Preventing the heterosexual spread of AIDS. Are we giving our patients the best advice?
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Acquired Immunodeficiency Syndrome↗
Biomedical subjects
N Hearst
Publications and source records attributed to N Hearst.
AIDS risk assessment in primary care.
BACKGROUND: Human immunodeficiency virus (HIV) disease is a major cause of premature death in the United States. Primary care physicians can and should play an important role in its prevention. Detailed acquired immunodeficiency syndrome (AIDS) education, however, is not a cost-effective use of physicians' time for the great majority of patients, most of whom are at low risk for HIV infection. METHODS: Recommendations for AIDS prevention in the primary care setting were formulated based on a review of the published literature and on the author's personal experience as an AIDS epidemiologist and a practicing family physician. RESULTS AND CONCLUSIONS: Because risk for HIV infection is not uniform, primary care physicians can have the greatest impact by concentrating their prevention efforts on the minority of patients who are at high risk. This article proposes a 30-second AIDS risk assessment for use in routine adult health care. Patients found to be at high risk should receive counseling on HIV risk reduction based on their individual needs. Also described are other situations when primary care providers should talk with their patients about AIDS prevention.
Acquired Immunodeficiency Syndrome↗
Multiple heterosexual partners and condom use among Hispanics and non-Hispanic whites.
A telephone survey of 1,592 Hispanic and 629 non-Hispanic white men and women aged 18-49, randomly selected from nine states in the northeastern and southwestern United States, found that married Hispanic men are more likely to have had two or more heterosexual partners in the previous 12 months than are married non-Hispanic men (18% and 9%, respectively). A large proportion of unmarried men (60% of Hispanics and 54% of non-Hispanic whites) report having had more than one partner in the past 12 months. After adjusting for other variables, the odds of having multiple partners are 2.5 times higher among Hispanic men aged 18-24 than among those aged 41-49 and 1.8 times higher among those who live in the Northeast than among those in the Southwest. Highly acculturated Hispanic men are less likely to have multiple partners than are less acculturated men. Among Hispanic women, those who are moderately or highly acculturated are more likely to have multiple partners (odds ratios of 4.9 and 8.4, respectively) than are less acculturated women. About half of men and women with multiple partners report always using condoms with secondary heterosexual partners.
Acculturation↗
Sexual risk and perception of risk for HIV infection among multiethnic family-planning clients.
Little is known about the relationship among having risks for human immunodeficiency virus (HIV) infection, perceiving oneself at risk, and initiating risk reduction for young sexually active women. We surveyed a multiethnic sample of 267 young-adult female family planning clients attending Planned Parenthood clinics to determine these relationships. Perceiving oneself at risk was significantly associated with having sex outside of a primary relationship in the past year, with having five or more sexual partners in the last five years, and with having a primary partner who has other partners. We found no significant relationship between perceiving oneself at risk and adopting risk-reduction strategies, such as inquiring about a partner's risks or using condoms. These data suggest that the women in this population may be overly optimistic about their invulnerability to HIV. While those women who perceived themselves to be at risk for becoming sexually infected with HIV were more likely to report high-risk behaviors, perception of risk did not motivate these women to adopt low-risk behavior. These data suggest that simple HIV education and acknowledgement may have little effect on reducing exposure to HIV among the women in this population. Alternative strategies for reducing risk must be explored.
Adult↗