AIDS Risk Reduction Model Research Articles

Exploring the willingness toward HIV immediate test and treat among MSM in Nairobi and its environs: a cross-sectional study.

In the test and treat initiative, high-risk populations are screened for human immunodeficiency virus (HIV) infection and start early treatment if diagnosed positive. This study explores factors associated with willingness to initiate testing and immediate treatment among men who have sex with men (MSM) in Nairobi and its environs. The study was informed by a conceptual framework combining the AIDS Risk Reduction Model (ARRM) and the Modified Social Ecological Model. This cross-sectional exploratory study targeted MSM (aged 18-60 years) reporting active engagement in anal or oral sex with men in Nairobi and its surrounding areas. Purposive sampling was used to identify data collection sites, and then snowballing was employed to reach the respondents. Data analysis was performed using SPSS version 23, and binary logistics regression was used for inferential analysis. Between July 2018 and June 2019, 391 MSM were recruited to fill out a self-administered questionnaire, out of which 345 complete questionnaires were analyzed. Never been tested for HIV, private/NGO as the facility of the last HIV test, and had unprotected anal sex were listed as the reasons for taking the most recent test, and the results of the most recent HIV test and seeking a post self-test confirmation were associated with a higher likelihood of accepting the immediate HIV test and treat initiative. Additionally, a preference for a health provider as the first source of support, belief in the efficacy of ARVs, and disclosure about being on ART were the other reasons. Additionally, being aged 25+ years, having more than 60 USD monthly income, and having inconsistent condom use during sex were associated with a higher likelihood of accepting the immediate HIV test and treat initiative. Barriers to the immediate test and treat strategy included stigma from healthcare providers and concerns about disruptions in lifestyle through antiretroviral therapy (ART) use. Interventions aimed at increasing the HIV test and treat initiative in Kenya may need to take into account the demographic and social characteristics of MSM, including age, lack of habitual HIV testing, and lifestyle changes before and upon enrollment in ART. Projects should also consider working closely with healthcare facilities to strengthen treatment preparation, especially for asymptomatic MSM and those who may not be immediately willing to choose the test and treat strategy.

Risk reduction model: A current approach to disease transmission prevention to clinical nurses in hospitals

Background & Aim: Nurses worldwide face serious challenges in dealing with infectious diseases. A transmission prevention model is expected to be a strategy to overcome these challenges. To date, most of the available models are in the form of disease prevention models primarily implemented to detect infections. In contrast, only a few models are implemented to improve disease transmission prevention behavior, especially in nurses. This study aims to find a model of infection transmission prevention adopted from the aids risk reduction model.
 Methods & Materials: This study was an analytic observational study and employed a cross-sectional approach. This study was conducted in two hospitals in Makassar City and involved 123 respondents. The data were analyzed using multiple linear regression tests.
 Results: This study finds that there is a correlation between organizational factors and nurses' commitment (b=.268) (p=.003); there is a correlation between self-justification and nurses’ self-labeling as at-risk individuals of contracting the disease (b=-.180 )(p=.049); there is a correlation between labeling and actions to reduce the risk of disease transmission (Enactment) (b=.255)(p=.001); there is a correlation between nurses' commitment and enactment (b=.651)(p=.001).
 Conclusion: The risk reduction model could represent the nurses' disease transmission prevention behavior.

Adherence to Antiretroviral Therapy (Art) among Pregnant Women Living with HIV/AIDS in Okigwe Imo State, Nigeria

The antiretroviral medication (ART) compliance of expectant HIV/AIDS patients in Nigeria's Okigwe Imo state was investigated in this study. In particular, the study established the prevalence of HIV among expectant mothers in Okigwe Imo State, Nigeria, identified the behavioral and demographic factors associated with ART adherence, and looked at the obstacles to ART use among expectant mothers in Okigwe Imo State, Nigeria. The study adopted the AIDS risk reduction model by Catania and Coates, (1990), the pathway of survival model theory by Mosley and Chen (1984) and the health belief model by Rosenstock et al (1950). From the responses obtained and analysed, the findings revealed that the extent of the prevalence of HIV among pregnant women in Okigwe Imo State, Nigeria is low. Also, the findings revealed that there is a significant relationship between demography and ART adherence among pregnant women in Okigwe Imo State, Nigeria. The findings further revealed that there is a significant relationship between behaviour and ART adherence among pregnant women in Okigwe Imo State, Nigeria. The study therefore recommends that PMTCT services should be accessible to every pregnant woman attending antenatal care, either onsite or through a referral to a nearby clinic, to improve coverage. When it comes to locating PMTCT facilities, using a geographic information system can help eliminate inequity and enhance accessibility within states.

Analyzing the Effect of Organizational Factors on Reducing the Disease Transmission Risk in Nurses using an AIDS Risk Reduction Model.

Aims:Nurses are one of the health workers who face a high risk of contracting a disease at their workplace. The officers who are inconsistent in maintaining standard precautions when treating patients render nurses to be exposed to infectious disease.Settings and Design:This was an analytic observational study with a longitudinal design.Materials and Methods:This study was carried out in two Provincial B Type Government Hospitals, namely, Labuang Baji Provincial Regional Hospital and Makassar Haji Regional General Hospital, in Makassar City, with a sample size of 104 respondents. The data were subjected to ANOVA test to determine the effect of organizational factors on reducing the risk of AIDS risk reduction model-based disease transmission.Results:The results of this study indicate that the organizational factors do not affect the labeling of nurses related to the reduction of the risk of disease transmission (b = 0.086, ρ = 0.379). The organizational factors influence nurses commitment related to the reduction of the risk of disease transmission (b = 0.328, ρ = <0.001) and also their enactment related to the reduction of the risk of disease transmission (b = 0.199, ρ = 0.030).Conclusions:The organizational factors related to the reduction of the risk of disease transmission affect the action of nurses to reduce the risk (enactment) through the commitment. These organizational factors also affect the labeling of nurses as individuals who are at a risk of contracting a disease so as to facilitate the adoption of a behavior to reduce the risk of disease transmission in hospital.

Asian Women's Action for Resilience and Empowerment Intervention: Stage I Pilot Study.

This study describes the development and pilot test of Asian Women's Action for Resilience and Empowerment (AWARE), a culturally informed group psychotherapy intervention designed to reduce depressive symptoms, suicidality, substance use, and HIV and sexual risk behaviors among 1.5 and second generation Asian American (AA) women. To participate, AA women had to meet the criteria for posttraumatic stress disorder (PTSD) or have a history of exposure to interpersonal violence (IPV) as determined using the Clinician-Administered PTSD Scale (CAPS) and Traumatic Life Events Questionnaire (TLEQ). This article also presents the preliminary feasibility and acceptability of AWARE from its Stage I pilot study of nine Chinese, Korean, and Vietnamese American women. To foster holistic treatment, AWARE was developed based on original research findings from Stage 0 and integrated theoretical models including fractured identity theory, empowerment theory, cognitive behavioral therapy (CBT), mindfulness-based techniques, and the AIDS Risk Reduction Model (ARRM). The development of AWARE was an iterative process informed by participant feedback, which led to frequent intervention modifications for a future randomized controlled trial (RCT) in Stage II. A qualitative analysis of participant feedback informed the following modifications: further exploration of feelings, improvements in technology delivery, learning and practicing coping skills, more specific cultural tailoring related to sexual health, decreased number of sessions and increased time per session. Findings provide support for the acceptability and feasibility of AWARE as "culturally informed" for AA young women with IPV histories, high-risk behaviors, and mental health issues.

Theory-based interventions for contraception.

The explicit use of theory in research helps expand the knowledge base. Theories and models have been used extensively in HIV-prevention research and in interventions for preventing sexually transmitted infections (STIs). The health behavior field uses many theories or models of change. However, many educational interventions addressing contraception have no explicit theoretical base. To review randomized controlled trials (RCTs) that tested a theoretical approach to inform contraceptive choice and encourage or improve contraceptive use. To 1 November 2016, we searched for trials that tested a theory-based intervention for improving contraceptive use in PubMed, CENTRAL, POPLINE, Web of Science, ClinicalTrials.gov, and ICTRP. For the initial review, we wrote to investigators to find other trials. Included trials tested a theory-based intervention for improving contraceptive use. Interventions addressed the use of one or more methods for contraception. The reports provided evidence that the intervention was based on a specific theory or model. The primary outcomes were pregnancy and contraceptive choice or use. We assessed titles and abstracts identified during the searches. One author extracted and entered the data into Review Manager; a second author verified accuracy. We examined studies for methodological quality.For unadjusted dichotomous outcomes, we calculated the Mantel-Haenszel odds ratio (OR) with 95% confidence interval (CI). Cluster randomized trials used various methods of accounting for the clustering, such as multilevel modeling. Most reports did not provide information to calculate the effective sample size. Therefore, we presented the results as reported by the investigators. We did not conduct meta-analysis due to varied interventions and outcome measures. We included 10 new trials for a total of 25. Five were conducted outside the USA. Fifteen randomly assigned individuals and 10 randomized clusters. This section focuses on nine trials with high or moderate quality evidence and an intervention effect. Five based on social cognitive theory addressed preventing adolescent pregnancy and were one to two years long. The comparison was usual care or education. Adolescent mothers with a home-based curriculum had fewer second births in two years (OR 0.41, 95% CI 0.17 to 1.00). Twelve months after a school-based curriculum, the intervention group was more likely to report using an effective contraceptive method (adjusted OR 1.76 ± standard error (SE) 0.29) and using condoms during last intercourse (adjusted OR 1.68 ± SE 0.25). In alternative schools, after five months the intervention group reported more condom use during last intercourse (reported adjusted OR 2.12, 95% CI 1.24 to 3.56). After a school-based risk-reduction program, at three months the intervention group was less likely to report no condom use at last intercourse (adjusted OR 0.67, 95% CI 0.47 to 0.96). The risk avoidance group (abstinence-focused) was less likely to do so at 15 months (OR 0.61, 95% CI 0.45 to 0.85). At 24 months after a case management and peer-leadership program, the intervention group reported more consistent use of hormonal contraceptives (adjusted relative risk (RR) 1.30, 95% CI 1.06 to 1.58), condoms (RR 1.57, 95% CI 1.28 to 1.94), and dual methods (RR 1.36, 95% CI 1.01 to 1.85).Four of the nine trials used motivational interviewing (MI). In three studies, the comparison group received handouts. The MI group more often reported effective contraception use at nine months (OR 2.04, 95% CI 1.47 to 2.83). In two studies, the MI group was less likely to report using ineffective contraception at three months (OR 0.31, 95% CI 0.12 to 0.77) and four months (OR 0.56, 95% CI 0.31 to 0.98), respectively. In the fourth trial, the MI group was more likely than a group with non-standard counseling to initiate long-acting reversible contraception (LARC) by one month (OR 3.99, 95% CI 1.36 to 11.68) and to report using LARC at three months (OR 3.38, 95% CI 1.06 to 10.71). The overall quality of evidence was moderate. Trials based on social cognitive theory focused on adolescents and provided multiple sessions. Those using motivational interviewing had a wider age range but specific populations. Sites with low resources need effective interventions adapted for their settings and their typical clients. Reports could be clearer about how the theory was used to design and implement the intervention.

Women Living with HIV in Rural Areas. Implementing a Response using the HIV and AIDS Risk Assessment and Reduction Model.

The global fight against HIV is progressing; however, women living in rural areas particularly in sub-Saharan Africa (SSA) continue to face the devastating consequences of HIV and AIDS. Lack of knowledge and geographical barriers to HIV services are compounded by gender norms often limiting the negotiation of safe sexual practices among women living in rural areas. This paper discusses findings from a qualitative study conducted in rural areas of Mozambique examining factors that influenced women to engage in HIV risk-reduction practices. The findings from this study led to the emergence of an HIV and AIDS risk assessment and reduction (HARAR) model, which is described in detail. The model helps in understanding gender-related factors influencing men and women to engage in risk-reduction practices, which can be used as a framework in other settings to design more nuanced and contextual policies and programs.

Exploring HIV-testing intentions in young Asian/Pacific Islander (API) women as it relates to acculturation, theory of gender and power (TGP), and the AIDS risk reduction model (ARRM)

While HIV rates are low for Asian/Pacific Islanders (APIs), they have been increasing, especially for API women in the USA. We conducted a cross-sectional study with 299 young API women (18–24 years old) in the Inland Empire region of Southern California to better understand their intention for HIV testing and their perceptions about HIV/AIDS. Data analyses included descriptive statistics, bivariate exploration for model building and multivariate analyses to determine variables associated with HIV-testing intentions. Results suggest that more lifetime sexual partners, greater perceived gender susceptibility, higher HIV/AIDS knowledge, sexually active, more positive attitudes about HIV testing and higher self-perceptions/experiences related to risk contribute to stronger intentions for HIV testing in young API women. Findings from this study will contribute to the limited literature on HIV/AIDS in API women and provide information that can be used for developing and implementing culturally appropriate programs that encourage HIV prevention and testing in this population.

Psychosocial Outcomes of Sexual Risk Reduction in a Brief Intervention for Urban African American Female Adolescents

The authors describe psychosocial outcomes of a group randomized controlled trial of a friendship-based HIV/sexually transmitted infection (STI) prevention intervention grounded in the AIDS Risk Reduction Model (ARRM). A total of 264 African American adolescent girls were randomized to a single-session Project ÒRÉ HIV/STI prevention intervention or a nutrition/exercise health promotion intervention with their friendship group. At posttest, Project ÒRÉ participants scored higher on knowledge of HIV/STI prevention and protection (p < .01), knowledge of living with HIV/STI (p < .01), perceived HIV risk (p < .05), perceived STI risk (p < .01), and intentions to use condoms for vaginal sex (p < .05). Findings suggest that a brief friendship-based HIV/STI prevention intervention for youth can impact ARRM factors that increase the ability to recognize and label risky sexual behaviors as problematic and promote commitment to changing high-risk behaviors.

Vulnerabilidade às dst/aids entre estudantes da saúde: estudo comparativo entre primeira e última série

This study aimed to identify and compare the aspects of individual vulnerability to STD/AIDS among students enrolled in the first and last years of the Nursing and Medical Undergraduate Programs at State University of Londrina. A convenience sample was selected from 263 enrolled students in 2000, and the 183 students who were sexually active (70,4%) had their data assessed. The AIDS Risk Reduction Model framework was used to design the questionnaire, considering a significance level of 5%. First year students began their sex lives earlier than the seniors and the number of sexual partners varied between one and 15 in their life, and the general mean is 3.07 partners for the freshman and 3.42 for the seniors. Many students showed a low perception of personal risk to get STD/AIDS and, although they discuss it with their colleagues, they continue to expose themselves to partners that had or have other partners in the past and did not use condom. We can conclude that the experiences lived during their graduate years were not enough to improve their responsibility to use condoms in their senior year, probably due to keeping more stable relationships which create a confidence bond between the partners.

HIV/AIDS knowledge, contraceptive knowledge, and condom use among unmarried youth in China

This study aims to describe HIV/AIDS knowledge, contraceptive knowledge, and their relationships to condom use among unmarried youth in China, especially the mediating effect of consciousness. The first nationally representative survey data on sexual and reproductive health of unmarried Chinese youth was used and analysis was carried out according to the AIDS Risk Reduction Model. Among the sexually active respondents, about 30% had not used a condom during their most recent intercourse. Levels of both types of knowledge were low. HIV/AIDS knowledge was not significantly associated with condom use, even through the mediation of HIV/AIDS consciousness. And, communication about contraception between sexual partners played a key role in the disconnection between HIV/AIDS consciousness and condom use. By contrast, contraceptive knowledge and consciousness exhibited a larger effect on condom use. In conclusion, to increase condom use among unmarried youth in China, interventions and policies should provide more information to help youth build a store of systematic HIV/AIDS knowledge and help them realize the personal vulnerability to HIV/AIDS. Contraceptive knowledge and consciousness are also important factors to promote condom use. Besides, more of an effort should be made to improve youth's skill on communication and negotiation about condom use during sex. These conclusions are also useful to other countries with similar situation with China.

Comparison of a theory-based (AIDS Risk Reduction Model) cognitive behavioral intervention versus enhanced counseling for abused ethnic minority adolescent women on infection with sexually transmitted infection: Results of a randomized controlled trial

BackgroundEthnic minority adolescent women with a history of sexual or physical abuse and sexually transmitted infections represent a vulnerable population at risk for HIV. Community-based interventions for behavior modification and subsequent risk reduction have not been effective among these women. ObjectivesTo evaluate the effects of a theory-based (AIDS Risk Reduction Model) cognitive behavioral intervention model versus enhanced counseling for abused ethnic minority adolescent women on infection with sexually transmitted infection at 6 and 12 months follow-up. DesignControlled randomized trial with longitudinal follow-up. SettingsSouthwestern United States, Metropolitan community-based clinic. ParticipantsMexican-and-African American adolescent women aged 14–18 years with a history of abuse or sexually transmitted infection seeking sexual health care. MethodsExtensive preliminary study for intervention development was conducted including individual interviews, focus groups, secondary data analysis, pre-testing and feasibility testing for modification of an evidence-based intervention prior to testing in the randomized controlled trial. Following informed consents for participation in the trial, detailed interviews concerning demographics, abuse history, sexual risk behavior, sexual health and physical exams were obtained. Randomization into either control or intervention groups was conducted. Intervention participants received workshop, support group and individual counseling sessions. Control participants received abuse and enhanced clinical counseling. Follow-up including detailed interview and physical exam was conducted at 6 and 12 months following study entry to assess for infection. Intention to treat analysis was conducted to assess intervention effects using chi-square and multiple regression models. Results409 Mexican-(n=342) and African-(n=67) American adolescent women with abuse and sexually transmitted infection histories were enrolled; 90% intervention group attendance; longitudinal follow-up at 6 (93%) and 12 (94%) months. Intervention (n=199) versus control (n=210) group participants experienced fewer infections at 0–6 (0% versus 6.6%, p=.001), 6–12 (3.6% versus 7.8%, p=.005, CI 95% lower-upper .001–.386) and 0–12 (4.8% versus 13.2%, p=.002, CI 95% lower-upper, .002–.531) month intervals. ConclusionsA cognitive behavioral intervention specifically designed for ethnic minority adolescent women with a history of abuse and sexually transmitted infection was effective for prevention of infection. These results provide evidence for development of evidence-based interventions for sexually transmitted infection/HIV. Implications include translation to community-clinic-based settings for prevention of adverse outcomes regarding sexual health of adolescent women.

Knowledge, attitude and practice of HIV/AIDS: Behavior change among tertiary education students in Lagos, Nigeria

Background : Globally, the spread of HIV/AIDS remains on the rise with young people at increased risk of infection. Sexual behavior change remains the most effective way of preventing further transmission. Aim: To gain the knowledge needed to develop appropriate interventions that will enable young people to adopt safe sexual practices. Materials and Methods: A cross-sectional study was conducted using structured questionnaires among 315 randomly selected students enrolled at a tertiary institution in Lagos State, Nigeria. Results: The mean age of the respondents was 23 years. Although the mean score of the participants' responses to ten HIV/AIDS knowledge questions was 8.3 of 10 points, 73.5% of them did not perceive themselves at risk of being infected. Majority (53.8%) had not changed their dating behaviors as a result of concerns for HIV/AIDS and 70.3% had multiple lifetime sexual partners. Those who perceived themselves at risk of infection are significantly (P = 0.019) more likely to always use condoms. Using the AIDS Risk Reduction Model (ARRM), it was found that the students are in the first stage of behavior change process: recognition of the problem. The low risk perception has prevented movement to the second stage of making commitment to change behavior. Conclusion: The awareness and knowledge of HIV/AIDS is high among tertiary education students in Lagos, Nigeria. However, risk perception is low with high-risk sexual behaviors. The failure to perceive HIV/AIDS as a personal risk has prevented commitment to behavior change. Interventions aimed at influencing risk perception are paramount to curb the spread of this dreaded disease.

Initial commitment to pre-exposure prophylaxis and circumcision for HIV prevention amongst Indian truck drivers.

Studies of HIV prevention interventions such as pre-exposure prophylaxis (PREP) and circumcision in India are limited. The present study sought to investigate Indian truck-drivers initial commitment to PREP and circumcision utilizing the AIDS Risk Reduction Model. Ninety truck-drivers completed an in-depth qualitative interview and provided a blood sample for HIV and HSV-2 testing. Truck-drivers exhibited low levels of initial commitment towards PREP and even lower for circumcision. However, potential leverage points for increasing commitment were realized in fear of infecting family rather than self, self-perceptions of risk, and for PREP focusing on cultural beliefs towards medication and physicians. Cost was a major barrier to both HIV prevention interventions. Despite these barriers, our findings suggest that the ARRM may be useful in identifying several leverage points that may be used by peers, health care providers and public health field workers to enhance initial commitment to novel HIV prevention interventions in India.

Do stigma, blame and stereotyping contribute to unsafe sexual behaviour? A test of claims about the spread of HIV/AIDS arising from social representation theory and the AIDS risk reduction model

In the context of social representation theory and the AIDS risk reduction model, it has been claimed that stigmatizing, blaming and stereotyping attitudes make people feel less at risk of contracting HIV/AIDS, and that this, in turn, results in them taking fewer precautions in their sexual behaviour. Previous research has failed to provide convincing evidence to support these claims. The present study provided a test of the claims that addressed some of the methodological issues identified in the earlier research. A sample of 460 young people from Ghana, ranging in age from 15 to 28 years (mean=18), completed a questionnaire that measured the relevant constructs. The results supported the claims in relation to stigmatizing and intended sexual risk behaviour, but not stigmatizing and actual sexual risk behaviour. Although the latter two were correlated, this was not mediated by reduced perceptions of vulnerability. Claims in relation to blaming and stereotyping were not supported. Contrary to expectation, specific blaming and stereotyping attitudes that constructed HIV/AIDS as a sexual disease were associated with safer intended sexual behaviour, and this relationship was mediated by feeling at greater risk.

A Quasi-Experimental Evaluation of a Community-Based HIV Prevention Intervention for Mexican American Female Adolescents: The Shero's Program

This article describes a quasi-experimental evaluation of a community-based, culturally and ecologically tailored HIV prevention intervention for Mexican American female adolescents grounded in the AIDS risk reduction model. A total of 378 Mexican American female adolescents (mean age = 15.2) participated in either the nine-session SHERO's (a female-gendered version of the word hero) intervention or a single session information-only HIV prevention intervention. Assessment data were collected at pretest, posttest, and 2-month follow up. Significant improvements across all time points were revealed on measures of self-esteem, condom attitudes, beliefs regarding a woman's control of her sexuality, beliefs regarding sexual assault, perceived peer norms, and HIV/AIDS and STI knowledge. At posttest SHERO's participants were more likely to carry condoms and to report abstaining from vaginal sex in the previous 2 months; and at 2-month follow up they reported using condoms more often in the preceding 2 months and planned on using them more frequently in the coming 2 months. Findings support the development of community-based adolescent HIV prevention interventions that address culturally specific ecological factors.

Male Adolescent Sexual Behavior

There is a need to involve sexual partners when addressing sexual behavior of high-risk adolescent women. This study explored men's perceptions of their role in sexual relationships with adolescent women with a history of sexually transmitted infection (STI) and abuse. The AIDS risk reduction model was used to assess sexual risk behaviors of these men for development of cognitive behavioral risk reduction interventions for themselves and partner. Qualitative interviews were conducted with African and Mexican American men (n = 14; ages 18 to 21 years), recruited via adolescent women enrolled in a control-randomized trial of behavioral interventions for reduction of unintended pregnancy, abuse, substance use, and STI. Participants varied in their perceptions of personal susceptibility to STI or HIV, access to informational resources regarding sexual behavior, and level of adult support for safer sexual behavior. These men shared perceptions of inadequate sexual health preparation, including education concerning risk, ultimately contributing to adverse outcomes of sexual behavior.

Does Alcohol Use Among Sexually Active College Students Moderate HIV Risk Behavior?

College students frequently use alcohol and are very sexually active, but do the two behaviors result in greater HIV risk? We employed the AIDS Risk Reduction Model to assess condom use during vaginal intercourse for sexually active college students using and not using alcohol proximal to sex. Students reported multiple lifetime sex partners and used condoms inconsistently during vaginal intercourse. According to the model, condom use was slightly better among sexually active alcohol users than among sexually active nonusers. Similar rates in condom use among both groups may be a reflection of the prevailing attitudes toward condoms, rather than indicative of the effect of alcohol use on preventive behaviors.

Low perceived benefits and self-efficacy are associated with hepatitis C virus (HCV) infection-related risk among injection drug users

Hepatitis C prevention counselling and education are intended to increase knowledge of disease, clarify perceptions about vulnerability to infection, and increase personal capacity for undertaking safer behaviours. This study examined the association of drug equipment sharing with psychosocial constructs of the AIDS Risk Reduction Model, specifically, knowledge and perceptions related to hepatitis C virus (HCV) among injection drug users (IDUs). Active IDUs were recruited between April 2004 and January 2005 from syringe exchange and methadone maintenance treatment programs in Montreal, Canada. A structured, interviewer-administered questionnaire elicited information on drug preparation and injection practices, self-reported hepatitis C testing and infection status, and AIDS Risk Reduction Model constructs. Separate logistic regression models were developed to examine variables in relation to: (1) the sharing of syringes, and (2) the sharing of drug preparation equipment (drug containers, filters, and water). Among the 321 participants, the mean age was 33 years, 70% were male, 80% were single, and 91% self-identified as Caucasian. In the multivariable analyses, psychosocial factors linked to syringe sharing were lower perceived benefits of safer injecting and greater difficulty to inject safely. As with syringe sharing, the sharing of drug preparation equipment was associated with lower perceived benefits of safer injecting but also with low self-efficacy to convince others to inject more safely. Interventions should aim to heighten awareness of the benefits of risk reduction and provide IDUs with the skills necessary to negotiate safer injecting with their peers.

Psychosocial and behavioral factors associated to STD/AIDS risk among health students

This study aimed to identify and compare psychosocial and behavioral factors associated to STD/AIDS risk among students enrolled in the first and last years of the Nursing and Medical Undergraduate Programs at State University of Londrina. A convenience sample was selected from 263 enrolled students, and the 183 students who were sexually active (70.4%) had their data assessed. The Aids Risk Reduction Model framework was used to design the questionnaire in which a 5% statistical significance level was considered. Some risk factors were identified such as the perception of invulnerability, multiple sexual partners, consumption of alcoholic beverages before intercourse, and the discontinuous use or no use of condom. The risk factors are common both to the freshman and senior students, with no significant differences related to the passage of time or to the students' higher educational level. Senior students tend to be monogamous which makes them feel safer and decrease the use of condom with their sexual partners.