AIDS Education and Prevention via MedWorm.com

HIV Counseling, Testing and Referral Experiences of Persons Diagnosed with HIV Who Have Never Entered HIV Medical Care

AIDS Education and Prevention — Sun, 19 Jun 2011 23:00:00 +0100

AIDS Education and Prevention 23(3_supplement): 117-127 The HIV counseling, testing, and referral (CTR) encounter represents an important opportunity to actively facilitate entry into medical care for those who test positive for HIV, but its potential is not always realized. Ways to improve facilitation of linkage to care through the CTR encounter haven't been explored among HIV-infected persons who have not entered care. We conducted 42 structured and qualitative interviews among HIV-infected persons, diagnosed 5-19 months previously, in Indiana, Philadelphia and Washington State, who had not received HIV medical care. Respondents related individual and system-level barriers, as well as recommendations for improving the effectiveness of CTR as a facilitator of linkage to HIV medical care ...

Iterative Evaluation in a Mobile Counseling and Testing Program to Reach People of Color at Risk for HIV--New Strategies Improve Program Acceptability, Effectiveness, and Evaluation Capabilities

AIDS Education and Prevention — Sun, 19 Jun 2011 23:00:00 +0100

This article highlights findings from an evaluation that explored the impact of mobile versus clinic-based testing, rapid versus central-lab based testing, incentives for testing, and the use of a computer counseling program to guide counseling and automate evaluation in a mobile program reaching people of color at risk for HIV. The program's results show that an increased focus on mobile outreach using rapid testing, incentives and health information technology tools may improve program acceptability, quality, productivity and timeliness of reports. This article describes program design decisions based on continuous quality assessment efforts. It also examines the impact of the Computer Assessment and Risk Reduction Education computer tool on HIV testing rates, staff perception of counsel...

An Evaluation of a Routine OPT-Out Rapid HIV Testing Program in a Rhode Island Jail

AIDS Education and Prevention — Sun, 19 Jun 2011 23:00:00 +0100

AIDS Education and Prevention 23(3_supplement): 96-109 There is an increased prevalence of HIV among incarcerated populations. We conducted a rapid HIV testing pilot program using oral specimens at the Rhode Island Department of Corrections (RIDOC) jail. Detainees (N = 1,364) were offered rapid testing upon jail entrance and 98% completed testing. Twelve detainees had reactive rapid tests, one of which was a new HIV diagnosis. To evaluate the program qualitatively, we conducted key informant interviews and focus groups with key stakeholders. There was overwhelming support for the oral fluid rapid HIV test. Correctional staff reported improved inmate processing due to the elimination of phlebotomy required with conventional HIV testing. Delivering negative rapid HIV test results in real-tim...

Barriers and Facilitators to Enhancing HIV Testing in Publicly Funded Primary Care Clinics: Findings from San Francisco

AIDS Education and Prevention — Sun, 19 Jun 2011 23:00:00 +0100

This study holds lessons for other jurisdictions seeking to expand HIV testing in primary care. (Source: AIDS Education and Prevention)

General Internists' Beliefs, Behaviors, and Perceived Barriers to Routine HIV Screening in Primary Care

AIDS Education and Prevention — Sun, 19 Jun 2011 23:00:00 +0100

AIDS Education and Prevention 23(3_supplement): 70-83 The Centers for Disease Control and Prevention (CDC) recommends routine HIV screening in primary care but little is known about general internists' views of this practice. We conducted a national, cross-sectional, Internet-based survey of 446 general internists in 2009 regarding their HIV screening behaviors, beliefs, and perceived barriers to routine HIV screening in outpatient internal medicine practices. Internists' awareness of revised CDC guidelines was high (88%), but only 52% had increased HIV testing, 61% offered HIV screening regardless of risk, and a median 2% (range 0-67%) of their patients were tested in the past month. Internists practicing in perceived higher risk communities reported greater HIV screening. Consent require...

Emergency Department HIV Screening with Rapid Tests: A Cost Comparison of Alternative Models

AIDS Education and Prevention — Sun, 19 Jun 2011 23:00:00 +0100

AIDS Education and Prevention 23(3_supplement): 58-69 Although previous studies have shown that HIV screening in emergency departments (EDs) is feasible, the costs and outcomes of alternative methods of implementing ED screening have not been examined. We compared the costs and outcomes of a model that used the hospital's ED staff to conduct screening, a supplemental staff model that used non-ED staff hired to conduct screening and a hypothetical hybrid model that combined aspects of both approaches. We developed a decision analytic model to estimate the cost per HIV-infected patient identified using alternative ED testing models. The cost per new HIV infection identified was $3,319, $2,084 and $1,850 under the supplemental, existing staff and hybrid models, respectively. Assuming an annua...

Costs And Effectiveness of Finding New HIV Diagnoses by Using Rapid Testing In Transgender Communities

AIDS Education and Prevention — Sun, 19 Jun 2011 23:00:00 +0100

AIDS Education and Prevention 23(3_supplement): 49-57 We assessed the costs and effectiveness of rapid HIV testing services provided to transgender communities in New York City and San Francisco from April 2005 to December 2006. Program costs were estimated based on service provider's perspective and included the costs attributable to staff time, incentives, transportation, test kits, office space, equipment, supplies, and utilities. The average annual numbers of persons tested were 195 and 106 persons and numbers notified of new HIV diagnoses were 35 (18.2%) in New York City and 8 (7.3%) in San Francisco, respectively. The estimated annual program costs were $125,879 and $64,323 and average costs per person notified of new diagnosis were $3,563 and $8,284 in New York City and San Francisc...

Utilization of HIV Voluntary Counseling and Testing in Vietnam: An Evaluation of 5 Years of Routine Program Data for National Response

AIDS Education and Prevention — Sun, 19 Jun 2011 23:00:00 +0100

This study evaluated the utilization of HIV voluntary counseling-and-testing (VCT) services targeting high-risk populations in Vietnam in order to inform decisions on program improvement and expansion. A total of 158,888 records collected from 55 VCT sites supported by the U.S. Centers for Disease Control and Prevention's Global AIDS Program in the period of 2002 to 2007 were used to analyze sociodemographic characteristics, risk exposures, seropositivity, test refusal, and failure to return for test results among VCT clients. High-risk exposures, such as injection drug use, commercial sex work, homosexual contacts or heterosexual contacts with high-risk sex partners, were reported in 126,815 (81%) records. Among high-risk clients, any condom use in the past month ranged from 34% to 71%. D...

Characteristics of First-Time and Repeat HIV Tests Among Men Who Have Sex With Men Who Test at CDC-Supported Sites, 2007

AIDS Education and Prevention — Sun, 19 Jun 2011 23:00:00 +0100

This report describes characteristics of HIV test data for men who have sex with men (MSM) tested in 2007 through programs funded by the Centers for Disease Control and Prevention (CDC). HIV test-level data of MSM submitted by 29 health departments were analyzed to explore test characteristics among all tests, first-time tests, and repeat tests. Characteristics significantly associated with HIV-positive results among first-time tests were identified through logistic regression. Of the 129,893 tests conducted, 18% were first-time tests and 82% were repeat tests. HIV positivity among first-time tests was 4.1% and 3.7% among repeat tests. Among first-time tests, 46% of tests were among White MSM and 48% of HIV-positive test results were among African Americans. An HIV-positive test among firs...

HIV Prevalence Estimates and Alignment Among Recent Diagnoses, Targeted Tests, and Prevention Services by Demographic and Racial/Ethnic Group in Wisconsin

AIDS Education and Prevention — Sun, 19 Jun 2011 23:00:00 +0100

AIDS Education and Prevention 23(3_supplement): 7-16 The article provides HIV prevalence estimates by demographic group (men who have sex with men [MSM], non-MSM males, and females) and race/ethnicity for Wisconsin. Using the estimate that 4-8% of males aged 15-59 are MSM, we estimate that 14-28% of Black MSM in Wisconsin are HIV-positive. The proportions of HIV diagnoses by racial/ethnic and demographic group were compared with the proportions of targeted tests and HIV prevention clients in 2009. Among Blacks, MSM accounted for 58% of HIV diagnoses in Wisconsin but only 19% of targeted tests and 11% of HIV prevention clients. Disparities between cases and services also exist for Latinos and Whites. Jurisdiction-level testing targets were developed for 2010 using the estimated number of pe...

Introduction to Special Supplement: Monitoring and Evaluation of HIV Counseling, Testing and Referral (CTR) and HIV Testing Services

AIDS Education and Prevention — Tue, 31 May 2011 23:00:00 +0100

AIDS Education and Prevention 23(3_supplement): 1-6 (Source: AIDS Education and Prevention)

Targeted Expansion Project for Outreach and Treatment for Substance Abuse and HIV Risk Behaviors in Asian and Pacific Islander Communities

AIDS Education and Prevention — Sun, 24 Apr 2011 23:00:00 +0100

AIDS Education and Prevention 23(2): 175-191 Access to culturally competent HIV/AIDS and substance abuse treatment and prevention services is limited for Asian and Pacific Islanders (APIs). Based on the intake data for a community outreach project in the San Francisco Bay Area (N = 1,349), HIV risk behaviors were described among the targeted API risk groups. The self-reported HIV prevalence was 6% among MSM. Inconsistent condom use for vaginal sex with casual partners in the past 6 months was reported among substance users (43%) and incarcerated participants (60%), whereas 26% of men who have sex with men reported inconsistent condom use for anal sex with casual partners. Overall, 56% and 29% had engaged in sex with casual partners under the influence of alcohol and drugs in the past 6 mon...

Translating an Effective Group-Based HIV Prevention Program to a Program Delivered Primarily by a Computer: Methods and Outcomes

AIDS Education and Prevention — Sun, 24 Apr 2011 23:00:00 +0100

We describe development of SAHARA (SISTAS Accessing HIV/AIDS Resources At-a-click), an innovative HIV prevention program that uses a computer to deliver an updated version of SiSTA, a widely used, effective group-level HIV prevention intervention for African American women ages 18-29. Fidelity to SiSTA's core components was achieved using: (1) video clips featuring group discussions and modeling of appropriate sexual- and contraceptive-related behavior; and (2) interactive Flash modules facilitating cognitive rehearsal, providing learning experiences through games and quizzes, and providing opportunities for simulated role-play. A preliminary outcome study of SAHARA conducted at Planned Parenthood, Atlanta, found that SAHARA, when followed by a brief 20-minute wrap-up group session facilit...

Strategies for Managing Racism and Homophobia among U.S. Ethnic and Racial Minority Men Who Have Sex with Men

AIDS Education and Prevention — Sun, 24 Apr 2011 23:00:00 +0100

AIDS Education and Prevention 23(2): 145-158 Despite widespread recognition that experiences of social discrimination can lead to poor physical and mental health outcomes for members of minority groups, little is known about how U.S. ethnic minority men who have sex with men (MSM) manage their experiences of racism and homophobia. We conducted six focus group discussions (n = 50) and 35 in-depth interviews with African American, Latino, and Asian and Pacific Islander MSM (aged 18 or older) recruited in Los Angeles. This process revealed five strategies that MSM of color employed in order to mitigate the impact of racism and homophobia. To minimize opportunities for stigmatization, men used (a) concealment of homosexuality and (b) disassociation from social settings associated with stigmati...

Evaluating the Acceptability and Feasibility of Project ACCEPT: An Intervention for Youth Newly Diagnosed with HIV

AIDS Education and Prevention — Sun, 24 Apr 2011 23:00:00 +0100

AIDS Education and Prevention 23(2): 128-144 Given the potential for negative psychosocial and medical outcomes following an HIV diagnosis, Project ACCEPT, a 12-session behavioral intervention, was developed and pilot-tested for youth (aged 16-24) newly diagnosed with HIV. Fifty participants recently diagnosed with HIV were enrolled from 4 sites selected through the Adolescent Medicine Trials Network (ATN). The majority of participants identified as African American (78%). Feasibility and acceptability data demonstrated high rates of participation and high levels of satisfaction with the intervention program from both participants and staff. Exploratory outcome data demonstrated improved levels of HIV knowledge that were sustained over time (Cohen's effect [d] d = .52) and improvements in ...

You've Got Male: Internet Use, Rural Residence, and Risky Sex in Men Who Have Sex With Men Recruited in 12 U.S. Cities

AIDS Education and Prevention — Sun, 24 Apr 2011 23:00:00 +0100

This study assessed whether the relationship between using the Internet to meet sex partners and unprotected anal intercourse (UAI) differs for men who have sex with men (MSM) living in rural and urban areas. Data on Internet use, residence and UAI were collected from MSM attending Gay Pride events in 12 U.S. cities. Rural MSM who used the Internet to meet sex partners were more likely to report any UAI (adjusted odds ratio[AOR]: 1.89 [1.12-3.19]) and insertive UAI (AOR: 2.16 [1.13-4.10]) with the last sex partner than those who did not use the Internet. For urban MSM, UAI was not more commonly reported by men who used the Internet to meet sex partners. The association between using the Internet to meet sex partners and UAI depended on whether MSM resided in rural or urban areas. Rural MSM...

Providers' Perceptions of and Receptivity Toward Evidence-Based HIV Prevention interventions

AIDS Education and Prevention — Sun, 24 Apr 2011 23:00:00 +0100

AIDS Education and Prevention 23(2): 105-117 Since 1999, the Centers for Disease Control and Prevention have trained over 10,000 service providers from more than 5,000 agencies to implement evidence-based HIV prevention interventions through its Diffusion of Effective Behavioral Interventions DEBI) program. Based on in-depth, semistructured interviews with a convenience sample of 22 HIV prevention service providers from eight agencies in Wisconsin who participated in DEBI training, this article explores providers' motivations for attending DEBI training, perceptions of the utility and value of the DEBI program, and criticisms of the program. Providers indicated that they attended training as part of general skill-building efforts, as a way to improve services through the adoption of eviden...

Race and Emotion in Computer-Based HIV Prevention Videos for Emergency Department Patients

AIDS Education and Prevention — Thu, 31 Mar 2011 23:00:00 +0100

This study employs a new and highly replicable methodology that enables comparisons of multiple video segments, each based on conflicting theories of multimedia learning. Patients in the main treatment areas of a large urban hospital's emergency department used handheld computers running custom-designed software to view video segments and respond to pre-intervention and postintervention data collection items. The videos examine whether participants learn more depending on the race of the person who appears onscreen and whether positive or negative emotional content better facilitates learning. The results indicate important differences by participant race. African American participants responded better to video segments depicting White people. White participants responded better to positiv...

HIV-Disclosure, Social Support, and Depression Among HIV-Infected African American Women Living in the Rural Southeastern United States

AIDS Education and Prevention — Tue, 22 Feb 2011 00:00:00 +0100

AIDS Education and Prevention 23(1): 78-90 This cross-sectional study examined the relationships between social support, HIV disclosure, and depression among 340 rural African American women with HIV disease living in the southeastern United States. Three aspects of social support (perceived availability of support, sources of available support, and satisfaction with available support) were measured along with HIV disclosure and depression. Perceived availability of support (p < .0001), sources of support (p = .03), satisfaction with support (p = .003), and HIV disclosure (total and to children; p = .05 and .04, respectively) were significantly and inversely correlated with depression. Perceived availability of support and satisfaction with support mediated the relationship between HIV dis...

Health Care Providers: A Missing Link in Understanding Acceptability of The Female Condom

AIDS Education and Prevention — Tue, 22 Feb 2011 00:00:00 +0100

AIDS Education and Prevention 23(1): 65-77 Health care providers can play a key role in influencing clients to initiate and maintain use of the female condom, an underused method for HIV/STI and pregnancy prevention. In 2001-2002, based on semistructured interviews with 78 health care providers from four types of settings in New York City, we found that most providers had seen the female condom, but they had not used it and did not propose the method to clients. They lacked details about the method-when to insert it, where it can be obtained, and its cost. Gender of provider, provider level of training, and setting appeared to influence their attitudes. Unless and until provider training on the female condom is greatly improved, broader acceptance of this significant public health contribu...

HIV Testing Behavior among Pacific Islanders in Southern California: Exploring the Importance of Race/Ethnicity, Knowledge, and Domestic Violence

AIDS Education and Prevention — Tue, 22 Feb 2011 00:00:00 +0100

This article presents an analysis of a 2008 community needs assessment survey of a convenience sample of 179 Pacific Islander respondents in southern California; the needs assessment focused on HIV knowledge, HIV testing behavior, and experience with intimate partner/relationship violence. Multivariate logistic regression results indicated that race/ethnicity and reported experience with intimate partner/relationship violence were the most important variables in explaining the variation in reported HIV testing among Chamorro/Guamanian and Samoan respondents. However, when analyzed separately, self-reported experience with intimate partner/relationship violence was associated with reported HIV testing only for Chamorro respondents and not for Samoan respondents. As U.S. Pacific Islanders ex...

Making HIV Prevention Programming Count: Identifying Predictors of Success in a Parent-Based HIV Prevention Program for Youth

AIDS Education and Prevention — Tue, 22 Feb 2011 00:00:00 +0100

AIDS Education and Prevention 23(1): 38-53 Predictors of change in the number of sexual topics parents discussed and responsiveness during sex communication with their preadolescent after participating in a five-session sexual risk reduction intervention for parents were examined. Data were from 339 African American parents of preadolescents enrolled in the intervention arm of a randomized-controlled trial of the Parents' Matter! Program (PMP). Four categories of predictors of success were examined: time and resource constraints, personal characteristics, the parent-child relationship, and parent perceptions of child readiness for sex communication. There were only sporadic associations between success and time and resource constraints for either outcome. Parent perception of child readine...

Effects of a Theory-Based Audio HIV/AIDS Intervention for Illiterate Rural Females in Amhara, Ethiopia

AIDS Education and Prevention — Tue, 22 Feb 2011 00:00:00 +0100

In this study, we investigated the effects of an audio HIV/AIDS prevention intervention targeted at rural illiterate females. In the intervention we used social-oriented presentation formats, such as discussion between similar females and role-play. In a pretest and posttest experimental study with an intervention group (n = 210) and control group (n = 210), we investigated the effects on HIV/AIDS knowledge and social cognitions. The intervention led to significant and relevant increases in HIV/AIDS knowledge, self-efficacy, perceived vulnerability to HIV/AIDS infection, response efficacy of condoms and condom use intention. In the intervention group, self-efficacy at posttest was the main determinant of condom use intention, with also a significant contribution of vulnerability. We conclu...

The Role of Critical Self-Reflection of Assumptions in an Online HIV Intervention for Men Who Have Sex With Men

AIDS Education and Prevention — Tue, 22 Feb 2011 00:00:00 +0100

AIDS Education and Prevention 23(1): 13-24 The Men's INTernet Study II included a randomized controlled trial to develop and test an Internet-based HIV prevention intervention for U.S men who use the Internet to seek sex with men. In 2008, participants (n = 560) were randomized to an online, interactive, sexual risk-reduction intervention or to a wait list null control. After 3 months, participants in both conditions reported varying degrees of change in sexual beliefs or behaviors. Using content analysis and logistic regression, this mixed-methods study sought to understand why these changes occurred. Level of critical self-reflection of assumptions appeared to facilitate the labeling of sexual beliefs and behaviors as risky, which in turn encouraged men to commit to and enact change. New...

HealthMpowerment.org: Development Of A Theory-Based HIV/STI Website for Young Black MSM

AIDS Education and Prevention — Tue, 01 Feb 2011 00:00:00 +0100

We describe results from our formative work in developing a theory-based online HIV/STI prevention intervention for young BMSM including focus groups, semistructured interviews, and usability testing. The Intervention, HealthMpowerment.org, was created based on the Institute of Medicine's integrated model of behavior change with extensive input from young BMSM. Key interactive Web site features include live chats, quizzes, personalized health and hook-up/sex journals, and decision support tools for assessing risk behaviors. Creating an interactive HIV/sexually transmitted infection web site for BMSM was a complex process requiring many adjustments based on iterative feedback throughout all development stages. Preliminary satisfaction, content acceptability, and usability findings support t...

Author Index to Volume 22

AIDS Education and Prevention — Tue, 04 Jan 2011 00:00:00 +0100

AIDS Education and Prevention 22(6): 571-578 (Source: AIDS Education and Prevention)

Influence of Perceived Secondary Stigma and Family on the Response to HIV Infection Among Injection Drug Users in Vietnam

AIDS Education and Prevention — Tue, 04 Jan 2011 00:00:00 +0100

AIDS Education and Prevention 22(6): 558-570 The full impact of secondary stigma (stigma directed at family) on an HIV-positive individual is unknown. This qualitative research explores perceptions of secondary stigma in the Vietnamese context and its influence on the ways in which an injection drug user (IDU) copes with HIV infection. Data on experiences learning one's HIV status, disclosure decisions, family reactions, and stigma from family and community were collected through in-depth interviews with 25 HIV-positive IDUs recruited through a health center in Thai Nguyen, Vietnam. Participants felt despair when learning they were HIV-positive and expressed concerns focused on the emotional burden and the consequences of HIV stigma that extended to family. Many participants engaged in sel...

Role of Service Providers of Needle Syringe Program in Preventing HIV/AIDS

AIDS Education and Prevention — Tue, 04 Jan 2011 00:00:00 +0100

This study confirms that NSP service providers play an essential role in providing comprehensive activities to reduce HIV/AIDS infection for drug misusers. Knowledge and attitudes of service providers were found to be independently and important predictors of NSP service provisions. Community-based and clinical-based providers had diverse service schemes and encountered operation problems due to different organization characteristics, professional training, and ethical concern. For the future planning of NSP programs, service-specific education and professional support are essential component of service delivery and quality. (Source: AIDS Education and Prevention)

How Physicians Test: Clinical Practice Guidelines and HIV Screening Practices with Adolescent Patients

AIDS Education and Prevention — Tue, 04 Jan 2011 00:00:00 +0100

AIDS Education and Prevention 22(6): 538-545 The aim of this study is to examine how physicians use clinical practice guidelines that call for routine HIV screening in a general adolescent medicine clinic and to determine how adolescent patients respond to routine screening. Physicians offered screening to 116 of 217 patients (53%) aged 13-21 who completed a survey. Physicians' offers conformed to the latest Centers for Disease Control and Prevention (CDC) guidelines with 73% of patients because some patients not offered a test had been screened within the last year. Physicians were three times more likely (OR = 3.0; 95% CI = 1.3-6.8) to offer HIV screening to sexually active adolescents than to adolescents who reported no sexual history. Adolescent medicine physicians and their patients e...

What do Deaf High School Students Know about HIV?

AIDS Education and Prevention — Tue, 04 Jan 2011 00:00:00 +0100

The objective of this study was to develop and administer, on laptop computer, an HIV knowledge and risk survey in ASL. Findings among 700 deaf adolescent participants attending high schools for the deaf throughout the United States showed that, on average, students knew correct answers to approximately half (x = 7.2) of 14 knowledge items (median: 7.0; range: 0-14; sd = 3.8) on a highly reliable knowledge scale (alpha = .83). Knowledge score was found in multivariable analysis to be strongly related to receiving HIV information in school. This population is clearly in need of linguistically and culturally accessible HIV prevention education delivered in school. (Source: AIDS Education and Prevention)

Individual and Neighborhood Correlates of HIV Testing among African American Youth Transitioning from Adolescence into Young Adulthood

AIDS Education and Prevention — Tue, 04 Jan 2011 00:00:00 +0100

AIDS Education and Prevention 22(6): 509-522 Disparities in HIV testing rates exist among socially disadvantaged communities. Using a longitudinal sample of urban African American youth followed from adolescence into young adulthood (n = 396; 51% female), we examined whether HIV testing was associated with individual (e.g., gender, socioeconomic status [SES], education, and history of sexually transmitted infections [STIs]) and area (i.e., neighborhood disadvantage and HIV prevalence) characteristics. In our multilevel regressions, we found females were more likely to have tested for HIV, with the magnitude of this association increasing if they lived in areas of greater disadvantage yet decreasing in higher HIV prevalence areas. Those without a high school degree, with a lower SES, or wit...

HIV Status Differences in Venues Where Highly Sexually Active Gay and Bisexual Men Meet Sex Partners: Results from a Pilot Study

AIDS Education and Prevention — Tue, 04 Jan 2011 00:00:00 +0100

AIDS Education and Prevention 22(6): 496-508 Highly sexually active men who have sex with men (MSM) are a critical population in which to provide HIV prevention and education. To inform the tailoring and placement of such services, this study reports on HIV status differences in nine venues where 50 highly sexually active MSM (defined as those who had nine or more male partners in the past 90 days) met recent male sex partners. HIV-positive men (95%) were significantly more likely than HIV-negative/unknown status men (68%) to have used the Internet to meet partners but were less likely to meet partners in bars/clubs (37% vs. 71%). Although both HIV-positive and HIV-negative/unknown status men reported a sizable portion of their total partners from the Internet (55% and 29%, respectively), ...

Levels and Predictors of Sexual HIV Risk in Social Networks of Men who Have Sex with Men in the Midwest

AIDS Education and Prevention — Wed, 01 Dec 2010 00:00:00 +0100

This study identified 75 indexes in venues frequented by men who have sex with men and then recruited all willing persons named as members of each index's egocentric social network. Two hundred fifty-five unique network members completed assessments of risk-related characteristics and also sociometric measures that were used to identify the influence leader of each network. White and African American networks were composed primarily of men of the same race. Over 70% of men reported recent casual sexual partners. About one fourth of men engaged in unprotected anal intercourse (UAI) with a casual partner or with multiple partners in the past 3 months. The social network to which a man belonged, weaker risk reduction intentions, and greater substance use independently predicted a range of hig...

Central American Sex Workers' Introduction of the Female Condom to Different Types of Sexual Partners

AIDS Education and Prevention — Sun, 24 Oct 2010 23:00:00 +0100

AIDS Education and Prevention 22(5): 466-481 Formative research was conducted in El Salvador and Nicaragua to inform promotion of female condoms to sex workers. Two rounds of focus groups with sex workers were conducted, with female condom training and supplies provided. Structured interviews with sex workers and direct observations of health educators were conducted. One third of sex acts were protected with female condoms in the previous 7 days. Women recommended nonpaying partners as first try partners but most frequently reported trying female condoms with clients. With clients, women preferred female condoms over male condoms but expressed no preference with nonpaying partners. Lack of exposure to female condoms among men and women was cited as a key barrier to female condom use. Stra...

Condom Access: Associations with Consistent Condom Use among Female Sex Workers in Two Northern Border Cities of Mexico

AIDS Education and Prevention — Sun, 24 Oct 2010 23:00:00 +0100

AIDS Education and Prevention 22(5): 455-465 To determine whether condom access is associated with consistent condom use among female sex workers (FSWs) in Tijuana and Ciudad Juarez, between 2004 and 2006 we administered a questionnaire to 924 FSWs who reported unprotected sex with a client in the past 2 months. Of these women, 43% reported consistent (often or always) condom use, 74% said condoms were available, and 38% reported having access to free condoms. In a logistic regression, factors positively associated with consistent condom use were condom availability (adjusted odds ratio [AOR] = 2.00; 95% confidence interval [CI]: 1.32-3.03), condom affordability (AOR = 1.72; 95% CI: 1.25-2.38) and self-efficacy (AOR = 2.16; 95% CI: 1.54-3.04). Factors inversely associated with consistent c...

Stigma Against HIV-Infected Persons among Migrant Women Living in Shanghai, China

AIDS Education and Prevention — Sun, 24 Oct 2010 23:00:00 +0100

We examined the characteristics of 601 female migrants in Shanghai regarding stigmatizing attitudes toward people living with HIV/AIDS (PLWHA). A community-based cross-sectional study was conducted July and August 2008, using an anonymous questionnaire. Most participants (88%) were married, 9.2% reported multiple sexual partners, 19.1% knew about voluntary counseling and testing clinics, and 3.7% had been tested for HIV. About half (56.4%) agreed that people who acquire HIV/AIDS through sex or drug use deserve it. About 80% admitted that they were afraid of PLWHA. Low knowledge of HIV/AIDS, being older, low levels of education, and longer duration in Shanghai were correlates for having stigmatizing attitudes, while having premarital sex and/or multiple sex partners correlated with less sti...

The Role of Peer Support on Condom Use among Black and Latino MSM in Three Urban Areas

AIDS Education and Prevention — Sun, 24 Oct 2010 23:00:00 +0100

This article examines the sociodemographic/behavioral variables associated with low peer support of condom use and the relation between low peer support of condom use and unprotected anal sex for Black and Latino MSM in cities heavily impacted by the HIV/AIDS epidemic. Our findings indicate that perceived low peer support of condom use is associated with increased odds of recent unprotected anal intercourse (UAI) among Black and Latino MSM, regardless of male partner type. Although many participants reported having high peer support of condom use, this analysis highlights a considerable subgroup of Black and Latino MSM, 21% and 30%, respectively, who report low peer support of condoms. Given the prevalence of low peer support of condom use and its association with UAI in these highly impac...

Coping, Drug Use, and Religiosity/Spirituality in Relation to HIV Serostatus among Gay and Bisexual Men

AIDS Education and Prevention — Sun, 24 Oct 2010 23:00:00 +0100

AIDS Education and Prevention 22(5): 417-429 Cross-sectional data were collected on a sample of 259 gay and bisexual, male-identified individuals as part of a larger study of the psychosocial functioning of lesbian, gay, bisexual, and transgender persons. Analyses considered differences between HIV-positive and HIV-negative men in relation to active and religious coping strategies; avoidant coping strategies (specifically, illicit drug use); and the psychosocial states of anxiety, hostility, and depression in relation to self-reported HIV-status of the participants. As compared with HIV-negative men, the HIV positive participants indicated a greater likelihood of engaging in illicit substance use within the previous 3 months, as well as higher levels of both active and religious coping str...

Preventing AIDS through Live Movement and Sound: Efficacy of a Theater-Based HIV Prevention Intervention Delivered to High-Risk Male Adolescents in Juvenile Justice Settings

AIDS Education and Prevention — Sun, 24 Oct 2010 23:00:00 +0100

AIDS Education and Prevention 22(5): 402-416 (Source: AIDS Education and Prevention)

Strategies Used by Community-Based Organizations to Evaluate Their Locally Developed HIV Prevention Interventions: Lessons Learned from the CDC's Innovative Interventions Project

AIDS Education and Prevention — Thu, 30 Sep 2010 23:00:00 +0100

This article describes operational issues that the CBOs identified as being particularly salient to their evaluations and the strategies they developed to address the issues and successfully complete their evaluations. These issues included the development of organizational capacity to conduct a rigorous outcome evaluation, difficulties with recruitment and retention of evaluation participants, and the use of process monitoring data to improve intervention delivery. The strategies described in this article can be used by CBOs when evaluating their locally developed HIV prevention interventions and may be of interest to funding agencies and researchers that collaborate with CBOs to evaluate their interventions. (Source: AIDS Education and Prevention)

Reducing Sexual Risk Among Filipina Female Bar Workers: Effects of a CBPR-Developed Structural and Network Intervention

AIDS Education and Prevention — Thu, 12 Aug 2010 23:00:00 +0100

AIDS Education and Prevention 22(4): 371-385 The effects of three interventions designed to reduce sexual risk among Filipina female bar workers (FBWs) were compared with each other and with usual care (nonintervention). The interventions were developed iteratively by a community-based participatory research (CBPR) partnership comprising lay community members, organizational representatives (including nongovernmental organizations), and academic researchers from the United States and the Philippines. Peer educators and bar managers from 110 different establishments in three southern regions were recruited and trained to increase knowledge of HIV and of condom use rules and regulations within establishments, as well as to change attitudes about risk reduction, provide HIV and sexually trans...

HIV Testing Among Bisexual Men in the United States

AIDS Education and Prevention — Thu, 12 Aug 2010 23:00:00 +0100

AIDS Education and Prevention 22(4): 356-370 Little is known about HIV testing among bisexual men in the United States. Existing studies lack adequate representation, multivariate analytical strategies, and measurement of bisexuality indicators. To address these limitations, this study used the National Survey of Family Growth (N = 3,875). Sexual behavior and identity measures compared bisexual and other men along HIV testing history, reasons for testing, and recency of testing. Multivariate analyses adjusted for sociodemographic and risk factors that covary with testing. Bisexually active men were significantly less likely than homosexually active men to ever test, and they tested less often to know their HIV serostatuses. Bisexual identification decreased the odds of testing among bisexu...

Theory-Based HIV-Related Sexual Risk Reduction Prevention for Chinese Female Rural-to-Urban Migrants

AIDS Education and Prevention — Thu, 12 Aug 2010 23:00:00 +0100

The objective of this pilot study was to evaluate the initial efficacy of a protection motivation theory-based behavioral HIV prevention intervention in increasing HIV knowledge, condom use perception, condom use intention and consistent condom use among female rural-to-urban migrants in Beijing, China. Three hundred female migrants were assigned to the intervention group (N = 200) and control group (N = 100). Data were collected at baseline and a 4-month follow-up. The results suggest that HIV-related knowledge, condom use perceptions, condom use intention and condom use skills at the follow-up were significantly improved among female migrants in the intervention group compared with those in the control group. Moreover, a significantly higher rate of consistent condom use at post interven...

Evaluation of a U.S. Evidence-Based Parenting Intervention in Rural Western Kenya: From Parents Matter! to Families Matter!

AIDS Education and Prevention — Thu, 12 Aug 2010 23:00:00 +0100

AIDS Education and Prevention 22(4): 328-343 We evaluated Families Matter! Program (FMP), an intervention designed to improve parent-child communication about sexual risk reduction and parenting skills. Parents of 10- to 12-year-olds were recruited in western Kenya. We aimed to assess community acceptability and FMP's effect on parenting practices and effective parent-child communication. Data were collected from parents and their children at baseline and 1 year postintervention. The intervention's effect was measured on six parenting and parent-child communication composite scores reported separately for parents and children. Of 375 parents, 351 (94%) attended all five intervention sessions. Parents' attitudes regarding sexuality education changed positively. Five of the six composite par...

CDC HIV Testing Guidelines and the Rapid and Conventional Testing Practices of Homeless Youth

AIDS Education and Prevention — Thu, 12 Aug 2010 23:00:00 +0100

AIDS Education and Prevention 22(4): 312-327 The study's aims were to describe rapid and conventional HIV testing practices and referrals/linkages to services posttest among homeless youth in New York City. We also examined variation among service-involved youth, street youth, and nomads. Respondent-driven sampling was used to recruit 217 homeless youth who participated in structured interviews. Almost all youth were tested in the past year (82%). Most received pretest/posttest counseling (> 77%). Rapid testing was common and conducted in diverse settings. However, youth reported that rates of referral/linkage to services posttest were low (< 44.4%). Service-involved youth were significantly more likely to receive rapid testing, be tested in the past year, and be tested at a high frequency...

Examining HIV Infection Among Male Sex Workers in Bangkok, Thailand: A Comparison of Participants Recruited at Entertainment and Street Venues

AIDS Education and Prevention — Thu, 12 Aug 2010 23:00:00 +0100

AIDS Education and Prevention 22(4): 299-311 HIV prevalence and associated factors were examined among male sex workers (MSWs, N = 414) in Bangkok, Thailand. Cross-sectional venue-day-time sampling was used to collect data in entertainment and street venues. Chi-square and logistic regression were used to identify HIV risk factors. HIV prevalence was 18.8% overall, but differences were found between MSW recruited in entertainment and street venues. Significant relationships were found between several demographic, behavioral, exposure to HIV prevention, and other characteristics, and recruitment location. In multivariate analyses, being sexually attracted to men was significantly associated with HIV infection among both groups of sex workers. In addition, among street-based sex workers, not...

Harassment, Discrimination, Violence, and Illicit Drug Use Among Young Men Who Have Sex with Men

AIDS Education and Prevention — Thu, 12 Aug 2010 23:00:00 +0100

We examined the relationship among social discrimination, violence, and illicit drug use among an ethnically diverse cohort of young men who have sex with men (YMSM) residing in Los Angeles. Five Hundred twenty-six YMSM (aged 18-24 years) were recruited using a venue-based, stratified probability sampling design. Surveys assessed childhood financial hardship, violence (physical assault, sexual assault, intimate partner violence), social discrimination (homophobia and racism), and illicit drug use in the past 3 months. Analyses examined main and interaction effects of key variables on drug use. Experiences of financial hardship, physical intimate partner violence and homophobia predicted drug use. Although African American participants were less likely to report drug use than their Caucasia...

Cultural Adaptation of a U.S. Evidence-Based Parenting Intervention for Rural Western Kenya: From Parents Matter! to Families Matter!

AIDS Education and Prevention — Sat, 31 Jul 2010 23:00:00 +0100

We describe the process of adapting the Parents Matter! Program, an EBI originally developed for African American parents to promote effective parent-child communication about sexual risk reduction and parenting skills, for use in rural Kenya. A systematic process was used to assess the community's needs, identify potential EBIs, identify and make adaptations, pilot-test the adapted intervention, and implement and monitor the adapted EBI. Evaluation results showed the adapted EBI retained its effectiveness, successfully increasing parent-child sexual communication and parenting skills. Our experience suggests an EBI can be successfully adapted for a new context if it is relevant to local needs, the process is led by a multidisciplinary team with community representation, and pilot-testing ...

Challenges, Strategies, and Lessons Learned from a Participatory Community Intervention Study to Promote Female Condoms among Rural Sex Workers in Southern China

AIDS Education and Prevention — Sun, 06 Jun 2010 23:00:00 +0100

This article presents lessons learned from our experiences in the first two study sites of this intervention trial. (Source: AIDS Education and Prevention)

A Community-Based Approach to Linking Injection Drug Users with Needed Services Through Pharmacies: An Evaluation of a Pilot Intervention in New York City

AIDS Education and Prevention — Sun, 06 Jun 2010 23:00:00 +0100

AIDS Education and Prevention 22(3): 238-251 Studies suggest that community-based approaches could help pharmacies expand their public health role, particularly pertaining to HIV prevention. Thirteen pharmacies participating in New York's Expanded Syringe Access Program, which permits nonprescription syringe sales to reduce syringe-sharing among injection drug users (IDUs), were enrolled in an intervention to link IDU syringe customers to medical/social services. Sociodemographics, injection practices, beliefs about and experiences with pharmacy use, and medical/social service utilization were compared among 29 IDUs purchasing syringes from intervention pharmacies and 66 IDUs purchasing syringes from control pharmacies using chi-square tests. Intervention IDUs reported more positive experi...

Taking it to the Pews: A CBPR-Guided HIV Awareness and Screening Project with Black Churches

AIDS Education and Prevention — Sun, 06 Jun 2010 23:00:00 +0100

AIDS Education and Prevention 22(3): 218-237 Utilizing a community-based participatory research (CBPR) approach is a potentially effective strategy for exploring the development, implementation, and evaluation of HIV interventions in African American churches. This CBPR-guided study describes a church-based HIV awareness and screening intervention (Taking It to the Pews [TIPS]) that fully involved African American church leaders in all phases of the research project. Findings from the implementation and evaluation phases indicated that church leaders delivered TIPS Tool Kit activities on an ongoing basis (about twice a month) over a 9-month period. TIPS church members were highly exposed to TIPS activities (e.g., 91% reported receiving HIV educational brochures, 84% heard a sermon about HI...

YOUR Blessed Health: A Faith-Based CBPR Approach to Addressing HIV/AIDS among African Americans

AIDS Education and Prevention — Sun, 06 Jun 2010 23:00:00 +0100

This article describes the historical context and development of YBH, discusses the results of the pilot study, and illustrates how YBH grew into a community mobilization effort led by faith leaders and their congregations to address HIV/AIDS. YBH highlights the importance of developing and testing intervention models that originate from community-based organizations to address complex and sensitive health issues among marginalized populations. (Source: AIDS Education and Prevention)

Intervention Mapping as a Participatory Approach to Developing an HIV Prevention Intervention in Rural African American Communities

AIDS Education and Prevention — Sun, 06 Jun 2010 23:00:00 +0100

We describe how Project GRACE integrated intervention mapping (IM) methodology with community-based participatory research (CBPR) principles to develop a multilevel, multigenerational HIV prevention intervention. IM was carried out in a series of steps from review of relevant data through producing program components. Through the IM process, all collaborators agreed that we needed a family-based intervention involving youth and their caregivers. We found that the structured approach of IM can be adapted to incorporate the principles of CBPR. (Source: AIDS Education and Prevention)

Community-Based Participatory Research: A New and Not-So-New Approach to HIV/AIDS Prevention, Care, and Treatment

AIDS Education and Prevention — Mon, 31 May 2010 23:00:00 +0100

AIDS Education and Prevention 22(3): 173-183 (Source: AIDS Education and Prevention)

Ethnic Differences in HIV Risk Perceptions and Behaviors Among Black 18-39 Year-Old Residents of Broward County, Florida

AIDS Education and Prevention — Mon, 12 Apr 2010 23:00:00 +0100

AIDS Education and Prevention 22(2): 160-171 The study assessed ethnic differences in the perceived risks of HIV infection, sexual experiences, and HIV-antibody testing histories among Black populations in Broward County, Florida. Data were analyzed for 2,731 well-characterized survey respondents 18-39 years old who indicated they were African Americans, Caribbean Islanders, English-speaking, or Creole-speaking Haitians. Creole-speaking Haitians were least likely to consider themselves at risk of HIV infection, report using condoms in the last 12 months, and indicate that they had ever been tested for HIV. English-speaking Haitians were more likely than African Americans to report never engaging in sexual intercourse and were less likely to have ever been tested for HIV. English-speaking C...

Sexual Risk Behavior in Emerging Adults: Gender-Specific Effects of Hedonism, Psychosocial Distress, and Sociocognitive Variables in a 5-Year Longitudinal Study

AIDS Education and Prevention — Mon, 12 Apr 2010 23:00:00 +0100

AIDS Education and Prevention 22(2): 148-159 The aim of this study was to examine the longitudinal effects of HIV protection intention, condom self-efficacy, psychosocial distress and hedonism on sexual risk behavior up to 5 years later. The sample included 1,290 Swiss heterosexual young adults aged 16-24 years. A series of hierarchical logistic regression analyses yielded clear gender-specific results showing that for women condom self-efficacy and psychosocial distress, and for men HIV protection intention and hedonism, predicted sexual risk behavior up to 5 years later. The relationship between psychosocial distress and sexual risk behavior in women was partially mediated by a lower condom self-efficacy but not by a lower HIV protection intention. High hedonism in young men did not decr...

Project Roadmap: Reeducating Older Adults in Maintaining AIDS Prevention: A Secondary Intervention for Older HIV-Positive Adults

AIDS Education and Prevention — Mon, 12 Apr 2010 23:00:00 +0100

AIDS Education and Prevention 22(2): 138-147 The number of older adults living with HIV/AIDS is larger than ever. Little is known about their sexual behaviors, although contrary to stereotypes, older adults desire and engage in sexual activity. Despite increased recognition of the need for prevention interventions targeting HIV-positive individuals, no secondary HIV prevention interventions have specifically targeted the older HIV-positive adult. Efforts to target high-risk sexual behaviors may be even more critical in the older population because of sociocultural, biological, and behavioral vulnerabilities. In response, Project ROADMAP (Reeducating Older Adult in Maintaining AIDS Prevention) intervention was developed to reduce high-risk sexual behaviors among older HIV-positive patients ...

HIV Treatment Optimism and Unsafe Anal Intercourse Among HIV-Positive Men Who Have Sex With Men: Findings from the Positive Connections Study

AIDS Education and Prevention — Mon, 12 Apr 2010 23:00:00 +0100

This study was designed to examine the impact of HIV treatment optimism on sexual risk among a racially diverse sample of HIV-positive MSM. Survey data were collected from 346 racially diverse HIV-positive MSM. Inclusion criteria: 18 years of age, male, at least one incident of unprotected anal intercourse (UAI) in the last year, currently on treatment. Other variables included demographics, sexual risk, depression, internalized homonegativity, HIV treatment history, alcohol/drug use and beliefs about HIV treatments (Susceptibility to transmit HIV, Severity of HIV infection and Condom Motivation). Those with lower income were more likely to report that HIV was less transmissible. A self-reported decrease in condom motivation was associated with being White, well-educated and increased alco...

Audience Reactions and Receptivity to HIV Prevention Message Concepts for People Living With HIV

AIDS Education and Prevention — Mon, 12 Apr 2010 23:00:00 +0100

This study measured audience reactions and receptivity to five draft HIV prevention messages developed for people living with HIV (PLWH) to inform future HIV message choice and audience targeting decisions. Our premise was that message concepts that receive wide audience appeal constitute a strong starting point for designing future HIV prevention messages, program activities, and health communication and marketing campaigns for PLWH. The majority of participants indicated agreement with evaluative statements that expressed favorable attitudes toward all five of the message concepts we evaluated. Participants gave the lowest approval to the message promoting sero-sorting. Sociodemographic characteristics played less of a role in predicting differences in message perceptions than attitudes,...

Inconsistent Condom Use Among Young Men Who Have Sex With Men, Male Sex Workers, and Transgenders in Thailand

AIDS Education and Prevention — Mon, 12 Apr 2010 23:00:00 +0100

AIDS Education and Prevention 22(2): 100-109 Young men who have sex with men (MSM) are at risk for HIV infection. We investigated inconsistent condom use among 827 sexually active young MSM (15-24 years), enrolled using venue-day-time sampling in Bangkok, Chiang Mai and Phuket, Thailand. Data was collected using palmtop computer-assisted self-interviewing. Of participants, 33.1% were regular MSM, 37.7% were male sex workers (MSWs) and 29.1% were transgenders (TGs). Of MSM, 46.7%, of MSWs, 34.9% and of TGs, 52.3% reported recent inconsistent condom use. In multivariate analysis, receptive anal intercourse (MSM, MSWs), receptive and insertive anal intercourse, living alone and a history of sexual coercion (MSWs), not carrying a condom when interviewed (MSM, TGs), lower education, worrying ab...

Provider Challenges in Implementing Antenatal Provider-Initiated HIV Testing and Counseling Programs in Uganda

AIDS Education and Prevention — Wed, 31 Mar 2010 23:00:00 +0100

AIDS Education and Prevention 22(2): 87-99 While provider-initiated HIV testing and counseling (PITC) programs are being increasingly implemented in antenatal care settings, there is scant information about the specific challenges providers face when offering these services. Through qualitative interviews with 30 HIV antenatal care providers from 10 clinics in central Uganda, we sought to understand specific challenges Ugandan providers face in implementing antenatal PITC programs, including how these challenges impact prevention of mother-to-child HIV transmission programs. Counseling-specific challenges included counseling discordant couples, incomplete follow-up of HIV-infected clients, low rates of both male involvement and HIV serostatus discourse, and inadequate training and support ...

Social Influence and Individual Risk Factors of HIV Unsafe Sex among Female Entertainment Workers in China

AIDS Education and Prevention — Thu, 18 Feb 2010 00:00:00 +0100

AIDS Education and Prevention 22(1): 69-86 Female entertainment workers in China are at increased sexual risk of HIV, but causes of their unprotected sex remain poorly understood. We develop a model that integrates information-motivation-behavioral skills (IMB) with social influences and test the model in a venue-based sample of 732 female entertainment workers in Shanghai. Most IMB and social influence measures are statistically significant in bivariate relationships to condom use; only HIV prevention motivation and behavioral self-efficacy remain significant in the multiple regressions. Self-efficacy in condom use is the most proximate correlate, mediating the relationship between information and motivation and condom use. Both peer and venue supports are important, but their influences ...

Violence, Coping, and Consistent Medication Adherence in HIV-Positive Couples

AIDS Education and Prevention — Thu, 18 Feb 2010 00:00:00 +0100

This study offers support for the inclusion of partners in conducting interventions. Furthermore, it underlines the importance of recognizing IPV as a barrier to medication adherence. (Source: AIDS Education and Prevention)

Outcomes of AIDS Education and Training Center HIV/AIDS Skill-Building Workshops on Provider Practices

AIDS Education and Prevention — Thu, 18 Feb 2010 00:00:00 +0100

AIDS Education and Prevention 22(1): 49-60 The Midwest AIDS Training and Education Center (MATEC) implemented a Web-based survey method to measure impact on practitioners of HIV/AIDS skill-building workshops offered in seven midwestern states. Surveys were sent to 2,949 participants from 230 workshops 4-6 weeks after each workshop. Of those surveyed, 631 respondents provided usable data (22.4%). Self-reported narrative responses described practice changes attributed to training. Changes were categorized as (a) practitioner attitude/knowledge, (b) practitioner practice behavior, (c) planning system change, and (d) implemented adaptations to the clinical care system. Other outcome measures were attending more programs and consulting with colleagues. Change was reported by 341 (54.0%) individ...

The Bruthas Project: Evaluation of a Community-Based HIV Prevention Intervention for African American Men Who Have Sex With Men and Women

AIDS Education and Prevention — Thu, 18 Feb 2010 00:00:00 +0100

AIDS Education and Prevention 22(1): 37-48 The Bruthas Project is a community-collaborative intervention to reduce HIV risk behavior among African American men who have sex with men and women (MSMW) but who do not form an identity around their same-sex behavior. The intervention was developed based on formative qualitative research with members of the population and involved four individualized risk reduction counseling sessions. Participants review general risk factors for HIV and are offered HIV testing and counseling (Session 1); discuss sexual dynamics and risk behaviors with female partners (Session 2); discuss sexual dynamics and risk behaviors with male partners (Session 3); review motivations and situational triggers for unsafe sex, and engage in role-play exercises that aim to rea...

Recruitment of Men Who Have Sex With Men for Large HIV Intervention Trials: Analysis of the EXPLORE Study Recruitment Effort

AIDS Education and Prevention — Thu, 18 Feb 2010 00:00:00 +0100

AIDS Education and Prevention 22(1): 28-36 Testing HIV prevention strategies requires that researchers recruit participants at high risk of HIV infection. Data from the EXPLORE Study, a behavioral intervention trial involving men who have sex with men (MSM), were used to examine the relationship between recruitment strategies and participant characteristics, sexual risk behaviors and HIV incidence. The EXPLORE Study used a wide variety of recruitment strategies; no one strategy accounted for more than 20% of enrolled men. Younger men and men of color were more likely to be recruited through club and bar outreach, friend referral, and street outreach. Men reporting 10 or more sexual partners were more likely to be recruited through advertising and street outreach. Men reporting unprotected ...

Mobilizing Communities Around HIV Prevention for Youth: How Three Coalitions Applied Key Strategies to Bring About Structural Changes

AIDS Education and Prevention — Thu, 18 Feb 2010 00:00:00 +0100

This article shares lessons and key strategies regarding how three community coalitions located in Miami and Tampa, Florida, and San Juan, Puerto Rico engaged their respective communities in bringing about structural changes affecting policies, practices and programs related to HIV prevention for 12-24-year-olds. Outcomes of this work include increased access to HIV testing and counseling in the juvenile correctional system (Miami), increased monitoring of sexual abuse between young women and older men within public housing, and support services to deter age discordant relationships (Tampa) and increased access to community-based HIV testing (San Juan). (Source: AIDS Education and Prevention)

Predictors of Condom Use in a Multisite Study of High-Risk Youth Living with HIV

AIDS Education and Prevention — Mon, 01 Feb 2010 00:00:00 +0100

AIDS Education and Prevention 22(1): 1-14 Young people between the ages of 13 to 24 are at persistent risk for HIV infection in the United States (Centers for Disease Control and Prevention [CDC], 2006). Young adulthood is a period characterized by experimentation, including engagement in risky behaviors (e.g., substance use and sexual behavior) (Moore & Parsons, 2000). Most young adults are sexually active, with the highest rates of sexual activity reported among youth of color (Park, Mulye, Adams, Brindis, & Irwin, 2006). The prevalence of sexually transmitted infections (STIs), especially chlamydia and gonorrhea, peak in young adulthood and are highest among youth of color (CDC, 2003). (Source: AIDS Education and Prevention)

Author Index to Volume 21

AIDS Education and Prevention — Wed, 23 Dec 2009 00:00:00 +0100

AIDS Education and Prevention 21(6): 594-604 (Source: AIDS Education and Prevention)

It's Better Not To Know: Perceived Barriers to HIV Voluntary Counseling and Testing among Sub-Saharan African Migrants in Belgium

AIDS Education and Prevention — Wed, 23 Dec 2009 00:00:00 +0100

This study explored perceptions, needs, and barriers of sub-Saharan African migrants in relation to HIV voluntary counseling and testing (VCT). Using an inductive qualitative methodological approach, data were obtained from focus group discussions. Results showed that participants were in principle in favor of VCT. However, they indicated that barriers outweighed advantages. Such barriers included fear of positive test results and its related personal and social consequences, lack of information, lack of preventive health behavior, denial of HIV risk, and missed opportunities. Limited financial resources were only a concern for some subgroups like young people, asylum seekers, and recent migrants. This study identified multiple and intertwined barriers to VCT from a community perspective. ...

Knowledge, Attitudes, and Practices of Voluntary HIV Counseling and Testing among Rural Migrants in Shanghai, China

AIDS Education and Prevention — Wed, 23 Dec 2009 00:00:00 +0100

This study suggests that a much greater effort is needed to promote safer sex and to improve VCT knowledge and services among rural migrants particularly those who are engaging in risky behaviors. (Source: AIDS Education and Prevention)

Pairing HIV-Positive Prisoners with Volunteer Life Coaches to Maintain Health-Promoting Behavior Upon Release: A Mixed-Methods Needs Analysis and Pilot Study

AIDS Education and Prevention — Wed, 23 Dec 2009 00:00:00 +0100

AIDS Education and Prevention 21(6): 552-569 Drawing on individuals who volunteer in US prisons to mentor HIV-infected inmates returning to the community may promote successful transitions. Evaluations published in the scientific literature of such community linkage programs are scant. Our quantitative and qualitative methods needs analysis and pilot study entailed interviewing convenience samples of 24 HIV-positive persons recently released from Georgia correctional facilities and 12 potential volunteer mentors. Both releasees and potential mentors were open to the establishment of a mentoring program. Releasees wanted nonjudgmental mentors. Releasees and volunteers had statistically significant differences in marital status, education, current employment, and possession of a driver's lic...

Acceptability and Use of the Female Condom and Diaphragm among Sex Workers in Dominican Republic: Results from a Prospective Study

AIDS Education and Prevention — Wed, 23 Dec 2009 00:00:00 +0100

AIDS Education and Prevention 21(6): 538-551 To assess the acceptability and use of the female condom and diaphragm among female sex workers in the Dominican Republic, 243 participants were followed for 5 months. Participants received female and male condoms and a diaphragm along with proper counseling at monthly visits. Seventy-six percent reported used of female condom at least once during the final month of the study, compared with 50% that used the diaphragm with male condoms and 9% that used the diaphragm alone. The proportion of women reporting every sex act protected with some barrier method increased from 66% at first month to 77% at final month (p < 0.05). Participants reported higher acceptability and use of the female condom than the diaphragm. The introduction of female-control...

Perceptions of Vulnerability to HIV/AIDS: A Comparison of Two College Cohorts, 1990 and 2005

AIDS Education and Prevention — Wed, 23 Dec 2009 00:00:00 +0100

AIDS Education and Prevention 21(6): 526-537 Theories of preventive health behavior posit that perceived vulnerability to health threats motivates self-protective behavior. Fifteen years after an initial study of college students' perceptions of their vulnerability to HIV, a replication was conducted on the same campus in 2005. Comparisons between cohorts on vulnerability judgements were conducted to examine whether, and to what extent, student perceptions had changed across time. Respondents in the 1990 study had judged themselves as less vulnerable to HIV/AIDS than others about whom they also made risk estimates; this pattern was replicated among 2005 respondents, even though many in both cohorts were involved in objectively risky practices. Comparisons between the cohorts on risk behavi...

Promoting Continuous Use as a Strategy for Achieving Adherence in a Trial of the Diaphragm with Candidate Microbicide

AIDS Education and Prevention — Wed, 23 Dec 2009 00:00:00 +0100

The objective of this analysis was to determine whether women who followed this continuous use approach more often used the diaphragm for 100% of sex acts as compared with other women. If so, this would support advising continuous diaphragm use in the upcoming RCT. To meet our objective, we analyzed qualitative data thematically, developed a measure of continuous diaphragm use based on qualitative data, and used multiple regression to evaluate the measure's association with adherence to diaphragm use during 100% of sex acts. Women who wore the diaphragm continuously had 4 times higher odds of reporting diaphragm use during 100% of sex acts (OR: 4.6, 95% CI: 1.2, 24.0). If the diaphragm proves effective against STI, continuous use may help women achieve high levels of protection. (Source: A...

Increasing Parent Involvement in Youth HIV Prevention: A Randomized Caribbean Study

AIDS Education and Prevention — Tue, 01 Dec 2009 00:00:00 +0100

This article presents preliminary findings of a randomized HIV prevention study in Trinidad and Tobago in the Caribbean. The study centers on a family HIV workshop aimed at strengthening parenting skills that are empirically linked to reducing adolescent HIV exposure and other sexual risks. These skills include parental monitoring; educating youth about HIV, sex, and other sexually transmitted infections (STI's); and discussing cultural and interpersonal pressures to have sex. Participants include 180 primary caregivers and their 12-14-year-old adolescents randomized to either the Trinidad and Tobago family HIV Workshop (N = 92) or a general workshop (N = 88). Intervention and control group participants completed pretest and posttest measures on parenting and HIV risk outcomes. Compared to...

From Research to Community-Based Practice--Working with Latino Researchers to Translate and Diffuse a Culturally Relevant Evidence-Based Intervention: The Modelo de Intervencion Psicomedica (MIP) Experience