Predictors Of High-risk Sexual Behavior Research Articles

Clinico-epidemiological profile and high-risk sexual behavior among clients attending sexually transmitted infection clinic at a tertiary care hospital in North India.

Context:Sexually transmitted infections (STIs) are one of the most catastrophic events of health causing huge psychosocial and economic morbidity consequences.Aim:The study aims to study the clinico-epidemiological profile and high-risk sexual behavior among clients attending STI clinic at tertiary care hospital in North India.Materials and Methods:The present study was conducted at STI clinic, King George's Medical University, Lucknow, Uttar Pradesh. Data from 1283 clients attending STI clinic between August 2015 and July 2016 were compiled using master client register and STI/reproductive tract infection patient-wise register, and a final completed data set of these patients was analyzed according to the aims and objectives.Results:On analyzing the various factors associated with high-risk sexual behavior among clients attending STI clinic marital status, sexual preference and employment status were found to be significantly associated with high-risk sexual behavior (P < 0.05). On multivariate analysis, unmarried/divorced/widow/separated marital status (odds ratio [OR]: 14.72; 95% confidence interval [CI]: 1.89–114.17; P = 0.00) and unemployed status (OR: 6.10; 95% CI: 2.00–18.60; P = 0.02) were found to be independent predictors of high-risk sexual behavior (unprotected sex).Conclusions:Based on findings of study, it is highly recommended to provide periodic screening to these STI patients for assessment of their sexual behavior along with specific counseling session.

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.

Brain Derived Neurotrophic Factor: From Neurobiology to Sexual Risk Prevention

Objective: The authors’ draw on neurobiological theory to posit that sexual risks might be associated with neurological changes, specifically, those neuro-adaptive changes associated with addictions. We propose that low levels of brain-derived neurotrophic factor (BDNF), a signaling molecule involved in cognitive, emotional, and addiction behaviors, may play a key role in the expression of high-risk sexual behaviors. Methods: In a prospective cohort of 400 people living with HIV (PLWH), information was collected regarding smoking (Fagerstrom Test for Nicotine Dependence), hazardous alcohol use (men >14 and women >7 drinks/week), sexual behaviors. To assess the role of BDNF, platelet poor plasma was obtained to measure BDNF levels and participants were dichotomized into Groups 1 (BDNF ≤ 5000 pg/mL) and 2 (BDNF >5000 pg/mL). Results: Over two-thirds of the participants reported multiple risk behaviors, confirming our hypothesis that Group 1 would have a general risk-taking tendency. Individuals in Group 1 were more likely to smoke (p=0.0001) and to drink alcohol hazardously (HAU) more days per week (p=0.04), particularly hard liquor (p=0.001). In support of our hypothesis, Group 1 was also more likely to report sex under the influence of drugs/alcohol (p=0.003) and to exchange sex for money (p=0.03). Men from Group 1 had multiple partners (p=0.09), and engaged in unprotected anal sex (p=0.08) more than those in Group 2. The results from regressions showed that BDNF (p=0.05), use of antidepressants (p=0.003), hazardous alcohol use (p=0.0001) and the BDNF x gender interaction (p=0.022) were significant predictors of high-risk sexual behaviors. Further supporting our postulate, participants with low BDNF showed triple the risk of herpes (p=0.05). Conclusion: This innovative approach demonstrated for the first time that substance abuse disorders (especially alcohol abuse), high-risk sexual behaviors, and sexually transmitted diseases occur more frequently in individuals with low BDNF levels. These findings suggest the importance of using BDNF modifiers in preventive interventions concerning people living with HIV. Given the limitations of the design, new studies among the general population are needed to confirm the generalizability of the findings.

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.

Modeling High Risk Sexual Behavior in HIV-Negative Gay Men

Several predictors of high-risk sexual behavior in gay men (internalized homophobia, locus of control, multiple AIDS-related loss, depression, and substance use) were examined. Eighty-seven HIV-negative gay males (M=36.7 years old, SD=5.9) were recruited through advertisements in the greater San Francisco, CA Bay Area. Structural equation modeling(SEM)analysis revealed that, as predicted, internalized homophobia, multiple AIDS-related losses, and substance use emerged as significant predictors of high-risk sexual behavior. Subsidiary analyses further revealed that multiple AIDS-related losses predicted both internalized homophobia and substance use suggesting that multiple losses experienced by gay men over the course of the AIDS epidemic may lead to other maladaptive behaviors.

Alcohol use and HIV serostatus of partner predict high-risk sexual behavior among patients receiving antiretroviral therapy in South Western Uganda

BackgroundAntiretroviral treatment restores the physical and immunological function for patients with HIV/AIDS and the return of sexual desire. The frequency and correlates of sexual activity among patients receiving ART have not been widely studied. There is concern that widespread availability of ART may result in sexual disinhibition including practice of high-risk sexual behavior. We determined the correlates of sexual activity and high-risk sexual behavior in an ART-treated population in rural and urban Uganda.MethodsWe conducted a cross-sectional study among 329 ART-treated adult patients at two hospitals, one located in rural and another in urban western Uganda. We collected data on sexual activity, frequency of condom use, pregnancy, viral load (VL) and CD4. Patients were considered sexually active if they had had sexual intercourse in the last 6 months. Any unprotected sex was considered high-risk sex. A two-stage logistic regression was performed to determine factors associated with sexual activity and high-risk sex among those sexually active.ResultsOverall, 222 (67%) patients were women, 138 (41.2%) had been on ART for at least one year, and 168 (51.4%) were sexually active of whom 127 (75.6%) used condoms at the last intercourse. Younger age (<=30 years) (Odds ratio; OR=2.3, 95% CI 1.2, 4.2), higher monthly income (OR=4.1, 95% CI 2.4, 7.4), and being married (OR=22.7, 95% CI 8.2, 62.9) were associated with being sexually active. Undetectable VL, CD4 count and treatment duration were not significantly associated with sexual activity. Among the sexually active, alcohol consumption (OR=3.3, 95% CI 1.2, 9.1) and unknown serostatus of partner (OR=5.8, 95% CI 1.5, 21.4) were significant predictors of high-risk sexual behavior. The frequency of unprotected sex at the last intercourse was 25.9% and 22.1% among the men and women respectively and was not significantly different (p value for chi square test =0.59).ConclusionYounger persons receiving ART are more likely to be sexually active. ART clients are more likely to engage in unprotected sex when sero-status of partner is unknown or report use of alcohol. Counseling on alcohol use and disclosure of sero-status may be useful in reducing high risk sexual behavior.

Online Sex-Seeking Behaviors of Men Who Have Sex With Men in New York City

The ongoing HIV epidemic among men who have sex with men (MSM) in New York City and the increased use of Internet sexual social networking websites by MSM fosters a need to understand the characteristics and sex-related behaviors of this group. The authors conducted an online survey of 195 MSM who use sexual social networking websites in New York City. Demographic characteristics, sexual sensation seeking, and HIV optimism-skepticism were compared among participants reporting sex with and without condom use (safe sex and high-risk sex, respectively) with partners met online. There was no difference in income, education, race, or employment status between the groups. The groups differed significantly in age, sexual sensation seeking, and HIV optimism-skepticism. In a multivariate logistic regression both HIV optimism-skepticism (p < .05) and sexual sensation seeking (p < .05) were significant predictors of high-risk sexual behavior (pseudo-R(2) = .24). This information should be considered when developing interventions for this group. For example, to reach those with high sexual sensation seeking, public health professionals should design sex-positive prevention messages for online distribution that highlight safer sex without condemning risky sexual practices.

Predictors of High-Risk Sexual Behavior Among Gay Men and Men Who Have Sex With Men

ABSTRACT This study of 576 gay men and men who have sex with men examined the predictive value of peer norms, self-efficacy, stigma, social support, age, and recreational drug use on high-risk sexual behavior that enables human immunodeficiency virus transmission. A bivariate analysis found each of these factors significant. A discriminant function analysis revealed that significant predictors of high-risk sexual behavior included low self-efficacy and low outcome expectancy with regard to successfully using a condom, disclosing infection status, and negotiating safer sex and low peer norms for safer sex. Counseling implications for this population are discussed.

Depression, Stress, and Social Support as Predictors of High-Risk Sexual Behaviors and STIs in Young Women

A total of 403 women (aged 14–25 years) were surveyed to determine the association of psychosocial variables with risky sexual behaviors and sexually transmitted infections (STIs). Depression, stress, and low social support were associated with high-risk sexual behaviors and past STIs. When comparing adolescent women (aged 14–19) to young women (aged 20–25), the adolescents had stronger associations with the outcome variables.

Belief in a Just World and Condom Use in a Sample of Gay and Bisexual Men1

Research has shown that, under certain conditions, people with a strong belief in a just world (BJW) perceive themselves to be less at risk for serious negative events (e.g., contracting AIDS). We extended this work by investigating the relation between BJW and high‐risk sexual behavior Gay and bisexual men (N= 102) responded to a questionnaire that measured individual differences in BJW, personality characteristics related to perceived relationship threat (e.g., interpersonal control), and frequency of condom use and anal intercourse. Results generally supported predictions. For example, among respondents low in interpersonal control, a strong BJW was associated with less frequent condom use. These results have implications for research on BJW, as well as research on the predictors of high‐risk sexual behavior.

Predictors of High-Risk Sexual Behavior Among People Living With HIV/AIDS

Several recent studies have found that a significant number of HIV+ individuals are engaging in unsafe sexual practices. This study was conducted to explore the correlates of high-risk sex among a sample of 360 HIV+ adults recruited from outpatient medical care facilities. The study showed that 34% of all respondents reported at least 1 occasion of unprotected anal or vaginal intercourse in the previous 6 months. Consistent with other research, there were multiple correlates of high-risk sex: lower income, an elevated number of sexual partners, negative attitudes about condoms, lack of risk avoidance strategies, and recreational and intravenous drug use prior to sex. However, contrary to other research, no association was found between low self-esteem, depression/anxiety, or the use of alcohol with unprotected sex. Unlike most studies that have focused exclusively on gay and bisexual men, this study included an additional sample of women and poorer, ethnically diverse individuals. Although there were some gender and ethnic differences, neither gender nor ethnicity moderated any of the significant relationships between psychosocial variables and sexual behavior, suggesting the commonality of issues confronting people living with HIV/AIDS in maintaining safer sex practices. Implications for designing interventions for HIV+ persons are discussed.

High-Risk Sexual Behavior Among Persons Living With HIV Disease in Small Towns and Rural Areas

Most investigations describing sexual behavior patterns among persons living with HIV / AIDS have been conducted in large urban centers. However, it is also likely that some individuals in small towns and rural areas who are aware of their HIV infection continue to engage in high-risk sexual behaviors that place their partners at risk for HIV infection. The present study examines rates and predictors of high-risk sexual behavior among 79 persons living with HIV / AIDS in nonmetropolitan areas of a midwestern state. In late 1995, an anonymous self-report survey assessing health-related quality of life, social support, access to health care services, illness-related coping strategies, substance use, and sexual behavior was distributed to persons living with HIV/AIDS in communities with populations under 50,000. One-third of HIV-infected persons reported they had engaged in unprotected sex in the preceding 6 months. Individuals who were more likely to have unprotected sex lived with their partners, reported higher levels of physical well-being, had poor relationships with their physicians, and more frequently used alcohol and illegal drugs. As the prevalence of AIDS in rural areas increases, and as HIV-infected rural residents live longer, interventions are needed to assist HIV-infected rural individuals who have difficulty avoiding high-risk sexual behaviors.

Predictors of High-Risk Sexual Behavior Among Individuals Living with HIV Disease and AIDS

An important focus of the 1996 World Aids Conference related to the extent of unprotected sex among gay men, particularly those in their twenties. This paper will use logistic analysis to explore the extent of unsafe sexual practices among individuals living in Bexar County, Texas, who are HIV+ assymptomatic, HIV+ symptomatic, or have AIDS. Using survey research data, we assess the significance and impact of various independent factors on whether respondents reported they did or did not engage in unprotected sex. The most striking finding is that unprotected sexual activity is prevalent regardless of demographic and/or status differences among respondents. Findings reinforce the use of community planning processes, which emphasize the importance of sound behavioral and social science combined with efforts to include the affected constituency to create effective HIV prevention programs.

A study of sexual behavior among rural residents of China.

Although the recent spread of HIV/AIDS and other sexually transmitted diseases (STDs) in China has been associated with sexual activities, little information has been available about sexual behavior in rural areas with high HIV prevalence. Studies identifying high-risk sexual behaviors are needed to formulate effective prevention programs. A cross-sectional study design was used to measure sexual activities using a two-stage cluster sampling method. A two-part anonymous questionnaire was used. Sensitive questions related to sexual behavior were administered using a tape recorder, earphones, and an answer sheet which did not include the text. In total, 1057 subjects were interviewed. Among 886 sexually active individuals, 7.8% had >1 sexual partner, 22.8% had premarital sex, 2.4% had anal intercourse, 4.1% had oral intercourse, and 2.3% had both anal and oral intercourse. Less than 2% reported past or current sexually transmitted diseases. Overall, 10.4% used condoms; only 11.2% for every sexual act. History of premarital and extramarital sex was higher in younger people. Sexual norms in rural China are changing rapidly and high-risk sexual behavior among young rural residents is increasing. Strategies to prevent HIV/AIDS should include education to promote delayed onset of sexual activity, safer sexual behavior, and condom use.

Psychosocial factors and high-risk sexual behavior: race differences among urban adolescents.

Adolescence is a period of sexual experimentation. We examined psychosocial predictors of high-risk sexual behavior and condom use. The sample included 824 ninth-graders, most of whom are African American. We conducted separate analyses for whites and African Americans. Predictors included alcohol and substance use, delinquency, prosocial behaviors, and family and peer influences. We found that problem behaviors predicted high-risk sexual behavior, but the effects were stronger for white youth. We also found that friends' behaviors were more predictive than family influences, except for family conflict. In general, the models explained more variance for white youths than for African-American youths. The results suggest that problem behavior theory and social interactions theory may be most relevant for white youth and that other models may be necessary to explain high-risk sexual behavior among African-American youths.

Optimal scaling of HIV-related sexual risk behaviors in ethnically diverse homosexually active men.

As HIV-related behavioral research moves increasingly in the direction of seeking to determine predictors of high-risk sexual behavior, more efficient methods of specifying patterns are needed. Two statistical techniques, homogeneity analysis and latent class analysis, useful in scaling binary multivariate data profiles are presented. Both were used to analyze reported sexual behavior patterns in two samples of homosexually active men, one sample of 343 primarily White gay men attending an HIV workshop and one sample of 837 African American gay men recruited nationally. Results support the existence of a single, nonlinear, latent dimension underlying male homosexual behaviors consistent with HIV-related risk taking. Both statistical methods provide an efficient means to optimally scale sexual behavior patterns, a critical outcome variable in HIV-related research.

Patterns and predictors of high-risk sexual behavior in female partners of HIV-infected men with hemophilia.

To characterize and quantify high-risk heterosexual activity in HIV-discordant couples. Analysis of cross-sectional and longitudinal questionnaire data from 217 HIV-negative female sexual partners of HIV-infected hemophilic men. Comparison of prevalence rates of anal sex, oral sex, vaginal intercourse with or without condoms, and use of other contraceptives between 1985 and 1991. Logistic regression analysis of demographic, sexual and clinical variables to predict unprotected vaginal sex. Actuarial estimates of semi-annual relapse rates to unsafe sex. The proportion of women at low risk increased from 7 to 69% between 1985 and 1991, mainly because more women were using condoms during all acts of vaginal intercourse. Other contraceptive practices did not change during this time. The proportion engaging in oral or anal sex decreased (from 26 to 13% and 13 to 4%, respectively). Unprotected vaginal sex was more common among women who enrolled earlier, had less education, engaged in oral or anal sex, and among those whose partners had not had AIDS. Unprotected vaginal sex before enrollment was the strongest predictor of this high-risk activity during follow-up. Two-year rates of relapse to high-risk behavior were significantly higher among women who enrolled at high risk compared with those who enrolled at low risk (39 versus 8%, P = 0.005). Although high-risk sexual behavior became much less prevalent in this population between 1985 and 1991, many continued to have unprotected vaginal sex occasionally. Counseling efforts should target couples who have been the most sexually active or have less education, and should emphasize not only initial risk reduction but also maintenance of low-risk behavior.

Relationship with multiple partners in university women: a comparative study in two institutions from the northwest of Mexico

Objective: To identify what variables influence having multiple sexual partners. Methods: A cross-sectional study was carried out with 542 women of two higher education institutions from the northwest of Mexico, who answered a questionnaire measuring psychological variables underlying high-risk sexual behaviors. The data were analyzed with T-tests, Mann-Whitney U tests, and with a multiple linear regression. Results: A multiple linear regression analysis showed the following results: for women from Hermosillo, Sonora, the predictors of high-risk sexual behaviors were biological age, age of sexual debut, and one biological state - «I was physically excited»-, with those variables explaining 53.4% of the total variance; for women from Ciudad Juarez, Chihuahua, the predictors were biological age, and two types of biological states -«I was physically excited» and «I was under the influence of alcohol», explaining 20.8% of the total variance. Conclusions: The results underscore the need to design prevention programs directed to avoid HIV infection based on behavioral competencies training.