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Okeke SR. "I always prefer to withdraw than use a condom": contextualising condomless sex among East Asian and sub-Saharan African international students in Sydney. Arch Public Health 2022; 80:20. [PMID: 34986875 PMCID: PMC8729151 DOI: 10.1186/s13690-021-00777-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Accepted: 12/21/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Incidence and prevalence of blood-borne viruses and sexually transmissible infections among young people continue to necessitate population-based studies to understand how contextualised sexual health services can be developed and implemented to promote protective behaviours such as consistent condom use. This study examined condomless sexual practice among a sample of East Asian and sub-Saharan African international university students in Sydney, Australia. METHODS This qualitative study was methodologically guided by interpretative phenomenological analysis. Data was provided by 20 international students sampled from five universities in Sydney, who participated in either face-to-face or telephone semi-structured in-depth interviews. The interview sessions were audio-recorded, transcribed verbatim, coded in NVivo and analysed using reflexive thematic analysis. RESULTS Condomless sexual practices appear to be common among the study group based on participants' self-reports of their own practices and the practices of friends and peers. Three themes contextualising condomless among the study participants were generated from the interview transcripts: (1) unanticipated sex, condom related stigma and alcohol use (2) pleasure-seeking, curiosity and intimacy (3) condomless sex as a gendered practice. CONCLUSIONS The result of this study has implications for public health research, practice and policy around design, implementation and evaluation of multi-layered and population-specific sexual health services that are tailored to addressing the needs of international students, who migrate from traditional sexual cultures to Australia, where sexual norms are more liberal.
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Palfai TP, Luehring-Jones P. How Alcohol Influences Mechanisms of Sexual Risk Behavior Change: Contributions of Alcohol Challenge Research to the Development of HIV Prevention Interventions. AIDS Behav 2021; 25:314-332. [PMID: 34148189 DOI: 10.1007/s10461-021-03346-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/10/2021] [Indexed: 10/21/2022]
Abstract
This paper examines the contributions of laboratory-based alcohol challenge research (ACR) to the development of HIV prevention interventions. Following a brief overview of HIV prevention interventions and related health behavior change models, we discuss how alcohol may influence mechanisms of behavior change. The paper highlights the value of ACR for: (1) elucidating mechanisms of action through which alcohol affects sexual risk behavior, (2) testing how alcohol may influence mechanisms thought to underlie HIV prevention interventions, (3) clarifying moderators of the causal influences of alcohol, (4) identifying novel intervention targets, and (5) developing strategies to reduce sexual risk among those who consume alcohol. We conclude with a discussion of the importance of using experimental research to identify mechanisms of behavior change that are specific to populations at high risk for HIV and outline some key implications for developing HIV prevention interventions that integrate the role of alcohol.
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Amaro H, Prado G. Then and Now: Historical Landscape of HIV Prevention and Treatment Inequities Among Latinas. Am J Public Health 2021; 111:1246-1248. [PMID: 34111360 DOI: 10.2105/ajph.2021.306336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Hortensia Amaro
- Hortensia Amaro is with the Robert Stempel College of Public Health and Social Work and the Herbert Wertheim College of Medicine, Florida International University, Miami. Guillermo Prado is with the School of Nursing and Public Health Studies, University of Miami, Miami, FL
| | - Guillermo Prado
- Hortensia Amaro is with the Robert Stempel College of Public Health and Social Work and the Herbert Wertheim College of Medicine, Florida International University, Miami. Guillermo Prado is with the School of Nursing and Public Health Studies, University of Miami, Miami, FL
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Behavioural Prevention Strategies for STI Control. Sex Transm Infect 2020. [DOI: 10.1007/978-3-030-02200-6_4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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5
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Hays R, Gordon EJ, Ison MG, LaPointe Rudow D. Impact of the OPTN transmissible diseases policy and US PHS increased risk donor guidelines on living donor candidates. Am J Transplant 2019; 19:3233-3239. [PMID: 31338956 DOI: 10.1111/ajt.15541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Revised: 06/28/2019] [Accepted: 07/19/2019] [Indexed: 01/25/2023]
Abstract
Donor-derived human immunodeficiency virus (HIV), hepatitis C virus (HCV), and hepatitis B virus (HBV) transmissions in transplantation have led to policies mandating assessment of donor behavioral history, and disclosure of donor increased risk (IR) status to recipients. Organ Procurement Transplantation Network (OPTN) policy safeguards were promulgated in the context of deceased donation, with its narrow time window for organ utilization and uncertainty about donor history. These policies have been applied to living donation without substantive data on risk of disease transmission in living donor transplantation. Unlike for deceased donors, the OPTN does not collect data on living donor IR status. Given the feasibility of thorough living donor evaluation via already-mandated lab tests and clinical assessments, living donor IR assessment and associated disclosures may have limited benefit in improving recipient informed consent. Applying the current IR policy to living donors may also introduce unintended consequences to donors and recipients, causing donors psychological harm, delays in donation to avoid IR status disclosure, and potential withdrawal from donation. We suggest strategies that reduce risk of harm to donor candidates while maintaining policy compliance, and review additional approaches for evaluating risk of disease transmission in living donor candidates. Data on the risk of disease transmission by living donors are needed to inform policy modification.
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Affiliation(s)
- Rebecca Hays
- Department of Coordinated Care, University of Wisconsin Madison, Madison, Wisconsin
| | - Elisa J Gordon
- Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Michael G Ison
- Department of Coordinated Care, University of Wisconsin Madison, Madison, Wisconsin
| | - Dianne LaPointe Rudow
- Recanati Miller Transplantation Institute New York, Mount Sinai Hospital, New York, New York
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Murali V, Jayaraman S. Substance use disorders and sexually transmitted infections: a public health perspective. BJPSYCH ADVANCES 2018. [DOI: 10.1192/bja.2017.14] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
SummaryIt has long been recognised that substance use disorders and sexually transmitted infections (STIs) are common comorbid conditions. It is clear that treating one condition while leaving the other leads to increased morbidity and mortality in this patient population. However, engaging patients in treatment is extremely challenging, which is a huge public health concern. This article focuses on various sexually transmitted infections seen in the substance misuse population and means of primary, secondary and tertiary prevention.Declaration of interestNone.Learning objectives•Be aware of the current extent of comorbidity between substance use disorders and STIs•Learn about primary, secondary and tertiary prevention of STIs in people with substance use disorders•Understand the links between high-risk sexual behaviour and illicit drug use, as shown by current evidence
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Daniel-Ulloa J, Ulibarri M, Baquero B, Sleeth C, Harig H, Rhodes SD. Behavioral HIV Prevention Interventions Among Latinas in the US: A Systematic Review of the Evidence. J Immigr Minor Health 2018; 18:1498-1521. [PMID: 26467788 DOI: 10.1007/s10903-015-0283-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Compared to White women, Latinas are 4 times more likely to contract HIV. In an effort to determine the overall state of the science meant to address this disparity, we reviewed the current HIV prevention intervention literature for U.S. Latinas. We searched 5 online electronic databases from their inception through July, 2014, for HIV prevention interventions including a majority sample of Latinas. Of 1041 articles identified, 20 studies met inclusion criteria. We documented study designs, participant characteristics, outcomes, theories used, and other intervention characteristics. Overall, HIV knowledge and attitudes were the predominant outcome; a small minority of studies included self-reported condom use or STD incidence. Strategies used to address cultural factors specific to Latinas and HIV included; lay health advisors, using ethnographic narratives, or using the Theory of Gender and Power, however few of the interventions adopted these strategies. This study identified several gaps in the intervention literature that need to be addressed. In addition to including more direct measures of decreased HIV risk (ex. condom use), more systematic use of strategies meant to address gender and cultural factors that may place Latinas at increased risk (e.g., gender inequity, traditional gender role norms such as machismo and marianismo, and relationship power dynamics).
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Affiliation(s)
- Jason Daniel-Ulloa
- Department of Community and Behavioral Health, College of Public Health, University of Iowa, CPHB, CBH N436, 145 Riverside Dr, Iowa City, IA, 52242, USA. .,University of Iowa, Prevention Research Center, Iowa City, IA, USA. .,Division of Public Health Sciences, Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, NC, USA.
| | - M Ulibarri
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
| | - B Baquero
- Department of Community and Behavioral Health, College of Public Health, University of Iowa, CPHB, CBH N436, 145 Riverside Dr, Iowa City, IA, 52242, USA.,University of Iowa, Prevention Research Center, Iowa City, IA, USA
| | - C Sleeth
- Department of Community and Behavioral Health, College of Public Health, University of Iowa, CPHB, CBH N436, 145 Riverside Dr, Iowa City, IA, 52242, USA.,University of Arizona College of Medicine, Tucson, AZ, USA
| | - H Harig
- University of Iowa, Prevention Research Center, Iowa City, IA, USA
| | - S D Rhodes
- Division of Public Health Sciences, Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, NC, USA
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Ruiz-Perez I, Murphy M, Pastor-Moreno G, Rojas-García A, Rodríguez-Barranco M. The Effectiveness of HIV Prevention Interventions in Socioeconomically Disadvantaged Ethnic Minority Women: A Systematic Review and Meta-Analysis. Am J Public Health 2017; 107:e13-e21. [PMID: 29048965 DOI: 10.2105/ajph.2017.304067] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND Surveys in the United States and Europe have shown a plateau of new HIV cases, with certain regions and populations disproportionately affected by the disease. Ethnic minority women and socioeconomically disadvantaged groups are disproportionately affected by HIV. Previous reviews have focused on prevention interventions targeting ethnic minority men who have sex with men, have not accounted for socioeconomic status, or have included only interventions carried out in clinical settings. OBJECTIVES To review and assess the effectiveness of HIV prevention interventions targeting socioeconomically disadvantaged ethnic minority women in member states of the Organisation for Economic Co-operation and Development (OECD). SEARCH METHODS On March 31, 2014, we executed a search using a strategy designed for the MEDLINE (Ovid), CINAHL, Embase, Scopus, and Web of Knowledge databases. Additional searches were conducted through the Cochrane Library, CRD Databases, metaRegister of Controlled Trials, EURONHEED, CEA Registry, and the European Action Program for Health Inequities as well as in gray literature sources. No language or date restrictions were applied. SELECTION CRITERIA We selected studies assessing the effectiveness of interventions to prevent HIV among ethnic minority women of low socioeconomic status in which at least 80% of participants were reported to belong to an ethnic minority group and to have a low income or be unemployed. We included only studies that were conducted in OECD member states and were randomized controlled trials or quasi-experimental investigations with a comparison group. DATA COLLECTION AND ANALYSIS A data extraction form was developed for the review and used to collect relevant information from each study. We summarized results both qualitatively and quantitatively. The main outcomes were categorized into 3 groups: improved knowledge regarding transmission of HIV, behavior changes related to HIV transmission, and reductions in the incidence of sexually transmitted infections (STIs). We then performed meta-analyses to assess the effectiveness of the prevention interventions in terms of the 3 outcome categories. MAIN RESULTS A total of 43 interventions were included, and 31 were judged to be effective, 7 were partially effective, and 5 were ineffective. The most frequently recurring characteristics of these interventions were cultural adaptation, a cognitive-behavioral approach, the use of small groups and trained facilitators, and a program duration of between 1 and 6 weeks. Our meta-analyses showed that the interventions improved knowledge of HIV transmission (odds ratio [OR] = 0.59; 95% confidence interval [CI] = 0.43, 0.75), increased the frequency of condom use (OR = 1.60; 95% CI = 1.16, 2.19), and significantly reduced the risk of STI transmission by 41% (relative risk = 0.59; 95% CI = 0.46, 0.75). CONCLUSIONS Our study demonstrates the feasibility and effectiveness of HIV prevention interventions targeting socioeconomically deprived ethnic minority women. Public Health Implications. This is one of the first studies to include a meta-analysis assessing reductions in STI incidence among at-risk women who have participated in HIV prevention programs. The fact that our meta-analyses showed a statistically significant reduction in STI transmission provides important evidence supporting the overall effectiveness of directing prevention programming toward this vulnerable population. For policymakers, this review demonstrates the feasibility of working with multiple intervention components while at the same time facilitating more effective interventions that take into account the principal outcome measures of knowledge, behavior change, and STI transmission rates. The review also underscores the need for additional research outside the United States on the effectiveness of prevention interventions in this vulnerable group.
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Affiliation(s)
- Isabel Ruiz-Perez
- Isabel Ruiz-Perez, Guadalupe Pastor-Moreno, and Miguel Rodríguez-Barranco are with the Andalusian School of Public Health, Granada, Spain. Isabel Ruiz-Perez and Miguel Rodríguez-Barranco are also with CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain. Matthew Murphy is with the Department of Internal Medicine, Alpert School of Medicine, Brown University, Providence, RI. Antonio Rojas-García is with the Department of Applied Health Research, University College London, London, England
| | - Matthew Murphy
- Isabel Ruiz-Perez, Guadalupe Pastor-Moreno, and Miguel Rodríguez-Barranco are with the Andalusian School of Public Health, Granada, Spain. Isabel Ruiz-Perez and Miguel Rodríguez-Barranco are also with CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain. Matthew Murphy is with the Department of Internal Medicine, Alpert School of Medicine, Brown University, Providence, RI. Antonio Rojas-García is with the Department of Applied Health Research, University College London, London, England
| | - Guadalupe Pastor-Moreno
- Isabel Ruiz-Perez, Guadalupe Pastor-Moreno, and Miguel Rodríguez-Barranco are with the Andalusian School of Public Health, Granada, Spain. Isabel Ruiz-Perez and Miguel Rodríguez-Barranco are also with CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain. Matthew Murphy is with the Department of Internal Medicine, Alpert School of Medicine, Brown University, Providence, RI. Antonio Rojas-García is with the Department of Applied Health Research, University College London, London, England
| | - Antonio Rojas-García
- Isabel Ruiz-Perez, Guadalupe Pastor-Moreno, and Miguel Rodríguez-Barranco are with the Andalusian School of Public Health, Granada, Spain. Isabel Ruiz-Perez and Miguel Rodríguez-Barranco are also with CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain. Matthew Murphy is with the Department of Internal Medicine, Alpert School of Medicine, Brown University, Providence, RI. Antonio Rojas-García is with the Department of Applied Health Research, University College London, London, England
| | - Miguel Rodríguez-Barranco
- Isabel Ruiz-Perez, Guadalupe Pastor-Moreno, and Miguel Rodríguez-Barranco are with the Andalusian School of Public Health, Granada, Spain. Isabel Ruiz-Perez and Miguel Rodríguez-Barranco are also with CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain. Matthew Murphy is with the Department of Internal Medicine, Alpert School of Medicine, Brown University, Providence, RI. Antonio Rojas-García is with the Department of Applied Health Research, University College London, London, England
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Effectiveness of a Brief Multi-Component Intervention to HIV Prevention Among Spanish Youth. AIDS Behav 2017; 21:2726-2735. [PMID: 28585101 DOI: 10.1007/s10461-017-1815-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
The greater rate of HIV infection occurs before age 30 in Spain. Our aim was to evaluate the long-term impact of a brief HIV preventive intervention on key sexual risk behavior components in Spanish young population. Participants were 467 young people aged 18-25 years who participated in B-PAPY intervention. They were evaluated at four times: a week, a month, three months and one year after intervention. A self-administered instrument was used. It was found a significant increase from pre-test to follow-ups in HIV knowledge, HIV susceptibility perception, confidence in condom and use of condoms. There were decreases statistically significant in the perceived severity of AIDS. The HIV intervention showed effectiveness over time in the main risk variables for HIV infection. Brief multi-component HIV interventions would be a useful resource to generalize HIV prevention.
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Klein CH, Kuhn T, Altamirano M, Lomonaco C. C-SAFE: A Computer-Delivered Sexual Health Promotion Program for Latinas. Health Promot Pract 2017; 18:516-525. [PMID: 28490203 DOI: 10.1177/1524839917707791] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This article describes the development and evaluation of C-SAFE (Sexual Awareness for Everyone), a computer-delivered sexual health promotion program for Latinas. We first describe the process of adapting an evidence-based, group-level intervention into an individually administered computer-delivered program. We then present the methods and results of a randomized control trial with 321 Latinas in California and Florida to test C-SAFE's preliminary efficacy in reducing sexual health risk. We found no statistically significant differences between the two conditions at a six-month follow-up in terms of sexual behaviors or attitudes toward sexually transmitted infections and condoms, although C-SAFE women reported fewer days in the past month when their mental health was not good (p = .02). C-SAFE condition women also reported more satisfaction than control condition women in their assessment of information presentation (on a scale of 1 = poor and 5 = excellent; C-SAFE = 4.45 vs. control = 4.25, p = .053) and having learned something new (C-SAFE = 95.1% vs. control = 79.3%, χ2 < 0.001), with utility of content for Latinas approaching significance (C-SAFE = 4.50 vs. control = 4.31, p = .058). In conclusion we discuss the importance of teachable moments, matching of delivery modalities to implementation contexts, and possible directions for evidence-based sexual health promotion programs given the current sexual health landscape.
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