PubMed Health⌕ Search

Biomedical subjects

P Flowers

Publications and source records attributed to P Flowers.

14 recordsLinked to original sources
PubMed2006

Cruising for sex: sexual risk behaviours and HIV testing of men who cruise, inside and outwith public sex environments (PSE).

This paper describes sexual risk behaviours and HIV testing amongst men who cruise an urban public sex environment (PSE) in southern England. Data were collated using a cross-sectional survey (response rate = 56%; n=216), sampling men from directly within the PSE. As such, this represents the first peer-review study generalizable to the wider population of urban PSE users. The current sample reflect a highly sexually active population, almost one-third (31%) reported over 50 sex partners in the last year. However, just one-quarter (26%) reported unprotected anal intercourse (UAI) with at least one partner outside of a 'safer sexual strategy'. Almost 1 in 12 (7%) reported UAI within the PSE. Over two-thirds (71%) had had a named HIV test of whom 16% had tested HIV positive. Just one-third (34%) of negative/untested PSE users had tested within the previous two years. Positive men were significantly more likely to report unsafe sex within the PSE in the last year. PSE users report lower levels of UAI than men in the local gay community but higher HIV prevalence. PSE-based UAI remains an HIV (re)infection risk. In concert, these findings suggest the importance of in situ targeted health promotion to prevent PSE-based risks.

Adolescent↗
PubMed2005

Men who have sex with men (MSM) in public sex environments (Pses): a systematic review of quantitative literature.

We systematically review quantitative research relating to the sexual behaviours of MSM in PSEs. We examine the methodological rigour of these studies to determine an appropriate framework for future PSE-based research and quantify sexual behavioural trends therein. Medline, BIDS, Web of Science and recent HIV/AIDS conferences were searched according to a systematic inclusion criteria. Nine papers were included for review. Recruitment of participants' outwith PSE settings, and low response rates (6%) of participants contacted in situ, question the validity and generalizability of current evidence. Most PSE users were gay or bisexually identified and half of men in the gay community reported recent PSE use. Around 10% of men reported casual status-unknown/serodiscordant unprotected anal intercourse (UAI) within PSEs. HIV testing rates amongst PSE users were similar to the wider gay community, though the proportion of men who tested positive was twice as high. Rates of casual UAI suggest that PSEs represent important sites for HIV prevention. However, since extant evidence is scant and methodologically flawed, further research is urgent. Such work must recruit participants in situ, and obtain satisfactory response rates, to be generalizable to the wider population of men who cruise.

HIV Infections↗
PubMed2004

Good in parts: the Gay Men's Task Force in Glasgow--a response to Kelly.

We know that peer education, or the use of popular opinion leaders (POLs), works in terms of reducing reported risk behaviour for HIV infection amongst gay men. The work of Jeffrey Kelly and his colleagues provides some of the best scientific evidence in support of this approach. Influenced by this work, we undertook a peer education intervention amongst gay men in bars in Glasgow--the Gay Men's Task Force (GMTF)--but failed to demonstrate any reduction in sexual risk behaviour for HIV infection. In this paper we describe why we were unable to repeat in Scotland the success in small cities in the USA of the POL model. Our explanations include: failure to replicate the 'core elements' of POL; spatial and temporal differences between the original POL settings and the bars of Glasgow; and the currency of ideas such as 'peer education' beyond the protocols designed for their implementation. However, we also describe some of the successful features of the GMTF in Glasgow, and the continued value of peer education in contributing to reductions in sexual risk behaviour for HIV infection.

HIV Infections↗
PubMed2002

Gay men's HIV testing behaviour in Scotland.

This paper reports on the social and demographic factors associated with HIV testing in gay men in Scotland. Trained sessional research staff administered a short self-complete questionnaire to men in gay bars during January and February 1999 in Glasgow and Edinburgh, Scotland. Questionnaires were completed by 2,498 men (response rate of 77.5%). Half (1,190; 50%) reported ever having been HIV antibody tested, with men in Edinburgh more likely to report testing. Testing was associated with being older (26 years plus), higher education, reporting one unprotected anal intercourse (UAI) partner, or six or more UAI partners, in the last year, genitourinary medicine clinic service use, and lifetime experience of sexually transmitted infections. There was no relationship between HIV testing and treatment optimism, or evidence of a "post-Vancouver" effect. Over a fifth of men who said that they knew their own HIV status at last UAI had never been tested. Current testing policy needs to be challenged if there is to be an increase in the number of gay men who know their HIV status and, if tested HIV-positive, to then access antiretroviral treatments.

Adolescent↗
PubMed2002

Does bar-based, peer-led sexual health promotion have a community-level effect amongst gay men in Scotland?

This paper evaluates the effectiveness of a bar-based, peer-led community-level intervention to promote sexual health amongst gay men. The intervention consisted of peer education within bars, gay specific genitourinary medicine (GUM) services and a free-phone hotline. Data were collected at baseline (1996) and at follow-up (1999) in gay bars in Glasgow (intervention city) and Edinburgh (control city). During the intervention peer educators interacted with 1484 men and new clients increased at the gay specific GUM service. However, the hotline was under-utilized and abused. The outcome measures were: reported hepatitis B vaccination; HIV testing; unprotected anal intercourse (UAI) with casual partners; negotiated safety; and amongst men reporting UAI with a regular partner, the proportion who knew their own and their partner's HIV status. Significant differences in sexual health behaviours were observed across locations and across time, but the only significant intervention effects were amongst men who had direct contact with the intervention, with higher uptake of hepatitis B vaccination and HIV testing. The intervention did not produce community-wide changes in sexual health behaviours. These results question the replication and transferability of peer-led, community-level sexual health promotion for gay men outwith the USA and across time.

Adolescent↗
PubMed2001

"I was terrified of being different": exploring gay men's accounts of growing-up in a heterosexist society.

This study examined retrospective accounts of gay identity formation during adolescence. Twenty in-depth interviews were conducted with working-class gay men from a small town in the north of England. Themes salient to understanding their adolescent experiences of identity formation were identified: "defined by difference", "self-reflection and inner conflict", "alienation and isolation", "living a lie", "telling others", and "wholeness and integrity". We illustrate how the socio-cultural context of compulsory heterosexuality is central in understanding accounts of both reported minority stress and identity construction. The implications of the research for future interventions designed to tackle homophobia and heterosexism are discussed.

Adolescent↗
PubMed2001

The Gay Men's Task Force: the impact of peer education on the sexual health behaviour of homosexual men in Glasgow.

OBJECTIVE: To assess the impact of a peer education intervention, based in the "gay" bars of Glasgow, which sought to reduce sexual risk behaviours for HIV infection and increase use of a dedicated homosexual men's sexual health service, and in particular increase the uptake of hepatitis B vaccination. DESIGN: Self completed questionnaires administered to men who have sex with men (MSM) in Glasgow's gay bars. SUBJECTS: 1442 men completed questionnaires in January 1999, 7 months after the end of the 9 month sexual health intervention. MAIN OUTCOME MEASURES: Self reported contact with the peer education intervention, reported behaviour change, and reported sexual health service use. RESULTS: The Gay Men's Task Force (GMTF) symbol was recognised by 42% of the men surveyed. Among men who reported speaking with peer educators 49% reported thinking about their sexual behaviour and 26% reported changing their sexual behaviour. Logistic regressions demonstrated higher levels of HIV testing, hepatitis B vaccination, and use of sexual health services among men who reported contact with the intervention. These men were more likely to have used the homosexual specific sexual health service. Peer education dose effects were suggested, with the likelihood of HIV testing, hepatitis B vaccination, and use of sexual health services being greater among men who reported talking to peer educators more than once. CONCLUSION: The intervention had a direct impact on Glasgow's homosexual men and reached men of all ages and social classes. Higher levels of sexual health service use and uptake of specific services among men who had contact with the intervention are suggestive of an intervention effect. Peer education, as a form of health outreach, appears to be an effective intervention tool in terms of the uptake of sexual health services, but is less effective in achieving actual sexual behaviour change among homosexual men.

Adolescent↗
PubMed1999

Homosexual men's HIV related sexual risk behaviour in Scotland.

OBJECTIVE: To date, the epidemic of HIV infection in Scotland has been primarily associated with injecting drug use. However, the epidemiology of HIV in Scotland changed in the late 1980s, with homosexual men becoming the largest group at risk of HIV infection and AIDS. Our aim was to describe homosexual men's sexual risk behaviours for HIV infection in a sample of men in Scotland's two largest cities. DESIGN/SETTING: Trained sessional research staff administered a short self completed questionnaire, to homosexual men present in all of Glasgow's and Edinburgh's "gay bars," during a 1 month period. SUBJECTS: A total of 2276 homosexual men participated, with a response rate of 78.5%. Of these, 1245 were contacted in Glasgow and 1031 in Edinburgh. MAIN OUTCOME MEASURES: Sociodemographic data, recent (past year) sexual behaviour, information on last occasion of anal intercourse with and without condoms, and sexual health service use. RESULTS: Anal intercourse is a common behaviour; 75% of men have had anal intercourse in the past year. A third of our sample report anal intercourse with one partner in the past year, but 42% have had anal intercourse with multiple partners. Over two thirds of the total population have not had any unprotected anal intercourse (UAI) in the past year and a quarter of the sample have had UAI with one partner only. 8% report UAI with two or more partners. More men in Edinburgh (17% v 10%) reported unprotected sex with casual partners only, but more men in Glasgow (29% v 20%) reported UAI with both casual and regular partners (chi 2 = 12.183 p < 0.02). Multiple logistical regression found that odds of UAI are 30% lower for men with degree level education and 40% lower for men who claim to know their own HIV status, whereas they are 40% higher for those who have been tested for HIV and 48% higher for infrequent visitors to the "gay scene". Men who have had an STI in the past year are 2.4 times more likely to report UAI than those who have not. Men with a regular partner were significantly more likely to report UAI, as were those who had known their partner for longer, and who claimed to know their partner's antibody status. CONCLUSION: On the basis of current sexual risk taking, the epidemic of HIV among homosexual men in Scotland will continue in future years. The data reported here will prove useful both for surveillance of sexual risk taking, and the effectiveness of Scotland-wide and UK-wide HIV prevention efforts among homosexual men.

Adolescent↗
PubMed1992

A continuous quality improvement team approach to adverse drug reaction reporting.

Crossfunctional teams can generate more new ideas, concepts, and possible solutions than does a department-based process alone. Working collaboratively can increase knowledge of teams using CQI approaches and appropriate tools. CQI produces growth and development at multiple levels resulting from involvement in the process of incremental improvement.

Adverse Drug Reaction Reporting Systems↗
PubMed1977

Stapedius reflex decay in myasthenia gravis.

Stapedius reflex decay, in response to a one-minute sound stimulus of 500 Hz occurred in six patients with myasthenia gravis. This decay is analagous to the decremental response of muscle action potentials to rapid nerve stimulation. Edrophonium chloride decreases the degree of decay. This represents a useful test in the diagnosis of myasthenia gravis.

Acoustic Stimulation↗
PubMedDate not supplied

Alabama's hospital legacy. Interview by Rosemary Blackmon.

Jackson, Carraway, and Flowers--three men who truly personify medicine in the state of Alabama. ALAHA public relations director Rosemary Blackmon recently spoke with each of them about the past and future of healthcare.

Alabama↗