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Tracey E. Wilson, PhD, Mary Elizabeth Gore, PhD, Ruth Greenblatt, MD, Mardge Cohen, MD, Howard Minkoff, MD, Sylvia Silver, DA, Esther Robison, PhD, Alexandra Levine, MD and Stephen J. Gange, PhD

Tracey E. Wilson and Howard Minkoff are with the State University of New York Downstate Medical Center, Brooklyn, NY. Mary Elizabeth Gore and Stephen J. Gange are with Johns Hopkins University, Baltimore, Md. Ruth Greenblatt is with the University of California, San Francisco. Mardge Cohen is with Cook County Hospital, Chicago, Ill. Sylvia Silver is with the George Washington University Medical Center, Washington, DC. Esther Robison is with Montefiore Medical Center, Bronx, NY. Alexandra Levine is with the University of Southern California School of Medicine, Los Angeles, Calif.

Correspondence: Requests for reprints should be sent to Tracey E. Wilson, PhD, Department of Preventive Medicine and Community Health, State University of New York, Downstate Medical Center, Box 1240, 450 Clarkson Ave, Brooklyn, NY 11203 (e-mail: tracey.wilson{at}downstate.edu).

Objectives. We assessed the association between initiation of highly active antiretroviral treatment (HAART) regimens and sexual risk behaviors among HIVinfected women.

Methods. We analyzed data from 724 women who initiated HAART between January 1996 and January 2001 and who had pre-HAART viral loads at or above 400 copies per milliliter.

Results. Sexually active women were less likely (odds ratio [OR] = 0.79) to report 2 or more partners during a 6-month period after HAART initiation than before HAART initiation. However, the risk for unprotected sex was higher after HAART initiation than before HAART initiation among all sexually active women (both those who reported 2 or more partners [OR = 1.84] and those who reported 1 partner [OR = 1.22]).

Conclusions. Sexual risk behaviors are associated with receipt of therapy but not with therapeutic response, indicating a risk for transmission among female HAART recipients.

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