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Concerns about HIV and sexually transmitted infection among low-risk and high-risk women, Puerto Rico.

In this study, the RESPECT-2, an HIV risk reduction intervention developed by the Centers for Disease Control and Prevention, was translated into Spanish and culturally adapted to the Puerto Rican population. A new intervention emerged called the RReduC-PR (Risk Reduction Counseling-Puerto Rico). This instrument allows the assessment of sexual behaviors and development of risk reduction plans. Women from three distinct risk behavior groups participated: women recruited from a community-based organization (CBO), which includes street sex workers, crack users, and sexual partners of intravenous drug users; participants from a sexually transmitted infection (STI) clinic; and participants from a family planning clinic (FPC) in Puerto Rico. As part of the RReduC-PR, participants were provided counseling before and after a rapid HIV test to explore their attitudes about sexual behaviors. At baseline, all participants from the FPC reported having monogamous relationships (100%), as compared with the participants from the STI clinic (70%) and those from the CBO (20%). STI risk-reduction behaviors varied by site. Most of the participants acknowledged risk behaviors that may have exposed them to HIV. They did not use condoms, or used them inconsistently, even though acquiring HIV was a great concern for them. Most regarded a positive HIV diagnosis as a negative event. Their attitudes toward an HIV diagnosis varied by site. The groups varied in the perception of risk behaviors, knowledge, and concerns. These findings provide useful information for future risk-reduction interventions with these women.