PubMed · 15197874
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Justine de Mierre. 2004. Lights camera action.. https://doi.org/10.7748/nop2004.06.16.4.10.c2312
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Unprotected sex among gay/bisexual men throughout the AIDS epidemic has usually been described as unintentional due to a relapse from safer sex behavior. The term "barebacking" emerged among HIV-positive men explicitly seeking unprotected sex with seroconcordant partners, but has come into use in the larger gay community to simply mean condomless sex. Some men have also taken on the identity as a "barebacker." The present study assessed prevalence and predictors of bareback identity in a sample 687 gay/bisexual men attending community events. Barebackers reported significantly more use of crystal methamphetamine and higher peer norms for unprotected sex; HIV-negative barebackers were higher in sexual compulsivity while HIV-positive barebackers were higher in romantic obsession as well as drug/alcohol influenced sexual expectancies. HIV prevention efforts targeting barebackers and barebacking must be carefully developed if programs and campaigns are to be effective given the open debates about this phenomenon in the gay community.
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BACKGROUND: Hypertension often clusters with metabolic risk factors and its optimal treatment may involve a number of changes in lifestyle. Nurse-led care regarding lifestyle change may improve outcomes in cardiovascular disease prevention involving. OBJECTIVE: To examine if lifestyle guidance given by a nurse improved components of the metabolic syndrome including blood pressure, lipids and waist circumference. SUBJECTS AND DESIGN: Subjects that participated in a health screening with systolic blood pressure 140-169 mm Hg and diastolic blood pressure 90-99 mm Hg at a minimum of three separate readings treated or not treated with antihypertensive drugs were randomly allocated either to monthly nurse-led lifestyle counselling (intervention group, N=31) or to conventional primary care (control group, N=20) to be followed by lifestyle counselling. RESULTS: The mean (S.D.) baseline and end of study blood pressure was 157 (9)/94 (6) mm Hg and 147 (9)/91 (8) mm Hg, respectively, in the intervention group versus 153 (9)/94 (4) and 143 (10)/92 (8) mm Hg, respectively, in the control group (NS between the groups). Waist circumference increased significantly between baseline and 6 months in the control but not in the intervention (mean difference between the groups, 3.1 cm [95% CI 1.2-5.0], p=0.04) and serum triglyceride concentrations were reduced in the intervention compared with the control group (mean difference, 0.56 mmol/l [95% CI 0.22-0.90], p=0.03). The number of risk factors of the metabolic syndrome was 2.1 (S.D. 1.1) at baseline and 2.6 (S.D. 1.2) at 6 months in the control group versus 2.2 (S.D. 1.1) and 1.9 (S.D. 1.0), respectively, in the intervention group (p=0.01). Change in triglycerides was correlated with change in weight (Pearson's correlation coefficient=0.73, p=0.001) and waist circumference (Pearson's correlation coefficient=0.63, p=0.009) in the control group. CONCLUSION: Nurse counselling did not reduce blood pressure but was associated with a lesser gain in waist circumference and reduced triglyceride concentrations. Metabolic risk factors may worsen rapidly in patients with mild hypertension in the waiting period for lifestyle intervention.