A gender comparison of HIV and drug use across the rural-urban continuum

Despite the central role of women drug users in escalating AIDS statistics, there is still a limited number of studies that examine the roles of gender and drug use type in HIV seroprevalence. This lacuna in the research literature has led to significant gaps in researchers' understanding of how and to what extent women may differ in their drug-using and HIV risk behaviors compared to their better-studied male counterparts. This study, derived from a sample of 3,555 out-of-treatment drug users residing in three South Florida urban and rural communities, attempts to compare the drug usage and needle and sexual risk behaviors of male and female drug users that put them at risk for HIV infection. The overall seropositivity rate for women drug users was 26.5% compared to 19.5% for their male counterparts. Results of multivariate analyses indicate that females compared to males were 1.4 times more likely to be HIV seropositive. Risk behaviors associated with this elevated seropositivity include living arrangements, homeless status, drug use, sexual trading behaviors, and history of STDs. Furthermore, there was a strong linear relationship between drug use type and HIV seroprevalence among women drug users. Compared to those who were neither crack smokers nor injectors of illicit drugs, those who were crack smokers only were 2 times more likely to be HIV seropositive, while those who were both crack smokers and injectors were 5 times more likely to be HIV seropositive, and those who were injectors only were 6 times more likely to be HIV seropositive. These findings indicate that among women, drug abuse and its associated risk behaviors, increase the vulnerability of this population for HIV and thus render them an extremely important priority population on which to focus HIV prevention and public health efforts and programs.     

HIV testing,perceptions of AIDS risk,and condom use motivation among US women

As STD infections including HIV increase in the United States, it has become increasingly important to policy makers to ascertain the extent to which knowledge and perceptions of AIDS risk affect an individual's probability of altering their sexual or contraceptive behavior to avoid infection. This paper examines the extent to which women's perceptions of their own and their partners' risk of HIV infection affects the probability of using a condom for protection against sexually transmitted diseases. This paper also examines the extent to which HIV testing may affect motivation for condom use. Crosstabulations reveal that prophylactic condom use is more prevalent among women who have been tested for HIV and increase as perceptions of their chance (and their partner's chance) of being positive increases. The multivariate results from this study indicate that having an HIV test significantly predicts the likelihood of using a condom for STD prevention for US women. Furthermore, women who perceive themselves to be at least somewhat likely to be HIV positive have a higher probability of using a condom to prevent sexually transmitted disease, and women who perceive their partners to be HIV positive are twice as likely as other women to use a condom for STD prevention. However, women who consider themselves likely to be HIV positive are no more likely to use a condom than those who consider themselves not at risk.     

Are young people in the Philippines taking chances with HIV / AIDS?

The numbers of AIDS cases and HIV infections detected in the Philippines have risen slowly but steadily since the first AIDS case in the country was diagnosed in 1984. By the end of 1995, 234 AIDS cases and 470 HIV infections had been reported to the country's Department of Health. However, given the limited extent to which people have been tested for HIV infection, there are most likely many more cases than reported. The HIV/AIDS epidemic is spreading within the Filipino population. The country's substantial commercial sex trade, reports suggesting that many unmarried young men have sexual intercourse with girlfriends and acquaintances, and IV drug use among a small number of young people are factors which contribute to the potential for a serious HIV/AIDS epidemic in the Philippines. Findings from the 1994 national Young Adult Fertility and Sexuality Study, a household survey covering 10,879 men and women aged 15-24 years in 959 different communities, are presented. Almost all respondents had heard of AIDS, but there was some degree of ignorance and misinformation on the modes of HIV transmission. 13% of all single men reported having had only one sex partner, 10% reported two or more partners, and 3% reported five or more. 98% of sexually active men had heard of condoms, 58% knew that condom use can protect against HIV infection, 23% reported ever having used one, and 4% reported using a condom during the most recent act of sexual intercourse.     

The Impact of HIV Testing on Subjective Expectations and Risky Behavior in Malawi

We investigate the causal impact of learning HIV status on HIV/AIDS-related expectations and sexual behavior in the medium run. Our analyses document several unexpected results about the effect of learning one's own, or one's spouse's, HIV status. For example, receiving an HIV-negative test result implies higher subjective expectations about being HIV-positive after two years, and individuals tend to have larger prediction errors about their HIV status after learning their HIV status. If individuals in HIV-negative couples also learn the status of their spouse, these effects disappear. In terms of behavioral outcomes, our analyses document that HIV-positive individuals who learned their status reported having fewer partners and using condoms more often than those who did not learn their status. Among married respondents in HIV-negative couples, learning only one's own status increases risky behavior, while learning both statuses decreases risky behavior. In addition, individuals in sero-discordant couples who learned both statuses are more likely to report some condom use. Overall, our analyses suggest that ensuring that each spouse learns the HIV status of the other, either through couple's testing or through spousal communication, may be beneficial in high-prevalence environments.     

Reaching Egyptian Gays Using Social Media: A Comprehensive Health Study and a Framework for Future Research

The Internet has revolutionized research on sexual minorities by providing direct and safe access to hidden, stigmatized, and high-risk populations. This study investigated the possibility of using Facebook to reach Egyptian gays. The questionnaire was manually distributed to an extensive list of Facebook pages and groups related to the topic that has been collected using a snowball-like technique. The recruitment lasted from August 2015 to May 2016. Among the 461 eligible participants, the mean age was 26.6 (SD = 7.6), and the majority (74%) were highly educated. Only 17% use condoms consistently, and 34% have ever tested for HIV. Guilt feelings and trying to change sexual orientation were very high and were associated with higher religiosity and low condom use and HIV testing (p < .05). Also, 10% have ever tried to end their life. Most of the participants did not disclose their sexual orientation to anybody other than their partners, and 60% will not disclose it to health care providers even if needed. The low health awareness among Egyptian gays requires Internet-based health campaigns.     

The prevalence and incidence of HIV among injection drug users: A five year panel study

Six hundred and one injection drug users (IDUs) who attended drug treatment programs in Miami, Florida, were enrolled in a panel study to determine the prevalence and incidence of human immunodeficiency virus (HIV) and associated risk factors. A structured questionnaire which elicited injection and sexual behaviors was administered and blood was obtained by venipduncture. All participants were reassessed at six month intervals for 5 years. The baseline prevalence of HIV was 16.3%. African–Americans had a prevalence of HIV (37.1%) that was significantly higher than that of non-Hispanic whites (7.6%); the prevalence of HIV among Hispanics was 27.2%. Persons who were more than thirty years of age were more likely to test HIV positive (17.8%) than were younger participants (9.7%). The annual incidence per 1000 person-years of exposure for the 503 initially seronegative participants was consistently low for each year of the study. The 5 year incidence was 4.1 per 1000 person years; 7.5 for men and 1.7 for women, 7.5 for African–Americans and 3.8 for non-Hispanic whites. No Hispanic participants seroconverted. Multivariate logistic techniques were used to identify the independent risk factors for HIV prevalence. Earlier injection, ethnicity, and income were independently associated with HIV serostatus. A history of a sexually transmitted disease was marginally associated with HIV prevalence. Low incidence probably is a function of the reduction of risk behavior that occurred over the course of the study and the stage of the epidemic.     

HIV seroprevalence and risk behaviors among clients attending a clinic for the homeless in Miami/Dade County,Florida, 1990–1996

In the early 1990s, HIV seroprevalence was highest at the Miami homeless clinic among 16 homeless sites participating in a nationwide sentinel survey. To examine dynamic seroprevalence patterns in Miami's homeless clients in relation to demographics and risk behaviors over six years, we analyzed data from an unlinked (blinded) serosurvey of clients attending the principal primary care clinic serving Miami's homeless. Data were from 3,797 medical encounters with homeless persons who, on their initial clinic visit within an annual survey period, received routine serologic testing and a risk behavior survey. Overall HIV seroprevalence was 15.9% and infection rates for men (16.4%) and women (14.5%) did not differ. Seroprevalence for blacks (19.9%) was significantly higher than for Hispanics (9.1%) or whites (8.3%) (p < 0.0001). Seroprevalence was 12.6% (35 times the national rate) for clients reporting heterosexual contact as their only risk. Significant increases in seroprevalence, above this heterosexual-contact-only 'baseline', were found for clients disclosing high-risk behaviors: male-to-male sex, drug injection, receiving or giving money/drugs for sex, and sexual contact with a drug injector or HIV-infected partner (p < 0.0001). Seroprevalence declined over six years from 23.2 to 7.2% (p < 0.0001). Significant downward trends were observed for men and women, blacks and Hispanics, men who have sex with men, and clients reporting heterosexual contact. The proportion of clients reporting high-risk behaviors decreased sharply (p < 0.0001). Elevated HIV seroprevalence in Miami's homeless clients was strongly associated with high-risk behaviors. Expansion of HIV prevention and HIV/drug treatment services for homeless persons is strongly recommended.     

AIDS in China

Although 10,676 people were officially reported to be infected with HIV on China's mainland by the end of June 1998, experts estimate that more than 300,000 Chinese are actually infected with HIV in China. They also believe HIV continues to spread in alarming fashion. Two thirds of reported HIV infection cases live in rural China, and nearly one third of the 301 people diagnosed as having AIDS have died. About 10% of all HIV infections occurred among teenagers under age 19 years old, with most infected through IV drug use. 60% of teens who responded to a survey in 1997 did not possess correct basic knowledge about AIDS, and 21% did not know how to protect themselves from contracting HIV.     

Hormonal Contraceptive Use and Discontinuation Because of Dissatisfaction: Differences by Race and Education

The unintended pregnancy rate in the United States remains high, and there are large race and education differences in unintended pregnancy and fertility. These differences make it important to study race and education differences in contraceptive behavior. Using nationally representative data from the 2002 National Survey of Family Growth, this study examines the effects of race and education on the likelihood that women have ever used particular types of hormonal contraception and have ever discontinued hormonal contraception because of dissatisfaction. The results show that blacks and Latinas were more likely to have used injectable contraceptives (??the shot??) and less likely to have used oral contraceptives (??the pill??) than were white women. Women with less education were more likely than college-educated women to have used the shot but there were no significant education differences in use of the pill. Among women who had ever used hormonal birth control, those with less than a college degree were more likely than college-educated women to discontinue the birth control because of dissatisfaction. However, net of education, this study found no significant racial/ethnic differences in discontinuation. The most commonly stated reason for discontinuation because of dissatisfaction was side effects.     

HIV diffusion patterns and mobility: Gender differences among drug users

Researchers have recently expanded the scope of study of transmission patterns of AIDS to incorporate spatial and geographical questions. United States diffusion patterns of this disease appear to indicate that it may emanate from urban area epicenters to areas of low and moderate prevalence. The travel patterns of injecting drug users (IDUs) and the extent to which they engage in high risk drug and sexual activities was examined as an explanation of diffusion of the HIV virus from one community to another. The study population of 49,621 was comprised of subjects recruited from approximately 60 sites nationwide from 1988–1991. While the data are limited in some ways, they partially support a diffusion explanation of HIV transmission for males and females. The analysis demonstrates that low prevalence cities were significantly more likely to have been the destinations of both men and women who engaged in high risk drug and sexual activities. In addition, HIV seropositive drug users who engaged in high risk drug and sexual behaviors in destination cities were more likely than seronegatives to travel to high or low seroprevalence areas than to moderate prevalence areas. The findings suggest a need for effective HIV prevention educational messages about the risks of traveling and participating in high risk activities.     

Mental health issues: a comparison of lesbian, bisexual and heterosexual women

This study examines mental health issues among women of different sexual orientations. An anonymous survey was administered at 33 health care sites across the United States; the sample (N = 1304) included lesbians (n = 524), bisexual (n = 143) and heterosexual women (n = 637). Not only did sexual orientation influence the probability of experiencing emotional stress, but also whether a bisexual woman or lesbian had disclosed her sexual orientation (was "out") impacted the likelihood of having or having had mental health problems. Bisexual women and lesbians experienced more emotional stress as teenagers than did heterosexual women. Bisexual women were more than twice as likely to have had an eating disorder compared to lesbians. If a bisexual woman reported being out she was twice as likely to have had an eating disorder compared to a heterosexual woman. Lesbians who were not out and bisexual women who were out were 2-2.5 times more likely to experience suicidal ideation in the past 12 months. Lesbians and bisexual women who were not out were more likely to have had a suicide attempt compared to heterosexual women. Lesbians used psychotherapy for depression more commonly than did heterosexual or bisexual women. This is one of the few studies that compares lesbians, bisexual and heterosexual women. The implications of these findings are discussed.     

The self-prescribed use of aromatherapy oils by pregnant women

BackgroundWhile some studies have reported effectiveness of aromatherapy oils use during labour there is no reported evidence of efficacy or risks of aromatherapy oils use for pregnancy-related symptoms or conditions. A number of aromatherapy oils are unsafe for use by pregnant women yet there is currently no research examining the prevalence and characteristics of women who use aromatherapy oils during pregnancy.AimTo conduct an empirical study of the prevalence and characteristics of women who use aromatherapy oils during pregnancy.MethodsThe research was conducted as part of the Australian Longitudinal Study on Women's Health (ALSWH), focusing on the nationally representative sample of Australian women aged 31–36 years. Data were collected via a cross-sectional questionnaire (n = 8200) conducted in 2009.ResultsSelf-prescribed aromatherapy oils were used by 15.2% of pregnant women. Pregnant women were 1.57 (95% CI: 1.01, 2.43) times more likely to self-prescribe use of aromatherapy oils if they have allergies or hayfever, and 2.26 (95% CI: 1.34, 3.79) times more likely to self-prescribe use of aromatherapy oils if they have a urinary tract infection (UTI).ConclusionOur study highlights a considerable use of aromatherapy oils by pregnant women. There is a clear need for greater communication between practitioners and patients regarding the use of aromatherapy oils during pregnancy, as well a need for health care practitioners to be mindful that pregnant women in their care may be using aromatherapy oils, some of which may be unsafe.     

Condom use among married and cohabiting women and its implications for HIV infection in Mahikeng,South Africa

Married and cohabiting women have been neglected in the promotion of condoms as the most effective prevention method of sexually transmitted infections (STIs) and HIV. As a result, HIV prevalence is increasing in this population group in high HIV prevalence settings. The study assesses the prevalence of and identifies the predictors of consistent use of male condoms among married and cohabiting women, and examines its implications for HIV transmission. The data used were obtained from a cross-sectional survey on sexual and reproductive health conducted among women aged 18–49 years of age in Mahikeng Local Municipality in 2012 using mixed methods. A structured questionnaire and in-depth interview guide were used to collect quantitative data from 568 and qualitative data from 33 married or cohabiting women. The data were analysed using logistic regression and thematic content analysis methods. The results show that only 16.2% of the women consistently used condoms. Women having no and 1–2 surviving children, educated women, women in relationships in which most sexual decisions were jointly made with husbands/partners, women having high risk perceptions of STIs and HIV infection and women who negotiate condom use with and know the HIV status of their husbands/partners were significantly more likely to have consistently used condoms. However, women who perceived that condoms reduce sexual pleasure, feared they would be blamed for infidelity by husbands/partners, trusted that their husbands/partners were faithful and feared condoms could lead to relationship instability used condoms inconsistently. We conclude that the prevalence of consistent use of condoms by married and cohabiting women in the study is low, indicating that promotion of condoms among married or cohabiting women is neglected, which could increase the risk of HIV transmission. Based on our findings, we recommend the review of condom programmes with a view to targeting married or cohabiting couples as an important group for condom promotion and uptake.     

A Population-Based Study of Coupling and Physical Activity by Sexual Orientation for Men

ABSTRACT

Research has suggested that men in relationships are more physically active than men who are single. This study provides a weighted analysis of physical activity by coupling status for men of different sexual orientations. Aggregated data from the United States 2013–2014 National Health Interview Survey were used to conduct multivariate logistic regression analyses. Compared to straight men (n = 29,926), gay men (n = 623) were less likely to be in a relationship (AOR 0.32, CI: 0.25–0.41). Coupled gay men did more physical activity than coupled straight men and were 1.62 (CI: 1.05–2.50) times more likely to be active, 1.67 (CI: 1.10–2.51) times more likely to be high active, 1.89 (CI: 1.24–2.89) times more likely to engage in muscle-strengthening activities, and 2.00 (CI: 1.28–3.11) times more likely to meet aerobic and muscle-strengthening recommendations. Coupling facilitates physical activity for men. However, more research is needed to help explore underlying mechanisms for differences by sexuality.     

Crack users' intentions to use condoms with different partner types

Purpose. Evidence suggests that farmworkers are practicing high risk behavior, particularly crack cocaine use and unprotected sex, that consequently places them at an increased risk for HIV transmission. This study examined the intention to use condoms with four different sexual partner types (loved partner, casual partner, paying partner, and new partner) among a sample of farm workers who were also cr Methods. Personal interviews (n = 205) were conducted with male and female farm workers who were crack users (confirmed by urine test). Participants were recruited from a Florida homebase community for migrant farmworkers. The questionnaire assessed sexual activity (including number of partners and partner type), drug use and attitudes and beliefs about condoms. Results. Hispanic males reported a significantly lower likelihood of condom use for all partner types. For commercial partners, intention to use condoms was reduced dramatically for Hispanics but was markedly higher among steadily employed subjects. Finally, women were half as likely as men to report that they intended to use a condom with a loved partner. Conclusions. This study indicates that ethnicity and the nature of sexual relationships both play important roles in determining whether subjects report that they intend to use condoms, even in a population known for the presence of multiple partners and a widely perceived epidemic of AIDS and other sexually transmitted diseases.     

HIV risk behavior and drug use among heterosexual male crack users by prostitution involvement

Crack and prostitution, or sex exchange, have been linked to the heterosexual spread of HIV (e.g. Inciardi 1993, 1995). Previous studies have found that among female crack users there are subgroups who do and do not become involved in prostitution (e.g. Logan, Farabee & Leukefeld 1998; Logan & Leukefeld 1998). However, there has been little focus in the literature on subgroups of male heterosexual crack users who are or are not involved in prostitution. The purpose of this study was to examine differences in male heterosexual crack users who reported no involvement in prostitution as clients (n = 4,208), males who reported involvement in prostitution as clients but not in the month preceding the interview (n = 2,774), and males who reported involvement in prostitution as clients the month preceding the interview (n = 2,283) from a multi-site sample of male crack users who participated in the National Institute of Drug Abuse (NIDA) AIDS Cooperative Agreement Project from 20 sites across the nation. Results of the logistic regression indicated that having an STD three or more times and using drugs during sex were associated with ever being involved in prostitution as clients, while using drugs during sex and having 5 or more sexual partners the month preceding the interview were significantly associated with being involved in prostitution as clients at the time of the interview. Implications for interventions are discussed.     

HIV Risk Among Men Who Have Sex with Men Only (MSMO) and Men Who Have Sex with Men and Women (MSMW) in Baltimore

Men who have sex with men and women (MSMW) are at high risk for HIV. However, the majority of research on populations of men who have sex with men (MSM) combines MSMW and men who have sex with men only (MSMO) samples, which limits our understanding of HIV risk behaviors and factors associated with HIV risk among MSMW populations. We used the BESURE-MSM2, a venue-based cross-sectional study of HIV risk behaviors among MSM in Baltimore, MD, to examine HIV risk among MSMW. MSMW were less likely to report unprotected receptive anal intercourse than MSMO (6.8% vs. 19.6%, p = .0024). Among MSMW, 43.0% reported unprotected sex with a woman in the past year, but only 19.4% reported unprotected sex with both men and women, representing only 5.0% of the total MSM sample. In multivariate analyses, we found that among MSMW having unprotected sex with women in the past year, disclosing same sex behavior and having a main female partner were associated with unprotected anal intercourse with male partners. HIV prevention programs for MSMW are needed that address the complex partnerships of MSMW and the social contextual factors within which relationships and behaviors are embedded.