Perceptions of human immunodeficiency virus and sexually transmitted disease risk among low-income adults: a pilot study

Cross-cultural differences and sexual risk behavior of emerging adults

PURPOSE

The authors examined population-specific risk factors that increase emerging adults' risk of acquiring sexually transmitted infections (STIs), including the human papillomavirus (HPV).

DESIGN AND METHOD

A cross-sectional sample of 335 diverse, emerging adults ages 18 to 24 years was recruited from a health center at a large university in the Southeastern United States. The mean age was 20.6 ± 1.9 years, majority were females (74.0%), and 61.0% were Hispanic.

RESULTS

Findings revealed inconsistent condom use, reasons for not using condoms, and a need for more culturally specific intervention strategies.

DISCUSSION AND CONCLUSIONS

Healthcare providers should identify culturally specific reasons for inconsistent condom use, examine cultural and geographic differences in sexual risk behaviors among groups and communities, and modify communication, educational programs, and interventions accordingly.

IMPLICATIONS FOR PRACTICE

By adopting a multicultural approach to the control of STIs, nurses can address specific cultural attitudes and behaviors that may influence exposure to STIs, including HPV.

Condom use and concurrent partnering among heterosexually active, African American men: a qualitative report

African Americans are overrepresented among heterosexual cases of HIV/AIDS in the USA. Inconsistent condom use and concurrent partnering are two sexual behaviors driving the heterosexual HIV epidemic in the African American community. To inform the development of an HIV prevention behavioral intervention to decrease concurrent partnering and increase condom use among African American heterosexual men, we conducted formative research, including 61 structured interviews, 5 focus groups with 25 men, and 30 in-depth qualitative interviews between July and December 2009. We used a grounded theoretical approach and categorizing strategies to code and analyze the qualitative data. Results around condom use confirmed earlier findings among heterosexual men in general: condoms diminish pleasure, interfere with erection, and symbolize infidelity. Although valued by some as a form of disease prevention and pregnancy prevention, condoms are often used only with specific types of female partners, such as new or casual partners, or due to visual risk assessment. Sex partner concurrency was described as normative and ascribed to men's "natural" desire to engage in a variety of sexual activities or their high sex drive, with little recognition of the role it plays in the heterosexual HIV epidemic. Fatherhood emerged among many men as a crucial life event and compelling motivation for reducing sexual risk behavior. Based on these results, we conclude that existing HIV prevention efforts to improve attitudes towards and motivate use of condoms either have not reached or have not been successful with African American heterosexual men. In designing behavioral interventions to decrease concurrent partnering and increase condom use, addressing negative attitudes towards condoms and partner risk assessment is critical, as is integrating novel motivational approaches related to identity as fathers and men in the African American community.

Understanding low-income, minority older adult self-perceptions of HIV risk

The number of people ages 50 or older living with HIV in the United States is increasing. Yet, few older adults see themselves at risk of infection. This study examines the heuristic reasoning that low income, minority adults, ages 50 or older use in calculating the likelihood of infection. The data are drawn from face-to-face interviews with a sample of 134 African American and Latino residents, ages 50 to 86, living in low-income housing in Chicago, Illinois, and Hartford, Connecticut. Results show that nearly half of the study's participants thought themselves to be at some level of risk for HIV. In self-assessing their risk, they relied on seven heuristic categories: self-imperilment, social imperilment, fate, incidental contact, situational safety, medical iatrogenesis, and self-protection. These findings extend our understanding of how individuals make sense of their likelihood of experiencing a major health threat and provide insight into more effective HIV prevention programming for older adults.

Determinants of actual condom use among adolescents in Thailand

This study examined the relationships among attitudes toward condom use, personal characteristics, condom use self-efficacy, and actual condom use among Thai adolescents. Predictors of condom use were also investigated. Bandura's self-efficacy model for safer sexual behavior provided the theoretical framework for this descriptive correlational design. The sample consisted of 270 Thai vocational students aged 18 to 21 years. Multiple regressions were used to estimate the correlates between the independent study variables and condom use among Thai adolescents. Additionally, two open-ended questions regarding attitudes toward premarital sex among males and females in Thai culture were asked. The results showed that self-reported history of alcohol/drug use, attitudes toward condom use, and condom use self-efficacy were related to actual condom use. Results that emerged from the open-ended questions suggested sexual double standards among Thais. This study contributes to strengthening Thai health policy and expanding nursing knowledge about condom use and prevention of sexually transmitted diseases.

Perception of HIV/AIDS risk among urban, low-income senior-housing residents

Despite the rising number of cases of HIV in adults over age 50, older persons rarely are considered to be at risk for HIV/AIDS, and even though they may be involved in risky behavior, such as unprotected penetrative sex, they may not consider themselves vulnerable to becoming infected. Informed awareness of risk is essential to making positive decisions about adopting preventive measures. We examined demographic, sociobehavioral, and contextual factors that predict urban, low-income older adults' perception of HIV/AIDS risk. Logistic regression results from 398 residents aged 50-93 living in six buildings in two American cities found that males, younger participants (aged 50-61), those living in higher risk buildings, and those who worried more about contracting HIV/AIDS were more likely to perceive themselves to be at HIV/AIDS risk. Findings accounted for 32% of the variance and the prediction success rate was 72%. Results point to the importance of considering sociodemographic characteristics and environmental (contextual) factors as they influence heuristic decision making in understanding HIV/AIDS risk perception among low-income urban older adults and when designing HIV/AIDS education and intervention strategies targeting this population.