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Khoei EM, Rezaei Z, Mohraz M, Bayat A, Ghanbarpour F, Killeen T, Korte JE. Risky Sexual Behaviors and Condom Use Barriers in Iranian Women with Substance Use Disorders. IRANIAN JOURNAL OF PUBLIC HEALTH 2023; 52:1673-1681. [PMID: 37744548 PMCID: PMC10512144 DOI: 10.18502/ijph.v52i8.13405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 05/13/2022] [Indexed: 09/26/2023]
Abstract
Background Scant information exists on Iranian women's protective behaviors mainly constant condom use. Inconsistent condom use seems prevalent among women with substance use problems. We aimed to investigate risky sexual behaviors (RSBs) and condom use barriers in Iranian women with substance use disorders (SUDs). Methods In our cross-sectional study, we recruited 300 women who sought treatments for their SUDs from the active outpatient drug free (ODF) and Methadone Maintenance Therapy (MMT) centers in Tehran, Iran during 2017-2021. We used three batteries including demographic questionnaire, the Risky Sexual Behavior Questionnaire (RSBQ); and the Condom Barriers Scale (CBS). The statistical software R, analysis of variance post hoc and multivariate analysis of variance (MANOVA) logistic regression tests were used in data analysis. Results The majority reported at least one lifetime experience of RSBs. Our results show that only 22% of the participants 'always' use condom in their sexual encounters. The lowest and highest subscale scores of the CBS were related to Sexual Experience (SE) (2.47 ± 0.86) and access/availability structure (3.52 ± 0.7), respectively. RSBs had negative significant association with Partner Barrier (PB) subscale scores (OR = 0.4; 95% CI: 0.22 to 0.73) and effect on SE subscale scores (OR= 0.54; 95% CI: 0.31 to 0.94). Conclusion RSBs was prevalent among our study population. RSBs and condom use barriers are significantly interwoven. The condom use barriers were highly associated with the types of sexual encounters such as group sex or casual sexual relations than specific mean of sexual performance (i.e. anal sex). Gender-specific RSBs, STIs/HIV/AIDS prevention program is recommended for women with SUDs.
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Affiliation(s)
- Effat Mergati Khoei
- Iranian National Center for Addiction Studies, Tehran University of Medical Sciences, Tehran, Iran
- Brian and Spinal Cord Injury Research Center, Neuroscince Institution, Tehran University of Medical Sciences, Tehran, Iran
| | - Zahed Rezaei
- Social Determinants of Health Research Center, Gonabad University of Medical sciences, Gonabad, Iran
- Asadabad School of Medical Sciences, Asadabad, Iran
| | - Minoo Mohraz
- Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High-Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran
| | - Alireza Bayat
- Iranian National Center for Addiction Studies, Tehran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Ghanbarpour
- Iranian National Center for Addiction Studies, Tehran University of Medical Sciences, Tehran, Iran
| | - Therese Killeen
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, USA
| | - Jeffrey E. Korte
- Department of Public Health Sciences, School of Medicine, Medical University of South Carolina, Charleston, USA
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Levy E, Warner LM, Fleig L, Kaufman MR, Gidron Y. Associations Between Implicit and Explicit Condom Use Measures With Condom Use Barriers: Relationships Make A Difference. Psychol Rep 2023:332941231164334. [PMID: 36927133 DOI: 10.1177/00332941231164334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/18/2023]
Abstract
OBJECTIVE The association between explicit and implicit psychological measures might be affected by the similarity of the assessment method and by the overlap of the components of the constructs being assessed. This study examined the association between condom use barriers and explicit and implicit measurements of condom use and the moderating role of sexual intercourse in these associations. DESIGN This was a cross sectional correlational study. An analysis of baseline data from a randomized controlled trial including 149 university students was included. MAIN MEASURES These included a questionnaire assessing condom use barriers, an implicit condom use test (a structured semi-projective test), and an explicit condom use question. Hierarchical regressions and correlations were examined in the full sample and by groups of participants with and without sexual intercourse. RESULTS In those without sexual intercourse, all barriers sub-scales were significantly and negatively correlated with implicit condom use and unrelated to explicit condom use. In contrast, among those engaged in sexual intercourse, barriers were significantly and negatively correlated with the explicit condom use measure, and only barriers concerning partner and motivation correlated with implicit condom use tendencies. CONCLUSION Having a sexual partner plays a major role in the relations between barriers and implicit and explicit condom use measures. The pattern of the results is discussed in relation to cognitive and social factors.
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Affiliation(s)
- Einav Levy
- Department of Social Work, Ringgold: 54625Tel Hai College, Qiryat Shemona, Israel.,The Israeli School of Humanitarian Action, Tel Aviv, Israel.,Tel Aviv University, Tel Aviv, Israel
| | - Lisa M Warner
- Department of Psychology, Ringgold: 381458MSB Medical School Berlin, Berlin, Germany
| | - Lena Fleig
- Department of Psychology, Ringgold: 381458MSB Medical School Berlin, Berlin, Germany
| | - Michelle R Kaufman
- Blomberg School of Public Health, Department of Health, Behavior & Society, Ringgold: 25802Johns Hopkins University Baltimore, Baltimore, MD, USA
| | - Yori Gidron
- Department of Nursing, Ringgold: 26748Haifa University, Haifa, Israel
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Phiri M, Lemba M, Chomba C, Kanyamuna V. Examining differentials in HIV transmission risk behaviour and its associated factors among men in Southern African countries. HUMANITIES & SOCIAL SCIENCES COMMUNICATIONS 2022; 9:295. [PMID: 36060615 PMCID: PMC9419142 DOI: 10.1057/s41599-022-01312-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 08/15/2022] [Indexed: 06/15/2023]
Abstract
Sub-Saharan Africa (SSA), particularly Southern and East Africa, has the highest AIDS deaths and HIV-infected people in the world. Even though considerable effort has been made over the years to study HIV transmission risk behaviours of different population groups in SSA, there is little evidence of studies that have looked at pooled effects of associated HIV risk factors among men, particularly in Southern Africa. Thus, this study sought to fill this gap in knowledge by investigating the variations in HIV risk behaviours among men in the region. The study analysed cross-sectional data based on the most recent country Demographic and Health Survey (DHS) for six countries, namely Lesotho, Mozambique, Namibia, South Africa, Zambia and Zimbabwe. The study employed multivariate logistic regression models on a pooled dataset and individual country data to examine the relative risk of education and other factors on HIV risk behaviour indicators. It considered: (i) condom use during high risk-sex, (ii) multiple sexual partnerships, and (iii) HIV testing among men aged 15-59 years. Findings show that the proportion of men who engaged in HIV transmission risk behaviour was high in Southern Africa. Two-thirds of men reported non-use of a condom during last sex with most recent partners while 22% engaged in multiple sexual partnerships. The percentage of men who used condoms during sex with most recent partners ranged from 18% in Mozambique to 58% in Namibia. Age, residence, marital status and household wealth status were associated with HIV risk factors in the region. The study has established country variations in terms of how individual factors influence HIV transmission risk behaviour among men. Results show that the level of education was associated with increased use of condoms, only in Zambia and Mozambique. Delay in starting a sexual debut was associated with reduced odds of having multiple sexual partnerships in the region. Suggesting the need to strengthen comprehensive sexuality education among young men in school, to promote social behaviour change during adolescence age. The study presents important results to inform direct health policy, programme and government action to address HIV prevalence in the Southern region of Africa.
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Affiliation(s)
- Million Phiri
- Department of Population Studies, School of Humanities and Social Sciences, University of Zambia, Lusaka, Zambia
- Department of Demography and Population Studies, Schools of Public Health and Social Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Musonda Lemba
- Department of Population Studies, School of Humanities and Social Sciences, University of Zambia, Lusaka, Zambia
| | - Chrispin Chomba
- Department of Community and Family Medicine, School of Public Health, University of Zambia, Lusaka, Zambia
| | - Vincent Kanyamuna
- Department of Development Studies, School of Humanities and Social Sciences, University of Zambia, Lusaka, Zambia
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Collica-Cox K. Do As I Say, Not What I Do: The Practices of HIV Prison Peer Educators. JOURNAL OF CORRECTIONAL HEALTH CARE 2021; 27:245-252. [PMID: 34374566 DOI: 10.1089/jchc.19.10.0080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The rate of new HIV infections has declined over the past several years. Mass education pertaining to preventive measures is often credited for its decline, particularly among incarcerated populations where the infection rates are often higher than in the general community. Interestingly, those tasked with providing the education may not always practice the preventive measures taught. Interviews were conducted with 49 incarcerated women who worked in two HIV prison-based peer programs during their incarceration. Responses indicated that although participants were comfortable discussing their sex/drug histories with partners or potential partners, approximately half of participants did not practice safer sex consistently during/after the time they were working as HIV peer educators.
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Affiliation(s)
- Kimberly Collica-Cox
- Department of Criminal Justice and Security, Dyson College of Arts and Sciences, Pace University, New York, New York, USA
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Vakili F, Alipour A, Khoei EM, Rasoolinejad M. "Demand what you prefer": the role of sexual assertiveness among HIV-infected women. CENTRAL EUROPEAN JOURNAL OF NURSING AND MIDWIFERY 2019. [DOI: 10.15452/cejnm.2019.10.0013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Medina-Perucha L, Family H, Scott J, Chapman S, Dack C. Factors Associated with Sexual Risks and Risk of STIs, HIV and Other Blood-Borne Viruses Among Women Using Heroin and Other Drugs: A Systematic Literature Review. AIDS Behav 2019; 23:222-251. [PMID: 30073636 PMCID: PMC6342849 DOI: 10.1007/s10461-018-2238-7] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
This systematic literature review identified factors associated with sexual risks related to sexually transmitted infections (STI), HIV and other blood-borne viruses (BBV) among women using heroin and other drugs. The search strategy included five databases (PubMed, EMBASE, PsycNET, Web of Science, Scopus), and PsycEXTRA for grey literature. Out of the 12,135 publications screened, 30 peer-reviewed articles were included. Most publications were cross-sectional (n = 25), quantitative (n = 23) and included 11,305 women. Factors identified were: (1) socio-demographics; (2) gender roles and violence against women; (3) substance use; (4) transactional sex; (5) partner characteristics, partner's drug use, and context of sex; (6) preferences, negotiation and availability of condoms; (7) HIV status and STIs; (8) number of sexual partners; (9) love and trust; (10) reproductive health and motherhood; and (11) risk awareness and perception of control. Overall, this review highlights important implications for future research and practice, and provides evidence for developing STI/BBV preventive strategies.
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Affiliation(s)
- L Medina-Perucha
- Department of Pharmacy and Pharmacology, University of Bath, Bath, BA2 7AY, UK.
- 5 West, 2.52, Department of Pharmacy and Pharmacology, University of Bath, Bath, BA2 7AY, UK.
| | - H Family
- Department of Pharmacy and Pharmacology, University of Bath, Bath, BA2 7AY, UK
| | - J Scott
- Department of Pharmacy and Pharmacology, University of Bath, Bath, BA2 7AY, UK
| | - S Chapman
- Department of Pharmacy and Pharmacology, University of Bath, Bath, BA2 7AY, UK
| | - C Dack
- Department of Psychology, University of Bath, Bath, UK
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Golub SA, Gamarel KE. Psychometric evaluation of the Condom Barriers and Motivations Scale (CBMS). J Behav Med 2017; 40:494-505. [PMID: 27995366 PMCID: PMC6372104 DOI: 10.1007/s10865-016-9815-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2016] [Accepted: 11/28/2016] [Indexed: 01/05/2023]
Abstract
The Condom Barriers and Motivations Scale (CBMS) was developed to measure four distinct categories of barriers and motives to condom use, including: risk reduction motivations, pleasure reduction barriers, intimacy interference barriers, and partner pressure barriers. The CBMS is a 16-item scale with four items that correspond to each of these subscales. The CBMS was tested in two samples of gay and bisexual men. Results support the reliability and validity of the scale and its structure. Results also indicate that CBMS subscales are distinct from general measures of sexual wellbeing, personality factors, or relationship quality (i.e., discriminant validity) and are associated with self-reported condom use with different partner types (i.e., construct validity). The CBMS can be helpful in better understanding the dynamics of condom use in the context of pre-exposure prophylaxis decision-making, and can shed light on innovative approaches to enhance condom use as part of comprehensive HIV prevention and sexual health goals.
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Affiliation(s)
- Sarit A Golub
- Department of Psychology, Hunter College of the City University of New York, 695 Park Avenue, New York, NY, 10065, USA.
- Basic and Applied Social Psychology PhD Program, The Graduate Center of the City University of New York, New York, NY, USA.
- Hunter HIV/AIDS Research Team (HART), New York, NY, USA.
| | - Kristi E Gamarel
- Hunter HIV/AIDS Research Team (HART), New York, NY, USA
- Department of Behavioral and Social Sciences, Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, RI, USA
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Toopchian A, Kanani S, Babazadeh T, Allahverdipour H, Nadrian H. Development and Psychometric Properties of a Condom Use and Its Cognitive Determinants Questionnaire (CUCDQ). Open Access Maced J Med Sci 2017; 5:79-85. [PMID: 28293322 PMCID: PMC5320913 DOI: 10.3889/oamjms.2017.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2016] [Revised: 11/29/2016] [Accepted: 12/01/2016] [Indexed: 11/26/2022] Open
Abstract
AIM The aim of this study was to assess the psychometric properties of Condom Use and its Cognitive Determinants Questionnaire (CUCDQ) among married women in Tabriz, Iran. MATERIALS AND METHODS In this cross-sectional study, applying multistage cluster sampling 388 married women were recruited to participate in the study. A comprehensive literature review was conducted to develop CUCDQ. Face, content, and construct validity, as well as reliability, were investigated. RESULTS Principal component factor analysis with varimax rotation demonstrated a six factors structure as the best solution [Bartlett's Test of Sphericity (Approx. Chi-Square= 4193.07, df= 780, p<0.001); KMO= 0.815] which explained 43.13% of all the variance between the items. CUCDQ represented a proper validity, reliability, simplicity and functionality. CONCLUSION CUCDQ may be helpful for family health care providers and family planning decision makers in precise assessing the behavioural, psychological, and educational factors related to condom use. This scale may be useful in a various range of studies including family planning or STIs prevention studies in different communities. Future research is recommended to assess the different dimensions of the tool in different communities.
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Affiliation(s)
- Arezoo Toopchian
- Department of Health Education and Promotion, Faculty of Health, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Safieh Kanani
- Department of Health Education and Promotion, Faculty of Health, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Towhid Babazadeh
- Department of Health Education and Promotion, Faculty of Health, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Hamid Allahverdipour
- Department of Health Education and Promotion, Faculty of Health, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Haidar Nadrian
- Department of Health Education and Promotion, Faculty of Health, Tabriz University of Medical Sciences, Tabriz, Iran
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Merghati-Khoei ES, Rezaei Z, Shojaei-Zadeh D, Azadi NA, Rimaz S, Bayat A, Moayedi-Nia S, Omati S, Salimi F, Korte J, Killeen T, Mohraz M. Sexual Risk Behaviors and Condom Use Barriers in Iranian Men with Substance Use Disorders. ADDICTION & HEALTH 2017; 9:40-47. [PMID: 29026502 PMCID: PMC5628767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND We aimed to investigate risky sexual behaviors (RSBs) and condom use barriers in Iranian men with substance use disorders (SUDs). METHODS Of the total 1800 outpatient drug free (ODF) and methadone maintenance treatment program (MMTP) active centers in Tehran, Iran, six were selected to participate in the current study. Data were collected (n = 300 men) using three questionnaires including a demographic questionnaire, the Risky Sexual Behavior Questionnaire (RSBQ), and the Condom Barriers Scale (CBS). The statistical software R, analysis of variance post hoc and multivariate analysis of variance (MANOVA) logistic regression tests were used in data analysis. FINDINGS The majority, (n = 194, 64.7%) reported at least one lifetime episode of RSBs. Compared to married participants (23.1%), 88.5% of single and 87.0% of divorced men had a history of RSB. Generally, the lowest and highest subscale scores of the CBS were related to sexual experience (2.60 ± 0.71) and access/availability structure (3.77 ± 0.54), respectively. The results of MANOVA analysis showed that there was a statistically significant difference between the CSB subscales based on the participants' education and marital status (P < 0.001). Only the partner barrier subscale had a significant negative relationship (P = 0.003) with RSB. CONCLUSION Sexual dynamic of Iranian men with SUDs is different. Barriers to condom use seem to be socio-culturally determined. Culturally acceptable strategies need to be utilized in Iranian clinical settings reaching beyond simply condom accessibility for this at risk population.
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Affiliation(s)
- Effat Sadat Merghati-Khoei
- Associate Professor, Iranian National Center for Addiction Studies, Tehran University of Medical Sciences, Tehran, Iran
| | - Zahed Rezaei
- MSc Student, Department of Health Education and Health Promotion, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Davood Shojaei-Zadeh
- Professor, Department of Health Education and Health Promotion, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Nammam Ali Azadi
- Assistant Professor, Department of Biostatistics, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Shahnaz Rimaz
- Associate Professor, Department of Epidemiology, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Alireza Bayat
- Iranian National Center for Addiction Studies, Tehran University of Medical Sciences, Tehran, Iran
| | - Saeedeh Moayedi-Nia
- Iranian Research Center for HIV/AIDS, Institute for Reduction of High-Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran
| | - Sanaz Omati
- Psychologist, Iranian National Center for Addiction Studies, Tehran University of Medical Sciences, Tehran, Iran
| | - Farahnaz Salimi
- MSc Student, Iranian National Center for Addiction Studies, Tehran University of Medical Sciences, Tehran, Iran
| | - Jeffrey Korte
- Associate Professor, Iranian National Center for Addiction Studies, Tehran University of Medical Sciences, Tehran, Iran
| | - Therese Killeen
- Associate Professor, Iranian National Center for Addiction Studies, Tehran University of Medical Sciences, Tehran, Iran
| | - Minoo Mohraz
- Associate Professor, Iranian National Center for Addiction Studies, Tehran University of Medical Sciences, Tehran, Iran,Correspondence to: Minoo Mohraz PhD,
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