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Lauckner C, Takenaka BP, Sesenu F, Brown JS, Kirklewski SJ, Nicholson E, Haney K, Adatorwovor R, Boyd DT, Fallin-Bennett K, Restar AJ, Kershaw T. Combined Motivational Interviewing and Ecological Momentary Intervention to Reduce Hazardous Alcohol Use Among Sexual Minority Cisgender Men and Transgender Individuals: Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2024; 13:e55166. [PMID: 38578673 PMCID: PMC11031694 DOI: 10.2196/55166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Revised: 02/14/2024] [Accepted: 02/20/2024] [Indexed: 04/06/2024] Open
Abstract
BACKGROUND Sexual minority cisgender men and transgender (SMMT) individuals, particularly emerging adults (aged 18-34 years), often report hazardous drinking. Given that alcohol use increases the likelihood of HIV risk behaviors, and HIV disproportionately affects SMMT individuals, there is a need to test interventions that reduce hazardous alcohol use and subsequent HIV risk behaviors among this population. Ecological momentary interventions (EMIs), which use mobile phones to deliver risk reduction messages based on current location and behaviors, can help to address triggers that lead to drinking in real time. OBJECTIVE This study will test an EMI that uses motivational interviewing (MI), smartphone surveys, mobile breathalyzers, and location tracking to provide real-time messaging that addresses triggers for drinking when SMMT individuals visit locations associated with hazardous alcohol use. In addition, the intervention will deliver harm reduction messaging if individuals report engaging in alcohol use. METHODS We will conduct a 3-arm randomized controlled trial (N=405 HIV-negative SMMT individuals; n=135, 33% per arm) comparing the following conditions: (1) Tracking and Reducing Alcohol Consumption (a smartphone-delivered 4-session MI intervention), (2) Tracking and Reducing Alcohol Consumption and Environmental Risk (an EMI combining MI with real-time messaging based on geographic locations that are triggers to drinking), and (3) a smartphone-based alcohol monitoring-only control group. Breathalyzer results and daily self-reports will be used to assess the primary and secondary outcomes of drinking days, drinks per drinking day, binge drinking episodes, and HIV risk behaviors. Additional assessments at baseline, 3 months, 6 months, and 9 months will evaluate exploratory long-term outcomes. RESULTS The study is part of a 5-year research project funded in August 2022 by the National Institute on Alcohol Abuse and Alcoholism. The first 1.5 years of the study will be dedicated to planning and development activities, including formative research, app design and testing, and message design and testing. The subsequent 3.5 years will see the study complete participant recruitment, data collection, analyses, report writing, and dissemination. We expect to complete all study data collection in or before January 2027. CONCLUSIONS This study will provide novel evidence about the relative efficacy of using a smartphone-delivered MI intervention and real-time messaging to address triggers for hazardous alcohol use and sexual risk behaviors. The EMI approach, which incorporates location-based preventive messaging and behavior surveys, may help to better understand the complexity of daily stressors among SMMT individuals and their impact on hazardous alcohol use and HIV risk behaviors. The tailoring of this intervention toward SMMT individuals helps to address their underrepresentation in existing alcohol use research and will be promising for informing where structural alcohol use prevention and treatment interventions are needed to support SMMT individuals. TRIAL REGISTRATION ClinicalTrials.gov NCT05576350; https://www.clinicaltrials.gov/study/NCT05576350. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/55166.
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Affiliation(s)
- Carolyn Lauckner
- Center for Health Equity Transformation, University of Kentucky, Lexington, KY, United States
| | - Bryce Puesta Takenaka
- Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT, United States
| | - Fidelis Sesenu
- Center for Health Equity Transformation, University of Kentucky, Lexington, KY, United States
| | - Jaime S Brown
- Center for Health Equity Transformation, University of Kentucky, Lexington, KY, United States
| | - Sally J Kirklewski
- Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT, United States
| | - Erin Nicholson
- Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT, United States
| | - Kimberly Haney
- Center for Health Equity Transformation, University of Kentucky, Lexington, KY, United States
| | - Reuben Adatorwovor
- Department of Biostatistics, University of Kentucky, Lexington, KY, United States
| | - Donte T Boyd
- College of Social Work, The Ohio State University, Columbus, OH, United States
- Center for Interdisciplinary Research on AIDS, Yale University, New Haven, CT, United States
| | - Keisa Fallin-Bennett
- Department of Family and Community Medicine, University of Kentucky, Lexington, KY, United States
| | - Arjee Javellana Restar
- Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT, United States
- Department of Epidemiology, Department of Health Systems and Population Health, University of Washington, Seattle, WA, United States
| | - Trace Kershaw
- Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT, United States
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2
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Lee JJ, Kerani RP, Robles G, Sanchez TH, Katz DA. Reasons for Migration and Their Associations with HIV Risk and Prevention Among Cisgender Sexual Minority Men: A Latent Class Analysis. AIDS Behav 2024; 28:974-984. [PMID: 37812273 DOI: 10.1007/s10461-023-04204-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/28/2023] [Indexed: 10/10/2023]
Abstract
The immigrant population in the United States (U.S.) is rapidly growing; yet there is limited knowledge about how reasons for migrating to the U.S. are associated with HIV prevention behaviors. Using data from the American Men's Internet Survey (2018-2020), we performed a Latent Class Analysis (LCA) to identify patterns in reasons for migration among cisgender gay, bisexual, and other sexual minority men (SMM) who born outside the U.S. We used multivariable logistic regression controlling for demographic characteristics to assess class associations with the following in the past 12 months: condomless anal sex (CAS), illicit drug use, marijuana use, HIV testing, and PrEP use. LCA identified six distinct patterns in reasons for migration among the sample (n = 1,657): (1) Family and friends (14%); (2) Financial (17%); (3) Personal freedom related to being gay (10%); (4) Pursuit of opportunities while living openly as SMM (12%); (5) Educational purposes (18%); (6) Not my decision (29%). While HIV testing (range = 57.6-65.4%) and PrEP use (range = 15.6-21.4%) did not vary by class (p > .05 for all), CAS and illicit drug use were significantly different (p < .05). SMM who migrated to pursue opportunities while living openly and whose reasons were not their decision had greater odds of CAS than SMM who migrated for educational purposes (aOR:1.72, 95% confidence interval [95%CI]:1.15-2.59; 1.57, 1.13-2.19, respectively). Reasons for migration among SMM were associated with behaviors that can increase HIV risk, but not testing or PrEP. Push and pull factors related to migration should be considered when developing behavioral HIV interventions for immigrant SMM.
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Affiliation(s)
- Jane J Lee
- School of Social Work, University of Washington, 4101 15th Avenue NE, Seattle, WA, 98105, USA.
| | - Roxanne P Kerani
- Department of Medicine, University of Washington, Seattle, WA, USA
| | - Gabriel Robles
- School of Social Work, Rutgers University, New Brunswick, NJ, USA
| | | | - David A Katz
- Department of Global Health, University of Washington, Seattle, WA, USA
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3
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Algarin AB, Werb D, Shumskaya N, Kurmanalieva A, Blyum A, Cepeda J, Patterson TL, Baral S, Smith LR. Financial Vulnerability and Its Association with HIV Transmission Risk Behaviors Among People Who Inject Drugs in Kyrgyzstan. AIDS Behav 2024; 28:310-319. [PMID: 37523049 DOI: 10.1007/s10461-023-04129-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/01/2023] [Indexed: 08/01/2023]
Abstract
The Family Resource Scale (FRS) is a three-factor financial vulnerability (FV) measure. FV may impact HIV transmission risks. Cross-sectional data from 279 people who inject drugs (PWID) in Kyrgyzstan surveyed April-October 2021 was used to validate the FRS and estimate associations between FV on past 6-month injection and sexual HIV risk outcomes. The three-factor FRS reflected housing, essential needs, and fiscal independence, and had good internal reliability and structural validity. Greater cumulative, housing, and essential needs FRS scores were associated with increased relative risk on public injection (adjusted risk ratio [aRR], 95% confidence interval [95% CI]: 1.03 [1.01, 1.04]; aRR [95% CI]: 1.06 [1.02, 1.09]; aRR [95% CI]: 1.06 [1.03, 1.08], respectively, all p < 0.001) and preparing injections with unsafe water sources (aRR [95% CI]: 1.04 [1.02, 1.07]; aRR [95% CI]: 1.09 [1.04, 1.15]; aRR [95% CI]: 1.08 [1.03, 1.14], respectively, all p < 0.001). Results suggest that PWID housing- and essential needs-related FV may exacerbate injection HIV transmission risks. Reducing PWIDs' FV may enhance the HIV response in Kyrgyzstan.
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Affiliation(s)
- Angel B Algarin
- Center for Health Promotion and Disease Prevention, Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ, USA
| | - Dan Werb
- Division of Infectious Diseases and Global Public Health, Department of Medicine, University of California, San Diego, La Jolla, CA, 92093-0507, USA
- Centre On Drug Policy Evaluation, St. Michael's Hospital, University of Toronto, Toronto, Canada
| | - Natalya Shumskaya
- AIDS Foundation - East West in the Kyrgyz Republic, Bishkek, Kyrgyzstan
| | | | - Anna Blyum
- Division of Infectious Diseases and Global Public Health, Department of Medicine, University of California, San Diego, La Jolla, CA, 92093-0507, USA
| | - Javier Cepeda
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Thomas L Patterson
- Department of Psychiatry, University of California, San Diego, La Jolla, USA
| | - Stefan Baral
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Laramie R Smith
- Division of Infectious Diseases and Global Public Health, Department of Medicine, University of California, San Diego, La Jolla, CA, 92093-0507, USA.
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4
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Kane JC, Figge C, Paniagua-Avila A, Michaels-Strasser S, Akiba C, Mwenge M, Munthali S, Bolton P, Skavenski S, Paul R, Simenda F, Whetten K, Cohen J, Metz K, Murray LK. Effectiveness of trauma-focused cognitive behavioral therapy compared to psychosocial counseling in reducing HIV risk behaviors, substance use, and mental health problems among orphans and vulnerable children in Zambia: a community-based randomized controlled trial. AIDS Behav 2024; 28:245-263. [PMID: 37812272 DOI: 10.1007/s10461-023-04179-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/15/2023] [Indexed: 10/10/2023]
Abstract
Orphans and vulnerable children (OVC) in sub-Saharan Africa are at high risk for HIV infection and transmission. HIV prevention and treatment efforts with OVC are hindered by mental health and substance use problems. This randomized controlled trial compared a mental health intervention, Trauma Focused Cognitive Behavioral Therapy (TF-CBT), to an enhanced version of an existing HIV Psychosocial Counseling (PC+) program among 610 adolescents who met PEPFAR criteria for OVC and had HIV risk behaviors in Lusaka, Zambia. Outcomes included HIV risk behaviors (e.g., risky sexual behaviors), mental health (internalizing symptoms, externalizing behaviors, PTSD) and substance use. At 12-month follow-up, there were significant within group reductions in both groups for all outcomes, with the only significant between group difference being for substance use, in which OVC who received TF-CBT had significantly greater reductions than OVC who received PC+. In a subgroup analysis of OVC with high levels of PTSD symptoms, TF-CBT was superior to PC + in reducing internalizing symptoms, functional impairment, and substance use. Findings support TF-CBT for reducing substance use among OVC. Subgroup analysis results suggest that a robust intervention such as TF-CBT is warranted for OVC with significant mental and behavioral health comorbidities. The similar performance of TF-CBT and PC + in the overall sample for risky sexual behavior and mild mental health problems indicates that enhancing existing psychosocial programs, such as PC, with standard implementation factors like having a defined training and supervision schedule (as was done to create PC+) may improve the efficacy of HIV risk reduction efforts.Clinical Trials Number: NCT02054780.
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Affiliation(s)
- Jeremy C Kane
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA.
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
| | - Caleb Figge
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Alejandra Paniagua-Avila
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA
| | - Susan Michaels-Strasser
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA
- ICAP, Columbia University Mailman School of Public Health, New York, NY, USA
| | - Christopher Akiba
- Department of Health Behavior, University of North Carolina Gillings School of Public Health, Chapel Hill, NC, USA
| | - Mwamba Mwenge
- Centre for Infectious Disease Research in Zambia, Lusaka, Zambia
| | - Saphira Munthali
- Centre for Infectious Disease Research in Zambia, Lusaka, Zambia
| | - Paul Bolton
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Stephanie Skavenski
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Ravi Paul
- School of Medicine, University of Zambia, University Teaching Hospital, Lusaka, Zambia
| | | | - Kathryn Whetten
- Duke Global Health Instittute, Durham, NC, USA
- Duke Sanford School of Public Policy, Durham, NC, USA
- Center for Health Policy and Inequalities Research, Durham, NC, USA
| | - Judith Cohen
- Drexel University College of Medicine, Allegheny Health Network/Allegheny General Hospital, Pittsburgh, PA, USA
| | - Kristina Metz
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Laura K Murray
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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5
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DesLauriers N, Sambai B, Mbogo L, Ludwig-Barron N, Kingston H, Chohan B, Gitau E, Sinkele W, Masyuko S, Herbeck J, Bukusi D, Guthrie BL, Farquhar C, Monroe-Wise A. Alcohol use among people who inject drugs living with HIV in Kenya is associated with needle sharing, more new sex partners, and lower engagement in HIV care. AIDS Behav 2023; 27:3970-3980. [PMID: 37318665 DOI: 10.1007/s10461-023-04113-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/06/2023] [Indexed: 06/16/2023]
Abstract
We assessed the prevalence and correlates of alcohol use among 870 people who inject drugs living with HIV in Kenya, with attention toward (1) sexual and injecting risk behaviors for HIV transmission and (2) HIV care engagement. We defined heavy alcohol use as > 14 drinks/week for men and > 7 drinks/week for women, moderate alcohol use as any lesser but non-zero amount, and any alcohol use as either moderate or heavy use. Approximately 39% of participants reported any alcohol use and 15% heavy use. In multivariate analysis, any alcohol use compared to no use was associated with needle sharing, > 3 new sex partners in the past 3 months, being unaware of HIV status, never enrolling in HIV care, and not being on ART (all p < 0.05). Heavy alcohol use as compared to no use was associated with needle sharing (aOR = 2.72; 95% CI 1.43, 5.13), injection equipment sharing (aOR = 1.80; 95% CI 1.00, 3.16), > 3 new sex partners in the past 3 months (aOR = 1.99; 95% CI 1.12, 3.49), and being unaware of HIV status (aOR = 2.77; 95% CI 1.46, 5.19). There was no association between any measure of alcohol use and unsuppressed viral load. Alcohol use among people who inject drugs living with HIV may carry elevated risk of HIV transmission mediated by sexual and injecting practices and is associated with lower engagement in multiple stages of the HIV care cascade.
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Affiliation(s)
- N DesLauriers
- Department of Medicine, University of Washington, Seattle, USA.
| | - B Sambai
- HIV Testing and Counseling and HIV Prevention, Kenyatta National Hospital, Nairobi, Kenya
| | - L Mbogo
- HIV Testing and Counseling and HIV Prevention, Kenyatta National Hospital, Nairobi, Kenya
| | - N Ludwig-Barron
- Department of Global Health, University of Washington, Seattle, USA
- Department of Epidemiology, University of Washington, Seattle, USA
| | - H Kingston
- Institute for Public Health Genetics, University of Washington, Seattle, USA
| | - B Chohan
- Department of Global Health, University of Washington, Seattle, USA
- Kenya Medical Research Institute (KEMRI), Nairobi, Kenya
| | - E Gitau
- Support for Addiction Prevention and Treatment in Africa, Nairobi, Kenya
| | - W Sinkele
- Support for Addiction Prevention and Treatment in Africa, Nairobi, Kenya
| | - S Masyuko
- Department of Global Health, University of Washington, Seattle, USA
- National AIDS and STI Control Programme (NASCOP), Kenya Ministry of Health, Nairobi, Kenya
| | - J Herbeck
- Department of Global Health, University of Washington, Seattle, USA
| | - D Bukusi
- HIV Testing and Counseling and HIV Prevention, Kenyatta National Hospital, Nairobi, Kenya
| | - B L Guthrie
- Department of Global Health, University of Washington, Seattle, USA
- Department of Epidemiology, University of Washington, Seattle, USA
| | - C Farquhar
- Department of Medicine, University of Washington, Seattle, USA
- Department of Global Health, University of Washington, Seattle, USA
- Department of Epidemiology, University of Washington, Seattle, USA
| | - A Monroe-Wise
- Department of Global Health, University of Washington, Seattle, USA
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6
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Savoie SJ, Leonhard C, Smith M, Drake M. Predicting and influencing PrEP use: the role of motivational and attitudinal factors. AIDS Care 2023:1-11. [PMID: 36781301 DOI: 10.1080/09540121.2023.2176427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2023]
Abstract
This study examined PrEP attitude and HIV risk factors associated with PrEP motivation and evaluated the efficacy of a mock public health video that addresses both motivational and stigma issues for improving PrEP uptake over a standard educational video. Gay, bisexual, and other men who have sex with men (GBMSM; N = 604) were enrolled. One-way between subject analysis of variance (ANOVA) and post-hoc comparisons revealed that GBMSM in later stages of change had significantly higher endorsement of positive PrEP attitudes, PrEP stigma, objective and perceived HIV risk, HIV worry, and valued health benefits of PrEP more. Stepwise multiple regression revealed five significant predictors of PrEP motivation: HIV worry, objective HIV risk, anticipated PrEP stigma, positive PrEP attitudes, and perceived social consequences of PrEP use. Video conditions did not differ in their impact on PrEP attitudes or motivation; however, regardless of video condition, participants experienced a pre- to post-video increase in positive PrEP attitudes and motivation. Findings suggest HIV worry, objective HIV risk, positive PrEP attitudes, and perceived PrEP health benefits are important factors to optimize PrEP motivation, which can inform secondary prevention efforts. Further study is needed on promotional PrEP campaigns that disconfirm stigmatizing PrEP misconceptions.
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Affiliation(s)
- S J Savoie
- Clinical PsyD Program, The Chicago School of Professional Psychology at Xavier University of Louisiana, New Orleans, LA, USA
| | - C Leonhard
- Clinical PsyD Program, The Chicago School of Professional Psychology at Xavier University of Louisiana, New Orleans, LA, USA
| | - M Smith
- Clinical PsyD Program, The Chicago School of Professional Psychology at Xavier University of Louisiana, New Orleans, LA, USA
| | - M Drake
- CrescentCare, New Orleans, LA, USA.,Tulane University School of Social Work, New Orleans, LA, USA
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Dharan NJ, Jin F, Vaccher S, Bavinton B, Yeung B, Guy R, Carr A, Zablotska I, Amin J, Read P, Templeton DJ, Ooi C, Martin SJ, Ryder N, Smith DE, McNulty A, Brown K, Price K, Holden J, Grulich AE. Characteristics of Human Immunodeficiency Virus (HIV) Seroconversions in a Large Prospective Implementation Cohort Study of Oral HIV Preexposure Prophylaxis in Men Who Have Sex with Men (EPIC-NSW). Clin Infect Dis 2023; 76:e622-e628. [PMID: 35982613 DOI: 10.1093/cid/ciac660] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 07/26/2022] [Accepted: 08/12/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Most human immunodeficiency virus (HIV) seroconversions in people who have initiated preexposure prophylaxis (PrEP) occur in the context of insufficient adherence. We describe participants who seroconverted after being dispensed PrEP in a large PrEP implementation study in Australia. METHODS Expanded PrEP Implementation in Communities in New South Wales was an implementation study of daily oral PrEP in individuals aged ≥18 years at high risk for acquiring HIV. HIV seroconversions were defined as a positive HIV test by either antigen, antibody, or detectable HIV viral load after enrollment. Insufficient adherence, measured by dispensing logs or participant self-report, was defined as <4 PrEP doses per week. RESULTS A total of 9596 participants were enrolled and dispensed PrEP between 1 March 2016 and 30 April 2018; 30 were diagnosed with HIV by 31 March 2019. The median (interquartile range [IQR]) age was 31 (25-38) years, all identified as male, 29 (97%) identified as gay or homosexual, and 20 (69%) lived in a postcode with a low concentration of gay male residents. The median (IQR) days from first PrEP dispensing to diagnosis was 409 (347-656). There was no evidence that participants who seroconverted had been sufficiently adherent to PrEP. Nineteen (63%) participants who seroconverted were diagnosed with chlamydia, gonorrhoea, syphilis, or new hepatitis C infection. One participant had resistance to emtricitabine (M184V mutation) at diagnosis. CONCLUSIONS Participants who seroconverted were insufficiently adherent to PrEP despite being at high risk for acquiring HIV. Understanding the reasons for poor PrEP adherence in individuals who subsequently acquire HIV is critical to improving PrEP effectiveness.
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Affiliation(s)
- Nila J Dharan
- Kirby Institute, University of New South Wales Sydney, Sydney, New South Wales, Australia
| | - Fengyi Jin
- Kirby Institute, University of New South Wales Sydney, Sydney, New South Wales, Australia
| | - Stefanie Vaccher
- Kirby Institute, University of New South Wales Sydney, Sydney, New South Wales, Australia
| | - Benjamin Bavinton
- Kirby Institute, University of New South Wales Sydney, Sydney, New South Wales, Australia
| | - Barbara Yeung
- Kirby Institute, University of New South Wales Sydney, Sydney, New South Wales, Australia
| | - Rebecca Guy
- Kirby Institute, University of New South Wales Sydney, Sydney, New South Wales, Australia
| | - Andrew Carr
- St Vincent's Hospital, Darlinghurst, New South Wales, Australia.,University of New South Wales Sydney, Sydney, New South Wales, Australia
| | - Iryna Zablotska
- Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, Westmead, New South Wales, Australia.,Marie Bashir Institute for Infectious Diseases and Biosecurity, University of Sydney, Westmead, New South Wales, Australia.,Western Sydney Sexual Health Centre, Western Sydney Local Health District, Parramatta, New South Wales, Australia
| | - Janaki Amin
- Department Health Sciences, Macquarie University, Macquarie Park, New South Wales, Australia
| | - Philip Read
- Kirketon Road Centre, South Eastern Sydney Local Health District, Sydney, New South Wales, Australia
| | - David J Templeton
- Kirby Institute, University of New South Wales Sydney, Sydney, New South Wales, Australia.,Department of Sexual Health Medicine, Sydney Local Health District, Camperdown, New South Wales, Australia.,Central Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | - Catriona Ooi
- Clinic 16, St Leonards, New South Wales, Australia.,Northern Clinical School, Faculty of Health and Medicine, University of Sydney, Sydney, New South Wales, Australia
| | - Sarah J Martin
- Canberra Sexual Health Centre, Canberra Health Services, Woden, Australia Capital Territory, Australia.,The Australian National University Medical School, Canberra, Australia Capital Territory, Australia
| | - Nathan Ryder
- Kirby Institute, University of New South Wales Sydney, Sydney, New South Wales, Australia.,School of Medicine and Public Health, University of Newcastle, Callaghan, New South Wales, Australia
| | - Don E Smith
- Albion Centre, South Eastern Sydney Local Health District, Sydney, New South Wales, Australia
| | - Anna McNulty
- School of Population Health, University of New South Wales Sydney, Sydney, New South Wales, Australia
| | - Katherine Brown
- Illawarra Sexual Health, Warrawong, New South Wales, Australia
| | - Karen Price
- AIDS Council of New South Wales (ACON), Sydney, New South Wales, Australia
| | - Jo Holden
- New South Wales Health, Sydney, New South Wales, Australia
| | - Andrew E Grulich
- Kirby Institute, University of New South Wales Sydney, Sydney, New South Wales, Australia
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8
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Orr LV, Crawford FW, Khoshnood K, Khouri D, Fouad FM, Seal DW, Heimer R. Sociodemographic characteristics and HIV risk behaviors of native-born and displaced Syrian men and transgender women who have sex with men in Lebanon. AIDS Behav 2022; 26:4004-4011. [PMID: 35672550 DOI: 10.1007/s10461-022-03726-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/20/2022] [Indexed: 11/28/2022]
Abstract
HIV rates among men and transgender women who have sex with men (MTWSM) in Lebanon are consistent with a concentrated epidemic. Geopolitical and social circumstances leave these communities vulnerable to HIV spread. To document this risk encountered by Lebanese native and displaced Syrian MTWSM, participants, recruited by respondent driven sampling beginning with Syrian seeds, completed a survey with questions covering sociodemographic, behavioral, medical, and stigma, followed by opt-out HIV testing. Analyses included descriptive statistics and linear regression to differentiate between native Lebanese and Syrians who migrated after the onset of the civil war to identify correlations among sociodemographic factors, stigma, and risk behavior as a function of country of birth. Experienced and internalized stigmas were higher in the Syrian born MTWSM and correlated with elements of HIV risk. Combatting the intersectional stigmas of Syrian MTWSM in Lebanon would be most beneficial in mitigating HIV risk for these individuals.
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Affiliation(s)
- Lilla V Orr
- Immigration Policy Lab, Stanford University, Stanford, CA, United States
| | - Forrest W Crawford
- Department of Biostatistics, Yale School of Public Health, New Haven, CT, United States
| | - Kaveh Khoshnood
- Department of the Epidemiology of Microbial Diseases, Yale School of Public Health, 06520-8034, New Haven, CT, USA
| | - Danielle Khouri
- Department of Epidemiology & Population Health, American University of Beirut (AUB), Beirut, Lebanon
| | - Fouad M Fouad
- Department of Epidemiology & Population Health, American University of Beirut (AUB), Beirut, Lebanon
| | - David W Seal
- Global Community Health and Behavioral Sciences, Tulane University School of Public Health & Tropical Medicine, New Orleans, LA, United States
| | - Robert Heimer
- Department of the Epidemiology of Microbial Diseases, Yale School of Public Health, 06520-8034, New Haven, CT, USA.
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9
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Nemoto T, Xie H, Iwamoto M, Piroth K, Hazratzai M, Teh YK. HIV Risk Behaviors and Psychological Well-Being Among Men Who Have Sex With Men (MSM) in Kuala Lumpur, Malaysia. AIDS Educ Prev 2022; 34:427-439. [PMID: 36181498 DOI: 10.1521/aeap.2022.34.5.427] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
HIV risk behaviors and psychological well-being among men who have sex with men (MSM) in Kuala Lumpur, Malaysia (n = 140), were quantitatively described in relation to demographic and psychosocial factors. Most participants were tested for HIV and 41.4% reported living with HIV. Malay participants had significantly higher levels of depression (p < .05), homophobia (p < .01), and needs for social support (p < .01) than Chinese. More Chinese participants reported suicidal thoughts than Malaysians (p < .05). A multivariate analysis revealed that participants with gay/MSM-identified or had lower levels of self-esteem showed significantly higher levels of depression. Future intervention projects should address depression and mental health issues among MSM and strengthen self-esteem and social support through culturally competent support and individual counseling programs (e.g., addressing MSM's conflicts with religious beliefs and norms). Structural changes must be made incrementally to reduce homophobia against MSM in Malaysia while advocating human rights.
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Affiliation(s)
| | - Hui Xie
- Public Health Institute, Oakland, California
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10
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Leddy AM, Selin A, Lippman SA, Kimaru LJ, Twine R, Gómez-Olivé X, Kahn K, Pettifor A. Emotional Violence is Associated with Increased HIV Risk Behavior Among South African Adolescent Girls and Young Women in the HPTN 068 Cohort. AIDS Behav 2022; 26:1863-1870. [PMID: 34800183 PMCID: PMC9046300 DOI: 10.1007/s10461-021-03535-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/06/2021] [Indexed: 11/05/2022]
Abstract
Limited research has explored how emotional intimate partner violence (IPV) shapes HIV risk behaviors. Using cross-sectional data from the HPTN 068 post-trial visit (N = 1942), we assessed the association between emotional IPV and its sub-domains (verbal abuse and threats) with condomless sex, transactional sex, and frequent alcohol use among young women in South Africa. In adjusted multivariable logistic regression models, any emotional IPV and verbal IPV were associated with increased odds of condomless sex (aOR: 1.47; 95% CI: 1.15, 1.87; and aOR: 1.48; 95% CI: 1.15, 1.89), transactional sex (aOR: 2.32; 95% CI: 1.74, 3.08; and aOR: 2.02; 95% CI: 1.51, 2.71) and alcohol use (aOR: 1.88; 95% CI: 1.39, 2.53; and aOR: 1.87; 95% CI: 1.37, 2.55). Threats were associated with transactional sex (aOR: 3.67; 95% CI: 2.62, 5.14). Future research should examine this relationship over-time and HIV prevention programs should consider and address emotional IPV.
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Affiliation(s)
- Anna M Leddy
- Department of Medicine, University of California, San Francisco, 550 16th St., 3rd floor, San Francisco, CA, 94158, USA.
| | - Amanda Selin
- Stanford University School of Medicine, Stanford, CA, USA
| | - Sheri A Lippman
- Department of Medicine, University of California, San Francisco, 550 16th St., 3rd floor, San Francisco, CA, 94158, USA
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), Faculty Health Sciences, School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
| | - Linda J Kimaru
- Department of Epidemiology, Gillings School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Rhian Twine
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), Faculty Health Sciences, School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
| | - Xavier Gómez-Olivé
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), Faculty Health Sciences, School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
| | - Kathleen Kahn
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), Faculty Health Sciences, School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
- Department of Public Health and Clinical Medicine, Umeå Centre for Global Health Research, Umeå University, Umeå, Sweden
| | - Audrey Pettifor
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), Faculty Health Sciences, School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
- Department of Epidemiology, Gillings School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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11
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Dyer TV, Turpin RE, Hawthorne DJ, Jain V, Sayam S, Mittal M. Sexual Risk Behavior and Lifetime HIV Testing: The Role of Adverse Childhood Experiences. Int J Environ Res Public Health 2022; 19:4372. [PMID: 35410050 DOI: 10.3390/ijerph19074372] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 04/01/2022] [Accepted: 04/02/2022] [Indexed: 11/16/2022]
Abstract
Despite the success of HIV prevention drugs such as PrEP, HIV incident transmission rates remain a significant problem in the United States. A life-course perspective, including experiences of childhood adversity, may be useful in addressing the HIV epidemic. This paper used 2019 BRFSS data to elucidate the role that childhood adversity plays in the relationship between HIV risk and HIV testing. Participants (n = 58,258) completed self-report measures of HIV risk behaviors, HIV testing, and adverse childhood experiences (ACEs). The median number ACEs in the sample was 1, with verbal abuse (33.9%), and parental separation (31.3%) being the most common ACEs reported. Bivariate findings showed that all ACEs were associated with increased HIV risk and testing. However, increased risk was not correlated with increased HIV testing, with the highest incongruence related to mental health problems of household member (53.48%). While both self-reported HIV risk and ACEs were positively associated with HIV testing, their interaction had a negative association with testing (aPR = 0.51, 95%CI 0.42, 0.62). The results highlight the need for targeted HIV prevention strategies for at-risk individuals with a history of childhood adversity.
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12
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Jawa R, Stein MD, Anderson B, Liebschutz JM, Stewart C, Phillips KT, Barocas JA. Behavioral Risk Factors for HIV Infection in Hospitalized Persons Who Co-use Stimulants and Opioids. AIDS Behav 2022; 26:1047-1055. [PMID: 34510289 PMCID: PMC8435119 DOI: 10.1007/s10461-021-03460-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/01/2021] [Indexed: 01/03/2023]
Abstract
We investigated the association of 90-day opioid and stimulant co-use and HIV risk behaviors in a cross-sectional analysis of hospitalized HIV-negative people who inject drugs (PWID). We compared those injecting opioids alone to two sub-groups who co-used opioids with (1) cocaine, (2) amphetamine-type stimulants (ATS), on sex and injection drug risk behaviors assessed via the Risk Assessment Battery (RAB), where a higher score indicates a higher risk. Of 197 participants who injected opioids, 53% co-used cocaine only, 5% co-used ATS only, 18% co-used both cocaine and ATS, 24% co-used neither stimulant. PWID who injected opioids alone had a mean RAB drug risk score of 5.98 points and sex risk score of 2.16 points. Compared to PWID who injected opioids alone, PWID who co-used stimulants had higher mean drug risk RAB scores: cocaine, b = 2.84 points [95% confidence interval (CI) 1.01; 4.67]; ATS, b = 3.43 points (95% CI 1.29; 5.57). Compared to PWID who injected opioids alone, cocaine co-use was associated with higher sex RAB scores b = 1.06 points (95% CI 0.32; 1.79). Overall, we found a significant association between stimulant co-use and higher HIV sex and drug risk scores.
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Affiliation(s)
- Raagini Jawa
- Section of Infectious Diseases, Boston Medical Center, 801 Massachusetts Ave, 2nd Floor, Boston, MA, 02118, USA.
- Boston University School of Medicine, Boston, MA, USA.
| | - Michael D Stein
- Boston University School of Public Health, Boston, MA, USA
- Behavioral Medicine and Addictions Research, Butler Hospital, Providence, RI, USA
| | - Bradley Anderson
- Behavioral Medicine and Addictions Research, Butler Hospital, Providence, RI, USA
| | - Jane M Liebschutz
- Division of General Internal Medicine, Center for Research On Health Care, University of Pittsburgh, Pittsburgh, PA, USA
| | | | - Kristina T Phillips
- Center for Integrated Health Care Research, Kaiser Permanente Honolulu, Honolulu, HI, USA
| | - Joshua A Barocas
- Section of Infectious Diseases, Boston Medical Center, 801 Massachusetts Ave, 2nd Floor, Boston, MA, 02118, USA
- Boston University School of Medicine, Boston, MA, USA
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13
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Chuang DM, Newman PA, Fang L, Lai MC. Familism and HIV Risk Among Men Who Have Sex With Men in Taiwan: The Mediating Roles of Stressful Life Events and Coping Strategies. AIDS Educ Prev 2022; 34:1-S2. [PMID: 35192392 DOI: 10.1521/aeap.2022.34.1.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Familism may play an important role in HIV risk behaviors among men who have sex with men (MSM) living in a collectivist culture. This study examined a hypothesized path from familism, stressful life events (i.e., adverse childhood experiences, intimate partner violence, and sexuality-related discriminatory experiences), and coping strategies to condomless anal sex (CAS) among Taiwanese MSM. Participants were 1,000 MSM (mean age = 28.5 years) recruited through five community-based organizations. Structural equation modeling using bootstrapping with 3,000 iterations evaluated the mediating effects of 14 coping strategies. We found a pathway from familism to CAS through stressful life events and substance use coping. The protective effects of familism on stressful life events and CAS suggest that integrating components of family support and family connection into HIV prevention and education programs may increase the effectiveness of these programs in reducing HIV risk behaviors and dysfunctional coping strategies among MSM in Taiwan.
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Affiliation(s)
- Deng-Min Chuang
- Assistant Professor at the Graduate Institute of Social Work, National Taiwan Normal University
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14
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Blue TR, Gordon MS, Crable EL, Rich JD. Long-term follow-up of individuals under community supervision who refused rapid HIV testing. J Offender Rehabil 2021; 60:329-340. [PMID: 37206630 PMCID: PMC10195011 DOI: 10.1080/10509674.2021.1931625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
Many criminal justice-involved persons on probation or parole do not receive HIV testing despite being at an increased risk for infection and transmission. Between April, 2011 and May, 2012 in Baltimore, MD and Providence, RI, a two-group randomized controlled trial was conducted in order to examine the uptake of on-site rapid HIV testing compared to off-site referral-based HIV testing at a community clinic. Adults under community supervision were recruited to complete baseline assessments and then offered optional, free rapid-HIV testing. Of the 1263 participants who completed baseline measures, 566 declined HIV testing prior to randomization to the on-site testing at the Probation/Parole office or referral to off-site testing in a community health clinic. Follow-up data from 50 individuals who declined HIV testing were collected from September 2016-June 2017 and are examined in the present study. We describe the long-term outcomes of these 50 individuals in terms of HIV testing, HIV status, and frequencies of drug and sex risk behaviors.
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Affiliation(s)
- Thomas R. Blue
- Friends Research Institute, Baltimore MD, USA
- , Friends Research Institute, 1040 Park Avenue, Suite 103, Baltimore, MD 21201
| | | | - Erika L. Crable
- Department of Health Law, Policy and Management, Boston University, Boston, MA, USA
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15
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Singh D, Narayanan S, Abdullah MFIL, Vicknasingam B. Effects of kratom ( Mitragyna speciosa Korth.) in reducing risk-behaviors among a small sample of HIV positive opiate users in Malaysia. J Ethn Subst Abuse 2020; 21:1-11. [PMID: 33190622 DOI: 10.1080/15332640.2020.1845899] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Out-of-treatment HIV positive opiate users often engage in risky injecting and sexual behaviors. We sought the self-reported experiences on whether or not kratom (Mitragyna speciosa Korth.) use was associated with a reduction in HIV risk behaviors among them. A convenience sample consisting of thirty-two HIV positive opiate users participated in the study. Of this, three-fifths (n = 20/32) used kratom to suppress opiate withdrawal, increase energy, as a heroin substitute, to reduce heroin dependence and self-treat psychological problems. More than one-third (38%) in the sample claimed that kratom use reduced their risky injecting and sexual behaviors. Given the small sample size, the perceived association between kratom use and the reduction in HIV risk behaviors could not be established more convincingly. However, the findings provide the basis for a broader-based study to evaluate the potential of kratom in curtailing HIV risk behaviors among HIV positive opiate users.
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Affiliation(s)
- Darshan Singh
- Centre for Drug Research, Universiti Sains Malaysia, Minden, Malaysia
| | - Suresh Narayanan
- School of Social Sciences, Universiti Sains Malaysia, Minden, Malaysia
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16
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Wang W, Yang Y, Kelifa MO, Li S, Cao Y, Li X, Yan H. Associations Between Personality Traits and Patterns of HIV Risk Behaviors Among Young Men Who Have Sex with Men in China. AIDS Res Hum Retroviruses 2020; 36:775-781. [PMID: 32536184 DOI: 10.1089/aid.2019.0291] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
This study aimed to ascertain the patterns of human immunodeficiency virus (HIV) risk behaviors among young men who have sex with men (YMSM) and explore the relationships between personality traits and patterns of HIV risk behaviors. Three hundred and seventy-five YMSM were recruited from March to December 2013, in central China. Latent class analysis (LCA) was utilized to identify underlying subgroups of HIV risk behaviors; multinomial logistic regression was used to examine predictors of HIV risk behaviors patterns. LCA identified four latent classes: low risk (LR), moderate risk (MR), high risk (HR), and drug use (DU). YMSM reporting high levels of sexual sensation seeking (SSS) tended to be classified to the MR class [adjusted odds ratio (aOR) = 2.96, 95% confidence interval (CI) = 1.33-6.57] and HR class (aOR = 13.77, 95% CI = 3.06-61.96) than the LR class. Those with low degrees of self-control were more likely to be in the HR class (aOR = 4.06, 95% CI = 1.11-14.83) and DU class (aOR = 4.64, 95% CI = 1.50-14.32), compared to LR class. These findings highlight the significance of personality traits on predicting HIV risk behaviors. Future HIV interventions should prioritize YMSM with high SSS and low self-control.
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Affiliation(s)
- Wei Wang
- Department of General Practice, School of Public Health, Xuzhou Medical University, Xuzhou, China
- Department of Epidemiology and Health Statisitics, School of Health Sciences, Wuhan University, Wuhan, China
| | - Yinmei Yang
- Department of Epidemiology and Health Statisitics, School of Health Sciences, Wuhan University, Wuhan, China
| | - Mohammedhamid Osman Kelifa
- Department of Epidemiology and Health Statisitics, School of Health Sciences, Wuhan University, Wuhan, China
| | - Shiyue Li
- Department of Epidemiology and Health Statisitics, School of Health Sciences, Wuhan University, Wuhan, China
| | - Yue Cao
- Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Xiaoyan Li
- Department of Epidemiology and Health Statisitics, School of Health Sciences, Wuhan University, Wuhan, China
| | - Hong Yan
- Department of Epidemiology and Health Statisitics, School of Health Sciences, Wuhan University, Wuhan, China
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17
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Diaz JE, Schrimshaw EW, Tieu HV, Nandi V, Koblin BA, Frye V. Acculturation as a Moderator of HIV Risk Behavior Correlates Among Latino Men Who Have Sex with Men. Arch Sex Behav 2020; 49:2029-2043. [PMID: 31858309 PMCID: PMC7302998 DOI: 10.1007/s10508-019-01604-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Revised: 10/16/2019] [Accepted: 12/03/2019] [Indexed: 05/18/2023]
Abstract
Acculturation is associated with increased sexual risk behaviors among heterosexual Latinos, but its influence among Latino gay, bisexual, and other men who have sex with men (MSM) remains less clear. Elements of acculturation may create distinct lived experiences among sexual minority Latinos, moderating how beneficial and adverse influences contribute to their sexual risk behaviors. Latino MSM living in New York City (n = 412) were recruited using a modified time-space venue- and web-based sampling method. Negative binomial regression models estimated associations between indicators of acculturation (i.e., language use, nativity status, ethnic identification), sexual minority stressors (i.e., internalized homophobia, sexual orientation-based discrimination), peer condom use norms, and the number of serodiscordant condomless anal intercourse (SDCAI) encounters. Acculturation indicators were then tested as simultaneous moderators of the influence of each predictor variable on the outcome. The association between internalized homophobia and SDCAI was significant only among English language speakers (aIRR = 3.05 [2.13, 4.37]) and those born outside of the U.S. (foreign-born = 0, aIRR = 0.17 [0.08, 0.36]). Sexual orientation-based discrimination and SDCAI were also positively associated among both English-speaking (aIRR = 1.82 [1.22, 2.72]) and foreign-born men (aIRR = 0.34 [0.14, 0.84]). Stronger ethnic identification also moderated the protective effects of peer condom use norms on SDCAI (aIRR = 0.28 [0.15, 0.52]). Results suggest that different dimensions of acculturation help shape how both stressors and protective factors influence HIV risk among Latino MSM. Future research is needed to examine the mechanisms through which these differences in acculturation may act on sexual risk behaviors among Latino MSM.
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Affiliation(s)
- José E Diaz
- Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 West 168th Street, New York, NY, 10032, USA.
- Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA.
| | - Eric W Schrimshaw
- Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Hong-Van Tieu
- Laboratory of Infectious Disease Prevention, Lindsley F. Kimball Research Institute, New York, NY, USA
| | - Vijay Nandi
- Laboratory of Data Analytic Services, Lindsley F. Kimball Research Institute, New York, NY, USA
| | - Beryl A Koblin
- Laboratory of Infectious Disease Prevention, Lindsley F. Kimball Research Institute, New York, NY, USA
| | - Victoria Frye
- Department of Community Health and Social Medicine, City University of New York School of Medicine, New York, NY, USA
- Laboratory of Social and Behavioral Sciences, Lindsley F. Kimball Research Institute, New York, NY, USA
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18
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Olusanya OO, Wigfall LT, Rossheim ME, Tomar A, Barry AE. Binge drinking, HIV/HPV co-infection risk, and HIV testing: Factors associated with HPV vaccination among young adults in the United States. Prev Med 2020; 134:106023. [PMID: 32061685 PMCID: PMC7195993 DOI: 10.1016/j.ypmed.2020.106023] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Revised: 01/12/2020] [Accepted: 02/10/2020] [Indexed: 12/30/2022]
Abstract
Human papillomavirus (HPV) is a common sexually transmitted infection. Binge drinkers often engage in HIV/HPV co-infection high-risk behaviors. We examined the association between binge drinking, HIV/HPV co-infection risk, HIV testing and HPV vaccination among young adults. Data from the 2017 Behavioral Risk Factor Surveillance System survey were examined. Participants (N = 430/450,016; 0.11%) were HPV vaccine-eligible young adults ages 18-26 years. Multivariable logistic regression examined the association between binge drinking in the past 30 days, HIV/HPV co-infection high-risk risk behaviors, HIV testing, and HPV vaccination (initiated/completed, unvaccinated) among young adults. Respondents were primarily cisgender (99.8%), non-Hispanic White (41.4%), employed (46.2%) or student (35.4%), and insured (68.2%). Most did not binge drink (55.2%). The majority did not engage in HIV/HPV co-infection high-risk risk behaviors (78.2%). More than one-half had never been tested for HIV (59%) nor vaccinated against HPV (60.6%). Although binge drinkers (44.8%) were significantly more likely to engage in HIV/HPV co-infection high-risk behaviors (OR = 2.1; 95% CI: 1.0-4.5), binge drinking was not positively associated with HIV testing (OR = 0.98; 95% CI: 0.63-1.53). After adjusting for demographics and HIV/HPV co-infection high-risk behaviors, one (aOR = 2.71; 95% CI: 1.11-6.65) and two episodes (aOR = 3.05; 95% CI: 1.26-7.41) of binge drinking in the past 30 days were significantly associated with HPV vaccination uptake. Positive associations between HPV vaccination and participants having an HIV test in 2017 (aOR = 3.86; 95% CI: 1.42-10.55) and before 2017 (aOR = 2.62; 95% CI: 1.23-5.56) were also statistically significant. Because young adult binge drinkers are more likely to engage in HIV/HPV co-infection high-risk behaviors, promoting HPV vaccination and HIV testing are important public health objectives.
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Affiliation(s)
- O O Olusanya
- Department of Biology, Texas A&M University, Butler Hall, 3258, 525 Lubbock Street, College Station, TX 77843, United States of America.
| | - L T Wigfall
- Texas A&M University, College of Education and Human Development, Department of Health and Kinesiology, Division of Health Education, United States of America.
| | - M E Rossheim
- Department of Global and Community Health, George Mason University, 4400 University Drive, MS5B7, Peterson Family Health Sciences Hall, Fairfax, VA 22030, United States of America.
| | - A Tomar
- Texas A&M University, College of Education and Human Development, Department of Health and Kinesiology, Division of Health Education, United States of America.
| | - A E Barry
- Texas A&M University, College of Education and Human Development, Department of Health and Kinesiology, Division of Health Education, United States of America.
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Nemoto T, Xie H, Iwamoto M, Sakata M. HIV Risk Behaviors in Relation to Psychosocial Factors and Internet Usage Among Asian and Pacific Islander (API) Men Who Had Sex With Men (MSM) in California. AIDS Educ Prev 2020; 32:117-136. [PMID: 32539477 DOI: 10.1521/aeap.2020.32.2.117] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Very few studies have been conducted to investigate HIV risk and protective behaviors in relation to psychosocial factors among Asian and Pacific Islander (API) MSM whose HIV/AIDS prevalence is lower than those of other racial/ethnic groups. This study, based on an online survey targeting API MSM in California revealed that API MSM often met sex partners online and that psychosocial factors (e.g., homophobia and identity with API gay community) were correlated with condomless receptive anal sex (RAS) with casual partners. In particular, an Asian cultural construct, interdependency, was correlated with condom use for RAS; that is, those who consider sex partners' health and value harmony tend to engage in safe sex. This finding sheds light on re-thinking the current over-emphasis on assertiveness and self-responsibility to keep free from HIV/STIs during negotiation with partners. Future STI prevention programs for API MSM should incorporate Asian cultural constructs and target specific risk groups.
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20
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Smith MK, Wei C, Liu C, Pan SW, Ong JJ, Tucker JD. Gender Identity and Sexual Orientation in Chinese Men Who Have Sex with Men: A Latent Class Analysis. Arch Sex Behav 2020; 49:721-731. [PMID: 31571020 PMCID: PMC7035172 DOI: 10.1007/s10508-019-01481-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Revised: 05/24/2019] [Accepted: 06/01/2019] [Indexed: 06/10/2023]
Abstract
Men who have sex with men (MSM) are a diverse population yet are often treated as a monolithic risk group. In China, MSM have long been characterized as a "bridge population" of closeted men who are married to (or will marry) women due to sociocultural expectations. Latent class models can inform a more nuanced yet empirical characterization of this population. In total, 1424 eligible respondents recruited online provided self-reported behavioral data. Nine items related to constructs including sexual behaviors, sexual orientation, and gender identity informed the latent class model. Logistic regression was used to measure associations between latent class membership and HIV-related sexual and health-seeking behaviors. Model fit indicated a population structure made up of four classes that we characterized as "Gender nonconforming" (4.3%), "Closeted-unmarried" (29.9%), "Closeted-married" (24.6%), and "Out" (41.2%). Members of the "gender nonconforming" class were more likely to report HIV-related risk behaviors, and "Closeted-unmarried" class members were less likely to report health-seeking behaviors, both relative to "Out" members. The largest latent class was made up of members of the "Out" class, an enlightening revision of a population traditionally viewed as largely closeted men. Two types of "closeted" classes emerged, distinguished by divergent tendencies regarding marriage and health seeking. Findings suggest that current understandings of Chinese MSM are simplistic (regarding closeted behaviors) and too narrow (in its definition of MSM as cisgender men). A more nuanced understanding of MSM subgroups and their heterogeneous risk behaviors will be critical for provision of more meaningful prevention services.
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Affiliation(s)
- M Kumi Smith
- Division of Epidemiology and Community Health, University of Minnesota Twin Cities, 1300 South 2nd St., Suite 300, Minneapolis, MN, 55454, USA.
- University of North Carolina Project-China, Guangzhou, China.
| | - Chongyi Wei
- University of North Carolina Project-China, Guangzhou, China
- Center for Health, Identity, Behavior and Prevention Studies, Rutgers University, New Brunswick, NJ, USA
| | - Chuncheng Liu
- University of North Carolina Project-China, Guangzhou, China
- Department of Sociology, University of California San Diego, San Diego, CA, USA
| | - Stephen W Pan
- University of North Carolina Project-China, Guangzhou, China
- Xi'an Jiatong-Liverpool University, Suzhou, China
| | - Jason J Ong
- University of North Carolina Project-China, Guangzhou, China
- London School of Hygiene and Tropical Medicine, London, England, UK
| | - Joseph D Tucker
- University of North Carolina Project-China, Guangzhou, China
- Department of Medicine, University of North Carolina Chapel Hill, Chapel Hill, NC, USA
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Shrestha R, Altice FL, DiDomizio E, Sibilio B, Ranjit YS, Copenhaver MM. Feasibility and Acceptability of an mHealth-Based Approach as an HIV Prevention Strategy Among People Who Use Drugs on Pre-Exposure Prophylaxis. Patient Prefer Adherence 2020; 14:107-118. [PMID: 32021122 PMCID: PMC6971384 DOI: 10.2147/ppa.s236794] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Accepted: 01/07/2020] [Indexed: 12/21/2022] Open
Abstract
INTRODUCTION There has been increasing interest in the use of mHealth technology in health care. To our knowledge, however, there is a lack of empirical evidence on the utilization of text messaging services (short message service; SMS) for HIV prevention among opioid-dependent people who use drugs (PWUD). As part of our formative work, we conducted an in-depth feasibility and acceptability study on the use of SMS reminders for HIV prevention in this risk group. METHODS Forty HIV-negative, opioid-dependent PWUD who are currently taking pre-exposure prophylaxis (PrEP) were enrolled in the study. Participants received daily PrEP text reminders and weekly HIV risk reduction-related messages, which were developed using a user-centered approach. Participants were assessed at baseline and immediately post-intervention. Following the post-intervention assessment, participants completed an in-depth qualitative interview. RESULTS Feasibility of text messaging service was high, as assessed by participants' willingness to receive text messages (100%), retention (95%), and successful delivery of text messages (97%). Results further showed that participants were satisfied and perceived the use of daily PrEP reminder text messages as valuable and acceptable [mean: 75.0 (range 0-100)]. Whereas, acceptability for the weekly text messages on HIV risk reduction was 60.3 (±15.6), with 58.3% recommending them for future use. Thematic data exploration revealed important information for understanding and refining SMS content as well as logistical preferences. CONCLUSION Our findings provide preliminary evidence of the feasibility and acceptability of a text messaging-based approach as a potential tool for primary HIV prevention to improve PrEP adherence and HIV risk reduction among this underserved population. HIV risk reduction text messages need further modifications to become more appealing, with participant feedback taken into consideration.
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Affiliation(s)
- Roman Shrestha
- Aasaman Nepal, HIV Prevention Group, Lalitpur, Nepal
- Correspondence: Roman Shrestha Asaman Nepal, HIV Prevention Group, Ring Road, Lalitpur44700, NepalTel +977-9849783132 Email
| | - Frederick L Altice
- Section of Infectious Diseases, Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA
| | - Elizabeth DiDomizio
- Section of Infectious Diseases, Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA
| | - Brian Sibilio
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT, USA
| | - Yerina S Ranjit
- Section of Infectious Diseases, Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA
| | - Michael M Copenhaver
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT, USA
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Craddock JB, Barman-Adhikari A, Combs KM, Fulginiti A, Rice E. Individual and Social Network Correlates of Sexual Health Communication Among Youth Experiencing Homelessness. AIDS Behav 2020; 24:222-232. [PMID: 31471815 PMCID: PMC6954958 DOI: 10.1007/s10461-019-02646-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Despite the potential for sexual health communication to be leveraged for HIV prevention among youth experiencing homelessness (YEH), there has yet to be a rigorous examination of individual and network or relational characteristics associated with sexual health communication in this group of young people. Cross-sectional survey and social network data from 1014 YEH aged 14-25 recruited in Los Angeles, California, were utilized to assess individual and network or relational characteristics associated with communication regarding condom use and HIV testing among YEH. Results suggest that social networks are key to understanding sexual health communication; YEH's engagement in sexual health communication was significantly related to the composition of their networks. To increase testing and decrease new HIV cases, a prudent strategy would be to train existing social network members (e.g., staff members, home-based peers, or partners) as agents of change in naturally occurring social networks of YEH.
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Affiliation(s)
- Jaih B Craddock
- University of Maryland School of Social Work, University of Maryland, Baltimore, Baltimore, MD, USA.
| | | | | | - Anthony Fulginiti
- Graduate School of Social Work, University of Denver, Denver, CO, USA
| | - Eric Rice
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA, USA
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Arasteh K, Des Jarlais DC, McKnight C, Feelemyer J. Injection and Heterosexual Risk Behaviors for HIV Infection Among Non-gay Identifying Men Who Have Sex with Men and Women. AIDS Behav 2019; 23:3315-23. [PMID: 31154560 DOI: 10.1007/s10461-019-02551-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Non-gay identifying men who have sex with men and women (MSMW) are an important subgroup of men who have sex with men (MSM) and have been underrepresented in studies of MSM that only use gay venues to draw their samples. We assessed heterosexual and drug use risks of MSMW who use drugs in a sample of male entrants to the Mount Sinai Beth Israel drug treatment programs from 2005 to 2018. Blood samples were collected and tested for HIV and HSV-2 infections. Among HIV seronegative participants, MSMW had significantly greater odds of sharing used needles with others, and reporting unprotected sex with female casual partners and female commercial sex partners, compared to their counterparts who reported sex with women exclusively (MSWE). Although not recruited from gay venues, MSMW had a significantly higher HIV prevalence than MSWE (23% vs. 10%, p < 0.001). Interventions that are specifically tailored to HIV prevention among MSMW are needed to ameliorate the prevalence of HIV risks and infection.
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24
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Saref A, Suraya S, Singh D, Grundmann O, Narayanan S, Swogger MT, Prozialeck WC, Boyer E, Balasingam V. Self-Report Data on Regular Consumption of Illicit Drugs and HIV Risk Behaviors after Kratom ( Mitragyna Speciosa korth.) Initiation among Illicit Drug Users in Malaysia. J Psychoactive Drugs 2019; 52:138-144. [PMID: 31682782 DOI: 10.1080/02791072.2019.1686553] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
This study sought to determine the relationship between kratom (Mitragyna speciosa) initiation and regular consumption of illicit drugs and HIV risk behaviors in a cohort of illicit drug users in Malaysia. 260 illicit drug users with current kratom use were recruited through convenience sampling for this cross-sectional study. All were male, with the majority being Malays (95%, n = 246/260). Results suggest that kratom initiation was associated with significant decrease in the regular use of heroin (odds ratio (OR) = 0.50, 95% confidence interval (CI): 0.40- 0.72; p = .0001), methamphetamine (OR = 0.23, CI: 0.16- 0.35; p < .0001), and amphetamine (OR = 0.17, CI: 0.09- 0.34; p < .0001). Kratom initiation was also associated with reduction in regular HIV risk behaviors such as having sex with sex workers (OR = 0.20, CI: 0.12-0.32; p < .0001), using drugs before sexual intercourse (OR = 0.20, CI: 0.13- 0.31; p < .0001), injecting behaviors (OR = 0.10, CI: 0.04- 0.25; p < .0001), sharing of injection equipment (OR = 0.13, CI: 0.04- 0.43; p < .0001), and injecting with other injection drug users (IDUs) (OR = 0.07, CI: 0.02- 0.24; p < .0001).
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Affiliation(s)
- Azlin Saref
- Centre for Drug Research, Universiti Sains Malaysia , Penang, Malaysia
| | - Sharifah Suraya
- School of Social Sciences, Universiti Sains Malaysia , Penang, Malaysia
| | - Darshan Singh
- Centre for Drug Research, Universiti Sains Malaysia , Penang, Malaysia
| | - Oliver Grundmann
- Department of Medicinal Chemistry, College of Pharmacy, University of Florida , Gainesville, FL, USA
| | - Suresh Narayanan
- School of Social Sciences, Universiti Sains Malaysia , Penang, Malaysia
| | - Marc T Swogger
- Department of Psychiatry, University of Rochester Medical Center , Rochester, NY, USA
| | - Walter C Prozialeck
- Department of Pharmacology, College of Graduate Studies, Midwestern University , Downers Grove, IL, USA
| | - Edward Boyer
- Department of Emergency Medicine, Brigham and Women's Hospital, Harvard Medical School , Boston, MA, USA
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25
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Padilla M, Frazier EL, Carree T, Luke Shouse R, Fagan J. Mental health, substance use and HIV risk behaviors among HIV-positive adults who experienced homelessness in the United States - Medical Monitoring Project, 2009-2015. AIDS Care 2019; 32:594-599. [PMID: 31650855 DOI: 10.1080/09540121.2019.1683808] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Homelessness is a challenge to retention in HIV care and adherence to antiretroviral therapy. We describe the sociodemographic and behavioral characteristics of HIV-positive adults who reported recent homelessness. The Medical Monitoring Project is a complex sample survey of HIV-positive adults receiving medical care in the United States. We used weighted interview and medical record data collected from June 2009 to May 2015 to estimate the prevalence of depression, substance use, and HIV risk behaviors among adults experiencing recent homelessness. From 2009 to 2015, 8.3% of HIV-positive adults experienced recent homelessness. Homeless adults were more likely than housed adults to have major depression, to binge drink, use non-injection drugs, use injection drugs, and smoke. Over 60% of homeless adults were sexually active during the past year, with homeless adults reporting more condomless sex with an HIV-negative or unknown status sex partner than housed adults. Programs attempting to improve the health outcomes of HIV-positive homeless persons and reduce ongoing HIV transmission can focus on providing basic needs, such as housing, and ancillary services, such as mental health counseling or substance abuse treatment and counseling.
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Affiliation(s)
- Mabel Padilla
- Division of HIV/AIDS Prevention, National Centers for HIV, Viral Hepatitis, STD and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Emma L Frazier
- Division of HIV/AIDS Prevention, National Centers for HIV, Viral Hepatitis, STD and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Tamara Carree
- Division of HIV/AIDS Prevention, National Centers for HIV, Viral Hepatitis, STD and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA.,ICF International, Atlanta, GA, USA
| | - R Luke Shouse
- Division of HIV/AIDS Prevention, National Centers for HIV, Viral Hepatitis, STD and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Jennifer Fagan
- Division of HIV/AIDS Prevention, National Centers for HIV, Viral Hepatitis, STD and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
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26
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Lee J, Yu G, Zhou Y. Complex Patterns Across the Migration Process and Associated HIV Testing and Risk Behaviors among Latino Immigrants. Int J Behav Med 2019; 26:175-84. [PMID: 30635873 DOI: 10.1007/s12529-019-09768-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
BACKGROUND Migrants are at elevated risk for adverse HIV-related outcomes. Yet, there is limited understanding about the complexity of the migration process and the different migration experiences that may influence HIV testing and risk behaviors. This study examined whether patterns in immigrants' migration experience were associated with HIV risk and preventive behaviors. METHODS Surveys were conducted with Latino immigrant adults (n = 306) in New York City during the spring of 2017. Informed by formative interviews, variables were developed to assess the migration process and document information about Latino immigrants' experiences during six particular stages of migration (pre-departure, travel, destination, interception, return, and settlement). We conducted a Latent Class Analysis (LCA) to detect patterns in the migration experience among participants and examined the associations between the latent classes and HIV testing and risk behaviors. RESULTS LCA clustered participants into three migration experience classes: positive experience (50.3%), neutral experience (36.3%), and negative experience (13.4%). The migration classes were significantly associated with sociodemographic variables, including sex, age, and income. Different experiences during the migration process did not influence immigrants' past or current HIV testing or risk behaviors. However, the migration classes were associated with immigrants' future intentions to test for HIV with the positive migration experience class reporting greater intentions to test for HIV in the next 12 months than the negative experience class (aOR, 2.95; 95% CI, 1.21-7.17; p < .05). CONCLUSION Results suggest the applicability of a migration experience framework for understanding future HIV risk and preventive behaviors among immigrants.
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27
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Joe GW, Lehman WEK, Rowan GA, Knight K, Flynn PM. Evaluating the Impact of a Targeted Brief HIV Intervention on Multiple Inter-Related HIV Risk Factors of Knowledge and Attitudes among Incarcerated Drug Users. J HIV AIDS Soc Serv 2019; 18:61-79. [PMID: 36092275 PMCID: PMC9455226 DOI: 10.1080/15381501.2019.1584140] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Revised: 01/15/2019] [Accepted: 02/12/2019] [Indexed: 06/15/2023]
Abstract
Increases in HIV prevalence indicate ongoing need for HIV interventions. A brief manualized intervention called TCU WaySafe, which addresses multiple HIV risks, was further evaluated to determine how it addressed individual's knowledge deficiencies in the assessed risks. The sample of 1256 offenders in 8 correctional substance abuse treatment programs participated either in treatment as usual (TAU) or TCU WaySafe. From multivariate multi-level analysis, WaySafe was more effective in improving the greatest need area, whether knowledge, motivation, or confidence regarding HIV risky behaviors. Findings underscored the importance of addressing HIV risk areas with greatest need for change and strengthens previous findings of the intervention's potential for individuals with varying HIV risks.
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Affiliation(s)
- George W Joe
- Institute of Behavioral Research, Texas Christian University, Fort Worth, TX, USA
| | - Wayne E K Lehman
- Institute of Behavioral Research, Texas Christian University, Fort Worth, TX, USA
| | - Grace A Rowan
- Institute of Behavioral Research, Texas Christian University, Fort Worth, TX, USA
| | - Kevin Knight
- Institute of Behavioral Research, Texas Christian University, Fort Worth, TX, USA
| | - Patrick M Flynn
- Institute of Behavioral Research, Texas Christian University, Fort Worth, TX, USA
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28
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Abstract
Latino immigrants in the United States are at elevated risk for HIV infection and delayed HIV diagnosis. Immigration documentation status and its contribution to fears are important barriers to accessing health services including HIV testing. A currently changing political climate within the United States may have increased the complexity of the intersection of documentation status and health care access. This study used an anonymous survey conducted in March and April 2017 in New York City to compare: sociodemographic characteristics, HIV testing behaviors, HIV risk behaviors, and perceptions of fear around HIV testing among documented and undocumented Latino immigrants (N = 301). We found that undocumented immigrants reported lower levels of education, income, and health insurance than did documented immigrants. However, groups did not differ in having tested for HIV in the last 12 months, in future intentions to test for HIV, or in emotional/cognitive perceptions of fear around HIV testing. Undocumented immigrants reported lower rates of having ever tested for HIV in their lifetime (68.6%) than documented immigrants (80.5%) (p = 0.027). In conclusion, we found that despite sociodemographic challenges, undocumented immigrants had similar HIV testing behaviors as their documented counterparts in our study community. Further understanding of the mitigating factors that resulted in seemingly equal access to HIV testing in this community for undocumented immigrants is warranted.
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29
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Rogers AH, Jardin C, Mayorga NA, Bakhshaie J, Leonard A, Lemaire C, Zvolensky MJ. The relationship of discrimination related to sexual orientation and HIV-relevant risk behaviors among men who have sex with men. Psychiatry Res 2018; 267:102-107. [PMID: 29886271 DOI: 10.1016/j.psychres.2018.05.081] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Revised: 05/04/2018] [Accepted: 05/29/2018] [Indexed: 10/16/2022]
Abstract
Men who have sex with men (MSM) are at high risk for contraction and transmission of Human Immunodeficiency Virus (HIV). Increased risk of infection has been linked to high risk behaviors, such as alcohol and drug use, as well as engaging in unsafe sexual behaviors. Experiences of discrimination related to sexual orientation often experienced in this population predict risky behavior outcomes, but little research has examined the mechanisms implicated in this model. The current study examined the effect of anxiety and depressive symptoms in the relationship between discrimination related to sexual orientation and high-risk behaviors of alcohol use, drug use, using sex to cope with negative emotions, frequency of sex without a condom, and frequency of sex with an HIV+ or unknown status partner. Three hundred and eighty-nine MSM were recruited to participate in a survey based study. Results indicated anxiety was maintained a significant indirect effect between discrimination related to sexual orientation and coping behaviors (using sex to cope, alcohol, substance use), but showed no significant indirect associations with risky sexual behavior. Overall, the current study provides novel empirical evidence that discrimination related to sexual orientation is associated with increased anxiety, which in turn, is associated with certain HIV risk behaviors. Importantly, it is possible that alcohol use, drug use, and using sex to cope with negative emotions may be precursors to more risky sexual behavior, such as engaging in anal sex without a condom or having sex with an HIV+ or unknown status partner. Clinically, reducing symptoms of anxiety in the context of discrimination related to sexual orientation may help reduce HIV risk behavior among MSM.
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Affiliation(s)
- Andrew H Rogers
- Department of Psychology, University of Houston, Houston, TX, United States
| | - Charles Jardin
- Department of Psychology, University of Houston, Houston, TX, United States
| | - Nubia A Mayorga
- Department of Psychology, University of Houston, Houston, TX, United States
| | - Jafar Bakhshaie
- Department of Psychology, University of Houston, Houston, TX, United States
| | - Amy Leonard
- Legacy Community Health Services, Houston, TX, United States
| | - Chad Lemaire
- Legacy Community Health Services, Houston, TX, United States
| | - Michael J Zvolensky
- Department of Psychology, University of Houston, Houston, TX, United States; Department of Behavioral Sciences, University of Texas MD Anderson Cancer Center, Houston, TX, United States.
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30
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Wagman JA, Samet JH, Cheng DM, Gnatienko N, Raj A, Blokhina E, Toussova O, Forman LS, Lioznov D, Tsui JI. Female Gender and HIV Transmission Risk Behaviors Among People Living with HIV Who Have Ever Used Injection Drugs in St. Petersburg, Russia. AIDS Behav 2018; 22:2830-2839. [PMID: 29797161 DOI: 10.1007/s10461-018-2149-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Among persons who inject drugs, women have a higher HIV prevalence (than men) in many settings. Understanding how gender affects risk for infection among HIV-negative, and transmission among HIV-positive people who currently or previously injected drugs is key to designing effective prevention and treatment programs. We analyzed data from 291 persons living with HIV who had ever injected drugs. Participants were drawn from the Russia Alcohol Research Collaboration on HIV/AIDS cohort (2012-2015) to examine associations between female gender and HIV transmission risk. Primary outcomes were sharing drug injecting equipment (e.g., needle/syringes) and condomless sex. Secondary outcomes were alcohol use before sharing drug injecting equipment; before condomless sex; and both sharing drug injecting equipment and condomless sex. Logistic regression models assessed associations between gender and outcomes, controlling for demographics, partner HIV status and use of antiretroviral treatment. Female gender was not significantly associated with sharing drug injecting equipment [aOR = 1.45, 95% confidence interval (CI) 0.85-2.46, p value = 0.18] but was associated with condomless sex (aOR = 1.91, 95% CI 1.12-3.23, p = 0.02) in adjusted models. Female gender was not significantly associated with any secondary outcomes. Better understanding of risky sex and drug use behaviors among people who currently or previously injected drugs can support the design of effective gender-tailored HIV prevention interventions.
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Affiliation(s)
- Jennifer A Wagman
- Center on Gender Equity and Health, University of California San Diego, San Diego, CA, USA.
- Division of Infectious Diseases and Global Public Health, Department of Medicine, University of California, San Diego, 9500 Gilman Drive, MC 0507, La Jolla, CA, 92093-0507, USA.
| | - Jeffrey H Samet
- Clinical Addiction Research and Education Unit, Section of General Internal Medicine, Department of Medicine, Boston University School of Medicine/Boston Medical Center, Boston, MA, USA
- Department of Community Health Sciences, Boston University School of Public Health, Boston, MA, USA
| | - Debbie M Cheng
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA
| | - Natalia Gnatienko
- Clinical Addiction Research and Education Unit, Section of General Internal Medicine, Department of Medicine, Boston Medical Center, Boston, MA, USA
| | - Anita Raj
- Center on Gender Equity and Health, University of California San Diego, San Diego, CA, USA
| | - Elena Blokhina
- Laboratory of Clinical Pharmacology of Addictions, First Pavlov State Medical University, St. Petersburg, Russia
| | - Olga Toussova
- Laboratory of Clinical Pharmacology of Addictions, First Pavlov State Medical University, St. Petersburg, Russia
| | - Leah S Forman
- Biostatistics and Epidemiology Data Analytics Center, Boston University School of Public Health, Boston, MA, USA
| | - Dmitry Lioznov
- Laboratory of Clinical Pharmacology of Addictions, First Pavlov State Medical University, St. Petersburg, Russia
- Research Institute of Influenza, St. Petersburg, Russia
| | - Judith I Tsui
- Section of General Internal Medicine, Department of Medicine, University of Washington School of Medicine and Harborview Hospital, Seattle, WA, USA
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Shushtari ZJ, Hosseini SA, Sajjadi H, Salimi Y, Latkin C, Snijders TAB. Social network and HIV risk behaviors in female sex workers: a systematic review. BMC Public Health 2018; 18:1020. [PMID: 30115056 PMCID: PMC6097207 DOI: 10.1186/s12889-018-5944-1] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2017] [Accepted: 08/09/2018] [Indexed: 12/12/2022] Open
Abstract
Background Social network characteristics have an important role in understanding HIV transmission among female sex workers. The purpose of this systematic review was to summarize and critically appraise the existing studies on the social network characteristics and HIV risk behaviors among female sex workers. Method A systematic review was performed using predefined eligibility criteria through searching electronic databases. Two independent reviewers assessed the methodological quality of studies. Results Nineteen papers met the eligible review criteria. The synthesized evidence suggests that characteristics of social networks, especially functional characteristics such as social support and social capital, are important constructs for understanding the HIV risk behaviors. Conclusions The findings of the present review enhance our understanding of the role of social network characteristics in HIV risk behaviors among female sex workers. However, the findings also highlighted a dearth of knowledge about the association of structural characteristics of social networks with HIV risk behaviors among female sex workers.
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Affiliation(s)
- Zahra Jorjoran Shushtari
- Social Determinants of Health Research Center, University of Social Welfare and Rehabilitation Sciences, P.O Box: 1985713834, Tehran, Iran
| | - Seyed Ali Hosseini
- Social Determinants of Health Research Center, University of Social Welfare and Rehabilitation Sciences, P.O Box: 1985713834, Tehran, Iran.
| | - Homeira Sajjadi
- Social welfare Management Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Yahya Salimi
- Social Development & Health Promotion Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Carl Latkin
- Department of Health, Behavior and Society, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
| | - Tom A B Snijders
- Department of Sociology, University of Groningen, 9712, TG Groningen, Netherlands.,Nuffield College, University of Oxford, Oxford, OX1 1NF, UK
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32
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Reback CJ, Clark K, Holloway IW, Fletcher JB. Health Disparities, Risk Behaviors and Healthcare Utilization Among Transgender Women in Los Angeles County: A Comparison from 1998-1999 to 2015-2016. AIDS Behav 2018; 22:2524-33. [PMID: 29804273 DOI: 10.1007/s10461-018-2165-7] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
Data from two studies of transgender women in Los Angeles County that used the same methodology and survey assessment (Study 1: 1998-1999, N = 244; Study 2: 2015-2016, N = 271), compared structural determinants of health, HIV/STI prevalence, HIV risk behaviors, substance use, gender confirmation procedures, and perceived discrimination and harassment/abuse across a 17-year time period. Findings demonstrated that participants in the latter study reported significantly higher access to healthcare insurance and prescription hormones. However, participants in the latter study also reported lower levels of income; and, elevated prevalence of homelessness, HIV and lifetime STIs, receptive condomless anal intercourse with casual partner(s), and reported physical harassment/abuse. Given the timeframe of these results, these findings elucidate specific areas of transgender women's health and risk profiles that improved or worsened across 17 years. While healthcare access has improved, transgender women continue to face significant barriers to good health, indicating the need for increased attention to this population.
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33
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Zarwell MC, Robinson WT. The Influence of Constructed Family Membership on HIV Risk Behaviors among Gay, Bisexual, and Other Men Who Have Sex with Men in New Orleans. J Urban Health 2018; 95:179-87. [PMID: 29047021 DOI: 10.1007/s11524-017-0203-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Gay, bisexual, and other men who have sex with men (MSM) represent more new HIV infections than all other at-risk populations. Many young black MSM belong to constructed families (i.e., the house ball community, gay families, and pageant families) which are often organized in a family structure with members referred to as parents and children. Many constructed families are associated with a family surname which is informally adopted by members. In some cases, however, constructed families do not identify with a collective family name. In 2014, 553 MSM were recruited through venue-based time-space sampling during the National HIV Behavioral Surveillance (NHBS) in New Orleans to complete a structured survey and HIV test. Black, Latino, and other race MSM were more likely to belong to constructed families in comparison to white MSM. In addition, participants who belonged to constructed families with a family name were more likely to engage in protective behaviors including wearing condoms at last sexual intercourse. Overall, younger, white MSM who did not belong to any social groups were more likely to engage in at least one risk behavior. These findings significantly contribute to understanding variations in HIV risk behavior among members of constructed families.
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34
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Serovich JM, Reed SJ, O'Connell AA, Laschober TC. Relationship between serostatus disclosure and categories of HIV transmission risk in men who have sex with men living with HIV. Int J STD AIDS 2018; 29:744-750. [PMID: 29431024 DOI: 10.1177/0956462417752267] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
In prior studies, the relationship between serostatus disclosure and reduced HIV transmission risk has been mixed. The demonstration of a clear connection may be restricted by three main methodological limitations. This study evaluates the relationship between (1) more refined measures of serostatus disclosure and (2) eight categories of HIV transmission risk (lowest to highest risk) among men who have sex with men (MSM) living with HIV, while (3) considering a number of control variables. Results demonstrate that disclosure is more likely in sexual encounters involving no intercourse or involving protected and unprotected anal intercourse with HIV-positive partners than unprotected insertive anal intercourse with HIV-negative/unknown status partners. Additionally, substance use prior to sexual encounters is less likely in lower risk categories than the highest risk category. Results of this study are important to the design of future studies, prevention, and intervention programs for MSM and to the methods used to evaluate their effectiveness.
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Affiliation(s)
- Julianne M Serovich
- 1 College of Behavioral and Community Sciences, University of South Florida, Tampa, FL, USA
| | - Sandra J Reed
- 2 College of Education and Human Ecology, The Ohio State University, Columbus, OH, USA
| | - Ann A O'Connell
- 2 College of Education and Human Ecology, The Ohio State University, Columbus, OH, USA
| | - Tanja C Laschober
- 1 College of Behavioral and Community Sciences, University of South Florida, Tampa, FL, USA
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Salas-Espinoza KJ, Menchaca-Diaz R, Patterson TL, Urada LA, Smith D, Strathdee SA, Pitpitan EV. HIV Prevalence and Risk Behaviors in Male to Female (MTF) Transgender Persons in Tijuana, Mexico. AIDS Behav 2017; 21:3271-3278. [PMID: 29032411 PMCID: PMC5736304 DOI: 10.1007/s10461-017-1931-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Compared to HIV research on men who have sex with men, less is known about the risks and vulnerabilities for HIV among Male to Female (MTF) transgender persons, particularly in different geographic regions like Mexico. In Tijuana, Mexico, a border city experiencing a dynamic HIV epidemic, no precedent data exists on the MTF transgender population. Our aims were to estimate HIV prevalence and examine the behaviors and characteristics of the population. We conducted a cross-sectional study of 100 MTF transgender persons recruited through time location sampling in 2012. Participants underwent interviewer-administered (paper and pen) surveys and rapid tests for HIV. Descriptive univariate analyses were conducted on various factors, including sociodemographics, substance use, accessing social services (requested vs. received), stigma, and sex behaviors. A total of 22% tested positive for HIV, a prevalence higher than other key populations at risk for HIV in Tijuana.
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Affiliation(s)
| | - Rufino Menchaca-Diaz
- Escuela de Medicina y Psicología, Universidad Autónoma de Baja California, Tijuana, Mexico
| | - Thomas L Patterson
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
| | - Lianne A Urada
- Division of Global Public Health, Department of Medicine, School of Medicine, University of California San Diego, 9500 Gilman Drive, MC 0507, La Jolla, CA, 92093-0507, USA
- School of Social Work, San Diego State University, San Diego, CA, USA
| | - Davey Smith
- Division of Global Public Health, Department of Medicine, School of Medicine, University of California San Diego, 9500 Gilman Drive, MC 0507, La Jolla, CA, 92093-0507, USA
| | - Steffanie A Strathdee
- Division of Global Public Health, Department of Medicine, School of Medicine, University of California San Diego, 9500 Gilman Drive, MC 0507, La Jolla, CA, 92093-0507, USA
| | - Eileen V Pitpitan
- Division of Global Public Health, Department of Medicine, School of Medicine, University of California San Diego, 9500 Gilman Drive, MC 0507, La Jolla, CA, 92093-0507, USA.
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Bohora S, Chaffin M, Shaboltas A, Bonner B, Isurina G, Batluk J, Bard D, Tsvetkova L, Skitnevskaya L, Volkova E, Balachova T. Latent Class Analysis of HIV Risk Behaviors Among Russian Women at Risk for Alcohol-Exposed Pregnancies. AIDS Behav 2017; 21:243-252. [PMID: 29047000 DOI: 10.1007/s10461-017-1929-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
The number of HIV cases attributed to heterosexual contact and the proportion of women among HIV positive individuals has increased worldwide. Russia is a country with the highest rates of newly diagnosed HIV infections in the region, and the infection spreads beyond traditional risk groups. While young women are affected disproportionately, knowledge of HIV risk behaviors in women in the general population remains limited. The objectives of this study were to identify patterns of behaviors that place women of childbearing age at high risk for HIV transmission and determine whether socio-demographic characteristics and alcohol use are predictive of the risk pattern. A total of 708 non-pregnant women, aged between 18 and 44 years, who were at risk for an alcohol-exposed pregnancy were enrolled in two regions in Russia. Participants completed a structured interview focused on HIV risk behaviors, including risky sexual behavior and alcohol and drug use. Latent class analysis was utilized to examine associations between HIV risk and other demographic and alcohol use characteristics and to identify patterns of risk among women. Three classes were identified. 34.93% of participants were at high risk, combining their risk behaviors, e.g., having multiple sexual partners, with high partner's risk associated with partner's drug use (class I). Despite reporting self-perceived risk for HIV/STI, this class of participants was unlikely to utilize adequate protection (i.e., condom use). The second high risk class included 13.19% of participants who combined their risky sexual behaviors, i.e., multiple sexual partners and having STDs, with partner's risk that included partner's imprisonment and partner's sex with other women (class II). Participants in this class were likely to utilize protection/condoms. Finally, 51.88% of participants were at lower risk, which was associated primarily with their partners' risk, and these participants utilized protection (class III). The odds of being in class I compared with class III were 3.3 (95% CI [1.06, 10.38]) times higher for those women who had Alcohol Use Disorders Identification Test scores ≥ 8 than those who had lower scores, and were 3.9 (95% CI [1.69, 8.97]) times higher for those who used alcohol before sex than those who did not. In addition, women who drank more days per week were 1.36 times more likely to be in class II than in class III. The study informs prevention by identifying specific population groups and targets for interventions. Alcohol use is a significant predictor and an overarching factor of HIV risk in women. Since at-risk drinking is common among young Russian women, alcohol risk reduction should be an essential component of HIV prevention efforts.
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Pardo G, Saisaengjan C, Gopalan P, Ananworanich J, Lakhonpon S, Nestadt DF, Bunupuradah T, Mellins CA, McKay MM. Cultural Adaptation of an Evidence-Informed Psychosocial Intervention to Address the Needs of PHIV+ Youth in Thailand. Glob Soc Welf 2017; 4:209-218. [PMID: 29104848 PMCID: PMC5660129 DOI: 10.1007/s40609-017-0100-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Globally, pediatric HIV has largely become an adolescent epidemic. Thailand has the highest HIV prevalence in Asia (1.2%), with more than 14,000 children living with HIV. There is growing demand for evidence-based psychosocial interventions for this population that include health and mental health support and sexual risk reduction, which can be integrated into HIV care systems. To address this need, a multidisciplinary team of Thai and US researchers adapted an existing evidence-informed, family-based intervention, The Collaborative HIV Prevention and Adolescent Mental Health Program + (CHAMP+), which has been tested in multiple global trials. Using community-based participatory research methods, changes to the intervention curriculum were made to address language, culture, and Thai family life. Involvement of families, youth, and stakeholders in the adaptation process allowed for identification of salient issues and of program delivery methods that would increase engagement. Participants endorsed using a cartoon-based curriculum format for fostering discussion (as in CHAMP+ South Africa) given stigma around discussing HIV in the Thai context. The Thai version of CHAMP+ retained much of the curriculum content incorporating culturally appropriate metaphors and story line. Sessions focus on family communication, coping, disclosure, stigma, social support, and HIV education. This paper explores lessons learned through the adaption process of CHAMP+ Thailand that are applicable to other interventions and settings. It discusses how culturally informed adaptations can be made to interventions while maintaining core program components.
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Affiliation(s)
- Gisselle Pardo
- McSilver Institute for Poverty Policy and Research, New York University Silver School of Social Work, 41 East 11th Street, 7th Floor, New York, NY 10003 USA
| | - Chutima Saisaengjan
- The Children and Youth Program, SEARCH, HIV-NAT, The Thai Red Cross AIDS Research Centre, Bangkok, Thailand
| | - Priya Gopalan
- McSilver Institute for Poverty Policy and Research, New York University Silver School of Social Work, 41 East 11th Street, 7th Floor, New York, NY 10003 USA
| | - Jintanat Ananworanich
- The Children and Youth Program, SEARCH, HIV-NAT, The Thai Red Cross AIDS Research Centre, Bangkok, Thailand
- Present Address: U.S. Military HIV Research Program, Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, USA
| | - Sudrak Lakhonpon
- The Children and Youth Program, SEARCH, HIV-NAT, The Thai Red Cross AIDS Research Centre, Bangkok, Thailand
| | - Danielle Friedman Nestadt
- HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute and Columbia University, New York, USA
| | - Torsak Bunupuradah
- The HIV Netherlands Australia Thailand Research Collaboration (HIV-NAT), The Thai Red Cross AIDS Research Centre, Bangkok, Thailand
| | - Claude Ann Mellins
- HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute and Columbia University, New York, USA
| | - Mary McKernan McKay
- McSilver Institute for Poverty Policy and Research, New York University Silver School of Social Work, 41 East 11th Street, 7th Floor, New York, NY 10003 USA
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Roy É, Arruda N, Jutras-Aswad D, Berbiche D, Perreault M, Bertrand K, Dufour M, Bruneau J. Examining the link between cocaine binging and individual, social and behavioral factors among street-based cocaine users. Addict Behav 2017; 68:66-72. [PMID: 28103534 DOI: 10.1016/j.addbeh.2017.01.012] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2016] [Revised: 12/22/2016] [Accepted: 01/04/2017] [Indexed: 01/27/2023]
Abstract
AIMS To estimate the prevalence of cocaine binging and examine associated factors, to characterize binge episodes and to study the relationship between cocaine binging and HIV and HCV risk behaviors among street-based cocaine users. METHODS A prospective cohort study was conducted in Montréal, Canada. Interviewer-administered questionnaire were carried out at 3-month intervals. Cocaine binging was defined as using large quantities of cocaine, without stopping, over a limited period of time, until resources run out or until being physically incapable of consuming. Generalized Estimation Equations (GEE) analyses were used. Covariates considered included demographic, behavioral, mental health and social risk factors. FINDINGS In total, 605 participants were recruited. Prevalence of cocaine binging over the month prior to recruitment was 24.5%. Correlates of cocaine binging were older age (AOR 1.46), homelessness (AOR 1.44), criminal/marginal income strategies (AOR 1.61), high psychological distress (AOR 1.31), high cocaine dependence (AOR 3.71), drug overdoses (AOR 1.56) and smoking as the main route of cocaine administration (AOR 1.38). Additional GEE analyses showed that cocaine binging was significantly associated with the sharing of drug paraphernalia (AOR 1.35) and sexual relations under the influence of cocaine (AOR 1.21). CONCLUSION Cocaine binging is frequent among street-based cocaine users and is associated with markers of vulnerability. It is also associated with increased odds of both sexual and drug use risk behaviors. Interventions need to be tailored in order to help cocaine bingers develop personal strategies that could prevent binging. Harm reduction programs should help cocaine bingers adequately assess their drug equipment needs.
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Shrestha R, Karki P, Huedo-Medina TB, Copenhaver M. Intent to Use Preexposure Prophylaxis (PrEP), HIV Risk Behaviors, and Self-Report Neurocognitive Symptoms by High-Risk Drug Users: A Mediation Analysis. J Assoc Nurses AIDS Care 2017; 28:612-621. [PMID: 28478870 DOI: 10.1016/j.jana.2017.04.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2016] [Accepted: 04/07/2017] [Indexed: 11/17/2022]
Abstract
Neurocognitive impairment (NCI) and HIV risk are significant correlates of intent to use preexposure prophylaxis (PrEP). The extent to which similar outcomes could occur when these factors operate together, particularly for people who use drugs (PWUD), remains an important unanswered question. We therefore sought evidence that HIV risk behavior mediated the relationship between NCI and intent to use PrEP in high-risk PWUD in treatment. HIV-uninfected, methadone-maintained people who reported HIV-risk behaviors were enrolled (n = 400). Variables of interest (NCI, HIV risk behaviors, intent to use PrEP) were assessed using audio computer-assisted self-interview. We found preliminary evidence of indirect effect of HIV risk behaviors, such that NCI had an increased impact on intent to use PrEP via HIV risk behaviors. As a result of having this information, clinicians and researchers will be better equipped for evidence-informed targeting and dissemination efforts to optimize PrEP uptake by this underserved population.
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Shehadeh N, Rubens M, Attonito J, Jennings T. Social Support and Its Impact on Ethnic Identity and HIV Risk among Migrant Workers. J Racial Ethn Health Disparities 2017; 5:96-103. [PMID: 28281177 DOI: 10.1007/s40615-017-0347-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2016] [Revised: 01/23/2017] [Accepted: 01/31/2017] [Indexed: 11/26/2022]
Abstract
Migrant workers are disproportionately affected by HIV due to poverty, social isolation, lack of access to and availability of health care services, acculturation, language barriers, constant mobility, and lack of knowledge. This study examined the impact of changes in social support on ethnic identity and HIV risk behaviors among migrant workers in South Florida. For this study, baseline and 6-month follow-up data were collected from an HIV intervention study among migrant workers in South Florida (n = 270) who reported unprotected sex in the past 30 days. The Multigroup Identity Measure was used to assess ethnic identity and the Social Provisions Scale examined the degree to which respondents' social relationships provide various dimensions of social support. Social support was a significant predictor of ethnic identity and of ethnic identity subscales, ethnic identity belonging and ethnic identity explore. There were small but statistically significant short-term changes in ethnic identity and ethnic identity subscales among the migrant workers over the 6-month time period assessed after controlling for the intervention. Future studies should be conducted over a longer period of time to better assess this relationship and possible factors to reduce HIV risk behaviors. There is a need to focus on improving the quality of health and reduce HIV and other risks experienced by this marginalized community.
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Affiliation(s)
- Nancy Shehadeh
- Health Administration Department, College of Business, Florida Atlantic University, 777 Glades Road, Boca Raton, FL, 33431, USA.
| | - Muni Rubens
- Department of Health Promotion and Disease Prevention, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, USA
| | - Jennifer Attonito
- Health Administration Department, College of Business, Florida Atlantic University, 777 Glades Road, Boca Raton, FL, 33431, USA
| | - Terri Jennings
- Social Science and Research Consulting, McKinleyville, CA, USA
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Prendergast ML, McCollister K, Warda U. A randomized study of the use of screening, brief intervention, and referral to treatment (SBIRT) for drug and alcohol use with jail inmates. J Subst Abuse Treat 2017; 74:54-64. [PMID: 28132701 DOI: 10.1016/j.jsat.2016.12.011] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2016] [Revised: 12/14/2016] [Accepted: 12/28/2016] [Indexed: 11/23/2022]
Abstract
BACKGROUND Screening, brief intervention, and referral to treatment (SBIRT) is an evidence-based practice that has been shown to reduce alcohol and drug use in healthcare, educational, and other settings, but research on the effectiveness of SBIRT with populations involved in the criminal justice system is limited. These populations have high rates of substance use but have limited access to interventions. METHODS The study randomized 732 jail inmates from a large urban jail to the SBIRT intervention or to the control group. Using the Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST), the intervention assessed the risk level for drug and alcohol misuse by inmates and provided those who were at low or medium risk with a brief intervention in jail and referred those at high risk to community treatment following release, including the opportunity to participate in a brief treatment (eight sessions) protocol. Using interview and records data from a 12-month follow-up, analyses compared the two groups with respect to the primary study outcomes of reductions in drug and alcohol use and the secondary outcomes of participation in treatment, rearrest, reduction in HIV risk behaviors, and quality of life. In addition, the costs of delivering the SBIRT intervention were calculated. RESULTS When baseline differences were controlled, the groups did not differ at follow-up on any of the primary or secondary outcomes. CONCLUSIONS Future research should develop and evaluate SBIRT models that are specifically adapted to the characteristics and needs of the jail population. Until more favorable results emerge, attempts to use SBIRT with jail inmates should be implemented with caution, if at all. TRIAL REGISTRATION NUMBER NCT01683643.
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Osilla KC, Kennedy DP, Hunter SB, Maksabedian E. Feasibility of a computer-assisted social network motivational interviewing intervention for substance use and HIV risk behaviors for housing first residents. Addict Sci Clin Pract 2016; 11:14. [PMID: 27604543 PMCID: PMC5015231 DOI: 10.1186/s13722-016-0061-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2016] [Accepted: 08/11/2016] [Indexed: 11/17/2022] Open
Abstract
Background Social networks play positive and negative roles in the lives of homeless people influencing their alcohol and/or other drug (AOD) and HIV risk behaviors. Methods We developed a four-session computer-assisted social network motivational interviewing intervention for homeless adults transitioning into housing. We examined the acceptability of the intervention among staff and residents at an organization that provides permanent supportive housing through iterative rounds of beta testing. Staff were 3 men and 3 women who were residential support staff (i.e., case managers and administrators). Residents were 8 men (7 African American, 1 Hispanic) and 3 women (2 African American, 1 Hispanic) who had histories of AOD and HIV risk behaviors. We conducted a focus group with staff who gave input on how to improve the delivery of the intervention to enhance understanding and receptivity among new residents. We conducted semi-structured qualitative interviews and collected self-report satisfaction data from residents. Results Three themes emerged over the course of the resident interviews. Residents reported that the intervention was helpful in discussing their social network, that seeing the visualizations was more impactful than just talking about their network, and that the intervention prompted thoughts about changing their AOD use and HIV risk networks. Conclusions This study is the first of its kind that has developed, with input from Housing First staff and residents, a motivational interviewing intervention that targets both the structure and composition of one’s social network. These results suggest that providing visual network feedback with a guided motivational interviewing discussion is a promising approach to supporting network change. ClinicalTrials.gov Identifier NCT02140359
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Affiliation(s)
- Karen Chan Osilla
- RAND Corporation, 1776 Main Street, PO Box 2138, Santa Monica, CA, 90407-2138, USA.
| | - David P Kennedy
- RAND Corporation, 1776 Main Street, PO Box 2138, Santa Monica, CA, 90407-2138, USA
| | - Sarah B Hunter
- RAND Corporation, 1776 Main Street, PO Box 2138, Santa Monica, CA, 90407-2138, USA
| | - Ervant Maksabedian
- RAND Corporation, 1776 Main Street, PO Box 2138, Santa Monica, CA, 90407-2138, USA
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Martinez O, Arreola S, Wu E, Muñoz-Laboy M, Levine E, Rutledge SE, Hausmann-Stabile C, Icard L, Rhodes SD, Carballo-Diéguez A, Rodríguez-Díaz CE, Fernandez MI, Sandfort T. Syndemic factors associated with adult sexual HIV risk behaviors in a sample of Latino men who have sex with men in New York City. Drug Alcohol Depend 2016; 166:258-62. [PMID: 27449272 PMCID: PMC4983513 DOI: 10.1016/j.drugalcdep.2016.06.033] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2016] [Revised: 06/08/2016] [Accepted: 06/27/2016] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Syndemic theory has been proposed as a framework for understanding the role of multiple risk factors driving the HIV epidemic among sexual and gender minority individuals. As yet, the framework has been relatively absent in research on Latinos/as. METHODS We used logistic regression to assess relationships among cumulative syndemic conditions - including clinically significant depression, high-risk alcohol consumption, discrimination, and childhood sexual abuse - engagement with multiple partners and condomless anal intercourse (CAI) in a sample of 176 Latino men who have sex with men (MSM) in New York City. RESULTS In bivariate analyses, an increase in the number of syndemic factors experienced was associated with an increased likelihood of reporting multiple partners and CAI. In multivariable analyses, participants with 2, 3, and 4 factors were significantly more likely to report multiple partners than those with 0 (aOR=4.66, 95% CI [1.29, 16.85); aOR=7.28, 95% CI [1.94, 27.28] and aOR=8.25, 95% CI [1.74, 39.24] respectively; p<0.05. Regarding CAI, only participants with 3 and 4 factors differed from those with 0 aOR=7.35, 95% CI [1.64, 32.83] and OR=8.06, 95% CI [1.39, 46.73] respectively. CONCLUSIONS Comprehensive approaches that address syndemic factors, and capitalize on resiliency, are needed to address the sexual health needs of Latino MSM.
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Affiliation(s)
- Omar Martinez
- School of Social Work, College of Public Health, Temple University, 1301 Cecil B. Moore Avenue, Ritter Annex, 505, Philadelphia, PA 19122, United States.
| | - Sonya Arreola
- Global Forum on MSM and HIV, 436 14th Street, Suite 100, Oakland, CA 94612, United States.
| | - Elwin Wu
- School of Social Work at Columbia University, 1255 Amsterdam Avenue, New York, NY 10027, United States.
| | - Miguel Muñoz-Laboy
- School of Social Work, College of Public Health, Temple University, 1301 Cecil B. Moore Avenue, Ritter Annex, 551, Philadelphia, PA 19122, United States.
| | - Ethan Levine
- Department College of Liberal Arts at Temple University, Ritter Annex, 505, Philadelphia, PA, 19122
| | - Scott Edward Rutledge
- College of Public Health, Temple University, 1101 W. Montgomery Ave. 3rd Floor, Philadelphia, PA 19122, United States.
| | - Carolina Hausmann-Stabile
- School of Social Work, College of Public Health, Temple University, 1301 Cecil B. Moore Avenue, Ritter Annex, Philadelphia, PA 19122, United States.
| | - Larry Icard
- School of Social Work, College of Public Health, Temple University, Ritter Annex, Philadelphia, PA, United States.
| | - Scott D. Rhodes
- Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, N.C. 27157
| | - Alex Carballo-Diéguez
- HIV Center for Clinical and Behavioral Studies at the New York State Psychiatric Institute and Columbia University, 1051 Riverside Drive, Unit 15, New York, NY 10032, United States.
| | - Carlos E. Rodríguez-Díaz
- University of Puerto Rico - Medical Sciences Campus, School of Public Health, PO Box 365067, San Juan, Puerto Rico 00936-5067
| | - M. Isabel Fernandez
- Department of Public Health at Nova Southeastern University, 2000 South Dixie Highway, Fort Lauderdale, FL, 33133
| | - Theo Sandfort
- Clinical Sociomedical Sciences (in Psychiatry), Columbia University, 1051 Riverside Drive, Unit 15, NY, NY 10032, United States.
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Stein R, Shapatava E, Williams W, Griffin T, Bell K, Lyons B, Uhl G. Reduced Sexual Risk Behaviors Among Young Men of Color Who Have Sex with Men: Findings from the Community-Based Organization Behavioral Outcomes of Many Men, Many Voices (CBOP-3MV) Project. Prev Sci 2015; 16:1147-58. [PMID: 26031542 DOI: 10.1007/s11121-015-0565-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
In 2006, the Centers for Disease Control and Prevention (CDC) funded community-based organizations (CBOs) to deliver Many Men, Many Voices (3MV) to young men of color who have sex with men. Although 3MV, a group-level behavioral intervention designed to reduce human immunodeficiency virus (HIV) risk behaviors of black men who have sex with men (MSM), has shown effectiveness when delivered in a controlled research environment, there is limited evidence that the intervention is associated with similar outcomes in "real world" settings. For the current project, CDC funded three CBOs to conduct outcome monitoring of the 3MV intervention to determine if young MSM of color report changes in HIV risk behaviors postintervention. Using a repeated measures design, risk behaviors were collected at baseline and again at 3 and 6 months postintervention. Changes in risk behaviors were assessed using generalized estimating equations. Participants (n = 337) reported decreases in sexual risk behaviors at both follow-up time points, such as sex without a condom, sex without a condom and multiple partners, and sex without a condom with serodiscordant or status unknown partners. Results suggest that 3MV may be an effective tool for reducing HIV risk behaviors in this critical target population.
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Hahm HC, Augsberger A, Feranil M, Jang J, Tagerman M. The Associations Between Forced Sex and Severe Mental Health, Substance Use, and HIV Risk Behaviors Among Asian American Women. Violence Against Women 2016; 23:671-691. [PMID: 27230614 DOI: 10.1177/1077801216647797] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
We examined the association between forced sex history and mental health, sexual health, and substance use among Asian American women ( n = 720); 14.3% of our sample ( n = 103) reported forced sex experiences. Multiple logistic regression analyses revealed that participants with forced sex histories were 2-8 times more likely to have higher rates of mental health problems, HIV risk behavior, and substance use. Qualitative analysis was used to supplement the quantitative results and give depth to our findings. Our results suggest that interventions for Asian American women who experienced forced sex should integrate mental health, substance use, and sexual health treatments.
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Affiliation(s)
| | | | - Mario Feranil
- 2 Beth Israel Deaconness Medical Center, Boston, MA, USA
| | - Jisun Jang
- 3 Boston Children's Hospital, Boston, MA, USA
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Fang L, Chuang DM, Lee Y. Adverse childhood experiences, gender, and HIV risk behaviors: Results from a population-based sample. Prev Med Rep 2016; 4:113-20. [PMID: 27413671 DOI: 10.1016/j.pmedr.2016.05.019] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2016] [Revised: 05/27/2016] [Accepted: 05/29/2016] [Indexed: 11/23/2022] Open
Abstract
Recent HIV research suggested assessing adverse childhood experiences (ACEs) as contributing factors of HIV risk behaviors. However, studies often focused on a single type of adverse experience and very few utilized population-based data. This population study examined the associations between ACE (individual and cumulative ACE score) and HIV risk behaviors. We analyzed the 2012 Behavioral Risk Factor Surveillance Survey (BRFSS) from 5 states. The sample consisted of 39,434 adults. Eight types of ACEs that included different types of child abuse and household dysfunctions before the age of 18 were measured. A cumulative score of ACEs was also computed. Logistic regression estimated of the association between ACEs and HIV risk behaviors using odds ratio (OR) with 95% confidence intervals (CIs) for males and females separately. We found that ACEs were positively associated with HIV risk behaviors overall, but the associations differed between males and females in a few instances. While the cumulative ACE score was associated with HIV risk behaviors in a stepwise manner, the pattern varied by gender. For males, the odds of HIV risk increased at a significant level as long as they experienced one ACE, whereas for females, the odds did not increase until they experienced three or more ACEs. Future research should further investigate the gender-specific associations between ACEs and HIV risk behaviors. As childhood adversities are prevalent among general population, and such experiences are associated with increased risk behaviors for HIV transmission, service providers can benefit from the principles of trauma-informed practice.
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Bradley J, Rajaram SP, Isac S, Gurav K, Ramesh BM, Gowda C, Moses S, Alary M. Pornography, Sexual Enhancement Products, and Sexual Risk of Female Sex Workers and their Clients in Southern India. Arch Sex Behav 2016; 45:945-954. [PMID: 25905909 DOI: 10.1007/s10508-015-0486-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/05/2013] [Revised: 01/13/2015] [Accepted: 01/16/2015] [Indexed: 06/04/2023]
Abstract
Despite their large numbers, and important role in the HIV epidemic in India, male clients of female sex workers (FSWs) are a difficult to reach population and little is known about their sexual behaviors. Using data from an integrated behavioral and biological assessment of 684 clients in Bangalore in 2012, we examined factors associated with their reports of having sex with three or more different female sex workers in the last month, and anal sex with sex workers. We included sociodemographic and sexual behavior factors and, for the first time in client studies in India, included data on the use of pornography and sexual enhancement products (SEPs) such as pills, oils, and sprays, in our multivariable analyses of client risk. Seventy-eight percent of clients had seen pornographic material and 8% reported ever having used SEPs. The profiles of men practicing the two risk behaviors examined were quite different. Travel in the past year, drunkenness in the past month, young age at first commercial sex, non-use of condoms at last sex, and finding sex workers in public places (but not use of pornography and SEPs) were independently associated with multiple partnering. Sex with a man or transsexual, being a white collar worker, seeking out FSWs at home, pornography and SEP use, and condom use at last FSW sex, were all independently associated with anal sex with an FSW. More research is needed to better understand the links between pornography and SEPs, and HIV risk behaviors, and HIV prevention programs need to be cognizant of the importance of ensuring that condom use is adequately promoted and supported in the context of anal sex in female sex worker-client interactions.
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Affiliation(s)
- Janet Bradley
- Population Health and Optimal Health Practices Research Unit, Centre de recherche du CHU de Québec, Hôpital du Saint-Sacrement, Quebec City, PQ, Canada.
- Centre for Global Public Health, Faculty of Medicine, University of Manitoba, 771 McDermot Avenue, Medical Rehabilitation Building, Room R070, Winnipeg, MB, R3E 0T6, Canada.
| | - Subramanian Potty Rajaram
- Population Health and Optimal Health Practices Research Unit, Centre de recherche du CHU de Québec, Hôpital du Saint-Sacrement, Quebec City, PQ, Canada
- CHARME-India Project, Bangalore, India
- India KHPT Office, Bangalore, India
| | | | | | | | | | - Stephen Moses
- Centre for Global Public Health, Faculty of Medicine, University of Manitoba, 771 McDermot Avenue, Medical Rehabilitation Building, Room R070, Winnipeg, MB, R3E 0T6, Canada
| | - Michel Alary
- Population Health and Optimal Health Practices Research Unit, Centre de recherche du CHU de Québec, Hôpital du Saint-Sacrement, Quebec City, PQ, Canada
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Shrestha R, Karki P, Pandey S, Copenhaver M. Adapting an Evidence-Based HIV Prevention Intervention Targeting High-Risk Migrant Workers: The Process and Outcome of Formative Research. Front Public Health 2016; 4:61. [PMID: 27066474 PMCID: PMC4815003 DOI: 10.3389/fpubh.2016.00061] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2015] [Accepted: 03/21/2016] [Indexed: 11/16/2022] Open
Abstract
Background Historically, HIV prevention efforts in Nepal have primarily focused on heterosexual transmission, particularly, among female sex workers and their male clients, with little acknowledgment of the contribution of migrant workers to the epidemic. The very few HIV prevention efforts that have been attempted with migrants have been unsuccessful primarily due to stigma, discrimination, and insufficient availability of culturally relevant evidence-based interventions (EBIs). As an initial step toward addressing this unmet need, we conducted formative research aimed at adapting an evidence-based HIV risk-reduction intervention for implementation among migrants in Nepal. Methods Our formative work involved a critical examination of established EBIs and associated published reports complemented by data elicited through structured interviews with members of the target population and key stakeholders. Between July and August, 2014, we conducted structured one-on-one interview with migrants (n = 5) and key stakeholder (e.g., counselors, field workers, and project coordinator; n = 5), which focused on the HIV risk profiles of the migrants and on ways to optimize intervention content, delivery, and placement within the community-based settings. Data analysis followed a thematic analysis approach utilizing several qualitative data analysis techniques, including inductive analysis, cross-case analysis, and analytical coding of textual data. Results Based on formative research, we adapted the Holistic Health Recovery Program, an EBI, to consist of four 30-min sessions that cover a range of topics relevant to migrants in Nepal. The intervention was adapted with flexibility, so that it could be provided in an individual format, implemented within or outside the community-based organization, and it can be delivered in either consecutive or weekly sessions based on time constraints. Conclusion This paper provides a detailed description of the formative research process in preparation for the adaptation of an EBI – taking into account both empirical evidence and input from target population and key stakeholders – for use with migrants in Nepal. We hope that this study will help to inform similar work in the future as a growing number of EBIs have become widely available, but may not yet be in optimal form for implementation in real-world community-based settings.
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Affiliation(s)
- Roman Shrestha
- Department of Community Medicine and Health Care, University of Connecticut Health Center, Farmington, CT, USA; Institute for Collaboration on Health, Intervention, and Policy, Storrs, CT, USA; HIV Prevention Project, Aasaman Nepal, Lalitpur, Nepal
| | - Pramila Karki
- Institute for Collaboration on Health, Intervention, and Policy, Storrs, CT, USA; Department of Allied Health Sciences, University of Connecticut, Farmington, CT, USA
| | - Santosh Pandey
- HIV Prevention Project, Aasaman Nepal , Lalitpur , Nepal
| | - Michael Copenhaver
- Institute for Collaboration on Health, Intervention, and Policy, Storrs, CT, USA; Department of Allied Health Sciences, University of Connecticut, Farmington, CT, USA
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Kennedy DP, Hunter SB, Chan Osilla K, Maksabedian E, Golinelli D, Tucker JS. A computer-assisted motivational social network intervention to reduce alcohol, drug and HIV risk behaviors among Housing First residents. Addict Sci Clin Pract 2016; 11:4. [PMID: 26979982 PMCID: PMC4791809 DOI: 10.1186/s13722-016-0052-y] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2015] [Accepted: 03/01/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Individuals transitioning from homelessness to housing face challenges to reducing alcohol, drug and HIV risk behaviors. To aid in this transition, this study developed and will test a computer-assisted intervention that delivers personalized social network feedback by an intervention facilitator trained in motivational interviewing (MI). The intervention goal is to enhance motivation to reduce high risk alcohol and other drug (AOD) use and reduce HIV risk behaviors. METHODS/DESIGN In this Stage 1b pilot trial, 60 individuals that are transitioning from homelessness to housing will be randomly assigned to the intervention or control condition. The intervention condition consists of four biweekly social network sessions conducted using MI. AOD use and HIV risk behaviors will be monitored prior to and immediately following the intervention and compared to control participants' behaviors to explore whether the intervention was associated with any systematic changes in AOD use or HIV risk behaviors. DISCUSSION Social network health interventions are an innovative approach for reducing future AOD use and HIV risk problems, but little is known about their feasibility, acceptability, and efficacy. The current study develops and pilot-tests a computer-assisted intervention that incorporates social network visualizations and MI techniques to reduce high risk AOD use and HIV behaviors among the formerly homeless. CLINICALTRIALS. GOV IDENTIFIER NCT02140359.
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Affiliation(s)
| | - Sarah B Hunter
- RAND, 1776 Main Street, Santa Monica, CA, 90407-2138, USA
| | | | | | | | - Joan S Tucker
- RAND, 1776 Main Street, Santa Monica, CA, 90407-2138, USA
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50
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Shrestha R, Copenhaver M. The Influence of Neurocognitive Impairment on HIV Risk Behaviors and Intervention Outcomes among High-Risk Substance Users: A Systematic Review. Front Public Health 2016; 4:16. [PMID: 26904535 PMCID: PMC4746254 DOI: 10.3389/fpubh.2016.00016] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2015] [Accepted: 01/28/2016] [Indexed: 11/18/2022] Open
Abstract
Neurocognitive impairment (NCI) among high-risk substance users poses a substantial barrier to reducing risk behaviors in this population. Previous work suggests that NCI is intertwined in a close, reciprocal relationship with risk behaviors. Not only does substance use worsen cognitive impairment but cognitive impairment may also reduce the efficacy of interventions aimed at reducing risk and improving medication adherence. In this systematic review, we examine the potential impact of substance abuse and cognitive functioning in the context of HIV risk behaviors and risk-reduction intervention outcomes. The findings thus far suggest that, in order to be effective, risk-reduction interventions must take into account the impact of NCI on learning, memory, and behavior.
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Affiliation(s)
- Roman Shrestha
- Department of Community Medicine and Health Care, University of Connecticut Health Center, Farmington, CT, USA; Center for Health, Intervention, and Prevention, University of Connecticut, Storrs, CT, USA
| | - Michael Copenhaver
- Department of Allied Health Sciences, University of Connecticut , Storrs, CT , USA
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