Seroprevalence, risk factors and attitude to HIV-1 in a representative sample of lesbians in Turin

Abstract

Objective - To estimate the HIV-1 seroprevalence, behavioural risks and attitude to HIV-1 infection among lesbians. Setting - Institute of Infectious Diseases, University of Turin, Italy. Subjects - From March 1992 to May 1993, 181 lesbians were tested for HIV-1 and included in the study. Methods - Sociodemographic details, nonsexual risks for HIV-1, sexual behaviour, STD history and attitude to HIV-1 were obtained from an anonymous, standardised, self-administered, 30-item questionnaire. Snow-ball techniques were used to recruit the largest possible number of participants. Results - 11 lesbians (6.1%) were found to be HIV-1 antibody positive. Of them, 10 were intravenous (IV) drug users. STD episodes were higher among lesbians with HIV-1 than without (p = 0.04), increasing in both groups over time. Syphilis, genital herpes and viral hepatitis were highly associated with HIV-1 (p = 0.000). In univariate analysis, IV drug use, bisexual behaviour, history of STDs, sex during menses and vaginal/anal manipulation were significantly linked to HIV- 1 (p = 0.000). In multivariate analysis only history of IV drug use (p = 0.04) and bisexual behaviour (p = 0.06) remained independently associated with HIV-1. Seventy-one participants (39.3%) had already undergone AIDS testing. Only 3.5% admitted to be at risk for HIV-1 and 11% changed their sex habits after first hearing of AIDS. No lesbian had ever practised safe-sex. Television was the most important source of information on HIV-1 (84%). Conclusion - IV drug use was the most likely means of HIV-1 infecting the lesbians of Turin. The high rate of STDs and the low perceived risk to HIV-1 require programmes of STD prevention and AIDS information to be targeted at the lesbian community.