French intravenous drug users: Knowledge and sexual behavior change

In a population based survey conducted in France in 1988, 41 respondents reported present or past intravenous drug use. Controlling for age and gender, intravenous drug users (IDUs) engage in more high risk sexual behavior than the general population (sex with other IDUs, multiple partners), but they do not use condoms more frequently. They are five times more likely to have had an HIV test.Corresponding author.     

四川省艾滋病行为监测

目的　通过对目标人群进行行为学调查 ,为艾滋病防治规划提供依据。方法　按照艾滋病行为监测方案的操作程序及调查方法对不同的目标人群进行行为监测。结果　高危人群艾滋病传播与预防知识普遍缺乏 ;2 4 84 %的暗娼在上次与客人发生性关系时没有使用安全套 ,只有 2 9 6 4%的吸毒者在最近一次与商业性伴发生关系时使用了安全套 ,只有 30 86 %的长卡司机在与商业性伴发生关系时每次都使用安全套 ;有 2 8 70 %的吸毒者最近 1次与别人共用注射器。结论　根据监测结果调整健康教育的策略 ;干预的重点应放在推广安全套、针具交换等行为干预方面 ;应进一步提高医务人员的认识 ,加强对医务人员的培训 ;在社区大力推行自愿检测咨询工作 ,引导目标人群正确求医行为。     

Beliefs as predictors of condom use by injecting drug users in treatment

This study was conducted to clarify (1) the extent to which health beliefs selected from Protection Motivation Theory can combine to correctly classify 72 injecting drug users (IDUs) as condom users or non-users and (2) which of the beliefs ('vulnerability to a regular partner', 'vulnerability to a casual partner', 'self-efficacy', 'response efficacy', 'response costs' and 'social norms') were most influential in this distinction. Results of a logistic regression indicated that these beliefs were significant predictors of condom use. Overall, 83.3% of participants were correctly classified according to condom use, with condom 'non-users' being more accurately predicted (94.0%) than 'users' (59.1%). 'Vulnerability to a regular partner' and 'social norms' were significant multivariate and univariate predictors of condom use, and 'response costs' were significant univariate predictors. IDUs were confident of their ability to use condoms, considered themselves highly vulnerable to HIV infection from casual partners and were confident in the efficacy of condoms to protect them from AIDS. However, the majority of IDUs were not condom users, particularly with 'regular' partners. Findings suggest that HIV prevention programmes should target beliefs regarding risks from known partners, perceived norms and negative consequences of condom use in order to increase condom use by IDUs in treatment.     

凉山州2003～2004年HIV/AIDS的综合监测

目的：了解凉山州各类人群艾滋病病毒感染者／艾滋病(HIV／AIDS)的感染情况及高危行为，和其流行现状和趋势。方法：按照艾滋病行为和血清学监测方案的操作程序及调查方法对全州吸毒者、女性商业性性工作者、孕产妇进行行为及血清学监测。结果：2227例吸毒者艾滋病感染率为15．5％(346人)，吸毒者共用针具率为13．1％；女性商业性性工作者感染率为0．8％(3人)，只有51．1％的CSW(女性性商业工作者)在每次与客人发生性关系时都使用安全套；孕产妇监测中2004年发现首例HIV感染者。结论：我州HIV感染途径主要还是静脉吸毒共用针具及性乱，女性商业性性行为者性行为将在艾滋病向普通人群传播中起重要作用，应当加强综合干预措施等。     

HIV infection and sexual behaviour among homosexual and bisexual men in Bratislava

OBJECTIVE: To determine sexual behaviour and HIV prevalence in a sample of homosexual and bisexual men in Bratislava. PATIENTS AND METHODS: Participants were recruited at gay discotheque in Bratislava in February and June 1996. Saliva samples were collected for testing the presence of anti-HIV antibodies and a questionnaire regarding sexual practice was completed. RESULTS: In the study 170 men (1st discotheque) and 124 men (2nd discotheque) were enrolled. The prevalence of antibodies against HIV was 5.4% and 1.6%, respectively. A group of 119 attenders (mean age: 25 years) was voluntarily questioned about their sexual lifestyle and related behaviour. Sexual orientation of participants was following: 66.4% homosexuals, 20.2% bisexuals, 13.4% others. Most responders were single and did not ever been married (86.55% vs. 12.6%, respectively). The figures of sexual intercourse were: steady partners: 45.38%, non-steady partners: 49.58%. More individuals were using condoms (70.58% vs. 15.97%, respectively), while only 28.57% were using them by each chance sexual intercourse. 6.7% responders suffered from an other STD and 3.36% were intravenous drug users. CONCLUSION: The HIV prevalence (5.4% and 1.6%) was relatively low. Considering the high prevalence of unsafe sexual practice further spread of HIV infection among homosexual men in Slovakia is to be expected.     

北京地区海洛因注射者HIV、HBV和HCV感染的高危性行为分析

目的对海洛因注射者（IDUs）,中的高危性行为情况进行分析。方法收集北京300名戒毒者的临床资料,HIV、HBV、HCV感染情况,性行为,艾滋病毒／艾滋病（HIV／AIDS）相关知识和态度及其他社会心理学因素,并分析IDUs高危性行为的影响因素。结果IDUs中86．8％不能坚持使用安全套,25．7％有多个性伙伴,49．0％有IDUs性伙伴,70．7％不了解对方HIV感染情况;首次吸毒年龄小、注射过量次数多、对安全套的否定态度、共用不洁注射工具与不安全性行为有关,而未婚、继续使用安全套意愿、自愿HIV检测等与安全性行为有关。结论北京地区IDUs中高危性行为普遍存在,不能忽视对IDUs中高危性行为的研究。     

HIV prevalence and risk behaviours among injecting drug users in six indonesian cities implications for future HIV prevention programs

ABSTRACT: BACKGROUND: The HIV prevalence among injecting drug users (IDUs) in Indonesia reached 50% in 2005. While drug use remains illegal in Indonesia, a needle and syringe program (NSP) was implemented in 2006. METHODS: In 2007, an integrated behavioural and biological surveillance survey was conducted among IDUs in six cities. IDUs were selected via time-location sampling and respondent-driven sampling. A questionnaire was administered face-to-face. IDUs from four cities were tested for HIV, syphilis, gonorrhoea and chlamydia. Factors associated with HIV were assessed using generalized estimating equations. Risk for sexual transmission of HIV was assessed among HIV-positive IDUs. RESULTS: Among 1,404 IDUs, 70% were daily injectors and 31% reported sharing needles in the past week. Most (76%) IDUs received injecting equipment from NSP in the prior week; 26% always carried a needle and those who didn't, feared police arrest. STI prevalence was low (8%). HIV prevalence was 52%; 27% among IDUs injecting less than 1 year, 35% among those injecting for 1-3 years compared to 61% in long term injectors (p < 0.001). IDUs injecting for less than 3 years were more likely to have used clean needles in the past week compared to long term injectors (p < 0.001). HIV-positive status was associated with duration of injecting, ever been imprisoned and injecting in public parks. Among HIV-infected IDUs, consistent condom use last week with steady, casual and commercial sex partners was reported by 13%, 24% and 32%, respectively. CONCLUSIONS: Although NSP uptake has possibly reduced HIV transmission among injectors with shorter injection history, the prevalence of HIV among IDUs in Indonesia remains unacceptably high. Condom use is insufficient, which advocates for strengthening prevention of sexual transmission alongside harm reduction programs.     

县级娱乐场所性服务者艾滋病知识与行为调查

目的 了解艾滋病综合防治示范区性服务者艾滋病相关知识与行为状况，为改善其性行为干预提供依据。方法 由当地卫生专业人员担任调查员，采取单独面对面访谈的形式，记录并完成问卷的填写。结果512名性服务者艾滋病相关知识的总体知晓率为74．6％，其中对防治知识、传播途径和非传播途径的知晓率分别为68．5％，88．4％，73．2％。20岁年龄段对传播途径的知晓率最高，为89．5％，30岁年龄段对传播途径的知晓率最低，为58．0％。宴际获得知识途径的前3位为电视（85．9％）、招贴画和挂图（57．8％）、报纸杂志，希望获得知识的途径前3位．则为电视（76．8％）、医生（40．0％）和报纸杂志（31．1％）。过去3个月性服务中每次使用安全套的占57．9％，与固定性伴每次使用的占13．4％。结论 应加强对性服务者艾滋病非传播途径及预防知识的教育，并以高年龄组为重点；要突出大众媒介以及医生在健康教育中的作用，从单纯关注性服务者的知识了解转变为促进其行为改变。     

Trends in HIV prevalence and risk behaviour among injecting drug users in Rotterdam, I994-2002

OBJECTIVE: To gain insight into the prevalence of HIV infection, the determinants thereof and the risk behaviour in injecting drug users (IDUs) in Rotterdam, The Netherlands, in 2002 in comparison to the HIV survey data from 1994 and 1997. DESIGN: Questionnaire study. METHOD: In 1994-2002, three periodic HIV surveys were conducted in Rotterdam among IDUs using semi-structured questionnaires on risk behaviour and saliva samples for HIV-antibody determination. In the present study, the data for 2002 were analysed and compared with those from 1994 and 1997. RESULTS: The number of participants recruited was 494, 470 and 452, respectively. HIV prevalence did not change over time: 1994: 11.4%, 1997: 9.4% and 2002: 10.2%. In the 2002 survey, independent risk factors for HIV were homelessness and onset of injecting drug use at an early age. The percentage of IDUs that had recently shared needles declined from 18% in 1994 to 8% in 2002. Risky sexual behaviour remained prevalent: inconsistent condom use was reported by 85% with steady partners, 43% with casual partners and 31% with clients. The IDUs who knew that they were HIV positive used condoms consistently more often. CONCLUSION: The combination of a relatively high HIV prevalence among IDUs in Rotterdam and the high level of unsafe sexual behaviour results in a serious risk of further spread of HIV among both IDUs and the general population.     

Barriers to condom use and needle cleaning among impoverished minority female injection drug users and partners of injection drug users.

This study was undertaken to describe sexual behaviors and drug use and other factors that inhibit condom use and needle cleaning among impoverished women who are injection drug users (IDUs) or sexual partners of IDUs. This study also investigated whether risky sexual behavior or barriers to risk reduction differ with ethnicity and level of acculturation. Survey instruments to assess drug and sexual activity were administered to 378 African American and Latina women recruited primarily from homeless shelters and drug recovery programs. The most commonly cited barriers to condom use were belief that partners did not have acquired immunodeficiency syndrome (AIDS), lack of knowledge about where to get and how to use condoms, and discomfort discussing condom use with partners. African American women were more likely to report having multiple partners and unprotected sex, and more likely to report barriers in using, discussing, and obtaining condoms. Latina women were more likely to report partners'' dislike of condoms. African American and highly acculturated Latina women were more likely to be IDUs than less acculturated Latina women. The most pervasive barriers for needle cleaning were not having personal needles, being high and not interested in needle cleaning, and not having disinfectant available. In a multiple logistic regression analysis for engaging in unprotected sex and cleaning needles, not ethnic or acculturation differences were found after controlling for selected demographic characteristics and risk factors.(ABSTRACT TRUNCATED AT 250 WORDS)     

Unsafe Injection and Sexual Risk Behavior among Injecting Drug Users in Georgia

Injection drug users (IDUs) are at risk for acquiring human immunodeficiency virus (HIV) through parenteral and sexual transmission. In this paper, we describe the prevalence and correlates of unsafe drug injecting and sexual behaviors among IDUs recruited across five cities in Georgia in 2009. IDUs were administered a questionnaire collecting information on demographics, drug use, sexual behaviors, and HIV testing behaviors. Correlates of risky injecting and sexual behaviors were determined using logistic regression. Of 1,127 IDUs, the majority (98.7%) were men, and the median duration of injecting drugs was 7 years. Unsafe injecting behavior at last injection was reported by 51.9% of IDUs, while 16.8% reported both unsafe injecting behavior and not using condoms with last occasional and/or commercial partner. In the multivariate analysis, independent correlates of unsafe injecting behavior at last injection were types of drugs injected [p = 0.0096; (for ephedrine, adjusted odds ratio (aOR) = 7.38; 95% CI, 1.50–36.26)] and not using condoms at last commercial sex (aOR = 2.29, 1.22–4.32). The following variables were significantly associated with unsafe injecting behavior at last injection and not using condoms at last sex with commercial and/or occasional partners in the multivariate analysis: marital status [p = 0.0002; (for divorced, widowed, and separated aOR = 2.62, 1.62–4.25; for single aOR = 1.61, 1.08–2.39)], being a member of a regular injecting group (aOR = 0.62, 0.44–0.88), types of drugs injected in the past month [p = 0.0024; (for buprenorphine aOR = 0.34, 0.18–0.63)], city of residence (p = 0.0083), and not receiving information on HIV (aOR = 1.82, 1.07–3.09). Though only ephedrine was injected by a smaller number of IDUs (9.1%), the vast majority of these (81.4%) reported unsafe injecting practices at last injection. High prevalence of unsafe injecting behaviors and diverse and at-risk sexual partnerships highlight the need to implement complex and targeted HIV interventions among IDUs in Georgia.     

Partnership Concurrency Status and Condom Use Among Women Diagnosed with Trichomonas vaginalis

INTRODUCTION AND BACKGROUND: Partner concurrency increases the risk of sexually transmitted infections (STIs) such as Trichomonas vaginalis. Women diagnosed with T. vaginalis have a 2- to 3-fold higher risk of acquiring the human immunodeficiency virus and developing the acquired immunodeficiency syndrome. GOALS: We sought to describe partnership concurrency (multiple sexual partners during the same time period) and condom use among women diagnosed with T. vaginalis, and to compare reports of concurrency between matched female and male dyads. METHODS: A baseline interview on partnership status and condom use was administered to women diagnosed with T. vaginalis at a public sexually transmitted infections (STI) clinic. A male partner substudy was also conducted. Seventy-three dyads were matched by unique identifier and female and male responses were compared. RESULTS: The participants were 319 African American women and 10 white women aged 15-40 years (N = 329). Almost three fourths (72.3%) had only 1 partner over a 3-month period, compared with more than one fourth (27.7%) with >/=2 partners. Regular condom use was low (16.4%), especially with regular partners (9.1%). In the matched substudy, men reported significantly higher rates of concurrency than women (47.3% vs. 23.0%; p 相似文献   

STDs and HIV / AIDS: a KAP study among drug operators

This study presents the findings of a Knowledge, Attitude, and Practice Survey about sexually transmitted diseases (STDs) and HIV/AIDS in Rajasthan, India. Data were obtained from 153 truck drivers covering "Dhabas" at different highways. Truck operators (TOs), commercial sex workers (CSWs), and iv drug users are the primary at risk populations for HIV/AIDS. In 1997, 73.3% of the 3188 HIV-infected persons were infected through heterosexual intercourse. Findings from TOs indicate a high level of knowledge about STDs, which are prevalent among TOs. Many TOs rely on cleanliness (68.9%) as a safety measure, followed by use of condoms with multiple partners (56.8%). About 50% go for regular check-ups at clinics to avoid the problem of STDs. About 75% of 132 TOs had had at least one problem with STDs during the prior year. About 46.2% consulted a doctor for treatment, 26.5% ignored the problem, and 18.2% received no treatment. 72.7% of 132 TOs had accurate knowledge about AIDS, 62.1% were aware of transmission routes, and 50% knew about prevention. About 85% visited CSWs. Only 14.3% of 112 TOs who visited CSWs used condoms during sexual relations. 10.7% used condoms most of the time, 47.3% used condoms irregularly, and 27.7% never used condoms. Condom availability was an issue. Most TOs learned about HIV/AIDS from mass media, especially posters and banners, followed by the radio. Only 28% of all TOs had complete knowledge of STDs; 13.6% had misconceptions. 37.1% had complete knowledge of HIV/AIDS; 10.6% had misconceptions.     

The prevalence and risk behaviours associated with the transmission of blood-borne viruses among ethnic-Vietnamese injecting drug users

OBJECTIVE: To measure the prevalence and determinants of blood-borne virus (BBV) transmission in ethnic Vietnamese injecting drug users (IDUs). METHODS:The study was conducted in Melbourne, Australia, in 2003. It was a cross-sectional design with participants recruited from street-based illicit drug markets predominately using a snowball technique. One hundred and twenty-seven participants completed a questionnaire that asked about illicit drug use and participants' blood samples were tested for HIV, HCV and HBV. RESULTS: One hundred and three (81.1%) ethnic Vietnamese IDU study participants were HCV positive and three (2.4%) were HIV positive. More than 60% had evidence of being infected with HBV (either in the past, acute infection or chronic infection). Almost 60% had injected daily over the past 12 months. Fifty-nine participants had recently travelled to Vietnam; 24 (41%) had injected drugs in Vietnam; and three (12.5%) reported sharing injecting equipment in Vietnam. CONCLUSION: The prevalence of BBVs was higher in this study's IDU population compared with IDUs in Australia generally, despite the fact that the injecting risk behaviours were similar to IDUs more generally. IMPLICATIONS: Culturally sensitive drug treatment and education programs need to be developed in Australia for both ethnic Vietnamese IDUs and their families to reduce this group's risk of contracting a BBV.     

Sociodemographic and sexual health profile of users of emergency hormonal contraception: data from a British probability sample survey

OBJECTIVE: This study aimed to identify factors associated with the use of emergency hormonal contraception (EHC). METHODS: Data from a probability sample survey of 12,110 men and women aged 16-44 living in Britain were used for this study; 5916 women were selected as potential users of EHC, defined as women reporting at least one male partner in the year prior to the survey. RESULTS: Of the 5916 women, 2.3% reported EHC use in the previous year. EHC use was more common among younger, single women, those with more than one sexual partner in the past year and those using condoms for contraception. It was significantly associated with experience of abortion (odds ratio adjusted for age, marital status and number of male partners: 2.40) but not with sexually transmitted infection (STI) diagnosis. CONCLUSIONS: The use of EHC identifies a group of women at increased risk of unplanned pregnancy and condom use but not STI acquisition. Provision of information on more reliable contraceptive methods is needed to reduce the risk of unplanned pregnancy recurrence.     

基于暗娼收集性伴精液检测HIV的可行性及相关因素分析

目的 探讨通过女性性工作者(FSWs)的男性伴安全套中的精液(套存精液)进行HIV检测的可行性及相关影响因素.方法 通过外展人员招募FSWs,对与之发生性行为的男性伴(嫖客或固定性伴)的套存精液进行HIV检测,然后对FSWs及其男性伴进行问卷调查,并对FSWs及其男性伴的静脉血进行HIV检测.结果 共招募了54名FSWs、57名嫖客和43名固定性伴,FSWs、嫖客及固定性伴血清学HIV阳性率分别为33.33%、29.82%和23.26%;嫖客和固定性伴精液HIV阳性率分别为40.35%和30.23%,这两类精液的HIV抗体检测灵敏度均为100%,特异度分别为85.00%和90.91%.单因素分析显示,FSWs自我报告共用注射器吸毒行为及男性伴有子女这两个因素与血液和精液HIV抗体检测不一致有关.结论 套存精液HIV抗体检测特异度较低,其原因可能为套存精液标本受到HIV阳性FSWs的污染,所以基于FSWs收集男性伴套存精液进行HIV检测可能高估这两类人群的HIV感染率.     

A pilot study for an HIV prevention programme among commercial sex workers in Bulawayo, Zimbabwe

In a health education pilot study for a programme to reduce HIV transmission among commercial sex workers (CSWs), 113 CSWs were interviewed and observed in Bulawayo, Zimbabwe during 1989. The educational level of the sample was low and less than a quarter had another job, either as a self-employed vendor/hawker or a domestic servant. Inability to earn income in other ways was the major reason cited for engaging in commercial sex. Nearly half the sample went for check-ups every 3 months or more often. All interviewees had heard about AIDS, but they were uniformed about several facets of AIDS. CSWs reported that they worked an average of 3.6 nights a week, averaged 1.3 clients a night and charged a mean of U.S. $2.8 a session and U.S. $6.5 a night. CSWs reportedly saw a total of 221 clients in the past 7 days and used condoms with 87 (39.3%) clients. Nearly all CSWs said they had done something to reduce the risk of getting AIDS, but when asked what they had done, only 40% said they were using condoms more frequently and many cited ineffective precautions. CSWs who had a job, charged higher fees, experienced little client violence and believed that they were susceptible to AIDS were more likely to use condoms. Clients were a cross-section of Bulawayo society, with widely varying education, incomes and occupations and shared little except an interest in commercial sex. Ethnographic approaches demonstrated a lack of cohesion among CSWs and a consequent need to foster organized, motivated groups for health education, the importance of incorporating clients in health education and the feasibility of using bar security and sales personnel as health educators. It is concluded that health education is urgently needed among CSWs, but that it is equally important to direct health interventions at clients, many of whom are resistant to condom use.     

Homelessness and unstable housing associated with an increased risk of HIV and STI transmission among street-involved youth

The role that environmental factors play in driving HIV and STI transmission risk among street-involved youth has not been well examined. We examined factors associated with number of sex partners using quasi-Poisson regression and consistent condom use using logistic regression among participants enroled in the At Risk Youth Study (ARYS). Among 529 participants, 253 (47.8%) reported multiple partners while only 127 (24.0%) reported consistent condom use in the past 6 months. Homelessness was inversely associated with consistent condom use (adjusted odds ratio [aOR]=0.47, p=0.008), while unstable housing was positively associated with greater numbers of sex partners (adjusted incidence rate ratio [aIRR]=1.44, p=0.010). These findings indicate the need for interventions which modify environmental factors that drive risk among young street-involved populations.     

Variations in Condom Use by Locale: A Comparison of Mobile Chinese Female Sex Workers in Hong Kong and Mainland China

The present study investigated the prevalence of HIV and HIV-related behaviors and perceptions among 336 female sex workers (FSW) traveling from mainland China to work in Hong Kong. None of the participants tested HIV positive. Of the participants, 13.2% and 26.8%, respectively, would have unprotected sex with a client in Hong Kong or in mainland China if they liked the client; 16.7% and 21.7%, respectively, would have unprotected sex with a client in Hong Kong and in mainland China if he paid more. Of the participants, 98.5% used condoms in the last episode of sex work in Hong Kong and 78.1% were consistent condom users in Hong Kong in the last month. Yet, among those who previously worked as FSW in mainland China (n = 141), only 28.6% used condoms consistently in mainland China in the last year; 60% of those who used condoms inconsistently while in mainland China became consistent condom users in Hong Kong. Among those who did not use condoms in mainland China, willingness to have unprotected sex with a client who was liked by the FSW was a strong predictor for consistent condom use in Hong Kong (OR = 18.67, p < .001). Among those who were consistent condom users in Hong Kong, the same variable predicted inconsistent condom use while in mainland China (OR = 14.02, p < .05). Condom use behaviors change when FSW are working in different social contexts and behavioral changes are possible. Education programs should take socio-contextual factors into account.