Avoid HIV Infection Research Articles

HIV/AIDS and sexuality: concerns of youths in rural Zimbabwe

Concerns regarding HIV and AIDS were elicited from 546 school youths (51% female, age range 9–25 years) in a Zimbabwean rural district, through a self-generated question-writing process. Concerns emerged around how to avoid HIV infection at a time when they were undergoing secondary sexual development, had growing feelings of love, and were even engaging in sexual activity, while they had limited access to preventive methods due to denial by the adult world. Fears were expressed in regard to how to tell one's HIV status, even just after sex. HIV and AIDS were visualised in terms of suffering, loneliness, quarantine and death. The youths stressed they would have difficulties communicating with other people should they suspect or find they were infected with HIV, as this would imply they had been sexually active. They seemed to have knowledge about HIV and AIDS which either was incomplete or they could not apply, given a context of silence and denial about their sexuality. Some of their knowledge was coloured with misconceptions, suggesting contradictory information from multiple sources. After more than two decades of the epidemic in Zimbabwe, the scenario portrayed raises questions about HIV/AIDS interventions targeting young people. The question posed is why is the situation of these youths in this state when several stakeholders are actively participating in debates and interventions for the sake of their wellbeing? HIV/AIDS campaigns and interventions may need to consider young people's complex social contexts, the factors generating and sustaining their situation, and what role diverse actors and social-change processes play in this.

T11-O-01 Sexual practices and attitude of men towards prevention of HIV-AIDS and promotion of safer sex in Nigeria

The study investigated the sexual practices and attitudes of men towards the prevention of HIV/AIDS in Nigeria. A population- based survey was conducted using a total number of 1,400 Nigerian men aged 15-24years. These men were randomly selected from the general population. The researcher gave an adopted anonymous self-administered questionnaire to respondents. The questionnaire had a reliability coefficient of 0.80. Frequency counts and percentages were used to describe the data while Pearson Product Moment Correlation was used to test all hypotheses, which were tested at 0.05 level of significance.The study reveal that majority of practice risky behaviors which could promote HIV transmission, that most men would neither abstain from sex or insist on a condom to have sex in order to avoid HIV infection. Other findings show that men have discriminatory attitude towards people living with HIV, many felt they would be embarrassed to get an HIV antibody test. A correlation exists between negative attitude and the risky behaviour of men. Based on these findings, it was recommended that the role of men in the transmission of HIV virus needs to be understood a given relative attention in researchers and that role of men in HIV transmission should not be overlooked if HIV prevention is to succeed in Nigeria.

Responses to VCT for HIV among young people in Kampala, Uganda

Attitudes to voluntary counselling and testing (VCT) for HIV among young men and women in a slum area of Kampala, Uganda, were studied through 22 individual semi-structured interviews and 5 focus group discussions. Attitudes to VCT ranged from having no problem with the procedure to being very reluctant. Despite fear of stigma, the participants perceived 'positive living' after HIV testing as realistic. VCT was regarded as an important step to avoid HIV infection, but informants expressed the need for the service to be more accessible in terms of cost, time and quality of pre- and post-test counselling. We argue that counselling without HIV testing should be available for those who are reluctant to test. Poverty and gender power imbalances appeared to limit youths' possibility of making rational decisions about sexual behaviour and accessing VCT. The importance of considering the context in which such issues are being negotiated and decided is highlighted.

Use of commercial sex workers among Hispanic migrants in North Carolina: implications for the spread of HIV.

Rates of HIV and AIDS have risen among U.S. Hispanics and in migrant-sending regions of Mexico and Central America, pointing to a link between migration and HIV. However, little is known about male migrants' sexual risk behaviors, such as the use of commercial sex workers. The prevalence and frequency of commercial sex worker use was examined among 442 randomly selected Hispanic migrants in Durham, North Carolina. Logistic and Poisson regression techniques were used to model predictors of commercial sex worker use, and descriptive data on condom use with commercial sex workers were examined. Twenty-eight percent of respondents reported using the services of a commercial sex worker during the previous year; rates reached 46% among single men and 40% among married men living apart from their wives. Men with spouses in Durham were less likely than other men to use commercial sex workers (odds ratio, 0.1). Among men who used commercial sex workers, the frequency of visits declined with greater education (incidence rate ratio, 0.9) and increased with hourly wage (1.1). Frequency and use declined with years of residence, although the results were of borderline significance. Reported rates of condom use with commercial sex workers were high, but were likely to fall if familiarity with a commercial sex worker increased. Commercial sex workers represent an important potential source of HIV infection. Educational and behavioral interventions that take into account social context and target the most vulnerable migrants are needed to help migrants and their partners avoid HIV infection.

Poverty and HIV/AIDS in South Africa: an empirical contribution

This study sets out to establish and explain the empirical link between HIV/AIDS and poverty using data collected by the 1998 South African Demographic and Health Survey (SADHS). Analysis is restricted to women of reproductive age (15 – 49 years). The results indicate an increased risk of HIV infection among the poor, due to poverty-related characteristics of low education and low knowledge of the means of avoiding HIV infection, as opposed to the non-poor. Moreover, the poor and the less educated were found to be more likely not to use condoms than the non-poor. The results do not, however, provide the reasons for these relations and as such further research is required. One possible explanation was financial dependence on their partners, as it was found that women who received money from their partners, as well as those who came from households where hunger was a common phenomenon, were more likely not to use condoms because their partners disliked condoms, than those who did not receive money from their partners. The results also hinted at the intricacy of the poverty-HIV/AIDS relationship, so that it was not only low socio-economic status that increased susceptibility to HIV infection but also high socio-economic status.

HIV vaccine efficacy trial participation: men who have sex with men's experiences of risk reduction counselling and perceptions of risk behaviour change

Qualitative interviews were conducted with 35 men who have sex with men, enrolled in the world's first phase III HIV vaccine efficacy trial at five US sites, regarding their risk reduction counselling experiences and their perceptions of its impact on risk behaviour. Respondents ranged in age from 20 to 58 years and were predominately white (71.4%) in racial/ethnic origin. Systematic qualitative analysis revealed that a positive counselling experience meant having good rapport with clinic staff. Differences in attitudes toward counselling were related to either a personal approach of balancing an enjoyable sex life with safe sex behaviours (balancing risks) or accepting the consequences of risky sexual behaviour rather than making changes (risk homeostasis). Respondents seeking to balance risks indicated that they saw themselves engaging in safer sexual behaviour almost twice as often as in riskier behaviours. They perceived counselling and behavioural risk assessments to help increase their awareness of personal risk-taking behaviours. Conversely, those with a risk homeostasis approach reported that they had established sexual boundaries prior to trial participation that had thus far proven to be effective in avoiding HIV infection, and that they were comfortable with the level of risk taken. Thus, risk reduction counselling had little to no influence on their sexual practices. Some of these men also indicated that while they had not found the risk reduction information imparted to them by clinic staff to be novel, counselling was beneficial in reinforcing their HIV/AIDS and safe sex knowledge base.

Correlates of Hiv-Risk Behaviors among Prison Inmates: Implications for Tailored Aids Prevention Programming

AIDS was first identified among prison inmates in 1983. In 2001, the rate of confirmed cases of HIV infection was four times greater among federal and state prison inmates than in the general population. This study used extensive interviews to assess Illinois prison inmates’ sexual and drug-use practices, their knowledge about HIV riskreduction techniques, and their beliefs regarding their own HIV-risk status and their ability to avoid HIV infection. Respondents were classified into risk groups based on their sexual and drug-use behaviors prior to incarceration. Compared to those in the low-risk group, respondents in the high-risk group were more likely to have used or sold drugs and to have lower self-efficacy and perceived-risk scores. Respondents in the moderate-risk group were more likely than those in the low-risk group to be young, to have sold drugs, and to have lower self-efficacy scores. The implications of these differences for HIV-prevention programs tailored by risk profile are discussed.

Use of Commercial Sex Workers Among Hispanic Migrants In North Carolina: Implications for the Spread of HIV

Rates of HIV and AIDS have risen among U.S. Hispanics and in migrant-sending regions of Mexico and Central America, pointing to a link between migration and HIV. However, little is known about male migrants' sexual risk behaviors, such as the use of commercial sex workers.The prevalence and frequency of commercial sex worker use was examined among 442 randomly selected Hispanic migrants in Durham, North Carolina. Logistic and Poisson regression techniques were used to model predictors of commercial sex worker use, and descriptive data on condom use with commercial sex workers were examined.Twenty-eight percent of respondents reported using the services of a commercial sex worker during the previous year; rates reached 46% among single men and 40% among married men living apart from their wives. Men with spouses in Durham were less likely than other men to use commercial sex workers (odds ratio, 0.1). Among men who used commercial sex workers, the frequency of visits declined with greater education (incidence rate ratio, 0.9) and increased with hourly wage (1.1). Frequency and use declined with years of residence, although the results were of borderline significance. Reported rates of condom use with commercial sex workers were high, but were likely to fall if familiarity with a commercial sex worker increased.Commercial sex workers represent an important potential source of HIV infection. Educational and behavioral interventions that take into account social context and target the most vulnerable migrants are needed to help migrants and their partners avoid HIV infection.

Profilaxis postexposición al virus de la inmunodeficiencia humana no ocupacional. Conocimientos y prácticas de profesionales y grupos con conductas de riesgo

Although occupational post-exposure HIV prophylaxis is widely admitted and used, the non-occupational post-exposure prophylaxis (NONOPEP) is controversial. Prevention of mother-to-child HIV transmission, experimental studies in animal models and retrospective studies in health workers, along with biological plausibility, would justify the use of NONOPEP in certain circumstances. Our objectives were: 1) To review the existence of recommendations; 2) To describe the attitudes, knowledge and practices of the professionals involved in the attention of non-occupational exposures to HIV; 3) To describe the attitudes and knowledge on such a prophylaxis by people with risk behaviours (homosexual men and intravenous drug users (IDU)); and 4) To describe the NONOPEP-related responses of telephone services of public attention on AIDS. Descriptive study by means of a survey of each defined target population between September 1999 and July 2000, using self-administered questionnaires and personal interviews. Structured and simulated interviews were used to survey the telephone services. To date, no official recommendations exist. 84% (97/116) of consulted doctors have taken care of some of non-occupational accidental exposure to HIV over the last six months. 77% (75/97) have prescribed NONOPEP, and 76% of doctors prescribing NONOPEP (57/75) have used the 1998 CDC recommendations for occupational exposures. Most frequent observed cases were related to needle sticks in the street and preservative breakage. The assessment of certain risk factors and therapeutic performance in cases of intermediate risk showed discrepancies among doctors. 41% (103/252) among homosexuals and 2% (3/160) among IDU on treatment know the NONOPEP. 15% (15/98) and 98% (70/118) respectively would take less prevention to avoid HIV infection if they took the NONOPEP. It was mentioned the possibility of NONOPEP in 20% (12/59) of calls to the information telephone services on AIDS. HIV risk accidents susceptible of NONOPEP are relatively frequent. Without forgetting the greater importance of primary prevention, it is advisable to reach and agreement on homogeneous recommendations. It is also advisable to draw up a surveillance system to evaluate the application and eventually the effectiveness of these recommendations.

Third-Person Perception and Optimistic Bias Among Urban Minority At-Risk Youth

Recent third-person perception articles suggest that optimistic bias is the mechanism underlying the perceptual bias but fail to empirically test the assumption. A small inverse relationship between third-person perception and optimistic bias was found among the youth surveyed: 51% of the students exhibited third-person perceptions, believing they were less influenced by televised safer-sex messages than were their peers. These students were less optimistic about their chances of becoming HIV infected than their peers; 34% exhibited first-person perceptions, believing they were more influenced by the messages than were peers, and were more optimistic than were their peers concerning HIV infection. Most students (89%) exhibited some degree of optimistic bias regarding their chances of avoiding HIV infection in the future. The findings effectively link the two literatures within a sample neglected by previous studies: urban, minority, at-risk youth. The study advances knowledge of third-person perceptions by suggesting underlying social-psychological mechanisms.

Injection drug users as social actors: A stigmatized community's participation in the syringe exchange programmes of New York City

In 1992, New York State Department of Health regulations provided for fully legal syringe exchange programmes in the state. The policies and procedures mandated that: 'Each program must seek to recruit for inclusion on its advisory board program participants Programs are also urged to establish other advisory bodies, such as Users' Advisory Boards made up of program participants, to provide input and guidance on program policies and operations.' The inclusion of drug users as official advisors to the legal programmes was seen as a method for incorporating the views of the consumers of the service in operational decisions. The 1992 regulations implied a new public image for users of illicit psychoactive drugs: active drug users were seen to be capable not only of self-protective actions (such as avoiding HIV infection), but alsoof serving as competent collaborators in programmes to preserve the public health. This development has important implications with regard to the evolution of official drug policy, since it will be difficult in future to treat IDUs simply as the passive objects of state intervention. Whether as individuals or representatives of a wider population of illicit drug users, they have acquired a legitimacy and sense of personal worth which would have been unthinkable in previous periods.

"Why I am not infected with HIV": implications for long-term HIV risk reduction and HIV vaccine trials.

To describe beliefs about remaining HIV-seronegative in injecting drug users in two high-seroprevalence cities, and to consider implications of these beliefs for ongoing risk reduction efforts and for HIV vaccine efficacy trials. Cross-sectional survey with open- and closed-ended questions. 58 HIV-seronegative injecting drug users participating in HIV vaccine preparation cohort studies in New York City, New York, U.S.A., and Bangkok, Thailand. Large majorities of subjects in Bangkok (90%) and in New York (89%) believed their "own efforts" to practice safer injection methods and safer sex were very important in avoiding HIV infection. More Bangkok subjects (30%) believed that they would "probably" become infected with HIV in the future than New York subjects (4%). Three percent of Bangkok subjects and 70% of New York subjects believed "having an immune system strong enough to avoid becoming infected with HIV despite exposure to the virus" was very important in avoiding HIV infection. This belief in New York subjects was associated with having previously engaged in high-risk behaviors (i.e., sharing injection equipment, unprotected sex, or both) with partners known to be HIV-seropositive. Risk reduction programming for high-HIV-seroprevalence populations and within HIV vaccine trials should address not only specific HIV risk behaviors, but also the complex belief systems about avoiding HIV infection that develop within such groups. The person's "own efforts/self-efficacy" appears to be central in the psychology of risk reduction. Members of some high-risk populations may overestimate greatly the frequency of any possible natural immunity to becoming infected with HIV. Prevention programs for these populations will need to address explicitly the probabilistic nature of HIV transmission.

An empirical examination of the implications of assortative matching on the incidence of HIV

Using data from The San Francisco Home Health Study (SFHHS), this paper analyzes the degree to which the incentives to avoid HIV infection result in infection-dependent (assortative) matching patterns based on HIV status. The incidence implications induced by such matching are compared to infection independent matching, an implicit assumption in canonical models within epidemiology. We estimate that an HIV-positive individual is more than twice as likely as an HIV-negative individual to have an HIV-positive partner, and that this results in a decrease in HIV incidence of about one-third compared to the predictions implied by standard epidemiological models.

Knowledge, attitudes and perception of AIDS in rural Senegal: relationship to sexual behaviour and behaviour change.

To describe the determinants of 'at risk' sexual behaviour and perception of AIDS-related prevention messages in rural Africa. A rural area in Southern Senegal. Cross-sectional study using a standardized questionnaire administered by local interviewers to 240 men and 242 women aged 15-59 years, randomly selected among the general population. Twenty-eight per cent of the sexually active men and 27% of the sexually active women declared at least one casual sexual partner in the 12 months preceding the interview. Among these, 27% of men and 30% of women declared having used a condom in most acts of casual intercourse. Seasonal migrants and divorced or widowed women were more likely to declare casual sex. Causal sex was motivated by material needs for 66% of the women who experienced it, and those of the women who reported casual sexual intercourse were less likely to feel at risk of AIDS [odds ratio (OR), 3.9; P = 0.01] and were more optimistic about their future (OR, 3.6; P = 0.03). For men, the motivations explaining a change in sexual behaviour in order to avoid HIV infection included the perception of AIDS as a health problem (OR, 11; P = 0.004), the perception of the disease as serious (OR, 5.4; P = 0.001) and the feeling of personal risk of becoming HIV-infected (OR, 3.2; P = 0.02). Perceived skill in changing one's behaviour was strongly associated with declaration of past behaviour change for both men and women (men: OR, 3.4; P = 0.02; women: OR, 6.3; P = 0.0001). Men and women exhibit two different patterns regarding their behaviour and perception towards AIDS. Material needs appear to be of importance for women, whereas perception of a real threat lead men to adopt protective behaviours. In the very area of this study, widowed and divorced women as well as male seasonal migrants are particularly exposed to HIV infection. They are characterized by a higher risk behaviour, a low rate of condom use and seldom declared any protective measures to avoid HIV infection.

Preservation of Scleral Grafts to Avoid HIV Infection

Preservation of Scleral Grafts to Avoid HIV Infection

Risk Behaviors and Perceptions of AIDS among Street Injection Drug Users

Standardized survey interviews (n = 325) and guided in-depth interviews (n = 22) were conducted with injection drug users (IDUs) in Long Beach, California, to document drug usage and injection patterns, sexual practices, perceived risk of HIV infection, sources of health information, and knowledge and attitudes about AIDS. Most IDUs reported sharing needles (87.9%), and a large minority reported regular sterilization of needles/syringes (40.3%). Lower rates of needle sharing were reported among cocaine users than among heroin and speedball users. HIV seroprevalence was 5.7 percent (11/194). Sexually active female (60.7%) and male (20.5%) IDUs reported exchanging sex for money or drugs. Overall, 48.3 percent of IDUs reported having made changes in their injection practices and one-third reported modifying their sexual behavior in order to avoid HIV infection. Differences in drug use, sexual practices, and drug treatment history were found with regard to gender, ethnicity, age, and type of drug injected. Implications of findings for the development of AIDS risk-reduction programs are presented.