HIV Disclosure and Transmission Risks to Sex Partners among HIV-Positive Men

Disclosure of HIV-positive status to sex partners is critical to protecting uninfected partners. In addition, people living with HIV often risk criminal prosecution when they do not inform sex partners of their HIV status. 

The current study examined factors associated with nondisclosure of HIV status by men living with HIV in Atlanta, GA (92% African African, mean age = 43.8), who engage in condomless sex with uninfected sex partners. 

Sexually active HIV-positive men (N = 538) completed daily electronic sexual behavior assessments over the course of 28 days and completed computerized interviews, drug testing, medication adherence assessments, and HIV viral load retrieved from medical records. 

Results showed that 

• 30% men had engaged in condomless vaginal or anal intercourse with an HIV-uninfected or unknown HIV status sex partner to whom they had not disclosed their HIV status. 
• Men who engaged in nondisclosed condomless sex were 
• less adherent to their HIV treatment, 
• more likely to have unsuppressed HIV, 
• demonstrated poorer disclosure self-efficacy, 
• enacted fewer risk reduction communication skills, and 
• held more beliefs that people with HIV are less infectious when treated with antiretroviral therapy. 

We conclude that undisclosed HIV status is common and related to condomless sex with uninfected partners. Men who engage in nondisclosed condomless sex may also be more infectious given their nonadherence and viral load. 

Interventions are needed in HIV treatment as prevention contexts that attend to disclosure laws and enhance disclosure self-efficacy, improve risk reduction communication skills, and increase understanding of HIV infectiousness.

Purchase full article at: http://goo.gl/JF8GBM

By:  Kalichman SC1, Kalichman MO1, Cherry C1, Grebler T1.

• 1Department of Psychology, University of Connecticut , Storrs, Connecticut.
• AIDS Patient Care STDS. 2016 May;30(5):221-8. doi: 10.1089/apc.2015.0333. 

More at:  https://twitter.com/hiv insight

And: http://twitter.com/Prison Health 

Predictors of Perceived Male Partner Concurrency among Women at Risk for HIV & STI Acquisition in Durban, South Africa

Background

Women in sub-Saharan Africa continue to be at greater risk for HIV acquisition than men. Concurrency, viz. multiple sexual partnerships that overlap over time, has been studied as a possible risk factor for HIV transmission. The aim of this study was to identify predictors of perceived male partner concurrency among sexually active, HIV negative women.

Methods

Socio-demographic and behavioural data from women enrolled in a biomedical HIV prevention clinical trial were assessed in relation to perceived male partner concurrency using the Chi squared test. Univariate and multivariate logistic regression was performed to assess the independent predictors of perceived male partner concurrency. Kaplan–Meier survival estimates were obtained for HIV and STI incidence in relation to male partner concurrency. A Cox Proportional Hazards model was used to assess the association between perceived male partner concurrency and HIV and STI incidence.

Results

The results revealed that 29 % of women reported their male partners to be in concurrent sexual relationships, 22 % reported partners that were not engaging in concurrency, whilst 49 % reported not knowing their partners concurrency status. Older women, having never married, experiencing economic abuse, and women reporting individual concurrency, were found to be significant predictors of perceived male partner concurrency in the studied population. Perceived male partner concurrency was not found to be a significantly associated with incident HIV and STI infections in this analysis.

Conclusions

The study provides insight into predictors of perceived male partner concurrency among women at high risk for STI and HIV acquisition. These results may inform the design of behavioural and biomedical interventions, to address the role of multiple sexual partnerships in HIV prevention.

Below:  Kaplan-Meier survival curve for HIV incidence versus partner concurrency status, among a cohort of women in Durban, South Africa

Below:  Kaplan-Meier survival curve for STI incidence versus partner concurrency status, among a cohort of women in Durban, South Africa

Full article at:   http://goo.gl/PHHOQV

By:  Zakir Gaffoor, Handan Wand, Renée A. Street, Nathlee Abbai, and Gita Ramjee

HIV Prevention Research Unit, South African Medical Research Council, Durban, South Africa

The Kirby Institute, University of New South Wales, Sydney, Australia

Zakir Gaffoor, Phone: + (27)-31 242 3600

AIDS Res Ther. 2016; 13: 14. Published online 2016 Mar 8. doi:  10.1186/s12981-016-0098-7

More at:  https://twitter.com/hiv insight

And: http://twitter.com/Prison Health

The Influence of Sensation-Seeking & Parental & Peer Influences in Early Adolescence on Risk Involvement through Middle Adolescence

This study examined the relationships between youth and parental sensation-seeking, peer influence, parental monitoring and youth risk involvement in adolescence using structural equation modeling. 

Beginning in grade-six, longitudinal data were collected from 543 students over three years. Youth sensation-seeking in grade six contributed to risk involvement in early adolescence (grades six and seven) indirectly through increased peer risk influence and decreased parental monitoring but did not have a direct contribution. It contributed directly and indirectly to risk involvement in middle adolescence (grades eight and nine). 

Parent sensation-seeking at baseline was positively associated with peer risk influence and negatively associated with parental monitoring; it had no direct effect on adolescent risk involvement. Parental monitoring buffers negative peer influence on adolescent risk involvement. 

Results highlight the need for intervention efforts to provide normative feedback about adolescent risky behaviors and to vary among families in which parents and/or youth have high sensation-seeking propensities.

Proportions of youth involved in risky behaviors at baseline, 12, 24, and 36 months

Risky behaviors	Baseline	12 months	24 months	36 months	z
Sample size	543	494	458	451
Delinquent behaviors
Was suspended from school	1.9%	2.5%	11.9%	16.9%	9.12c
Was truant	3.2%	1.9%	3.8%	3.6%	0.82
Carried a weapon	4.4%	4.1%	5.3%	9.7%	3.45c
Engaged in a fight	33.2%	21.8%	22.5%	24.6%	3.20b
Substance use behaviors
Smoked cigarettes	2.0%	1.6%	2.4%	1.8%	0.01
Drank alcohol	18.5%	14.7%	18.6%	29.3%	3.60c
Used marijuana	0.4%	1.0%	1.1%	2.7%	2.97b
Sold or carried drugs	1.1%	0.6%	1.3%	2.2%	1.58
Been asked to sell drugs	1.5%	1.6%	2.4%	2.7%	1.47
Sexual behaviors
Ever had sex	3.6%	9.6%	20.8%	28.6%	13.90c
Had sex in the last 6 months	1.0%	3.1%	7.9%	13.7%	9.15c
Ever had anal sex	0.8%	2.1%	6.8%	8.7%	8.14c
Had multiple sex partners	0.2%	0.6%	2.9%	4.4%	6.12c
Did not use a condom during last sexual encounter	66.7%	59.6%	44.0%	27.3%	5.04c

Full article at:   http://goo.gl/IZYp7q

By:  Bo Wang,1 Lynette Deveaux,2 Sonja Lunn,2 Veronica Dinaj-Koci,1 Xiaoming Li,1 and Bonita Stanton1

¹Pediatric Prevention Research Center, Department of Pediatrics, Wayne State University School of Medicine, Detroit, Michigan, USA

²Office of HIV/AIDS, the Bahamas Ministry of Health, Nassau, The Bahamas

Corresponding author: Bo Wang, Ph.D., Pediatric Prevention Research Center, Wayne State University School of Medicine, 4707 St. Antoine, Suite W534, Detroit, MI 48201, Phone: 313-966-2366, Fax: 313-745-4993

Youth Soc. 2016 Mar; 48(2): 220–241.

Published online 2013 May 6. doi:  10.1177/0044118X13487228

More at:  https://twitter.com/hiv insight

And: http://twitter.com/Prison Health

Factors Associated with High-Risk Behaviors among People Newly Diagnosed with HIV Through Heterosexual Contact Before & After Diagnosis in Some Areas in Henan Province

OBJECTIVE:

To understand the factors associated with high risk behaviors among people newly diagnosed to be infected with HIV through heterosexual contact before and after diagnoses in some areas in Henan province, and evaluate the risk of secondary transmission.

METHODS:

A face to face interview was conducted among people infected with HIV through heterosexual contact by using self-designed questionnaires during January-May in 2015.

RESULTS:

Among 361 HIV infected persons, the proportions of those with commercial heterosexual behaviors or sex with irregular sex partners decreased from 77.3%(279/361) and 28.5%(103/361) before diagnosis to 13.6% (49/361) and 2.5%(9/361) after diagnosis, the difference was significant (χ(2)=16.66,P<0.001;χ(2)= 4.80,P=0.03). The subjects surveyed always had more commercial heterosexual behaviors in Henan, Guangdong and Zhejiang provinces before and after diagnosis. After HIV infection confirmation, the condom use rates were 51.0%(25/49) for commercial heterosexual behaviors, 88.5% (184/208) for sex with regular partners and 88.9%(8/9) for sex with irregular partners, respectively. Multivariate logistic regression analysis indicated that risk behaviors associated with HIV transmission included commercial sexual behaviors, previous HIV detection and age of 35 years or older.

CONCLUSIONS:

Extramarital heterosexual behavior has posed serious challenge to the prevention and control of HIV spread. It is necessary to inform the HIV test results, improve the intervention and promote condom use in people with history of commercial sex and people aged ≥35 years.

Purchase full article [Article in Chinese] at:   http://goo.gl/jj3npC

By:  Fan PY1, Bai YJ2, Yang WJ1, Li N1, Sun DY1, Zhu Q1, Wang Z1.

• 1Henan Provincial Center for Disease Control and Prevention, Zhengzhou 450016, China.
• 2Zhoukou Prefecture Centre for Disease Control and Prevention, Zhoukou 466000, China.
• Zhonghua Liu Xing Bing Xue Za Zhi. 2016 Mar 10;37(3):367-70. doi: 10.3760/cma.j.issn.0254-6450.2016.03.015. 

More at:  https://twitter.com/hiv insight

And: http://twitter.com/Prison Health

Trauma Symptoms, Internalized Stigma, Social Support & Sexual Risk Behavior among HIV-Positive Gay & Bisexual MSM Who Have Sought Sex Partners Online

Gay, bisexual, and other men who have sex with men (MSM) remain the highest risk group for HIV infection. One reason is the increased use of the Internet to meet potential sex partners, which is associated with greater sexual risk behavior. 

To date, few studies have investigated psychosocial predictors of sexual risk behavior among gay and bisexual men seeking sex partners online. The purpose of the current study was to test a conceptual model of the relationships between trauma symptoms indexed on the event of HIV diagnosis, internalized HIV stigma, and social support on sexual risk behavior among gay and bisexual MSM who seek sex partners online. 

A sample of 142 gay and bisexual MSM recruited on- and offline completed a comprehensive online assessment battery assessing the factors noted above. A number of associations emerged; most notably internalized HIV stigma mediated the relationship between trauma-related symptoms indexed on the event of HIV diagnosis and sexual risk behavior with HIV-negative and unknown serostatus sex partners. This suggests that gay and bisexual MSM who are in greater distress over their HIV diagnosis and who are more sensitive to HIV stigma engage in more HIV transmission risk behavior. 

As sexual risk environments expand with the increasing use of the Internet to connect with others for sex, it is important to understand the predictors of sexual risk behavior so that tailored interventions can promote sexual health for gay and bisexual MSM seeking sex online.

Purchase full article at:   http://goo.gl/093nmj

By:  Burnham KE1, Cruess DG1, Kalichman MO1, Grebler T1, Cherry C1, Kalichman SC1.

• 1 Department of Psychology , University of Connecticut , Storrs , CT , USA. 
• AIDS Care. 2016 Mar;28(3):347-53. doi: 10.1080/09540121.2015.1096894. Epub 2015 Oct 13.

More at:  https://twitter.com/hiv insight

And: http://twitter.com/Prison Health

The Male Factor: Outcomes from a Cluster Randomized Field Experiment with a Couples-Based HIV Prevention Intervention in a South African Township

Highlights

• Men in the couples arm were less likely to report heavy drinking at 6-months.
• Men in the couples arm were more likely to report past-month consistent condom use.
• Women tested at twice the prevalence of HIV (26%) as men (13%).
• At 6-months, HIV incidence was significantly lower among women in the intervention.
• Couples-based interventions focusing on intersecting HIV risks can improve outcomes.

BACKGROUND:

This study examined the effects of the Couples Health CoOp intervention on heavy drinking, condom use, and HIV incidence.

METHODS:

Thirty neighborhoods from one South African township were cluster randomized into three intervention arms: Couples Health CoOp (CHC), Women's Health CoOp/Men's Health CoOp (WHC/MHC), or a comparison arm. We recruited 290 men from informal drinking establishments who reported drinking alcohol regularly. We also recruited their main heterosexual sex partners.

RESULTS:

At 6-month follow-up, men in the CHC arm were less likely to report heavy drinking (OR 0.47, 95% CI: 0.25, 0.90) and were more likely to report consistent condom use during the past month (OR 2.66, 95% CI: 1.23, 5.76) than men in the comparison arm. At baseline, 26% of women and 13% of men were HIV-infected; at 6-month follow-up, 16 females and 5 males had seroconverted. HIV incidence was significantly lower among women in the CHC arm (IRR 0.22, 95% CI: 0.04, 1.01) than in the WHC/MHC arm.

CONCLUSIONS:

A couples-based intervention focusing on intersecting risks for HIV can improve biobehavioral outcomes, underscoring the importance of engaging couples together in HIV prevention.

Purchase full article at:   http://goo.gl/lyOHw9

By:  Wechsberg WM1, Zule WA2, El-Bassel N3, Doherty IA4, Minnis AM5, Novak SD2, Myers B6, Carney T7.

• 1RTI International, 3040 East Cornwallis Road, Research Triangle Park, NC, United States; University of North Carolina, Chapel Hill, NC, United States; Department of Psychology in the Public Interest, North Carolina State University, Raleigh, NC, United States; Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, United States. Electronic address: wmw@rti.org.
• 2RTI International, 3040 East Cornwallis Road, Research Triangle Park, NC, United States.
• 3Columbia University School of Social Work, New York, NY, United States.
• 4RTI International, 3040 East Cornwallis Road, Research Triangle Park, NC, United States; University of North Carolina, Chapel Hill, NC, United States.
• 5RTI International, 351 California Street, San Francisco, CA, United States.
• 6Alcohol, Tobacco & Other Drug Research Unit, South African Medical Research Council, Cape Town, South Africa; Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa.
• 7Alcohol, Tobacco & Other Drug Research Unit, South African Medical Research Council, Cape Town, South Africa. 
• Drug Alcohol Depend. 2016 Apr 1;161:307-15. doi: 10.1016/j.drugalcdep.2016.02.017. Epub 2016 Feb 18.

More at:  https://twitter.com/hiv insight

And: http://twitter.com/Prison Health

The Meaning of 'Regular Partner' in HIV Research among Gay and Bisexual Men: Implications of an Australian Cross-Sectional Survey

Estimates of the proportion of HIV infections coming from within regular sexual relationships among gay and bisexual men (GBM) vary widely. Research surveys use various partner type categories, but there is little understanding of how men classify their partners. We conducted an online cross-sectional survey of Australian GBM exploring sexual relationships, including 2057 men reporting on 2566 regular partnerships. 

Just over half of the partnerships were considered 'relationships', while the remainder were non-romantic 'fuckbuddy'-style arrangements. In multivariable analysis, factors associated with considering the partnership a 'relationship' were: using a 'romantic' descriptor, partnership length, monogamous agreements, any condomless anal sex with each other, love, and commitment. The category of 'regular partner' can mask diverse partnership types, which have different meanings to GBM, associated behaviours, and HIV risks. 

Certain HIV prevention techniques may be more suited to particular types of partnerships. 'Fuckbuddy' arrangements need to be more explicitly acknowledged in HIV prevention.

Purchase full article at:   http://goo.gl/jee5Hz

By:  Bavinton BR1, Duncan D2, Grierson J3, Zablotska IB4, Down IA4, Grulich AE4, Prestage GP4,5.

• 1Kirby Institute, University of New South Wales, Sydney, NSW, 2052, Australia. bbavinton@kirby.unsw.edu.au.
• 2University of New England, Armidale, Australia.
• 3Anglia Ruskin University, Cambridge, England, UK.
• 4Kirby Institute, University of New South Wales, Sydney, NSW, 2052, Australia.
• 5Australian Research Centre in Sex, Health and Society, La Trobe University, Melbourne, Australia. 
• AIDS Behav. 2016 Mar 12.

More at:  https://twitter.com/hiv insight

And: http://twitter.com/Prison Health

Number of Sexual Partners and Relationship Status Are Associated with Unprotected Sex Across Emerging Adulthood

Sex with multiple partners, consecutively or concurrently, is a risk factor for contracting sexually transmitted infections (STIs) as multiple partner-partner contacts present increased opportunity for transmission. It is unclear, however, if individuals who tend to have more partners also use protection less reliably than those with sexual histories of fewer partners. 

Longitudinal data can elucidate whether an individual shows a consistent pattern of sex with multiple partners. We used latent class growth analyses to examine emerging adult survey data (N = 2244) spanning 10 waves of assessment across 6 years. 

We identified three trajectory classes described with respect to number of partners as 

1. Multiple, 
2. Single, and 
3. Rare. 

Trajectory group, relationship status, and their interactions were tested as predictors of using protection against STIs and pregnancy at each wave. 

The Multiple Partners class had the greatest odds ratio of reporting sex without protection against STIs and pregnancy, followed by the Single and Rare classes. Exclusive relationship status was a risk factor for unprotected sex at earlier waves, but a protective factor at most later waves. There was no significant interaction between relationship status and trajectory class in predicting use of protection. The Multiple Partners class reported more permissive values on sex and an elevated proportion of homosexual behavior. This group overlaps with an already identified at-risk population, men who have sex with men. 

Potential mechanisms explaining the increased risk for sex without protection, including communication, risk assessment, and co-occurring risk behaviors are discussed as targets for intervention.

Purchase full article at:   http://goo.gl/dPJjdy

By:  Ashenhurst JR1, Wilhite ER2, Harden KP2, Fromme K2.

• 1Department of Psychology, The University of Texas at Austin, 1 University Station, A8000, Austin, TX, 78712, USA. james.ashenhurst@utexas.edu.
• 2Department of Psychology, The University of Texas at Austin, 1 University Station, A8000, Austin, TX, 78712, USA. 
• Arch Sex Behav. 2016 Mar 3.

More at:  https://twitter.com/hiv insight

And: http://twitter.com/Prison Health

Risk Factors for Hepatitis C Virus (HCV) Infection in Areas with a High Prevalence of HCV in the Republic of Korea in 2013

BACKGROUND/AIMS:

The prevalence of hepatitis C virus (HCV) infection in Busan, Gyeongnam, and Jeonnam Provinces in Korea is more than twice the national average. This study aimed to examine whether demographic and lifestyle characteristics are associated with HCV infection in these areas.

METHODS:

A case control study was performed at three study hospitals. HCV cases were matched with two controls for sex and age. Patient controls were selected from non-HCV patients at the same hospital. Healthy controls were subjects participating in medical checkups. Conditional logistic regression models were used.

RESULTS:

A total of 234 matched-case and patient- and healthy-control pairs were analyzed. The significant risk factors for both controls were sharing razors (adjusted odds ratio [aOR], 2.39 and 3.29, respectively) and having more than four lifetime sexual partners (aOR, 2.15 and 6.89, respectively). Contact dockworkers (aOR, 1.91) and tattoos (aOR, 2.20) were significant risk factors for the patient controls. Transfusion (aOR, 5.38), a bloody operation (aOR, 5.02), acupuncture (aOR, 2.08), and piercing (aOR, 5.95) were significant risk factors for the healthy controls. Needle stick injuries and intravenous drug abuse were significant in the univariate analysis.

CONCLUSIONS:

More education concerning the dangers of sharing razors, tattoos and piercings is required to prevent HCV infection. More attention should be paid to needle stick injuries in hospitals and the community.

Full article at:  http://goo.gl/0O7JnR

By:  Sohn HS1, Kim JR2, Ryu SY3, Lee YJ4, Lee MJ5, Min HJ6, Lee J7, Choi HY8, Song YJ9, Ki M8.

• 1Department of Preventive Medicine, Inje University College of Medicine, Busan, Korea.
• 2Department of Preventive Medicine, Gyeongsang National University School of Medicine, Jinju, Korea.
• 3Department of Preventive Medicine, Chosun University Medical School, Gwangju, Korea.
• 4Department of Internal Medicine, Inje University Busan Paik Hospital, Busan, Korea.
• 5Department of Health and Medical Administration, Suncheon Jeil College, Suncheon, Korea.
• 6Department of Internal Medicine, Gyeongsang National University School of Medicine, Jinju, Korea.
• 7Department of Internal Medicine, Chosun University Medical School, Gwangju, Korea.
• 8Department of Cancer Control and Policy, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Korea.
• 9Department of Preventive Medicine, College of Medicine, Eulji University, Daejeon, Korea. 
• Gut Liver. 2016 Jan 23;10(1):126-32. doi: 10.5009/gnl14403.

More at:  https://twitter.com/hiv insight

And: http://twitter.com/Prison Health