The malleability of fertility-related attitudes and behavior in a filipino migrant sample

The malleability of fertility-related attitudes and behavior was studied by analyzing data collected from cross-sectional groups of Filipino migrants who had lived in the United States for varying lengths of time, in conjunction with data from a comparison group of Caucasians from the Filipinos’ neighborhoods. With increasing number of years lived in the United States, Filipino migrants’ fertility-related knowledge, attitudes, and desires became increasingly similar to those of the Caucasian group, but their contraceptive behavior did not. While approximately equal numbers of Filipinos and Caucasians were contracepting, Filipino couples regardless of duration of stay in the United States were using less effective methods with less regularity. Despite these contraceptive behavior patterns, Filipino migrants perceived that they would have 0.32 fewer children in the United States than they would have had had they remained in the Philippines. By far the most predominant reason given by Filipino respondents for changing fertility patterns in the United States was the difficulty of obtaining child care in the new environment.     

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.     

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.     

艾滋病的人口学研究——以云南省为例

随着世界及我国艾滋病感染者的急剧上升,艾滋病的防治已不仅仅是一个医学上的问题,艾滋病的流行及传播影响到人类生活的各个领域,加强艾滋病的预防控制的研究显得尤为迫切。以人口学理论为基础,系统地分析研究艾滋病的人口学特征,从人口学的角度提出艾滋病的预防控制对策,对于艾滋病流行程度较高的云南来说,具有重要的意义。     

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.     

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.     

On Holiday: A Risk Behavior Profile for Men Who Have Vacationed at Gay Resorts

Sexual risk behavior is higher when people vacation as compared to when they are at home. The current study uses survey data to compare sexual risk behavior of gay men who vacation at gay resorts to those who do not. Independent predictors of vacationing at gay resorts included income level, relationship status, ever having attended a circuit party, and HIV serostatus. For men who visit resorts to meet sex partners, independent predictors included relationship status, ever having attended a circuit party, HIV serostatus, number of male sex partners in the past six months, and number of anal insertive male partners using a condom. These results show a need for the development of structural interventions in the gay resort and hotel setting.     

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.     

Musical chairs: The occupational experience of migrants to Alberta, 1976–80

This research questions whether the economic benefits gained by Canada's interprovincial migrants justify the associated costs, even during an economic boom. A re-analysis of data collected by Statistics Canada as part of the December 1980 Labour Force Survey examines the experiences of recent migrants to Alberta and gives rise to a mixed assessment. On the one hand, migrants who came to Alberta and stayed did enjoy a solid reduction in their pre-migration unemployment, despite higher labour market participation. On the other hand, migrants who came and stayed changed their industry and occupation in large numbers, but most of this was just ‘musical chairs’: exchange mobility, rather than structural mobility. Women were more likely than men to experience structural mobility but they were primarily downgrading rather than upgrading their status. Neither for women nor for men do we find much evidence of upward mobility across the manual-non-manual line. Thus for the most part migrants are entering jobs that may require the learning of new skills but, since they exist within the same status level of pre-migration jobs, deliver no more apparent rewards than the jobs they left. The costs of migration and readjustment are not, according to these data fully justified by the available rewards. The paper ends by recognizing that additional information is needed on the characteristics of pre- and post-migration jobs, before we can judge conclusively that the migration costs outweighed the benefits.     

Gender comparisons of injection drug use practices in shooting galleries

Previous research studies and anecdotal evidence portray shooting galleries as locales that place injection drug users at great risk for HIV infection, drug use and violence. Collectively, these studies highlight the need to intervene with injectors who frequent shooting galleries. However, few researchers have studied an often-forgotten risk group – women injecting drug users who frequent shooting galleries – and compared their risk behaviors to their male counterparts. To address this gap in the research literature and to evaluate the functionality of the shooting gallery as a setting for HIV prevention, we collected data on risk practices from 201 injectors (101 men and 100 women) who were recruited from eight shooting galleries in Miami, Florida. Results indicate that, compared with men, women injectors engaged in a similar variety and frequency of injection risk behaviors and had more shooting companions. While only minor gender differences were apparent, relatively few injectors – male or female – adhered to current recommendations for needle hygiene practices. Needle hygiene practices existed equally among injectors of both sexes, however very few adhered to current recommendations. Furthermore, contrary to common images of shooting galleries, use of other drugs was infrequently reported, episodes of violence or victimization were uncommon, and sexual contact almost never occurred. Operators of shooting galleries, both men and women, indicated their willingness to participate in HIV prevention efforts. Implications of these findings for HIV intervention indicate that (1) there is a great need to intervene with both men and women IDUs who frequent shooting galleries and that (2) shooting galleries can be an optimal setting for HIV prevention.     

吸毒人群对艾滋病防治的接纳现状与影响因素

近年来我国已经把吸毒人群作为艾滋病防治的重要干预对象之一,然而现状不容乐观,吸毒人群传播艾滋病的风险远未得到有效控制。探讨影响吸毒人群对艾滋病防治措施的认同和接纳的因素,以便为完善艾滋病防治措施提供新的思路。研究表明,吸毒人群的认知水平、社会支持、政策保障、人生态度等因素对其接纳艾滋病防治措施有影响。只有将吸毒人群视为弱势群体予以增权和关爱,以"合作"的社会政策导向和"平等"的社会工作价值介入,从其需求入手开展务实多样的防治措施,才有可能真正改变吸毒人群的观念与行为,从而获得艾滋病防治的良效。     

Migration,Marital Change,and HIV Infection in Malawi

Research on the relationship between migration and HIV infection in sub-Saharan Africa often suggests that migrants are at higher risk of HIV infection because they are more likely to engage in HIV risk behaviors than nonmigrants, and they tend to move to areas with a relatively higher HIV prevalence. Although migration may be a risk factor for HIV infection, I instead focus on the possibility that the HIV positive are more likely to migrate. Using a longitudinal data set of permanent rural residents and migrants from Malawi, I find that migrants originating from rural areas are indeed more likely than nonmigrants to be HIV positive and to have engaged in HIV risk behaviors. The increased HIV risk among migrants may be due to the selection of HIV-positive individuals into migration; I find that HIV-positive individuals are more likely to migrate than those who are HIV negative. The explanation for this phenomenon appears to be marital instability, which occurs more frequently among HIV-positive individuals and leads to migration after marital change.     

Drug dependency and HIV testing among state prisoners

HIV and drug use are higher among prisoners than the general US population. This study examines drug dependency/use and differences between prisoners who volunteered for HIV testing and those who did not in a less densely populated state. It was hypothesized that prisoners who volunteered for an HIV test were engaged in more drug use and other risky behaviors than those who did not. Survey data were collected from 600 randomly selected inmates (567 males and 33 females) from 15 state prisons. Subjects were male (95%), white (63%), never married (43%), and 44% volunteered for an HIV test since entering prison. Ninety-two percent of inmates met DSM criteria for drug dependence in their lifetime. Those who volunteered for HIV testing were 2.6 times more likely to ever have used PCP; 1.5 times more likely to ever have used cocaine; 1.4 times more likely to ever have had a problem with drugs; 1.3 times more likely to have used opiates, and 1.6 times more likely to report having been sexually or physically abused. Implications for interventions are discussed.     

A Profile of the World's Young Developing Country International Migrants

Individual‐level census and household survey data are used to present a rich profile of young developing country international migrants around the world. They are found to comprise a large share of the flow of migrants, particularly among migrants to other developing countries, with the age distribution of migrants peaking in the late teens or early twenties. Detailed data are presented on the age and sex composition of migrants, on whether young migrants move alone or with a parent or spouse, on their participation in schooling and work in the destination country, on the types of jobs they have, and on the incidence and age of return migration. The results suggest a high degree of commonality in the youth immigrant experience across a number of destination countries. Recent developing country young migrants tend to work in similar occupations and are more concentrated in these occupations than recent older migrants or young immigrants who arrived at an earlier age. Nevertheless, there is also considerable heterogeneity among young immigrants with respect to school attendance and work in their destination country. The potential of international migration for building human capital is significant but far from being fully used.     

Women are key players in the economies of East and Southeast Asia

In 1996, the East-West Center's Program on Population investigated the links between population change and economic growth in Japan, South Korea, Taiwan, Singapore, Thailand, and Indonesia. This document discusses the findings pertaining to women's changing marriage and childbearing patterns, education attainment, and labor force participation as well as changes in family life. In eastern and southeastern Asia, women are delaying marriage and having fewer children as a result of their overwhelming acceptance of modern contraception. Concurrently, women's secondary school enrollment has increased dramatically since 1960, and women have accounted for steadily increasing proportions of total labor force growth. Economic development has led to fewer women employed in agriculture and more in clerical positions. Women continue to be marginalized in low-paying manufacturing jobs and to lose these jobs more frequently than do men. Women's labor force participation continues to be dependent upon their child care responsibilities, but women are beginning to combine both activities with the help of live-in grandparents. Women have made an important contribution to economic growth in Asia. Policies should address job discrimination against married women, wage discrimination, the problems faced by young women who leave home for employment in the manufacturing and service sectors, and the lack of child care facilities.     

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.     

Is population decentralization lengthening commuting distances?

This study questions the conventional wisdom about how commuting distances change when workers migrate from metropolitan to nonmetropolitan areas. It does not appear that decentralization yields a more energy-intensive configuration of residences and job locations: we find no indication that this migration lengthens the aggregate distance that workers commute. Some migrants do commute long distances, but their numbers are offset by many more who end up closer to their jobs. Our findings relate to two contrasting views (“sprawl” and “nucleation”) of how workers are becoming repositioned in relation to their jobs as settlement patterns change; the latter view appears more realistic. We briefly discuss policy implications pertaining to alternative transportation modes for commuting, setting priority travel needs in an energy emergency, and telecommunications as a substitute for commuting.     

The psychic costs of migration: evidence from Irish return migrants

Within the economics literature, the ‘psychic costs’ of migration have been incorporated into theoretical models since Sjaastad (J Polit Econ 70:80–93, 1962). However, the existence of such costs has rarely been investigated in empirical papers. In this paper, we look at the psychic costs of migration by using alcohol problems as an indicator. Rather than comparing immigrants and natives, we look at the native-born in a single country and compare those who have lived away for a period of their lives and those who have not. We use data from the first wave of the Irish Longitudinal Study on Ageing which is a large, nationally representative sample of older Irish adults. We find that men who lived away are more likely to have suffered from alcohol problems than men who stayed. For women, we again see a higher incidence of alcohol problems for short-term migrants. However, long-term female migrants are less likely to have suffered from alcohol problems. For these women, it seems that migration provided psychic benefits, and this is consistent with findings from other research which showed how migration provided economic independence to this group. The results remain when we adjust for endogeneity and when we use propensity score matching methods.     

HIV seroprevalence and risk behaviors among clients attending tuberculosis clinics in Miami-Dade County,Florida, 1989–1996

Miami-Dade County is a major HIV epicenter and a port of entry for immigrants from nations with high endemic rates of tuberculosis (TB). We analyzed data from an unlinked (blinded) serosurvey of clients attending four Miami TB clinics to elucidate the dynamic HIV seroprevalence patterns in relation to demographics and risk behaviors. Data were analyzed from 3,107 consecutive TB patients at four TB treatment clinics over eight years. Overall HIV seroprevalence was 23.6% with a significantly higher infection rate for men (26.6%) compared to women (17.3%) (p < 0.0001). In rank order, the HIV infection rates were 30.3% for black non-Hispanics, 24.7% for white non-Hispanics and 14.2% for Hispanics. U.S.-born clients had significantly higher HIV rates compared with foreign-born clients (32.4% vs. 18.5%, p < 0.0001). HIV rates declined over six years from (32.5% to 15.9%, p < 0.0001) with significant trends observed for men and women; and for blacks, whites and Hispanics. Seroprevalence was 15.7% for clients identifying heterosexual contact as their only risk. Highly significant increases in seroprevalence above this heterosexual-contact-only `baseline', were found for clients disclosing the following high-risk behaviors: male-to-male sex, drug injection, smoking crack cocaine, receiving or giving money/drugs for sex, and sexual contact with a drug injector or HIV-infected partner. While highly significant elevations in HIV seroprevalence were associated with each of these definitive risk behaviors, even the baseline HIV infection rate of 15.7% in heterosexual-contact-only clients was markedly higher than that of the general population. These findings underscore the need to obtain routine HIV serology on all TB patients.     

Accessibility of health and human services for the HIV-infected

Most research on services for the HIV/AIDS population has focused on primary medical care or on service brokering by advocacy groups. Little research data exist on the extent to which services of programs that do not specialize in HIV/AIDS clients are available to these individuals who often have multiple and multi-dimensional problems. The reported research examines selected data from a sample of 236 medical, behavioral health and social service programs in Miami-Dade County, Florida. A constructed measure of involvement in services for HIV/AIDS clients, pertinent provider program and client characteristics are examined in the context of geo-distributed data on reported AIDS cases and census data. In logistic regression analyses, two aspects of race/– the population in the zip code area served by the program, and the clients or patients seen in the program – were significant in predicting program under-response, defined as level of response relative to cumulative reported AIDS cases from the program's zip code area. The analysis is briefly discussed regarding its relevance and methodological generalizability for HIV/AIDS and related public health policy and applied purposes.