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  1. A Social Ecological Model of Syndemic Risk affecting Women with and At-Risk for HIV in Impoverished Urban Communities.

    PubMed

    Batchelder, A W; Gonzalez, J S; Palma, A; Schoenbaum, E; Lounsbury, D W

    2015-12-01

    Syndemic risk is an ecological construct, defined by co-occurring interdependent socio-environmental, interpersonal and intrapersonal determinants. We posited syndemic risk to be a function of violence, substance use, perceived financial hardship, emotional distress and self-worth among women with and at-risk for HIV in an impoverished urban community. In order to better understand these interrelationships, we developed and validated a system dynamics (SD) model based upon peer-reviewed literature; secondary data analyses of a cohort dataset including women living with and at-risk of HIV in Bronx, NY (N = 620); and input from a Bronx-based community advisory board. Simulated model output revealed divergent levels and patterns of syndemic risk over time across different sample profiles. Outputs generated new insights about how to effectively explore multicomponent multi-level programs in order to strategically develop more effective services for this population. Specifically, the model indicated that effective multi-level interventions might bolster women's resilience by increasing self-worth, which may result in decreased perceived financial hardship and risk of violence. Overall, our stakeholder-informed model depicts how self-worth may be a major driver of vulnerability and a meaningful addition to syndemic theory affecting this population. PMID:26370203

  2. Does participation in an HIV vaccine efficacy trial affect risk behaviour in South Africa?

    PubMed Central

    Gray, GE; Metch, B; Churchyard, G; Mlisana, K; Nchabeleng, M; Allen, M; Moodie, Z; Kublin, J; Bekker, L-G

    2014-01-01

    Background Increased sexual risk behaviour in participants enrolled in HIV prevention trials has been a concern. The HVTN 503/Phambili study, a phase 2B study of the Merck Ad-5 multiclade HIV vaccine in South Africa, suspended enrollment and vaccinations following the results of the Step study. Participants were notified of their treatment allocation and continue to be followed. We investigated changes in risk behaviour over time and assessed the impact of study unblinding. Methods 801 participants were enrolled. Risk behaviors were assessed with an interviewer-administered questionnaire at 6-month intervals. We assessed change from enrolment to the first 6-month assessment pre-unblinding and between enrolment and at least 6 months post-unblinding on all participants with comparable data. A one-time unblinding risk perception questionnaire was administered post-unblinding. Results A decrease in participants reporting unprotected sex was observed in both measured time periods for men and women, with no differences by treatment arm. At 6 months (pre-unblinding), 29.6% of men and 35.8% of women reported changing from unprotected to protected sex (p <0.0001 for each).Men (22%) were more likely than women (14%) to report behavior change after unblinding (p=0.009). Post-enrolment, 142 (45%) of 313 previously uncircumcised men underwent medical circumcision. 663 participants completed the unblinding questionnaire. More vaccine (24.6%) as compared to placebo recipients (12.0%) agreed that they were more likely to get HIV than most people (p<0.0001), and attributed this to receiving the vaccine. Conclusion We did not find evidence of risk compensation during this clinical trial. Some risk behaviour reductions including male circumcision were noted irrespective of treatment allocation. PMID:23370155

  3. Risk and protective factors for depression symptoms among children affected by HIV/AIDS in rural China: a structural equation modeling analysis.

    PubMed

    Wang, Bo; Li, Xiaoming; Barnett, Douglas; Zhao, Guoxiang; Zhao, Junfeng; Stanton, Bonita

    2012-05-01

    Previous research has revealed a negative impact of orphanhood and HIV-related stigma on the psychological well-being of children affected by HIV/AIDS. Little is known about psychological protective factors that can mitigate the effect of orphanhood and HIV-related stigma on psychological well-being. This research examines the relationships among several risk and protective factors for depression symptoms using structural equation modeling. Cross-sectional data were collected from 755 AIDS orphans and 466 children of HIV-positive parents aged 6-18 years in 2006-2007 in rural central China. Participants reported their experiences of traumatic events, perceived HIV-related stigma, perceived social support, future orientation, trusting relationships with current caregivers, and depression symptoms. We found that the experience of traumatic events and HIV-related stigma had a direct contributory effect on depression among children affected by HIV/AIDS. Trusting relationships together with future orientation and perceived social support mediated the effects of traumatic events and HIV-related stigma on depression. The final model demonstrated a dynamic interplay among future orientation, perceived social support and trusting relationships. Trusting relationships was the most proximate protective factor for depression. Perceived social support and future orientation were positively related to trusting relationships. We conclude that perceived social support, trusting relationships, and future orientation offer multiple levels of protection that can mitigate the effect of traumatic events and HIV-related stigma on depression. Trusting relationships with caregivers provides the most immediate source of psychological support. Future prevention interventions seeking to improve psychological well-being among children affected by HIV/AIDS should attend to these factors. PMID:22405505

  4. Risk and Protective Factors for Depression Symptoms among Children Affected by HIV/AIDS in Rural China: A Structural Equation Modeling Analysis

    PubMed Central

    Wang, Bo; Li, Xiaoming; Barnett, Douglas; Zhao, Guoxiang; Zhao, Junfeng; Stanton, Bonita

    2012-01-01

    Previous research has revealed a negative impact of orphanhood and HIV-related stigma on the psychological well-being of children affected by HIV/AIDS. Little is known about psychological protective factors that can mitigate the effect of orphanhood and HIV-related stigma on psychological well-being. This research examines the relationships among several risk and protective factors for depression symptoms using structural equation modeling. Cross-sectional data were collected from 755 AIDS orphans and 466 children of HIV-positive parents aged 6–18 years in 2006–2007 in rural central China. Participants reported their experiences of traumatic events, perceived HIV-related stigma, perceived social support, future orientation, trusting relationships with current caregivers, and depression symptoms. We found that the experience of traumatic events and HIV-related stigma had a direct contributory effect on depression among children affected by HIV/AIDS. Trusting relationships together with future orientation and perceived social support mediated the effects of traumatic events and HIV-related stigma on depression. The final model demonstrated a dynamic interplay among future orientation, perceived social support and trusting relationships. Trusting relationships was the most proximate protective factor for depression. Perceived social support and future orientation were positively related to trusting relationships. We conclude that perceived social support, trusting relationships, and future orientation offer multiple levels of protection that can mitigate the effect of traumatic events and HIV-related stigma on depression. Trusting relationships with caregivers provides the most immediate source of psychological support. Future prevention interventions seeking to improve psychological well-being among children affected by HIV/AIDS should attend to these factors. PMID:22405505

  5. Reduce HIV Risk

    MedlinePlus

    ... incidence could be reduced if people changed their sexual behaviors. Our research has demonstrated remarkable success in reducing HIV risk-associated sexual behaviors among African American adolescents and adults." Spring 2008 ...

  6. Factors Affecting Glomerular Filtration Rate, as Measured by Iohexol Disappearance, in Men with or at Risk for HIV Infection

    PubMed Central

    Margolick, Joseph B.; Jacobson, Lisa P.; Schwartz, George J.; Abraham, Alison G.; Darilay, Annie T.; Kingsley, Lawrence A.; Witt, Mallory D.; Palella, Frank J.

    2014-01-01

    Objective Formulae used to estimate glomerular filtration rate (GFR) underestimate higher GFRs and have not been well-studied in HIV-infected (HIV(+)) people; we evaluated the relationships of HIV infection and known or potential risk factors for kidney disease with directly measured GFR and the presence of chronic kidney disease (CKD). Design Cross-sectional measurement of iohexol-based GFR (iGFR) in HIV(+) men (n = 455) receiving antiretroviral therapy, and HIV-uninfected (HIV(−)) men (n = 258) in the Multicenter AIDS Cohort Study. Methods iGFR was calculated from disappearance of infused iohexol from plasma. Determinants of GFR and the presence of CKD were compared using iGFR and GFR estimated by the CKD-Epi equation (eGFR). Results Median iGFR was higher among HIV(+) than HIV(−) men (109 vs. 106 ml/min/1.73 m2, respectively, p = .046), and was 7 ml/min higher than median eGFR. Mean iGFR was lower in men who were older, had chronic hepatitis C virus (HCV) infection, or had a history of AIDS. Low iGFR (≤90 ml/min/1.73 m2) was associated with these factors and with black race. Other than age, factors associated with low iGFR were not observed with low eGFR. CKD was more common in HIV(+) than HIV(−) men; predictors of CKD were similar using iGFR and eGFR. Conclusions iGFR was higher than eGFR in this population of HIV-infected and -uninfected men who have sex with men. Presence of CKD was predicted equally well by iGFR and eGFR, but associations of chronic HCV infection and history of clinically-defined AIDS with mildly decreased GFR were seen only with iGFR. PMID:24516530

  7. Affective differences in Iowa Gambling Task performance associated with sexual risk taking and substance use among HIV-positive and HIV-negative men who have sex with men

    PubMed Central

    Golub, Sarit A.; Thompson, Louisa I.; Kowalczyk, William J.

    2016-01-01

    We investigated the relationship between emotional distress and decision-making in sexual risk and substance use behavior among 174 (ages 25 to 50, 53% black) men who have sex with men (MSM), a population at increased risk for HIV. The sample was stratified by HIV status. Measures of affective decision-making (Iowa Gambling Task, IGT, Bechara et al., 1994), depression, anxiety, sex acts, and substance use during the past 60 days were collected at our research center. Negative binomial regression models were used to examine the relationship between age, HIV status, anxiety, depression, and IGT performance in the prediction of number of risky sex acts and substance use days. Among those without anxiety or depression, both number of risky sex acts and drug use days decreased with better performance during risky trials (i.e., last two blocks) of the IGT. For those with higher rates of anxiety, but not depression, IGT risk trial performance and risky sex acts increased concomitantly. Anxiety also interacted with IGT performance across all trials to predict substance use, such that anxiety was associated with greater substance use among those with better IGT performance. The opposite was true for those with depression, but only during risk trials. HIV-positive participants reported fewer substance use days than HIV-negative participants, but there was no difference in association between behavior and IGT performance by HIV status. Our findings suggest that anxiety may exacerbate risk-taking behavior when affective decision-making ability is intact. The relationship between affective decision-making and risk taking may be sensitive to different profiles of emotional distress, as well as behavioral context. Investigations of affective decision-making in sexual risk taking and substance use should examine different distress profiles separately, with implications for HIV prevention efforts. PMID:26745769

  8. Pathways That Affect Wives' HIV Risk Among Serodiscordant Couples in India: Results From the Positive Jeevan Saathi Study.

    PubMed

    Patel, Shilpa N; Hennink, Monique M; Hynes, Michelle E; Yount, Kathryn M; Kosambiya, Jayesh K; Wingood, Gina M; Sutton-Brown-Fox, Camille; McCarty, Frances; Windle, Michael

    2016-09-01

    This study examined factors that mitigate or heighten HIV risk among HIV-negative wives in serodiscordant relationships in Gujarat, India. Grounded theory was used to analyze 46 interviews (23 couples) where husbands were HIV-positive and wives were HIV-negative. A conceptual framework emerged from analysis from which we identified five pathways and four key behaviors: (a) safer sex, (b) no sex, (c) coercive sex, and (d) unprotected sex. Most couples either practiced safe sex or abstained from sex. Factors such as wives' assertiveness, a wife's fear of acquiring HIV, mutual understanding, positive sex communication, and a husband's desire to protect wife influenced safe sex/sexual abstinence. Factors such as desire for children, a husband's alcohol use, and intimate partner violence influenced coercive and unprotected sex. Counseling topics on sex communication, verbal and non-verbal safer sex strategies, as well as addressing intimate partner violence and alcohol use may be important in preventing risk to HIV-negative wives. PMID:26848084

  9. Neural correlates of HIV risk feelings.

    PubMed

    Häcker, Frank E K; Schmälzle, Ralf; Renner, Britta; Schupp, Harald T

    2015-04-01

    Field studies on HIV risk perception suggest that people rely on impressions they have about the safety of their partner. The present fMRI study investigated the neural correlates of the intuitive perception of risk. First, during an implicit condition, participants viewed a series of unacquainted persons and performed a task unrelated to HIV risk. In the following explicit condition, participants evaluated the HIV risk for each presented person. Contrasting responses for high and low HIV risk revealed that risky stimuli evoked enhanced activity in the anterior insula and medial prefrontal regions, which are involved in salience processing and frequently activated by threatening and negative affect-related stimuli. Importantly, neural regions responding to explicit HIV risk judgments were also enhanced in the implicit condition, suggesting a neural mechanism for intuitive impressions of riskiness. Overall, these findings suggest the saliency network as neural correlate for the intuitive sensing of risk. PMID:24982263

  10. Neural correlates of HIV risk feelings

    PubMed Central

    Schmälzle, Ralf; Renner, Britta; Schupp, Harald T.

    2015-01-01

    Field studies on HIV risk perception suggest that people rely on impressions they have about the safety of their partner. The present fMRI study investigated the neural correlates of the intuitive perception of risk. First, during an implicit condition, participants viewed a series of unacquainted persons and performed a task unrelated to HIV risk. In the following explicit condition, participants evaluated the HIV risk for each presented person. Contrasting responses for high and low HIV risk revealed that risky stimuli evoked enhanced activity in the anterior insula and medial prefrontal regions, which are involved in salience processing and frequently activated by threatening and negative affect-related stimuli. Importantly, neural regions responding to explicit HIV risk judgments were also enhanced in the implicit condition, suggesting a neural mechanism for intuitive impressions of riskiness. Overall, these findings suggest the saliency network as neural correlate for the intuitive sensing of risk. PMID:24982263

  11. Comparisons of HIV-Affected and Non-HIV-Affected Families Over Time

    PubMed Central

    Rotheram-Borus, Mary Jane; Rice, Eric; Comulada, W. Scott; Best, Karin; Li, Li

    2012-01-01

    This study compares HIV-affected families and their non-HIV-affected neighbors’ behavioral health outcomes and family conflict. To compare two groups from the same neighborhoods at four points over 18 months, mothers with HIV (MLH) (N=167) and their school-age children (age 6 to 20) were recruited from clinical care settings in Los Angeles, CA and neighborhood control mothers (NCM) without HIV (N=204) were recruited from modal neighborhoods. In addition, children living at home who were 12 years and older were recruited. We assessed parenting behaviors, family conflict, mental health, sexual behavior, substance use, and HIV-related health behaviors over time. MLH perceived greater economic insecurity at baseline, less employment, and involvement in romantic relationships. MLH reported more emotional distress and substance use than NCM. MLH, however, reported lowered HIV transmission risk. The random regressions indicated that MLH exhibited higher levels and became significantly less depressed and less anxious over time than their non-HIV-affected neighbors. MLH also reported less initial family violence and conflict reasoning than NCM; violence decreased and conflict increased over time for MLH relative to NCM. Children of MLH decreased their marijuana use but hard drug users of MLH increased their risk, over time, compared to children of NCM. Moreover, children of MLH reported more internalizing behaviors than children of NCM. Even when compared to other families living in the same economically disadvantaged communities, MLH and their children continue to face challenges surrounding family conflict, and key behavioral health outcomes, especially with respect to substance use and mental health outcomes. These families, however, show much resilience and MLH report lowered levels of HIV transmission risk, their children report no greater levels of HIV transmission risk and levels of family violence were lower than reported by families in the same neighborhoods

  12. HIV Infection Seems to Affect Nervous System

    MedlinePlus

    ... fullstory_159344.html HIV Infection Seems to Affect Nervous System But symptoms tend to subside once antiretroviral drugs ... mild, it is clear that HIV affects the nervous system within days of infection," she said in a ...

  13. A Small Dose of HIV? HIV Vaccine Mental Models and Risk Communication

    ERIC Educational Resources Information Center

    Newman, Peter A.; Seiden, Danielle S.; Roberts, Kathleen J.; Kakinami, Lisa; Duan, Naihua

    2009-01-01

    Existing knowledge and beliefs related to HIV vaccines provide an important basis for the development of risk communication messages to support future HIV vaccine dissemination. This study explored HIV vaccine mental models among adults from segments of the population disproportionately affected by HIV/AIDS. Nine focus groups were conducted with…

  14. Management of diarrhea in HIV-affected infants and children

    PubMed Central

    Pavlinac, Patricia B.; Tickell, Kirkby D; Walson, Judd L

    2015-01-01

    Globally, diarrhea is the second leading cause of death in children less than 5 years of age. HIV-infected and HIV-exposed uninfected (HEU) children are at high risk of dying from diarrhea and may be more susceptible to the highest risk enteric pathogens. This increased risk associated with HIV infection and HIV exposure is likely multifactorial. Factors such as immunosuppression, proximity to individuals more likely to be shedding pathogens, and exposure to antimicrobial prophylaxis may alter the risk profile in these children. Current international guidelines do not differentiate management strategies on the basis of whether children are infected or affected by HIV, despite likely differences in etiologies and consequences. Reducing diarrhea mortality in high HIV prevalence settings will require strengthening of HIV testing and treatment programs; improvements in water, sanitation and hygiene interventions targeted at HIV-affected households; and reconsideration of the use of empiric antimicrobial treatment of pathogens known to infect HIV-infected and HEU children disproportionately. PMID:25384353

  15. [Risk of contracting HIV].

    PubMed

    Becerra, Valeria Peixoto; Gaspar, Maria Filomena M; Alves, Maria Do Socorro C F

    2009-04-01

    The authors identify social activities related to the risk of contracting HIV in nursing students, bearing in mind their influence while using bio-secure methods, by means of an exploratory and qualitative study; 168 Superior School of Nursing in Lisbon, Portugal students participated in this study. Data were gathered by means of a Free Association Word Test which includes social demographic variables related to the participants. 90% of the 168 students in this study were female and 10% male. The majority 79,2%, of the participants age fell between 21 and 25 years and 97,6% of these participants were Portuguese. In the free association word test when responding to the stimulus HIV/AIDS, participants expressed disease (which is contagious in a clinical setting), and death as the awaited outcome for it. For the test term "risk of contagion when dealing with an AIDS patient" the participants often mentioned the words protection against contagion, as well as fear to contact blood and gloves as the main prevention method. To the stimulus measures of bio-security the words most frequently cited were glove as a protective measure in the context of professional activity and preservative (condom) to avoid contagion in other social contexts experienced by the participants. PMID:19554898

  16. Contextual factors influencing HIV risk behavior in Central Asia

    PubMed Central

    Smolak, Alex

    2010-01-01

    Central Asia has experienced a rapid increase in HIV. HIV interventions and prevention programmes are needed that adequately appreciate and account for the ways that ongoing cultural, political, and economic changes in this region affect HIV risk reduction efforts. Drawing on relevant literature, this paper provides a contextual foundation to better understand the impact of context on HIV risk behaviour in the countries of Central Asia and to begin the conversation on the contextual factors of Islam and polygamy. PMID:20301020

  17. Risk Factors for HIV Transmission and Barriers to HIV Disclosure: Metropolitan Atlanta Youth Perspectives.

    PubMed

    Camacho-Gonzalez, Andres F; Wallins, Amy; Toledo, Lauren; Murray, Ashley; Gaul, Zaneta; Sutton, Madeline Y; Gillespie, Scott; Leong, Traci; Graves, Chanda; Chakraborty, Rana

    2016-01-01

    Youth carry the highest incidence of HIV infection in the United States. Understanding adolescent and young adult (AYA) perspectives on HIV transmission risk is important for targeted HIV prevention. We conducted a mixed methods study with HIV-infected and uninfected youth, ages 18-24 years, from Atlanta, GA. We provided self-administered surveys to HIV-infected and HIV-uninfected AYAs to identify risk factors for HIV acquisition. By means of computer-assisted thematic analyses, we examined transcribed focus group responses on HIV education, contributors to HIV transmission, and pre-sex HIV status disclosure. The 68 participants had the following characteristics: mean age 21.5 years (standard deviation: 1.8 years), 85% male, 90% black, 68% HIV-infected. HIV risk behaviors included the perception of condomless sex (Likert scale mean: 8.0) and transactional sex (88% of participants); no differences were noted by HIV status. Qualitative analyses revealed two main themes: (1) HIV risk factors among AYAs, and (2) barriers to discussing HIV status before sex. Participants felt the use of social media, need for immediate gratification, and lack of concern about HIV disease were risk factors for AYAs. Discussing HIV status with sex partners was uncommon. Key reasons included: fear of rejection, lack of confidentiality, discussion was unnecessary in temporary relationships, and disclosure negatively affecting the mood. HIV prevention strategies for AYAs should include improving condom use frequency and HIV disclosure skills, responsible utilization of social media, and education addressing HIV prevention including the risks of transactional sex. PMID:26588663

  18. Should the threat of HIV affect breastfeeding?

    PubMed

    Finger, W R

    1992-10-01

    About 33% of infants born to HIV positive women acquire HIV. Since breast milk has disease-protecting antibodies and diluting infant formula with unsafe water poses sizable health hazards, it is difficult for countries to set sound policy on breast feeding and for health workers to counsel HIV infected mothers and those at high risk of HIV infection. In 1985, US and UK public health officials advised HIV infected mothers to bottle feed. They eventually amended their position by claiming the guidelines only applied to the US and the UK where safe water is exists. WHO recommends that the only HIV infected women who should use a breast milk substitute are those in countries where infectious diseases are not the leading causes of infant death or those in countries with widespread malnutrition and infectious diseases which do cause infant death, but whose conditions would allow an appropriate alternative. In Rwanda, a study on HIV transmission via breast milk shows infants seroconvert during the same month as do the mothers. So the researchers advise mothers at high risk for seroconversion to not breast feed; yet all women in Rwanda are at high risk. In Haiti, where all women are also at such risk and have no breast milk substitutes, the HIV transmission rate among breast fed infants is 25%, equalling that of non breast fed infants in the US and Europe. A European and Australian study also reveals a higher risk of HIV transmission via breast milk in mothers who acquired HIV postpartum than in those who acquired it prenatally. Some research shows that 24% of the colostrum of HIV infected mothers has P24 antigen, while there is no P24 antigen in 4-day postpartum breast milk. Policymakers should develop an algorithm for health providers to use to advise mothers about the relative benefits and risks of breast feeding concerning HIV transmission. PMID:12286077

  19. Reduce HIV Risk

    MedlinePlus

    ... are increasing among younger people from 13 to 30 years of age. The key to defeating HIV lies ... Control and Prevention (CDC) has used them as models, and Dr. Jemmott was invited to South Africa to help decrease HIV/AIDS there. "For the past 15 years, I have observed how the HIV/AIDS epidemic ...

  20. Understanding HIV Transmission Risk Behavior Among HIV-Infected South Africans Receiving Antiretroviral Therapy: An Information—Motivation—Behavioral Skills Model Analysis

    PubMed Central

    Kiene, Susan M.; Fisher, William A.; Shuper, Paul A.; Cornman, Deborah H.; Christie, Sarah; MacDonald, Susan; Pillay, Sandy; Mahlase, Gethwana; Fisher, Jeffrey D.

    2014-01-01

    The current study applied the Information—Motivation—Behavioral Skills (IMB) model (J. D. Fisher & Fisher, 1992; W. A. Fisher & Fisher, 1993) to identify factors associated with HIV transmission risk behavior among HIV-infected South Africans receiving antiretroviral therapy (ART), a population of considerable significance for curtailing, or maintaining, South Africa’s generalized HIV epidemic. HIV prevention information, HIV prevention motivation, HIV prevention behavioral skills, and HIV transmission risk behavior were assessed in a sample of 1,388 South Africans infected with HIV and receiving ART in 16 clinics in KwaZulu-Natal, South Africa. Results confirmed the assumptions of the IMB model and demonstrated that HIV prevention information and HIV prevention motivation work through HIV prevention behavioral skills to affect HIV transmission risk behavior in this population. Subanalyses confirmed these relationships for HIV transmission risk behavior overall and for HIV transmission risk behavior with partners perceived to be HIV-negative or HIV-status unknown. A consistent pattern of gender differences showed that for men, HIV prevention information and HIV prevention motivation may have direct links with HIV preventive behavior, while for women, the effects of HIV prevention information and HIV prevention motivation work through HIV prevention behavioral skills to affect HIV preventive behavior. These IMB model-based findings suggest directions for HIV prevention interventions with South African men and women living with HIV and on ART as an important component of overall strategies to contain South Africa’s generalized HIV epidemic. PMID:23477576

  1. Factors are not the same for risk of stopping exclusive breast-feeding and introducing different types of liquids and solids in HIV-affected communities in Ghana.

    PubMed

    Marquis, Grace S; Lartey, Anna; Perez-Escamilla, Rafael; Mazur, Robert E; Brakohiapa, Lucy; Birks, Katherine A

    2016-07-01

    Exclusive breast-feeding (EBF) for 6 months supports optimal infant growth, health and development. This paper examined whether maternal HIV status was associated with EBF and other infant feeding practices. Pregnant women were enrolled after HIV counselling, and their babies were followed up for up to 1 year. Data on household socio-economics and demographics, maternal characteristics and infants' daily diet were available for 482 infants and their mothers (150 HIV-positive (HIV-P), 170 HIV-negative (HIV-N) and 162 HIV-unknown (HIV-U)). Survival analyses estimated median EBF duration and time to introduction of liquids and foods; hazards ratios (HR) used data from 1-365 and 1-183 d, adjusting for covariates. Logistic regression estimated the probability of EBF for 6 months. Being HIV-P was associated with a shorter EBF duration (139 d) compared with HIV-N (163 d) and HIV-U (165 d) (P=0·004). Compared with HIV-N, being HIV-P was associated with about a 40 % higher risk of stopping EBF at any time point (HR 1·39; 95 % CI 1·06, 1·84; P=0·018) and less than half as likely to complete 6 months of EBF (adjusted OR 0·42; 95 % CI 0·22, 0·81; P=0·01). Being HIV-P tended to be or was associated with a higher risk of introducing non-milk liquids (HR 1·34; 95 % CI 0·98, 1·83; P=0·068), animal milks (HR 2·37; 95 % CI 1·32, 4·24; P=0·004) and solids (HR 1·56; 95 % CI 1·10, 2·22; P=0·011) during the first 6 months. Weight-for-age Z-score was associated with EBF and introducing formula. Different factors (ethnicity, food insecurity, HIV testing strategy) were associated with the various feeding behaviours, suggesting that diverse interventions are needed to promote optimal infant feeding. PMID:27149980

  2. HIV testing, risk perception, and behaviour in the British population

    PubMed Central

    Clifton, Soazig; Nardone, Anthony; Field, Nigel; Mercer, Catherine H.; Tanton, Clare; Macdowall, Wendy; Johnson, Anne M.; Sonnenberg, Pam

    2016-01-01

    Objective: To examine the relationship between HIV risk behaviour, risk perception and testing in Britain. Design: A probability sample survey of the British population. Methods: We analyzed data on sexual behaviour, self-perceived HIV risk and HIV testing (excluding testing because of blood donation) from 13 751 sexually experienced men and women aged 16–74, interviewed between 2010 and 2012 using computer-assisted face-to-face and self-interviewing. Results: Altogether, 3.5% of men and 5.4% of women reported having an HIV test in the past year. Higher perceived risk of HIV was associated with sexual risk behaviours and with HIV testing. However, the majority of those rating themselves as ‘greatly’ or ‘quite a lot’ at risk of HIV (3.4% of men, 2.5% of women) had not tested in the past year. This was also found among the groups most affected by HIV: MSM and black Africans. Within these groups, the majority reporting sexual risk behaviours did not perceive themselves as at risk and had not tested for HIV. Overall, 29.6% of men and 39.9% of women who tested for HIV in the past year could be classified as low risk across a range of measures. Conclusion: Most people who perceive themselves as at risk of HIV have not recently tested, including among MSM and black Africans. Many people tested in Britain are at low risk, reflecting current policy that aims to normalize testing. Strategies to further improve uptake of testing are needed, particularly in those at greatest risk, to further reduce undiagnosed HIV infection at late diagnoses. PMID:26963528

  3. HIV risk behavior and access to services: what predicts HIV testing among heterosexually active homeless men?

    PubMed

    Wenzel, Suzanne L; Rhoades, Harmony; Tucker, Joan S; Golinelli, Daniela; Kennedy, David P; Zhou, Annie; Ewing, Brett

    2012-06-01

    HIV is a serious epidemic among homeless persons, where rates of infection are estimated to be three times higher than in the general population. HIV testing is an effective tool for reducing HIV transmission and for combating poor HIV/AIDS health outcomes that disproportionately affect homeless persons, however, little is known about the HIV testing behavior of homeless men. This study examined the association between individual (HIV risk) and structural (service access) factors and past year HIV testing. Participants were a representative sample of 305 heterosexually active homeless men interviewed from meal programs in the Skid Row region of Los Angeles. Logistic regression examined the association between past year HIV testing and demographic characteristics, HIV risk behavior, and access to other services in the Skid Row area in the past 30 days. Despite high rates of past year HIV testing, study participants also reported high rates of HIV risk behavior, suggesting there is still significant unmet need for HIV prevention among homeless men. Having recently used medical/dental services in the Skid Row area (OR: 1.91; CI: 1.09, 3.35), and being a military veteran (OR: 2.10; CI: 1.01-4.37) were significantly associated with HIV testing service utilization. HIV testing was not associated with HIV risk behavior, but rather with access to services and veteran status, the latter of which prior research has linked to increased service access. We suggest that programs encouraging general medical service access may be important for disseminating HIV testing services to this high-risk, vulnerable population. PMID:22676465

  4. Abuse and HIV-related risk.

    PubMed

    Benson, J D

    1995-04-01

    Research has been conducted on the effects of childhood abuse that may lead to HIV risk-taking behaviors in adolescence and adulthood. There is evidence of a higher incidence of childhood abuse among HIV-infected individuals and those at highest risk, but not enough evidence to confirm childhood abuse as a root cause of risk-taking. Research is beginning to show important connections between psychological trauma and risk, and to suggest therapeutic approaches. The trauma of childhood sexual abuse is retained by the victims, which can cause dissociative defenses and damaging feelings of self-efficacy which may affect safer sex practices. To identify sexual abuse as an issue in therapy, it is advised that counselors develop client histories regarding relationships, sexual expression and identity, substance use, suicidality, and other recurring self-destructive patterns of thought and behavior. The treatment goal is to assist the patient in understanding how abuse has affected feelings, thoughts, and relationship styles, and to recognize patterns that lead directly to HIV-related risk or that set the stage for risky activities. The critical aspect of treatment is to accurately assess the patient's coping skills when determining the course of treatment. ¿¿¿¿¿¿¿ PMID:11362459

  5. HIV Risk Behaviors Among Latina Women Tested for HIV in Florida by Country of Birth, 2012.

    PubMed

    Taveras, Janelle; Trepka, Mary Jo; Khan, Hafiz; Madhivanan, Purnima; Gollub, Erica L; Devieux, Jessy

    2016-10-01

    Latina women in the United States (US) are disproportionately affected by human immunodeficiency virus (HIV) infection. Data are limited on the risk differences in HIV among Latinas by country of birth. This paper describes the risk behaviors among Latina women tested for HIV at public sites in Florida. Multivariate logistic regression was used to assess the demographic characteristics associated with the report of specific risk behaviors. Results indicate that foreign-born Latina women were 54 % less likely to report partner risk [95 % confidence interval (CI) 0.40, 0.54] than US-born Latina women. Reported risk behaviors varied by race/ethnicity, US-born versus foreign-born status, and by Latina country of origin. Knowledge of these differences can aid in targeting HIV prevention messaging, program decision-making, and allocation of resources, corresponding to the central approach of High Impact Prevention and the National HIV/AIDS Strategy. PMID:26250610

  6. Family ecology and HIV sexual risk behaviors among African American and Puerto Rican adolescent males.

    PubMed

    Voisin, Dexter R

    2002-04-01

    This study examined the relationship between family ecology and HIV sexual risk behavior among African American and Puerto Rican adolescent males. Family, psychosocial, and HIV risk factors were assessed in 171 African American and 187 Puerto Rican adolescent males. Findings suggest that family ecology, culture, and gender role variables may differentially affect HIV sexual risk behaviors within these groups. PMID:15792069

  7. Attitudes and stereotypes regarding older women and HIV risk.

    PubMed

    Beaulaurier, Richard; Fortuna, Karen; Lind, Danielle; Emlet, Charles A

    2014-01-01

    Persons aged 50 years and over will soon disproportionately represent the future of the HIV/AIDS epidemic. It is estimated that by 2015 older adults will represent 50% of persons living with HIV in the United States. Despite the HIV/AIDS growing population among older adults, attitudes, beliefs, and stereotypes toward older adults that exist in general society have affected HIV prevention, education, and care. Specifically, ageist attitudes about the sexuality of older adults in general and older women in particular, low clinical HIV suspicion among healthcare providers, lack of knowledge about risk among older women, and differentials in power related to negotiating sexual practices all lead to heightened concerns for the prevention, identification, and treatment of HIV disease in mature women. This article examines common attitudes, beliefs, and stereotypes that exist within general society as well as health and social service providers that place older women at a disadvantage when it comes to HIV prevention, education, and treatment. PMID:25133946

  8. The relationships between HIV stigma, emotional status, and emotional regulation among HIV-affected children in rural China

    PubMed Central

    Wei, Wei; Li, Xiaoming; Harrison, Sayward; Zhao, Junfeng; Zhao, Guoxiang

    2016-01-01

    ABSTRACT Children affected by HIV/AIDS have unique psychosocial needs that often go unaddressed in traditional treatment approaches. They are more likely than unaffected peers to encounter stigma, including overt discriminatory behaviors, as well as stereotyped attitudes. In addition, HIV-affected children are at risk for experiencing negative affect, including sadness and depression. Previous studies have identified a link between HIV stigma and the subsequent emotional status of children affected by HIV/AIDS. However, limited data are available regarding protective psychological factors that can mitigate the effects of HIV stigma and thus promote resiliency for this vulnerable population. Utilizing data from 790 children aged 6–17 years affected by parental HIV in rural central China this study aims to examine the association between HIV stigma, including both enacted and perceived stigma, and emotional status among HIV-affected children, as well as to evaluate the mediating effects of emotional regulation on the relationship between HIV stigma and emotional status. In addition, the moderating role of age is tested. Multiple regression was conducted to test the mediation model. We found that the experience of HIV stigma had a direct positive effect on negative emotions among children affected by HIV. Emotional regulation offers a level of protection, as it mediated the impact of HIV stigma on negative emotions. Moreover, age was found to moderate the relationship between perceived stigma and negative emotions. A significant interaction between perceived stigma and age suggested that negative emotions increase with age among those who perceived a higher level of stigmatization. Results suggest that children affected by HIV may benefit from interventions designed to enhance their capacity to regulate emotions and that health professionals should be aware of the link between stigma and negative emotion in childhood and adolescence and use the knowledge to inform

  9. HIV risk and preventive interventions in transgender women sex workers

    PubMed Central

    Poteat, Tonia; Wirtz, Andrea L; Radix, Anita; Borquez, Annick; Silva-Santisteban, Alfonso; Deutsch, Madeline B; Khan, Sharful Islam; Winter, Sam; Operario, Don

    2015-01-01

    Worldwide, transgender women who engage in sex work have a disproportionate risk for HIV compared with natal male and female sex workers. We reviewed recent epidemiological research on HIV in transgender women and show that transgender women sex workers (TSW) face unique structural, interpersonal, and individual vulnerabilities that contribute to risk for HIV. Only six studies of evidence-based prevention interventions were identified, none of which focused exclusively on TSW. We developed a deterministic model based on findings related to HIV risks and interventions. The model examines HIV prevention approaches in TSW in two settings (Lima, Peru and San Francisco, CA, USA) to identify which interventions would probably achieve the UN goal of 50% reduction in HIV incidence in 10 years. A combination of interventions that achieves small changes in behaviour and low coverage of biomedical interventions was promising in both settings, suggesting that the expansion of prevention services in TSW would be highly effective. However, this expansion needs appropriate sustainable interventions to tackle the upstream drivers of HIV risk and successfully reach this population. Case studies of six countries show context-specific issues that should inform development and implementation of key interventions across heterogeneous settings. We summarise the evidence and knowledge gaps that affect the HIV epidemic in TSW, and propose a research agenda to improve HIV services and policies for this population. PMID:25059941

  10. HIV risk and preventive interventions in transgender women sex workers.

    PubMed

    Poteat, Tonia; Wirtz, Andrea L; Radix, Anita; Borquez, Annick; Silva-Santisteban, Alfonso; Deutsch, Madeline B; Khan, Sharful Islam; Winter, Sam; Operario, Don

    2015-01-17

    Worldwide, transgender women who engage in sex work have a disproportionate risk for HIV compared with natal male and female sex workers. We reviewed recent epidemiological research on HIV in transgender women and show that transgender women sex workers (TSW) face unique structural, interpersonal, and individual vulnerabilities that contribute to risk for HIV. Only six studies of evidence-based prevention interventions were identified, none of which focused exclusively on TSW. We developed a deterministic model based on findings related to HIV risks and interventions. The model examines HIV prevention approaches in TSW in two settings (Lima, Peru and San Francisco, CA, USA) to identify which interventions would probably achieve the UN goal of 50% reduction in HIV incidence in 10 years. A combination of interventions that achieves small changes in behaviour and low coverage of biomedical interventions was promising in both settings, suggesting that the expansion of prevention services in TSW would be highly effective. However, this expansion needs appropriate sustainable interventions to tackle the upstream drivers of HIV risk and successfully reach this population. Case studies of six countries show context-specific issues that should inform development and implementation of key interventions across heterogeneous settings. We summarise the evidence and knowledge gaps that affect the HIV epidemic in TSW, and propose a research agenda to improve HIV services and policies for this population. PMID:25059941

  11. Modeling HIV Risk in Highly Vulnerable Youth

    ERIC Educational Resources Information Center

    Huba, G. J.; Panter, A. T.; Melchior, Lisa A.; Trevithick, Lee; Woods, Elizabeth R.; Wright, Eric; Feudo, Rudy; Tierney, Steven; Schneir, Arlene; Tenner, Adam; Remafedi, Gary; Greenberg, Brian; Sturdevant, Marsha; Goodman, Elizabeth; Hodgins, Antigone; Wallace, Michael; Brady, Russell E.; Singer, Barney; Marconi, Katherine

    2003-01-01

    This article examines the structure of several HIV risk behaviors in an ethnically and geographically diverse sample of 8,251 clients from 10 innovative demonstration projects intended for adolescents living with, or at risk for, HIV. Exploratory and confirmatory factor analyses identified 2 risk factors for men (sexual intercourse with men and a…

  12. Relative Foster Parents of HIV-Affected Children.

    ERIC Educational Resources Information Center

    Mason, Sally; Linsk, Nathan

    2002-01-01

    The permanency planning needs of 28 HIV-affected relative foster parents were examined. Findings indicated that the HIV-affected caregivers' greatest need was a more adequate response from social workers and therapy services for the children; nonaffected caregivers needed financial assistance most. More HIV-affected caregivers were considering…

  13. Drug and Alcohol Use -- A Significant Risk Factor for HIV

    MedlinePlus

    ... A Significant Risk Factor for HIV Drug and Alcohol Use - A Significant Risk Factor for HIV Email ... with HIV currently use drugs or binge on alcohol. Many people are unaware that the increased risk ...

  14. Early syphilis affects markers of HIV infection.

    PubMed

    Kotsafti, Ourania; Paparizos, Vassilios; Kourkounti, Sofia; Chatziioannou, Argiro; Nicolaidou, Electra; Kapsimali, Violetta; Antoniou, Christina

    2016-08-01

    The objective of this study was to investigate if early syphilis infection affects markers of HIV infection; CD4 T cells and viral load (VL). A retrospective study was performed on 160 HIV-positive patients (111 receiving antiretroviral therapy [ART] and 49 without ART). Early syphilis diagnosis was made in HIV patients during their follow-up at the HIV/AIDS Unit at a Greek Dermatology and Venereology Unit. The patients' blood tests were available at the time of diagnosis, as well as before and 12 weeks after early syphilis diagnosis. CD4 T cell counts and VL levels were measured. It was found that syphilis infection had a negative impact on the CD4 T cell counts in both groups, with reduced CD4 T cell counts observed in 84.6% (99/111) and 79.5% (39/49) of patients receiving and not receiving ART, respectively. After treatment for syphilis, CD4 T cell counts returned to pre-treatment levels in most patients, especially those receiving ART. There was a slight and transient VL increase. Patients receiving ART had a 27% increase in VL, compared to 71.4% among patients not receiving ART. Although the VL increase was slight (41-14,000 copies/ml) in the group under treatment, 4-5% (5/111) patients did not return to pre-treatment levels. Moreover, viral mutations associated with treatment resistance were identified in these patients. Early syphilis accelerates and complicates the progression of HIV infection. Early diagnosis and treatment of syphilis may prevent infection-associated complications in most instances. Consequently, prevention of syphilis and other sexually transmitted infections is of great importance for patients infected with HIV. PMID:26113517

  15. Sexual Behavior and Risk Practices of HIV Positive and HIV Negative Rwandan Women.

    PubMed

    Adedimeji, Adebola A; Hoover, Donald R; Shi, Qiuhu; Gard, Tracy; Mutimura, Eugene; Sinayobye, Jean d'Amour; Cohen, Mardge H; Anastos, Kathryn

    2015-07-01

    It is not well understood how infection with HIV and prior experience of sexual violence affects sexual behavior in African women. We describe factors influencing current sexual practices of Rwandan women living with or without HIV/AIDS. By design, 75 % of participants were HIV positive and ~50 % reported having experienced genocidal rape. Univariate and multivariate logistic regression models were fit to describe demographic and clinical characteristics that influenced sexual behavior in the previous 6 months, condom use, history of transactional sex, and prior infection with a non-HIV sexually transmitted disease. Respondents' age, where they lived, whether or not they lived with a husband or partner, experience of sexual trauma, CD4 count, CES-D and PTSD scores were strongly associated with risky sexual behavior and infection with non-HIV STI. HIV positive women with a history of sexual violence in the contexts of war and conflict may be susceptible to some high-risk sexual behaviors. PMID:25488169

  16. Forced Sex and HIV Risk in Violent Relationships

    PubMed Central

    Campbell, Jacquelyn C.; Lucea, Marguerite Baty; Stockman, Jamila K.; Draughon, Jessica E.

    2012-01-01

    Problem The intersecting epidemics of gender-based violence, specifically forced sex, and HIV continue to affect women worldwide. Both in the US and worldwide, women of African descent are disproportionately affected. Results This brief review synthesizes research on the linkages between forced sex and behavioral risk factors for HIV infection. We explore forced sex from the perspective of the perpetrator being a current or former intimate partner, as well as the first sexual intercourse experience occurring through the use of physical force (i.e., forced sexual initiation). The review also emphasizes the importance of expanding current research to understand the physiological mechanisms linking forced sex to HIV risk. Conclusions The factors linking intimate partner forced sex and forced sexual initiation with HIV/AIDS are varied and complex. The review concludes with recommendations for future research in this area and implications this research could have on preventing violence and mitigating the health consequences. PMID:23066950

  17. Social Marginalization and Children's Rights: HIV-Affected Children in the Republic of Trinidad and Tobago

    ERIC Educational Resources Information Center

    Jones, Adele

    2009-01-01

    This article examines the social epidemiology of HIV/AIDS within a Caribbean context and the specific ways in which children are affected. In particular, the article explores the nature of risk and vulnerability among especially marginalized children: street children. Literature on HIV/AIDS was reviewed, and semistructured interviews with 44 key…

  18. Neural correlates of perceived risk: the case of HIV

    PubMed Central

    Renner, Britta; Schupp, Harald T.

    2012-01-01

    Research indicates that many people do not use condoms consistently but rather rely on illusory control strategies for avoiding an infection with HIV. Preliminary evidence suggests that people form impressions of a partner’s HIV risk based on his or her physical appearance. To examine the neural correlates of such appearance-based HIV risk impressions, event-related potentials were recorded while participants viewed portraits of unacquainted persons. Participants’ explicit HIV risk ratings for each of the presented unacquainted persons were used to form categories of low and high HIV risk persons. Results showed that risky, compared to safe persons elicited distinct event-related potential (ERP) modulations. Viewing risky persons was associated with an increased positivity over right frontal regions between 180 and 240 ms. This suggests that impressions related to HIV risk occur rapidly, presumably reflecting automatic person evaluations eluding introspection. In a time window between 450 and 600 ms, risky persons elicited an increased late positive potential. Consistent with previous findings reporting augmented late positive potentials (LPP) amplitudes to affectively significant stimuli, the results support the assumption that risky faces draw more attention resources. These findings are in accordance with the ‘risk as feeling’ notion. PMID:21672948

  19. HIV Risk Behavior and Access to Services: What Predicts HIV Testing among Heterosexually-Active Homeless Men?

    PubMed Central

    Wenzel, Suzanne L.; Rhoades, Harmony; Tucker, Joan S.; Golinelli, Daniela; Kennedy, David P.; Zhou, Annie; Ewing, Brett

    2013-01-01

    Objectives HIV is a serious epidemic among homeless persons, where rates of infection are estimated to be three times higher than in the general population. HIV testing is an effective tool for reducing HIV transmission and for combating poor HIV/AIDS health outcomes that disproportionately affect homeless persons, however, little is known about the HIV testing behavior of homeless men. This study examined the association between individual (HIV risk) and structural (service access) factors and past year HIV testing. Methods Participants were a representative sample of 305 heterosexually active homeless men interviewed from meal programs in the Skid Row region of Los Angeles. Logistic regression examined the association between past year HIV testing and demographic characteristics, HIV risk behavior, and access to other services in the Skid Row area in the past 30 days. Results Despite high rates of past year HIV testing, study participants also reported high rates of HIV risk behavior, suggesting there is still significant unmet need for HIV prevention among homeless men. Having recently used medical/dental services in the Skid Row area (OR: 1.91; CI: 1.09, 3.35), and being a military veteran (OR: 2.10; CI: 1.01 – 4.37) were significantly associated with HIV testing service utilization. Conclusions HIV testing was not associated with HIV risk behavior, but rather with access to services and veteran status, the latter of which prior research has linked to increased service access. Therefore, we suggest that programs encouraging general medical service access may be important for disseminating HIV testing services to this high-risk, vulnerable population. PMID:22676465

  20. Considerations in HIV Prevention for Women Affected by the Criminal Justice System

    PubMed Central

    Comfort, Megan

    2011-01-01

    Within the national dialogue of HIV prevention strategies, relatively little consideration is given to the millions of women and girls affected by the criminal justice system either through their own incarceration or that of their partners. Yet statistics indicate that these women and girls are disproportionately infected or at risk for HIV and other sexually transmitted infections and much of this risk is directly related to the dynamics and circumstances that led to their incarceration or relationships with incarcerated men. As we look for the link between public health and correctional health within our National HIV/AIDS Strategy, it is imperative that the risks, obstacles, and opportunities facing women and girls affected by incarceration are brought into the discussion. Gender responsive HIV prevention policies and practices must be developed to address the unique risks and opportunities for these women and girls. This paper presents data on HIV risk and other health issues specific to this community of women and girls, discusses key factors for consideration when developing gender-responsive HIV strategies for these communities, and makes recommendations for inclusion in the National HIV/AIDS Strategy and other state and local HIV prevention efforts. PMID:21782463

  1. Reward, attention, and HIV-related risk in HIV+ individuals.

    PubMed

    Anderson, Brian A; Kronemer, Sharif I; Rilee, Jessica J; Sacktor, Ned; Marvel, Cherie L

    2016-08-01

    Human immunodeficiency virus (HIV) is often contracted through engaging in risky reward-motivated behaviors such as needle sharing and unprotected sex. Understanding the factors that make an individual more vulnerable to succumbing to the temptation to engage in these risky behaviors is important to limiting the spread of HIV. One potential source of this vulnerability concerns the degree to which an individual is able to resist paying attention to irrelevant reward information. In the present study, we examine this possible link by characterizing individual differences in value-based attentional bias in a sample of HIV+ individuals with varying histories of risk-taking behavior. Participants learned associations between experimental stimuli and monetary reward outcome. The degree of attentional bias for these reward-associated stimuli, reflected in their ability to capture attention when presented as task-irrelevant distractors, was then assessed both immediately and six months following reward learning. Value-driven attentional capture was related to substance abuse history and non-planning impulsiveness during the time leading up to contraction of HIV as measured via self-report. These findings suggest a link between the ability to ignore reward-associated information and prior HIV-related risk-taking behavior. Additionally, particular aspects of HIV-associated neurocognitive disorders were related to attentional bias, including motor deficits commonly associated with HIV-induced damage to the basal ganglia. PMID:26484383

  2. Positive Affect Promotes Engagement in Care After HIV Diagnosis

    PubMed Central

    Carrico, Adam W.; Moskowitz, Judith Tedlie

    2016-01-01

    Objective Revised Stress and Coping Theory proposes that positive affect serves adaptive functions and its beneficial effects are heightened during stressful periods. This study examined the prospective relationship between positive affect and engagement in care during the 18 months following a HIV seropositive diagnosis. Methods The Coping, HIV, and Affect Interview (CHAI) cohort study enrolled 153 individuals who had recently received a HIV seropositive diagnosis. Using logistic and linear regression, baseline positive affect was examined as a predictor of linkage to HIV care, anti-retroviral therapy (ART) persistence (i.e., starting ART and remaining on it during subsequent follow-up assessments), and mean log10 HIV viral load over follow-up. Results After controlling for education, T-helper (CD4+) count, HIV viral load, and negative affect, higher baseline positive affect independently predicted increased odds of linkage to HIV care at 3 months post-diagnosis (adjusted OR [AOR] = 1.10; 95% CI = 1.01 – 1.21) and ART persistence over the 18-month follow-up period (AOR = 1.08; 95% CI = 1.01 – 1.16). Positive affect was not directly associated with lower mean HIV viral load over follow-up. However, one standard deviation higher positive affect indirectly predicted 6.7% lower HIV viral load via greater odds of ART persistence (βindirect = −0.18, p < .05). Conclusions Greater positive affect predicts linkage to HIV care and ART persistence. ART persistence, in turn, is associated with lower HIV viral load. Clinical research is needed to examine if interventions designed to enhance positive affect can boost the effectiveness of HIV treatment as prevention. PMID:24245846

  3. Silence, assent and HIV risk.

    PubMed

    Adam, Barry D; Husbands, Winston; Murray, James; Maxwell, John

    2008-11-01

    Based on interviews with 34 men, almost all of whom have unprotected sex with men most or all of the time, this paper documents the interactional process, narrative elements and meaning construction in situations of 'bareback' sex. Narratives show the differentiated cultural capital circulating among distinct circuits of gay and bisexual men that define the taken-for-granted rules of conduct for sexual interactions and give rise to high-risk situations. Many of the positive men speak of being part of a social environment where 'everybody knows' a set of rules whereby sex without condoms can happen as a default circumstance to be interrupted only when a partner asserts a need to protect himself. The practical reasoning processes and interactional back-and-forth in the unfolding of sexual interactions, both on the internet and in person, show the uneven and fallible accomplishment of sero-sorting and the generation of situations of high HIV risk and vulnerability when men from different micro-cultures encounter each other. PMID:18975225

  4. Masculinity and HIV Risk among Homeless Men in Los Angeles

    PubMed Central

    Kennedy, David P.; Brown, Ryan A.; Golinelli, Daniela; Wenzel, Suzanne L.; Tucker, Joan S.; Wertheimer, Samuel R.

    2012-01-01

    HIV continues to be a serious public health problem for men who have sex with women (MSW), especially homeless MSW. Although consideration of gender has improved HIV prevention interventions, most of the research and intervention development has targeted how women’s HIV risk is affected by gender roles. The effect of gender roles on MSW has received relatively little attention. Previous studies have shown mixed results when investigating the association between internalization of masculine gender roles and HIV risk. These studies use a variety of scales that measure individual internalization of different aspects of masculinity. However, this ignores the dynamic and culturally constructed nature of gender roles. The current study uses cultural consensus analysis (CCA) to test for the existence of culturally agreed upon masculinity and gender role beliefs among homeless MSW in Los Angeles, as well as the relationship between these beliefs and HIV-related behaviors and attitudes. Interviews included 30 qualitative and 305 structured interviews with homeless MSW in Los Angeles’s Skid Row area. Analysis identified culturally relevant aspects of masculinity not represented by existing masculinity scales, primarily related to barriers to relationships with women. Behaviors, attitudes, and knowledge related to HIV were significantly associated with men’s level of agreement with the group about masculinity. The findings are discussed in light of implications for MSW HIV intervention development. PMID:23730216

  5. Masculinity and HIV Risk among Homeless Men in Los Angeles.

    PubMed

    Kennedy, David P; Brown, Ryan A; Golinelli, Daniela; Wenzel, Suzanne L; Tucker, Joan S; Wertheimer, Samuel R

    2013-01-01

    HIV continues to be a serious public health problem for men who have sex with women (MSW), especially homeless MSW. Although consideration of gender has improved HIV prevention interventions, most of the research and intervention development has targeted how women's HIV risk is affected by gender roles. The effect of gender roles on MSW has received relatively little attention. Previous studies have shown mixed results when investigating the association between internalization of masculine gender roles and HIV risk. These studies use a variety of scales that measure individual internalization of different aspects of masculinity. However, this ignores the dynamic and culturally constructed nature of gender roles. The current study uses cultural consensus analysis (CCA) to test for the existence of culturally agreed upon masculinity and gender role beliefs among homeless MSW in Los Angeles, as well as the relationship between these beliefs and HIV-related behaviors and attitudes. Interviews included 30 qualitative and 305 structured interviews with homeless MSW in Los Angeles's Skid Row area. Analysis identified culturally relevant aspects of masculinity not represented by existing masculinity scales, primarily related to barriers to relationships with women. Behaviors, attitudes, and knowledge related to HIV were significantly associated with men's level of agreement with the group about masculinity. The findings are discussed in light of implications for MSW HIV intervention development. PMID:23730216

  6. Will HIV Vaccination Reshape HIV Risk Behavior Networks? A Social Network Analysis of Drug Users' Anticipated Risk Compensation

    PubMed Central

    Young, April M.; Halgin, Daniel S.; DiClemente, Ralph J.; Sterk, Claire E.; Havens, Jennifer R.

    2014-01-01

    Background An HIV vaccine could substantially impact the epidemic. However, risk compensation (RC), or post-vaccination increase in risk behavior, could present a major challenge. The methodology used in previous studies of risk compensation has been almost exclusively individual-level in focus, and has not explored how increased risk behavior could affect the connectivity of risk networks. This study examined the impact of anticipated HIV vaccine-related RC on the structure of high-risk drug users' sexual and injection risk network. Methods A sample of 433 rural drug users in the US provided data on their risk relationships (i.e., those involving recent unprotected sex and/or injection equipment sharing). Dyad-specific data were collected on likelihood of increasing/initiating risk behavior if they, their partner, or they and their partner received an HIV vaccine. Using these data and social network analysis, a "post-vaccination network" was constructed and compared to the current network on measures relevant to HIV transmission, including network size, cohesiveness (e.g., diameter, component structure, density), and centrality. Results Participants reported 488 risk relationships. Few reported an intention to decrease condom use or increase equipment sharing (4% and 1%, respectively). RC intent was reported in 30 existing risk relationships and vaccination was anticipated to elicit the formation of five new relationships. RC resulted in a 5% increase in risk network size (n = 142 to n = 149) and a significant increase in network density. The initiation of risk relationships resulted in the connection of otherwise disconnected network components, with the largest doubling in size from five to ten. Conclusions This study demonstrates a new methodological approach to studying RC and reveals that behavior change following HIV vaccination could potentially impact risk network connectivity. These data will be valuable in parameterizing future network models

  7. How Parental HIV Affects Children. Research Highlights

    ERIC Educational Resources Information Center

    RAND Corporation, 2009

    2009-01-01

    The shadow cast by HIV reaches beyond individuals diagnosed with the condition. It touches the lives of family members, friends, coworkers, and many others. One group in particular that feels these effects keenly is the children of HIV-positive parents. With improved treatments that have extended the life expectancies of HIV-infected people and…

  8. Genital HIV-1 RNA Quantity Predicts Risk of Heterosexual HIV-1 Transmission

    PubMed Central

    Baeten, Jared M.; Kahle, Erin; Lingappa, Jairam R.; Coombs, Robert W.; Delany-Moretlwe, Sinead; Nakku-Joloba, Edith; Mugo, Nelly R.; Wald, Anna; Corey, Lawrence; Donnell, Deborah; Campbell, Mary S.; Mullins, James I.; Celum, Connie

    2011-01-01

    High plasma HIV-1 RNA concentrations are associated with an increased risk of HIV-1 transmission. Although plasma and genital HIV-1 RNA concentrations are correlated, no study has evaluated the relationship between genital HIV-1 RNA and the risk of heterosexual HIV-1 transmission. In a prospective study of 2521 African HIV-1 serodiscordant couples, we assessed genital HIV-1 RNA quantity and HIV-1 transmission risk. HIV-1 transmission linkage was established within the partnership by viral sequence analysis. We tested endocervical samples from 1805 women, including 46 who transmitted HIV-1 to their partner, and semen samples from 716 men, including 32 who transmitted HIV-1 to their partner. Genital and plasma HIV-1 concentrations were correlated: For endocervical swabs, Spearman’s rank correlation coefficient rho was 0.56 (p<0.001), and for semen rho was 0.55 (p<0.001). Each 1 log10 increase in genital HIV-1 RNA was associated with a 2.20-fold (for endocervical swabs, 95% confidence interval 1.60–3.04, p<0.001) and a 1.79-fold (for semen, 95% confidence interval 1.30–2.47, p<0.001) increased risk of HIV-1 transmission. Genital HIV-1 RNA independently predicted HIV-1 transmission risk after adjusting for plasma HIV-1 quantity (hazard ratio 1.67 for endocervical swabs and 1.68 for semen). Seven female-to-male and four male-to-female HIV-1 transmissions (incidence <1% per year) occurred from persons with undetectable genital HIV-1 RNA, but in all eleven plasma HIV-1 RNA was detected. Thus, higher genital HIV-1 RNA concentrations are associated with greater risk of heterosexual HIV-1 transmission, and this effect was independent of plasma HIV-1 concentrations. These data suggest that HIV-1 RNA in genital secretions could be used as a marker of HIV-1 sexual transmission risk. PMID:21471433

  9. Effects of Disengagement Coping with HIV Risk on Unprotected Sex among HIV-Negative Gay Men in New York City

    PubMed Central

    Yi, Huso; Sandfort, Theo G. M.; Shidlo, Ariel

    2009-01-01

    Objective This study examined how disengagement coping with HIV risk mediated the association between internalized homophobia and unprotected anal intercourse (UAI) and how sexual encounters in public venues (public sex) and drug use moderated the association between disengagement coping and UAI among HIV-negative gay men. Disengagement coping included fatalistic beliefs about maintaining HIV-negative seronegative serostatus (fatalism), optimistic attitudes toward medical seriousness of HIV infection and reduced concern about HIV risk due to HAART (optimism), and negative affective states associated with sexual risk (anxiety). Design A survey was conducted among 285 HIV-negative gay men at an HIV prevention counseling program in New York City. Main Outcome Measures Sexual risk was defined as having had UAI with non-primary partners in the past six months. Results In addition to the positive association between internalized homophobia, disengagement coping, and UAI, fatalism mediated the association between internalized homophobia and UAI; and optimism mediated the association between anxiety and UAI. A significant moderation effect of public sex was found between fatalism and UAI. Conclusions The findings highlight the importance of understanding disengagement coping as it affects sexual risk practices among HIV-negative gay men in the continuing epidemic. PMID:20230094

  10. Novel Neuroimaging Methods to Understand How HIV Affects the Brain.

    PubMed

    Thompson, Paul M; Jahanshad, Neda

    2015-06-01

    In much of the developed world, the HIV epidemic has largely been controlled by antiretroviral treatment. Even so, there is growing concern that HIV-infected individuals may be at risk for accelerated brain aging and a range of cognitive impairments. What promotes or resists these changes is largely unknown. There is also interest in discovering factors that promote resilience to HIV and combat its adverse effects in children. Here, we review recent developments in brain imaging that reveal how the virus affects the brain. We relate these brain changes to changes in blood markers, cognitive function, and other patient outcomes or symptoms, such as apathy or neuropathic pain. We focus on new and emerging techniques, including new variants of brain MRI. Diffusion tensor imaging, for example, can map the brain's structural connections, while fMRI can uncover functional connections. Finally, we suggest how large-scale global research alliances, such as ENIGMA, may resolve controversies over effects where evidence is now lacking. These efforts pool scans from tens of thousands of individuals and offer a source of power not previously imaginable for brain imaging studies. PMID:25902966

  11. Novel Neuroimaging Methods to Understand How HIV Affects the Brain

    PubMed Central

    Thompson, Paul

    2015-01-01

    In much of the developed world, the HIV epidemic has largely been controlled by anti-retroviral treatment. Even so, there is growing concern that HIV-infected individuals may be at risk for accelerated brain aging, and a range of cognitive impairments. What promotes or resists these changes is largely unknown. There is also interest in discovering factors that promote resilience to HIV, and combat its adverse effects in children. Here we review recent developments in brain imaging that reveal how the virus affects the brain. We relate these brain changes to changes in blood markers, cognitive function, and other patient outcomes or symptoms, such as apathy or neuropathic pain. We focus on new and emerging techniques, including new variants of brain MRI. Diffusion tensor imaging, for example, can map the brain’s structural connections while fMRI can uncover functional connections. Finally, we suggest how large-scale global research alliances, such as ENIGMA, may resolve controversies over effects where evidence is now lacking. These efforts pool scans from tens of thousands of individuals, and offer a source of power not previously imaginable for brain imaging studies. PMID:25902966

  12. Risk of Anal Cancer in HIV-Infected and HIV-Uninfected Individuals in North America

    PubMed Central

    Lau, Bryan; Justice, Amy C.; Engels, Eric; Gill, M. John; Goedert, James J.; Kirk, Gregory D.; D’Souza, Gypsyamber; Bosch, Ronald J.; Brooks, John T.; Napravnik, Sonia; Hessol, Nancy A.; Jacobson, Lisa P.; Kitahata, Mari M.; Klein, Marina B.; Moore, Richard D.; Rodriguez, Benigno; Rourke, Sean B.; Saag, Michael S.; Sterling, Timothy R.; Gebo, Kelly A.; Press, Natasha; Martin, Jeffrey N.; Dubrow, Robert

    2012-01-01

    Background. Anal cancer is one of the most common cancers affecting individuals infected with human immunodeficiency virus (HIV), although few have evaluated rates separately for men who have sex with men (MSM), other men, and women. There are also conflicting data regarding calendar trends. Methods. In a study involving 13 cohorts from North America with follow-up between 1996 and 2007, we compared anal cancer incidence rates among 34 189 HIV-infected (55% MSM, 19% other men, 26% women) and 114 260 HIV-uninfected individuals (90% men). Results. Among men, the unadjusted anal cancer incidence rates per 100 000 person-years were 131 for HIV-infected MSM, 46 for other HIV-infected men, and 2 for HIV-uninfected men, corresponding to demographically adjusted rate ratios (RRs) of 80.3 (95% confidence interval [CI], 42.7–151.1) for HIV-infected MSM and 26.7 (95% CI, 11.5–61.7) for other HIV-infected men compared with HIV-uninfected men. HIV-infected women had an anal cancer rate of 30/100 000 person-years, and no cases were observed for HIV-uninfected women. In a multivariable Poisson regression model, among HIV-infected individuals, the risk was higher for MSM compared with other men (RR, 3.3; 95% CI, 1.8–6.0), but no difference was observed comparing women with other men (RR, 1.0; 95% CI, 0.5–2.2). In comparison with the period 2000–2003, HIV-infected individuals had an adjusted RR of 0.5 (95% CI, .3–.9) in 1996–1999 and 0.9 (95% CI, .6–1.2) in 2004–2007. Conclusions. Anal cancer rates were substantially higher for HIV-infected MSM, other men, and women compared with HIV-uninfected individuals, suggesting a need for universal prevention efforts. Rates increased after the early antiretroviral therapy era and then plateaued. PMID:22291097

  13. Migration and HIV risk: Life histories of Mexican-born men living with HIV in North Carolina

    PubMed Central

    Mann, Lilli; Valera, Erik; Hightow-Weidman, Lisa B.; Barrington, Clare

    2015-01-01

    Latino men in the Southeastern USA are disproportionately affected by HIV, but little is known about how the migration process influences HIV-related risk. In North Carolina (NC), a relatively new immigrant destination, Latino men are predominantly young and from Mexico. We conducted 31 iterative life history interviews with 15 Mexican-born men living with HIV. We used holistic content narrative analysis methods to examine HIV vulnerability in the context of migration and to identify important turning points. Major themes included the prominence of traumatic early life experiences, migration as an ongoing process rather than a finite event, and HIV diagnosis as a final turning point in migration trajectories. Findings provide a nuanced understanding of HIV vulnerability throughout the migration process and have implications including the need for bi-national HIV prevention approaches, improved outreach around early testing and linkage to care, and attention to mental health. PMID:24866206

  14. HIV-negative gay men at risk.

    PubMed

    1995-01-01

    According to a study conducted by the Gay and Lesbian Medical Association, HIV-negative gay and bisexual men are at great risk of becoming HIV-positive unless changes in prevention education are made. Investigators studied gay men in four cities and projected their chances of becoming infected with HIV. They found an infection rate of three percent per year for gay and bisexual men under thirty. Low self-esteem, peer pressure, and a need for intimacy were contributing factors to unsafe sexual behavior. PMID:11362379

  15. Communication About HIV and Risk Behaviors Among Mothers Living With HIV and Their Early Adolescent Children

    ERIC Educational Resources Information Center

    O'Sullivan, Lucia F.; Dolezal, Curtis; Brackis-Cott, Elizabeth; Traeger, Lara; Mellins, Claude A.

    2005-01-01

    Little is known about how mothers living with HIV communicate to their children about HIV risk. The current study explored communication between mothers and children about prevention and risk behaviors, the impact of maternal HIV infection and child knowledge of HIV, and concordance in reports from mothers and their children. The sample comprised…

  16. Maternal HIV Serostatus, Mother–Daughter Sexual Risk Communication and Adolescent HIV Risk Beliefs and Intentions

    PubMed Central

    Hutchinson, M. Katherine; Duan, Lei; Jemmott, Loretta S.

    2012-01-01

    Daughters of HIV-positive women are often exposed to the same factors that placed their mothers at risk. This cross-sectional study (N = 176 dyads) examined HIV status, parent-teen sexual risk communication (PTSRC), and daughters’ abstinence and condom use beliefs and intentions. Maternal HIV status was not associated with PTSRC. Path analyses show that maternal depression was associated with PTSRC behavioral and normative beliefs; relationship satisfaction was associated with PTSRC normative and control beliefs. Control beliefs were solely predictive of maternal PTSRC intention. PTSRC was associated with adolescent behavioral and normative beliefs. Abstinence beliefs were associated with abstinence intentions; condom beliefs were associated with condom use intentions. Relationship satisfaction was associated with adolescent control beliefs about both abstinence and condom use. There is a need for interventions that help HIV-positive mothers recognize their daughter’s HIV risk and provide them with relationship building and parent process skills to help reduce these risks. PMID:22677973

  17. Sociometric risk networks and risk for HIV infection.

    PubMed Central

    Friedman, S R; Neaigus, A; Jose, B; Curtis, R; Goldstein, M; Ildefonso, G; Rothenberg, R B; Des Jarlais, D C

    1997-01-01

    OBJECTIVES: This study examined whether networks of drug-injecting and sexual relationships among drug injectors are associated with individual human immunodeficiency virus (HIV) serostatus and with behavioral likelihood of future infection. METHODS: A cross-sectional survey of 767 drug injectors in New York City was performed with chain-referral and linking procedures to measure large-scale (sociometric) risk networks. Graph-theoretic algebraic techniques were used to detect 92 connected components (drug injectors linked to each other directly or through others) and a 105-member 2-core within a large connected component of 230 members. RESULTS: Drug injectors in the 2-core of the large component were more likely than others to be infected with HIV. Seronegative 2-core members engaged in a wide range of high-risk behaviors, including engaging in risk behaviors with infected drug injectors. CONCLUSIONS: Sociometric risk networks seem to be pathways along which HIV travels in drug-injecting peer groups. The cores of large components can be centers of high-risk behaviors and can become pockets of HIV infection. Preventing HIV from reaching the cores of large components may be crucial in preventing widespread HIV epidemics. PMID:9279263

  18. HIV risk practices by female sex workers according to workplace

    PubMed Central

    Damacena, Giseli Nogueira; Szwarcwald, Célia Landmann; de Souza, Paulo Roberto Borges

    2014-01-01

    OBJECTIVE To investigate differences in HIV infection- related risk practices by Female Sex Workers according to workplace and the effects of homophily on estimating HIV prevalence. METHODS Data from 2,523 women, recruited using Respondent-Driven Sampling, were used for the study carried out in 10 Brazilian cities in 2008-2009. The study included female sex workers aged 18 and over. The questionnaire was completed by the subjects and included questions on characteristics of professional activity, sexual practices, use of drugs, HIV testing, and access to health services. HIV quick tests were conducted. The participants were classified in two groups according to place of work: on the street or indoor venues, like nightclubs and saunas. To compare variable distributions by place of work, we used Chi-square homogeneity tests, taking into consideration unequal selection probabilities as well as the structure of dependence between observations. We tested the effect of homophily by workplace on estimated HIV prevalence. RESULTS The highest HIV risk practices were associated with: working on the streets, lower socioeconomic status, low regular smear test coverage, higher levels of crack use and higher levels of syphilis serological scars as well as higher prevalence of HIV infection. The effect of homophily was higher among sex workers in indoor venues. However, it did not affect the estimated prevalence of HIV, even after using a post-stratification by workplace procedure. CONCLUSIONS The findings suggest that strategies should focus on extending access to, and utilization of, health services. Prevention policies should be specifically aimed at street workers. Regarding the application of Respondent-Driven Sampling, the sample should be sufficient to estimate transition probabilities, as the network develops more quickly among sex workers in indoor venues. PMID:25119937

  19. HIV risk practices by female sex workers according to workplace.

    PubMed

    Damacena, Giseli Nogueira; Szwarcwald, Célia Landmann; Souza Júnior, Paulo Roberto Borges de

    2014-06-01

    OBJECTIVE To investigate differences in HIV infection- related risk practices by Female Sex Workers according to workplace and the effects of homophily on estimating HIV prevalence. METHODS Data from 2,523 women, recruited using Respondent-Driven Sampling, were used for the study carried out in 10 Brazilian cities in 2008-2009. The study included female sex workers aged 18 and over. The questionnaire was completed by the subjects and included questions on characteristics of professional activity, sexual practices, use of drugs, HIV testing, and access to health services. HIV quick tests were conducted. The participants were classified in two groups according to place of work: on the street or indoor venues, like nightclubs and saunas. To compare variable distributions by place of work, we used Chi-square homogeneity tests, taking into consideration unequal selection probabilities as well as the structure of dependence between observations. We tested the effect of homophily by workplace on estimated HIV prevalence. RESULTS The highest HIV risk practices were associated with: working on the streets, lower socioeconomic status, low regular smear test coverage, higher levels of crack use and higher levels of syphilis serological scars as well as higher prevalence of HIV infection. The effect of homophily was higher among sex workers in indoor venues. However, it did not affect the estimated prevalence of HIV, even after using a post-stratification by workplace procedure. CONCLUSIONS The findings suggest that strategies should focus on extending access to, and utilization of, health services. Prevention policies should be specifically aimed at street workers. Regarding the application of Respondent-Driven Sampling, the sample should be sufficient to estimate transition probabilities, as the network develops more quickly among sex workers in indoor venues. PMID:25119937

  20. HIV Infection Seems to Affect Nervous System

    MedlinePlus

    ... is a clinical fellow in the department of neurology at the University of California, San Francisco (UCSF). " ... early [HIV] infection." Valcour is a professor of neurology at UCSF. "Additionally, the ubiquity of symptoms in ...

  1. Grappling with HIV Transmission Risks: Narratives of Rural Women in Eastern Kenya Living with HIV

    PubMed Central

    Kako, Peninnah M.; Stevens, Patricia E.; Karani, Anna K; Mkandawire-Valhmu, Lucy; Banda, Anne

    2011-01-01

    As people live longer and more productively with HIV infection, issues of agency in reducing HIV risk are particularly important for HIV-infected women living in high prevalence, under-resourced countries such as Kenya. Because of their gendered lives, in that being masculine is associated with dominance, while being feminine is associated with passiveness, women in rural Kenya must cope with continued HIV transmission risk even after knowing they are infected with HIV. In this narrative interview study, informed by theories of gender and post-colonial feminism, we examined personal accounts of HIV risk and risk reduction of 20 rural women in eastern Kenya who were living with HIV. From our analysis of the women's narratives, two major themes emerged: gender-based obstacles even in the context of a known HIV diagnosis, and struggles with economic pressures amid HIV risks. Implications for policy, programs, and research are discussed. PMID:22137546

  2. Grappling with HIV transmission risks: narratives of rural women in eastern Kenya living with HIV.

    PubMed

    Kako, Peninnah M; Stevens, Patricia E; Karani, Anna K; Mkandawire-Valhmu, Lucy; Banda, Anne

    2012-01-01

    As people live longer and more productively with HIV infection, issues of agency in reducing HIV risk are particularly important for HIV-infected women living in high prevalence, underresourced countries such as Kenya. Because of their gendered lives, in that being masculine is associated with dominance and being feminine is associated with passiveness, women in rural Kenya must cope with continued HIV transmission risk even after knowing they are infected with HIV. In this narrative interview study, informed by theories of gender and postcolonial feminism, we examined personal accounts of HIV risk and risk reduction of 20 rural women in eastern Kenya who were living with HIV. From our analysis of the women's narratives, two major themes emerged: gender-based obstacles even in the context of a known HIV diagnosis, and struggles with economic pressures amid HIV risks. Implications for policy, programs, and research are discussed. PMID:22137546

  3. Patterns of HIV Prevalence and HIV Risk Behaviors among Injection Drug Users Prior to and 24 Months following Implementation of Cross-Border HIV Prevention Interventions in Northern Vietnam and Southern China

    ERIC Educational Resources Information Center

    Hammett, Theodore M.; Kling, Ryan; Johnston, Patrick; Liu, Wei; Ngu, Doan; Friedmann, Patricia; Binh, Kieu Thanh; Dong, Ha Viet; Van, Ly Kieu; Donghua, Meng; Chen, Yi; Des Jarlais, Don C.

    2006-01-01

    In 2002, we implemented a 4-year HIV prevention intervention for injection drug users (IDUs) in Lang Son Province, Vietnam, and Ning Ming County, Guangxi Province, China, a cross-border region seriously affected by inter-twined epidemics of heroin injection and HIV infection. The interventions involve peer education on HIV risk reduction and…

  4. HIV-negative Men-who-Have-Sex-with-Men who Bareback are Concerned about HIV Infection: Implications for HIV Risk Reduction Interventions

    PubMed Central

    Balán, Iván C.; Carballo-Diéguez, Alex; Ventuneac, Ana; Remien, Robert H.; Dolezal, Curtis; Ford, Jordan

    2012-01-01

    The emergence of barebacking (intentional unprotected anal intercourse in situations where there is risk of HIV infection) among men who have sex with men (MSM) has been partially attributed to a decrease in HIV-related concerns due to improved anti-retroviral treatment. It is important to understand the level of concern these men have regarding HIV infection because it can affect their interest in risk reduction behaviors as well as their possible engagement in risk reduction interventions. As part of a study on MSM who use the Internet to seek sexual partners, 89 ethnic and racially diverse men who reported never having an HIV-positive test result completed an in-depth qualitative interview and a computer-based quantitative assessment. Of the 82 men who were asked about concerns of HIV infection during the qualitative interviews, 30 expressed “significant concern” about acquiring HIV, while 42 expressed “moderate concern,” and 10 expressed “minimal concern. Themes that emerged across the different levels of concern were their perceptions of the severity of HIV infection, having friends who are HIV positive, and their own vulnerability to HIV infection. However, these themes differed depending on the level of concern. Among the most frequently mentioned approaches to decrease risk of HIV infection, participants mentioned avoiding HIV-positive sex partners, limiting the number of partners with whom they barebacked, and not allowing partners to ejaculate inside their rectum. Findings suggest that many MSM who bareback would be amenable to HIV prevention efforts that do not depend solely on condom use. PMID:22218787

  5. HIV transmission risk at a gay bathhouse.

    PubMed

    Binson, Diane; Pollack, Lance M; Blair, Johnny; Woods, William J

    2010-11-01

    Previous research found up to 14% of men who go to bathhouses engage in unprotected anal intercourse (UAI) and tend to have multiple sexual partners during their bathhouse visit, thus appearing to support concerns that such venues could foster acute outbreaks of new HIV infections. We conducted a two-stage probability sample of men exiting a gay bathhouse, and focused our analysis on whether the partnering patterns of the men who engaged in UAI present such a risk. Among patrons who had oral or anal sex during their visit (n = 758), 16.7% were HIV+, and 13.9% engaged in UAI. Although men had multiple sex partners during a visit, they had UAI with only one of those partners, on average, and withdrawal prior to ejaculation occurred in the vast majority of UAI incidences. Thus, the risk of sexual transmission of HIV during the bathhouse visit was typically within isolated dyads rather than patterns of multiple sexual encounters that might put many men at risk during a single visit, and men who did engage in UAI tended to withdraw prior to ejaculation, potentially mitigating the risk of HIV transmission. PMID:19753499

  6. HIV Risk Behavior and Access to Services: What Predicts HIV Testing among Heterosexually Active Homeless Men?

    ERIC Educational Resources Information Center

    Wenzel, Suzanne L.; Rhoades, Harmony; Tucker, Joan S.; Golinelli, Daniela; Kennedy, David P.; Zhou, Annie; Ewing, Brett

    2012-01-01

    HIV is a serious epidemic among homeless persons, where rates of infection are estimated to be three times higher than in the general population. HIV testing is an effective tool for reducing HIV transmission and for combating poor HIV/AIDS health outcomes that disproportionately affect homeless persons, however, little is known about the HIV…

  7. Sociocultural Determinants of HIV/AIDS Risk and Service Use among Immigrant Latinos in North Carolina

    ERIC Educational Resources Information Center

    Bowden, W. Patrick; Rhodes, Scott D.; Wilkin, Aimee M.; Jolly, Christine P.

    2006-01-01

    Latinos in the United States have been disproportionately affected by the intersecting epidemics of HIV and sexually transmitted diseases. Using a community-based participatory research approach to problem identification, the objective of this study is to explore sociocultural determinants of HIV/AIDS risk and service use among immigrant Latino…

  8. Reductions in Transmission Risk Behaviors in HIV-Positive Clients Receiving Prevention Case Management Services: Findings from a Community Demonstration Project

    ERIC Educational Resources Information Center

    Gasiorowicz, Mari; Llanas, Michelle R.; DiFranceisco, Wayne; Benotsch, Eric G.; Brondino, Michael J.; Catz, Sheryl L.; Hoxie, Neil J.; Reiser, William J.; Vergeront, James M.

    2005-01-01

    Prevention case management (PCM) for HIV-infected persons is an HIV risk reduction intervention designed to assist clients who are aware of their HIV infection and who continue to engage in risk transmission behaviors. PCM combines individual risk reduction counseling with case management to address the psychosocial factors affecting HIV…

  9. Crack, crack house sex, and HIV risk.

    PubMed

    Inciardi, J A

    1995-06-01

    Limited attention has been focused on HIV risk behaviors of crack smokers and their sex partners, yet there is evidence that the crack house and the crack-using life-style may be playing significant roles in the transmission of HIV and other sexually transmitted diseases. The purposes of this research were to study the attributes and patterns of "sex for crack" exchanges, particularly those that occurred in crack houses, and to assess their potential impact on the spread of HIV. Structured interviews were conducted with 17 men and 35 women in Miami, Florida, who were regular users of crack and who had exchanged sex for crack (or for money to buy crack) during the past 30 days. In addition, participant observation was conducted in 8 Miami crack houses. Interview and observational data suggest that individuals who exchange sex for crack do so with considerable frequency, and through a variety of sexual activities. Systematic data indicated that almost a third of the men and 89% of the women had had 100 or more sex partners during the 30-day period prior to study recruitment. Not only were sexual activities anonymous, extremely frequent, varied, uninhibited (often undertaken in public areas of crack houses), and with multiple partners but, in addition, condoms were not used during the majority of contacts. Of the 37 subjects who were tested for HIV and received their test results 31% of the men and 21% of the women were HIV seropositive. PMID:7611845

  10. Sexual HIV Risk Among Male Parolees and Their Female Partners: The Relate Project

    PubMed Central

    Comfort, Megan; Reznick, Olga Grinstead; Dilworth, Samantha E.; Binson, Diane; Darbes, Lynae A.; Neilands, Torsten B.

    2014-01-01

    Background The massively disproportionate impact of America’s prison boom on communities of color has raised questions about how incarceration may affect health disparities, including disparities in HIV. Primary partners are an important source of influence on sexual health. In this paper, we investigate sexual HIV risk among male-female couples following a man’s release from prison. Methods We draw upon data from the Relate Project, a novel cross-sectional survey of recently released men and their female partners in Oakland and San Francisco, California (N=344). Inferential analyses use the actor-partner model to explore actor and partner effects on sexual HIV risk outcomes. Results Dyadic analyses of sexual HIV risk among male parolees and their female partners paint a complex portrait of couples affected by incarceration and of partners’ influences on each other. Findings indicate that demographic factors such as education level and employment status, individual psycho-social factors such as perception of risk, and relationship factors such as commitment and power affect sexual HIV risk outcomes. Conclusion The Relate Project provides a novel dataset for the dyadic analysis of sexual risk among male parolees and their female partners, and results highlight the importance of focusing on the couple as a unit when assessing HIV risk and protective behaviors. Results also indicate potentially fruitful avenues for population-specific interventions that may help to reduce sexual health disparities among couples affected by incarceration. PMID:25642396

  11. Risk management information for HIV infection.

    PubMed

    Edwards, A J

    1990-01-01

    This article discusses HIV infection in terms of the risk manager's information needs in the health care environment. The malpractice problem, increasing workman's compensation suits, the greater role of the ombudsman, implementation of the National Practitioner Data Bank, and the Joint Commission on Accreditation of Health Care Organizations' (JCAHO) emphasis on clinical excellence are conditions which have given greater importance to the risk manager's position. Included in this article are hedges to retrieve various components of risk management and a select bibliography from AIDSLINE. PMID:10110456

  12. We Are All Affected: Considering the Recovery of HIV/AIDS Infected and Affected Children

    ERIC Educational Resources Information Center

    Nelson, Carla

    2008-01-01

    This essay acknowledges that the HIV/AIDS pandemic has created entire communities for whom loss has become a common and a shared experience. As a result of this impact of HIV/AIDS, several questions surface. However, the one question upon which this essay focuses is, "What type of environment is required for children infected and affected by…

  13. Parental HIV disclosure: from perspectives of children affected by HIV in Henan, China.

    PubMed

    Zhao, Junfeng; Li, Xiaoming; Qiao, Shan; Zhao, Guoxiang; Zhang, Liying; Stanton, Bonita

    2015-01-01

    Culturally and developmentally appropriate parental HIV disclosure (i.e., parents disclose their HIV infection to children) has been shown to be closely related with the well-being of both HIV-infected parents and their children. However, current practices and effects of parental HIV disclosure remain poorly understood in low- and middle-income countries including China. Quantitative data from 626 children affected by parental HIV (orphans and vulnerable children) in Henan, China, were collected in 2011 to examine children's perceptions and knowledge regarding their parents' HIV disclosure practices and to assess the associations of these practices with children's demographic and psychosocial factors. The data in the current study revealed that only a small proportion of children learned parental HIV infection from their parents (direct disclosure), and many of these disclosure seemed being unplanned. Among the children who were not told by their parents, at least 95% of them either knew parental illness from others (indirect disclosure) or from their own observations or suspicions. The children reported similar disclosure practices by fathers and mothers. There were minimum differences between disclosed and nondisclosed children on a number of psychosocial measures. The findings support the notion that parental HIV disclosure is a complex process and can only be beneficial if it is carefully planned. The data in the current study suggest the needs for the culturally and developmentally appropriate approach in parental HIV disclosure in order to maximize both short- and long-term benefits to children, parents, and family functioning. PMID:25465533

  14. HIV risk behaviors, knowledge, and prevention education among offenders under community supervision: a hidden risk group.

    PubMed

    Belenko, Steven; Langley, Sandra; Crimmins, Susan; Chaple, Michael

    2004-08-01

    Numerous studies have established that incarcerated populations are at substantial risk for HIV infection. In response, many jails and prisons have increased HIV prevention and related services. However, although twice as many offenders are under community supervision as are incarcerated at any given time, HIV prevention needs have been largely ignored among probationers and parolees, and little is known about their HIV risk behaviors or HIV prevention needs. Compared with inmates, probationers and parolees have substantially greater opportunities to engage in HIV risk behaviors. In the present study, we describe HIV risk behaviors, knowledge, and prevention education experiences of probationers and parolees in New York City. We find that probationers and parolees have high rates of unprotected sex, and limited current exposure to effective HIV education and prevention interventions. Probation and parole departments need to improve HIV training for officers and make HIV risk reduction services more available. PMID:15342338

  15. Perceived discrimination and stigma toward children affected by HIV/AIDS and their HIV-positive caregivers in central Haiti.

    PubMed

    Surkan, Pamela J; Mukherjee, Joia S; Williams, David R; Eustache, Eddy; Louis, Ermaze; Jean-Paul, Thierry; Lambert, Wesler; Scanlan, Fiona C; Oswald, Catherine M; Fawzi, Mary Smith

    2010-07-01

    In many settings worldwide, HIV-positive individuals have experienced a significant level of stigma and discrimination. This discrimination may also impact other family members affected by the disease, including children. The aim of our study was to identify factors associated with stigma and/or discrimination among HIV-affected youth and their HIV-positive caregivers in central Haiti. Recruitment of HIV-positive patients with children aged 10-17 years was conducted in 2006-2007. Data on HIV-related stigma and/or discrimination were based on interviews with 451 youth and 292 caregivers. Thirty-two percent of caregivers reported that children were discriminated against because of HIV/AIDS. Commune of residence was associated with discrimination against children affected by HIV/AIDS and HIV-related stigma among HIV-positive caregivers, suggesting variability across communities. Multivariable regression models showed that lacking social support, being an orphan, and caregiver HIV-related stigma were associated with discrimination in HIV-affected children. Caregiver HIV-related stigma demonstrated a strong association with depressive symptoms. The results could inform strategies for potential interventions to reduce HIV-related stigma and discrimination. These may include increasing social and caregiver support of children affected by HIV, enhancing support of caregivers to reduce burden of depressive symptoms, and promoting reduction of HIV-related stigma and discrimination at the community-level. PMID:20635244

  16. Perceived discrimination and stigma toward children affected by HIV/AIDS and their HIV-positive caregivers in central Haiti

    PubMed Central

    Surkan, Pamela J.; Mukherjee, Joia S.; Williams, David R.; Eustache, Eddy; Louis, Ermaze; Jean-Paul, Thierry; Lambert, Wesler; Scanlan, Fiona C.; Oswald, Catherine M.; Fawzi, Mary C. Smith

    2010-01-01

    In many settings worldwide, HIV-positive individuals have experienced a significant level of stigma and discrimination. This discrimination may also impact other family members affected by the disease, including children. The aim of our study was to identify factors associated with stigma and/or discrimination among HIV-affected youth and their HIV-positive caregivers in central Haiti. Recruitment of HIV-positive patients with children aged 10–17 years was conducted in 2006–2007. Data on HIV-related stigma and/or discrimination were based on interviews with 451 youth and 292 caregivers. Thirty-two percent of caregivers reported that children were discriminated against because of HIV/AIDS. Commune of residence was associated with discrimination against children affected by HIV/AIDS and HIV-related stigma among HIV-positive caregivers, suggesting variability across communities. Multivariable regression models showed that lacking social support, being an orphan, and caregiver HIV-related stigma were associated with discrimination in HIV-affected children. Caregiver HIV-related stigma demonstrated a strong association with depressive symptoms. The results could inform strategies for potential interventions to reduce HIV-related stigma and discrimination. These may include increasing social and caregiver support of children affected by HIV, enhancing support of caregivers to reduce burden of depressive symptoms, and promoting reduction of HIV-related stigma and discrimination at the community-level. PMID:20635244

  17. Risk analysis. HIV / AIDS country profile: Mozambique.

    PubMed

    1996-12-01

    Mozambique's National STD/AIDS Control Program (NACP) estimates that, at present, about 8% of the population is infected with human immunodeficiency virus (HIV). The epidemic is expected to peak in 1997. By 2001, Mozambique is projected to have 1,650,000 HIV-positive adults 15-49 years of age, of whom 500,000 will have developed acquired immunodeficiency syndrome (AIDS), and 500,000 AIDS orphans. Incidence rates are highest in the country's central region, the transport corridors, and urban centers. The rapid spread of HIV has been facilitated by extreme poverty, the social upheaval and erosion of traditional norms created by years of political conflict and civil war, destruction of the primary health care infrastructure, growth of the commercial sex work trade, and labor migration to and from neighboring countries with high HIV prevalence. Moreover, about 10% of the adult population suffers from sexually transmitted diseases (STDs), including genital ulcers. NACP, created in 1988, is attempting to curb the further spread of HIV through education aimed at changing high-risk behaviors and condom distribution to prevent STD transmission. Theater performances and radio/television programs are used to reach the large illiterate population. The integration of sex education and STD/AIDS information in the curricula of primary and secondary schools and universities has been approved by the Ministry of Education. Several private companies have been persuaded to distribute condoms to their employees. Finally, the confidentiality of HIV patients has been guaranteed. In 1993, the total AIDS budget was US $1.67 million, 50% of which was provided by the European Union. The European Commission seeks to develop a national strategy for managing STDs within the primary health care system. PMID:12320532

  18. HIV Infection and Cancer Risk

    MedlinePlus

    ... Other Funding Find NCI funding for small business innovation, technology transfer, and contracts Training Cancer Training at ... Engels EA, Pfeiffer RM, Goedert JJ, et al. Trends in cancer risk among people with AIDS in ...

  19. Social Support and HIV-related Risk Behaviors: A Systematic Review of the Global Literature

    PubMed Central

    Li, Xiaoming; Stanton, Bonita

    2013-01-01

    Existing empirical evidence has well documented the role of social support in both physical and psychological well-being among various populations. In the context of HIV prevention, the rapid increase of studies on social support merits a systematic review to synthesize the current global literature on association between social support and HIV-related risk behaviors. The current review reveals a complex picture of this relationship across diverse populations. Existing studies indicate that higher levels of social support are related to fewer HIV-related risk behaviors among female sex workers and people living with HIV/AIDS and heterosexual adults in general. However, influences of social support on HIV-related risk behaviors are inconsistent within drug users, men who have sex with men and adolescents. These variations in findings may be attributed to different measurement of social support in different studies, specific context of social support for diverse population, or various characteristics of the social networks the study population obtained support from. Future studies are needed to explore the mechanism of how social support affects HIV-related risk behaviors. HIV prevention intervention efforts need to focus on the positive effect of social support for various vulnerable and at-risk populations. Future efforts also need to incorporate necessary structure change and utilize technical innovation in order to maximize the protective role of social support in HIV risk prevention or reduction. PMID:23921582

  20. HIV diagnosis and sexual risk behavior intentions among couple VCT clients in Ethiopia.

    PubMed

    Bonnenfant, Yung-Ting; Hindin, Michelle J; Gillespie, Duff

    2012-01-01

    This research examines whether members of HIV affected couples are more likely to change their abstinence and condom intentions than members of HIV- couples during couple voluntary counseling and testing (VCT). A total of 1260 couple VCT clients in Ethiopia were asked about their sexual risk behavior intentions for the next two months after pre-test and post-test counseling. Multinomial logistic regression was used to determine whether the couple's HIV status was associated with changed intentions to abstain or use condoms between pre-test and post-test. Individuals belonging to male HIV+ serodiscordant couples (aRRR = 7.98, p < 0.001), female HIV+ serodiscordant couples (aRRR = 5.85, p < 0.001), and HIV+ concordant couples (aRRR = 3.12, p = 0.05) were more likely to have increased their intentions to abstain or use condoms in the next two months than individuals in HIV- concordant relationships. The couple's HIV status was not associated with decreased intentions to abstain or use condoms in the next two months. Counseling for all HIV affected couples should include practical information on obtaining and using condoms. This includes HIV affected couples who intend to abstain from sex, whether for a short or long period of time, so that they are prepared to have protected sex if their intentions change. PMID:22428865

  1. An empiric risk scoring tool for identifying high-risk heterosexual HIV-1 serodiscordant couples for targeted HIV-1 prevention

    PubMed Central

    KAHLE, Erin M.; HUGHES, James P.; LINGAPPA, Jairam R.; JOHN-STEWART, Grace; CELUM, Connie; NAKKU-JOLOBA, Edith; NJUGUNA, Stella; MUGO, Nelly; BUKUSI, Elizabeth; MANONGI, Rachel; BAETEN, Jared M.

    2012-01-01

    Background and objectives Heterosexual HIV-1 serodiscordant couples are increasingly recognized as an important source of new HIV-1 infections in sub-Saharan Africa. A simple risk assessment tool could be useful for identifying couples at highest risk for HIV-1 transmission. Methods Using data from three prospective studies of HIV-1 serodiscordant couples from seven African countries and standard methods for development of clinical prediction rules, we derived and validated a risk scoring tool developed from multivariate modeling and composed of key predictors for HIV-1 risk that could be measured in standard research and clinical settings. Results The final risk score included age of the HIV-1 uninfected partner, married and/or cohabiting partnership, number of children, unprotected sex, uncircumcised male HIV-1 uninfected partner, and plasma HIV-1 RNA in the HIV-1 infected partner. The maximum risk score was 12, scores ≥5 were associated with an annual HIV-1 incidence of >3%, and couples with a score ≥6 accounted for only 28% of the population but 67% of HIV-1 transmissions. The area under the curve for predictive ability of the score was 0.74 (95% CI 0.70–0.78). Internal and external validation showed similar predictive ability of the risk score, even when plasma viral load was excluded from the risk score. Conclusions A discrete combination of clinical and behavioral characteristics defines highest-risk HIV-1 serodiscordant couples. Discriminating highest-risk couples for HIV-1 prevention programs and clinical trials using a validated risk score could improve research efficiency and maximize the impact of prevention strategies for reducing HIV-1 transmission. PMID:23187945

  2. 75 FR 51273 - Expanded Human Immunodeficiency Virus (HIV) Testing for Disproportionately Affected Populations

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-19

    ... (HIV) Testing for Disproportionately Affected Populations AGENCY: Centers for Disease Control and... Affected Populations''. Additional funding from the Patient Protection and Affordable Care Act has been... (HIV) Testing for Disproportionately Affected Populations'' to make awards to state and county...

  3. Sexual power and HIV risk, South Africa.

    PubMed

    Pettifor, Audrey E; Measham, Diana M; Rees, Helen V; Padian, Nancy S

    2004-11-01

    Gender power inequities are believed to play a key role in the HIV epidemic through their effects on women's power in sexual relationships. We hypothesized that lack of sexual power, measured with a four-point relationship control scale and by a woman's experience of forced sex with her most recent partner, would decrease the likelihood of consistent condom use and increase the risk for HIV infection among sexually experienced, 15- to 24-year-old women in South Africa. While limited sexual power was not directly associated with HIV, it was associated with inconsistent condom use: women with low relationship control were 2.10 times more likely to use condoms inconsistently (95% confidence interval [CI] 1.17-3.78), and women experiencing forced sex were 5.77 times more likely to use condoms inconsistently (95% CI 1.86-17.91). Inconsistent condom use was, in turn, significantly associated with HIV infection (adjusted odds ratio 1.58, 95% CI 1.10-2.27). PMID:15550214

  4. Sex and secrecy: How HIV-status disclosure affects safe sex among HIV-positive adolescents

    PubMed Central

    Toska, Elona; Cluver, Lucie D.; Hodes, Rebecca; Kidia, Khameer K.

    2015-01-01

    HIV-positive adolescents who engage in unsafe sex are at heightened risk for transmitting or re-acquiring HIV. Disclosure of HIV-status to sexual partners may impact on condom use, but no study has explored the effects of (i) adolescent knowledge of one's HIV-status, (ii) knowledge of partner status and (iii) disclosure to partners, on safer sex behaviour. This study aimed to identify whether knowledge of HIV-status by HIV-positive adolescents and partners was associated with safer sex. Eight fifty eight HIV-positive adolescents (10–19 years old, 52% female, 68.1% vertically infected) who had ever initiated antiretroviral treatment in 41 health facilities in the Eastern Cape, South Africa, were interviewed using standardised questionnaires. Quantitative analyses used multivariate logistic regressions, controlling for confounders. Qualitative research included interviews, focus group discussions and observations with 43 HIV-positive teenagers and their healthcare workers. N = 128 (14.9%) of the total sample had ever had sex, while N = 109 (85.1%) of sexually active adolescents had boy/girlfriend. In total, 68.1% of the sample knew their status, 41.5% of those who were sexually active and in relationships knew their partner's status, and 35.5% had disclosed to their partners. For adolescents, knowing one's status was associated with safer sex (OR = 4.355, CI 1.085–17.474, p = .038). Neither knowing their partner's status, nor disclosing one's HIV-status to a partner, were associated with safer sex. HIV-positive adolescents feared rejection, stigma and public exposure if disclosing to sexual and romantic partners. Counselling by healthcare workers for HIV-positive adolescents focused on benefits of disclosure, but did not address the fears and risks associated with disclosure. These findings challenge assumptions that disclosure is automatically protective in sexual and romantic relationships for HIV-positive adolescents, who may be ill-equipped to

  5. Sex and secrecy: How HIV-status disclosure affects safe sex among HIV-positive adolescents.

    PubMed

    Toska, Elona; Cluver, Lucie D; Hodes, Rebecca; Kidia, Khameer K

    2015-01-01

    HIV-positive adolescents who engage in unsafe sex are at heightened risk for transmitting or re-acquiring HIV. Disclosure of HIV-status to sexual partners may impact on condom use, but no study has explored the effects of (i) adolescent knowledge of one's HIV-status, (ii) knowledge of partner status and (iii) disclosure to partners, on safer sex behaviour. This study aimed to identify whether knowledge of HIV-status by HIV-positive adolescents and partners was associated with safer sex. Eight fifty eight HIV-positive adolescents (10-19 years old, 52% female, 68.1% vertically infected) who had ever initiated antiretroviral treatment in 41 health facilities in the Eastern Cape, South Africa, were interviewed using standardised questionnaires. Quantitative analyses used multivariate logistic regressions, controlling for confounders. Qualitative research included interviews, focus group discussions and observations with 43 HIV-positive teenagers and their healthcare workers. N = 128 (14.9%) of the total sample had ever had sex, while N = 109 (85.1%) of sexually active adolescents had boy/girlfriend. In total, 68.1% of the sample knew their status, 41.5% of those who were sexually active and in relationships knew their partner's status, and 35.5% had disclosed to their partners. For adolescents, knowing one's status was associated with safer sex (OR = 4.355, CI 1.085-17.474, p = .038). Neither knowing their partner's status, nor disclosing one's HIV-status to a partner, were associated with safer sex. HIV-positive adolescents feared rejection, stigma and public exposure if disclosing to sexual and romantic partners. Counselling by healthcare workers for HIV-positive adolescents focused on benefits of disclosure, but did not address the fears and risks associated with disclosure. These findings challenge assumptions that disclosure is automatically protective in sexual and romantic relationships for HIV-positive adolescents, who may be ill-equipped to

  6. Knowledge, attitudes, self-awareness, and factors affecting HIV/AIDS prevention among Thai university students.

    PubMed

    Durongritichai, Vanida

    2012-11-01

    The objectives of this study were to describe knowledge, attitudes, and self-awareness, and to identify predictable factors affecting HIV/AIDS prevention among Thai university students. A cross sectional survey was conducted among 844 first-year university students using a validated, self-administered questionnaire as a research instrument. The questionnaire included items assessing knowledge, attitudes, self-awareness, and HIV/AIDS preventive behaviors. It was found that 22.4% of the subjects received various sexually provocative media. The university student's knowledge, attitudes, self-awareness, and preventive behaviors toward HIV/AIDS were at a high level. The results from the multiple regression analysis identified self-awareness, faculty, sex, sexual-risk score, income-per-month, GPA, and knowledge as significant independent predictors of HIV/AIDS preventive behaviors. These factors contributed to 36.9% of the explanation of HIV preventive behaviors, and the strongest predictor was found to be self-awareness. Scientific information, and useful and productive life skills are needed to educate the university students regarding the health consequences of HIV/AIDS. An integrated approach is strongly suggested for creating knowledge, attitudes, and awareness to control the spread of HIV/AIDS among young people. PMID:23413715

  7. Relationship characteristics and HIV transmission risk in same-sex male couples in HIV serodiscordant relationships.

    PubMed

    Starks, Tyrel J; Gamarel, Kristi E; Johnson, Mallory O

    2014-01-01

    Unprotected anal intercourse (UAI) remains a main risk factor for HIV among men who have sex with men (MSM) and this is of particular concern for partners of HIV serodiscordant status. However, HIV transmission risk has been demonstrated to vary by the sexual position adopted among partners. Guided by interdependence theory, this study examined how relational factors were differentially associated with risk taking (HIV-positive/insertive and HIV-negative/receptive) and strategic positioning (HIV-positive/receptive and HIV-negative/insertive) UAI within serodiscordant same-sex male couples. HIV-positive men and their HIV-negative partners (n couples = 91; n individuals = 182) simultaneously but independently completed computerized questionnaires and HIV-positive men had blood drawn for viral load. A minority of couples (30 %) engaged in risk taking and/or strategic positioning unprotected anal sex. Results of multinomial logistic regression indicated that HIV-negative partners' levels of relationship commitment were positively associated with the odds of engaging in strategic positioning sexual behaviors. For HIV-negative partners, reports of relationship intimacy, and sexual satisfaction were negatively associated with odds of reporting risk taking behavior. In contrast, HIV-positive partners' reported sexual satisfaction was positively associated with odds of engaging in risk taking behavior. Findings suggested that aspects of relational quality may be differentially associated with sexual decision making for same-sex male couples in serodiscordant relationships. Study findings lend support for the incorporation of discussions of HIV risk reduction strategies, enhancing communication between partners, and support for general relationship functioning in HIV care. PMID:24243004

  8. Factors That Influence HIV Risk among Hispanic Female Immigrants and Their Implications for HIV Prevention Interventions

    PubMed Central

    Hernandez, Amy M.; Zule, William A.; Karg, Rhonda S.; Browne, Felicia A.; Wechsberg, Wendee M.

    2012-01-01

    Hispanics are the fastest growing minority group in North Carolina with increasing incidence of HIV infection. Gender roles, cultural expectations, and acculturation of women may explain some of Hispanic women's risks. The perspectives of Hispanic female immigrants and community-based providers were sought to identify services they offer, understand HIV risk factors, and support the adaptation of a best-evidence HIV behavioural intervention for Hispanic women. Two sets of focus groups were conducted to explicate risks and the opportunities to reach women or couples and the feasibility to conduct HIV prevention in an acceptable manner. Salient findings were that Hispanic female immigrants lacked accurate HIV/AIDS and STI knowledge and that traditional gender roles shaped issues surrounding sexual behaviour and HIV risks, as well as condom use, partner communication, and multiple sexual partnerships. Intervention implications are discussed such as developing and adapting culturally appropriate HIV prevention interventions for Hispanics that address gender roles and partner communication. PMID:22518308

  9. Patterns and Predictors of HIV Risk among Urban American Indians.

    ERIC Educational Resources Information Center

    Walters, Karina L.; Simoni, Jane M.; Harris, Curtis

    2000-01-01

    A survey of 100 American Indians in New York City examined sexual behaviors, lifetime HIV risk behaviors, substance use, sexual attitudes, experience of domestic or stranger violence, and HIV information needs and preferred information sources. Although relatively knowledgeable about HIV, respondents did not reflect that knowledge in safe sex…

  10. Maternal Substance Use and HIV Status: Adolescent Risk and Resilience

    ERIC Educational Resources Information Center

    Leonard, Noelle R.; Gwadz, Marya Viorst; Cleland, Charles M.; Vekaria, Pooja C.; Ferns, Bill

    2008-01-01

    We examined the risk and protective factors and mental health problems of 105 low SES, urban adolescents whose mothers were coping with alcohol abuse and other drug problems. Approximately half of the mothers were also HIV-infected. As hypothesized, there were few differences between adolescents of HIV-infected and HIV-uninfected mothers in…

  11. HIV/STI Risk Behavior of Drug Court Participants

    ERIC Educational Resources Information Center

    Robertson, Angela A.; St. Lawrence, Janet S.; McCluskey, D. Lee

    2012-01-01

    Drug abusing offenders have high rates of HIV and other sexually transmitted infections (STI). To date, the HIV/STI prevention needs of offenders in drug court programs have been ignored. This multi-method study employed interviews to assess drug court professionals' perceptions of the need for an HIV risk reduction intervention to be integrated…

  12. Relative importance of various measures of HIV-related stigma in predicting psychological outcomes among children affected by HIV.

    PubMed

    Zhao, Guoxiang; Li, Xiaoming; Zhao, Junfeng; Zhang, Liying; Stanton, Bonita

    2012-06-01

    To assess the relative importance of four different measures of HIV-related stigma in predicting psychological problems among children affected by HIV in rural China. Cross-sectional data were collected from 755 orphans (i.e., children who lost one or both of their parents to HIV), 466 vulnerable children (children who were living with HIV-infected parents), and 404 comparison children who were from the same community and did not have HIV-related illness or death in their families. Four HIV-related stigma measures include perceived public stigma against people living with HIV/AIDS (PLWHA), perceived public stigma against children affected by HIV (orphans and vulnerable children), personal stigmatizing attitudes against PLWHA, and enacted stigma among children affected by HIV. Psychological problems included depression and adjustment problems. Various measures of HIV-related stigma independently and differentially contribute to children's psychological problems. Enacted stigma and children's perceived public stigma against PLWHA or children affected by HIV are generally stronger predictors of psychological problems than their own feelings or attitudes towards PLWHA. Various aspects of HIV-related stigma are important for us to understand the perception, attitudes, and experience of children affected by HIV, including both children experiencing HIV-related parental illness and death in their own family and children who were living in the communities hardly hit by HIV. Future health promotion and psychological care efforts for children affected by HIV need to consider the effect of various forms of HIV-related stigma on these children's psychosocial well-being and mobilize the community resources to mitigate the negative effect of HIV-related stigma on PLWHA and their children. PMID:21681458

  13. Group Intervention to Reduce HIV Transmission Risk Behavior Among Persons Living With HIV/AIDS

    ERIC Educational Resources Information Center

    Kalichman, Seth C.; Rompa, David; Cage, Marjorie

    2005-01-01

    Results of a randomized controlled trial show that a behavioral intervention grounded in social cognitive theory reduces unprotected sexual behaviors among men and women living with HIV infection, with the greatest reductions in HIV transmission risk behaviors occurring with non-HIV-positive sex partners. In this article, the authors describe the…

  14. Perceptions of Sexual Risks and Injection for HIV among African American Women Who Use Crack Cocaine in Nashville, Tennessee

    ERIC Educational Resources Information Center

    MacMaster, Samuel A.; Rasch, Randolph F. R.; Kinzly, Mark L.; Cooper, R. Lyle; Adams, Susan M.

    2009-01-01

    Significant health disparities in the rates of HIV infection primarily affect African American women. Although research has demonstrated that for some individuals HIV is connected to preventable high-risk behaviors related to substance use, a further examination of how these risks are perceived by the individuals involved in these activities is…

  15. Estimating HIV incidence among key affected populations in China from serial cross-sectional surveys in 2010–2014

    PubMed Central

    Cui, Yan; Guo, Wei; Li, Dongmin; Wang, Liyan; Shi, Cynthia X; Brookmeyer, Ron; Detels, Roger; Ge, Lin; Ding, Zhengwei; Wu, Zunyou

    2016-01-01

    Introduction HIV incidence is an important measure for monitoring the development of the epidemic, but it is difficult to ascertain. We combined serial HIV prevalence and mortality data to estimate HIV incidence among key affected populations (KAPs) in China. Methods Serial cross-sectional surveys were conducted among KAPs from 2010 to 2014. Trends in HIV prevalence were assessed by the Cochran-Armitage test, adjusted by risk group. HIV incidence was estimated from a mathematical model that describes the relationship between changes in HIV incidence with HIV prevalence and mortality. Results The crude HIV prevalence for the survey samples remained stable at 1.1 to 1.2% from 2010 to 2014. Among drug users (DUs), HIV prevalence declined from 4.48 to 3.29% (p<0.0001), and among men who have sex with men (MSM), HIV prevalence increased from 5.73 to 7.75% (p<0.0001). Changes in HIV prevalence among female sex workers (FSWs) and male patients of sexually transmitted disease clinics were more modest but remained statistically significant (all p<0.0001). The MSM population had the highest incidence estimates at 0.74% in 2011, 0.59% in 2012, 0.57% in 2013 and 0.53% in 2014. Estimates of the annual incidence for DUs and FSWs were very low and may not be reliable. Conclusions Serial cross-sectional prevalence data from representative samples may be another approach to construct approximate estimates of national HIV incidence among key populations. We observed that the MSM population had the highest incidence for HIV among high-risk groups in China, and we suggest that interventions targeting MSM are urgently needed to curb the growing HIV epidemic. PMID:26989062

  16. HIV-Risk Reduction with Juvenile Offenders on Probation

    PubMed Central

    Donenberg, Geri R.; Emerson, Erin; Mackesy-Amiti, Mary Ellen; Udell, Wadiya

    2014-01-01

    Youth involved in the juvenile justice system are at elevated risk for HIV as a result of high rates of sexual risk taking, substance use, mental health problems and sexually transmitted infections. Yet few HIV prevention programs exist for young offenders. This pilot study examined change in juvenile offenders’ sexual activity, drug/alcohol use, HIV testing and counseling, and theoretical mediators of risk taking following participation in PHAT Life, an HIV-prevention program for teens on probation. Participants (N=54) were 13–17 year-old arrested males and females remanded to a detention alternative setting. Youth participated in a uniquely tailored HIV prevention intervention and completed a baseline and 3-month follow up assessment of their HIV and substance use knowledge, attitudes, beliefs, and behaviors. At 3-month follow up, teens reported less alcohol use, more positive attitudes toward peers with HIV, greater ability to resist temptation to use substances, and for males, improved HIV prevention self-efficacy and peer norms supporting prevention. Teens were also more likely to seek HIV counseling and males were more likely to get tested for HIV. Effect sizes revealed moderate change in sexual behavior. Findings support PHAT Life as a promising intervention to reduce HIV-risk among youth in juvenile justice. PMID:26097376

  17. Annual Research Review: Mental Health and Resilience in HIV/AIDS-Affected Children--A Review of the Literature and Recommendations for Future Research

    ERIC Educational Resources Information Center

    Betancourt, Theresa S.; Meyers-Ohki, Sarah E.; Charrow, Alexandra; Hansen, Nathan

    2013-01-01

    Background: To date, research on mental health in HIV-affected children (children who have an HIV-positive caregiver or live with the virus themselves) has focused on risk factors associated with the disease. However, simultaneous identification of factors that contribute to resilience in the face of risks is also needed. A greater understanding…

  18. Metabolic Syndrome, Diabetes, and Cardiovascular Risk in HIV

    PubMed Central

    Nix, Linda

    2014-01-01

    HIV infection and its treatment have been associated with adipose tissue changes and disorders of glucose and lipid metabolism. The proportion of HIV-infected adults over the age of 50 is also growing placing HIV-infected adults at particular risk for metabolic perturbations and cardiovascular disease. The metabolic syndrome in HIV-infected adults has been increasingly studied but whether HIV is associated with greater risk remains unclear, likely because of the interplay of host, viral and antiretroviral factors that are associated with the components of the metabolic syndrome. While the Framingham Risk Score is a well-accepted measure of 10-year cardiovascular risk in the general population, it may not accurately predict risk in the HIV setting due to HIV-related factors such as inflammation that are not accounted for. The relationship between HIV and diabetes mellitus (DM) risk has also been debated. We summarize the recent literature on metabolic syndrome, DM, and cardiovascular risk in HIV-infected adults. PMID:25027062

  19. Intergenerational Pathways Linking Childhood Sexual Abuse to HIV Risk Among Women

    PubMed Central

    Cavanaugh, Courtenay E.; Classen, Catherine C.

    2009-01-01

    Childhood sexual abuse is prevalent among women and it has been linked to a number of problems affecting women's health and functioning including women's parenting practices. Another body of literature has linked specific maternal parenting practices to daughters’ HIV risk, including mother-daughter sex communication, monitoring/knowledge about daughters’ activities, mother-daughter relationship quality, attitudes towards sex, and modeling of sexual values. This paper reviews and links these two bodies of literature to indicate how maternal histories of childhood sexual abuse may compromise mothers’ parenting practices, which may in turn impact daughters’ HIV risk. We also build upon Malow and colleagues’ model (2006) of the associations between childhood sexual abuse and HIV risk to present a model indicating potential intergenerational pathways between childhood sexual abuse and HIV risk among women. The literature supporting this model and gaps in the literature are described. PMID:19333846

  20. HIV Disclosure and Transmission Risks to Sex Partners Among HIV-Positive Men.

    PubMed

    Kalichman, Seth C; Kalichman, Moira O; Cherry, Chauncey; Grebler, Tamar

    2016-05-01

    Disclosure of HIV-positive status to sex partners is critical to protecting uninfected partners. In addition, people living with HIV often risk criminal prosecution when they do not inform sex partners of their HIV status. The current study examined factors associated with nondisclosure of HIV status by men living with HIV in Atlanta, GA (92% African African, mean age = 43.8), who engage in condomless sex with uninfected sex partners. Sexually active HIV-positive men (N = 538) completed daily electronic sexual behavior assessments over the course of 28 days and completed computerized interviews, drug testing, medication adherence assessments, and HIV viral load retrieved from medical records. Results showed that 166 (30%) men had engaged in condomless vaginal or anal intercourse with an HIV-uninfected or unknown HIV status sex partner to whom they had not disclosed their HIV status. Men who engaged in nondisclosed condomless sex were less adherent to their HIV treatment, more likely to have unsuppressed HIV, demonstrated poorer disclosure self-efficacy, enacted fewer risk reduction communication skills, and held more beliefs that people with HIV are less infectious when treated with antiretroviral therapy. We conclude that undisclosed HIV status is common and related to condomless sex with uninfected partners. Men who engage in nondisclosed condomless sex may also be more infectious given their nonadherence and viral load. Interventions are needed in HIV treatment as prevention contexts that attend to disclosure laws and enhance disclosure self-efficacy, improve risk reduction communication skills, and increase understanding of HIV infectiousness. PMID:27158850

  1. A Brief Assessment for HIV Risk: The TCU HVHP Form.

    PubMed

    Rowan, Grace A; Joe, George W; Lehman, Wayne E K; Knight, Kevin

    2016-07-01

    Targeted HIV screens may help identify some risk-related concerns of drug-using offenders. The present study describes the Texas Christian University HIV/Hepatitis Risk Assessment (TCU HVHP) form, a 19-item self-report instrument measuring HIV and hepatitis risks based on a sample (N = 1,056) of offenders in eight prisons. Principal components analysis indicated four scales (Injection Risk, Condom Attitudes, Sex Risk, and AIDS Concern) with reliable psychometric properties with coefficient α reliabilities ranging from .72 to .88. Concurrent validities indicated the four scales were related to motivation for treatment, level of drug use, psychosocial functioning, and criminal thinking, although the patterns varied by gender. The TCU HVHP Form should be attractive to programs needing a brief assessment measuring HIV risk behaviors, attitudes toward condom use, and concerns about acquiring and transmitting HIV. PMID:27302708

  2. Interrelationship of alcohol misuse, HIV sexual risk and HIV screening uptake among emergency department patients

    PubMed Central

    2013-01-01

    Background Emergency department (ED) patients comprise a high-risk population for alcohol misuse and sexual risk for HIV. In order to design future interventions to increase HIV screening uptake, we examined the interrelationship among alcohol misuse, sexual risk for HIV and HIV screening uptake among these patients. Methods A random sample of 18-64-year-old English- or Spanish-speaking patients at two EDs during July-August 2009 completed a self-administered questionnaire about their alcohol use using the Alcohol Use Questionnaire, the Alcohol Use Disorders Identification Test (AUDIT), and the HIV Sexual Risk Questionnaire. Study participants were offered a rapid HIV test after completing the questionnaires. Binging (≥ five drinks/occasion for men, ≥ four drinks for women) was assessed and sex-specific alcohol misuse severity levels (low-risk, harmful, hazardous, dependence) were calculated using AUDIT scores. Analyses were limited to participants who had sexual intercourse in the past 12 months. Multivariable logistic regression was used to assess the associations between HIV screening uptake and (1) alcohol misuse, (2) sexual risk for HIV, and (3) the intersection of HIV sexual risk and alcohol misuse. Adjusted odds ratios (AORs) with 95% confidence intervals (CIs) were estimated. All models were adjusted for patient demographic characteristics and separate models for men and women were constructed. Results Of 524 participants (55.0% female), 58.4% identified as white, non-Hispanic, and 72% reported previous HIV testing. Approximately 75% of participants reported drinking alcohol within the past 30 days and 74.5% of men and 59.6% of women reported binge drinking. A relationship was found between reported sexual risk for HIV and alcohol use among men (AOR 3.31 [CI 1.51-7.24]) and women (AOR 2.78 [CI 1.48-5.23]). Women who reported binge drinking were more likely to have higher reported sexual risk for HIV (AOR 2.55 [CI 1.40-4.64]) compared to women who do

  3. Parental HIV Disclosure: From Perspectives of Children Affected by HIV in Henan China

    PubMed Central

    Zhao, Junfeng; Li, Xiaoming; Qiao, Shan; Zhao, Guoxiang; Zhang, Liying; Stanton, Bonita

    2014-01-01

    Culturally and developmentally appropriate parental HIV disclosure (i.e., parents disclose their HIV infection to children) has been shown to be closely related with the well-being of both HIV-infected parents and their children. However, current practices and effects of parental HIV disclosure remain poorly understood in low and middle-income countries including China. Quantitative data from 626 children affected by parental HIV (orphans and vulnerable children) in Henan, China, were collected in 2011 to examine children’s perceptions and knowledge regarding their parents’ HIV disclosure practices and to assess the associations of these practices with children’s demographic and psychosocial factors. The data in the current study revealed that only a small proportion of children learned parental HIV infection from their parents (direct disclosure) and many of these disclosure seemed being unplanned. Among the children who were not told by their parents, at least 95% of them either knew parental illness from others (indirect disclosure) or from their own observations or suspicions. The children reported similar disclosure practices by fathers and mothers. There were minimum differences between disclosed and non-disclosed children on a number of psychosocial measures. The findings support the notion that parental HIV disclosure is a complex process and can only be beneficial if it is carefully planned. The data in the current study suggest the needs for the culturally and developmentally appropriate approach in parental HIV disclosure in order to maximize both short and long term benefits to children, parents, and family functioning. PMID:25465533

  4. HIV Risk Behaviors among African American Women with at-Risk Male Partners

    PubMed Central

    Paxton, Keisha C.; Williams, John K.; Bolden, Sherica; Guzman, Yesenia; Harawa, Nina T.

    2014-01-01

    Background HIV continues to impact African American women at alarming rates. Yet, few researchers have examined the relationship factors promoting unprotected sex within African American communities, especially instances in which women are aware that their male partners are engaging in high risk behaviors. This qualitative study explored the sexual behaviors, relationship characteristics, and HIV prevention strategies utilized by African American women in relationships with African American men at-risk for HIV. Method To understand the issues that should be addressed in a sexual risk-reduction intervention, data were collected from three, two-hour focus group discussions (n=24) comprised primarily of low-income African American women with histories of at-risk male sex partners. At-risk partners included specifically men who had sex with other men or with transgender individuals, used crack cocaine or injection drugs, had lengthy incarceration periods, or an unknown sexual history. Discussion questions examined external factors affecting sexual risk behaviors such as societal pressures, peer norms, and financial vulnerability. Discussions were audiotaped, transcribed, and analyzed using a consensual qualitative research approach. Results Five themes, including self-esteem, social influences on behavior, relationship fidelity, sexual risk behavior, and partners' sexual behaviors, were identified as placing women at increased risk for HIV. Reasons for inconsistent condom use included concern for maintaining the relationship and substance use before and during sex. African American women also believed that men who have sex with men and women (MSMW) were dishonest about their sexuality due to stigma towards homosexuality/bisexuality. Despite these challenges, participants indicated that African American women have a strong sense of pride that can positively impact behaviors in relationships. Conclusion The findings of this study support that social and contextual factor

  5. Biomedical risk, psychosocial influences, and developmental outcomes: lessons from the pediatric HIV population in Africa.

    PubMed

    Abubakar, Amina

    2014-01-01

    Sub-Saharan Africa is home to millions of HIV-affected children. These children are likely to experience multiple developmental delays. In this chapter, I present data highlighting compromised neurobehavioral, mental health, and scholastic outcomes for children affected by HIV. Furthermore, I discuss biomedical factors (e.g., disease severity and nutritional status) that may exacerbate the adverse effects of HIV on childhood outcomes. I also present evidence on how psychosocial risk factors such as poor maternal mental health, orphanhood, and poverty may aggravate the effects of HIV. The concluding section of the chapter highlights conceptual and methodological refinements in research on the impact of HIV on child development in Sub-Saharan Africa. PMID:25512044

  6. Intervention Outcomes among HIV-affected Families Over 18 Months

    PubMed Central

    Rotheram-Borus, Mary Jane; Rice, Eric; Comulada, W. Scott; Best, Karin; Elia, Carla; Peters, Katherine; Li, Li; Green, Sara; Valladares, Ena

    2012-01-01

    We evaluate the efficacy of a family-based intervention over time among HIV-affected families. Mothers Living with HIV (MLH; n=339) in Los Angeles and their school-aged children were randomized to either an intervention or control condition and followed for 18 months. MLH and their children in the intervention received 16 cognitive-behavioral, small-group sessions designed to help them maintain physical and mental health, parent while ill, address HIV-related stressors, and reduce HIV-transmission behaviors. At recruitment, MLH reported few problem behaviors related to physical health, mental health, or sexual or drug transmission acts. Compared to MLH in the control condition, intervention MLH were significantly more likely to monitor their own CD4 cell counts and their children were more likely to decrease alcohol and drug use. Most MLH and their children had relatively healthy family relationships. Family-based HIV interventions should be limited to MLH who are experiencing substantial problems. PMID:22020758

  7. HIV/AIDS Knowledge Scores and Perceptions of Risk Among African American Students Attending Historically Black Colleges and Universities

    PubMed Central

    Sutton, Madeline Y.; Hardnett, Felicia P.; Wright, Pierre; Wahi, Sagina; Pathak, Sonal; Warren-Jeanpiere, Lari; Jones, Sandra

    2011-01-01

    Objective African American young adults are disproportionately affected by the HIV/AIDS epidemic and often unaware of their personal risk for HIV. Historically black colleges and universities (HBCUs) enroll 25% of college-educated African American young adults and can play an important role in HIV prevention. We examined HIV/AIDS knowledge of students at HBCUs to inform and strengthen our HIV prevention efforts at HBCUs. Methods African American undergraduate HBCU students completed online surveys assessing HIV/AIDS knowledge and behaviors, and we analyzed data to assess their knowledge and behaviors. Results A total of 1,051 of 1,230 surveys completed (85.4%) were analyzable. Eighty-two percent of students had average/high HIV knowledge scores. Seventy-nine percent of students surveyed perceived themselves to be at low risk for HIV infection; 64% of those who had at least two or more sex partners had not used a condom at last sex encounter. In the final model, significant independent effects were identified for average/high knowledge of HIV risk, including agreeing with assessing a potential partner's HIV risk by all of the five actions listed (adjusted odds ratio [AOR] = 2.7, 95% confidence interval [CI] 1.7, 4.3) and never using a needle to inject drugs (AOR=5.6, 95% CI 3.2, 9.7). Conclusions Educating students about effectively assessing sex partner risk will improve HIV knowledge and prevention efforts at HBCUs. PMID:21886325

  8. HIV Risk Behaviors among African American Male Violent Youth Offenders

    ERIC Educational Resources Information Center

    Richardson, Joseph B., Jr.; Brown, Jerry; Van Brakle, Mischelle; Godette, Dionne C.

    2010-01-01

    Bay City (pseudonym) is one of the nation's urban epicenters of the HIV epidemic. Although researchers have examined HIV risk behaviors among juvenile offenders detained in juvenile facilities, no study has examined these risk behaviors among youth offenders who have been waived to adult criminal court and detained in U.S. jails. In the present…

  9. HIV Risk Behavior among College Students in the United States

    ERIC Educational Resources Information Center

    Lewis, John E.; Miguez-Burban, Maria-Jose; Malow, Robert M.

    2009-01-01

    Objective: This article updates our 1997 review that examined the literature on HIV risk behavior among college students. Methods: The current review focuses on college student sex-risk behaviors related to HIV-related knowledge, communication with sex partners, self efficacy, and behavioral skills. Results: As reported in our original review, the…

  10. Implications of "Amae" for HIV Risk in Japanese Young Adults.

    ERIC Educational Resources Information Center

    Onuoha, Francis N.; Munakata, Tsunetsugu

    2005-01-01

    Assertiveness, defined as perceived confidence to express true feelings in interpersonal relationships, has been reported to correlate with HIV risk avoidance. However, Japanese social structure encourages "amae" or self-repression. The present study investigated the implications of "amae" for HIV risk avoidance among Japanese university students.…

  11. Longitudinal association of HIV conspiracy beliefs with sexual risk among black males living with HIV.

    PubMed

    Bogart, Laura M; Galvan, Frank H; Wagner, Glenn J; Klein, David J

    2011-08-01

    Research is needed to identify culturally relevant factors that may contribute to sexual risk among African Americans. We investigated HIV-specific medical mistrust as one such cultural factor, often exhibited as conspiracy beliefs about HIV (e.g., "AIDS was produced in a government laboratory"), which may be indicative of general suspicion of HIV treatment and prevention messages. Over a 6-month time-period, we measured endorsement of HIV conspiracy beliefs three times and frequency of condom use monthly among 181 HIV-positive African American males. A hierarchical multivariate repeated-measures logistic random effects model indicated that greater belief in HIV conspiracies was associated with a higher likelihood of reporting unprotected intercourse across all time-points. An average of 54% of participants who endorsed conspiracies reported unprotected intercourse, versus 39% who did not endorse conspiracies. Secondary prevention interventions may need to address medical mistrust as a contributor to sexual risk among African Americans living with HIV. PMID:20734227

  12. Transgender populations and HIV: unique risks, challenges and opportunities.

    PubMed

    Wansom, Tanyaporn; Guadamuz, Thomas E; Vasan, Sandhya

    2016-01-01

    Due to unique social, behavioural, structural and biological issues, transgender (TG) populations, especially TG women, are at high risk for HIV acquisition. This increased risk is multifactorial, due to differing psychosocial risk factors, poorer access to TG-specific healthcare, a higher likelihood of using exogenous hormones or fillers without direct medical supervision, interactions between hormonal therapy and antiretroviral therapy, and direct effects of hormonal therapy on HIV acquisition and immune control. Further research is needed to elucidate these mechanisms of risk and to help design interventions to reduce HIV risk among transgender populations. PMID:27482441

  13. Shared communities, structural contexts, and HIV risk: prioritizing the HIV risk and prevention needs of Black heterosexual men.

    PubMed

    Bowleg, Lisa; Raj, Anita

    2012-05-01

    Black heterosexual men (BHM) are seldom mentioned in HIV prevention research, policy, and interventions, despite evidence that heterosexual contact is becoming the leading exposure category for BHM. The disparate effect of HIV/AIDS on BHM; the debunked "down low" myth; the contexts of BHM's lives in terms of disproportionate poverty, unemployment, and incarceration; and a growing empirical base linking these factors to increased HIV risk, underscore the need to prioritize HIV risk and prevention initiatives for BHM. We highlighted the structural contexts of HIV risk for BHM, and four community-based approaches to address HIV risk and prevention for BHM: (1) men's health programs; (2) workforce and postincarceration release programs; (3) linkages to women's prevention programs; and (4) faith-based initiatives. PMID:22401513

  14. Health Costs of Wealth Gains: Labor Migration and Perceptions of HIV/AIDS Risks in Mozambique

    ERIC Educational Resources Information Center

    Agadjanian, Victor; Arnaldo, Carlos; Cau, Boaventura

    2011-01-01

    The study employs survey data from rural Mozambique to examine how men's labor migration affects their non-migrating wives' perceptions of HIV/AIDS risks. Using a conceptual framework centered on tradeoffs between economic security and health risks that men's migration entails for their left-behind wives, it compares women married to migrants and…

  15. Community-Level HIV Risk Behaviors and HIV Prevalence among Women and Men in Zimbabwe

    PubMed Central

    Speizer, Ilene S.; Gómez, Anu Manchikanti; Stewart, James; Voss, Paul

    2013-01-01

    Most studies on HIV risk in sub-Saharan Africa focus on individual-level socio-demographic and behavioral correlates of risk. Only recently have researchers and programmers considered the context within which individuals live. This study uses the 2005–6 Zimbabwe Demographic and Health Survey to examine the correlation between the prevalence of HIV at the community level and the prevalence of HIV risk-taking behaviors. Results show that women and men living in communities with higher HIV prevalence in the opposite sex are at increased risk of HIV. In addition, rural women and men living in communities with greater premarital and non-marital sex are at greater risk of HIV. Finally, HIV prevalence is higher among women and men living in urban areas with higher intimate partner violence. Programs should address community-level social norms that make high-risk behaviors acceptable and thus increase all women and men’s risk of HIV, not just those engaged in high-risk behaviors. PMID:22010807

  16. HIV-Affected Children and Adolescents: What School Social Workers Should Know.

    ERIC Educational Resources Information Center

    Gilbert, Dorie J.

    2001-01-01

    Provides an overview of issues facing HIV-affected children and adolescents and aims to help school social workers become better equipped to recognize the secondary effects of the AIDS epidemic among HIV-affected children. Concludes with recommendations for addressing the needs of HIV-affected children and adolescents through school social work.…

  17. Is Sex Like Driving? HIV Prevention and Risk Compensation*

    PubMed Central

    Wilson, Nicholas L.; Xiong, Wentao; Mattson, Christine L.

    2015-01-01

    Risk compensation has been called the “Achilles’ heel” of HIV prevention policies (Cassell et al 2006). This paper examines the behavioral response to male circumcision, a major HIV prevention policy currently being implemented throughout much of Sub-Saharan Africa. Contrary to the presumption of risk compensation, we find that the response due to the perceived reduction in HIV transmission appears to have been a reduction in risky sexual behavior. We suggest a mechanism for this finding: circumcision may reduce fatalism about acquiring HIV/AIDS and increase the salience of the tradeoff between engaging in additional risky behavior and avoiding acquiring HIV. We also find what appears to be a competing effect that does not operate through the circumcision recipient’s belief about the reduction in the risk of acquiring HIV. PMID:26997745

  18. Application of an ecological framework to examine barriers to the adoption of safer conception strategies by HIV-affected couples.

    PubMed

    Saleem, Haneefa T; Surkan, Pamela J; Kerrigan, Deanna; Kennedy, Caitlin E

    2016-01-01

    Safer conception interventions can significantly reduce the risk of horizontal HIV transmission between HIV-serodiscordant partners. However, prior to implementing safer conception interventions, it is essential to understand potential barriers to their adoption so that strategies can be developed to overcome these barriers. This paper examines potential barriers to the adoption of safer conception strategies by HIV-affected couples in Iringa, Tanzania using an ecological framework. We interviewed 30 HIV-positive women, 30 HIV-positive men and 30 health providers engaged in delivering HIV-related services. We also conducted direct observations at five health facilities. Findings suggest that there are multiple barriers to safer conception that operate at the individual, relational, environmental, structural, and super-structural levels. The barriers to safer conception identified are complex and interact across these levels. Barriers at the individual level included antiretroviral adherence, knowledge of HIV status, knowledge and acceptability of safer conception strategies, and poor nutrition. At the relational level, unplanned pregnancies, non-disclosure of status, gendered power dynamics within relationships, and patient-provider interactions posed a threat to safer conception. HIV stigma and distance to health facilities were environmental barriers to safer conception. At the structural level there were multiple barriers to safer conception, including limited safer conception policy guidelines for people living with HIV (PLHIV), lack of health provider training in safer conception strategies and preconception counseling for PLHIV, limited resources, and lack of integration of HIV and sexual and reproductive health services. Poverty and gender norms were super-structural factors that influenced and reinforced barriers to safer conception, which influenced and operated across different levels of the framework. Multi-level interventions are needed to ensure

  19. Finding those at risk: Acute HIV infection in Newark, NJ

    PubMed Central

    Martin, Eugene G.; Salaru, Gratian; Mohammed, Debbie; Coombs, Robert W.; Paul, Sindy M.; Cadoff, Evan M.

    2014-01-01

    Background A screening strategy combining rapid HIV-1/2 (HIV) antibody testing with pooled HIV-1 RNA testing increases identification of HIV infections, but may have other limitations that restrict its usefulness to all but the highest incidence populations. Objective By combining rapid antibody detection and pooled nucleic acid amplification testing (NAAT) testing, we sought to improve detection of early HIV-1 infections in an urban Newark, NJ hospital setting. Study design Pooled NAAT HIV-1 RNA testing was offered to emergency department patients and out-patients being screened for HIV antibodies by fingerstick-rapid HIV testing. For those negative by rapid HIV and agreeing to NAAT testing, pooled plasma samples were prepared and sent to the University of Washington where real-time reverse transcription-polymerase chain reaction (RT-PCR) amplification was performed. Results Of 13,226 individuals screened, 6381 had rapid antibody testing alone, and 6845 agreed to add NAAT HIV screening. Rapid testing identified 115 antibody positive individuals. Pooled NAAT increased HIV-1 case detection by 7.0% identifying 8 additional cases. Overall, acute HIV infection yield was 0.12%. While males represent only 48.1% of those tested by NAAT, all samples that screened positive for HIV-1 RNA were obtained from men. Conclusion HIV-1 RNA testing of pooled, HIV antibody-negative specimens permits identification of recent infections. In Newark, pooled NAAT increased HIV-1 case detection and provided an opportunity to focus on treatment and prevention messages for those most at risk of transmitting infection. Although constrained by client willingness to participate in testing associated with a need to return to receive further results, use of pooled NAAT improved early infection sensitivity. PMID:23953941

  20. Ethnicity and HIV risk behaviour, testing and knowledge in Guatemala

    PubMed Central

    Taylor, Tory M.; Hembling, John; Bertrand, Jane T.

    2015-01-01

    Objectives. To describe levels of risky sexual behaviour, HIV testing and HIV knowledge among men and women in Guatemala by ethnic group and to identify adjusted associations between ethnicity and these outcomes. Design. Data on 16,205 women aged 15–49 and 6822 men aged 15–59 from the 2008–2009 Encuesta Nacional de Salud Materno Infantil were used to describe ethnic group differences in sexual behaviour, HIV knowledge and testing. We then controlled for age, education, wealth and other socio-demographic factors in a multivariate logistic regression model to examine the effects of ethnicity on outcomes related to age at sexual debut, number of lifetime sex partners, comprehensive HIV knowledge, HIV testing and lifetime sex worker patronage (men only). Results. The data show low levels of risky sexual behaviour and low levels of HIV knowledge among indigenous women and men, compared to other respondents. Controlling for demographic factors, indigenous women were more likely than other women never to have been tested for HIV and to lack comprehensive HIV knowledge. They were less likely to report early sexual debut and three or more lifetime sexual partners. Indigenous men were more likely than other men to lack comprehensive HIV knowledge and demonstrated lower odds of early sexual debut, 10 or more lifetime sexual partners and sex worker patronage. Conclusions. The Mayan indigenous population in Guatemala, while broadly socially vulnerable, does not appear to be at elevated risk for HIV based on this analysis of selected risk factors. Nonetheless, low rates of HIV knowledge and testing may be cause for concern. Programmes working in indigenous communities should focus on HIV education and reducing barriers to testing. Further research into the factors that underlie ethnic self-identity and perceived ethnicity could help clarify the relative significance of these measures for HIV risk and other health outcomes. PMID:24834462

  1. Enhancing awareness to mitigate the risk of HIV/AIDS in older adults.

    PubMed

    Inelmen, Emine Meral; Sergi, Giuseppe; De Rui, Marina; Manzato, Enzo

    2014-12-01

    HIV is often assumed to only affect younger people, and many older people do not realize that they might risk acquiring the virus. Given that sexual transmission is by far the most common way to contract HIV around the world, health care professionals do not usually pay enough attention to the possibility of HIV/AIDS in older adults, based on the common conviction that they no longer have any sexual desires and that they are sexually inactive. Nevertheless, the sexual behavior of older people is likely to change over time, as aging baby boomers progress into their 60s and 70s, meeting the criteria for "successful aging", and not conforming to the stereotype of "sexless elderly". Hence the urgent need to awareness is that HIV remains as a major health threat even in advanced age. Prompt diagnosis and treatment are especially crucial in older adults because of their general frailty and high comorbidity levels. This article reviews recent literature concerning HIV/AIDS in older adults, as regard the related epidemiological, clinical and public health issues, with a view to suggesting how the rising rate of HIV transmission in this age group might be mitigated, and shows the main points that HCP should tackle to identify older people at risk of HIV infection. In summary, there is a pressing need to develop effective prevention schemes and to adapt clinical and programmatic approaches to improve the survival of older people with HIV. PMID:24789219

  2. The when and how of male circumcision and the risk of HIV: a retrospective cross-sectional analysis of two HIV surveys from Guinea-Bissau

    PubMed Central

    Rasmussen, Dlama Nggida; Wejse, Christian; Larsen, Olav; Da Silva, Zacarias; Aaby, Peter; Sodemann, Morten

    2016-01-01

    Introduction Male circumcision (MC) reduces the risk of HIV, and this risk reduction may be modified by socio-cultural factors such as the timing and method (medical and traditional) of circumcision. Understanding regional variations in circumcision practices and their relationship to HIV is crucial and can increase insight into the HIV epidemic in Africa. Methods We used data from two retrospective HIV surveys conducted in Guinea-Bissau from 1993 to 1996 (1996 cohort) and from 2004 to 2007 (2006 cohort). Multivariate logistical models were used to investigate the relationships between HIV risk and circumcision status, timing, method of circumcision, and socio-demographic factors. Results MC was protective against HIV infection in both cohorts, with adjusted odds ratios (AORs) of 0.28 (95% CI 0.12-0.66) and 0.30 (95% CI 0.09-0.93), respectively. We observed that post-pubertal (≥13 years) circumcision provided the highest level of HIV risk reduction in both cohorts compared to non-circumcised. However, the difference between pre-pubertal (≤12 years) and post-pubertal (≥13 years) circumcision was not significant in the multivariate analysis. Seventy-six percent (678/888) of circumcised males in the 2006 cohort were circumcised traditionally, and 7.7% of those males were HIV-infected compared to 1.9% of males circumcised medically, with AOR of 2.7 (95% CI 0.91-8.12). Conclusion MC is highly prevalent in Guinea-Bissau, but ethnic variations in method and timing may affect its protection against HIV. Our findings suggest that sexual risk behaviour and traditional circumcision may increases HIV risk. The relationship between circumcision age, sexual behaviour and HIV status remains unclear and warrants further research. PMID:27200126

  3. Linearity and Nonlinearity in HIV/STI Transmission: Implications for the Evaluation of Sexual Risk Reduction Interventions

    ERIC Educational Resources Information Center

    Pinkerton, Steven D.; Chesson, Harrell W.; Crosby, Richard A.; Layde, Peter M.

    2011-01-01

    A mathematical model of HIV/sexually transmitted infections (STI) transmission was used to examine how linearity or nonlinearity in the relationship between the number of unprotected sex acts (or the number of sex partners) and the risk of acquiring HIV or a highly infectious STI (such as gonorrhea or chlamydia) affects the utility of sexual…

  4. Are Rural Women Powerless When it Comes to HIV & AIDS Risk? Implications for Adult Education Programmes in South Africa

    ERIC Educational Resources Information Center

    Kiggundu, Edith; Castle, Jane

    2007-01-01

    There is an urgent need for fresh approaches to HIV & AIDS education for adults and youth in South Africa, particularly for those marginalised by society, such as rural black women. In this article we explore the factors which affect awareness, condom use and HIV & AIDS risk among a group of women who attend classes in a rural Adult Education…

  5. Assessing Maladaptive Responses to the Stress of Being At-Risk of HIV Infection among HIV-Negative Gay Men in New York City

    PubMed Central

    Yi, Huso; Shidlo, Ariel; Sandfort, Theo

    2009-01-01

    The aim of this study was to examine the psychometric properties and preliminary validity of a newly developed 16-item measure to assess maladaptive responses to the stress of being at risk for HIV infection among HIV-negative gay men. The measure consisted of three factors: (1) fatalistic beliefs about maintaining an HIV-negative serostatus; (2) reduced perceived severity of HIV infection due to advances in medical treatment of HIV/AIDS; and (3) negative affective states associated with the risk of HIV infection. A total of 285 HIV-negative gay men at a counseling program in New York City participated in the study. Confirmatory factor analyses supported the three-factor model as an acceptable model fit: NNFI = .91, CFI = .92, GFI = .90, RMSEA = .07. The measure and its subscales obtained in this sample achieved adequate internal consistency coefficients. Construct validity was supported by significant positive associations with internalized homophobia, depression, self-justifications for the last unprotected anal intercourse (UAI), and actual UAI with casual sex partners. Understanding the dynamics of maladaptive responses to the epidemic and intense anxieties elicited by HIV risk among HIV-negative gay men living in a place of high seroprevalence provides useful information to guide psychosocial interventions in the population. PMID:20043254

  6. Hepatitis B and C Co-Infection in HIV Patients from the TREAT Asia HIV Observational Database: Analysis of Risk Factors and Survival

    PubMed Central

    Chen, Marcelo; Wong, Wing-Wai; Law, Matthew G.; Kiertiburanakul, Sasisopin; Yunihastuti, Evy; Merati, Tuti Parwati; Lim, Poh Lian; Chaiwarith, Romanee; Phanuphak, Praphan; Lee, Man Po; Kumarasamy, Nagalingeswaran; Saphonn, Vonthanak; Ditangco, Rossana; Sim, Benedict L. H.; Nguyen, Kinh Van; Pujari, Sanjay; Kamarulzaman, Adeeba; Zhang, Fujie; Pham, Thuy Thanh; Choi, Jun Yong; Oka, Shinichi; Kantipong, Pacharee; Mustafa, Mahiran; Ratanasuwan, Winai; Durier, Nicolas; Chen, Yi-Ming Arthur

    2016-01-01

    Background We assessed the effects of hepatitis B (HBV) or hepatitis C (HCV) co-infection on outcomes of antiretroviral therapy (ART) in HIV-infected patients enrolled in the TREAT Asia HIV Observational Database (TAHOD), a multi-center cohort of HIV-infected patients in the Asia-Pacific region. Methods Patients testing HBs antigen (Ag) or HCV antibody (Ab) positive within enrollment into TAHOD were considered HBV or HCV co-infected. Factors associated with HBV and/or HCV co-infection were assessed by logistic regression models. Factors associated with post-ART HIV immunological response (CD4 change after six months) and virological response (HIV RNA <400 copies/ml after 12 months) were also determined. Survival was assessed by the Kaplan-Meier method and log rank test. Results A total of 7,455 subjects were recruited by December 2012. Of patients tested, 591/5656 (10.4%) were HBsAg positive, 794/5215 (15.2%) were HCVAb positive, and 88/4966 (1.8%) were positive for both markers. In multivariate analysis, HCV co-infection, age, route of HIV infection, baseline CD4 count, baseline HIV RNA, and HIV-1 subtype were associated with immunological recovery. Age, route of HIV infection, baseline CD4 count, baseline HIV RNA, ART regimen, prior ART and HIV-1 subtype, but not HBV or HCV co-infection, affected HIV RNA suppression. Risk factors affecting mortality included HCV co-infection, age, CDC stage, baseline CD4 count, baseline HIV RNA and prior mono/dual ART. Shortest survival was seen in subjects who were both HBV- and HCV-positive. Conclusion In this Asian cohort of HIV-infected patients, HCV co-infection, but not HBV co-infection, was associated with lower CD4 cell recovery after ART and increased mortality. PMID:26933963

  7. Protective Factors and HIV Risk Behavior among South African Men

    PubMed Central

    Heeren, G Anita; Icard, Larry D.; O’Leary, Ann; Jemmott, John B.; Ngwane, Zolani; Mtose, Xoliswa

    2014-01-01

    The primary mode of HIV transmission in South Africa is heterosexual sexual behavior. HIV prevention research specifically focusing on men in South Africa is limited. We assessed self-reported HIV risk behaviors in 1,181 men ages 18 to 45 years in randomly selected neighborhoods in Eastern Cape Province, South Africa. Older men were less likely to report having multiple partners. Religiosity was a protective factor for condom use and unprotected sex with steady partners. Discussing using condoms was a protective factor for condom use and unprotected sex with both steady and casual partners. Having a child was associated with decreased condom use with steady partners and employment was associated with decreased condom use with casual partners. The findings suggest the need for HIV risk-reduction behavioral interventions tailored for South African men with regard to age, religiosity, and types of sexual partners. Implications for behavioral interventions to reduce HIV risk are discussed. PMID:24722765

  8. HIV Risk Behavior among Delinquent and Mentally Ill Teens: Case Manager Perspectives

    ERIC Educational Resources Information Center

    Smith, Michael D.; Seal, David Wyatt; Hartley, Shannon

    2006-01-01

    An HIV knowledge survey and qualitative interview were administered to 20 case managers in community-based programs for troubled youth to assess HIV knowledge and their perception of client HIV risk behaviors. Participants had good HIV knowledge. Case managers perceived client youth to be at high risk for HIV infection due to unsafe sexual…

  9. people who inject drugs, HIV risk, and HIV testing uptake in sub-Saharan Africa.

    PubMed

    Asher, Alice K; Hahn, Judith A; Couture, Marie-Claude; Maher, Kelsey; Page, Kimberly

    2013-01-01

    Dramatic rises in injection drug use (IDU) in sub-Saharan Africa account for increasingly more infections in a region already overwhelmed by the HIV epidemic. There is no known estimate of the number of people who inject drugs (PWID) in the region, or the associated HIV prevalence in PWID. We reviewed literature with the goal of describing high-risk practices and exposures in PWID in sub-Saharan Africa, as well as current HIV prevention activities aimed at drug use. The literature search looked for articles related to HIV risk, injection drug users, stigma, and HIV testing in sub-Saharan Africa. This review found evidence demonstrating high rates of HIV in IDU populations in sub-Saharan Africa, high-risk behaviors of the populations, lack of knowledge regarding HIV, and low HIV testing uptake. There is an urgent need for action to address IDU in order to maintain recent decreases in the spread of HIV in sub-Saharan Africa. PMID:23164598

  10. Documentation Status as a Contextual Determinant of HIV Risk Among Young Transgender Latinas

    PubMed Central

    Palazzolo, Sarah L.; De Jesus, Maria; Maguire-Marshall, Molly; Barker, Suyanna L.

    2016-01-01

    Abstract Purpose: The purpose of this study was to explore the contextual factors that determine or mitigate vulnerability to HIV among Latina transgender women. Documentation status (legal authorization to live in the United States) has been cited by other studies as a barrier to recruitment or engagement in HIV-related care among immigrant Latinos, but not explored as a determinant of HIV risk for transgender immigrant Latinas. Methods: We collaborated with a community-based organization to explore these contextual, including social and structural, factors. In-depth interviews in Spanish captured life histories of eight 18- to 29-year-old transgender Latinas, who collectively self-identify as chicas trans. Codes were assigned deductively from the interview guide, and emerging themes were identified throughout data collection. Results: Most participants migrated to the United States from Central America after experiencing discrimination and violence in their countries of origin. Participants emphasized documentation status as a critical factor in three areas related to social and structural determinants of HIV risk: gender identity expression, access to services, and relationship power dynamics. Chicas trans who gained legal asylum reported greater control over sexual relationships, improved access to services, and less risky employment. Conclusions: Documentation status emerged as a key HIV risk factor for this population. For undocumented transgender Latinas, legal asylum appears to be a promising HIV-related protective factor. Further research could assess whether legal assistance combined with wraparound support services affects HIV prevention for this population. PMID:26669583

  11. Sexual Risk Behavior: HIV, STD, & Teen Pregnancy Prevention

    MedlinePlus

    ... behaviors place individuals at greatest risk for infection. HIV awareness and education should be universally integrated into all educational environments. * CDC recommends all adolescents and adults 13-64 get tested for HIV at least once as part of routine medical ...

  12. Neurocognitive Impairment and HIV Risk Factors: A Reciprocal Relationship

    PubMed Central

    Anand, Pria; Springer, Sandra A.; Copenhaver, Michael M.

    2010-01-01

    Cognitive impairment among populations at risk for HIV poses a significant barrier to managing risk behaviors. The impact of HIV and several cofactors, including substance abuse and mental illness, on cognitive function is discussed in the context of HIV risk behaviors, medication adherence, and risk-reduction interventions. Literature suggests that cognitive impairment is intertwined in a close, reciprocal relationship with both risk behaviors and medication adherence. Not only do increased risk behaviors and suboptimal adherence exacerbate cognitive impairment, but cognitive impairment also reduces the effectiveness of interventions aimed at optimizing medication adherence and reducing risk. In order to be effective, risk-reduction interventions must therefore take into account the impact of cognitive impairment on learning and behavior. PMID:20232242

  13. Telling stories and adding scores: Measuring resilience in young children affected by maternal HIV and AIDS.

    PubMed

    Ebersöhn, Liesel; Eloff, Irma; Finestone, Michelle; Grobler, Adri; Moen, Melanie

    2015-01-01

    "Telling stories and adding scores: Measuring resilience in young children affected by maternal HIV and AIDS", demonstrates how a concurrent mixed method design assisted cross-cultural comparison and ecological descriptions of resilience in young South African children, as well as validated alternative ways to measure resilience in young children. In a longitudinal randomised control trial, which investigated psychological resilience in mothers and children affected by HIV/AIDS, we combined a qualitative projective story-telling technique (Düss Fable) with quantitative data (Child Behaviour Checklist). The children mostly displayed adaptive resilience-related behaviours, although maladaptive behaviours were present. Participating children use internal (resolve/agency, positive future expectations, emotional intelligence) and external protective resources (material resources, positive institutions) to mediate adaptation. Children's maladaptive behaviours were exacerbated by internal (limited problem-solving skills, negative emotions) and external risk factors (chronic and cumulative adversity). PMID:26291644

  14. Defining HIV Risk and Determining Responsibility in Postsocialist Poland

    PubMed Central

    Owczarzak, Jill

    2014-01-01

    Drawing on 15 months of ethnographic research on HIV prevention programs in Poland, I explore the consequences of the shift from models of HIV prevention that emphasize “risk groups” and AIDS blame, to models that focus on “risky behaviors” and universal risk. The centrality of choice making and individual risk management in these models suggests objective risk assessment free from moralizing arguments. The Polish national prevention strategy shifted to focus on choice making, address all risk groups, and include concrete prevention strategies. This shift created a backlash that resulted in the reassertion of moral arguments about risk and risk groups that positioned those most vulnerable to HIV outside the purview of prevention efforts. AIDS organizations working with marginalized, “morally problematic” populations used the label “at risk” to legitimize claims to resources. They enacted a model of risk reduction in which the relevant actor is the individual buffeted by social forces, and behavior change, and therefore HIV risk reduction, is a long process because of myriad forms of vulnerability clients face. Despite efforts to reconceptualize risk, organizations positioned the individual as the locus of HIV prevention interventions, rather than attempting to address the social context that shapes risk. PMID:20092052

  15. Endorsement of Compulsory HIV Vaccination Policy among Populations at High Risk of HIV Exposure (LA VOICES)

    PubMed Central

    Newman, Peter A.; Lee, Sung-Jae; Rudy, Ellen T.; Diamant, Allison; Duan, Naihua; Nakazano, Terry; Cunningham, William E.

    2014-01-01

    Compulsory vaccination is a frequently implemented policy option for ensuring comprehensive vaccine coverage. Ongoing controversies around human papillomavirus vaccine dissemination, and suboptimal coverage, suggest the value of assessing acceptability of compulsory vaccinations—particularly among likely target populations—in advance of their public availability to support evidence-informed interventions. With the first HIV vaccine to demonstrate partial efficacy in a large-scale clinical trial, we examined individual characteristics and attitudes associated with support for compulsory HIV vaccination policy among a diverse, representative sample of adults attending probable HIV vaccine dissemination venues in a large urban county. Participants were recruited using three-stage probability sampling from likely venues for future HIV vaccine dissemination. We used Audio-CASI to administer a 60-minute structured questionnaire. Items included endorsement of compulsory HIV vaccination policy, sociodemographic characteristics, injecting drug use, vaccine attitudes and perceived HIV risk. Among 1225 participants (mean age = 36.8 years; 55.6% males, 37.6% non-English speaking Hispanic, 78.8% heterosexual, 25.7% injection drug users), almost half (48.2%) endorsed a compulsory HIV vaccination policy. Non-English speaking Hispanics compared to whites, participants with less than high school education, higher positive vaccine attitude scores and higher perceived HIV risk were significantly more likely, and people who inject drugs significantly less likely to endorse compulsory HIV vaccination. Public health interventions to promote positive vaccine attitudes and accurate perceptions of HIV risk among vulnerable populations, and strategies tailored for people who inject drugs, may build support for compulsory HIV vaccination policy and promote broad HIV vaccine coverage. PMID:24464325

  16. Endorsement of compulsory HIV vaccination policy among populations at high risk of HIV exposure (LA VOICES).

    PubMed

    Newman, Peter A; Lee, Sung-Jae; Rudy, Ellen T; Diamant, Allison; Duan, Naihua; Nakazono, Terry; Nakazano, Terry; Cunningham, William E

    2014-06-01

    Compulsory vaccination is a frequently implemented policy option for ensuring comprehensive vaccine coverage. Ongoing controversies around human papillomavirus vaccine dissemination, and suboptimal coverage, suggest the value of assessing acceptability of compulsory vaccinations-particularly among likely target populations-in advance of their public availability to support evidence-informed interventions. With the first HIV vaccine to demonstrate partial efficacy in a large-scale clinical trial, we examined individual characteristics and attitudes associated with support for compulsory HIV vaccination policy among a diverse, representative sample of adults attending probable HIV vaccine dissemination venues in a large urban county. Participants were recruited using three-stage probability sampling from likely venues for future HIV vaccine dissemination. We used Audio-CASI to administer a 60-min structured questionnaire. Items included endorsement of compulsory HIV vaccination policy, sociodemographic characteristics, injecting drug use, vaccine attitudes and perceived HIV risk. Among 1,225 participants (mean age = 36.8 years; 55.6 % males, 37.6 % non-English speaking Hispanic, 78.8 % heterosexual, 25.7 % injection drug users), almost half (48.2 %) endorsed a compulsory HIV vaccination policy. Non-English speaking Hispanics compared to whites, participants with less than high school education, higher positive vaccine attitude scores and higher perceived HIV risk were significantly more likely, and people who inject drugs significantly less likely to endorse compulsory HIV vaccination. Public health interventions to promote positive vaccine attitudes and accurate perceptions of HIV risk among vulnerable populations, and strategies tailored for people who inject drugs, may build support for compulsory HIV vaccination policy and promote broad HIV vaccine coverage. PMID:24464325

  17. HIV infection is a risk factor for venous thromboembolism.

    PubMed

    Copur, A Sinan; Smith, Peter R; Gomez, Victor; Bergman, Michael; Homel, Peter

    2002-05-01

    The reported incidence of venous thromboembolism (VTE) in patients with human immunodeficiency virus (HIV) infection has ranged from 0.25 to 0.96% in clinical studies, but up to 17% at autopsy. A preliminary analysis at our hospital suggested that the frequency of VTE among HIV-positive individuals might be higher than previously reported. To further evaluate this issue, we performed a retrospective study of patients with a diagnosis of VTE and/or HIV infection discharged from our hospital between July 1, 1998 and June 30, 1999. A total of 13,496 patients were discharged during the year of the study. There were 244 patients with VTE and 362 who were HIV-positive. Ten of the 244 patients with VTE were HIV-positive (4.1%). The frequency of VTE among HIV-positive individuals was 10/362 (2.8%) compared to 234/13134 (1.8%) in the non-HIV-positive group, but the difference is not statistically significant. However, in patients under age 50, the frequencies were significantly different: 10/302 (3.31%) versus 35/6594 (0.53%), respectively (p < 0.0001). The frequency of VTE in HIV-positive patients less than 50 years old (3.31%) was greater than in HIV-positive patients over 50 years of age (0/60), but the difference did not reach statistical significance. In contrast, in the non-HIV-positive group, VTE was significantly more frequent in those 50 and older compared to younger patients (3.04% versus 0.53%, p = 0.0001). Statistical analysis indicated that the direction of association between age and diagnosis of VTE differed for HIV-positive patients versus non-HIV-positive patients. Our results suggest that HIV-positive patients under age 50 are at increased risk for VTE compared with non-HIV-positive individuals. PMID:12055028

  18. Mental Health and Resilience in HIV/AIDS-Affected Children: A Review of the Literature and Recommendations for Future Research

    PubMed Central

    Betancourt, T.S.; Meyers-Ohki, S.E.; Charrow, A.; Hansen, N.

    2012-01-01

    Background To date, research on mental health in HIV-affected children (children who have an HIV-positive caregiver or live with the virus themselves) has focused on risk factors associated with the disease. However, simultaneous identification of factors that contribute to resilience in the face of risks is also needed. A greater understanding of modifiable protective processes that contribute to resilience in the mental health of children affected by HIV can inform the design of interventions that bolster naturally-occurring supports and contribute to early prevention or better management of risks. Methods We reviewed the recent literature on mental health and resilience in children and adolescents affected by HIV/AIDS. Literature searches of PsycInfo and PubMed were conducted during July-December 2011 consistent with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) standards. Qualitative and quantitative studies were included for review if primary research questions pertained to mental health and coping or protective processes in children and families affected by HIV/AIDS. All studies subject to full review were evaluated for quality using a modified Systematic Assessment of Quality in Observational Research (SAQOR) rating system. Results 171 unique studies were returned from online searches of the literature and bibliography mining. Of these, 29 were evaluated as pertaining directly to mental health and resilience in families and children living with HIV/AIDS. Eight studies presented qualitative analyses. Ten quantitative studies examined individual resources contributing to child resilience and four quantitative studies looked at family-level resources. Ten studies also investigated community-level interactions. Four presented findings from resilience-focused interventions. Conclusions There is a clear need for rigorous research on mental health and resilience in HIV-affected children and adolescents. The evidence base would greatly

  19. Developing a Brief Scale to Measure HIV Transmission Risk Among Injecting Drug Users

    PubMed Central

    Shahesmaeili, Armita; Haghdoost, Ali Akbar; Soori, Hamid

    2015-01-01

    Background: One of the main concerns of policymakers is to measure the impact of harm reduction programs and different interventions on the risk of HIV transmission among Injecting Drug Users (IDUs). Looking simultaneously at multiple factors and conditions that affect the risk of HIV transmission may provide policymakers a better insight into the mixed nature of HIV transmission. Objectives: The present study aimed to design a simple, brief, and multi-dimensional scale for measuring HIV transmission risk among IDUs. Patients and Methods: From October 2013 to March 2014, we conducted face-to-face interviews with 147 IDUs. Eligible participants were individuals 18 years or older who had injected drugs at least once during the last year and had not participated in similar studies within the 2 months before the interview. To design a scale for measuring HIV transmission risk, we specified 11 items, which address different dimensions of HIV risk taking behaviors/situations based on experts’ opinion. We applied exploratory factor analysis (EFA) with principal component extraction to develop scales. Eigen values greater than 1 were used as a criterion for factor extraction. Results: We extracted 7 items based on first factor, which were accounted for 21% of the variations. The final scale contained 7 items: 4 items were related to injecting practice and 3 items related to sexual behaviors. The Cronbach’s α coefficient was 0.66, acceptable for such a brief scale. Conclusions: Applying a simple and brief scale that incorporates the different dimensions of HIV transmission risk may provide policymakers and harm reductionists with a better understanding of HIV transmission in this key group and may be advantageous for evaluating intervention programs. PMID:26870713

  20. Adolescents and HIV: knowledge, behaviors, influences, and risk perceptions.

    PubMed

    Facente, A C

    2001-08-01

    Although the rate of progression from HIV to AIDS has slowed, the incidence of HIV infection has continued to rise. Many teenagers are knowledgeable about the risks and consequences of HIV, yet a large percentage do not perceive that they are personally at risk. Gaining insight into the perceptions and factors influencing the behavior of teens is critical in HIV and AIDS prevention. A structured 39-item questionnaire was designed to elicit answers that explored 4 areas: knowledge of HIV and AIDS, reported sexual behavior, perceived susceptibility to HIV, and factors influencing behavior. The mean age of the 78 respondents was 15.9 years. One important finding was that 74% of respondents perceived their knowledge of HIV transmission to be "good," yet only 33% were able to answer all of the 8 test questions in this area correctly. In addition, 80% of those who reported engaging in risky behavior such as multiple sexual partners or having sex without condoms also felt they were not personally at risk for HIV. PMID:11885323

  1. Promoting Reproductive Options for HIV-Affected Couples in Sub-Saharan Africa

    PubMed Central

    Mmeje, Okeoma; Cohen, Craig R.; Murage, Alfred; Ong’ech, John; Kiarie, James; van der Poel, Sheryl

    2014-01-01

    HIV-affected couples have unique challenges that require access to information and reproductive services which prevent HIV transmission to the uninfected partner and offspring while allowing couples to fulfill their reproductive goals. In high HIV prevalent regions of sub-Saharan Africa, HIV-affected couples require multipurpose prevention technologies (MPTs) to enhance their reproductive healthcare options beyond contraception and prevention of HIV/sexually transmitted infections (STIs) to include assistance in childbearing. The unique characteristics of the condom and its accepted use in conjunction with safer conception interventions allow HIV-serodiscordant couples an opportunity to maintain reproductive health, prevent HIV/STI transmission, and achieve their reproductive goals while timing conception. Rethinking the traditional view of the condom and incorporating a broader reproductive health perspective of HIV-affected couples into MPT methodologies will impact demand, acceptability, and uptake of these future technologies. PMID:25335844

  2. Behavioural risk factors for HIV/AIDS in a low-HIV prevalence Muslim nation: Bangladesh.

    PubMed

    Gibney, L; Choudhury, P; Khawaja, Z; Sarker, M; Vermund, S H

    1999-03-01

    A review of published and unpublished data indicates the prevalence of high-risk behaviours for HIV transmission in segments of the Bangladeshi population. These include casual unprotected sex, heterosexual as well as between males, prior to and after marriage. Intravenous drug use (IVDU) exists though illicit drugs are more commonly inhaled. There is a fear, however, that inhalers may turn to injecting drugs, as is common in neighbouring countries. The lack of public awareness of HIV/AIDS, and misconceptions about the disease, may contribute to continued high-risk behaviours by segments of the population and, thus, to the spread of HIV. Bangladesh's proximity to India and Myanmar (countries with high HIV endemicity and a rapidly growing number of cases) increases fears of an epidemic in Bangladesh. This proximity will only be a risk factor, however, if high-risk contacts occur between nationals of these countries. PMID:10340200

  3. Behavioural risk factors for HIV/AIDS in a low-HIV prevalence Muslim nation: Bangladesh

    PubMed Central

    Gibney, L; Choudhury, P; Khawaja, Z; Sarker, M; Vermund, SH

    2008-01-01

    Summary A review of published and unpublished data indicates the prevalence of high-risk behaviours for HIV transmission in segments of the Bangladeshi population. These include casual unprotected sex, heterosexual as well as between males, prior to and after marriage. Intravenous drug use (IVDU) exists though illicit drugs are more commonly inhaled. There is a fear, however, that inhalers may turn to injecting drugs, as is common in neighbouring countries. The lack of public awareness of HIV/AIDS, and misconceptions about the disease, may contribute to continued high-risk behaviours by segments of the population and, thus, to the spread of HIV. Bangladesh’s proximity to India and Myanmar (countries with high HIV endemicity and a rapidly growing number of cases) increases fears of an epidemic in Bangladesh. This proximity will only be a risk factor, however, if high-risk contacts occur between nationals of these countries. PMID:10340200

  4. Strengthening families to support children affected by HIV and AIDS.

    PubMed

    Richter, Linda M; Sherr, Lorraine; Adato, Michele; Belsey, Mark; Chandan, Upjeet; Desmond, Chris; Drimie, Scott; Haour-Knipe, Mary; Hosegood, Victoria; Kimou, Jose; Madhavan, Sangeetha; Mathambo, Vuyiswa; Wakhweya, Angela

    2009-01-01

    This paper provides an overview of the arguments for the central role of families, defined very broadly, and we emphasise the importance of efforts to strengthen families to support children affected by HIV and AIDS. We draw on work conducted in the Joint Learning Initiative on Children and AIDS's Learning Group 1: Strengthening Families, as well as published data and empirical literature to provide the rationale for family strengthening. We close with the following recommendations for strengthening families to ameliorate the effects of HIV and AIDS on children. Firstly, a developmental approach to poverty is an essential feature of responses to protect children affected by HIV and AIDS, necessary to safeguard their human capital. For this reason, access to essential services, such as health and education, as well as basic income security, must be at the heart of national strategic approaches. Secondly, we need to ensure that support garnered for children is directed to families. Unless we adopt a family oriented approach, we will not be in a position to interrupt the cycle of infection, provide treatment to all who need it and enable affected individuals to be cared for by those who love and feel responsible for them. Thirdly, income transfers, in a variety of forms, are desperately needed and positively indicated by available research. Basic economic security will relieve the worst distress experienced by families and enable them to continue to invest in the health care and education of their children. Lastly, interventions are needed to support distressed families and prevent knock-on negative outcomes through programmes such as home visiting, and protection and enhancement of children's potential through early child development efforts. PMID:22380973

  5. Strengthening families to support children affected by HIV and AIDS

    PubMed Central

    Richter, Linda M.; Sherr, Lorraine; Adato, Michèle; Belsey, Mark; Chandan, Upjeet; Desmond, Chris; Drimie, Scott; Haour-Knipe, Mary; Hosegood, Victoria; Kimou, Jose; Madhavan, Sangeetha; Mathambo, Vuyiswa; Wakhweya, Angela

    2009-01-01

    This paper provides an overview of the arguments for the central role of families, defined very broadly, and we emphasise the importance of efforts to strengthen families to support children affected by HIV and AIDS. We draw on work conducted in the Joint Learning Initiative on Children and AIDS's Learning Group 1: Strengthening Families, as well as published data and empirical literature to provide the rationale for family strengthening. We close with the following recommendations for strengthening families to ameliorate the effects of HIV and AIDS on children. Firstly, a developmental approach to poverty is an essential feature of responses to protect children affected by HIV and AIDS, necessary to safeguard their human capital. For this reason, access to essential services, such as health and education, as well as basic income security, must be at the heart of national strategic approaches. Secondly, we need to ensure that support garnered for children is directed to families. Unless we adopt a family oriented approach, we will not be in a position to interrupt the cycle of infection, provide treatment to all who need it and enable affected individuals to be cared for by those who love and feel responsible for them. Thirdly, income transfers, in a variety of forms, are desperately needed and positively indicated by available research. Basic economic security will relieve the worst distress experienced by families and enable them to continue to invest in the health care and education of their children. Lastly, interventions are needed to support distressed families and prevent knock-on negative outcomes through programmes such as home visiting, and protection and enhancement of children's potential through early child development efforts. PMID:22380973

  6. An Empiric HIV Risk Scoring Tool to Predict HIV-1 Acquisition in African Women

    PubMed Central

    Brown, Elizabeth; Palanee, Thesla; Nair, Gonasagrie; Gafoor, Zakir; Zhang, Jingyang; Richardson, Barbra A.; Chirenje, Zvavahera M.; Marrazzo, Jeanne M.; Baeten, Jared M.

    2016-01-01

    Objective: To develop and validate an HIV risk assessment tool to predict HIV acquisition among African women. Design: Data were analyzed from 3 randomized trials of biomedical HIV prevention interventions among African women (VOICE, HPTN 035, and FEM-PrEP). Methods: We implemented standard methods for the development of clinical prediction rules to generate a risk-scoring tool to predict HIV acquisition over the course of 1 year. Performance of the score was assessed through internal and external validations. Results: The final risk score resulting from multivariable modeling included age, married/living with a partner, partner provides financial or material support, partner has other partners, alcohol use, detection of a curable sexually transmitted infection, and herpes simplex virus 2 serostatus. Point values for each factor ranged from 0 to 2, with a maximum possible total score of 11. Scores ≥5 were associated with HIV incidence >5 per 100 person-years and identified 91% of incident HIV infections from among only 64% of women. The area under the curve (AUC) for predictive ability of the score was 0.71 (95% confidence interval [CI]: 0.68 to 0.74), indicating good predictive ability. Risk score performance was generally similar with internal cross-validation (AUC = 0.69; 95% CI: 0.66 to 0.73) and external validation in HPTN 035 (AUC = 0.70; 95% CI: 0.65 to 0.75) and FEM-PrEP (AUC = 0.58; 95% CI: 0.51 to 0.65). Conclusions: A discrete set of characteristics that can be easily assessed in clinical and research settings was predictive of HIV acquisition over 1 year. The use of a validated risk score could improve efficiency of recruitment into HIV prevention research and inform scale-up of HIV prevention strategies in women at highest risk. PMID:26918545

  7. HIV testing behaviour and use of risk reduction strategies by HIV risk category among MSM in Vancouver.

    PubMed

    Bogowicz, Paul; Moore, David; Kanters, Steve; Michelow, Warren; Robert, Wayne; Hogg, Robert; Gustafson, Réka; Gilbert, Mark

    2016-03-01

    We carried out an analysis of a serobehavioural study of men who have sex with men >19 years of age in Vancouver, Canada to examine HIV testing behaviour and use of risk reduction strategies by HIV risk category, as defined by routinely gathered clinical data. We restricted our analysis to those who self-identified as HIV-negative, completed a questionnaire, and provided a dried blood spot sample. Of 842 participants, 365 (43.3%) were categorised as lower-risk, 245 (29.1%) as medium-risk and 232 (27.6%) as higher-risk. The prevalence of undiagnosed HIV infection was low (lower 0.8%, medium 3.3%, higher 3.9%; p = 0.032). Participants differed by risk category in terms of having had an HIV test in the previous year (lower 46.5%, medium 54.6%, higher 67.0%; p < 0.001) and in their use of serosorting (lower 23.3%, medium 48.3%, higher 43.1%; p < 0.001) and only having sex with HIV-positive men if those men had low viral loads or were taking HIV medication (lower 5.1%, medium 4.8%, higher 10.9%; p = 0.021) as risk reduction strategies. These findings speak to the need to consider segmented health promotion services for men who have sex with men with differing risk profiles. Risk stratification could be used to determine who might benefit from tailored multiple health promotion interventions, including HIV pre-exposure prophylaxis. PMID:25736346

  8. The STD and HIV Epidemics in African American Youth: Reconceptualizing Approaches to Risk Reduction

    ERIC Educational Resources Information Center

    Miller, Kim S.; Boyer, Cherrie B.; Cotton, Garnette

    2004-01-01

    Sexually transmitted infections, including human immunodeficiency virus (HIV), disproportionately affect African American adolescents and young adults. Many of our current strategies and approaches have been inadequate in the promotion of risk reduction among youth and need to be reconceptualized. This article identifies issues that may guide…

  9. TB/HIV risk factors identified from a General Household Survey of South Africa in 2006

    PubMed Central

    Appunni, Sathiya Susuman; Blignaut, Renette; Lougue, Siaka

    2014-01-01

    Abstract The level of human immunodeficiency virus (HIV), tuberculosis (TB) as well as the co-infection TB/HIV in South Africa is among the highest in the world. TB is curable while HIV is not, yet the combination of both is a growing feature in the world. This study examined TB and HIV affecting people living in South Africa. Analyses have been undertaken based on data from the General Household Survey of South Africa in 2006. The study focused on respondents aged 15–49 years, corresponding to a total of 55,384 people composed of 25,859 males and 29,525 females. Among this population, 5935 people suffered from illness/injury, including 2469 (41.6%) males and 3466 (58.4%) females. Weighted multivariate logistic regression is performed on TB and/or HIV in association with the province, background characteristics of the target population, and selected socioeconomic and demographic variables included in the survey. In this study we focus on variables of health status and whether subjects suffered from TB and/or HIV. Findings of this investigation show that TB is the second most common cause of illness in the provinces of KwaZulu-Natal (KN) (9.1%), North West (5.4%) and Limpopo (4.2%). People who are married have a 50% lower risk compared to those currently not married to suffer from TB and/or HIV. Those with living spouses have a 5% lower risk to suffer from TB and/or HIV than those whose partners are not alive. This study concluded that rapid action is needed to curb the spread of TB and/or HIV to produce a healthy population. Therefore, follow-up care and special preventative measures are urgently needed in provinces with higher reported rates of TB and/or HIV such as KN. PMID:24820431

  10. TB/HIV risk factors identified from a General Household Survey of South Africa in 2006.

    PubMed

    Appunni, Sathiya Susuman; Blignaut, Renette; Lougue, Siaka

    2014-01-01

    The level of human immunodeficiency virus (HIV), tuberculosis (TB) as well as the co-infection TB/HIV in South Africa is among the highest in the world. TB is curable while HIV is not, yet the combination of both is a growing feature in the world. This study examined TB and HIV affecting people living in South Africa. Analyses have been undertaken based on data from the General Household Survey of South Africa in 2006. The study focused on respondents aged 15-49 years, corresponding to a total of 55,384 people composed of 25,859 males and 29,525 females. Among this population, 5935 people suffered from illness/injury, including 2469 (41.6%) males and 3466 (58.4%) females. Weighted multivariate logistic regression is performed on TB and/or HIV in association with the province, background characteristics of the target population, and selected socioeconomic and demographic variables included in the survey. In this study we focus on variables of health status and whether subjects suffered from TB and/or HIV. Findings of this investigation show that TB is the second most common cause of illness in the provinces of KwaZulu-Natal (KN) (9.1%), North West (5.4%) and Limpopo (4.2%). People who are married have a 50% lower risk compared to those currently not married to suffer from TB and/or HIV. Those with living spouses have a 5% lower risk to suffer from TB and/or HIV than those whose partners are not alive. This study concluded that rapid action is needed to curb the spread of TB and/or HIV to produce a healthy population. Therefore, follow-up care and special preventative measures are urgently needed in provinces with higher reported rates of TB and/or HIV such as KN. PMID:24820431

  11. [Amniocentesis and viral risk (hepatitis B, C virus and HIV)].

    PubMed

    Ducarme, G; Ceccaldi, P-F; Bernuau, J; Luton, D

    2009-10-01

    Very few studies have properly addressed to the risk of fetal hepatitis B (HBV), hepatitis C (HCV) or human immunodeficiency virus (HIV) infection through amniocentesis. For HBV, this risk is low. However, knowledge of the maternal hepatitis B e antigen status is valuable in the counselling of risks associated with amniocentesis. For HCV, the risk is not well known but cannot be excluded. For HIV, it seems rational to propose a viral test before amniocentesis for patients with contamination's risk and to postpone the sampling in cases with positive results in order to obtain an undetectable HIV-1 RNA viral load. For these reasons, it can be useful to analyse for each virus the benefit of amniocentesis and the risk of mother-to-infant transmission, and to inform the patient. PMID:19679409

  12. HIV-Risk Index: Development and Validation of a Brief Risk Index for Hispanic Young People.

    PubMed

    Ballester-Arnal, Rafael; Gil-Llario, María Dolores; Castro-Calvo, Jesús; Giménez-García, Cristina

    2016-08-01

    The prevalence of HIV risk behaviors among young people facilitates the spread of HIV, in particular regarding unsafe sex behavior, although this trend is different within this population. For this reason, identifying the riskier young population is required to prevent HIV infection. The main purpose of this study was to develop and validate a risk index to assess the different sexual HIV risk exposure among Hispanic Young people. For this purpose, 9861 Spanish young people were randomly distributed into two groups (derivation and validation group). According to the results, the factor analyses grouped the nine items of the HIV- risk index into two factors (factor 1, direct sexual risk indicators and factor 2, indirect sexual risk indicators) with an equal structure for men and women by a multi-group confirmatory factor analysis. The variance explained was 54.26 %. Moreover, the Cronbach's alpha coefficient revealed high internal reliability (α = .79) and the convergent validity supported its evidence based on different HIV risk indexes. Therefore, the HIV-risk index seem to be a rigorous and valid measure to estimate HIV risk exposure among young people. PMID:27125242

  13. Universal HIV screening at a major metropolitan TB clinic: HIV prevalence and high-risk behaviors among TB patients.

    PubMed Central

    Weis, S E; Foresman, B; Cook, P E; Matty, K J

    1999-01-01

    OBJECTIVES: This study assessed the outcome of implementing a policy of universal screening of patients with tuberculosis (TB) for HIV infection at a major metropolitan public health TB clinic. METHODS: HIV serologic testing was completed on 768 (93%) of 825 eligible patients. Ninety-eight HIV-positive cases (13%) were compared with 670 HIV-negative cases. The presence of adult HIV risk factors was determined by structured interview and review of medical records. RESULTS: One or more HIV risk factors were present in 93% of HIV-positive cases and 42% of HIV-negative cases. CONCLUSIONS: The metropolitan TB clinic is well suited for HIV screening, and HIV-antibody testing and counseling should be provided to all TB patients. PMID:9987468

  14. Trends in Serosorting and the Association With HIV/STI Risk Over Time Among Men Who Have Sex With Men

    PubMed Central

    Dombrowski, Julia C.; Swanson, Fred; Kerani, Roxanne P.; Katz, David A.; Barbee, Lindley A.; Hughes, James P.; Manhart, Lisa E.; Golden, Matthew R.

    2016-01-01

    Background: Serosorting among men who have sex with men (MSM) is common, but recent data to describe trends in serosorting are limited. How serosorting affects population-level trends in HIV and other sexually transmitted infection (STI) risk is largely unknown. Methods: We collected data as part of routine care from MSM attending a sexually transmitted disease clinic (2002–2013) and a community-based HIV/sexually transmitted disease testing center (2004–2013) in Seattle, WA. MSM were asked about condom use with HIV-positive, HIV-negative, and unknown-status partners in the prior 12 months. We classified behaviors into 4 mutually exclusive categories: no anal intercourse (AI); consistent condom use (always used condoms for AI); serosorting [condom-less anal intercourse (CAI) only with HIV-concordant partners]; and nonconcordant CAI (CAI with HIV-discordant/unknown-status partners; NCCAI). Results: Behavioral data were complete for 49,912 clinic visits. Serosorting increased significantly among both HIV-positive and HIV-negative men over the study period. This increase in serosorting was concurrent with a decrease in NCCAI among HIV-negative MSM, but a decrease in consistent condom use among HIV-positive MSM. Adjusting for time since last negative HIV test, the risk of testing HIV positive during the study period decreased among MSM who reported NCCAI (7.1%–2.8%; P= 0.02), serosorting (2.4%–1.3%; P = 0.17), and no CAI (1.5%–0.7%; P = 0.01). Serosorting was associated with a 47% lower risk of testing HIV positive compared with NCCAI (adjusted prevalence ratio = 0.53; 95% confidence interval: 0.45 to 0.62). Conclusions: Between 2002 and 2013, serosorting increased and NCCAI decreased among Seattle MSM. These changes paralleled a decline in HIV test positivity among MSM. PMID:26885806

  15. Stresses on Grandparents and Other Relatives Caring for Children Affected by HIV/AIDS

    ERIC Educational Resources Information Center

    Linsk, Nathan L.; Mason, Sally

    2004-01-01

    This study investigated the needs of relative caregivers of children in the child welfare system whose parents had HIV. Families of children supported by the state child welfare agency were invited to participate in the study; 17 families reported that HIV affected them and 11 families did not identify HIV as an issue. The findings indicate that…

  16. The Role of Community in Meeting the Needs of African-American HIV Affected Families.

    ERIC Educational Resources Information Center

    Mason, Sally

    2002-01-01

    Assessed the service needs of HIV-affected families in an inner city African American community with a high HIV/AIDS seroprevalence. Data from focus group interviews indicated a lack of family-sensitive HIV/AIDS community services. Participants noted the problem with stigma and identified community awareness and education as critical to serving…

  17. Fatherhood, marriage and HIV risk among young men in rural Uganda.

    PubMed

    Mathur, Sanyukta; Higgins, Jenny A; Thummalachetty, Nityanjali; Rasmussen, Mariko; Kelley, Laura; Nakyanjo, Neema; Nalugoda, Fred; Santelli, John S

    2016-01-01

    Compared to a large body of work on how gender may affect young women's vulnerability to HIV, we know little about how masculine ideals and practices relating to marriage and fertility desires shape young men's HIV risk. Using life-history interview data with 30 HIV-positive and HIV-negative young men aged 15-24 years, this analysis offers an in-depth perspective on young men's transition through adolescence, the desire for fatherhood and experience of sexual partnerships in rural Uganda. Young men consistently reported the desire for fatherhood as a cornerstone of masculinity and transition to adulthood. Ideally young men wanted children within socially sanctioned unions. Yet, most young men were unable to realise their marital intentions. Gendered expectations to be economic providers combined with structural constraints, such as limited access to educational and income-generating opportunities, led some young men to engage in a variety of HIV-risk behaviours. Multiple partnerships and limited condom use were at times an attempt by some young men to attain some part of their aspirations related to fatherhood and marriage. Our findings suggest that young men possess relationship and parenthood aspirations that - in an environment of economic scarcity - may influence HIV-related risk. PMID:26540470

  18. Predicting the impact of a partially effective HIV vaccine and subsequent risk behavior change on the heterosexual HIV epidemic in low- and middle-income countries: A South African example.

    PubMed

    Andersson, Kyeen M; Owens, Douglas K; Vardas, Eftyhia; Gray, Glenda E; McIntyre, James A; Paltiel, A David

    2007-09-01

    We developed a mathematical model to simulate the impact of various partially effective preventive HIV vaccination scenarios in a population at high risk for heterosexually transmitted HIV. We considered an adult population defined by gender (male/female), disease stage (HIV-negative, HIV-positive, AIDS, and death), and vaccination status (unvaccinated/vaccinated) in Soweto, South Africa. Input data included initial HIV prevalence of 20% (women) and 12% (men), vaccination coverage of 75%, and exclusive male negotiation of condom use. We explored how changes in vaccine efficacy and postvaccination condom use would affect HIV prevalence and total HIV infections prevented over a 10-year period. In the base-case scenario, a 40% effective HIV vaccine would avert 61,000 infections and reduce future HIV prevalence from 20% to 13%. A 25% increase (or decrease) in condom use among vaccinated individuals would instead avert 75,000 (or only 46,000) infections and reduce the HIV prevalence to 12% (or only 15%). Furthermore, certain combinations of increased risk behavior and vaccines with <43% efficacy could worsen the epidemic. Even modestly effective HIV vaccines can confer enormous benefits in terms of HIV infections averted and decreased HIV prevalence. However, programs to reduce risk behavior may be important components of successful vaccination campaigns. PMID:17589368

  19. Feasibility and Acceptability of Cell Phone Diaries to Measure HIV Risk Behavior Among Female Sex Workers

    PubMed Central

    Hensel, Devon J.; Fortenberry, J. Dennis; Garfein, Richard S.; Gunn, Jayleen K. L.; Wiehe, Sarah E.

    2015-01-01

    Individual, social, and structural factors affecting HIV risk behaviors among female sex workers (FSWs) are difficult to assess using retrospective surveys methods. To test the feasibility and acceptability of cell phone diaries to collect information about sexual events, we recruited 26 FSWs in Indianapolis, Indiana (US). Over 4 weeks, FSWs completed twice daily digital diaries about their mood, drug use, sexual interactions, and daily activities. Feasibility was assessed using repeated measures general linear modeling and descriptive statistics examined event-level contextual information and acceptability. Of 1,420 diaries expected, 90.3 % were completed by participants and compliance was stable over time (p > .05 for linear trend). Sexual behavior was captured in 22 % of diaries and participant satisfaction with diary data collection was high. These data provide insight into event-level factors impacting HIV risk among FSWs. We discuss implications for models of sexual behavior and individually tailored interventions to prevent HIV in this high-risk group. PMID:24643312

  20. Social environment and HIV risk among MSM in Hanoi and Thai Nguyen

    PubMed Central

    Berry, MC; Go, VF; Quan, VM; Minh, NL; Ha, TV; Mai, NV; Sarin, E; Beyrer, C

    2016-01-01

    Little is known about the effect of the social environment on HIV risk in gay men in northern Vietnam, particularly in rural areas. This qualitative research study conducted 4 key informant interviews and 30 in-depth interviews of men in two northern Vietnamese cities: Hanoi, a large city, and Thai Nguyen, a smaller town. Hanoi has experienced a growth in the number of places where gay men can socialize, access HIV prevention services, and discuss health issues. Thai Nguyen lacks these open venues. However, homosexuality is still highly stigmatized in the general population in both cities. This stigma affects the number of partners and level of sexual risk of participants. Also, men generally reported little communication between partners about sexual risk. While stigma in the general community is difficult to change, social environments where gay men can openly communicate creates an opportunity for HIV prevention and social support. PMID:22624852

  1. Social models of HIV risk among young adults in Lesotho.

    PubMed

    Bulled, Nicola L

    2015-01-01

    Extensive research over the past 30 years has revealed that individual and social determinants impact HIV risk. Even so, prevention efforts focus primarily on individual behaviour change, with little recognition of the dynamic interplay of individual and social environment factors that further exacerbate risk engagement. Drawing on long-term research with young adults in Lesotho, I examine how social environment factors contribute to HIV risk. During preliminary ethnographic analysis, I developed novel scales to measure social control, adoption of modernity, and HIV knowledge. In survey research, I examined the effects of individual characteristics (i.e., socioeconomic status, HIV knowledge, adoption of modernity) and social environment (i.e., social control) on HIV risk behaviours. In addition, I measured the impact of altered environments by taking advantage of an existing situation whereby young adults attending a national college are assigned to either a main campus in a metropolitan setting or a satellite campus in a remote setting, irrespective of the environment in which they were socialised as youth. This arbitrary assignment process generates four distinct groups of young adults with altered or constant environments. Regression models show that lower levels of perceived social control and greater adoption of modernity are associated with HIV risk, controlling for other factors. The impact of social control and modernity varies with environment dynamics. PMID:26284999

  2. The efficacy of serostatus disclosure for HIV Transmission risk reduction.

    PubMed

    O'Connell, Ann A; Reed, Sandra J; Serovich, Julianne A

    2015-02-01

    Interventions to assist HIV+ persons in disclosing their serostatus to sexual partners can play an important role in curbing rates of HIV transmission among men who have sex with men (MSM). Based on the methods of Pinkerton and Galletly (AIDS Behav 11:698-705, 2007), we develop a mathematical probability model for evaluating effectiveness of serostatus disclosure in reducing the risk of HIV transmission and extend the model to examine the impact of serosorting. In baseline data from 164 HIV+ MSM participating in a randomized controlled trial of a disclosure intervention, disclosure is associated with a 45.0 % reduction in the risk of HIV transmission. Accounting for serosorting, a 61.2 % reduction in risk due to disclosure was observed in serodisconcordant couples. The reduction in risk for seroconcordant couples was 38.4 %. Evidence provided supports the value of serostatus disclosure as a risk reduction strategy in HIV+ MSM. Interventions to increase serostatus disclosure and that address serosorting behaviors are needed. PMID:25164375

  3. MULTIPLE TRANSITIONS AND HIV RISK AMONG AFRICAN SCHOOL GIRLS

    PubMed Central

    Mojola, Sanyu A

    2012-01-01

    Why are orphaned girls at particular risk of contracting HIV? Using a transition to adulthood framework, this paper uses qualitative data from Nyanza province, Kenya to explore pathways to HIV risk among orphaned and non-orphaned high school girls. I show how co-occurring processes such as residential transition out of the parental home, negotiating financial access and relationship transitions interact to produce disproportionate risk for orphan girls. I also explore the role of financial provision and parental love in modifying girls’ trajectories to risk. I propose a testable theoretical model based on the qualitative findings and suggest policy implications. PMID:21500699

  4. A Descriptive Analysis of HIV Prevalence, HIV Service Uptake, and HIV-Related Risk Behaviour among Patients Attending a Mental Health Clinic in Rural Malawi

    PubMed Central

    Lommerse, Kinke; Stewart, Robert C.; Chilimba, Queen; van den Akker, Thomas; Lund, Crick

    2013-01-01

    Background Human immunodeficiency virus (HIV) and mental illness are interlinked health problems; mental illness may pose a risk for contracting HIV and HIV-positive individuals are at higher risk of mental illness. However, in countries with high HIV prevalence, the main focus of HIV-related health programmes is usually on prevention and treatment of somatic complications of HIV, and mental illness is not given high priority. We examined HIV prevalence, uptake of HIV services, and HIV-related risk behaviour among people attending a mental health clinic in rural Malawi. Methodology Semi-structured interviews were performed with patients capable to consent (94%), and with those accompanied by a capable caregiver who consented. HIV counselling and testing was offered to participants. Findings Among 174 participants, we collected 162 HIV test results (91%). HIV prevalence was 14.8%. Women were three times as likely to be HIV-positive compared to men. Two-thirds of participants reported having been tested for HIV prior to this study. The uptake of HIV-services among HIV-positive patients was low: 35% did not use recommended prophylactic therapy and 44% of patients not receiving antiretroviral treatment (ART) had never been assessed for ART eligibility. The reported rate of sexual activity was 61%, and 9% of sexually active participants had multiple partners. Inconsistent condom use with stable (89%) and occasional (79%) sexual partners, and absence of knowledge of the HIV status of those partners (53%, 63%) indicate high levels of sexual risk behaviour. Conclusions HIV-prevalence among persons attending the clinic, particularly men, was lower than among the general population in a population survey. The rate of HIV testing was high, but there was low uptake of preventive measures and ART. This illustrates that HIV-positive individuals with mental illness or epilepsy constitute a vulnerable population. HIV programmes should include those with neuropsychiatric illness

  5. Latent Model Analysis of Substance Use and HIV Risk Behaviors among High-Risk Minority Adults

    ERIC Educational Resources Information Center

    Wang, Min Qi; Matthew, Resa F.; Chiu, Yu-Wen; Yan, Fang; Bellamy, Nikki D.

    2007-01-01

    Objectives: This study evaluated substance use and HIV risk profile using a latent model analysis based on ecological theory, inclusive of a risk and protective factor framework, in sexually active minority adults (N=1,056) who participated in a federally funded substance abuse and HIV prevention health initiative from 2002 to 2006. Methods: Data…

  6. Structural drivers and social protection: mechanisms of HIV risk and HIV prevention for South African adolescents

    PubMed Central

    Cluver, Lucie Dale; Orkin, Frederick Mark; Meinck, Franziska; Boyes, Mark Edward; Sherr, Lorraine

    2016-01-01

    Introduction Social protection is high on the HIV-prevention agenda for youth in sub-Saharan Africa. However, questions remain: How do unconditional cash transfers work? What is the effect of augmenting cash provision with social care? And can “cash plus care” social protection reduce risks for adolescents most vulnerable to infection? This study tackles these questions by first identifying mediated pathways to adolescent HIV risks and then examining potential main and moderating effects of social protection in South Africa. Methods This study was a prospective observational study of 3515 10-to-17-year-olds (56.7% female; 96.8% one-year retention). Within randomly selected census areas in four rural and urban districts in two South African provinces, all homes with a resident adolescent were sampled between 2009/2010 and 2011/2012. Measures included 1) potential structural drivers of HIV infection such as poverty and community violence; 2) HIV risk behaviours; 3) hypothesized psychosocial mediating factors; and 4) types of social protection involving cash and care. Using gender-disaggregated analyses, longitudinal mediation models were tested for potential main and moderating effects of social protection. Results Structural drivers were associated with increased onset of adolescent HIV risk behaviour (p<0.001, B=0.06, SE=0.01), fully mediated by increased psychosocial problems. Both cash and care aspects of social protection were associated with reductions in HIV risk behaviour and psychosocial deprivations. In addition, cash social protection moderated risk pathways: for adolescent girls and boys experiencing more acute structural deprivation, social protection had the greatest associations with HIV risk prevention (e.g. moderation effects for girls: B=−0.08, p<0.002 between structural deprivation and psychosocial problems, and B=−0.07, p<0.001 between psychosocial problems and HIV risk behaviour). Conclusions Adolescents with the greatest structural

  7. HIV risk of transmission behaviour amongst HIV-infected prisoners and its correlates.

    PubMed

    O'Mahony, P; Barry, M

    1992-11-01

    Thirty-eight from a total of 42 known HIV-positive prisoners in the Irish prison system voluntarily cooperated in a survey of psychological attitudes, knowledge of risk behaviour, intentions with respect to future risk behaviour, and actual past risk behaviour. Of this group, 65% reported that they had put others at risk of HIV, since they became aware of their own HIV+ status. Only 16% stated that they would definitely not share their drug-taking equipment in the future and 32% that they would always use a condom in sexual intercourse. In general, psychological and biographical variables were not strongly related to whether or not the respondents had put others at risk of HIV. Nor were there any significant differences in knowledge of at risk behaviour between those who had and those who had not put others at risk. However, there was some evidence for considerable independence between risk-taking behaviour in the sexual and in the drug-taking domains, in that risk-taking in one area was not highly predictive of risk-taking in the other. PMID:1458034

  8. Our fears about HIV. Reducing risk at work.

    PubMed

    1997-01-01

    The responses of hospital staff in Lusaka, Zambia, to HIV/AIDS were investigated in a series of small group discussions. Included were nurses, midwives, porters, cleaners, laundry workers, mortuary attendants, and medical students. The hospital had no clear guidelines for health workers to follow in the event of a needle-stick injury (experienced by most nurses) and does not make zidovudine available to medical staff after exposure to HIV. Many health workers indicated they would refuse HIV testing after such an injury because of fears the result would be positive and they would face social stigmatization and ostracism. Most discussants felt they were highly likely to contract HIV through occupational exposure, but had a fatalistic attitude toward the possibility of risk reduction. Overall, these findings indicate an urgent need to educate hospital workers about HIV transmission and reduce the fear and stigma associated with AIDS. PMID:12293312

  9. The Relationship between Housing Status and HIV Risk among Active Drug Users: A Qualitative Analysis

    PubMed Central

    Dickson-Gomez, Julia; Hilario, Helena; Convey, Mark; Corbett, A. Michelle; Weeks, Margaret; Martinez, Maria

    2009-01-01

    This paper examines the relationship between housing status and HIV risk using longitudinal, qualitative data collected in 2004-2005, from a purposeful sample of 65 active drug users in a variety of housed and homeless situations in Hartford, Connecticut. These data were supplemented with observations and in-depth interviews regarding drug use behavior collected in 2001-2005 to evaluate a peer-led HIV prevention intervention. Data reveal differences in social context within and among different housing statuses that affect HIV risky or protective behaviors including the ability to carry drug paraphernalia and HIV prevention materials, the amount of drugs in the immediate environment, access to subsidized and supportive housing, and relationships with others with whom drug users live. Policy implications of the findings, limitations to the data and future research are discussed. PMID:19142817

  10. Stigma and HIV risk among Metis in Nepal.

    PubMed

    Wilson, Erin; Pant, Sunil Babu; Comfort, Megan; Ekstrand, Maria

    2011-03-01

    Similar to other parts of Asia, the HIV epidemic in Nepal is concentrated among a small number of groups, including transgender people, or Metis. This study was conducted to explore the social context of stigma among Metis in Nepal to better understand their risk for HIV. Fourteen in-depth interviews were conducted with Metis in Kathmandu, Nepal. We found that stigma from families leading to rural-urban migration exposed Metis to discrimination from law enforcement, employers and sexual partners, which influenced their risk for HIV. Specific HIV-related risks identified were rape by law enforcement officers, inconsistent condom use and high reported numbers of sexual partners. These data point to an immediate need to work with law enforcement to reduce violence targeting Metis. HIV prevention, housing and employment outreach to Metis in rural areas and those who migrate to urban areas is also needed. Finally, there is a need for more research to determine the prevalence of HIV among Metis, to explore risk within sexual networks and to better understand of the relationship between Metis and their families in order to develop future programmes and interventions. PMID:21058085

  11. Stigma and HIV risk among Metis in Nepal

    PubMed Central

    Wilson, Erin; Pant, Sunil Babu; Comfort, Megan; Ekstrand, Maria

    2011-01-01

    Similar to other parts of Asia, the HIV epidemic in Nepal is concentrated among a small number of groups, including transgender people, or Metis. This study was conducted to explore the social context of stigma among Metis in Nepal to better understand their risk for HIV. Fourteen in-depth interviews were conducted with Metis in Kathmandu, Nepal. We found that stigma from families leading to rural-urban migration exposed Metis to discrimination from law enforcement, employers and sexual partners, which influenced their risk for HIV. Specific HIV-related risks identified were rape by law enforcement officers, inconsistent condom use and high reported numbers of sexual partners. These data point to an immediate need to work with law enforcement to reduce violence targeting Metis. HIV prevention, housing and employment outreach to Metis in rural areas and those who migrate to urban areas is also needed. Finally, there is a need for more research to determine the prevalence of HIV among Metis, to explore risk within sexual networks and to better understand of the relationship between Metis and their families in order to develop future programmes and interventions. PMID:21058085

  12. HLA class II genes modulate vaccine-induced antibody responses to affect HIV-1 acquisition.

    PubMed

    Prentice, Heather A; Tomaras, Georgia D; Geraghty, Daniel E; Apps, Richard; Fong, Youyi; Ehrenberg, Philip K; Rolland, Morgane; Kijak, Gustavo H; Krebs, Shelly J; Nelson, Wyatt; DeCamp, Allan; Shen, Xiaoying; Yates, Nicole L; Zolla-Pazner, Susan; Nitayaphan, Sorachai; Rerks-Ngarm, Supachai; Kaewkungwal, Jaranit; Pitisuttithum, Punnee; Ferrari, Guido; McElrath, M Juliana; Montefiori, David C; Bailer, Robert T; Koup, Richard A; O'Connell, Robert J; Robb, Merlin L; Michael, Nelson L; Gilbert, Peter B; Kim, Jerome H; Thomas, Rasmi

    2015-07-15

    In the RV144 vaccine trial, two antibody responses were found to correlate with HIV-1 acquisition. Because human leukocyte antigen (HLA) class II-restricted CD4(+) T cells are involved in antibody production, we tested whether HLA class II genotypes affected HIV-1-specific antibody levels and HIV-1 acquisition in 760 individuals. Indeed, antibody responses correlated with acquisition only in the presence of single host HLA alleles. Envelope (Env)-specific immunoglobulin A (IgA) antibodies were associated with increased risk of acquisition specifically in individuals with DQB1*06. IgG antibody responses to Env amino acid positions 120 to 204 were higher and were associated with decreased risk of acquisition and increased vaccine efficacy only in the presence of DPB1*13. Screening IgG responses to overlapping peptides spanning Env 120-204 and viral sequence analysis of infected individuals defined differences in vaccine response that were associated with the presence of DPB1*13 and could be responsible for the protection observed. Overall, the underlying genetic findings indicate that HLA class II modulated the quantity, quality, and efficacy of antibody responses in the RV144 trial. PMID:26180102

  13. HLA class II genes modulate vaccine-induced antibody responses to affect HIV-1 acquisition

    PubMed Central

    Prentice, Heather A.; Tomaras, Georgia D.; Geraghty, Daniel E.; Apps, Richard; Fong, Youyi; Ehrenberg, Philip K.; Rolland, Morgane; Kijak, Gustavo H.; Krebs, Shelly J.; Nelson, Wyatt; DeCamp, Allan; Shen, Xiaoying; Yates, Nicole L.; Zolla-Pazner, Susan; Nitayaphan, Sorachai; Rerks-Ngarm, Supachai; Kaewkungwal, Jaranit; Pitisuttithum, Punnee; Ferrari, Guido; Juliana McElrath, M.; Montefiori, David C.; Bailer, Robert T.; Koup, Richard A.; O’Connell, Robert J.; Robb, Merlin L.; Michael, Nelson L.; Gilbert, Peter B.; Kim, Jerome H.; Thomas, Rasmi

    2016-01-01

    In the RV144 vaccine trial, two antibody responses were found to correlate with HIV-1 acquisition. Because human leukocyte antigen (HLA) class II–restricted CD4+ T cells are involved in antibody production, we tested whether HLA class II genotypes affected HIV-1–specific antibody levels and HIV-1 acquisition in 760 individuals. Indeed, antibody responses correlated with acquisition only in the presence of single host HLA alleles. Envelope (Env)–specific immunoglobulin A (IgA) antibodies were associated with increased risk of acquisition specifically in individuals with DQB1*06. IgG antibody responses to Env amino acid positions 120 to 204 were higher and were associated with decreased risk of acquisition and increased vaccine efficacy only in the presence of DPB1*13. Screening IgG responses to overlapping peptides spanning Env 120–204 and viral sequence analysis of infected individuals defined differences in vaccine response that were associated with the presence of DPB1*13 and could be responsible for the protection observed. Overall, the underlying genetic findings indicate that HLA class II modulated the quantity, quality, and efficacy of antibody responses in the RV144 trial. PMID:26180102

  14. HIV Prevalence and Risk among Heterosexual Methamphetamine Injectors in California

    PubMed Central

    Kral, Alex H.; Lorvick, Jennifer; Martinez, Alexis; Lewis, Megan A.; Orr, Alexander; Anderson, Rachel; Flynn, Neil; Bluthenthal, Ricky N.

    2013-01-01

    This CDC-funded study compares HIV prevalence and risk behavior among heterosexual methamphetamine (n=428) and non-methamphetamine (n=878) injectors in California, USA during 2001–2003. While HIV was not highly prevalent among methamphetamine injectors (3%), sexual and injection risk behaviors were highly prevalent (ranging from 21% to 72%). In multivariate analyses, methamphetamine injectors had higher odds than non-methamphetamine injectors of unprotected vaginal intercourse and sex with five or more sexual partners in the past six months, and of distributive and receptive syringe sharing in the past thirty days. There was no significant difference in HIV sero-status by methamphetamine use. Suggestions are made for designing HIV prevention programs. PMID:21391786

  15. HIV and smoking: associated risks and prevention strategies.

    PubMed

    Kariuki, Wanjiku; Manuel, Jennifer I; Kariuki, Ngaruiya; Tuchman, Ellen; O'Neal, Johnnie; Lalanne, Genevieve A

    2016-01-01

    High rates of smoking among persons living with HIV (PLWH) may reduce the effectiveness of HIV treatment and contribute to significant morbidity and mortality. Factors associated with smoking in PLWH include mental health comorbidity, alcohol and drug use, health-related quality of life, smoking among social networks and supports, and lack of access to care. PLWH smokers are at a higher risk of numerous HIV-associated infections and non-HIV related morbidity, including a decreased response to antiretroviral treatment, impaired immune functioning, reduced cognitive functioning, decreased lung functioning, and cardiovascular disease. Seventeen smoking cessation interventions were identified, of which seven were randomized controlled trials. The most effective studies combined behavioral and pharmacotherapy treatments that incorporated comprehensive assessments, multiple sessions, and cognitive-behavioral and motivational strategies. Smoking cessation interventions that are tailored to the unique needs of diverse samples and incorporate strategies to reduce the risk of relapse are essential to advancing health outcomes in PLWH. PMID:26766919

  16. HIV and smoking: associated risks and prevention strategies

    PubMed Central

    Kariuki, Wanjiku; Manuel, Jennifer I; Kariuki, Ngaruiya; Tuchman, Ellen; O’Neal, Johnnie; Lalanne, Genevieve A

    2016-01-01

    High rates of smoking among persons living with HIV (PLWH) may reduce the effectiveness of HIV treatment and contribute to significant morbidity and mortality. Factors associated with smoking in PLWH include mental health comorbidity, alcohol and drug use, health-related quality of life, smoking among social networks and supports, and lack of access to care. PLWH smokers are at a higher risk of numerous HIV-associated infections and non-HIV related morbidity, including a decreased response to antiretroviral treatment, impaired immune functioning, reduced cognitive functioning, decreased lung functioning, and cardiovascular disease. Seventeen smoking cessation interventions were identified, of which seven were randomized controlled trials. The most effective studies combined behavioral and pharmacotherapy treatments that incorporated comprehensive assessments, multiple sessions, and cognitive-behavioral and motivational strategies. Smoking cessation interventions that are tailored to the unique needs of diverse samples and incorporate strategies to reduce the risk of relapse are essential to advancing health outcomes in PLWH. PMID:26766919

  17. Protective factors and HIV risk behavior among South African men.

    PubMed

    Heeren, G Anita; Icard, Larry D; O'Leary, Ann; Jemmott, John B; Ngwane, Zolani; Mtose, Xoliswa

    2014-10-01

    The primary mode of HIV transmission in South Africa is heterosexual sexual behavior. HIV prevention research specifically focusing on men in South Africa is limited. We assessed self-reported HIV risk behaviors in 1,181 men ages 18 to 45 years in randomly selected neighborhoods in Eastern Cape Province, South Africa. Older men were less likely to report having multiple partners. Religiosity was a protective factor for condom use and unprotected sex with steady partners. Discussing using condoms was a protective factor for condom use and unprotected sex with both steady and casual partners. Having a child was associated with decreased condom use with steady partners and employment was associated with decreased condom use with casual partners. The findings suggest the need for HIV risk-reduction behavioral interventions tailored for South African men with regard to age, religiosity, and types of sexual partners. Implications for the development of such interventions are discussed. PMID:24722765

  18. "At risk" women who think that they have no chance of getting HIV: self-assessed perceived risks.

    PubMed

    Klein, Hugh; Elifson, Kirk W; Sterk, Claire E

    2003-01-01

    During the past two decades, a fair amount of inconclusive research has been conducted to examine the relationship between perceived risk of contracting HIV and actual HIV risk behavior practices. The present study examines HIV risk perceptions among a sample of 250 urban, economically-disadvantaged, primarily minority women. In particular, we focus on differences between those saying that they have no chance whatsoever of contracting HIV and those who indicated at least some possibility of becoming HIV-infected. Three research questions are addressed: (1) Are there differences between these groups attributable to their risk behavior practices? (2) To what extent do women who think that they are not at risk for HIV engage in risky behaviors that could expose them to HIV? (3) What are the most salient predictors of the women's perceived risk classification? Results showed that women perceiving themselves to have at least some HIV risk engaged in higher rates of risky behaviors than their counterparts who perceived themselves to have no possibility of contracting HIV. Despite this finding, more than one-half of the "no perceived risk of HIV" sample had engaged in at least one risky practice during the preceding year and more than one-quarter had engaged in at least two such behaviors. Age, childhood maltreatment experiences, self-esteem, number of HIV risk behaviors practiced, amount of illegal drug use reported, and number of times having sex were significant predictors of women's perception of having some HIV risk versus having no HIV risk. PMID:14655794

  19. A discussion of key values to inform the design and delivery of services for HIV-affected women and couples attempting pregnancy in resource-constrained settings

    PubMed Central

    Heffron, Renee; Davies, Natasha; Cooke, Ian; Kaida, Angela; Mergler, Reid; van der Poel, Sheryl; Cohen, Craig R; Mmeje, Okeoma

    2015-01-01

    Introduction HIV-affected women and couples often desire children and many accept HIV risk in order to attempt pregnancy and satisfy goals for a family. Risk reduction strategies to mitigate sexual and perinatal HIV transmission include biomedical and behavioural approaches. Current efforts to integrate HIV and reproductive health services offer prime opportunities to incorporate strategies for HIV risk reduction during pregnancy attempts. Key client and provider values about services to optimize pregnancy in the context of HIV risk provide insights for the design and implementation of large-scale “safer conception” programmes. Discussion Through our collective experience and discussions at a multi-disciplinary international World Health Organization–convened workshop to initiate the development of guidelines and an algorithm of care to support the delivery of services for HIV-affected women and couples attempting pregnancy, we identified four values that are key to the implementation of these programmes: (1) understanding fertility care and an ability to identify potential fertility problems; (2) providing equity of access to resources enabling informed decision-making about reproductive choices; (3) creating enabling environments that reduce stigma associated with HIV and infertility; and (4) creating enabling environments that encourage disclosure of HIV status and fertility status to partners. Based on these values, recommendations for programmes serving HIV-affected women and couples attempting pregnancy include the following: incorporation of comprehensive reproductive health counselling; training to support the transfer and exchange of knowledge between providers and clients; care environments that reduce the stigma of childbearing among HIV-affected women and couples; support for safe and voluntary disclosure of HIV and fertility status; and increased efforts to engage men in reproductive decision-making at times that align with women's desires

  20. Longitudinal Association of HIV Conspiracy Beliefs with Sexual Risk Among Black Males Living with HIV

    PubMed Central

    Galvan, Frank H.; Wagner, Glenn J.; Klein, David J.

    2010-01-01

    Research is needed to identify culturally relevant factors that may contribute to sexual risk among African Americans. We investigated HIV-specific medical mistrust as one such cultural factor, often exhibited as conspiracy beliefs about HIV (e.g., “AIDS was produced in a government laboratory”), which may be indicative of general suspicion of HIV treatment and prevention messages. Over a 6-month time-period, we measured endorsement of HIV conspiracy beliefs three times and frequency of condom use monthly among 181 HIV-positive African American males. A hierarchical multivariate repeated-measures logistic random effects model indicated that greater belief in HIV conspiracies was associated with a higher likelihood of reporting unprotected intercourse across all time-points. An average of 54% of participants who endorsed conspiracies reported unprotected intercourse, versus 39% who did not endorse conspiracies. Secondary prevention interventions may need to address medical mistrust as a contributor to sexual risk among African Americans living with HIV. PMID:20734227

  1. Risk analysis. HIV / AIDS country profile: Senegal.

    PubMed

    1996-12-01

    Since the first acquired immunodeficiency syndrome (AIDS) case was confirmed in 1986, Senegal has conducted an aggressive prevention campaign. Senegal's National AIDS Committee has noted the contributions of poverty and migration to the spread of AIDS. By June 1994, 1297 AIDS cases had been reported and an estimated 500,000 people (1.4% of the population) were infected with human immunodeficiency virus (HIV)-1 and 2. The highest rate of HIV infection (14%) exists among commercial sex workers. At present, HIV/AIDS cases are concentrated in Dakar, Kaolack, the Matam region, and Ziguinchor; however, the growing importance of inter-regional trading is expected to spread HIV to the smaller towns and rural areas. Also salient is the recent devaluation by 50% of the CFA franc, which has reduced the public sector workforce and led many poor urban residents into commercial sex work. CFA devaluation has made Senegal attractive to tourists and business visitors--another factor responsible for growth of the legalized commercial sex industry. Although sex workers are instructed in condom use and tested annually for HIV, only 850 of the 2000 registered sex workers have reported for check-ups, and the majority of prostitutes are unregistered. Senegal's AIDS Plan for 1994-98 focuses on care of AIDS patients, pressures placed on family structures by HIV, and AIDS-related erosions in the status of women. Each health service region has its own local plan for AIDS/HIV and sexually transmitted diseases, supervised by a regional committee. Public education has involved outreach to religious leaders, promotion of affordable condoms, and distribution of over 75,000 leaflets to key target populations. About US $16 million of the $25,688,875-budget HIV/AIDS program for 1994-98 was pledged by external donors. PMID:12320531

  2. Men at Risk; a Qualitative Study on HIV Risk, Gender Identity and Violence among Men Who Have Sex with Men Who Report High Risk Behavior in Kampala, Uganda

    PubMed Central

    King, Rachel; Barker, Joseph; Nakayiwa, Sylvia; Katuntu, David; Lubwama, George; Bagenda, Danstan; Lane, Tim; Opio, Alex; Hladik, Wolfgang

    2013-01-01

    In Uganda, men who have sex with men (MSM) are at high risk for HIV. Between May 2008 and February 2009 in Kampala, Uganda, we used respondent driven sampling (RDS) to recruit 295 MSM≥18 years who reported having had sex with another man in the preceding three months. The parent study conducted HIV and STI testing and collected demographic and HIV-related behavioral data through audio computer-assisted self-administered interviews. We conducted a nested qualitative sub-study with 16 men purposively sampled from among the survey participants based on responses to behavioral variables indicating higher risk for HIV infection. Sub-study participants were interviewed face-to-face. Domains of inquiry included sexual orientation, gender identity, condom use, stigma, discrimination, violence and health seeking behavior. Emergent themes included a description of sexual orientation/gender identity categories. All groups of men described conflicting feelings related to their sexual orientation and contextual issues that do not accept same-sex identities or behaviors and non-normative gender presentation. The emerging domains for facilitating condom use included: lack of trust in partner and fear of HIV infection. We discuss themes in the context of social and policy issues surrounding homosexuality and HIV prevention in Uganda that directly affect men's lives, risk and health-promoting behaviors. PMID:24358239

  3. Sex and HIV serostatus differences in decision making under risk among substance-dependent individuals.

    PubMed

    Martin, Eileen; Gonzalez, Raul; Vassileva, Jasmin; Maki, Pauline M; Bechara, Antoine; Brand, Matthias

    2016-05-01

    HIV+ individuals with and without substance use disorders make significantly poorer decisions when information about the probability and magnitude of wins and losses is not available. We administered the Game of Dice Task, a measure of decision making under risk that provides this information explicitly, to 92 HIV+ and 134 HIV- substance-dependent men and women. HIV+ participants made significantly poorer decisions than HIV- participants, but this deficit appeared more prominent among HIV+ women. These data indicate that decision making under risk is impaired among HIV+ substance-dependent individuals (SDIs). Potential factors for the HIV+ women's relatively greater impairment are discussed. PMID:26882176

  4. Factors Enabling Access to HIV Voluntary Counseling and Testing for Key Affected Populations in Thailand.

    PubMed

    Thepthien, Bang-on; Srivanichakorn, Supattra; Apipornchaisakul, Kanya

    2015-10-01

    The objective was to study the factors that enabled persons at risk of HIV to obtain voluntary counseling and testing (VCT) in Thailand. This research was a cross-sectional study and data were collected during May to July 2013 in 8, purposively selected provinces. The method for selecting respondents used time-location quota sampling to achieve a total sample of 751 persons. The proportion who had VCT in the year prior to the survey was 56%.The significant enabling factors associated with VCT were having someone encourage them to go for testing and receiving information about VCT In addition, other significant factors for female sex workers were self-assessed risk for HIV and having had risk behavior, and for men who have sex with men the factors were awareness of eligibility for VCT. Thus, in order to achieve the VCT target for higher risk populations by 2016, there should be special mechanisms to inform the different groups, along with improvements in outreach services to make VCT more convenient for key affected populations. PMID:26069165

  5. Context of risk for HIV and sexually transmitted infections among incarcerated women in the south: individual, interpersonal, and societal factors.

    PubMed

    Fogel, Catherine I; Gelaude, Deborah J; Carry, Monique; Herbst, Jeffrey H; Parker, Sharon; Scheyette, Anna; Neevel, A

    2014-01-01

    Incarcerated women are disproportionately affected by HIV and sexually transmitted infections (STIs) due to risk factors before, during, and after imprisonment. This study assessed the behavioral, social, and contextual conditions that contribute to continuing sexual risk behaviors among incarcerated women to inform the adaptation of an evidenced-based behavioral intervention for this population. Individual, in-depth interviews were conducted with 25 current and 28 former women prisoners to assess HIV/STI knowledge, perceptions of risk, intimate relationships, and life circumstances. Interviews were independently coded using an iterative process and analyzed using established qualitative analytic methods. Major themes identified in the interviews involved three focal points: individual risk (substance abuse, emotional need, self-worth, perceptions of risk, and safer sex practices); interpersonal risk (partner pressure, betrayal, and violence); and risk environment (economic self-sufficiency and preparation for reentry). These findings highlight the critical components of HIV/STI prevention interventions for incarcerated women. PMID:25204565

  6. Perspectives of healthcare providers and HIV-affected individuals and couples during the development of a Safer Conception Counseling Toolkit in Kenya: stigma, fears, and recommendations for the delivery of services.

    PubMed

    Mmeje, Okeoma; Njoroge, Betty; Akama, Eliud; Leddy, Anna; Breitnauer, Brooke; Darbes, Lynae; Brown, Joelle

    2016-06-01

    Reproduction is important to many HIV-affected individuals and couples and healthcare providers (HCPs) are responsible for providing resources to help them safely conceive while minimizing the risk of sexual and perinatal HIV transmission. In order to fulfill their reproductive goals, HIV-affected individuals and their partners need access to information regarding safer methods of conception. The objective of this qualitative study was to develop a Safer Conception Counseling Toolkit that can be used to train HCPs and counsel HIV-affected individuals and couples in HIV care and treatment clinics in Kenya. We conducted a two-phased qualitative study among HCPs and HIV-affected individuals and couples from eight HIV care and treatment sites in Kisumu, Kenya. We conducted in-depth interviews (IDIs) and focus group discussions (FGDs) to assess the perspectives of HCPs and HIV-affected individuals and couples in order to develop and refine the content of the Toolkit. Subsequently, IDIs were conducted among HCPs who were trained using the Toolkit and FGDs among HIV-affected individuals and couples who were counseled with the Toolkit. HIV-related stigma, fears, and recommendations for delivery of safer conception counseling were assessed during the discussions. One hundred and six individuals participated in FGDs and IDIs; 29 HCPs, 49 HIV-affected women and men, and 14 HIV-serodiscordant couples. Participants indicated that a safer conception counseling and training program for HCPs is needed and that routine provision of safer conception counseling may promote maternal and child health by enhancing reproductive autonomy among HIV-affected couples. They also reported that the Toolkit may help dispel the stigma and fears associated with reproduction in HIV-affected couples, while supporting them in achieving their reproductive goals. Additional research is needed to evaluate the Safer Conception Toolkit in order to support its implementation and use in HIV care and

  7. Risk and protection for HIV/AIDS in African-American, Hispanic, and White adolescents.

    PubMed

    Bartlett, Robin; Buck, Raymond; Shattell, Mona M

    2008-07-01

    African-Americans and Hispanics are disproportionately affected by HIV/AIDS in the United States. HIV infection is often acquired during adolescence, a time when risky sexual behaviors are at their peak. This study explored relationships among selected risk factors, protective factors, and risky sexual behaviors among African-American, Hispanic, and White adolescents, from a sample of adolescents from the National Longitudinal Study of Adolescent Health. African-Americans and Hispanics were more likely to have sexual intercourse without the use of birth control than were Whites. African-Americans were more likely to have sexual behavior with multiple sexual partners than either Hispanics or Whites were, and African-Americans had higher self-esteem than did Hispanics and Whites. In order to develop culturally sensitive, effective interventions to prevent HIV/AIDS in adolescents, racial differences in risk and protective factors must be examined. PMID:18807775

  8. Drugscapes and the Role of Place and Space in Injection Drug Use-Related HIV Risk Environments

    PubMed Central

    Tempalski, Barbara; McQuie, Hilary

    2013-01-01

    Although considerable research has been conducted to identify the behavioural characteristics that predispose individuals to inject drugs or become infected with HIV via injection drug use, much less research has been conducted on structural and policy determinants, cultural norms, stigma, and ecological factors which may affect drug use risk behaviour, users’ networks and HIV rates associated with drug use across geographic areas. For programme planners, whether official or grassroots, an understanding of place-based characteristics can help better identify risk environments to injection drug use-related HIV, and determine how to facilitate actions regarding public policy and harm reduction to aid in the reduction of risk. As such, we consider in this commentary the importance of geographic place and the socio-spatial and political processes related to place that may help determine where IDU-related HIV risk environments occur. PMID:18554896

  9. HIV-negative and HIV-discordant Gay Male Couples’ Use of HIV Risk-Reduction Strategies: Differences by Partner Type and Couples’ HIV-status

    PubMed Central

    Mitchell, Jason W.

    2014-01-01

    Previous research has found that gay men and other men who have sex with men (MSM) have adopted a variety of HIV risk-reduction strategies to engage in unprotected anal intercourse (UAI). However, whether gay male couples’ use these strategies within and out of their relationships remains unknown. The present national cross-sectional study collected dyadic data from an online sample of 275 HIV-negative and 58 discordant gay male couples to assess their use of these strategies, and whether their use of these strategies had differed by partner type and couples’ HIV-status. The sample used a variety of risk-reduction strategies for UAI. Some differences and patterns by partner type and couples’ HIV status were detected about men’s use of these strategies. Findings indicate the need to bolster HIV prevention and education with gay male couples about their use of these strategies within and outside of their relationships. PMID:23247364

  10. Domestic chores workload and depressive symptoms among children affected by HIV/AIDS in China.

    PubMed

    Yu, Yun; Li, Xiaoming; Zhang, Liying; Zhao, Junfeng; Zhao, Guoxiang; Zheng, Yu; Stanton, Bonita

    2013-01-01

    Limited data are available regarding the effects of domestic chores workload on psychological problems among children affected by HIV/AIDS in China. The current study aims to examine association between children's depressive symptoms and the domestic chores workload (i.e., the frequency and the amount of time doing domestic chores). Data were derived from the baseline survey of a longitudinal study which investigated the impact of parental HIV/AIDS on psychological problems of children. A total of 1449 children in family-based care were included in the analysis: 579 orphaned children who lost one or both parents due to AIDS, 466 vulnerable children living with one or both parents being infected with HIV, and 404 comparison children who did not have HIV/AIDS-infected family members in their families. Results showed differences on domestic chores workload between children affected by HIV/AIDS (orphans and vulnerable children) and the comparison children. Children affected by HIV/AIDS worked more frequently and worked longer time on domestic chores than the comparison children. Multivariate linear regression analysis showed that domestic chores workload was positively associated with depressive symptoms. The data suggest that children affected by HIV/AIDS may face increasing burden of domestic chores and it is necessary to reduce the excessive workload of domestic chores among children affected by HIV/AIDS through increasing community-based social support for children in the families affected by HIV/AIDS. PMID:22970996

  11. Genital Inflammation and the Risk of HIV Acquisition in Women

    PubMed Central

    Masson, Lindi; Passmore, Jo-Ann S.; Liebenberg, Lenine J.; Werner, Lise; Baxter, Cheryl; Arnold, Kelly B.; Williamson, Carolyn; Little, Francesca; Mansoor, Leila E.; Naranbhai, Vivek; Lauffenburger, Douglas A.; Ronacher, Katharina; Walzl, Gerhard; Garrett, Nigel J.; Williams, Brent L.; Couto-Rodriguez, Mara; Hornig, Mady; Lipkin, W. Ian; Grobler, Anneke; Abdool Karim, Quarraisha; Abdool Karim, Salim S.

    2015-01-01

    Background. Women in Africa, especially young women, have very high human immunodeficiency virus (HIV) incidence rates that cannot be fully explained by behavioral risks. We investigated whether genital inflammation influenced HIV acquisition in this group. Methods. Twelve selected cytokines, including 9 inflammatory cytokines and chemokines (interleukin [IL]-1α, IL-1β, IL-6, tumor necrosis factor-α, IL-8, interferon-γ inducible protein-10 [IP-10], monocyte chemoattractant protein-1, macrophage inflammatory protein [MIP]-1α, MIP-1β), hematopoietic IL-7, and granulocyte macrophage colony-stimulating factor, and regulatory IL-10 were measured prior to HIV infection in cervicovaginal lavages from 58 HIV seroconverters and 58 matched uninfected controls and in plasma from a subset of 107 of these women from the Centre for the AIDS Programme of Research in South Africa 004 tenofovir gel trial. Results. HIV seroconversion was associated with raised genital inflammatory cytokines (including chemokines MIP-1α, MIP-1β, and IP-10). The risk of HIV acquisition was significantly higher in women with evidence of genital inflammation, defined by at least 5 of 9 inflammatory cytokines being raised (odds ratio, 3.2; 95% confidence interval, 1.3–7.9; P = .014). Genital cytokine concentrations were persistently raised (for about 1 year before infection), with no readily identifiable cause despite extensive investigation of several potential factors, including sexually transmitted infections and systemic cytokines. Conclusions. Elevated genital concentrations of HIV target cell–recruiting chemokines and a genital inflammatory profile contributes to the high risk of HIV acquisition in these African women. PMID:25900168

  12. HIV Transmission Risk Behavior Among HIV-Positive Patients Receiving Antiretroviral Therapy in KwaZulu-Natal, South Africa

    PubMed Central

    Kiene, Susan M.; Mahlase, Gethwana; MacDonald, Susan; Christie, Sarah; Cornman, Deborah H.; Fisher, William A.; Greener, Ross; Lalloo, Umesh G.; Pillay, Sandy; van Loggerenberg, Francois; Fisher, Jeffrey D.

    2014-01-01

    The aim of this investigation was to identify factors associated with HIV transmission risk behavior among HIV-positive women and men receiving antiretroviral therapy (ART) in KwaZulu-Natal, South Africa. Across 16 clinics, 1,890 HIV+ patients on ART completed a risk-focused audio computer-assisted self-interview upon enrolling in a prevention-with-positives intervention trial. Results demonstrated that 62 % of HIV-positive patients’ recent unprotected sexual acts involved HIV-negative or HIV status unknown partners. For HIV-positive women, multivariable correlates of unprotected sex with HIV-negative or HIV status unknown partners were indicative of poor HIV prevention-related information and of sexual partnership-associated behavioral skills barriers. For HIV-positive men, multivariable correlates represented motivational barriers, characterized by negative condom attitudes and the experience of depressive symptomatology, as well as possible underlying information deficits. Findings suggest that interventions addressing gender-specific and culturally-relevant information, motivation, and behavioral skills barriers could help reduce HIV transmission risk behavior among HIV-positive South Africans. PMID:24158486

  13. High-Risk Enteric Pathogens Associated with HIV-Infection and HIV-Exposure in Kenyan Children with Acute Diarrhea

    PubMed Central

    PAVLINAC, PB; JOHN-STEWART, GC; NAULIKHA, JM; ONCHIRI, FM; DENNO, DM; ODUNDO, EA; SINGA, BO; RICHARDSON, BA; WALSON, JL

    2015-01-01

    Objective HIV-infection is an established risk for diarrheal severity, less is known about specific enteric pathogens associated with HIV status. We determined associations of selected enteric pathogens with HIV-infection and HIV-exposure among Kenyan children. Design Cross-sectional study among 6 months to 15 year olds presenting to two Western Kenya District hospitals with acute diarrhea between 2011–2013. Methods Stool was tested using standard bacterial culture and microscopy for ova and parasites. HIV testing was obtained on children and mothers. Enteric pathogen prevalence was compared between HIV-infected and HIV-uninfected children and between HIV-exposed uninfected (HEU) and HIV-unexposed. Unadjusted and adjusted prevalence ratios (PR) for selected pathogens by HIV-status were estimated using relative risk (RR) regression and P-values. Age, site, income, household crowding, water source/treatment, anthropometrics, cotrimoxazole use, and breastfeeding history were accounted for in multivariable models. Results Among 1,076 children, median age was 22 months (interquartile range: 11–42), 56 (5.2%) were HIV-infected, and 10.3%(105/1020) of HIV-uninfected children were HIV-exposed. The following organisms were most frequently isolated from stool: enteroaggregative Escherichia coli (13.3%), Giardia spp. (11.1%) Campylobacter (6.3%), enteropathogenic Escherichia coli (EPEC) (6.1%) and Cryptosporidium spp. (3.7%). Accounting for age, HIV-infection was associated with EPEC infection (PR: 3.70, P=0.002) while HIV-exposure was associated with Cryptosporidium among HIV-uninfected children (PR: 2.81, P=0.005). Conclusion EPEC and Cryptosporidium infections were more common in HIV-infected and HIV-exposed children, respectively. This could explain the increased mortality attributed to these pathogens in other studies. Interventions targeting EPEC and Cryptosporidium may reduce morbidity and mortality in high HIV-prevalence settings. PMID:25028987

  14. Cardiovascular disease in HIV: traditional and nontraditional risk factors.

    PubMed

    Grinspoon, Steven K

    2014-01-01

    A new paradigm for atherogenesis in HIV infection is emerging, in which viral replication and microbial translocation result in ongoing T-cell and monocyte activation, with persistent inflammation leading to the development of atypical, high-risk morphology plaques. These plaques, characterized by low attenuation and positive remodeling, can be found even among HIV-infected patients who are at low risk for cardiovascular disease based on traditional risk factors. Prevention of cardiovascular events in HIV infection requires modulation of traditional risk factors and is also likely to require effective antiinflammatory treatment strategies. Statins, which are traditionally used to treat dyslipidemia, have also been shown to exert antiinflammatory effects associated with clinical benefit and may be useful to treat and prevent cardiovascular disease in HIV-infected patients. However, large-scale studies of statins in the context of HIV infection must be conducted. This article summarizes a presentation by Steven K. Grinspoon, MD, at the IAS-USA continuing education program held in Chicago, Illinois, in May 2014. PMID:25398068

  15. Elevated Risk of Suicidal Ideation in HIV-Positive Persons

    PubMed Central

    Schlebusch, L.; Govender, R. D.

    2015-01-01

    Globally, suicide and HIV/AIDS remain two of the greatest healthcare issues, particularly in low- and middle-income countries. Several studies have observed a relationship between suicidal behaviour and HIV/AIDS. Materials and Methods. The main objective of this research was to determine the prevalence of elevated risk of suicidal ideation in HIV-positive persons immediately following voluntary HIV counselling and testing (VCT). The study sample consisted of adult volunteers attending the VCT clinic at a university-affiliated, general state hospital. Participants completed a sociodemographic questionnaire, Beck's Hopeless Scale, and Beck's Depression Inventory. Results. A significantly elevated risk of suicidal ideation was found in 83.1% of the patients who tested seropositive. Despite a wide age range in the cohort studied, the majority of patients with suicidal ideation were males in the younger age group (age < 30 years), consistent with the age-related spread of the disease and an increase in suicidal behaviour in younger people. Relevant associated variables are discussed. Conclusion. The results serve as important markers that could alert healthcare professionals to underlying suicide risks in HIV-positive patients. It is recommended that screening for elevated risk of suicidal ideation and prevention of suicidal behaviour should form a routine aspect of comprehensive patient care at VCT clinics. PMID:26491561

  16. Implications of Mobility Patterns and HIV Risks for HIV Prevention Among Migrant Market Vendors in Kazakhstan

    PubMed Central

    Gilbert, Louisa; Terlikbayeva, Assel; West, Brooke; Bearman, Peter; Wu, Elwin; Zhussupov, Baurzhan; Platais, Ingrida; Brisson, Anne

    2011-01-01

    Objectives. We examined the relationships between mobility characteristics and sexual risk behaviors among male and female migrant market vendors in Almaty, Kazakhstan. Methods. Participants completed a structured interview covering sociodemographics, mobility characteristics, sexual behaviors, and biomarkers for HIV, HCV, and syphilis. We used multivariate analyses to examine associations between mobility patterns and HIV risks after adjusting for sociodemographics. Results. Longer duration of a participant's last trip outside Almaty increased the odds of reporting multiple sexual partners. More frequent travel to visit family or friends was associated with multiple sexual partners and unprotected sex with steady partners. More frequent travel to buy goods in the past year was associated with multiple sexual partners. Men who traveled more often to buy goods were more likely to have purchased sex within the previous 90 days. Conclusions. Relationships between mobility patterns and sexual risk behaviors underscore the need for HIV-prevention strategies targeting the specific transmission dynamics that migrant vendors are likely to present. PMID:21493929

  17. Homophobia and communal coping for HIV risk management among gay men in relationships.

    PubMed

    Stachowski, Courtney; Stephenson, Rob

    2015-02-01

    Men who have sex with men (MSM) remain disproportionately affected by the HIV epidemic in the US and estimates suggest that one to two-thirds of new infections occur among main partners. Previous research has focused on individual MSM and their risk for HIV, yet couples' ability to manage risk has been largely understudied. In particular, the role that homophobia plays in shaping the ability of gay male couples to cope with HIV risk is currently understudied. A sample of 447 gay/bisexual men with main partners was taken from a 2011 survey of gay and bisexual men in Atlanta. Linear regression models were fitted for three couples' coping outcome scales (outcome efficacy, couple efficacy, communal coping) and included indicators of homophobia (internalized homophobia and homophobic discrimination). Findings indicate that reporting of increased levels of internalized homophobia were consistently associated with decreased outcome measures of couples' coping ability regarding risk management. The results highlight the role that homophobia plays in gay male couples' relationships and HIV risk, extending the existing literature in the field of same-sex relationships as influenced by homophobia. PMID:25614049

  18. Homophobia and Communal Coping for HIV risk management among Gay Men in Relationships

    PubMed Central

    Stachowski, Courtney; Stephenson, Rob

    2015-01-01

    Men who have sex with men (MSM) remain disproportionately affected by the HIV epidemic in the US and estimates suggest that one to two-thirds of new infections occur among main partners. Previous research has focused on individual MSM and their risk for HIV, yet couples’ ability to manage risk has been largely understudied. In particular, the role that homophobia plays in shaping the ability of gay male couples to cope with HIV risk is currently under-studied. A sample of 447 gay/bisexual men with main partners was taken from a 2011 survey of gay and bisexual men in Atlanta. Linear regression models were fitted for three couples’ coping outcome scales (outcome efficacy, couple efficacy, communal coping) and included indicators of homophobia (internalized homophobia and homophobic discrimination). Findings indicate that reporting of increased levels of internalized homophobia were consistently associated with decreased outcome measures of couples’ coping ability regarding risk management. The results highlight the role that homophobia plays in gay male couples’ relationships and HIV risk, extending the existing literature in the field of same-sex relationships as influenced by homophobia. PMID:25614049

  19. Orphan Status, HIV Risk Behavior, and Mental Health Among Adolescents in Rural Kenya

    PubMed Central

    Drabkin, Anya S.; Stashko, Allison L.; Broverman, Sherryl A.; Ogwang-Odhiambo, Rose A.; Sikkema, Kathleen J.

    2012-01-01

    Objective To examine orphan status, mental health, social support, and HIV risk among adolescents in rural Kenya. Methods Randomly selected adolescents aged 10–18 years completed surveys assessing sexual activity, sex-related beliefs and self-efficacy, mental health, social support, caregiver–child communication, time since parental death, and economic resources. Analysis of covariance and regression analyses compared orphans and nonorphans; orphan status was tested as a moderator between well-being and HIV risk. Results Orphans reported poorer mental health, less social support, and fewer material resources. They did not differ from nonorphans on HIV risk indicators. Longer time since parental death was associated with poorer outcomes. In moderator analyses, emotional problems and poorer caregiver–youth communication were more strongly associated with lower sex-related self-efficacy for orphans. Conclusions Orphans are at higher risk for psychosocial problems. These problems may affect orphans’ self-efficacy for safer sex practices more than nonorphans. Decreased HIV risk could be one benefit of psychosocial interventions for orphans. PMID:22728899

  20. Increased Risk of HIV-1 Transmission in Pregnancy: A Prospective Study among African HIV-1 Serodiscordant Couples

    PubMed Central

    MUGO, Nelly R.; HEFFRON, Renee; DONNELL, Deborah; WALD, Anna; WERE, Edwin O.; REES, Helen; CELUM, Connie; KIARIE, James N.; COHEN, Craig R.; KAYINTEKORE, Kayitesi; BAETEN, Jared M.

    2011-01-01

    Background Physiologic and behavioral changes during pregnancy may alter HIV-1 susceptibility and infectiousness. Prospective studies exploring pregnancy and HIV-1 acquisition risk in women have found inconsistent results. No study has explored the effect of pregnancy on HIV-1 transmission risk from HIV-1 infected women to male partners. Methods In a prospective study of African HIV-1 serodiscordant couples, we evaluated the relationship between pregnancy and the risk of 1) HIV-1 acquisition among women and 2) HIV-1 transmission from women to men. Results 3321 HIV-1 serodiscordant couples were enrolled, 1085 (32.7%) with HIV-1 susceptible female partners and 2236 (67.3%) with susceptible male partners. HIV-1 incidence in women was 7.35 versus 3.01 per 100 person-years during pregnant and non-pregnant periods (hazard ratio [HR] 2.34, 95% confidence interval [CI] 1.33–4.09). This effect was attenuated and not statistically significant after adjusting for sexual behavior and other confounding factors (adjusted HR 1.71, 95% CI 0.93–3.12). HIV-1 incidence in male partners of infected women was 3.46 versus 1.58 per 100 person-years when their partners were pregnant versus not pregnant (HR 2.31, 95% CI 1.22–4.39). This effect was not attenuated in adjusted analysis (adjusted HR 2.47, 95% CI 1.26–4.85). Conclusions HIV-1 risk increased two-fold during pregnancy. Elevated risk of HIV-1 acquisition in pregnant women appeared in part to be explained by behavioral and other factors. This is the first study to show pregnancy increased the risk of female-to-male HIV-1 transmission, which may reflect biological changes of pregnancy that could increase HIV-1 infectiousness. PMID:21785321

  1. Impact of national HIV and AIDS communication campaigns in South Africa to reduce HIV risk behaviour.

    PubMed

    Peltzer, Karl; Parker, Warren; Mabaso, Musawenkosi; Makonko, Elias; Zuma, Khangelani; Ramlagan, Shandir

    2012-01-01

    In South Africa social and behavioural communication interventions are a critical component of HIV/AIDS prevention, and numerous communication campaigns have been implemented intensively across the country through government initiatives and nongovernmental organisations over the past decade. The aim of this paper is to assess the reach of HIV and AIDS communication campaigns in conjunction with contributions to knowledge, attitudes, and HIV risk behaviours in the general population in South Africa. The sample included in this nationally representative cross-sectional survey was 13234 people aged 15-55 years. Overall, the study found that there was high exposure to 18 different HIV communication programmes (median 6 programmes and 14 programmes more than 30%) across different age groups. Most programmes were more often seen or heard by young people aged between 15 and 24 years. In multivariate analysis, greater exposure to HIV mass communication programmes was associated with greater HIV knowledge, condom use at last sex, having tested for HIV in the past 12 months, and less stigmatizing attitude toward PLWHA. PMID:23213285

  2. Impact of National HIV and AIDS Communication Campaigns in South Africa to Reduce HIV Risk Behaviour

    PubMed Central

    Peltzer, Karl; Parker, Warren; Mabaso, Musawenkosi; Makonko, Elias; Zuma, Khangelani; Ramlagan, Shandir

    2012-01-01

    In South Africa social and behavioural communication interventions are a critical component of HIV/AIDS prevention, and numerous communication campaigns have been implemented intensively across the country through government initiatives and nongovernmental organisations over the past decade. The aim of this paper is to assess the reach of HIV and AIDS communication campaigns in conjunction with contributions to knowledge, attitudes, and HIV risk behaviours in the general population in South Africa. The sample included in this nationally representative cross-sectional survey was 13234 people aged 15–55 years. Overall, the study found that there was high exposure to 18 different HIV communication programmes (median 6 programmes and 14 programmes more than 30%) across different age groups. Most programmes were more often seen or heard by young people aged between 15 and 24 years. In multivariate analysis, greater exposure to HIV mass communication programmes was associated with greater HIV knowledge, condom use at last sex, having tested for HIV in the past 12 months, and less stigmatizing attitude toward PLWHA. PMID:23213285

  3. High Risk of Obesity and Weight Gain for HIV-Infected Uninsured Minorities

    PubMed Central

    Taylor, Barbara S.; Liang, Yuanyuan; Garduño, L. Sergio; Walter, Elizabeth A.; Gerardi, Margit; Anstead, Gregory M.; Bullock, Delia; Turner, Barbara J.

    2014-01-01

    Background Obesity and HIV disproportionately affect minorities and have significant health risks, but few studies have examined disparities in weight change in HIV-seropositive (HIV+) cohorts. Objective To determine racial and health insurance disparities in significant weight gain in a predominately Hispanic HIV+ cohort. Methods Our observational cohort study of 1,214 non-underweight HIV+ adults from 2007-2010 had significant weight gain (≥3% annual BMI increase) as primary outcome. The secondary outcome was continuous BMI over time. A four-level race-ethnicity/insurance predictor reflected the interaction between race-ethnicity and insurance: insured white (non-Hispanic), uninsured white, insured minority (Hispanic or black), or uninsured minority. Logistic and mixed effects models adjusted for: baseline BMI; age; gender; household income; HIV transmission category; antiretroviral therapy type; CD4+ count; plasma HIV-1 RNA; observation months; and visit frequency. Results The cohort was 63% Hispanic and 14% black; 13.3% were insured white, 10.0% uninsured white, 40.9% insured minority, and 35.7% uninsured minority. At baseline, 37.5% were overweight, 22.1% obese. Median observation was 3.25 years. 24.0% had significant weight gain, which was more likely for uninsured minority patients than insured whites (adjusted odds ratio=2.85 , 95%CI: 1.66, 4.90). The rate of BMI increase in mixed effects models was greatest for uninsured minorities. Of 455 overweight at baseline, 29% were projected to become obese in 4 years. Conclusions and Relevance In this majority Hispanic HIV+ cohort, 60% were overweight or obese at baseline, and uninsured minority patients gained weight more rapidly. These data should prompt greater attention by HIV providers to prevention of obesity. PMID:24121754

  4. Sexual HIV Risk Behaviors in a Treatment-Refractory Opioid-Dependent Sample

    PubMed Central

    McHugh, R. Kathryn; Weitzman, Meara; Safren, Steven A.; Murray, Heather W.; Pollack, Mark H.; Otto, Michael W.

    2013-01-01

    The propensity to engage in risk behaviors confers an elevated risk of HIV and other infectious disease transmission in opioid-dependent populations. Although drug abuse treatment may decrease drug-related risk behaviors such as needle-sharing, additional intervention may be needed to reduce HIV risk behavior. In this investigation, we assessed sexual HIV risk behaviors in opioid-dependent patients who were engaging in regular drug use despite ongoing counseling and methadone maintenance therapy. Potential risk and protective factors for engaging in sexual HIV risk behavior were examined. Taking into account demographic, psychiatric, substance use, and psychological variables, the only significant predictor of risk behavior was age. Specifically, younger patients were more likely to engage in sexual HIV risk behavior. The implications of these results for reducing sexual HIV risk behavior and for HIV prevention in methadone-maintained, treatment-refractory opioid-dependent patients are discussed. PMID:23061323

  5. HIV risks and testing behavior among Asians and Pacific Islanders: results of the HIV Testing Survey, 2002-2003.

    PubMed Central

    Kahle, Erin M.; Freedman, Mark S.; Buskin, Susan E.

    2005-01-01

    INTRODUCTION: The HIV Testing Survey (HITS) was developed to examine HIV testing and risk behavior in individuals at risk for HIV infection. The first Seattle HITS was conducted in 2000 (HITS-2000); HITS was conducted in Seattle again in 2002-2003 among Asians and Pacific Islanders (HITS-API). METHODS: Both HITS projects, HITS-API and HITS-2000, included anonymously targeted participants from at-risk populations. Data from the surveys were compared to see whether there were differences in HIV testing behavior between API and a general at-risk population in the Seattle area. Data were analyzed for 165 participants in HITS-API and 270 in HITS-2000. RESULTS: More API (90%) perceived themselves at some HIV risk relative to HITS-2000 participants (71%, chi2 p<0.05). In HITS-API and HITS-2000, participants reported significant HIV risks--no or inconsistent condom use with nonprimary partners or sharing injection equipment. Only 47% of HITS-API participants tested in the past year compared with 64% of HITS-2000. There was no association between HIV testing and risks in HITS-API. CONCLUSIONS: Based on self-report from HITS-API, the overall perceived risk for HIV infection was high, many engaged in high-risk behaviors, and HIV testing was suboptimal. PMID:16080452

  6. Yoga lifestyle intervention reduces blood pressure in HIV-infected adults with cardiovascular disease risk factors

    PubMed Central

    Cade, Todd; Reeds, Dominic N.; Mondy, Kristin E.; Overton, Turner; Grassino, Joseph; Tucker, Shawn; Bopp, Coco; Laciny, Erin; Hubert, Sara; Lassa-Claxton, Sherry; Yarasheski, Kevin E.

    2009-01-01

    People living with human immunodeficiency virus infection (HIV) are at increased risk for developing cardiovascular disease (CVD). Safe and effective interventions for lowering CVD risk in HIV are high priorities. Objective We conducted a prospective, randomized, controlled study to evaluate whether a yoga lifestyle intervention improves CVD risk factors, virologic or immunologic status, or quality of life in HIV-infected adults more than in a matched control group. Methods Sixty HIV-infected adults with mild-moderate CVD risk were assigned to 20 wks of supervised yoga practice or standard of care treatment. Baseline and week 20 measures were; 2hr-oral glucose tolerance test with insulin monitoring, body composition, fasting serum lipid/lipoprotein profile, resting blood pressures, CD4+ T-cell number and plasma HIV RNA, and the Medical Outcomes Study SF-36 health-related quality of life inventory. Results Resting systolic and diastolic blood pressures were reduced more (p=0.04) in the yoga group (−5±2 and −3±1 mmHg) than in the standard of care group (+1±2 and +2±2 mmHg), despite no greater reduction in body weight, fat mass, proatherogenic lipids, or improvements in glucose tolerance or overall quality of life after yoga. Immune and virologic status was not adversely affected. Conclusion Among traditional lifestyle modifications, yoga is a low cost, simple to administer, non-pharmacological, popular behavioral intervention that can lower blood pressure in pre-hypertensive HIV-infected adults with mild-moderate CVD risk factors. PMID:20059570

  7. Perceptions of Community HIV/STI Risk Among U.S Women Living in Areas with High Poverty and HIV Prevalence Rates.

    PubMed

    Blackstock, Oni J; Frew, Paula; Bota, Dorothy; Vo-Green, Linda; Parker, Kim; Franks, Julie; Hodder, Sally L; Justman, Jessica; Golin, Carol E; Haley, Danielle F; Kuo, Irene; Adimora, Adaora A; Rompalo, Anne; Soto-Torres, Lydia; Wang, Jing; Mannheimer, Sharon B

    2015-08-01

    Although studies have consistently demonstrated that women at high risk for HIV and non-HIV sexually transmitted infections (STIs) tend to underestimate their individual risk, little is known about how women at risk perceive their community's HIV/STI risk. We explored perceptions of community HIV/STI risk among U.S. women living in areas with high poverty and HIV prevalence rates as part of a qualitative substudy of the Women's HIV SeroIncidence Study. Semi-structured focus groups were conducted. Data were coded and analyzed using the constant comparative method. Participants expressed the perception that their communities were at elevated HIV/STI risk, mostly due to contextual and structural factors such as lack of access to health care and education. Findings suggest that HIV prevention messages that target U.S. women at high risk for HIV may be strengthened by addressing the high perceived community HIV/STI risk driven by structural factors. PMID:26320916

  8. Perspectives of healthcare providers and HIV-affected individuals and couples during the development of a Safer Conception Counseling Toolkit in Kenya: stigma, fears, and recommendations for the delivery of services

    PubMed Central

    Mmeje, Okeoma; Njoroge, Betty; Akama, Eliud; Leddy, Anna; Breitnauer, Brooke; Darbes, Lynae; Brown, Joelle

    2016-01-01

    Reproduction is important to many HIV-affected individuals and couples and healthcare providers (HCPs) are responsible for providing resources to help them safely conceive while minimizing the risk of sexual and perinatal HIV transmission. In order to fulfill their reproductive goals, HIV-affected individuals and their partners need access to information regarding safer methods of conception. The objective of this qualitative study was to develop a Safer Conception Counseling Toolkit that can be used to train HCPs and counsel HIV-affected individuals and couples in HIV care and treatment clinics in Kenya. We conducted a two-phased qualitative study among HCPs and HIV-affected individuals and couples from eight HIV care and treatment sites in Kisumu, Kenya. We conducted in-depth interviews (IDIs) and focus group discussions (FGDs) to assess the perspectives of HCPs and HIV-affected individuals and couples in order to develop and refine the content of the Toolkit. Subsequently, IDIs were conducted among HCPs who were trained using the Toolkit and FGDs among HIV-affected individuals and couples who were counseled with the Toolkit. HIV-related stigma, fears, and recommendations for delivery of safer conception counseling were assessed during the discussions. One hundred and six individuals participated in FGDs and IDIs; 29 HCPs, 49 HIV-affected women and men, and 14 HIV–serodiscordant couples. Participants indicated that a safer conception counseling and training program for HCPs is needed and that routine provision of safer conception counseling may promote maternal and child health by enhancing reproductive autonomy among HIV-affected couples. They also reported that the Toolkit may help dispel the stigma and fears associated with reproduction in HIV-affected couples, while supporting them in achieving their reproductive goals. Additional research is needed to evaluate the Safer Conception Toolkit in order to support its implementation and use in HIV care and

  9. The Influence of Knowing Someone with AIDS on Youth HIV Sexual Risk Behaviors

    ERIC Educational Resources Information Center

    Cederbaum, Julie A.; Marcus, Steven C.; Hutchinson, M. Katherine

    2007-01-01

    Research indicates that knowing someone with HIV/AIDS is associated with greater perceived risk of contracting HIV and changes in sexual risk behaviors. The current study with a sample of 1,172 examined whether knowing someone with HIV/AIDS influenced sexual risk communication and youth engagement in sexual intercourse using the Philadelphia…

  10. Global Epidemiology of HIV Infection and Related Syndemics Affecting Transgender People

    PubMed Central

    Scheim, Ayden; Xavier, Jessica; Reisner, Sari; Baral, Stefan

    2016-01-01

    Introduction: Transgender populations have been underrepresented in HIV epidemiologic studies and consequently in HIV prevention, care, and treatment programs. Since 2012, there has been a dramatic increase in research focused on transgender people. Studies highlight the burden of HIV and risk determinants, including intersecting stigmas, as drivers of syndemics among transgender populations. This review synthesizes the most recent global epidemiology of HIV infection and describes current gaps in research and interventions to inform prioritization of HIV research for transgender populations. Methods: A systematic review was conducted of the medical literature published between January 1, 2012 and November 30, 2015. The data focused on HIV prevalence, determinants of risk, and syndemics among transgender populations. Results: Estimates varied dramatically by location and subpopulation. Transfeminine individuals have some of the highest concentrated HIV epidemics in the world with laboratory-confirmed prevalence up to 40%. Data were sparse among trans masculine individuals; however, they suggest potential increased risk for trans masculine men who have sex with men (MSM). No prevalence data were available for transgender people across Sub-Saharan Africa or Eastern Europe/Central Asia. Emerging data consistently support the association of syndemic conditions with HIV risk in transgender populations. Discussion: Addressing syndemic conditions and gender-specific challenges is critical to ensure engagement and retention in HIV prevention by transgender populations. Future research should prioritize: filling knowledge gaps in HIV epidemiology; elucidating how stigma shapes syndemic factors to produce HIV and other deleterious effects on transgender health; and understanding how to effectively implement HIV interventions for transgender people. PMID:27429185

  11. Alcohol and HIV sexual risk behaviors among injection drug users.

    PubMed

    Arasteh, Kamyar; Des Jarlais, Don C; Perlis, Theresa E

    2008-05-01

    We analyzed data from 6341 injection drug users (IDUs) entering detoxification or methadone maintenance treatment in New York City between 1990 and 2004 to test the hypothesis that alcohol use and intoxication is associated with increased HIV sexual risk behaviors. Two types of associations were assessed: (1) a global association (i.e., the relationship between HIV sexual risk behaviors during the 6 months prior to the interview and at-risk drinking in that period, defined as more than 14 drinks per week for males or 7 drinks per week for females), and (2) an event-specific association (i.e., the relationship between HIV sexual risk behaviors during the most recent sex episode and alcohol intoxication during that episode). Sexual risk behaviors included multiple sex partners and engaging in unprotected sex. After adjusting for the effects of other variables, at-risk-drinkers were more likely to report multiple sex partners and engaging in unprotected sex with casual sex partners (both global associations). IDUs who reported both they and their casual partners were intoxicated during the most recent sex episode were more likely to engage in unprotected sex (an event-specific association). We also observed two significant interactions. Among IDUs who did not inject cocaine, moderate-drinkers were more likely to report multiple partners. Among self-reported HIV seropositive IDUs, when both primary partners were intoxicated during the most recent sex episode they were more likely to engage in unprotected sex. These observations indicate both global and event-specific associations of alcohol and HIV sexual-risk behaviors. PMID:18242009

  12. Modified social ecological model: a tool to guide the assessment of the risks and risk contexts of HIV epidemics

    PubMed Central

    2013-01-01

    Background Social and structural factors are now well accepted as determinants of HIV vulnerabilities. These factors are representative of social, economic, organizational and political inequities. Associated with an improved understanding of multiple levels of HIV risk has been the recognition of the need to implement multi-level HIV prevention strategies. Prevention sciences research and programming aiming to decrease HIV incidence requires epidemiologic studies to collect data on multiple levels of risk to inform combination HIV prevention packages. Discussion Proximal individual-level risks, such as sharing injection devices and unprotected penile-vaginal or penile-anal sex, are necessary in mediating HIV acquisition and transmission. However, higher order social and structural-level risks can facilitate or reduce HIV transmission on population levels. Data characterizing these risks is often far more actionable than characterizing individual-level risks. We propose a modified social ecological model (MSEM) to help visualize multi-level domains of HIV infection risks and guide the development of epidemiologic HIV studies. Such a model may inform research in epidemiology and prevention sciences, particularly for key populations including men who have sex with men (MSM), people who inject drugs (PID), and sex workers. The MSEM builds on existing frameworks by examining multi-level risk contexts for HIV infection and situating individual HIV infection risks within wider network, community, and public policy contexts as well as epidemic stage. The utility of the MSEM is demonstrated with case studies of HIV risk among PID and MSM. Summary The MSEM is a flexible model for guiding epidemiologic studies among key populations at risk for HIV in diverse sociocultural contexts. Successful HIV prevention strategies for key populations require effective integration of evidence-based biomedical, behavioral, and structural interventions. While the focus of epidemiologic

  13. HIV prevention among psychiatric inpatients: a pilot risk reduction study.

    PubMed

    Meyer, I; Cournos, F; Empfield, M; Agosin, B; Floyd, P

    1992-01-01

    An HIV prevention program was piloted on an acute inpatient admission ward. Patients who volunteered to participate had significantly higher rates of histories of substance use than non-participants, suggesting that patients participated based on rational concerns about past HIV risk behavior. The program consisted of 75 minute sessions once a week for seven weeks and was co-led by an HIV counselor and the ward's social worker. Each session focused on a specific topic and included a short presentation of informational material, viewing of an educational videotape, a discussion, and role play and other educational games. In spite of a wide range in functioning among the participants, discussion was lively and participation was good. The pilot program demonstrates that chronic mentally ill patients can engage in, and benefit from, risk reduction programs and that frank and explicit discussion of sexual issues is well tolerated. Recommendations for improvement in the program are discussed. PMID:1488461

  14. Coevolution of risk perception, sexual behaviour, and HIV transmission in an agent-based model.

    PubMed

    Tully, Stephen; Cojocaru, Monica; Bauch, Chris T

    2013-11-21

    Risk perception shapes individual behaviour, and is in turn shaped by the consequences of that behaviour. Here we explore this dynamics in the context of human immunodeficiency virus (HIV) spread. We construct a simplified agent-based model based on a partner selection game, where individuals are paired with others in the population, and through a decision tree, agree on unprotected sex, protected sex, or no sex. An individual's choice is conditioned on their HIV status, their perceived population-level HIV prevalence, and the preferences expressed by the individual with whom they are paired. HIV is transmitted during unprotected sex with a certain probability. As expected, in model simulations, the perceived population-level HIV prevalence climbs along with actual HIV prevalence. During this time, HIV- individuals increasingly switch from unprotected sex to protected sex, HIV+ individuals continue practicing unprotected sex whenever possible, and unprotected sex between HIV+ and HIV- individuals eventually becomes rare. We also find that the perceived population-level HIV prevalence diverges according to HIV status: HIV- individuals develop a higher perceived HIV prevalence than HIV+ individuals, although this result is sensitive to how much information is derived from global versus local sources. This research illustrates a potential mechanism by which distinct groups, as defined by their sexual behaviour, HIV status, and risk perceptions, can emerge through coevolution of HIV transmission and risk perception dynamics. PMID:23988796

  15. Thoughts, Attitudes, and Feelings of HIV-Positive MSM Associated with High Transmission-Risk Sex

    ERIC Educational Resources Information Center

    Skinta, Matthew D.; Murphy, Jessie L.; Paul, Jay P.; Schwarcz, Sandra K.; Dilley, James W.

    2012-01-01

    This study presents survey data collected from a sample of HIV-positive men (N = 182) who had high transmission-risk sex, defined as unprotected anal intercourse with a man whose HIV-status was negative or unknown, in the previous 6 months. Despite the tremendous changes in HIV treatment and their impact on people living with HIV, little recent…

  16. Factors Affecting Ejection Risk in Rollover Crashes

    PubMed Central

    Funk, James R.; Cormier, Joseph M.; Bain, Charles E.; Wirth, Jeffrey L.; Bonugli, Enrique B.; Watson, Richard A.

    2012-01-01

    Ejection greatly increases the risk of injury and fatality in a rollover crash. The purpose of this study was to determine the crash, vehicle, and occupant characteristics that affect the risk of ejection in rollovers. Information from real world rollover crashes occurring from 2000 – 2010 was obtained from the National Automotive Sampling System (NASS) in order to analyze the effect of the following parameters on ejection risk: seatbelt use, rollover severity, vehicle type, seating position, roof crush, side curtain airbag deployment, glazing type, and occupant age, gender, and size. Seatbelt use was found to reduce the risk of partial ejection and virtually eliminate the risk of complete ejection. For belted occupants, the risk of partial ejection risk was significantly increased in rollover crashes involving more roof inversions, light trucks and vans (LTVs), and larger occupants. For unbelted occupants, the risk of complete ejection was significantly increased in rollover crashes involving more roof inversions, LTVs, far side occupants, and higher levels of roof crush. Roof crush was not a significant predictor of ejection after normalizing for rollover severity. Curtain airbag deployment was associated with reduced rates of partial and complete ejection, but the effect was not statistically significant, perhaps due to the small sample size (n = 89 raw cases with curtain deployments). A much greater proportion of occupants who were ejected in spite of curtain airbag deployment passed through the sunroof and other portals as opposed to the adjacent side window compared to occupants who were ejected in rollovers without a curtain airbag deployment. The primary factors that reduce ejection risk in rollover crashes are, in generally decreasing order of importance: seatbelt use, fewer roof inversions, passenger car body type, curtain airbag deployment, near side seating position, and small occupant size. PMID:23169130

  17. Factors affecting ejection risk in rollover crashes.

    PubMed

    Funk, James R; Cormier, Joseph M; Bain, Charles E; Wirth, Jeffrey L; Bonugli, Enrique B; Watson, Richard A

    2012-01-01

    Ejection greatly increases the risk of injury and fatality in a rollover crash. The purpose of this study was to determine the crash, vehicle, and occupant characteristics that affect the risk of ejection in rollovers. Information from real world rollover crashes occurring from 2000 - 2010 was obtained from the National Automotive Sampling System (NASS) in order to analyze the effect of the following parameters on ejection risk: seatbelt use, rollover severity, vehicle type, seating position, roof crush, side curtain airbag deployment, glazing type, and occupant age, gender, and size. Seatbelt use was found to reduce the risk of partial ejection and virtually eliminate the risk of complete ejection. For belted occupants, the risk of partial ejection risk was significantly increased in rollover crashes involving more roof inversions, light trucks and vans (LTVs), and larger occupants. For unbelted occupants, the risk of complete ejection was significantly increased in rollover crashes involving more roof inversions, LTVs, far side occupants, and higher levels of roof crush. Roof crush was not a significant predictor of ejection after normalizing for rollover severity. Curtain airbag deployment was associated with reduced rates of partial and complete ejection, but the effect was not statistically significant, perhaps due to the small sample size (n = 89 raw cases with curtain deployments). A much greater proportion of occupants who were ejected in spite of curtain airbag deployment passed through the sunroof and other portals as opposed to the adjacent side window compared to occupants who were ejected in rollovers without a curtain airbag deployment. The primary factors that reduce ejection risk in rollover crashes are, in generally decreasing order of importance: seatbelt use, fewer roof inversions, passenger car body type, curtain airbag deployment, near side seating position, and small occupant size. PMID:23169130

  18. HIV Risk Perceptions, the Transition to Marriage, and Divorce in Southern Malawi.

    PubMed

    Grant, Monica J; Soler-Hampejsek, Erica

    2014-09-01

    Little is known about whether the timing of marriage is used as a strategy to avoid HIV infection among young people in sub-Saharan Africa. Analyzing five rounds of longitudinal data from the Malawi Schooling and Adolescent Survey, we do not find support for the hypothesis that young women's perceived chances of future HIV infection are associated with the transition to marriage, but we do find evidence that young married women who see themselves as at risk of future infection have a greater likelihood of divorcing than do women who perceive no chance of future infection. We also use individual-level fixed-effects regressions to examine how the transition to marriage affects respondents' expectations of future HIV infection. Respondents are consistently more likely to perceive any chance of future HIV infection in the years following marriage than in the years preceding it. Our findings suggest that young women revise their risk perceptions based on their marital experiences and that divorce may serve as a protective strategy for young married women concerned about their chance of future HIV infection. PMID:25207495

  19. HIV prevalence and risk behaviour among prostitutes and clients in Amsterdam: migrants at increased risk for HIV infection.

    PubMed Central

    van Haastrecht, H J; Fennema, J S; Coutinho, R A; van der Helm, T C; Kint, J A; van den Hoek, J A

    1993-01-01

    OBJECTIVES--To study groups of prostitutes and clients of prostitutes in order (i) to determine HIV prevalence and sexual risk behaviour, (ii) to determine differences between samples recruited within and outside a clinic for sexually transmitted diseases (STD) and (iii) to determine correlates of inconsistent condom use (ICU) among both groups. DESIGN--Participants were interviewed and anonymously tested for HIV-antibody; approximately half were recruited at a clinic for sexually transmitted diseases (STD) and half at prostitute working places. SETTING--An STD clinic and prostitute working places in Amsterdam in 1991. SUBJECTS--201 female prostitutes without a history of injecting drugs and 213 male clients of female prostitutes. MAIN OUTCOME MEASURES--antibodies to HIV, consistency of condom use in commercial vaginal contacts in the preceding 6 months. RESULTS--HIV prevalence was low: three prostitutes (1.5%; 95% CI 0.5-4.6%) and one client (0.5%; 95% CI 0.1-3.3%) were infected. All three HIV positive prostitutes originated from AIDS-endemic countries, came to the Netherlands only recently and were recruited outside the STD clinic. Large differences between subgroups resulted from the two recruitment methods: while clients of prostitutes with relatively high risk behaviour were strongly represented among the STD clinic sample, high risk prostitutes were underrepresented in this sample. Consistent condom use (with 100% of contacts) was reported by 66% of prostitutes and 56% of clients of prostitutes. Inconsistent condom use was found to be high among prostitutes who had migrated from Latin America and among migrant clients of prostitutes. CONCLUSIONS--When monitoring HIV infection one must take into account imported cases. HIV prevention efforts should be particularly focused at prostitutes from Latin America and at clients of prostitutes who migrated to the Netherlands. PMID:7721282

  20. HIV Risk and Perceptions of Masculinity among Young Black MSM

    PubMed Central

    Fields, Errol L.; Bogart, Laura M.; Smith, Katherine C.; Malebranche, David J.; Ellen, Jonathan; Schuster, Mark A.

    2011-01-01

    Purpose Young Black men who have sex with men (MSM) have among the highest rates of HIV infection in the US. Although reported rates of unprotected anal intercourse are similar to MSM of other racial/ethnic backgrounds, young Black MSM (YBMSM) aged 15–22 are 5 times more likely than comparably aged white MSM to be HIV-infected. We explored contextual social-environmental factors that may influence how YBMSM assess risk, choose partners, and make decisions about condom use. Methods We analyzed semi-structured interviews with 35 YBMSM (18–24) in New York City, upstate NY, and Atlanta. We used structured analytic coding based on a theoretical scheme that emerged from the data. Results Perception of masculinity was the primary contextual factor influencing partner selection, risk assessment, and condom decision-making. Four primary themes emerged: 1) greater preference for partners perceived as masculine; 2) discomfort with allowing men perceived as feminine to be the insertive partner in anal intercourse; 3) a power dynamic such that partners perceived as more masculine made condom-use decisions within the dyad; and 4) use of potential partners’ perceived masculinity to assess HIV risk. Conclusions Perceived masculinity may play a significant role in HIV risk for YBMSM and may be an important concept to consider in prevention strategies directed towards this population. PMID:22325136

  1. How Teenagers Are at Risk for HIV Infection.

    ERIC Educational Resources Information Center

    Tonks, Douglas

    1993-01-01

    Significant numbers of teenagers participate in high-risk activities that place them in danger of contacting the human immunodeficiency virus (HIV) that causes the acquired immune deficiency syndrome (AIDS). Recently surveys have been remarkably consistent in reporting numbers of sexually active teens. (15 references) (MLF)

  2. New operative technique to reduce surgeons' risk of HIV infection.

    PubMed

    Raahave, D; Bremmelgaard, A

    1991-06-01

    The surgical team is potentially at risk of acquiring human immunodeficiency virus (HIV) from the patient. Assuming that the probability of an accidental injury during surgery is 0.01 (P2), the prevalence of HIV is 0.01 (P3) and the seroconversion rate is 0.01 (P1), we have estimated the risk (actuarial model) for a surgeon as 0.2% per year, and 5.82% for 30 years of surgery. In view of this we have made changes in surgical technique to reduce the risk to the surgical team from splash or injury. The surgeon must handle tissue with instruments only and minimize the use of fingers. Whenever possible, sharp instruments should be replaced by a blunt type. The surgical nurse loads needles to the needle carrier using forceps. Sharp instruments are placed in a neutral zone on the nurse's stand so that the surgeon and the nurse never touch the same sharp instrument at the same time. Movements should be controlled, and instrument handling accompanied by eye contact. We consider that these changes will reduce the risk of accidental injuries and thereby the transmission of HIV during operations to a greater degree than knowledge of the patient's HIV status. PMID:1716276

  3. Youth-Initiated HIV Risk and Substance Use Prevention Program.

    ERIC Educational Resources Information Center

    Goggin, K.; Metcalf, K.; Wise, D.; Kennedy, S.; Murray, T.; Burgess, D.; Reese-Smith, J.; Terhune, N.; Broadus, K.; Downes, A.; Buckendahl, H.

    This study evaluates the first year of a novel HIV and substance use prevention program for inner city youth (Offering New Youth eXperiences--ONYX). Baseline and follow-up measures of knowledge, attitudes, and risk behaviors were administered seven months apart to 441 youth participating in the ONYX program. Youth (n=71) who provided data at both…

  4. Implicit and Explicit Processes in Risk Perception: Neural Antecedents of Perceived HIV Risk

    PubMed Central

    Schmälzle, Ralf; Schupp, Harald T.; Barth, Alexander; Renner, Britta

    2011-01-01

    Field studies on HIV risk suggest that people may rely on impressions they have about the safety of their partner at the dispense of more objective risk protection strategies. In this study, ERP recordings were used to investigate the brain mechanisms that give rise to such impressions. First, in an implicit condition, participants viewed a series of photographs of unacquainted persons while performing a task that did not mention HIV risk. Second, in an explicit condition, participants estimated the HIV risk for each presented person. Dense sensor EEG was recorded during the implicit and explicit conditions. In the analysis, explicit risk ratings were used to categorize ERP data from the implicit and explicit conditions into low and high HIV risk categories. The results reveal implicit ERP differences on the basis of subsequent ratings of HIV risk. Specifically, the processing of risky individuals was associated with an early occipital negativity (240–300 ms) and a subsequent central positivity between 430 and 530 ms compared to safe. A similar ERP modulation emerged in the explicit condition for the central positivity component between 430 and 530 ms. A subsequent late positive potential component between 550 and 800 ms was specifically enhanced for risky persons in the explicit rating condition while not modulated in the implicit condition. Furthermore, ratings of HIV risk correlated substantially with ratings of trustworthiness and responsibility. Taken together, these observations provide evidence for theories of intuitive risk perception, which, in the case of HIV risk, seem to operate via appearance-based stereotypic inferences. PMID:21633492

  5. AIDS Knowledge and HIV Stigma among Children Affected by HIV/AIDS in Rural China

    ERIC Educational Resources Information Center

    Zhao, Qun; Li, Xiaoming; Zhao, Guoxiang; Zhao, Junfeng; Fang, Xiaoyi; Lin, Xiuyun; Stanton, Bonita

    2011-01-01

    The current study was designed to assess the level of AIDS knowledge and its relationship with personal stigma toward people living with HIV/AIDS (PLWHA) among children living in communities of high HIV prevalence in rural China. The data were collected in 2009 from 118 orphanage orphans (children who had lost both of their parents to HIV and…

  6. Declining relative risk for myocardial infarction among HIV-positive compared with HIV-negative individuals with access to care.

    PubMed

    Klein, Daniel B; Leyden, Wendy A; Xu, Lanfang; Chao, Chun R; Horberg, Michael A; Towner, William J; Hurley, Leo B; Marcus, Julia L; Quesenberry, Charles P; Silverberg, Michael J

    2015-04-15

    Concerns remain for an increased myocardial infarction (MI) risk among individuals infected with human immunodeficiency virus (HIV). We conducted a cohort study evaluating MI risk from 1996 to 2011 by HIV status. The adjusted MI rate ratio for HIV status declined over time, reaching 1.0 (95% confidence interval, .7-1.4) in 2010-2011, the most recent study period. PMID:25595743

  7. HIV Tat protein affects circadian rhythmicity by interfering with the circadian system

    PubMed Central

    Wang, T; Jiang, Z; Hou, W; Li, Z; Cheng, S; Green, LA; Wang, Y; Wen, X; Cai, L; Clauss, M; Wang, Z

    2014-01-01

    Objectives Sleep disorders are common in patients with HIV/AIDS, and can lead to poor quality of life. Although many studies have investigated the aetiology of these disorders, it is still unclear whether impaired sleep quality is associated with HIV itself, social problems, or side effects of antiretroviral therapy (ART). Moreover, despite its known neurological associations, little is known about the role of the trans-activator of transcription (Tat) protein in sleep disorders in patients with HIV/AIDS. The purpose of this study was to test the hypothesis that the sleep quality of patients with HIV/AIDS affected by an altered circadian rhythm correlates with cerebrospinal HIV Tat protein concentration. Methods Ninety-six patients with HIV/AIDS between 20 and 69 years old completed the Pittsburgh Sleep Quality Index. Their circadian rhythm parameters of blood pressure, Tat concentration in cerebrospinal fluid, melatonin concentration, CD4 cell count and HIV RNA viral load in serum were measured. Results The circadian amplitude of systolic blood pressure and the score for sleep quality (Pittsburgh Sleep Quality Index) were negatively correlated with HIV Tat protein concentration, while the melatonin value was positively correlated with Tat protein concentration. Conclusions The HIV Tat protein affects circadian rhythmicity by interfering with the circadian system in patients with HIV/AIDS and further increases the melatonin excretion value. A Tat protein-related high melatonin value may counteract HIV-related poor sleep quality during the progression of HIV infection. This study provides the first clinical evidence offering an explanation for why sleep quality did not show an association with progression of HIV infection in previous studies. PMID:24750691

  8. Physical Activity Affects Brain Integrity in HIV + Individuals

    PubMed Central

    Ortega, Mario; Baker, Laurie M.; Vaida, Florin; Paul, Robert; Basco, Brian; Ances, Beau M.

    2015-01-01

    Prior research has suggested benefits of aerobic physical activity (PA) on cognition and brain volumes in HIV uninfected (HIV−) individuals, however, few studies have explored the relationships between PA and brain integrity (cognition and structural brain volumes) in HIV-infected (HIV +) individuals. Seventy HIV + individuals underwent neuropsychological testing, structural neuroimaging, laboratory tests, and completed a PA questionnaire, recalling participation in walking, running, and jogging activities over the last year. A PA engagement score of weekly metabolic equivalent (MET) hr of activity was calculated using a compendium of PAs. HIV + individuals were classified as physically active (any energy expended above resting expenditure, n = 22) or sedentary (n = 48). Comparisons of neuropsychological performance, grouped by executive and motor domains, and brain volumes were completed between groups. Physically active and sedentary HIV + individuals had similar demographic and laboratory values, but the active group had higher education (14.0 vs. 12.6 years, p = .034). Physically active HIV + individuals performed better on executive (p = .040, unadjusted; p = .043, adjusted) but not motor function (p = .17). In addition, among the physically active group the amount of physical activity (METs) positively correlated with executive (Pearson’s r = 0.45, p = 0.035) but not motor (r = 0.21; p = .35) performance. In adjusted analyses the physically active HIV + individuals had larger putamen volumes (p = .019). A positive relationship exists between PA and brain integrity in HIV + individuals. Results from the present study emphasize the importance to conduct longitudinal interventional investigation to determine if PA improves brain integrity in HIV + individuals. PMID:26581799

  9. The challenge of HIV prevention among high-risk adolescents.

    PubMed

    Sullivan, T R

    1996-02-01

    This article reports findings from an exploratory study of HIV knowledge and risk behaviors among 60 teenagers and young men engaged in the street life of Hollywood, California. The sample was composed largely of youths of homosexual or bisexual orientation who were substance abusers, prostitutes, or both. The data suggest that although community-based education efforts may be associated with lower-risk behavior among this population, the overall risk profiles of these socially marginalized youths remained high. Inferences are drawn about the cofactors of risk that must be addressed and the education needed to enhance the health prospects of these youths. PMID:8626159

  10. Stress and Burnout among Health-Care Staff Working with People Affected by HIV.

    ERIC Educational Resources Information Center

    Miller, David

    1995-01-01

    The nature, causes, consequences, and symptoms of stress and burnout among health-care staff working with people affected by HIV are identified. The extent to which these characteristics are specific to HIV/AIDS workers is discussed. Some options for prevention and management of burnout are presented. (Author)

  11. Risk factors for HIV acquisition in high risk women in a generalised epidemic setting

    PubMed Central

    Naicker, Nivashnee; Kharsany, Ayesha BM; Werner, Lise; van Loggerenberg, Francois; Mlisana, Koleka; Garrett, Nigel; Karim, Salim S. Abdool

    2015-01-01

    In South Africa young women bear a disproportionate burden of HIV infection however, risk factors for HIV acquisition are not fully understood in this setting. In a cohort of 245 women, we used proportional hazard regression analysis to examine the association of demographic, clinical and behavioural characteristics with HIV acquisition. The overall HIV incidence rate (IR) was 7.20 per 100 women years (wy), 95% Confidence Interval (CI) 4.50–9.80]. Women 18–24 years had the highest HIV incidence [IR 13.20 per 100 wy, 95% CI 6.59–23.62] and were almost three times more likely to acquire HIV compared to women 25 years and older [adjusted Hazard Ratio (aHR) 2.61, 95% CI 1.05–6.47]. Similarly, women in relationships with multiple sex partners had more than twice the risk of acquiring HIV when compared to women who had no partner or who had a husband or stable partner (aHR 2.47, 95% CI 0.98–6.26). HIV prevention programmes must address young women's vulnerability and sex partner reduction in this setting. PMID:25662962

  12. HIV Risk Perception among HIV Negative or Status-Unknown Men Who Have Sex with Men in China

    PubMed Central

    Fan, Wensheng; Yin, Lu; Li, Dongliang; Shao, Yiming; Vermund, Sten H.; Ruan, Yuhua; Zhang, Zheng

    2014-01-01

    Objective. To evaluate HIV risk perception and its associated factors among Chinese MSM. Methods. A cross-sectional study was conducted among MSM with an HIV negative or unknown status in Beijing, China, between 2011 and 2012. A questionnaire interview was conducted and a blood sample was collected for HIV and syphilis testing. Results. Of 887 MSM who reported they were HIV negative or did not know their HIV status before recruitment, only 7.3% reported a high risk of HIV infection, 28.0% medium risk, 52.2% low risk, and 12.5% no risk. In multivariate logistic regression models using those who reported a medium self-perceived risk as a reference group, self-reported high risk of HIV perception was associated with minority ethnicity (odds ratio [OR]: 2.91; 95% confidence interval [CI]: 1.03–8.19), self-reported history of sexually transmitted diseases (OR: 2.27; 95% CI: 1.25–4.10), and HIV testing times since the last HIV testing (OR: 0.47; 95% CI: 0.26–0.84); low self-perceived risk of HIV infection was related to full-time employment (OR: 1.58; 95% CI: 1.15–2.18) and illicit drug use (OR: 0.28; 95% CI: 0.10–0.75). Conclusions. The HIV/AIDS epidemic is rapidly rising among Beijing MSM, but more than half MSM did not perceive this risk. PMID:24795880

  13. Adapting an evidence-based intervention for HIV to avail access to testing and risk-reduction counseling for female victims of sexual violence in post-earthquake Haiti.

    PubMed

    Rahill, Guitele J; Joshi, Manisha; Hernandez, Anthony

    2016-01-01

    Haiti has the highest prevalence of HIV/AIDS in the Caribbean. Before the 2010 earthquake, Haitian women bore a disproportionate burden of HIV/AIDS, had lower HIV knowledge, less capacity to negotiate for safer sex, and limited access to HIV testing and risk-reduction (RR) counseling. Since 2010, there has been an increase in sexual violence against women, characterized by deliberate vaginal injuries by non-intimate partners, increasing victims' risk of sexually transmitted infections including HIV/AIDS. Needed is an adaptation of evidence-based interventions for HIV that include HIV testing and counseling for this stigmatized population. We reviewed several features of Centers for Disease Control and Prevention's 103 evidence-based interventions for HIV (e.g., measures used, participant risk characteristics, theoretical framework, outcome variables, and evidence tier) in an attempt to seek a feasibly adaptable evidence-based intervention for HIV that could be used for victims of sexual violence (VOSV). RESPECT, one of the reviewed evidence-based HIV interventions, comprises of one-on-one, client-focused HIV prevention/RR counseling, and RAPID HIV testing. Adapting RESPECT can enhance access to testing for Haitian VOSV and can influence their perceptions of HIV risk, and establishment of RR goals for future consensual intimate relations. Adapting and implementing RESPECT can increase uptake of evidence-based HIV interventions among Haitians and positively affect a region with high HIV prevalence and increased rates of sexual violence. PMID:26278002

  14. HIV Testing for At-Risk Adolescents at Rhode Island Hospital.

    PubMed

    Ryoo, Hyeon-Ju; Nazareth, Kristina; Chan, Philip A; Reinert, Steven E; Koster, Michael

    2015-08-01

    Early detection of HIV has great potential to reduce transmission, especially when newly diagnosed individuals are treated early. Early treatment and suppression of viral loads is known to effectively attenuate HIV transmission. However, little is known about whether persons at high risk for HIV are being appropriately tested during healthcare encounters according to national guidelines. Specifically, the at-risk adolescent population may be under tested and are not routinely monitored by state-level surveillance system. This study reviewed HIV testing rates for at-risk adolescents from 2005-2012 at the main tertiary care and pediatric center in Rhode Island. While the absolute number of HIV tests for at-risk adolescents continued to increase, the HIV testing rates for this population decreased during the seven year period. Increasing awareness of HIV testing for patients, their families, and physicians may improve the HIV testing rate among at-risk adolescents in Rhode Island. PMID:26230109

  15. Pre-exposure prophylaxis (PrEP) in HIV-uninfected individuals with high-risk behaviour.

    PubMed

    Nadery, S; Geerlings, S E

    2013-01-01

    The global incidence of human immunodeficiency virus (HIV) infection has decreased by 15% over the past years, but is still too high. Despite current programs to reduce the incidence of HIV infection, further approaches are needed to limit this epidemic. Oral antiretroviral pre-exposure prophylaxis (PrEP) is currently one of the most discussed possible prevention methods. This literature study demonstrates whether orally antiretroviral chemoprophylaxis in HIV-uninfected individuals with high-risk behaviour reduces the transmission of HIV. We used the PICO method and conducted a search to identify relevant studies. Subjects of the study were HIV-uninfected individuals with high-risk behaviour. Intervention was oral PrEP with tenofovir disoproxil fumarate (TDF) alone or plus emtricitabine (FTC) versus placebo. The primary outcome was the HIV incidence among this high-risk group. Secondary outcomes were adherence to PrEP, frequency and type of adverse effects. We identified ten studies from which five randomised control trials (RCTs) were included after screening. The results from three out of five trials showed a reduction, but two trials showed no protection in acquiring HIV infection. There were no significant differences in adverse events. The adherence was different among different groups and affected the outcome of the studies. In conclusion, this prophylaxis might offer protection when used in combination with intense monitoring and guidance in uninfected individuals with a high risk of HIV acquisition. However, there are still many unresolved questions. Drug adherence seems to be a crucial factor in the effectiveness of PrEP. Therefore, individual risk behaviour remains an important determinant for success in the prevention of HIV transmission. PMID:23956310

  16. Perceived Susceptibility to AIDS Predicts Subsequent HIV Risk: A Longitudinal Evaluation of Jail Inmates

    PubMed Central

    Adams, Leah M.; Stuewig, Jeffrey B.; Tangney, June P.; Kashdan, Todd B.

    2013-01-01

    Theories of health behavior change suggest that perceived susceptibility to illness precedes health-protective behavior. We used a cross-lagged panel design to explore the relationship between perceived susceptibility to AIDS, and HIV risk behavior pre-incarceration and post-release in a sample of 499 jail inmates, a group at high risk for HIV. We also explored moderators of this relationship. HIV risk was calculated with a Bernoulli mathematical process model. Controlling for pre-incarceration HIV risk, perceived susceptibility to AIDS predicted less post-release HIV risk; the reverse relationship was not supported. Consistent with health behavior change theories, perceived susceptibility seemed to partially guide behavior. However, this relationship was not true for everyone. African-Americans and individuals high in borderline personality features exhibited no relationship between perceived susceptibility and changes in HIV risk. This suggests that targeted interventions are needed to use information about risk level to prevent HIV contraction. PMID:23591920

  17. Perceived susceptibility to AIDS predicts subsequent HIV risk: a longitudinal evaluation of jail inmates.

    PubMed

    Adams, Leah M; Stuewig, Jeffrey B; Tangney, June P; Kashdan, Todd B

    2014-06-01

    Theories of health behavior change suggest that perceived susceptibility to illness precedes health-protective behavior. We used a cross-lagged panel design to explore the relationship between perceived susceptibility to AIDS, and HIV risk behavior pre-incarceration and post-release in a sample of 499 jail inmates, a group at high risk for HIV. We also explored moderators of this relationship. HIV risk was calculated with a Bernoulli mathematical process model. Controlling for pre-incarceration HIV risk, perceived susceptibility to AIDS predicted less post-release HIV risk; the reverse relationship was not supported. Consistent with health behavior change theories, perceived susceptibility seemed to partially guide behavior. However, this relationship was not true for everyone. African-Americans and individuals high in borderline personality features exhibited no relationship between perceived susceptibility and changes in HIV risk. This suggests that targeted interventions are needed to use information about risk level to prevent HIV contraction. PMID:23591920

  18. Using Respondent Driven Sampling in a Hidden Population at Risk of HIV Infection: Who do HIV-positive recruiters recruit?

    PubMed Central

    Abramovitz, Daniela; Volz, Erik M.; Strathdee, Steffanie A.; Patterson, Thomas L.; Vera, Alicia; Frost, Simon D.W.

    2009-01-01

    Background Respondent driven sampling (RDS) is a network-based method used to recruit hidden populations. Since it is respondent-driven, RDS is prone to bias. However, these biases could facilitate recruitment of high risk networks. We examined recruitment patterns of HIV-positive injection drug users (IDUs) and identified factors associated with being recruited by an HIV-positive IDU in a RDS-based study. Methods IDUs aged >=18, who injected within the last month and resided in Tijuana, Mexico, were recruited using RDS and underwent interviews and testing for HIV, syphilis, and TB. Weighted logistic regression was used to identify predictors of being recruited by an HIV-positive IDU. Results Of 1056 IDUs, HIV-positive subjects comprised 4.4% of the sample and generated 4.7% of recruits, indicating that recruitment effectiveness did not vary by HIV-status. However, 10% of the subjects recruited by HIV-positive recruiters were infected with HIV as compared to 4.1% of subjects recruited by HIV-negative recruiters, (P=0.06), a difference that, after controlling for whether the recruiter and recruit injected drugs together, attained statistical significance (P=0.04), indicating that recruitment patterns differed by HIV-status. Factors independently associated with being recruited by an HIV-positive IDU included lifetime syphilis infection, ever having sex with an HIV-positive person, knowing someone with HIV/AIDS, being recruited at a shooting gallery, having recently used the local needle exchange program, and having a larger number of recent arrests for track-marks. Conclusion HIV-positive IDUs have different recruitment patterns than HIV-negative IDUs, with HIV-positive IDUs tending to recruit other HIV-positive IDUs. Social and environmental factors along with risk behaviors were independently associated with being the recruit of an HIV-positive IDU in Tijuana. While the goal of this study was not to recruit HIV+ or other high-risk persons, our results suggest that

  19. Addressing HIV knowledge, risk reduction, social support, and patient involvement using SMS: results of a proof-of-concept study.

    PubMed

    Uhrig, Jennifer D; Lewis, Megan A; Bann, Carla M; Harris, Jennie L; Furberg, Robert D; Coomes, Curtis M; Kuhns, Lisa M

    2012-01-01

    Men who have sex with men continue to be severely and disproportionately affected by the HIV/AIDS epidemic in the United States. Effective antiretroviral therapy has altered the HIV epidemic from being an acute disease to a chronic, manageable condition for many people living with HIV. The pervasiveness, low cost, and convenience of short message service suggests its potential suitability for supporting the treatment of conditions that must be managed over an extended period. The purpose of this proof-of-concept study was to develop, implement, and test a tailored short message service-based intervention for HIV-positive men who have sex with men. The messages focused on reducing risk-taking behaviors and enhancing HIV knowledge, social support, and patient involvement. Participants reported strong receptivity to the messages and the intervention. The authors detected a statistically significant increase in HIV knowledge and social support from baseline to follow-up. Among participants who received sexual risk reduction messages, the authors also detected a statistically significant reduction in reported risk behaviors from baseline to follow-up. Results confirm the feasibility of a tailored, short message service-based intervention designed to provide ongoing behavioral reinforcement for HIV-positive men who have sex with men. Future research should include a larger sample, a control group, multiple sites, younger participants, and longer term follow-up. PMID:22548606

  20. Residual Injection Risk Behavior, HIV Infection, and the Evaluation of Syringe Exchange Programs

    ERIC Educational Resources Information Center

    Des Jarlais, Don C.; Braine, Naomi; Yi, Huso; Turner, Charles

    2007-01-01

    This study assessed relationships between residual risk behavior (risk behavior among persons participating in effective HIV prevention programs) and HIV infection. Structured interviews and HIV tests were obtained from participants in six large U.S. syringe exchange programs. Program characteristics were obtained through interviews with the…

  1. Risk for HIV Infection among Adolescents in the Border City of Tijuana, Mexico

    ERIC Educational Resources Information Center

    Martinez-Donate, Ana P.; Blumberg, Elaine J.; Hovell, Melbourne F.; Sipan, Carol L.; Zellner, Jennifer A.; Hughes, Suzanne

    2004-01-01

    Previous studies have suggested high rates of HIV infection and other sexually transmitted infections in theU.S.-Mexico border region. However, no information is available on the risk for HIV infection among Mexican adolescents living in this geographic area. This study examines the prevalence of HIV risk practices and psychosocial correlates…

  2. Prostitution and risk of HIV: female prostitutes in London.

    PubMed Central

    Ward, H; Day, S; Mezzone, J; Dunlop, L; Donegan, C; Farrar, S; Whitaker, L; Harris, J R; Miller, D L

    1993-01-01

    OBJECTIVE--To measure the prevalence of HIV and to describe established risk factors in female prostitutes. DESIGN--A cross sectional survey. SETTING--A genitourinary medicine clinic, streets, and magistrates' courts in London. SUBJECTS--280 female prostitutes recruited between April 1989 and August 1991. MAIN OUTCOME MEASURES--Infection with HIV-1, reported risk behaviours, and prevalence of sexually transmitted infections. RESULTS--228 of the women had HIV tests, and two (0.9% (95% confidence interval 0% to 2.1%)) were infected with HIV-1. Reported use of condoms was high for commercial clients and low for non-paying partners: 98% (251/255) of women used condoms with all clients and 12% (25/207) with non-paying partners for vaginal intercourse. Twenty two women were current or past injecting drug users. Of the 193 women examined for sexually transmitted infections, 27 had an acute infection (gonorrhoea, chlamydia, trichomonas, or primary genital herpes) at the time of interview. Infection was associated with younger age and increasing numbers of non-paying sexual partners, but not with duration of prostitution, numbers of clients, or reports of condom failures. When age and numbers of non-paying partners were analysed by logistic regression they remained significantly associated with sexually transmitted infections. CONCLUSIONS--A large and diverse sample of prostitutes had a low prevalence of infection with HIV and high levels of use of condoms in commercial sex. There was a significant risk of other sexually transmitted infections associated with prostitutes' non-commercial sexual relationships, in which unprotected sex is common. Interventions to reduce the risk of sexually transmitted infections in prostitutes should address both commercial and non-commercial sexual partnerships. PMID:8374417

  3. Substance Use and HIV Among Female Sex Workers and Female Prisoners: Risk Environments and Implications for Prevention, Treatment, and Policies.

    PubMed

    Strathdee, Steffanie A; West, Brooke S; Reed, Elizabeth; Moazen, Babak; Moazan, Babak; Azim, Tasnim; Dolan, Kate

    2015-06-01

    Female sex workers (FSWs) and female prisoners experience elevated HIV prevalence relative to the general population because of unprotected sex and unsafe drug use practices, but the antecedents of these behaviors are often structural in nature. We review the literature on HIV risk environments for FSWs and female prisoners, highlighting similarities and differences in the physical, social, economic, and policy/legal environments that need to be understood to optimize HIV prevention, treatment, and policy responses. Sex work venues, mobility, gender norms, stigma, debt, and the laws and policies governing sex work are important influences in the HIV risk environment among FSWs, affecting their exposure to violence and ability to practice safer sex and safer drug use behaviors. Female prisoners are much more likely to have a drug problem than do male prisoners and have higher HIV prevalence, yet are much less likely to have access to HIV prevention and treatment and access to drug treatment in prison. Women who trade sex or are imprisoned and engage in substance use should not be considered in separate silos because sex workers have high rates of incarceration and many female prisoners have a history of sex work. Repeated cycles of arrest, incarceration, and release can be socially and economically destabilizing for women, exacerbating their HIV risk. This dynamic interplay requires a multisectoral approach to HIV prevention and treatment that appreciates and respects that not all women are willing, able, or want to stop sex work or drug use. Women who engage in sex work, use drugs, or are imprisoned come from all communities and deserve sustained access to HIV prevention and treatment for substance use and HIV, helping them and their families to lead healthy and satisfying lives. PMID:25978477

  4. Substance Use and HIV Among Female Sex Workers and Female Prisoners: Risk Environments and Implications for Prevention, Treatment, and Policies

    PubMed Central

    Strathdee, Steffanie A.; West, Brooke S.; Reed, Elizabeth; Moazan, Babak; Azim, Tasnim; Dolan, Kate

    2015-01-01

    Female sex workers (FSWs) and female prisoners experience elevated HIV prevalence relative to the general population because of unprotected sex and unsafe drug use practices, but the antecedents of these behaviors are often structural in nature. We review the literature on HIV risk environments for FSWs and female prisoners, highlighting similarities and differences in the physical, social, economic, and policy/legal environments that need to be understood to optimize HIV prevention, treatment, and policy responses. Sex work venues, mobility, gender norms, stigma, debt, and the laws and policies governing sex work are important influences in the HIV risk environment among FSWs, affecting their exposure to violence and ability to practice safer sex and safer drug use behaviors. Female prisoners are much more likely to have a drug problem than do male prisoners and have higher HIV prevalence, yet are much less likely to have access to HIV prevention and treatment and access to drug treatment in prison. Women who trade sex or are imprisoned and engage in substance use should not be considered in separate silos because sex workers have high rates of incarceration and many female prisoners have a history of sex work. Repeated cycles of arrest, incarceration, and release can be socially and economically destabilizing for women, exacerbating their HIV risk. This dynamic interplay requires a multisectoral approach to HIV prevention and treatment that appreciates and respects that not all women are willing, able, or want to stop sex work or drug use. Women who engage in sex work, use drugs, or are imprisoned come from all communities and deserve sustained access to HIV prevention and treatment for substance use and HIV, helping them and their families to lead healthy and satisfying lives. PMID:25978477

  5. Efficacy of Enhanced HIV Counseling for Risk Reduction during Pregnancy and in the Postpartum Period: A Randomized Controlled Trial

    PubMed Central

    Maman, Suzanne; Moodley, Dhayendre; McNaughton-Reyes, Heathe Luz; Groves, Allison K.; Kagee, Ashraf; Moodley, Prashini

    2014-01-01

    Introduction Pregnancy and the postpartum period present important intervention opportunities. Counseling can leverage the motivation women have during this time to change behaviors that may negatively affect their health and the heath of their infants. Methods Pregnant women attending an antenatal clinic in South Africa were randomly allocated to treatment (n = 733) and control arms (n = 747). Treatment arm participants received enhanced HIV pre- and post-test counseling, legal support and access to support groups at baseline, which occurred at the first antenatal visit, and then six and ten weeks postpartum. Control arm participants received standard HIV testing and counseling (HTC) and two postpartum attention control sessions. Outcomes were incidence of sexually transmitted infection (STI) by 14 weeks postpartum and past 30-day inconsistent condom use at 14 weeks and 9 months postpartum. Results There were no intervention effects on incident STIs for either HIV-negative (adjusted risk ratio (aRR) 1.01, 95% CI 0.71–1.44) or HIV-positive participants (aRR 0.86, 95% CI 0.61–1.23). The intervention was associated with a 28% decrease in risk of past 30-day inconsistent condom use at nine-months among HIV-negative women (aRR 0.72,95% CI 0.59–0.88), but did not affect inconsistent condom use among HIV-positive women (aRR1.08; 95% CI 0.67–1.75). Discussion An enhanced counseling intervention during pregnancy and the postpartum period can lead to reductions in inconsistent condom use among HIV-negative women. Results underscore the importance of the counseling that accompanies HIV HTC. More work is needed to understand how to promote and sustain risk reduction among HIV-positive women. Trial Registration ClinicalTrials.gov NCT01683461 PMID:24824050

  6. The shifting locus of risk-reduction: the critical role of HIV infected individuals.

    PubMed

    Indyk, Debbie; Golub, Sarit A

    2006-01-01

    This article discusses the shifting locus of control over risk-reduction and examines its implications for the care and support of HIV-positive individuals. We begin by presenting a brief history of the continuum of HIV related risk, illustrating the ways in which advances in risk-assessment and intervention have led to this important shift. Second, we discuss the current state of risk assessment and intervention as it relates to three factors: (a) the point along the continuum of risk at which risk assessment and intervention occurs; (b) the locus of control over risk reduction; and (c) the distinction between primary and secondary risk reduction efforts. Finally, we discuss the meaning of HIV risk and the role of HIV-positive individuals in the new geometry of care that integrates treatment and prevention. How is HIV-risk defined and understood? Who is of risk to whom? Who is responsible for reducing risk?. PMID:16687378

  7. Differential Risk Factors for HIV Drug and Sex Risk-Taking Among Non-treatment-seeking Hospitalized Injection Drug Users

    PubMed Central

    Crooks, Denise; Tsui, Judith; Anderson, Bradley; Dossabhoy, Shernaz; Herman, Debra; Liebschutz, Jane M.; Stein, Michael D.

    2016-01-01

    Injection drug users (IDUs) are at increased risk of contracting HIV. From a clinical trial assessing an intervention to enhance the linkage of hospitalized patients to opioid treatment after discharge, we conducted multivariate analysis of baseline data from hospitalized IDUs with a history of opioid dependence (n = 104) to identify differences in factors predicting HIV drug and sex risk behaviors. Factors significantly associated with HIV drug risk were being non-Hispanic Caucasian and recent cocaine use. Being female, binge drinking, and poorer mental health were significantly associated with higher sex risk. Because factors predicting HIV sex risk behaviors differ from those predicting HIV drug risk, interventions aimed at specific HIV risks should have different behavioral and substance use targets. PMID:25063229

  8. Extracurricular interest as a resilience building block for children affected by parental HIV/AIDS.

    PubMed

    Zhao, Junfeng; Chi, Peilian; Li, Xiaoming; Tam, Cheuk Chi; Zhao, Guoxiang

    2014-01-01

    Parental illness and death due to human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) impose challenges to children's psychological adjustment. Positive psychology emphasizes individual's resilience in the face of adversity, trauma, and tragedy. Limited data are available regarding the factors that can cultivate resilience of children affected by HIV/AIDS. This study aims to examine the role of extracurricular interest in strengthening resilience among children affected by HIV/AIDS. Participants included 755 children orphaned by parental HIV/AIDS, 466 vulnerable children living with HIV-positive parent(s), and 404 comparison children from HIV-free families in the same community in rural China. The measures include extracurricular interest (i.e., reading, sports, music, painting, science, and playing chess) and indicators of psychological adjustment (i.e., depression, loneliness, and self-esteem). Having extracurricular interest was positively associated with self-esteem and negatively associated with depression and loneliness. Having extracurricular interest attenuated the negative effect of parental HIV/AIDS on children's self-esteem and loneliness, after controlling for children's age, gender, and family socioeconomic status. The findings underscore the importance of nurturing extracurricular interest and make available of such activities to promote resilience for children affected by HIV/AIDS in resource-limited settings. PMID:24107136

  9. The relationship between discrimination and high-risk social ties by race/ethnicity: examining social pathways of HIV risk.

    PubMed

    Crawford, Natalie D; Galea, Sandro; Ford, Chandra L; Latkin, Carl; Link, Bruce G; Fuller, Crystal

    2014-02-01

    High-risk social ties portend differences in opportunity for HIV exposures and may contribute to racial/ethnic disparities in HIV transmission. Discrimination may affect the formation of high-risk social ties and has not been explored as a possible explanation for these persistent disparities. Using data from injection and non-injection drug users, we examined the association between the number of high-risk sex and drug ties with discrimination due to race, drug use, and incarceration stratified by race/ethnicity. Negative binomial regression models were used. While blacks had significantly fewer injecting ties than Latinos and whites, blacks who reported racial discrimination compared to blacks who did not, had more sex and injecting ties. Latinos who reported drug use discrimination compared to Latinos who did not also had more sex ties. Latinos and whites who reported drug use discrimination had more injecting ties than Latinos and whites who did not. Discrimination is associated with high-risk social ties among all racial/ethnic groups. But, these data highlight different forms of discrimination within racial/ethnic group are associated with risky social ties. More research is needed to confirm these findings and further explore the association between various forms of discrimination and social ties that may help explain racial/ethnic disparities in HIV. PMID:23749458

  10. Importance of substance use and violence in psychosocial syndemics among women with and at-risk for HIV.

    PubMed

    W Batchelder, Abigail; Lounsbury, David W; Palma, Anton; Carrico, Adam; Pachankis, John; Schoenbaum, Ellie; Gonzalez, Jeffrey S

    2016-10-01

    Women in the US continue to be affected by HIV through heterosexual contact. Sexual risk behaviors among women have been associated with a syndemic, or a mutually reinforcing set of conditions, including childhood sexual abuse (CSA), depression, substance use, violence, and financial hardship. Baseline data from a cohort of women with and at-risk for HIV (N = 620; 52% HIV+) were analyzed with Poisson regression to assess evidence for additive, independent and interactive effects among syndemic conditions in relation to reported sexual risk behaviors (e.g., unprotected and transactional sex) over the past 6 months, controlling for age and HIV status. The number of syndemic conditions was incrementally associated with more types of sexual risk behaviors. For example, women with all five syndemic conditions reported 72% more types of risk behaviors over 6 months, as compared to women without any syndemic conditions. Compared to women with no syndemic conditions, women with three syndemic conditions reported 34% more and women with one syndemic condition reported 13% more types of risk behaviors. Endorsing substance use in the past 6 months, reporting CSA, and experiencing violence as an adult were independently associated with 49%, 12%, and 8% more types of risk behaviors, respectively compared to women without these conditions. Endorsing both substance use and violence was associated with 27% more types of risk behaviors. These associations were not moderated by HIV status. Understanding specific relationships and interactions are needed to more effectively prioritize limited resources in addressing the psychosocial syndemic associated with sexual risk behavior among women with and at-risk for HIV. Our results identify interrelated psychosocial factors that could be targeted by intervention studies aiming to reduce high-risk sex in this population. PMID:27110841

  11. Venues for Meeting Sex Partners and Partner HIV Risk Characteristics: HIV Prevention Trials Network (HPTN064) Women's HIV Seroincidence Study (ISIS).

    PubMed

    Roman Isler, M; Golin, C; Wang, J; Hughes, J; Justman, J; Haley, D; Kuo, I; Adimora, A; Chege, W; Hodder, S

    2016-06-01

    Identifying venues where women meet sexual partners, particular partners who increase women's risk of acquiring HIV, could inform prevention efforts. We categorized venues where women enrolled in HPTN 064 reported meeting their last three sex partners as: (1) Formal, (2) Public, (3) Private, and (4) Virtual spaces. We used multinomial logistic regression to assess the association between these venues and women's individual characteristics and reports of their partners' HIV risk characteristics. The 2099 women reported meeting 3991 partners, 51 % at Public, 30 % Private, 17 % Formal and 3 % at Virtual venues. Women meeting partners at Formal venues reported more education and condom use than women meeting partners at other venues. Fewer partners met through Formal venues had "high" risk characteristics for HIV than through other venues and hence may pose less risk of HIV transmission. HIV prevention interventions can help women choose partners with fewer risk characteristics across all venue types. PMID:25863466

  12. Sex and HIV serostatus differences in decision making under risk among substance dependent individuals

    PubMed Central

    Martin, Eileen; Gonzalez, Raul; Vassileva, Jasmin; Maki, Pauline M.; Bechara, Antoine; Brand, Matthias

    2016-01-01

    HIV+ individuals with and without substance use disorders make significantly poorer decisions when information about the probability and magnitude of wins and losses is not available. We administered the Game of Dice Task, a measure of decision making under risk that provides this information explicitly, to 92 HIV+ and 134 HIV− substance dependent men and women. HIV+ participants made significantly poorer decisions compared with HIV− participants, but this deficit appeared more prominent among HIV+ women. These data indicate that decision making under risk is impaired among HIV+ SDIs. Potential factors for the HIV+ women’s relatively greater impairment are discussed. PMID:26882176

  13. Individual and Contextual Factors of Sexual Risk Behavior in Youth Perinatally Infected with HIV

    PubMed Central

    Bauermeister, José A.; Robbins, Reuben N.; Gromadzka, Olga; Abrams, Elaine J.; Wiznia, Andrew; Bamji, Mahrukh; Mellins, Claude A.

    2012-01-01

    Abstract This study prospectively examines the effects of maternal and child HIV infection on youth penetrative and unprotected penetrative sex, as well as the role of internal contextual, external contextual, social and self-regulatory factors in influencing the sexual behaviors of HIV−infected (PHIV+), HIV−affected (uninfected with an HIV+ caregiver), and HIV unaffected (uninfected with an HIV− caregiver) youth over time. Data (N=420) were drawn from two longitudinal studies focused on the effects of pediatric or maternal HIV on youth (51% female; 39% PHIV+) and their caregivers (92% female; 46% HIV+). PHIV+ youth were significantly less likely to engage in penetrative sex than HIV− youth at follow-up, after adjusting for contextual, social, and self-regulatory factors. Other individual- and contextual-level factors such as youth alcohol and marijuana use, residing with a biological parent, caregiver employment, caregiver marijuana use, and youth self-concept were also associated with penetrative sex. Youth who used alcohol were significantly more likely to engage in unprotected penetrative sex. Data suggest that, despite contextual, social, and self-regulatory risk factors, PHIV+ youth are less likely to engage in sexual behavior compared to HIV− youth from similar environments. Further research is required to understand delays in sexual activity in PHIV+ youth and also to understand potential factors that promote resiliency, particularly as they age into older adolescence and young adulthood. PMID:22694193

  14. Individual and Population Level Impact of Key HIV Risk Factors on HIV Incidence Rates in Durban, South Africa

    PubMed Central

    Ramjee, Gita; Moonsamy, Suri; Abbai, Nathlee Samantha; Wand, Handan

    2016-01-01

    We aimed to estimate the individual and joint impact of age, marital status and diagnosis with sexually transmitted infections (STIs) on HIV acquisition among young women at a population level in Durban, KwaZulu-Natal, South Africa. A total of 3,978 HIV seronegative women were recruited for four biomedical intervention trials from 2002–2009. Point and interval estimates of partial population attributable risk (PAR) were used to quantify the proportion of HIV seroconversions which can be prevented if a combination of risk factors is eliminated from a target population. More than 70% of the observed HIV acquisitions were collectively attributed to the three risk factors: younger age (<25 years old), unmarried and not cohabiting with a stable/regular partner and diagnosis with STIs. Addressing these risks requires targeted structural, behavioural, biomedical and cultural interventions in order to impact on unacceptably high HIV incidence rates among young women and the population as a whole. PMID:27104835

  15. HIV status disclosure, depressive symptoms, and sexual risk behavior among HIV-positive young men who have sex with men

    PubMed Central

    Cook, Stephanie H.; Valera, Pamela

    2015-01-01

    The rate of HIV infection among young men who have sex with men (YMSM) is increasing in the United States, and targeted research is needed to inform interventions aimed at reducing HIV transmission in this population. This study aims to understand the association between HIV status disclosure and sexual risk behavior among HIV-positive YMSM. A particular focus is given to depressive symptoms and their potential role in explaining the association between HIV disclosure and sexual risk behavior. In a sample of 991 YMSM receiving care at 20 clinics across the United States, Univariate and multivariate analyses were conducted to explore these associations. Approximately one-half (52.4 %) of participants reported disclosing to their current sexual/romantic partner. Disclosure to family members was negatively associated with sexual risk behavior. Also, depressive symptoms were positively associated with sexual risk behavior. We discuss the implications of our findings for future research and intervention. PMID:25773478

  16. HIV sexual transmission risks in the context of clinical care: a prospective study of behavioural correlates of HIV suppression in a community sample, Atlanta, GA, USA

    PubMed Central

    Kalichman, Seth C; Cherry, Chauncey; Kalichman, Moira O; Washington, Christopher; Grebler, Tamar; Merely, Cindy; Welles, Brandi; Pellowski, Jennifer; Kegler, Christopher

    2015-01-01

    Introduction Antiretroviral therapy (ART) improves the health of people living with HIV and has the potential to reduce HIV infectiousness, thereby preventing HIV transmission. However, the success of ART for HIV prevention hinges on sustained ART adherence and avoiding sexually transmitted infections (STI). Objectives To determine the sexual behaviours and HIV transmission risks of individuals with suppressed and unsuppressed HIV replication (i.e., viral load). Methods Assessed HIV sexual transmission risks among individuals with clinically determined suppressed and unsuppressed HIV. Participants were 760 men and 280 women living with HIV in Atlanta, GA, USA, who completed behavioural assessments, 28-daily prospective sexual behaviour diaries, one-month prospective unannounced pill counts for ART adherence, urine screening for illicit drug use and medical record chart abstraction for HIV viral load. Results Individuals with unsuppressed HIV demonstrated a constellation of behavioural risks for transmitting HIV to uninfected sex partners that included symptoms of STI and substance use. In addition, 15% of participants with suppressed HIV had recent STI symptoms/diagnoses, indicating significant risks for sexual infectiousness despite their HIV suppression in blood plasma. Overall, 38% of participants were at risk for elevated sexual infectiousness and just as many engaged in unprotected sexual intercourse with non-HIV-infected partners. Conclusions Implementation strategies for using HIV treatments as HIV prevention requires enhanced behavioural interventions that extend beyond ART to address substance use and sexual health that will otherwise undermine the potential preventive impact of early ART. PMID:26249127

  17. HIV Prevalence and Risks Associated with HIV Infection among Transgender Individuals in Cambodia

    PubMed Central

    Ngak, Song; Srean, Chhim; Sansothy, Neth; Mills, Stephen; Ferradini, Laurent

    2016-01-01

    Introduction Recognizing transgender individuals have a high risk of HIV acquisition, and to inform policies and programming, we conducted an HIV prevalence and risk behaviors survey among transgender individuals in Cambodia. Methods Cross-sectional survey using a respondent driven sampling method with self-administered audio-computer assisted interviews. HIV testing was performed prior to the questionnaire with results available immediately after. Eligible participants were ≥18 years, identified as male at birth and self-identified/expressed as a different gender, and reported having sex with at least one male partner in past year. From six major urban centers of Cambodia, 891 transgender individuals were recruited. Results The majority of the 891 participants self-identified as third gender or female (94.5%), were young (median age 23, IQR [20–27]), had secondary education or higher (80.5%), not married (89.7%), and employed (90.2%). The majority had first sex before 18 years (66.8%), with a male (79.9%), 37.9% having been paid or paying for this first sex. The rate of HIV positivity among participants was found to be 4.15%. Consistent condom use with male and female partners was low with all partner types, but particularly low with male partners when paying for sex (20.3%). The majority of participants reported having experienced discrimination in their lifetime (54.8%) and 30.3% had been assaulted. Multivariate analysis revealed that older age (adjusted OR = 14.73 [4.20, 51.67] for age 35–44 and adjusted OR = 7.63 [2.55, 22.81] for age 30–34), only having a primary school education or no schooling at all (adjusted OR = 2.62 [1.18, 5.80], being a resident of Siem Reap (adjusted OR = 7.44 [2.37,23.29], receiving payment at first sex (adjusted OR = 2.26 [1.00, 5.11], having sex during/after using drugs (adjusted OR = 2.90 [1.09,7.73]), inconsistent condom use during last anal sex (adjusted OR = 3.84 [1.58, 9.33]), and reporting low self-esteem (adjusted OR

  18. Syndemic vulnerability, sexual and injection risk behaviors, and HIV continuum of care outcomes in HIV-positive injection drug users

    PubMed Central

    Mizuno, Yuko; Purcell, David W.; Knowlton, Amy R.; Wilkinson, James D.; Gourevitch, Marc N.; Knight, Kelly R.

    2015-01-01

    Limited investigations have been conducted on syndemics and HIV continuum of care outcomes. Using baseline data from a multi-site, randomized controlled study of HIV-positive injection drug users (n=1052), we examined whether psychosocial factors co-occurred, and whether these factors were additively associated with behavioral and HIV continuum of care outcomes. Experiencing one type of psychosocial problem was significantly (p<0.05) associated with an increased odds of experiencing another type of problem. Persons with 3 or more psychosocial problems were significantly more likely to report sexual and injection risk behaviors and were less likely to be adherent to HIV medications. Persons with 4 or more problems were less likely to be virally suppressed. Reporting any problems was associated with not currently taking HIV medications. Our findings highlight the association of syndemics not only with risk behaviors, but also with outcomes related to the continuum of care for HIV-positive persons. PMID:25249392

  19. HIV-1 subtype C is not associated with higher risk of heterosexual HIV-1 transmission: a multinational study among African HIV-1 serodiscordant couples

    PubMed Central

    Kahle, Erin; Campbell, Mary; Lingappa, Jairam; Donnell, Deborah; Celum, Connie; Ondondo, Raphael; Mujugira, Andrew; Fife, Kenneth; Mugo, Nelly; Kapiga, Saidi; Mullins, James I.; Baeten, Jared M.

    2014-01-01

    Background HIV-1 subtype C has emerged as the most prevalent strain of HIV-1 worldwide, leading to speculation that subtype C may be more transmissible than other subtypes. We compared the risk of HIV-1 transmission for subtype C versus non-C subtypes (A, D, G and recombinant forms) among heterosexual African HIV-1 serodiscordant couples. Methods We conducted a nested case-control analysis using data from two prospective cohort studies of heterosexual HIV-1 serodiscordant couples from 6 countries in eastern and southern Africa. Cases (N=121) included incident HIV-1 transmissions that were established as linked within the serodiscordant partnership by viral sequencing; controls (N=501) were non-transmitting HIV-1 infected partners. Subtype was determined for partial env and gag genes. Multiple logistic regression controlled for age and gender of the HIV-1 infected partner and self-reported unprotected sex. Plasma and genital HIV-1 RNA concentrations were compared between subtype C and non-C subtypes using generalized estimating equations. Results HIV-1 subtype C was not associated with increased risk of HIV-1 transmission compared to non-C subtypes: env adjusted odds ratio (adjOR) 1.14 (95% confidence interval [CI] 0.74–1.75, p=0.6) and gag adjOR 0.98 (95% CI 0.63–1.52, p=0.9). Plasma and genital HIV-1 RNA levels did not differ significantly for subtype C versus non-C. Conclusion In a geographically diverse population of heterosexual African HIV-1 serodiscordant couples, subtype C was not associated with greater risk of HIV-1 transmission compared to non-C subtypes, arguing against the hypothesis that subtype C is more transmissible compared to other common subtypes. PMID:24413311

  20. Myocardial dysfunction in patients infected with HIV: prevalence and risk factors

    PubMed Central

    Jacob, A J; Sutherland, G R; Bird, A G; Brettle, R P; Ludlam, C A; McMillan, A; Boon, N A

    1992-01-01

    Objectives—To determine the prevalence of and risk factors for myocardial dysfunction in HIV infection. Subjects—173 patients infected with HIV underwent echocardiography. 119 were current or previous injection drug users, 38 were homosexuals, 10 were haemophiliac patients, and six were heterosexual. Main outcome measure—Detection of impaired ventricular function. Results—26 patients with abnormalities of ventricular size or function or both were identified. The abnormality was (a) dilated cardiomyopathy in 13 patients (eight homosexuals, three drug users, and two haemophiliacs) with a mean CD4 count of 38 cells/mm3, which accords with end-stage disease (in addition, three patients were identified as having borderline impairment of left ventricular function); (b) left ventricular dilatation without loss of function in a further six patients; and (c) isolated right ventricular dilation in seven patients. Follow up echocardiograms were obtained in 71 patients, 18 of whom had myocardial dysfunction (103 echocardiograms, mean (SD) 2·5 (0·6) scans per patient, mean interval 200 (116) days, range 14–538 days). These showed that in four cases of isolated right ventricular dilatation, one of isolated left ventricular dilatation, and two with borderline left ventricular dysfunction myocardial function subsequently reverted to normal. There was no excess of exposure to zidovudine in the patients with myocardial dysfunction. Similarly, patients with myocardial dysfunction had no serological evidence of excess secondary infection with Toxoplasma gondii and cytomegalovirus. Conclusions—There was a high prevalence and wide range of myocardial dysfunction in HIV positive patients. Dilated cardiomyopathy was a feature of advanced HIV disease and affected all major risk groups for HIV infection. In contrast, isolated dilatation of either ventricle occurred at an earlier stage of HIV infection and, particularly in the case of the right ventricle, often was transient

  1. A New Approach to Measuring Partnership Concurrency and its Association with HIV Risk in Couples

    PubMed Central

    Mkandawire, James; Kohler, Hans-Peter

    2015-01-01

    Empirical estimates of the association between concurrent partnerships (CP) and HIV risk are affected by non-sampling errors in survey data on CPs, e.g., because respondents misreport the extent of their CPs. We propose a new approach to measuring CPs in couples, which permits assessing how respondent errors affect estimates of the association between CPs and HIV risk. Each couple member is asked (1) to report whether s/he has engaged in CPs and (2) to assess whether his/her partner has engaged in CPs, since their couple started. Cross-tabulating these data yields multiple classifications (with varying combinations of sensitivity/specificity) of the CPs of each couple member. We then measure the association between CPs and HIV outcomes according to each classification. The resulting range of estimates is an indicator of the uncertainty associated with respondent errors. We tested this approach using data on 520 matched couples drawn from the Likoma Network Study. Results suggest that existing tests of the concurrency hypothesis are affected by significant uncertainty. PMID:24817498

  2. Impulsivity, Sensation Seeking, and Risk-Taking Behaviors among HIV-Positive and HIV-Negative Heroin Dependent Persons.

    PubMed

    Paydary, Koosha; Mahin Torabi, Somayeh; SeyedAlinaghi, SeyedAhmad; Noori, Mehri; Noroozi, Alireza; Ameri, Sara; Ekhtiari, Hamed

    2016-01-01

    Objective. The aim of this study was to compare impulsivity and risky decision making among HIV-positive and negative heroin dependent persons. Methods. We compared different dimensions of impulsivity and risky decision making in two groups of 60 HIV-positive and 60 HIV-negative male heroin dependent persons. Each group was comprised of equal numbers of current (treatment seeker) and former (abstinent) heroin addicts. Data collection tools included Balloon Analogue Risk Task (BART), Iowa Gambling Task (IGT), Barratt Impulsiveness Scale (BIS), and Zuckerman Sensation Seeking Scale (SSS). Results. In SSS, comprised of four subscales including thrill and adventure seeking (TAS), experience seeking (ES), disinhibition (DIS), and boredom susceptibility (BS), there was a borderline difference in DIS (P = 0.08) as HIV-positive group scored higher than HIV-negative group. Also, ES and total score were significantly higher among HIV-positive patients. In BART, HIV-positive subjects scored higher in risk taking than HIV-negative subjects as reflected in higher Average Number of puffs in Successful Balloons (ANSB). In BIS, HIV-positive group scored significantly higher in cognitive impulsivity (CI) (P = 0.03) and nonplanning impulsivity (NPI) (P = 0.05) in comparison to HIV-negative group. Also, current heroin addicts scored significantly higher in NPI compared to former addict HIV-negative participants (P = 0.015). IGT did not show any significant difference between groups. Conclusion. Higher levels of impulsivity and risk taking behaviors among HIV-positive heroin addicts will increase serious concerns regarding HIV transmission from this group to other opiate dependents and healthy people. PMID:27051528

  3. Impulsivity, Sensation Seeking, and Risk-Taking Behaviors among HIV-Positive and HIV-Negative Heroin Dependent Persons

    PubMed Central

    Paydary, Koosha; Mahin Torabi, Somayeh; SeyedAlinaghi, SeyedAhmad; Noori, Mehri; Noroozi, Alireza; Ameri, Sara; Ekhtiari, Hamed

    2016-01-01

    Objective. The aim of this study was to compare impulsivity and risky decision making among HIV-positive and negative heroin dependent persons. Methods. We compared different dimensions of impulsivity and risky decision making in two groups of 60 HIV-positive and 60 HIV-negative male heroin dependent persons. Each group was comprised of equal numbers of current (treatment seeker) and former (abstinent) heroin addicts. Data collection tools included Balloon Analogue Risk Task (BART), Iowa Gambling Task (IGT), Barratt Impulsiveness Scale (BIS), and Zuckerman Sensation Seeking Scale (SSS). Results. In SSS, comprised of four subscales including thrill and adventure seeking (TAS), experience seeking (ES), disinhibition (DIS), and boredom susceptibility (BS), there was a borderline difference in DIS (P = 0.08) as HIV-positive group scored higher than HIV-negative group. Also, ES and total score were significantly higher among HIV-positive patients. In BART, HIV-positive subjects scored higher in risk taking than HIV-negative subjects as reflected in higher Average Number of puffs in Successful Balloons (ANSB). In BIS, HIV-positive group scored significantly higher in cognitive impulsivity (CI) (P = 0.03) and nonplanning impulsivity (NPI) (P = 0.05) in comparison to HIV-negative group. Also, current heroin addicts scored significantly higher in NPI compared to former addict HIV-negative participants (P = 0.015). IGT did not show any significant difference between groups. Conclusion. Higher levels of impulsivity and risk taking behaviors among HIV-positive heroin addicts will increase serious concerns regarding HIV transmission from this group to other opiate dependents and healthy people. PMID:27051528

  4. Sexual Risk Behaviors for HIV/AIDS in Chuuk State, Micronesia: The Case for HIV Prevention in Vulnerable Remote Populations

    PubMed Central

    Russell, Toya V.; Do, Ann N.; Setik, Eleanor; Sullivan, Patrick S.; Rayle, Victoria D.; Fridlund, Carol A.; Quan, Vu M.; Voetsch, Andrew C.; Fleming, Patricia L.

    2007-01-01

    Background After the first two cases of locally-acquired HIV infection were recognized in Chuuk State, Federated States of Micronesia (FSM), a public health response was initiated. The purpose of the response was to assess the need for HIV education and prevention services, to develop recommendations for controlling further spread of HIV in Chuuk, and to initiate some of the prevention measures. Methodology/Principal Findings A public health team conducted a survey and rapid HIV testing among a sample of residents on the outer islands in Chuuk. Local public health officials conducted contact tracing and testing of sex partners of the two locally-acquired cases of HIV infection. A total of 333 persons completed the survey. The majority knew that HIV is transmitted through unprotected sexual contact (81%), injection drug use (61%), or blood transfusion (64%). Sexual activity in the past 12 months was reported among 159 participants, including 90 females and 69 males. Compared to women, men were more likely to have had multiple sex partners, to have been drunk during sex, but less likely to have used a condom in the past 12 months. The two men with locally acquired HIV infection had unprotected anal sex with a third Chuukese man who likely contracted HIV while outside of Chuuk. All 370 persons who received voluntary, confidential HIV counseling and testing had HIV negative test results. Conclusions/Significance Despite the low HIV seroprevalence, risky sexual behaviors in this small isolated population raise concerns about the potential for rapid spread of HIV. The lack of knowledge about risks, along with stigmatizing attitudes towards persons infected with HIV and high risk sexual behaviors indicate the need for resources to be directed toward HIV prevention in Chuuk and on other Pacific Islands. PMID:18074009

  5. TB/HIV Co-Infection Care in Conflict-Affected Settings: A Mapping of Health Facilities in the Goma Area, Democratic Republic of Congo

    PubMed Central

    Kaboru, Berthollet Bwira; Ogwang, Brenda. A.; Namegabe, Edmond Ntabe; Mbasa, Ndemo; Kabunga, Deka Kambale; Karafuli, Kambale

    2013-01-01

    Background: HIV/AIDS and Tuberculosis (TB) are major contributors to the burden of disease in sub-Saharan Africa. The two diseases have been described as a harmful synergy as they are biologically and epidemiologically linked. Control of TB/HIV co-infection is an integral and most challenging part of both national TB and national HIV control programmes, especially in contexts of instability where health systems are suffering from political and social strife. This study aimed at assessing the provision of HIV/TB co-infection services in health facilities in the conflict-ridden region of Goma in Democratic Republic of Congo. Methods: A cross-sectional survey of health facilities that provide either HIV or TB services or both was carried out. A semi-structured questionnaire was used to collect the data which was analysed using descriptive statistics. Results: Eighty facilities were identified, of which 64 facilities were publicly owned. TB care was more available than HIV care (in 61% vs. 9% of facilities). Twenty-three facilities (29%) offered services to co-infected patients. TB/HIV co-infection rates among patients were unknown in 82% of the facilities. Only 19 facilities (24%) reported some coordination with and support from concerned diseases’ control programmes. HIV and TB services are largely fragmented, indicating imbalances and poor coordination by disease control programmes. Conclusion: HIV and TB control appear not to be the focus of health interventions in this crisis affected region, despite the high risks of TB and HIV infection in the setting. Comprehensive public health response to this setting calls for reforms that promote joint TB/HIV co-infection control, including improved leadership by the HIV programmes that accuse weaknesses in this conflict-ridden region. PMID:24596866

  6. Projecting Sexual and Injecting HIV Risks into Future Outcomes with Agent-Based Modeling

    NASA Astrophysics Data System (ADS)

    Bobashev, Georgiy V.; Morris, Robert J.; Zule, William A.

    Longitudinal studies of health outcomes for HIV could be very costly cumbersome and not representative of the risk population. Conversely, cross-sectional approaches could be representative but rely on the retrospective information to estimate prevalence and incidence. We present an Agent-based Modeling (ABM) approach where we use behavioral data from a cross-sectional representative study and project the behavior into the future so that the risks of acquiring HIV could be studied in a dynamical/temporal sense. We show how the blend of behavior and contact network factors (sexual, injecting) play the role in the risk of future HIV acquisition and time till obtaining HIV. We show which subjects are the most likely persons to get HIV in the next year, and whom they are likely to infect. We examine how different behaviors are related to the increase or decrease of HIV risks and how to estimate the quantifiable risk measures such as survival HIV free.

  7. High prevalence of suicide risk in people living with HIV: who is at higher risk?

    PubMed

    Passos, Susane Müller Klug; Souza, Luciano Dias de Mattos; Spessato, Bárbara Coiro

    2014-01-01

    A cross-sectional study was developed to evaluate suicide risk and associated factors in HIV/AIDS patients at a regional reference center for the treatment of HIV/AIDS in southern Brazil. We assessed 211 patients in regard to suicide risk, clinical and sociodemographic characteristics, drug use, depression, and anxiety. Suicide risk was assessed with Mini International Neuropsychiatric Interview, Module C. Multivariate analysis was performed using Poisson regression. Of the total sample, 34.1% were at risk of suicide. In the multivariate analysis, the following variables were independently associated with suicide risk: female gender; age up to 47 years; unemployment; indicative of anxiety; indicative of depression; and abuse or addiction on psychoactive substances. Suicide risk is high in this population. Psychosocial factors should be included in the physical and clinical evaluation, given their strong association with suicide risk. PMID:24797027

  8. Behavioral Interventions to Reduce Sexual Risk Behavior in Adults with HIV/AIDS Receiving HIV Care: A Systematic Review.

    PubMed

    Laisaar, Kaja-Triin; Raag, Mait; Rosenthal, Marika; Uusküla, Anneli

    2015-05-01

    Regular interactions with people living with HIV/AIDS (PLWHA) who are receiving care provide caregivers opportunities to deliver interventions to reduce HIV-related risks. We conducted a systematic review of behavioral interventions for PLWHA (provided at individual level by caregivers at HIV care settings) to determine their efficacy in reducing sexual risk behavior. Conference websites and biomedical literature databases were searched for studies from 1981 to 2013. Randomized and quasi-randomized controlled trials (with standard-of-care control groups), considering at least one of a list of HIV-related behavioral or biological outcomes in PLWHA aged ≥18 receiving HIV care with at least 3-month follow-up were included. No language or publication status restrictions were set. Standardized search, data abstraction, and evaluation methods were used. Five randomized controlled trials were included in the review. We found limited evidence that sexual risk reduction interventions increase condom use consistency in HIV transmission risk acts, and reduce the number of (casual) sexual partners. We still believe that regular interactions between HIV care providers and PLWHA provide valuable opportunities for theory-based sexual risk reduction interventions to restrain the spread of HIV. PMID:25844941

  9. First Impressions of HIV Risk: It Takes Only Milliseconds to Scan a Stranger

    PubMed Central

    Renner, Britta; Schmälzle, Ralf; Schupp, Harald T.

    2012-01-01

    Research indicates that many people do not use condoms consistently but instead rely on intuition to identify sexual partners high at risk for HIV infection. The present studies examined neural correlates for first impressions of HIV risk and determined the association of perceived HIV risk with other trait characteristics. Participants were presented with 120 self-portraits retrieved from a popular online photo-sharing community (www.flickr.com). Factor analysis of various explicit ratings of trait characteristics yielded two orthogonal factors: (1) a ‘valence-approach’ factor encompassing perceived attractiveness, healthiness, valence, and approach tendencies, and (2) a ‘safeness’ factor, entailing judgments of HIV risk, trustworthiness, and responsibility. These findings suggest that HIV risk ratings systematically relate to cardinal features of a high-risk HIV stereotype. Furthermore, event-related brain potential recordings revealed neural correlates of first impressions about HIV risk. Target persons perceived as risky elicited a differential brain response in a time window from 220–340 ms and an increased late positive potential in a time window from 350–700 ms compared to those perceived as safe. These data suggest that impressions about HIV risk can be formed in a split second and despite a lack of information about the actual risk profile. Findings of neural correlates of risk impressions and their relationship to key features of the HIV risk stereotype are discussed in the context of the ‘risk as feelings’ theory. PMID:22291959

  10. Molecular Mechanisms Linking High Dose Medroxyprogesterone with HIV-1 Risk

    PubMed Central

    Irvin, Susan C.; Herold, Betsy C.

    2015-01-01

    Background Epidemiological studies suggest that medroxyprogesterone acetate (MPA) may increase the risk of HIV-1. The current studies were designed to identify potential underlying biological mechanisms. Methods Human vaginal epithelial (VK2/E6E7), peripheral blood mononuclear (PBMC), and polarized endometrial (HEC-1-A) cells were treated with a range of concentrations of MPA (0.015-150 μg/ml) and the impact on gene expression, protein secretion, and HIV infection was evaluated. Results Treatment of VK2/E6E7 cells with high doses (>15μg/ml] of MPA significantly upregulated proinflammatory cytokines, which resulted in a significant increase in HIV p24 levels secreted by latently infected U1 cells following exposure to culture supernatants harvested from MPA compared to mock-treated cells. MPA also increased syndecan expression by VK2/E6E7 cells and cells treated with 15 μg/ml of MPA bound and transferred more HIV-1 to T cells compared to mock-treated cells. Moreover, MPA treatment of epithelial cells and PBMC significantly decreased cell proliferation resulting in disruption of the epithelial barrier and decreased cytokine responses to phytohaemagglutinin, respectively. Conclusion We identified several molecular mechanisms that could contribute to an association between DMPA and HIV including proinflammatory cytokine and chemokine responses that could activate the HIV promoter and recruit immune targets, increased expression of syndecans to facilitate the transfer of virus from epithelial to immune cells and decreased cell proliferation. The latter could impede the ability to maintain an effective epithelial barrier and adversely impact immune cell function. However, these responses were observed primarily following exposure to high (15-150 μg/ml) MPA concentrations. Clinical correlation is needed to determine whether the prolonged MPA exposure associated with contraception activates these mechanisms in vivo. PMID:25798593

  11. Occupational HIV risk for health care workers: risk factor and the risk of infection in the course of professional activities

    PubMed Central

    Wyżgowski, Przemysław; Rosiek, Anna; Grzela, Tomasz; Leksowski, Krzysztof

    2016-01-01

    Virtually created panic among health care workers about pandemic acquired immune deficiency syndrome prompted us to review the scientific literature to investigate the risk of human immunodeficiency virus (HIV) transmission in the daily works of health care workers, especially surgeons and anesthesiologists. In this review, we report worldwide valuations of the number of HIV infections that may occur from unsafe daily work in health care. We also present how to minimize the risk of infection by taking precautions and how to utilize postexposure prophylaxis in accordance with the latest reports of the Centers for Disease Control and Prevention. HIV-infected patients will be aging, and most of them will become the candidates for procedures such as major vascular reconstruction and artery bypass grafting, where the risks of blood contact and staff injury are high. For these reasons, all health care workers need to know how to prevent, and fight following the accidental exposure to HIV. PMID:27366077

  12. The Role of Acculturation and Family Functioning in Predicting HIV Risk Behaviors Among Hispanic Delinquent Youth

    PubMed Central

    Farrelly, Colleen; Cordova, David; Huang, Shi; Estrada, Yannine

    2012-01-01

    The present study examined the relationship between Berry’s acculturation typology and HIV risk behaviors and whether family functioning mediated any such effects. A total of 235 high risk Hispanic adolescents were categorized into one of Berry’s four acculturation typologies through the use of cut-off scores on measures of Hispanicism and Americanism. Structural equation modeling was used to examine the effects of acculturation typology on HIV risk behaviors and the indirect effects of acculturation typology on HIV risk behaviors through family functioning. Acculturation typology was related to HIV risk behaviors. Family functioning partially mediated the effects of acculturation typology on the HIV risk behavior outcomes. These findings suggest that both Americanism and Hispanicism play an important role in the etiology of HIV risk behaviors among Hispanic youth and that both, along with family functioning, are important to consider when designing preventive interventions for this population. PMID:22532299

  13. The role of acculturation and family functioning in predicting HIV risk behaviors among Hispanic delinquent youth.

    PubMed

    Farrelly, Colleen; Cordova, David; Huang, Shi; Estrada, Yannine; Prado, Guillermo

    2013-06-01

    The present study examined the relationship between Berry's acculturation typology and HIV risk behaviors and whether family functioning mediated any such effects. A total of 235 high risk Hispanic adolescents were categorized into one of Berry's four acculturation typologies through the use of cut-off scores on measures of Hispanicism and Americanism. Structural equation modeling was used to examine the effects of acculturation typology on HIV risk behaviors and the indirect effects of acculturation typology on HIV risk behaviors through family functioning. Acculturation typology was related to HIV risk behaviors. Family functioning partially mediated the effects of acculturation typology on the HIV risk behavior outcomes. These findings suggest that both Americanism and Hispanicism play an important role in the etiology of HIV risk behaviors among Hispanic youth and that both, along with family functioning, are important to consider when designing preventive interventions for this population. PMID:22532299

  14. Development and Validation of an HIV Risk Exposure and Indicator Conditions Questionnaire to Support Targeted HIV Screening

    PubMed Central

    Elías, María Jesús Pérez; Gómez-Ayerbe, Cristina; Elías, Pilar Pérez; Muriel, Alfonso; de Santiago, Alberto Diaz; Martinez-Colubi, María; Moreno, Ana; Santos, Cristina; Polo, Lidia; Barea, Rafa; Robledillo, Gema; Uranga, Almudena; Espín, Agustina Cano; Quereda, Carmen; Dronda, Fernando; Casado, Jose Luis; Moreno, Santiago

    2016-01-01

    Abstract The aim of our study was to develop a Spanish-structured HIV risk of exposure and indicator conditions (RE&IC) questionnaire. People attending to an emergency room or to a primary clinical care center were offered to participate in a prospective, 1 arm, open label study, in which all enrolled patients filled out our developed questionnaire and were HIV tested. Questionnaire accuracy, feasibility, and reliability were evaluated. Valid paired 5329 HIV RE&IC questionnaire and rapid HIV tests were performed, 69.3% in the primary clinical care center, 49.6% women, median age 37 years old, 74.9% Spaniards, 20.1% Latin-Americans. Confirmed hidden HIV infection was detected in 4.1%, while HIV RE&IC questionnaire was positive in 51.2%. HIV RE&IC questionnaire sensitivity was 100% to predict HIV infection, with a 100% negative predictive value. When considered separately, RE or IC items sensitivity decreases to 86.4% or 91%, and similarly their negative predictive value to 99.9% for both of them. The majority of people studied, 90.8% self-completed HIV RE&IC questionnaire. Median time to complete was 3 minutes. Overall HIV RE&IC questionnaire test-retest Kappa agreement was 0.82 (almost perfect), likewise for IC items 0.89, while for RE items was lower 0.78 (substantial). A feasible and reliable Spanish HIV RE&IC self questionnaire accurately discriminated all non–HIV-infected people without missing any HIV diagnoses, in a low prevalence HIV infection area. The best accuracy and reliability were obtained when combining HIV RE&IC items. PMID:26844471

  15. Development and Validation of an HIV Risk Exposure and Indicator Conditions Questionnaire to Support Targeted HIV Screening.

    PubMed

    Elías, María Jesús Pérez; Gómez-Ayerbe, Cristina; Elías, Pilar Pérez; Muriel, Alfonso; de Santiago, Alberto Diaz; Martinez-Colubi, María; Moreno, Ana; Santos, Cristina; Polo, Lidia; Barea, Rafa; Robledillo, Gema; Uranga, Almudena; Espín, Agustina Cano; Quereda, Carmen; Dronda, Fernando; Casado, Jose Luis; Moreno, Santiago

    2016-02-01

    The aim of our study was to develop a Spanish-structured HIV risk of exposure and indicator conditions (RE&IC) questionnaire. People attending to an emergency room or to a primary clinical care center were offered to participate in a prospective, 1 arm, open label study, in which all enrolled patients filled out our developed questionnaire and were HIV tested. Questionnaire accuracy, feasibility, and reliability were evaluated.Valid paired 5329 HIV RE&IC questionnaire and rapid HIV tests were performed, 69.3% in the primary clinical care center, 49.6% women, median age 37 years old, 74.9% Spaniards, 20.1% Latin-Americans. Confirmed hidden HIV infection was detected in 4.1%, while HIV RE&IC questionnaire was positive in 51.2%. HIV RE&IC questionnaire sensitivity was 100% to predict HIV infection, with a 100% negative predictive value. When considered separately, RE or IC items sensitivity decreases to 86.4% or 91%, and similarly their negative predictive value to 99.9% for both of them. The majority of people studied, 90.8% self-completed HIV RE&IC questionnaire. Median time to complete was 3 minutes. Overall HIV RE&IC questionnaire test-retest Kappa agreement was 0.82 (almost perfect), likewise for IC items 0.89, while for RE items was lower 0.78 (substantial).A feasible and reliable Spanish HIV RE&IC self questionnaire accurately discriminated all non-HIV-infected people without missing any HIV diagnoses, in a low prevalence HIV infection area. The best accuracy and reliability were obtained when combining HIV RE&IC items. PMID:26844471

  16. A Qualitative Exploration of Sexual Risk and HIV Testing Behaviors among Men Who Have Sex with Men in Beirut, Lebanon

    PubMed Central

    Wagner, Glenn J.; Aunon, Frances M.; Kaplan, Rachel L.; Rana, Yashodhara; Khouri, Danielle; Tohme, Johnny; Mokhbat, Jacques

    2012-01-01

    Men who have sex with men (MSM) may account for most new HIV infections in Lebanon, yet little is known about the factors that influence sexual risk behavior and HIV testing in this population. Qualitative interviews were conducted with 31 MSM living in Beirut, and content analysis was used to identify emergent themes. Mean age of the participants was 28.4 years, and all identified as either gay (77%) or bisexual (23%). Half reported not using condoms consistently and one quarter had not been HIV-tested. Many described not using condoms with a regular partner in the context of a meaningful relationship, mutual HIV testing, and a desire to not use condoms, suggesting that trust, commitment and intimacy play a role in condom use decisions. Condoms were more likely to be used with casual partners, partners believed to be HIV-positive, and with partners met online where men found it easier to candidly discuss HIV risk. Fear of infection motivated many to get HIV tested and use condoms, but such affect also led some to avoid HIV testing in fear of disease and social stigma if found to be infected. Respondents who were very comfortable with their sexual orientation and who had disclosed their sexuality to family and parents tended to be more likely to use condoms consistently and be tested for HIV. These findings indicate that similar factors influence the condom use and HIV testing of MSM in Beirut as those observed in studies elsewhere of MSM; hence, prevention efforts in Lebanon can likely benefit from lessons learned and interventions developed in other regions, particularly for younger, gay-identified men. Further research is needed to determine how prevention efforts may need to be tailored to address the needs of men who are less integrated into or do not identify with the gay community. PMID:23029103

  17. A qualitative exploration of sexual risk and HIV testing behaviors among men who have sex with men in Beirut, Lebanon.

    PubMed

    Wagner, Glenn J; Aunon, Frances M; Kaplan, Rachel L; Rana, Yashodhara; Khouri, Danielle; Tohme, Johnny; Mokhbat, Jacques

    2012-01-01

    Men who have sex with men (MSM) may account for most new HIV infections in Lebanon, yet little is known about the factors that influence sexual risk behavior and HIV testing in this population. Qualitative interviews were conducted with 31 MSM living in Beirut, and content analysis was used to identify emergent themes. Mean age of the participants was 28.4 years, and all identified as either gay (77%) or bisexual (23%). Half reported not using condoms consistently and one quarter had not been HIV-tested. Many described not using condoms with a regular partner in the context of a meaningful relationship, mutual HIV testing, and a desire to not use condoms, suggesting that trust, commitment and intimacy play a role in condom use decisions. Condoms were more likely to be used with casual partners, partners believed to be HIV-positive, and with partners met online where men found it easier to candidly discuss HIV risk. Fear of infection motivated many to get HIV tested and use condoms, but such affect also led some to avoid HIV testing in fear of disease and social stigma if found to be infected. Respondents who were very comfortable with their sexual orientation and who had disclosed their sexuality to family and parents tended to be more likely to use condoms consistently and be tested for HIV. These findings indicate that similar factors influence the condom use and HIV testing of MSM in Beirut as those observed in studies elsewhere of MSM; hence, prevention efforts in Lebanon can likely benefit from lessons learned and interventions developed in other regions, particularly for younger, gay-identified men. Further research is needed to determine how prevention efforts may need to be tailored to address the needs of men who are less integrated into or do not identify with the gay community. PMID:23029103

  18. HIV Risk Behavior among Youth in the Dominican Republic: The Role of Alcohol and Other Drugs

    PubMed Central

    Guilamo-Ramos, Vincent; Jaccard, James; Lushin, Vincent; Martinez, Roberto; Gonzalez, Bernardo; McCarthy, Katharine

    2012-01-01

    Existing literature related to HIV in the Dominican Republic has tended to neglect the unique role of tourism areas as distinct ecologies facilitative of sexual risk behavior, particularly HIV vulnerability and transmission. Furthermore, limited attention has focused on Dominican adolescents living in close proximity to tourism areas who have become increasingly exposed to alcohol due to the expanding tourism industry in the Dominican Republic. While most previous analyses of the effects of alcohol on adolescent sexual risk behavior have focused on the transient effects of alcohol on judgment and decision making, the effects of chronic alcohol use on sexual behavior has been a neglected area of research. Our study explores the relationship between chronic alcohol use, the parent–adolescent relationship, affective factors such as self-esteem, and intentions to engage in sex. We examine the above factors within the context of tourism areas which represent a unique ecology of alcohol availability and consumption and HIV risk. We discuss implications for developing applied family-based programs to target Dominican adolescent alcohol use and sexual risk behavior in tourism areas of high alcohol exposure. PMID:21911848

  19. Targeted interventions required against genital ulcers in African countries worst affected by HIV infection.

    PubMed Central

    O'Farrell, N.

    2001-01-01

    It remains unclear why there is such marked variation in the severity of the human immunodeficiency virus (HIV) epidemic between African countries. The prevalence of HIV infection has reached high levels in many parts of southern Africa but in most countries of West Africa the levels are much lower. Although there is good evidence that sexually transmitted infections (STIs) and genital ulcers in particular facilitate heterosexual transmission of HIV, there is little comparative STI data from the African countries worst affected by HIV infection. A MEDLINE search covering the period 1966 to August 2000 using the keywords "sexually transmitted diseases", "genital ulcers" and "Africa" was performed to identify factors that might be relevant to the spread of HIV infection in countries with the highest prevalences of the virus. In the countries worst affected by HIV infection, the proportions of men and women with STI who had genital ulcers lay in the ranges 45-68% and 13-68%, respectively. The proportions were much lower in countries of West Africa than in those of southern Africa. The African countries worst affected by HIV infection should adopt a more specialized approach to STI control than hitherto and specifically target the high incidence of genital ulceration. Locally, technical STI committees should draw up country-specific guidelines taking into account the prevalence of the various causes of genital ulceration. In these countries, national AIDS control programmes and donor agencies should develop a specific focus for decreasing the incidence of genital ulcer disease. PMID:11436480

  20. HIV transmission and related risk factors among serodiscordant couples in Liuzhou, China.

    PubMed

    Zhang, Yu-Jing; Feng, Xian-Xiang; Fan, Yin-Guang; Jiang, Zhi-Yu; Zhong, Xiang-Hai; Li, Ming-Qiang; Ye, Dong-Qing

    2015-04-01

    To evaluate the incidence and risk factors for human immunodeficiency virus (HIV) seroconversion of HIV-negative partners among HIV-discordant couples in Liuzhou, China, 1854 eligible HIV-serodiscordant couples were retrospectively identified through the HIV epidemiology and follow-up database from January 1, 1996 to June 30, 2013. Cox proportional-hazards model was used to examine risk factors related to HIV seroconversion of negative partners. Finally, 125 HIV seroconversion occurred over 4963.5 person-years, resulting in an overall HIV incidence of 2.52/100 person-years. HIV-positive partners with the last CD4 counts of 350 cells/ul or more were significantly protected against HIV seroconversion compared with those CD4 counts of less than 200 cells/ul (aHR = 0.46, 95% CI: 0.27-0.81, P < 0.01). Men with HIV-positive wives (aHR: 1.96, 95% CI: 1.27-3.02, P < 0.01), HIV-positive partners who did not receive ART before their HIV-negative partners' seroconversion (aHR: 2.22, 95% CI, 1.41-3.51, P < 0.01) and patients reported intermittent condom use (aHR: 7.60, 95% CI, 4.37-13.21, P < 0.01) were associated with increased risk of HIV seroconversion. HIV-negative partners remain high risk of HIV infection in Liuzhou city. Comprehensive package of HIV prevention services should contribute to reduction in HIV transmission of discordant couples. PMID:25583348

  1. Educational software for simulating risk of HIV infection

    NASA Astrophysics Data System (ADS)

    Rothberg, Madeleine A.; Sandberg, Sonja; Awerbuch, Tamara E.

    1994-03-01

    The AIDS epidemic is still growing rapidly and the disease is thought to be uniformly fatal. With no vaccine or cure in sight, education during high school years is a critical component in the prevention of AIDS. We propose the use of computer software with which high school students can explore via simulation their own risk of acquiring an HIV infection given certain sexual behaviors. This particular software is intended to help students understand the three factors that determine their risk of HIV infection (number of sexual acts, probability that their partners are infected, and riskiness of the specific sexual activities they choose). Users can explicitly calculate their own chances of becoming infected based on decisions they make. Use of the program is expected to personalize the risk of HIV infection and thus increase users' concern and awareness. Behavioral change may not result from increased knowledge alone. Therefore the effectiveness of this program in changing attitudes toward risky sexual behaviors would be enhanced when the simulation is embedded in an appropriate curriculum. A description of the program and an example of its use are presented.

  2. Women Living with HIV in Rural Areas. Implementing a Response using the HIV and AIDS Risk Assessment and Reduction Model

    PubMed Central

    Bandali, Sarah

    2014-01-01

    The global fight against HIV is progressing; however, women living in rural areas particularly in sub-Saharan Africa (SSA) continue to face the devastating consequences of HIV and AIDS. Lack of knowledge and geographical barriers to HIV services are compounded by gender norms often limiting the negotiation of safe sexual practices among women living in rural areas. This paper discusses findings from a qualitative study conducted in rural areas of Mozambique examining factors that influenced women to engage in HIV risk-reduction practices. The findings from this study led to the emergence of an HIV and AIDS risk assessment and reduction (HARAR) model, which is described in detail. The model helps in understanding gender-related factors influencing men and women to engage in risk-reduction practices, which can be used as a framework in other settings to design more nuanced and contextual policies and programs. PMID:25089093

  3. HIV-Related Stigma, Shame, and Avoidant Coping: Risk Factors for Internalizing Symptoms Among Youth Living with HIV?

    PubMed

    Bennett, David S; Hersh, Jill; Herres, Joanna; Foster, Jill

    2016-08-01

    Youth living with HIV (YLH) are at elevated risk of internalizing symptoms, although there is substantial individual variability in adjustment. We examined perceived HIV-related stigma, shame-proneness, and avoidant coping as risk factors of internalizing symptoms among YLH. Participants (N = 88; ages 12-24) completed self-report measures of these potential risk factors and three domains of internalizing symptoms (depressive, anxiety, and PTSD) during a regularly scheduled HIV clinic visit. Hierarchical regressions were conducted for each internalizing symptoms domain, examining the effects of age, gender, and maternal education (step 1), HIV-related stigma (step 2), shame- and guilt-proneness (step 3), and avoidant coping (step 4). HIV-related stigma, shame-proneness, and avoidant coping were each correlated with greater depressive, anxiety, and PTSD symptoms. Specificity was observed in that shame-proneness, but not guilt-proneness, was associated with greater internalizing symptoms. In multivariable analyses, HIV-related stigma and shame-proneness were each related to greater depressive and PTSD symptoms. Controlling for the effects of HIV-related stigma and shame-proneness, avoidant coping was associated with PTSD symptoms. The current findings highlight the potential importance of HIV-related stigma, shame, and avoidant coping on the adjustment of YLH, as interventions addressing these risk factors could lead to decreased internalizing symptoms among YLH. PMID:26458909

  4. Risk factors for HIV among prostitutes in Chiangmai, Thailand.

    PubMed

    Siraprapasiri, T; Thanprasertsuk, S; Rodklay, A; Srivanichakorn, S; Sawanpanyalert, P; Temtanarak, J

    1991-05-01

    The discovery of a 44% (44 out of 100) prevalence rate of HIV infection among female prostitutes working in brothels in Chiangmai in Thailand in June 1989, prompted this follow-up study in August to confirm the high prevalence rate and to look for risk factors for infection. We studied 238 female prostitutes working in 14 brothels and confirmed this high prevalence rate. Eighty-seven (36.5%) out of 238 prostitutes were found to be HIV-positive by enzyme-linked immunosorbent assay with IFA or Western blot confirmation. Logistic regressions found a significant association between HIV infection and frequency of sexual intercourse greater than 3 times per day [odds ratio (OR) = 2.82, 95% confidence interval (CI) = 1.47-5.41], sexual service charge less than 150 Baht (OR = 9.1, 95% CI = 2.9-33.3), and post sexual cleansing with water alone (OR = 3.85, 95% CI = 1.90-7.80). Of 56 women found seronegative in the June survey, 35 were re-tested in the August study. Seven (20%) of them were seropositive, giving an HIV seroconversion incidence rate of 10% per month. The findings of this study prompted intensive health education programmes among prostitutes, their customers, and owners of brothels. PMID:1863411

  5. Mothers Affected by HIV & AIDS: The "Kgolo Mmogo" Project

    ERIC Educational Resources Information Center

    Eloff, Irma

    2008-01-01

    In this short report, I discuss the way in which an assumption at the outset of a longitudinal study on HIV-positive mothers has been challenged three years into the study. The assumption concerns the employment status of the participants. The "Kgolo Mmogo" project is investigating the resilience factors in mothers (n = 440) and children (n = 440)…

  6. Maternal HIV status affects the infant hemoglobin level

    PubMed Central

    Feleke, Berhanu Elfu

    2016-01-01

    Abstract Children, especially infants, are highly vulnerable to iron-deficiency anemia because of their rapid growth of the brain and the rest of the body. The objectives of this study were to compare the prevalence of iron-deficiency anemia in infants born from HIV-positive mothers and HIV-negative mothers and to identify the determinants of iron-deficiency anemia in infants. A comparative cross-sectional study was conducted in Bahir Dar city. Simple random sampling technique was used to select the study participants. Mothers were interviewed; blood samples were collected from mothers and infants to measure the hemoglobin level and anthropometric indicators were obtained from the infants using world health organization standards. Descriptive statistics were used to estimate the prevalence of infantile anemia. Binary logistic regression and multiple linear regressions were used to identify the determinants of infant anemia. A total of 1459 infants born from HIV-positive and HIV-negative mothers were included. The prevalence of iron-deficiency anemia in infants born from HIV-positive and HIV-negative mothers was 41.9% (95% CI: 39–44). Infantile iron-deficiency anemia was associated with maternal HIV infection (adjusted odds ratio [AOR] 2.54 [95% CI: 1.65–3.9]), stunting (AOR 3.46 [95% CI: 2.41–4.97]), low income (AOR 2.72 [95% CI: 2–3.73]), maternal malaria during pregnancy (AOR 1.81 [95% CI: 1.33–2.47]), use of cow milk before 6 month (AOR 1.82 [95% CI: 1.35–2.45]), residence (AOR 0.09 [95% CI: 0.06–0.13]), history of cough or fever 7 days preceding the survey (AOR 2.71 [95% CI: 1.99–3.69]), maternal hemoglobin (B 0.65 [95% CI: 0.61–0.68]), educational status of mother (B 0.22 [95% CI: 0.2–0.23]), age of the mother (B –0.03 [95% CI: –0.03, –0.02]), and family size (B –0.14 [95% CI: –0.18,–0.11]). PMID:27495044

  7. Mitochondrial DNA Haplogroup A Decreases the Risk of Drug Addiction but Conversely Increases the Risk of HIV-1 Infection in Chinese Addicts.

    PubMed

    Zhang, A-Mei; Hu, Qiu-Xiang; Liu, Feng-Liang; Bi, Rui; Yang, Bi-Qing; Zhang, Wen; Guo, Hao; Logan, Ian; Zheng, Yong-Tang; Yao, Yong-Gang

    2016-08-01

    Drug addiction is one of the most serious social problems in the world today and addicts are always at a high risk of acquiring HIV infection. Mitochondrial impairment has been reported in both drug addicts and in HIV patients undergoing treatment. In this study, we aimed to investigate whether mitochondrial DNA (mtDNA) haplogroup could affect the risk of drug addiction and HIV-1 infection in Chinese. We analyzed mtDNA sequence variations of 577 Chinese intravenous drug addicts (289 with HIV-1 infection and 288 without) and compared with 2 control populations (n = 362 and n = 850). We quantified the viral load in HIV-1-infected patients with and without haplogroup A status and investigated the potential effect of haplogroup A defining variants m.4824A > G and m.8794C > T on the cellular reactive oxygen species (ROS) levels by using an allotopic expression assay. mtDNA haplogroup A had a protective effect against drug addiction but appeared to confer an increased risk of HIV infection in addicts. HIV-1-infected addicts with haplogroup A had a trend for a higher viral load, although the mean viral load was similar between carriers of haplogroup A and those with other haplogroup. Hela cells overexpressing allele m.8794 T showed significantly decreased ROS levels as compared to cells with the allele m.8794C (P = 0.03). Our results suggested that mtDNA haplogroup A might protect against drug addiction but increase the risk of HIV-1 infection. The contradictory role of haplogroup A might be caused by an alteration in mitochondrial function due to a particular mtDNA ancestral variant. PMID:26162319

  8. Affective disorders in patients with HIV infection: impact of antiretroviral therapy.

    PubMed

    Arendt, Gabriele

    2006-01-01

    At the beginning of the AIDS pandemic, affective disorders (such as depressed mood) were seen in a considerable number of HIV-1-infected individuals. These disorders were a result of the poor physical condition of the patients, brain involvement by the virus (e.g. encephalopathy) or a reaction to disadvantageous living conditions (losing friends, jobs, etc.). In the era of highly active antiretroviral therapy (HAART), mental illness related to physical weakness is declining, as is the incidence of HIV-1-associated encephalopathy. However, depressed mood and fatigue caused by efavirenz (a standard component of HAART) is becoming increasingly important, particularly in individuals who are infected long-term with HIV-1. Whatever the cause of affective disorders, their presence has been shown to negatively influence adherence to HAART and HIV-1 disease progression. Specialist knowledge of HIV-1 infection, and HAART and its psychiatric complications (particularly in subgroups of patients such as drug abusers and older people), is needed to care adequately for patients. Furthermore, prospective studies are needed to more fully differentiate between the various aetiologies of affective disorders seen in individuals living with HIV/AIDS and to determine their incidence and prevalence. Such information is important to ensure that affective disorders are recognised and adequately treated, which will in turn improve the efficacy of HAART. PMID:16734500

  9. HIV-Helicobacter pylori Co-Infection: Antibiotic Resistance, Prevalence, and Risk Factors

    PubMed Central

    Nkuize, Marcel; De Wit, Stéphane; Muls, Vinciane; Delforge, Marc; Miendje Deyi, Véronique Y.; Cadière, Guy B.; Buset, Michel

    2015-01-01

    Background Patients infected with human immunodeficiency virus (HIV) are living longer due to the availability of more potent treatments. However, prescription of antibiotics to treat or prevent infections in these patients may increase the likelihood of co-infection with antibiotic-resistant species. Aim To compare antimicrobial susceptibility of Helicobacter pylori (H. pylori) in HIV-positive and HIV-negative patients and assess risk-factors for resistance. Methods We prospectively collected data from consecutive HIV-positive and HIV-negative patients undergoing upper gastrointestinal endoscopy. Patients with H. pylori-positive gastric biopsies who had never received H. pylori treatment were included. Results Of the 353 patients included, 93 were HIV-positive and 260 HIV-negative. Among the HIV-positive patients, 56 (60%) had been infected for <10 years, the median CD4+ count was 493 cells/μl and median viral load was 61 copies/mL; 66 (71%) were receiving antiretroviral therapy. HIV-positive patients were more often male (p = 0.009), had a lower body mass index (p<0.0001), and had less frequently received antibiotics during the 12-months prior to the endoscopy (p<0.0001) than HIV-negative patients. HIV-positive patients were more likely to have H. pylori resistant to levofloxacin (p = 0.0004), metronidazole (p = 0.01), or multiple antibiotics (p = 0.006). HIV-positive Black Africans were more likely to have resistant strains than were HIV-negative Black Africans (p = 0.04). Ethnicity and HIV status were independent risk factors for H. pylori resistance in all patients and acquired immune deficiency syndrome (AIDS) and sex were risk factors in HIV-positive patients. Conclusions There was a higher prevalence of primary H. pylori-resistant strains in HIV-positive than in HIV-negative patients. AIDS and sex were predictors of H. pylori resistance in HIV-positive patients. PMID:26691198

  10. Shared Illness and Social Support Within Two HIV-Affected African American Communities.

    PubMed

    Mosack, Katie E; Stevens, Patricia E; Brouwer, Amanda M; Wendorf, Angela R

    2016-09-01

    A key source of resiliency within HIV-affected African American communities is informal social support. Data from dyadic conversations and focus groups were used to address the following research question: What are HIV-positive African Americans' social support experiences within their informal social networks in response to HIV-related problems? Circumstances that exacerbated HIV-related problems included others' fear of contagion, reticence to be involved, judgment and rejection, and disregard for privacy Support from HIV-negative others buffered the impact of problems when others communicate interest, take the initiative to help, or make a long-term investment in their success. Support from other HIV-positive persons was helpful given the shared connection because of HIV, the opportunity to commiserate about what is mutually understood, and the fight for mutual survival Based on these findings, we offer suggestions for future research and social network interventions aimed at bolstering connections between HIV-positive peers, reducing stigma, and improving family support. PMID:26515921

  11. Lay Counsellor-Based Risk Reduction Intervention with HIV Positive Diagnosed Patients at Public HIV Counselling and Testing Sites in Mpumalanga, South Africa

    ERIC Educational Resources Information Center

    Peltzer, Karl; Tabane, Cily; Matseke, Gladys; Simbayi, Leickness

    2010-01-01

    Objective: To evaluate the feasibility, fidelity, and effect of a human immunodeficiency virus (HIV) risk reduction intervention delivered to HIV-infected patients by lay counsellors during routine HIV counselling and testing (HCT) public service in Mpumalanga, South Africa. Methods: A total of 488 HIV-infected patients, aged 18 years and older,…

  12. Secondary disclosure of parental HIV status among children affected by AIDS in Henan, China.

    PubMed

    Qiao, Shan; Li, Xiaoming; Zhao, Guoxiang; Zhao, Junfeng; Stanton, Bonita

    2012-09-01

    For children affected by AIDS, one psychological challenge is whether or how to disclose their parents' HIV status to others (secondary disclosure). The current study, utilizing data from 962 rural children affected by AIDS in central China, examines children's perceptions regarding secondary disclosure (intention of disclosure, openness, and negative feelings) and their association with children's demographic and psychosocial factors. The findings indicated that a high proportion of children preferred not to disclose parental HIV status to others, would not like to tell the truth to others in the situations of having to talk about parental HIV, and also had strong negative feelings about the disclosure. The study findings confirmed that keeping secrecy of parental HIV infection was associated with higher level of negative psychological outcomes (e.g., depression, loneliness, perceived stigma, and enacted stigma), and children's age was strongly associated with both their perceptions of secondary disclosure and psychological measures. PMID:22845686

  13. The Experience of Sexual Risk Communication in African American Families Living with HIV

    ERIC Educational Resources Information Center

    Cederbaum, Julie A.

    2012-01-01

    Mother-daughter communication plays an influential role in adolescent development. The impact of maternal HIV infection on family communication is not clear. This study explores how living with HIV impacts sexual risk communication between mothers and daughters and whether maternal HIV status influences adolescent choices about engagement in HIV…

  14. Sources of HIV-Prevention Information for Individuals at High Risk.

    ERIC Educational Resources Information Center

    Sagrestano, Lynda M.; Heiss-Wendt, Renate M.; Mizan, Ainon N.; Kittleson, Mark J.; Sarvela, Paul D.

    2001-01-01

    Identified the best methods of reaching people at high risk with HIV-prevention messages. Data from men who had sex with men, injection drug users, sex workers, HIV-positive people, heterosexuals, migrant workers, and perinatal women indicated that over 70 percent were exposed to HIV-prevention messages, though sources of exposure varied by risk…

  15. Antiretroviral Medication Adherence and Amplified HIV Transmission Risk Among Sexually Active HIV-Infected Individuals in Three Diverse International Settings.

    PubMed

    Magidson, Jessica F; Li, Xin; Mimiaga, Matthew J; Moore, Ayana T; Srithanaviboonchai, Kriengkrai; Friedman, Ruth Khalili; Limbada, Mohammad; Hughes, James P; Cummings, Vanessa; Gaydos, Charlotte A; Elharrar, Vanessa; Celentano, David; Mayer, Kenneth H; Safren, Steven A

    2016-04-01

    Successful biomedical prevention/treatment-as-prevention (TasP) requires identifying individuals at greatest risk for transmitting HIV, including those with antiretroviral therapy (ART) nonadherence and/or 'amplified HIV transmission risk,' defined as condomless sex with HIV-uninfected/unknown-status partners when infectious (i.e., with detectable viremia or STI diagnosis according to Swiss criteria for infectiousness). This study recruited sexually-active, HIV-infected patients in Brazil, Thailand, and Zambia to examine correlates of ART nonadherence and 'amplified HIV transmission risk'. Lower alcohol use (OR = .71, p < .01) and higher health-related quality of life (OR = 1.10, p < .01) were associated with greater odds of ART adherence over and above region. Of those with viral load data available (in Brazil and Thailand only), 40 % met Swiss criteria for infectiousness, and 29 % had 'amplified HIV transmission risk.' MSM had almost three-fold (OR = 2.89, p < .001) increased odds of 'amplified HIV transmission risk' (vs. heterosexual men) over and above region. TasP efforts should consider psychosocial and contextual needs, particularly among MSM with detectable viremia. PMID:26246068

  16. An Empirical Test of Ecodevelopmental Theory in Predicting HIV Risk Behaviors among Hispanic Youth

    ERIC Educational Resources Information Center

    Prado, Guillermo; Huang, Shi; Maldonado-Molina, Mildred; Bandiera, Frank; Schwartz, Seth J.; de la Vega, Pura; Brown, C. Hendricks; Pantin, Hilda

    2010-01-01

    Ecodevelopmental theory is a theoretical framework used to explain the interplay among risk and protective processes associated with HIV risk behaviors among adolescents. Although ecodevelopmentally based interventions have been found to be efficacious in preventing HIV risk behaviors among Hispanic youth, this theory has not yet been directly…

  17. Self-Perceived Risk of HIV among Women with Protective Orders against Male Partners

    ERIC Educational Resources Information Center

    Cole, Jennifer; Logan, TK; Shannon, Lisa

    2008-01-01

    Previous research indicates that many individuals who perceive themselves to be at no risk of HIV have recently engaged in risky sexual behaviors (Klein et al., 2003; Schroder et al., 2001). Because HIV risk has been associated with partner violence (Maman et al., 2000), it is important to examine self-perceived risk and actual sexual risk…

  18. Estimating the Sizes of Populations At Risk of HIV Infection From Multiple Data Sources Using a Bayesian Hierarchical Model

    PubMed Central

    Bao, Le; Raftery, Adrian E.; Reddy, Amala

    2014-01-01

    In most countries in the world outside of sub-Saharan Africa, HIV is largely concentrated in sub-populations whose behavior puts them at higher risk of contracting and transmitting HIV, such as people who inject drugs, sex workers and men who have sex with men. Estimating the size of these sub-populations is important for assessing overall HIV prevalence and designing effective interventions. We present a Bayesian hierarchical model for estimating the sizes of local and national HIV key affected populations. The model incorporates multiple commonly used data sources including mapping data, surveys, interventions, capture-recapture data, estimates or guesstimates from organizations, and expert opinion. The proposed model is used to estimate the numbers of people who inject drugs in Bangladesh. PMID:26015851

  19. HIV Risk, Partner Violence, and Relationship Power Among Filipino Young Women: Testing a Structural Model

    PubMed Central

    LUCEA, MARGUERITE B.; HINDIN, MICHELLE J.; KUB, JOAN; CAMPBELL, JACQUELYN C.

    2012-01-01

    A person’s ability to minimize HIV risk is embedded in a complex, multidimensional context. In this study, we tested a model of how relationship power impacts IPV victimization, which in turn impacts HIV risk behaviors. We analyzed data from 474 young adult women (aged 15–31) in Cebu Province, Philippines, using structural equation modeling, and demonstrated good fit for the models. High relationship power is directly associated with increased IPV victimization, and IPV victimization is positively associated with increased HIV risk. We highlight in this article the complex dynamics to consider in HIV risk prevention among these young women. PMID:22420674

  20. Adverse childhood experiences, gender, and HIV risk behaviors: Results from a population-based sample.

    PubMed

    Fang, Lin; Chuang, Deng-Min; Lee, Yookyong

    2016-12-01

    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. PMID:27413671

  1. HIV and drug users in Ukraine: building confidence to reduce HIV risk.

    PubMed

    Hyde, L

    1999-09-01

    This article discusses the programs of nongovernmental organizations (NGOs) towards the drug practices and sexual behaviors of HIV infected individuals and drug users in Mykolaiv, Ukraine. Blagodiynist (Charity Foundation), one of the NGOs operating in Ukraine, has been helping drug users and sex workers. This group has collaborated with other group projects to produce better and effective interventions. As such, the needle-exchange project was organized, where drug users could not only exchange needles for clean ones, but also obtain information, advice, and even condoms. Role model stories approach was also another effective method that Blagodiynist utilized to make drug users and sex workers aware not only of the risk and reality of HIV, but to encourage behavior change as well, and to generate the self-confidence needed to alter their erroneous practices. The fact that sex workers and drug users have begun to take the risks of HIV infection seriously and have taken measures to protect themselves, reflect the success of these programs. PMID:12322332

  2. What leads some people to think they are HIV-positive before knowing their diagnosis? A systematic review of psychological and behavioural correlates of HIV-risk perception.

    PubMed

    Evangeli, Michael; Baker, Laura L E; Pady, Kirsten; Jones, Bethanie; Wroe, Abigail L

    2016-08-01

    Current HIV-risk perception refers to the extent to which individuals think they might be HIV-positive. This belief, distinct from the perceived risk about being infected with HIV in the future, is likely to have a range of important consequences. These consequences may include both psychological effects (e.g., impacts on well-being) and behavioural effects (e.g., HIV testing uptake). Given these possible outcomes, and the suggested importance of risk perception in health behaviour models, understanding the behavioural and psychological antecedents of current HIV-risk perception is crucial. This systematic review investigates the relationship between behavioural and psychological factors and current HIV-risk perception (in individuals who are unaware of their actual HIV status). Eight studies were eligible for inclusion in the review (five quantitative and three qualitative studies). Drug risk behaviour and sexual risk behaviour (both self and partner) were often associated with current HIV-risk perception, although other studies failed to show a relationship between one's own sexual risk behaviour and risk perception. Psychological factors were only rarely assessed in relation to current HIV-risk perception. Where these variables were included, there was evidence that experiencing symptoms perceived to be consistent with HIV and prompts to test were associated with increased current HIV-risk perception. These findings are consistent with the Common-Sense Model (CSM) of illness representation and self-regulation. Methodological quality criteria were rarely met for the included studies. In addition, it was often difficult to ascertain whether potentially includable studies were eligible due to imprecise definitions of HIV-risk perception. Research and practice implications are discussed, with particular emphasis on the role of risk appraisals as a potential mediator of the relationship between HIV-risk behaviour, symptoms and current HIV-risk perception. PMID

  3. Understanding the link between trafficking in persons and HIV and AIDS risk in Tanzania.

    PubMed

    Kamazima, Switbert R; Ezekiel, Mangi J; Kazaura, Method R; Fimbo, Benett

    2012-01-01

    The magnitude of trafficking in persons in Tanzania is unknown. Consequently, available information on health risks of persons trafficked for different forms of exploitation is extremely scanty. We conducted a baseline study in eight administrative regions of Tanzania using both qualitative and quantitative methods to generate data on the health conditions of trafficked persons to inform trafficking in persons control measures through HIV and AIDS interventions. Study participants included the national, regional and district community development officers, district medical officers, local government leaders, managers or representatives of non-governmental organizations involved in anti-trafficking in persons activities, members of the community and victims. Findings indicated that common forms of labour into which persons are trafficked include domestic services, agriculture (farming), construction, mining/quarrying, fishing, lumbering and manufacturing. Trafficked persons are reported to be exposed to risks like overcrowding, long working hours, psychological problems, physical injuries, impotence, breathing problems and sexually transmitted infections including HIV. It is concluded that the reported occupational hazards in industries where trafficked persons are forced into are not specific to trafficked persons as they affect all labourers. However, the underground nature of the trafficking in persons process increases health problems and risks, including the vulnerability to HIV infection. More tailored research is needed, especially to find means of how to reach out and provide services to this particular vulnerable population, validate labour forms of exploitation into which persons are trafficked to enable the integration or mainstreaming of HIV and AIDS and trafficking in persons at the policy and programmatic levels. In addition, findings would facilitate the understanding of the link between increased risk of IRV and trafficking in persons. PMID:26591750

  4. Seroconversion risk perception among jail populations: a call for gender-specific HIV prevention programming.

    PubMed

    Alarid, Leanne Fiftal; Hahl, Jeannie M

    2014-04-01

    The prevalence of HIV/AIDS infection among prisoners is 3 to 4 times higher than in the U.S. population. Given that one in seven HIV-positive Americans pass through a correctional facility every year, the criminal justice system is in an ideal position to aggressively implement effective HIV education, treatment, and prevention. This study examines barriers to the effective delivery of these services and evaluates differences in risk perception among nearly 600 female and male inmates. The results underscore gender differences in Perceived Risk of Seroconversion and Exposure to HIV Education, suggesting that jails should implement gender-specific HIV prevention programming. PMID:24659758

  5. Family-Based Processes Associated with Adolescent Distress, Substance Use and Risky Sexual Behavior in Families Affected by Maternal HIV

    ERIC Educational Resources Information Center

    Lester, Patricia; Stein, Judith A.; Bursch, Brenda; Rice, Eric; Green, Sara; Penniman, Typhanye; Rotheram-Borus, Mary Jane

    2010-01-01

    The present study investigated how maternal HIV and mediating family processes are associated with adolescent distress, substance use, and risky sexual behavior. Mother-adolescent (ages 12-21) dyads (N = 264) were recruited from neighborhoods where the HIV-affected families resided (161 had mothers with HIV). Mediating family processes were youth…

  6. A Contextualized Approach to Faith-Based HIV Risk Reduction for African American Women

    PubMed Central

    Stewart, Jennifer M.; Rogers, Christopher K.; Bellinger, Dawn; Thompson, Keitra

    2016-01-01

    HIV/AIDS has a devastating impact on African Americans (AA), particularly women and young adults. We sought to characterize risks, barriers, content and delivery needs for a faith-based intervention to reduce HIV risk among AA women ages 18–25. In a convergent parallel mixed methods study we conducted four focus groups (n=38) and surveyed 71 young adult women. Data were collected across 4 AA churches for a total of 109 participants. We found the majority of women in this sample were engaged in behaviors that put them at risk for contracting HIV, struggled with religiously based barriers and matters of sexuality, and had a desire to incorporate their intimate relationships, parenting and financial burdens into faith-based HIV risk reduction interventions (RRIs). Incorporating additional social context related factors into HIV RRIs for young AA women is critical to adapting and developing HIV interventions to reduce risk among young adult women in faith settings. PMID:26879828

  7. It's harder for boys? Children's representations of their HIV/AIDS-affected peers in Zimbabwe.

    PubMed

    LeRoux-Rutledge, Emily; Guerlain, Madeleine A; Andersen, Louise B; Madanhire, Claudius; Mutsikiwa, Alice; Nyamukapa, Constance; Skovdal, Morten; Gregson, Simon; Campbell, Catherine

    2015-01-01

    This study examines whether children in rural Zimbabwe have differing representations of their HIV/AIDS-affected peers based on the gender of those peers. A group of 128 children (58 boys, 70 girls) aged 10-14 participated in a draw-and-write exercise, in which they were asked to tell the story of either an HIV/AIDS-affected girl child, or an HIV/AIDS-affected boy child. Stories were inductively thematically coded, and then a post hoc statistical analysis was conducted to see if there were differences in the themes that emerged in stories about girls versus stories about boys. The results showed that boys were more often depicted as materially deprived, without adult and teacher support, and heavily burdened with household duties. Further research is needed to determine whether the perceptions of the children in this study point to a series of overlooked challenges facing HIV/AIDS-affected boys, or to a culture of gender inequality facing HIV/AIDS-affected girls - which pays more attention to male suffering than to female suffering. PMID:26615976

  8. It's harder for boys? Children's representations of their HIV/AIDS-affected peers in Zimbabwe

    PubMed Central

    LeRoux-Rutledge, Emily; Guerlain, Madeleine A.; Andersen, Louise B.; Madanhire, Claudius; Mutsikiwa, Alice; Nyamukapa, Constance; Skovdal, Morten; Gregson, Simon; Campbell, Catherine

    2015-01-01

    ABSTRACT This study examines whether children in rural Zimbabwe have differing representations of their HIV/AIDS-affected peers based on the gender of those peers. A group of 128 children (58 boys, 70 girls) aged 10–14 participated in a draw-and-write exercise, in which they were asked to tell the story of either an HIV/AIDS-affected girl child, or an HIV/AIDS-affected boy child. Stories were inductively thematically coded, and then a post hoc statistical analysis was conducted to see if there were differences in the themes that emerged in stories about girls versus stories about boys. The results showed that boys were more often depicted as materially deprived, without adult and teacher support, and heavily burdened with household duties. Further research is needed to determine whether the perceptions of the children in this study point to a series of overlooked challenges facing HIV/AIDS-affected boys, or to a culture of gender inequality facing HIV/AIDS-affected girls – which pays more attention to male suffering than to female suffering. PMID:26615976

  9. Prevalence of and risk factors for pulmonary tuberculosis among newly diagnosed HIV-1 infected Nigerian children

    PubMed Central

    Ebonyi, Augustine O.; Oguche, Stephen; Ejeliogu, Emeka U.; Agbaji, Oche O.; Shehu, Nathan Y.; Abah, Isaac O.; Sagay, Atiene S.; Ugoagwu, Placid O.; Okonkwo, Prosper I.; Idoko, John A.; Kanki, Phyllis J.

    2016-01-01

    Introduction Studies on the prevalence of and risk factors for tuberculosis (TB) among newly diagnosed human immunodeficiency virus (HIV)-infected children in sub-Saharan Africa are scarce and in Nigeria there is paucity of reported data. We determined the prevalence of and risk factors for pulmonary TB (PTB) in newly diagnosed (treatment-naïve) HIV-1 infected children at the pediatric HIV clinic of the Jos University Teaching Hospital (JUTH) in Nigeria. Methods We performed a retrospective analysis of 876 children, aged 2 months – 13 years, diagnosed with HIV-1 infection between July 2005 and December 2012, of which 286 were diagnosed with PTB at presentation after TB screening. The study site was the AIDS Prevention Initiative in Nigeria (APIN)-supported Pediatric HIV clinic at JUTH, Jos. A multivariate forward logistic regression modelling was used to identify risk factors for PTB-HIV co-infection. Results The prevalence of PTB-HIV co-infection was 32% (286/876). Severe immunosuppression (SI) and World Health Organization (WHO) HIV clinical stage 3/4 were identified as independent risk factors for PTB-HIV co-infection in HIV infected children. The odds of PTB-HIV co-infection was increased two-fold in HIV-infected children with WHO clinical stage 3/4 compared to those with stage 1/2 (adjusted odds ratio (AOR) 1.76 [1.31-2.37], p<0.001) and 1.5-fold in children with SI compared to those without SI (AOR 1.52 [1.12-2.06], p=0.007). Conclusion In our setting, the burden of PTB was high among newly diagnosed HIV-infected children, and late WHO HIV clinical stage and severe immunosuppression were associated with PTB-HIV co-infection. Therefore there is a clear need to improve strategies for early diagnosis of both HIV and PTB to optimize clinical outcomes. PMID:27019829

  10. HIV and Recent Illicit Drug Use Interact to Affect Verbal Memory in Women

    PubMed Central

    Meyer, Vanessa J.; Rubin, Leah H.; Martin, Eileen; Weber, Kathleen M.; Cohen, Mardge H.; Golub, Elizabeth T.; Valcour, Victor; Young, Mary A.; Crystal, Howard; Anastos, Kathryn; Aouizerat, Bradley E.; Milam, Joel; Maki, Pauline M.

    2013-01-01

    Objective HIV infection and illicit drug use are each associated with diminished cognitive performance. This study examined the separate and interactive effects of HIV and recent illicit drug use on verbal memory, processing speed and executive function in the multicenter Women's Interagency HIV Study (WIHS). Methods Participants included 952 HIV-infected and 443 HIV-uninfected women (mean age=42.8, 64% African-American). Outcome measures included the Hopkins Verbal Learning Test - Revised (HVLT-R) and the Stroop test. Three drug use groups were compared: recent illicit drug users (cocaine or heroin use in past 6 months, n=140), former users (lifetime cocaine or heroin use but not in past 6 months, n=651), and non-users (no lifetime use of cocaine or heroin, n=604). Results The typical pattern of recent drug use was daily or weekly smoking of crack cocaine. HIV infection and recent illicit drug use were each associated with worse verbal learning and memory (p's<.05). Importantly, there was an interaction between HIV serostatus and recent illicit drug use such that recent illicit drug use (compared to non-use) negatively impacted verbal learning and memory only in HIV-infected women (p's <0.01). There was no interaction between HIV serostatus and illicit drug use on processing speed or executive function on the Stroop test. Conclusion The interaction between HIV serostatus and recent illicit drug use on verbal learning and memory suggests a potential synergistic neurotoxicity that may affect the neural circuitry underlying performance on these tasks. PMID:23392462

  11. [Adaptive behaviors to HIV risk of transmission in different populations].

    PubMed

    Grémy, I

    2005-05-01

    Since the beginning of the HIV epidemic in France, surveys aimed at better understanding risk perceptions of HIV infection and preventive sexual behaviors have been implemented in the general population, and in populations such as IVDU and homosexual men, more concerned by risks of HIV transmission. The objective of this article is to describe these surveys, to present their main results and to assess what has been the overall impact of prevention campaigns on the adoption of preventive sexual behaviors in these populations. The results show that very early after the beginning of the AIDS epidemic, both general and homosexual populations have adopted preventive sexual behaviors, mainly increasing condom use and implementing other preventive strategies. However, with the introduction of HAART in 1996, a slackening of these preventive behaviors is noted. The use of condom is less frequent, especially in the youngest generations of both general and homosexual populations. On the opposite, among IVDU, the use of sterile syringes increased dramatically as soon as over-the-counter sales of syringes was authorized in 1987, as well as the adoption of ways other than intravenous to take drugs. Both have contributed to almost stop the HIV epidemic in this specific group. The results of these surveys show that the benefits of prevention campaigns are different between populations and are reversible. It is necessary to renew the messages, campaigns and programs of prevention with the renewal of generations. It is also necessary to adapt these messages to the new scientific data, and to the evolution of social and individual representations of the disease. PMID:15878250

  12. Migration and HIV Risk Among Men Who Have Sex With Men, San Francisco, 2011.

    PubMed

    Lama, T T; Sudhinaraset, M; McFarland, W; Raymond, H F

    2015-12-01

    In San Francisco, MSM account for nearly 90% of HIV infections. Studies have postulated increased risk for HIV faced by MSM who migrate, particularly to urban environments, yet empirical data are lacking. In this study we analyzed data from the National HIV Behavioral Surveillance System collected in 2011 to ascertain whether nativity (U.S. versus foreign born) was associated with HIV prevalence, risk behavior, and service use. Among 510 MSM enrolled, HIV prevalence was 23.0%. Multivariable analyses demonstrate that while nativity was not associated with increased risk for HIV infection, those who had lived in San Francisco for more than five years had higher HIV prevalence compared to those who had lived for less than a year even after adjusting for age, race, income, education, and location of birth. PMID:26595266

  13. Children’s representations of school support for HIV-affected peers in rural Zimbabwe

    PubMed Central

    2014-01-01

    Background HIV has left many African children caring for sick relatives, orphaned or themselves HIV-positive, often facing immense challenges in the absence of significant support from adults. With reductions in development funding, public sector budgetary constraints, and a growing emphasis on the importance of indigenous resources in the HIV response, international policy allocates schools a key role in ‘substituting for families’ (Ansell, 2008) in supporting child health and well-being. We explore children’s own accounts of the challenges facing their HIV-affected peers and the role of schools in providing such support. Methods Contextualised within a multi-method study of school support for HIV-affected children in rural Zimbabwe, and regarding children’s views as a key resource for child-relevant intervention and policy, 128 school children (10–14) wrote a story about an HIV-affected peer and how school assisted them in tackling their problems. Results Children presented harrowing accounts of negative impacts of HIV on the social, physical and mental well-being of peers, and how these manifested in the school setting. Whilst relationships with fellow learners and teachers were said to provide a degree of support, this was patchy and minimal, generally limited to small-scale and often one-off acts of material help or kindness (e.g. teachers giving children pens and exercise books or peers sharing school lunches), with little potential to impact significantly on the wider social drivers of children’s daily challenges. Despite having respect for the enormity of the challenges many HIV-affected peers were coping with, children tended to keep a distance from them. School was depicted as a source of the very bullying, stigma and social exclusion that undermined children’s opportunities for well-being in their lives more generally. Conclusions Our findings challenge glib assumptions that schools can serve as a significant ‘indigenous’ supports of

  14. Self-Efficacy for Sexual Risk Reduction and Partner HIV Status as Correlates of Sexual Risk Behavior Among HIV-Positive Adolescent Girls and Women

    PubMed Central

    Boone, Melissa R.; Cherenack, Emily M.

    2015-01-01

    Abstract Little is known about the correlates of sexual risk behavior among HIV-positive adolescent girls and women in the United States. This study investigates two potential factors related to unprotected vaginal and anal intercourse (UVAI) that have yet to be thoroughly studied in this group: self-efficacy for sexual risk reduction and partner HIV status. Data was analyzed from 331 HIV-positive adolescent girls and women between 12 and 24 years old who reported vaginal and/or anal intercourse with a male partner in the past 3 months at fifteen sites across the United States. Results show that overall self-efficacy (B = −0.15, p=0.01), self-efficacy to discuss safe sex with one's partner (B = −0.14, p=0.01), and self-efficacy to refuse unsafe sex (B = −0.21, p=0.01) are related to UVAI episodes. Participants with only HIV-positive partners or with both HIV-positive and HIV-negative partners showed a trend towards higher percentages of UVAI episodes compared to participants with only HIV-negative partners (F(2, 319)=2.80, p=0.06). These findings point to the importance of including self-efficacy and partner HIV status in risk-reduction research and interventions developed for HIV-positive adolescent girls and young women. PMID:25856632

  15. Marriage as a risk factor for HIV: learning from the experiences of HIV-infected women in Malawi.

    PubMed

    Mkandawire-Valhmu, Lucy; Wendland, Claire; Stevens, Patricia E; Kako, Peninnah M; Dressel, Anne; Kibicho, Jennifer

    2013-01-01

    The gender inequalities that characterise intimate partner relationships in Malawi, a country with one of the highest HIV prevalence rates in the world, arguably place marriage as an important risk factor for HIV infection among women, yet few studies detail the complex interactions of marriage and risk. In order to develop HIV-prevention interventions that have lasting impacts in such communities, we need a deeper understanding of the intricacies of women's lives, how and why they are involved in marital relationships, and the implications of these relationships for HIV transmission or prevention. This article describes how women understand marriage's effects on their lives and their HIV risks. Drawing from focus group discussions with 72 women attending antiretroviral clinics in Malawi, we explore why women enter marriage, what women's experiences are within marriage and how they leave spouses for other relationships. Based on their narratives, we describe women's lives after separation, abandonment or widowhood, and report their reflections on marriage after being married two or three times. We then review women's narratives in light of published work on HIV, and provide recommendations that would minimise the risks of HIV attendant on marriage. PMID:23350930

  16. Sexual orientation- and race-based discrimination and sexual HIV risk behavior among urban MSM.

    PubMed

    Frye, Victoria; Nandi, Vijay; Egan, James; Cerda, Magdalena; Greene, Emily; Van Tieu, Hong; Ompad, Danielle C; Hoover, Donald R; Lucy, Debbie; Baez, Eduardo; Koblin, Beryl A

    2015-02-01

    Understanding what social factors are associated with risk of HIV acquisition and transmission among gay, bisexual and other men who have sex with men (MSM) is a critical public health goal. Experiencing discrimination may increase risk of HIV infection among MSM. This analysis assessed relations between experiences of sexual orientation- and race-based discrimination and sexual HIV risk behavior among MSM in New York City. 1,369 MSM completed a self-administered computerized assessment of past 3-month sexual behavior, experience of social discrimination and other covariates. Regression models assessed relations between recent experience of discrimination and sexual HIV risk behavior. Mean age was 32 years; 32 % were white; 32 % Latino/Hispanic; 25 % African American/Black. Of MSM who self-reported HIV-positive or unknown status (377), 7 % (N = 27) reported having unprotected insertive anal intercourse with an HIV-negative or unknown status partner ("HIV transmission risk"). Of MSM who self-reported HIV-negative status (992), 11 % (110) reported unprotected receptive anal intercourse with an HIV-positive or unknown status partner ("HIV acquisition risk"). HIV acquisition risk was positively associated with sexual orientation-based discrimination in home or social neighborhoods, but not race-based discrimination. We observed that sexual orientation-based discrimination was associated with sexual HIV risk behavior among urban-dwelling MSM. Addressing environmental sources of this form of discrimination, as well as the psychological distress that may result, should be prioritized in HIV prevention efforts. PMID:25381561

  17. Multiple Risk Associated with Prenatal HIV Exposure: An Interagency, Community-Focused Demonstration (Project RISK). Final Report.

    ERIC Educational Resources Information Center

    O'Donnell, Karen J.; Fair, Cynthia D.

    This report describes the activities and outcomes of Project RISK, a 3+2 years service delivery demonstration and replication project that was based on the assumption that infants of HIV positive women are at significant developmental risk from prenatal exposure to HIV infection and, possibly, teratogenic drugs, as well as from the complex…

  18. Family Adversity and Autonomic Reactivity Association With Immune Changes in HIV-Affected School Children

    PubMed Central

    Thomas, Melanie; Wara, Diane; Saxton, Katherine; Truskier, Mary; Chesney, Margaret; Boyce, W. Thomas

    2013-01-01

    Objective To explore whether primary school entry is associated with changes in immune system parameters in HIV-affected children. HIV-affected children are vulnerable to psychosocial stressors, regardless of their own HIV serological status. Methods Data from 38 HIV+ and 29 HIV− children born to seropositive women were obtained before and after school entry. Measures included family adversity questionnaires, autonomic nervous system (ANS) reactivity (based on mean arterial responses to challenge tasks), and enumerative and functional changes in peripheral blood immune parameters. Results In comparison to children who were HIV−, children who were HIV+ at baseline had fewer CD4+ T lymphocytes (M = 916 vs. 1206 cells/mm3 × 103; F = 7.8, p = .007), more CD8+ cells (M = 1046 vs. 720 cells/mm3 ×103; F = 7.98, p = .006), and diminished NK cell cytotoxicity (M =−.29 vs. .41; F = 8.87, p = .004). School entry was associated with changes in immune parameters, but HIV status was not associated with the magnitude of changes. Changes in immune parameters following school entry were associated with family stress and pre school entry ANS reactivity. Highly ANS reactive children had either the greatest increase in CD8+ cells following school entry or the greatest decrease, depending upon reported levels of family adversity (B = 215.35; t = 3.74, p < .001). Changes in functional immune assays were significantly associated with the interactions between HIV status and ANS reactivity. Conclusions These results suggest that autonomic reactivity is associated with increased immunological sensitivity to adverse or challenging social contexts among children affected by HIV. PMID:23766380

  19. Family-based HIV prevention and intervention services for youth living in poverty-affected contexts: the CHAMP model of collaborative, evidence-informed programme development

    PubMed Central

    2010-01-01

    Family-based interventions with children who are affected by HIV and AIDS are not well established. The Collaborative HIV Prevention and Adolescent Mental Health Program (CHAMP) represents one of the few evidence-based interventions tested in low-income contexts in the US, Caribbean and South Africa. This paper provides a description of the theoretical and empirical bases of the development and implementation of CHAMP in two of these countries, the US and South Africa. In addition, with the advent of increasing numbers of children infected with HIV surviving into adolescence and young adulthood, a CHAMP+ family-based intervention, using the founding principles of CHAMP, has been developed to mitigate the risk influences associated with being HIV positive. PMID:20573290

  20. Pathways to poor educational outcomes for HIV/AIDS-affected youth in South Africa.

    PubMed

    Orkin, Mark; Boyes, Mark E; Cluver, Lucie D; Zhang, Yuning

    2014-01-01

    A recent systematic review of studies in the developing world has critically examined linkages from familial HIV/AIDS and associated factors such as poverty and child mental health to negative child educational outcomes. In line with several recommendations in the review, the current study modelled relationships between familial HIV/AIDS, poverty, child internalising problems, gender and four educational outcomes: non-enrolment at school, non-attendance, deficits in grade progression and concentration problems. Path analyses reveal no direct associations between familial HIV/AIDS and any of the educational outcomes. Instead, HIV/AIDS-orphanhood or caregiver HIV/AIDS-sickness impacted indirectly on educational outcomes via the poverty and internalising problems that they occasioned. This has implications for evidence-based policy inferences. For instance, by addressing such intervening variables generally, rather than by seeking to target families affected by HIV/AIDS, interventions could avoid exacerbating stigmatisation, while having a more direct and stronger impact on children's educational outcomes. This analytic approach also suggests that future research should seek to identify causal paths, and may include other intervening variables related to poverty (such as child housework and caring responsibilities) or to child mental health (such as stigma and abuse), that are linked to both familial HIV/AIDS and educational outcomes. PMID:23965029

  1. Evaluating the Risks: A Bernoulli Process Model of HIV Infection and Risk Reduction.

    ERIC Educational Resources Information Center

    Pinkerton, Steven D.; Abramson, Paul R.

    1993-01-01

    A Bernoulli process model of human immunodeficiency virus (HIV) is used to evaluate infection risks associated with various sexual behaviors (condom use, abstinence, or monogamy). Results suggest that infection is best mitigated through measures that decrease infectivity, such as condom use. (SLD)

  2. Psychosocial risk factors for HIV sexual risk among Indian men who have sex with men.

    PubMed

    Mimiaga, Matthew J; Biello, Katie Brooks; Sivasubramanian, Murugesan; Mayer, Kenneth H; Anand, Vivek Raj; Safren, Steven A

    2013-01-01

    Indian men who have sex with men (MSM) are at increased risk for HIV compared to the general Indian population. Psychosocial factors may be uniquely associated with HIV risk among Indian MSM and may moderate the beneficial impact of standard HIV prevention approaches. Psychiatric diagnostic interviews and psychosocial and sexual risk assessments were conducted among 150 MSM in Mumbai, India. Logistic regression was employed to examine the association of psychiatric disorders and psychosocial problems to recent sexual risk behavior. Twenty-five percent of participants reported engaging in unprotected anal sex (UAS) during their last sexual contact with a man. Men who were married to a woman were more likely to have engaged in UAS during their last sexual contact with a man (35% vs. 17%, p=0.018). In multivariable models, significant predictors of engaging in UAS were current major depression (adjusted odds ratio [AOR]=2.61; 95% confidence interval [CI] 1.07, 6.39) and number of stressful life events (AOR=0.91; 95% CI 0.83, 0.99). Alcohol dependence, anxiety, and self-esteem were not associated with engaging in UAS. Indian MSM with depression are at higher odds of engaging in UAS compared to MSM without depression. HIV prevention programs for Indian MSM may benefit from incorporating treatment or triage for mental health problems. PMID:23339580

  3. Predictors of HIV risk among Hispanic farm workers in South Florida: women are at higher risk than men.

    PubMed

    Fernández, M Isabel; Collazo, Jose B; Hernández, Nilda; Bowen, G Stephen; Varga, Leah M; Vila, Christie Kibort; Arheart, Kristopher L; Perrino, Tatiana

    2004-06-01

    This study examined factors associated with being at risk of sexually acquiring HIV among a community sample of 244 Hispanic migrant and seasonal farm workers. Bilingual staff interviewed respondents anonymously at worksites, camps, and other public venues in South Florida during the 2002 winter/spring growing season. The following variables were positively associated with being at risk of sexually acquiring HIV in multivariable analyses: being female; being married; having "some" or "a lot" of knowledge about HIV transmission, having ever used marijuana, having two or more sex partners in the last 12 months, and having had a sexually transmitted infection. The findings heighten the importance of recognizing women's elevated risk of HIV infection and conducting further studies to examine the factors associated with this increased risk. The study is an important first step toward developing tailored HIV prevention interventions for this at-risk, understudied population. PMID:15187478

  4. An exploration of men's knowledge, attitudes, and perceptions of HIV, HIV risk, and willingness to test for HIV in Yendi District, Northern Ghana.

    PubMed

    Leblanc, Natalie M; Andes, Karen L

    2015-01-01

    We explored men's HIV knowledge, perceptions of HIV risk, and willingness to test for HIV in preparation for the initiation of formalized voluntary counseling and testing (VCT) services at Yendi Hospital in Yendi District, Ghana. A multi-method approach was used, including surveys of 129 male hospital patrons, three men-only focus group discussions, and eight interviews with clinical staff at the hospital. History of condom use, perception of risk, paying for an HIV test, and age were all significantly associated (p < .05) with willingness to test. An aversion to the hospital was the most prominent theme among participants. Aversion was due to perceived lack of confidentiality, preference for traditional healers, perceived costs, and fear of testing. Our participants (a) expressed the need for VCT services, (b) recommended that VCT target men for HIV prevention and VCT patronage, and (c) thought locations outside of hospitals should provide testing services. PMID:25456835

  5. Psychosocial challenges of young people affected by HIV: experiences from Hamilton County, Chattanooga, Tennessee.

    PubMed

    Chama, Samson; Ramirez, Octavio

    2015-01-01

    The number of young people affected by HIV and AIDS in Tennessee has steadily grown over the last few years. As a response to this situation, several organizations are working hard to address the needs of families impacted by HIV and AIDS. However, a close examination of some of the services provided suggests that young people within these families are ignored. Most of the services are geared toward HIV and AIDS-infected adult members of these families. Young people within these household are not targeted, and little is known about psychosocial challenges they experience in living with HIV-positive parents or guardians. In an attempt to address this gap, this small-scale qualitative study investigated the psychosocial challenges of young people affected by HIV and AIDS as a result of living with HIV-positive parents or guardians. Perceived sense of depression, experiencing stigma, self-blame, and lack of communication and loneliness were challenges that young people faced regularly. PMID:25495702

  6. Labor Migration and HIV Risk: A Systematic Review of the Literature

    PubMed Central

    Weine, Stevan M.; Kashuba, Adrianna B.

    2013-01-01

    To inform the development of multilevel strategies for addressing HIV risk among labor migrants, 97 articles from the health and social science literatures were systematically reviewed. The study locations were Africa (23 %), the Americas (26 %), Europe (7 %), South East Asia (21 %), and Western Pacific (24 %). Among the studies meeting inclusion criteria, HIV risk was associated with multilevel determinants at the levels of policy, sociocultural context, health and mental health, and sexual practices. The policy determinants most often associated with HIV risk were: prolonged and/or frequent absence, financial status, and difficult working and housing conditions. The sociocultural context determinants most often associated with HIV risk were: cultural norms, family separation, and low social support. The health and mental health factors most often associated with HIV risk were: substance use, other STIs, mental health problems, no HIV testing, and needle use. The sexual practices most often associated with increased HIV risk were: limited condom use, multiple partnering, clients of sex workers, low HIV knowledge, and low perceived HIV risk. Magnitude of effects through multivariate statistics were demonstrated more for health and mental health and sexual practices, than for policy or sociocultural context. The consistency of these findings across multiple diverse global labor migration sites underlines the need for multilevel intervention strategies. However, to better inform the development, implementation, and evaluation of multilevel interventions, additional research is needed that overcomes prior methodological limitations and focuses on building new contextually tailored interventions and policies. PMID:22481273

  7. Attitudes and beliefs regarding depression, HIV/AIDS and HIV risk-related sexual behaviors among clinically depressed African American adolescent females

    PubMed Central

    Brawner, Bridgette M.

    2012-01-01

    Individuals’ attitudes and beliefs toward behaviors are key indicators of behavioral performance. The purpose of this study was to elucidate attitudes and beliefs about depression, HIV/AIDS and HIV risk-related sexual behaviors among clinically depressed African American adolescent females and to develop an understanding of their context for HIV risk. For this descriptive qualitative inquiry, semi-structured interviews and surveys were employed (N = 24). The narratives reveal that behavioral sequelae of depression (i.e. loneliness) can produce risk for HIV. These findings may guide psychiatric nurse educators, scientists, and practitioners to modify HIV risk among clinically depressed African American adolescent females. PMID:23164403

  8. Attitudes and beliefs regarding depression, HIV/AIDS, and HIV risk-related sexual behaviors among clinically depressed African American adolescent females.

    PubMed

    Brawner, Bridgette M

    2012-12-01

    Individuals' attitudes and beliefs toward behaviors are key indicators of behavioral performance. The purposes of this study were to elucidate attitudes and beliefs about depression, HIV/AIDS, and HIV risk-related sexual behaviors among clinically depressed African American adolescent females and to develop an understanding of their context for HIV risk. For this descriptive qualitative inquiry, semistructured interviews and surveys were employed (N = 24). The narratives reveal that behavioral sequelae of depression (i.e., loneliness) can produce risk for HIV. These findings may guide psychiatric nurse educators, scientists, and practitioners to modify HIV risk among clinically depressed African American adolescent females. PMID:23164403

  9. High-risk behaviors among adult men and women in Botswana: implications for HIV/AIDS prevention efforts.

    PubMed

    Keetile, Mpho

    2014-01-01

    The government of Botswana has been spending a lot of money in the prevention, treatment, care and support for HIV/AIDS patient for decades. This paper uses data from the third Botswana AIDS Impact Survey (BAIS III) to explore high-risk behaviors of adults and how they affect government efforts to stop the spread of HIV/AIDS. The objective of this paper is to fill in the gap on the assessment of high-risk behaviors associated with HIV/AIDS and their implications on HIV/AIDS prevention efforts. A nationally representative sample of 10,159 men and women aged 20-64 years who had successfully completed the BAIS III individual questionnaire were used in the study. Both descriptive and binary logistic regression analyses were used for analysis. Crude odds ratios were obtained from gross effects model while adjusted odds ratios (AOR) were obtained from the net effects model. Statistically significant association was observed between multiple current partners and alcohol consumption (AOR = 1.5), drug abuse (AOR = 1.7), transactional sex (AOR = 2.6) and intergenerational sex (AOR = 1.07). Furthermore, statistically significant association was seen for inconsistent condom use and having tested for HIV (AOR = 1.5). These results show a worrying tendency that despite government's efforts to stop the spread of HIV/AIDS, adults in Botswana continue to indulge in high-risk behaviors. Therefore, any programs and policies on HIV/AIDS should first target these high-risk behaviors. PMID:25293869

  10. Risk factors for acquisition and clearance of oral human papillomavirus infection among HIV-infected and HIV-uninfected adults.

    PubMed

    Beachler, Daniel C; Sugar, Elizabeth A; Margolick, Joseph B; Weber, Kathleen M; Strickler, Howard D; Wiley, Dorothy J; Cranston, Ross D; Burk, Robert D; Minkoff, Howard; Reddy, Susheel; Xiao, Weihong; Guo, Yingshi; Gillison, Maura L; D'Souza, Gypsyamber

    2015-01-01

    Human papillomavirus (HPV) causes the majority of oropharyngeal cancers in the United States, yet the risk factors for and natural history of oral HPV infection are largely unknown. In 2010-2011, a US-based longitudinal cohort study of 761 human immunodeficiency virus (HIV)-infected and 469 at-risk HIV-uninfected participants from the Multicenter AIDS Cohort Study and the Women's Interagency HIV Study was initiated. Semiannually collected oral rinses were evaluated for 37 HPV genotypes using the Roche LINEAR ARRAY HPV Genotyping Test (Roche Molecular Systems, Pleasanton, California), and factors associated with oral HPV incidence and clearance were explored using adjusted Wei-Lin-Weissfeld modeling. Through 2013, the 2-year cumulative incidence of any type of oral HPV infection was 34% in HIV-infected persons and 19% in HIV-uninfected persons. However, many of these infections cleared. Seven percent of incident infections and 35% of prevalent infections persisted for at least 2 years. After adjustment for other risk factors, HIV infection (adjusted hazard ratio = 2.3, 95% confidence interval: 1.7, 3.2), reduced current CD4 cell count, and increased numbers of oral sex and "rimming" partners increased the risk of incident oral HPV infection, whereas male sex, older age, and current smoking increased the risk of oral HPV persistence (each P < 0.05). This helps explain the consistent associations observed between these factors and prevalent oral HPV infection in previous cross-sectional studies. PMID:25480823

  11. Risk Factors for Acquisition and Clearance of Oral Human Papillomavirus Infection Among HIV-Infected and HIV-Uninfected Adults

    PubMed Central

    Beachler, Daniel C.; Sugar, Elizabeth A.; Margolick, Joseph B.; Weber, Kathleen M.; Strickler, Howard D.; Wiley, Dorothy J.; Cranston, Ross D.; Burk, Robert D.; Minkoff, Howard; Reddy, Susheel; Xiao, Weihong; Guo, Yingshi; Gillison, Maura L.; D'Souza, Gypsyamber

    2015-01-01

    Human papillomavirus (HPV) causes the majority of oropharyngeal cancers in the United States, yet the risk factors for and natural history of oral HPV infection are largely unknown. In 2010–2011, a US-based longitudinal cohort study of 761 human immunodeficiency virus (HIV)-infected and 469 at-risk HIV-uninfected participants from the Multicenter AIDS Cohort Study and the Women's Interagency HIV Study was initiated. Semiannually collected oral rinses were evaluated for 37 HPV genotypes using the Roche LINEAR ARRAY HPV Genotyping Test (Roche Molecular Systems, Pleasanton, California), and factors associated with oral HPV incidence and clearance were explored using adjusted Wei-Lin-Weissfeld modeling. Through 2013, the 2-year cumulative incidence of any type of oral HPV infection was 34% in HIV-infected persons and 19% in HIV-uninfected persons. However, many of these infections cleared. Seven percent of incident infections and 35% of prevalent infections persisted for at least 2 years. After adjustment for other risk factors, HIV infection (adjusted hazard ratio = 2.3, 95% confidence interval: 1.7, 3.2), reduced current CD4 cell count, and increased numbers of oral sex and “rimming” partners increased the risk of incident oral HPV infection, whereas male sex, older age, and current smoking increased the risk of oral HPV persistence (each P < 0.05). This helps explain the consistent associations observed between these factors and prevalent oral HPV infection in previous cross-sectional studies. PMID:25480823

  12. Everyday moral reasoning in the governmentality of HIV risk.

    PubMed

    Cristian Rangel, J; Adam, Barry D

    2014-01-01

    Drawing on the sociology of morality, this article analyses the social contexts, discourses and ethno-methods of everyday life that shape real-world decisions of gay men around HIV prevention. Through an analysis of the predominant narratives in an online public forum created for an HIV prevention campaign, this article explores the ways in which homosexually active men engage in everyday moral reasoning and challenge a neoliberal moral order of risk and responsibility. The article concludes that gay and bisexual men engage in forms of practical morality with their sexual partners and imagine larger communities of interest, love, companionship and pleasure. At the same time, they draw heavily from discourses on individual and rational responsibility, as well as narratives of romance and community, that shape forms of moral selfhood. Risk management techniques that are grounded in notions of rational choice and that are insensitive to the emotional worlds that these men inhabit create situations of risk avoidance but also inadvertently open them to new forms of vulnerability. PMID:24438226

  13. The difference practice makes: Evidence, articulation, and affect in HIV prevention.

    PubMed

    Race, Kane

    2014-06-01

    This paper considers the difference that a conception of sex as social practice has made to the relations articulated in HIV social research in Australia. In defining sexual practice as "fluid, embedded in specific social formations, and involving the negotiation of meaning" (Kippax & Stephenson, 2005), social researchers put their own research categories and questions at risk by constructing situations in which the objects of research were given occasions to counter researchers' presumptions through the use of their own categories. Taking this risk produced sharp insights about the evolving dynamics of gay sexuality in this context and produced distinctive, interesting findings. It enabled the articulation of the practice of negotiated safety and later strategies of HIV risk reduction emerging from gay men's practice, for example. I draw on Latour's (2004) concept of articulation to make sense of these innovations and cut through some of the key distinctions that organize HIV research: qualitative/quantitative; social/biomedical; subject/ object; human/nonhuman; interpretations/evidence. Rather than rest on the organizing power of these distinctions, keeping HIV prevention effective, engaging and interesting will require specific attention to the embodied articulation of HIV relations in the present. PMID:24846488

  14. Factors mediating HIV risk among female sex workers in Europe: a systematic review and ecological analysis

    PubMed Central

    Platt, Lucy; Jolley, Emma; Rhodes, Tim; Hope, Vivian; Latypov, Alisher; Reynolds, Lucy; Wilson, David

    2013-01-01

    Objectives We reviewed the epidemiology of HIV and selected sexually transmitted infections (STIs) among female sex workers (FSWs) in WHO-defined Europe. There were three objectives: (1) to assess the prevalence of HIV and STIs (chlamydia, syphilis and gonorrhoea); (2) to describe structural and individual-level risk factors associated with prevalence and (3) to examine the relationship between structural-level factors and national estimates of HIV prevalence among FSWs. Design A systematic search of published and unpublished literature measuring HIV/STIs and risk factors among FSWs, identified through electronic databases published since 2005. ‘Best’ estimates of HIV prevalence were calculated from the systematic review to provide national level estimates of HIV. Associations between HIV prevalence and selected structural-level indicators were assessed using linear regression models. Studies reviewed Of the 1993 papers identified in the search, 73 peer-reviewed and grey literature documents were identified as meeting our criteria of which 63 papers provided unique estimates of HIV and STI prevalence and nine reported multivariate risk factors for HIV/STI among FSWs. Results HIV in Europe remains low among FSWs who do not inject drugs (<1%), but STIs are high, particularly syphilis in the East and gonorrhoea. FSWs experience high levels of violence and structural risk factors associated with HIV, including lack of access to services and working on the street. Linear regression models showed HIV among FSWs to link with injecting drug use and imprisonment. Conclusions Findings show that HIV prevention interventions should be nested inside strategies that address the social welfare of sex workers, highlighting in turn the need to target the social determinants of health and inequality, including regarding access to services, experience of violence and migration. Future epidemiological and intervention studies of HIV among vulnerable populations need to better

  15. Self-competence Among Early and Middle Adolescents Affected by Maternal HIV/AIDS

    PubMed Central

    Marelich, William D.; Murphy, Debra A.; Payne, Diana L.; Herbeck, Diane M.; Schuster, Mark A.

    2012-01-01

    Adolescent children of mothers with HIV face a host of stressors that place them at increased risk for poor outcomes. Using covariance structure analysis, this study examines adolescent risk outcomes and their relationships to maternal health, as well as the potentially protective factors of family environment and self-competence. The final model indicated that poor maternal health was negatively related to a protective family environment, which in turn was negatively related to adolescent risk outcomes. A protective family environment was also positively related to adolescent self-competence, which was negatively related to adolescent risk outcomes. Implications of the study are discussed, including how these findings can influence interventions aimed at reducing the risk for poor outcomes among adolescent youth with HIV-infected mothers. PMID:22485061

  16. HIV and Childhood Sexual Violence: Implications for Sexual Risk Behaviors and HIV Testing in Tanzania.

    PubMed

    Chiang, Laura F; Chen, Jieru; Gladden, Matthew R; Mercy, James A; Kwesigabo, Gideon; Mrisho, Fatma; Dahlberg, Linda L; Nyunt, Myo Zin; Brookmeyer, Kate A; Vagi, Kevin

    2015-10-01

    Prior research has established an association between sexual violence and HIV. Exposure to sexual violence during childhood can profoundly impact brain architecture and stress regulatory response. As a result, individuals who have experienced such trauma may engage in sexual risk-taking behavior and could benefit from targeted interventions. In 2009, nationally representative data were collected on violence against children in Tanzania from 13-24 year old respondents (n=3,739). Analyses show that females aged 19-24 (n=579) who experienced childhood sexual violence, were more likely to report no/infrequent condom use in the past 12 months (AOR=3.0, CI [1.5, 6.1], p=0.0017) and multiple sex partners in the past 12 months (AOR=2.3, CI [1.0, 5.1], p=0.0491), but no more likely to know where to get HIV testing or to have ever been tested. Victims of childhood sexual violence could benefit from targeted interventions to mitigate impacts of violence and prevent HIV. PMID:26485236

  17. HIV testing experience and risk behavior among sexually active Black young adults: a CBPR-based study using respondent-driven sampling in Durham, North Carolina

    PubMed Central

    MacQueen, Kathleen M.; Chen, Mario; Jolly, David; Mueller, Monique P.; Okumu, Eunice; Eley, Natalie T.; Laws, Michelle; Isler, Malika Roman; Kalloo, Allison; Rogers, Randy C.

    2015-01-01

    African Americans are disproportionately affected by the HIV epidemic inclusive of men who have sex with men, heterosexual men, and women. As part of a community-based participatory research study we assessed HIV testing experience among sexually active 18 to 30 year old Black men and women in Durham, North Carolina. Of 508 participants, 173 (74%) men and 236 (86%; p=.0008) women reported ever being tested. Barriers to testing (e.g., perceived risk and stigma) were the same for men and women, but men fell behind mainly because a primary facilitator of testing---routine screening in clinical settings---was more effective at reaching women. Structural and behavioral risk factors associated with HIV infection were prevalent but did not predict HIV testing experience. Reduced access to health care services for low income Black young adults may exacerbate HIV testing barriers that already exist for men and undermine previous success rates in reaching women. PMID:25893817

  18. HIV Testing Experience and Risk Behavior Among Sexually Active Black Young Adults: A CBPR-Based Study Using Respondent-Driven Sampling in Durham, North Carolina.

    PubMed

    MacQueen, Kathleen M; Chen, Mario; Jolly, David; Mueller, Monique P; Okumu, Eunice; Eley, Natalie T; Laws, Michelle; Isler, Malika Roman; Kalloo, Allison; Rogers, Randy C

    2015-06-01

    African Americans are disproportionately affected by the HIV epidemic inclusive of men who have sex with men, heterosexual men, and women. As part of a community-based participatory research study we assessed HIV testing experience among sexually active 18-30 year old Black men and women in Durham, NC. Of 508 participants, 173 (74 %) men and 236 (86 %; p = 0.0008) women reported ever being tested. Barriers to testing (e.g., perceived risk and stigma) were the same for men and women, but men fell behind mainly because a primary facilitator of testing-routine screening in clinical settings-was more effective at reaching women. Structural and behavioral risk factors associated with HIV infection were prevalent but did not predict HIV testing experience. Reduced access to health care services for low income Black young adults may exacerbate HIV testing barriers that already exist for men and undermine previous success rates in reaching women. PMID:25893817

  19. Antagonist Models for Relapse Prevention and Reducing HIV Risk.

    PubMed

    Woody, George E; Krupitsky, Evgeny; Zvartau, Edwin

    2016-09-01

    Naltrexone is an antagonist that binds tightly to μ-opioid receptors and blocks the subjective and analgesic effects of opioids. It does not produce physiologic dependence and precipitates withdrawal if administered to an opioid dependent person, thus starting it must begin with detoxification. It was first available in the mid-1970s as a 50 mg tablet that blocked opioids for 24-36 h if taken daily, or every 2-3 days at higher doses - for example: 100 mg Monday and Wednesday, 150 mg on Friday. From a pharmacological perspective it worked very well and was hoped to be an effective treatment but results were disappointing due to low patient interest and high dropout followed by relapse. Interest in it waned but rose again in the late 1990's when injecting opioid use and the rapid spread of HIV in the Russian Federation converged with an international interest in reducing the spread of HIV. One result was a series of meetings sponsored by the U.S. National Institute on Drug Abuse (NIDA) and Pavlov State Medical University in St. Petersburg, Russian Federation, on ways to reduce the spread of HIV in that country. Addiction treatment was a clear priority and discussions showed that naltrexone could have a role since agonist treatment is against Russian law but naltrexone is approved and the government funds over 25,000 beds for detoxification, which is the first step in starting naltrexone treatment. These meetings were followed by NIDA studies that showed better compliance to oral naltrexone than in prior U.S. studies with the expected reductions in HIV injecting risk for those that stayed in treatment. These events and findings provided a background and identified an infrastructure for the study that led to FDA approval of extended release injectable naltrexone for preventing relapse to opioid dependence. This paper will briefly review findings from these studies and end with comments on the potential role of extended release naltrexone as a meaningful addition

  20. Caregivers' Attitudes towards HIV Testing and Disclosure of HIV Status to At-Risk Children in Rural Uganda.

    PubMed

    Lorenz, Rick; Grant, Eisha; Muyindike, Winnie; Maling, Samuel; Card, Claire; Henry, Carol; Nazarali, Adil J

    2016-01-01

    Caregivers of HIV-positive children were interviewed in the Mbarara and Isingiro districts of Uganda to identify current trends in practices related to HIV testing and the disclosure of HIV status to the child. A total of 28 caregivers of at least one HIV-positive child participated in semi-structured interviews exploring when and why they tested the child for HIV, when the child was informed of their positive status, and what the caregiver did to prepare themselves and the child for status disclosure. For a majority (96%) of respondents, the decision to test the child for HIV was due to existing illness in either the child or a relative. Other common themes identified included the existence of stigma in the caregivers' communities and doubt that the children truly understood what was being explained to them when their status was disclosed. Most (65%) children were informed of their HIV status between the ages of 5 and 9, with the mean age of disclosure occurring at the age of 7. General provision of HIV information typically began at the same age as disclosure, and as many as two thirds (64%) of the caregivers sought advice from an HIV counsellor prior to disclosure. How a caregiver chose to prepare themselves and the child did not affect the caregiver's perception of whether the disclosure experience was beneficial or not. These findings suggest that the HIV disclosure experience in Mbarara and Isingiro districts differs from current guidelines, especially with respect to age of disclosure, how caregivers prepare themselves and the child, and approaching disclosure as an ongoing process. The doubts expressed by caregivers regarding the child's level of HIV understanding following the disclosure experience suggest the children may be insufficiently prepared at the time of the initial disclosure event. The findings also suggest that examining the content of pre-disclosure counselling and HIV education, and how health care professionals are trained to facilitate the

  1. Sexual Behavior and Perceived Peer Norms: Comparing Perinatally HIV-Infected and HIV-Affected Youth

    ERIC Educational Resources Information Center

    Bauermeister, Jose A.; Elkington, Katherine; Brackis-Cott, Elizabeth; Dolezal, Curtis; Mellins, Claude Ann

    2009-01-01

    A large proportion of perinatally HIV-infected (PHIV) children are becoming adolescents and exploring their sexuality. This study explored the prevalence of sexual behaviors (kissing, touching, engaging in oral sex, or having vaginal/anal intercourse) in a sample of predominantly ethnic minority youths (N = 339; 54.1% Black and 30.4% Latino; 51%…

  2. Unserved, Unseen, and Unheard: Integrating Programs for HIV-Infected and HIV-Affected Older Adults

    ERIC Educational Resources Information Center

    Emlet, Charles A.; Poindexter, Cynthia Cannon

    2004-01-01

    This article explores the parallel structures and service delivery systems of the Older Americans' Act and the Ryan White CARE Act, argues that social workers should have a working knowledge of both pieces of public policy, and suggests integration or coordination of aging and HIV services. Two vignettes illuminate the issues and implications for…

  3. Sexual Orientation- and Race-Based Discrimination and Sexual HIV Risk Behavior Among Urban MSM

    PubMed Central

    Frye, Victoria; Nandi, Vijay; Egan, James; Cerda, Magdalena; Greene, Emily; Van Tieu, Hong; Ompad, Danielle C.; Hoover, Donald R.; Lucy, Debbie; Baez, Eduardo; Koblin, Beryl A.

    2014-01-01

    Understanding what social factors are associated with risk of HIV acquisition and transmission among gay, bisexual and other men who have sex with men (MSM) is a critical public health goal. Experiencing discrimination may increase risk of HIV infection among MSM. This analysis assessed relations between experiences of sexual orientation- and race-based discrimination and sexual HIV risk behavior among MSM in New York City. 1,369 MSM completed a self-administered computerized assessment of past 3-month sexual behavior, experience of social discrimination and other covariates. Regression models assessed relations between recent experience of discrimination and sexual HIV risk behavior. Mean age was 32 years; 32 % were white; 32 % Latino/Hispanic; 25 % African American/Black. Of MSM who self-reported HIV-positive or unknown status (377), 7 % (N = 27) reported having unprotected insertive anal intercourse with an HIV-negative or unknown status partner (“HIV transmission risk”). Of MSM who self-reported HIV-negative status (992), 11 % (110) reported unprotected receptive anal intercourse with an HIV-positive or unknown status partner (“HIV acquisition risk”). HIV acquisition risk was positively associated with sexual orientation-based discrimination in home or social neighborhoods, but not race-based discrimination. We observed that sexual orientation-based discrimination was associated with sexual HIV risk behavior among urban-dwelling MSM. Addressing environmental sources of this form of discrimination, as well as the psychological distress that may result, should be prioritized in HIV prevention efforts. PMID:25381561

  4. Psychological Resilience among Children Affected by Parental HIV/AIDS: A Conceptual Framework

    PubMed Central

    Li, Xiaoming; Chi, Peilian; Sherr, Lorraine; Cluver, Lucie; Stanton, Bonita

    2015-01-01

    HIV-related parental illness and death have a profound and lasting impact on a child's psychosocial wellbeing, potentially compromising the child's future. In response to a paucity of theoretical and conceptual discussions regarding the development of resilience among children affected by parental HIV, we proposed a conceptual framework of psychological resilience among children affected by HIV based on critical reviews of the existing theoretical and empirical literature. Three interactive social ecological factors were proposed to promote the resilience processes and attenuate the negative impact of parental HIV on children's psychological development. Internal assets, such as cognitive capacity, motivation to adapt, coping skills, religion/spirituality, and personality, promote resilience processes. Family resources and community resources are two critical contextual factors that facilitate resilience process. Family resources contain smooth transition, functional caregivers, attachment relationship, parenting discipline. Community resources contain teacher support, peer support, adult mentors, and effective school. The implications of the conceptual framework for future research and interventions among children affected by parental HIV were discussed. PMID:26716068

  5. Mania Symptoms and HIV-Risk Behavior among Adolescents in Mental Health Treatment

    ERIC Educational Resources Information Center

    Stewart, Angela J.; Theodore-Oklota, Christina; Hadley, Wendy; Brown, Larry K.; Donenberg, Geri; DiClemente, Ralph

    2012-01-01

    This study explored whether adolescents with elevated symptoms of mania (ESM+) engage in more HIV risk behaviors than those with other psychiatric disorders and examined factors associated with HIV risk behavior among ESM+ adolescents. Eight hundred forty adolescents (56% female, 58% African American, "M" age = 14.9 years) who received mental…

  6. HIV/Sexually Transmitted Infection Risk Behaviors in Delinquent Youth with Psychiatric Disorders: A Longitudinal Study

    ERIC Educational Resources Information Center

    Elkington, Katherine; Teplin, Linda A.; Mericle, Amy A.; Welty, Leah J.; Romero, Erin G.; Abram, Karen M.

    2008-01-01

    The effect of psychiatric disorders on human immunodeficiency virus/sexually transmitted infection (HIV/STI) risk behaviors in juvenile justice youths is examined. Prevalence, persistence and prediction are addressed among four mutually exclusive diagnostic groups and results show a high prevalence rate of many HIV/STI sexual risk behaviors that…

  7. The Intersection of Gender and Ethnicity in HIV Risk, Interventions, and Prevention: New Frontiers for Psychology

    ERIC Educational Resources Information Center

    Wyatt, Gail E.; Gomez, Cynthia A.; Hamilton, Alison B.; Valencia-Garcia, Dellanira; Gant, Larry M.; Graham, Charles E.

    2013-01-01

    This article articulates a contextualized understanding of gender and ethnicity as interacting social determinants of HIV risk and acquisition, with special focus on African Americans and Hispanics/Latinos--2 ethnic groups currently at most risk for HIV/AIDS acquisition in the United States. First, sex and gender are defined. Second, a conceptual…

  8. Perception of HIV/AIDS Risk among Urban, Low-Income Senior-Housing Residents

    ERIC Educational Resources Information Center

    Ward, Elijah G.; Disch, William B.; Levy, Judith A.; Schensul, Jean J.

    2004-01-01

    Despite the rising number of cases of HIV in adults over age 50, older persons rarely are considered to be at risk for HIV/AIDS, and even though they may be involved in risky behavior, such as unprotected penetrative sex, they may not consider themselves vulnerable to becoming infected. Informed awareness of risk is essential to making positive…

  9. High-Risk Behaviors among Youth and Their Reasons for Not Getting Tested for HIV

    ERIC Educational Resources Information Center

    Moyer, Matthew B.; Silvestre, Anthony J.; Lombardi, Emilia L.; Taylor, Christopher A.

    2007-01-01

    Concerned about reports of a 15% decline in HIV testing among high-risk youth in an earlier study in Pittsburgh, this study was initiated to explore reasons why young people are not getting tested for HIV, while gathering data on their respective level of risk taking behaviors. A total of 580 surveys were collected from youth aged between 14 and…

  10. Youths' HIV Risk in the Justice System: A Critical but Neglected Issue

    ERIC Educational Resources Information Center

    Brown, Larry K.; Tolou-Shams, Marina; Whiteley, Laura Brave

    2008-01-01

    Preventive measures that can help in the juvenile system to address HIV risk and psychiatric disorders among detained youths are discussed. Early holistic interventions concluded by incorporating relevant family, peer, school and community factors could decrease later HIV risk behavior is presented.

  11. Age and HIV Risk and Protective Behaviors among African American Women

    ERIC Educational Resources Information Center

    Corneille, Maya A.; Zyzniewski, Linda E.; Belgrave, Faye Z.

    2008-01-01

    Though HIV prevention efforts have focused on young adult women, women of all ages may engage in HIV risk behaviors and experience barriers to condom use. This article examines the effect of age on sexual risk and protective attitudes and behaviors among African American women. Unmarried heterosexual African American women between the ages of 18…

  12. A critical review of social and structural conditions that influence HIV risk among Mexican deportees

    PubMed Central

    Pinedo, Miguel; Burgos, José Luis; Ojeda, Victoria D.

    2014-01-01

    Mexican migrants who are deported from the US may be at elevated risk for HIV infection. Deportations of Mexican migrants by the US have reached record numbers. We critically reviewed existing literature to assess how social and structural conditions in post-deportation settings can influence Mexican deported migrants' HIV risk. We also identify critical research gaps and make research recommendations. PMID:24583278

  13. HIV/AIDS awareness and risk behavior among students in Semey, Kazakhstan: a cross-sectional survey

    PubMed Central

    Hansson, Marit; Stockfelt, Leo; Urazalin, Marat; Ahlm, Clas; Andersson, Rune

    2008-01-01

    Background Until recently, young people in Kazakhstan have been only moderately affected by the global HIV epidemic. Today, however, the HIV epidemic in Central Asia is one of the most rapidly increasing epidemics in the world. It is mainly concentrated to vulnerable groups such as intravenous drug users, sex workers, the purchasers of sexual services and the financially marginalized. Young, sexually active people may however be the gateway for the epidemic to the general population, and knowledge about their attitudes and behavior is therefore important in planning preventive measures. Methods To gather information about young students and their attitudes and knowledge about HIV/AIDS, we collected 600 structured questionnaires and made 23 semi-structured interviews among three groups of students. Response rate was 99%. Results Almost 99% of the respondents had heard of HIV/AIDS, and 89% could identify ways to protect oneself against sexually transmitted HIV/AIDS. The main routes of transmission, sexual contact without condom and intravenous drug use, were both identified by 97% of the students. Twenty-five percent of the female students and 75% of the male students had had one or more sexual partners. More than 30% of the young men had purchased sex, and homosexuality was widely stigmatized. Conclusion Risks for the spread of HIV/AIDS among young people in Kazakhstan include prostitution as well as stigmatization of the HIV positive and of homosexuals. Protective factors are good knowledge about risks and protection, and opportunities to talk and gather information about sexuality and HIV/AIDS. PMID:19087297

  14. HIV/AIDS knowledge and high risk sexual practices among southern California Vietnamese.

    PubMed Central

    Gellert, G A; Maxwell, R M; Higgins, K V; Mai, K K; Lowery, R; Doll, L

    1995-01-01

    OBJECTIVES--Vietnamese immigration to the U.S. since the conclusion of the Vietnam war has been substantial and in Orange County, CA, Vietnamese Americans comprise 3% of the population (the largest community in the US). Our objective was to collect data on the HIV/AIDS knowledge, attitudes and self-reported high risk behaviours within this community. METHODS--A survey instrument was administered anonymously in Vietnamese to 532 respondents in their homes. Individuals from three population strata were randomly sampled: men 18 to 35 years old (N = 193); men 36 to 45 years old (N = 137); and women 18 to 35 years old (N = 202). Data were gathered on: (1) degree of acculturation; (2) knowledge and attitudes towards HIV/AIDS; and (3) self-reported sexual and other high risk practices. RESULTS--Survey data indicated that 38% of respondents were very worried about themselves and 83% were worried about a family member getting AIDS. Knowledge about actual modes of HIV transmission was generally accurate, but a substantial minority still believed that HIV can be transmitted through casual contact, and 68% from needles used in hospitals. Women demonstrated less accurate knowledge than men on five key items. Quarantine of the HIV infected was agreed to by 45%. Twenty-nine percent did not believe that the epidemic would affect them personally, and 49% stated that they did not have enough information about AIDS to protect themselves. Regarding sexual practices, 31% reported never having had sex. Of the others, 8% had two or more sexual partners in the prior 12 months. No same sex behaviour was reported. Six percent of men had visited a female prostitute; of these, 24% had visited 2 or more in the prior 12 months; half of encounters in this time period were outside the US. Substantial percentages of sexually active, unmarried respondents indicated that they never use (17-40%) or only sometimes use (10-32%) condoms. Less than 1% had used injection drugs. CONCLUSIONS

  15. Perceptions of HIV risks and prevention strategies by rural and small city African Americans who use cocaine: views from the inside.

    PubMed

    Brown, Emma J; Hill, Mary Angelique

    2005-05-01

    HIV/AIDS disproportionately affects African Americans, yet knowledge gaps exist regarding their views of risks and effective prevention strategies. This focus group study of rural and small city African Americans who use drugs sought to assess these perceptions. Common views of HIV risks included drug use, physical appearance as an indicator of HIV status, intentional transmission, having multiple partners, unprotected sex, bisexuality, and unfounded trust. Trading sex for drugs and unprotected sex when high were seen as drug use/HIV risk links, while HIV education and condom use were identified as ways to decrease risk. Perceptions of effective strategies included community-based programs, gender specific groups, providing food or other incentives, and making the program fun. Healthcare professionals and parents were viewed as the best people to promote HIV prevention. Based on the findings, effective intervention for this target group should encompass ethnocentric community-based strategies that focus on HIV education, condom use skills, and drug risk reduction. PMID:16020054

  16. HIV vaccine knowledge and beliefs among communities at elevated risk: conspiracies, questions and confusion.

    PubMed

    Roberts, Kathleen Johnston; Newman, Peter A; Duan, Naihua; Rudy, Ellen T

    2005-12-01

    HIV vaccines offer the best long-term hope of controlling the AIDS pandemic. We explored HIV vaccine knowledge and beliefs among communities at elevated risk for HIV/AIDS. Participants (N=99; median age=33 years; 48% female; 22% African-American; 44% Latino; 28% white; 6% other) were recruited from seven high-risk venues in Los Angeles, California, using purposive, venue-based sampling. Results from nine focus groups revealed: 1) mixed beliefs and conspiracy theories about the existence of HIV vaccines; 2) hopefulness and doubts about future HIV vaccine availability; 3) lack of information about HIV vaccines; and 4) confusion about vaccines and how they work. Tailored HIV vaccine education that addresses the current status of HIV vaccine development and key vaccine concepts is warranted among communities at risk. Ongoing dialogue among researchers, public health practitioners and communities at risk may provide a vital opportunity to dispel misinformation and rumors and to cultivate trust, which may facilitate HIV vaccine trial participation and uptake of future HIV vaccines. PMID:16396058

  17. HIV vaccine knowledge and beliefs among communities at elevated risk: conspiracies, questions and confusion.

    PubMed Central

    Roberts, Kathleen Johnston; Newman, Peter A.; Duan, Naihua; Rudy, Ellen T.

    2005-01-01

    HIV vaccines offer the best long-term hope of controlling the AIDS pandemic. We explored HIV vaccine knowledge and beliefs among communities at elevated risk for HIV/AIDS. Participants (N=99; median age=33 years; 48% female; 22% African-American; 44% Latino; 28% white; 6% other) were recruited from seven high-risk venues in Los Angeles, California, using purposive, venue-based sampling. Results from nine focus groups revealed: 1) mixed beliefs and conspiracy theories about the existence of HIV vaccines; 2) hopefulness and doubts about future HIV vaccine availability; 3) lack of information about HIV vaccines; and 4) confusion about vaccines and how they work. Tailored HIV vaccine education that addresses the current status of HIV vaccine development and key vaccine concepts is warranted among communities at risk. Ongoing dialogue among researchers, public health practitioners and communities at risk may provide a vital opportunity to dispel misinformation and rumors and to cultivate trust, which may facilitate HIV vaccine trial participation and uptake of future HIV vaccines. PMID:16396058

  18. HIV Risk Perception and Behavior among Sex Workers in Three Major Urban Centers of Mozambique

    PubMed Central

    Langa, Judite; Sousa, César; Sidat, Mohsin; Kroeger, Karen; McLellan-Lemal, Eleanor; Belani, Hrishikesh; Patel, Shama; Shodell, Daniel; Shodell, Michael; Benech, Irene; Needle, Richard

    2014-01-01

    HIV risk perceptions and behaviors of 236 commercial sex workers from three major Mozambican urban centers were studied using the International Rapid Assessment, Response and Evaluation (I-RARE) methodology. All were offered HIV testing and, in Maputo, syphilis testing was offered as well. Sixty-three of the 236 opted for HIV testing, with 30 (48%) testing positive for HIV. In Maputo, all 30 receiving HIV tests also had syphilis testing, with 6 (20%) found to be positive. Results include interview excerpts and qualitative results using I-RARE methodology and AnSWR-assisted analyses of the interviews and focus group sessions. PMID:24736653

  19. The risk less known: female-to-male transgender persons' vulnerability to HIV infection.

    PubMed

    Kenagy, G P; Hsieh, C-M

    2005-02-01

    Studies have consistently found high levels of HIV infection among male-to-female (MTF) transgender people, particularly MTF sex workers. Due to lack of empirical data, HIV/AIDS risk among female-to-male (FTM) transgender people, however, is not well understood. This study analysed data from two needs assessment surveys to compare risk for HIV infection between 122 MTF and 62 FTM transgender people. Results show that there was a significant gender difference in HIV risk among the survey respondents. Compared to MTFs, FTMs were significantly less likely to have used protection the last time they had sex and significantly more likely to have engaged in recent high risk sexual activity. The gender difference existed even after controlling for demographic variables, AIDS knowledge, perceived AIDS knowledge, perceived effectiveness of condom usage, perceived susceptibility to AIDS and self-esteem. Findings from this study suggest that a thorough examination of HIV risk factors among FTMs is necessary. PMID:15763714

  20. Cumulative Impact of HIV and Multiple Concurrent Human Papillomavirus Infections on the Risk of Cervical Dysplasia

    PubMed Central

    Adler, David H.; Wallace, Melissa; Bennie, Thola; Abar, Beau; Meiring, Tracy L.; Williamson, Anna-Lise; Bekker, Linda-Gail

    2016-01-01

    Infection with HIV is known to increase the risk of cervical cancer. In addition, evidence suggests that concurrent infection with multiple human papillomavirus (HPV) genotypes increases the risk of cervical dysplasia more than infection with a single HPV genotype. However, the impact of the combination of HIV coinfection and presence of multiple concurrent HPV infections on the risk of cervical dysplasia is uncertain. We compared the results of HPV testing and Pap smears between HIV-infected and HIV-uninfected young women to assess the cumulative impact of these two conditions. We found that both HIV and the presence of multiple concurrent HPV infections are associated with increased risk of associated Pap smear abnormality and that the impact of these two risk factors may be additive. PMID:26997954

  1. Cumulative Impact of HIV and Multiple Concurrent Human Papillomavirus Infections on the Risk of Cervical Dysplasia.

    PubMed

    Adler, David H; Wallace, Melissa; Bennie, Thola; Abar, Beau; Meiring, Tracy L; Williamson, Anna-Lise; Bekker, Linda-Gail

    2016-01-01

    Infection with HIV is known to increase the risk of cervical cancer. In addition, evidence suggests that concurrent infection with multiple human papillomavirus (HPV) genotypes increases the risk of cervical dysplasia more than infection with a single HPV genotype. However, the impact of the combination of HIV coinfection and presence of multiple concurrent HPV infections on the risk of cervical dysplasia is uncertain. We compared the results of HPV testing and Pap smears between HIV-infected and HIV-uninfected young women to assess the cumulative impact of these two conditions. We found that both HIV and the presence of multiple concurrent HPV infections are associated with increased risk of associated Pap smear abnormality and that the impact of these two risk factors may be additive. PMID:26997954

  2. Does Anticipation Training Affect Drivers' Risk Taking?

    ERIC Educational Resources Information Center

    McKenna, Frank P.; Horswill, Mark S.; Alexander, Jane L.

    2006-01-01

    Skill and risk taking are argued to be independent and to require different remedial programs. However, it is possible to contend that skill-based training could be associated with an increase, a decrease, or no change in risk-taking behavior. In 3 experiments, the authors examined the influence of a skill-based training program (hazard…

  3. Smartphone Delivery of Mobile HIV Risk Reduction Education

    PubMed Central

    Phillips, Karran A.; Epstein, David H.; Mezghanni, Mustapha; Vahabzadeh, Massoud; Reamer, David; Agage, Daniel; Preston, Kenzie L.

    2013-01-01

    We sought to develop and deploy a video-based smartphone-delivered mobile HIV Risk Reduction (mHIVRR) intervention to individuals in an addiction treatment clinic. We developed 3 video modules that consisted of a 10-minute HIVRR video, 11 acceptability questions, and 3 knowledge questions and deployed them as a secondary study within a larger study of ecological momentary and geographical momentary assessments. All 24 individuals who remained in the main study long enough completed the mHIVRR secondary study. All 3 videos met our a priori criteria for acceptability “as is” in the population: they achieved median scores of ≤2.5 on a 5-point Likert scale; ≤20% of the individuals gave them the most negative rating on the scale; a majority of the individuals stated that they would not prefer other formats over video-based smartphone-delivered one (all P < 0.05). Additionally, all of our video modules met our a priori criteria for feasibility: ≤20% of data were missing due to participant noncompliance and ≤20% were missing due to technical failure. We concluded that video-based mHIVRR education delivered via smartphone is acceptable, feasible and may increase HIV/STD risk reduction knowledge. Future studies, with pre-intervention assessments of knowledge and random assignment, are needed to confirm these findings. PMID:24159383

  4. Smartphone Delivery of Mobile HIV Risk Reduction Education.

    PubMed

    Phillips, Karran A; Epstein, David H; Mezghanni, Mustapha; Vahabzadeh, Massoud; Reamer, David; Agage, Daniel; Preston, Kenzie L

    2013-01-01

    We sought to develop and deploy a video-based smartphone-delivered mobile HIV Risk Reduction (mHIVRR) intervention to individuals in an addiction treatment clinic. We developed 3 video modules that consisted of a 10-minute HIVRR video, 11 acceptability questions, and 3 knowledge questions and deployed them as a secondary study within a larger study of ecological momentary and geographical momentary assessments. All 24 individuals who remained in the main study long enough completed the mHIVRR secondary study. All 3 videos met our a priori criteria for acceptability "as is" in the population: they achieved median scores of ≤2.5 on a 5-point Likert scale; ≤20% of the individuals gave them the most negative rating on the scale; a majority of the individuals stated that they would not prefer other formats over video-based smartphone-delivered one (all P < 0.05). Additionally, all of our video modules met our a priori criteria for feasibility: ≤20% of data were missing due to participant noncompliance and ≤20% were missing due to technical failure. We concluded that video-based mHIVRR education delivered via smartphone is acceptable, feasible and may increase HIV/STD risk reduction knowledge. Future studies, with pre-intervention assessments of knowledge and random assignment, are needed to confirm these findings. PMID:24159383

  5. A Comparison of Men Who Have Sex with Men, People Who Inject Drugs and High-Risk Heterosexuals' Risk for HIV Infection, San Francisco.

    PubMed

    Raymond, H F; Ick, T O; Chen, Y-H

    2016-02-01

    HIV in the United States is concentrated in populations such as men who have sex with men (MSM), people who inject drugs (PWID), women of color and people living in poverty. These populations are labeled high-risk for HIV infection because of the higher levels of HIV or HIV risk taking behaviors seen in these groups compared to other sub-populations. It is also possible that a group may engage in behaviors that are "high-risk" for HIV infection but never become infected since HIV is not present or not present to a great extent in their social or sexual networks. We analyzed samples of MSM, PWID and high-risk heterosexuals (HRH) collected through the National HIV Behavioral Surveillance (NHBS) system in San Francisco to examine HIV risk taking and HIV burden to determine if the label "high-risk" is appropriately applied. NHBS samples MSM using time location sampling and PWID and HRH using Respondent Driven Sampling. We sampled 508 MSM in 2011, 570 PWID in 2012 and 267 HRH in 2013. There were, as expected, differences in demographic characteristics across the three groups. HRH had a greater number of high-risk behaviors compared to MSM and PWID but had the lowest HIV prevalence. Focusing on risk behavior alone to label populations without considering the background HIV prevalence in communities, the types of risks engaged in and actual HIV infections may obscure which populations truly merit the label "high-risk" for HIV infection. PMID:26334446

  6. Risk of Window Period HIV Infection in High Infectious Risk Donors: Systematic Review and Meta-Analysis

    PubMed Central

    Kucirka, Lauren M.; Sarathy, Harini; Govindan, Priyanka; Wolf, Joshua H.; Ellison, Trevor A.; Hart, Leah J.; Montgomery, Robert A.; Ros, R. Lorie; Segev, Dorry L.

    2010-01-01

    The OPTN defines high risk donors (HRDs), colloquially known as “CDC high risk donors,” as those thought to carry an increased risk of HIV window period (WP) infection prior to serologic detectability. However, the true risk of such infection remains unknown. To quantify the risk of WP infection in each HRD behavior category, we performed a systematic review and meta-analysis of studies of HIV prevalence and incidence. Of 3,476 abstracts reviewed, 27 eligible studies of HIV infection in HRD populations were identified. Pooled HIV incidence estimates were calculated for each category of HRD behavior and used to calculate the risk of WP HIV infection. Risks ranged from 0.09–12.1 per 10,000 donors based on WP for ELISA and 0.04–4.9 based on nucleic acid testing (NAT), with NAT reducing WP risk by over 50% in each category. Injection drug users had the greatest risk of WP infection (4.9 per 10,000 donors by NAT WP), followed by men who have sex with men (4.2:10,000), commercial sex workers (2.7:10,000), incarcerated donors (0.9:10,000), donors exposed to HIV through blood (0.6:10,000), donors engaging in high risk sex (0.3:10,000), and hemophiliacs (0.035:10,000). These estimates can help inform patient and provider decision-making regarding HRDs. PMID:21366859

  7. Adapting the Information-Motivation-Behavioral Skills Model: Predicting HIV-Related Sexual Risk among Sexual Minority Youth

    ERIC Educational Resources Information Center

    Fisher, Colleen M.

    2012-01-01

    Young sexual minority males are among those at highest risk for HIV infection, yet we know relatively little about the impact of sexual identity development on HIV risk. This study used cross-sectional data to investigate factors associated with HIV-related sexual risk among a sample of sexual minority males (n = 156), ages 14 to 21 years, using…

  8. Unique factors that place older Hispanic women at risk for HIV: intimate partner violence, machismo, and marianismo.

    PubMed

    Cianelli, Rosina; Villegas, Natalia; Lawson, Sarah; Ferrer, Lilian; Kaelber, Lorena; Peragallo, Nilda; Yaya, Alexandra

    2013-01-01

    Hispanic women who are 50 years of age and older have been shown to be at increased risk of acquiring HIV infection due to age and culturally related issues. The purpose of our study was to investigate factors that increase HIV risk among older Hispanic women (OHW) as a basis for development or adaptation of an age and culturally tailored intervention designed to prevent HIV-related risk behaviors. We used a qualitative descriptive approach. Five focus groups were conducted in Miami, Florida, with 50 participants. Focus group discussions centered around eight major themes: intimate partner violence (IPV), perimenopausal-postmenopausal-related biological changes, cultural factors that interfere with HIV prevention, emotional and psychological changes, HIV knowledge, HIV risk perception, HIV risk behaviors, and HIV testing. Findings from our study stressed the importance of nurses' roles in educating OHW regarding IPV and HIV prevention. PMID:23790277

  9. "She mixes her business": HIV transmission and acquisition risks among female migrants in western Kenya.

    PubMed

    Camlin, Carol S; Kwena, Zachary A; Dworkin, Shari L; Cohen, Craig R; Bukusi, Elizabeth A

    2014-02-01

    Migration and HIV research in sub-Saharan Africa has focused on HIV risks to male migrants, yet women's levels of participation in internal migration have met or exceeded those of men in the region. Moreover, studies that have examined HIV risks to female migrants found higher risk behavior and HIV prevalence among migrant compared to non-migrant women. However, little is known about the pathways through which participation in migration leads to higher risk behavior in women. This study aimed to characterize the contexts and processes that may facilitate HIV acquisition and transmission among migrant women in the Kisumu area of Nyanza Province, Kenya. We used qualitative methods, including 6 months of participant observation in women's common migration destinations and in-depth semi-structured interviews conducted with 15 male and 40 female migrants selected from these destinations. Gendered aspects of the migration process may be linked to the high risks of HIV observed in female migrants - in the circumstances that trigger migration, livelihood strategies available to female migrants, and social features of migration destinations. Migrations were often precipitated by household shocks due to changes in marital status (as when widowhood resulted in disinheritance) and gender-based violence. Many migrants engaged in transactional sex, of varying regularity, from clandestine to overt, to supplement earnings from informal sector trading. Migrant women are at high risk of HIV transmission and acquisition: the circumstances that drove migration may have also increased HIV infection risk at origin; and social contexts in destinations facilitate having multiple sexual partners and engaging in transactional sex. We propose a model for understanding the pathways through which migration contributes to HIV risks in women in high HIV prevalence areas in Africa, highlighting potential opportunities for primary and secondary HIV prevention at origins and destinations, and at

  10. Contraceptive methods and risk of HIV acquisition or female-to-male transmission.

    PubMed

    Haddad, Lisa B; Polis, Chelsea B; Sheth, Anandi N; Brown, Jennifer; Kourtis, Athena P; King, Caroline; Chakraborty, Rana; Ofotokun, Igho

    2014-12-01

    Effective family planning with modern contraception is an important intervention to prevent unintended pregnancies which also provides personal, familial, and societal benefits. Contraception is also the most cost-effective strategy to reduce the burden of mother-to-child HIV transmission for women living with HIV who wish to prevent pregnancy. There are concerns, however, that certain contraceptive methods, in particular the injectable contraceptive depot medroxyprogesterone acetate (DMPA), may increase a woman's risk of acquiring HIV or transmitting it to uninfected males. These concerns, if confirmed, could potentially have large public health implications. This paper briefly reviews the literature on use of contraception among women living with HIV or at high risk of HIV infection. The Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO) recommendations place no restrictions on the use of hormonal contraceptive methods by women with or at high risk of HIV infection, although a clarification recommends that, given uncertainty in the current literature, women at high risk of HIV who choose progestogen-only injectable contraceptives should be informed that it may or may not increase their risk of HIV acquisition and should also be informed about and have access to HIV preventive measures, including male or female condoms. PMID:25297973

  11. Contraceptive Methods and Risk of HIV Acquisition or Female-to-Male Transmission

    PubMed Central

    Polis, Chelsea B.; Sheth, Anandi N.; Brown, Jennifer; Kourtis, Athena P.; King, Caroline; Chakraborty, Rana; Ofotokun, Igho

    2015-01-01

    Effective family planning with modern contraception is an important intervention to prevent unintended pregnancies which also provides personal, familial, and societal benefits. Contraception is also the most cost-effective strategy to reduce the burden of mother-to-child HIV transmission for women living with HIV who wish to prevent pregnancy. There are concerns, however, that certain contraceptive methods, in particular the injectable contraceptive depot medroxyprogesterone acetate (DMPA), may increase a woman's risk of acquiring HIV or transmitting it to uninfected males. These concerns, if confirmed, could potentially have large public health implications. This paper briefly reviews the literature on use of contraception among women living with HIV or at high risk of HIV infection. The Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO) recommendations place no restrictions on the use of hormonal contraceptive methods by women with or at high risk of HIV infection, although a clarification recommends that, given uncertainty in the current literature, women at high risk of HIV who choose progestogen-only injectable contraceptives should be informed that it may or may not increase their risk of HIV acquisition and should also be informed about and have access to HIV preventive measures, including male or female condoms. PMID:25297973

  12. The effect of psychosocial syndemic production on 4-year HIV incidence and risk behavior in a large cohort of sexually active men who have sex with men

    PubMed Central

    MIMIAGA, Matthew J.; O’CLEIRIGH, Conall; BIELLO, Katie B.; ROBERTSON, Angela M.; SAFREN, Steven A.; COATES, Thomas J.; KOBLIN, Beryl A.; CHESNEY, Margaret A.; DONNELL, Deborah J.; STALL, Ron D.; MAYER, Kenneth H.

    2014-01-01

    Background Cross-sectional studies have suggested that co-occurring epidemics or “syndemics” of psychosocial health problems may accelerate HIV transmission among men who have sex with men (MSM) in the United States. We aimed to assess how five syndemic conditions (depressive symptoms, heavy alcohol use, stimulant use, polydrug use, and childhood sexual abuse) affected HIV incidence and sexual risk behavior over time. Methods Eligible men in a large, prospective cohort of sexually active, HIV-uninfected MSM completed HIV testing and behavioral surveys at baseline and every 6 months for 48 months. We examined interrelationships between psychosocial problems and whether these interactions increased the odds of HIV risk behaviors and risk of seroconversion over study follow-up. Results Among 4295 men, prevalence of psychosocial conditions was substantial at baseline and was positively associated with each other. We identified a statistically significant positive dose-response relationship between numbers of syndemic conditions and HIV seroconversion for all comparisons (with the greatest hazard among those with 4-5 conditions, aHR=8.69; 95% CI: 4.78-15.44). The number of syndemic conditions also predicted increased HIV related risk behaviors over time, which mediated the syndemic-HIV seroconversion association. Conclusions The accumulation of “syndemic” psychosocial problems predicted HIV-related sexual risk behaviors and seroconversion in a large sample of U.S. MSM. Given the high prevalence of syndemic conditions among MSM and the moderate effect sizes attained by traditional brief behavioral interventions to date, the HIV prevention agenda requires a shift toward improved assessment of psychosocial comorbidities and stronger integration with mental health and substance abuse treatment services. PMID:25501609

  13. Predicting the Onset of Sexual and Drug Risk Behaviors in HIV-Negative Youths with HIV-Positive Mothers: The Role of Contextual, Self-Regulation, and Social-Interaction Factors

    ERIC Educational Resources Information Center

    Mellins, Claude A.; Dolezal, Curtis; Brackis-Cott, Elizabeth; Nicholson, Ouzama; Warne, Patricia; Meyer-Bahlburg, Heino F. L.

    2007-01-01

    HIV-negative, inner-city adolescents with HIV-infected parents are considered to be at high risk for acquiring HIV themselves. Using a modified theory of health behavior, this study examined the effects of maternal HIV infection and psychosocial variables on the onset of sexual and drug risk behavior in 144 HIV-negative adolescents with and…

  14. Psychosocial Well-Being of Children in HIV/AIDS-Affected Families in Southwest China: A Qualitative Study

    ERIC Educational Resources Information Center

    Xu, Tao; Yan, Zhihua; Duan, Song; Wang, Changhe; Rou, Keming; Wu, Zunyou

    2009-01-01

    We investigated the psychosocial well-being of children in HIV/AIDS-affected families in rural China from the child's and caregiver's perspectives. Semi-structured interviews were conducted among children living in HIV/AIDS-affected families (n = 16), their caregivers (n = 16) and key community informants (n = 5). Our findings showed that all of…

  15. Drug choice, spatial distribution, HIV risk, and HIV prevalence among injection drug users in St. Petersburg, Russia

    PubMed Central

    Kruse, Gina Rae; Barbour, Russell; Heimer, Robert; Shaboltas, Alla V; Toussova, Olga V; Hoffman, Irving F; Kozlov, Andrei P

    2009-01-01

    Background The HIV epidemic in Russia has been driven by the unsafe injection of drugs, predominantly heroin and the ephedrine derived psychostimulants. Understanding differences in HIV risk behaviors among injectors associated with different substances has important implications for prevention programs. Methods We examined behaviors associated with HIV risk among 900 IDUs who inject heroin, psychostimulants, or multiple substances in 2002. Study participants completed screening questionnaires that provided data on sociodemographics, drug use, place of residence and injection- and sex-related HIV risk behaviors. HIV testing was performed and prevalence was modeled using general estimating equation (GEE) analysis. Individuals were clustered by neighborhood and disaggregated into three drug use categories: Heroin Only Users, Stimulant Only Users, and Mixed Drug Users. Results Among Heroin Only Users, younger age, front/backloading of syringes, sharing cotton and cookers were all significant predictors of HIV infection. In contrast, sharing needles and rinse water were significant among the Stimulant Only Users. The Mixed Drug Use group was similar to the Heroin Only Users with age, front/back loading, and sharing cotton significantly associated with HIV infection. These differences became apparent only when neighborhood of residence was included in models run using GEE. Conclusion The type of drug injected was associated with distinct behavioral risks. Risks specific to Stimulant Only Users appeared related to direct syringe sharing. The risks specific to the other two groups are common to the process of sharing drugs in preparation to injecting. Across the board, IDUs could profit from prevention education that emphasizes both access to clean syringes and preparing and apportioning drug with these clean syringes. However, attention to neighborhood differences might improve the intervention impact for injectors who favor different drugs. PMID:19646255

  16. The Mental Health Risk of Mothers and Children: The Role of Maternal HIV Infection

    ERIC Educational Resources Information Center

    Brackis-Cott, Elizabeth; Mellins, Claude Ann; Dolezal, Curtis; Spiegel, Dina

    2007-01-01

    Rates of mental health problems in mothers and children in families affected by maternal HIV as compared to those not affected by maternal HIV but living in similar inner-city, low-SES, primarily ethnic-minority neighborhoods were examined. In addition, correspondence between mother and child mental health was explored. Interviews were conducted…

  17. Biomedical Risk, Psychosocial Influences, and Developmental Outcomes: Lessons from the Pediatric HIV Population in Africa

    ERIC Educational Resources Information Center

    Serpell, Robert; Marfo, Kofi; Abubakar, Amina

    2014-01-01

    Sub-Saharan Africa is home to millions of HIV-affected children. These children are likely to experience multiple developmental delays. In this chapter, I present data highlighting compromised neurobehavioral, mental health, and scholastic outcomes for children affected by HIV. Furthermore, I discuss biomedical factors (e.g., disease severity and…

  18. Quantitative, Qualitative and Geospatial Methods to Characterize HIV Risk Environments

    PubMed Central

    Conners, Erin E.; West, Brooke S.; Roth, Alexis M.; Meckel-Parker, Kristen G.; Kwan, Mei-Po; Magis-Rodriguez, Carlos; Staines-Orozco, Hugo; Clapp, John D.; Brouwer, Kimberly C.

    2016-01-01

    Increasingly, ‘place’, including physical and geographical characteristics as well as social meanings, is recognized as an important factor driving individual and community health risks. This is especially true among marginalized populations in low and middle income countries (LMIC), whose environments may also be more difficult to study using traditional methods. In the NIH-funded longitudinal study Mapa de Salud, we employed a novel approach to exploring the risk environment of female sex workers (FSWs) in two Mexico/U.S. border cities, Tijuana and Ciudad Juárez. In this paper we describe the development, implementation, and feasibility of a mix of quantitative and qualitative tools used to capture the HIV risk environments of FSWs in an LMIC setting. The methods were: 1) Participatory mapping; 2) Quantitative interviews; 3) Sex work venue field observation; 4) Time-location-activity diaries; 5) In-depth interviews about daily activity spaces. We found that the mixed-methodology outlined was both feasible to implement and acceptable to participants. These methods can generate geospatial data to assess the role of the environment on drug and sexual risk behaviors among high risk populations. Additionally, the adaptation of existing methods for marginalized populations in resource constrained contexts provides new opportunities for informing public health interventions. PMID:27191846

  19. Quantitative, Qualitative and Geospatial Methods to Characterize HIV Risk Environments.

    PubMed

    Conners, Erin E; West, Brooke S; Roth, Alexis M; Meckel-Parker, Kristen G; Kwan, Mei-Po; Magis-Rodriguez, Carlos; Staines-Orozco, Hugo; Clapp, John D; Brouwer, Kimberly C

    2016-01-01

    Increasingly, 'place', including physical and geographical characteristics as well as social meanings, is recognized as an important factor driving individual and community health risks. This is especially true among marginalized populations in low and middle income countries (LMIC), whose environments may also be more difficult to study using traditional methods. In the NIH-funded longitudinal study Mapa de Salud, we employed a novel approach to exploring the risk environment of female sex workers (FSWs) in two Mexico/U.S. border cities, Tijuana and Ciudad Juárez. In this paper we describe the development, implementation, and feasibility of a mix of quantitative and qualitative tools used to capture the HIV risk environments of FSWs in an LMIC setting. The methods were: 1) Participatory mapping; 2) Quantitative interviews; 3) Sex work venue field observation; 4) Time-location-activity diaries; 5) In-depth interviews about daily activity spaces. We found that the mixed-methodology outlined was both feasible to implement and acceptable to participants. These methods can generate geospatial data to assess the role of the environment on drug and sexual risk behaviors among high risk populations. Additionally, the adaptation of existing methods for marginalized populations in resource constrained contexts provides new opportunities for informing public health interventions. PMID:27191846

  20. Parenting styles and emotional intelligence of HIV-affected children in Thailand.

    PubMed

    Lee, Sung-Jae; Li, Li; Thammawijaya, Panithee

    2013-01-01

    The purpose of this study was to examine the impact of parenting styles on emotional intelligence of HIV-affected children in Thailand. This study uses data from 205 HIV-affected children in northern and northeastern Thailand. Correlation and regression analyses were used to examine the predictors of emotional intelligence. Children reporting higher levels of stress reported less caring parenting style (standardized beta [B]=-0.18, p=0.050). Children with higher self-esteem were also more likely to perceive their parents as caring (B=0.48, p=0.002). Children who scored lower on their self-esteem reported their parents to be more overprotective (B=-0.30, p=0.030), and children reporting higher levels of stress reported their parents to be more overprotective (B=0.12, p=0.010). Children reporting caring parenting style were significantly more likely to report higher emotional intelligence (B=0.66, p=0.001). Parenting styles play an important role in the emotional intelligence. Identifying and testing interventions to help parents improve their parenting styles, while helping their HIV-affected children cope with stress and self-esteem, are essential in promoting mental health of HIV-affected children in Thailand. PMID:23651471

  1. Parenting Styles and Emotional Intelligence of HIV-affected Children in Thailand

    PubMed Central

    Lee, Sung-Jae; Li, Li; Thammawijaya, Panithee

    2013-01-01

    The purpose of this study was to examine the impact of parenting styles on emotional intelligence of HIV-affected children in Thailand. This study uses data from 205 HIV-affected children in northern and northeastern Thailand. Correlation and regression analyses were used to examine the predictors of emotional intelligence. Children reporting higher levels of stress reported less caring parenting style (Standardized beta [B] = −0.18, p=0.050). Children with higher self-esteem were also more likely to perceive their parents as caring (B = 0.48, p = 0.002). Children who scored lower on their self-esteem reported their parents to be more overprotective (B = −0.30, p = 0.030), and children reporting higher levels of stress reported their parents to be more overprotective (B = 0.12, p = 0.010). Children reporting caring parenting style were significantly more likely to report higher emotional intelligence (B = 0.66, p = 0.001). Parenting styles play an important role in the emotional intelligence. Identifying and testing interventions to help parents improve their parenting styles, while helping their HIV-affected children cope with stress and self-esteem, are essential in promoting mental health of HIV-affected children in Thailand. PMID:23651471

  2. A Sharing Experience: Development of a Group for Families Affected by HIV Infection.

    ERIC Educational Resources Information Center

    Melvin, Diane; Appleby, Sue

    1995-01-01

    Describes the establishment and development of a support group for the parents of children infected and/or affected by HIV infection. The group is hospital-based, meeting monthly since April 1992, facilitated by professionals but with a self-help and peer support emphasis. Explains the planning, setting, and running of the group. Identifies…

  3. Behavioral surveillance among people at risk for HIV infection in the U.S.: the National HIV Behavioral Surveillance System.

    PubMed

    Gallagher, Kathleen M; Sullivan, Patrick S; Lansky, Amy; Onorato, Ida M

    2007-01-01

    The Centers for Disease Control and Prevention, in collaboration with 25 state and local health departments, began the National HIV Behavioral Surveillance System (NHBS) in 2003. The system focuses on people at risk for HIV infection and surveys the three populations at highest risk for HIV in the United States: men who have sex with men, injecting drug users, and high-risk heterosexuals. The project collects information from these three populations during rotating 12-month cycles. Methods for recruiting participants vary for each at-risk population, but NHBS uses a standardized protocol and core questionnaire for each cycle. Participating health departments tailor their questionnaire to collect information about specific prevention programs offered in their geographic area and to address local data needs. Data collected from NHBS will be used to describe trends in key behavioral risk indicators and evaluate current HIV prevention programs. This information in turn can be used to identify gaps in prevention services and target new prevention activities with the goal of reducing new HIV infections in the United States. PMID:17354525

  4. Sexual behavior, risk perception, and HIV transmission can respond to HIV antiviral drugs and vaccines through multiple pathways.

    PubMed

    Tully, Stephen; Cojocaru, Monica; Bauch, Chris T

    2015-01-01

    There has been growing use of highly active antiretroviral treatment (HAART) for HIV and significant progress in developing prophylactic HIV vaccines. The simplest theories of counterproductive behavioral responses to such interventions tend to focus on single feedback mechanisms: for instance, HAART optimism makes infection less scary and thus promotes risky sexual behavior. Here, we develop an agent based, age-structured model of HIV transmission, risk perception, and partner selection in a core group to explore behavioral responses to interventions. We find that interventions can activate not one, but several feedback mechanisms that could potentially influence decision-making and HIV prevalence. In the model, HAART increases the attractiveness of unprotected sex, but it also increases perceived risk of infection and, on longer timescales, causes demographic impacts that partially counteract HAART optimism. Both HAART and vaccination usually lead to lower rates of unprotected sex on the whole, but intervention effectiveness depends strongly on whether individuals over- or under-estimate intervention coverage. Age-specific effects cause sexual behavior and HIV prevalence to change in opposite ways in old and young age groups. For complex infections like HIV-where interventions influence transmission, demography, sexual behavior and risk perception-we conclude that evaluations of behavioral responses should consider multiple feedback mechanisms. PMID:26507957

  5. The Impact of Methadone Maintenance Treatment on HIV Risk Behaviors among High-Risk Injection Drug Users: A Systematic Review

    PubMed Central

    Karki, Pramila; Shrestha, Roman; Huedo-Medina, Tania B.; Copenhaver, Michael

    2016-01-01

    Injection drug users (IDUs) are at high risk of acquiring HIV infection through preventable drug- and sex-related HIV risk behaviors. In recent decade, there has been a growing evidence that methadone maintenance treatment (MMT) is associated with a significant decrease in both drug- and sex-related risk behaviors among this high-risk population. The better understanding of the relationship between MMT and HIV-related risk behaviors will help to better inform future HIV prevention strategies, which may have policy implications as well. In this systematic review, we therefore aimed to explore the relevant literature to more clearly examine the possible impact of MMT on HIV risks behaviors among high-risk IDUs. The findings thus far suggest that MMT is associated with a significant decrease in injecting drug use and sharing of injecting equipment. Evidence on sex-related risk behavior is limited, but suggest that MMT is associated with a lower incidence of multiple sex partners and unprotected sex. The literature also suggests that the most significant factor in reducing HIV risks was treatment adherence. As such, more attention needs to be given in future studies to ensure the higher rates of access to MMT as well as to improve the adherence to MMT. PMID:27066590

  6. Conditional Economic Incentives for Reducing HIV Risk Behaviors: Integration of Psychology and Behavioral Economics

    PubMed Central

    Operario, Don; Kuo, Caroline C.; Sosa-Rubí, Sandra G.; Gálarraga, Omar

    2014-01-01

    Objective This paper reviews psychology and behavioral economic approaches to HIV prevention, and examines the integration and application of these approaches in conditional economic incentive (CEI) programs for reducing HIV risk behavior. Methods We discuss the history of HIV prevention approaches, highlighting the important insights and limitations of psychological theories. We provide an overview of the theoretical tenets of behavioral economics that are relevant to HIV prevention, and utilize CEIs as an illustrative example of how traditional psychological theories end behavioral economics can be combined into new approaches for HIV prevention. Results Behavioral economic interventions can complement psychological frameworks for reducing HIV risk by introducing unique theoretical understandings about the conditions under which risky decisions are amenable to intervention. Findings from illustrative CEI programs show mixed but generally promising effects of economic interventions on HIV and STI prevalence, HIV testing, HIV medication adherence, and drug use. Conclusion CEI programs can complement psychological interventions for HIV prevention and behavioral risk reduction. To maximize program effectiveness, CEI programs must be designed according to contextual and population-specific factors that may determine intervention applicability and success. PMID:24001243

  7. Negative Affect, Risk Perception, and Adolescent Risk Behavior

    ERIC Educational Resources Information Center

    Curry, Laura A.; Youngblade, Lise M.

    2006-01-01

    The prevalence, etiology, and consequences of adolescent risk behavior have stimulated much research. The current study examined relationships among anger and depressive symptomatology (DS), risk perception, self-restraint, and adolescent risk behavior. Telephone surveys were conducted with 290 14- to 20-year-olds (173 females; M = 15.98 years).…

  8. Substance Use and HIV Risk in a Sample of Severely Mentally Ill Puerto Rican Women

    PubMed Central

    Sajatovic, Martha; Mendez, Nancy

    2012-01-01

    Latinos, and Puerto Ricans in particular, have been disproportionately impacted by HIV/AIDS. Severe mental illness (SMI) is associated with an increase in HIV risk. Relatively little research has focused on the role of SMI among Puerto Rican injection drug users (IDUs) and non-IDUs in susceptibility to and transmission of HIV and there are few published reports on HIV risk among Latina SMI. We conducted a longitudinal mixed methods study with 53 Puerto Rican women with schizophrenia, bipolar disorder, or major depression to examine the cultural context of HIV risk and HIV knowledge, beliefs, and behaviors among a larger study with Puerto Rican and Mexican women with serious mental illness (SMI). There was a high prevalence of past and current substance use and a high prevalence of substance use-associated HIV risk behaviors, such as unprotected sexual relations with an IDU. The violence associated with substance use frequently increased participants’ HIV risk. Choice of substance of abuse depended on cost, availability, and use within the individual participant's network. Participants attributed their substance use to the need to relieve symptoms associated with their mental illness, ameliorate unpleasant feelings, and deaden emotional pain. HIV prevention interventions for poorer Puerto Rican women with SMI must target the individuals themselves and others within their networks if the women are to be supported in their efforts to reduce substance use-related risk. The content of any intervention must address past and current trauma and its relationship to substance use and HIV risk, as well as strategies to prevent HIV transmission. PMID:21327967

  9. Venue-Based Recruitment of Women at Elevated Risk for HIV: An HIV Prevention Trials Network Study

    PubMed Central

    Golin, Carol; El-Sadr, Wafaa; Hughes, James P.; Wang, Jing; Roman Isler, Malika; Mannheimer, Sharon; Kuo, Irene; Lucas, Jonathan; DiNenno, Elizabeth; Justman, Jessica; Frew, Paula M.; Emel, Lynda; Rompalo, Anne; Polk, Sarah; Adimora, Adaora A.; Rodriquez, Lorenna; Soto-Torres, Lydia; Hodder, Sally

    2014-01-01

    Abstract Background: The challenge of identifying and recruiting U.S. women at elevated risk for HIV acquisition impedes prevention studies and services. HIV Prevention Trials Network (HPTN) 064 was a U.S. multisite, longitudinal cohort study designed to estimate HIV incidence among women living in communities with prevalent HIV and poverty. Venue-based sampling (VBS) methodologies and participant and venue characteristics are described. Methods: Eligible women were recruited from 10 U.S. communities with prevalent HIV and poverty using VBS. Participant eligibility criteria included age 18–44 years, residing in a designated census tract/zip code, and self-report of at least one high-risk personal and/or male sexual partner characteristic associated with HIV acquisition (e.g., incarceration history). Ethnography was conducted to finalize recruitment areas and venues. Results: Eight thousand twenty-nine women were screened and 2,099 women were enrolled (88% black, median age 29 years) over 14 months. The majority of participants were recruited from outdoor venues (58%), retail spaces (18%), and social service organizations (13%). The proportion of women recruited per venue category varied by site. Most participants (73%) had both individual and partner characteristics that qualified them for the study; 14% were eligible based on partner risk only. Conclusion: VBS is a feasible and effective approach to rapidly recruit a population of women at enhanced risk for HIV in the United States. Such a recruitment approach is needed in order to engage women most at risk and requires strong community engagement. PMID:24742266

  10. HIV among people who use drugs: a global perspective of populations at risk.

    PubMed

    Stockman, Jamila K; Strathdee, Steffanie A

    2010-12-01

    This article examines the epidemiology of HIV among selected subgroups of drug users around the world who are "most at risk"--men who have sex with men, female sex workers, prisoners, and mobile populations. The underlying determinants of HIV infection among these populations include stigma, physical and sexual violence, mental illness, social marginalization, and economic vulnerability. HIV interventions must reach beyond specific risk groups and individuals to address the micro-level and macro-level determinants that shape their risk environments. Public health interventions that focus on the physical, social, and health policy environments that influence HIV risk-taking in various settings are significantly more likely to impact the incidence of HIV and other blood-borne and sexually transmitted infections across larger population groups. PMID:21045594

  11. Does Powerlessness Explain Elevated HIV Risk Amongst Tajik Labor Migrants? An Ethnographic Study

    PubMed Central

    Jing, Luo; Weine, Stevan; Bahromov, Mahbat; Golobof, Alexandra

    2013-01-01

    To investigate the role of powerlessness in elevated HIV risk among labor migrants, we compared internal verses external male migrant workers from Tajikistan using minimally structured interviews and focused field observations. The sample included 30 male labor migrants who traveled to work in Regar, Tajikistan (internal labor migrants), and 30 who traveled to work in Moscow, Russia (external labor migrants). Though powerlessness did not appear to account for whether labor migrants engaged in more HIV risk behaviors, the harsh living and working conditions of external labor migration impacted how the migrants manifested these HIV risks by amplifying group masculine norms and behaviors. Progress in preventing HIV infection amid the difficult social conditions of labor migration is contingent upon adequate conceptualization of how such conditions impact HIV risk behaviors PMID:24143129

  12. Perceptions of Community HIV/ STI Risk Among U.S Women Living in Areas with High Poverty and HIV Prevalence Rates

    PubMed Central

    Blackstock, Oni J.; Frew, Paula; Bota, Dorothy; Vo-Green, Linda; Parker, Kim; Franks, Julie; Hodder, Sally L.; Justman, Jessica; Golin, Carol E.; Haley, Danielle F.; Kuo, Irene; Adimora, Adaora A.; Rompalo, Anne; Soto-Torres, Lydia; Wang, Jing; Mannheimer, Sharon B.

    2015-01-01

    Although studies have consistently demonstrated that women at high risk for HIV and non-HIV sexually transmitted infections (STIs) tend to underestimate their individual risk, little is known about how women at risk perceive their community’s HIV/STI risk. We explored perceptions of community HIV/ STI risk among U.S. women living in areas with high poverty and HIV prevalence rates as part of a qualitative substudy of the Women’s HIV SeroIncidence Study. Semi-structured focus groups were conducted. Data were coded and analyzed using the constant comparative method. Participants expressed the perception that their communities were at elevated HIV/STI risk, mostly due to contextual and structural factors such as lack of access to health care and education. Findings suggest that HIV prevention messages that target U.S. women at high risk for HIV may be strengthened by addressing the high perceived community HIV/ STI risk driven by structural factors. PMID:26320916

  13. Impact of ASUMA Intervention on HIV Risk Behaviors among Puerto Rican Adolescents

    PubMed Central

    Fernandez-Santos, Diana M.; Miranda-Diaz, Christine; Figueroa-Cosme, Wanda I.; Ramon, Raul O.; Mayor, Angel M.; Rios-Olivares, Eddy; Hunter-Mellado, Robert F.

    2015-01-01

    The purpose of this manuscript is to assess and compare HIV risk behaviors among early adolescents after a three-year pilot study. A total of 135 public and private junior high schools students completed the intervention protocol. A self-administered questionnaire was given at baseline and at the end of the third year (fourth measure). Descriptive and inferential analyses were performed using SPSS 20.0. About 60% of the students were 14 years old at the fourth measure. The proportion of students that did not report at least one HIV risk behavior at baseline and those that reported any risk behavior at the fourth measure was lower in the intervention group (45.0%) than in the control group (54.5%). The proportion of students that reported at least one HIV risk behavior at baseline and those that did not report any HIV risk behavior at the fourth measure was higher in the intervention group than in the control group (33.3% vs. 8.3%). The proportion of students engaging in HIV risk behaviors was higher in the control group than in the intervention group at the fourth measure, suggesting that A Supportive Model for HIV Risk Reduction in Early Adolescence (ASUMA) intervention might be a promising initiative to reduce adolescents’ engagement in HIV risk behaviors. PMID:26703684

  14. Impact of ASUMA Intervention on HIV Risk Behaviors among Puerto Rican Adolescents.

    PubMed

    Fernandez-Santos, Diana M; Miranda-Diaz, Christine; Figueroa-Cosme, Wanda I; Ramon, Raul O; Mayor, Angel M; Rios-Olivares, Eddy; Hunter-Mellado, Robert F

    2016-01-01

    The purpose of this manuscript is to assess and compare HIV risk behaviors among early adolescents after a three-year pilot study. A total of 135 public and private junior high schools students completed the intervention protocol. A self-administered questionnaire was given at baseline and at the end of the third year (fourth measure). Descriptive and inferential analyses were performed using SPSS 20.0. About 60% of the students were 14 years old at the fourth measure. The proportion of students that did not report at least one HIV risk behavior at baseline and those that reported any risk behavior at the fourth measure was lower in the intervention group (45.0%) than in the control group (54.5%). The proportion of students that reported at least one HIV risk behavior at baseline and those that did not report any HIV risk behavior at the fourth measure was higher in the intervention group than in the control group (33.3% vs. 8.3%). The proportion of students engaging in HIV risk behaviors was higher in the control group than in the intervention group at the fourth measure, suggesting that A Supportive Model for HIV Risk Reduction in Early Adolescence (ASUMA) intervention might be a promising initiative to reduce adolescents' engagement in HIV risk behaviors. PMID:26703684

  15. Maternal HIV-1 envelope–specific antibody responses and reduced risk of perinatal transmission

    PubMed Central

    Permar, Sallie R.; Fong, Youyi; Vandergrift, Nathan; Fouda, Genevieve G.; Gilbert, Peter; Parks, Robert; Jaeger, Frederick H.; Pollara, Justin; Martelli, Amanda; Liebl, Brooke E.; Lloyd, Krissey; Yates, Nicole L.; Overman, R. Glenn; Shen, Xiaoying; Whitaker, Kaylan; Chen, Haiyan; Pritchett, Jamie; Solomon, Erika; Friberg, Emma; Marshall, Dawn J.; Whitesides, John F.; Gurley, Thaddeus C.; Von Holle, Tarra; Martinez, David R.; Cai, Fangping; Kumar, Amit; Xia, Shi-Mao; Lu, Xiaozhi; Louzao, Raul; Wilkes, Samantha; Datta, Saheli; Sarzotti-Kelsoe, Marcella; Liao, Hua-Xin; Ferrari, Guido; Alam, S. Munir; Montefiori, David C.; Denny, Thomas N.; Moody, M. Anthony; Tomaras, Georgia D.; Gao, Feng; Haynes, Barton F.

    2015-01-01

    Despite the wide availability of antiretroviral drugs, more than 250,000 infants are vertically infected with HIV-1 annually, emphasizing the need for additional interventions to eliminate pediatric HIV-1 infections. Here, we aimed to define humoral immune correlates of risk of mother-to-child transmission (MTCT) of HIV-1, including responses associated with protection in the RV144 vaccine trial. Eighty-three untreated, HIV-1–transmitting mothers and 165 propensity score–matched nontransmitting mothers were selected from the Women and Infants Transmission Study (WITS) of US nonbreastfeeding, HIV-1–infected mothers. In a multivariable logistic regression model, the magnitude of the maternal IgG responses specific for the third variable loop (V3) of the HIV-1 envelope was predictive of a reduced risk of MTCT. Neutralizing Ab responses against easy-to-neutralize (tier 1) HIV-1 strains also predicted a reduced risk of peripartum transmission in secondary analyses. Moreover, recombinant maternal V3–specific IgG mAbs mediated neutralization of autologous HIV-1 isolates. Thus, common V3-specific Ab responses in maternal plasma predicted a reduced risk of MTCT and mediated autologous virus neutralization, suggesting that boosting these maternal Ab responses may further reduce HIV-1 MTCT. PMID:26053661

  16. Men's Behavior Predicts Women's Risks for HIV/AIDS: Multilevel Analysis of Alcohol-Serving Venues in South Africa.

    PubMed

    Pitpitan, Eileen V; Kalichman, Seth C; Eaton, Lisa A; Sikkema, Kathleen J; Watt, Melissa H; Skinner, Donald; Pieterse, Desiree

    2016-05-01

    South Africa has among the highest rates of HIV infection in the world, with women disproportionately affected. Alcohol-serving venues, where alcohol use and sexual risk often intersect, play an important role in HIV risk. Previous studies indicate alcohol use and gender inequity as drivers of this epidemic, yet these factors have largely been examined using person-level predictors. We sought to advance upon this literature by examining venue-level predictors, namely men's gender attitudes, alcohol, and sex behavior, to predict women's risks for HIV. We recruited a cohort of 554 women from 12 alcohol venues (6 primarily Black African, and 6 primarily Coloured [i.e., mixed race] venues) in Cape Town, who were followed for 1 year across four time points. In each of these venues, men's (N = 2216) attitudes, alcohol use, and sexual behaviors were also assessed. Men's attitudes and behaviors at the venue level were modeled using multilevel modeling to predict women's unprotected sex over time. We stratified analyses by venue race. As predicted, venue-level characteristics were significantly associated with women's unprotected sex. Stratified results varied between Black and Coloured venues. Among Black venues where men reported drinking alcohol more frequently, and among Coloured venues where men reported meeting sex partners more frequently, women reported more unprotected sex. This study adds to the growing literature on venues, context, and HIV risk. The results demonstrate that men's behavior at alcohol drinking venues relate to women's risks for HIV. This novel finding suggests a need for social-structural interventions that target both men and women to reduce women's risks. PMID:26768432

  17. Theorizing "Big Events" as a potential risk environment for drug use, drug-related harm and HIV epidemic outbreaks.

    PubMed

    Friedman, Samuel R; Rossi, Diana; Braine, Naomi

    2009-05-01

    Political-economic transitions in the Soviet Union, Indonesia, and China, but not the Philippines, were followed by HIV epidemics among drug users. Wars also may sometimes increase HIV risk. Based on similarities in some of the causal pathways through which wars and transitions can affect HIV risk, we use the term "Big Events" to include both. We first critique several prior epidemiological models of Big Events as inadequately incorporating social agency and as somewhat imprecise and over-generalizing in their sociology. We then suggest a model using the following concepts: first, event-specific HIV transmission probabilities are functions of (a) the probability that partners are infection-discordant; (b) the infection-susceptibility of the uninfected partner; (c) the infectivity of the infected--as well as (d) the behaviours engaged in. These probabilities depend on the distributions of HIV and other variables in populations. Sexual or injection events incorporate risk behaviours and are embedded in sexual and injection partnership patterns and community networks, which in turn are shaped by the content of normative regulation in communities. Wars and transitions can change socio-economic variables that can sometimes precipitate increases in the numbers of people who engage in high-risk drug and sexual networks and behaviours and in the riskiness of what they do. These variables that Big Events affect may include population displacement; economic difficulties and policies; police corruption, repressiveness, and failure to preserve order; health services; migration; social movements; gender roles; and inter-communal violence--which, in turn, affect normative regulation, youth alienation, networks and behaviours. As part of these pathways, autonomous action by neighbourhood residents, teenagers, drug users and sex workers to maintain their economic welfare, health or happiness may affect many of these variables or otherwise mediate whether HIV epidemics follow

  18. Factors affecting brain structure in men with HIV disease in the post-HAART era

    PubMed Central

    Maruca, Victoria; Kingsley, Lawrence A.; Sanders, Joanne M.; Alger, Jeffery R.; Barker, Peter B.; Goodkin, Karl; Martin, Eileen; Miller, Eric N.; Ragin, Ann; Sacktor, Ned; Selnes, Ola

    2011-01-01

    Introduction The purpose of this study was to characterize brain volumetric differences in HIV seropositive and seronegative men and to determine effects of age, cardiovascular risk, and HIV infection on structural integrity. Methods Magnetic resonance imaging was used to acquire high-resolution neuroanatomic data in 160 men aged 50 years and over, including 84 HIV seropositive and 76 seronegative controls. Voxel-based morphometry was used to derive volumetric measurements at the level of the individual voxel. Data from a detailed neuropsychological test battery were recombined into four summary scores representing psychomotor speed, visual memory, verbal memory, and verbal fluency. Results Both age and HIV status had a significant effect on both gray matter (GM) and white matter (WM) volume. The age-related GM atrophy was primarily in the superior temporal and inferior frontal regions; the HIV-related GM loss included the posterior and inferior temporal lobes, the parietal lobes, and the cerebellum. Among all subjects, the performance on neuropsychological tests, as indexed by a summary variable, was related to the volume of both the GM and WM. Contrary to our predictions, the CVD variables were not linked to brain volume in statistically adjusted models. Conclusion In the post-HAART era, having HIV infection is still linked to atrophy in both GM and WM. Secondly, advancing age, even in this relatively young cohort, is also linked to changes in GM and WM volume. Thirdly, CNS structural integrity is associated with overall cognitive functions, regardless of the HIV infection status of the study volunteers. PMID:21424708

  19. Gender Differences in the Rates and Correlates of HIV Risk Behaviors Among Drug Abusers

    PubMed Central

    BROOKS, AUDREY; MEADE, CHRISTINA S.; POTTER, JENNIFER SHARPE; LOKHNYGINA, YULIYA; CALSYN, DONALD A.; GREENFIELD, SHELLY F.

    2011-01-01

    This study examined gender differences in the rates and correlates of HIV risk behaviors among 1,429 clients participating in multi-site trials throughout the United States between 2001 and 2005 as part of the National Institute on Drug Abuse-funded Clinical Trials Network. Women engaged in higher risk sexual behaviors. Greater alcohol use and psychiatric severity were associated with higher risk behaviors for women, while impaired social relations were associated with decreased risk for men. Specific risk factors were differentially predictive of HIV risk behaviors for women and men, highlighting the need for gender-specific risk-reduction interventions. Limitations of the study are discussed. PMID:20536356

  20. Promotion of Latina Health: Intersectionality of IPV and Risk for HIV/AIDS.

    PubMed

    Rountree, Michele A; Granillo, Teresa; Bagwell-Gray, Meredith

    2016-04-01

    Latina women in the United States are vulnerable to two intersecting public health concerns: intimate partner violence (IPV) and subsequent risk for HIV/AIDS infection. Examination of the cultural and contextual life factors of this understudied population is crucial to developing culturally relevant HIV interventions. Focus groups with Latinas (15 monolingual; 10 bilingual) who have experienced IPV were conducted. Monolingual and bilingual Latinas endorsed that they were concerned about HIV infection, naming partner infidelity and experiences of forced and coerced sex as primary reasons for their concern. However, monolingual participants had lower levels of HIV knowledge, spending much time discussing myths of HIV infection, whereas bilingual participants spent more time discussing specific prevention techniques, including challenges related to the violence in their relationships. These findings suggest that HIV/AIDS prevention programs for Latinas need to pay close attention to the different historical, contextual, and cultural experiences of this at-risk group of women. PMID:26472666

  1. Differing HIV risks and prevention needs among men and women injection drug users (IDU) in the District of Columbia.

    PubMed

    Magnus, Manya; Kuo, Irene; Phillips, Gregory; Rawls, Anthony; Peterson, James; Montanez, Luz; West-Ojo, Tiffany; Jia, Yujiang; Opoku, Jenevieve; Kamanu-Elias, Nnemdi; Hamilton, Flora; Wood, Angela; Greenberg, Alan E

    2013-02-01

    Washington, DC has among the highest HIV/AIDS rates in the US. Gender differences among injection drug users (IDUs) may be associated with adoption of prevention opportunities including needle exchange programs, HIV testing, psychosocial support, and prevention programming. National HIV Behavioral Surveillance data on current IDUs aged ≥18 were collected from 8/09 to 11/09 via respondent-driven sampling in Washington, DC. HIV status was assessed using oral OraQuick with Western Blot confirmation. Weighted estimates were derived using RDSAT. Stata was used to characterize the sample and differences between male and female IDU, using uni-, bi-, and multivariable methods. Factors associated with HIV risk differed between men and women. Men were more likely than women to have had a history of incarceration (86.6 % vs. 66.8 %, p < 0.01). Women were more likely than men to have depressive symptoms (73.9 % vs. 47.4 %, p < 0.01), to have been physically or emotionally abused (66.1 % vs. 16.1 %, p < 0.0001), to report childhood sexual abuse (42.7 % vs. 4.7 %, p < 0.0001), and pressured or forced to have sex (62.8 % vs. 4.0 %, p < 0.0001); each of these differences was significant in the multivariable analysis. Despite a decreasing HIV/AIDS epidemic among IDU, there remain significant gender differences with women experiencing multiple threats to psychosocial health, which may in turn affect HIV testing, access, care, and drug use. Diverging needs by gender are critical to consider when implementing HIV prevention strategies. PMID:22692841

  2. Community Sexual Bridging Among Heterosexuals at High-Risk of HIV in New York City.

    PubMed

    Neaigus, Alan; Jenness, Samuel M; Reilly, Kathleen H; Youm, Yoosik; Hagan, Holly; Wendel, Travis; Gelpi-Acosta, Camila

    2016-04-01

    Community sexual bridging may influence the socio-geographic distribution of heterosexually transmitted HIV. In a cross-sectional study, heterosexual adults at high-risk of HIV were recruited in New York City (NYC) in 2010 for the Centers for Disease Control and Prevention-sponsored National HIV Behavioral Surveillance system. Eligible participants were interviewed about their HIV risk behaviors and sexual partnerships and tested for HIV. Social network analysis of the geographic location of participants' recent sexual partnerships was used to calculate three sexual bridging measures (non-redundant ties, flow-betweenness and walk-betweenness) for NYC communities (defined as United Hospital Fund neighborhoods), which were plotted against HIV prevalence in each community. The analysis sample comprised 494 participants and 1534 sexual partnerships. Participants were 60.1 % male, 79.6 % non-Hispanic black and 19.6 % Hispanic race/ethnicity; the median age was 40 years (IQR 24-50); 37.7 % had ever been homeless (past 12 months); 16.6 % had ever injected drugs; in the past 12 months 76.7 % used non-injection drugs and 90.1 % engaged in condomless vaginal or anal sex; 9.6 % tested HIV positive (of 481 with positive/negative results). Sexual partnerships were located in 33 (78.6 %) of 42 NYC communities, including 13 "high HIV-spread communities", 7 "hidden bridging communities", 0 "contained high HIV prevalence communities", and 13 "latent HIV bridging communities". Compared with latent HIV bridging communities, the population racial/ethnic composition was more likely (p < 0.0001) to be black or Hispanic in high HIV-spread communities and to be black in hidden bridging communities. High HIV-spread and hidden bridging communities may facilitate the maintenance and spread of heterosexually transmitted HIV in black and Hispanic populations in NYC. PMID:26558628

  3. Community Sexual Bridging Among Heterosexuals at High-Risk of HIV in New York City

    PubMed Central

    Jenness, Samuel M.; Reilly, Kathleen H.; Youm, Yoosik; Hagan, Holly; Wendel, Travis; Gelpi-Acosta, Camila

    2016-01-01

    Community sexual bridging may influence the socio-geographic distribution of heterosexually transmitted HIV. In a cross-sectional study, heterosexual adults at high-risk of HIV were recruited in New York City (NYC) in 2010 for the Centers for Disease Control and Prevention-sponsored National HIV Behavioral Surveillance system. Eligible participants were interviewed about their HIV risk behaviors and sexual partnerships and tested for HIV. Social network analysis of the geographic location of participants’ recent sexual partnerships was used to calculate three sexual bridging measures (non-redundant ties, flow-betweenness and walk-betweenness) for NYC communities (defined as United Hospital Fund neighborhoods), which were plotted against HIV prevalence in each community. The analysis sample comprised 494 participants and 1534 sexual partnerships. Participants were 60.1 % male, 79.6 % non-Hispanic black and 19.6 % Hispanic race/ethnicity; the median age was 40 years (IQR 24–50); 37.7 % had ever been homeless (past 12 months); 16.6 % had ever injected drugs; in the past 12 months 76.7 % used non-injection drugs and 90.1 % engaged in condomless vaginal or anal sex; 9.6 % tested HIV positive (of 481 with positive/negative results). Sexual partnerships were located in 33 (78.6 %) of 42 NYC communities, including 13 “high HIV-spread communities”, 7 “hidden bridging communities”, 0 “contained high HIV prevalence communities”, and 13 “latent HIV bridging communities”. Compared with latent HIV bridging communities, the population racial/ethnic composition was more likely (p < 0.0001) to be black or Hispanic in high HIV-spread communities and to be black in hidden bridging communities. High HIV-spread and hidden bridging communities may facilitate the maintenance and spread of heterosexually transmitted HIV in black and Hispanic populations in NYC. PMID:26558628

  4. Relationships Among HIV Infection, Metabolic Risk Factors, and Left Ventricular Structure and Function

    PubMed Central

    Overton, Edgar Turner; Mondy, Kristin; de las Fuentes, Lisa; Davila-Roman, Victor G.; Waggoner, Alan D.; Reeds, Dominic N.; Lassa-Claxton, Sherry; Krauss, Melissa J.; Peterson, Linda R.; Yarasheski, Kevin E.

    2013-01-01

    Abstract Our objective was to determine if the presence of metabolic complications (MC) conveyed an additional risk for left ventricular (LV) dysfunction in people with HIV. HIV+ and HIV− men and women were categorized into four groups: (1) HIV+ with MC (43±7 years, n=64), (2) HIV+ without MC (42±7 years, n=59), (3) HIV− with MC (44±8 years, n=37), or (4) HIV− controls without MC (42±8 years, n=41). All participants underwent two-dimensional (2-D), Doppler, and tissue Doppler echocardiography. Overall, the prevalence of systolic dysfunction (15 vs. 4%, p=0.02) and LV hypertrophy (9 vs. 1%, p=0.03) was greater in HIV+ than in HIV− participants. Participants with MC had a greater prevalence of LV hypertrophy (10% vs. 1%). Early mitral annular velocity during diastole was significantly (p<0.005) lower in groups with MC (HIV+/MC+: 11.6±2.3, HIV−/MC+: 12.0±2.3 vs. HIV+/MC−: 12.4±2.3, HIV−/MC−: 13.1±2.4 cm/s) and tended to be lower in groups with HIV (p=0.10). However, there was no interaction effect of HIV and MC for any systolic or diastolic variable. Regardless of HIV status, participants with MC had reduced LV diastolic function. Although both the presence of MC and HIV infection were associated with lower diastolic function, there was no additive negative effect of HIV on diastolic function beyond the effect of MC. Also, HIV was independently associated with lower systolic function. Clinical monitoring of LV function in individuals with metabolic risk factors, regardless of HIV status, is warranted. PMID:23574474

  5. The Effect of Relationship Characteristics on HIV Risk Behaviors and Prevention Strategies in Young Gay and Bisexual Men.

    PubMed

    Cuervo, Migling; Whyte, James

    2015-01-01

    We examined whether relationship status, relationship ideation, and sexual agreements affected HIV/sexually transmitted disease (STD) prevention strategies and high-risk behaviors in young men who have sex with men (MSM). Using an online survey, we found that partnered MSM more commonly used condoms with casual partners and knew the reported HIV status of all their partners, compared to single MSM (p < .05). Men scoring high in relationship exclusivity reported higher condom use with casual partners compared to men scoring lower (p < .05). Of partnered MSM, 58% reported a sexual agreement. MSM reporting restricted sexual agreements more commonly used condoms during oral and anal intercourse with their main partners and casual partners compared to MSM reporting unrestricted sexual agreements. The data suggest that relationship status should be considered by health care providers when counseling MSM and that behavioral interventions should target sexual agreements as a mechanism to reduce HIV/STD transmission. PMID:26066694

  6. Felt Stigma in Injection Drug Users and Sex Workers: Focus Group Research with HIV-Risk Populations in Puerto Rico

    PubMed Central

    Jiménez, Julio; Puig, Marieva; Sala, Ana Cecilia; Ramos, Juan Carlos; Castro, Eida; Morales, Marangelie; Santiago, Lydia; Zorrilla, Carmen

    2016-01-01

    Though many studies have conclusively linked felt stigma and HIV, few have focused on the experiences of rejection felt by members of such socially marginalized groups as intravenous drug users (IDU) and sex workers (SW). Using focus groups, our study explored these experiences in 34 individuals (17 male UDUs and 17 female SWs) at risk of becoming infected with HIV, the objective being to discover why they engaged in maladaptive behaviors as a way of coping with felt stigma. We used deductive and inductive analysis to codify the resulting data. Concepts associated with the word stigma, emotional reactions to felt stigma, and the impact of felt stigma on self-schema helped elucidate how the internalization of felt stigma can lead to negative affective states and self-destructive behaviors (e.g., drug use and syringe exchange). Results underline the importance of developing intervention models that reduce stigma as a means of HIV prevention in vulnerable populations. PMID:27013930

  7. Psychosocial predictors of self-esteem in a multiethnic sample of women over 50 at risk for HIV.

    PubMed

    Jacobs, Robin J; Kane, Michael N

    2011-01-01

    Self-esteem is linked to high-risk behaviors in other populations but has not been examined in women aged 50 and older. This study explored how self-esteem is related to variables that can influence high-risk sexual behaviors in women over 50. A multiethnic community-based sample of 572 women aged 50 and older completed an anonymous questionnaire on sexual behaviors, sociodemographic characteristics, and psychosocial measures relevant to midlife and older women. Regression analysis showed sensation-seeking, HIV stigma, sexual assertiveness, and self-silencing predicted self-esteem in women over 50 (F = 43.632, p < .001). Factors such as relational context, interpersonal power, and silencing can affect self-esteem and may be contributing to HIV risk in this group. PMID:21271442

  8. Stable complex formation between HIV Rev and the nucleosome assembly protein, NAP1, affects Rev function

    SciTech Connect

    Cochrane, Alan; Murley, Laura Lea; Gao Mian; Wong, Raymond; Clayton, Kiera; Brufatto, Nicole; Canadien, Veronica; Mamelak, Daniel; Chen, Tricia; Richards, Dawn; Zeghouf, Mahel; Greenblatt, Jack; Burks, Christian; Frappier, Lori

    2009-05-25

    The Rev protein of HIV-1 is essential for HIV-1 proliferation due to its role in exporting viral RNA from the nucleus. We used a modified version of tandem affinity purification (TAP) tagging to identify proteins interacting with HIV-1 Rev in human cells and discovered a prominent interaction between Rev and nucleosome assembly protein 1 (Nap1). This interaction was also observed by specific retention of Nap1 from human cell lysates on a Rev affinity column. Nap1 was found to bind Rev through the Rev arginine-rich domain and altered the oligomerization state of Rev in vitro. Overexpression of Nap1 stimulated the ability of Rev to export RNA, reduced the nucleolar localization of Rev, and affected Rev nuclear import rates. The results suggest that Nap-1 may influence Rev function by increasing the availability of Rev.

  9. HIV and AIDS in suburban Asian and Pacific Islander communities: factors influencing self-efficacy in HIV risk reduction.

    PubMed

    Takahashi, Lois M; Magalong, Michelle G; Debell, Paula; Fasudhani, Angela

    2006-12-01

    Though AIDS case rates among Asian Pacific Islander Americans (APIs) in the United States remain relatively low, the number has been steadily increasing. Scholars, policy makers, and service providers still know little about how confident APIs are in carrying out different HIV risk reduction strategies. This article addresses this gap by presenting an analysis of a survey of API women and youth in Orange County, California (N = 313), a suburban county in southern California with large concentrations of Asian residents. Multivariate logistic regression models using subsamples of API women and API youth respondents were used. Variations in reported self-efficacy for female respondents were explained by acculturation, comfort in asking medical practitioners about HIV/AIDS, and to a lesser degree, education, household size, whether respondents were currently dating, HIV knowledge, and whether respondents believed that HIV could be identified by physical appearance. For respondents younger than 25 years, variations in self-efficacy were related to gender, age, acculturation, HIV knowledge, taking-over-the-counter medicines for illness, whether respondents were dating, and to a lesser degree, employment, recent serious illness, whether they believe that one could identify HIV by how one looks, and believing that illness was caused by germs. Implications for HIV prevention programs and future research are provided. PMID:17166079

  10. Repeat HIV Testing at Voluntary Testing and Counseling Centers in Croatia: Successful HIV Prevention or Failure to Modify Risk Behaviors?

    PubMed Central

    Matković Puljić, Vlatka; Kosanović Ličina, Mirjana Lana; Kavić, Marija; Nemeth Blažić, Tatjana

    2014-01-01

    HIV testing plays a critical role in preventing the spread of the virus and identifying infected individuals in need of care. Voluntary counseling and testing centers (VCTs) not only conduct testing but they also provide counseling. Since a proportion of people who test negative for HIV on their previous visit will return for retesting, the frequency of retesting and the characteristics of those who retest may provide insights into the efficacy of testing and counseling strategies. In this cross-sectional, retrospective study of 1,482 VCT clients in Croatia in 2010, 44.3% had been tested for HIV before. The rate of repeat HIV testing is lower in Croatia than in other countries. Men who have sex with men (MSM) clients, those with three or more sexual partners in the last 12 months, consistent condom users with steady partners, and intravenous drug users were more likely to be repeat testers. This finding suggests that clients presenting for repeat HIV testing are those who self-identify as being at a higher risk of infection. Our data showed that testing positive for HIV was not associated with repeat testing. However, the effects of repeat testing on HIV epidemiology needs to be explored. PMID:24705595

  11. HIV testing among heterosexuals at elevated risk for HIV in the District of Columbia: has anything changed over time?

    PubMed Central

    Kuo, Irene; Magnus, Manya; Phillips, Gregory; Castel, Amanda; Opoku, Jenevieve; Peterson, James; Jia, Yujiang; West, Tiffany; Greenberg, Alan

    2016-01-01

    The District of Columbia launched a routine HIV testing initiative in 2006. We examined HIV testing behaviors among heterosexuals at risk for HIV over time using CDC National HIV Behavioral Surveillance data from Washington, DC for the heterosexual cycles from 2006-7 (“Cycle 1”) and 2010 (“Cycle 2”). Past year and past two-year HIV testing across study cycles were compared using chi-square tests. Weighted multivariable logistic regression identified correlates of past year testing. The majority of participants across both cycles were black and female. Cycle 1 participants were significantly more likely to have ≥4 partners in the past year, casual sex partners, and have anal sex at last sexual encounter (p<0.05). Lifetime testing was high, and individuals from Cycle 2 versus Cycle 1 were more likely to have been tested in the past two years. There were no significant differences in past year testing or being offered the HIV test at last health care visit by cycle. Independent correlates of past year testing were seeing a health care provider in the past year and using condoms at last vaginal sex. In conclusion, although past year testing did not differ between the two data collection years, the proportion of heterosexuals testing in the past two years was higher in Cycle 2 versus Cycle 1, suggesting successful expansion of HIV testing between the two time periods. PMID:24057933

  12. Sexuality, Sexual Practices, and HIV Risk among Incarcerated African-American Women in North Carolina

    PubMed Central

    Farel, Claire E.; Parker, Sharon D.; Muessig, Kathryn E.; Grodensky, Catherine A.; Jones, Chaunetta; Golin, Carol E.; Fogel, Catherine I.; Wohl, David A.

    2013-01-01

    Background Women who have been in prison carry a greater lifetime risk of HIV for reasons that are not well understood. This effect is amplified in the Southeastern United States, where HIV incidence and prevalence is especially high among African American (AA) women. The role of consensual sexual partnerships in the context of HIV risk, especially same-sex partnerships, merits further exploration. Methods We conducted digitally recorded qualitative interviews with 29 AA women (15 HIV-positive, 14 HIV-negative) within three months after entry into the state prison system. We explored potential pre-incarceration HIV risk factors, including personal sexual practices. Two researchers thematically coded interview transcripts and a consensus committee reviewed coding. Results Women reported complex sexual risk profiles during the six months prior to incarceration, including sex with women as well as prior sexual partnerships with both men and women. Condom use with primary male partners was low and a history of transactional sex work was prevalent. These behaviors were linked to substance use, particularly among HIV-positive women. Conclusions Although women may not formally identify as bisexual or lesbian, sex with women was an important component of this cohort’s sexuality. Addressing condom use, heterogeneity of sexual practices, and partner concurrency among at-risk women should be considered for reducing HIV acquisition and preventing forward transmission in women with a history of incarceration. PMID:24183410

  13. Comprehensively Assessing Cognitive and Behavioral Risks for HIV Infection among Middle-Aged and Older Adults

    ERIC Educational Resources Information Center

    Paniagua, Freddy A.; O'Boyle, Michael

    2008-01-01

    A comprehensive survey of HIV/AIDS with middle-aged and older adults should include six domains (e.g., factual knowledge regarding the acquisition and transmission of HIV, traditionally-accepted behavioral risks for HIV infection). A sample of 23 women (54.8%) and 19 men (45.2%), ranging in age from 51 to 85 were surveyed across such domains.…

  14. Combining social and genetic networks to study HIV transmission in mixing risk groups

    NASA Astrophysics Data System (ADS)

    Zarrabi, Narges; Prosperi, Mattia C. F.; Belleman, Robbert G.; Di Giambenedetto, Simona; Fabbiani, Massimiliano; De Luca, Andrea; Sloot, Peter M. A.

    2013-09-01

    Reconstruction of HIV transmission networks is important for understanding and preventing the spread of the virus and drug resistant variants. Mixing risk groups is important in network analysis of HIV in order to assess the role of transmission between risk groups in the HIV epidemic. Most of the research focuses on the transmission within HIV risk groups, while transmission between different risk groups has been less studied. We use a proposed filter-reduction method to infer hypothetical transmission networks of HIV by combining data from social and genetic scales. We modified the filtering process in order to include mixing risk groups in the model. For this, we use the information on phylogenetic clusters obtained through phylogenetic analysis. A probability matrix is also defined to specify contact rates between individuals form the same and different risk groups. The method converts the data form each scale into network forms and combines them by overlaying and computing their intersection. We apply this method to reconstruct networks of HIV infected patients in central Italy, including mixing between risk groups. Our results suggests that bisexual behavior among Italian MSM and IDU partnership are relatively important in heterosexual transmission of HIV in central Italy.

  15. Dual HIV risk: receptive syringe sharing and unprotected sex among HIV-negative injection drug users in New York City.

    PubMed

    Neaigus, Alan; Reilly, Kathleen H; Jenness, Samuel M; Hagan, Holly; Wendel, Travis; Gelpi-Acosta, Camila

    2013-09-01

    HIV-negative injection drug users (IDUs) who engage in both receptive syringe sharing and unprotected sex ("dual HIV risk") are at high risk of HIV infection. In a cross-sectional study conducted in New York City in 2009, active IDUs aged ≥18 years were recruited using respondent-driven sampling, interviewed, and tested for HIV. Participants who tested HIV-negative and did not self-report as positive were analyzed (N = 439). Adjusted odds ratios (aOR) and 95 % confidence intervals (95 % CI) were estimated using multinomial logistic regression. The sample was: 77.7 % male; 54.4 % Hispanic, 36.9 % white, and 8.7 % African-American/black. Dual risk was engaged in by 26.2 %, receptive syringe sharing only by 3.2 %, unprotected sex only by 49.4 %, and neither by 21.2 %. Variables independently associated with engaging in dual risk versus neither included Hispanic ethnicity (vs. white) (aOR = 2.0, 95 % CI = 1.0-4.0), married or cohabiting (aOR = 6.3, 95 % CI = 2.5-15.9), homelessness (aOR = 3.4, 95 % CI = 1.6-7.1), ≥2 sex partners (aOR = 8.7, 95 % CI = 4.4-17.3), ≥2 injecting partners (aOR = 2.9, 95 % CI = 1.5-5.8), and using only sterile syringe sources (protective) (aOR = 0.5, 95 % CI = 0.2-0.9). A majority of IDUs engaged in HIV risk behaviors, and a quarter in dual risk. Interventions among IDUs should simultaneously promote the consistent use of sterile syringes and of condoms. PMID:23640654

  16. Prevalence of HCV and HIV infections in 2005-Earthquake-affected areas of Pakistan

    PubMed Central

    Khan, Saeed; Rai, Mohammad A; Khan, Adnan; Farooqui, Amber; Kazmi, Shahana U; Ali, Syed H

    2008-01-01

    Background On October 8, 2005, an earthquake of magnitude 7.6 hit the Northern parts of Pakistan. In the post-earthquake scenario, overcrowding, improper sewage disposal, contamination of food and drinking water, hasty surgical procedures, and unscreened blood transfusions to earthquake victims most likely promotes the spread of infections already prevalent in the area. Objective The objective of the study reported here was to determine the prevalence of Human Immunodeficiency and Hepatitis C viruses (respectively, HIV and HCV) in the earthquake-affected communities of Pakistan. The samples were analyzed 2 months and then again 11 months after the earthquake to estimate the burden of HIV and HCV in these areas, and to determine any rise in the prevalence of these viral infections as a result of the earthquake. Methods Blood samples were initially collected during December, 2005 to March 2006, from 245 inhabitants of the earthquake-affected areas. These samples were screened for HCV and HIV, using immunochromatography and Enzyme-Linked Immuno-Sorbent Assay (ELISA). Results Out of 245 samples tested, 8 (3.26%) were found positive for HCV, and 0 (0.0%) for HIV, indicating the existence of HCV infection in the earthquake-stricken areas. The same methods were used to analyze the samples collected in the second round of screening in the same area, in September, 2006 – 11 months after the earthquake. This time 290 blood samples were collected, out of which 16 (5.51%) samples were positive for HCV, and 0 for HIV. Conclusion A slightly higher prevalence of HCV was recorded 11 months after the earthquake; this increase, however, was not statistically significant. None of the study participants was found HIV-infected. PMID:18954443

  17. Gendered differences in the perceived risks and benefits of oral PrEP among HIV-serodiscordant couples in Kenya.

    PubMed

    Carroll, Jennifer J; Ngure, Kenneth; Heffron, Renee; Curran, Kathryn; Mugo, Nelly R; Baeten, Jared M

    2016-08-01

    Pre-exposure prophylaxis (PrEP) is effective for preventing HIV among HIV-serodiscordant heterosexual couples. Gender roles may influence perceived personal and social risks related to HIV-prevention behaviors and may affect use of PrEP. In this study, interviews and focus groups were conducted with 68 individuals from 34 mutually disclosed serodiscordant heterosexual partnerships in Thika, Kenya. Sociocultural factors that affect adherence to PrEP were explored using grounded analysis. Three factors were identified, which shape perceptions of PrEP: gendered power dynamics and control over decision-making in the household; conflicts between risk-reduction strategies and male sexual desire; culture-bound definitions of women's work. Adherence to PrEP in the Partners PrEP Study was high; however, participants articulated conflicting interests related to PrEP in connection with traditional gender roles. The successful delivery of PrEP will require understanding of key social factors, particularly related to gender and dyadic dynamics around HIV serostatus. PMID:26754017

  18. Gender relations and risks of HIV transmission in South India: the discourse of female sex workers' clients.

    PubMed

    Aubé-Maurice, Joanne; Clément, Michèle; Bradley, Janet; Lowndes, Catherine M; Gurav, Kaveri; Alary, Michel

    2012-01-01

    In South India, where the majority of the country's cases of HIV are concentrated, transmission of infection occurs mainly within networks composed of female sex workers, their clients and the other sexual partners of the latter. This study aims to determine how gender relations affect the risks of HIV transmission in this region. Semi-structured interviews were carried out with 30 clients and analysed qualitatively. Results show that clients perceive sexual relations with female sex workers as a vice involving loss of control and contact with women at the bottom of the social ladder. Paradoxically, this sometimes allows them to conform to the masculine ideal, in giving sexual satisfaction to a woman, in a context of incompatibility between the idealised and actual masculine and feminine archetypes. Attitudes to condoms, affected by various facets of the client-female sex worker relationship, are indicators of the link between this relationship and the risks of contracting HIV. The results suggest that there is a need for expanding targeted HIV prevention towards clients and female sex workers alongside more general interventions on gender issues, particularly among young people, focusing on the structural elements moulding current relations between men and women, with particular consideration of local cultural characteristics. PMID:22574910

  19. Sexual HIV risk behaviour and associated factors among pregnant women in Mpumalanga, South Africa

    PubMed Central

    2013-01-01

    Background The HIV risk increases during pregnancy. The elevated risk of HIV acquisition in pregnant women may be explained by behavioural and other factors. The aim of this study was to assess sexual HIV risk behaviour and its associated factors among pregnant women in Mpumalanga, South Africa. Methods A cross-sectional study was conducted among 1 502 pregnant women (age range 18–47 years, mean age 26.6 years, standard deviation (SD) 6.1, and the mean gestational age was 6.5 months (SD 1.6). Antenatal women were selected, using systematic sampling from 63 primary care clinics and community health centres in Nkangala District. Data were collected by using a structured questionnaire and multivariate logistic regression analysis was used. Results The majority (63%) of the participants had never used a condom with their primary sexual partner in the past 3 months, 60% were not aware of the HIV status of their sexual partner, 7.6% had a casual sexual partner in the past 3 months, 20% had two or more sexual partners in the past 12 months and 17.3% reported to have been diagnosed with a sexually transmitted infection (STI) (other than HIV) in the past 12 months. The various HIV risk behaviours were predicted, by being single and alcohol use for multiple sexual partners; by fewer antenatal visits, being HIV negative and not having used alcohol for lack of condom use; by being HIV positive, having experienced physical partner violence and psychological distress for having been diagnosed with a sexually transmitted infection (other than HIV); and by lower education, unplanned pregnancy, non-antenatal care attendance by expectant father, the belief that antiretrovirals can cure HIV and being HIV positive for having a partner with HIV positve or unknown status. Conclusion High levels of sexual HIV risk behaviour were found during pregnancy. Pregnant women need to be informed of their increased risk of HIV and the importance of sexual HIV risk reduction including the

  20. Social ecological factors associated with future orientation of children affected by parental HIV infection and AIDS.

    PubMed

    Lin, Xiuyun; Fang, Xiaoyi; Chi, Peilian; Heath, Melissa Allen; Li, Xiaoming; Chen, Wenrui

    2016-07-01

    From a social ecological perspective, this study examined the effects of stigma (societal level), trusting relationships with current caregivers (familial level), and self-esteem (individual level) on future orientation of children affected by HIV infection and AIDS. Comparing self-report data from 1221 children affected by parental HIV infection and AIDS and 404 unaffected children, affected children reported greater stigma and lower future orientation, trusting relationships, and self-esteem. Based on structural equation modeling, stigma experiences, trusting relationships, and self-esteem had direct effects on future orientation, with self-esteem and trusting relationships partially mediating the effect of stigma experiences on children's future orientation. Implications are discussed. PMID:25370572

  1. Association of HIV-1 Envelope-Specific Breast Milk IgA Responses with Reduced Risk of Postnatal Mother-to-Child Transmission of HIV-1

    PubMed Central

    Pollara, Justin; McGuire, Erin; Fouda, Genevieve G.; Rountree, Wes; Eudailey, Josh; Overman, R. Glenn; Seaton, Kelly E.; Deal, Aaron; Edwards, R. Whitney; Tegha, Gerald; Kamwendo, Deborah; Kumwenda, Jacob; Nelson, Julie A. E.; Liao, Hua-Xin; Brinkley, Christie; Denny, Thomas N.; Ochsenbauer, Christina; Ellington, Sascha; King, Caroline C.; Jamieson, Denise J.; van der Horst, Charles; Kourtis, Athena P.; Tomaras, Georgia D.; Ferrari, Guido

    2015-01-01

    ABSTRACT Infants born to HIV-1-infected mothers in resource-limited areas where replacement feeding is unsafe and impractical are repeatedly exposed to HIV-1 throughout breastfeeding. Despite this, the majority of infants do not contract HIV-1 postnatally, even in the absence of maternal antiretroviral therapy. This suggests that immune factors in breast milk of HIV-1-infected mothers help to limit vertical transmission. We compared the HIV-1 envelope-specific breast milk and plasma antibody responses of clade C HIV-1-infected postnatally transmitting and nontransmitting mothers in the control arm of the Malawi-based Breastfeeding Antiretrovirals and Nutrition Study using multivariable logistic regression modeling. We found no association between milk or plasma neutralization activity, antibody-dependent cell-mediated cytotoxicity, or HIV-1 envelope-specific IgG responses and postnatal transmission risk. While the envelope-specific breast milk and plasma IgA responses also did not reach significance in predicting postnatal transmission risk in the primary model after correction for multiple comparisons, subsequent exploratory analysis using two distinct assay methodologies demonstrated that the magnitudes of breast milk total and secretory IgA responses against a consensus HIV-1 envelope gp140 (B.con env03) were associated with reduced postnatal transmission risk. These results suggest a protective role for mucosal HIV-1 envelope-specific IgA responses in the context of postnatal virus transmission. This finding supports further investigations into the mechanisms by which mucosal IgA reduces risk of HIV-1 transmission via breast milk and into immune interventions aimed at enhancing this response. IMPORTANCE Infants born to HIV-1-infected mothers are repeatedly exposed to the virus in breast milk. Remarkably, the transmission rate is low, suggesting that immune factors in the breast milk of HIV-1-infected mothers help to limit transmission. We compared the antibody

  2. Perceptions of HIV Risk and Explanations of Sexual Risk Behavior Offered by Heterosexual Black Male Barbershop Patrons in Brooklyn, NY

    PubMed Central

    Taylor, Tonya N.; Joseph, Michael; Henny, Kirk D.; Pinto, Angelo R.; Agbetor, Francis; Camilien, Brignel; Williams, Kim M.; Browne, Ruth C.; White, Marilyn; Gousse, Yolene; Brown, Humberto; Taylor, Raekiela D.; Wilson, Tracey E.

    2015-01-01

    To describe HIV risk factors among adult heterosexual Black men recruited from four barbershops located in high HIV seroprevalent neighborhoods of Brooklyn, NY. Data on HIV-risk related behaviors and other characteristics were collected from barbershop clients. All participants (n=60) completed brief risk assessments; and a subset (n=22) also completed focus groups and/or individual interviews. Of the subset of 22 men, 68% were US born, 59% had been in jail/prison, 32% were unemployed; and during the 3 months before the interviews, 68% reported at least two partners and 45% reported unprotected vaginal or anal sex with two or more women. Emergent themes included: 1) the psychological function of multiple partnerships; 2) calculated risk taking regarding condom use; 3) the role of emotional attachment and partner trust in condom use; 4) low perceived HIV risk and community awareness; and 5) lack of relationship between HIV testing and safer sex practices. Interventions among heterosexual Black men should focus not only on increasing HIV awareness and reducing sexual risk, but also on contextual and interpersonal factors that influence sexual risk. PMID:25699198

  3. Deliberative and spontaneous cognitive processes associated with HIV risk behavior

    PubMed Central

    Ames, Susan L.; Stacy, Alan W.

    2012-01-01

    Dual process models of decision-making suggest that behavior is mediated by a spontaneous behavior selection process or by a more deliberative evaluation of behavioral options. We examined whether the deliberative system moderates the influence of spontaneous cognition on HIV-risk behaviors. A measure of spontaneous sex-related associations (word association), a measure of deliberative working memory capacity (operation span), and two measures of sexual behavior (condom use and multiple partners) were assessed in a cross-sectional study among 490 adult drug offenders. Significant effects were observed among men but not among women in two latent interaction models. In a novel finding, the accessibility of spontaneous safe sex-related associations was significantly more predictive of condom use among men with higher working memory capacity than among men with lower capacity. These results have implications for the design of interventions to promote safe sex practices. PMID:22331437

  4. Health Costs of Wealth Gains: Labor Migration and Perceptions of HIV/AIDS Risks in Mozambique

    PubMed Central

    Agadjanian, Victor; Arnaldo, Carlos; Cau, Boaventura

    2012-01-01

    The study employs survey data from rural Mozambique to examine how men’s labor migration affects their non-migrating wives’ perceptions of HIV/AIDS risks. Using a conceptual framework centered on tradeoffs between economic security and health risks that men’s migration entails for their left-behind wives, it compares women married to migrants and those married to non-migrants while also distinguishing between economically successful and unsuccessful migration. The analysis finds that the economic success of men’s migration, rather than migration itself, significantly predicts women’s worries about getting infected by their husbands or their own extramarital partners, and their husbands’ stance on condom use. These findings are situated within a broader context of socio-economic, gender, and marital dynamics and vulnerabilities produced or amplified by male labor migration in sub-Saharan and similar developing settings. PMID:22500057

  5. The Moderating Effect of Marijuana Use on the Relationship between Delinquent Behavior and HIV Risk among Adolescents in Foster Care

    PubMed Central

    Auslander, Wendy F.; Thompson, Ronald G.; Gerke, Donald R.

    2014-01-01

    Adolescents in foster care experience mental health and substance use problems that place them at risk for HIV, yet the exact nature of the relationship remains unclear. This study examined the co-occurring influences of mental health problems and substance use on HIV risk and determined whether substance use moderated the effect of mental health problems on HIV risk behaviors among adolescents in foster care. Regression analyses of cross-sectional data collected through structured interviews with 334 adolescents, aged 15–18 years, determined which mental health problems and substances increased HIV risk behaviors. Adolescents with delinquency and anxiety/depression engaged in significantly more HIV risk behaviors than their counterparts, controlling for race, gender, and type of childhood abuse. Further, any marijuana use significantly moderated the effects of delinquent behaviors on HIV risk, differentially increasing HIV risk among those who engaged in delinquent behaviors. PMID:25214818

  6. Generational Sex And HIV Risk Among Indigenous Women In A Street-Based Urban Canadian Setting

    PubMed Central

    Bingham, Brittany; Leo, Diane; Zhang, Ruth; Montaner, Julio

    2014-01-01

    In Canada, indigenous women are overrepresented among new HIV infections and street-based sex workers. Scholars suggest that Aboriginal women’s HIV risk stems from intergenerational effects of colonisation and racial policies. This research examined generational sex work involvement among Aboriginal and non-Aboriginal women and the effect on risk for HIV acquisition. The sample included 225 women in street-based sex work and enrolled in a community-based prospective cohort, in partnership with local sex work and Aboriginal community partners. Bivariate and multivariate logistic regression modeled an independent relationship between Aboriginal ancestry and generational sex work; and the impact of generational sex work on HIV infection among Aboriginal sex workers. Aboriginal women (48%) were more likely to be HIV-positive, with 34% living with HIV compared to 24% non-Aboriginal. In multivariate logistic regression model, Aboriginal women remained 3 times more likely to experience generational sex work (aOR:2.97; 95%CI:1.5,5.8). Generational sex work was significantly associated with HIV (aOR=3.01, 95%CI: 1.67–4.58) in a confounder model restricted to Aboriginal women. High prevalence of generational sex work among Aboriginal women and 3-fold increased risk for HIV infection are concerning. Policy reforms and community-based, culturally safe and trauma informed HIV prevention initiatives are required for Indigenous sex workers. PMID:24654881

  7. Exploring Factors Associated with Recent HIV Testing among Heterosexuals at High Risk for HIV Infection Recruited with Venue-based Sampling

    PubMed Central

    Gwadz, Marya; Cleland, Charles M.; Jenness, Samuel M.; Silverman, Elizabeth; Hagan, Holly; Ritchie, Amanda S.; Leonard, Noelle R.; McCright-Gill, Talaya; Martinez, Belkis; Swain, Quentin; Kutnick, Alexandra; Sherpa, Dawa

    2016-01-01

    Annual HIV testing is recommended for high-risk populations in the United States, to identify HIV infections early and provide timely linkage to treatment. However, heterosexuals at high risk for HIV, due to their residence in urban areas of high poverty and elevated HIV prevalence, test for HIV less frequently than other risk groups, and late diagnosis of HIV is common. Yet the factors impeding HIV testing in this group, which is predominantly African American/Black and Latino/Hispanic, are poorly understood. The present study addresses this gap. Using a systematic community-based sampling method, venue-based sampling (VBS), we estimate rates of lifetime and recent (past year) HIV testing among high-risk heterosexuals (HRH), and explore a set of putative multi-level barriers to and facilitators of recent testing, by gender. Participants were 338 HRH African American/Black and Latino/Hispanic adults recruited using VBS, who completed a computerized structured assessment battery guided by the Theory of Triadic Influence, comprised of reliable/valid measures on socio-demographic characteristics, HIV testing history, and multi-level barriers to HIV testing. Logistic regression analysis was used to identify factors associated with HIV testing within the past year. Most HRH had tested at least once (94%), and more than half had tested within the past year (58%), but only 37% tested annually. In both men and women, the odds of recent testing were similar and associated with structural factors (better access to testing) and sexually transmitted infection (STI) testing and diagnosis. Thus VBS identified serious gaps in rates of annual HIV testing among HRH. Improvements in access to high-quality HIV testing and leveraging of STI testing are needed to increase the proportion of HRH testing annually for HIV. Such improvements could increase early detection of HIV, improve the long-term health of individuals, and reduce HIV transmission by increasing rates of viral

  8. Gender and HIV risk behavior among intravenous drug users in Sichuan Province, China.

    PubMed

    Choi, Susanne Y P; Cheung, Yuet Wah; Chen, Kanglin

    2006-04-01

    Using data from a community-based study of injection drug users (IDUs) in Sichuan Province in China, this study compared the level of HIV risk behavior (needle sharing and unsafe sex) amongst female and male IDUs, and examined the risk factors separately for these two groups. Five risk factors were examined in the analysis, including a lack of family support, having an IDU primary sex partner, economic pressure, lack of access to a methadone program, and younger age. Regression results showed that male and female IDUs had different risk factors. For male IDUs, younger age and a lack of family support increased their level of HIV risk behavior. For female IDUs, having an IDU primary sex partner and economic pressure were predictive of their HIV risk behavior. Sex differences in risk factors are explained with respect to gender norms surrounding HIV risk behavior in the context of social relations. Female IDUs who were sex workers suffered additional HIV risk due to their powerlessness in negotiating safe sex with male customers. Practical implications of the findings for HIV/AIDS prevention and intervention work in China are discussed. PMID:16185801

  9. Dual process interaction model of HIV-risk behaviors among drug offenders.

    PubMed

    Ames, Susan L; Grenard, Jerry L; Stacy, Alan W

    2013-03-01

    This study evaluated dual process interaction models of HIV-risk behavior among drug offenders. A dual process approach suggests that decisions to engage in appetitive behaviors result from a dynamic interplay between a relatively automatic associative system and an executive control system. One synergistic type of interplay suggests that executive functions may dampen or block effects of spontaneously activated associations. Consistent with this model, latent variable interaction analyses revealed that drug offenders scoring higher in affective decision making were relatively protected from predictive effects of spontaneous sex associations promoting risky sex. Among drug offenders with lower levels of affective decision making ability, spontaneous sexually-related associations more strongly predicted risky sex (lack of condom use and greater number of sex partners). These findings help elucidate associative and control process effects on appetitive behaviors and are important for explaining why some individuals engage in risky sex, while others are relatively protected. PMID:22331391

  10. Dual Process Interaction Model of HIV-Risk Behaviors Among Drug Offenders

    PubMed Central

    Grenard, Jerry L.; Stacy, Alan W.

    2012-01-01

    This study evaluated dual process interaction models of HIV-risk behavior among drug offenders. A dual process approach suggests that decisions to engage in appetitive behaviors result from a dynamic interplay between a relatively automatic associative system and an executive control system. One synergistic type of interplay suggests that executive functions may dampen or block effects of spontaneously activated associations. Consistent with this model, latent variable interaction analyses revealed that drug offenders scoring higher in affective decision making were relatively protected from predictive effects of spontaneous sex associations promoting risky sex. Among drug offenders with lower levels of affective decision making ability, spontaneous sexually-related associations more strongly predicted risky sex (lack of condom use and greater number of sex partners). These findings help elucidate associative and control process effects on appetitive behaviors and are important for explaining why some individuals engage in risky sex, while others are relatively protected. PMID:22331391

  11. Risk factors affecting dental implant survival.

    PubMed

    Vehemente, Valerie A; Chuang, Sung-Kiang; Daher, Shadi; Muftu, Ali; Dodson, Thomas B

    2002-01-01

    Given the predictability of dental implant success, the attention of the scientific community is moving from descriptions of implant success toward a more detailed analysis of factors associated with implant failure. The purposes of this study were (1) to estimate the 1- and 5-year survival of Bicon dental implants and (2) to identify risk factors associated with implant failure in an objective, statistically valid manner. To address the research purposes, we used a retrospective cohort study design and a study sample composed of patients who had one or more implants placed. The predictor variables were grouped into the following categories: demographic, health status, anatomic, implant fixture-specific, prosthetic, perioperative, and ancillary variables. The major outcome variable of interest was implant failure defined as implant removal. Overall implant survival was estimated using the Kaplan-Meier analysis. Risk factors for implant failure were identified using the Cox proportional hazard regression models. The study sample was composed of 677 patients who had 677 implants randomly selected for analysis. The overall 1- and 5-year survival of the Bicon implant system was 95.2% and 90.2%, respectively. After adjusting for other covariates in a multivariate model, both tobacco use (P = .0004) and single-stage implant placement (P = .01) were statistically associated with an increased risk for failure. The results of these analyses suggest that the overall survival of the Bicon dental implant is comparable with other current implant systems. In addition, after controlling for covariates, we identified 2 exposures associated with implant survival, tobacco use and implant staging. Of interest, both of these exposures are under the clinician's control. PMID:12498449

  12. Incidence and risk factors for steatosis progression in adults coinfected with HIV and hepatitis C virus

    PubMed Central

    Woreta, Tinsay A.; Sutcliffe, Catherine G.; Mehta, Shruti H.; Brown, Todd T.; Higgins, Yvonne; Thomas, David L.; Torbenson, Michael S.; Moore, Richard D.; Sulkowski, Mark S.

    2010-01-01

    Background and Aims Hepatic steatosis is a common histological finding in patients that are co-infected with HIV and hepatitis C virus (HCV), although little is known about its natural history. We prospectively examined the natural history of steatosis in patients co-infected with HIV and HCV that attended an urban HIV clinic. Methods The study cohort consisted of 222 co-infected patients (87% African American, 94% with HCV genotype 1 infection) who had at least 2 liver biopsies performed between 1993 and 2008. Biopsies were scored by a single pathologist; samples were classified as having trivial (< 5% of hepatocytes affected) or significant (>5%) levels of fat (steatosis). We characterized progression to significant levels of fat among patients whose first biopsy samples had no or trivial levels of fat, and regression among those with significant fat, using logistic regression. Results Initial biopsies from most patients (88%) had no or trivial amounts of fat. Among second biopsy samples, 74% had no or trivial fat and 13% had significant amounts of fat. The strongest risk factors for steatosis progression were alcohol abuse and overweight/obesity; cumulative exposure to anti-retroviral therapy between biopsies and high counts of CD4+ T cells were associated with reduced progression of steatosis. Among the 28 patients whose initial biopsy had significant fat levels, most (75%) regressed. Conclusions Antiretroviral therapy and high counts of CD4+ T cells are associated with reduced progression of steatosis in patients co-infected with HIV and HCV. Efforts to diagnose and prevent steatosis should focus on persons with high body mass index and excessive alcohol intake. PMID:21134375

  13. Resilience Moderates the Association Between Childhood Sexual Abuse and Depressive Symptoms Among Women with and At-Risk for HIV.

    PubMed

    Dale, Sannisha K; Weber, Kathleen M; Cohen, Mardge H; Kelso, Gwendolyn A; Cruise, Ruth C; Brody, Leslie R

    2015-08-01

    Childhood sexual abuse (CSA) places women at risk for HIV infection and once infected, for poor mental health outcomes, including lower quality of life and depressive symptoms. Among HIV-positive and demographically matched HIV-negative women, we investigated whether resilience and HIV status moderated the relationships between CSA and health indices as well as the relationships among CSA, depressive symptoms, and health-related quality of life (HRQOL). Participants included 202 women (138 HIV+, 64 HIV-, 87 % African American) from the Women's Interagency HIV Study Chicago CORE Center site. Results indicated that in both HIV-positive and HIV-negative women, higher resilience significantly related to lower depressive symptoms and higher HRQOL. CSA related to higher depressive symptoms only for women scoring low in resilience. Interventions to promote resilience, especially in women with a CSA history, might minimize depressive symptoms and poor HRQOL among HIV-positive and HIV-negative women. PMID:25085079

  14. Anal Intercourse and HIV Risk Among Low-Income Heterosexual Women: Findings from Chicago HIV Behavioral Surveillance

    PubMed Central

    Livak, Britt S; Prachand, Nikhil G; Benbow, Nanette

    2012-01-01

    Background: Anal intercourse (AI) is a highly efficient route for HIV transmission and has not been well elucidated among heterosexual (HET) women. Heterosexual women living in impoverished urban areas in the US are at increased risk for HIV acquisition. We aim to describe rates of AI and characteristics associated with AI among heterosexual women at increased risk for HIV acquisition living in Chicago. Methods: The Chicago Department of Public Health conducted a survey of HET during 2007 as part of the National HIV Behavioral Surveillance System. Venue-based, time-location sampling was used to select participants from venues in high-risk areas (census tracts with concurrently high rates of heterosexual AIDS and household poverty). Eligible participants were interviewed anonymously and offered a HIV test. Results: In total, 407 heterosexual women were interviewed. Seventy-one (17%) women reported having AI in the past 12 months, with 61 of the 71 (86%) reporting unprotected AI. In multivariate analysis, women who engaged in AI were more than three times as likely to have three or more sex partners in the past 12 months (OR=3.27, 95% CI 1.53-6.99). AI was also independently associated with STI diagnosis in the past 12 months (2.13, 95% CI 1.06-4.26), and having sexual intercourse for the first time before the age of 15 years (2.23, 95% CI 1.28-3.89). Conclusion: AI was associated with multiple high risk behaviors including a greater number of sexual partners, STI diagnosis, and earlier age at first sex. The combination of risk factors found to be associated with AI call for new HIV prevention services tailored to the needs of women and young girls living in poverty. PMID:23049662

  15. Exploring risk of experiencing intimate partner violence after HIV infection: a qualitative study among women with HIV attending postnatal services in Swaziland

    PubMed Central

    Mulrenan, Claire; Colombini, Manuela; Kikuvi, Joshua; Mayhew, Susannah H

    2015-01-01

    Objective To explore risks of experiencing intimate partner violence (IPV) after HIV infection among women with HIV in a postnatal care setting in Swaziland. Design A qualitative semistructured in-depth interview study, using thematic analysis with deductive and inductive coding, of IPV experiences after HIV infection extracted from service-integration interview transcripts. Setting Swaziland. Participants 19 women with HIV, aged 18–44, were purposively sampled for an in-depth interview about their experiences of services, HIV and IPV from a quantitative postnatal cohort participating in an evaluation of HIV and reproductive health services integration in Swaziland. Results Results indicated that women were at risk of experiencing IPV after HIV infection, with 9 of 19 disclosing experiences of physical violence and/or coercive control post-HIV. IPV was initiated through two key pathways: (1) acute interpersonal triggers (eg, status disclosure, mother-to-child transmission of HIV) and (2) chronic normative tensions (eg, fertility intentions, initiating contraceptives). Conclusions The results highlight a need to mitigate the risk of IPV for women with HIV in shorter and longer terms in Swaziland. While broader changes are needed to resolve gender disparities, practical steps can be institutionalised within health facilities to reduce, or avoid increasing, IPV pathways for women with HIV. These might include mutual disclosure between partners, greater engagement of Swazi males with HIV services, and promoting positive masculinities that support and protect women. Trial registration number NCT01694862. PMID:25976760

  16. HIV risk differences between African-American and white men who have sex with men.

    PubMed Central

    Heckman, T. G.; Kelly, J. A.; Bogart, L. M.; Kalichman, S. C.; Rompa, D. J.

    1999-01-01

    African-American men who have sex with men remain at disproportionately greater risk for contracting human immunodeficiency virus (HIV) infection. While high HIV seroincidence has been documented among homosexual African-American men, behavioral research has rarely studied the HIV risk issues confronting these men. This study assessed a sample of 253 men who have sex with men to determine if African-American (n = 79) and white (n = 174) men report different rates of HIV risk behaviors and differ in characteristics indicative of risk. African-American men who have sex with men were more likely to be HIV-seropositive, to report past treatment for gonorrhea and syphilis, and to have a recent unprotected sex partner known or believed to be HIV-seropositive. Multivariate analyses of covariance, controlling for group differences in age, education, and income, revealed that African-American men who have sex with men were less open about their sexual orientation, scored lower in HIV risk behavior knowledge, had more female sexual partners, and more frequently used cocaine in association with sex relative to white men who have sex with men. Human immunodeficiency virus prevention programs tailored to the needs and risk issues of African-American men who have sex with men are needed. PMID:10083778

  17. An exploratory study of HIV risk behaviours and testing among male sex workers in Beirut, Lebanon

    PubMed Central

    Aunon, Frances M.; Wagner, Glenn J.; Maher, Rabih; Khouri, Danielle; Kaplan, Rachel L.; Mokhbat, Jacques

    2015-01-01

    Male sex workers (MSW) are a particularly high-risk subset of men who have sex with men in Lebanon and report higher numbers of sex partners and lower rates of condom use. The purpose was to explore the factors influencing sexual risk behaviors and HIV testing among MSW. Qualitative interviews were conducted with 16 MSW living in Beirut and working in bathhouses (hammam) or as escorts; content analysis identified emergent themes. Escorts reported more consistent condom use with clients and HIV testing than hammam MSW, with influential factors including HIV risk knowledge and perceived risk susceptibility, job security, and internalized stigma and related feelings of self-worth and fatalism regarding health and HIV risk. In contrast, both groups of MSW typically opted not to condoms with nonclient sex partners, in an effort to differentiate sex for work versus pleasure. The uptake of HIV testing was limited by concerns about the confidentiality of the test results and fear of repercussions of a positive test result for their health and employment. The respondents described an insular existence within the sex work culture, in part to limit exposure to stigma, which has implications for access to support as well as the influence of peer norms regarding sexual risk behavior and health seeking behaviors such as HIV testing. Further research is needed to tailor prevention and HIV testing efforts to reflect the distinct sexual health “cultures” that distinguish these two populations of MSW in Lebanon. PMID:25950906

  18. An Exploratory Study of HIV Risk Behaviors and Testing among Male Sex Workers in Beirut, Lebanon.

    PubMed

    Aunon, Frances M; Wagner, Glenn J; Maher, Rabih; Khouri, Danielle; Kaplan, Rachel L; Mokhbat, Jacques

    2015-01-01

    Male sex workers (MSW) are a particularly high-risk subset of men who have sex with men in Lebanon and report higher numbers of sex partners and lower rates of condom use. The purpose was to explore the factors influencing sexual risk behaviors and HIV testing among MSW. Qualitative interviews were conducted with 16 MSW living in Beirut and working in bathhouses (hammam) or as escorts; content analysis identified emergent themes. Escorts reported more consistent condom use with clients and HIV testing than hammam MSW, with influential factors including HIV risk knowledge and perceived risk susceptibility, job security, and internalized stigma and related feelings of self-worth and fatalism regarding health and HIV risk. In contrast, both groups of MSW typically opted not to condoms with nonclient sex partners, in an effort to differentiate sex for work versus pleasure. The uptake of HIV testing was limited by concerns about the confidentiality of the test results and fear of repercussions of a positive test result for their health and employment. The respondents described an insular existence within the sex work culture, in part to limit exposure to stigma, which has implications for access to support as well as the influence of peer norms regarding sexual risk behavior and health seeking behaviors such as HIV testing. Further research is needed to tailor prevention and HIV testing efforts to reflect the distinct sexual health "cultures" that distinguish these two populations of MSW in Lebanon. PMID:25950906

  19. Targeted Expansion Project for Outreach and Treatment for Substance Abuse and HIV Risk Behaviors in Asian and Pacific Islander Communities

    ERIC Educational Resources Information Center

    Nemoto, Tooru; Iwamoto, Mariko; Kamitani, Emiko; Morris, Anne; Sakata, Maria

    2011-01-01

    Access to culturally competent HIV/AIDS and substance abuse treatment and prevention services is limited for Asian and Pacific Islanders (APIs). Based on the intake data for a community outreach project in the San Francisco Bay Area (N = 1,349), HIV risk behaviors were described among the targeted API risk groups. The self-reported HIV prevalence…

  20. Sexual behavior, risk perception, and HIV transmission can respond to HIV antiviral drugs and vaccines through multiple pathways

    PubMed Central

    Tully, Stephen; Cojocaru, Monica; Bauch, Chris T.

    2015-01-01

    There has been growing use of highly active antiretroviral treatment (HAART) for HIV and significant progress in developing prophylactic HIV vaccines. The simplest theories of counterproductive behavioral responses to such interventions tend to focus on single feedback mechanisms: for instance, HAART optimism makes infection less scary and thus promotes risky sexual behavior. Here, we develop an agent based, age-structured model of HIV transmission, risk perception, and partner selection in a core group to explore behavioral responses to interventions. We find that interventions can activate not one, but several feedback mechanisms that could potentially influence decision-making and HIV prevalence. In the model, HAART increases the attractiveness of unprotected sex, but it also increases perceived risk of infection and, on longer timescales, causes demographic impacts that partially counteract HAART optimism. Both HAART and vaccination usually lead to lower rates of unprotected sex on the whole, but intervention effectiveness depends strongly on whether individuals over- or under-estimate intervention coverage. Age-specific effects cause sexual behavior and HIV prevalence to change in opposite ways in old and young age groups. For complex infections like HIV—where interventions influence transmission, demography, sexual behavior and risk perception—we conclude that evaluations of behavioral responses should consider multiple feedback mechanisms. PMID:26507957

  1. Psychosocial support intervention for HIV-affected families in Haiti: implications for programs and policies for orphans and vulnerable children.

    PubMed

    Smith Fawzi, Mary C; Eustache, Eddy; Oswald, Catherine; Louis, Ermaze; Surkan, Pamela J; Scanlan, Fiona; Hook, Sarah; Mancuso, Anna; Mukherjee, Joia S

    2012-05-01

    Given the increased access of antiretroviral therapy (ART) throughout the developing world, what was once a terminal illness is now a chronic disease for those receiving treatment. This requires a paradigmatic shift in service provision for those affected by HIV/AIDS in low-resource settings. Although there is a need for psychosocial support interventions for HIV-affected youth and their caregivers, to date there has been limited empirical evidence on the effectiveness of curriculum-based psychosocial support groups in HIV-affected families in low-income countries. Therefore, the purpose of this study is to examine the feasibility and assess the preliminary effectiveness of a psychosocial support group intervention for HIV-affected youth and their caregivers in central Haiti. The study was conducted at six Partners In Health-affiliated sites between February 2006 and September 2008 and included quantitative as well as qualitative methods. HIV-affected youth (n = 168) and their caregivers (n = 130) completed a baseline structured questionnaire prior to participation in a psychosocial support group intervention. Ninety-five percent of families completed the intervention and a follow-up questionnaire. Psychological symptoms, psychosocial functioning, social support, and HIV-related stigma at baseline were compared with outcomes one year later. Qualitative methods were also used to assess the participants' perspectives of the intervention. Comparing pre- and post-intervention assessment, youth affected by HIV experienced decreased psychological symptoms as well as improved psychosocial functioning and social support. Caregivers (95% HIV-positive) demonstrated a significant reduction in depressive symptoms, improved social support, and decreased HIV-related stigma. Although further study is needed to assess effectiveness in a randomized controlled trial, corroborative findings from qualitative data reflected reduced psychological distress, less social isolation and

  2. MOBILE SCREENING TO IDENTIFY AND FOLLOW-UP WITH HIGH RISK, HIV NEGATIVE YOUTH

    PubMed Central

    Aronson, Ian David; Cleland, Charles M.; Perlman, David C.; Rajan, Sonali; Sun, Wendy; Ferraris, Christopher; Mayer, Jennifer; Ferris, David C.; Bania, Theodore C.

    2016-01-01

    Background HIV prevalence remains disproportionately high among youth, especially among young men who have sex with men, young people with substance use disorders, and recently incarcerated youth. However, youth may not report behavioral risks because they fear stigma or legal consequences. While routine HIV screening programs have increased testing, current programs are not designed to identify, or provide prevention services to, high-risk patients who test HIV negative. Aims To examine the feasibility and preliminary efficacy of: a tablet-based screening designed to facilitate HIV risk reporting and testing among a sample of young urban emergency department (ED) patients; and a text message-based follow up protocol for patients who test HIV-negative and report increased behavioral risk. Methods 100 ED patients aged 18 – 24, who declined HIV tests offered at triage, completed a tablet-based intervention that included a risk screening, an educational video, and offered participants HIV tests. If patients accepted testing and reported increased risk, the tablets offered follow-up text messages. Results 30 participants accepted HIV tests following the intervention and 21 participants, identified by custom software as high-risk, agreed to receive text messages. Two thirds (66.7%) of text recipients responded to questions at week 6, more than half (57.1%) responded at week 8, one (4.76%) re-tested after week 12. Conclusion Results indicate our intervention provides a feasible way to facilitate risk reporting, increase HIV testing, and maintain ongoing contact with hard-to-reach youth via tablet computers and text messages. PMID:27110294

  3. Depression and HIV risk among men who have sex with men in Tanzania

    PubMed Central

    Ahaneku, Hycienth; Ross, Michael W.; Nyoni, Joyce E.; Selwyn, Beatrice; Troisi, Catherine; Mbwambo, Jessie; Adeboye, Adeniyi; McCurdy, Sheryl

    2016-01-01

    ABSTRACT Studies have shown high rates of depression among men who have sex with men (MSM) in developed countries. Studies have also shown association between depression and HIV risk among MSM. However, very little research has been done on depression among African MSM. We assessed depression and HIV risk among a sample of MSM in Tanzania. We reviewed data on 205 MSM who were recruited from two Tanzanian cities using the respondent driven sampling method. Demographic and behavioral data were collected using a structured questionnaire. HIV and sexually transmitted infections data were determined from biological tests. Depression scores were assessed using the Patient Health Questionnaire (PHQ-9). For the analysis, depression scores were dichotomized as depressed (PHQ > 4) and not depressed (PHQ ≤ 4). Bivariate and multivariable Poisson regression analyses were conducted to assess factors associated with depression. The prevalence of depression in the sample was 46.3%. The mean (±SD) age of the sample was 25 (±5) years. In bivariate analysis, depression was associated with self-identifying as gay (p = .001), being HIV positive (p < .001: <8% of MSM knew they were HIV infected) and having a high number of sexual partners in the last 6 months (p = .001). Depression was also associated with sexual (p = .007), physical (p = .003) and verbal (p < .001) abuse. In the Poisson regression analysis, depression was associated with verbal abuse (APR = 1.91, CI = 1.30–2.81). Depression rates were high among MSM in Tanzania. It is also associated with abuse, HIV and HIV risk behaviors. Thus, reducing the risk of depression may be helpful in reducing the risk of HIV among MSM in Africa. We recommend the colocation of mental health and HIV preventive services as a cost-effective means of addressing both depression and HIV risk among MSM in Africa. PMID:27002772

  4. Peer-Led Interventions to Reduce HIV Risk of Youth: A Review

    ERIC Educational Resources Information Center

    Maticka-Tyndale, Eleanor; Barnett, Jessica Penwell

    2010-01-01

    One approach in HIV prevention programming targeting youth is to use peer leaders in what is referred to as peer education programming. This paper critically reviews and synthesizes the results and lessons learned from 24 evaluated peer-led programs with an HIV/AIDS risk reduction component that target youth in the communities where they live and…

  5. Sexual Risk Taking among HIV-Positive Injection Drug Users: Contexts, Characteristics, and Implications for Prevention

    ERIC Educational Resources Information Center

    Knight, Kelly R.; Purcell, David; Dawson-Rose, Carol; Halkitis, Perry N.; Gomez, Cynthia A.

    2005-01-01

    HIV-positive injection drug users (IDUs) (N = 161) were recruited to complete a qualitative interview and a quantitative survey about sexual behavior and transmission risk. We identified two contexts in which exposure encounters occurred most commonly for HIV-positive IDUs: in intimate serodiscordant relationships and in the drug/sex economy.…

  6. Correlates of HIV knowledge and Sexual risk behaviors among Female Military Personnel

    PubMed Central

    Essien, E. James; Monjok, Emmanuel; Chen, Hua; Abughosh, Susan; Ekong, Ernest; Peters, Ronald J.; Holmes, Laurens; Holstad, Marcia M.; Mgbere, Osaro

    2010-01-01

    Objective Uniformed services personnel are at an increased risk of HIV infection. We examined the HIV/AIDS knowledge and sexual risk behaviors among female military personnel to determine the correlates of HIV risk behaviors in this population. Method The study used a cross-sectional design to examine HIV/AIDS knowledge and sexual risk behaviors in a sample of 346 females drawn from two military cantonments in Southwestern Nigeria. Data was collected between 2006 and 2008. Using bivariate analysis and multivariate logistic regression, HIV/AIDS knowledge and sexual behaviors were described in relation to socio-demographic characteristics of the participants. Results Multivariate logistic regression analysis revealed that level of education and knowing someone with HIV/AIDS were significant (p<0.05) predictors of HIV knowledge in this sample. HIV prevention self-efficacy was significantly (P<0.05) predicted by annual income and race/ethnicity. Condom use attitudes were also significantly (P<0.05) associated with number of children, annual income, and number of sexual partners. Conclusion Data indicates the importance of incorporating these predictor variables into intervention designs. PMID:20387111

  7. Assessing the Validity of a Single-Item HIV Risk Stage-of-Change Measure

    ERIC Educational Resources Information Center

    Napper, Lucy E.; Branson, Catherine M.; Fisher, Dennis G.; Reynolds, Grace L.; Wood, Michelle M.

    2008-01-01

    This study examined the validity of a single-item measure of HIV risk stage of change that HIV prevention contractors were required to collect by the California State Office of AIDS. The single-item measure was compared to the more conventional University of Rhode Island Change Assessment (URICA). Participants were members of Los Angeles…

  8. Healthy Choices: Motivational Enhancement Therapy for Health Risk Behaviors in HIV-Positive Youth

    ERIC Educational Resources Information Center

    Naar-King, Sylvie; Wright, Kathryn; Parsons, Jeffrey T.; Frey, Maureen; Templin, Thomas; Lam, Phebe; Murphy, Debra

    2006-01-01

    This study piloted a brief individual motivational intervention targeting multiple health risk behaviors in HIV-positive youth aged 16-25. Interviews about sexual behavior and substance use and viral load testing were obtained from 51 HIV-positive youth at baseline and post intervention. Youth were randomized to receive a four-session motivational…

  9. Microbiome in HIV infection

    PubMed Central

    Salas, January T.; Chang, Theresa L.

    2014-01-01

    HIV primary infection occurs at mucosa tissues, suggesting an intricate interplay between microbiome and HIV infection. Recent advanced technologies of high-throughput sequencing and bioinformatics allow researchers to explore nonculturable microbes including bacteria, virus and fungi and their association with diseases. HIV/SIV infection is associated with microbiome shifts and immune activation that may affect the outcome of disease progression. Similarly, altered microbiome and inflammation are associated with increased risks of HIV acquisition, suggesting the role of microbiome in HIV transmission. In this review, we will focus on microbiome in HIV infection at various mucosal compartments. Understanding the relationship between microbiome and HIV may offer insights into development of better strategies for HIV prevention and treatment. PMID:25439273

  10. Risk Factors for HIV Acquisition in a Prospective Nairobi-Based Female Sex Worker Cohort.

    PubMed

    McKinnon, Lyle R; Izulla, Preston; Nagelkerke, Nico; Munyao, Julius; Wanjiru, Tabitha; Shaw, Souradet Y; Gichuki, Richard; Kariuki, Cecilia; Muriuki, Festus; Musyoki, Helgar; Gakii, Gloria; Gelmon, Lawrence; Kaul, Rupert; Kimani, Joshua

    2015-12-01

    With two million new HIV infections annually, ongoing investigations of risk factors for HIV acquisition is critical to guide ongoing HIV prevention efforts. We conducted a prospective cohort analysis of HIV uninfected female sex workers enrolled at an HIV prevention clinic in Nairobi (n = 1640). In the initially HIV uninfected cohort (70 %), we observed 34 HIV infections during 1514 person-years of follow-up, i.e. an annual incidence of 2.2 % (95 % CI 1.6-3.1 %). In multivariable Cox Proportional Hazard analysis, HIV acquisition was associated with a shorter baseline duration of sex work (aHR 0.76, 95 % CI 0.63-0.91), minimum charge/sex act (aHR 2.74, 0.82-9.15, for low vs. intermediate; aHR 5.70, 1.96-16.59, for high vs. intermediate), N. gonorrhoeae infection (aAHR 5.89, 95 % CI 2.03-17.08), sex with casual clients during menses (aHR 6.19, 95 % CI 2.58-14.84), Depo Provera use (aHR 5.12, 95 % CI 1.98-13.22), and estimated number of annual unprotected regular partner contacts (aHR 1.004, 95 % CI 1.001-1.006). Risk profiling based on baseline predictors suggested that substantial heterogeneity in HIV risk is evident, even within a key population. These data highlight several risk factors for HIV acquisition that could help to re-focus HIV prevention messages. PMID:26091706

  11. Community-Based HIV and Health Testing for High-Risk Adolescents and Youth.

    PubMed

    Reif, Lindsey K; Rivera, Vanessa; Louis, Bianca; Bertrand, Rachel; Peck, Mireille; Anglade, Benedict; Seo, Grace; Abrams, Elaine J; Pape, Jean W; Fitzgerald, Daniel W; McNairy, Margaret L

    2016-08-01

    Adolescents account for 40% of new HIV infections, and HIV testing strategies to increase uptake of testing are needed. A community-based adolescent and youth HIV and health testing campaign was conducted in seven slum neighborhoods of Port-au-Prince, Haiti, from December 2014 to September 2015. Community health workers provided community sensitization and recruited 10- to 24-year-olds to test for HIV, syphilis, gonorrhea/chlamydia, and to screen for tuberculosis (TB) and pregnancy. HIV-infected individuals were escorted to the GHESKIO HIV clinic for same-day enrollment in care. Among 3425 individuals eligible for testing, 3348 (98%) accepted an HIV test. HIV prevalence was 2.65% (n = 89). Median age was 19 [interquartile range (IQR) 17-20]; 73% were female. HIV prevalence was 0.6-7.4% across slum neighborhoods. All HIV-infected individuals enrolled in care the same day as testing; median CD4 was 529 cells/μL [IQR 363-761]. Syphilis prevalence was 2.60% (65/2536) and gonorrhea/chlamydia prevalence was 6.25% (96/1536). Among 168 (5%) individuals who reported TB symptoms, 7.7% (13/168) had microbiologically confirmed disease. One hundred twenty-nine females (5% of all females) were pregnant. This community-based testing campaign identified an adolescent and youth population with an HIV prevalence six times higher than the estimated national adolescent HIV prevalence (0.4%) in Haiti, including perinatally infected adolescents. This type of community-based campaign for HIV testing within a package of services can serve as a model for other resource-poor settings to identify high-risk adolescents and youth, and curb the global HIV epidemic among adolescents. PMID:27509237

  12. Does HIV increase the risk of spousal violence in sub-Saharan Africa?

    PubMed

    Chin, Yoo-Mi

    2013-09-01

    Although a positive association is found between HIV prevalence and intimate partner violence, a causal interpretation is hard to establish due to the endogeneity of HIV prevalence. Using the distance from the origin of the virus as an instrument, I find that an exogenous increase in HIV prevalence in a cluster has a sizable positive effect on the risk of physical and sexual violence against women within marriage. The results of this study confirm a gender-specific negative externality of the disease and encourage policy efforts to incorporate services for violence against women into existing HIV programs. PMID:24012689

  13. HIV testing and preventive services accessibility among men who have sex with men at high risk of HIV infection in Beijing, China.

    PubMed

    Zhao, Yuejuan; Zhang, Li; Zhang, Heng; Xia, Dongyan; Pan, Stephen W; Yue, Hai; Lu, Hongyan; Xing, Hui; He, Xiong; Shao, Yiming; Ruan, Yuhua

    2015-02-01

    The HIV epidemic among men who have sex with men (MSM) has been increasing at an alarming rate in most areas of China in recent years. Many Chinese MSM still lack sufficient access to HIV prevention services, despite ongoing scale-up of comprehensive HIV testing and intervention services. The purpose of this study was to investigate utilization of HIV testing and prevention services, and related factors that influence the MSM people to access HIV test or other services to prevent HIV among MSM in Beijing, China.Three successive cross-sectional surveys of MSM were conducted in Beijing from September 2009 to January 2010, September 2010 to January 2011, and September 2011 to January 2012. Demographic and behavioral data were collected and analyzed. Blood samples were tested for HIV and syphilis. Three models were established to analyze factors associated with HIV testing and preventive services.Of the 1312 participants, prevalence of HIV and syphilis was 7.9% and 15.4%, respectively. Sixty-nine percent ever had an HIV test, 56.2%, 78.7%, and 46.1% received HIV test, free condom/lubricants, and sexually transmitted infection services in the past 12 months (P12M), respectively. MSM with larger social networks and who knew someone infected with HIV were more likely to receive HIV testing and preventive services; lower degrees of stigma and discriminatory attitudes toward HIV/AIDS were positively associated with having an HIV test, whereas unprotected anal intercourse in the past 6 months (P6M) was associated with less preventive services participation. The most reported barriers to HIV testing were fear of testing HIV positive (79.3%) and perceiving no risk for HIV (75.4%). Almost all participants felt that ensuring confidentiality would encourage more MSM to have an HIV test. The two main reasons for not seeking HIV test was not knowing where to go for a test (63.2%) and perceiving low risk of HIV infection (55.1%).Given a high prevalence of HIV, syphilis, and risky

  14. HIV Testing and Preventive Services Accessibility Among Men Who Have Sex With Men at High Risk of HIV Infection in Beijing, China

    PubMed Central

    Zhao, Yuejuan; Zhang, Li; Zhang, Heng; Xia, Dongyan; Pan, Stephen W.; Yue, Hai; Lu, Hongyan; Xing, Hui; He, Xiong; Shao, Yiming; Ruan, Yuhua

    2015-01-01

    Abstract The HIV epidemic among men who have sex with men (MSM) has been increasing at an alarming rate in most areas of China in recent years. Many Chinese MSM still lack sufficient access to HIV prevention services, despite ongoing scale-up of comprehensive HIV testing and intervention services. The purpose of this study was to investigate utilization of HIV testing and prevention services, and related factors that influence the MSM people to access HIV test or other services to prevent HIV among MSM in Beijing, China. Three successive cross-sectional surveys of MSM were conducted in Beijing from September 2009 to January 2010, September 2010 to January 2011, and September 2011 to January 2012. Demographic and behavioral data were collected and analyzed. Blood samples were tested for HIV and syphilis. Three models were established to analyze factors associated with HIV testing and preventive services. Of the 1312 participants, prevalence of HIV and syphilis was 7.9% and 15.4%, respectively. Sixty-nine percent ever had an HIV test, 56.2%, 78.7%, and 46.1% received HIV test, free condom/lubricants, and sexually transmitted infection services in the past 12 months (P12M), respectively. MSM with larger social networks and who knew someone infected with HIV were more likely to receive HIV testing and preventive services; lower degrees of stigma and discriminatory attitudes toward HIV/AIDS were positively associated with having an HIV test, whereas unprotected anal intercourse in the past 6 months (P6M) was associated with less preventive services participation. The most reported barriers to HIV testing were fear of testing HIV positive (79.3%) and perceiving no risk for HIV (75.4%). Almost all participants felt that ensuring confidentiality would encourage more MSM to have an HIV test. The two main reasons for not seeking HIV test was not knowing where to go for a test (63.2%) and perceiving low risk of HIV infection (55.1%). Given a high prevalence of HIV, syphilis

  15. Hispanic Women’s Experiences With Substance Abuse, Intimate Partner Violence, and Risk for HIV

    PubMed Central

    Gonzalez-Guarda, Rosa Maria; Vasquez, Elias P.; Urrutia, Maria T.; Villarruel, Antonia M.; Peragallo, Nilda

    2011-01-01

    Hispanic females are disproportionately affected by substance abuse, intimate partner violence, and HIV. Despite these disparities, research describing the cultural and gender-specific experiences of Hispanic women with regard to these conditions is lacking. The purpose of this study is to describe the experiences that Hispanic community-dwelling women have with regard to substance abuse, violence, and risky sexual behaviors. Eight focus groups with 81 women were conducted. A bilingual, bicultural moderator asked women open-ended questions regarding the experiences that Hispanic women have with these conditions. Focus groups were audiotaped, transcribed, translated, verified, and then analyzed using qualitative content analysis. Participants discussed substance abuse, violence, and risky sexual behaviors interchangeably, often identifying common risk factors associated with these. Nevertheless, intimate partner violence was the most salient of conditions discussed. Three major themes emerged from the analysis: Transplantadas en otro mundo (Uprooted in another world), El criador de abuso (The breeding ground of abuse), and Rompiendo el silencio (Breaking the silence). This study supports the importance of addressing substance abuse, violence, and risk for HIV in an integrated manner and stresses the importance of addressing associated cultural factors (e.g., acculturation, machismo) in interventions targeting Hispanics. PMID:21191036

  16. Risk factors for HIV infection among circumcised men in Uganda: a case-control study

    PubMed Central

    Ediau, Michael; Matovu, Joseph KB; Byaruhanga, Raymond; Tumwesigye, Nazarius M; Wanyenze, Rhoda K

    2015-01-01

    Introduction Male circumcision (MC) reduces the risk of HIV infection. However, the risk reduction effect of MC can be modified by type of circumcision (medical, traditional and religious) and sexual risk behaviours post-circumcision. Understanding the risk behaviours associated with HIV infection among circumcised men (regardless of form of circumcision) is critical to the design of comprehensive risk reduction interventions. This study assessed risk factors for HIV infection among men circumcised through various circumcision approaches. Methods This was a case-control study which enrolled 155 cases (HIV-infected) and 155 controls (HIV-uninfected), all of whom were men aged 18–35 years presenting at the AIDS Information Center for HIV testing and care. The outcome variable was HIV sero-status. Using SPSS version 17, multivariable logistic regression was performed to identify factors independently associated with HIV infection. Results Overall, 83.9% among cases and 56.8% among controls were traditionally circumcised; 7.7% of cases and 21.3% of controls were religiously circumcised while 8.4% of cases and 21.9% of controls were medically circumcised. A higher proportion of cases than controls reported resuming sexual intercourse before complete wound healing (36.9% vs. 14.1%; p<0.01). Risk factors for HIV infection prior to circumcision were:being in a polygamous marriage (AOR: 6.6, CI: 2.3–18.8) and belonging to the Bagisu ethnic group (AOR: 6.1, CI: 2.6–14.0). After circumcision, HIV infection was associated with: being circumcised at >18 years (AOR: 5.0, CI: 2.4–10.2); resuming sexual intercourse before wound healing (AOR: 3.4, CI: 1.6–7.3); inconsistent use of condoms (AOR: 2.7, CI: 1.5–5.1); and having sexual intercourse under the influence of peers (AOR: 2.9, CI: 1.5–5.5). Men who had religious circumcision were less likely to have HIV infection (AOR: 0.4, 95% CI: 0.2–0.9) than the traditionally circumcised but there was no statistically

  17. HIV Prevalence Correlates with High-Risk Sexual Behavior in Ethiopia's Regions

    PubMed Central

    Kenyon, Chris R.; Tsoumanis, Achilleas; Schwartz, Ilan Steven

    2015-01-01

    Background HIV prevalence varies between 0.9 and 6.5% in Ethiopia’s eleven regions. Little has been published examining the reasons for this variation. Methods We evaluated the relationship between HIV prevalence by region and a range of risk factors in the 2005 and 2011 Ethiopian Demographic Health Surveys. Pearson’s correlation was used to assess the relationship between HIV prevalence and each variable. Results There was a strong association between HIV prevalence and three markers of sexual risk: mean lifetime number of partners (men: r = 0.87; P < 0.001; women: r = 0.60; P = 0.05); reporting sex with a non-married, non-cohabiting partner (men: r = 0.92; P < 0.001, women r = 0.93; P < 0.001); and premarital sex. Condom usage and HIV testing were positively associated with HIV prevalence, while the prevalence of circumcision, polygamy, age at sexual debut and male migration were not associated with HIV prevalence. Conclusion Variation in sexual behavior may contribute to the large variations in HIV prevalence by region in Ethiopia. Population-level interventions to reduce risky sexual behavior in high HIV incidence regions should be considered. PMID:26496073

  18. Marriage and the Risk of Incident HIV infection in Rakai, Uganda

    PubMed Central

    Nalugoda, Fred; Guwatudde, David; Bwaninka, John B; Makumbi, Fredrick E; Lutalo, Tom; Kagaayi, Joseph; Sewankambo, Nelson K; Kigozi, Godfrey; Serwadda, David M; Kong, Xiangrong; Wawer, Maria J; Wabwire-Mangen, Fred; Gray, Ronald H

    2013-01-01

    Objective Studies suggest that the prevalence of HIV is higher among long term marital/consensual relationships than in the unmarried. We assessed the risk of incident HIV infection by marital status in rural Rakai, Uganda. Design Longitudinal data from the Rakai Community Cohort Study (RCCS) between 1999 - 2011 Methods We estimated HIV incidence per 100 person years (py) in sexually active individuals aged 15-49 with a total of 44,179.6 person years (py) who were never married (females 2,929py, males 4,261py), currently married or in long-term consensual relationships (“currently married females 29,823py, males 21,299py) and previously married (females 3,563py, males 1,475). Poisson multivariable regression was used to estimate the unadjusted and adjusted incident rate ratios (IRRs) and 95% confidence intervals (95% CI) of HIV acquisition. Results HIV incidence among currently married persons was 0.93/100py, which was lower than the never married (1.51/100py) and previously married (2.85/100py). The risk of HIV acquisition was significantly lower in the currently married compared to the never married among women (Adj IRR=0.26, 95% CI: 0.16-0.42), but not men (Adj IRR=0.69, 95% CI: 0.31-1.52). HIV incidence was lower among first marriages (0.73/100py) compared to second or higher order marriages (1.38/100py). Multiple sex partners significantly increased the risk of HIV acquisition in both women (Adj IRR=2.53, 95% CI: 1.6, 3.97) and men (Adj IRR=1.77, 95% CI: 1.20-2.60). Conclusion Current marriage especially first order marriage was associated with reduced risk of HIV acquisition in women, but not in men, and multiple sex partnerships increased HIV risk for both sexes. PMID:24419066

  19. Caregivers’ Attitudes towards HIV Testing and Disclosure of HIV Status to At-Risk Children in Rural Uganda

    PubMed Central

    Lorenz, Rick; Grant, Eisha; Muyindike, Winnie; Maling, Samuel; Card, Claire; Henry, Carol; Nazarali, Adil J.

    2016-01-01

    Caregivers of HIV-positive children were interviewed in the Mbarara and Isingiro districts of Uganda to identify current trends in practices related to HIV testing and the disclosure of HIV status to the child. A total of 28 caregivers of at least one HIV-positive child participated in semi-structured interviews exploring when and why they tested the child for HIV, when the child was informed of their positive status, and what the caregiver did to prepare themselves and the child for status disclosure. For a majority (96%) of respondents, the decision to test the child for HIV was due to existing illness in either the child or a relative. Other common themes identified included the existence of stigma in the caregivers’ communities and doubt that the children truly understood what was being explained to them when their status was disclosed. Most (65%) children were informed of their HIV status between the ages of 5 and 9, with the mean age of disclosure occurring at the age of 7. General provision of HIV information typically began at the same age as disclosure, and as many as two thirds (64%) of the caregivers sought advice from an HIV counsellor prior to disclosure. How a caregiver chose to prepare themselves and the child did not affect the caregiver’s perception of whether the disclosure experience was beneficial or not. These findings suggest that the HIV disclosure experience in Mbarara and Isingiro districts differs from current guidelines, especially with respect to age of disclosure, how caregivers prepare themselves and the child, and approaching disclosure as an ongoing process. The doubts expressed by caregivers regarding the child’s level of HIV understanding following the disclosure experience suggest the children may be insufficiently prepared at the time of the initial disclosure event. The findings also suggest that examining the content of pre-disclosure counselling and HIV education, and how health care professionals are trained to

  20. HIV prevalence and risk behaviors among male clients of female sex workers in Yunnan, China

    PubMed Central

    Jin, Xia; Smith, Kumi; Chen, Ray Y.; Ding, Guowei; Yao, Yan; Wang, Haibo; Qian, Han-Zhu; Chang, Dongfang; Wang, Guixiang; Wang, Ning

    2009-01-01

    Objectives To assess the prevalence and risk factors of HIV among male clients of female sex workers in China. Methods Convenience sampling methods were used to recruit 315 clients using FSW-client and client-client networks. Subjects provided information on socio-demographic characteristics and sexual and drug behavior patterns. Blood samples were collected for HIV testing and urine samples for opiate testing. Results Overall HIV prevalence was 6.0%; among drug users it was 30.8%. 33.7% of respondents reported that they always use condoms in commercial sex and 63.5% that they used a condom in the last commercial sex episode. Drug use (OR: 6.1; 95% CI: 1.7–21.4) and lack of a regular sexual partner (OR: 6.3; 95% CI: 1.8–21.9) were significantly associated with HIV infection. Conclusions Clients of FSWs serve as potential bridges for HIV transmission from the high-risk FSWs to the low-risk general population, making them a key target for intervention. High HIV prevalence rates among clients in Kaiyuan is particularly alarming given their risk behavior patterns including high rates of partner exchange, low condom use rates, and drug using behaviors. Innovative interventions are needed to reduce the risk of HIV among clients and reduce the bridge of transmission to the general population. PMID:19730110

  1. Severity of heroin dependence and HIV risk. I. Sexual behaviour.

    PubMed

    Gossop, M; Griffiths, P; Powis, B; Strang, J

    1993-01-01

    The HIV risks associated with the sexual behaviour of drug injectors have sometimes been overshadowed by the more obvious risks of injection behaviour. In this study, 408 heroin users were interviewed in the community; 50% were not currently in treatment and 42% had never had any treatment contact. In addition to data on drug use, information was collected on sexual risk behaviour by means of a linked anonymous questionnaire (96% returned). Eighty-nine per cent of the sample had had at least one sexual partner in the previous year and 58% had a regular sexual partner at the time of interview. Drug users who had a sexual partner who was injecting drugs were more severely dependent upon heroin. Twenty-three per cent of the men and 20% of the women reported having had anal intercourse in the previous year. Seventeen per cent of the women and 6% of the men had engaged in some form of prostitution. Severity of heroin dependence was positively related to the occurrence and to the frequency of sex-for-money transactions and to the less well recognized phenomenon of sex-for-drugs; this association with severity of dependence applied to the women and to the men who have sex with men. The overall level of condom use was low in this sample, though condom use was more frequent among those involved in sex-for-money or sex-for-drugs transactions. Low levels of condom use were reported even for such high risk activities as anal sex.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:8329480

  2. Psychosocial Functioning Among HIV-Affected Youth and Their Caregivers in Haiti: Implications for Family-Focused Service Provision in High HIV Burden Settings

    PubMed Central

    Eustache, Eddy; Oswald, Catherine; Surkan, Pamela; Louis, Ermaze; Scanlan, Fiona; Wong, Richard; Li, Michelle; Mukherjee, Joia

    2010-01-01

    Abstract The study is an analysis of baseline data from a pilot psychosocial support intervention for HIV-affected youth and their caregivers in Haiti. Six sites in Haiti's Central Department affiliated with Partners In Health/Zanmi Lasante (PIH/ZL) and the Haitian Ministry of Health were included. Participants were recruited from a list of HIV-positive patients receiving care at PIH/ZL. The baseline questionnaire was administered from February 2006 to January 2007 with HIV-affected youth (n = 492), ages 10–17, and their caregivers (n = 330). According to findings at baseline, the youth reported high levels of anxiety, including constant fidgeting (86%), restlessness (83%), and worrying a lot (56%). Their parents/caregivers also reported a high level of depressive symptoms, such as low energy (73%), feeling everything is an effort (71%), and sadness (69%). Parents' depressive symptoms were positively associated with their children's psychological symptoms (odds ratio [OR] =1.6–2.4) and psychosocial functioning (OR =1.6 according to parental report). The significant levels of anxiety and depression observed among HIV-affected youth and their caregivers suggest that psychosocial interventions are needed among HIV-affected families in central Haiti and other high HIV burden areas. The results suggest that a family-focused approach to service provision may be beneficial, possibly improving quality of life, as well as psychosocial and physical health-related outcomes among HIV-affected youth and their caregivers, particularly HIV-positive parents. PMID:20214482

  3. Rejection Sensitivity, Perceived Power, and HIV Risk in the Relationships of Low-Income Urban Women.

    PubMed

    Berenson, Kathy R; Paprocki, Christine; Thomas Fishman, Marget; Bhushan, Devika; El-Bassel, Nabila; Downey, Geraldine

    2015-01-01

    The psychological processes associated with HIV infection in long-term relationships differ from those operative in casual sexual encounters, and relatively little research has considered the aspects of personality applicable in the ongoing heterosexual relationships in which women are at greatest risk. Sensitivity to rejection has been linked with efforts to prevent rejection at a cost to the self and, therefore, may be relevant to the health risks that many women incur in relationships. We examined the association of rejection sensitivity with women's sexual risk behavior in a sample of women at heightened risk for HIV exposure. Women in long-term heterosexual relationships (N = 159) were recruited for study participation in the hospital emergency room serving a low-income neighborhood in New York City, in 2001-2003. Rejection sensitivity and known HIV risk factors were assessed using verbally administered questionnaires. Rejection sensitivity was associated with lower perceived relationship power and, in turn, more frequent unprotected sex with a partner perceived to