151
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Devos-Comby L, Daniel J, Lange JE. Alcohol Consumption, Dating Relationships, and Preliminary Sexual Outcomes in Collegiate Natural Drinking Groups. JOURNAL OF APPLIED SOCIAL PSYCHOLOGY 2013; 43:2391-2400. [PMID: 26236043 DOI: 10.1111/jasp.12187] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
This study tested the effects of committed relationships and presence of dates on alcohol consumption and preliminary sexual outcomes in natural drinking groups (NDGs). Undergraduate drinkers (N = 302) answered an online questionnaire on their most recent participation in a NDG. The interaction between relationship commitment and presence of a date on alcohol consumption was significant. Among students not in committed relationships, those dating within their NDG reported heavier drinking than those not dating. Students in committed relationships drank less than those who were not committed only when their partners were present. The positive correlation between drinking and sexual contact was significant only for those who were not in committed relationships. Implications for future research and interventions are discussed.
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Affiliation(s)
- Loraine Devos-Comby
- AOD Initiatives Research, Student Health Services & Department of Psychology, San Diego State University
| | - Jason Daniel
- AOD Initiatives Research, Student Health Services & Department of Psychology, San Diego State University
| | - James E Lange
- AOD Initiatives Research, Student Health Services & Department of Psychology, San Diego State University
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152
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Scherer M, Trenz R, Harrell P, Mauro P, Latimer W. The role of drinking severity on sex risk behavior and HIV exposure among illicit drug users. Am J Addict 2013; 22:239-45. [PMID: 23617865 DOI: 10.1111/j.1521-0391.2012.12006.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2011] [Revised: 01/09/2012] [Accepted: 03/05/2012] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVES The current study examined how drinking severity among injection and non-injection drug users is associated with sex risk behaviors and risk of HIV exposure. METHOD The study is a secondary analysis of an investigation of risk factors among drug users in Baltimore known as the NEURO-HIV epidemiologic study. Participants (N = 557) completed an interview, self-reported 30-day alcohol use, lifetime injection and non-injection drug use, and provided blood samples to screen for HIV. Participants were grouped into one of three drinking severity conditions: abstinent (no reported alcohol use in prior 30 days), moderate alcohol use (≤30 drinks for females, or ≤60 drinks for males), or problematic alcohol use (>30 drinks for females, or >60 drinks for males). Drinking severity groups were significantly different on lifetime injection drug use, heroin injection, snorting/sniffing cocaine, and smoking crack. RESULTS Logistic regression analyses found problematic alcohol users to be more likely than alcohol abstainers to inject drugs before or during sex (AOR = 5.78; 95% CI = 2.07-16.10), and more likely than moderate alcohol users to use alcohol before/during sex (AOR = 4.96; 95% CI = 2.09-11.81), inject drugs before/during sex (AOR = 2.96; 95% CI = 1.29-6.80), and to be HIV+ among Black participants (AOR = 2.72; 95% CI = 1.14-6.49). CONCLUSIONS These results outline the necessity for research and clinical intervention among this population to reduce sex risk behaviors and potential HIV exposure, while highlighting the need to examine drinking severity as a predictor of sex risk behaviors.
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Affiliation(s)
- Michael Scherer
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA.
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153
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Hayaki J, Anderson BJ, Stein MD. Sexual risk-taking mediates the association between impulsivity and acquisition of sexually transmitted infections among hazardously drinking incarcerated women. Am J Addict 2013; 21 Suppl 1:S63-71. [PMID: 23786513 DOI: 10.1111/j.1521-0391.2012.00296.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND A growing literature has identified associations between impulsivity and negative behaviors such as sexual risk-taking among high-risk and/or vulnerable populations, but few studies have linked impulsivity to biological outcomes of sexual risk-taking. The main purpose of this study was to document associations among impulsivity, sexual risk-taking, and biological measures of sexually transmitted infection (STI+) in a sample of hazardously drinking incarcerated women. METHODS Two hundred forty-five hazardously drinking incarcerated women self-reported alcohol consumption and consequences, impulsivity, and sexual behavior. RESULTS Biological testing revealed a 22.9% prevalence rate for STI+. In this sample, sexual risk-taking fully mediated the association between impulsivity and likelihood of STI+. In addition, individuals reporting sexual activity with multiple partners were significantly more likely to test STI+ than those reporting sexual activity with a primary partner. CONCLUSION These results support previous research on impulsivity by demonstrating that impulsivity leads to STI+ through risky behavioral choices. These findings also extend prior work by documenting this association using biologically confirmed measures in a vulnerable female population that carries multiple risk factors and thus warrants increased research attention.
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Affiliation(s)
- Jumi Hayaki
- Department of Psychology, College of the Holy Cross, Worcester, MA 01602, USA.
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154
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GUILAMO-RAMOS V, JACCARD J, MCCARTHY K, QUIÑONES Z, LUSHIN V, SKINNER-DAY M, PADILLA M, MEISTERLIN L. Taxonomy of Caribbean tourism alcohol venues: implications for HIV transmission. Drug Alcohol Depend 2013; 132:238-43. [PMID: 23478154 PMCID: PMC3724765 DOI: 10.1016/j.drugalcdep.2013.02.010] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2012] [Revised: 02/06/2013] [Accepted: 02/06/2013] [Indexed: 11/24/2022]
Abstract
BACKGROUND Tourism areas represent ecologies of heightened HIV vulnerability characterized by a disproportionate concentration of alcohol venues. Limited research has explored how alcohol venues facilitate HIV transmission. METHODS We spatially mapped locations of alcohol venues in a Dominican tourism town and conducted a venue-based survey of key informants (n=135) focused on three facets of alcohol venues: structural features, type of patrons, and HIV risk behaviors. Using latent class analysis, we identified evidence-based typologies of alcohol venues for each of the three facets. Focused contrasts identified the co-occurrence of classes of structural features, classes of types of patrons, and classes of HIV risk behavior, thus elaborating the nature of high risk venues. RESULTS We identified three categories of venue structural features, three for venue patrons, and five for HIV risk behaviors. Analysis revealed that alcohol venues with the greatest structural risks (e.g. sex work on-site with lack of HIV prevention services) were most likely frequented by the venue patron category characterized by high population-mixing between locals and foreign tourists, who were in turn most likely to engage in the riskiest behaviors. CONCLUSION Our results highlight the stratification of venue patrons into groups who engage in behaviors of varying risk in structural settings that vary in risk. The convergence of high-risk patron groups in alcohol venues with the greatest structural risk suggests these locations have potential for HIV transmission. Policymakers and prevention scientists can use these methods and data to target HIV prevention resources to identified priority areas.
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Affiliation(s)
- Vincent GUILAMO-RAMOS
- Silver School of Social Work, New York University, 1 Washington Square North, New York, NY 10003-6654 R321,Center for Latino Adolescent and Family Health, New York University, 15 Washington Place, New York, NY 10003
| | - James JACCARD
- Silver School of Social Work, New York University, 1 Washington Square North, New York, NY 10003-6654 R321,Center for Latino Adolescent and Family Health, New York University, 15 Washington Place, New York, NY 10003
| | - Katharine MCCARTHY
- Center for Latino Adolescent and Family Health, New York University, 15 Washington Place, New York, NY 10003
| | - Zahira QUIÑONES
- Pontificia Universidad Católica Madre y Maestra, Santiago de los Caballeros, Dominican Republic
| | - Viktor LUSHIN
- Silver School of Social Work, New York University, 1 Washington Square North, New York, NY 10003-6654 R321,Center for Latino Adolescent and Family Health, New York University, 15 Washington Place, New York, NY 10003
| | - Molly SKINNER-DAY
- Center for Latino Adolescent and Family Health, New York University, 15 Washington Place, New York, NY 10003
| | - Mark PADILLA
- Department of Global & Sociocultural Studies, Florida International University, Modesto A. Maidique Campus, SIPA 3rd Floor, Miami, Florida 33199
| | - Leah MEISTERLIN
- Center for Latino Adolescent and Family Health, New York University, 15 Washington Place, New York, NY 10003
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155
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Matthews AK, Cho YI, Hughes T, Wilsnack SC, Johnson T, Martin K. The relationships of sexual identity, hazardous drinking, and drinking expectancies with risky sexual behaviors in a community sample of lesbian and bisexual women. J Am Psychiatr Nurses Assoc 2013; 19:259-70. [PMID: 24071822 PMCID: PMC5088734 DOI: 10.1177/1078390313505644] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
This study examined the influence of demographic characteristics, sexual identity, hazardous drinking, and sexuality/intimacy enhancement alcohol expectancies on rates of risky sexual behaviors in a community sample of women who self-identified as lesbian, mostly lesbian, and bisexual (N = 349). Structured interview data were collected as part of a larger longitudinal study of sexual minority women's health, the Chicago Health and Life Experiences of Women study. We used structural equation modeling, controlling for demographic characteristics, to evaluate the influence of sexual identity, hazardous drinking, and alcohol-related sexuality/intimacy enhancement expectancies on sexual risk behaviors. Controlling for demographic characteristics and for sexual identity, higher levels of both hazardous drinking and sexuality/intimacy enhancement alcohol expectancies were associated with higher sexual risk scores. The final model predicted 36% of the variance in risky sexual behavior scores. Our findings regarding the central role of alcohol use and sexuality/intimacy enhancement expectancies in sexual risk behaviors among sexual minority women are consistent with previous research focusing on predominantly heterosexual women. Future efforts at sexual risk reduction in sexual minority women will need to address the influences of alcohol use and drinking-related expectancies on sexual behaviors and decision making.
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Affiliation(s)
- Alicia K Matthews
- Alicia K. Matthews, PhD, University of Illinois at Chicago, IL, USA; Howard Brown Health Center, Chicago, IL, USA
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156
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Deiss RG, Clark JL, Konda KA, Leon SR, Klausner JD, Caceres CF, Coates TJ. Problem drinking is associated with increased prevalence of sexual risk behaviors among men who have sex with men (MSM) in Lima, Peru. Drug Alcohol Depend 2013; 132:134-9. [PMID: 23434130 PMCID: PMC3932358 DOI: 10.1016/j.drugalcdep.2013.01.011] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2012] [Revised: 01/21/2013] [Accepted: 01/23/2013] [Indexed: 10/27/2022]
Abstract
BACKGROUND Alcohol use is an important but understudied HIV risk factor among men who have sex with men (MSM), particularly in Latin America. We studied the relationship between problem drinking and sexual risk among MSM in Lima, Peru. METHODS We recruited 718 participants from 24 neighborhoods for a study on sexually transmitted infections and community-building among MSM. Multivariate analysis was used to identify factors independently associated with problem drinking, which was defined via the CAGE Questionnaire. RESULTS Of 718 participants, 58% met criteria for problem drinking. In univariate analysis, problem drinkers were significantly more likely to report failing to always use condoms, use alcohol or drugs prior to their most recent sexual encounter, report a history of sexual coercion and to engage in transactional sex. Problem drinkers also reported significantly higher numbers of recent and lifetime sexual partners. In multivariate analysis, factors independently associated with problem drinking included a history of sexual coercion [OR 1.8 95%, CI 1.2-2.6], having consumed alcohol prior to the most recent sexual encounter [OR 2.1 95%, CI 1.5-2.9], receiving compensation for sex in the last six months [OR 1.6, 95% CI 1.1-2.2] or having reported a prior HIV+ test [OR 0.5, 95% CI 0.2-0.9]. DISCUSSION We found a high prevalence of problem drinking among MSM in Lima, Peru, which was associated with increased sexual risk in our study. Of note, individuals who were already HIV-infected were less likely to be problem drinkers. Further studies and targeted interventions to reduce problem drinking among MSM are warranted.
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Affiliation(s)
- Robert G Deiss
- Division of Infectious Diseases, Harbor-UCLA Medical Center, Torrance, CA 90502, USA.
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157
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Suffoletto B, Akers A, McGinnis KA, Calabria J, Wiesenfeld HC, Clark DB. A sex risk reduction text-message program for young adult females discharged from the emergency department. J Adolesc Health 2013; 53:387-93. [PMID: 23707402 DOI: 10.1016/j.jadohealth.2013.04.006] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2012] [Revised: 04/02/2013] [Accepted: 04/02/2013] [Indexed: 11/25/2022]
Abstract
PURPOSE To pilot test a text message (SMS) sex risk reduction program among at-risk young adult female patients discharged from an emergency department (ED). METHODS A convenience sample of 52 female patients with hazardous drinking behavior and recent risky sexual encounters were recruited from an urban ED and randomized to the SMS program (n = 23) or a control group (n = 29). All participants completed a web-based questionnaire in the ED and at 3-month follow-up. For 12 weeks, SMS participants were asked to report whether they had a risky sexual encounter in the past week, received theory-based feedback, and were asked if they were willing set a goal to refrain from having another risky encounter. RESULTS Thirty-nine percent of SMS participants completed all weeks of SMS reports, and noncompletion increasing from 12% on week 1 to a 33% by week 12. Three-month follow-up was completed in 56% of participants. In the intervention group, there was an increase in the proportion with condom use with last vaginal sex from 20% (95% CI 4%-48%) to 53% (95% CI 27%-79%) and an increase in always condom use over the past 28 days from 0% (95% CI 0%-22%) to 33% (95% CI 12%-62%). These changes were not statistically different from control participants. CONCLUSIONS SMS programs may be useful to reduce risk for sexually transmitted diseases among at-risk young adults being discharged from the ED. Future trials should examine ways to improve adherence to SMS dialog over time and measure objective outcomes in a larger sample.
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Affiliation(s)
- Brian Suffoletto
- Department of Emergency Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
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158
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HIV prevalence and risk behaviours from three consecutive surveys among men who have multiple female sexual partners in Cape Town. AIDS Behav 2013; 17:2367-75. [PMID: 22797932 DOI: 10.1007/s10461-012-0264-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
HIV bio-behavioural surveillance surveys conducted at regular intervals are critical for monitoring of, and informing a targeted response to the HIV pandemic. We used Respondent-driven Sampling in 2006, 2008 and 2010 to recruit men who have multiple female sexual partners. We performed several logistic regression analyses to compare HIV sexual risk behaviours, and HIV infection over time. Decreases in inconsistent condom use with main partners were not sustained in 2010. Inconsistent condom use with non-main partners, partner numbers and having one-time partners continued to decrease over time. Levels of alcohol consumption in 2010 reverted to a level higher than in 2006. Non-significant increases in HIV prevalence and reporting a symptom of a sexually transmitted infection (STI) were found. The decrease in numbers of and one-time sexual partners, and in inconsistent condom use with non-main partners augers well for decreasing HIV incidence among men in the study community, but might be offset by decreases in consistent condom use with main partners, and increases in alcohol consumption and STIs.
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159
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Shacham E, Lian M, Önen NF, Donovan M, Overton ET. Are neighborhood conditions associated with HIV management? HIV Med 2013; 14:624-32. [PMID: 23890194 DOI: 10.1111/hiv.12067] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/12/2013] [Indexed: 11/28/2022]
Abstract
OBJECTIVES HIV infection has become a manageable chronic disease as a result of treatment advances. Secondary prevention efforts have proved inadequate to reduce the estimated incidence of new HIV infections. Epidemiological data suggest that geographical clustering of new HIV infections is a common phenomenon, particularly in urban areas among populations of low socioeconomic status. This study aimed to assess the relationship between neighbourhood conditions and HIV management and engagement in high-risk behaviours. METHODS During routine out-patient HIV clinic visits, 762 individuals from the St Louis metropolitan area completed behavioural assessments in 2008. Biomedical markers were abstracted from their medical records. Multi-level analyses were conducted based on individuals' census tracts. RESULTS The majority of the sample were male and African American. In the adjusted models, individuals residing in neighbourhoods with higher poverty rates were more likely to have lower CD4 cell counts and be current smokers. In neighbourhoods with higher rates of unemployment, individuals were less likely to have a current antiretroviral prescription. In more racially segregated neighbourhoods, individuals reported more depressive symptoms. CONCLUSIONS Despite the advances in HIV disease management, neighbourhood characteristics contribute to disparities in HIV care. Interventions that address neighbourhood conditions as barriers to HIV management may provide improved health outcomes.
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Affiliation(s)
- E Shacham
- College for Public Health and Social Justice, Saint Louis University, St. Louis, MO, USA
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160
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Nuken A, Kermode M, Saggurti N, Armstrong G, Medhi GK. Alcohol and condom use among HIV-positive and HIV-negative female sex workers in Nagaland, India. Int J STD AIDS 2013; 24:695-702. [DOI: 10.1177/0956462413480722] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
This study examines the relationship between alcohol use, HIV status, and condom use among female sex workers in Nagaland, India. We analyzed data from a cross-sectional survey undertaken in 2009, using descriptive and multivariate statistics. Out of 417 female sex workers, one-fifth used alcohol daily and one-tenth were HIV-positive. HIV-positive female sex workers were more likely than HIV-negative female sex workers to consume alcohol daily (30.2% vs. 18.0%). HIV-positive daily alcohol users reported lower condom use at last sex with regular clients compared to HIV-positive non-daily alcohol users (46.2% vs. 79.3%), a relationship not evident among HIV-negative female sex workers. There is a need to promote awareness of synergies between alcohol use and HIV, and to screen for problematic alcohol use among female sex workers in order to reduce the spread of HIV.
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Affiliation(s)
- Amenla Nuken
- Nossal Institute Limited, India Branch, New Delhi, India
| | - Michelle Kermode
- Nossal Institute for Global Health, University of Melbourne, Australia
| | | | - Greg Armstrong
- Nossal Institute for Global Health, University of Melbourne, Australia
| | - Gajendra Kumar Medhi
- Regional Medical Research Centre, NE Region, Indian Council of Medical Research, Dibrugarh, Assam, India
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161
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Ong J, Wong W, Lee A, Holroyd E, Huang SY. Sexual activity and adolescent health risk behaviours amongst high school students in three ethnic Chinese urban populations. J Clin Nurs 2013; 22:3270-9. [DOI: 10.1111/jocn.12267] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/04/2013] [Indexed: 11/28/2022]
Affiliation(s)
- Jason Ong
- School of Population Health, University of Melbourne; Carlton Vic. Australia
| | - William Wong
- Department of Family Medicine & Primary Care; The University of Hong Kong; Hong Kong China
| | - Albert Lee
- Centre for Health Education and Health Promotion; The Chinese University of Hong Kong; Hong Kong China
| | - Eleanor Holroyd
- School of Health Sciences, RMIT University; Melbourne Vic. Australia
| | - Song Yuen Huang
- Department of Health Education and Health promotion; National Taiwan Normal University; Taipei Taiwan
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162
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Dir AL, Cyders MA, Coskunpinar A. From the bar to the bed via mobile phone: A first test of the role of problematic alcohol use, sexting, and impulsivity-related traits in sexual hookups. COMPUTERS IN HUMAN BEHAVIOR 2013. [DOI: 10.1016/j.chb.2013.01.039] [Citation(s) in RCA: 73] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
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163
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Maguiña JL, Konda KA, Leon SR, Lescano AG, Clark JL, Hall ER, Klausner JD, Coates TJ, Caceres CF. Relationship between alcohol consumption prior to sex, unprotected sex and prevalence of STI/HIV among socially marginalized men in three coastal cities of Peru. AIDS Behav 2013; 17:1724-33. [PMID: 23054035 PMCID: PMC3943345 DOI: 10.1007/s10461-012-0310-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
This article presents data about the relationship between alcohol consumption prior to sex and unprotected sex and the prevalence of at least one sexually transmitted infection (STI) including HIV among socially marginalized men in three coastal Peruvians cities. During an epidemiological survey with 2,146 men, we assessed their STI prevalence, frequency of alcohol consumption prior to sex, unprotected sex and other sexual risk behaviors. The overall prevalence of at least one STI/HIV was 8.5 % (95 % CI 7.3-9.7), the prevalence of unprotected sex was 79.1 % (95 % CI 77.8-80.3) and alcohol consumption prior to sex with any of the last five sex partners in the previous 6 months was 68.9 % (95 % CI 66.9-70.9). Bivariate and multivariate analysis showed that alcohol consumption of participants or their partners prior to sex were associated with the prevalence of at least one STI, adjusted Prevalence Ratio (aPR) = 1.3 (95 % CI 1.01-1.68). Unprotected sex was significantly associated with alcohol consumption prior to sex when both partners used alcohol, aPR = 1.15 (95 % CI 1.10-1.20) or when either one of them used alcohol aPR = 1.14 (95 % CI 1.09-1.18). These findings concur with previous literature suggesting a relationship between alcohol consumption prior to sex and STI and HIV. These data improve our understanding of this relationship in this context and could be used to enhance STI and HIV prevention strategies for socially marginalized men in Peru.
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Affiliation(s)
- Jorge L. Maguiña
- Unit of Health, Sexuality and Human Development, Cayetano Heredia Peruvian University, Lima, Peru
- Department of Parasitology, US Naval Medical Research Unit 6, Lima, Peru
- Post-graduate School, Cayetano Heredia Peruvian University, Lima, Peru
| | - Kelika A. Konda
- David Geffen School of Medicine at University of California Los Angeles, Los Angeles, CA, USA
| | - Segundo R. Leon
- Unit of Health, Sexuality and Human Development, Cayetano Heredia Peruvian University, Lima, Peru
- Sexual Health Laboratory, Research and Development Laboratory, Cayetano Heredia Peruvian University, Lima, Peru
| | - Andrés G. Lescano
- Department of Parasitology, US Naval Medical Research Unit 6, Lima, Peru
| | - Jesse L. Clark
- David Geffen School of Medicine at University of California Los Angeles, Los Angeles, CA, USA
| | - Eric R. Hall
- Naval Medical Research Center, Bethesda, MD, USA
| | - Jeffrey D. Klausner
- David Geffen School of Medicine at University of California Los Angeles, Los Angeles, CA, USA
| | - Tom J. Coates
- David Geffen School of Medicine at University of California Los Angeles, Los Angeles, CA, USA
| | - Carlos F. Caceres
- Unit of Health, Sexuality and Human Development, Cayetano Heredia Peruvian University, Lima, Peru
- Sexual Health Laboratory, Research and Development Laboratory, Cayetano Heredia Peruvian University, Lima, Peru
- National Institute of Mental Health, Bethesda, MD, USA
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Cain D, Pare V, Kalichman SC, Harel O, Mthembu J, Carey MP, Carey KB, Mehlomakulu V, Simbayi LC, Mwaba K. HIV risks associated with patronizing alcohol serving establishments in South African Townships, Cape Town. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2013; 13:627-34. [PMID: 22992872 DOI: 10.1007/s11121-012-0290-5] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Alcohol use has been closely linked with HIV risk behaviors in South Africa. The places where people drink are often the same settings in which they meet new sex partners and may contribute independently to sexual risk. This current study examines the independent effects of patronizing alcohol serving establishments (shebeens) and alcohol use in predicting HIV risk behaviors. Men (n = 981) and women (n = 492) were recruited from inside shebeens and surrounding areas proximal to shebeens in eight separate neighborhoods in a Township in Cape Town, South Africa. Anonymous community surveys measured demographic characteristics, alcohol use, shebeen attendance, and sexual risk behaviors. Comparisons of 1210 (82 %) participants who patronized shebeens in the past month with 263 (18 %) participants who did not patronize shebeens demonstrated higher rates of alcohol use frequency and quantity, more sexual partners, and higher rates of vaginal intercourse without condoms for the patrons. Multiple linear regression analysis found shebeen attendance in the past month predicted greater sexual risk for HIV beyond demographic characteristics and alcohol use. Social influences and environmental factors in shebeens could be contributing to sexual risk behavior independently of alcohol consumption. Further research is needed to understand the environmental factors of shebeens that promote and influence HIV risk behaviors.
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Affiliation(s)
- Demetria Cain
- Center for Health Intervention and Prevention, University of Connecticut, 2006 Hillside Road, Unit 1248, Storrs, CT 06269, USA.
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165
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Adams S, Savahl S, Carels C, Isaacs S, Brown Q, Malinga M, Monageng B, Zozulya M. Alcohol consumption and risky sexual behaviour amongst young adults in a low-income community in Cape Town. JOURNAL OF SUBSTANCE USE 2013. [DOI: 10.3109/14659891.2012.754059] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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166
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Parsons JT, Lelutiu-Weinberger C, Botsko M, Golub SA. Predictors of day-level sexual risk for young gay and bisexual men. AIDS Behav 2013; 17:1465-77. [PMID: 22614745 PMCID: PMC3463644 DOI: 10.1007/s10461-012-0206-1] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
As HIV infection rates remain high among young gay and bisexual men, investigations into determinants of sexual risk are paramount. This study examined independent and interactive effects of substance use, mental health, perceived benefits of unprotected sex, and type of sex partner on odds of not using condoms. Analyses included 188 high-risk substance using HIV-negative and unknown status young gay and bisexual men (ages 18-29). Substance use and endorsing favorable attitudes towards unprotected sex strongly predicted sexual risk. Mental health moderated the relationship between partner type (main vs. casual) and condom use such that increased anxiety and depression were associated with increased odds of using condoms with main partners and not using condoms with casual partners. Understanding how these determinants of HIV risk converge to predict unprotected anal sex can identify essential risk relationships for prevention, obtain effects sizes of greater magnitude and prolonged sustainability, and build robust couples-based interventions.
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Affiliation(s)
- Jeffrey T Parsons
- Center for HIV/AIDS Educational Studies and Training (CHEST), Hunter College of the City University of New York, 142 West 36th Street, 9th Floor, New York, NY 10018, USA.
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167
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Mahapatra B, Lowndes CM, Mohanty SK, Gurav K, Ramesh BM, Moses S, Washington R, Alary M. Factors associated with risky sexual practices among female sex workers in Karnataka, India. PLoS One 2013; 8:e62167. [PMID: 23637991 PMCID: PMC3630134 DOI: 10.1371/journal.pone.0062167] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2013] [Accepted: 03/18/2013] [Indexed: 11/20/2022] Open
Abstract
Introduction The objectives of this study are to develop a summary measure of risky sexual practice and examine the factors associated with this among female sex workers (FSWs) in Karnataka, India. Materials and Methods Data were drawn from special behavioral surveys (SBS) conducted in 2007 among 577 FSWs in two districts of Karnataka, India: Belgaum and Bangalore. FSWs were recruited using the two-stage probability sampling design. FSWs' sexual practice was considered risky if they reported inconsistent condom use with any sexual partner and reported experience of one of the following vulnerabilities to HIV risk: anal sex, alcohol consumption prior to sex and concurrent sexual relationships. Results About 51% of FSWs had engaged in risky sexual practice. The odds of engaging in risky sex were higher among FSWs who were older (35+ years) than younger (18–25 years) (58% vs. 45%, Adjusted Odds Ratio (AOR): 2.0, 95% confidence interval (CI): 1.2–3.4), who were currently married than never married (61% vs. 51%, AOR: 4.8, 95% CI: 2.5–9.3), who were in sex work for 10+ years than those who were in sex work for less than five years (66% vs. 39%, AOR: 2.6, 95% CI: 1.6–4.2), and who had sex with 3+ clients/day than those who had sex with fewer clients (67% vs. 38%, AOR: 3.7, 95% CI:2.5–5.5). Conclusion FSWs who are older, currently married, practicing sex work for longer duration and with higher clientele were more likely to engage in risky sexual practices. HIV prevention programs should develop strategies to reach these most-at risk group of FSWs to optimize the effectiveness of such programs.
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168
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Scott-Sheldon LAJ, Senn TE, Carey KB, Urban MA, Carey MP. Quantity, not frequency, of alcohol use moderates the association between multiple sexual partners and Trichomonas vaginalis among women attending an urban STD clinic. Sex Transm Infect 2013; 89:498-503. [PMID: 23580608 DOI: 10.1136/sextrans-2012-050983] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVE The purpose of this study is to investigate alcohol use, sexual risk behaviour and trichomoniasis in a sample of low-income, largely minority, women patients at a publicly funded sexually transmitted disease (STD) clinic in the USA. METHODS Baseline data, collected as part of a clinical trial, were used. Patients (688 women, 46% of the overall sample) completed an audio computer-assisted self-interview that included questions about their alcohol use and sexual behaviours. Trichomoniasis was determined from vaginal swab specimens obtained during a standard clinical exam. RESULTS Women (n=580; 18-56 years of age; 64% African-American) who reported that they had consumed alcohol at least once in the past year were included in the analyses. Of the 580 women, 157 were diagnosed with an STD and 80 tested positive for trichomoniasis. Trichomoniasis was associated with having multiple sexual partners (OR=1.09; 95% CI 1.01 to 1.17) but not with the number or proportion of unprotected sex events (p>0.05) in the past 3 months. Quantity of alcohol use (drinks per drinking day, drinks per week, and peak consumption) moderated the association between the number of sexual partners and trichomoniasis. CONCLUSIONS The number of sexual partners predicted the probability of trichomoniasis when women reported drinking large quantities of alcohol. Because having multiple sexual partners increases the risk for STD transmission, interventions designed for at-risk women should address the quantity of alcohol consumed as well as partner reduction to reduce the risk for trichomoniasis.
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Affiliation(s)
- Lori A J Scott-Sheldon
- Centers for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, Rhode Island 02906, USA.
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169
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Malaju MT, Asale GA. Association of Khat and alcohol use with HIV infection and age at first sexual initiation among youths visiting HIV testing and counseling centers in Gamo-Gofa Zone, South West Ethiopia. BMC INTERNATIONAL HEALTH AND HUMAN RIGHTS 2013; 13:10. [PMID: 23375131 PMCID: PMC3568407 DOI: 10.1186/1472-698x-13-10] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/13/2012] [Accepted: 01/31/2013] [Indexed: 11/12/2022]
Abstract
Background HIV/AIDS is the major problem and an obstacle to both the health and development of people in Ethiopia today. It is also indicated that the use of substances have dramatically increased despite the serious concern about HIV infection. Methods Unmatched case control study was conducted in South West Ethiopia using a sample of 105 cases and 305 controls. Multivariate logistic regression was used to assess the degree of association between dependent and independent variables. Result HIV infection was positively associated with being in the age of 20 – 24 years [OR & (95% CI) = 2.892 (1.266, 6.607)], being female [OR & (95% CI) = 2.013 (1.061, 3.822)], alcohol use [OR & (95% CI) = 5.883 (3.034, 11.408)], having no education [OR & (95% CI) = 3.193 (1.523, 6.695)] and primary education level [OR & (95% CI) = 3.160 (1.351, 7.388)]. Early sexual initiation was also positively associated with being not employed Adj. HR & (95% CI) = 7.372 (1.455, 37.357)], not having comprehensive knowledge on HIV/AIDS [Adj. HR & (95% CI) = 8.247 (2.121, 32.067)], alcohol use [Adj. HR & (95% CI) = 3.815 (1.315, 11.070)] and khat use [Adj. HR & (95% CI) = 7.241 (1.871, 28.016)]. Conclusion Strategies should be designed to control the use of alcohol and khat which were found to be predictors of HIV infection and early sexual initiation in this study.
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Affiliation(s)
- Marelign Tilahun Malaju
- Department of Public Health, College of Medicine and Health Sciences, Arba-Minch University, P.O. Box 21, Arba-Minch, Ethiopia.
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170
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Kermode M, Sono CZ, Songput CH, Devine A. Falling through the cracks: a qualitative study of HIV risks among women who use drugs and alcohol in Northeast India. BMC INTERNATIONAL HEALTH AND HUMAN RIGHTS 2013; 13:9. [PMID: 23360360 PMCID: PMC3564695 DOI: 10.1186/1472-698x-13-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/29/2012] [Accepted: 01/24/2013] [Indexed: 12/15/2022]
Abstract
Background HIV risks for women who inject drugs and those who engage in sex work are well documented. Women who are dependent on non-injecting drugs and alcohol are also likely to have increased vulnerability to HIV infection, but until they actually inject drugs or engage in sex work, are unlikely to come to the attention of HIV prevention programs. Methods We undertook a qualitative study involving nine focus group discussions (FGDs) and 27 key informant interviews to investigate the context of female drug and alcohol use in two high HIV prevalence states of India (Manipur and Nagaland) and to describe their HIV risks. The FGD and interview transcripts were thematically analyzed Results The women were relatively young (mean age 31 years in Manipur and 28 years in Nagaland), but 64% in Manipur and 35% in Nagaland were widowed or divorced. Both heroin and alcohol were commonly used by the women from Manipur, while alcohol was primarily used by the women from Nagaland, especially in the context of ‘booze joints’ (illicit bars). Reasons for drug and alcohol use included: to avoid symptoms of withdrawal, to suppress emotional pain, to overcome the shame of sex work, pleasure, and widowhood. HIV vulnerability was clearly described, not only in relation to injecting drug use and sex work, but also alcohol consumption. Conclusions The contribution of alcohol use to the HIV vulnerability of women is not currently considered when HIV prevention programs are being designed and implemented leaving a group of high-risk women uncovered by much needed services such as treatment for a range of health problems including alcohol dependence.
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Affiliation(s)
- Michelle Kermode
- Nossal Institute for Global Health, University of Melbourne, Level 4, 161 Barry St., Carlton, VIC, 3010, Australia.
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171
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Lelutiu-Weinberger C, Pachankis JE, Golub SA, Garrett-Walker JJ, Bamonte AJ, Parsons JT. Age cohort differences in the effects of gay-related stigma, anxiety and identification with the gay community on sexual risk and substance use. AIDS Behav 2013; 17:340-9. [PMID: 22038078 DOI: 10.1007/s10461-011-0070-4] [Citation(s) in RCA: 77] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
Abstract
Different cohorts of gay/bisexual men experience unique developmental factors given their distinct socio-historical contexts. This study examined the moderating effects of age on three psychosocial predictors of HIV risk behavior and substance use. Analyses drew on data from a study of substance using HIV-negative and unknown status gay/bisexual men (N= 302) at risk for HIV infection. Anxiety was a strong independent predictor of sexual risk and substance use, and its effects on the sex risk outcomes were moderated by age, such that older and more anxious participants had more frequent instances of sexual risk. Identification with the gay community protected against HIV risk, and its effects on sex risk outcomes were moderated by age, such that younger participants who identified with the gay community reported less sexual risk. Understanding HIV risk within socio-historical contexts is essential in tailoring prevention by taking into account recipients' ages.
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172
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Chen NE, Strathdee SA, Uribe-Salas FJ, Patterson TL, Rangel MG, Rosen P, Brouwer KC. Correlates of STI symptoms among female sex workers with truck driver clients in two Mexican border towns. BMC Public Health 2012; 12:1000. [PMID: 23164289 PMCID: PMC3528625 DOI: 10.1186/1471-2458-12-1000] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2012] [Accepted: 08/28/2012] [Indexed: 11/10/2022] Open
Abstract
Background Female sex workers (FSW) are at increased risk for HIV and other STI due to occupation-related risks and exposures. Long-distance truck drivers have been implicated in the spread of HIV, but less is known about HIV/STI risks of FSW servicing truck drivers, especially in North America. As part of an international collaborative pilot study, we interviewed FSWs servicing truck driver clients along two major transportation corridors to explore factors associated with recent STI symptoms. Methods A cross-sectional study of 200 FSW was conducted in Mexico: 100 from Nuevo Laredo (U.S. border); 100 from Ciudad Hidalgo (Guatemalan border). Eligibility criteria included age ≥18 years, speaking English or Spanish, and having ≥1 truck driver client in the past month. The main outcome was reporting any recent STI symptoms, defined as experiencing genital/anal warts, genital ulcers/sores, genital itching, or abnormal vaginal discharge in the past 6 months. Logistic regression was used to identify correlates of recent STI symptoms. Results Median age of FSW was 29 years, 74% were single, 87% had <9th grade education, and median income was 4000 pesos/month ($300 USD). Sex work occurred at a bar/cantina for 70%. One-quarter had never been tested for HIV, 53% reported lifetime drug use, 22% reported drinking alcohol before/during transactional sex and 17% reported recent STI symptoms. After controlling for age and study site, factors associated with STI symptoms were lifetime drug use (AOR 2.9, 95% CI 1.2-6.9), drug use before/during sex (AOR 2.8, 95% CI 1.1-7.1), alcohol use before/during sex (AOR 5.2, 95% CI 2.2, 12.6), forced sex ever (AOR 2.6, 95% CI 1.1-6.1), lifetime history of arrest (AOR 2.3, 95% CI 1.0-5.0), and being surveyed in Nuevo Laredo rather than Ciudad Hidalgo (AOR 4.8, 95% CI 2.0-10.0). Conclusions The associations we observed between recent STI symptoms and drug and alcohol use suggest that interventions are needed that promote consistent and effective safer sex practices, especially while under the influence of alcohol or other substances.
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Affiliation(s)
- Nadine E Chen
- Department of Medicine, University of California San Diego, San Diego, CA, USA.
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Fennell J. Calculating contraceptive decisions while intoxicated. Contraception 2012; 87:850-4. [PMID: 23153899 DOI: 10.1016/j.contraception.2012.10.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2012] [Revised: 10/05/2012] [Accepted: 10/05/2012] [Indexed: 11/28/2022]
Abstract
BACKGROUND Experimental research in laboratory conditions indicates that intoxication makes unprotected sex more favorable to subjects, while event-level research indicates little causal effect of intoxication on condom use. Little work has addressed the effect of intoxication on hormonal contraceptive use. STUDY DESIGN This study analyzes in-depth interviews with 30 men and 30 women between the ages of 18 and 30 years on the East Coast of the United States about their contraceptive decisions and use. RESULTS Respondents believed that frequent intoxication discouraged condom use and consistent contraceptive pill-taking. Their accounts suggested that intoxication discouraged calculated contraceptive decision-making, and consequently, they mostly reverted to their standard contraceptive habits. People who were consistent contraceptors sober were usually consistent contraceptors while intoxicated, and people who were inconsistent contraceptors sober were usually inconsistent contraceptors while intoxicated. This pattern applied to both condom use and hormonal contraceptive use.
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Affiliation(s)
- Julie Fennell
- Department of Sociology, Gallaudet University, Washington, DC 20002, USA.
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174
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Meeting the needs of women who use drugs and alcohol in North-east India - a challenge for HIV prevention services. BMC Public Health 2012; 12:825. [PMID: 23013114 PMCID: PMC3490718 DOI: 10.1186/1471-2458-12-825] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2012] [Accepted: 09/24/2012] [Indexed: 12/04/2022] Open
Abstract
Background The North-east Indian states of Manipur and Nagaland consistently report relatively high HIV prevalence. The targeted HIV prevention interventions in these two states are mostly delivered by non-government organizations (NGOs), and prevention of HIV transmission by injecting drug use is their main focus. Most injecting drug users (IDUs) are male, and the services are primarily tailored to meet their needs, which are not necessarily the same as those for women. This qualitative study describes the health service needs of women who use drugs and alcohol in Manipur and Nagaland, with the goal of identifying strategies and activities that can be implemented by NGOs wanting to improve their reach among vulnerable women. Methods In 2009-10, semi-structured in-depth interviews were conducted with 27 key informants and nine focus group discussions (FGDs) with women who use drugs and alcohol, and two FGDs with male IDUs. The thematic areas covered included: the context of female drug and alcohol use; drug and alcohol use patterns; HIV risk behaviours; barriers and facilitators of service use; perceived health needs; and expressed health service needs. The data were recorded, transcribed, translated and thematically analysed. Results The most problematic substance for women from Nagaland was alcohol, and for women from Manipur it was heroin. The most commonly identified health problems were primarily related to the women’s drug and alcohol use, reproductive health and mental health. Other problems of major concern included social exclusion, violence, children’s welfare, and financial difficulties. The expressed service needs of these women were women-only integrated health services, women-only detoxification and rehabilitation services, mental health services, desensitization of mainstream health workers, free access to medicines, assistance to meet basic needs, and a safe place for engaging in sex work. Conclusion The expressed health and other service needs of women who use drugs and alcohol in Manipur and Nagaland do not match the services currently provided by HIV prevention NGOs, and this may, in part, account for the relatively poor uptake of these services by women. Strategies and activities that can be implemented by NGOs to strengthen their reach to vulnerable women are identified. However, many of these women’s needs are beyond the scope of services typically offered by HIV prevention NGOs, and require a coordinated multi-sectoral response.
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175
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Prado G, Cordova D, Huang S, Estrada Y, Rosen A, Bacio GA, Jimenez GL, Pantin H, Brown CH, Velazquez MR, Villamar J, Freitas D, Tapia MI, McCollister K. The efficacy of Familias Unidas on drug and alcohol outcomes for Hispanic delinquent youth: main effects and interaction effects by parental stress and social support. Drug Alcohol Depend 2012; 125 Suppl 1:S18-25. [PMID: 22776441 PMCID: PMC3435476 DOI: 10.1016/j.drugalcdep.2012.06.011] [Citation(s) in RCA: 74] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2011] [Revised: 06/01/2012] [Accepted: 06/05/2012] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Drug and alcohol use disproportionately affect Hispanic youth. Despite these disparities, few empirically supported preventive interventions are available to ameliorate this public health concern among Hispanic youth. This study examined the effects of Familias Unidas, relative to Community Practice, in reducing past 90-day substance use, alcohol and marijuana dependence, and having sex while under the influence of alcohol or drugs. Additionally, this study explored whether Familias Unidas' effects varied by environmental context, namely parental stress and social support for parents. METHODS A total of 242 delinquent Hispanic youth aged 12-17 years and their primary caregivers were randomized to either Familias Unidas or Community Practice and assessed at three time points. RESULTS Familias Unidas was efficacious in reducing past 90-day substance use, illicit drug use, and in reducing the proportion of youth with an alcohol dependence diagnosis, relative to Community Practice. Results also showed a reduction in the proportion of youth who reported having sex while under the influence of alcohol or drugs. No differences between conditions were observed in past 90-day alcohol use or marijuana dependence. Intervention effects on illicit drug use and alcohol dependence varied by environmental context. For example, Familias Unidas was most efficacious for adolescents with parents exhibiting high stress and lower levels of social support. CONCLUSIONS Familias Unidas was efficacious in reducing some drug and alcohol related outcomes. The findings also support the concept of targeting family-based interventions, such as Familias Unidas, for adolescents with parents exhibiting high stress and low levels of social support.
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Affiliation(s)
- Guillermo Prado
- Department of Epidemiology and Public Health, Miller School of Medicine, University of Miami, Miami, FL 33136, United States.
| | - David Cordova
- Department of Epidemiology and Public Health, Miller School of Medicine, University of Miami
| | - Shi Huang
- Department of Epidemiology and Public Health, Miller School of Medicine, University of Miami
| | - Yannine Estrada
- Department of Epidemiology and Public Health, Miller School of Medicine, University of Miami
| | - Alexa Rosen
- Department of Epidemiology and Public Health, Miller School of Medicine, University of Miami
| | | | - Giselle Leon Jimenez
- Department of Epidemiology and Public Health, Miller School of Medicine, University of Miami
| | - Hilda Pantin
- Department of Epidemiology and Public Health, Miller School of Medicine, University of Miami
| | - C. Hendricks Brown
- Department of Epidemiology and Public Health, Miller School of Medicine, University of Miami
| | - Maria-Rosa Velazquez
- Department of Epidemiology and Public Health, Miller School of Medicine, University of Miami
| | - Juan Villamar
- Department of Epidemiology and Public Health, Miller School of Medicine, University of Miami
| | - Derek Freitas
- Department of Epidemiology and Public Health, Miller School of Medicine, University of Miami
| | - Maria I. Tapia
- Department of Epidemiology and Public Health, Miller School of Medicine, University of Miami
| | - Kathryn McCollister
- Department of Epidemiology and Public Health, Miller School of Medicine, University of Miami
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176
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Chen Y, Li X, Zhou Y, Zhang C, Wen X, Guo W. Alcohol consumption in relation to work environment and key sociodemographic characteristics among female sex workers in China. Subst Use Misuse 2012; 47:1086-99. [PMID: 22564178 PMCID: PMC8170665 DOI: 10.3109/10826084.2012.678540] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
The study explores the variation in pattern of alcohol use and related risk behaviors by types of sex work environments and sociodemographic characteristics among female sex workers (FSWs) in China. Data were collected from 1,022 FSWs in Guangxi, China, through a self-administered questionnaire. Chi-square and analysis of variance (ANOVA) were used to assess the variations. Results showed that younger FSWs were more susceptible than older FSWs to nearly all the risk drinking behaviors. FSWs of non-Han ethnicity as compared with those of Han ethnicity were more at risk of drinking large amounts of alcohol and having sex under the influence of alcohol. FSWs in entertainment establishments were most likely to have all kinds of risk drinking behaviors. Street-based FSWs were least likely to drink alcohol but more or equally likely to engage in alcohol-related sexual risk behaviors. The study highlights a need to develop tailored alcohol risk reduction intervention that takes into consideration these differences.
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Affiliation(s)
- Yiyun Chen
- Carman and Ann Adams Department of Pediatrics, Prevention Research Center, Wayne State University School of Medicine, Detroit, Michigan 48201, USA.
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177
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Thorley N, Hettiarachchi N, Nightingale P, Radcliffe K. Screening for hazardous alcohol consumption in a sexual health clinic: a service evaluation. Int J STD AIDS 2012; 23:585-8. [DOI: 10.1258/ijsa.2011.011142] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
On the basis of National Institute for Health and Clinical Excellence (NICE) guidance we conducted a survey in a sexual health clinic to assess acceptability of an alcohol screening questionnaire, rates of hazardous drinking and success of referral to a specialist alcohol service (Aquarius). Seventy-two percent of patients accepted the offer of screening, of whom 34% were hazardous drinkers; 2.6% consented to referral to Aquarius but failed to attend. We estimate the cost range to screen and deliver a five-minute brief intervention at £3.62–£9.19 per case. Opportunistic alcohol screening identifies high rates of hazardous drinkers and is acceptable to patients, but onward referral by untrained staff to an external specialist alcohol service is unsatisfactory to patients. Research into the cost-effectiveness of screening and delivery of brief interventions within sexual health clinics is required.
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Affiliation(s)
- N Thorley
- Department of Genitourinary Medicine, Whittall Street Clinic, Whittall Street, Birmingham B4 6DH
| | - N Hettiarachchi
- Department of Genitourinary Medicine, Whittall Street Clinic, Whittall Street, Birmingham B4 6DH
| | - P Nightingale
- University Hospitals Birmingham NHS Foundation Trust Queen Elizabeth Hospital, Queen Elizabeth Medical Centre, Birmingham B15 2TH, UK
| | - K Radcliffe
- Department of Genitourinary Medicine, Whittall Street Clinic, Whittall Street, Birmingham B4 6DH
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Rajapure V, Tirwa R, Poudyal H, Thakur N. Prevalence and Risk Factors Associated with Sexually Transmitted Diseases (STDs) in Sikkim. J Community Health 2012; 38:156-62. [DOI: 10.1007/s10900-012-9596-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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179
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Pitpitan EV, Kalichman SC, Eaton LA, Sikkema KJ, Watt MH, Skinner D. Gender-based violence and HIV sexual risk behavior: alcohol use and mental health problems as mediators among women in drinking venues, Cape Town. Soc Sci Med 2012; 75:1417-25. [PMID: 22832324 DOI: 10.1016/j.socscimed.2012.06.020] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2011] [Revised: 04/19/2012] [Accepted: 06/08/2012] [Indexed: 12/29/2022]
Abstract
Gender-based violence is a key determinant of HIV infection among women in South Africa as elsewhere. However, research has not examined potential mediating processes to explain the link between experiencing abuse and engaging in HIV sexual risk behavior. Previous studies suggest that alcohol use and mental health problems may explain how gender-based violence predicts sexual risk. In a prospective study, we examined whether lifetime history of gender-based violence indirectly affects future sexual risk behavior through alcohol use, depression and post-traumatic stress disorder (PTSD) in a high-risk socio-environmental context. We recruited a cohort of 560 women from alcohol drinking venues in a Cape Town, South African township. Participants completed computerized interviews at baseline and 4 months later. We tested prospective mediating associations between gender-based violence, alcohol use, depression, PTSD, and sexual risk behavior. There was a significant indirect effect of gender-based violence on sexual risk behavior through alcohol use, but not mental health problems. Women who were physically and sexually abused drank more, which in turn predicted more unprotected sex. We did not find a mediated relationship between alcohol use and sexual risk behavior through the experience of recent abuse or mental health problems. Alcohol use explains the link between gender-based violence and sexual risk behavior among women attending drinking venues in Cape Town, South Africa. Efforts to reduce HIV risk in South Africa by addressing gender-based violence must also address alcohol use.
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180
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Malunguza NJ, Hove-Musekwa SD, Musuka G, Mukandavire Z. Investigating Alcohol Consumption as a Risk Factor for HIV Transmission in Heterosexual Settings in Sub-Saharan African Communities. Bull Math Biol 2012; 74:2094-124. [DOI: 10.1007/s11538-012-9747-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2010] [Accepted: 06/26/2012] [Indexed: 11/24/2022]
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181
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Langhorst DM, Choi YJ, Keyser-Marcus L, Svikis DS. Reducing Sexual Risk Behaviors for HIV/STDs in Women with Alcohol Use Disorders. RESEARCH ON SOCIAL WORK PRACTICE 2012; 22:367-379. [PMID: 24076752 PMCID: PMC3783343 DOI: 10.1177/1049731512441683] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Objective: A pilot randomized clinical trial (RCT) examined effectiveness of HIV/STD Safer Sex Skills Building + Alcohol (SSB+A) intervention for women with Alcohol Use Disorders (AUDs) in a residential treatment setting. Method: After randomizing thirty-six women with AUDs and reporting having intercourse with a male partner in the past 180 days to SSB+A or HE (standard HIV/STD education) groups, rates of penetrative intercourse with and without condoms at 60 day and 180 day follow-up were compared between SSB+A or HE groups. Results: There was a significant difference in mean number of sex acts with condoms between SSB+A and HE groups over time. Specifically, SSB+A and HE groups did not differ at 60 day follow-up, but at 180 day follow-up, mean sex acts with condoms among SSB+A group was significantly higher than HE. Conclusion: Pilot study findings affirm the effectiveness of the SSB+A in reducing sexual risk behaviors of AUD women and support the need for further research, testing the SSB+A intervention in a larger sample of women and across different treatment modalities. The present study also illustrates the critical link between practice and use of a step by step model of intervention research.
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Affiliation(s)
- Diane M Langhorst
- Addiction & Women's Health: Advancing Research and Evaluation (AWHARE), Virginia Commonwealth University
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182
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Sexonomics: a commentary and review of selected sexually transmitted disease studies in the economics literature. Sex Transm Dis 2012; 39:161-6. [PMID: 22337100 DOI: 10.1097/olq.0b013e3182389a11] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND The purpose of this review is to highlight selected studies in the economics literature that address sexually transmitted disease (STD)-related topics that are typically not examined in the STD literature. METHODS Two databases (EconLit and Web of Science) were searched to locate STD-related articles in the economics journals. Relevant articles were also identified in other ways, such as informal discussions with colleagues familiar with the literature. To maintain a focus on unique STD-related topics, studies with topics common in the STD literature (e.g., cost-effectiveness, transmission modeling) were excluded. RESULTS Selected STD-related studies in the economics literature were grouped into the following 8 topics: impact of abortion laws and policies on sexual health outcomes; same-sex marriage and syphilis rates; alcohol policy and STD rates; welfare laws and STD rates; discounting the future; HIV disclosure laws; the impact of tolerance for gays on HIV incidence; and economic versus epidemiologic models of HIV dynamics. CONCLUSIONS A general theme of STD-related studies in the economics literature is that laws and policies that increased the "cost" of risky sex tended to reduce the demand for risky sex, and therefore reduce the incidence of STDs. Economic research can contribute in novel ways to our understanding of influences on risky sexual behavior at the individual level and STD incidence at the population level. Economists and STD experts could mutually benefit from increased collaboration.
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von Sternberg K, Cardoso JB, Jun J, Learman J, Velasquez MM. An Examination of the Path Between Recent Sexual Violence and Sexually Transmitted Infections. Womens Health Issues 2012; 22:e283-92. [DOI: 10.1016/j.whi.2012.01.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2011] [Revised: 01/21/2012] [Accepted: 01/24/2012] [Indexed: 11/25/2022]
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184
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Pitpitan EV, Kalichman SC, Eaton LA, Cain D, Sikkema KJ, Skinner D, Watt MH, Pieterse D. Gender-based violence, alcohol use, and sexual risk among female patrons of drinking venues in Cape Town, South Africa. J Behav Med 2012; 36:295-304. [PMID: 22526526 DOI: 10.1007/s10865-012-9423-3] [Citation(s) in RCA: 76] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2011] [Accepted: 03/31/2012] [Indexed: 12/14/2022]
Abstract
Gender-based violence is a well-recognized risk factor for HIV infection among women. Alcohol use is associated with both gender-based violence and sexual risk behavior, but has not been examined as a correlate of both in a context of both high HIV risk and hazardous drinking. The purpose of this paper is to examine the association between recent abuse by a sex partner with alcohol and sexual risk behavior among female patrons of alcohol serving venues in South Africa. Specifically, the aim of this study is to determine whether sexual risk behaviors are associated with gender-based violence after controlling for levels of alcohol use. We surveyed 1,388 women attending informal drinking establishments in Cape Town, South Africa to assess recent history of gender-based violence, drinking, and sexual risk behaviors. Gender-based violence was associated with both drinking and sexual risk behaviors after controlling for demographics among the women. A hierarchical logistic regression analysis showed that after controlling for alcohol use sexual risk behavior remained significantly associated with gender-based violence, particularly with meeting a new sex partner at the bar, recent STI diagnosis, and engaging in transactional sex, but not protected intercourse or number of partners. In South Africa where heavy drinking is prevalent women may be at particular risk of physical abuse from intimate partners as well as higher sexual risk. Interventions that aim to reduce gender-based violence and sexual risk behaviors must directly work to reduce drinking behavior.
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Affiliation(s)
- Eileen V Pitpitan
- Center for Health, Intervention and Prevention, University of Connecticut, 2006 Hillside Rd, Storrs, CT 06269-1020, USA.
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185
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Self-screening for Neisseria gonorrhoeae and Chlamydia trachomatis in the human immunodeficiency virus clinic--high yields and high acceptability. Sex Transm Dis 2012; 38:1107-9. [PMID: 22082720 DOI: 10.1097/olq.0b013e31822e6136] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Despite antiretroviral therapy (ART), incident human immunodeficiency virus (HIV) continues to rise, and sexually transmitted infections (STI) are well known for their part in HIV transmission. National guidelines recommend routine STI screening in HIV-positive individuals, but despite this, reported uptake remains low. METHODS We implemented a nurse-led self-screening program for Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (GC) in asymptomatic HIV patients. Self-collected samples were tested for CT and GC using the GenProbe Aptima Combo 2 assay. Clinical records were reviewed for ART history, CD4 T-cell count, and plasma viral load. A screening service evaluation questionnaire was handed out. RESULTS During an 8-month period, 976 screens were performed. In all, 143 infections were detected which would have been missed without the screening program. Overall prevalence of infection among men who have sex with men was 17.4%: rectal CT and GC, 9.8% (56/571) and 4.2% (24/571), respectively; urethal CT and GC, 2.6% (16/605) and 1.3% (8/605), respectively; and pharyngeal CT and GC, 1.7% (10/589) and 3.9% (23/589), respectively. Among heterosexual men and women, the rates of CT were 2.1% (3/141) and 1.5% (3/201), and there was no GC. Transient viremia was observed at the time of STI diagnosis in 6 patients on ART. All men who have sex with men and most women found self-swabbing acceptable, and most patients indicated that they would like to be offered testing in future. CONCLUSION These findings highlight the need for the introduction of similar screening approaches in HIV clinics. Self-collected specimens using sensitive and specific GC and CT nucleic acid amplification tests are a convenient and acceptable way of testing, and it may address some of the barriers to screening in this population.
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186
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Katsulis Y, Durfee A. Prevalence and correlates of sexual risk among male and female sex workers in Tijuana, Mexico. Glob Public Health 2012; 7:367-83. [PMID: 22304493 DOI: 10.1080/17441692.2012.656672] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
We investigated prevalence and correlates of sexual risk behaviours among male and female sex workers in Tijuana, Mexico, the busiest border crossing area on the US - Mexico border, analysing survey data from a purposive, cross-sectional sample of male and female sex workers who worked in a range of indoor and outdoor settings. Logistic regression was used to determine factors that were associated with sexual risk-taking, defined as failing to use a condom with last client. In bivariate regression models, gender, work setting (e.g., indoor vs. outdoor), poverty, engaging in survival sex, marital status and perceived drug addiction were correlated with sexual risk. When controlling for work location, housing insecurity, poverty, survival sex, marital status and perceived drug addiction, male sex workers were still 10 times more likely than female sex workers (FSW) to engage in sex without a condom during their last encounter with a client. And, although FSW were significantly more likely than males to have used a condom with a client, they were significantly less likely than males to have used a condom with their regular partner. Future research should further examine how gender shapes sexual risk activities in both commercial and non-commercial relationships.
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187
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Rehm J, Shield KD, Joharchi N, Shuper PA. Alcohol consumption and the intention to engage in unprotected sex: systematic review and meta-analysis of experimental studies. Addiction 2012; 107:51-9. [PMID: 22151318 DOI: 10.1111/j.1360-0443.2011.03621.x] [Citation(s) in RCA: 210] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
AIMS To review and analyse in experimentally controlled studies the impact of alcohol consumption on intentions to engage in unprotected sex. To draw conclusions with respect to the question of whether alcohol has an independent effect on the incidence of human immunodeficiency virus (HIV) and other sexually transmitted infections (STIs). METHODS A systematic review and meta-analysis of randomized controlled studies examined the association between blood alcohol content (BAC) and self-perceived likelihood of using a condom during intercourse. The systematic review and meta-analysis were conducted according to internationally standardized protocols (Preferred Reporting Items for Systematic Reviews and Meta-Analyses: PRISMA). The meta-analysis included an estimate of the dose-response effect, tests for publication bias and sensitivity analyses. RESULTS Of the 12 studies included in the quantitative synthesis, our pooled analysis indicated that an increase in BAC of 0.1 mg/ml resulted in an increase of 5.0% (95% CI: 2.8-7.1%) in the indicated likelihood (indicated by a Likert scale) of engaging in unprotected sex. After adjusting for potential publication bias, this estimate dropped to 2.9% (95% CI: 2.0-3.9%). Thus, the larger the alcohol intake and the subsequent level of BAC, the higher the intentions to engage in unsafe sex. The main results were homogeneous, persisted in sensitivity analyses and after correction for publication bias. CONCLUSIONS Alcohol use is an independent risk factor for intentions to engage in unprotected sex, and as risky sex intentions have been shown to be linked to actual risk behavior, the role of alcohol consumption in the transmission of HIV and other STIs may be of public health importance.
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Affiliation(s)
- Jürgen Rehm
- Centre for Addiction and Mental Health, Toronto, Canada
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188
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Mwanga JR, Mshana G, Kaatano G, Changalucha J. "Half plate of rice to a male casual sexual partner, full plate belongs to the husband": findings from a qualitative study on sexual behaviour in relation to HIV and AIDS in northern Tanzania. BMC Public Health 2011; 11:957. [PMID: 22202562 PMCID: PMC3296677 DOI: 10.1186/1471-2458-11-957] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2011] [Accepted: 12/28/2011] [Indexed: 11/10/2022] Open
Abstract
Background A thorough understanding of the contexts of sexual behaviour of the people who are vulnerable to HIV infection is an important component in the battle against AIDS epidemic. We conducted a qualitative study to investigate perceptions, attitudes and practices of sexually active people in three districts of northern Tanzania with the view of collecting data to inform the formulation of appropriate complementary interventions against HIV and AIDS in the study communities. Methods We conducted 96 semi-structured interviews and 48 focus group discussions with sexually active participants (18-60 years of age) who were selected purposively in two fishing and one non-fishing communities. Results The study revealed a number of socio-economic and cultural factors which act as structural drivers of HIV epidemic. Mobility and migration were mentioned to be associated with the risk of HIV acquisition and transmission. Sexual promiscuous behaviour was common in all study communities. Chomolea, (a quick transactional sex) was reported to exist in fishing communities, whereas extramarital sex in the bush was reported in non-fishing community which was predominantly Christian and polygamous. Traditional practices such as Kusomboka (death cleansing through unprotected sex) was reported to exist. Other risky sexual behaviour and traditional practices together with their socio-economic and cultural contexts are presented in details and discussed. Knowledge of condom was low as some people mistook them for balloons to play with and as decorations for their living rooms. Acute scarcity of condoms in some remote areas such as vizingani (fishing islands) push some people to make their own condoms locally known as kondomu za pepsi using polythene bags. Conclusions HIV prevention efforts can succeed by addressing sexual behaviour and its socio-economic and cultural contexts. More innovative, interdisciplinary and productive structural approaches to HIV prevention need to be developed in close collaboration with affected communities and be closely related to policy-making and implementation; to go beyond the limited success of traditional behavioural and biomedical interventions to particularly address the underlying social and structural drivers of HIV risk and vulnerability in the study communities.
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Affiliation(s)
- Joseph R Mwanga
- National Institute for Medical Research, PO Box 1462, Mwanza, Tanzania.
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189
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Griffin KW, Scheier LM, Acevedo B, Grenard JL, Botvin GJ. Long-term effects of self-control on alcohol use and sexual behavior among urban minority young women. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2011; 9:1-23. [PMID: 22470274 PMCID: PMC3315087 DOI: 10.3390/ijerph9010001] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/28/2011] [Revised: 12/11/2011] [Accepted: 12/19/2011] [Indexed: 11/16/2022]
Abstract
High risk alcohol use and sexual behaviors peak in young adulthood and often occur in the same individuals. Alcohol use has been found to impair decision-making and contribute to high risk sexual activity. However, the association between alcohol use and risky sexual behavior may also reflect enduring individual differences in risk taking, sociability, self-control, and related variables. Both behaviors can serve similar functions related to recreation, interpersonal connection, and the pursuit of excitement or pleasure. The present study examined the extent to which high risk drinking and sexual behavior clustered together in a sample of urban minority young adult women, a demographic group at elevated risk for negative outcomes related to sexual health. We tested whether psychosocial functioning measured at the beginning of high school predicted classes of risk behaviors when girls were tracked longitudinally into young adulthood. Latent class analysis indicated three distinct profiles based on high risk drinking and sexual behavior (i.e., multiple sex partners) in young adulthood. The largest class (73% of the sample) reported low levels of risky drinking and sexual behavior. The next largest class (19%) reported high risk drinking and low risk sexual behavior, and the smallest class (8%) reported high levels of both behaviors. Compared to women from other racial/ethnic groups, black women were more likely to be categorized in the high risk drinking/low risk sex class. Multinomial logistic regression indicated that self-control in adolescence had a broad and enduring protective effect on risk behaviors eight years later and was associated with a greater probability of being in the low risk drinking/low risk sex class. Findings are discussed in terms of understanding the phenotypic expressions of risk behavior as they relate to early psychosocial development and the long-term protective function of self-control in reducing high risk drinking and sexual behaviors.
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Affiliation(s)
- Kenneth W. Griffin
- Department of Public Health, Weill Cornell Medical College, New York, NY 10065, USA; (B.A.); (G.J.B.)
- Author to whom correspondence should be addressed; ; Tel.: +1-646-962-8056; Fax: +1-646-962-0284
| | | | - Bianca Acevedo
- Department of Public Health, Weill Cornell Medical College, New York, NY 10065, USA; (B.A.); (G.J.B.)
| | - Jerry L. Grenard
- School of Community & Global Health, Claremont Graduate University, Claremont, CA 91773, USA;
| | - Gilbert J. Botvin
- Department of Public Health, Weill Cornell Medical College, New York, NY 10065, USA; (B.A.); (G.J.B.)
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190
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TYDÉN TANJA, PALMQVIST MARIA, LARSSON MARGARETA. A repeated survey of sexual behavior among female university students in Sweden. Acta Obstet Gynecol Scand 2011; 91:215-9. [DOI: 10.1111/j.1600-0412.2011.01297.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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191
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Khan MR, Berger AT, Wells BE, Cleland CM. Longitudinal associations between adolescent alcohol use and adulthood sexual risk behavior and sexually transmitted infection in the United States: assessment of differences by race. Am J Public Health 2011; 102:867-76. [PMID: 22493999 DOI: 10.2105/ajph.2011.300373] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We examined race differences in the longitudinal associations between adolescent alcohol use and adulthood sexually transmitted infection (STI) risk in the United States. METHODS We estimated multivariable logistic regression models using Waves I (1994-1995: adolescence) and III (2001-2002: young adulthood) of the National Longitudinal Study of Adolescent Health (n = 10 783) to estimate associations and assess differences between Whites and African Americans. RESULTS In adjusted analyses, adolescent alcohol indicators predicted adulthood inconsistent condom use for both races but were significantly stronger, more consistent predictors of elevated partnership levels for African Americans than Whites. Among African Americans but not Whites, self-reported STI was predicted by adolescent report of any prior use (adjusted odds ratio [AOR] = 1.47; 95% confidence interval [CI] = 1.00, 2.17) and past-year history of getting drunk (AOR = 1.53; 95% CI = 1.01, 2.32). Among Whites but not African Americans, biologically confirmed STI was predicted by adolescent report of past-year history of getting drunk (AOR = 1.68; 95% CI = 1.07, 2.63) and consistent drinking (AOR = 1.65; 95% CI = 1.03, 2.65). CONCLUSIONS African American and White adolescent drinkers are priority populations for STI prevention. Prevention of adolescent alcohol use may contribute to reductions in adulthood STI risk.
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Affiliation(s)
- Maria R Khan
- Department of Epidemiology and Biostatistics, University of Maryland, College Park, MD, USA.
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192
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Mitchell L, Lewis L, Hussey J. Screening for alcohol use disorders in a genitourinary medicine setting. Int J STD AIDS 2011; 22:682-3. [PMID: 22096057 DOI: 10.1258/ijsa.2011.011004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The new National Institute for Health and Clinical Excellence (NICE) guidance cites genitourinary (GU) medicine clinics as one setting where screening for alcohol-use disorders should be part of routine clinical practice. Northumberland GU medicine service has routinely used the Fast Alcohol Screening Tool (FAST) since June 2009. An audit of all first attendees to the service in April 2010 (n = 256) was carried out. This audit found that the FAST questionnaire was acceptable to both patients and staff (uptake of 95.7%). Statistically significant associations between excessive alcohol and higher rates of unprotected sex (P < 0.01), an increased number of sexual partners (P < 0.01) and higher rates of sexually transmitted infection (STI) diagnosis (P < 0.05) were also demonstrated.
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Affiliation(s)
- L Mitchell
- New Croft Centre, Newcastle-upon-Tyne, UK.
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193
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Reducing sexual HIV/STI risk and harmful alcohol use among female sex workers in Mongolia: a randomized clinical trial. AIDS Behav 2011; 15:1785-94. [PMID: 21739290 DOI: 10.1007/s10461-011-9984-0] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
This study examined the efficacy of an enhanced intervention to reduce sexual risk of HIV/STI and harmful alcohol use among female sex workers in Mongolia. Women (n = 166) were recruited and randomized to either (1) a relationship-based HIV sexual risk reduction intervention; (2) the same sexual risk reduction intervention plus motivational interviewing; or (3) a control condition focused on wellness promotion. At three and six month follow-up, both treatment interventions and the wellness promotion condition were effective in reducing the percentage and the number of unprotected acts of vaginal sex with paying partners in the past 90 days. All three conditions demonstrated efficacy in reducing harmful alcohol use. No significant differences in effects were observed between conditions. Findings suggest that even low impact behavioral interventions can achieve considerable reductions of HIV/STI risk and harmful alcohol use with a highly vulnerable population in a low resourced setting.
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194
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Johnson ME, Hanson BL, Metzger JS, Brems C, Dewane SL. Changes in sexual activity following substance dependence treatment. JOURNAL OF SUBSTANCE USE 2011. [DOI: 10.3109/14659891.2011.587093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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195
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Rodgers CRR, Nichols TR, Botvin GJ. Alcohol and Cigarette Free: Examining Social Influences on Substance Use Abstinence among Black Non-Latina and Latina Urban Adolescent Girls. JOURNAL OF CHILD & ADOLESCENT SUBSTANCE ABUSE 2011. [DOI: 10.1080/1067828x.2011.599274] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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196
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Puente D, Zabaleta E, Rodríguez-Blanco T, Cabanas M, Monteagudo M, Pueyo MJ, Jané M, Mestre N, Mercader M, Bolíbar B. Gender differences in sexual risk behaviour among adolescents in Catalonia, Spain. GACETA SANITARIA 2011; 25:13-9. [PMID: 21315492 DOI: 10.1016/j.gaceta.2010.07.012] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/05/2010] [Revised: 07/08/2010] [Accepted: 07/14/2010] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To analyze the factors associated with sexual risk behavior in adolescent girls and boys in order to plan future school health interventions. METHODS A cross-sectional study with two-stage cluster sampling that included 97 schools and 9,340 students aged between 14 and 16 years old was carried out in 2005-2006 in Catalonia (Spain). For the survey, a self-administered paper-based questionnaire was used. The questionnaire contained items on sociodemographic variables, use of addictive substances and mood states, among other items. These variables were tested as risk factors for unsafe sexual behavior. RESULTS This study included 4,653 boys and 4,687 girls with a mean age of 15 years. A total of 38.7% of students had had sexual relations at least once and 82.3% of boys and 63.0% of girls were engaged in sexual risk behaviors. The prevalence of sexual relations and risk behaviors was generally higher in boys than in girls, independently of the variables analyzed. Boys had more sexual partners (P<.001) and used condoms as a contraceptive method less frequently than girls (P<.001). Foreign origin was related to unsafe sexual activity in both genders. Alcohol consumption was also a risk factor in boys. CONCLUSIONS Sexual risk behaviors among adolescents in Catalonia are higher in boys than in girls. Factors related to unsafe sexual activity in boys were foreign origin and alcohol consumption. In girls only foreign origin was a significant risk factor.
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197
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Townsend L, Rosenthal SR, Parry CDH, Zembe Y, Mathews C, Flisher AJ. Associations between alcohol misuse and risks for HIV infection among men who have multiple female sexual partners in Cape Town, South Africa. AIDS Care 2011; 22:1544-54. [PMID: 20824551 DOI: 10.1080/09540121.2010.482128] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
The occurrence of high rates of alcohol consumption in a context of high HIV prevalence in South Africa poses a significant health challenge for this country. This paper aims to answer three questions that could further our knowledge regarding the links between alcohol use and HIV infection: (a) "Are problem drinkers more likely to have multiple concurrent partners than those who are not?"; (b) "Are condoms applied less effectively and less consistently by problem drinkers compared to those who are not?"; (c) "Are the female sexual partners of problem drinkers different from those who are not?" Two cross-sectional HIV bio-behavioural surveillance surveys using Respondent-Driven Sampling were conducted in two peri-urban settings on the outskirts of Cape Town, South Africa. Eight hundred and forty-eight men aged 25-55 years who have multiple, concurrent female sexual partners were recruited. Problem drinkers had a score of ≥3 on the CAGE questionnaire. Questions enquired about partner numbers, condom use and partner traits. Multivariate logistic regression models were developed to determine significant associations between outcome variables and problem drinking. Fifty-eight percent of men were problem drinkers. Compared to non-problem drinkers, problem drinkers were significantly more likely to report having any symptom of a STI; not using condoms due to drinking; inconsistent condom use with all partner types; that their most recent once-off partner was unemployed; having met their most recent partner at an alcohol-serving venue; and having had a once-off sexual relationship. Alcohol may fuel once-off sexual encounters, often characterised by transactional sex and women's limited authority to negotiate sex and condom use; factors that can facilitate transmission of HIV. HIV prevention interventions specifically targeting drinkers, the contexts in which problem drinking occurs and multiple sexual partnering are urgently needed.
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198
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Abstract
BACKGROUND Interpersonal violence has increasingly been identified as a risk factor for sexually transmitted infections. Understanding the pathways between violence and sexually transmitted infections is essential to designing effective interventions. OBJECTIVE The aim of this study was to examine dissociative symptoms, alcohol use, and intimate partner physical violence and sexual coercion as mediators of child sexual abuse and lifetime sexually transmitted infection diagnosis among a sample of women. METHODS A convenience sample of 202 women was recruited from healthcare settings, with 189 complete cases for analysis. A multiple mediation model tested the proposed mediators of child sexual abuse and lifetime sexually transmitted infection diagnosis. Bootstrapping, a resampling method, was used to test for mediation. Key variables included child sexual abuse, dissociative symptoms, alcohol use, and intimate partner violence. RESULTS Child sexual abuse was reported by 46% of the study participants (n = 93). Child sexual abuse was found to have an indirect effect on lifetime sexually transmitted infection diagnosis, with the effect occurring through dissociative symptoms (95% confidence interval = 0.0033-0.4714) and sexual coercion (95% confidence interval = 0.0359-0.7694). Alcohol use and physical violence were not found to be significant mediators. DISCUSSION This study suggests that dissociation and intimate partner sexual coercion are important mediators of child sexual abuse and sexually transmitted infection diagnosis. Therefore, interventions that consider the roles of dissociative symptoms and interpersonal violence may be effective in preventing sexually transmitted infections among women.
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Affiliation(s)
- Melissa A Sutherland
- School of Nursing, Boston College, Chestnut Hill, Massachusetts 02467-3812, USA.
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199
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Seth P, Wingood GM, DiClemente RJ, Robinson LS. Alcohol use as a marker for risky sexual behaviors and biologically confirmed sexually transmitted infections among young adult African-American women. Womens Health Issues 2011; 21:130-5. [PMID: 21276736 PMCID: PMC4232951 DOI: 10.1016/j.whi.2010.10.005] [Citation(s) in RCA: 78] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2010] [Revised: 07/01/2010] [Accepted: 10/27/2010] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Previous research has primarily focused on the relationship between illicit drug use and HIV/sexually transmitted infection (STI) risk behavior among African-American women. Very few studies have solely reviewed the role of alcohol use on risky sexual behavior. The present study examined the relationship between alcohol use at non-abuse levels and risky sexual behaviors and STIs among young adult African-American women. METHODS Eight hundred forty-eight African American women, ages 18 to 29, participated at baseline, with 669 and 673 women at 6 and 12 months follow-up, respectively. Participants completed an Audio Computer Assisted Survey Interview assessing sociodemographics, alcohol use, and risky sexual behaviors. Subsequently, participants provided two vaginal swab specimens for STIs. RESULTS Multivariate logistic regression analyses were conducted for cross-sectional analyses, with illicit drug use as a covariate. Women who consumed alcohol were more likely to have multiple partners and risky partners. Binary generalized estimating equation models assessed the impact of alcohol use at baseline on risky sexual behavior and STIs over a 12-month period. Illicit drug use, intervention group, and baseline outcome measures were entered as covariates. Alcohol consumption predicted positive results for chlamydia, positive results for any STI, and never using a condom with a casual partner over a 12-month follow-up period. DISCUSSION Frequency of alcohol use at non-abuse levels was correlated with and predicted risky sexual behaviors and STIs. Prevention programs for African-American women should incorporate education regarding the link between alcohol and HIV/STI risk behaviors and the potential negative health consequences.
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Affiliation(s)
- Puja Seth
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University
- Emory Center for AIDS Research, Social and Behavioral Sciences Core
| | - Gina M. Wingood
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University
- Emory Center for AIDS Research, Social and Behavioral Sciences Core
- 1518 Clifton Road NE, Room 556, Atlanta, GA 30322; Telephone: (404) 727-0241; Fax: (404) 727-1369
| | - Ralph J. DiClemente
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University
- Emory Center for AIDS Research, Social and Behavioral Sciences Core
- 1518 Clifton Road NE, Room 554, Atlanta, GA 30322; Telephone: (404) 727-0237; Fax: (404) 727-1369
| | - LaShun S. Robinson
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University
- 1520 Clifton Road NE, Room 274, Atlanta, GA 30322; Telephone: (404) 712-9189; Fax: (404) 712-9738
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200
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Alcohol use, unprotected sex, and sexually transmitted infections among female sex workers in China. Sex Transm Dis 2011; 37:629-36. [PMID: 20601927 DOI: 10.1097/olq.0b013e3181e2118a] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND AND OBJECTIVE Alcohol use has been suggested to interfere with condom use and to increase sexual risk behaviors. However, data on the prevalence of this practice among female sex workers and its association with condom use and sexually transmitted infections (STIs) are limited. METHODS Data were collected through the baseline survey of an HIV prevention project among 454 establishment-based female sex workers in Guangxi, China, in 2004. Both global association and situational analysis were performed using 2 measures of alcohol use (alcohol intoxication and drinking alcohol before having sex with a client). Multiple logistic regression analyses were performed to examine the association of alcohol use with women's condom use and STIs. RESULTS One-third of women reported being intoxicated with alcohol at least once a month during the previous 6 months, and about 30% reported using alcohol before having sex with clients. In comparison with women who did not use alcohol before engaging in sex with clients, women who did so reported significantly less consistent condom use and higher rates of both current STIs and a history of STI. However, alcohol intoxication was not associated with condom use and STIs. These findings indicate event-specific rather than global associations of alcohol use with inconsistent condom use and STIs. CONCLUSION Alcohol use before commercial sex is associated with unprotected sex and increased risk for STIs. Interventions that address both alcohol use and HIV risk behaviors in the context of commercial sex may have a great impact in preventing the spread of HIV in China.
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