Childhood victimization and HIV risk behaviors among university students in Saint-Petersburg,Russia

Exposure to childhood victimization and abuse has been shown to affect HIV risk in adult populations. In Russia, the existence of child abuse was largely unrecognized until 1990s and its behavioral consequences remain understudied. Our goal was to assess childhood victimization and HIV risk behavior among young adults in Saint-Petersburg, Russia: 743 students from 15 local universities were surveyed. Unprotected sexual intercourse was the most common type of HIV risk behavior: study participants reported no condom use at last intercourse (65.17%), inconsistent condom use (58.43%) and 30.81% never used condoms in the past 3 months. Childhood sexual victimization was significantly associated with unprotected sex at last intercourse and with inconsistent condom use in the past 3 months. Young adults in Russia are vulnerable to HIV epidemic due to the pervasiveness of unprotected sexual intercourse, and childhood sexual victimization is associated with risky sexual behavior in this population. Efforts to combat HIV epidemic in Russia must include programming for the prevention of childhood sexual abuse and the development of services for the survivors of childhood victimization.     

133例大学生HIV感染者新型毒品使用及危险性行为特征

目的 调查133例大学生HIV感染者新型毒品使用情况、危险性行为特征,分析两者间的相关性.方法 对某省会城市133例在校大学生HIV感染者进行匿名问卷调查,收集调查对象新型毒品使用、危险性行为特征的相关信息,采用二分类非条件Logistic回归模型分析新型毒品使用与危险性行为特征的相关性.结果 37.6％(50/133...     

北京市农村流动人口的HIV/STD高危性行为和知识分析

目的调查北京市流动人口中存在的感染艾滋病病毒/性传播疾病(HIV/STD)的高危性行为和他们所掌握的艾滋病知识状况。方法在北京市流动人口集中的行业中,用按比例抽样的方法抽取了2222名流动人员,采取问卷调查了解他们拥有的性伙伴数量、参与商业性性行为、安全套使用等高危性行为的情况和艾滋病知识掌握的状况。结果对被调查者中报告有性行为的900人进行了统计分析,结果发现67.4%的人有婚前性行为,31.0%的人有多个性伙伴,9.4%的人参与了商业性性行为,而只有39.0%的人使用过安全套。对全体被调查者的艾滋病知识分析发现,他们的艾滋病知识掌握的相对比较多,熟悉艾滋病传播的三大途径,但对不传播途径没有多大把握。结论加强对流动人口感染HIV/STD的危险和使用安全套的干预。     

Alcohol use and its association with HIV risk behaviors among a cohort of patients attending HIV clinical care in Tanzania,Kenya, and Namibia

This article describes the frequency of alcohol use among HIV-positive patients attending clinical care in sub-Saharan Africa and explores the association between alcohol use, medication adherence, and sexual risk behavior. Data from 3538 patients attending an HIV clinic in Kenya, Tanzania, or Namibia were captured through interview and medical record abstraction. Participants were categorized into three drinking categories: nondrinkers, nonharmful drinkers, and harmful/likely dependent drinkers. A proportional odds model was used to identify correlates associated with categories of alcohol use. Overall, 20% of participants reported alcohol use in the past 6 months; 15% were categorized as nonharmful drinkers and 5% as harmful/likely dependent drinkers. Participants who reported missing a dose of their HIV medications [adjusted odds ratio (AOR): 2.04, 95% confidence interval (CI): 1.67, 2.49]; inconsistent condom use (AOR: 1.49, 95% CI: 1.23, 1.79); exchanging sex for food, money, gifts, or a place to stay (AOR: 1.57, 95% CI: 1.06, 2.32); and having a sexually transmitted infection symptom (AOR: 1.40, 95% CI: 1.10, 1.77) were more likely to be categorized in the higher risk drinking categories. This research highlights the need to integrate alcohol screening and counseling into the adherence and risk reduction counseling offered to HIV-positive patients as part of their routine care. Moreover, given the numerous intersections between alcohol and HIV, policies that focus on reducing alcohol consumption and alcohol-related risk behavior should be integrated into HIV prevention, care, and treatment strategies.     

云南省美沙酮维持治疗门诊HIV阳性服药人员阴性配偶的高危行为及新发感染情况

目的了解云南省美沙酮门诊中,阳性服药人员阴性配偶的高危行为及其艾滋病病毒（HIV）抗体阳转情况,为开展后续的配偶间干预服务提供参考。方法在部分美沙酮门诊HIV抗体阳性服药人员的阴性配偶中,开展5次横断面调查,收集人口学特征、高危行为信息和HIV阳转原因,并抽血检测HIV抗体。使用Epidata 3.1建立数据库,使用SPSS 17.0进行数据分析。结果 5次横断面调查分别招募107名、101名、119名、136名和85名对象。各次调查中研究对象的艾滋病知识知晓率均在90%以上,最近1次性行为安全套的使用率有显著性提高（P〈0.001）。检出HIV抗体阳转男性和女性各1例,分别因共用针具和配偶间性行为没有使用安全套而感染。HIV发病密度为1.12/100人年,男、女性发病密度分别为4.17/100人年和0.65/100人年。结论共用针具以及不安全的性行为,是阳性美沙酮维持治疗人员阴性配偶发生HIV抗体阳转的主要危险因素,未来的干预中要采取相应的措施。     

东莞市MSM高危行为特征及HIV感染状况

目的了解东莞市男男性行为人群（MSM）的高危行为特征,艾滋病病毒（HIV）感染情况及影响因素,为在该人群中开展防控措施提供依据。方法利用2010—2012年东莞市MSM哨点监测数据,对MSM的人口学特征、行为学特征、性病症状、接受干预服务、HIV和梅毒感染水平等进行分析。结果共调查MSM984人,平均年龄为（30．36±6．71）岁;最近6个月发生过同性、异性性行为的比例分别为73．37％和37．5％,与同性、异性发生性行为时坚持使用安全套的比例分别为48．89％和29．27％。近1年有性病相关症状的MSM的比例为6．81％,接受过于预服务的比例为59．04％。HIV和梅毒抗体阳性率分别为14．23％和15．35％,其中2010—2012年HIV阳性率分别为10．5％、11．33％和22．91％。多因素Logistic回归分析结果表明：艾滋病知识知晓和接受过干预服务与最近6个月同性性行为时坚持使用安全套的关系有统计学意义（P〈0．05）;梅毒抗体阳性、近1年有性病相关症状、年龄在≥40岁、样本来源等因素,与HIV感染的关系有统计学意义（P〈0．05）。结论东莞市MSM的HIV感染率高,且上升趋势明显,迫切需要加强行为干预,防止艾滋病向一般人群蔓延。     

男性性工作者的STI/HIV高危行为研究

目的 监测男性性工作者(MSW)的性传播感染(STI)/艾滋病病毒(HIV)感染的高危行为。方法 以定向抽样获取的男男性接触者(MSM)中从事(过)性工作的男性为样本，将之与年龄相匹配的一般的MSM进行比较。结果 相对年轻、未婚、低教育水平、原来在农村地区从事体力劳动、低收入或无收入阶层的男性，更倾向于从事性工作。MSW组的首次性交年龄早于对照组，其累计男性伴侣数、累计肛交男性伴侣数、累计口交男性伴侣数、近1年内男性伴侣数、近1年内陌生男性伴侣数和近1年内口交男性伴侣数均大于对照组；近1年内曾接受同性性服务和近1年内曾群交的比例均高于对照组。结论 MSW较一般的MSM有更多的高危性行为，应加大对这一亚人群的STI／HIV干预力度。     

Discordance of voluntary HIV testing with HIV sexual risk-taking and self-perceived HIV infection risk among social media-using black,Hispanic, and white young-men-who-have-sex-with-men (YMSM)

Discordance between self-perceived HIV risk and actual risk-taking may impede efforts to promote HIV testing among young adult men-who-have-sex-with-men (YMSM) in the United States (US). Understanding the extent of, and reasons for, the discordance of HIV risk self-perception, HIV risk-taking and voluntary HIV testing among black, Hispanic and white YMSM could aid in the development of interventions to increase HIV testing among this higher HIV risk population. HIV-uninfected 18–24-year-old black, Hispanic, and white YMSM were recruited from across the US through multiple social media websites. Participants were queried about their voluntary HIV testing history, perception of currently having an undiagnosed HIV infection, and condomless anal intercourse (CAI) history. We assessed the association between previous CAI and self-perceived possibility of currently having an HIV infection by HIV testing status using Cochran-Mantel-Haenszel testing. Of 2275 black, Hispanic and white social media-using 18–24 year-old YMSM, 21% had never been tested for HIV voluntarily, 87% ever had CAI with another man, 77% believed that it was perhaps possible (as opposed to not possible at all) they currently could have an undiagnosed HIV infection, and 3% who reported CAI with casual or exchange partners, but had not been tested for HIV, self-perceived having no possibility of being HIV infected. Of 471 YMSM who had not been HIV tested, 57% reported CAI with casual or exchange partners, yet self-perceived having no possibility of being HIV infected. Per the Cochran-Mantel-Haenszel test results, among those reporting HIV risk behaviors, the self-perception of possibly being HIV-infected was not greater among those who had never been tested for HIV, as compared to those who had been tested. Future interventions should emphasize promoting self-realization of HIV risk and translating that into seeking and accepting voluntary HIV testing among this higher HIV risk population.     

Sexual behaviors among women living with HIV in Ontario,Canada

Understanding the sexual activities and partnerships of women living with human immunodeficiency virus (HIV) remains important to promote healthy sexuality and to reduce the transmission of HIV and other sexually transmitted infections. We described sexual behaviors of women living with HIV enrolled in an ongoing study in Ontario, Canada. Data were available from 582 women who self-completed a sexual behavior questionnaire between 2010 and 2012. Nearly half (46.1%) of women reported a sexual partner in the preceding three months; women less likely to be sexually active were older, Black/African, separated, divorced, widowed, single, and unemployed. Most sexually active women had one partner (76.4%), a regular partner (75.9%), male (96.2%) partner(s), and partners who were HIV-negative or unknown HIV status (75.2%). Women were more likely to use a condom with HIV-negative/status unknown partners (81.3%) than with HIV-positive partners (58.6%; p ?=?.008). Only 8.0% of sexually active women reported condomless sex with a discordant HIV-negative/status unknown partner when their viral load was detectable. Overall, most women living with HIV were sexually inactive or engaged in sexual activities that were low risk for HIV transmission.     

Anxiety and depression strongly associated with sexual risk behaviors among networks of young men in Dar es Salaam,Tanzania

This study tested the association between mental health scores and sexual risk behaviors among male members of social groups known as “camps” in Dar es Salaam, Tanzania. Anxiety and depression were measured using the HSCL-25 and condom use and sexual partner concurrency were assessed through self-report. A total of 1113 sexually active men with an average age of 27 years were included in the analyses. Higher anxiety and depression scores were significantly associated with both condom use (Anxiety AOR?=?0.58, 95% CI: 0.44, 0.77; Depression AOR?=?0.60, 95% CI: 0.47, 0.77) and concurrency (Anxiety AOR?=?2.32, 95% CI: 1.73, 3.12; Depression AOR?=?2.08, 95% CI: 1.60, 2.70). The results of this study provide information salient to the development of effective HIV prevention interventions targeting populations with high burdens of anxiety and depression. The feasibility and effect of integrating mental health promotion activities into HIV prevention interventions should be explored.     

Reducing risky relationships: a multisite randomized trial of a prison-based intervention for reducing HIV sexual risk behaviors among women with a history of drug use

Women involved in the criminal justice system, particularly those with a history of drug use, are at elevated risk of HIV infection, yet few HIV prevention interventions have been tailored for delivery to incarcerated women. Drawing on the Relational Model, the Reducing Risky Relationships for HIV (RRR-HIV) intervention was developed and evaluated in a multisite randomized clinical trial. Women with weekly drug use prior to incarceration (n = 444) who were incarcerated within correctional institutions in four states were randomized to (1) the RRR-HIV intervention consisting of an HIV educational video, five group sessions, and one postrelease booster session or (2) a control condition consisting of the HIV educational video. The RRR-HIV intervention combined didactic and interactive content regarding seven “thinking myths” about intimate relationships that may result in decisions to engage in risky sexual behaviors. Data were collected while women were still incarcerated and approximately 90 days following release from prison by trained interviewers. A negative binomial regression (NBR) model of unprotected sexual behaviors at the 90-day follow-up indicated that RRR-HIV participants reported fewer unprotected sexual behaviors than women in the control condition once the analysis was adjusted for study site. Future studies should examine the sustainability of the RRR-HIV intervention's effect on risk reduction. Implementation research is needed to determine whether delivery of this intervention by correctional staff or peers, rather than research staff, yields similar reductions in unprotected sexual behaviors.     

HIV infection and related risk behaviors: does school support level the playing field between orphans and nonorphans in Zimbabwe?

Research is limited on whether providing school support to female adolescent orphans mitigates their HIV risk disadvantage compared to other female adolescents. This paper examines 2011 Zimbabwe Demographic and Health Survey (ZDHS) HIV-related biomarker and behavior data for orphaned and nonorphaned rural adolescent females to compare findings from a similar sample participating in a randomized controlled trial (RCT) testing school support as HIV prevention. HIV status, marriage, pregnancy, sexual debut, school dropout, years of schooling, and socioeconomic status were analyzed with the combined data-sets. Bivariate analyses compared variables between RCT comprehensive intervention and delayed partial intervention conditions, and between ZDHS orphan and nonorphan groups. Multivariable analyses included a series of group comparisons as follows: ZDHS orphans vs. ZDHS nonorphans; RCT orphans in each condition vs. ZDHS nonorphans; RCT orphans in each condition vs. ZDHS orphans. Analyses methods accounted for the complex survey sampling design within each data-set. A total of 751 observations were included. All orphan groups had consistently higher odds of HIV infection than ZDHS nonorphans. ZDHS orphans had higher odds of marriage, pregnancy, and sexual debut than ZDHS nonorphans. Comprehensive intervention participants had lower odds of marriage, sexual debut, and school dropout than ZDHS nonorphans. RCT participants in both conditions had lower odds of marriage, sexual debut, and school dropout than ZDHS orphans. The findings indicate that orphans are at a distinct disadvantage to HIV risk compared to nonorphans, and much of this is likely related to vertical transmission. We found no evidence that provision of school fees to orphans will reduce their risk of HIV infection relative to nonorphans but further evidence that such programs may reduce risk behaviors including early sexual debut, child marriage, and school dropout. Further research is needed to determine how these programs can be sustainably scaled-up in resource-limited settings.     

Rates and predictors of prenatal depression in women living with and without HIV

Depression is a significant mental health and public health concern, and women living with HIV are at increased risk for depression. This risk may be especially elevated during pregnancy; however, few studies have attempted to identify rates and predictors of depression in pregnant, HIV-infected women. The purpose of the present study was to investigate rates and predictors of prenatal depression, such as history of depression, childhood sexual abuse (CSA), and social support among HIV-infected and HIV-uninfected women in Philadelphia, Pennsylvania. It was hypothesized that pregnant women with HIV will have higher rates of depressive symptoms and will exhibit a greater number of mood disorder diagnoses as compared to HIV-uninfected pregnant women. It was also hypothesized that HIV status, history of depression, CSA, and inadequate social support will emerge as predictors of depressive symptoms. A sample of 163 women, 31% (n=50) of whom were HIV-infected and 69% (n=113) of whom were HIV-uninfected, were recruited from an obstetrics/gynecology clinic affiliated with an urban university hospital. The Center for Epidemiological Studies-Depression Scale (CES-D) was used to identify depressive symptoms, and Modules A and D of the Structured Clinical Interview for DSM-IV (SCID) confirmed the presence of a mood disorder. Findings demonstrated that rates of depressive symptoms and mood disorder diagnoses during pregnancy did not differ according to HIV serostatus. History depression, CSA, and inadequate social support predicted depressive symptoms during pregnancy in this sample. Due to their association with depressive symptoms, history of depression, CSA, and inadequate social support may be important to identify during pregnancy.     

Age differences in sexual risk behaviors and related factors among people living with HIV in Guangxi,China

Sexual risk behaviors by people living with HIV (PLHIV) can result in secondary HIV transmission and other health problems. Given the dearth of research on age differences in sexual behaviors among PLHIV, the objective of the study is to compare sexual risk behaviors and related factors among PLHIV by age groups. Data used in the current study were derived from a cross-sectional survey conducted from 2012 to 2013 in Guangxi, China. PLHIV were selected randomly from 12 sites with the largest number of HIV/AIDS cases. The 2,987 PLHIV completing the survey were included in the study. Participants were asked about key sociodemographic characteristics, health condition, same-sex behavior, and sexual risk behaviors (number of sex partners, condom use consistency, and change in condom use after HIV diagnosis). Univariate logistic regression analyses were conducted to evaluate associations of sexual risk behaviors with age and other factors. Those variables with a p-value of less than 0.2 were entered into multivariate logistic regression models. All statistical analyses were conducted using SAS 9.4. Differences in sexual risk behaviors across age groups were observed. Compared with their younger counterparts, who were ≥?50 years of age were more likely to have multiple partners, use condoms inconsistently, and use condoms less than before HIV diagnosis. Moreover, lower education attainment, being in the lowest or highest category of income, having a sero-concordant or sero-unknown steady partner or no steady partner, and having contracted HIV from steady or casual/commercial partners, or through injection drug use appeared to be predictive of at least one of the sexual risk behaviors examined in the study. The findings call for HIV prevention interventions to be tailored to different age groups. The interventions that can help reduce unprotected sex among older PLHIV are urgently needed.     

Descriptive systematic review of sub-Saharan African studies on the association between alcohol use and HIV infection

The purpose of this review was to identify and assess studies that have quantified the association between alcohol consumption and HIV infection in sub-Saharan Africa. PubMed, CAB Abstracts and article references were searched to identify studies published in English between 2000 and 2008 that reported relative measures of the association between alcohol use and HIV prevalence and/or seroconversion rates. Twenty-one eligible studies were described in detail and information on study characteristics extracted. All of the identified studies were conducted either in east or southern Africa, and varied substantially regarding study population and alcohol use definitions. Overall, users of alcohol and especially problem drinkers were more likely to be HIV seropositive (HIV+) than non-users, frequency or quantity of alcohol use was positively associated with HIV prevalence, and the association varied by gender. The use of alcohol in sexual contexts was significantly associated with an increased risk of HIV acquisition and prevalence. The findings of this review of sub-Saharan African research strongly support an association between alcohol consumption and HIV infection. Although a causal relationship could not be established with certainty from the mainly cross-sectional studies, the negative consequences of such an association have profound implications for the burden of disease in this region. To confirm causality, future research should use prospective study designs, use clearly defined standardised measures of alcohol use (and problematic drinking) and an ‘event-specific’ approach to examine the situational links between alcohol use and HIV acquisition.     

女性静脉注射吸毒感染HIV危险因素的病例对照研究

目的探讨女性静脉注射吸毒（IDus）感染艾滋病病毒（HIv）的危险因素,为制定针对这一人群的干预措施提供理论依据。方法通过1：1配对50对女性IDUs病例对照研究,探索其感染HIV的危险因素。结果对各个变量进行单因素条件Logistic回归分析后发现,与HIV感染有显著相关的因素有：无固定居所、共用针具史、过去1年有多性伴或以性换钱／毒品、有HIV阳性固定性伴、有IDU性伴、有暴力虐待史、曾感染梅毒、认为自己有很大／一定感染HIV危险。HIV感染的危险因素为：有HIV阳性的固定性伴（OR=28．05;95％CI=2．34,335．67）,过去一年曾以性换钱鹰品（OR=5．89;95％CI=1．12,31．09）,以及无固定居所（OR=10．77;95％CI=1．21,96．06）。结论广东省的女性IDUs中,性行为较注射行为对于HIV传播更为危险,干预重点应该放在如何减少在吸毒情况下经性途径传播HIV的危险因素上。     

Sexual health and treatment seeking behaviour among currently married women living with HIV/AIDS in Karnataka,India

Abstract

An attempt is made to understand sexual health problems and health-seeking behavior among women living with HIV/AIDS (WLHA) in Bagalkot district, Karnataka, India. The data set is from a cross-sectional survey of 633 young married WLHA. The results of the study indicate that sexually transmitted infection (STI) were the main concern as 33% of respondents experienced STI during the past three months. Among those experienced STI, only about 57% sought treatment for the STI they had in the past 3?months. While health-seeking behavior is more or less same by age group and literacy level, however, those from rural areas were more likely to seek treatment compared to their urban counterparts. As far as the place of treatment is concerned, a large majority visit government hospital for the STI treatment (84%). For the remaining women, special strategies are required so that they can access and utilize health care services.     

Socioeconomic status and risk of HIV infection in an urban population in Kenya

OBJECTIVE: To examine the relationship between socioeconomic status (SES), risk factors for HIV infection and HIV status in an urban population with high prevalence of HIV infection in sub-Saharan Africa. METHODS: Cross-sectional population survey of adults from the city of Kisumu, Kenya, in 1996. Around 1000 men and 1000 women aged 15-49 years were interviewed using a structured questionnaire, and most gave a venous blood sample for HIV testing. SES was represented by a composite variable of educational status, occupation and household utilities. Multiple regression was used to examine whether SES was associated with HIV infection or with risk factors for HIV infection. RESULTS: Human immunodeficiency virus prevalence was 19.8% in males and 30.2% in females. Higher SES was associated with a more mobile lifestyle, later sexual debut and marriage among both sexes, and with circumcision among men aged 25-49 and condom use among women aged 25-49. Higher levels of alcohol consumption were associated with an increased risk of HIV infection and were more common amongst those of higher SES. HSV-2 infection was strongly associated with an increased risk of HIV infection and was more common among those of lower SES. HIV was associated with a lower SES among females aged 15-24 whereas in males aged 15-24 and females aged 25-49 there was some indication that it was associated with higher SES. Among males aged 25-49 there was no association between HIV infection and SES. CONCLUSIONS: Risk of infection was high among groups of all SES. Risk profiles suggested men and women of lower SES maybe at greater risk of newly acquired HIV infection. New infections may now be occurring fastest among young women of the lowest SES.