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Sadeghian B, Abedi P, Hamid N, Maraghi E, Molavi S. The effect of 8-week mindfulness counseling on sexual self-efficacy of women suffering from human immunodeficiency syndrome: A randomized controlled trial in Iran. Health Sci Rep 2024; 7:e1956. [PMID: 38469109 PMCID: PMC10926193 DOI: 10.1002/hsr2.1956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 02/16/2024] [Accepted: 02/18/2024] [Indexed: 03/13/2024] Open
Abstract
Background and Aims Sexual self-efficacy refers to a woman's belief that she can be sexually active and attractive for her sexual partner and has acceptable sexual function. One of the issues that may negatively affect sexual self-efficacy is HIV infection. The present study aimed to evaluate the effect of 8 weeks of counseling based on mindfulness on sexual self-efficacy of women affected with HIV. Methods This was a randomized controlled trial involving 62 HIV-positive women in their reproductive age. Women in the intervention group were further divided into four groups. Each group received eight sessions of counseling based on mindfulness, while the control group received no intervention. A demographic questionnaire and sexual self-efficacy questionnaire were used to collect the data. The independent t test, χ 2, and repeated measure tests were used to analyze the data. Results The mean change of total score of sexual self-efficacy in Week 8 compared with before intervention was 37.04 (95% CI: 31.38-42.70, p < 0001) and in Week 12 compared with before intervention was 36.97 (95% CI: 31.59-42.34, p < 0.0001), while in the control group, it almost remained unchanged. The score of readiness for sexual relationship, sexual self-stimulation, intimacy without sexual intercourse, and orgasm improved significantly 8 and 12 weeks after intervention (p < 0.0001), whereas no significant differences were observed in these dimensions in the control group. Conclusion The results of this study showed that 8 weeks of counseling based on mindfulness could significantly improve all dimensions of sexual self-efficacy and its total score in women affected with HIV. Thus, this method of counseling is recommended for HIV-positive women.
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Affiliation(s)
- Bahareh Sadeghian
- Midwifery Department, Reproductive Health Promotion Research CenterAhvaz Jundishapur University of Medical SciencesAhvazIran
| | - Parvin Abedi
- Midwifery Department, Menopause Andropause Research CenterAhvaz Jundishapur University of Medical SciencesAhvazIran
| | - Najmeh Hamid
- Counseling DepartmentShahid Chamran University of AhvazAhvazIran
| | - Elham Maraghi
- Department of Biostatistics and Epidemiology, Faculty of Public HealthAhvaz Jundishapur University of Medical SciencesAhvazIran
| | - Shahla Molavi
- Department of Health Psychology, School of MedicineAhvaz Jundishapur University of Medical SciencesAhvazIran
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Brasileiro J, Widman L, Hurst JL. Sexual self-efficacy and sexual communication among adolescent girls: moderated mediation results from a randomized controlled trial. Psychol Health 2023; 38:1273-1287. [PMID: 34905990 PMCID: PMC9210825 DOI: 10.1080/08870446.2021.2012573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 10/28/2021] [Accepted: 11/25/2021] [Indexed: 10/19/2022]
Abstract
OBJECTIVE Guided by the Operating Conditions Framework, the goal of this study was to identify how and for whom an online sexual health program called Health Education and Relationship Training (HEART) worked. DESIGN Data come from a randomized controlled trial among 198 U.S. high school girls who completed HEART or an attention-matched control. We conducted mediation and moderated mediation models to determine if sexual self-efficacy was a mediator and if program acceptability and sexual activity status were moderators of HEART efficacy. MAIN OUTCOME MEASURE Sexual communication skills were assessed with a behavioral role-play task. RESULTS HEART significantly improved sexual communication skills. These effects were fully mediated through sexual self-efficacy. Specifically, HEART improved sexual self-efficacy which in turn increased sexual communication skills. Also, when participants liked the program more, the effect of HEART on sexual self-efficacy was stronger. Further, among girls who had engaged in sexual activity, sexual self-efficacy was significantly associated with sexual communication skills. CONCLUSION This study provides insights into the mechanisms of behavior change underlying HEART. Results highlight the need to further 'unpack' the effects of other sexual health programs, as we showed that programs may work better under certain conditions.
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Affiliation(s)
- Julia Brasileiro
- Department of Psychology, North Carolina State University, Raleigh, USA
| | - Laura Widman
- Department of Psychology, North Carolina State University, Raleigh, USA
| | - Jeffrey L Hurst
- Department of Psychology, North Carolina State University, Raleigh, USA
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Fahs B. ‘I just tell myself it’s okay’: U.S. women’s narratives about sexual safety and how they assess risk for sexually-transmitted infections. PSYCHOLOGY & SEXUALITY 2022. [DOI: 10.1080/19419899.2021.1871775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Breanne Fahs
- Women and Gender Studies Program, Arizona State University, Glendale, AZ, USA
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Brar P, Dworkin J, Brady SS. Adolescent Women's Sexual Self-Efficacy: Associations with Personal and Perceived Partner Beliefs that Condoms Interfere with Pleasure. AMERICAN JOURNAL OF SEXUALITY EDUCATION 2020; 15:336-356. [PMID: 38264627 PMCID: PMC10805473 DOI: 10.1080/15546128.2020.1763882] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/25/2024]
Abstract
Sexual self-efficacy, an individual's confidence in the domain of sexual health behaviors, was studied among an ethnically diverse sample of 128 sexually active adolescent women between the ages of 14 and 18 years. A hypothesized interaction between women's belief that condoms interfere with sexual pleasure and her perception of a partner's belief that condoms interfere with sexual pleasure was not supported. Both adolescent women's belief that condoms interfere with pleasure and their perception that their partner believed condoms interfere with pleasure were separately associated with lower self-efficacy to refuse sex without condoms and use condoms. Both a partner's and one's own sexual pleasure may be important determinants of adolescent women's confidence to engage in health protective sexual behaviors. Adolescents' self-efficacy to experience pleasure when using condoms should be enhanced.
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Affiliation(s)
- Pooja Brar
- Division of General Pediatrics and Adolescent Health, Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA
| | - Jodi Dworkin
- Department of Family Social Science, University of Minnesota, Minneapolis, MN, USA
| | - Sonya S. Brady
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA
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Thior I, Rowley E, Mavhu W, Kruse-Levy N, Messner L, Falconer-Stout ZJ, Mugurungi O, Ncube G, Leclerc-Madlala S. Urban-rural disparity in sociodemographic characteristics and sexual behaviors of HIV-positive adolescent girls and young women and their perspectives on their male sexual partners: A cross-sectional study in Zimbabwe. PLoS One 2020; 15:e0230823. [PMID: 32324764 PMCID: PMC7179911 DOI: 10.1371/journal.pone.0230823] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2019] [Accepted: 03/09/2020] [Indexed: 11/19/2022] Open
Abstract
We conducted a cross sectional survey in Zimbabwe to describe urban-rural disparity in socio-demographic characteristics and sexual behaviors of HIV-positive adolescent girls and young women (AGYW) and their male sexual partners. Between September and November 2016, we interviewed 360 sexually active HIV positive AGYW, aged 15––24 years attending ART and PMTCT clinics in urban and rural health facilities in Harare and Mazowe district respectively. HIV positive AGYW in rural areas as compared to those in urban areas were older, less educated, more frequently married or cohabiting, had lower number of male sexual partners in their lifetime and in the last 12 months preceding the survey. They were mostly heterosexually infected, more likely to disclose their status to a family member and to be more adherent to ART (OR = 2.5–95% CI = 1.1–5.5). Most recent male sexual partners of HIV positive AGYW in urban areas as compared to those from rural areas were mainly current or former boyfriends, single, more educated, less likely to have a child with them and to engage in couple voluntary counseling and testing (CVCT). They were more likely to patronize dancing and drinking venues and involved in transactional sex (OR = 2.2–95% CI: 1.2–4). They were also more likely to be circumcised (OR = 2.3–95% CI: 1.3–4.1) and to use condom more consistently in the last 12 months preceding the survey. Our study findings called for the strengthening of HIV prevention interventions in urban areas among HIV positive AGYW who had more than one partner in their lifetime or are patronizing dancing and drinking venues. In Zimbabwe, promotion of CVCT, index testing, male circumcision and condom use should be sustained to engage male sexual partners of both urban and rural HIV positive AGYW in HIV prevention.
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Affiliation(s)
- Ibou Thior
- PATH, Washington, D.C, United States of America
- * E-mail:
| | | | - Webster Mavhu
- Centre for Sexual Health & HIV/AIDS Research, Harare, Zimbabwe
| | | | - Lyn Messner
- EnCompass LLC, Rockville, Maryland, United States of America
| | | | - Owen Mugurungi
- AIDS and TB, Ministry of Health and Child Care, Harare, Zimbabwe
| | - Getrude Ncube
- AIDS and TB, Ministry of Health and Child Care, Harare, Zimbabwe
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Farmanfarmaee S, Habibi M, Darharaj M, Khoshnood K, Zadeh Mohammadi A, Kazemitabar M. Predictors of HIV-related high-risk sexual behaviors among female substance users. JOURNAL OF SUBSTANCE USE 2017. [DOI: 10.1080/14659891.2017.1378739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
| | - Mojtaba Habibi
- Department of Health Psychology, School of Behavioral Sciences and Mental Health, Iran University of Medical Sciences, Tehran, Iran
| | - Mohammad Darharaj
- Department of Clinical Psychology, Kharazmi University, Tehran, Iran
| | - Kaveh Khoshnood
- Yale School of Public Health, Center for Interdisciplinary Research on AIDS, New Haven, Connecticut, USA
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Pittiglio L. Learned Helplessness and Sexual Risk Taking in Adolescent and Young Adult African American Females. AIDS Patient Care STDS 2017; 31:356-361. [PMID: 28719226 DOI: 10.1089/apc.2017.0052] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
Research involving adolescent and young African American (AA) females has demonstrated that they face uncontrollable obstacles which can interfere with the negotiation of safer sexual behaviors. If these obstacles are perceived as uncontrollable, then these females may be at risk for the development of Learned Helplessness (LH). As the LH model predicts, if these obstacles are believed not to be in their control, it may lead to deficits in motivational or cognitive decision-making, deficits that could certainly influence their sexual risk taking behaviors. Therefore, the primary objective for this pilot study was to trial the Learned Helplessness Scale (LHS) to examine the perceptions of LH in this population. A convenience sample of 50 adolescent and young AA females between the ages of 16 and 21 were recruited from two clinics in Southeast Michigan. Scores on the LHS ranged from 20 to 57, with a mean score of 39.1 (standard deviation = 10.49). The higher range of scores in the sample demonstrates a continuum of LH among the participants in the study.
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Jones KA, Cornelius MD, Silverman JG, Tancredi DJ, Decker MR, Haggerty CL, De Genna NM, Miller E. Abusive Experiences and Young Women's Sexual Health Outcomes: Is Condom Negotiation Self-Efficacy a Mediator? PERSPECTIVES ON SEXUAL AND REPRODUCTIVE HEALTH 2016; 48:57-64. [PMID: 27077497 PMCID: PMC4909564 DOI: 10.1363/48e8616] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/18/2015] [Revised: 11/19/2015] [Accepted: 11/20/2015] [Indexed: 05/12/2023]
Abstract
CONTEXT Intimate partner violence and reproductive coercion are associated with unintended pregnancies and STDs. Greater condom negotiation self-efficacy among young women may mediate these associations. METHODS A sample of 841 female adolescents (aged 16-19) and 1,387 young adult women (aged 20-24) recruited from 24 family planning clinics in western Pennsylvania in 2011-2012 reported on intimate partner violence, reproductive coercion, condom negotiation self-efficacy and sexual health outcomes at baseline and four- and 12-month follow-ups. Mixed models were used to test associations of intimate partner violence and reproductive coercion with unintended pregnancy and STD diagnosis. The Sobel test of mediation was used to measure indirect effects of condom negotiation self-efficacy. RESULTS At baseline, 15% of adolescents and 11% of young adults reported recent intimate partner violence victimization; 7% and 6%, respectively, reported recent reproductive coercion. For both age-groups, intimate partner violence and reproductive coercion were associated with a reduced level of condom negotiation self-efficacy (coefficients, -0.27 to -0.13) and increased odds of STD diagnosis (odds ratios, 1.03-1.1). However, only reproductive coercion was associated with unintended pregnancy (odds ratios, 1.1 for each group). The only association that condom negotiation self-efficacy mediated was between reproductive coercion and unintended pregnancy among young adults (17% of total effect). CONCLUSIONS Targeting condom negotiation self-efficacy alone in abusive relationships would likely not translate into improved sexual health outcomes in this population. Other strategies are needed to prevent unintended pregnancy and STDs.
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Affiliation(s)
- Kelley A Jones
- Division of Adolescent and Young Adult Medicine, School of Medicine, University of Pittsburgh.
| | - Marie D Cornelius
- Department of Psychiatry, School of Medicine, University of Pittsburgh
| | - Jay G Silverman
- Division of Global Public Health, School of Medicine, University of California, San Diego, La Jolla, CA
| | - Daniel J Tancredi
- Department of Pediatrics, School of Medicine, University of California, Davis, Sacramento, CA
| | - Michele R Decker
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore
| | - Catherine L Haggerty
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh
| | | | - Elizabeth Miller
- Department of Pediatrics, School of Medicine, University of Pittsburgh
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Brothers J, Hotton AL, Hosek SG, Harper GW, Fernandez MI. Young Women Living with HIV: Outcomes from a Targeted Secondary Prevention Empowerment Pilot Trial. AIDS Patient Care STDS 2016; 30:229-35. [PMID: 27158851 DOI: 10.1089/apc.2015.0294] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
UNLABELLED Women account for 1 in 5 new HIV infections in the US, make up 24% of people living with HIV, and represent a quarter of AIDS diagnoses. Despite the need for continued prevention among young women living with HIV, there is very little in the literature on how best to reduce sexual risk and increase the health and well-being of young women living with HIV. This article explores the primary and secondary outcomes of a randomized controlled pilot trial of an intervention entitled EVOLUTION Young Women Taking Charge and Growing Stronger. This behavioral intervention aimed to decrease sexual risk and empower young women living with HIV by enhancing young women's knowledge and skills pertaining to HIV risk reduction as well as to the factors that increase women's vulnerability, such as sexual inequality, gender, and power imbalances. Findings from this trial demonstrate that group-based behavioral interventions for young women living with HIV have promise to reduce the total number of sexual partners and reduce unprotected vaginal and anal intercourse. However, more work is needed to understand how best to address the challenges young women face in their day to day lives that impact their sexual risk as well as their overall health and access to care and treatment.
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Affiliation(s)
- Jennifer Brothers
- Division of Child and Adolescent Psychiatry, John Stroger Hospital of Cook County, Chicago, Illinois
| | - Anna L. Hotton
- Division of Child and Adolescent Psychiatry, John Stroger Hospital of Cook County, Chicago, Illinois
| | - Sybil G. Hosek
- Division of Child and Adolescent Psychiatry, John Stroger Hospital of Cook County, Chicago, Illinois
| | - Gary W. Harper
- Division of Child and Adolescent Psychiatry, John Stroger Hospital of Cook County, Chicago, Illinois
| | - M. Isabel Fernandez
- Division of Child and Adolescent Psychiatry, John Stroger Hospital of Cook County, Chicago, Illinois
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10
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Lee L, Yehia BR, Gaur AH, Rutstein R, Gebo K, Keruly JC, Moore RD, Nijhawan AE, Agwu AL. The Impact of Youth-Friendly Structures of Care on Retention Among HIV-Infected Youth. AIDS Patient Care STDS 2016; 30:170-7. [PMID: 26983056 DOI: 10.1089/apc.2015.0263] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Limited data exist on how structures of care impact retention among youth living with HIV (YLHIV). We describe the availability of youth-friendly structures of care within HIV Research Network (HIVRN) clinics and examine their association with retention in HIV care. Data from 680 15- to 24-year-old YLHIV receiving care at 7 adult and 5 pediatric clinics in 2011 were included in the analysis. The primary outcome was retention in care, defined as completing ≥2 primary HIV care visits ≥90 days apart in a 12-month period. Sites were surveyed to assess the availability of clinic structures defined a priori as 'youth-friendly'. Univariate and multivariable logistic regression models assessed structures associated with retention in care. Among 680 YLHIV, 85% were retained. Nearly half (48%) of the 680 YLHIV attended clinics with youth-friendly waiting areas, 36% attended clinics with evening hours, 73% attended clinics with adolescent health-trained providers, 87% could email or text message providers, and 73% could schedule a routine appointment within 2 weeks. Adjusting for demographic and clinical factors, YLHIV were more likely to be retained in care at clinics with a youth-friendly waiting area (AOR 2.47, 95% CI [1.11-5.52]), evening clinic hours (AOR 1.94; 95% CI [1.13-3.33]), and providers with adolescent health training (AOR 1.98; 95% CI [1.01-3.86]). Youth-friendly structures of care impact retention in care among YLHIV. Further investigations are needed to determine how to effectively implement youth-friendly strategies across clinical settings where YLHIV receive care.
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Affiliation(s)
- Lana Lee
- Divisions of General Pediatrics and Adolescent Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Baligh R. Yehia
- Department of Infectious Diseases, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
| | - Aditya H. Gaur
- Department of Infectious Diseases, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Richard Rutstein
- Division of General Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Kelly Gebo
- Divisions of Infectious Diseases, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Jeanne C. Keruly
- Divisions of Infectious Diseases, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Richard D. Moore
- Divisions of Infectious Diseases, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Ank E. Nijhawan
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Allison L. Agwu
- Divisions of Adult and Pediatric Infectious Diseases, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland
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11
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Lee YH, Salman A. Depression and AIDS Preventive Self-efficacy Among Taiwanese Adolescents. Arch Psychiatr Nurs 2016; 30:84-9. [PMID: 26804507 DOI: 10.1016/j.apnu.2015.09.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2015] [Revised: 08/29/2015] [Accepted: 09/06/2015] [Indexed: 11/15/2022]
Abstract
Effectively reducing adolescents' risky sexual behaviors has been an urgent need since the HIV/AIDS infections among young people has been acknowledged as a priority. Self-efficacy has been considered playing an essential role in behavioral changes, and depressed individuals may demonstrate lower self-efficacy. The purpose of this cross-sectional study was to gain insights into self-reported depression among 16-18 years-old Taiwanese adolescents as well as to explore psychosocial predictors of AIDS preventive self-efficacy. A convenience sample of 734 adolescents from southern Taiwan was recruited, and several reliable and valid questionnaires were used to collect data. Descriptive statistics, odds ratio, independent t-test, and hierarchical multiple regression analyses were utilized to analyze data. Results showed that the differences in self-reported depression and in the AIDS preventive self-efficacy varied by gender, substance use, and having sexual experience. Furthermore, depression was a significant predictor of AIDS preventive self-efficacy while controlling the covariates. This study suggests that gender and mental health status such as depression may play significant roles in AIDS preventive self-efficacy. Nurses and health care providers should take the influence of mental health into consideration when designing AIDS preventive interventions for male and female Taiwanese adolescents. The provided information may also enhance psychiatric nurses' capability to provide care and to enhance the prevention of HIV infection for adolescents.
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Affiliation(s)
- Yi-Hui Lee
- College of Nursing and Health, Wright State University-Miami Valley, Dayton, OH.
| | - Ali Salman
- Faculty of Health Studies, Brandon University, MB, Canada; Al-Andalus University for Medical Sciences, Tartus, Syria
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12
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Camacho-Gonzalez AF, Wallins A, Toledo L, Murray A, Gaul Z, Sutton MY, Gillespie S, Leong T, Graves C, Chakraborty R. Risk Factors for HIV Transmission and Barriers to HIV Disclosure: Metropolitan Atlanta Youth Perspectives. AIDS Patient Care STDS 2016; 30:18-24. [PMID: 26588663 PMCID: PMC4717512 DOI: 10.1089/apc.2015.0163] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Youth carry the highest incidence of HIV infection in the United States. Understanding adolescent and young adult (AYA) perspectives on HIV transmission risk is important for targeted HIV prevention. We conducted a mixed methods study with HIV-infected and uninfected youth, ages 18-24 years, from Atlanta, GA. We provided self-administered surveys to HIV-infected and HIV-uninfected AYAs to identify risk factors for HIV acquisition. By means of computer-assisted thematic analyses, we examined transcribed focus group responses on HIV education, contributors to HIV transmission, and pre-sex HIV status disclosure. The 68 participants had the following characteristics: mean age 21.5 years (standard deviation: 1.8 years), 85% male, 90% black, 68% HIV-infected. HIV risk behaviors included the perception of condomless sex (Likert scale mean: 8.0) and transactional sex (88% of participants); no differences were noted by HIV status. Qualitative analyses revealed two main themes: (1) HIV risk factors among AYAs, and (2) barriers to discussing HIV status before sex. Participants felt the use of social media, need for immediate gratification, and lack of concern about HIV disease were risk factors for AYAs. Discussing HIV status with sex partners was uncommon. Key reasons included: fear of rejection, lack of confidentiality, discussion was unnecessary in temporary relationships, and disclosure negatively affecting the mood. HIV prevention strategies for AYAs should include improving condom use frequency and HIV disclosure skills, responsible utilization of social media, and education addressing HIV prevention including the risks of transactional sex.
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Affiliation(s)
- Andres F Camacho-Gonzalez
- 1 Division of Pediatric Infectious Diseases, Emory University School of Medicine , Atlanta, Georgia
- 2 Ponce Family and Youth Clinic , Grady Infectious Diseases Program, Grady Health Systems, Atlanta, Georgia
| | - Amy Wallins
- 1 Division of Pediatric Infectious Diseases, Emory University School of Medicine , Atlanta, Georgia
- 2 Ponce Family and Youth Clinic , Grady Infectious Diseases Program, Grady Health Systems, Atlanta, Georgia
| | - Lauren Toledo
- 3 Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention , Atlanta, Georgia
- 4 ICF International , Atlanta, Georgia
| | - Ashley Murray
- 3 Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention , Atlanta, Georgia
| | - Zaneta Gaul
- 3 Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention , Atlanta, Georgia
- 4 ICF International , Atlanta, Georgia
| | - Madeline Y Sutton
- 3 Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention , Atlanta, Georgia
| | - Scott Gillespie
- 5 Department of Pediatrics, Emory University School of Medicine , Atlanta, Georgia
| | - Traci Leong
- 6 Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University School of Medicine , Atlanta, Georgia
| | - Chanda Graves
- 2 Ponce Family and Youth Clinic , Grady Infectious Diseases Program, Grady Health Systems, Atlanta, Georgia
- 7 Department of Psychiatry and Behavioral Sciences, School of Medicine, Emory University School of Medicine , Atlanta, Georgia
| | - Rana Chakraborty
- 1 Division of Pediatric Infectious Diseases, Emory University School of Medicine , Atlanta, Georgia
- 2 Ponce Family and Youth Clinic , Grady Infectious Diseases Program, Grady Health Systems, Atlanta, Georgia
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