共查询到20条相似文献,搜索用时 296 毫秒
1.
Jennifer R. Lim Patrick S. Sullivan Laura Salazar Anne C. Spaulding Elizabeth A. DiNenno 《Journal of urban health》2011,88(4):677-689
Incarceration has been proposed to be a driving factor in the disproportionate impact of HIV in African-American communities.
However, few data have been reported on disparities in criminal justice involvement by race among men who have sex with men
(MSM). To describe history of arrest and associated factors among, we used data from CDC’s National HIV Behavioral Surveillance
system. Respondents were recruited by time–space sampling in venues frequented by MSM in 15 US cities from 2003 to 2005. Data
on recent arrest (in the 12 months before the interview), risk behaviors, and demographic information were collected by face-to-face
interview for MSM who did not report being HIV-positive. Six hundred seventy-nine (6.8%) of 10,030 respondents reported recent
arrest. Compared with white MSM, black MSM were more likely to report recent arrest history (odds ratio (OR), 1.6; 95% confidence
interval (CI), 1.3–2.1). Men who were less gay-identified (bisexual [OR, 1.5; 95% CI, 1.1–1.9] or heterosexual [OR, 2.0; 95%
CI, 1.2–3.5]) were more likely to report recent arrest than homosexually identified men. In addition, men who reported arrest
history were more likely to have used non-injection (OR, 3.0; 95% CI, 2.4–3.6) and injection (OR, 4.7; 95%, 3.3–6.7) drugs,
exchanged sex (OR, 2.7; 95% CI, 2.1–3.4), and had a female partner (OR, 1.5; 95% CI, 1.2–2.0) in the 12 months before interview.
Recent arrest was associated with insertive unprotected anal intercourse in the 12 months before interview (OR, 1.4; 95% CI,
1.2–1.7). Racial differences in arrest seen in the general US population are also present among MSM, and history of arrest
was associated with high-risk sex. Future research and interventions should focus on clarifying the relationship between criminal
justice involvement and sexual risk among MSM, particularly black MSM. 相似文献
2.
Susan E. Manning Lorna E. Thorpe Chitra Ramaswamy Anjum Hajat Melissa A. Marx Adam M. Karpati Farzad Mostashari Melissa R. Pfeiffer Denis Nash 《Journal of urban health》2007,84(2):212-225
Population-based estimates of human immunodeficiency virus (HIV) prevalence and risk behaviors among men who have sex with
men (MSM) are valuable for HIV prevention planning but not widely available, especially at the local level. We combined two
population-based data sources to estimate prevalence of diagnosed HIV infection, HIV-associated risk-behaviors, and HIV testing
patterns among sexually active MSM in New York City (NYC). HIV/AIDS surveillance data were used to determine the number of
living males reporting a history of sex with men who had been diagnosed in NYC with HIV infection through 2002 (23% of HIV-infected
males did not have HIV transmission risk information available). Sexual behavior data from a cross-sectional telephone survey
were used to estimate the number of sexually active MSM in NYC in 2002. Prevalence of diagnosed HIV infection was estimated
using the ratio of HIV-infected MSM to sexually active MSM. The estimated base prevalence of diagnosed HIV infection was 8.4%
overall (95% confidence interval [CI] = 7.5–9.6). Diagnosed HIV prevalence was highest among MSM who were non-Hispanic black
(12.6%, 95% CI = 9.8–17.6), aged 35–44 (12.6%, 95% CI = 10.4–15.9), or 45–54 years (13.1%, 95% CI = 10.2–18.3), and residents
of Manhattan (17.7%, 95% CI = 14.5–22.8). Overall, 37% (95% CI = 32–43%) of MSM reported using a condom at last sex, and 34%
(95% CI = 28–39%) reported being tested for HIV in the past year. Estimates derived through sensitivity analyses (assigning
a range of HIV-infected males with no reported risk information as MSM) yielded higher diagnosed HIV prevalence estimates
(11.0–13.2%). Accounting for additional undiagnosed HIV-infected MSM yielded even higher prevalence estimates. The high prevalence
of diagnosed HIV among sexually active MSM in NYC is likely due to a combination of high incidence over the course of the
epidemic and prolonged survival in the era of highly active antiretroviral therapy. Despite high HIV prevalence in this population,
condom use and HIV testing are low. Combining complementary population-based data sources can provide critical HIV-related
information to guide prevention efforts. Individual counseling and education interventions should focus on increasing condom
use and encouraging safer sex practices among all sexually active MSM, particularly those groups with low levels of condom
use and multiple sex partners
At the time this work was conducted, Manning and Marx were with the Epidemic Intelligence Service, Office of Workforce and
Career Development, Centers for Disease Control and Prevention, Atlanta, GA, USA; Thorpe, Ramaswamy, Hajat, Marx, Karpati,
Mostashari, and Pfeiffer are with the New York City Department of Health and Mental Hygiene, New York, NY, USA; Nash is with
the Department of Epidemiology and International Center for AIDS Care and Treatment Programs, Columbia Mailman School of Public
Health, New York, NY, USA; Manning is with the Massachusetts Department of Public Health, Bureau of Family and Community Health,
Boston, MA, USA. 相似文献
3.
Kimberly C. Brouwer Steffanie A. Strathdee Carlos Magis-Rodríguez Enrique Bravo-García Cecilia Gayet Thomas L. Patterson Stefano M. Bertozzi Robert S. Hogg 《Journal of urban health》2006,83(2):299-307
Tijuana, Mexico, just south of San Diego, California, is located by the busiest land border crossing in the world. Although
UNAIDS considers Mexico to be a country of “low prevalence, high risk,” recent surveillance data among sentinel populations
in Tijuana suggests HIV prevalence is increasing. The aim of this study was to estimate the number of men and women aged 15
to 49 years infected with HIV in Tijuana. Gender and age-specific estimates of the Tijuana population were obtained from the
2000 Mexican census. Population and HIV prevalence estimates for at-risk groups were obtained from published reports, community
based studies, and data from the Centro Nacional para la Prevención y Control del VIH/SIDA (CENSIDA). Age-specific fertility
rates for Mexico were used to derive the number of low and high-risk pregnant women. Numbers of HIV-positive men and women
were estimated for each at-risk group and then aggregated. A high growth scenario based on current HIV prevalence and a conservative,
low growth estimate were determined. A total of 686,600 men and women in Tijuana were aged 15 to 49 years at the time of the
2000 census. Considering both scenarios, the number of infected persons ranged from 1,803 to 5,472 (HIV prevalence: 0.26 to
0.80%). The majority of these persons were men (>70%). The largest number of infected persons were MSM (N = 1,146 to 3,300) and IDUs (N = 147 to 650). Our data suggest that up to one in every 125 persons aged 15–49 years in Tijuana is HIV-infected. Interventions
to reduce ongoing spread of HIV are urgently needed.
Brouwer, Strathdee, and Hogg are with the Division of International Health & Cross-Cultural Medicine, Department of Family
and Preventive Medicine, School of Medicine, University of California, 9500 Gilman Drive,MC0622, La Jolla, San Diego, CA 93093-0622,
USA; Magis-Rodríguez, Bravo-García, and Gayet are with the Centro Nacional para la Prevención y Control del VIH/SIDA (CENSIDA),
Secretaria de Salud, Mexico City,México; Patterson is with the Department of Psychiatry, University of California, San Diego,
CA, USA; Bertozzi is with the Instituto Nacional de Salud Pública, Cuernavaca, Morelos, México; Gayet is with the Facultad
Latinoamericana de Ciencias Sociales (FLACSO), México, México; Hogg is with the Bristish Columbia Centre for Excellence in
HIV/AIDS, Faculty of Medicine, University of British Columbia, Vancouver, Canada. 相似文献
4.
There is growing evidence of the public health and community harms associated with crack cocaine smoking, particularly the
risk of blood-borne transmission through non-parenteral routes. In response, community advocates and policy makers in Vancouver,
Canada are calling for an exemption from Health Canada to pilot a medically supervised safer smoking facility (SSF) for non-injection
drug users (NIDU). Current reluctance on the part of health authorities is likely due to the lack of existing evidence surrounding
the extent of related harm and potential uptake of such a facility among NIDUs in this setting. In November 2004, a feasibility
study was conducted among 437 crack cocaine smokers. Univariate analyses were conducted to determine associations with willingness
to use a SSF and logistic regression was used to adjust for potentially confounding variables (p < 0.05). Variables found
to be independently associated with willingness to use a SSF included recent injection drug use (OR = 1.72, 95% CI: 1.09–2.70),
having equipment confiscated or broken by police (OR = 1.96, 95% CI: 1.24–2.85), crack bingeing (OR = 2.16, 95% CI: 1.39–3.12),
smoking crack in public places (OR = 2.48, 95% CI: 1.65–3.27), borrowing crack pipes (OR = 2.50, 95% CI: 1.86–3.40), and burns/
inhaled brillo due to rushing smoke in public places (OR = 4.37, 95% CI: 2.71–8.64). The results suggest a strong potential
for a SSF to reduce the health related harms and address concerns of public order and open drug use among crack cocaine smokers
should a facility be implemented in this setting. 相似文献
5.
Little is known about the prevalence of intimate partner violence (IPV) among men who have sex with men (MSM) or about childhood
adversity as a predictor of IPV among MSM. Studies have documented high rates of childhood sexual abuse among MSM. To evaluate
associations of early-life sexual and physical abuse with IPV among African American heterosexual men or MSM, prevalence of
early-life (≤21 years) sexual and physical abuse was measured among 703 nonmonogamous African American men. Men were classified
as (1) MSM who disclosed male sex partners; (2) MSM who initially denied male sex partners but subsequently reported oral-genital
and anal-genital behaviors with men; (3) non-MSM. MSM who initially disclosed male sex partners reported significantly (P < 0.0001) higher rates of early physical abuse (36%) and lifetime abuse (49%) compared with non-MSM (15 and 22%), respectively.
These MSM reported significantly higher rates of sexual abuse by age 11, age 21, and over a lifetime compared with non-MSM
(P < 0.0001). Being an MSM who initially disclosed male sex partners (OR: 2.1; 95% CI: 1.2, 3.6) and early-life sexual abuse
(OR: 2.8; 95% CI: 1.8, 4.3) was associated with IPV victimization in current relationships. Similarly, being an MSM with early-life
physical and sexual abuse was associated (0.0004 ≤ P ≤ 0.07) with IPV perpetration. Early-life physical and sexual abuse was higher among MSM who disclosed male sex partners
compared with heterosexual men; however, all MSM who experienced early-life abuse were more likely to be IPV victims or perpetrators. 相似文献
6.
Nizal Sarrafzadegan Nafiseh Toghianifar Hamidreza Roohafza Zahradana Siadat Noushin Mohammadifard Jennifer O’Loughlin 《Journal of community health》2010,35(1):36-42
To identify lifestyle-related determinants of hookah and cigarette smoking in Iranian adults, a total of 12,514 men and women
aged ≥19 years in three counties in central Iran (Isfahan, Najafabad, Arak) were selected in multistage random sampling. Data
on socio-demographic characteristics and lifestyle were collected in interviewer-administered questionnaires, as part of the
baseline survey of the Isfahan Healthy Heart Program. Unhealthy lifestyle-related factors independently associated with cigarette
and hookah smoking, were identified in sex-specific multivariate logistic regression analyses. High stress levels (OR: 1.55;
95% CI: 1.35–1.78 for men; OR: 1.63; 95% CI: 1.17–2.27 for women), family member smoking (OR: 1.61; 95% CI: 1.27–4.92 for
men; OR: 2.49; 95% CI: 2.20–2.95 for women), and short/long sleep duration (OR: 1.18; 95% CI: 1.01–1.39 for men; OR: 1.52;
95% CI: 1.10–2.35 for women) were associated with cigarette smoking in both men and women. Poor diet was also related to cigarette
smoking in men (OR: 1.55; 95% CI: 1.62–1.89). Family member smoking was associated with hookah smoking in both men (OR: 1.16;
95% CI: 1.05–3.12) and women (OR: 1.56; 95% CI: 1.02–4.92), and in addition high stress levels (OR: 2.87; 95% CI: 1.14–5.83)
and short/long sleep duration (OR: 1.07; 95% CI: 1.02–2.41) were associated with hookah smoking in women. Unhealthy lifestyle-related
factors co-occur with cigarette and hookah smoking in Iranian adults, likely increasing the risk for chronic health problems.
Sex differences in the determinants of hookah and cigarette smoking may need to be taken into account in planning tobacco
control strategies. 相似文献
7.
Eugenia Oviedo-Joekes Bohdan Nosyk Suzanne Brissette Jill Chettiar Pascal Schneeberger David C. Marsh Aslam Anis Martin T. Schechter 《Journal of urban health》2008,85(6):812-825
The North American Opiate Medication Initiative (NAOMI) is a randomized controlled trial evaluating the feasibility and effectiveness
of heroin-assisted treatment (HAT) in the Canadian context. Our objective is to analyze the profile of the NAOMI participant
cohort in the context of illicit opioid use in Canada and to evaluate its comparability with patient profiles of European
HAT studies. Recruitment began in February 2005 and ended in March 2007. Inclusion criteria included opioid dependence, 5
or more years of opioid use, regular opioid injection, and at least two previous opiate addiction treatment attempts. Standardized
assessment instruments such as the European Addiction Severity Index and the Maudsley Addiction Profile were employed. A total
of 251 individuals were randomized from Vancouver, BC (192, 76.5%), and Montreal, Quebec (59, 23.5%); 38.5% were female, the
mean age was 39.7 years (SD:8.6), and participants had injected drugs for 16.5 years (SD:9.9), on average. In the prior month,
heroin was used a mean of 26.5 days (SD:7.4) and cocaine 16 days (SD;12.6). Vancouver had significantly more patients residing
in unstable housing (88.5 vs. 22%; p < 0.001) and higher use of smoked crack cocaine (16.9 days vs. 2.3 days in the prior month; p < 0.001), while a significantly higher proportion of Montreal participants reported needle sharing in the prior 6 months
(25% vs. 3.7%; p < 0.001). In many respects, the patient cohort was similar to the European trials; however, NAOMI had a higher proportion
of female participants and participants residing in unstable housing. This study suggests that the NAOMI study successfully
recruited participants with a profile indicated for HAT. It also raises concern about the high levels of crack cocaine use
and social marginalization.
Oviedo-Joekes, Marsh, Anis, and Schechter are with the School of Population and Public Health, University of British Columbia,
Vancouver, BC, Canada; Oviedo-Joekes, Nosyk, Chettiar, Marsh, Krausz, Anis, and Schechter are with the Centre for Health Evaluation
and Outcome Sciences, Providence Health Care, Vancouver, BC, Canada; Brissette and Schneeberger are with the Centre de recherche
du l’Université de Montréal, Montreal, QC, Canada; Marsh and Krausz are with the Department of Psychiatry, University of British
Columbia, Vancouver, BC, Canada; Marsh is with the Vancouver Coastal Health, Vancouver, BC, Canada; Marsh is with the Centre
for Addiction Research British Columbia, Vancouver, BC, Canada. 相似文献
8.
Marc Nocon Thomas Keil Stefan N Willich 《Zeitschrift fur Gesundheitswissenschaften》2007,15(5):401-405
Aim Socio-economic status is associated with a variety of health-related behaviours. In our study, we determined the independent
effects of income, educational attainment and occupational status on overweight, smoking and physical activity in the German
population.
Subjects and methods The German National Health Interview and Examination Survey is a representative sample of the German adult population and
includes 7,124 men and women. Prevalences of obesity, smoking and physical inactivity stratified for education, income and
occupational status were calculated. Multiple logistic regression models were used to estimate the odds ratios (OR) and 95%
confidence intervals (CI) for education, income, occupational status and health-related behaviour, adjusted for age and gender.
Results Health risk behaviours were more prevalent in subjects with lower education, income or occupational status. After mutual adjustment,
education, income and occupation were independently associated with physical inactivity. Low education was strongly associated
with both obesity (OR: 2.58, 95% CI: 1.99–3.34) and smoking (OR: 2.09, 95% CI: 1.71–2.54). Low income was associated with
smoking (OR: 1.40, 95% CI: 1.07–1.83), but not with obesity, and low occupational status was associated with obesity (OR:
1.42, 95% CI: 1.05–1.92), but not with smoking. High income or occupation could not compensate for the impact of low education
on obesity and smoking.
Conclusion Low socio-economic status is associated with health risk behaviours. Concerning obesity and smoking, education was more important
than income or occupational status. Public health programmes to reduce these risk factors should focus on early-life health
education. 相似文献
9.
Spencer Lieb Daniel R. Thompson Shyam Misra Gary J. Gates Wayne A. Duffus Stephen J. Fallon Thomas M. Liberti Evelyn M. Foust Robert M. Malow For the Southern AIDS Coalition MSM Project Team 《Journal of urban health》2009,86(6):887-901
Population estimates of men who have sex with men (MSM) by state and race/ethnicity are lacking, hampering effective HIV epidemic
monitoring and targeting of outreach and prevention efforts. We created three models to estimate the proportion and number
of adult males who are MSM in 17 southern states. Model A used state-specific census data stratified by rural/suburban/urban
area and national estimates of the percentage MSM in corresponding areas. Model B used a national estimate of the percentage
MSM and state-specific household census data. Model C partitioned the statewide estimates by race/ethnicity. Statewide Models
A and B estimates of the percentages MSM were strongly correlated (r = 0.74; r-squared = 0.55; p < 0.001) and had similar means (5.82% and 5.88%, respectively) and medians (5.5% and 5.2%, respectively). The estimated percentage
MSM in the South was 6.0% (range 3.6–13.2%; median, 5.4%). The combined estimated number of MSM was 2.4 million, including
1,656,500 (69%) whites, 339,400 (14%) blacks, 368,800 (15%) Hispanics, 34,600 (1.4%) Asian/Pacific Islanders, 7,700 (0.3%)
American Indians/Alaska Natives, and 11,000 (0.5%) others. The estimates showed considerable variability in state-specific
racial/ethnic percentages MSM. MSM population estimates enable better assessment of community vulnerability, HIV/AIDS surveillance,
and allocation of resources. Data availability and computational ease of our models suggest other states could similarly estimate
their MSM populations. 相似文献
10.
Circumcision and HIV Infection among Men Who Have Sex with Men in Britain: The Insertive Sexual Role
Rita Doerner Eamonn McKeown Simon Nelson Jane Anderson Nicola Low Jonathan Elford 《Archives of sexual behavior》2013,42(7):1319-1326
The objective was to examine the association between circumcision status and self-reported HIV infection among men who have sex with men (MSM) in Britain who predominantly or exclusively engaged in insertive anal intercourse. In 2007–2008, a convenience sample of MSM living in Britain was recruited through websites, in sexual health clinics, bars, clubs, and other venues. Men completed an online survey which included questions on circumcision status, HIV testing, HIV status, sexual risk behavior, and sexual role for anal sex. The analysis was restricted to 1,521 white British MSM who reported unprotected anal intercourse in the previous 3 months and who said they only or mostly took the insertive role during anal sex. Of these men, 254 (16.7 %) were circumcised. Among men who had had a previous HIV test (n = 1,097), self-reported HIV seropositivity was 8.6 % for circumcised men (17/197) and 8.9 % for uncircumcised men (80/900) (unadjusted odds ratio [OR], 0.97; 95 % confidence interval [95 % CI], 0.56, 1.67). In a multivariable logistic model adjusted for known risk factors for HIV infection, there was no evidence of an association between HIV seropositivity and circumcision status (adjusted OR, 0.79; 95 % CI, 0.43, 1.44), even among the 400 MSM who engaged exclusively in insertive anal sex (adjusted OR, 0.84; 95 % CI, 0.25, 2.81). Our study provides further evidence that circumcision is unlikely to be an effective strategy for HIV prevention among MSM in Britain. 相似文献
11.
Victoria Frye DrPh Mary H. Latka Beryl Koblin Perry N. Halkitis Sara Putnam Sandro Galea David Vlahov 《Journal of urban health》2006,83(2):308-324
Increasingly, studies show that characteristics of the urban environment influence a wide variety of health behaviors and
disease outcomes, yet few studies have focused on the sexual risk behaviors of men who have sex with men (MSM). This focus
is important as many gay men reside in or move to urban areas, and sexual risk behaviors and associated outcomes have increased
among some urban MSM in recent years. As interventions aimed at changing individual-level risk behaviors have shown mainly
short-term effects, consideration of broader environmental influences is needed. Previous efforts to assess the influence
of environmental characteristics on sexual behaviors and related health outcomes among the general population have generally
applied three theories as explanatory models: physical disorder, social disorganization and social norms theories. In these
models, the intervening mechanisms specified to link environmental characteristics to individual-level outcomes include stress,
collective efficacy, and social influence processes, respectively. Whether these models can be empirically supported in generating
inferences about the sexual behavior of urban MSM is underdeveloped. Conceptualizing sexual risk among MSM to include social
and physical environmental characteristics provides a basis for generating novel and holistic disease prevention and health
promotion interventions.
Frye, Latka, Putnam, Galea, and Vlahov are with the Center for Urban Epidemiologic Studies, New York Academy of Medicine,
1216 Fifth Avenue, New York, NY 10029, USA; Koblin is with the New York Blood Center, New York, NY, USA; Halkitis is with
the Department of Applied Psychology, New York University, New York, NY, USA; Vlahov is with the Department of Epidemiology,
Columbia University, New York, NY, USA; Galea is with the Department of Epidemiology, University of Michigan, Ann Arbor, MI,
USA. 相似文献
12.
Background: The drug misuse and asthma are major health problemsin urban settings. There are effective interventions to reducecigarette smoking and also to treat heroin use; in the contextof European System of Urban Health Indicators Project (EURO-URHIS),we explored the use of Population Impact Measures (PIMs) todescribe the potential for increase in methadone use and reductionin cigarette smoking to reduce deaths -from heroin use- andasthma events in examples of urban populations. Methods: Thetwo PIMs calculated here are the Number of Events Preventedin your Population (NEPP) and the Population Impact Number ofEliminating (or reducing the prevalence of) a Risk Factor (PIN-ER-t).Results: Increasing methadone treatment uptake from its currentlevels to 90% would prevent 21 (95% CI: 11–34) deathsin Manchester City, 218 (95% CI: 114–339) in Greater Londonand overall 1 243 (95% CI: 641–1953) in England in 1 year.In males 2 (95% CI: –22 to 28), 27 (95% CI: –296to 363) and 170 (95% CI: –1757 to 2186) and in females36 (95% CI: 6–70), 0 and 2312 (95% CI: 934–3783)fewer asthma cases per year would have been expected in ManchesterCity, Greater London and overall in England respectively, ifthe smoking prevalence is reduced from current levels to 20%in both sexes. Conclusions: PIMs provide estimates of absoluterisk and benefit to a total population, of potential use topolicy-makers since current practice and intervention goalsare taken into account. 相似文献
13.
Valin N Flahault A Lassau F Janier M Massari V 《European journal of epidemiology》2007,22(11):799-804
During the last decade, the incidence of male urethritis stopped declining in France. Risk factors associated with unprotected
intercourse have been extensively studied in men who have sex with men, but not in men in general. The purpose of the study
was to determine major risk factors for urethritis among men and to describe the sociodemographic and medical characteristics
of this population in 2005. We conducted a prospective case-crossover study of sexual behaviors among men with acute urethritis
attending at general practitioners or sexually transmitted infection (STI) clinics in France. Each patient filled out a selfcompleted
questionnaire focusing on sociodemographic characteristics, and on sexual behaviors for the month before urethritis onset
and for the preceding 3 months. The doctor reported medical information on a separate questionnaire. Between January and September
2005, 121 cases of male urethritis, defined as recent-onset pain on micturition and/or purulent or mucoid discharge, were
included. Median age was 33 years, 22.3% were MSM, 55.1% were single, and 72.0% had at least high school education. Conditional
logistic regression analysis showed that intercourse with only casual partners or with both casual and steady partners (OR = 2.6,
CI 95%: 0.8–8.7, and OR = 8.7, CI 95%: 2.7–28.0), as well as inconsistent condom use (OR = 5.8, CI 95%: 1.7–19.2) significantly
increased the risk of male urethritis. STI prevention campaigns should continue to focus on consistent condom use and should
not neglect men over 30 years of age. 相似文献
14.
Ekberg-Aronsson M Nilsson PM Nilsson JA Löfdahl CG Löfdahl K 《European journal of epidemiology》2007,22(5):301-309
Increased mortality risks associated with smoking are well established among men. There are very few population-based studies
comprising a sufficient number of heavily smoking women, measuring the direct effect of smoking on mortality risks. Between
1974 and 1992, 8,499 women and 13,888 men attended a health screening programme including reporting of smoking habits. Individuals
were followed for total mortality until 2005. All-cause, cancer, cardiovascular, lung cancer and respiratory mortality were
calculated in smoking categories <10 g per day, 10–19 g per day, and ≥20 g per day with never-smokers as a reference group
and with adjustments for co-morbidities, socio-economic and marital status. For respiratory mortality and lung cancer adjustments
for FEV1, socio-economic and marital status were performed. Smoking was associated with a two to almost threefold increased mortality
risk among women and men. The relative risk (RR) with 95% confidence interval, (CI) for women who smoked 10–19 g per day was
2.44 (2.07–2.87), and for those who smoked 20 g per day or more the RR (95% CI) was 2.42 (2.00–2.92). Smoking was a strong
risk factor for cardiovascular mortality among women, the RR (95% CI) for women who smoked 10–19 g per day was 4.52 (3.07–6.64).
Ex-smoking women showed increased risks of all-cause mortality; RR (95% CI) 1.26 (1.04–1.52) cancer (excluding lung cancer);
RR (95% CI) 1.42 (1.07–1.88) and lung cancer RR (95% CI) 2.71 (1.02–7.23) mortality. However, the cardiovascular; RR (95%
CI) 1.18 (0.69–2.00) and respiratory; RR (95% CI) 0.79 (0.16–3.84) mortality risks were not statistically significant. This
study confirms that as for men, middle-aged heavily smoking women have a two to threefold increased mortality risk. Adjustments
for co-morbidity, socio-economic and marital status did not change these results. 相似文献
15.
Pamina M. Gorbach Ryan Murphy Robert E. Weiss Christopher Hucks-Ortiz Steven Shoptaw 《Journal of urban health》2009,86(Z1):63-76
The purpose of the study was to determine the potential contribution of bisexual men to the spread of HIV in Los Angeles.
We compare the characteristics and behaviors of men who have sex with men and women (MSMW) to men who have sex with only women
(MSW) and men who have sex with only men (MSM) in Los Angeles. Men (N = 1,125) who participated in one of the two waves of data collection from 2005 to 2007 at the Los Angeles site for NIDA’s
Sexual Acquisition and Transmission of HIV—Cooperative Agreement Program were recruited using Respondent Driven Sampling.
Participants completed Audio Computer Assisted Self Interviews and received oral HIV rapid testing with confirmatory blood
test by Western Blot and provided urine specimens for detection of recent powder cocaine, crack cocaine, methamphetamine,
or heroin use. MSM, MSW, or MSMW were defined by the gender of whom they reported sex with in the past 6 months. Chi-square
tests and ANOVAs were used to test independence between these groups and demographic characteristics, substance use, and sexual
behaviors. We fit generalized linear random intercept models to predict sexual risk behaviors at the partner level. Men were
mostly of low income, unemployed, and minority, with many being homeless; 66% had been to jail or prison, 29% had ever injected
drugs, and 25% had used methamphetamine in the past 30 days. The sample had high HIV prevalence: 12% of MSMW, 65% of MSM,
and 4% of MSW. MSMW were behaviorally between MSW and MSM, except that more MSMW practiced sex for trade (both receiving and
giving), and more MSMW had partners who are drug users than MSW. Generalized linear random intercept models included a partner-level
predictor with four partner groups: MSM, MSMW-male partners, MSMW-female partners, and MSW. The following were significantly
associated with unprotected anal intercourse (UAI): MSW (AOR 0.15, 95% CI 0.08, 0.27), MSMW-female partners (AOR 0.4, 95%
CI 0.27, 0.61), HIV-positive partners (AOR 2.03, 95% CI 1.31, 3.13), and being homeless (AOR 1.37, 95% CI 1.01, 1.86). The
factors associated with giving money or drugs for sex were MSMW-female partners (AOR 1.70, 95% CI 1.09, 2.65), unknown HIV
status partners (AOR 1.72, 95% CI 1.29, 2.30), being older (AOR 1.02, 95% CI 1.00, 1.04), history of incarceration (AOR 1.64,
95% CI 1.17, 2.29), and being homeless (AOR 1.73, 95% CI 1.27, 2.36). The following were associated with receiving money or
drugs for sex: MSW (AOR 0.53, 95% CI 0.32, 0.89), African American (AOR 2.42, 95% CI 1.56, 3.76), Hispanic (AOR 1.85, 95%
CI 1.12, 3.05), history of incarceration (AOR 1.44, 95% CI 1.04, 2.01), history of injecting drugs (AOR 1.57, 95% CI 1.13,
2.19), and had been recently homeless (AOR 2.14, 95% CI 1.57, 2.94). While overall HIV-positive MSM had more UAI with partners
of any HIV status than MSMW with either partner gender, among HIV-positive MSMW, more had UAI with HIV-negative and HIV status
unknown female partners than male partners. Findings highlight the interconnectedness of sexual and drug networks in this
sample of men—as most have partners who use drugs and they use drugs themselves. We find a concentration of risk that occurs
particularly among impoverished minorities—where many men use drugs, trade sex, and have sex with either gender. Findings
also suggest an embedded core group of drug-using MSMW who may not so much contribute to spreading the HIV epidemic to the
general population, but driven by their pressing need for drugs and money, concentrate the epidemic among men and women like
themselves who have few resources. 相似文献
16.
Lucia F. O’Sullivan Susie Hoffman Abigail Harrison Curtis Dolezal 《Journal of urban health》2006,83(4):695-708
Heterosexual transmission of HIV and other sexually transmitted infections has become a primary health concern worldwide. Gender roles for heterosexual interactions appear to sanction men’s sexual risk-taking, especially the pursuit of multiple sexual partners. Using measures developed in this study, the current study assessed the associations between men’s and women’s relationship attitudes and experiences and their sexual risk encounters. Participants were 104 men and 103 women (18–24 years) from a large, urban college located in a high HIV risk neighborhood of New York City. All completed a survey assessing HIV risk and the battery of relationship measures assessing traditional sexual roles, sexual conflicts, significance of sex, relationship investment, need for relationship, and unwanted sex. For men, greater sexual conflict in their primary relationships was associated with more sexual partners and fewer unprotected vaginal intercourse encounters with a primary partner and across sex partners overall. In addition, men’s endorsement of more traditional sexual roles and lower relationship investment were associated with higher numbers of sexual partners. Among women, compliance with men to engage in unwanted sex was associated with higher levels of participation in unprotected sex. For both men and women, greater significance given to sex in a relationship was associated with fewer extradyadic partners. This study demonstrates the utility of measures of relationship attitudes and experiences to characterize sexual risk, especially among men. Findings are discussed in terms of implications for prevention program targeting young urban adults.O’Sullivan is with the Department of Family & Social Medicine, Albert Einstein College of Medicine, 1300 Morris Park Avenue, Mazer 100, Bronx, NY 10461, USA; O’Sullivan, Hoffman, and Dolezal are with the HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute and Columbia University, New York, NY, USA; Hoffman is with the Department of Epidemiology, Joseph L. Mailman School of Public Health, Columbia University, New York, NY, USA; Harrison is with the Department of Medicine, Division of Infectious Diseases and Population Studies and Training Center, Brown University, Providence, RI 02912, USA. 相似文献
17.
Maria R. Khan David A. Wohl Sharon S. Weir Adaora A. Adimora Caroline Moseley Kathy Norcott Jesse Duncan Jay S. Kaufman William C. Miller 《Journal of urban health》2008,85(1):100-113
Incarceration is strongly associated with HIV infection and may contribute to viral transmission by disrupting stable partnerships
and promoting high-risk partnerships. We investigated incarceration and STI/HIV-related partnerships among a community-based
sample recruited for a sexual behavior interview while frequenting venues where people meet sexual partners in a North Carolina
city (N = 373). Men reporting incarceration in the past 12 months were more likely than men without recent incarceration to experience
multiple new sexual partnerships (unadjusted prevalence ratio [PR] 1.8, 95% confidence interval [CI]: 1.1–3.1) and transactional
sex defined as trading sex for money, goods, or services (unadjusted PR: 4.0, 95% CI: 2.3–7.1) in the past 4 weeks. Likewise,
women who were ever incarcerated were more likely than never-incarcerated women to experience recent multiple new partnerships
(unadjusted PR: 3.1, 95% CI: 1.8–5.4) and transactional sex (unadjusted PR: 5.3, 95% CI: 2.6–10.9). Sexual partnership in
the past 12 months with someone who had ever been incarcerated versus with partners with no known incarceration history was associated with recent multiple new partnerships (men: unadjusted PR
2.0, 95% CI 1.4–2.9, women: unadjusted PR 4.8, 95% CI 2.3–10.1) and transactional sex (men: unadjusted PR 3.3, 95% CI 1.7–6.6,
women: unadjusted PR 6.1, 95% CI 2.4–15.4). Adjustment for demographic and socioeconomic variables had minimal effect on estimates.
However, the strong overlap between incarceration, partner incarceration, and substance abuse had substantial effects in multivariable
models. Correctional-facility and community-based HIV prevention, with substance abuse treatment, should reach currently and
formerly incarcerated individuals and their sexual partners.
Khan, Weir, Adimora, Kaufman, and Miller are with the Department of Epidemiology, School of Public Health, University of North
Carolina, Chapel Hill, NC, USA; Wohl is with the Center for AIDS Research, University of North Carolina, Chapel Hill, NC,
USA; Wohl, Adimora, and Miller are with the Division of Infectious Diseases, School of Medicine, University of North Carolina,
Chapel Hill, NC, USA; Weir is with the The MEASURE Evaluation Project, Carolina Population Center, University of North Carolina,
Chapel Hill, NC, USA; Moseley is with the Guilford County Department of Public Health, Greensboro, NC, USA; Norcott is with
the Sickle Cell Disease Association of the Piedmont, Guilford County, NC, USA; Duncan is with the Triad Health Project, Guilford
County, NC, USA. 相似文献
18.
Evan Wood Thomas Kerr Patricia M. Spittal William Small Mark W. Tyndall Michael V. O’Shaughnessy Martin T. Schechter 《Journal of urban health》2003,80(3):455-464
In Vancouver, British Columbia, Canada, difficulty accessing syringes at night has been shown to be strongly associated with
human immunodeficiency virus (HIV) risk behavior among the city’s injection drug users (IDUs). On September 1, 2001, the Vancouver
Area Network of Drug Users (VANDU) initiated an unsanctioned all-night needle-exchange program on a street corner in the heart
of the neigh-borbood where many of the city’s IDUs are concentrated. An external evaluation of the population reached by the
VANDU exchange was performed through the Vancouver Injection Drug User’s Study, a prospective cohort study of IDUs begun in
1996. Persons accessing syringes through the exchange were compared to those active injectors who acquired their syringes
from other sources, including the city’s fixed site exchange, which closes at 8:00 pm. Overall, 587 active IDUs were seen during the period September 2001 to june 2002; of these individuals. 165 (28.1%) reported
using the VANDU exchange. In multivariate analyses, participants who used the VANDU table were more likely to frequently inject
cocaine (adjusted odds ratio [AOR]=1.56; 95% confidence interval [CI]=1.00–2.44), inject in public (AOR=2.71; 95% CI=1.62–4.53),
and require help injecting (OR=2.13; 95% CI=1.33–3.42). Interestingly, use of the table was also independently associated
with safer syringe disposal (AOR=2.69; 95% CI-1.38–5.21). Results indicate that the unsanctioned exchange appears to have
reached those IDUs at highest risk of HIV infection. Although the cross-sectional nature of the study design warrants caution,
we also found that use of the nighttime exchange was strongly associated with higher rates of safe syringe disposal. The data
suggest that drug user organizations can play a major role in reducing harm among their peers by reaching the highest risk
drug users with harm reduction services. The findings also suggest that other forms of syringe-exchange programs should consider
the benefits of offering fixed site nighttime service. 相似文献
19.
The objective of this study was to assess the prevalence and factors associated with simultaneous health risk behaviors in
freshmen college students enrolled in a Brazilian university. We interviewed 738 students (59.2% men) with average age of
20.1 years (CI 95%: 19.8–20.5). The risk behaviors assessed were smoking habit, alcohol use, unhealthy diet and physical inactivity.
Independent variables were sex, age, employment, marital status, maternal education, study shift and socioeconomic level.
It was found that 8.7% were smokers, 45.9% showed alcohol abuse, 59.4% had inadequate diet and 18.5% were physically inactive.
Of the students, 20.2% showed no risk behavior, 39.1% one behavior, 29.0% two risk behaviors and 11.7% three and/or four risk
behaviors. Males (OR: 2.04, CI 95%: 1.13–3.67) and night shift students (OR: 1.83, CI 95%: 1.01–3.33) were more likely to
have three and/or four risk behaviors. Health promotion interventions focusing simultaneous behavior changes should be employed
at the university. 相似文献
20.
Sari L. Reisner Matthew J. Mimiaga Patricia Case Carey V. Johnson Steven A. Safren Kenneth H. Mayer 《Journal of urban health》2009,86(2):250-262
Studies have found that between 14% and 46% of US men who have sex with men (MSM) consistently report “barebacking” behavior
(i.e., intentional unprotected anal intercourse) with other men. This is of public health significance because MSM continue to constitute more
than 50% of new HIV infections in the USA. Men who self-identify as barebackers may represent a different and unique subset
of MSM with distinct HIV prevention needs. In 2007, 227 HIV seronegative MSM recruited through modified respondent-driven
sampling completed an interviewer-administered survey which assessed barebacker identity (i.e., personally identifying with
the barebacker scene), demographics, sexual risk behaviors, psychosocial variables, and drug/alcohol use. Bivariate and multivariable
logistic regression procedures were used to examine predictors of barebacker identity in relation to HIV risk behavior. Overall,
31% of participants identified as a barebacker. In bivariate analyses, lower education (OR = 1.76; 95% CI = 0.99–3.13; p < 0.05), a current drinking problem (OR = 2.34, 95% CI = 1.29–4.23; p < 0.01), higher levels of HIV treatment optimism (OR = 1.06; 95% CI = 1.01–1.12; p < 0.05), meeting sexual partners at private sex parties (OR = 2.47; 95% CI = 1.28–4.74; p < 0.01) or at bars/cubs (OR = 1.97; 95% CI = 1.10–3.52; p < 0.05), and engaging in serodiscordant unprotected insertive anal sex (OR = 3.42; 95% CI = 1.27–9.21; p < 0.01) significantly predicted barebacker identification compared to those with no barebacker identification. In a multivariable
model, barebackers were more likely to screen in for alcohol abuse (adjusted OR = 2.16; 95% CI = 1.09–4.27; p < 0.05) and engage in serodiscordant unprotected insertive anal sex (adjusted OR = 3.17; 95% CI = 1.09–9.20; p < 0.05) compared to their non-barebacker counterparts. No significant differences were found in serodiscordant unprotected
receptive anal sex between barebackers and non-barebackers. These findings suggest that barebacker identity is related to
intentional HIV sexual risk taking and alcohol abuse. Furthermore, strategic positioning (i.e., engaging in insertive rather
than receptive sex) might be associated with barebacker identification and may indicate a harm-reduction strategy being used
among some HIV-uninfected MSM to reduce their risk of becoming infected. Additional research is warranted to understand the
social identity of barebacking among MSM in order to develop more nuanced prevention strategies. 相似文献