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Zewudie BT, Geze Tenaw S, Solomon M, Mesfin Y, Abebe H, Mekonnen Z, Tesfa S, Chekole Temere B, Aynalem Mewahegn A, lankrew T, Sewale Y. The magnitude of undiagnosed hypertension and associated factors among HIV-positive patients attending antiretroviral therapy clinics of Butajira General Hospital, Gurage Zone, Southern Ethiopia. SAGE Open Med 2022; 10:20503121221094454. [PMID: 35509957 PMCID: PMC9058352 DOI: 10.1177/20503121221094454] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Accepted: 03/29/2022] [Indexed: 11/16/2022] Open
Abstract
Objectives: The study aimed to assess the magnitude of undiagnosed hypertension, and its associated factors among adult HIV-positive patients receiving antiretroviral therapy at Butajira General Hospital, southern Ethiopia. Methods: We applied an institutional-based cross-sectional study design at Butajira General Hospital from 1 May to 1 July 2021. We used a systematic random sampling technique to select the total number of participants. A structured interviewer-administered questionnaire was applied to collect the data (sociodemographic characteristics, clinical-related factors, and lifestyle-related factors from the study participants. Data were entered using Epi-data version 3.1 and analyzed by statistical package for social science version 25. We applied a multivariable logistic regression analysis model to identify variables significantly associated with hypertension. Results: The study comprised 388 participants with 39 years (10.6 SD) as the mean age of the participants. Of the total participants, 235 (60.6%) were female. In this study the magnitude of undiagnosed hypertension among HIV-positive patients was 18.8% (95% CI: 14.7%–23.2%). Having comorbidity of diabetes mellitus (adjusted odds ratio = 5.29, 95% CI: 2.154, 12.99), habit of alcohol drinking (adjusted odds ratio = 2.909, 95% CI: 1.306, 6.481), duration of antiretroviral therapy ⩾ 5 years (adjusted odds ratio = 3.087, 95% CI: 1.558, 6.115), and age ⩾ 40 years (adjusted odds ratio = 2.642, 95% CI: 1.450, 4.813) were factors significantly associated with undiagnosed hypertension. Conclusions and recommendations: The magnitude of undiagnosed hypertension among HIV-positive patients attending the antiretroviral therapy clinic of Butajira General Hospital is high. The findings of this study implied that HIV-positive patients attending antiretroviral therapy clinics should be monitored routinely for hypertension; especially participants aged ⩾40 years, highly active antiretroviral therapy duration ⩾5 years, having diabetes mellitus comorbidity need more attention. Primary healthcare integration is also vital to enhance the health of HIV-positive patients on antiretroviral therapy.
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Affiliation(s)
- Bitew Tefera Zewudie
- Department of Nursing, College of Medicine and Health Science, Wolkite University, Wolkite, Ethiopia
| | - Shegaw Geze Tenaw
- Department of Midwifery, College of Medicine and Health Science, Wolkite University, Wolkite, Ethiopia
| | - Mamo Solomon
- Department of Nursing, College of Medicine and Health Science, Wolkite University, Wolkite, Ethiopia
| | - Yibeltal Mesfin
- Department of Midwifery, College of Medicine and Health Science, Wolkite University, Wolkite, Ethiopia
| | - Haimanot Abebe
- Department of Nursing, College of Medicine and Health Science, Wolkite University, Wolkite, Ethiopia
| | - Zebene Mekonnen
- Department of Nursing, College of Medicine and Health Science, Wolkite University, Wolkite, Ethiopia
| | - Shegaw Tesfa
- Department of Nursing, College of Medicine and Health Science, Wolkite University, Wolkite, Ethiopia
| | - Bogale Chekole Temere
- Department of Nursing, College of Medicine and Health Science, Wolkite University, Wolkite, Ethiopia
| | - Agerie Aynalem Mewahegn
- Department of Nursing, College of Medicine and Health Science, Wolkite University, Wolkite, Ethiopia
| | - Tadele lankrew
- Department of Nursing, College of Medicine and Health Science, Wolaita Sodo University, Wolaita, Ethiopia
| | - Yihenew Sewale
- Department of Nursing, College of Medicine and Health Science, Debre Birhan University, Debre Birhan, Ethiopia
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Sewale Y, Afenigus AD, Haile D, Shiferaw WS. Magnitude of Hypertension and Associated Factors Among Human Immunodeficiency Virus Positive Adults Receiving Anti-Retroviral Therapy at Debre Markos Referral Hospital, Northwest, Ethiopia. HIV AIDS (Auckl) 2020; 12:629-637. [PMID: 33116925 PMCID: PMC7588266 DOI: 10.2147/hiv.s280630] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Accepted: 10/14/2020] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND People living with human immunodeficiency virus are at increased risk for cardiovascular diseases such as hypertension. Current evidence on the proportion of hypertension is essential to inform policymaker to strengthen interventions and regular monitoring of hypertension, yet information is scarce concerning hypertension in this study area. OBJECTIVE This study aimed to assess the magnitude of hypertension and associated factors among human immunodeficiency virus-positive adults receiving antiretroviral therapy at Debre Markos Referral Hospital, Northwest Ethiopia. METHODS A facility-based cross-sectional study was employed. Data were collected from systematically selected 412 participants using pre-tested, interviewer administered structured questionnaire. Data were entered and coded using Epi-data version 3.1 and analyzed using STATA version 14. The assumption of the logistic regression model was checked using a correlation matrix and Hosmer and Lemeshow's tests. Bivariate and multivariate logistic regression analyses were conducted. RESULTS In the present study, the prevalence of hypertension among human immunodeficiency virus-positive adults who received antiretroviral therapy was found to be 41.3% (95% CI; 36.7-46.0). Age groups 35-45 years (AOR: 2.48, 95% CI: 1.17, 5.27), greater than 45 years (AOR: 5.00, 95% CI: 2.190, 11.44), no physical exercise (AOR: 2.72, 95% CI: 1.33, 5.57), body mass index greater than or equal to 25 kg/m2 (AOR: 2.87 95% CI: 1.52, 5.39), and antiretroviral therapy regimens of 2 h/2f/2e/ABC+3TC+ATV/r (AOR: 3.05, 95% CI: 1.41, 6.60) were significantly associated with hypertension. CONCLUSION In the current study, the magnitude of hypertension was high among HIV-positive adults. Therefore, educating about the use of lifestyle change, counseling the use of regular physical activities, promoting weight reduction, and intervention in this situation are highly recommended.
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Affiliation(s)
- Yihenew Sewale
- Department of Nursing, College of Health Science, Debre Berhan University, Debre Berhan, Ethiopia
| | - Abebe Dilie Afenigus
- Department of Nursing, College of Health Science, Debre Markos University, Debre Markos, Ethiopia
| | - Dessalegn Haile
- Department of Nursing, College of Health Science, Debre Markos University, Debre Markos, Ethiopia
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Rumbwere Dube BN, Marshall TP, Ryan RP, Omonijo M. Predictors of human immunodeficiency virus (HIV) infection in primary care among adults living in developed countries: a systematic review. Syst Rev 2018; 7:82. [PMID: 29859533 PMCID: PMC5985063 DOI: 10.1186/s13643-018-0744-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2018] [Accepted: 05/11/2018] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Early diagnosis of human immunodeficiency virus (HIV) is important because antiretroviral therapies are more effective if infected individuals are diagnosed early. Diagnosis of HIV relies on laboratory testing and determining the demographic and clinical characteristics of undiagnosed HIV-infected patients may be useful in identifying patients for testing. This systematic review aims to identify characteristics of HIV-infected adults prior to diagnosis that could be used in a prediction model for early detection of patients for HIV testing in UK primary care. METHODS The population of interest was adults aged ≥ 18 years in developed countries. The exposures were demographic, socio-economic or clinical characteristics associated with the outcome, laboratory confirmed HIV/AIDS infection. Observational studies with a comparator group were included in the systematic review. Electronic searches for articles from January 1995 to April 2016 were conducted on online databases of EMBASE, MEDLINE, The Cochrane Library and grey literature. Two reviewers selected studies for inclusion. A checklist was developed for quality assessment, and a data extraction form was created to collate data from selected studies. RESULTS Full-text screening of 429 articles identified 17 cohort and case-control studies, from 26,819 retrieved articles. Demographic and socio-economic characteristics associated with HIV infection included age, gender and measures of deprivation. Lifestyle choices identified were drug use, binge-drinking, number of lifetime partners and having a partner with risky behaviour. Eighteen clinical features and comorbid conditions identified in this systematic review are included in the 51 conditions listed in the British HIV Association guidelines. Additional clinical features and comorbid conditions identified but not specified in the guidelines included hyperlipidemia, hypertension, minor trauma and diabetes. CONCLUSION This systematic review consolidates existing scientific evidence on characteristics of HIV-infected individuals that could be used to inform decision making in prognostic model development. Further exploration of availability of some of the demographic and behavioural predictors of HIV, such as ethnicity, number of lifetime partners and partner characteristics, in primary care records will be required to determine whether they can be applied in the prediction model.
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Affiliation(s)
| | - Tom P. Marshall
- Institute of Applied Health Research, University of Birmingham, Birmingham, B15 2TT UK
| | - Ronan P. Ryan
- Institute of Applied Health Research, University of Birmingham, Birmingham, B15 2TT UK
| | - Modupe Omonijo
- Public Health England, Health and Wellbeing Directorate, London, UK
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Emlet CA, Fredriksen-Goldsen KI, Kim HJ, Hoy-Ellis C. The Relationship Between Sexual Minority Stigma and Sexual Health Risk Behaviors Among HIV-Positive Older Gay and Bisexual Men. J Appl Gerontol 2017; 36:931-952. [PMID: 26100507 PMCID: PMC4704987 DOI: 10.1177/0733464815591210] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
This study investigates how internalized sexual minority stigma and enacted sexual minority stigma in health care settings are associated with sexual health risk behaviors (SRBs) and the mediating role of infrequent routine health care and perceived stress among older gay and bisexual (G/B) men living with HIV disease. Survey responses from 135 sexually active older G/B men living with HIV were analyzed using hierarchical linear regression models. Results indicate that one fifth of G/B older adult men living with HIV are engaged in multiple SRBs. Internalized sexual minority stigma and enacted sexual minority stigma in health care settings are significantly associated with SRBs. The relationship between internalized sexual minority stigma and SRBs are mediated by infrequent routine health care and elevated levels of perceived stress. Improved primary and secondary prevention strategies are needed for the growing number of sexually active older G/B men.
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Xu Y, Chen X, Wang K. Global prevalence of hypertension among people living with HIV: a systematic review and meta-analysis. ACTA ACUST UNITED AC 2017; 11:530-540. [PMID: 28689734 DOI: 10.1016/j.jash.2017.06.004] [Citation(s) in RCA: 143] [Impact Index Per Article: 20.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2017] [Revised: 05/30/2017] [Accepted: 06/08/2017] [Indexed: 12/11/2022]
Abstract
The purpose of this study was to estimate, through meta-analysis, the global prevalence of hypertension among people living with HIV (PLWH). A total of 49 studies published during 2011-2016 with 63,554 participants were included in analysis. These studies were conducted in America (25), Europe (13), Africa (10), and Asia (1) with data collected during 1996-2014. Prevalence of hypertension and confidence interval was estimated and stratified by participants' age, antiretroviral therapy (ART), and calendar-years using random effects modeling. The quality assessed using the Joanna Briggs Institute Prevalence Critical Appraisal Tool was high for all included studies. The estimated prevalence (95% confidence interval) of hypertension was 25.2% (21.2%, 29.6%) for the overall sample, 34.7% (27.4%, 42.8%) for ART-experienced, and 12.7% (7.4%, 20.8%) for ART-naïve participants. The estimated prevalence was found increased with age and in studies conducted after 2010. Hypertension among PLWH shows an increasing trend and is associated with receiving ART and older age. Findings of this study provide data for decision makers to incorporate blood pressure assessment in primary prevention and for researchers to further investigate factors and mechanisms related to hypertension among PLWH.
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Affiliation(s)
- Yunan Xu
- Department of Epidemiology, University of Florida, Gainesville, FL, USA.
| | - Xinguang Chen
- Department of Epidemiology, University of Florida, Gainesville, FL, USA
| | - Kai Wang
- Department of Epidemiology, University of Florida, Gainesville, FL, USA
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Sales JM, Smearman EL, Swartzendruber A, Brown JL, Brody G, DiClemente RJ. Socioeconomic-related risk and sexually transmitted infection among African-American adolescent females. J Adolesc Health 2014; 55:698-704. [PMID: 24974317 PMCID: PMC4209307 DOI: 10.1016/j.jadohealth.2014.05.005] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2014] [Revised: 05/12/2014] [Accepted: 05/13/2014] [Indexed: 11/17/2022]
Abstract
PURPOSE Virtually no studies have examined the potential role that chronic stress, particularly the stress associated with socioeconomic status (SES) strain, may play on sexually transmitted infection (STI) risk. This study examined the association between SES-related risk at baseline to STI acquisition and reinfection over 36 months of follow-up. METHODS Six hundred twenty-seven African-American female adolescents, ages 14-20 years, recruited from sexual health clinics in Atlanta, GA, participated in a randomized controlled HIV prevention trial and returned for at least one follow-up assessment. Following baseline assessment, six waves of data collection occurred prospectively over 36 months. Chronic SES-related risk was assessed as a sum of yes-no exposure to seven risk indicators. Laboratory-confirmed tests for Chlamydia trachomatis and Neisseria gonorrhoeae were performed at each follow-up. RESULTS In multivariable regression analysis, SES-related risk significantly predicted STI acquisition over 36 months (adjusted odds ratio = 1.22) and STI reinfection (adjusted odds ratio = 1.16) above and beyond other known correlates of STI. CONCLUSIONS Findings demonstrate that SES-related risk was predictive of both STI acquisition and reinfection among young African-American females. They are consistent with propositions that some health disparities observed in adulthood may be linked to earlier chronically stress-inducing life experiences, particularly experiences associated with low SES conditions. Although various explanations exist for the observed connection between SES-related risk and subsequent STI acquisition and/or reinfection across 36 months of follow-up, these findings highlight the need for further research to elucidate the exact pathway(s) by which SES-related risk influences later STI acquisition to refine STI prevention interventions for this population.
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Affiliation(s)
- Jessica M Sales
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health at Emory University, Atlanta, Georgia; Center for AIDS Research, Social and Behavioral Sciences Core, Emory University, Atlanta, Georgia; Center for Contextual Genetics and Prevention Science, University of Georgia, Athens, Georgia.
| | - Erica L Smearman
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health at Emory University, Atlanta, Georgia
| | - Andrea Swartzendruber
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health at Emory University, Atlanta, Georgia; Center for AIDS Research, Social and Behavioral Sciences Core, Emory University, Atlanta, Georgia
| | - Jennifer L Brown
- Center for AIDS Research, Social and Behavioral Sciences Core, Emory University, Atlanta, Georgia; Department of Psychology, Texas Tech University, Lubbock, Texas
| | - Gene Brody
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health at Emory University, Atlanta, Georgia; Center for AIDS Research, Social and Behavioral Sciences Core, Emory University, Atlanta, Georgia; Center for Contextual Genetics and Prevention Science, University of Georgia, Athens, Georgia
| | - Ralph J DiClemente
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health at Emory University, Atlanta, Georgia; Center for AIDS Research, Social and Behavioral Sciences Core, Emory University, Atlanta, Georgia; Center for Contextual Genetics and Prevention Science, University of Georgia, Athens, Georgia
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Stephenson R, Hast M, Finneran C, Sineath CR. Intimate partner, familial and community violence among men who have sex with men in Namibia. CULTURE, HEALTH & SEXUALITY 2014; 16:473-87. [PMID: 24735113 PMCID: PMC4492211 DOI: 10.1080/13691058.2014.889753] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Men who have sex with men in sub-Saharan Africa are known to experience high levels of violence, yet little research has focused on their perceptions of intimate partner violence (IPV). This study examines the perceived typologies and sources of multiple forms of violence, including IPV, family/community violence and discrimination from healthcare workers, among men who have sex with men in Namibia. Focus-group discussions and in-depth interviews were conducted with a 52 men residing in five cities across Namibia. Results indicate that violence, in varying forms, is commonplace in the lives of men who have sex with men in this community, and may be associated with HIV testing patterns.
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Affiliation(s)
- Rob Stephenson
- Hubert Department of Global Health, Rollins School of Public Health, Atlanta, USA
| | - Marisa Hast
- Hubert Department of Global Health, Rollins School of Public Health, Atlanta, USA
| | - Catherine Finneran
- Hubert Department of Global Health, Rollins School of Public Health, Atlanta, USA
| | - Craig R. Sineath
- Department of Epidemiology, Rollins School of Public Health, Atlanta, USA
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Mallinson RK. Grief in the context of HIV: recommendations for practice. J Assoc Nurses AIDS Care 2013; 24:S61-71. [PMID: 23290378 DOI: 10.1016/j.jana.2012.08.012] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2012] [Accepted: 08/16/2012] [Indexed: 10/27/2022]
Abstract
Grief is a universal human response to loss. While the symptoms of grief are distressing and uncomfortable, they usually diminish over time without therapy. For persons grieving an HIV-related death, however, a variety of unique factors may interfere with the healthy resolution of symptoms. When the grief process becomes complicated, a person may experience serious alterations in physical health and/or disruptions in daily functioning. To assess grief, nurses need to apply interpersonal skills and therapeutic communication techniques in a compassionate manner; currently, no one screening instrument is optimal for evaluating grief in the clinical setting. The person experiencing grief or complicated grief may be referred for support services or counseling, pharmacologic interventions, or cognitive behavioral therapy. This report summarizes evidence from the literature and clinical practice to support recommendations for the practice of nurses caring for persons with HIV-associated grief; recommended strategies are illustrated through an exemplar case study.
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Affiliation(s)
- R Kevin Mallinson
- Barnes-Jewish Hospital Professor, Goldfarb School of Nursing, St Louis, Missouri, USA
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Zhan W, Shaboltas AV, Skochilov RV, Kozlov AP, Krasnoselskikh TV, Abdala N. Depressive symptoms and unprotected sex in St. Petersburg, Russia. J Psychosom Res 2012; 72:371-5. [PMID: 22469279 PMCID: PMC3319656 DOI: 10.1016/j.jpsychores.2012.01.015] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2011] [Revised: 01/11/2012] [Accepted: 01/25/2012] [Indexed: 11/24/2022]
Abstract
OBJECTIVE Growing evidence indicates that emotional distress such as depression may have the potential to increase the risk for HIV and other sexually transmitted infections (STIs). This study investigated the association between depressive symptoms and unprotected sex among STI clinic patients in Russia. METHODS We used pre-intervention data collected between 2009 and 2010 among 307 participants who were enrolled in a randomized intervention trial conducted in an STI clinic in St. Petersburg, Russia. The 10-item Center for Epidemiological Studies Depression Scale was used to identify depressive symptoms and two indicators were used to measure unprotected sex. Logistic regression models were applied for the analysis and controlled for the following potential confounders: demographic characteristics, being a commercial sex worker, history of drug injection and alcohol misuse. RESULTS Of the participants, 20.2% were classified as having depressive symptoms. About 59.6% of the participants did not use a condom during the last sexual intercourse and 24.4% never used condoms in the past 3months. Depressive symptoms were significantly associated with both indicators of unprotected sex in two different models: odds ratio (OR)=2.36, 95% confidence interval (CI), 1.24-4.48 for unprotected sex in the last sexual intercourse; and OR=2.71, 95% CI, 1.43-5.11 for unprotected sex in the past 3months. CONCLUSION Depressive symptoms were common and were strongly associated with unprotected sex among study participants in St. Petersburg, Russia. Efforts to promote condom use should address lack of condom use due to depressive symptoms.
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Affiliation(s)
- Weihai Zhan
- Wesleyan University, 117 Allbritton Center, 207 High Street, Middletown, CT, 06459, USA
| | - Alla V. Shaboltas
- Saint Petersburg, State University, 7/9 Universitetskaya nab, St Petersburg, 199034, Russian Federation
| | - Roman V. Skochilov
- Saint Petersburg, State University, 7/9 Universitetskaya nab, St Petersburg, 199034, Russian Federation
| | - Andrei P. Kozlov
- Saint Petersburg, State University, 7/9 Universitetskaya nab, St Petersburg, 199034, Russian Federation
| | - Tatiana V. Krasnoselskikh
- Saint Petersburg, State University, 7/9 Universitetskaya nab, St Petersburg, 199034, Russian Federation
| | - Nadia Abdala
- Yale School of Public Health, 60 College Street, New Haven, CT, 06520, USA
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Calzavara LM, Burchell AN, Lebovic G, Myers T, Remis RS, Raboud J, Corey P, Swantee C, Hart TA. The impact of stressful life events on unprotected anal intercourse among gay and bisexual men. AIDS Behav 2012; 16:633-43. [PMID: 21274612 DOI: 10.1007/s10461-010-9879-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
We investigated the hypothesis that gay and bisexual men experiencing stressful life events are more likely to engage in risky sexual behavior. Data were from a cohort study of 155 HIV-positive and 207 HIV-negative men in Ontario, Canada (1998-2007). We quantified the relation between stressful life events and unprotected anal intercourse with a non-regular partner. In the past 6 months, 19% reported unprotected intercourse (HIV+: 28%; HIV-: 13%) and 58% reported one or more stressful life events (HIV+: 64%; HIV-: 55%). Among HIV-negative men, the odds of unprotected intercourse increased by 1.15 for each additional event (95%CI 1.06, 1.24). Among HIV-positive men, those who reported the event "problems due to alcohol or drugs" were 1.80 (95%CI 1.27, 2.56) times more likely to report unprotected intercourse. Interventions to assist men to cope with stress may help to prevent population spread of HIV and improve overall health.
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Affiliation(s)
- Liviana M Calzavara
- Dalla Lana School of Public Health, University of Toronto, 5th Floor, Health Sciences Building, 155 College Street, Toronto, ON, M5T 3M7, Canada.
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Jie W, Ciyong L, Xueqing D, Hui W, Lingyao H. A syndemic of psychosocial problems places the MSM (men who have sex with men) population at greater risk of HIV infection. PLoS One 2012; 7:e32312. [PMID: 22479319 PMCID: PMC3316524 DOI: 10.1371/journal.pone.0032312] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2011] [Accepted: 01/26/2012] [Indexed: 11/18/2022] Open
Abstract
Background The MSM (Men who have sex with men) population suffers from very high rates of concurrent psychosocial problems. Together, these problems comprise a syndemic that increases the risk of HIV infection for this community. The precise mechanisms through which this syndemic can raise the likelihood of HIV infection warrant further exploration. Methodology/Principal Findings A total of 522 MSM were enrolled via a multiframe sampling approach and were asked to report psychosocial problems, risky sexual behaviors and HIV test results. A count of psychosocial health problems was calculated to test the additive relationship of these factors on HIV risk. Adjusting analysis and restriction analysis were used to determine a proposed intermediate pathway. Psychosocial health problems are highly concurrent and intercorrelated among urban MSM. Greater numbers of health problems are significantly and positively associated with HIV infection, which is mediated, at least partially, by risky sexual behaviors. Conclusions/Significance MSM experience concurrent psychosocial health problems that correlate with HIV infection in this community. We recommend the development of coping strategies for this population to deal with these psychosocial problems, both in prevention research and health policy.
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Affiliation(s)
| | - Lu Ciyong
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
- * E-mail:
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Abstract
This review discusses evidence-based perspectives on risk and resilience in coping with chronic life stress. Future directions for inquiry and practice also are addressed.
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Affiliation(s)
- Lisa Terre
- Department of Psychology, University of Missouri–Kansas City
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