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Biomedical subjects

Michael W Ross

Publications and source records attributed to Michael W Ross.

At least 19 recordsLinked to original sources
PubMed2007

Differences in HIV risk behaviors by gender in a sample of Tanzanian injection drug users.

This study investigated differences in drug use and sexual behaviors among from 237 male and 123 female heroin users in Dar es Salaam, Tanzania. Multivariate models of risk of needle sharing were estimated using multivariate logistic regression. Men were significantly older, more likely to inject only white heroin, share needles, and give or lend used needles to other injectors. Women were more likely to be living on the streets, have injected brown heroin, have had sex, have had a higher number of sex partners, and have used a condom with the most recent sex partner. Being male and earning less than US $46 in the past month were significant predictors of increased risk of needle sharing. Despite differences in sociodemographic, drug use, and sexual behaviors by gender, both male and female injectors in Dar es Salaam exhibit elevated risk of HIV infection associated with drug use.

Adult↗
PubMed2007

Factors associated with suboptimal antiretroviral therapy adherence to dose, schedule, and dietary instructions.

The purpose of this study was to assess the degree of suboptimal antiretroviral therapy adherence to dose, schedule, and dietary instructions and to examine the effects of extra-personal, intra-personal, and inter-personal factors on suboptimal adherence across the three types of instructions. Self-report and clinical data were collected from 193 sexually infected Swedish patients receiving ART. Effects of extra-personal, intra-personal, and inter-personal factors on suboptimal adherence were examined using multivariate logistic regression models. Suboptimal adherence to dose instructions was recorded in 12% of patients. Equivalent percentage for suboptimal adherence to schedule instructions was 37% and for suboptimal adherence to dietary instructions 58%. Anxiety was the only risk factor for suboptimal adherence to dose. Heavy pill burden was a risk factor for suboptimal adherence to schedule. Older age and HIV-related post-traumatic stress disorder (PTSD) symptoms decreased the risk of suboptimal adherence to schedule. No factors investigated had an effect on suboptimal adherence to dietary instructions. To improve adherence to dose and schedule instructions, clinicians caring for patients with HIV should assess and treat anxiety and be alert to HIV-related PTSD symptoms.

Adult↗
PubMed2007

Knowledge and attitudes of Pakistani medical students towards HIV-positive and/or AIDS patients.

As the incidence of HIV increases, one of the major steps in preventing a widespread epidemic is to make certain that medical students are prepared to recognize and treat HIV infections and their related conditions, and to counsel patients about avoiding risks that might lead to infections. This cross-sectional study assessed the knowledge level of 357 medical students and their attitudes about AIDS and HIV enrolled in a Medical College in Karachi, Pakistan. Only 6% of the students had complete knowledge on symptoms of HIV/AIDS and 7% of the students had complete knowledge on the modes of transmission of HIV. Statistical analysis of demographic factors affecting knowledge was done. Linear regression and Maentel-Haenszel tests showed that older and clinical students were more knowledgeable of symptoms and modes of transmission of HIV/AIDS. Ten attitudes were correlated with knowledge and none of these showed an association. These results on knowledge indicate that education about HIV/AIDS should be incorporated in the curriculum and interventions must be taken by public health professionals to avoid poor treatment outcomes.

Acquired Immunodeficiency Syndrome↗
PubMed2006

Conducting Internet-based HIV/STD prevention survey research: considerations in design and evaluation.

The aim of this paper is to advance rigorous Internet-based HIV/STD Prevention quantitative research by providing guidance to fellow researchers, faculty supervising graduates, human subjects' committees, and review groups about some of the most common and challenging questions about Internet-based HIV prevention quantitative research. The authors represent several research groups who have gained experience conducting some of the first Internet-based HIV/STD prevention quantitative surveys in the US and elsewhere. Sixteen questions specific to Internet-based HIV prevention survey research are identified. To aid rigorous development and review of applications, these questions are organized around six common criteria used in federal review groups in the US: significance, innovation, approach (broken down further by research design, formative development, procedures, sampling considerations, and data collection); investigator, environment and human subjects' issues. Strategies promoting minority participant recruitment, minimizing attrition, validating participants, and compensating participants are discussed. Throughout, the implications on budget and realistic timetabling are identified.

HIV Infections↗
PubMed2006

Why healthcare workers don't wash their hands: a behavioral explanation.

OBJECTIVE: To elucidate behavioral determinants of handwashing among nurses. DESIGN: Statistical modeling using the Theory of Planned Behavior and relevant components to handwashing behavior by nurses that were derived from focus-group discussions and literature review. SETTING: The community and 3 tertiary care hospitals. PARTICIPANTS: Children aged 9-10 years, mothers, and nurses. RESULTS: Responses from 754 nurses were analyzed using backward linear regression for handwashing intention. We reasoned that handwashing results in 2 distinct behavioral practices--inherent handwashing and elective handwashing--with our model explaining 64% and 76%, respectively, of the variance in behavioral intention. Translation of community handwashing behavior to healthcare settings is the predominant driver of all handwashing, both inherent (weighted beta =2.92) and elective (weighted beta =4.1). Intended elective in-hospital handwashing behavior is further significantly predicted by nurses' beliefs in the benefits of the activity (weighted beta =3.12), peer pressure of senior physicians (weighted beta =3.0) and administrators (weighted beta =2.2), and role modeling (weighted beta =3.0) but only to a minimal extent by reduction in effort (weighted beta =1.13). Inherent community behavior (weighted beta =2.92), attitudes (weighted beta =0.84), and peer behavior (weighted beta =1.08) were strongly predictive of inherent handwashing intent. CONCLUSIONS: A small increase in handwashing adherence may be seen after implementing the use of alcoholic hand rubs, to decrease the effort required to wash hands. However, the facilitation of compliance is not simply related to effort but is highly dependent on altering behavioral perceptions. Thus, introduction of hand rub alone without an associated behavioral modification program is unlikely to induce a sustained increase in hand hygiene compliance.

Adult↗
PubMed2006

Prevalence of childhood sexual abuse among incarcerated males in county jail.

OBJECTIVE: The current study examined the prevalence and characteristics of childhood sexual abuse in a jailed-based population. METHODOLOGY: A retrospective, self-reported survey was administered over an 8-week period to a random sample of 100 men who were incarcerated in a county jail in Southeastern Texas. The survey included questions about childhood sexual experiences before and after puberty, drug history and use, and sexual risk-taking behaviors. RESULTS: Of the 100 male inmates who participated in this study, 59% reported experiencing some form of sexual abuse before puberty, and all such instances occurred before or at the age of 13 years. The first episode of childhood sexual abuse began at an average age of 9.6 years (SD = 2.4), and ended at an average age of 13.0 years (SD = 2.3). Kissing and touching without intercourse (64%) was the common pattern of sexual abuse experience reported. The total number of perpetrators was 165, with 10% male and 90% female. Friends (n = 72) and family (n = 56) were the most frequent perpetrators. CONCLUSION: Childhood sexual abuse may be more prevalent among inmates than among males in the general population. These results show a high percentage of inmates who report a history of childhood sexual abuse; this rate is higher than those reported by other studies for incarcerated males. The findings support the belief held by professionals in the criminal justice field that a significant number of incarcerated males may have been victims of sexual abuse.

Adolescent↗
PubMed2006

HIV/AIDS and injection drug use in the neighborhoods of Dar es Salaam, Tanzania.

This study examines the intersection between needle-sharing practices and HIV recovered from used syringes collected from 73 heroin injection drug users (IDUs) in Dar es Salaam, Tanzania, between October 2003 and January 2004. To extract blood residue, syringes were flushed and 10 microliters of solution mixed with 120 microliters of a latex solution was placed on a Capillus HIV-1/2 slide. Thirty-five (57%) of the useable syringes tested positive for HIV antibodies. Results varied significantly: 90% of syringes tested HIV positive in a mixed-income neighborhood 2 kilometers from the city center: 0% of syringes tested HIV positive in the outlying areas. In addition, semistructured interviews were conducted with 51 IDUs. The interviews were content coded, and codes were collapsed into emergent themes regarding syringe-use practices. Injecting is a recent practice, particularly among heroin users in neighborhoods far from the city center. Sharing syringes has resulted in a high proportion of used syringes containing HIV-positive blood residue. Geographic distance is an indicator of recent adoption of IDU in neighborhoods and correlates strongly with the distribution of syringes containing HIV-positive blood residue.

Acquired Immunodeficiency Syndrome↗
PubMed2006

Psychological correlates of trading sex for money among African American crack cocaine smokers.

This article compares demographic characteristics, sexual practices, and psychosocial status among 193 African American female crack cocaine users who currently, previously, or never traded sex for money. Current traders were less likely to have a main sexual partner, more likely to have a casual sexual partner, and more likely to smoke larger quantities of crack. There was a significant trend towards current traders reporting lower self-esteem, greater depression and anxiety, poorer decision-making confidence, more hostility, less social conformity, greater risk taking behaviors, and more problems growing up, compared to previous and never traders. These differences suggest that interventions should address self-esteem, risk-taking practices, depression and anxiety as well as other psychosocial factors.

Adolescent↗
PubMed2006

Conspiracy beliefs about the origin of HIV/AIDS in four racial/ethnic groups.

We examined beliefs about the origin of HIV as a genocidal conspiracy in men and women of four racial/ethnic groups in a street intercept sample in Houston, Texas. Groups sampled were African American, Latino, non-Hispanic white, and Asian. Highest levels of conspiracy theories were found in women, and in African American and Latino populations (over a quarter of African Americans and over a fifth of Latinos) with slightly lower rates in whites (a fifth) and Asians (less than one in ten). Reductions in condom use associated with such beliefs were however only apparent in African American men. Conspiracy beliefs were an independent predictor of reported condom use along with race/ethnicity, gender, education, and age group. Data suggest that genocidal conspiracy beliefs are relatively widespread in several racial/ethnic groups and that an understanding of the sources of these beliefs is important to determine their possible impact on HIV prevention and treatment behaviors.

Adolescent↗
PubMed2006

Relationship between expressed HIV/AIDS-related stigma and HIV-beliefs/knowledge and behaviour in families of HIV infected children in Kenya.

OBJECTIVES: To quantify expressed stigma in clients of the Kangemi program for HIV+ children, and to characterize the association between stigma and other population characteristics. METHODS: By means of a household survey we created a stigma index and indices for other social and knowledge domains that influence HIV-related healthcare. We used chi2, anova, and correlation to identify associations between domains. RESULTS: The mean (+/-SD) expressed stigma on a six points scale (6 = least stigma) was 3.65 +/- 1.64. Composite scores on knowledge about AIDS were skewed toward more knowledge; and analysis of individual knowledge items indicates that most respondents reject erroneous traditional beliefs and myths about the causes and transmission routes of AIDS. Respondents who were younger, had never married, and had less education expressed greater stigma. Differences in stigma were associated with poor knowledge about AIDS and negative attitudes toward testing, but not with gender or tribal affiliation. Condom use at last intercourse, unrelated to stigma, was only 40% (n = 218). CONCLUSIONS: While this population has good knowledge about AIDS and appraises risks realistically, it fails to reduce these risks. Associations between stigma and other domains can inform interventions that improve HIV care and mitigate spread of HIV.

Acquired Immunodeficiency Syndrome↗
PubMed2006

An investigation of concurrent sex partnering in two samples of drug users having large numbers of sex partners.

The objective of this study was to quantitatively measure the nature of concurrent sex partnering in two samples of drug users having large numbers of sex partners. The purpose of this study was to measure concurrent sex partnering and overlap in concurrent sex partners in two samples of drug users in which some or all participants were trading sex-for-money. Two samples having large numbers of sex partners were used to conduct the analyses: drug-using male sex workers (MSW) and male and female crack cocaine smokers (CS) having vaginal sex. To reflect the quality of concurrent partnering, three measures were used: the proportion of the samples having concurrent partners; the proportions of the samples having intimate, casual, and sex-for-money of partners; and overlap in concurrent partners. Proportions of each sample having concurrent partners were essentially the same. However, the kinds of concurrent partners and overlap in concurrent partners were significantly different. Concurrent partners in the MSW sample were mostly sex-for-money or sex-for-drugs partners. Most concurrent partners in the CS sample were initimate or casual sex partners. Overlap in concurrent partners was also significantly different. The measure of overlap for the CS sample was three times higher than that of the MSW sample. These data suggest that concurrent sex partnering in the two samples, beyond the proportion having concurrent partners, was different. The patterns of concurrent sex partners in each sample may reflect different reasons for engaging in concurrent partnering. Different reasons for engaging in concurrent partnering may also be reflected in different overlap scores between the two samples. Efforts should be made in future studies to better capture the complexities of concurrent partnering and to examine the implications of these for disease spread and control.

Adult↗
PubMed2006

HIV prevention and street-based male sex workers: an evaluation of brief interventions.

The purpose of this study was to evaluate the acceptability and the comparative efficacy of brief HIV risk reduction interventions to increase condom use during paid anal sex by street-based male sex workers (MSWs). Of the 399 street-based MSWs who participated in the evaluation of acceptability, 112 participated in the evaluation of efficacy. Acceptability was evaluated by assessing completion rates. Intervention efficacy was assessed across two brief interventions, a "standard" and a "standard-plus" interventions. The primary outcome of concern was condom use during paid anal sexual encounters. In addition to this variable, changes in drug use, needle use, condom use beliefs, and condom use intention were also assessed. Results showed that almost two thirds of MSWs enrolled in a brief intervention completed it. Completion rates varied by age, race/ethnicity, sexual orientation, and HIV status. Condom use during paid anal sex increased postintervention. In addition, condom use intentions, positive condom use outcome expectations, and condom use normative expectations increased preintervention to postintervention. However, there were no significant differences between the standard and the standard-plus brief interventions in any of the outcomes measured. Brief interventions to reduce the HIV risks are acceptable to MSWs and are efficacious for reducing unprotected anal sex during paid sexual encounters.

Adolescent↗
PubMed2006

Outcomes of Project Wall Talk: an HIV/AIDS peer education program implemented within the Texas State Prison system.

We report select outcomes from an evaluation of Project Wall Talk, a community-based, peer-led HIV prevention education program implemented in 36 Texas State prison units. Peer educators completed questionnaires prior to receipt of a 40-hour intensive training (N = 590) and at 9-month follow-up (N = 257). Students (N = 2506) completed questionnaires pre- and post-receipt of peer educator-led HIV education sessions. Peer educators and their students showed significant increases in HIV-related knowledge. Peer educators showed significant increases in assessment of their skills as educators. For both peer educators and students, significant differences in HIV-related knowledge were indicated across categories of prior educational level attained and race/ethnicity; no such differences were indicated at follow-up. Compared with baseline, a significantly greater proportion of peer educators reported ever having had an HIV test. After receiving peer-led education, a significantly smaller proportion of students reported they knew their HIV status and more indicated plans to take an HIV test. Additionally, in months 12 and 18 following program implementation, the numbers of HIV tests at the five units that implemented the peer education program were roughly twice that of five, matched comparison units without the peer education program. Based on peer educator reports, we projected that peer educators (N = 257) may have as many as 84,000 or more annual opportunities to share HIV-related knowledge with other prisoners outside the classroom.

Adult↗
PubMed2006

The impact of a situationally focused individual human immunodeficiency virus/sexually transmitted disease risk-reduction intervention on risk behavior in a 1-year cohort of Nigerian military personnel.

Human immunodeficiency virus (HIV) and sexually transmitted disease (STD)-related risks in peacekeeping troops is a concern when they are stationed in areas of high HIV prevalence. We carried out an assessment of a situationally focused individual HIV/STD reduction intervention (where avoidance of risk situations, as well as risk behaviors, are emphasized) in one Nigerian military unit (N = 1,222), with a comparable unit from the same service as a waiting list control (N = 987). The intervention consisted of a possible five modules that were presented to groups of up to 50 personnel. Data were collected on reported sexual behaviors, condom beliefs, sexual risk behaviors with casual partners, and number of interventions attended. Data indicated significant increases in reported condom use with casual partners and positive condom beliefs at 6- and 12-month follow-up. Risk behavior was reduced 30% from baseline at 6 months and 23% from baseline at 12 months. There was also a significant dose-response effect for number of interventions attended. These data suggest that relatively brief situationally focused individual interventions are effective in military and West African contexts in reducing HIV/STD risk behaviors.

Adolescent↗
PubMed2005

Surgical and nonsurgical management of sagittal slab fractures of the third carpal bone in racehorses: 32 cases (1991-2001).

OBJECTIVE: To compare results (ie, return to racing and earnings per race start) of surgical versus nonsurgical management of sagittal slab fractures of the third carpal bone in racehorses. DESIGN: Retrospective study. ANIMALS: 32 racehorses (19 Thoroughbreds, 11 Standardbreds, and 2 Arabians). PROCEDURE: Medical records and radiographs were reviewed to obtain information regarding signalment and treatment. Follow-up information was obtained from race records. Robust regression analysis was performed to evaluate earnings per start in horses that raced at least once before and after injury. RESULTS: 22 (69%) horses raced at least once after treatment of the fracture. All 7 horses treated by means of interfragmentary compression raced after treatment, and horses that underwent interfragmentary compression had significantly higher earnings per start after the injury than did horses treated without surgery. Eight of 9 horses treated by means of arthroscopic debridement of the damaged cartilage and bone raced after treatment, but only 7 of 16 horses treated without surgery (ie, stall rest) were able to return to racing after treatment. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that racehorses with sagittal slab fractures of the third carpal bone have a favorable prognosis for return to racing after treatment. Horses treated surgically were more likely to race after treatment than were horses treated without surgery.

Animals↗
PubMed2005

Spatial bridging in a network of drug-using male sex workers.

This study sought to determine whether drug-using male sex workers (MSWs) spatially bridge sexual networks across cities and to determine whether the behaviors of MSWs who bridge differ from the behaviors of those who do not. Data were collected from 42 MSWs in Houston, Texas, between May 2003 and February 2004. Spatial bridging was defined as having traded sex for money in another city before traveling to and trading in Houston. Cities bridged by MSWs were geographically plotted and were primarily located in the Gulf Coast and in Florida. Slightly less than half of MSWs were identified as spatially bridging from one city to another. A significantly higher proportion of MSWs who bridged cities were homosexual (55% vs. 23%) and HIV positive (31% vs. 5%). Those who bridged cities used marijuana and injected drugs more frequently and had significantly more male sex partners than MSWs who did not bridge cities. Despite the small sample size, this study found that many drug-using MSWs spatially bridge sexual networks in cities where they trade sex for money.

Adult↗
PubMed2005

Biases in internet sexual health samples: comparison of an internet sexuality survey and a national sexual health survey in Sweden.

The internet is becoming a favored technology for carrying out survey research, and particularly sexual health research. However, its utility is limited by unresolved sampling questions such as how biased internet samples may be. This paper addresses this issue through comparison of a 'gold standard' random selection population-based sexual survey (The Swedish Sexual Life Survey) with an internet-based survey in Sweden which used identical demographic, sexual and relationship questions, to ascertain the biases and degree of comparability between the recruitment methods. On the internet questionnaire, there were significant differences between males and females on all the measured indices. There were no significant differences in proportions of males and females, or nationality, between the two samples. However, the internet samples for both males and females were significantly more likely to be younger, originally from and currently living in a major city, better educated, and more likely to be students and less likely to be retired. Relationship variables were less likely to be significantly different between samples: there were no differences for males or females between the SSS and the internet samples on having been in a committed relationship, and how they met their present partner, nor for males in having discussed separation in the past year. However, there was a higher proportion of people attracted to the same sex, and higher numbers of sex partners (as well as a higher proportion of people reporting no sex) in the past year, in the internet sample. These data suggest that apart from the demographics of age, location, and education, currently being in a committed relationship, and the number of sex partners in the past year, internet samples are comparable for relationship characteristics and history with a national sexual life survey. Comparison of internet data with random survey data in other western countries should occur to determine if these patterns are replicated.

Adolescent↗