Life events and sexual risk among HIV-negative, heterosexual, methamphetamine users

Military-to-civilian transition strains and risky behavior among post-9/11 veterans

Many military veterans face significant challenges in civilian reintegration that can lead to troublesome behavior. Drawing on military transition theory (MTT) and using data from a survey of post-9/11 veterans in two metropolitan areas (n = 783), we investigate previously unexamined relationships between post-discharge strains, resentment, depression, and risky behavior, taking into account a set of control variables, including combat exposure. Results indicated that unmet needs at time of discharge and perceived loss of military identity are associated with increased risky behavior. Much of the effects of unmet discharge needs and loss of military identity are mediated by depression and resentment toward civilians. The results of the study are consistent with insights from MTT, providing evidence of specific ways in which transitions can affect behavioral outcomes. Moreover, the findings highlight the importance of helping veterans meet their post-discharge needs and adapt to changing identity, in order to reduce the risk of emotional and behavioral problems.

Food insecurity, childhood hunger and caregiver life experiences among households with children in South Carolina, USA

OBJECTIVE

We explored how positive and negative life experiences of caregivers are associated with household food insecurity.

DESIGN

The Midlands Family Study (MFS) was a cross-sectional study with three levels of household food security: food secure, food insecure without child hunger and food insecure with child hunger. Ordinal logistic regression analysis was used for analyses of negative and positive life experiences (number, impact, type) associated with food insecurity.

SETTING

An eight-county region in South Carolina, USA, in 2012-2013.

PARTICIPANTS

Caregivers (n 511) in households with children.

RESULTS

Caregivers who reported greater numbers of negative life experiences and greater perceived impact had increased odds of household food insecurity and reporting their children experienced hunger. Each additional negative life experience count of the caregiver was associated with a 16 % greater odds of food insecurity without child hunger and a 28 % greater odds of child hunger. Each one-unit increase in the negative impact score (e.g. a worsening) was associated with 8 % higher odds of food insecurity without child hunger and 12 % higher odds of child hunger. Negative work experiences or financial instability had the strongest association (OR = 1·8; 95 % CI 1·5, 2·2) with child hunger. Positive life experiences were generally not associated with food security status, with one exception: for each unit increase in the number of positive experiences involving family and other relationships, the odds of child hunger decreased by 22 %.

CONCLUSIONS

More research is needed to understand approaches to build resilience against negative life experiences and strengthen positive familial, community and social relationships.

Sexual Risk Behaviors Constructed in Iranian Women's Life with Substance Use Disorders: A New Implication of Human Ecological Theory

BACKGROUND

Drug abuse is one of the important variables influencing protective sexual behavior. The objective of this study was to explore how risky sexual behaviors develop in drug abusing women using human ecological theory.

METHODS

In this study, we used a descriptive exploratory approach. The participants were 32 drug abusing women from two of the selected drop-in centers (DICs) in south Tehran, Iran, where we could have access to a vast number of female drug users. Data was collected using semi-structured face-to-face interviews. Qualitative content analysis was used to analyze the data using Graneheim and Lundman procedure.

FINDINGS

Risky sexual behavior in drug use disorders in women was found in four themes with thirteen emerged; sexual untaught at micro-system with two subthemes "unsafe home" and "drop out of school", Perception of differences at meso-system with three subthemes "lack of link between family and school", "doing manly behavior" and "low awareness of health puberty than peers", inappropriate marriages at exo-system with three subthemes "stigma", "fear of losing love relationship" and "self-devotion", marginalization at macro-system with four subthemes "barrier access to rights", "selling sex as a tool of security", "lack of belief as a sex worker" and "mistrust and doubt partner" using implication of human ecological theory.

CONCLUSION

Findings suggest that strategies supporting the discovery of risky sexual behaviors in drug use disorders in women are important in order to provide counseling and education to form their decisions toward safety sex.

Associations between recent gay-related stressful events, emotional distress, social support and unprotected anal intercourse behavior among Chinese men who have sex with men

BACKGROUND

This study was designed to assess the levels of and associations between gay-related stressful events, social support, emotional distress and the number of unprotected anal intercourse partners among Chinese men who have sex with men.

METHODS

Using a respondent-driven sampling method, 807 men who have sex with men were recruited in urban areas of northeast China and data were collected via face-to-face interviews. Gay-related stressful events were measured using the Gay-Related Stressful Life Events Scale; levels of depression, anxiety symptoms and social support were measured using the Self-Rating Depression Scale, the Self-Rating Anxiety Scale and the Social Support Rating Scale, respectively.

RESULTS

Over a quarter of study participants experienced gay-related stressful events during the preceding 3 months. Their average Self-Rating Depression Scale, Self-Rating Anxiety Scale and Social Support scores differed significantly from the national norm. Gay-related stressful events significantly correlated with anxiety (r = 0.167, p < 0.001), depression (r = 0.165, p < 0.001), social support (r = -0.107, p = 0.002) and number of unprotected anal intercourse partners (r = 0.13, p < 0.001), showing a clear dose-response relationship.

CONCLUSION

Gay-related stressful events are common and are significantly associated with emotional distress, lack of social support and high-risk sexual behaviors among Chinese men who have sex with men. Multifaceted approaches are warranted to increase social support and reduce intolerance toward homosexual behaviors and to reduce risky sexual behaviors related to the rapid HIV epidemic among men who have sex with men population in China.

Occupational and demographic factors associated with drug use among female sex workers at the China-Myanmar border

BACKGROUND

Within the last decade, the use of amphetamine type stimulants (ATS) has swelled in Myanmar. Regionally, female sex workers have reported turning to ATS for occupational reasons. In doing so, drug-using female sex workers (FSW) face compounded risks for HIV and other sexually transmitted infections (STI). Here, we examine the factors that impact FSW drug use in Muse, a town along the China-Myanmar border.

METHODS

In 2012, 101 FSW were recruited from entertainment venues and brothels along the Myanmar-Chinese border. Participants participated in a self-administered behavioral survey covering demographics, drug use, sex work, and risk behaviors. Bivariate and regression analyses were conducted in SPSS.

RESULTS

Thirty four percent of respondents indicated current drug use. ATS derivatives were the most commonly used drugs (87.5%) with injection drug use being nearly non-existent in the sample. Drug using FSWs were older, had engaged in sex work longer, had more Chinese clients, and were more likely to have a previous boyfriend who had used drugs. They were also 3.5 times more likely to report a STI. Client condom use, HIV testing rates, and familiarity with public health resources did not statistically differ by drug use status.

CONCLUSION

More research is needed to examine how romantic and professional sexual relationships push-and-pull FSW into using drugs. Our results suggest that diverse safer sex strategies, beyond client condom use, should be promoted with drug using FSWs, including strategies that acknowledge the impact of ATS use.

Methamphetamine-using parents: the relationship between parental role strain and depressive symptoms

OBJECTIVE

The methamphetamine epidemic in the United States involves a large number of men and women with dependent-age children. However, we know little about the parenting strains experienced by methamphetamine-using mothers and fathers and the relationship of these parenting strains to mental health outcomes, specifically depressive symptoms.

METHOD

The primary goal of this study was to examine five dimensions of parental role strain in relation to depressive symptoms in a sample of 180 methamphetamine-using parents of dependent-age children in San Diego, CA. Dimensions of parental role strain included child emotional and behavioral problems, child physical health problems, child-related financial strain, interpersonal conflict involving children, and intrapsychic strain related to children.

RESULTS

Methamphetamineusing mothers reported significantly more child-related emotional and behavioral problems compared with methamphetamine-using fathers (7.9 vs. 6.8; t = 2.5, p < .05). In multiple regression analysis, higher Beck depression scores were associated with being a mother (β = .186, p < .05), having more children younger than 18 years old (β = .165, p < .05), less emotional support (β = -.230, p < .01), and higher scores on intrapsychic parental role strain related to children (β = .288, p < .01).

CONCLUSIONS

These findings suggest the importance of considering the multidimensional nature of parenting strain in the development of drug treatment and counseling programs for methamphetamine-using parents.

Correlates of trading sex for methamphetamine in a sample of HIV-negative heterosexual methamphetamine users

While many studies have examined correlates of trading sex for money, few have examined factors associated with exclusive trading of sex for drugs. We identified sociodemographic, behavioral, and psychological correlates of trading sex for methamphetamine in a sample of HIV-negative heterosexual men and women who were enrolled in a sexual risk reduction intervention in San Diego, California. Of 342 participants, 26% overall (21% of males and 31% of females) reported trading sex for methamphetamine in the past two months. Multiple logistic regression analysis revealed that recently trading sex for methamphetamine was independently associated with being female, homeless, binging on methamphetamine, sexual victimization in the past two months, engaging in anal sex 24 or more times in the past two months, and higher sexual compulsivity scores. Effective interventions for this high-risk population should consider gender-focused counseling for sexual abuse, motivational enhancement therapy, social-cognitive skills training, as well as enhanced access and utilization of social services, including drug treatment.

The role of religiosity, social support, and stress-related growth in protecting against HIV risk among transgender women

Transgender women completed questionnaires of religiosity, social support, stigma, stress-related growth, and sexual risk behavior. In a multivariate model, both social support and religious stress-related growth were significant negative predictors of unprotected anal sex, but religious behaviors and beliefs emerged as a significant positive predictor. The interaction between religious behaviors and beliefs and social support was also significant, and post-hoc analyses indicated that high-risk sex was least likely among individuals with high-levels of social support but low levels of religious behaviors and beliefs. These data have important implications for understanding factors that might protect against HIV risk for transgender women.

Use of crystal methamphetamine, Viagra, and sexual behavior

PURPOSE OF REVIEW

Methamphetamine (meth) use has been shown in the literature to be associated with high-risk sexual behavior for both homosexual (MSM) and heterosexual samples for over a decade. The use of Viagra has also been shown to be associated with high-risk sexual behavior. The purpose of this review is to update the record on Viagra and on the combination of Viagra and meth use.

RECENT FINDINGS

There is now strong evidence that the use of Viagra is associated with HIV seroconversion in MSM. The combination of taking both meth and Viagra is strongly associated with much higher sexually transmitted disease and HIV rates. There is some evidence that Viagra is associated with insertive and meth is associated with receptive anal intercourse by men.

SUMMARY

The evidence is strong to support the relationship between Viagra use and HIV seroconversion now that more sophisticated analyses have been done. The meth-Viagra recreational drug combination is of very high risk. More research is needed to generate longitudinal and event-level data that are necessary to answer fine-grained questions about drug combinations and the relationship with sexual behavior.