Gender-Specific Situational Correlates of Syringe Sharing During a Single Injection EpisodeHottes, Travis; Bruneau, Julie; Daniel, Mark
doi: 10.1007/s10461-009-9530-5pmid: 19224359
Factors associated with syringe sharing differ between women and men; however, it is uncertain whether these hold within the setting of a single injection episode. A questionnaire eliciting information about the last injection episode with others present was administered to participants in a cohort of Montréal injection drug users (IDUs). Logistic regression was used to identify correlates of syringe sharing and to test potential gender differences in relation to syringe sharing. Data from 467 participants revealed significant differences between men and women with regard to situational factors; however, the relationships between situational factors and syringe sharing did not vary according to gender. In multivariate models including both genders, syringe sharing was associated with various attributes of other IDUs who were present as well as alcohol use during that specific episode. These results highlight the relevance of situational factors in injection drug use activity, regardless of gender.
HIV Risks and Seroprevalence Among Mexican American Injection Drug Users in CaliforniaMartinez, Alexis; Bluthenthal, Ricky; Flynn, Neil; Anderson, Rachel; Kral, Alex
doi: 10.1007/s10461-009-9614-2pmid: 20020194
Latinos in the United States are an ethnically diverse group disproportionately affected by HIV/AIDS. We describe HIV seroprevalence, HIV risk behaviors and utilization of health services among Mexican American injection drug users (IDUs) in California (n = 286) and compare them to White (n = 830) and African American (n = 314) IDUs. Study participants were recruited from syringe exchange programs (n = 24) in California. HIV seroprevalence among Mexican Americans (0.5%) was dramatically lower than Whites (5%) and African Americans (8%). Mexican Americans reported fewer sex-related risks than Whites and African Americans though injection-related risks remained high. Compared to Whites, Mexican Americans were more likely to participate in drug treatment during a 6 month period (AOR 1.5, 95% CI 1.1, 2.0) but less likely to receive any health care (AOR 0.6, 95% CI 0.5, 0.8). Exploring cultural and structural factors among Mexican American IDUs may offer new insights into how to maintain low rates of HIV seroprevalence and reduce barriers to health care utilization.
Age and HIV Sexual Risk among Women in Methadone TreatmentEngstrom, Malitta; Shibusawa, Tazuko; El-Bassel, Nabila; Gilbert, Louisa
doi: 10.1007/s10461-009-9625-zpmid: 19936912
This study examines the relationship between age and HIV sexual risk behaviors among a random sample of 372 women in methadone treatment in New York City. Logistic regression results indicate that women of all ages are at risk for HIV through inconsistent condom use. Exposure to intimate partner violence (IPV), alcohol use, and HIV-negative status are associated with inconsistent condom use during vaginal sex. Age (35–44), having a main sexual partner with an HIV risk factor, IPV, and alcohol use are associated with using crack or cocaine during sex. Similarly, age (35–44), having a main sexual partner with an HIV risk factor, IPV, and drug use are associated with consuming four or more drinks prior to sex. The findings highlight the importance of age-appropriate HIV prevention and intervention strategies, as well as the need to address intimate partner violence, mental health, polysubstance use, and relational factors associated with HIV sexual risk behaviors among women in methadone treatment.
Spousal Intimate Partner Violence is Associated with HIV and Other STIs Among Married Rwandan WomenDude, Annie
doi: 10.1007/s10461-009-9526-1pmid: 19205864
HIV is a health problem in Rwanda, where the adult HIV prevalence is 3.1% (WHO 2008 in Online database of HIV/AIDS epidemiological data, found at:
http://www.who.int/globalatlas
); the majority of those infected are women (UNAIDS 2008 in
http://data.unaids.org/pub/Report/2008/rwanda_2008_country_progress_report_en.pdf
). Prior studies indicate that intimate partner violence is frequently associated with increased HIV risk in women, often because men who abuse their wives also exhibit riskier sexual behaviors (Silverman et al. in JAMA 300:703–710 2008. Population—based data from the 2005 Rwanda Demographic and Health Survey indicate that women with few, if any, other sexual risk factors who have experienced sexual, physical, or emotional abuse within their marriages are 1.61–3.46 times as likely to test positive for HIV, and 2.14–4.11 times more likely to report another STI. These findings confirm prior clinical studies that indicate that intimate partner violence is a correlate of HIV/STIs in Rwanda. Further research is needed to determine whether Rwandan men that abuse their wives have higher baseline rates of HIV/STI infection.
Depression Among HIV-Positive Individuals in Botswana: A Behavioral SurveillanceLawler, Kathy; Mosepele, Mosepele; Seloilwe, Esther; Ratcliffe, Sarah; Steele, Katherine; Nthobatsang, Rudo; Steenhoff, Andrew
doi: 10.1007/s10461-009-9622-2pmid: 19821023
This study examined incidence of depression in HIV-positive individuals in Botswana. One hundred and twenty HIV-positive individuals were administered a measure of daily activities and two measures of depression. Twenty four to 38% were diagnosed with depression, suicidal ideation ranged from 9 to 12%, with a positive correlation between scores on the two depression measures. Depression was associated with greater impairment in activities of daily living, especially the ability to take medication. These instruments can diagnose depression in persons living with HIV in developing countries, which will help to target those at risk for poor adherence, and will enable better allocation of limited resources.
Alcohol Consumption is Associated with Poor Health in HIV Clinic Patient Population: A Behavioral Surveillance StudyShacham, Enbal; Agbebi, Abayomi; Stamm, Kate; Overton, E.
doi: 10.1007/s10461-009-9652-9pmid: 20013042
Previous research reports that populations with HIV consume higher rates of alcohol than general population. This cross-sectional study (n = 391) was conducted to measure alcohol consumption, factors associated with consumption, and the relationship between alcohol and HIV viral loads among individuals receiving HIV care. Increased alcohol consumption was associated with being male, lower education attainment, and lacking a current HAART prescription. Additionally, among those currently on HAART, unsuppressed viremia was associated with higher levels of alcohol consumption. These findings suggest that there may be a relatively low level of alcohol consumption that is detrimental to virologic suppression among populations with HIV.