Syndemic Factors associated with Drinking Patterns among Latino Men and Latina Transgender Women Who Have Sex with Men in New York City

Alcohol consumption is a significant public health concern among Latino men and Latina transgender women who have sex with men. However, characteristics and behaviors associated with alcohol consumption in this population, particularly in regard to the complex influence of syndemic factors, remain understudied. 

The purpose of this study was to examine predictors of high-risk alcohol consumption (i.e. binge or heavy drinking). Between January and March of 2014, 176 Latino men and Latina transgender women in New York City completed an interviewer-administered questionnaire. We developed a syndemics scale to reflect the total number of syndemic factors – clinically significant depression, childhood sexual abuse, intimate partner violence, and discrimination – reported by each participant. 

We also carried out a multinomial logistic regression model predicting binge and heavy drinking. Forty-seven percent of participants reported high-risk alcohol consumption in the past 30 days (21% binge and 26% heavy). Approximately 16% of participants reported no syndemic factors, 27% reported one factor, 39% reported two factors, and 18% reported three or four. 

In the multinomial logistic regression model, our syndemic factors scale was not significantly associated with binge drinking. However, participants who reported three or four factors were significantly more likely to report heavy drinking. In addition, having multiple sexual partners was associated with an increased risk of binge and heavy drinking; involvement in a same-sex relationship was associated with binge drinking. 

Further work is needed to develop effective prevention intervention approaches for high-risk alcohol consumption within this population.

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By:  Omar Martinez^a*, Elwin Wu^b, Ethan C. Levine^c, Miguel Muñoz-Laboy^d, Joseph Spadafino^e, Brian Dodge^f, Scott D. Rhodes^g,Javier López Rios^h, Hugo Ovejeroⁱ, Eva M. Moya^j, Silvia Chavez Baray^j, Alex Carballo-Diéguez^h & M. Isabel Fernandez^k

• ^a Temple University School of Social Work, Philadelphia, PA, USA;
• ^b School of Social Work at Columbia University, New York, NY, USA;
• ^c Department College of Liberal Arts at Temple University, Philadelphia, PA, USA;
• ^d College of Public Health at Temple University, Philadelphia, PA, USA;
• ^e Bureau of Public Health Statistics, Phoenix, AZ, USA;
• ^f School of Public Health at Indiana University – Bloomington, Bloomington, IN, USA;
• ^g Wake Forest School of Medicine, Winston-Salem, NC, USA;
• ^h HIV Center for Clinical and Behavioral Studies at the New York State Psychiatric Institute and Columbia University, New York, NY, USA;
• ⁱ Lutheran Family Health Center, Brooklyn, NY, USA;
• ^j School of Social Work at the University of Texas at El Paso, El Paso, TX, USA;
• ^k Department of Public Health at Nova Southeastern University, Fort Lauderdale, FL, USA

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Relationships among Substance Use, Multiple Sexual Partners & Condomless Sex: Differences Between Male & Female U.S. High School Adolescents

Male and female students manifest different behaviors in condomless sex. This cross-sectional, exploratory, correlational study examined the differences in risk factors for condomless sex between male and female high school students, using secondary data from 4,968 sexually active males and females participating in the 2011 National Youth Risk Behavior Survey. 

Results in descriptive statistics and multivariate binary logistic regressions revealed that condomless sex was reported as 39.70% in general. A greater proportion of females engaged in condomless sex (23.26%) than did males (16.44%). 

Physical abuse by sex partners was a common reason for failure to use condoms regardless of gender. Lower condom use was found in 

• those experiencing forced sex by a partner in males, 
• female smokers, and 
• female with multiple sex partners. 

Thus, sexual health education should address the different risk factors and consider gender characteristics to reduce condomless sex.

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

By:  Zhao YL1, Kim H2, Peltzer J3.

• 1School of Nursing, University of Kansas, Kansas City, KS, USA School of Nursing, Boise State University, Boise, ID, USA.
• 2College of Nursing, Yonsei University, Seoul, South Korea Mo-Im Kim Nursing Research Institute, Seoul, South Korea hkim80@yuhs.ac.
• 3School of Nursing, University of Kansas, Kansas City, KS, USA. 
• J Sch Nurs. 2016 Mar 31. pii: 1059840516635712

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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. 

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A Multilevel Understanding of HIV/AIDS Disease Burden among African American Women

Disproportionate HIV/AIDS rates among African American women have been examined extensively—primarily from an individually-centered focus. Beyond individual behaviors, factors such as the hyper-incarceration of African American men and geographically concentrated disadvantage may better explain inequitable disease burden. This paper proposes a conceptual model of individual, social, and structural factors that influence HIV transmission among African American women. The model can be used to develop comprehensive assessments and guide prevention programs in African American communities.

…Limited educational attainment, poverty, and imbalanced male-female sex ratios all fuel the HIV epidemic among African American populations (Dean & Fenton, 2010). Thus, structural interventions should continue to be incorporated in our HIV prevention dialogue, especially since they have proven to be efficacious (Adimora & Auerbach, 2010). Similar to others, this author argues that HIV is an individual, social and structural concern, requiring community engagement and mobilization toward its eradication. Although a universal “test-and-treat” model could potentially eliminate new HIV infections over time, social and structural barriers exist to widespread implementation and sustainability (Kulkarni, Shah, Sarma, & Mahajan, 2013). Neither a biomedical nor behavioral approach to HIV prevention can be sustained in the absence of considering the broader contexts. It is important to note, however, that there are substantial challenges associated with the implementation of structural interventions so as not to minimize the arduous nature in which they are executed (Auerbach et al., 2011). This becomes particularly difficult when opposing entrenched systems and interests that continue to marginalize and oppress certain groups (Miller, Reed, Francisco, & Ellen, 2012), such as African American women…

Below:  A Conceptual Model (with Presumed Pathways [P_x]) for Understanding Geobehavioral Vulnerability to HIV among African Americans

Full article at:   http://goo.gl/hIrFc9

By:  Bridgette M. Brawner, PhD, APRN, Assistant Professor of Nursing

Bridgette M. Brawner, Center for Health Equity Research, Center for Global Women's Health, University of Pennsylvania School of Nursing, 418 Curie Blvd., 4th Floor, Room 419, Philadelphia, PA 19104-4217, 215-898-0715 (office), 215-746-3374 (fax),

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Estimating the Prevalence and Predictors of Incorrect Condom Use among Sexually Active Adults in Kenya: Results From a Nationally Representative Survey

BACKGROUND:

Condom use continues to be an important primary prevention tool to reduce the acquisition and transmission of HIV and other sexually transmitted infections. However, incorrect use of condoms can reduce their effectiveness.

METHODS:

Using data from a 2012 nationally representative cross-sectional household survey conducted in Kenya, we analyzed a subpopulation ofsexually active adults and estimated the percent that used condoms incorrectly during sex, and the type of condom errors. We used multivariable logistic regression to determine variables to be independently associated with incorrect condom use.

RESULTS:

Among 13,720 adolescents and adults, 8014 were sexually active in the previous 3 months (60.3%). Among those who used a condom with a sex partner, 20% experienced at least one instance of incorrect condom use in the previous 3 months. Of incorrect condom users, condom breakage or leakage was the most common error. Factors found to be associated with incorrect condom use were multiple sexual partnerships in the past 12 months and reporting symptoms of a sexually transmitted infection.

CONCLUSIONS:

Incorrect condom use is frequent among sexually active Kenyans and this may translate into substantial HIV transmission. Further understanding of the dynamics of condom use and misuse, in the broader context of other prevention strategies, will aid program planners in the delivery of appropriate interventions aimed at limiting such errors.

Purchase full article at:   http://goo.gl/Aot64B

By:  Grasso MA1, Schwarcz S, Galbraith JS, Musyoki H, Kambona C, Kellogg TA; KAIS Study Group.

• 1From the *Global Health Sciences (http://globalhealthsciences.ucsf.edu/), University of California, San Francisco, San Francisco, CA; †Prevention Branch, DGHA, CDC-Kenya, Nairobi,Kenya; ‡National AIDS and STI Control Program, Nairobi, Kenya; and §Kenya Medical Research Institution, Nairobi, Kenya.
• Sex Transm Dis. 2016 Feb;43(2):87-93. doi: 10.1097/OLQ.0000000000000393. 

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Response Inhibition Moderates the Association between Drug Use and Risky Sexual Behavior

Background

HIV infection is problematic among all drug users, not only injection drug users. Drug users are at risk for contracting HIV by engaging in risky sexual behaviors.

Objective

The present study sought to determine whether inhibitory processes moderate the relationship between problematic drug use and HIV-risk behaviors (unprotected sex and multiple sex partners).

Methods

One hundred ninety-six drug offenders enrolled in drug education programs were administered a battery of computer-based assessments. Measures included a cued go/no-go assessment of inhibitory processes, the Drug Abuse Screening Test (DAST) assessment of problematic drug use, and self-report assessment of condom use and multiple sex partners.

Results

Findings revealed that response inhibition assessed by the proportion of false alarms on the cued go/no-go moderated the relationship between problematic drug use and an important measure of HIV risk (condom nonuse) among drug offenders. However, response inhibition did not moderate the relationship between problematic drug use and another measure of HIV risk: multiple sex partners.

Conclusions

Among this sample of drug offenders, we have found a relationship between problematic drug use and condom nonuse, which is exacerbated by poor control of inhibition. These findings have implications for the development of HIV intervention components among high-risk populations.

Below:  Plot of the interactions between cued go/no-go and DAST in the prediction of the likelihood of not using a condom. The cued go/no-go is plotted at the mean (medium response disinhibition), the mean plus 1 SD (high response disinhibition), and the mean minus 1 SD (low response disinhibition).

Full article at:  http://goo.gl/t7OYm5

By:  Liesl A. Nydegger, Susan L. Ames, Alan W. Stacy, and Jerry L. Grenard

Claremont Graduate University, School of Community & Global Health, Claremont, California, USA

Address correspondence to Liesl A. Nydegger, MPH, Claremont Graduate University, School of Community & Global Health, 675 W. Foothill, Blvd., Claremont, CA 91711 USA; Email: ude.ugc@reggedyn.lseil

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Alcohol Use Problems and Sexual Risk among Young Adult African American Mothers

Studies have documented high levels of alcohol use and sexual risk among young mothers. We examined parenting satisfaction and self-efficacy in relation to alcohol use problems and sexual risk among 346 young African American women enrolled in an HIV prevention trial, 41 % (n = 141) of whom were mothers. 

Among mothers, greater parenting satisfaction was associated with a reduced likelihood of problematic alcohol use, having multiple sex partners, and testing positive for Trichomonas vaginalis. Relative to non-parenting women, mothers reported lower condom use. 

Compared to non-parenting women, mothers with the highest parenting satisfaction reported fewer alcohol use problems; mothers with the lowest parenting satisfaction reported lower condom use and were more likely to have multiple partners and test positive for T. vaginalis. 

Parenting self-efficacy was not associated with the outcomes examined. Future research investigating relationships between parenting satisfaction, alcohol use and sexual risk may be useful for improving multiple maternal health outcomes.

Purchase full article at: http://goo.gl/2W8FHb

By: Swartzendruber A1,2, Sales JM3,4, Rose ES3, DiClemente RJ3,4,5.

• 1Department of Behavioral Sciences & Health Education, Rollins School of Public Health, Emory University, 1518 Clifton Rd, NE, Atlanta, GA, 30322, USA. alswart@emory.edu.
• 2Centers for AIDS Research, Emory University, Atlanta, GA, USA. alswart@emory.edu.
• 3Department of Behavioral Sciences & Health Education, Rollins School of Public Health, Emory University, 1518 Clifton Rd, NE, Atlanta, GA, 30322, USA.
• 4Centers for AIDS Research, Emory University, Atlanta, GA, USA.
• 5Division of Infectious Diseases, Epidemiology, and Immunology, Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA.  

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