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Saiyed FK, Segura ER, Tan D, Clark JL, Lake JE, Holloway IW. Social networks and condomless intercourse with female partners among male sex workers in the Dominican Republic. Int J STD AIDS 2020; 32:176-183. [PMID: 33334269 PMCID: PMC10387283 DOI: 10.1177/0956462420920406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Male sex workers (MSW) in the Dominican Republic (DR) have multiple sexual partners, including personal and client-relationships, and are disproportionately affected by human immunodeficiency virus (HIV). We examined the prevalence of condomless anal and/or vaginal intercourse (CI) among MSW in the DR as a function of social network factors. Self-report surveys and social network interviews were administered to MSW recruited through venue-based sampling (N = 220). A generalized linear model was used to complete a Poisson Regression model and identify variables significantly associated with the outcome of interest. CI was more common with female (28.3%) than with male partners (4.9%). Factors associated with CI with the last female partner included older age of MSW, CI with the last male partner, having a stable female partner (a consistent or main partner), and having ≥1 family member in the participants' social network. Partner and social network characteristics associated with CI among MSW suggest the utility of dyadic and network interventions to reduce HIV risk.
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Affiliation(s)
- Faiez K Saiyed
- McGovern Medical School at UTHealth, Houston, TX, USA.,South American Program in HIV Prevention Research, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Eddy R Segura
- South American Program in HIV Prevention Research, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA.,Escuela de Medicina, Universidad Peruana de Ciencias Aplicadas, Lima, Perú
| | - Diane Tan
- Center for HIV Identification, Prevention, and Treatment Services, Department of Family Medicine, UCLA, Los Angeles, CA, USA.,Department of Health Policy and Management, UCLA Fielding School of Public Health, Los Angeles, CA, USA
| | - Jesse L Clark
- South American Program in HIV Prevention Research, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA.,Center for HIV Identification, Prevention, and Treatment Services, Department of Family Medicine, UCLA, Los Angeles, CA, USA
| | - Jordan E Lake
- McGovern Medical School at UTHealth, Houston, TX, USA.,South American Program in HIV Prevention Research, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Ian W Holloway
- South American Program in HIV Prevention Research, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA.,Center for HIV Identification, Prevention, and Treatment Services, Department of Family Medicine, UCLA, Los Angeles, CA, USA.,Department of Social Welfare, Luskin School of Public Affairs, University of California, Los Angeles, CA, USA
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2
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Rocha-Jiménez T, Morales-Miranda S, Fernández-Casanueva C, Brouwer KC. The influence of migration in substance use practices and HIV/STI-related risks of female sex workers at a dynamic border crossing. J Ethn Subst Abuse 2020; 19:503-520. [PMID: 30795721 PMCID: PMC8638352 DOI: 10.1080/15332640.2018.1556763] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
We explored the association of international migration with substance use and HIV/STI risk factors among female sex workers (FSW). Using modified time-location sampling, we recruited 266 FSW at the Mexico-Guatemala border. Crude and adjusted logistic regression models were used to evaluate the relationships. HIV risks, such as frequent hard drug use and drug use in another country, were greater for migrant compared to nonmigrant FSW. However, more migrant versus nonmigrant FSW reported consistent condom use with clients and having a health card. Our study highlights regional patterns of substance use among FSW and risk or protective behaviors related to migration status.
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Affiliation(s)
- Teresita Rocha-Jiménez
- Division of Infectious Diseases and Global Public Health, University of California San Diego, La Jolla, California
- Graduate School of Public Health, San Diego State University, Center for U.S.-Mexican Studies, University of California, San Diego, California
| | | | - Carmen Fernández-Casanueva
- Centro de Investigaciones y Estudios Superiores en Antropología Social CIESAS, San Cristóbal de las Casas, Chiapas, México
| | - Kimberly C Brouwer
- Division of Infectious Diseases and Global Public Health, University of California San Diego, La Jolla, California
- Department of Family Medicine and Public Health, University of California San Diego, La Jolla, California
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3
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Paulino-Ramirez R, Tapia L, Ruiz-Matuk C, Charow R, Budhwani H, Routy JP. Human T-cell lymphotropic virus 1/2 and human immunodeficiency virus antibodies identification among transactional sex workers and drug users in the Dominican Republic. Trans R Soc Trop Med Hyg 2020; 113:293-297. [PMID: 30892643 DOI: 10.1093/trstmh/trz012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2018] [Revised: 02/09/2019] [Accepted: 02/15/2019] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Human immunodeficiency virus (HIV) increases the risk of acquiring human T-cell lymphotropic virus (HTLV) and subsequently HTLV's progression to tropical spastic paraparesis/HTLV-1-associated myelopathy (TSP/HAM). Existing data have exclusively reported generalized rates of HIV and HTLV-1 chronic viral infections in the Dominican Republic. To our knowledge, no published studies have focused on the rates of HTLV-1/2 in transactional sex workers and drug users, both higher risk groups, in the Dominican Republic. METHODS From December 2012 to April 2013 we conducted a study to estimate the seroprevalence of HTLV-1/2 immunoglobulin G (IgG) and HIV antibodies among transactional sex workers and intravenous drug users in Santo Domingo, Dominican Republic. Serological status was analysed with behaviour and demographic data. RESULTS We collected and analysed plasma from 200 participants with a mean age of 27.4 y in men and 25.2 y in women. The overall weighted seroprevalence of HTLV-1/2 IgG antibodies was 13.91% (95% CI 7.59 to 20.23) in men and 10.59% (95% CI 4.05 to 17.13) in women. The overall weighted seroprevalence of HIV-1 was 13.91% (95% CI 7.59 to 20.23%) in men and 17.65% (95% CI 9.55 to 25.75) in women. Male intravenous drug users had an exceptionally high rate of HTLV-positive HIV co-infection, at 75% (95% CI 44.99 to 105.01). Although there an association has been found between HTLV/HIV co-infections and sex work, the adjusted odds revealed a confounding role of HIV infection. CONCLUSIONS The results highlight the urgent need for enhanced public health preventive strategies among high-risk populations in the Dominican Republic and other resource-constrained Caribbean settings, as well as global adoption of routine screening for HTLV-associated infections, particularly in these high-risk, underserved populations.
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Affiliation(s)
- Robert Paulino-Ramirez
- Instituto de Medicina Tropical & Salud Global, Universidad Iberoamericana (UNIBE), Calle Majoma 13, Los Rios, Santo Domingo, Dominican Republic
| | - Leandro Tapia
- Instituto de Medicina Tropical & Salud Global, Universidad Iberoamericana (UNIBE), Calle Majoma 13, Los Rios, Santo Domingo, Dominican Republic
| | - Carlos Ruiz-Matuk
- Instituto de Medicina Tropical & Salud Global, Universidad Iberoamericana (UNIBE), Calle Majoma 13, Los Rios, Santo Domingo, Dominican Republic
| | - Rebecca Charow
- Centro de Orientación e Investigación Integral (COIN), Calle Anibal de Espinosa 352, Santo Domingo, Dominican Republic
| | - Henna Budhwani
- University of Alabama at Birmingham (UAB), School of Public Health, Department of Health Care Organization and Policy, 1720 2nd Avenue South, Birmingham, AL
| | - Jean-Pierre Routy
- McGill University Health Centre: Glenn Site, Research Institute, Block E Suite EM 3-3232, Mezzanine 3M, 1001 Boulevard Décaire, Montreal, Quebec, Canada
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Burgos JFC, Padilla M, Nuñez A, Varas-Díaz N, Matiz-Reyes A. An ethnographic study of 'touristic escapism' and health vulnerability among Dominican male tourism workers. Glob Public Health 2019; 14:1578-1588. [PMID: 31397201 PMCID: PMC7231409 DOI: 10.1080/17441692.2019.1651370] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Accepted: 07/12/2019] [Indexed: 10/26/2022]
Abstract
Health research on tourism has expanded over the past two decades, focusing on understanding how the social, economic, and political configuration of tourism zones might contribute to health vulnerabilities among the diverse populations that interact in these areas. While there are few studies of HIV and drug use interactions in the region, research has indicated that these two outcomes are often interwoven in tourism zones, potentially producing 'syndemics' of HIV infection and problematic drug use. One framework that has been used in public health research on tourism is one that we refer to as touristic escapism or situational disinhibition that may be heightened for some tourists while on vacation, potentially leading to the abandonment of normative constraints on behaviour and contributing to health risks such as unprotected sex or binge drinking. In this article, we draw upon tourism theory and ethnographic research with male tourism workers employed in two popular tourist areas of the Dominican Republic to explore whether touristic escapism offers insights in understanding health vulnerabilities within tourism spaces.
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Affiliation(s)
- José Félix Colón Burgos
- Center for Research on US Latino HIV/AIDS and Drug Abuse (CRUSADA), Robert Stempel School of Public Health and Social Work, Florida International University, Miami, FL, USA
| | - Mark Padilla
- Global and Sociocultural Studies, Florida International University, Miami, FL, USA
| | - Andrea Nuñez
- Global and Sociocultural Studies, Florida International University, Miami, FL, USA
| | - Nelson Varas-Díaz
- Global and Sociocultural Studies, Florida International University, Miami, FL, USA
| | - Armando Matiz-Reyes
- Kimberly Green Latin American and Caribbean Center, Florida International University, Miami, FL, USA
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5
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Kibicho J, Campbell JK. Community perspectives of second-generation alcohol misuse and HIV risk in rural Kenya: A gendered syndemic lens. Glob Public Health 2019; 14:1733-1743. [PMID: 31291832 DOI: 10.1080/17441692.2019.1638958] [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] [Indexed: 10/26/2022]
Abstract
Sub-Saharan Africa is at the intersection of the HIV epidemic and the highest burden of alcohol-related disease and injury. Alcohol consumption is associated with an increased likelihood of HIV infection, high rates of intimate partner violence and is considered both a cause and a contributor of economic stress and poverty. Our study integrates the syndemic and socio-ecological system theoretical frameworks to qualitatively explore the effect of second-generation alcohol consumption on sexual risk behaviours, alcohol misuse, violence and economic stress (SAVE) factors and HIV infection risk. We recruited 80 people from rural Kenya to participate in 12 focus groups. Consistent with the literature, we found evidence of syndemic associations of second-generation alcohol consumption with SAVE factors, including HIV infection risk. Structural-level factors including availability of cheap second-generation alcohol and widespread unemployment are the biggest risk factors for alcohol misuse. Because of the psychological effect of women's increasing economic independence on men, gendered syndemic programming - that includes both men and women - and addresses the complex web of risk factors for second-generation alcohol misuse can interrupt the vicious cycle of poverty, violence, sexual risk behaviours and mitigate HIV infection risk in rural Kenya.
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Affiliation(s)
- Jennifer Kibicho
- College of Nursing, University of Wisconsin-Milwaukee , Milwaukee , WI , USA
| | - Julie Kieffer Campbell
- College of Nursing, University of Wisconsin-Milwaukee , Milwaukee , WI , USA.,School of Nursing, Lee University , Cleveland , TN , USA
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Abstract
To examine how alcohol-related HIV risk behaviors within MSM sex workers' social networks (SN) may be associated with individual risk behaviors, respondent-driven and venue-based sampling were used to collect demographic, behavioral and SN characteristics among MSM sex workers in Santo Domingo and Boca Chica (N = 220). The majority of participants reported problem drinking (71.0%) or alcohol use at their last sexual encounter (71.4%). Self-reported problem drinking was associated with SN characteristics (at least one member who recently got drunk aOR = 7.5, no religious/spiritual adviser aOR = 3.0, non-sexual network density aOR = 0.9), while self-reported alcohol use at last sex was associated with individual (drug use at last sex aOR = 4.4) and SN characteristics (at least one member with previous HIV/STI testing aOR = 4.7). Dominican MSM sex workers reported high alcohol use, which may increase their risk for HIV. A better understanding of SN factors associated with individual risk behaviors can help guide appropriate intervention development.
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7
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Budhwani H, Hearld KR, Milner AN, McGlaughlin E, Charow R, Rodriguez-Lauzurique RM, Rosario S, Paulino-Ramirez R. Transgender Women's Drug Use in the Dominican Republic. Transgend Health 2017; 2:188-194. [PMID: 29142909 PMCID: PMC5684664 DOI: 10.1089/trgh.2017.0032] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Purpose: Studies on drug use in transgender populations, particularly those in resource-limited settings, are scarce. Considering that drug use can be a coping mechanism to deal with stigma and traumatic experiences, we examined associations between stigma, trauma, and drug use in a national sample of transgender women from the Dominican Republic. Methods: Bivariate analyses examined differences between drug users and abstainers (n=287). Multivariate analyses reported odds ratios (OR) with general drug, marijuana, and cocaine use as outcomes (n=243). Results: A quarter of respondents (24.5%) experienced sexual abuse, 12.1% were tortured, and 20.1% experienced a murder attempt. More than a quarter reported using illegal drugs (26.1%). Drug users had lower socioeconomic status; 30.0% of drug users had a primary level of education or less (18.2% of abstainers) and 17.6% of drug users had higher income, defined as greater than 10,001 pesos (∼$210 United States Dollars, USD) per month (28.1% of abstainers). More than half of drug users experienced some form of trauma (51.4%) compared to 43.5% of abstainers, and 28.4% of drug users, compared to 17.1% of abstainers, experienced a murder attempt on her life. Independent sample t-tests found significant differences between drug users and abstainers. Transgender women who experienced sexual abuse had three times high odds of using cocaine. Drug users were more likely to have experienced sexual abuse and attempted suicide (p<0.05 for both). Respondents who attempted suicide had higher odds of using drugs generally and using marijuana specifically, compared to respondents who had not attempted suicide (OR=2.665 and 3.168, respectively). Higher scores on the stigma scale were associated with higher odds of any drug use and cocaine use (OR=1.132 and 1.325, respectively). Conclusions: Although some nations have implemented antidiscrimination policies protecting transgender citizens, these policies are not consistently enforced. Eliminating stigma and stigmatizing policies may reduce rates of drug use as a coping mechanism.
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Affiliation(s)
- Henna Budhwani
- University of Alabama at Birmingham, Birmingham, Alabama
| | | | | | - Elaine McGlaughlin
- United Nations Family Planning Association (UNFPA), Tegucigalpa, Honduras
| | - Rebecca Charow
- Institute for Tropical Medicine and Global Health, Universidad Iberoamericana, Santo Domingo, República Dominicana
| | | | - Santo Rosario
- Centro de Orientación e Investigación Integral (COIN), Santo Domingo, Dominican Republic
| | - Robert Paulino-Ramirez
- Institute for Tropical Medicine and Global Health, Universidad Iberoamericana, Santo Domingo, República Dominicana
- Centro de Orientación e Investigación Integral (COIN), Santo Domingo, Dominican Republic
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8
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Substance Use and HIV Risk Among Men Who Have Sex With Men in Africa: A Systematic Review. J Acquir Immune Defic Syndr 2017; 76:e34-e46. [PMID: 28903126 DOI: 10.1097/qai.0000000000001462] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
BACKGROUND Substance use and its relation to HIV risk among men who have sex in Africa, a population at high risk for HIV, has received little attention. METHODS This systematic review summarizes and discusses findings from 68 empirical studies, published between 1980 and 2016 that included data about substance use in men who have sex with men (MSM) in Africa. RESULTS Substance use has rarely been the primary focus of studies in African MSM. In general, measurement of substance use was suboptimal. Whereas prevalence of alcohol use varied across studies, partly resulting from variety in assessment strategies, it seemed higher than in the general male population across countries. Alcohol use was associated with sexual risk practices, but not with HIV infection. The most frequently reported drug used by African MSM was cannabis. The use of other drugs, such as cocaine and heroin seemed relatively rare, although injection drug use was exceptionally high in a few studies. As alcohol, drugs were regularly used in conjunction with sex. Both alcohol and drug use were often associated with other risk factors for HIV infection, including violence and transactional sex. No interventions were found addressing substance use among African MSM. CONCLUSIONS Given high HIV risk and prevalence in this population, substance use should be studied more in-depth, taking into account the specific social and cultural context. Assessment of substance use practices in this population has to be improved. The available information suggests, though, that there is an urgent need for interventions addressing substance use tailored to the needs of this critical population.
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9
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Almeida-González M, Henríquez-Hernández LA, P Luzardo O, Zumbado M, Zaragoza E, Meilán MJ, Camacho M, D Boada L. Ethanol levels in legally autopsied subjects: Analytical approach and epidemiological relevance in a prospective study in the touristic region of the Canary Islands (Spain). J Forensic Leg Med 2017; 52:40-45. [PMID: 28858689 DOI: 10.1016/j.jflm.2017.08.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2017] [Revised: 04/17/2017] [Accepted: 08/23/2017] [Indexed: 11/29/2022]
Abstract
The aim of this study was to analyze the presence of alcohol in individuals (137) that were subjected to a mandatory medico-legal autopsy in the Institute of Legal Medicine of Las Palmas (Canary Islands, Spain) during 2015. Blood and vitreous humor samples (232) were analyzed by gas chromatography. 46.0% of the individuals were positive for alcohol, being half of them tourists. Blood alcohol concentrations (BAC) was higher in men over 60 years (p = 0.041). 10.2% of the series died in a traffic accident, and victims had the highest proportion of positives to alcohol (64.3%) and the highest BAC (2.56 g/L, p = 0.048). The BAC:VHAC (alcohol in vitreous humor) ratio was higher among victims of traffic crashes (p = 0.036), suggesting a short elapsed interval between the alcohol intake and the fatal accident. The results of this study indicate that ethanol is still heavily involved in non-natural deaths.
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Affiliation(s)
- Maira Almeida-González
- Laboratory of Toxicology, Institute of Legal Medicine, Government of the Canary Islands, Spain; Toxicology Unit, Research Institute of Biomedical and Health Sciences (IUIBS), Universidad de Las Palmas de Gran Canaria, Paseo Blas Cabrera Felipe s/n, 35016 Las Palmas de Gran Canaria, Spain.
| | - Luis A Henríquez-Hernández
- Laboratory of Toxicology, Institute of Legal Medicine, Government of the Canary Islands, Spain; Toxicology Unit, Research Institute of Biomedical and Health Sciences (IUIBS), Universidad de Las Palmas de Gran Canaria, Paseo Blas Cabrera Felipe s/n, 35016 Las Palmas de Gran Canaria, Spain.
| | - Octavio P Luzardo
- Laboratory of Toxicology, Institute of Legal Medicine, Government of the Canary Islands, Spain; Toxicology Unit, Research Institute of Biomedical and Health Sciences (IUIBS), Universidad de Las Palmas de Gran Canaria, Paseo Blas Cabrera Felipe s/n, 35016 Las Palmas de Gran Canaria, Spain.
| | - Manuel Zumbado
- Laboratory of Toxicology, Institute of Legal Medicine, Government of the Canary Islands, Spain; Toxicology Unit, Research Institute of Biomedical and Health Sciences (IUIBS), Universidad de Las Palmas de Gran Canaria, Paseo Blas Cabrera Felipe s/n, 35016 Las Palmas de Gran Canaria, Spain.
| | - Enrique Zaragoza
- Laboratory of Toxicology, Institute of Legal Medicine, Government of the Canary Islands, Spain.
| | - María J Meilán
- Laboratory of Toxicology, Institute of Legal Medicine, Government of the Canary Islands, Spain.
| | - María Camacho
- Toxicology Unit, Research Institute of Biomedical and Health Sciences (IUIBS), Universidad de Las Palmas de Gran Canaria, Paseo Blas Cabrera Felipe s/n, 35016 Las Palmas de Gran Canaria, Spain.
| | - Luis D Boada
- Laboratory of Toxicology, Institute of Legal Medicine, Government of the Canary Islands, Spain; Toxicology Unit, Research Institute of Biomedical and Health Sciences (IUIBS), Universidad de Las Palmas de Gran Canaria, Paseo Blas Cabrera Felipe s/n, 35016 Las Palmas de Gran Canaria, Spain.
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10
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Milhausen RR, Crosby RA, Yarber WL, Graham CA, Sanders SA, Ingram H, Barr VM, Macdonald IR. An intervention study assessing a peer outreach model to promote safer-sex for tourism workers. THE CANADIAN JOURNAL OF HUMAN SEXUALITY 2016. [DOI: 10.3138/cjhs.253-a5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Tourism destinations provide unique social contexts which foster sexual risk-taking. Banff, Alberta, Canada is one such destination with high rates of STI and risk-taking, particularly among tourism workers (TWs).Twenty-five TWs (14 women and 11 men) completed a single session intervention designed to promote the consistent and correct use of condoms. The intervention, comprised of motivational and skills-based training and the provision of a range of high-quality condoms and lubricants, was delivered in a one-to-one format in community settings. Pre- and post-intervention (three weeks following) paper and pencil questionnaires were administered. Sexual experience barriers to condom use significantly decreased (P<.001) after the intervention and confidence in condom use negotiation (P=.005) significantly increased. Confidence in using condoms without loss of pleasure (P=.001) also significantly increased. The number of condom use errors significantly decreased (P<.001). All except two of the behavioral outcomes were also significant: TWs were more likely to discuss condom use before having sex (P=.025), more likely to report condom use the last time sex occurred (P=.005), and more likely to add lubrication to condoms for penile-vaginal sex (P=.027). Significant changes in frequency of unprotected penile-anal sex and frequency of unprotected penile-vaginal sex were not observed; however a large effect size was observed relative to decreases in unprotected penile-vaginal sex. Together the behavioural outcomes and psychosocial outcomes suggest the potential utility for this single session program to be applied in other tourist destinations.
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Affiliation(s)
- Robin R. Milhausen
- Department of Family Relations and Applied Nutrition, University of Guelph, Guelph, ON
- The Kinsey Institute, Indiana University, Bloomington, IN
- Rural Center for AIDS/STD Prevention, Indiana University, Bloomington, IN
| | - Richard A. Crosby
- The Kinsey Institute, Indiana University, Bloomington, IN
- Rural Center for AIDS/STD Prevention, Indiana University, Bloomington, IN
- Department of Health Behavior, College of Public Health, University of Kentucky, Lexington, KY
| | - William L. Yarber
- The Kinsey Institute, Indiana University, Bloomington, IN
- Rural Center for AIDS/STD Prevention, Indiana University, Bloomington, IN
- Department of Applied Health Science, Indiana University, Bloomington, IN
- Department of Gender Studies, Indiana University, Bloomington, IN
| | - Cynthia A. Graham
- The Kinsey Institute, Indiana University, Bloomington, IN
- Rural Center for AIDS/STD Prevention, Indiana University, Bloomington, IN
- Department of Psychology, University of Southampton, Southampton, UK
| | - Stephanie A. Sanders
- The Kinsey Institute, Indiana University, Bloomington, IN
- Rural Center for AIDS/STD Prevention, Indiana University, Bloomington, IN
- Department of Gender Studies, Indiana University, Bloomington, IN
| | - Hailey Ingram
- Department of Applied Psychology and Human Development, Ontario Institute for Studies in Education, University of Toronto, Toronto, ON
| | | | - Ian R. Macdonald
- Alpine Medical Clinic, Banff, AB
- Mineral Spring Hospital, Banff, AB
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11
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The Prevalence of and Factors Associated with Alcohol-Related Problems in a Community Sample of African American Women. JOURNAL OF ADDICTION 2016; 2016:7513827. [PMID: 27752388 PMCID: PMC5056303 DOI: 10.1155/2016/7513827] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/07/2016] [Revised: 07/20/2016] [Accepted: 08/11/2016] [Indexed: 11/18/2022]
Abstract
Purpose. This study examines the prevalence of alcohol-related problems, the factors underlying these problems, and whether or not there is evidence of syndemic effects in a community population of southern, urban African American women. Methods. Questionnaire-based interviews were conducted with 817 women, all African American, from 80 targeted census block groups in Atlanta, Georgia. Results. Most of the alcohol users (67.8%) experienced at least one problem as a result of their alcohol (ab)use, with most women experiencing two or more such problems. Eight factors were found to be associated with experiencing more alcohol problems: being aged 30 or older, having had no recent health insurance, lower levels of educational attainment, self-identifying as lesbian or bisexual, experiencing greater amounts of childhood maltreatment, greater impulsivity, perceiving one's local community or neighborhood to be unsafe, and having a larger number of criminally involved friends. Conclusions. Drinking-related problems were prevalent in this population. Numerous factors underlie the extent to which African American women experienced problems resulting from their alcohol use. There is strong evidence of syndemic-type effects influencing drinking problems in this population, and future efforts to reduce the negative impact of alcohol (ab)use ought to consider the adoption of programs using a syndemics' theory approach.
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12
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Semple SJ, Pitpitan EV, Chavarin CV, Strathdee SA, Mendoza DV, Aarons GA, Patterson TL. Correlates of unprotected sex with male clients among female sex workers in 13 Mexican cities. Glob Public Health 2016; 12:1538-1552. [PMID: 27416059 DOI: 10.1080/17441692.2016.1206603] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
This study examined correlates of unprotected vaginal and anal sex (UVA) with male clients among female sex workers (FSWs). Baseline data were gathered from 1089 FSWs recruited from 13 cities across Mexico enrolled in an evidence-based sexual risk reduction intervention. We used generalised estimating equations (GEE) to predict total UVA while controlling for the nested structure of the data. Total UVA with clients in the past month was examined in relation to selected sociodemographic, substance-use, and micro- and macro-environmental factors. A greater number of UVA acts was associated with three micro-level environmental factors (i.e. never getting condoms for free, unaffordability of condoms, greater number of clients per month), and three macro-level environmental factors (i.e. lower health and higher education indices, greater population size of city). These findings suggest the development of social and structural approaches to HIV prevention for FSWs in Mexico, including modification of venue-based policies that pressure FSWs to maximise client volume, changes to the work environment that promote availability and affordability of condoms, and improved population health. Moreover, our findings call for the development of context-specific HIV interventions that take into account variations in the sexual risk behaviours and HIV risk environments of FSWs throughout Mexico.
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Affiliation(s)
- Shirley J Semple
- a Department of Psychiatry , University of California , San Diego , CA , USA
| | - Eileen V Pitpitan
- b Division of Global Public Health, Department of Medicine , University of California , San Diego , CA , USA
| | - Claudia V Chavarin
- a Department of Psychiatry , University of California , San Diego , CA , USA
| | - Steffanie A Strathdee
- b Division of Global Public Health, Department of Medicine , University of California , San Diego , CA , USA
| | - Doroteo V Mendoza
- c Evaluation and Research Department , Mexican Foundation for Family Planning (Mexfam) , Mexico City , Mexico
| | - Gregory A Aarons
- a Department of Psychiatry , University of California , San Diego , CA , USA
| | - Thomas L Patterson
- a Department of Psychiatry , University of California , San Diego , CA , USA
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Kaljee L, Wang B, Deveaux L, Lunn S, Rolle G, Villar ME, Stanton B. Cross-sectional data on alcohol and marijuana use and sexual behavior among male and female secondary school students in New Providence, The Bahamas. Int J Adolesc Med Health 2016; 28:133-40. [PMID: 25781669 DOI: 10.1515/ijamh-2014-0079] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2014] [Accepted: 01/17/2015] [Indexed: 11/15/2022]
Abstract
BACKGROUND While The Bahamas have significantly reduced poor reproductive health outcomes among adolescents and emerging adults, data indicate that youth are engaged in sexual risk behaviors. Substance use has been linked to increased risk for HIV and sexually transmitted infections in other contexts. There are limited data on Bahamian youth in relation to consumption of alcohol and marijuana use and engagement in sexual behaviors. OBJECTIVE This study aimed to assess potential relationships between alcohol and marijuana use and engagement in sexual behavior among government secondary school students in New Providence, The Bahamas. MATERIALS AND METHODS Total sample size was 2572, and about 56% of respondents were female. Mean age was 14.2 (SD 2.7 years). Cross-sectional data came from a baseline survey conducted as part of a longitudinal randomized controlled evaluation of a school-based HIV prevention and reproductive health program in New Providence. RESULTS Overall, 46.5% (519) males and 44.8% (652) females reported alcohol consumption; 7.3% (82) males and 1.7% (25) females reported use of marijuana in the last 6 months. About 43% (477) male respondents and 16% (231) female respondents reported ever having vaginal sex. Logistic regression analysis indicates that increased likelihood of engaging in sex during the past 6 months is associated with being older, male, and consuming alcohol and marijuana. CONCLUSION These data provide a 'global correlation' between substance use and engagement in sexual behaviors among Bahamian adolescents. Longitudinal research is needed to assess event specific risks and identify mediating and moderating factors. These findings indicate the importance of integrating reproductive health and substance use education.
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Simkhada PP, Sharma A, van Teijlingen ER, Beanland RL. Factors Influencing Sexual Behaviour Between Tourists and Tourism Employees: A Systematic Review. Nepal J Epidemiol 2016; 6:530-8. [PMID: 27152234 PMCID: PMC4850236 DOI: 10.3126/nje.v6i1.14735] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2015] [Revised: 03/25/2016] [Accepted: 03/29/2016] [Indexed: 11/18/2022] Open
Abstract
Background: Increased travel abroad has a significant impact on the incidence and prevalence of Sexually Transmitted Infections (STIs). Previous reviews have focused on the knowledge, attitudes and behaviour of tourists and acquisition of STIs. Less is known about the impact on tourism operators in countries visited by tourists. The aim of this review is to ascertain factors influencing sexual behaviour between workers in the tourism industry and tourists; exploring the prevalence of sexual behaviour between the two populations, their perceptions of sexual risk while engaging in sexual activities and the knowledge of tourism operators regarding STIs. Methods: A systematic review was conducted. Database searches were performed in Medline/Ovid, EMBASE, Cochrane library and CINAHL for studies published between 2000 and March 2016. Grey literature searches were completed in the NHS database and Google Scholar between 2000 and December 2013. Papers were independently selected by two researchers. Data were extracted and critically appraised using a pre-designed extraction form and adapted CASP checklist. Results: The search identified 1,602 studies and 16 were included after review of the full text. Studies were conducted in nine countries. Findings suggest that STI knowledge, attitude and practice were fairly good among tourists and tourism workers, but there is a need for pre-travel advice for travellers, especially those travelling to low and middle-income countries. Greater importance was given to tourists than to tourism operators and locals interacting with tourists. Studies suggest that as a group both tourist and tourist workers were likely to engage in sexual activities. Overall, both condom use and STI screening were low, among tourists as well as tourism operators. Furthermore, studies reported links between drug and alcohol use and sexual behaviour and risk taking. Conclusion: Although less research appeared to have been conducted among tourism workers than tourists, it does demonstrate the need for education, training and promotion of travel medicine. STI screening, pre-travel advice, travel history in terms of contracting STIs and safe-sex awareness-raising are needed. More and better sexual health education and relevant tourism policies are needed globally.
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Alcohol use behaviors among indigenous migrants: a transnational study on communities of origin and destination. J Immigr Minor Health 2015; 16:348-55. [PMID: 24366542 DOI: 10.1007/s10903-013-9964-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
The association between international and domestic migration and alcohol use among indigenous communities is poorly understood. We explored migration-related factors associated with alcohol use behaviors among an indigenous Mayan, binational population. From January to March 2012, 650 indigenous participants from the high-emigration town of Tunkás in the Mexican state of Yucatán (n = 650) residing in Mexico and California completed surveys. Multivariate logistic regression identified migration-related factors associated with alcohol use behaviors. US migration of shorter duration (<5 years) was independently associated with at-risk drinking (adjusted odds ratio (AOR) 2.34; 95% confidence interval (CI) 1.09-5.03), as was longer-duration domestic migration (≥5 years) (AOR 2.34; 95% CI 1.12-4.87). Ability to speak Maya (AOR 0.26; 95% CI 0.13-0.48) was protective against at-risk drinking. Culturally appropriate alcohol use prevention interventions are needed for domestic and international indigenous Mexican migrants to address alcohol use behavior in the context of migration.
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Figueroa JP. Review of HIV in the Caribbean: significant progress and outstanding challenges. Curr HIV/AIDS Rep 2015; 11:158-67. [PMID: 24623473 DOI: 10.1007/s11904-014-0199-7] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
This paper reviews the recent literature on HIV in the Caribbean and discusses the challenges faced. HIV incidence in the Caribbean has declined by 49 % in the past decade, coverage of persons living with HIV among those eligible for antiretroviral treatment as per national guidelines was 70 % in 2012, and some countries are meeting the target of virtual elimination of mother-to-child transmission. HIV prevalence in the Caribbean is 1 % with features of both a generalized and concentrated HIV epidemic. HIV prevalence among female sex workers has declined but remains unacceptably high among men who have sex with men. Social and cultural factors, gender norms, and strong stigma associated with HIV and homosexuality contribute to the continued spread of HIV. Caribbean countries and their partners have invested significant resources, creative effort and impressive research in strengthening the HIV response nationally and regionally. However, in order to control the HIV epidemic, leaders at all levels, and the people, must address fundamental structural barriers in society that deny marginalized persons their rights, undermine public health goals, and impede universal access to HIV prevention, treatment, and care.
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Affiliation(s)
- J Peter Figueroa
- Department of Community Health and Psychiatry, University of the West Indies, Mona, Kingston 7, Jamaica,
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Bauer IL. Romance tourism or female sex tourism? Travel Med Infect Dis 2013; 12:20-8. [PMID: 24332659 DOI: 10.1016/j.tmaid.2013.09.003] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2013] [Revised: 09/17/2013] [Accepted: 09/19/2013] [Indexed: 10/26/2022]
Abstract
BACKGROUND Love, sex and the female traveller: romance tourism or female sex tourism? The phenomenon of women travelling in search of relationships with local men in developing countries has been studied for the last 20 years. However, it appears little known in travel medicine. METHODS Relevant literature was found through PubMed, Science Direct, ProQuest and Google Scholar. The reference lists of selected articles identified further sources. RESULTS Historical records of women travellers to far-away countries abound. Then, as now, women not only searched for the erotic 'other' but made romance and sex the purpose of their trip. Today, increasing numbers of women travel to destinations in developing countries where sex with local men is the main attraction. This pastime raises concerns not only for the women themselves but for the local men involved as well as their sex partners and the local communities. CONCLUSIONS Although more research is necessary, comparing the criteria that describe men travelling for sex and relationships and women travelling for sex and relationships appears to suggest that there is very little difference between the two, regardless of what the pursuit is called. Women looking for sex with local men are sex tourists, too. Recognition of this fact needs to influence the pre and post travel care of female travellers.
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Affiliation(s)
- Irmgard L Bauer
- School of Nursing, Midwifery & Nutrition, James Cook University, Townsville, QLD 4811, Australia; Tropical Health Research Unit for Nursing and Midwifery Practice, James Cook University, Townsville, QLD 4811, Australia; International Health Program, Curtin University of Technology, GPO Box U1987, Perth, WA 6845, Australia.
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GUILAMO-RAMOS V, JACCARD J, MCCARTHY K, QUIÑONES Z, LUSHIN V, SKINNER-DAY M, PADILLA M, MEISTERLIN L. Taxonomy of Caribbean tourism alcohol venues: implications for HIV transmission. Drug Alcohol Depend 2013; 132:238-43. [PMID: 23478154 PMCID: PMC3724765 DOI: 10.1016/j.drugalcdep.2013.02.010] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2012] [Revised: 02/06/2013] [Accepted: 02/06/2013] [Indexed: 11/24/2022]
Abstract
BACKGROUND Tourism areas represent ecologies of heightened HIV vulnerability characterized by a disproportionate concentration of alcohol venues. Limited research has explored how alcohol venues facilitate HIV transmission. METHODS We spatially mapped locations of alcohol venues in a Dominican tourism town and conducted a venue-based survey of key informants (n=135) focused on three facets of alcohol venues: structural features, type of patrons, and HIV risk behaviors. Using latent class analysis, we identified evidence-based typologies of alcohol venues for each of the three facets. Focused contrasts identified the co-occurrence of classes of structural features, classes of types of patrons, and classes of HIV risk behavior, thus elaborating the nature of high risk venues. RESULTS We identified three categories of venue structural features, three for venue patrons, and five for HIV risk behaviors. Analysis revealed that alcohol venues with the greatest structural risks (e.g. sex work on-site with lack of HIV prevention services) were most likely frequented by the venue patron category characterized by high population-mixing between locals and foreign tourists, who were in turn most likely to engage in the riskiest behaviors. CONCLUSION Our results highlight the stratification of venue patrons into groups who engage in behaviors of varying risk in structural settings that vary in risk. The convergence of high-risk patron groups in alcohol venues with the greatest structural risk suggests these locations have potential for HIV transmission. Policymakers and prevention scientists can use these methods and data to target HIV prevention resources to identified priority areas.
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Affiliation(s)
- Vincent GUILAMO-RAMOS
- Silver School of Social Work, New York University, 1 Washington Square North, New York, NY 10003-6654 R321,Center for Latino Adolescent and Family Health, New York University, 15 Washington Place, New York, NY 10003
| | - James JACCARD
- Silver School of Social Work, New York University, 1 Washington Square North, New York, NY 10003-6654 R321,Center for Latino Adolescent and Family Health, New York University, 15 Washington Place, New York, NY 10003
| | - Katharine MCCARTHY
- Center for Latino Adolescent and Family Health, New York University, 15 Washington Place, New York, NY 10003
| | - Zahira QUIÑONES
- Pontificia Universidad Católica Madre y Maestra, Santiago de los Caballeros, Dominican Republic
| | - Viktor LUSHIN
- Silver School of Social Work, New York University, 1 Washington Square North, New York, NY 10003-6654 R321,Center for Latino Adolescent and Family Health, New York University, 15 Washington Place, New York, NY 10003
| | - Molly SKINNER-DAY
- Center for Latino Adolescent and Family Health, New York University, 15 Washington Place, New York, NY 10003
| | - Mark PADILLA
- Department of Global & Sociocultural Studies, Florida International University, Modesto A. Maidique Campus, SIPA 3rd Floor, Miami, Florida 33199
| | - Leah MEISTERLIN
- Center for Latino Adolescent and Family Health, New York University, 15 Washington Place, New York, NY 10003
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