Biomedical subjects

Shirley J Semple

Publications and source records attributed to Shirley J Semple.

18 recordsLinked to original sources

PubMed2006

Sexual risk behavior of HIV-positive methamphetamine-using men who have sex with men: the role of partner serostatus and partner type.

This study examined the role of partner serostatus and partner type in relation to the sexual risk behaviors and disclosure practices of HIV-positive methamphetamine (meth)-using men who have sex with men (MSM). The sample consisted of 132 HIV-positive meth-using MSM who reported having both serodiscordant (i.e., HIV-negative and unknown serostatus) and seroconcordant (i.e., HIV-positive) partners. HIV-positive meth-using MSM engaged in significantly fewer acts of anal sex with serodiscordant partners as compared to seroconcordant partners. However, mean levels of unprotected anal and oral sex were high, and mean levels of protected sex were low for both seroconcordant and serodiscordant partners. Oral sex was practiced twice as often as anal sex; however, both types of sex were primarily unprotected. This pattern of risky sexual behavior was reported for steady, casual, and anonymous partners, regardless of partner serostatus. Despite high rates of unprotected sex, rates of HIV serostatus disclosure were consistently high for HIV-positive and HIV-negative steady, casual, and anonymous partners. However, rates of disclosure to unknown serostatus partners were low, particularly in relation to anonymous partners. Future research should address the reasons why HIV-positive meth-using MSM engage in risky sexual activity with serodiscordant partners, and HIV prevention programs for this population should emphasize the risks associated with unprotected sex with seroconcordant partners.

Adult↗

PubMed2006

Sexual compulsivity in a sample of HIV-positive methamphetamine-using gay and bisexual men.

Little research has been done on the relationship between sexual compulsivity and the sexual risk behaviors of methamphetamine (meth) users. This exploratory study sought to identify correlates of sexual compulsivity in a sample of 217 HIV-positive meth-using gay and bisexual men. Participants reported a mean score of 2.4 on the Sexual Compulsivity Scale (SCS) (SD=.76, range 1-4). Sexual compulsivity was positively associated with high-risk sexual behaviors (e.g., number of unprotected sex acts with anonymous partners, total number of HIV-negative or unknown serostatus partners). In multivariate analyses, higher scores on sexual compulsivity were associated with older age, meth use before or during sex, visits to sex clubs and street corners to find sex partners, lower self-efficacy for condom use, lower levels of self-esteem, higher scores on a measure of disinhibition, and a greater number of HIV-negative or unknown serostatus partners. The results suggest that more attention should be focused on sexual compulsivity and its correlates to determine how they may contribute to resistance to sexual behavior change in this high-risk population.

Bisexuality↗

PubMed2006

Comparison of sexual and drug use behaviors between female sex workers in Tijuana and Ciudad Juarez, Mexico.

Female sex workers (FSWs) have been documented to have high rates of sexually transmitted diseases and HIV in many parts of the world. However, little work has been done to characterize the prevalence of these infections along the U.S.-Mexican border, where sexual tourism and culturally sanctioned sex work among nationals is widespread. The objective of this study was to compare differences in background characteristics, HIV risk behaviors, drug use, and sexually transmitted infection/HIV prevalence between FSWs who participated in a behavioral risk intervention in two U.S.-Mexican border cities. Baseline data were collected from March 2004 through September 2005. Data from 295 FSWs were compared between Tijuana and Ciudad (Cd.) Juarez. Among 155 FSWs in Tijuana and 140 in Cd. Juarez, HIV seroprevalence was 4.8% and 4.9%, respectively. FSWs in Cd. Juarez were more likely to test positive for active syphilis (31.3%) compared with Tijuana (11.8%) but did not differ in terms of the prevalence of gonorrhea and chlamydia. FSWs in both sites reported high levels of unprotected sex and use of drugs; however, FSWs in Cd. Juarez were more likely than those in Tijuana to ever have injected drugs (75% vs. 25%, p <.001). Heroin and cocaine use and injection drug use were significantly more common in Cd. Juarez, whereas methamphetamine use was more common in Tijuana. Injection of vitamins was common in both cities. Logistic regression analyses suggested that being younger, working in Cd. Juarez, and using heroin or cocaine were independently associated with active syphilis infection. In Tijuana, methamphetamine use was strongly associated with active syphilis infection. These preliminary results suggest that risk profiles for HIV/sexually transmitted infection among FSWs in these two Mexico-U.S. border cities differ, suggesting a need to tailor interventions to the specific needs in each city.

Adult↗

PubMed2006

Methamphetamine use, impulsivity, and sexual risk behavior among HIV-positive men who have sex with men.

This study examined impulsivity as a moderator of the relationship between meth use and sexual risk behavior in a sample of HIV-positive meth-using Men who have Sex with Men (MSM). Higher impulsivity was associated with less education, lower income, being unemployed, psychiatric diagnosis, and higher Beck depression scores. Intensity of meth use and sexual risk behavior were significantly correlated. In a multiple regression analysis, more education, greater intensity of meth use and higher levels of impulsivity predicted more unprotected sex. To test for moderating effects of impulsivity, an interaction term was added to the regression. The interactive effects model was statistically significant. A plot of the interaction revealed that the relationship between intensity of meth use and total unprotected sex was strongest among participants who had higher levels of impulsivity. This suggests that targeting impulsivity in interventions may help reduce sexual risk behaviors in high intensity meth-using HIV-positive MSM.

Adult↗

PubMed2005

Methamphetamine-using HIV-positive men who have sex with men: correlates of polydrug use.

Methamphetamine use has become a major problem among communities of men having sex with men (MSM), where it has been associated with high-risk behaviors. Methamphetamine is often combined with other drugs that may increase its risks and adverse health consequences. To examine differences in background characteristics, HIVrisk behaviors, and psychosocial variables among polydrug-using HIV-positive MSM, the researchers classified a sample of 261 HIV-positive, methamphetamine-using MSM into three user groups: (1) methamphetamine only; (2) methamphetamine, marijuana, and poppers (light polydrug users); and (3) methamphetamine and other drugs (e.g., cocaine, heroin, hallucinogens, and ketamine; heavy polydrug users). Only 5% reported using only methamphetamine during the past 2 months; 31% were classified as light polydrug users, and 64% were classified as heavy polydrug users. Heavy polydrug users were significantly younger than light polydrug users (35.6 vs. 38.4, P<.01) and reported using methamphetamine for significantly fewer years (10.3 vs. 14.2 years, P<.001), but did not differ in the amount and frequency of methamphetamine or alcohol consumed. Heavy polydrug users reported significantly more sex partners of HIV-negative and unknown serostatus and had more unprotected sex with these partners. Heavy polydrug users had significantly higher scores on impulsivity and negative self-perceptions, as compared with those of light polydrug users. In this sample of HIV-positive MSM, most of those who used methamphetamine had a pattern of polydrug use. Heavy polydrug users reported significantly more high-risk sexual behaviors and tended toward higher levels of impulsivity than light polydrug users. The implications of these findings are two-fold: (1) Longitudinal research is needed to establish causal relationships among methamphetamine use, impulsivity, negative self-perceptions, and sexual risk behavior in this target population; (2) behavioral interventions should evaluate whether methamphetamine use and sexual risk behavior can be reduced by modifying impulsivity and negative self-perceptions.

Adult↗

PubMed2005

Impulsivity and methamphetamine use.

The purpose of this study was to explore the relationship between methamphetamine (meth) use and impulsivity in a sample of 385 HIV-negative heterosexually identified meth users. Participants who scored highest on a self-report measure of impulsivity were compared with those who scored lower in terms of background characteristics, meth use patterns, use of alcohol and other illicit drugs, sexual risk behavior, and psychiatric health variables. Methamphetamine users in the high impulsivity group were younger, less educated, used larger quantities of meth, were more likely to be binge users, had a larger number of sexual partners, engaged in more unprotected vaginal and oral sex, and scored higher on the Beck Depression Inventory as compared with those in the low impulsivity group. In a logistic regression analysis, Beck depression was the factor that best distinguished between meth users who scored high and those who scored low on impulsivity. Neurophysiological pathways that may underlie the relationship between impulsivity and meth use are discussed.

Adolescent↗

PubMed2005

Negative self-perceptions and sexual risk behavior among heterosexual methamphetamine users.

This research examined the relationship between negative self-perceptions and sexual risk behavior in a sample of 156 heterosexually identified, methamphetamine users from San Diego, California. The Beck Depression Inventory and the Self Esteem Rating Scale, respectively, were used to assess depression and negative self-perceptions. Measures of sexual risk behavior and methamphetamine use were developed specifically for this research. Data were gathered in 2001-2002. Participants were primarily male (76%), Caucasian (56%), never married (51%), and unemployed (73%), with a mean age of 39.1 years. Participants with high levels of negative self-perceptions evidenced the greatest degree of sexual risk behavior, including significantly more unprotected vaginal sex and a larger number of sexual partners as compared to individuals with low levels of negative self-perceptions. In cross-sectional analyses, negative self-perceptions predicted intensity of methamphetamine use and depressive symptoms. However, neither of these variables were found to mediate the relationship between negative self-perceptions and sexual risk behavior. Findings are discussed in relation to the need for further research into the role of negative self-perceptions as a determinant of sexual risk behavior among methamphetamine users.

Adolescent↗

PubMed2004

A comparison of injection and non-injection methamphetamine-using HIV positive men who have sex with men.

There is a paucity of research on the psychosocial and behavioral characteristics of individuals who inject methamphetamine (meth). The present study compared injection and non-injection users of meth in terms of background characteristics, drug use patterns, health and social problems, sexual risk behavior, and psychosocial factors. The sample consisted of 194 HIV+Men who have Sex with Men (MSM) who were enrolled in a sexual risk reduction intervention for meth users. Men who injected meth were significantly more likely to be Caucasian, bisexual, homeless, divorced/separated, with lower educational attainment as compared to non-injectors. Injectors also reported more years of meth use, greater frequency and amount of meth use, more social and health problems, including higher prevalence of STDs and Hepatitis C, and more sexual risk behaviors. In terms of psychosocial factors, injection users of meth scored significantly higher on measures of impulsivity and experiences of rejection, and lower on a measure of emotional support. A multivariate logistic regression revealed that educational attainment and experiences of rejection were the factors that best discriminated between injection and non-injection users of meth. The unique characteristics of injection meth users are discussed in relation to the development of effective HIV prevention programs for the target population.

Adult↗

PubMed2004

Determinants of condom use stage of change among heterosexually-identified methamphetamine users.

There is a paucity of research on the association between methamphetamine use (meth) and sexual risk behavior among heterosexual meth users. This study used a multiple theories approach to identify factors associated with stage of change for condom use in a sample of 181 HIV-negative, heterosexually identified meth users. Background characteristics, drug use variables, and theoretical mechanism of change variables were examined in relation to Prochaska's contemplative and preparation stages of change. Sexual risk behavior was highest among those in the contemplation stage of change. When compared with those in the preparation stage of change, contemplators were more likely to be never married, more likely to have an STD, consumed larger amounts of meth and other illicit drugs, had lower scores on self-efficacy and outcome expectancies for condom use and negotiation of safer sex practices, and had less positive social norms in relation to AIDS preventive behaviors. A multivariate logistic regression revealed that the preparation stage of change was associated with increased self-efficacy for condom use, stronger social norms regarding condom use, and reduced occurrence of sexually transmitted diseases. The findings are discussed in relation to the development of sexual risk reduction interventions for heterosexual meth users.

Adult↗

PubMed2004

The context of sexual risk behavior among heterosexual methamphetamine users.

Relatively little is known about the relationship between methamphetamine (meth) use and sexual risk behavior among heterosexual adults. This descriptive study explores the context of sexual risk behavior among HIV-negative, heterosexual meth-using men and women. Drug use history, motivations for meth use, relationship types, and the social-sexual context of meth use were examined as factors that relate to sexual risk behavior and meth use. The majority of participants were white males with an average age of 38.6 years. Primary motivations for current meth use were to get high, to get more energy, and to party. Participants used meth an average of 14 days per month and consumed an average of 7.9 g during this period. The average number of unprotected vaginal, anal, and oral sex acts over a 2-month period were 21.5, 6.3, and 41.7, respectively. Participants reported an average of 9.4 sex partners over 2 months. The findings are discussed in relation to HIV prevention messages and the development of sexual risk reduction interventions for HIV-negative, heterosexual meth users.

Adult↗

PubMed2004

A qualitative exploration of female sex work in Tijuana, Mexico.

Previous research has documented high rates of STDs and increased risk of HIV infection among female sex workers (FSWs) in Mexico; however, little is known about the sexual risk behaviors of this population. The purpose of this study was to explore work history, context of sex work, sexual risk practices, client characteristics, attitudes toward condoms, and potential barriers to condom use in a sample of FSWs in Tijuana, Mexico. Analysis of qualitative data from 25 FSWs revealed that most women entered the sex trade at a young age ( M = 23 years), primarily as a result of financial need. Forty percent were single mothers supporting children. Women worked an average of 6-7 days per week; work shifts ranged from 4 to 13 hr per day. Clients were both Mexican and foreign (mostly American and Asian), and ranged in age from 18 to 80 years. Positive aspects of the job included flexible work hours and good income. Negative aspects of sex work included risks associated with physical assault, diseases, and unwanted pregnancies. Most clients did not want to use a condom and many offered additional money for unprotected sex. FSWs did not like to use condoms because they were perceived as uncomfortable. Most FSWs did not negotiate the use of condoms, had a low knowledge regarding the proper use of condoms, and were reticent to report their own unsafe sex practices. These results suggest the need to develop culturally appropriate safer sex interventions for FSWs in Mexican border cities.

Adult↗

PubMed2004

Female methamphetamine users: social characteristics and sexual risk behavior.

The primary objective of this research was to expand our knowledge regarding the personal and social characteristics of female methamphetamine (meth) users, their motivations for using meth, patterns of meth use, medical and social problems associated with meth use, and the relationship between meth use and sexual risk behaviors. The sample consisted of 98 HIV-negative, heterosexually-identified, meth-using females residing in San Diego, California. Female meth users were characterized by personal and social disadvantage, high rates of psychiatric symptomatology, and high levels of sexual risk behavior, including multiple partners, risky partner types (e.g., anonymous sex partners), and high rates of unprotected vaginal and oral sex. Meth use was also associated with the subjective positive experience of sex. These finding suggest that behavioral interventions should be tailored to the social characteristics of female meth users, and program content should reflect the intertwining of women's sexual experience and meth use.

Adult↗

PubMed2003

Emotional expressiveness, hostility and blood pressure in a longitudinal cohort of Alzheimer caregivers.

OBJECTIVE: To assess the interactive effect of chronic stress and emotional expressiveness (EE) on blood pressure (BP) in older adults. METHOD: Among spousal caregivers (n=111) of Alzheimer's disease (AD) patients, BP was assessed at home by a visiting nurse every 6 months for 7 years. Caregiving demands, EE, social desirability and hostility were also assessed. RESULTS: State hostility was more prevalent among newer caregivers and those encountering more dementia problem behaviors and ADL limitations but unrelated to BP or BP change (P>.05). In a cross-sectional analysis, higher diastolic BP was associated with more spousal problem behaviors and being less emotionally expressive (P<.05). Longitudinal (growth curve analysis) increases in diastolic BP were predicted by providing more spousal ADL assistance (P<.05) but not by EE. CONCLUSION: Both caregiving stress and low EE may contribute independently to hypertension risk in the elderly.

Activities of Daily Living↗

PubMed2003

Sexual risk reduction among HIV-positive drug-using men who have sex with men.

According to the US Centers for Disease Control, the majority of new HIV infections are the direct result of unprotected sexual relations between serodiscordant individuals. Thus, the development of behavioral interventions to increase the safer sex practices of HIV-positive individuals has the potential to reduce the number of new infections. Currently, less than 1% of the total US population is infected with HIV. Targeting behavioral interventions to this smaller group of HIV-positive individuals has the potential for making cost-effective reductions in the number of new infections. Despite reports that some HIV-positive individuals continue to engage in high-risk behaviors, interventions designed to prevent secondary transmission of HIV are rare. In this era of highly active antiretroviral therapy (HAART), interventions for HIV-positive individuals are more critical than ever to address the unique challenges and issues they face regarding disclosure and partner notification, use of HAART and sexual risk behavior, and HIV-related stigma. Although a growing number of reports document the efficacy of sexual risk reduction interventions for HIV-positive individuals, to date none of these studies have focused on drug-using populations. This article focuses on sexual risk reduction interventions for HIV-positive men who have sex with men (MSM), the largest group of HIV-positive individuals in the United States. It reviews factors associated with high-risk behaviors and discusses some findings from research with HIV-positive methamphetamine users, including (1) data from a small qualitative study and its implications for the development of new interventions, and (2) baseline data from an ongoing large-scale study of the efficacy of a theory-based sexual risk reduction intervention for HIV-positive methamphetamine-using MSM. The article concludes with a discussion of future research issues, including, for example: Can sexual risks be reduced in the context of active drug use? Are different patterns of drug use, or specific drugs, associated with increased risk behavior? How do gender, race, and culture relate to the efficacy of specific interventions?

Amphetamine-Related Disorders↗

PubMed2003

Reducing the sexual risk behaviors of HIV+ individuals: outcome of a randomized controlled trial.

Testing behavioral interventions to increase safer sex practices of HIV+ individuals has the potential to significantly reduce the number of new infections. This study evaluated a behavioral intervention designed to reduce the sexual risk behaviors of HIV+individuals. HIV+individuals (N = 387) who reported engaging in unprotected sex with HIV- or partners of unknown serostatus were randomly assigned to (a) a single counseling session targeting problem areas identified by the participant in 3 possible intervention domains (i.e., condom use, negotiation, disclosure); (b) a single-session comprehensive intervention that covered all 3 intervention domains; (c) the same comprehensive intervention, plus 2 monthly booster sessions; or (d) a 3-session diet and exercise attention-control condition. The median number of unprotected sex acts decreased from 14 at baseline to 6, 6, and 4 at 4-, 8-, and 12-month follow-ups, respectively. A repeated measures analysis of variance revealed a significant decrease in unprotected sex acts across all groups across time. A significant Group x Time interaction revealed that the comprehensive-with-boosters group had the most unprotected sex at 8-month follow-up as compared to the other 3 groups. These findings suggest that a brief intervention can result in large reductions in HIV transmission risks among HIV+individuals, but the relative benefit of one intervention approach over another remains unclear.

Adult↗

PubMed2003

Binge use of methamphetamine among HIV-positive men who have sex with men: pilot data and HIV prevention implications.

This study compared the social and behavioral characteristics of binge users and nonbinge users of methamphetamine (meth) in a sample of 90 HIV-positive men who have sex with men. Forty-one participants (46%) self-identified as a binge user. Meth binges ranged from 2 to 33 days (mean = 5.6), and average consumption was 3.1 grams. Binge users were significantly more likely than nonbinge users to be ethnic minority and to have lower education. The two groups did not differ in terms of the total amount of meth used in the past 30 days; however, binge users reported significantly more social difficulties, more mental and physical health problems, and more sexual risk behaviors as compared with nonbinge users. The findings are discussed in relation to drug treatment approaches and the development of behavioral interventions.

Adult↗

PubMed2002

Motivations associated with methamphetamine use among HIV+ men who have sex with men.

Previous research has documented an association between methamphetamine (meth) use and high-risk sex among HIV- men who have sex with men (MSM); however, little is known about the sexual risk behaviors of HIV+ meth-using MSM. The purpose of this study was to explore personal motivators of meth use among HIV+ MSM, and to elaborate upon the interaction between meth use and risky sex. Thematic analysis of qualitative data from 25 HIV+ MSM revealed meth use was associated with high rates of anal sex, low rates of condom use, multiple sex partners, sexual marathons, and anonymous sex. Personal motivations associated with meth use included: sexual enhancement; and self-medication of negative affect associated with HIV+ serostatus. A variety of treatment approaches are used to describe how client insights into motivations can be used by clinicians to promote change in drug use and sexual risk behavior.

Adult↗

PubMedDate not supplied

Utilization of drug treatment programs by methamphetamine users: the role of social stigma.

We examined the link between drug use stigma and use of drug treatment services in a sample of 292 heterosexually identified, methamphetamine (meth) users. Participants who had ever been in treatment for their meth use (N = 82) were compared with those who had never been in treatment (N = 210). Three dimensions of stigma proposed by Link et al.(1) were examined. In univariate analyses, participants who had never been in treatment for meth use reported significantly more expectations of rejection and endorsed more stigma coping strategies as compared to those who had ever been in treatment. Regression analysis revealed that all three dimensions of stigma distinguished between participants who did and did not receive treatment for their meth use. Stigma is discussed as a potential barrier to drug use treatment.

Adaptation, Psychological↗