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At least 127 records · Page 7Linked to original sources
PubMed1998

Sex hustling, injection drug use, and non-gay identification by men who have sex with men. Associations with high-risk sexual behaviors and condom use.

OBJECTIVE: To explore differences in demographic characteristies, risk practices, and preventive behaviors among subgroups of men who have sex with men (MSM), including gay- and non-gay-identified MSM, MSM who inject drugs, and those engaging in sex hustling. DESIGN: A secondary analysis of cross-sectional data collected through interviewer-administered questionnaires in a purposive sample of MSM. SETTING: Gay bars, bath houses, adult video arcades, and out-door crusing areas in Denver and Long Beach. PARTICIPANTS: Men who reported oral or anal sex with another man in the past year with oversampling of non-gay-identified MSM. RESULTS: Of 1,290 MSM, 417 (32%) did not gay-identify, 86 (7%) were drug injectors, and 117 (9%) were hustlers. Of drug-injecting MSM, 55% reported sex hustling and 40% of hustlers reported injection drug use. Hustling was associated with higher number of partners, more frequent anal sex with men and women, and less frequent condom use during anal sex with occasional male partners. Hustlers and drug-injecting MSM used condoms less consistently during vaginal intercourse with female partners than did other MSM. CONCLUSIONS: Among MSM, subgroups at particularly high risk for HIV can be identified. Although these subgroups may be relatively small, they may be important epidemiologic links to the larger MSM and heterosexual communities and warrant focused behavioral interventions to prevent the further spread of HIV.

Adult↗
PubMed1997

Sexual relationships, risk behaviour, and condom use in the spread of sexually transmitted infections to heterosexual men.

OBJECTIVE: To examine the effect of patient defined non-regular sexual relationships and other risk behaviours on the incidence of sexually transmitted infections in heterosexual men and the role of condom use in the prevention of their spread. DESIGN: A prospective cross sectional study of sexual behaviour reported by a standardised self administered questionnaire in new patients who presented for screening and diagnosis. SETTING: A genitourinary medicine clinic in west London. SUBJECTS: 957 consecutive newly attending heterosexual men who completed a sexual behaviour questionnaire in 1993/94. MAIN OUTCOME MEASURES: Variables relating to sociodemographic status, sexual behaviour, condom use, sexually transmitted infections and testing for HIV infection, stratified by the reporting of non-regular partners. RESULTS: We found that the 65% of men who reported non-regular sexual partners were more likely to be white collar class (d = 7.5%, 95% CI = 1.3, 13.7) and to have had sexual intercourse with non-United Kingdom born women (d = 7.8%, 95% CI = 3.5, 12.2). They also reported coitarche before 16 years of age (d = 13.4%, 95% CI = 8.0, 18.8) and many more sexual partners both in the last year (d = 13.1%, 95% CI = 10.2, 16.0) and in their lifetime (d = 27.9%, 95% CI = 21.6, 34.2). They were significantly more likely to practise anal intercourse (d = 8.7%, 95% CI = 3.3, 14.1), to smoke (d = 16.3%, 95% CI = 9.8, 22.6), to drink alcohol (d = 4.9%, 95% CI = 1.2, 8.6), and to have chlamydial infection (d = 5.7%, 95% CI = 2.2, 9.2), of which 30% was subclinical. Increasing condom use with regular partners correlated with decreasing incidence of urethral infection (gonorrhoeal and/or chlamydial infection) (p < 0.03) and candidal balanitis (p < 0.03) and a greater likelihood of no infection being detected (p = 0.0002). Use of condoms with non-regular partners was much more frequent than with regular partners (d = 21.4%, 95% CI = 16.7, 26.1). However, we found evidence of oral transmission of urethral gonorrhoea and chlamydial infection among men who reported always using condoms. HIV infection was found in only two men (0.2%), both of whom reported intercourse with non-United Kingdom born women. CONCLUSIONS: Heterosexual men who reported non-regular sexual relationships compensated for their increased risk lifestyle by using condoms more frequently and showed only an increased incidence of chlamydial infection. More consistent condom use with regular partners was significantly associated with the absence of sexually transmitted infection. These findings suggest that transmission between regular partners has been underestimated.

Adolescent↗
PubMed1996

Orgasm without organisms: science or propaganda?

The worldwide epidemic of sexually transmitted diseases (STDs) presents a major public health challenge to medical practitioners and educators as they seek to implement preventive educational strategies in the adolescent population. The serious consequences of many STDs and the insufficient impact of condom promotion in this high-risk group have led to increasing recognition that sexual intercourse is medically unwise for young adolescents. As a result of this recognition, some educators have proposed that adolescent sexuality education focus on the explicit teaching of noncoital sexual activities, sometimes called outercourse. This paper explores the emergence of this educational strategy, the assertion that noncoital sexual activities will positively impact the rising incidence of STDs and unplanned pregnancy in teenagers, and the hypothetical benefits of adolescent noncoital sex.

Adolescent↗
PubMedDate not supplied

Predictors of AIDS knowledge, condom use and high-risk sexual behaviour among women in Dar-es-Salaam, Tanzania.

Reducing the number of sex partners and using condoms are the major means for individuals to protect themselves from STDs and AIDS in sub-Saharan Africa. To identify predictors of having only one sex partner in the last year and to assess knowledge and use of condoms among women of reproductive age in Dar-es-Salaam, Tanzania, we interviewed 2285 women at 3 representative family planning clinics between February 1991 and June 1992. After interview, blood and genital specimens were collected for laboratory diagnosis of HIV and other sexually transmitted diseases (STDs). Although knowledge of sexual transmission of AIDS was very high, less than a half of the respondents (42.8%) mentioned use of condoms as an AIDS preventive measure. Younger and more educated women were more likely to mention use of condoms for AIDS prevention, however only 4.6% of women interviewed were regular users of condoms, while 19.8% were occasional users. The majority of women who had never used a condom (57.5%) reported not using condoms because 'men did not like them'. Condom use was positively associated with increasing level of education and increasing number of sexual partners. 14.8% of women reported having more than one sex partner in the last year; this behaviour was more likely among cohabiting women (increased by 210%); HIV-positives (increased by 120%); and among women with STDs (increased by 50%).(ABSTRACT TRUNCATED AT 250 WORDS)

Acquired Immunodeficiency Syndrome↗
PubMed1997

Determinants of high-risk sexual behaviour and condom use among adults in the Arusha region, Tanzania.

Determinants of multiple sexual partners and condom use among adults were assessed through a population-based survey in one urban, one semi-urban and one rural community in the Arusha region, northern Tanzania. The study samples were obtained by randomly selecting clusters of 10 households from the 3 communities. Informed verbal consent was sought from each respondent for participation in the study. High-risk sexual behaviours and condom use were assessed using a structured questionnaire. It was observed that significantly more men than women reported having multiple sexual partners (49% vs 25.2%; OR = 1.69; 95% CI = 1.51-1.90) and urban men were significantly more likely to report having multiple sexual partners than men in rural areas. In both men and women, early sexual debut was associated with having multiple sexual partners while travel, alcohol use, and sex under the influence of alcohol were significantly associated with multiple sexual partners in men only. AIDS-related discussion was significantly associated with having fewer sexual partners in both men and women. Of the 1551 respondents, 320 (20.6%) reported having ever used a condom and of the 320 respondents who had ever used a condom, 34 (10.6%) reported having used it at the last sexual intercourse. Significantly more men than women reported having ever used a condom (34.1% vs 14.1%; OR = 1.77; 95% CI = 1.56-2.01). In both men and women, early sexual debut and being young, unmarried, travelling out of the Arusha region and having multiple sexual partners were associated with increased condom use. For both men and women, frequent discussion of AIDS with family members or friends was associated with increased condom use. These data suggest that interventions targeting adolescents and young adults may be effective for control of HIV transmission in Tanzania. In particular, creation of opportunities for people to come together and discuss AIDS might be an important strategy.

Adolescent↗
PubMed1996

Predictors of African American adolescents' condom use and HIV risk behavior.

This study evaluated predictors of risky and safer behavior in a sample of low-income African American adolescents, assessed their perceptions of the risk associated with their sexual behavior, and examined differences between adolescents who used condoms consistently, inconsistently, or engaged only in unprotected intercourse. African American adolescents (N = 312) completed measures related to AIDS knowledge, frequency of condom use, attitudes toward condoms, and sexual behavior over the preceding 2 months. Multiple regression analyses for the sexually active youths (N = 114) revealed that lower self-efficacy, higher perceived risk, and male gender were associated with high-risk behavior. Positive attitudes toward condoms and younger age had the strongest association with condom use. Consistent condom users were more knowledgeable and held more positive attitudes toward condoms, and nonusers were older. Regardless of their behavior, the adolescents generally did not perceive themselves to be a risk for HIV infection. The findings suggest that precautionary practices (condom use) and high-risk behavior (unprotected sex with multiple partners) may have different correlates. In addition, the data indicate that theoretical models developed with homosexual male populations may also be generalizable to African American adolescents' sexual behavior.

Adolescent↗
PubMedDate not supplied

The association between substance use, condom use and sexual risk among low-income women.

Substance use is frequently assumed to be associated with higher levels of sexual risk-taking and lower levels of condom use. An analysis of 668 black, Hispanic and white low-income women at public health and public assistance facilities in Miami show that 19% engaged in risky sexual behavior over the preceding six months, 24% in substance use and 31% in condom use. Overall, substance users are nearly four and one-half times more likely to take sexual risks than nonusers, but are about half as likely to have relied on condoms. When the probability of condom use is considered in the context of both substance use and sexual risk, substance users who take sexual risks appear just as likely to rely on condoms as are nonusers who take sexual risks and those who do not (odds of 0.43-0.49). However, substance users who do not take sexual risks are much less likely to use condoms (odds of 0.15). This pattern holds among black, Hispanic and white women, and suggests that perceptions of risk and the risks that partners bring to sexual encounters may be more important determinants of condom use than substance use per se.

Adolescent↗
PubMed1998

Applying social, behavioral and evaluation research to developing country HIV prevention programs.

OBJECTIVE: To examine the role that social, behavioral and evaluation research played in a 6-year global HIV prevention program working in 45 developing countries. METHODS: Computerized review of project database inventories: 320 research abstracts, 591 subproject abstracts, on-line literature search of project peer-reviewed literature, and hand review of 390 final project reports and country evaluations. DESIGN: Research included descriptive, correlational, ethnographic, survey, quasi-experimental and experimental designs. RESULTS: Over 400 social, behavioral and evaluation studies were conducted and consisted of program-related research, controlled intervention research and multi-year competitive research grants to advance the science of HIV prevention. Program research involved extensive use of qualitative methodologies and the development of innovative research tools such as rapid ethnographic assessments, behavioral surveillance surveys, and targeted intervention research. Intervention studies and multilevel evaluations of prevention programs in 19 countries demonstrated that HIV prevention has changed knowledge, attitudes, and behavior in target groups. Triangulating the results of a variety of data sources and methodologies, and increasing reliance on surveillance of behavioral trends among targeted population groups helped to circumvent numerous methodological problems. CONCLUSION: Linking research to program interventions is a critical component of effective HIV prevention but operationalizing the linking process remains a major challenge.

Developing Countries↗
PubMed1998

Attenders at young people's clinics in Southampton: variations in contraceptive use.

This paper presents findings from a survey of 424 people attending nine young people's clinics within the Southampton Community Health NHS Trust. In addition to recording some descriptive background data on the people attending the clinics, one major aim of the study was to investigate whether talking to the sexual partner about contraception before their first intercourse together and delaying this first intercourse influenced contraceptive use. Overall, 40 per cent of people attending the clinics were aged 16 or under, although there was some variation between clinics in the age groups attracted. Most clients were female (88 per cent), had ever had sexual intercourse (92 per cent), reported four or more lifetime partners (42 per cent) but only one partner within the last six months (73 per cent) and were currently in a relationship (75 per cent). Potential for contraception and sexually transmitted infection was widespread; 46 per cent (of non-virgins) had had intercourse without contraception at least 'a few times' and 18 per cent used condoms 'rarely' or 'never'. In terms of first intercourse with current/most recent partner, 17 per cent had not used any contraception and 32 per cent had failed to use condoms. The most important findings from this study were that use of contraception (and condoms in particular) on the occasion of first intercourse with the current or most recent partner was significantly associated with the following; if partners had talked to each other about contraception before having intercourse together for the first time (p<0.001), and also if this first intercourse was delayed beyond four weeks as opposed to over a few days of first 'going-out' together (p<0.001). Suggestions for further in-depth research are made.

Adolescent↗
PubMed1994

Outcome of psychoeducation for HIV risk reduction.

Our objectives were to assess the effects of a psychoeducational (PE) program designed to reduce HIV risk behaviors in recovering drug abusers and to evaluate mediating variables associated with risk reduction as described by the AIDS Risk Reduction Model (ARRM). Consecutive admissions to a Department of Veterans Affairs drug dependence inpatient treatment program (n = 152) were randomly assigned to PE or a standard information (INFO) condition. PE involved a 6-hour small group intervention designed to enhance knowledge and attitudes regarding HIV prevention, improve skills in condom use and needle sterilization, and modify high-risk sex- and drug-related behaviors. The INFO condition involved presentation of audiovisual and printed HIV prevention material with similar content. Following intervention, PE subjects showed significantly enhanced self-efficacy, condom use skills, and sexual communication skills relative to the INFO group. At 3-month follow-up, the PE group showed significantly greater reductions on some measures of sexual HIV risk behaviors relative to the INFO group. Hypotheses derived from the ARRM regarding presumed relationships between positive changes in mediating variables (e.g., self-efficacy and sexual communication) and ultimate outcome variables (e.g., condom use) were supported.

Adult↗
PubMed1994

HIV-infected women and sexual risk reduction: the relevance of existing models of behavior change.

This article utilizes constructs of the AIDS Risk Reduction Model (ARRM) to examine condom use in a sample of 215 HIV-infected women in New Jersey. We find evidence that processes affecting condom use in HIV-infected individuals are similar to those found in HIV-negative individuals. Results suggest that partner-related factors are important to consistent condom use in HIV-infected women. Women are more likely to use condoms consistently if they have high perceived power to influence their partner's condom use, have partners who are HIV seronegative, and have partners who do not want more children. Conflicts with the partner decrease the probability of consistent condom use. Also negatively associated with condom use are the woman's use of drugs and/or alcohol and her belief that condoms reduce sexual enjoyment. Implications of these findings for designing interventions for HIV-infected women are considered.

Adult↗
PubMed1994

The impact of AIDS on an urban population of high-risk female minority adolescents: implications for intervention.

PURPOSE: This study's purpose was to describe acquired immunodeficiency syndrome (AIDS)-related concerns, risk behaviors, and psychosocial/situational determinants of condom use among an urban minority population of sexually active, adolescent girls. In addition we sought to define the accuracy of personal AIDS risk-assessment, the relative importance of AIDS in relation to other concerns, and the broader context of sexual experience and attitudes in this population. METHODS: A cross-sectional interview study was conducted involving sexually active female adolescents attending a pediatric clinic in an inner-city university-affiliated community hospital. Sixty-nine subjects (ages 13-19 yr, 90% African-American) were enrolled. While the goals of this study were primarily descriptive, subject characteristics felt to impact on condom use were identified prior to data collection and were examined against several measures of usage including: use at the time of last sexual intercourse, overall frequency of condom use, and reported behavior change to include initiation of or increased condom usage. RESULTS: Forty-one percent of participants reported knowing someone with AIDS. Global concern regarding this disease was high, although worry about poverty-related issues was often greater. Despite concern and high measures of AIDS risk (median number of sex partners, 3; past sexually transmitted disease, 55%; past pregnancy 77%), most participants perceived themselves to be at low personal risk owing to current monogamy, lack of intravenous drug use, and implicit trust in their partner's safety. Discussion with their partner about actual risk and awareness of the importance of past behaviors was generally lacking. Although 98% were aware that condoms may prevent AIDS, 64% used condoms half of the time or less when they had sex and use appeared to be primarily for contraception. Several intrinsic cognitive/psychological and extrinsic social/situational factors were found to correlate with measures of condom use. CONCLUSIONS: Participants' sexual histories and behavior emphasize the need for concern regarding AIDS risk in this population. Patterns of sexual behavior and beliefs regarding committed relationships raise challenging questions regarding how to motivate sexually active members of this population to use condoms more frequently. Programs aimed at AIDS prevention among urban minority adolescents need to be cognizant of the larger personal and sociocultural context in which these teenagers are making health-behavior choices.

Acquired Immunodeficiency Syndrome↗
PubMed1998

The sexual practices of Asian and Pacific Islander high school students.

PURPOSE: To describe the sexual behaviors, beliefs, and attitudes of Asian and Pacific Islander California high school students and to compare them to other racial/ethnic groups. METHODS: Data were collected from an anonymous self-administered survey of 2026 ninth to 12th graders in a Los Angeles County school district; 186 of the respondents described themselves as Asian and Pacific Islander. The survey was conducted in April 1992. RESULTS: A higher percentage of Asian and Pacific Islander adolescents (73%) compared with African-American (28%, p < .001), Latino (43%, p < .001), white (50%, p < .001), and other (48%, p < .001) adolescents had never had vaginal intercourse. Asian and Pacific Islander adolescents were less likely than other adolescents to report having engaged in heterosexual genital sexual activities during the prior year, including masturbation of or by a partner, fellatio with ejaculation, cunnilingus, and anal intercourse. Few students in any group reported homosexual genital sexual activities. Asians and Pacific Islanders who had had vaginal intercourse were more likely than most other groups to have used a condom at first vaginal intercourse, but Asians and Pacific Islanders had not used condoms more consistently over the prior year. Asians and Pacific Islanders were more likely to expect parental disapproval if they had vaginal intercourse and less likely to think that their peers had had vaginal intercourse. CONCLUSIONS: Asian and Pacific Islander high school students in one California school district appear to be at lower sexual risk than other racial/ethnic groups. However, a large minority are engaging in activities that can transmit disease and lead to unwanted pregnancy. Therefore, current efforts to develop culturally sensitive clinical and community-based approaches to sexual risk prevention should include Asians and Pacific Islanders.

Adolescent↗
PubMed1997

Effects of a drinking event on behavioral skills and condom attitudes in men: implications for HIV risk from a controlled experiment.

This study experimentally tested the effects of a drinking event on HIV-related behavioral skills and condom attitudes. Sixty unmarried, heterosexual men were assigned to 1 of 3 conditions (sober, placebo, or alcohol). Participants who consumed alcohol demonstrated lower skill to negotiate for condom use relative to sober controls. More negative condom attitudes were expressed by participants with stronger sex-related alcohol expectancies, especially when these expectancies were triggered by subjective intoxication. Hierarchical regression analyses revealed that the experimental factors accounted for variance in behavioral skills and condom attitudes beyond that explained by known predictors of sexual risk.

Adult↗
PubMed1996

Sexual debut and predictors of condom use among secondary school students in Arusha, Tanzania.

A cross-sectional survey was conducted using interviews among 852 students attending seven secondary schools in the Arusha region, Northern Tanzania, to predict determinants of sexual debut and recent condom use among students. Schools were sampled according to location, school size and ownership criteria. Subjects were randomly sampled within grade-level and gender through use of class registers. Altogether, 528 students were sexually active. Males were more likely than females to report their sexual debut status (82.0% versus 33.3%; OR = 8.78; 95% CI: 6.17-12.49). Among males, incidence of sexual debut increased with grade-level, but decreased according to religious affiliation. None of the socio-demographic predictor variables used in this study had a significant association with sexual debut among females when age was controlled for. Of the sexually active students, 26.8% reported having ever used a condom and 21.5% reported use of condoms during their most recent sexual encounter. Late sexual debut, prolonged duration of dating before intercourse and having only one sex partner were significantly associated with increased condom use during the most recent occasion. Condom use increased with levels of education, but gender was not significantly linked to increased condom use. Condom use was particularly infrequent among casual sex partners. We observed a marked gender difference among students with respect to their sexual debut status, but no such difference was found in relation to condom use.

Adolescent↗
PubMed1996

Preventing cardiovascular disease through community-based risk reduction: the Bootheel Heart Health Project.

OBJECTIVES: The purpose of this study was to determine whether a community-based risk reduction project affected behavioral risk factors for cardiovascular disease. METHODS: Community-based activities (e.g., exercise groups, healthy cooking demonstrations, blood pressure and cholesterol screenings, and cardiovascular disease education) were conducted in six southeastern Missouri counties. Evaluation involved population-based, cross-sectional samples of adult residents of the state and the intervention region. Weighted prevalence estimates were calculated for self-reported physical inactivity, cigarette smoking, consumption of fruits and vegetables, overweight, and cholesterol screening. RESULTS: Physical inactivity decreased within the intervention region, that is, in communities where heart health coalitions were developed and among respondents who were aware of these coalitions. In addition, the prevalence rates for reports of cholesterol screening within the past 2 years were higher for respondents in areas with coalitions and among persons who were aware of the coalitions. CONCLUSIONS: Even with modest resources, community-based interventions show promise in reducing self-reported risk for cardiovascular disease within a relatively brief period.

Adolescent↗