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Biomedical subjects

R Stall

Publications and source records attributed to R Stall.

At least 37 records · Page 2Linked to original sources
PubMed1994

AIDS risk behaviors among late middle-aged and elderly Americans. The National AIDS Behavioral Surveys.

OBJECTIVES: Although 10% of all acquired immunodeficiency syndrome (AIDS) cases diagnosed in the United States have been among Americans aged 50 years of age or older, little attention has been devoted to understanding AIDS risk-taking behaviors among middle-aged or older Americans. This study describes the prevalence of AIDS risk among Americans aged 50 years of age or older. DESIGN AND STUDY POPULATION: We present data from the National AIDS Behavioral Surveys, two large cross-sectional national surveys taken in 1990-1991. MAIN OUTCOME VARIABLE: Prevalence of risk behaviors for human immunodeficiency virus (HIV) transmission and of HIV testing. RESULTS: Findings from both surveys provide replication of several important points. First, the prevalence of having at least one risk factor for HIV infection was about 10% among Americans aged 50 years or older in both samples. Very small proportions of Americans past the age of 50 years with a known behavioral risk for HIV infection used condoms during sex or had undergone HIV testing. At-risk Americans past the age of 50 years were one sixth as likely to use condoms during sex and one fifth as likely to have been tested for HIV as a comparison group of at-risk individuals in their 20s. CONCLUSIONS: Despite the fact that HIV infection is clearly present among those past the age of 50 years, a small proportion of individuals in this age group take behavioral risks for HIV infection. High-risk individuals older than 50 years are much less likely to have adopted AIDS prevention strategies than are younger individuals who engage in the same behavioral risks.

AIDS Serodiagnosis↗
PubMed1994

A comparison of public health care utilization by gay men and intravenous drug users with AIDS in San Francisco.

A group of gay-identified men (n = 81) and intravenous drug users (n = 88) diagnosed with AIDS in San Francisco were surveyed regarding their use and satisfaction with their health care services. The interview contained a mix of qualitative and quantitative questions. The two groups of AIDS patients were not statistically different in terms of age or self-reported level of health during the previous 3 months, although the gay men had been diagnosed with AIDS somewhat longer (20 months) than the group of intravenous drug users (15 months). Analysis of the quantitative data revealed that intravenous drug users receive more medical care for HIV disease than did gay men and were equally satisfied with the care that they did receive. Analysis of the qualitative data showed that considerable agreement exists between the perceptions of both gay men and intravenous drug users of the health care system.

Acquired Immunodeficiency Syndrome↗
PubMed1993

HIV antibody testing among those at risk for infection. The National AIDS Behavioral Surveys.

OBJECTIVE: To determine the prevalence of testing for human immunodeficiency virus (HIV) antibody among adults with various risk factors for infection, particularly those residing in large metropolitan areas where the bulk of cases of acquired immunodeficiency syndrome (AIDS) have occurred. DESIGN: A nationwide, population-based telephone survey eliciting testing, sexual, and injection drug use histories. PARTICIPANTS: A total of 2673 randomly chosen US residents and 8263 randomly chosen residents of 23 metropolitan areas containing 64% of reported cases of AIDS. INTERVENTIONS: None. MAIN OUTCOME MEASURE: Testing for HIV antibody. MAIN RESULTS: Overall, rates of individuals ever tested were only slightly higher in the urban areas (23%) than in the nation as a whole (21%). Testing frequencies were low among all risk groups (less than 40%), except men engaging in same-sex sexual activity (60%) and male and female injection drug users (46% and 73%, respectively). The low rate of testing (35%) among the largest risk group, heterosexual men and women engaging in unprotected sexual intercourse with multiple partners, was particularly worrisome. CONCLUSIONS: To encourage antibody testing among the many at risk for infection who have not yet been tested, promotional campaigns should explain the universal susceptibility to infection among those at risk, and the availability of prophylactic medical therapies and social support services to persons who are HIV-seropositive. As there were comparable levels of risk-taking behavior among subjects in both samples, these campaigns must be designed to reach all segments of the population.

AIDS Serodiagnosis↗
PubMed1993

Substance use and risky sexual behavior for exposure to HIV. Issues in methodology, interpretation, and prevention.

Recent reports have suggested that the use of alcohol or drugs is related to sexual behavior that is high risk for HIV infection. If substance use leads to unsafe sexual activity, understanding the dynamics of this relationship can contribute to research and preventive and educational efforts to contain the spread of AIDS. In this article, we review research on the relationship between substance use and high-risk sexual behavior. We then consider the inherent limitations of the research designs used to study this relationship, outline some methodological concerns including measurement and sampling issues, and comment on causal interpretations of correlational research findings. We end with a consideration of potential avenues for future research and a discussion of implications of these findings for current AIDS prevention policies.

Alcoholism↗
PubMed1993

Sexual risk for HIV transmission among gay/bisexual men in substance-abuse treatment.

A sample of San Francisco gay/bisexual men in substance-abuse treatment (N = 314) was compared to the San Francisco Men's Health Study (SFMHS) cohort to compare levels of sexual behaviors that are high-risk for HIV transmission. Quantitative data were supplemented by analysis of transcripts of focus group discussions with gay men in treatment at the same agency. Sexual risk for HIV infection was significantly higher for gay/bisexual men in substance-abuse treatment than among the community-based (SFMHS) sample of gay/bisexual men. Among those entering outpatient alcohol/drug treatment, 21% reported unprotected insertive and sex, 23% reported unprotected receptive anal sex, and 32% reported unprotected insertive and/or receptive anal sex during the previous 3 months. In comparison, in the SFMHS cohort, 17% reported unprotected insertive and sex, 15% reported unprotected receptive anal sex, and 22% reported unprotected insertive and/or receptive anal sex during the previous 6 months. Substance abusers in focus groups identified a number of factors that made it difficult to reduce their sexual risk behavior, including the perceived disinhibiting effects of alcohol and other drugs, learned patterns of association between substance use and sex (especially methamphetamine use and anal sex), low self-esteem, lack of assertiveness and negotiating skills, and perceived powerlessness.

Alcoholism↗
PubMed1992

Prevalence of AIDS-related risk factors and condom use in the United States.

A national probability survey of human immunodeficiency virus (HIV)-related risk factors among the general heterosexual population, the National AIDS (acquired immunodeficiency syndrome) Behavioral Surveys, has obtained data from 10,630 respondents. Data are presented on the prevalence of HIV-related risks in the general heterosexual population, on the distribution of the three largest risk groups across social strata, and on the prevalence and distribution of condom use among heterosexuals reporting a risk factor. Between 15 and 31 percent of heterosexuals nationally and 20 and 41 percent in cities with a high prevalence of AIDS reported an HIV risk factor. Condom use was relatively low. Only 17 percent of those with multiple sexual partners, 12.6 percent of those with risky sexual partners, and 10.8 percent of untested transfusion recipients used condoms all the time. Overall, the results suggest that current HIV prevention programs have, to a very limited extent, reached those heterosexuals with multiple sexual partners but have failed to reach many other groups of the heterosexual population at risk for HIV. New public health strategies may be needed for these specific risk groups.

Acquired Immunodeficiency Syndrome↗
PubMed1992

A comparison of younger and older gay men's HIV risk-taking behaviors: the Communication Technologies 1989 Cross-Sectional Survey.

Data from the 1989 Communication Technologies cross-sectional survey of gay men in San Francisco indicate that both levels and correlates of sexual risk are different between younger and older gay men. Gay men under the age of 30 report higher risk behavior for human immunodeficiency virus (HIV) infection than do gay men who are 30 years of age or older. Further, the set of correlates of unprotected anal intercourse are different between younger and older gay men. Both young and old gay men report that having a primary partner and a lower perceived impact of the AIDS epidemic on their sexual behavior are associated with risk. However, among young gay men, reporting a lower attributed risk for HIV infection to unprotected anal intercourse, higher concern about AIDS risks, and shorter length of residence in San Francisco are positively correlated with risk-taking behavior. These associations were not statistically significant among gay men 30 years of age or older. It appears that the circumstances and/or reasons for taking sexual risk are different between older and younger gay men. Prevention programs must be designed so that they are sensitive to the needs of each generation of gay men.

Adolescent↗
PubMed1991

Changes in condom use among homosexual men in San Francisco.

Employed data from two longitudinal surveys of gay men in San Francisco (a) to examine for cohort (Study 1) and attrition (Studies 1 and 2) bias effects on reported changes in condom use by gay men and (b) to investigate predictors of condom use (Study 2). Substantial increases in condom use were observed, and these changes were unrelated to attrition and cohort bias. In terms of predictors of condom use, men who always used condoms had higher levels of social support from informal sources of help, had more positive expectations that condoms would have positive interpersonal and personal consequences, and were more likely to be HIV positive than men who used condoms occasionally or never. The results are discussed in terms of their implications for HIV-prevention research.

Adult↗
PubMed1991

Tailoring AIDS prevention: differences in behavioral strategies among heterosexual and gay bar patrons in San Francisco.

Three groups of San Francisco bar patrons (heterosexual men, heterosexual women, and gay men) were compared on four sexual risk reduction strategies for AIDS: safer sex practices (particularly adoption of the use of condoms), reducing the number of sexual partners, taking the HIV antibody test, and determining the characteristics of a potential sexual partner. Heterosexuals reported fewer sex partners and were more likely than gay men to interview potential partners. Gay men were more likely to use condoms and the HIV antibody test than their heterosexual counterparts. These findings encourage the design of interventions that take advantage of shaping and reinforcing strategies already in use in each group, and suggest when it is necessary to teach new strategies.

Acquired Immunodeficiency Syndrome↗
PubMed1990

Relapse from safer sex: the next challenge for AIDS prevention efforts.

Prevention campaigns to reduce sexual transmission of human immunodeficiency virus (HIV) typically emphasize the initial adoption of safer sex techniques. We present data from a 5-year prospective study to show that the vast majority of resident gay men in San Francisco have made these initial risk reductions. Rather, relapse from safer sex techniques is now the predominant predominant kind of high-risk sex, accounting for approximately two thirds of all prevalent high-risk sex in the 1988 wave of data collection. Predictors of relapse from safer sex are identified, and these are discussed in terms of their implications for preventing relapse from the exclusive practice of safe sex. In communities that have already manifested widespread behavioral risk reductions and in which HIV infection is highly prevalent, finding ways to prevent relapse of behavioral risk reductions will be the next important challenge in the fight against acquired immune deficiency syndrome.

Acquired Immunodeficiency Syndrome↗
PubMed1989

Older Americans and AIDS: transmission risks and primary prevention research needs.

The growing number of AIDS cases among older Americans (50 years and older) is of increasing concern. In the context of primary prevention, findings are reviewed that bear on the modes of HIV transmission (blood transfusion, sexual) among older individuals and knowledge of the magnitude of the AIDS problem represented by these routes of infection. Lastly, a proposed research agenda is focused on questions of primary prevention of HIV transmission.

Acquired Immunodeficiency Syndrome↗
PubMed1988

A comparison of alcohol and drug use patterns of homosexual and heterosexual men: the San Francisco Men's Health Study.

Very high prevalence rates for problem drinking and/or alcoholism have been estimated for homosexual male populations. Populations characterized by high prevalence rates for problematic drug or alcohol use are of special interest since study of such groups may help to provide insights regarding the processes associated with problematic substance use. However, prevalence estimates for problematic substance use within gay male populations have most typically relied on convenience samples and generally contain an over-representation of bar patrons. This study reports data from a large scale random household sample of homosexual and heterosexual men who live in an urban district of San Francisco, California. Few differences were noted in the drinking patterns of these men, although important differences were found in the prevalence of drug use over a 6-month period. Differences in the prevalence of at least weekly drug use were comparatively minor, however. Health policy implications of these findings are discussed.

Adult↗
PubMed1987

Research issues concerning alcohol consumption among aging populations.

Research concerning alcohol consumption by the elderly has primarily focused on the extent of problem drinking among seniors. Although an important research agenda, an exclusive concern with problem drinking rates can work to obscure interesting health policy and theoretical questions which might be addressed through the study of drinking practices of older age strata. Primary among these is the study of how alcohol use patterns change across the life course, with the goal of showing how such lifelong drinking patterns influence consumption in old age. The literature concerning alcohol use and aging is reviewed to highlight reasons for change and stability in alcohol consumption during latter half of life. From this literature seven hypotheses, amenable to empirical testing, are identified for ongoing research.

Age Factors↗