1
|
Djiadeu P, Smith MDR, Kushwaha S, Odhiambo AJ, Absalom D, Husbands W, Tharao W, Regan R, Sa T, Zhang N, Kaul R, Nelson LE. Social, Clinical, and Behavioral Determinants of HIV Infection and HIV Testing among Black Men in Toronto, Ontario: A Classification and Regression Tree Analysis. J Int Assoc Provid AIDS Care 2020; 19:2325958220934613. [PMID: 32762398 PMCID: PMC7418239 DOI: 10.1177/2325958220934613] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Revised: 05/20/2020] [Accepted: 05/26/2020] [Indexed: 11/17/2022] Open
Abstract
Black men bear a disproportionate burden of HIV infection. These HIV inequities are influenced by intersecting social, clinical, and behavioral factors. The purpose of this analysis was to determine the combinations of factors that were most predictive of HIV infection and HIV testing among black men in Toronto. Classification and regression tree analysis was applied to secondary data collected from black men (N = 460) in Toronto, 82% of whom only had sex with women and 18% whom had sex with men at least once. For HIV infection, 10 subgroups were identified and characterized by number of lifetime male partners, age, syphilis history, and perceived stigma. Number of lifetime male partners was the best single predictor of HIV infection. For HIV testing, the analysis identified 8 subgroups characterized by age, condom use, number of sex partners and Chlamydia history. Age (>24 years old) was the best single predictor of HIV testing.
Collapse
Affiliation(s)
- Pascal Djiadeu
- School of Nursing, Yale University, Orange, CT, USA
- MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Unity Health Toronto, Toronto, Ontario, Canada
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Martez D. R. Smith
- School of Nursing, Yale University, Orange, CT, USA
- MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Unity Health Toronto, Toronto, Ontario, Canada
| | - Sameer Kushwaha
- MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Unity Health Toronto, Toronto, Ontario, Canada
- Department of Medicine, University of Toronto, Ontario, Canada
| | - Apondi J. Odhiambo
- MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Unity Health Toronto, Toronto, Ontario, Canada
| | - David Absalom
- MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Unity Health Toronto, Toronto, Ontario, Canada
| | | | - Wangari Tharao
- Women’s Health in Women’s Hands, Toronto, Ontario, Canada
| | - Rotrease Regan
- Division of Infectious Diseases, School of Medicine, Emory University, Atlanta, GA, USA
| | - Ting Sa
- Department of Biostatistics and Epidemiology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
| | - Nanhua Zhang
- Department of Biostatistics and Epidemiology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Rupert Kaul
- Department of Immunology, Faculty of Medicine, University of Toronto, Ontario, Canada
| | - LaRon E. Nelson
- School of Nursing, Yale University, Orange, CT, USA
- MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Unity Health Toronto, Toronto, Ontario, Canada
| |
Collapse
|
2
|
Pre-exposure Prophylaxis Among Men Who have Sex with Men: Dual Motivational Model of Intention to Use Pre-exposure Prophylaxis. AIDS Behav 2019; 23:534-543. [PMID: 29980993 DOI: 10.1007/s10461-018-2214-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Men who have sex with men (MSM) account for most new HIV infections in the United States. Despite representing a fraction of the population, MSM make up an estimated 65% of new infections. To address this epidemic, pre-exposure prophylaxis (PrEP) is recommended to supplement condom use. Despite its effectiveness, PrEP uptake among MSM is low. Few studies have employed theoretical approaches to understand PrEP use intention. Incorporating factors like safe sex fatigue, expectation of better sexual experiences, and perceived risk are proposed in this dual motivational path model of PrEP use intention. This model hypothesized that PrEP use intention is influenced by two key pathways: (1) protection motivation pathway, and (2) sexual expectancy pathway. Data were collected using social networking applications from 402 MSM. The model was tested using structural equation modeling. We elaborate the complex decision-making process proposed by this novel theoretical model and discuss its practical implications.
Collapse
|
3
|
Sullivan KM, Dawson Rose C, Phillips JC, Holzemer WL, Webel AR, Nicholas P, Corless IB, Kirksey K, Sanzero Eller L, Voss J, Tyer-Viola L, Portillo C, Johnson MO, Brion J, Sefcik E, Nokes K, Reid P, Rivero-Mendez M, Chen WT. Sexual transmission-risk behaviour among HIV-positive persons: a multisite study using social action theory. J Adv Nurs 2016; 73:162-176. [PMID: 27485796 DOI: 10.1111/jan.13087] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/06/2016] [Indexed: 12/19/2022]
Abstract
AIM Sexual risk behaviour was explored and described using Social Action Theory. BACKGROUND The sexual transmission of HIV is complex and multi-factorial. Social Action Theory provides a framework for viewing self-regulation of modifiable behaviour such as condom use. Condom use is viewed within the context of social interaction and interdependence. DESIGN Cross-sectional survey. METHODS Self-report questionnaire administered to adults living with HIV/AIDS, recruited from clinics, service organizations and by active outreach, between 2010 - 2011. FINDINGS Having multiple sex partners with inconsistent condom use during a 3-month recall period was associated with being male, younger age, having more years of education,substance use frequency and men having sex with men being a mode of acquiring HIV. In addition, lower self-efficacy for condom use scores were associated with having multiple sex partners and inconsistent condom use. CONCLUSION Social Action Theory provided a framework for organizing data from an international sample of seropositive persons. Interventions for sexually active, younger, HIV positive men who have sex with men, that strengthen perceived efficacy for condom use, and reduce the frequency of substance use, may contribute to reducing HIV-transmission risk.
Collapse
Affiliation(s)
- Kathleen M Sullivan
- University of Hawaii at Manoa School of Nursing and Dental Hygiene, Honolulu, Hawaii, USA
| | - Carol Dawson Rose
- University of California San Francisco School of Nursing, San Francisco, California, USA
| | - J Craig Phillips
- School of Nursing, University of Ottawa School of Nursing, Ottawa, Ontario, Canada
| | | | - Allison R Webel
- Case Western Reserve University School of Nursing, Cleveland, Ohio, USA
| | - Patrice Nicholas
- Massachusetts General Hospital Institute of Health Professions, Boston, Massachusetts, USA
| | - Inge B Corless
- Massachusetts General Hospital Institute of Health Professions, Boston, Massachusetts, USA
| | - Kenn Kirksey
- Nursing Strategic Initiatives Harris Health System, Houston, Texas, USA
| | | | - Joachim Voss
- Frances Payne Bolton School of Nursing, Cleveland, Ohio, USA
| | - Lynda Tyer-Viola
- Baylor College of Medicine and AVP Texas Children's Hospital, Houston, Texas, USA
| | - Carmen Portillo
- University of California San Francisco School of Nursing, San Francisco, California, USA
| | - Mallory O Johnson
- University of California San Francisco School of Nursing, San Francisco, California, USA
| | - John Brion
- Ohio State University College of Nursing, Columbus, Ohio, USA
| | - Elizabeth Sefcik
- Texas A&M University-Corpus Christi, Corpus, Christi, Texas, USA
| | - Kathleen Nokes
- Hunter College, CUNY School of Nursing, New York, New York, USA
| | - Paula Reid
- University of North Carolina at Wilmington, Wilmington, North Carolina, USA
| | | | - Wei-Ti Chen
- Yale University School of Nursing, New Haven, Connecticut, USA
| |
Collapse
|
4
|
Starks TJ, Millar BM, Parsons JT. Predictors of condom use with main and casual partners among HIV-positive men over 50. Health Psychol 2015; 34:1116-22. [PMID: 26010719 DOI: 10.1037/hea0000236] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Sexual health among the growing population of older adults living with HIV has garnered increased research attention. Previous studies have identified alcohol and drug use as factors increasing rates of sexual activity and sex risk behavior in this population. However, the influence of partner type (whether main or casual) on the links between substance use and sexual behavior in older men living with HIV remains understudied and was the focus of the current study. METHOD Data were collected from telephone interviews with 378 men, aged 50 years or older, living with HIV and residing in the New York City area. The sample included 224 (59%) men who identified as gay or bisexual and 154 (41%) who identified as heterosexual. The majority of the sample identified as Black (66%), and the average age was 55 years. Participants reported on recent sexual behavior, substance use, and viral load/detectability status. RESULTS Results of multinomial logistic regression analyses found that substance use was associated with increased rates of condomless sex with casual partners but not with main partners, whereas self-reported viral load (perceptions of immunological health) was a factor associated with condomless sex with main partners but not with casual partners. CONCLUSIONS The findings indicate that different factors are involved in instances of condomless sex depending on whether the partner is a main or casual partner. Research and intervention efforts aimed at reducing risk factors for older men living with HIV and their partners need to take into account the relational context of sexual behavior.
Collapse
Affiliation(s)
| | - Brett M Millar
- The Graduate Center of the City University of New York, Center for HIV/AIDS Educational Studies and Training
| | | |
Collapse
|
5
|
Cardoso LD, Malbergier A. Who is not using condoms among HIV-positive patients in treatment in the largest city in Brazil? AIDS Care 2014; 27:629-36. [PMID: 25495898 DOI: 10.1080/09540121.2014.986047] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Data on risky sexual behaviors in people living with HIV/AIDS (PLWHA) is still scarce in some populations around the world. The purpose of this study was to assess the factors associated with the use of condoms in a representative sample of PLWHA in outpatient treatment in the city of São Paulo. Six hundred and sixty-seven HIV-positive patients (383 men and 284 women) who were being treated at eight centers participated in this study. Data were collected using a sociodemographic survey, the Beck depression and anxiety inventories, a survey of alcohol and other drugs use, the Alcohol Use Disorders Identification Test, a sexual behavior survey, and the Sexual Risk Behavior Assessment Schedule. The majority of study participants were sexually active (almost 62% of the sample had at least one sexual partner in the last three months), and at least one-fourth engaged in unsafe sex (25.3% did not use condoms during at least one instance of anal and/or vaginal intercourse in the past three months). Multivariate logistic regression showed that engaging in unprotected sex was more likely among females (p < .001), persons with an HIV-positive partner (p < .001), and people using cannabis before sex (p = .002). These findings should stimulate health-care workers to create specific groups for women, seroconcordant couples, and cannabis users to discuss condom use, as they seem to be vulnerable groups.
Collapse
|
6
|
Bond KT, Frye V, Taylor R, Williams K, Bonner S, Lucy D, Cupid M, Weiss L, Koblin BA. Knowing is not enough: a qualitative report on HIV testing among heterosexual African-American men. AIDS Care 2014; 27:182-8. [PMID: 25298014 DOI: 10.1080/09540121.2014.963009] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Despite having higher rates of HIV testing than all other racial groups, African-Americans continue to be disproportionately affected by the HIV epidemic in the United States. Knowing one's status is the key step to maintaining behavioral changes that could stop the spread of the virus, yet little is known about the individual- and socio-structural-level barriers associated with HIV testing and communication among heterosexual African-American men. To address this and inform the development of an HIV prevention behavioral intervention for heterosexual African-American men, we conducted computerized, structured interviews with 61 men, focus group interviews with 25 men in 5 different groups, and in-depth qualitative interviews with 30 men living in high HIV prevalence neighborhoods in New York City. Results revealed that HIV testing was frequent among the participants. Even with high rates of testing, the men in the study had low levels of HIV knowledge; perceived little risk of HIV; and misused HIV testing as a prevention method. Factors affecting HIV testing, included stigma, relationship dynamics and communication, and societal influences, suggesting that fear, low perception of risk, and HIV stigma may be the biggest barriers to HIV testing. These results also suggest that interventions directed toward African-American heterosexual men must address the use of "testing as prevention" as well as correct misunderstandings of the window period and the meaning of HIV test results, and interventions should focus on communicating about HIV.
Collapse
Affiliation(s)
- Keosha T Bond
- a Department of Health and Behaviors Studies , Teachers College Columbia University , New York , NY , USA
| | | | | | | | | | | | | | | | | | | |
Collapse
|
7
|
August EM, Daley E, Kromrey J, Baldwin J, Romero-Daza N, Salmeron J, Lazcano-Ponce E, Villa LL, Bryant CA, Giuliano AR. Age-related variation in sexual behaviours among heterosexual men residing in Brazil, Mexico and the USA. ACTA ACUST UNITED AC 2013; 40:261-9. [PMID: 24099979 DOI: 10.1136/jfprhc-2012-100564] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVE To compare the prevalence of demographic characteristics and sexual behaviours across age groups and to estimate their significance in predicting sexual risk factors by age cohort. METHODS This cohort study examined sexually transmitted infection (STI) prevalence among heterosexual men in Brazil, Mexico and the USA (N=3047). Participants completed a sexual risk factor questionnaire and were tested for chlamydia, gonorrhoea, syphilis and genital herpes. We examined sexual risk in the study population through a composite measure of STI positivity by age cohort (young: 18-30 years; middle-aged: 31-44 years; older: 45-70 years). Multivariable logistic regression models were used to generate adjusted odds ratios (AORs) and 95% confidence intervals (CIs). RESULTS We found that STI positivity varied significantly by age group among heterosexual men by a number of covariates. In younger men, having more advanced education had a protective effect (16 years: AOR=0.37, 95% CI 0.15- 0.92), whereas higher numbers of sexual partners elevated the risk for STIs (20-49 partners: AOR=2.06, 95% CI 1.04-4.06; ≥ 50 partners: AOR=4.33, 95% CI 1.74-10.76). Middle-aged men who were black (AOR=1.64, 95% CI 1.10-2.42) and divorced/separated/widowed (AOR=1.91, 95% CI 1.21-3.02) had an increased risk for a positive STI test. Among older men, a younger age at first vaginal sexual encounter (AOR=3.75, 95% CI 1.45-9.74) and a history of exchanging sex for money or drugs heightened STI risk (AOR=2.30, 95% CI 1.0-5.04). CONCLUSIONS These findings demonstrate that age-related life experiences among heterosexual men influence sexual risk and STI transmission. This topic warrants further investigation to support the development and implementation of targeted interventions that may potentially reduce adverse sexual health outcomes.
Collapse
Affiliation(s)
- Euna M August
- Research Coordinator, Department of Community and Family Health, College of Public Health, University of South Florida, Tampa, FL, USA
| | - Ellen Daley
- Associate Professor, Department of Community and Family Health, College of Public Health, University of South Florida, Tampa, FL, USA
| | - Jeffrey Kromrey
- Professor, Department of Educational Measurement and Research, College of Education, University of South Florida, Tampa, FL, USA
| | - Julie Baldwin
- Professor, Department of Community and Family Health, College of Public Health, University of South Florida, Tampa, FL, USA
| | - Nancy Romero-Daza
- Associate Professor, Department of Anthropology, College of Arts and Sciences, University of South Florida, Tampa, FL, USA
| | - Jorge Salmeron
- Professor, Unidad de Investigación Epidemiológica en Servicios de Salud, Instituto Mexicano del Seguro Social, Cuernavaca, Morelos, México
| | - Eduardo Lazcano-Ponce
- Director, Centro de Investigación Salud Poblacional, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, México
| | - Luisa L Villa
- Professor, Faculty of Medical Sciences of Santa Casa of São Paulo, São Paulo, Brazil
| | - Carol A Bryant
- Distinguished Professor, Department of Community and Family Health, College of Public Health, University of South Florida, Tampa, FL, USA
| | - Anna R Giuliano
- Director, Center for Infection Research in Cancer, H Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| |
Collapse
|
8
|
Aging with HIV: a practical review. Braz J Infect Dis 2013; 17:464-79. [PMID: 23711587 PMCID: PMC9428066 DOI: 10.1016/j.bjid.2012.11.007] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2012] [Revised: 11/19/2012] [Accepted: 11/21/2012] [Indexed: 11/20/2022] Open
Abstract
The worldwide elderly population is expected to grow by an additional 694 million people by 2025. By that time, there will be approximately two billion elderly people in the world, most of whom (80%) will be living in developing countries. Based on recent estimates, this population will number over 40 million in 2030 in Brazil and a consequent increase in governmental spending for this population can be expected. Since highly active antiretroviral therapy became available in the mid-1990s, the life expectancy of people living with HIV has increased significantly. Approximately 12 million life years were added to the world between 1996 and 2008 as a consequence of wider access to highly active antiretroviral therapy. In Brazil, the incidence of AIDS among the population aged ≥50 years doubled between 1996 and 2006. The development of antiretroviral therapy has allowed individuals diagnosed at a younger age to live longer, which partially explains the aging tendency associated with the HIV/AIDS epidemic. It is estimated that by 2015, subjects aged ≥50 years will represent 50% of the people living with HIV undergoing clinical treatment. This scenario presents some challenges, including the fact that the diagnosis of HIV tends to be delayed in older patients compared to younger patients because the symptoms of HIV can be confused with those of other common diseases among the elderly and also because healthcare professionals do not consider this population to be at high risk for HIV infection. In regard to the individuals diagnosed with HIV, a further challenge is presented by the morbidity normally associated with aging. Finally, the elderly also exhibit higher susceptibility to the toxic effects and pharmacological interactions of medications. The present article reviews the literature regarding the profile of HIV infection among individuals aged ≥50 years focusing on practical features related to the clinical approach and long-term follow-up of this population.
Collapse
|
9
|
Ford JD, Beaumier M. Feeding the family during times of stress: experience and determinants of food insecurity in an Inuit community. THE GEOGRAPHICAL JOURNAL 2011; 177:44-61. [PMID: 21560272 DOI: 10.1111/j.1475-4959.2010.00374.x] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
This paper uses a mixed methods approach to characterise the experience of food insecurity among Inuit community members in Igloolik, Nunavut, and examine the conditions and processes that constrain access, availability, and quality of food. We conducted semi-structured interviews (n= 66) and focus groups (n= 10) with community members, and key informant interviews with local and territorial health professionals and policymakers (n= 19). The study indicates widespread experience of food insecurity. Even individuals and households who were food secure at the time of the research had experienced food insecurity in the recent past, with food insecurity largely transitory in nature. Multiple determinants of food insecurity operating over different spatial-temporal scales are identified, including food affordability and budgeting, food knowledge and preferences, food quality and availability, environmental stress, declining hunting activity, and the cost of harvesting. These determinants are operating in the context of changing livelihoods and climate change, which in many cases are exacerbating food insecurity, although high-order manifestations of food insecurity (that is, starvation) are no longer experienced.
Collapse
|
10
|
Villegas Rodríguez N, Ferrer Lagunas LM, Cianelli Acosta R, Miner S, Lara Campos L, Peragallo N. [Knowledge and Self Efficacy Related with HIV Prevention among Chilean Women]. INVESTIGACION Y EDUCACION EN ENFERMERIA 2011; 29:222-229. [PMID: 25284914 PMCID: PMC4183347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
OBJECTIVE To assess the relationship between knowledge and self efficacy associated to HIV/AIDS in women from Chile with social disadvantages. METHODOLOGY Correlation study that uses the baseline assessment of the "Testing an HIV and AIDS intervention in Chilean women" study, carried out between 2006 and 2008, with a sample of 496 women between 18 and 49 years old, in 2 neighborhoods of Santiago de Chile. Participants answered a structured survey conducted by trained interviewers. The survey included questions about sociodemographic information, risk behaviors and a self-efficacy knowledge scale among others. RESULTS The average age was 32.3±9.1 years, 72.2% live with their partner and 42.7% have completed high school education. The mean score of HIV infection knowledge was 8.9±2.5, while the mean score for the three scales used to measure self-efficacy were: "Peer rules" =9.8±3.6, "Risk reduction intentions =12.2±3.6 and "Self Efficacy Form"=20.2±4.7. HIV knowledge had a weak positive correlation with the "Risk reduction intentions" scale (r=0.19; p<0.0001) and the "Self Efficacy Form" scale (r=0.34; p<0.0001), however there was no correlation with the "Safe sex peer rules" (r=0.13;p=0.78). CONCLUSION There is a weak positive correlation between the HIV/AIDS related knowledge and self-efficacy among Chilean with social disadvantages.
Collapse
Affiliation(s)
| | | | - Rosina Cianelli Acosta
- Enfermera. Profesora Doctora de Escuela de Enfermería de la Pontificia Universidad Católica de Chile y de School of Nursing and Health Studies, University of Miami, Estados Unidos.
| | - Sarah Miner
- Enfermera, Magíster en Enfermería. Asistente de Investigación Mano a Mano de la Universidad Católica de Chile, Chile.
| | - Loreto Lara Campos
- Enfermera, Candidata a Magíster en Enfermería. Coordinadora de proyectos de Investigación Mano a Mano de la Universidad Católica de Chile, Chile.
| | - Nilda Peragallo
- Enfermera. Profesora de Nursing and Health Studies of University of Miami, United States.
| |
Collapse
|
11
|
Abstract
Although individuals and nurses value tailored health interventions, incorporating tailored interventions into research is fraught with pitfalls. This manuscript provides guidance on addressing challenges on developing, implementing, and evaluating tailored interventions (TIs). The initial step in designing TIs involves selecting the individual characteristics on which to tailor the intervention. After selecting critical characteristics for tailoring, researchers must decide how to assess these characteristics. Then researchers can use manuals, algorithms, or computer programs to tailor an intervention and maintain treatment fidelity. If desired outcomes are not achieved, focus groups or individual interviews may be conducted to gather information to improve the intervention for specific individuals/groups. Then, incorporating study arms of TIs in intervention studies, investigators may compare TIs with standardized interventions statistically and clinically. We believe TIs may have better outcomes, promote better adherence, and be more cost efficient.
Collapse
|
12
|
Coleman CL, Ball K. Sexual diversity and HIV risk among older heterosexual African American males who are seropositive. Appl Nurs Res 2009; 23:122-9. [PMID: 20643321 DOI: 10.1016/j.apnr.2008.07.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2007] [Revised: 07/03/2008] [Accepted: 07/05/2008] [Indexed: 10/21/2022]
Abstract
The purpose of this study is to describe the occurrence of non-condom use during vaginal or anal intercourse, controlling for HIV symptoms, AIDS knowledge, relationship status, and safe-sex discussion, in 73 self-identified heterosexual African American males who are seropositive. The participants were analyzed as a subset from a larger sample of 130 African American men who are HIV seropositive. HIV-related symptoms were reported by all of the study participants. Twenty-seven percent of the participants reported engaging in same-sex behavior, 37% reported not using condoms during vaginal sex, and 75% reported not using condoms during anal sex during the past 3 months. Twenty-four percent did not decrease sexual risk behaviors, despite being seropositive. The logistic regression analysis indicated that the odds for participants not using condoms who did not engage in safe-sex discussions were 77.4 times for vaginal sex and 14.2 times during anal sex. These findings are compelling given that African Americans comprise 50% of new HIV infections each year.
Collapse
Affiliation(s)
- Christopher Lance Coleman
- Center for Health Disparities Research, University of Pennsylvania School of Nursing, Philadelphia 19104-6096, USA.
| | | |
Collapse
|
13
|
Pathways from Interpersonal Violence to Sexually Transmitted Infections: A Mixed-Method Study of Diverse Women. J Womens Health (Larchmt) 2008; 17:1591-603. [DOI: 10.1089/jwh.2008.0885] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
|