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Sexual Behavior Patterns of Black Young Adults in Georgia: Results from a Latent Class Analysis. J Racial Ethn Health Disparities 2023; 10:271-281. [PMID: 35018580 DOI: 10.1007/s40615-021-01217-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 12/21/2021] [Accepted: 12/21/2021] [Indexed: 02/03/2023]
Abstract
The state of Georgia ranks first in the rate of new diagnosis of HIV/AIDS, yet studies focused on understanding the drivers of this epidemic in the most at-risk groups outside the Atlanta Metropolitan Statistical Area (MSA) remain sparse. Among the many consequences of this is the inability to effectively design tailored intervention programs that appropriately address the reduction of HIV/AIDS and other STDS in the state. Reducing disparities in HIV/AIDS remains an important goal in the National HIV/AIDS Strategy. Given the disproportionate burden of the HIV/AIDS epidemic among Blacks in the state of Georgia, there is a significant need to focus research attention on the sexual behavior of young people that predisposes them to increased risk of HIV/AIDS infection. The current study used latent class analysis (LCA) to examine the sexual behavior patterns of Black young adults living in Georgia. LCA results revealed a two-class fit with distinct sexual behavior patterns. Gender and educational attainment emerged as significant predictors of class membership. Our findings contribute to the vast literature showing that sexual behavior patterns of Black young adults are not homogenous, and underscore the significance of socio-demographic and contextual factors in shaping sexual risk behavior.
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Ozua ML, Artaman A. A Retrospective Study of the Incidence of Bacterial Sexually Transmitted Infection (Chlamydia and Gonorrhea) in the Mississippi Delta Before and During the COVID-19 Pandemic. Cureus 2022; 14:e23712. [PMID: 35505759 PMCID: PMC9056590 DOI: 10.7759/cureus.23712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/21/2022] [Indexed: 11/25/2022] Open
Abstract
Background: Sexually transmitted infections (STIs), such as gonorrhea and chlamydia infections, are prevalent worldwide, in the United States, and in Mississippi (MS). The COVID-19 pandemic has impacted the healthcare system, particularly in disadvantaged areas such as the MS Delta. Methods: A retrospective analysis of medical records of three clinics in the MS Delta was conducted during pre-COVID-19 (July 2019 to September 2019) and in the same months (July 2020 to September 2020) during COVID-19 in 2020. Patients tested for STIs were identified using infection diagnosis codes. We calculated percentages and means for demographic variables, changes between the two years, and computed the percentage of patients who tested positive for each year. Results: Out of the 25 patients tested for STIs, 11 were tested in 2019 and 14 in 2020. Among those tested in 2019 compared to 2020, patients were younger (average age: 34.3 years in 2019 vs. 29.6 years in 2020), had a larger percentage of females (81.2% in 2019 vs. 50.0% in 2020) and African Americans (72.7% in 2019 vs. 57.1% in 2020), and more were uninsured (27.3% in 2019 vs. 42.9% in 2020). Of the three clinics, clinic #1 tested most patients (72.7% in 2019 vs. 64.3% in 2020). Among the tested patients, 0% had confirmed positive results in 2019 and 21.4% in 2020. The incidence of positive results in 2020 was 7.1% for chlamydia and 14.3% for gonorrhea. Conclusion: The incidence of gonorrhea and chlamydia increased during COVID-19 in 2020. So, it is of paramount importance to encourage increased testing and targeted interventions for high-risk groups for STIs.
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Gottert A, Pulerwitz J, Heck CJ, Cawood C, Mathur S. Creating HIV risk profiles for men in South Africa: a latent class approach using cross-sectional survey data. J Int AIDS Soc 2020; 23 Suppl 2:e25518. [PMID: 32589340 PMCID: PMC7319107 DOI: 10.1002/jia2.25518] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2019] [Revised: 04/10/2020] [Accepted: 04/22/2020] [Indexed: 12/17/2022] Open
Abstract
INTRODUCTION Engaging at-risk men in HIV prevention programs and services is a current priority, yet there are few effective ways to identify which men are at highest risk or how to best reach them. In this study we generated multi-factor profiles of HIV acquisition/transmission risk for men in Durban, South Africa, to help inform targeted programming and service delivery. METHODS Data come from surveys with 947 men ages 20 to 40 conducted in two informal settlements from May to September 2017. Using latent class analysis (LCA), which detects a small set of underlying groups based on multiple dimensions, we identified classes based on nine HIV risk factors and socio-demographic characteristics. We then compared HIV service use between the classes. RESULTS We identified four latent classes, with good model fit statistics. The older high-risk class (20% of the sample; mean age 36) were more likely married/cohabiting and employed, with multiple sexual partners, substantial age-disparity with partners (eight years younger on-average), transactional relationships (including more resource-intensive forms like paying for partner's rent), and hazardous drinking. The younger high-risk class (24%; mean age 27) were likely unmarried and employed, with the highest probability of multiple partners in the last year (including 42% with 5+ partners), transactional relationships (less resource-intensive, e.g., clothes/transportation), hazardous drinking, and inequitable gender views. The younger moderate-risk class (36%; mean age 23) were most likely unmarried, unemployed technical college/university students/graduates. They had a relatively high probability of multiple partners and transactional relationships (less resource-intensive), and moderate hazardous drinking. Finally, the older low-risk class (20%; mean age 29) were more likely married/cohabiting, employed, and highly gender-equitable, with few partners and limited transactional relationships. Circumcision (status) was higher among the younger moderate-risk class than either high-risk class (p < 0.001). HIV testing and treatment literacy score were suboptimal and did not differ across classes. CONCLUSIONS Distinct HIV risk profiles among men were identified. Interventions should focus on reaching the highest-risk profiles who, despite their elevated risk, were less or no more likely than the lower-risk to use HIV services. By enabling a more synergistic understanding of subgroups, LCA has potential to enable more strategic, data-driven programming and evaluation.
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Affiliation(s)
| | | | | | - Cherie Cawood
- Epicentre Health ResearchPietermaritzburgSouth Africa
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Harawa NT, Brewer R, Buckman V, Ramani S, Khanna A, Fujimoto K, Schneider JA. HIV, Sexually Transmitted Infection, and Substance Use Continuum of Care Interventions Among Criminal Justice-Involved Black Men Who Have Sex With Men: A Systematic Review. Am J Public Health 2019; 108:e1-e9. [PMID: 30383433 DOI: 10.2105/ajph.2018.304698] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
BACKGROUND Because Black men who have sex with men (BMSM) experience high rates of both HIV and incarceration relative to other groups, the various stages of criminal justice involvement may serve as important intervention points for addressing HIV and related conditions in this group. Although systematic reviews of HIV interventions targeting MSM in general and BMSM in particular exist, no review has explored the range and impact of HIV, sexually transmitted infection (STI), and substance use prevention and care continuum interventions focused on criminal justice-involved (CJI) populations. OBJECTIVES To describe the range and impact of published HIV, STI, and related substance use interventions for US-based CJI populations and to understand their relevance for BMSM. SEARCH METHODS We conducted systematic searches in the following databases: PubMed, MEDLINE, Cochrane, CINAHL, and PsycINFO, covering the period preceding December 1, 2016. SELECTION CRITERIA We selected articles in scientific publications involving quantitative findings for studies of US-based interventions that focused on CJI individuals, with outcomes related to sexual or substance use risk behaviors, HIV, or STIs. We excluded studies if they provided no demographic information, had minimal representation of the population of interest (< 30 African American or Black male or transgender participants), had study populations limited to those aged younger than 18 years, or were limited to evaluations of preexisting programs. DATA COLLECTION AND ANALYSIS We abstracted data from these articles on study design; years covered; study location; participant number, demographics, and sexual orientation (if available); criminal justice setting or type; health condition; targeted outcomes; and key findings. We scored studies by using the Downs and Black quality and bias assessment. We conducted linear regression to examine changes in study quality by publication year. MAIN RESULTS Fifty-eight articles met inclusion criteria, including 8 (13.8%) modeling or cost-effectiveness studies and 13 (22.4%) randomized controlled trials. Just 3 studies (5.2%) focused on sexual or gender minorities, with only 1 focused on BMSM. In most studies (n = 36; 62.1%), however, more than 50% of participants were Black. The most common intervention addressed screening, including 20 empirical studies and 7 modeling studies. Education-focused interventions were also common (n = 15) and usually employed didactic rather than skill-building approaches. They were more likely to demonstrate increases in HIV testing, knowledge, and condom-use intentions than reductions in sex- and drug-risk behaviors. Screening programs consistently indicated cost-effectiveness, including with BMSM. Care continuum interventions for people living with HIV showed mixed results; just 3 involved randomized controlled trials, and these interventions did not show significant differences compared with control conditions. A minority of programs targeted non-custody-based CJI populations, despite their constituting a majority of the CJI population at any given time. AUTHORS' CONCLUSIONS Screening CJI populations for HIV and other STIs is effective and cost-efficient and holds promise for reducing HIV in BMSM. Education-based and care provision interventions also hold promise for addressing HIV, STIs, mental health, and substance use in CJI populations. Additional empirical and modeling studies and results specific to sexual minorities are needed; their paucity represents a disparity in how HIV is addressed. Public Health Implications. HIV and STI screening programs focused on CJI populations should be a priority for reducing HIV risk and numbers of undiagnosed infections among BMSM. Funding agencies and public health leaders should prioritize research to improve the knowledge base regarding which care continuum intervention approaches are most effective for BMSM with criminal justice involvement. Developments in modeling approaches could allow researchers to simulate the impacts and costs of criminal justice involvement-related interventions that might otherwise be cost, time, or ethically prohibitive to study empirically.
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Affiliation(s)
- Nina T Harawa
- Nina T. Harawa is with the Department of Medicine, David Geffen School of Medicine, University of California Los Angeles. At the time of the study, Russell Brewer was with the HIV/STI Portfolio, Louisiana Public Health Institute, New Orleans. Victoria Buckman is with The Chicago Center for HIV Elimination, University of Chicago, Chicago, IL. Santhoshini Ramani, Aditya Khanna, and John A. Schneider are with the Department of Medicine, University of Chicago. Kayo Fujimoto is with the Division of Health Promotion and Behavioral Sciences, University of Texas Health Science Center at Houston
| | - Russell Brewer
- Nina T. Harawa is with the Department of Medicine, David Geffen School of Medicine, University of California Los Angeles. At the time of the study, Russell Brewer was with the HIV/STI Portfolio, Louisiana Public Health Institute, New Orleans. Victoria Buckman is with The Chicago Center for HIV Elimination, University of Chicago, Chicago, IL. Santhoshini Ramani, Aditya Khanna, and John A. Schneider are with the Department of Medicine, University of Chicago. Kayo Fujimoto is with the Division of Health Promotion and Behavioral Sciences, University of Texas Health Science Center at Houston
| | - Victoria Buckman
- Nina T. Harawa is with the Department of Medicine, David Geffen School of Medicine, University of California Los Angeles. At the time of the study, Russell Brewer was with the HIV/STI Portfolio, Louisiana Public Health Institute, New Orleans. Victoria Buckman is with The Chicago Center for HIV Elimination, University of Chicago, Chicago, IL. Santhoshini Ramani, Aditya Khanna, and John A. Schneider are with the Department of Medicine, University of Chicago. Kayo Fujimoto is with the Division of Health Promotion and Behavioral Sciences, University of Texas Health Science Center at Houston
| | - Santhoshini Ramani
- Nina T. Harawa is with the Department of Medicine, David Geffen School of Medicine, University of California Los Angeles. At the time of the study, Russell Brewer was with the HIV/STI Portfolio, Louisiana Public Health Institute, New Orleans. Victoria Buckman is with The Chicago Center for HIV Elimination, University of Chicago, Chicago, IL. Santhoshini Ramani, Aditya Khanna, and John A. Schneider are with the Department of Medicine, University of Chicago. Kayo Fujimoto is with the Division of Health Promotion and Behavioral Sciences, University of Texas Health Science Center at Houston
| | - Aditya Khanna
- Nina T. Harawa is with the Department of Medicine, David Geffen School of Medicine, University of California Los Angeles. At the time of the study, Russell Brewer was with the HIV/STI Portfolio, Louisiana Public Health Institute, New Orleans. Victoria Buckman is with The Chicago Center for HIV Elimination, University of Chicago, Chicago, IL. Santhoshini Ramani, Aditya Khanna, and John A. Schneider are with the Department of Medicine, University of Chicago. Kayo Fujimoto is with the Division of Health Promotion and Behavioral Sciences, University of Texas Health Science Center at Houston
| | - Kayo Fujimoto
- Nina T. Harawa is with the Department of Medicine, David Geffen School of Medicine, University of California Los Angeles. At the time of the study, Russell Brewer was with the HIV/STI Portfolio, Louisiana Public Health Institute, New Orleans. Victoria Buckman is with The Chicago Center for HIV Elimination, University of Chicago, Chicago, IL. Santhoshini Ramani, Aditya Khanna, and John A. Schneider are with the Department of Medicine, University of Chicago. Kayo Fujimoto is with the Division of Health Promotion and Behavioral Sciences, University of Texas Health Science Center at Houston
| | - John A Schneider
- Nina T. Harawa is with the Department of Medicine, David Geffen School of Medicine, University of California Los Angeles. At the time of the study, Russell Brewer was with the HIV/STI Portfolio, Louisiana Public Health Institute, New Orleans. Victoria Buckman is with The Chicago Center for HIV Elimination, University of Chicago, Chicago, IL. Santhoshini Ramani, Aditya Khanna, and John A. Schneider are with the Department of Medicine, University of Chicago. Kayo Fujimoto is with the Division of Health Promotion and Behavioral Sciences, University of Texas Health Science Center at Houston
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Nguyen N, Powers KA, Miller WC, Howard AG, Halpern CT, Hughes JP, Wang J, Twine R, Gomez-Olive X, MacPhail C, Kahn K, Pettifor AE. Sexual Partner Types and Incident HIV Infection Among Rural South African Adolescent Girls and Young Women Enrolled in HPTN 068: A Latent Class Analysis. J Acquir Immune Defic Syndr 2019; 82:24-33. [PMID: 31169772 PMCID: PMC6692200 DOI: 10.1097/qai.0000000000002096] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND Sexual partners are the primary source of incident HIV infection among adolescent girls and young women (AGYW) in sub-Saharan Africa. Identifying partner types at greatest risk of HIV transmission could guide the design of tailored HIV prevention interventions. METHODS We conducted a secondary analysis of data from AGYW (aged 13-23 years) enrolled in a randomized controlled trial of cash transfers for HIV prevention in South Africa. Annually, AGYW reported behavioral and demographic characteristics of their 3 most recent sexual partners, categorized each partner using prespecified labels, and received HIV testing. We used latent class analysis (LCA) to identify partner types from reported characteristics, and generalized estimating equations to estimate the relationship between both LCA-identified and prespecified partner types and incident HIV infection. RESULTS Across 2140 AGYW visits, 1034 AGYW made 2968 partner reports and 63 AGYW acquired HIV infection. We identified 5 LCA partner types, which we named monogamous HIV-negative peer partner; one-time protected in-school peer partner; out-of-school older partner; anonymous out-of-school peer partner; and cohabiting with children in-school peer partner. Compared to AGYW with only monogamous HIV-negative peer partners, AGYW with out-of-school older partners had 2.56 times the annual risk of HIV infection (95% confidence interval: 1.23 to 5.33), whereas AGYW with anonymous out-of-school peer partners had 1.72 times the risk (95% confidence interval: 0.82 to 3.59). Prespecified partner types were not associated with incident HIV. CONCLUSION By identifying meaningful combinations of partner characteristics and predicting the corresponding risk of HIV acquisition among AGYW, LCA-identified partner types may provide new insights for the design of tailored HIV prevention interventions.
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Affiliation(s)
- Nadia Nguyen
- Department of Epidemiology, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, NC
- HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute and Columbia University, New York, NY
| | - Kimberly A. Powers
- Department of Epidemiology, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, NC
| | | | - Annie Green Howard
- Department of Biostatistics, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, NC
- Carolina Population Center, The University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Carolyn T. Halpern
- Carolina Population Center, The University of North Carolina at Chapel Hill, Chapel Hill, NC
- Department of Maternal and Child Health, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - James P. Hughes
- Department of Biostatistics, University of Washington, Seattle, WA
- Fred Hutchinson Cancer Research Center, Seattle, WA
| | - Jing Wang
- Fred Hutchinson Cancer Research Center, Seattle, WA
| | - Rhian Twine
- Medical Research Council/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of the Health Sciences, University of the Witwatersrand, South Africa
| | - Xavier Gomez-Olive
- Medical Research Council/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of the Health Sciences, University of the Witwatersrand, South Africa
- INDEPTH Network, Accra, Ghana
| | - Catherine MacPhail
- Medical Research Council/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of the Health Sciences, University of the Witwatersrand, South Africa
- Wits Reproductive Health and HIV Research Institute, University of the Witwatersrand, South Africa
- School of Health and Society, University of Wollongong, NSW, Australia
| | - Kathleen Kahn
- Medical Research Council/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of the Health Sciences, University of the Witwatersrand, South Africa
- INDEPTH Network, Accra, Ghana
- Epidemiology and Global Health Unit, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Audrey E. Pettifor
- Department of Epidemiology, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, NC
- Carolina Population Center, The University of North Carolina at Chapel Hill, Chapel Hill, NC
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Salomon T, Gomes I, Ozahata MC, Valente Moreira CH, Lorenzo Oliveira CD, Gonçalez TT, Duarte ME, Miranda C, de Freitas Carneiro Proietti AB, Sabino E, de Almeida Neto C, Custer B. Social and behavioral characteristics of male blood donors and their sexual partners: an analysis to define risk subsets. Transfusion 2019; 59:2584-2592. [PMID: 31158312 PMCID: PMC6679786 DOI: 10.1111/trf.15388] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Revised: 05/15/2019] [Accepted: 05/16/2019] [Indexed: 11/30/2022]
Abstract
BACKGROUND Men who have sex with men in Brazil are deferred from donation for 1 year since their last sexual contact. Legal proceedings in front of the Brazilian Supreme Court could compel blood collection agencies to discontinue use of sexual orientation questions. METHODS Data from male participants in a completed HIV risk factor case-control study were used to evaluate whether it is possible to differentiate donors at lower and higher risk for HIV using two analytical approaches: latent class and random forest analyses. RESULTS Male blood donors were divided into three distinct risk profile classes. Class 1 includes donors who are heterosexual (96.4%), are HIV negative (88.7%), have a main partner (99.4%), and practice unprotected sex (77.8%). Class 2 includes donors who are men who have sex with men /bisexuals' (100.0%), are HIV positive (97.4%), and were not aware of their sexual partners' HIV status (80.3%). Class 3 includes donors who are heterosexual (84.1%), practice unprotected vaginal/anal heterosexual sex (66.8% vs. 40.9%), and were both HIV positive and HIV negative (49.5% vs. 50.5%). We also found that asking donors about their partner(s)' HIV serostatus could replace asking about donors' sexual orientation and types of partners with relatively minor shifts in sensitivity (0.76 vs. 0.58), specificity (0.89 vs. 0.94), and positive predictive value (0.85 vs. 0.88). CONCLUSION Sexual orientation questions on the donor questionnaire could be replaced without great loss in the sensitivity, specificity, and positive predictive value. Social and sexual behaviors of donors and their partners are proxies for HIV risk and can help to develop modified questions that will need controlled trials to be validated.
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Affiliation(s)
- Tassila Salomon
- Hemominas, Minas Gerais – Brazil,Institute of Tropical Medicine, University of São Paulo, Brazil
| | - Isabel Gomes
- Faculdade Ciências Médicas – Belo Horizonte – Minas Gerais – Brazil
| | | | | | | | | | | | | | | | - Ester Sabino
- Institute of Tropical Medicine, University of São Paulo, Brazil
| | - Cesar de Almeida Neto
- Fundação Pró-Sangue - Hemocentro de São Paulo, São Paulo, Brazil,Disciplina de Ciências Médicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Brian Custer
- Vitalant Research Institute and University of California San Francisco
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Linton SL, Cooper HLF, Luo R, Karnes C, Renneker K, Haley DF, Dauria EF, Hunter-Jones J, Ross Z, Wingood GM, Adimora AA, Bonney L, Rothenberg R. Changing Places and Partners: Associations of Neighborhood Conditions With Sexual Network Turnover Among African American Adults Relocated From Public Housing. ARCHIVES OF SEXUAL BEHAVIOR 2017; 46:925-936. [PMID: 26927277 PMCID: PMC5003751 DOI: 10.1007/s10508-015-0687-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/19/2015] [Revised: 12/15/2015] [Accepted: 12/23/2015] [Indexed: 05/31/2023]
Abstract
Neighborhood conditions and sexual network turnover have been associated with the acquisition of HIV and other sexually transmitted infections (STIs). However, few studies investigate the influence of neighborhood conditions on sexual network turnover. This longitudinal study used data collected across 7 visits from a predominantly substance-misusing cohort of 172 African American adults relocated from public housing in Atlanta, Georgia, to determine whether post-relocation changes in exposure to neighborhood conditions influence sexual network stability, the number of new partners joining sexual networks, and the number of partners leaving sexual networks over time. At each visit, participant and sexual network characteristics were captured via survey, and administrative data were analyzed to describe the census tracts where participants lived. Multilevel models were used to longitudinally assess the relationships of tract-level characteristics to sexual network dynamics over time. On average, participants relocated to neighborhoods that were less economically deprived and violent, and had lower alcohol outlet densities. Post-relocation reductions in exposure to alcohol outlet density were associated with fewer new partners joining sexual networks. Reduced perceived community violence was associated with more sexual partners leaving sexual networks. These associations were marginally significant. No post-relocation changes in place characteristics were significantly associated with overall sexual network stability. Neighborhood social context may influence sexual network turnover. To increase understanding of the social-ecological determinants of HIV/STIs, a new line of research should investigate the combined influence of neighborhood conditions and sexual network dynamics on HIV/STI transmission over time.
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Affiliation(s)
- Sabriya L Linton
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, 1518 Clifton Road NE, Atlanta, GA, 30322, USA.
| | - Hannah L F Cooper
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, 1518 Clifton Road NE, Atlanta, GA, 30322, USA
| | - Ruiyan Luo
- Department of Epidemiology and Biostatistics, School of Public Health, Georgia State University, Atlanta, GA, USA
| | - Conny Karnes
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, 1518 Clifton Road NE, Atlanta, GA, 30322, USA
| | - Kristen Renneker
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, 1518 Clifton Road NE, Atlanta, GA, 30322, USA
| | - Danielle F Haley
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, 1518 Clifton Road NE, Atlanta, GA, 30322, USA
| | - Emily F Dauria
- Division of Infectious Disease, Alpert Medical School, Brown University, Providence, RI, USA
| | - Josalin Hunter-Jones
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, 1518 Clifton Road NE, Atlanta, GA, 30322, USA
| | - Zev Ross
- ZevRoss Spatial Analysis, Ithaca, NY, USA
| | - Gina M Wingood
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, 1518 Clifton Road NE, Atlanta, GA, 30322, USA
- Department of Sociomedical Sciences, Columbia University's Mailman School of Public Health, New York, NY, USA
| | - Adaora A Adimora
- Division of Infectious Diseases, University of North Carolina School of Medicine, Chapel Hill, NC, USA
- Department of Epidemiology, Gillings School of Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Loida Bonney
- Department of General Medicine, Emory University School of Medicine, Fayetteville, GA, USA
| | - Richard Rothenberg
- Department of Epidemiology and Biostatistics, School of Public Health, Georgia State University, Atlanta, GA, USA
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Condom use and incarceration among STI clinic attendees in the Deep South. BMC Public Health 2016; 16:971. [PMID: 27624443 PMCID: PMC5022228 DOI: 10.1186/s12889-016-3590-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2016] [Accepted: 08/25/2016] [Indexed: 01/08/2023] Open
Abstract
Background Incarceration history is associated with lower rates of condom use and increased HIV risk. Less is known about duration of incarceration and multiple incarcerations’ impact on condom use post-release. Methods In the current study, we surveyed 1,416 adults in Mississippi about their incarceration history and sexual risk behaviors. Generalized estimating equations (GEE) were used to test associations between duration of incarceration, multiple incarcerations, socio-demographic factors, substance use, sexual behavior, and event level condom use at last sex. Results After adjusting for covariates, having been incarcerated for at least 6 months two or more times remained significantly associated with condomless sex. Conclusions This study found a strong, independent relationship between condom use and multiple, long-term incarceration events among patients in an urban STI clinic in the Deep South. The results suggest that duration of incarceration and multiple incarcerations have significant effects on sexual risk behaviors, underscoring the deleterious impact of long prison or jail sentences on population health. Our findings also suggest that correctional health care professionals and post-release providers might consider offering comprehensive sexual and reproductive health services and those providing community care should consider screening for previous incarceration as a marker of risk.
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Individual and Partner-Level Factors Associated with Condom Non-Use Among African American STI Clinic Attendees in the Deep South: An Event-Level Analysis. AIDS Behav 2016; 20:1334-42. [PMID: 26683032 DOI: 10.1007/s10461-015-1266-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
The US HIV/AIDS epidemic is concentrated in the Deep South, yet factors contributing to HIV transmission are not fully understood. We examined relationships between substance use, sexual partnership characteristics, and condom non-use in an African American sample of STI clinic attendees in Jackson, Mississippi. We assessed condom non-use at last intercourse with up to three recent sexual partners reported by participants between January and June 2011. Participant- and partner-level correlates of condom non-use were examined using generalized estimating equations. The 1295 participants reported 2880 intercourse events, of which 1490 (51.7 %) involved condom non-use. Older age, lower educational attainment, reporting financial or material dependence on a sex partner, sex with a primary partner, and higher frequency of sex were associated with increased odds of condomless sex. HIV prevention efforts in the South should address underlying socioeconomic disparities and structural determinants that result in partner dependency and sexual risk behavior.
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Mirzaei M, Ahmadi K, Saadat SH, Ramezani MA. INSTRUMENTS OF HIGH RISK SEXUAL BEHAVIOR ASSESSMENT: A SYSTEMATIC REVIEW. Mater Sociomed 2016; 28:46-50. [PMID: 27047267 PMCID: PMC4789722 DOI: 10.5455/msm.2016.28.46-50] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2015] [Accepted: 01/15/2016] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND Sexual behavior is a complex activity affecting all aspects of human's life. Risky sexual behaviors impose negative outcomes on family, relationships and health. Unsafe sex is the second most leading cause of disability adjusted life years worldwide. Valid and reliable tools for assessment of risky sexual behaviors are necessary for implementing preventive measures. METHODS we searched Medline and the Cochrane Library of Systematic Reviews, with the keywords of "risky sexual behavior assessment", "sexual risk assessment", "high risk sexual behavior", "sexual risk taking". By reviewing references of the articles, some complementary studies were added. RESULTS Assessment can be performed by questionnaire or non-questionnaire instruments. Questionnaires vary depending on their target population, evaluation of risky sexual behavior as a whole or focusing on an associated risk factor. In order to avoid usual biases in self reports, objective biomarker assessment of unprotected sex are employed. These markers include prostate specific antigen, chromosome Y DNA and Seminogelin. CONCLUSION Risky sexual behavior can be assessed by various subjective and objective methods. While self-reports are more feasible, objective methods offer a higher degree of reliability. Further studies for finding more feasible methods of using biomarkers are recommended.
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Affiliation(s)
- Mojtaba Mirzaei
- Behavioral Sciences Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Khodabakhsh Ahmadi
- Behavioral Sciences Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Seyed-Hassan Saadat
- Behavioral Sciences Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Mohammad Arash Ramezani
- Behavioral Sciences Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
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