HIV-related Risk Factors Research Articles

Angina pectoris in patients with HIV/AIDS: Prevalence and risk factors

IntroductionThe incidence of ischemic heart disease is higher in patients with HIV/AIDS. However, the frequency of angina pectoris in these patients is still not known. Literature about this subject is still scarce. ObjectiveTo evaluate the prevalence of angina pectoris and risk factors for coronary disease and to examine the association between traditional risk factors and HIV-related risk factors and angina pectoris. MethodAn epidemiological cross-sectional study, analyzed as case-control study, involving 584 patients with HIV/AIDS. Angina pectoris was identified by Rose questionnaire, classified as definite or possible. Information regarding risk factors was obtained through a questionnaire, biochemical laboratory tests, medical records and anthropometric measures taken during consultations at AIDS treatment clinics in Pernambuco, Brazil, from June 2007 to February 2008. To adjust the effect of each factor in relation to others, multiple logistic regression was used. ResultsThere was a preponderance of men (63.2%); mean ages were 39.8 years for men, 36.8 years for women. The prevalence of definite and possible angina were 11% and 9.4%, respectively, totaling 20.4%, with independent associations between angina and smoking (OR = 2.88; 95% CI: 1.69-4.90), obesity (OR = 1.62; 95% CI: 0.97-2.70), family history of heart attack (OR = 1.70; 95% CI: 1.00-2.88), low schooling (OR = 2.11; 95% CI: 1.24-3.59), and low monthly income (OR = 2.93; 95% CI: 1.18-7.22), even after adjustment for age. ConclusionThis study suggests that angina pectoris is underdiagnosed, even in patients with medical monitoring, revealing lost opportunities in identification and prevention of cardiovascular morbidity.

Risk Factors for ESRD in HIV-Infected Individuals: Traditional and HIV-Related Factors

Despite improvements in survival with human immunodeficiency virus (HIV) infection, kidney disease remains an important complication. Few studies have evaluated risk factors associated with the development of end-stage renal disease (ESRD) in HIV-infected individuals. We sought to identify traditional and HIV-related risk factors for ESRD in HIV-infected individuals and compare ESRD risk by estimated glomerular filtration rate (eGFR) and proteinuria levels. Retrospective cohort study. 22,156 HIV-infected veterans without pre-existing ESRD receiving health care in the Veterans' Affairs medical system between 1996 and 2004. Hypertension, diabetes, cardiovascular disease, hypoalbuminemia (serum albumin <3.5 mg/dL), CD4 lymphocyte count, HIV viral load, hepatitis C virus coinfection, proteinuria, and eGFR were identified using the Veterans' Affairs electronic record system. ESRD was ascertained by the US Renal Data System. 366 cases of ESRD occurred, corresponding to 3 cases/1,000 person-years. Hypertension (HR, 1.9; 95% CI, 1.5-2.4), diabetes (HR, 1.7; 95% CI, 1.3-2.2), and cardiovascular disease (HR, 2.2; 95% CI, 1.7-2.7) were associated independently with ESRD risk in multivariate-adjusted models, as were CD4 lymphocyte count <200 cells/μL (HR, 1.5; 95% CI, 1.2-2.0), HIV viral load ≥30,000 copies/mL (HR, 2.0; 95% CI, 1.5-2.8), hepatitis C virus coinfection (HR, 1.9; 95% CI, 1.5-2.4), and hypoalbuminemia (HR, 2.1; 95% CI, 1.8-2.5). Compared with persons without chronic kidney disease, defined as eGFR >60 mL/min/1.73 m(2) and no proteinuria, lower eGFR and higher proteinuria categories were associated jointly with exponentially higher ESRD rates, ranging from 6.6 events/1,000 person-years for persons with urine protein excretion of 30-100 mg/dL and eGFR >60 mL/min/1.73 m(2) to 193 events/1,000 person-years for persons with urine protein excretion ≥300 mg/dL and eGFR <30 mL/min/1.73 m(2). Results may not be generalizable to female and nonveteran populations. In HIV-infected persons, ESRD risk appears attributable to a combination of traditional and HIV-related risk factors for kidney disease. Combining eGFR and proteinuria for chronic kidney disease staging is most effective for stratifying the risk of ESRD.

Resiliency and survival skills among newly homeless adolescents: Implications for future interventions

Recent studies on homeless adolescents suggest that the profiles of homeless adolescents are heterogeneous, and that certain clusters of homeless adolescents demonstrated resiliency and positive coping strategies. This study examined the relationship between human immunodeficiency virus (HIV)-related risk factors and resiliency (survival skills) of homeless adolescents over a two-year period. Those who did not engage in unprotected sex reported significantly higher survival skills scores. Similarly, those who were monogamous during the study period reported significantly higher survival skills scores. However, there was a significant decline in survival skills scores after 6 months, regardless of the HIV-related risk factors. Findings from this study point to the urgent need to identify and target resilient adolescents early on to provide interventions to facilitate the transition to stable living situations before their resiliency deteriorates.

An In-Depth Analysis of Medication Errors in Hospitalized Patients with HIV

It is well recognized that medication errors occur and can affect success in treating patients with HIV/AIDS. However, little information is available describing the prevalence, nature, and causes of medication errors. To determine the incidence of combination antiretroviral therapy (ART)- and opportunistic infection (OI)-related medication errors and describe the nature and cause(s) of errors to guide future interventions. A daily antiretroviral utilization report was used to identify adults who were receiving ART and had been admitted to a tertiary care teaching hospital during 2 consecutive months in 2005. Patients' charts, medication profiles, and medication administration records were reviewed for medication errors such as improper dosing, interactions, drug omissions, and missing doses. Once identified, etiology and cause were further investigated through provider interviews. An interdisciplinary team reviewed each case to establish validity of the error, severity, and cause. Sixty-nine combined ART- and OI-related medication errors were identified in 20 of 26 (77%) evaluated patients, with 2.7 medication errors per patient. Fifty-four percent of the errors occurred within the first 24 hours after admission. Inadequate medication reconciliation on admission caused 21 of 37 (57%) admission-related errors. The most prevalent error types included missing doses (20%), underdosing (13%), overdosing (13%), therapy omission (13%), and drug-drug interaction (12%). The primary cause of errors was provider lack of knowledge. Prospective investigation of medication errors provided in-depth insight into the diverse nature of HIV-related medication errors, risk factors, and potential preventive strategies. System changes such as hard stops in the clinical decision support software and improved medication reconciliation training, and changes in cart-fill time could prevent specific types of errors. Further studies are warranted to evaluate the impact of various strategies for preventing medication errors in the HIV population.

Associations of antiretroviral drug use and HIV-specific risk factors with carotid intima–media thickness

Previous research has demonstrated an increase in carotid intima-media thickness (cIMT) in HIV-infected individuals compared to controls. However, the reason for this increased level of subclinical vascular disease is unknown. To identify HIV-related risk factors for increased cIMT. We evaluated the relationship between HIV-related characteristics (including markers of HIV disease severity and use of antiretroviral therapy) and cIMT measurements in the internal/bulb and common carotid regions among 538 HIV-infected participants from the Study of Fat Redistribution and Metabolic Change in HIV Infection (FRAM). We used Bayesian model averaging to estimate the posterior probability of candidate HIV and non-HIV-related risk factors being true predictors of increased cIMT. Variables with a posterior probability of more than 50% were used to develop a selected regression model for each of the anatomic regions. For common cIMT, the Bayesian model selection process identified age, African-American race, and systolic and diastolic blood pressure with probability more than 95%, HDL cholesterol with probability 85% and Hispanic ethnicity with probability 51%. Among the HIV-related factors included in the analysis, only tenofovir use was selected (51% probability). In the selected model, duration of tenofovir use was associated with lower common cIMT (-0.0094 mm/year of use; 95% confidence interval: -0.0177 to -0.0010). For internal cIMT, no HIV-related risk factors were above the 50% posterior probability threshold. We observed an inverse association between duration of tenofovir use and common carotid cIMT. Whether this association is causal or due to confounding by indication needs further investigation.

HIV-related risk factors among male sex workers in different settings in Shenzhen, China

Results Among 394 subjects, the prevalence of HIV infection was 5.1%, with 6.9% among MSWs in parks (PMSW), 11.3% among MSWs in family clubs(FMSW, a kind of home-based brothels holding small group of MSWs 15). Syphilis prevalence was 14.2%, with 25.0% in PMSWs, 17.6% in FMSW and 10.6% in EMSWs. Both HIV and syphilis prevalence were significantly different among different type of MSWs. Independent PMSWs and small grouping FMSWs had a higher proportion of self-identifying as homosexual/gay and fewer female sex partners, elder or higher polarization in age. In addition, a higher proportion of MSWs was found coming from provinces with higher HIV prevalence, and lower coverage by HIV-related education program and relevant services. Discussion Different type of male sex work is associated with HIV infection. MSWs working in family clubs and parks are comparatively with higher risk of being infected, while MSWs working in big entertainment venues showed a lowest HIV prevalence within the past few years in Shenzhen. This situation indicated that current HIV prevention intervention strategy that focus on big venues is quiet effective and should be expanded to cover the MSM population frequenting small venues.

Micronutrient concentrations and subclinical atherosclerosis in adults with HIV

Extremes in micronutrient intakes are common in HIV-infected patients in developed countries and may affect the progression of atherosclerosis in this population. We completed a cross-sectional study examining the association between serum micronutrient concentrations and surrogate markers of atherosclerosis in a cohort of HIV-infected adults. We measured serum selenium, zinc, vitamin A, and vitamin E concentrations as well as carotid intima-media thickness (c-IMT) and coronary artery calcium (CAC) in 298 Nutrition for Healthy Living participants. We assessed cardiovascular disease risk factors, c-IMT, and CAC for each micronutrient tertile by using a chi-square test for binary variables and analysis of variance for continuous variables. We performed multivariate regression of c-IMT and CAC with each micronutrient with adjustment for HIV-related and cardiovascular disease risk factors. In the multivariate analysis, the highest tertile of serum vitamin E concentration was associated with higher common and internal c-IMT and CAC scores (P < 0.05 for c-IMT and CAC). Participants with higher vitamin E concentrations were more likely to have detectable CAC (50% compared with 44% compared with 67% for tertiles 1, 2, and 3, respectively; P = 0.004) and common c-IMT >0.8 mm (5% compared with 4% compared with 17% for tertiles 1, 2, and 3, respectively; P = 0.002). Other than vitamin E, micronutrients had no association with markers of atherosclerosis. Our study showed that elevated serum vitamin E concentrations are associated with abnormal markers of atherosclerosis and may increase the risk of cardiovascular complications in HIV-infected adults.

What Impact Might the Economic Crisis have on HIV Epidemics in Southeast Asia?

To evaluate the potential impact of the current global economic crisis (GEC) on the spread of HIV. To evaluate the impact of the economic downturn we studied two distinct HIV epidemics in Southeast Asia: the generalized epidemic in Cambodia where incidence is declining and the epidemic in Papua New Guinea (PNG) which is in an expansion phase. Major HIV-related risk factors that may change due to the GEC were identified and a dynamic mathematical transmission model was developed and used to forecast HIV prevalence, diagnoses, and incidence in Cambodia and PNG over the next 3 years. In Cambodia, the total numbers of HIV diagnoses are not expected to be largely affected. However, an estimated increase of up to 10% in incident cases of HIV, due to potential changes in behavior, may not be observed by the surveillance system. In PNG, HIV incidence and diagnoses could be more affected by the GEC, resulting in respective increases of up to 17% and 11% over the next 3 years. Decreases in VCT and education programs are the factors that may be of greatest concern in both settings. A reduction in the rollout of antiretroviral therapy could increase the number of AIDS-related deaths (by up to 7.5% after 3 years). The GEC is likely to have a modest impact on HIV epidemics. However, there are plausible conditions under which the economic downturns can noticeably influence epidemic trends. This study highlights the high importance of maintaining funding for HIV programs.

Young Parents’ Relationship Characteristics, Shared Sexual Behaviors, Perception of Partner Risks, and Dyadic Influences

Rising rates of heterosexually transmitted HIV among youth and young adults, particularly from ethnic minorities, create an urgent need to understand risk factors and perceptions of risk within the context of couple relationships. This study examined reports of young mothers and fathers (predominantly Latino) about background characteristics, relationship quality and length, HIV-related risk factors, and perceptions of partners’ behaviors and personal history. Higher concordance was found for relationship characteristics and partners' personal history (e.g., incarceration) than on shared sexual behaviors. Most males and females stated that they were monogamous; however, those whose partners reported concurrency were unaware of this. Many were unaware of their partners’ HIV testing status. Relationship quality was higher when females accurately perceived their partners' self-reported HIV-related risk behaviors. Length of the relationship did not influence concordance. Findings support the need for HIV prevention programs to promote open discussion about condom use and HIV testing within sexual partnerships.

“There's No Pamphlet for the Kind of Sex I Have”: HIV-Related Risk Factors and Protective Behaviors Among Transgender Men Who Have Sex With Nontransgender Men

Preliminary evidence has suggested that some transgender men who have sex with nontransgender men ("trans MSM") may be at risk for HIV and sexually transmitted infections and that their prevention needs are not being met. Quantitative (n =45) and qualitative (n =15) interviews explored risk behaviors, protective strategies, and perceptions of the impact of transgender identity on sexual decision making among trans MSM. A majority of the participants reported inconsistent condom use during receptive vaginal and anal sex with nontrans male partners; HIV prevalence was 2.2%. Risk factors included barriers to sexual negotiation such as unequal power dynamics, low self-esteem, and need for gender identity affirmation. Protective strategies included meeting and negotiating with potential partners online. Results of this study provide initial evidence that current risk behaviors could lead to rising HIV prevalence rates among trans MSM. Prevention programs must tailor services to include issues unique to trans MSM and their nontrans male partners.

Exploring the Relationship between Spirituality and HIV-Related Risk Factors among Young Black College Students

This exploratory study investigated the relationship between specific dimensions of spirituality and various HIV-related risk factors. A convenience sample of 95 young Black college students participated in the study. Primary measures assessed whether spirituality (i.e., prayer, a positive world view, and belief in the spirit world) was related to HIV self-efficacy and HIV-related risk factors (i.e., attitudes toward safer sex, peer norms endorsing safer sex, perceived susceptibility to HIV, substance use, intention to practice safer sex, and an expectation to practice safer sex). Regression findings indicated that higher levels of prayer were associated with greater HIV self-efficacy and a decreased perception of being at risk for contracting HIV. In addition, a positive world view was associated with greater peer norms endorsing safer sex. Findings indicated a direct relationship between specific components of spirituality and various HIV-related domains. Implications for social work research and practice are discussed in the context of these findings.

Multilevel analysis of HIV related risk behaviors among heroin users in a low prevalence community

BackgroundInjecting drug users (IDU) are at increased risk of human immunodeficiency virus (HIV) infection. Their HIV prevalence however varies from place to place and may not be directly linked with the level of individual risk. This study explores the relative importance of individual and community level characteristics in the practice of HIV-related risk behaviors in IDU in Hong Kong where the HIV prevalence has remained low at below 1%.MethodsMethadone clinics were used as the channel for accessing drug users in Hong Kong. HIV-related risk factors in drug users attending these clinics were retrieved from a questionnaire routinely administered to newly admitted and readmitted clients, and assessed using logistic regression and multilevel analyses.ResultsBetween 1999 and 2005, a total of 41196 person-admissions were recorded by 20 methadone clinics. Male gender, older age and new admissions in bigger clinics located in districts with older median age were more likely to have engaged in HIV related risk behaviors including heroin injection, needle sharing, unprotected sex and having multiple sex partners (p < 0.05).ConclusionMultilevel analysis is a useful adjunct for determining the association between risk behaviors and both individual and community factors in IDUs, which can be demonstrated even in low HIV prevalence settings.

Appendicitis in HIV-infected patients during the era of highly active antiretroviral therapy.

Limited studies have suggested increased incidence rates and unusual clinical presentations of appendicitis among HIV-infected patients during the pre-highly active antiretroviral therapy (HAART) era. Data in the HAART era are sparse, and no study has evaluated potential HIV-related risk factors for the development of appendicitis. We retrospectively studied 449 HIV-infected patients receiving care at a US Naval hospital involving 4750 person-years (PY) of follow-up. We also evaluated the rates of appendicitis among HIV-negative persons at our medical facility. We compared demographics, HIV-specific data, and HAART use in HIV-infected patients with and without appendicitis. Sixteen (3.6%) of 449 patients developed appendicitis after HIV seroconversion. The incidence rate was 337 cases/100 000 PY, more than fourfold higher than among HIV-negative persons. Eighty-eight per cent of cases among HIV-infected patients had an elevated white blood count at presentation, 39% were complicated, and 64% required hospitalization. HIV-infected patients with appendicitis compared with those who did not develop appendicitis were less likely to be receiving HAART (25 vs. 71%, P<0.001), had higher viral loads (3.5 vs. 1.7 log(10) HIV-1 RNA copies/mL, P=0.005), and were younger (median age of 30 vs. 41 years, P<0.002). In the multivariate model, receipt of HAART remained protective [odds ratio (OR) 0.21, P=0.012] for appendicitis, while younger age was positively associated (OR 1.08, P=0.048) with appendicitis. Acute appendicitis occurs at higher incidence rates among HIV-infected patients compared with the general population. Our study demonstrates that the lack of HAART may be a risk factor for appendicitis among HIV-infected patients; further studies are needed.

Vision Function in HIV-Infected Individuals without Retinitis: Report of the Studies of Ocular Complications of AIDS Research Group

To evaluate the prevalence and risk factors for vision loss in patients with clinical or immunologic AIDS without infectious retinitis. A prospective, multicenter cohort study of patients with AIDS. One thousand three hundred and fifty-one patients (2,671 eyes) at 19 clinical trials centers diagnosed with AIDS but without major ocular complications of HIV. Standardized measurements of visual acuity, automated perimetry, and contrast sensitivity were analyzed and correlated with measurements of patients' health and medical data relating to HIV infection. We evaluated correlations between vision function testing and HIV-related risk factors and medical testing. There were significant (P<.05) associations between measures of decreasing vision function and indices of increasing disease severity, including Karnofsky score and hemoglobin. A significant relationship was seen between low-contrast sensitivity and decreasing levels of CD4+ T-cell count. Three percent of eyes had a visual acuity worse than 20/40 Snellen equivalents, which was significantly associated with a history of opportunistic infections and low Karnofsky score. When compared with external groups with normal vision, 39% of eyes had abnormal mean deviation on automated perimetry, 33% had abnormal pattern standard deviation, and 12% of eyes had low contrast sensitivity. This study confirms that visual dysfunction is common in patients with AIDS but without retinitis. The most prevalent visual dysfunction is loss of visual field; nearly 40% of patients have some abnormal visual field. There is an association between general disease severity and less access to care and vision loss. The pathophysiology of this vision loss is unknown but is consistent with retinovascular disease or optic nerve disease.

Understanding Associations Between Serious Mental Illness and HIV Among Patients in the VA Health System

This study compared the recorded prevalence of HIV among veterans with and without serious mental illness. This cross-sectional study examined data from a national sample of veterans who received a diagnosis of serious mental illness (schizophrenia, bipolar disorder, and other, nonorganic psychoses) in fiscal year 2002 (FY2002) (N=191,625) and from a national random sample of veterans in FY2002 who did not receive serious mental illness diagnoses (N=67,965). Logistic regression was used to evaluate the recorded prevalence and predictors of HIV. HIV diagnoses were recorded for 1.0% of patients with serious mental illness and .5% of patients without serious mental illness. Multivariate analyses indicated that individuals with bipolar disorder were no more likely than those without serious mental illness to have a recorded HIV diagnosis (OR=1.08, CI=.93-1.24), whereas those with other psychoses were more likely to have one (OR=1.18, CI=1.01-1.38). An interaction was observed between schizophrenia and substance use disorder. Compared with patients who had neither schizophrenia nor a substance use disorder, those with schizophrenia without a substance use disorder were less likely to have a recorded HIV diagnosis (OR=.49, CI=.42-.58), whereas those with a substance use disorder were more likely to have a recorded HIV diagnosis (OR=1.22, CI=1.04-1.43). Despite the elevated crude recorded prevalence of HIV, multivariate analyses suggested that HIV-related risk factors underlie the associations between HIV and the serious mental illness diagnoses. For patients with schizophrenia, this study is the first to demonstrate reduced HIV risk in the absence of a substance use disorder.

Understanding Associations Between Serious Mental Illness and HIV Among Patients in the VA Health System

Understanding Associations Between Serious Mental Illness and HIV Among Patients in the VA Health System

Influence of Antiretroviral Therapy on Oxidative Stress and Cardiovascular Risk: A Prospective Cross-Sectional Study in HIV-Infected Patients

Background: Oxidative stress (OS) results from excessive free radical production, exceeding endogenous antioxidant defense mechanisms, which can damage awide variety of cellular components. One of the main consequences is the attack of free radicals on polyun-saturated fatty acids contained in low-density lipoprotein (LDL) lipids, causing lipid peroxidation and subsequent elevated concentrations of lipid peroxides and their metabolites, which are strongly suggestive of oxidative damage. OS is increased among HIV-infected patients, but whether it implicates a higher risk for cardiovascular disease or the influence of antiretroviral therapy (ART) on OS remains unknown. Objective: The aim of this study was to assess the relationship of OS with established cardiovascular risk factors and with ART as measured by total peroxide concentration. Methods: A prospective cross-sectional study was conducted in 245 consecutive HIV-infected patients during a 2-month period (September 15, 2003–November 15, 2003) at the HIV clinic of the Infectious Disease Unit, Hospital General Universitario de Elche, Universidad Miguel Hern~ndez, Elche, Spain. Laboratory measurements included total peroxide concentrations, C-reactive protein (CRP) levels, fasting lipid levels, white blood cell type CD4+ T-lymphocyte counts, plasma HIV RNA, and routine blood tests. To measure OS, total peroxide concentration was determined quantitatively with a colorimetric assay. The association of peroxide concentrations with HIV-related variables and cardiovascular risk factors was examined using univariate and multivariate analyses. Results: Two hundred forty-five patients were screened and enrolled in the study; no patients refused enrollment. Median (interquartile range [IQR]) age of the patients was 40.2 (35.4–46.2) years; 194 (79.2%) were male, and 238 (97.1%) white. Median (IQR) weight was 67.5 (60.4–76.0). Ninety-five (38.8%) patients were receiving a non-nucleoside reverse-transcriptase inhibitor (NNRTI)-based regimen at the time of enrollment; 52 (21.2%) were on a protease inhibitor (PI)-based regimen. Peroxide concentrations were above reference values (<400 μmol/L) in 121 (49.4%) patients. Peroxide levels correlated positively with CRP ( P < 0.001) and LDL-cholesterol (LDL-C) ( P = 0.003), and negatively with age ( P = 0.002) and body mass index ( P < 0.001). Among patients on ART, peroxide concentrations were significantly lower in those treated with NNRTI-based regimens than in those receiving PIs (median [IQR], 331.2 [196.2–495.7] vs 472.8 [302.5–586.5] μmol/L; P = 0.003). In multivariate analysis, when peroxide concentration was dichotomized according to reference values (< 400 μmol/L), age (odds ratio [OR], 0.96; 95% CI, 0.93–0.99; P = 0.007) and ART including NNRTI (OR, 0.52; 95% CI, 0.28–0.95; P = 0.03) were associated with low peroxide concentrations, while LDL-C

Fisherfolk are among groups most at risk of HIV: cross-country analysis of prevalence and numbers infected

HIV prevalence in some fishing communities in low and middle-income countries is known to be high relative to national average seroprevalence rates. Most of the studies supporting this claim refer to the men involved in fish-catching operations (fishermen). However they acknowledge that the men and women who work in associated occupations such as fish trading and processing are also vulnerable in part because they are often within the fishermen’s sexual networks. This vulnerability stems from the nature and dynamics of the fish trade and fishing lifestyle in which a number of known or hypothesized ‘risk factors’ converge. (excerpt)

HIV-Related Risk Factors Associated with Commercial Sex Among Female Migrants in China

Data from 633 sexually experienced female migrants were analyzed to examine the sociodemographic and psychosocial factors and human immunodeficiency virus (HIV)-related behaviors associated with involvement in commercial sex. Six percent (40/633) of the participants reported having had sex for money. Compared with women who had not engaged in commercial sex, women who had sold sex were younger, less educated, and more likely to be unmarried. They were more likely to have engaged in HIV-related risk behaviors, such as becoming intoxicated with alcohol and using drugs. Among women who engaged in commercial sex, only 28% of them consistently used condoms during the last three episodes of sexual intercourse. Women who had ever engaged in commercial sex demonstrated greater depressive symptoms than those without such a history (p < .01). Female migrants, especially those engaging in commercial sex, were vulnerable to HIV/sexually transmitted diseases (STDs). Sexual risk reduction and condom promotion are urgently needed among this population. Further studies are needed to examine the causal relationship between depression and HIV risk behaviors.

Abused women report greater male partner risk and gender-based risk for HIV: findings from a community-based study with Hispanic women

The purpose of this study was to assess the relationship between intimate partner violence (IPV) and sexual risk in terms of safer sex behaviour and intent, individual and gender-based HIV risk factors, and male partner HIV risk, among a lower-income community-based sample of Hispanic women reporting a current male sexual partner. Baseline survey data on HIV-related behaviours and risk factors gathered from participants (N=170) of an HIV intervention evaluation study for Hispanic women were used for current analyses. Participants were age 18–36 years, predominantly born outside of the continental US (88.8%) and not English fluent (68.2%). Adjusted logistic regression analyses and 95% confidence intervals were conducted to assess the relationships between male-perpetrated IPV in the past three months and sexual risk variables. One-fifth (21.2%) of the sample reported male-perpetrated IPV in the past three months. Abused women were significantly more likely than those not abused in the past three months to report high STD/HIV risk perceptions (OR=3.02, 95% CI=1.33–6.88), gender-based risk including sexual control by male partners (OR=3.09, 95% CI=1.41–6.76) and male partner risk including male infidelity (OR=4.58, 95% CI=1.57–13.32). Results support the need for emphasis on IPV prevention within HIV prevention programmes and demonstrate the need for HIV prevention efforts directed at men with a history of IPV perpetration.