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Huang G, Cheng W, Xu Y, Yang J, Jiang J, Pan X, Zhou X, Jiang J, Chai C. Development and Validation of a Risk Prediction Tool to Identify People at Greater Risk of Having Hepatitis C among Drug Users. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15677. [PMID: 36497751 PMCID: PMC9738321 DOI: 10.3390/ijerph192315677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 11/14/2022] [Accepted: 11/23/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND People who use drugs (PWUD) are among those with the highest risk for hepatitis C virus (HCV) infection. Highly effective direct-acting antiviral agents offer an opportunity to eliminate HCV. A simple tool for the prediction of HCV infection risk in PWUD is urgently needed. This study aimed to develop and validate a risk prediction tool to identify people at greater risk of having hepatitis C among PWUD that is applicable in resource-limited settings. METHODS We extracted data from national HIV/AIDS sentinel surveillance in PWUD (Zhejiang Province, 2016-2021) and developed and validated a risk score to improve HCV testing in PWUD. This risk score consists of seven risk factors identified using multivariable logistic regression modeling (2016-2020, exploratory group). We validated this score using surveillance data for 2021 (validation group). The accuracy of the model was determined using C-statistics. RESULTS We identified seven risk factors, including sex, age, marital status, educational attainment, and the use of heroin, morphine, and methamphetamine. In the exploratory group, the positive rates of detecting the HCV antibody in the low-risk (0-9 points), intermediate-risk (10-16 points), and high-risk (≥17 points) groups were 6.72%, 17.24%, and 38.02%, respectively (Ptrend < 0.001). In the validation group, the positive rates in the low-, medium-, and high-risk groups were 4.46%, 12.23%, and 38.99%, respectively (Ptrend < 0.001). CONCLUSIONS We developed and validated a drug-specific risk prediction tool for identifying PWUD at increased risk of HCV infection. This tool can complement and integrate the screening strategy for the purpose of early diagnosis and treatment.
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Affiliation(s)
- Gang Huang
- Medical School of Ningbo University, Ningbo University, Ningbo 315211, China
| | - Wei Cheng
- Department of AIDS and STDs Prevention and Control, Zhejiang Province Center for Disease Control and Prevention, Hangzhou 310051, China
| | - Yun Xu
- Department of AIDS and STDs Prevention and Control, Zhejiang Province Center for Disease Control and Prevention, Hangzhou 310051, China
| | - Jiezhe Yang
- Department of AIDS and STDs Prevention and Control, Zhejiang Province Center for Disease Control and Prevention, Hangzhou 310051, China
| | - Jun Jiang
- Department of AIDS and STDs Prevention and Control, Zhejiang Province Center for Disease Control and Prevention, Hangzhou 310051, China
| | - Xiaohong Pan
- Department of AIDS and STDs Prevention and Control, Zhejiang Province Center for Disease Control and Prevention, Hangzhou 310051, China
| | - Xin Zhou
- Department of AIDS and STDs Prevention and Control, Zhejiang Province Center for Disease Control and Prevention, Hangzhou 310051, China
| | - Jianmin Jiang
- Department of AIDS and STDs Prevention and Control, Zhejiang Province Center for Disease Control and Prevention, Hangzhou 310051, China
- Key Lab of Vaccine, Prevention and Control of Infectious Disease of Zhejiang Province, Hangzhou 310051, China
| | - Chengliang Chai
- Department of AIDS and STDs Prevention and Control, Zhejiang Province Center for Disease Control and Prevention, Hangzhou 310051, China
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Saing CH, Chhoun P, Chann N, Uk P, Mun P, Tuot S, Yi S. Sex Under the Influence of Drugs Among People Who Use Drugs in Cambodia: Findings From a National Survey. ARCHIVES OF SEXUAL BEHAVIOR 2022; 51:1461-1470. [PMID: 35194721 PMCID: PMC8917026 DOI: 10.1007/s10508-021-02243-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 08/01/2021] [Accepted: 11/20/2021] [Indexed: 05/20/2023]
Abstract
Studies in drug use settings rarely use sex under the influence of drugs as an indicator of sexual risk behaviors. This study explored the prevalence of sex under the influence of drugs and its correlates among people who use drugs (PWUD) in Cambodia. We included 1147 PWUD from 12 provinces in this study. A multiple logistic regression analysis was conducted to identify factors associated with sex under the influence of drugs. Of the total, 39.7% reported having had sex under the influence of drugs in the past three months. After adjustment, sex under the influence of drugs was significantly associated with living in urban areas (AOR 2.97, 95% CI 1.68-5.27), having two to three (AOR 2.48, 95% CI 1.76-3.49) and four or more sexual partners (AOR 6.46, 95% CI 4.24-9.85), engaging in transactional sex (AOR 1.69, 95% CI 1.19-2.39), using methamphetamine (AOR 2.97, 95% CI 2.06-4.31), using drugs for three years or longer (AOR 1.67, 95% CI 1.15-2.41), having been to a drug rehabilitation center (AOR 1.77, 95% CI 1.18-2.41), having a network of ten or more PWUD (AOR 1.82, 95% CI 1.25-2.66), and having high psychological distress (AOR 1.66, 95% CI 1.25-2.22). This study documents the high prevalence of sex under the influence of drugs and its risk factors among male and female PWUD in Cambodia. These findings point to the need for integrating HIV and harm-reduction programs using innovative approaches to address the overlapping risks in this key population.
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Affiliation(s)
- Chan Hang Saing
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, 12 Science Drive 2, #10-01, Singapore, 117549, Singapore
| | - Pheak Chhoun
- KHANA Center for Population Health Research, Phnom Penh, Cambodia
| | - Navy Chann
- National Center for HIV/AIDS, Dermatology and STD, Phnom Penh, Cambodia
| | - Ponha Uk
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, 12 Science Drive 2, #10-01, Singapore, 117549, Singapore
| | - Phalkun Mun
- National Center for HIV/AIDS, Dermatology and STD, Phnom Penh, Cambodia
| | - Sovannary Tuot
- KHANA Center for Population Health Research, Phnom Penh, Cambodia
| | - Siyan Yi
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, 12 Science Drive 2, #10-01, Singapore, 117549, Singapore.
- KHANA Center for Population Health Research, Phnom Penh, Cambodia.
- Center for Global Health Research, Touro University California, Vallejo, CA, USA.
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Shimane T, Takahashi M, Kobayashi M, Takagishi Y, Takeshita Y, Kondo A, Omiya S, Takano Y, Yamaki M, Matsumoto T. Gender Differences in the Relationship between Methamphetamine Use and High-risk Sexual Behavior among Prisoners: A Nationwide, Cross-sectional Survey in Japan. J Psychoactive Drugs 2021; 54:9-17. [PMID: 33977855 DOI: 10.1080/02791072.2021.1918805] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
This study aimed to examine the relationship between methamphetamine (MA) use and high-risk sexual behavior among newly incarcerated prisoners in Japan. We conducted a secondary analysis using cross-sectional survey data, which constituted a nationwide prison sample surveyed between July and November 2017. In total, 699 participants (462 male and 237 female prisoners), who completed the self-administered questionnaire during imprisonment were recruited for the study. The prevalence of high-risk sexual behaviors was as follows: inconsistent condom use (78.4% male, 81.7% female), multiple sexual partners (61.3% male, 41.3% female), history of sexually transmitted diseases (14.1% male, 23.6% female), and trading sex for drugs (15.6% male, 17.7% female). A logistic regression analysis showed that MA use during sex increased the likelihood of high-risk sexual behavior in both male (adjusted odds ratio [AOR] = 5.86; 95% confidence interval [CI] = 3.41-10.07) and female prisoners (AOR = 2.58; 95% CI = 1.33-5.00). Additionally, in female prisoners, a history of sharing MA injection (AOR = 1.60; 95% CI = 1.06-2.42) increased high-risk sexual behavior. Our results indicate that harm reduction programs tailored according to the specific necessities of each gender to reduce high-risk sexual behaviors among MA users should be included in Japanese drug policies.
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Affiliation(s)
- Takuya Shimane
- Department of Drug Dependence Research, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Masaru Takahashi
- Department of Drug Dependence Research, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan.,Ochanomizu University, Tokyo, Japan
| | - Michiko Kobayashi
- Research Department, Research and Training Institute, Ministry of Justice of Japan, Urayasu, Chiba, Japan
| | - Yuriko Takagishi
- Department of Drug Dependence Research, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan.,Department of Psychology, Surugadai University, Saitama, Japan
| | - Yoshiko Takeshita
- Kawagoe Juvenile Prison, Ministry of Justice of Japan, Saitama, Japan
| | - Ayumi Kondo
- Department of Drug Dependence Research, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Soichiro Omiya
- Department of Drug Dependence Research, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan.,Joetsu University of Education, Niigata, Japan
| | - Youichi Takano
- Yokohama Prison, Ministry of Justice of Japan, Kanagawa, Japan
| | - Mayuko Yamaki
- Training Institute for Correctional Personnel, Ministry of Justice of Japan, Tokyo, Japan
| | - Toshihiko Matsumoto
- Department of Drug Dependence Research, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
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4
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Pan Y, Metsch LR, Gooden LK, Mantero AMA, Feaster DJ. The Disaggregated Repeated Measures Design: A Novel Approach to Assess Sexual Risk Behaviors. ARCHIVES OF SEXUAL BEHAVIOR 2021; 50:311-322. [PMID: 32458301 PMCID: PMC7688506 DOI: 10.1007/s10508-019-01582-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Revised: 09/27/2019] [Accepted: 10/31/2019] [Indexed: 06/11/2023]
Abstract
Although numerous studies have examined sexual and substance use behaviors that put people at risk for sexually transmitted infections including HIV, most focus on an overall measure of aggregate risk or a few simple and particular subtypes of sexual acts assessed in separate analyses. In this article, we introduce a more sensitive approach to assess how the relative characteristics of sex acts may determine the level of risk in which an individual chooses to engage. Project AWARE, a randomized clinical trial conducted among 5012 patients in nine STD clinics across the U.S., is used to illustrate the approach. Our study was guided by two aims: (1) describe a new approach to examine the count of sexual acts using a disaggregated repeated measures design and (2) show how this new approach can be used to evaluate interactions among different categories of sexual risk behaviors and other predictors of interest (such as gender/sexual orientation). Profiles of different subtypes of sexual acts in the past 6 months were assessed. Potential interactions of the characteristics associated with each subtype which resulted in up to 48 distinct subtypes of sexual risk behaviors-sex with a primary/non-primary partner; partner's HIV status; vaginal/anal sex; condom use; and substance use before or during sex act-can be examined. Specifically, we chose condom use and primary and non-primary status of partner as an application in this paper to illustrate our method. There were significantly more condomless sex acts (M = 23, SE = 0.9) and sex acts with primary partners (M = 27.1, SE = 0.9) compared to sex acts with condoms (M = 10.9, SE = 0.4, IRR = 2.10, 95% CI 1.91-2.32, p < .001) and sex acts with non-primary partner (M = 10.9, SE = 0.5, IRR = 2.5, 95% CI 2.33-2.78, p < .001). In addition, there were significant differences for the count of sexual risk behaviors among women who have sex with men (WSM), men who have sex with women (MSW) and men who have sex with men (MSM) for sex acts with and without condom use, primary and non-primary partner, and their interaction (ps = .03, < .0001, and .001, respectively). This approach extends our understanding of how people make choices among sexual behaviors and may be useful in future research on disaggregated characteristics of sex acts.
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Affiliation(s)
- Yue Pan
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Clinical Research Building, Room 1034, 1120 N.W. 14th St., Miami, FL, 33136, USA.
| | - Lisa R Metsch
- Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Lauren K Gooden
- Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Alejandro Max Antonio Mantero
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Clinical Research Building, Room 1034, 1120 N.W. 14th St., Miami, FL, 33136, USA
| | - Daniel J Feaster
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Clinical Research Building, Room 1034, 1120 N.W. 14th St., Miami, FL, 33136, USA
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5
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The Healthy Young Men's Cohort: Health, Stress, and Risk Profile of Black and Latino Young Men Who Have Sex with Men (YMSM). J Urban Health 2020; 97:653-667. [PMID: 32864727 PMCID: PMC7560671 DOI: 10.1007/s11524-019-00398-6] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Young men who have sex with men (YMSM), especially YMSM of color, are at increased risk for a wide range of threats to their health and well-being. In this study, we recruited and surveyed an urban sample of 448 young African American/Black (Black), Hispanic/Latino (Latino), and multi-racial/ethnic YMSM, ages 16-24 years (mean = 22.3 years), about stressful life events, their health and mental health, their access to and utilization of care, and their involvement in risk-related behaviors. We found that the majority reported experiences of racism (87%) and homophobia (76%). A high percentage reported food insecurity/hunger (36%), residential instability (15%), financial hardship (63%), and conflict with family/friends (62%). The prevalence of risk behaviors was also high, including recent use of tobacco (46%), alcohol (88%), and marijuana (72%), and 41% tested positive for 1+ drugs. Furthermore, 26% tested positive for 1+ sexually transmitted infections (STIs). Over half (56%) reported being worried about their health, 33% reported having a chronic health condition and 31% a mental health condition, and 45% had wanted/needed mental health services during the past year. Further, 17% reported suicidal ideation/had planned a suicide attempt and 26% had ever engaged in self-injurious behaviors. Significant differences by race/ethnicity and HIV status included residential status/food insecurity, type of racism/homophobia, drug use, and STIs. These findings demonstrate how vulnerable this population is with respect to a wide range of structural and social determinants of health that may be important drivers of behavioral, health, mental health outcomes, and potentially long-term health disparities.
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6
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Heads AM, Glover AM, Castillo LG, Blozis S, Kim SY, Ali S. Perceived Discrimination and Risk Behaviors in African American Students: the Potential Moderating Roles of Emotion Regulation and Ethnic Socialization. J Racial Ethn Health Disparities 2020; 8:494-506. [PMID: 32607721 DOI: 10.1007/s40615-020-00807-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Revised: 05/11/2020] [Accepted: 06/23/2020] [Indexed: 11/29/2022]
Abstract
Prior research has identified perceived discrimination as being a contributing factor in health and mental health disparities. However, there is little research on the relationship between perceived discrimination and behaviors such as hazardous alcohol and illicit substance use and risky sexual behaviors that put people at risk for negative health consequences including HIV. The current research explores the role that cultural factors may play in a tendency for individuals to engage in unhealthy behaviors or an ability to avoid them. A total of 266 college students who self-identified as Black or African American were surveyed on measures of familial ethnic socialization, perceived discrimination, emotion regulation, substance use, and risky sexual behaviors. Findings indicate that perceived discrimination and emotion regulation-suppression were associated with higher levels of hazardous alcohol use, and that emotion regulation-cognitive reappraisal was associated with lower levels of illicit substance use. Implications for intervention and prevention in African American college students are discussed.
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Affiliation(s)
- Angela M Heads
- Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at Houston, McGovern Medical School, Houston, TX, USA.
| | - Angel M Glover
- Texas A&M University Student Counseling Services, College Station, TX, USA
| | - Linda G Castillo
- Department of Educational Psychology, Texas A&M University, College Station, TX, USA
| | - Shelley Blozis
- Department of Psychology University of California Davis, Davis, CA, USA
| | - Su Yeong Kim
- School of Human Ecology, University of Texas, Austin, TX, USA
| | - Sakina Ali
- Department of Educational Psychology, Texas A&M University, College Station, TX, USA
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7
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Gräf DD, Mesenburg MA, Fassa AG. Risky sexual behavior and associated factors in undergraduate students in a city in Southern Brazil. Rev Saude Publica 2020; 54:41. [PMID: 32321057 PMCID: PMC7135094 DOI: 10.11606/s1518-8787.2020054001709] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2019] [Accepted: 07/31/2019] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE To describe the sexual behavior of freshmen undergraduate students according to demographic, economic, psychosocial and behavioral characteristics, and evaluate the prevalence of risky sexual behavior and its associated factors. METHODS A cross-sectional study of the census type with undergraduate students over 18 years old of 80 undergraduate courses of the Universidade Federal de Pelotas (UFPel), in Rio Grande do Sul (RS), who entered in the first semester of 2017 and remained enrolled in the second semester. Undergraduate students who reported having had sex were evaluated. We considered as risky sexual behavior having more than one sexual partner within the last three months and not having used condoms in the last sexual intercourse. RESULTS The prevalence of risky sexual behavior was 9% (95%CI 7.6–10.5). Men presented more risky behavior than women, with a prevalence of 10.8% and 7.5%, respectively. Of the undergraduate students, 45% did not use condoms in the last sexual intercourse, and 24% had two partners or more within three months before the survey. Smartphone applications for sexual purposes were used by 23% of students within three months before the survey. Risky sexual behavior was associated with gender, age at first sexual intercourse, frequency of alcohol consumption, consumption of psychoactive substances before the last sexual intercourse and use of smartphone applications for sexual purposes. CONCLUSION Although undergraduate students are expected to be an informed population, the prevalence of risky sexual behavior was important, indicating the need to expand public investment in sexual education and awareness actions.
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Affiliation(s)
- Débora Dalmas Gräf
- Universidade Federal de Pelotas. Programa de Pós-Graduação em Epidemiologia. Pelotas, RS, Brasil
| | | | - Anaclaudia Gastal Fassa
- Universidade Federal de Pelotas. Faculdade de Medicina. Departamento de Medicina Social. Pelotas, RS, Brasil
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8
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Saw YM, Saw TN, Chan N, Cho SM, Jimba M. Gender-specific differences in high-risk sexual behaviors among methamphetamine users in Myanmar-China border city, Muse, Myanmar: who is at risk? BMC Public Health 2018; 18:209. [PMID: 29390989 PMCID: PMC5796492 DOI: 10.1186/s12889-018-5113-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2017] [Accepted: 01/23/2018] [Indexed: 01/15/2023] Open
Abstract
Background Methamphetamine (MA) use is a significant public health concern due to its negative effects on health. However, to date, no epidemiological research has examined high-risk sexual behaviors (inconsistent condom use, having multiple sexual partners and having a history of sexually transmitted infections) among MA users. This topic is particularly important in Myanmar, which is recognized as one of the key MA production countries in the Southeast Asia region. Therefore, this study examined factors associated with high-risk sexual behaviors among MA users in Muse city, Myanmar. Methods A community-based cross-sectional study was conducted from January to March 2013 in Muse city, Northern Shan State, Myanmar. In total, 1183 MA users (772 male; 411 female) were recruited using respondent-driven sampling and a computer assisted self-interviewing method. Generalized estimating equation models were used to examine factors associated with high-risk sexual behaviors. Results A large proportion of MA users engaged in high-risk sexual behaviors (inconsistent condom use: males, 90.7%, females, 85.2%; multiple sexual partners: males, 94.2%, females, 47.2%; and history of STIs: males, 55.7%, females, 56.0%). Among males, being a multiple stimulants drug user (adjusted odds ratio [AOR] =1.77; 95% confidence interval [CI] =1.30–2.41) and being a client of sex workers (AOR = 1.41; 95% CI = 1.08–1.83) were risk factors for engaging in high-risk sexual behaviors. Among females, being a migrant worker (AOR = 2.70; 95% CI = 1.86–3.93) and being employed (AOR = 1.57; 95% CI = 1.13–2.18) were risk factors for engaging in high-risk sexual behaviors as well. Conclusions High-risk sexual behaviors were particularly pronounced among both male and female MA users. MA prevention programs that reflect gender considerations should be developed to pay more attention to vulnerable populations such as migrants, clients of sex workers, and less educated female MA users.
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Affiliation(s)
- Yu Mon Saw
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, 65, Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan. .,Nagoya University Asian Satellite Campuses Institute, Nagoya, Japan.
| | - Thu Nandar Saw
- Myanma Perfect Research, Yangon, Myanmar.,Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Nyein Chan
- Department of Social Research, Defence Services Medical Research Centre, Tatkone Township, Nay Pyi Taw, Myanmar
| | - Su Myat Cho
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, 65, Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan
| | - Masamine Jimba
- Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
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Bujarski SJ, Capron DW, Gratz KL, Tull MT. Conformity motives for alcohol use are associated with risky sexual behavior among alcohol-dependent patients in residential substance abuse treatment. JOURNAL OF SUBSTANCE USE 2017; 22:469-473. [PMID: 30906221 DOI: 10.1080/14659891.2016.1245792] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Alcohol misuse is associated with a variety of negative outcomes, including risky sexual behavior (RSB). In an attempt to better identify the subset of individuals at greatest risk for these negative outcomes, a growing body of research has begun to examine the role of alcohol use motives in risk for alcohol use-related negative outcomes. Although the majority of research in this area has focused on coping motives, conformity motives may be particularly relevant to outcomes such as RSB. Specifically, conformity motives may operate as a proxy risk factor for RSB, reflecting the tendency to engage in interpersonally-oriented risk behaviors in order to avoid rejection, interpersonal conflict, or social ostracism. Therefore, the current study examined the relation between conformity motives for alcohol use and RSB in a sample of 94 patients in a residential substance abuse treatment center. Results indicated that conformity motives were associated with RSB above and beyond other motives for alcohol use, as well as relevant covariates. Findings support the notion that conformity motives may operate as a proxy risk factor that could assist in identifying individuals at elevated risk for engaging in RSB.
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Affiliation(s)
- Sarah J Bujarski
- VA Nebraska-Western Iowa Health Care System, Omaha, Nebraska, USA
| | - Daniel W Capron
- Department of Psychology, University of Southern Mississippi, Hattiesburg, Mississippi, USA
| | - Kim L Gratz
- Department of Psychology, University of Toledo, Toledo, Ohio, USA
| | - Matthew T Tull
- Department of Psychology, University of Toledo, Toledo, Ohio, USA
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10
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Knighton JS, Stevens-Watkins D, Oser C, Fisher S, Mahaffey CC, Crowell C, Leukefeld C. Perceived Risk of HIV Infection Among Drug-Using African American Male Prisoners: One Year After Community Re-entry. Subst Use Misuse 2016; 51:1610-1618. [PMID: 27484149 PMCID: PMC5055417 DOI: 10.1080/10826084.2016.1191510] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND African Americans represent 13% of the U.S. population but 46% of people living with HIV and nearly 40% of state and federal prisoners. Disproportionate rates of HIV among African American males involved in the criminal justice system have been associated with risk factors, including: contracting sexually transmitted infections (STIs), substance misuse, and inconsistent condom use. However, many African American males may not perceive an elevated risk of HIV upon re-entering the community. OBJECTIVE The current study examines correlates of perceived HIV risk among incarcerated African American drug-using males about one year after release from prison. METHODS Derived from a larger Health Services Utilization study, interviewing (N = 661) incarcerated men at baseline with a 92% follow-up rate approximately one year after community re-entry, the current study is a secondary data analyses from self-identified African American men (N = 250). After list-wise deletion, the total N = 221 for the final study results. RESULTS An ordered logistic regression model examining perceived risk of HIV as the dependent variable found age, cocaine use before sex, and condom use were significant correlates in the model. Alcohol use before sex mediated the relationship between cocaine use before sex and perceived HIV risk. CONCLUSIONS Results suggest men in this study are engaged in HIV risk behaviors and risk perception varies. Implications for individual-level, community-level and policy interventions are discussed.
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Affiliation(s)
| | | | - Carrie Oser
- a University of Kentucky , Lexington , Kentucky , USA
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Gowda C, Coppock D, Brickman C, Shaw PA, Gross R. Determinants of HIV Transmission Risk Among HIV-Infected Persons Engaged in Care. AIDS EDUCATION AND PREVENTION : OFFICIAL PUBLICATION OF THE INTERNATIONAL SOCIETY FOR AIDS EDUCATION 2016; 28:440-452. [PMID: 27710086 DOI: 10.1521/aeap.2016.28.5.440] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
People living with HIV (PLWH) engaged in medical care represent an accessible group to focus HIV prevention efforts. In an analysis of 1,883 PLWH from 2007 and 2015, we determined the proportion at risk of HIV transmission and identified factors associated with HIV transmission risk using multivariable mixed effects logistic regression models with random intercepts. HIV transmission risk was defined by an HIV viral load > 1,500 copies/mL and self-reported unprotected sex. We found that 174 (9.2%) individuals were at risk for HIV transmission at least once. Factors associated with HIV transmission risk included younger age (adjusted OR [95% CI] per decade decrease = 2.30 [1.84, 2.89]), illicit drug use (adjusted OR = 5.36 [3.02, 9.56]), depression (adjusted OR = 1.88 [1.10, 3.21]), and education <12th grade (adjusted OR = 2.05 [1.15, 3.67]). Thus, nearly 1 in 10 HIV-infected individuals engaged in care between 2007 and 2015 were potentially at risk of transmitting HIV. Behavioral interventions to decrease HIV transmission should focus on younger, less educated patients who are depressed and actively using illicit drugs.
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Affiliation(s)
- Charitha Gowda
- Division of Infectious Diseases, Nationwide Children's Hospital and the Department of Pediatrics, the Ohio State University College of Medicine, Columbus, Ohio
| | - Dagan Coppock
- Division of Infectious Diseases, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia
- Department of Biostatistics and Epidemiology, Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Cristina Brickman
- Division of Infectious Diseases, Department of Medicine, University of California San Francisco School of Medicine, San Francisco
| | - Pamela A Shaw
- Department of Biostatistics and Epidemiology, Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Robert Gross
- Division of Infectious Diseases, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia
- Department of Biostatistics and Epidemiology, Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia
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Kelly JA, St Lawrence JS, Tarima SS, DiFranceisco WJ, Amirkhanian YA. Correlates of Sexual HIV Risk Among African American Men Who Have Sex With Men. Am J Public Health 2015; 106:96-102. [PMID: 26562130 DOI: 10.2105/ajph.2015.302945] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
OBJECTIVES We examined correlates of condomless anal intercourse with nonmain sexual partners among African American men who have sex with men (MSM). METHODS We recruited social networks composed of 445 Black MSM from 2012 to 2014 in Milwaukee, Wisconsin; Cleveland, Ohio; and Miami Beach, Florida. Participants reported past-3-month sexual behavior, substance use, and background, psychosocial, and HIV-related characteristics. RESULTS Condomless anal intercourse outside main concordant partnerships, reported by 34.4% of MSM, was less likely in the case of no alcohol and marijuana use in the past 30 days, and higher risk-reduction behavioral intentions. High frequency of condomless anal intercourse acts with nonmain partners was associated with high gay community participation, weak risk-reduction intentions, safer sex not being perceived as a peer norm, low condom-use self-efficacy, and longer time since most recent HIV testing. CONCLUSIONS Condomless anal intercourse with nonmain partners among Black MSM was primarily associated with gay community participation, alcohol and marijuana use, and risk-reduction behavioral intentions.
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Affiliation(s)
- Jeffrey A Kelly
- Jeffrey A. Kelly, Sergey S. Tarima, Wayne J. DiFranceisco, and Yuri A. Amirkhanian are with Center for AIDS Intervention Research, Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee. Janet S. St Lawrence was with the College of Arts and Sciences, Mississippi State University, Meridian, when the study was conducted
| | - Janet S St Lawrence
- Jeffrey A. Kelly, Sergey S. Tarima, Wayne J. DiFranceisco, and Yuri A. Amirkhanian are with Center for AIDS Intervention Research, Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee. Janet S. St Lawrence was with the College of Arts and Sciences, Mississippi State University, Meridian, when the study was conducted
| | - Sergey S Tarima
- Jeffrey A. Kelly, Sergey S. Tarima, Wayne J. DiFranceisco, and Yuri A. Amirkhanian are with Center for AIDS Intervention Research, Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee. Janet S. St Lawrence was with the College of Arts and Sciences, Mississippi State University, Meridian, when the study was conducted
| | - Wayne J DiFranceisco
- Jeffrey A. Kelly, Sergey S. Tarima, Wayne J. DiFranceisco, and Yuri A. Amirkhanian are with Center for AIDS Intervention Research, Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee. Janet S. St Lawrence was with the College of Arts and Sciences, Mississippi State University, Meridian, when the study was conducted
| | - Yuri A Amirkhanian
- Jeffrey A. Kelly, Sergey S. Tarima, Wayne J. DiFranceisco, and Yuri A. Amirkhanian are with Center for AIDS Intervention Research, Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee. Janet S. St Lawrence was with the College of Arts and Sciences, Mississippi State University, Meridian, when the study was conducted
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Characteristics of high-risk sexual behaviors for human immunodeficiency virus infection among Iranian drug abusers. J Addict Med 2013; 6:153-8. [PMID: 22475984 DOI: 10.1097/adm.0b013e31823f5fa7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
OBJECTIVES This study was conducted to estimate the prevalence and the associated factors of high-risk sexual behaviors among drug abusers referred to a methadone clinic in Gorgan, the capital of Golestan province in the northeast of Iran, to help health care decision makers on designing interventional programs. METHODS In this cross-sectional study, 400 drug abusers referred to our methadone clinic were evaluated for high-risk sexual behavior. A logistic regression model was fitted for the association between independent variables and high-risk sexual behavior. RESULTS Approximately a quarter of patients (25.5%) had high-risk sexual behavior among which 47% had not used a condom in their last sexual contact. Drug abusers who had poor economic status had a lower chance of high-risk sexual behavior than those with good economic status (adjusted odds ratio [AOR] = 0.35, 95% confidence interval [CI] = 0.13-0.96). Also, 1-year increase in age reduced the chance by 6% (AOR = 0.94, 95% CI = 0.91-0.98). Heroin abusers, compared with opium abusers, had a duplicated chance of having high-risk sex (AOR = 2.11, 95% CI = 1.12-3.96). CONCLUSION According to this study, high-risk sexual behavior in the drug abusers referred to methadone clinic was associated with younger age, good economic status, and heroin addiction. Hence, in interventional planning, more attention should be paid to young drug abusers, patients with good economic status, and heroin addicts as well.
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Younge SN, Corneille MA, Lyde M, Cannady J. The paradox of risk: historically black college/university students and sexual health. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2013; 61:254-62. [PMID: 23768223 PMCID: PMC3703302 DOI: 10.1080/07448481.2013.799480] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
OBJECTIVE This literature review provides an analysis of the current state of the empirical research on sexual health among students attending historically black colleges and universities (HBCUs). METHODS Several electronic databases were used to identify 24 empirical studies that met criteria for inclusion in this review. RESULTS The results indicated that perceived human immunodeficiency virus (HIV) risk, religiosity, HIV testing, condom use, and substance use were as high or higher for black HBCU students in comparison with students of other racial/ethnic groups. COMMENT Consistent with past findings, sexually transmitted infections continue to be of concern among HBCU students, as seen in the general black population. LIMITATIONS This review only examined cross-sectional studies published between 2000 and 2013. CONCLUSIONS The findings in this review suggest the importance of moving beyond individual risk models to examining structural barriers and assets related to promoting sexual health on HBCU campuses.
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Affiliation(s)
- Sinead N Younge
- Department of Psychology, Morehouse College, Atlanta, Georgia 30314, USA.
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The prevalence of condom use among university students in zimbabwe: implications for planning and policy. J Biosoc Sci 2012. [PMID: 23194440 DOI: 10.1017/s0021932012000788] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Young people, especially university students, are at high risk of HIV infections because of little or no parental or administrative prohibitions in campus environments. The aim of this study was to ascertain the level of condom use among university students in Zimbabwe; that is, condom use at last sex and consistent condom use among both regular and casual partners. The study draws on self-completed questionnaires administered to university students. The results reveal that, while 78.3% of sexually active respondents had used condoms in penetrative sexual encounters before, only 56.2% had used condoms at their last sexual encounter. As expected, consistent condom use was lower in regular sexual partnerships than it was in casual partnerships (30.6% versus 54.6%). Condom use at first sex and high personal HIV risk perception were found to be the most important factors in explaining condom use at last sex and consistent condom use with casual partners. Condom use intentions were high, as 75% of respondents indicated that they would use condoms at their next sexual encounters. Whilst this is commendable, use rates should ideally be higher still. Campus HIV/AIDS programmers should endeavour to ensure that condoms are available at all times in order to help translate these intentions into actual condom use. In addition, promotional programmes should encourage those who have not yet initiated sexual intercourse to use condoms at their first sex and also to improve personal HIV risk perceptions in order to trigger initiation of protective sexual behaviours.
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The contribution of emotion regulation difficulties to risky sexual behavior within a sample of patients in residential substance abuse treatment. Addict Behav 2012; 37:1084-92. [PMID: 22658304 DOI: 10.1016/j.addbeh.2012.05.001] [Citation(s) in RCA: 69] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2011] [Revised: 04/27/2012] [Accepted: 05/15/2012] [Indexed: 11/23/2022]
Abstract
The present study examined the unique contribution of emotion regulation difficulties to past-year risky sexual behavior (RSB) among substance use disorder (SUD) patients (above and beyond other known RSB risk factors). A sample of 177 SUD patients completed a series of questionnaires. At the zero-order level, emotion regulation difficulties, were significantly positively associated with the number of commercial sexual (i.e., the exchange of sex for drugs or money) partners with which penetrative sex occurred and significantly negatively associated with the likelihood of using a condom when having sex with a commercial partner under the influence of drugs. Emotion regulation difficulties also significantly predicted these RSB indices above and beyond other RSB risk factors, including demographics, depression, sensation seeking, traumatic exposure, and substance use severity. The specific emotion regulation difficulty of lack of emotional clarity emerged as a unique predictor of RSB. The implications of these findings for understanding motivations for RSB and developing targeted interventions for RSB among SUD patients are discussed.
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Nguyen HV, Koo KH, Davis KC, Otto JM, Hendershot CS, Schacht RL, George WH, Heiman JR, Norris J. Risky sex: interactions among ethnicity, sexual sensation seeking, sexual inhibition, and sexual excitation. ARCHIVES OF SEXUAL BEHAVIOR 2012; 41:1231-9. [PMID: 22350123 PMCID: PMC3657292 DOI: 10.1007/s10508-012-9904-z] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2010] [Revised: 12/09/2011] [Accepted: 12/10/2011] [Indexed: 05/22/2023]
Abstract
Rates of sexually transmitted infections, including HIV, vary across ethnic minority groups, yet few studies have evaluated sexual risk behaviors and their psychological correlates to determine if risk and protective factors vary by ethnicity. The purpose of the current study was to assess sexual sensation seeking (SSS), sexual inhibition (SIS1 and SIS2), and sexual excitation (SES) as correlates of risky sexual behaviors in 106 (55 male and 51 female) Asian Americans, African Americans, and Caucasian Americans. Results revealed that higher SSS was associated with more vaginal and anal sex partners. Further, the association between SSS and the number of anal sex partners was positive among Asian Americans and Caucasians, but non-significant among African Americans. SIS1 was positively associated with unprotected sex on the first date among Asian Americans and African Americans. However, the association was not significant for Caucasians. SIS2 was negatively associated with general unprotected sex, and SES was positively associated with the number of vaginal sex partners. Findings suggest that ethnicity plays an important moderating role in the relationship between sexual traits and risky sexual behaviors.
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Affiliation(s)
- Hong V Nguyen
- Department of Psychology, University of Washington, Box 351525, Seattle, WA 98195-1525, USA.
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Wang Y, Storr CL, Browne DC, Wagner FA. Early sexual experience and later onset of illegal drug use among African American students on HBCU campuses. Subst Use Misuse 2010; 46:543-51. [PMID: 20735190 PMCID: PMC6252263 DOI: 10.3109/10826084.2010.509853] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Few studies examine whether early sexual experience is associated with subsequent illegal drug use among adolescents. A sample of 7,372 African American students who had not used illegal drugs before the age of 14 were identified in the dataset of the 2001 Historically Black Colleges and Universities (HBCU) Substance Use Survey. Using self-reported ages of onset, discrete-time survival models estimated the hazard of illegal drug use onset after age 13 subsequent to first sexual intercourse. Early sex was modestly associated with subsequent illegal drug initiation, particularly among females. Drug use prevention services should be provided to youth engaged in early sexual activity.
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Affiliation(s)
- Yan Wang
- Office of Policy and Planning, University of Maryland School of Medicine, 685 W. Baltimore St., HSF-1, Suite 618, MD 21201, USA
| | - Carla L. Storr
- Department of Family and Community Health, University of Maryland School of Nursing, 655-A W. Lombard Street, Baltimore, MD 21201, USA
| | - Dorothy C. Browne
- Department of Sociology and Social Work, College of Arts and Sciences, North Carolina Agricultural &Technical State University, 1601 E. Market Street, Greensboro, NC 27411-0001, USA
| | - Fernando A. Wagner
- Drug Abuse Research Program/Center for Health Disparities Solutions/Center for the Study and Prevention of Drug Use, School of Community Health and Policy, Morgan State University, 1700 East Cold Spring Lane, Portage Building, Suite 103, Baltimore, MD 21251, USA
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Washington TA, Wang Y, Browne D. Difference in condom use among sexually active males at historically black colleges and universities. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2009; 57:411-8. [PMID: 19114380 PMCID: PMC3676274 DOI: 10.3200/jach.57.4.411-418] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
UNLABELLED Black men who have sex with men (MSM) and black men who have sex with both men and women (MSMW) may not perceive themselves to be part of the larger gay community and hence may not heed prevention messages aimed at the community. OBJECTIVE AND PARTICIPANTS To better understand the participants behaviors, the authors examined differences in condom use between black MSM/W (including MSM and MSMW) and men who have sex with women (MSW) at historically black colleges and universities (HBCUs). METHODS A paper-and-pencil questionnaire survey investigated sexual behaviors of 1,865 freshmen from 35 HBCUs during the 2001-2002 school year. RESULTS MSM/W were about 0.37 times less likely to always use condoms compared with MSW (adjusted odds ratio = 0.63, 95% confidence interval = 0.42-0.95). Sexual behavior, age at survey, total family income, and religion were also associated with condom use. CONCLUSIONS These findings offer new directions for sexually transmitted disease and HIV prevention aimed at a highly marginalized population that remains at high risk for infection.
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