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Biomedical subjects

D Rompa

Publications and source records attributed to D Rompa.

At least 19 recordsLinked to original sources
PubMed2003

HIV treatment adherence and unprotected sex practices in people receiving antiretroviral therapy.

BACKGROUND: Poor HIV treatment adherence can result in the development of drug resistant strains of HIV and HIV positive people may transmit drug resistant virus to their sex partners. OBJECTIVE: To examine the association between HIV treatment adherence and sexual risk behaviour practices in people living with HIV-AIDS. METHODS: Surveys and interviews with 255 men and women living with HIV and receiving antiretroviral therapy. RESULTS: People who were currently taking antiretroviral medications and missed at least one dose of their medications in the past week scored significantly higher on a hopelessness scale and reported more current use of marijuana. People who had been non-adherent also reported significantly more sex partners, greater rates of unprotected vaginal intercourse, and less protected sex behaviours including less protected sex with partners who were HIV negative or of unknown HIV status. CONCLUSIONS: Associations between HIV treatment adherence and sexual transmission risk behaviours indicate the need for comprehensive and integrated health behaviour interventions for people living with HIV-AIDS.

Adult↗
PubMed2002

Sexual transmission risk perceptions and behavioural correlates of HIV concentrations in semen.

HIV transmission risk behaviours are related to perceived infectiousness and HIV-positive men who have undetectable blood viral loads may practise less protective behaviours. The current study extends previous research by reporting the association between perceived HIV transmission risks, risk behaviours and viral load in semen. Results showed significant associations between perceived risks for transmitting HIV, unprotected intercourse and viral load in semen. Further analyses showed that men with greater concentrations of HIV in their semen were practising higher rates of transmission risk behaviours while perceiving less risk for potentially transmitting HIV. We conclude that behavioural interventions are needed for HIV-positive men to inform them that HIV infectiousness cannot be inferred from peripheral blood viral loads and to support maintenance of HIV risk reduction behaviours.

Attitude to Health↗
PubMed2001

Human immunodeficiency virus in semen and plasma: investigation of sexual transmission risk behavioral correlates.

Risks for sexually transmitted HIV may be related to concentrations of virus detected in semen and previous research shows a small to moderate association between viral load in blood and semen. This study examined the association between viral load in semen and plasma in a community sample of HIV-infected men and is the first study to examine semen viral load in relation to sexual transmission risk behaviors. A sample of 44 HIV-positive men recruited from community service agencies provided semen, blood, and urine samples and completed clinical interviews assessing health and behavior. We failed to find an association between viral load in semen and plasma, Spearman rho = 0.07, p > 0.1. When restricted to participants with detectable virus in semen and plasma, the correlation remained nonsignificant, rho = -0.16, p > 0.1. Men who had higher semen viral loads relative to their plasma viral load were distinguished by having engaged in significantly higher rates of unprotected intercourse as the insertive sex partner in the previous 3 months. Semen viral load was not, however, related to recent or current sexually transmitted infections (STIs). This study is among the first to examine sexual transmission risk behaviors as marker for HIV infectiousness. Results caution against inferring sexual transmission infectiousness based on plasma viral load and suggest that HIV-positive men who practice higher rates of insertive intercourse may be more infectious even in the absence of other STIs.

Adult↗
PubMed2001

Effectiveness of an intervention to reduce HIV transmission risks in HIV-positive people.

BACKGROUND: As many as one in three HIV-positive people continue unprotected sexual practices after learning that they are HIV infected. This article reports the outcomes of a theory-based intervention to reduce risk of HIV transmission for people living with HIV infection. METHODS: Men (n=233) and women (n=99) living with HIV-AIDS were randomly assigned to receive either (1) a five-session group intervention focused on strategies for practicing safer sexual behavior, or (2) a five-session, contact-matched, health-maintenance support group (standard-of-care comparison). Participants were followed for 6 months post-intervention. RESULTS: The intervention to reduce risk of HIV transmission resulted in significantly less unprotected intercourse and greater condom use at follow-up. Transmission-risk behaviors with non-HIV-positive sexual partners and estimated HIV transmission rates over a 1-year horizon were also significantly lower for the behavioral risk-reduction intervention group. CONCLUSIONS: This study is among the first to demonstrate successful HIV-transmission risk reduction resulting from a behavioral intervention tailored for HIV-positive men and women.

Adaptation, Psychological↗
PubMed2001

The Sexual Compulsivity Scale: further development and use with HIV-positive persons.

We examined the reliability and validity of the Sexual Compulsivity Scale for use in assessing HIV-positive men and women. Measures collected from 287 men and women recruited from the community, the majority of whom were African American and over the age of 30, showed that the Sexual Compulsivity Scale was reliable for men (alpha = .89) and women (alpha = .92). Correlations with measures of sexual behaviors and numbers of sex partners supported the concurrent validity of the Sexual Compulsivity Scale for men and women. Results of discriminant function analyses that included participant age, use of nonalcohol drugs, the Sexual Compulsivity Scale, and scores on measures of trait anxiety, obsessive-compulsiveness, future pessimism, cognitive depression, and borderline personality characteristics showed that sexual compulsivity clearly discriminated between persons with 1 or no sex partners and persons with multiple partners in the past 3 months, for both men and women, suggesting evidence for criterion-related validity. Associations between sexual compulsivity scores and other markers of psychopathology showed different patterns for men and women; sexual compulsivity was associated with indexes of psychopathology in men but not in women. We conclude that the Sexual Compulsivity Scale is reliable and valid in assessing men and women infected with HIV, although sexual compulsivity may present differently between genders in relation to other forms of psychopathology.

Adult↗
PubMed2000

Functional health literacy is associated with health status and health-related knowledge in people living with HIV-AIDS.

BACKGROUND: Poor health literacy is a prevalent barrier to medical care and people with lower health literacy experience greater illness severity than people with higher health literacy. Health literacy may therefore be an important factor in the health and treatment of people living with HIV-AIDS. METHODS: A community-recruited sample of 339 HIV-infected men and women completed surveys and interviews that assessed functional health literacy, health status, AIDS-related disease and treatment knowledge, and health care perceptions and experiences. Medical records were available for chart abstraction of health status for a subsample of participants. RESULTS: About 1 of 4 people living with HIV-AIDS demonstrated difficulty comprehending simple medical instructions and therefore lower health literacy. HIV-infected people with lower health literacy had lower CD4 cell counts, higher viral loads, were less likely to be taking antiretroviral medications, reported a greater number of hospitalizations, and reported poorer health than those with higher health literacy. In addition, after adjusting for years of formal education, lower health literacy was associated with poorer knowledge of one's HIV-related health status, poorer AIDS-related disease and treatment knowledge, and more negative health care perceptions and experiences. CONCLUSIONS: Health literacy is a significant factor in the health and treatment of persons living with HIV-AIDS. Interventions are needed to improve medical care and the health status of people with lower health literacy that are living with HIV-AIDS.

Adult↗
PubMed2000

Health literacy and health-related knowledge among persons living with HIV/AIDS.

BACKGROUND: Functional health literacy is associated with illness-related knowledge, understanding, and treatment perceptions for several chronic illnesses. This study examined health literacy in relation to knowledge and understanding of HIV/AIDS. METHODS: Persons living with HIV/AIDS recruited from AIDS service organizations and HIV clinics completed the Test of Functional Health Literacy for Adults (TOFHLA) reading comprehension scale and measures of health status, knowledge and understanding of health status, perceptions of primary care givers, and perceptions of anti-HIV treatments. RESULTS: Eighteen percent of the sample scored below the cutoff for marginal functional health literacy on the TOFHLA. Controlling for years of education, persons of lower health literacy were significantly less likely to have an undetectable HIV viral load, somewhat less likely to know their CD4 cell count and viral load, and lower health-literacy persons who knew their CD4 count and viral load were less likely to understand their meaning. Lower health literacy was also related to misperceptions that anti-HIV treatments reduce risks for sexually transmitting HIV and beliefs that anti-HIV treatments can relax safer-sex practices. CONCLUSIONS: Poor health literacy creates barriers to fully understanding one's health, illness, and treatments. Misperceptions of treatment in the case of HIV infection creates danger for potentially transmitting treatment-resistant strains of HIV. These results have implications for patient education and treatment programming for people who have poor health-literacy skills and are living with HIV/AIDS.

Acquired Immunodeficiency Syndrome↗
PubMed2000

Distinguishing between overlapping somatic symptoms of depression and HIV disease in people living with HIV-AIDS.

HIV-AIDS is a prevalent medical diagnosis in U.S. cities, and symptoms of depression are common in persons with HIV infection. This study examined the effects of overlapping symptoms of HIV disease and somatic depression that can inflate scores on the Beck Depression Inventory (BDI) and the Centers for Epidemiological Studies Depression Scale (CESD). Results from 357 HIV positive men and women identified discrete subsets of depression symptoms that correspond with symptoms of HIV infection. Removing somatic subsets of depression symptoms improved the clinical utility of the BDI and CESD. Clearer symptom separation occurred with the BDI than the CESD, but the CESD may be more sensitive than the BDI to depression associated with progression of HIV disease. Findings suggest that depression scales that include somatic symptoms will inflate depression scores in people living with HIV infection, and available methods for distinguishing overlapping symptoms should be employed when assessing people living with HIV infection.

Acquired Immunodeficiency Syndrome↗
PubMed2000

Sexually transmitted infections among HIV seropositive men and women.

OBJECTIVES: To determine the prevalence of identified STIs and recognised symptoms of STIs and their association with health status, substance use, and sexual risk behaviour in a sample of HIV seropositive men and women. METHODS: 223 men, 112 women, and five transsexual people living with HIV infection completed confidential surveys. Participants were recruited through community based services, community health clinics, and snowball (chain) recruitment techniques in Atlanta, GA, USA in December 1999. RESULTS: We found that (263) 78% of participants had been sexually active in the previous 3 months. For the entire sample, 42 (12%) participants reported an STI in the past 3 months and 40 (11%) experienced symptoms of an STI without indicating a specific diagnosis in that time. Gonorrhoea, chlamydia, syphilis, and newly diagnosed herpes simplex virus (HSV) were identified at similar rates among men, whereas trichomonas, gonorrhoea, and newly diagnosed HSV occurred most often in women. STIs were associated with substance use in men and women, with "crack" cocaine users having the greatest likelihood of an STI relative to non-crack users. STIs were also associated with continued practice of sexual risk behaviours. CONCLUSIONS: This sample of people living with HIV-AIDS reported high rates of diagnoses and symptoms of STIs. There were significant associations between STIs, substance use, and continued high risk sexual practices in men and women. These findings support the need for studies that confirm prevalence of STIs using clinical laboratory tests.

Adult↗
PubMed2000

Factors associated with female condom use among HIV-seropositive women.

Female condoms are an effective option for preventing sexually transmitted diseases (STDs), including HIV transmission. Little is known, however, about female condom use in women living with HIV/AIDS. Ninety HIV-positive women completed measures of demographic characteristics, exposure and use of female condoms, attitudes toward female and male condoms, sexual behaviours, and substance use. Most women (77%) had been exposed to female condoms, however only 30% reported lifetime use, 16% reported recent use, and only 6% of the sample used female condoms as much or more than they used male condoms. The only factors consistently associated with female condom use were positive attitudes toward female condoms. Women who recently used female condoms were also more likely to have multiple male sex partners and reported fewer unprotected intercourse occasions. Female condoms are therefore used by a small number of HIV-infected women, particularly those with more than one male sex partner. Female condom use may be enhanced by removing barriers to their use, increasing cooperation of male partners, and enhancing proficiency of use.

Adult↗
PubMed2000

Reliability and validity of self-reported CD4 lymphocyte count and viral load test results in people living with HIV/AIDS.

Self-reporting is a common, convenient, and inexpensive method for collecting health status information in HIV/AIDS research, but the reliability and validity of these data remain suspect. HIV-positive persons (n=174) completed self-report measures of demographics, health status, and health literacy, and provided permission to collect CD4 cell counts and viral load results from provider charts. Clinically meaningful categories of CD4 cell counts were reliably and validly assessed using self-report measures. Self-reported viral load, however, demonstrated only marginally acceptable reliability and validity, with the greatest validity occurring for recall of undetectable viral load. Self-reported health status was most reliable and valid for persons with higher levels of education and literacy. CD4 cell counts can therefore be reliably and validly assessed through self-reporting, particularly when collected in clinically meaningful units from persons with higher education. Self-reported viral load should be interpreted with caution and is most reliable when dichotomized into detectable/undetectable categories.

Adult↗
PubMed2000

Bridging the gap between the science and service of HIV prevention: transferring effective research-based HIV prevention interventions to community AIDS service providers.

OBJECTIVES: AIDS service organizations (ASOs) rarely have access to the information needed to implement research-based HIV prevention interventions for their clients. We compared the effectiveness of 3 dissemination strategies for transferring HIV prevention models from the research arena to community providers of HIV prevention services. METHODS: Interviews were conducted with the directors of 74 ASOs to assess current HIV prevention services. ASOs were randomized to programs that provided (1) technical assistance manuals describing how to implement research-based HIV prevention interventions, (2) manuals plus a staff training workshop on how to conduct the implementation, or (3) manuals, the training workshop, and follow-up telephone consultation calls. Follow-up interviews determined whether the intervention model had been adopted. RESULTS: The dissemination package that provided ASOs with implementation manuals, staff training workshops, and follow-up consultation resulted in more frequent adoption and use of the research-based HIV prevention intervention for gay men, women, and other client populations. CONCLUSIONS: Strategies are needed to quickly transfer research-based HIV prevention methods to community providers of HIV prevention services. Active collaboration between researchers and service agencies results in more successful program adoption than distribution of implementation packages alone.

Diffusion of Innovation↗
PubMed1998

Protease inhibitor combination therapies and perceptions of gay men regarding AIDS severity and the need to maintain safer sex.

BACKGROUND: Advances in the treatment of HIV disease with protease inhibitor combination therapies have been widely documented in the media. OBJECTIVES: To investigate perceptions concerning the severity of HIV/AIDS and the need to maintain safer sex practices in the light of recent HIV treatment advances. METHODS: A survey eliciting demographic characteristics, HIV serostatus and treatment information, and HIV/AIDS severity and safer sex perceptions was administered to a community sample of 379 homo-/bisexual men who reported awareness of combination therapy regimens. RESULTS: Ten per cent of all respondents agreed or strongly agreed with the statement that 'AIDS is now very nearly cured' and 13% felt that the threat of AIDS is less serious than in the past. HIV-positive men were more likely to perceive AIDS as a less serious threat or as very nearly cured. Overall, 8% of men in the sample indicated that they practice safer sex less often since new AIDS treatments came along; 18% of HIV-positive men on combination therapy regimens said they practice safer sex less frequently since treatments have advanced. Regardless of serostatus, nearly 20% of men indicated they would stop practicing safer sex if an AIDS cure was announced. CONCLUSION: It is essential to integrate behavior change counseling into HIV treatment programs and to temper optimism concerning treatment advances with recognition that the threat of HIV/AIDS remains great.

Acquired Immunodeficiency Syndrome↗
PubMed1997

Continued high-risk sex among HIV seropositive gay and bisexual men seeking HIV prevention services.

The authors examined HIV risk-related sexual behaviors in an ethnically diverse sample of HIV seropositive gay and bisexual men (N = 86). Measures of sexual behavior, substance use, condom attitudes, behavior change intentions, and engagement in risk-reducing practices were completed. Thirty-nine percent of the men reported engaging in unprotected anal intercourse in the past 3 months. Unprotected anal intercourse was associated with using nitrite inhalants, sex partners who used substances before sex, and low intentions to change risk behavior. These results highlight the difficulties that people living with HIV infection face in maintaining a lifetime of safer sex and the necessity of integrating clinical and prevention interventions for these persons.

Adult↗
PubMed1997

Fatalism, current life satisfaction, and risk for HIV infection among gay and bisexual men.

This study surveyed 430 men at an urban gay pride celebration to assess fatalism, current life satisfaction, and perceived expected years of life among men who have sex with men. Analyses showed that men who engaged in unprotected anal intercourse outside of exclusive relationships reported a greater fatalistic outlook, were more dissatisfied with life, and perceived a shorter life for themselves than men who practiced only safer sex and men who were in exclusive relationships. Gay men in exclusive relationships scored higher than nonexclusively partnered gay men on the measure of current life satisfaction. These results suggest that efforts to prevent HIV infection among gay men should include building personal self-worth, support of long-term relationships, and future goal orientations.

Adult↗
PubMed1997

Lack of positive outcomes from a cognitive-behavioral HIV and AIDS prevention intervention for inner-city men: lessons from a controlled pilot study.

African American men are at increasingly high risk for HIV infection, but there have been few studies of HIV risk reduction interventions for heterosexual ethnic minority men. The present study randomly assigned 81 African American men to one of two HIV prevention interventions: a four-session cognitive-behavioral skills training HIV risk reduction intervention that has been successful with other populations or a four-session HIV risk education and sensitization control condition. Men were assessed at baseline, at immediate postintervention, and at a 3-month follow-up. Forty-five percent of participants dropped out of the intervention; dropouts were younger, more likely to have used condoms, and less likely to have been tested for HIV antibodies than men who completed the study. Outcome analyses showed that both interventions significantly increased AIDS-related knowledge, initial intentions to change HIV risk behaviors, and reduced unprotected vaginal intercourse. However, there were no significant differences between groups on any of the measures at postintervention or follow-up assessments. Recognizing the limitations of our small sample size, the results of this initial study caution against generalizing skills training HIV prevention interventions that have been successful with other populations to African American heterosexual men.

Adult↗
PubMed1996

Experimental component analysis of a behavioral HIV-AIDS prevention intervention for inner-city women.

A component analysis of a behavioral HIV risk reduction intervention was conducted among 87 women recruited from an inner-city community. Women were randomly assigned to an intervention consisting of (a) sexual communication skills training, (b) self-management skills training, (c) a combination of sexual communication and self-management skills, or (d) HIV education and risk sensitization. Results showed that all 4 intervention conditions increased AIDS knowledge and intentions to reduce risk behaviors. Communication skills training resulted in higher rates of risk reduction conversations and risk refusals. However, the combined skills training condition showed the lowest rates of unprotected sexual intercourse at the 3-month follow-up. This study is the first to experimentally control HIV risk reduction elements in an analysis of a skills-based HIV prevention intervention.

Acquired Immunodeficiency Syndrome↗