Notes


Last updated December 21, 2017