Knowledge Of HIV Transmission Research Articles

A personal issue: feminist standpoint theory, epistemologies of ignorance, and perceptions of HIV transmission among northern Tanzanian wildlife conservation professionals

Drawing on ten months of qualitative research from 2009/10, we present a case study of situated HIV transmission knowledge claims among wildlife conservation actors in northern Tanzania. Utilizing feminist standpoint theory and epistemologies of ignorance, this article explores why a single professional group consistently articulated divergent explanations of the causal forces shaping on-going HIV transmission dynamics. Elite respondents were more likely to consistently attribute viral transmission to individual-level behaviors, while non-elite conservation actors more often situated HIV transmission dynamics in relation to extra-personal structural forces. This case study reveals the experiential grounding of HIV-related knowledge claims; illuminates the partiality of authoritative knowledge and the intersections of practices of power, embodied understandings and socio-structural location with hierarchical matrices of status and privilege; disrupts the presumed accuracy of certain forms of knowledge by foregrounding the insights of those in positions of subordination; and exposes ineffectual HIV/AIDS interventions in northern Tanzania.

Assessing the effect of an online HIV/AIDS course on 1st-year pharmacy students’ knowledge

Background . More international HIV/AIDS intervention initiatives targeting young adults are needed to help reach targets set by the Joint United Nations Programme on HIV and AIDS (UNAIDS). Objectives. To determine the effect of an online HIV/AIDS course on 1st-year pharmacy students’ knowledge of HIV prevention and transmission and of the science of HIV infection. Methods. Online anonymous surveys, the Pre- and Post-Confirmation of Acceptance for Studies, were administered by means of an online survey tool, SurveyMonkey (USA), to 1st-year pharmacy students, from 2009 to 2013. These surveys were administered online during the first and last weeks of class, respectively. Results. With regard to HIV prevention and transmission, student knowledge of the manner in which HIV is transmitted improved during the course. Overall, students were more confident about their knowledge of HIV prevention. They also indicated that as a direct result of taking the AIDS Online International course they were more reluctant to have unsafe sex and more confident about how to protect themselves against HIV/AIDS. Their scientific knowledge also improved. Conclusion. The implementation of an online HIV/AIDS course has proved to be an effective method of HIV/AIDS education, and may also be a viable HIV intervention initiative.

"Inside These Fences Is Our Own Little World": Prison-Based HIV Testing and HIV-Related Stigma Among Incarcerated Men and Women.

Correctional facilities offer opportunities to provide comprehensive HIV services including education, testing, treatment, and coordination of post- release care. However, these services may be undermined by unaddressed HIV stigma. As part of a prison-based HIV testing study, we interviewed 76 incarcerated men and women from the North Carolina State prison system. The sample was 72% men, median age 31.5 years (range: 19 to 60). Thematic analysis revealed high levels of HIV-related fear and stigma, homophobia, incomplete HIV transmission knowledge, beliefs that HIV is highly contagious within prisons ("HIV miasma"), and the View of HIV testing as protective. Interviewees described social distancing behaviors and coping mechanisms they perceived to be protective, including knowing their HIV status and avoiding contact with others and shared objects. Interviewees endorsed universal testing, public HIV status disclosure, and segregation of HIV-positive inmates. Intensified education and counseling efforts are needed to ameliorate entrenched HIV-transmission fears and stigmatizing beliefs.

Knowledge of HIV infection and transmission: a knowledge, attitudes, beliefs and practices (KABP) survey among a sample of students at the "Magna Graecia", University of Catanzaro.

Continuous spreading of HIV infection may be due to lack of knowledge, especially among young people. It is important to monitor level of knowledge and risk behaviours especially in young people to set up appropriate preventative and informative campaigns. We assessed knowledge of HIV infection and risk factors in a sample of students at the "Magna Graecia" University of Catanzaro, using an anonymous multiple-choice questionnaire. Two-hundred and sixteen medical students attending the first year at "Magna Graecia" University (age: 18-20 years) were prescribed an anonymous multiple-choice questionnaire. Knowledge of HIV infection was scarce in a significant percentage of students. They were often practicing risk behaviours at risk for acquisition of HIV infection and other sexually transmitted infections. This study shows that preventative and informative campaigns are urgently needed in earlier stage of adolescence to avoid acquisition of HIV infection and other sexually transmitted diseases.

Risky Sexual Behavior and Its Determinants among Orphan and Vulnerable Children in Addis Ababa, Ethiopia

Back Ground: Risky sexual behavior among orphans and vulnerable children and its associated physical, psychological and social consequences is becoming a major public health concern globally. Objectives: To assess the prevalence of risky sexual behavior and its determinants among orphan and vulnerable children in Addis Ababa. Methodology: A community based cross sectional study was conducted on three support and care giving organizations for orphans and vulnerable children in Addis Ababa, Ethiopia from March to June 2014. A total of 422 orphan and vulnerable children were selected using systematic sampling. Data were collected using pre tested self-administered questionnaire. Logistic regression was used to analyze the data. Result: A total of 407 (96.4%) respondents participated in this study. Among them 112 (27.5%) had sexual intercourse in their life time, of these 50 (44.6%) started sex before the age of 15, 94 (83.9%) had forced sex, 84 (75.0%) had multiple sexual partners, only 16 (14.3%) used condom the first time they had sex and 96 (85.7%) participated in transactional sex. Females were about 3.25 (2.67 - 7.3) times more likely to engage in risky sexual behavior than male respondents, double orphans had 4.32 (2.45 - 9.54) odds of risky sexual behavior compared to their counterparts. Those respondents who had knowledge of HIV transmission and prevention were less likely to be involved in risky sexual behavior 0.58 (0.41 - 0.93). Conclusion: Orphan and vulnerable children are at a higher likelihood of risky sexual behavior. Intervention targeted at multilevel such as orphan survival training, assertive communication skills, sexuality education and education about HIV risk perception, physical, psychological and human right protection, social support, and economic access for basic needs need to be given consideration.

Addressing adolescents’ risk and protective factors related to risky behaviours: Findings from a school-based peer-education evaluation in the Western Cape

Background: Peer-education programmes aim to bring about attitudinal and behavioural changes in their target audience. In the South African educational context, peer education is a favoured approach in dealing with issues such as HIV and AIDS, sexual decision-making and substance misuse. Given the reliance on peer-education programmes in the educational system, it is important to establish how well they are working. This study aims to assess the effect of an extensive, structured, time-limited, curriculum-based, peer-led educational programme on first-year high school learners in public schools in the Western Cape Province of South Africa. Method: The curriculum called ‘Listen Up’ addresses issues such as supporting peers, sexual decision-making, healthy relationships, HIV risk, alcohol misuse and unwanted pregnancy in seven structured sessions. The programme targeted adolescents in Grade 8 growing up in what are considered to be risky environments in public schools in the Western Cape during 2012 and 2013. The intervention was evaluated based on 10 scales sourced from published literature related to the outcome indicators of future orientation, sensation-seeking, self-efficacy in sexual relations, HIV transmission knowledge, HIV prevention knowledge, HIV attitudes, sexual attitudes, decision-making, healthy relationships and social support. Descriptive statistics were used to analyse demographic and community characteristics and analyses of variance were used to detect differences between groups. The surveys were administered to a total of 7709 learners across three waves of the study in 27 peer intervention schools and eight control schools. Results: Immediately post intervention, statistically significant differences were noted for the intervention schools when compared to their baseline levels on measures of future orientation, self-efficacy in sexual relations, knowledge regarding HIV transmission, knowledge regarding HIV prevention and knowledge in terms of healthy relationships. Comparing baseline values with results collected between five and seven months post intervention, statistically significant results were noted for self-efficacy in sexual relations and knowledge regarding HIV transmission. Conclusion: The findings of this study suggest that peer-education can improve adolescents’ self-efficacy in sexual relations as well as knowledge regarding the transmission of HIV and therefore can contribute to the prevention of HIV transmission among adolescents.

Sexually transmissible infection and HIV prevention and treatment for young male sex workers in Vietnam: findings from the SHEATH intervention.

A targeted intervention (SHEATH) derived from Harm Reduction and Sexual Health Promotion intervention technology was implemented in an out-of-treatment population of YMSW in Hanoi and Ho Chi Minh City (n=919). YMSW reported high levels of satisfaction with each of the seven core modules within the intervention and for the intervention as a whole. The intervention conferred significant benefit in relation to improved knowledge of STI and HIV transmission (P<0.001). Although only 36% of participants had seen a healthcare provider in the past year, following the intervention 81% intended to see one in the next 6 months. Similarly, although 71% of participants did not disclose that they were MSM the last time they visited a healthcare provider, following the intervention 71% intended to do so at their next visit. High rates of STIs (>10%) and HIV (9.5%) were also found. The data show that the SHEATH intervention can be implemented in this population and setting, is met with high rates of acceptability, and positively impacts STI and HIV knowledge and multiple health services outcomes (including knowledge of HIV status and disposition towards habituation of HIV screening).

High-risk sexual behavior among people living with HIV/AIDS attending tertiary care hospitals in district of Northern India

Context:Prevention with a positive approach has been advocated as one of the main strategies to diminish the new instances of HIV and the target are those who are engaged in high-risk sexual behavior. Therefore, understanding the risky behaviors of the HIV-infected individual is important.Aims:This study aimed to assess the prevalence and the predictors of high-risk sexual behavior among people living with HIV/AIDS (PLHA).Settings and Design:A hospital-based cross-sectional study was conducted at antiretroviral therapy centers of two tertiary care hospitals in Lucknow.Materials and Methods:A total of 322 HIV-positive patients were interviewed about their sexual behaviors during last 3 months using a pretested questionnaire.Statistical Analysis Used:Probability (p) was calculated to test for statistical significance at 5% level of significance. Association between risk factors and high-risk sexual behavior was determined using bivariate analysis followed by multivariate logistic regression.Results:Prevalence of high-risk sexual behavior was 24.5%. Of these patients, multiple sexual partners were reported by 67.3% whereas about 46.9% were engaged in unprotected sex. Multivariate logistic regression analysis revealed that high-risk sexual behavior was significantly associated with nonsupporting attitude of spouse (odds ratio [OR]: 18; 95% confidence interval [CI]: 1.4–225.5; P = 0.02) and alcohol consumption (OR: 9.3; 95% CI: 2.4–35.4; P = 0.001).Conclusions:Specific intervention addressing alcohol consumption and encouragement of spouse and family support should be integrated in the routine HIV/AIDS care and treatment apart from HIV transmission and prevention knowledge.

High-risk sexual behavior among people living with HIV/AIDS attending tertiary care hospitals in district of Northern India.

Prevention with a positive approach has been advocated as one of the main strategies to diminish the new instances of HIV and the target are those who are engaged in high-risk sexual behavior. Therefore, understanding the risky behaviors of the HIV-infected individual is important. This study aimed to assess the prevalence and the predictors of high-risk sexual behavior among people living with HIV/AIDS (PLHA). A hospital-based cross-sectional study was conducted at antiretroviral therapy centers of two tertiary care hospitals in Lucknow. A total of 322 HIV-positive patients were interviewed about their sexual behaviors during last 3 months using a pretested questionnaire. Probability (p) was calculated to test for statistical significance at 5% level of significance. Association between risk factors and high-risk sexual behavior was determined using bivariate analysis followed by multivariate logistic regression. Prevalence of high-risk sexual behavior was 24.5%. Of these patients, multiple sexual partners were reported by 67.3% whereas about 46.9% were engaged in unprotected sex. Multivariate logistic regression analysis revealed that high-risk sexual behavior was significantly associated with nonsupporting attitude of spouse (odds ratio [OR]: 18; 95% confidence interval [CI]: 1.4-225.5; P = 0.02) and alcohol consumption (OR: 9.3; 95% CI: 2.4-35.4; P = 0.001). Specific intervention addressing alcohol consumption and encouragement of spouse and family support should be integrated in the routine HIV/AIDS care and treatment apart from HIV transmission and prevention knowledge.

Psychosocial and psychopathological predictors of HIV-risk injecting behavior among drug users in Portugal

Despite the introduction of needle and syringe exchange programs (NSPs), sharing of syringes and other materials remains common among injection drug users (IDUs) worldwide. For this reason, IDUs are at high-risk of HIV transmission. This paper studies the psychosocial and psychopathological determinants of sharing among IDUs. Understanding the relationship between psychological morbidity, HIV knowledge, HIV risk perception, and sharing behaviors is important to develop campaigns to curb sharing among IDUs. We recruited 120 male (76.7%) and female (23.3%) IDUs at a public outpatient treatment service in northern Portugal whose age average was 34 (sd=7.56). They were characterized for sociodemographic, clinical, and behavioral variables, as well as for knowledge on HIV transmission and prevention, HIV risk perception, and psychopathological symptoms. Almost all patients (95.8%) were tested for HIV and 31.7% were HIV positive. Half of them had a chronic disease (50.8%) and declared to engage in sharing (51.7%). Most had accurate knowledge of HIV transmission and prevention. A great majority deemed HIV risk to be high in their communities (80.8%) but deemed their personal risk to be zero or low (72.5%). Statistical analysis showed that sociodemographic variables (female sex, lower education, living alone) and psychopathological symptoms (obsessioncompulsion and somatization) predict sharing. We conclude that the development and implementation of campaigns to reduce sharing among IDUs should focus more on women, IDUs living alone, as well as early assessment and intervention on psychopathological disorders.

A cross-sectional study to evaluate factors related to condom use with commercial sexual partners in workers from Ecuadorian companies.

BackgroundUnprotected intercourse with sex workers is one of the major risk factors for HIV infection. Consistent condom use is a prerequisite to lower the incidence of HIV.MethodsWe assessed the prevalence of condom use and its determinants among company workers engaged with commercial sexual partners in Ecuador. The study was based on a random sample of 115 companies and 1,732 workers stratified by province and working sector and utilized the “Behavioral Surveillance Surveys – Adult questionnaire” developed by Family Health International.ResultsOf the 1,561 sexually active workers, 311 (19.9 %) reported having intercourse with sex workers. Among them 25.9 % did not use a condom at the last sexual intercourse. As for condom use frequency over the last 12 months, 29/208 (13.9 %) reported never, 23 (11.1 %) sometimes, 24 (11.5 %) almost every time and 132 (63.5 %) every time. Factors adversely affecting condom use frequency over the last 12 months were female gender (OR = 4.56, 95 % CI: 1.45-14.4), older age (OR = 1.07, 95 % CI: 1.03-1.10), low educational level (OR = 4.69, 95 % CI: 1.95-11.3) and married workers living with spouse (OR = 7.66, 95 % CI: 3.08-19.1). By contrast, factors such as age at first sexual intercourse, job category, HIV transmission and prevention measure knowledge, single workers, previous exposure to HIV intervention programs and having a casual sexual partner were not affecting condom use frequency. When considering condom use during the last sexual intercourse or during the past 12 months with commercial sexual partners, results were similar.ConclusionsWorkers with low education, older age, female gender and those married living with their spouse should be targeted for specific educational interventions.

O12.2 Understanding the relationship dynamics between female sex workers and their intimate partners in kumasi, ghana

Introduction Intimate partners (IP) of female sex workers (FSW) are a population of growing interest in Ghana. The study objectives were to: explore the emotional, financial, and power dynamics within these relationships; describe the sexual behaviours and HIV knowledge and vulnerabilities of both partners; and document the perceived availability and accessibility of social support and health services. Methods In-depth interviews (IDIs) were conducted with 24 male IP of FSW. Two focus group discussions were conducted with 13 male IPs and three with 20 FSWs. The age range of IPs was from 20–60 years and FSWs from 18–50. Results The IPs met their FSWs through introductions by close friends, patronising FSW’s services and/or by FSWs going after the IPs. The nature of relationships ranged from the IP offering protection for financial support (transactional), meeting emotional needs (intimate) to consensual reciprocal relationships. Forty percent of IPs were monogamous with their FSW partner, and about 50% of IPs and FSW couples used condoms. Lack of condom use was considered a sign of intimacy. The majority of respondents had some knowledge of HIV transmission and consequences. All respondents understood that condoms offer protection against HIV infection, but many FSW respondents reported difficulty in convincing regular clients to use condoms. Over half of the men who participated in the IDIs had recently tested for HIV, and half the men knew their FSW partner’s HIV status. Respondents showed varying levels of awareness of HIV testing options and pricing, and had suggestions for how to improve services. Conclusion Study results show a nuanced picture of IP of FSW relationships, and these dynamics are important in the context of HIV and STI transmission prevention. Expanded community-based services for FSW and IP and initiatives that increase availability and acceptability of condom use should be pursued. Disclosure of interest statement This study was implemented by Boston University in collaboration with the Kwame Nkrumah University of Science and Technology with support from the President’s Emergency Plan for AIDS Relief (PEPFAR) through the US Agency for International Development under Project SEARCH Task Order No. GHH-I-00- 07–00023–00, beginning August 27, 2010. The content and views expressed here are the authors’ and do not necessarily reflect the opinion or policy of USAID or the US Government.

Knowledge and Behavioural Factors Associated with Gender Gap in Acquiring HIV Among Youth in Uganda.

BackgroundThe increasing prevalence of HIV in Uganda during the last decade (7.5% in 2004-05 to 8.3% in 2011 among women and 5.0% in 2004-05 to 6.1% among men in 2011 of 15 to 49 years) clearly shows that women are disproportionately affected by HIV epidemic. Hence, we assessed the prevalence of HIV and focused on differences in risky sexual behaviour and knowledge of HIV among Ugandan youth.Design and MethodsUganda AIDS Indicator Survey 2011 data was used. The total samples of men and women (15 to 24 years), interviewed and tested for HIV, were 3450 and 4504 respectively. The analysis of risky sexual behaviour was based on 1941 men and 3127 women who had ever had sex and were tested for HIV. Pearson’s Chi-square test and multivariate logistic regression analysis were used.ResultsFindings showed that young women were almost two times more vulnerable than young men in acquiring HIV (OR=1.762, P<0.001). Women who had first sex under age 15 (7.3%), had more than 2 sexual partners (9.2%) and did not use condom during last sex (6.4%) were more HIV-positive. Higher risk was found among women (6.3%) than men (2.2%). Significantly (P<0.01) less percentage (81.3%) of women as compared to men (83.8%) perceived that the probability of HIV transmission may be reduced by correct and consistent use of the condom during sex.ConclusionsHence, there is an urgent need for effective strategies and programmes to raise awareness on sexual health and risky behaviour, particularly targeting the youth, which will reduce the gender gap in risky sexual behaviour and new transmission of HIV in Uganda.Significance for public healthThe present study represents the evidence of a recent increase in HIV infection in Uganda from the latest round of AIDs indicator survey. This manuscript describes how young women (15-24 years-old) are disproportionately HIV-infected compared to young men in Uganda. They are more vulnerable to HIV than young men. Moreover, it is also observed that young women are at greater risk of acquiring HIV because of their risky sexual behaviour and inappropriate knowledge of HIV transmission. Some educational programmes, growing gender equity in HIV/AIDS activities and services, dropping violence and coercion, addressing male norms and behaviours, improving women’s legal protection, and rising women’s access to income and productive resources can be very effective in minimising the vulnerability of young women to HIV/AIDS.

Differences in Sexual Practices, Sexual Behavior and HIV Risk Profile between Adolescents and Young Persons in Rural and Urban Nigeria.

IntroductionWe aimed to determine differences in sexual practices, HIV sexual risk behaviors, and HIV risk profile of adolescents and young persons’ in rural and urban Nigeria.MethodologyWe recruited 772 participants 15 to 24 years old from urban and rural townships in Nigeria through a household survey. Information on participants’ socio-demographic profile (age sex, residential area, number of meals taken per day), sexual practices (vagina, oral and anal sex; heterosexual and homosexual sex; sex with spouse, casual acquaintances, boy/girlfriend and commercial sex workers), sexual behavior (age of sexual debut, use of condom, multiple sex partners, transactional sex and age of sexual partner), and other HIV risk factors (use of alcohol and psychoactive substances, reason for sexual debut, knowledge of HIV prevention and HIV transmission, report of STI symptoms) were collected through an interviewer administered questionnaire. Differences in sexual behavior and sexual practices of adolescents and HIV risk profile of adolescents and young persons resident in urban and rural areas were determined.ResultsMore than half (53.5%) of the respondents were sexually active, with more residing in the rural than urban areas (64.9% vs 44.1%; p<0.001) and more resident in the rural area reporting having more than one sexual partner (29.5% vs 20.4%; p = 0.04). Also, 97.3% of sexually active respondents reported having vaginal sex, 8.7% reported oral sex and 1.9% reported anal sex. More male than female respondents in the urban area used condoms during the last vaginal sexual intercourse (69.1% vs 51.9%; p = 0.02), and reported sex with casual partners (7.0% vs 15.3%; p = 0.007). More female than male respondents residing in the rural area engaged in transactional sex (1.0% vs 6.7%; p = 0.005). More females than males in both rural (3.6% vs 10.2%; p = 0.04) and urban (4.7% vs 26.6%; p<0.001) areas self-reported a history of discharge. More females than males in both rural (1.4% vs 17.0%; p = 0.04) and urban (15.0% vs 29.1%; p<0.001) areas self-reported a history of itching.ConclusionThere are differences in the sexual behavior and practices of adolescents and young persons’ residing in the urban and rural area with implication for HIV prevention programming.

Predictors for Using a HIV Self-Test Among Migrant and Seasonal Farmworkers in North Carolina.

Background: Approximately, two million migrant and seasonal farmworkers (MSF) work in the United States annually. Several factors, such as lack of access to healthcare services and health behaviors, contribute to risk of HIV transmission. Relatively few studies have explored MSF knowledge of HIV transmission and testing options. Methods: A 12-question, self-administered survey of farmworkers (n = 178) from 19 migrant camps was conducted. The survey assessed knowledge of factors related to HIV transmission, testing, and intention to use a HIV home-test kit. Results: Participants with knowledge of treatment for HIV (p = 0.03) and that condom use protects against HIV (p = 0.04) were more willing to express intent to use a home test kit than those with less knowledge. Concern among farmworkers that HIV was a very or somewhat serious problem in their community was associated with expressing intent to use a home test kit (OR = 2.3, 95% CI = 0.92–5.5). Respondents with less knowledge were less likely to use a home test kit. Conclusions: MSF were concerned about HIV in their community and would be willing to use to a home test kit. This pilot study provides a basis for additional research related to HIV testing within the MSF community.

Effects of a Community-Based HIV Risk Reduction Intervention Among HIV-Positive Individuals: Results of a Quasi-Experimental Study in Nepal.

We evaluated the efficacy of a sexual risk reduction intervention utilizing protection motivation and social cognitive theories to address knowledge, threat and coping appraisals, and condom use intentions among HIV-positive individuals in Nepal. Using a quasi-experimental research design, we assigned 277 participants to intervention (n=146) and control (n=131) groups. The intervention group received six sessions on sexual risk reduction strategies and the control group six sessions on medication adherence, smoking, and mental health. Data were collected at baseline and immediately after the intervention. Results indicate that the sexual risk reduction intervention produced a significant increase in HIV transmission knowledge, perceived threat and coping appraisals, and intentions to use condoms with regular, HIV-positive, and HIV-negative partners. The positive effects of the intervention remained significant after adjusting for baseline scores and other potential confounders. In conclusion, our theory-based sexual risk reduction intervention was effective in improving HIV transmission knowledge, perceived threat and coping appraisals, and condom use intentions. Further studies are needed to evaluate the long-term efficacy of the intervention in increasing protection motivation and maintaining preventive behaviors.

Knowledge of HIV serodiscordance, transmission, and prevention among couples in Durban, South Africa.

ObjectiveCouples’ voluntary HIV counseling and testing (CVCT) significantly decreases HIV transmission within couples, the largest risk group in sub-Saharan Africa, but it is not currently offered in most HIV testing facilities. To roll out such an intervention, understanding locale-specific knowledge barriers is critical. In this study, we measured knowledge of HIV serodiscordance, transmission, and prevention before and after receipt of CVCT services in Durban.DesignPre- and post-CVCT knowledge surveys were administered to a selection of individuals seeking CVCT services.MethodsChanges in knowledge scores were assessed with McNemar Chi-square tests for balanced data and generalized estimating equation methods for unbalanced data.ResultsThe survey included 317 heterosexual black couples (634 individuals) who were primarily Zulu (87%), unemployed (47%), and had at least a secondary level education (78%). 28% of couples proved to be discordant. Only 30% of individuals thought serodiscordance between couples was possible pre‐CVCT compared to 95% post-CVCT. One-third thought there was at least one benefit of CVCT pre‐CVCT, increasing to 96% post‐CVCT. Overall, there were positive changes in knowledge about HIV transmission and prevention. However, many respondents thought all HIV positive mothers give birth to babies with AIDS (64% pre-CVCT, 59% post-CVCT) and that male circumcision does not protect negative men against HIV (70% pre-CVCT, 67% post-CVCT).ConclusionsCVCT was well received and was followed by improvements in understanding of discordance, the benefits of joint testing, and HIV transmission. Country-level health messaging would benefit from targeting gaps in knowledge about serodiscordance, vertical transmission, and male circumcision.

Cross-sectional study assessing HIV-related knowledge, attitudes and behavior in the Namibian truck transport sector: Readjusting HIV prevention programs in the workplace.

The objectives of this study were to assess the current status of HIV-related knowledge, attitudes, and behavior (KAB) of employees in the private transport sector in Namibia and to compare companies with established HIV workplace program (WPPs) with those that have recently initiated the implementation of such programs. The study was designed as a cross-sectional questionnaire-based survey. Between January and March 2011, the survey was conducted in the Namibian truck transport sector in six companies of different sizes. The participants were selected randomly from the workforce. Data collection was based on a KAB questionnaire. The range of correct answers to the survey concerning the knowledge of HIV transmission was 67-95%. Twenty percent of the employees had never been tested for HIV. Additionally, risky sexual behaviors were quite prevalent and included having multiple concurrent partners and the use of sex for incentives. This study revealed that drivers and laborers were especially at risk for such behaviors. The employees of companies with established WPPs were tested for HIV more often than those of companies with new WPPs; however, aside from this difference, only minor differences were observed between the two groups. The findings of this study highlight the need for on-going HIV information and prevention campaigns that focus on the special needs of mobile and low-income workers. WPPs should be tailored accordingly and shift their focus to more practical approaches, such as voluntary counseling and testing (VCT), to increase their effectiveness.

Continued explosive rise in HIV prevalence among Chinese men who have sex with men

strategies and the control group six sessions on treatment literacy, smoking and mental health. Data were collected at baseline and immediately after the intervention. Intervention effects were assessed using the adjusted standardized linear regression coefficients. Findings: Participants had a mean age of 34.3 years old, 54.9% were male, and 69.3% were currently married. The results indicated that the sexual risk reduction intervention significantly improved participants’ safer sex intention with regular partner (p1⁄40.002), HIV-positive partners (p1⁄40.001), and HIV-negative partners (p1⁄40.031). Similarly, the sexual risk reduction intervention significantly improved participants’HIV transmission knowledge (< 0.001], perceived severity [p< 0.001], and vulnerability [p < 0.001]), and coping appraisal (self-efficacy [p< 0.001], response efficacy [p< 0.001], and response cost [p< 0.001]). The positive effects of intervention remained significant after adjusting for baseline scores and other potential confounders. Interpretation: This is the first theory-based HIV prevention intervention to demonstrate an increase in safer sex intention and positive effects on HIV-preventive mediators among HIV-positive individuals in a resource-limited setting in Asia. Although further studies are needed to evaluate the long-term efficacy of the intervention in improving protection motivation and safer behaviors, scaling-up this intervention appears likely to improve the health of HIV-positive individuals and prevent HIV transmission in the general population. Funding: The study was supported by a grant from the National Center for Global Health and Medicine, Tokyo, Japan and by a Grant-in-Aid for Young Scientists (B22790581) Japan Society for the Promotion of Science, Japan. Abstract #: 02CD023

Drug use and sexual behavior: the multiple HIV vulnerabilities of men and women who inject drugs in Kumasi, Ghana.

Recent evidence suggests that injecting drug use presents a new challenge to HIV prevention in West Africa. Very little is known about the HIV vulnerability of people who inject drugs (PWID) in Ghana, and no HIV prevention efforts are currently targeting PWID. Purposive sampling was used to recruit 30 (20 men and 10 women) PWID to participate in in-depth interviews in Kumasi, Ghana. Transcripts were coded and analyzed by theme. Half the men and more than half the women in this study reported sharing needles/syringes (N/S); most shared a common mixing container; and all said they shared N/S with intimate partners. Some PWID who said that they do not share N/S with other PWID, also said they routinely use N/S that they find on the ground at injecting sites or in the hospital dumpster. Nearly, all the women (9/10) and more than half the men (12/20) were currently sexually active; most had more than 1 partner in the last 6 months, but very few reported condom use. Three women said they exchanged sex for money and 3 men reported buying sex in the last year. Several PWID had no knowledge of HIV transmission through injecting. PWID in Kumasi are highly vulnerable to HIV because of N/S sharing and reuse, lack of condom use, low knowledge of HIV transmission, and lack of services. Program and policy recommendations include N/S and condom distribution, peer education, opioid substitution therapy, and training of health providers, police, and pharmacy staff.