Risk Behaviors For HIV Infection Research Articles

946HIV prevalence and common risk factors in three at-risk populations in Vietnam

Abstract Background Despite the continuing decline of HIV/AIDS incidence and prevalence in the general population of Vietnam, HIV rates remains high in three key subpopulations: injecting drug users (IDUs), men who have sex with men (MSM) and female sex workers (FSWs). This study aims to identify the common sociodemographic characteristics and behavioural risk factors among three key populations for HIV infection in Vietnam. Methods This study used a systematic review and meta-analysis to synthesise findings from published studies on HIV prevalence and associated risk factors among the three at-risk groups. Five electronic databases were used to identify peer-reviewed articles in relevant topics. Comprehensive Meta-Analysis software was used to estimate pooled prevalence in the combined study population and to determine the effect sizes of the common risk factors on HIV outcome. Results Of the 18 included studies, 6 focused on IDUs, 8 on FSWs and 4 on MSM, accounting for a total of 16,304 participants. The overall prevalence of HIV among the three at-risk groups based on meta-analysis was 11.8% (95%CI: 0.072-0.188). The identified common risk behaviours for HIV infection included injecting drug use (OR: 21.3, 95%CI: 6.5-69.3), sharing injecting equipment (OR: 4.2, 95%CI: 2.1-8.2) and inconsistent condom use (OR: 2.6, 95%CI: 1.5-4.4). The associated socio-demographic characteristics with HIV (+) included young age, single/ unmarried, low education and income. Conclusions/Key messages The findings of this study suggested that injecting drug use may can contribute to developing more affective prevention measures targeting these high-risk groups and reducing the risk of HIV transmission to the general population.

\u201cI think everybody should take it if they\u2019re doing drugs, doing heroin, or having sex for money\u201d: a qualitative study exploring perceptions of pre-exposure prophylaxis among female participants in an opioid intervention court program

BackgroundWomen’s rise in opioid use disorder has increased their presence in the criminal justice system and related risk behaviors for HIV infection. Although pre-exposure prophylaxis (PrEP) is an effective biomedical HIV prevention treatment, uptake among this high-risk population has been particularly low. Considerably little is known about the interplay between justice-involved women with opioid use disorder and HIV prevention. The aim of this study was to explore PrEP knowledge, attitudes, and perceptions for personal and partner use among women participants in the nation’s first ever opioid intervention court program.MethodsThe authors conducted semi-structured, in-depth interviews with 31 women recruited from an Opioid Intervention Court, a recent fast-track treatment response to combat overdose deaths. We utilized a consensual qualitative research approach to explore attitudes, perceptions, and preferences about PrEP from women at risk for HIV transmission via sexual and drug-related behavior and used thematic analysis methods to code and interpret the data.ResultsPrEP interest and motivation were impacted by various factors influencing the decision to consider PrEP initiation or comfort with partner use. Three primary themes emerged: HIV risk perceptions, barriers and facilitators to personal PrEP utilization, and perspectives on PrEP use by sexual partners.ConclusionsFindings suggest courts may provide a venue to offer women PrEP education and HIV risk assessments. Study findings inform public health, substance use, and criminal justice research and practice with justice-involved participants experiencing opioid use disorder on the development of gender-specific PrEP interventions with the ultimate goal of reducing HIV incidence.

Assessment of Risk Behaviors for HIV Infection among Undergraduate Students at a Historically Black University

Aims: This study aimed to assess and compare risk behaviors for HIV Infection among undergraduate students by gender at a historically black university.
 Study Design: A cross-sectional survey.
 Place and Duration of Study: This study was conducted from January 10, 2016 to September 30, 2016. Participants were selected through convenience sampling among undergraduate students of Jackson State University (JSU).
 Methodology: Sample: We included 400 undergraduate students (141 males, 259 females; age range 18-57 years). Data were collected using a validated self-administered standardized questionnaire that was designed to measure their risk behaviors for HIV Infection.
 Results: Over seventy five percent of undergraduate students in this study have had at least one risk behavior related to HIV infection transmission. The engagement of these students in HIV sexual risk behaviors were not varied by gender (Chi-square test = 2.76; P = 0.1). However, participants engaged in various risk behaviors related to HIV infection transmission such as multiple sexual partners, unprotected sexual intercourse, low and inconsistent condom use.
 Conclusion: We concluded that about 75.8% of the students have had at least one risk behavior related to HIV infection and engaged in various risk behaviors related to HIV infection transmission. The engagement of these students in HIV sexual risk behaviors were not varied by gender. This investigation calls for sustained effective youth appealing interventions tailored toward addressing various risk behaviors identified in this study.

Prevalence and attitudes to HIV testing among adults visiting public outpatient clinics in Rome: results of the MeDi (Measuring health Disparities in HIV prevention) survey. Part 1.

It is estimated that, in Italy, 12 000-18 000 (11-13% of 130 000) HIV-infected subjects are not aware of their serostatus. People in this condition may visit the healthcare system multiple times without being diagnosed. If tested on one of these occasions, they could modify their high-risk behaviours and benefit from treatment, factors that reduce HIV transmission. In Italy, no data on HIV testing in the general population are available so far and little is known on the relationship between socioeconomic determinants (at individual and neighbourhood levels) and testing uptake. A large anonymous survey was performed in 2012-2014 on more than 10 000 individuals 18-59 years old who underwent 21 public ambulatories in Rome to determine the proportion of subjects tested for HIV and factors related to testing uptake. Subjects' socio-demographic characteristics, sexual orientation, number of sexual partners, HIV risk behaviour, HIV testing uptake were collected by a self-administered questionnaire. Level of area deprivation was measured at the postal code level by the index of social disadvantage (ISD). Multilevel Poisson regressions were carried out to take heterogeneity between clusters (post code and clinics) into account. Among people participating in the study, 58.1% of subjects self-reported to have been tested at least once for HIV. Those who had one high risk behaviour for HIV-infection were 11% more likely to test than those not reporting any, and subjects who had had a STI (sexually-transmitted-infection) in the past were 12% more likely to test than those who had not had a STI. However only 44% (54% among subjects aged 18-35 years) of those with self-reported risks of contracting HIV had been tested at least once in life. This percentage increases, as expected, with the level of education, but, even so, about 40% of university educated subjects self-reporting risks of contracting HIV had never undergone an HIV test. This study highlights that, while the percentage of subjects tested is even higher than observed in other western nations, only 44% of subjects, self-reporting risks of contracting HIV, had tested at least once in life and about 40% of university educated subjects self reporting risks of contracting HIV had never tested.

PERSONALIZED COGNITIVE COUNSELING IN PREVENTING RISK BEHAVIOR AMONG MEN WHO HAVE SEX WITH MEN (MSM): A LITERATURE REVIEW

The current trend of HIV infection shows an increase in cases among men who have sex with men (MSM). Risk behavior in MSM has shown a high prevalence of moderate and worrying risk behaviors for HIV infection, including unprotected anal intercourse (UAI) and drug use. This literature review aims to explore the effectiveness of Personalized Cognitive Counseling (PCC) interventions in reducing risk behaviors for HIV transmission to MSM. Articles discussed in this literature study were obtained from several databases using the keywords “personalized cognitive counseling," “men who have sex with men," and "risk behavior." Cognitive counseling interventions are effective in reducing episodes of anal intercourse. Adapted Personalized Cognitive Counseling (PCC) intervention also has been effective in reducing sexual risk behavior in drug users MSM. This intervention is possible and essential to developing in dealing with risk behavior in MSM that tends to increase in its population.
 
 Keywords: cognitive counseling, personalized cognitive counseling, men who have sex with men (MSM), risk behavior

Vulnerability to HIV among older men who have sex with men users of dating apps in Brazil

IntroductionThe elderly population is increasingly benefiting from recent technological advances. In this scenario, geolocation-based dating applications provide a viable alternative for finding partners in a practical and timely manner, but may be accompanied by certain risk behaviors for HIV infection. Although there are considerable number of users over 50 on these applications, no studies have addressed this problem. The aim of the present study was to analyze factors of vulnerability to HIV/Aids among the population of men who have sex with men (MSM) age 50 years or older who use dating apps. MethodsThis was a cross-sectional, population-survey-based, analytical study, conducted exclusively online with a sample of 412 MSM. The data was collected from the following apps: Grindr®, Hornet®, Scruff® and Daddy Hunter®. ResultsFactors associated with a higher chance of having HIV were: sexual relations with an HIV-infected partner (ORa=5.53; 95%CI=2.23–13.73); chemsex (ORa=3.97; 95%CI=1.72–8.92); and, above all, having an HIV-infected partner (ORa=8.02; 95%CI=2.01–32.01). The belief that apps increase protection against sexually transmitted infections (ORa=0.43; 95%CI=0.19–0.95) and not being familiar with post-exposure prophylaxis (ORa=0.43; 95%CI=0.19–0.95) were associated with decreased chances of having HIV. ConclusionsWe highlight some important factors that structure the vulnerability of the MSM surveyed in relation to HIV infection. The findings should be used to customize care for this population, which could bring them in more for health care services.

Injection and Heterosexual Risk Behaviors for HIV Infection Among Non-gay Identifying Men Who Have Sex with Men and Women.

Non-gay identifying men who have sex with men and women (MSMW) are an important subgroup of men who have sex with men (MSM) and have been underrepresented in studies of MSM that only use gay venues to draw their samples. We assessed heterosexual and drug use risks of MSMW who use drugs in a sample of male entrants to the Mount Sinai Beth Israel drug treatment programs from 2005 to 2018. Blood samples were collected and tested for HIV and HSV-2 infections. Among HIV seronegative participants, MSMW had significantly greater odds of sharing used needles with others, and reporting unprotected sex with female casual partners and female commercial sex partners, compared to their counterparts who reported sex with women exclusively (MSWE). Although not recruited from gay venues, MSMW had a significantly higher HIV prevalence than MSWE (23% vs. 10%, p < 0.001). Interventions that are specifically tailored to HIV prevention among MSMW are needed to ameliorate the prevalence of HIV risks and infection.

Risk behaviors for HIV infection. A review of emerging trends.

HIV infection, acquired with the conscious participation of the recipient, is a complex problem of international concern, especially among men who have sex with men. Behaviors emerge such as bareback (intentionally unprotected anal sex between men) and bugchasing (bareback sex when one participant is HIV+ and the other is not). A group of emerging risk behaviors for HIV infection was characterized. A review of the literature in the MEDLINE, Web of Science and regional SciELO databases was performed. HIV-related search terms such as unprotected sex, barebacking/bareback and bug chasing, were used. Bareback and bug chaser behaviors occur, among other factors, through social homonegativity, ART positive coverage, insufficient prevention campaigns, search for new sensations and attempts to strengthen the relationship with the HIV+ member. Unprotected sex is primarily associated with having HIV/AIDS diagnoses, physical violence due to sexual orientation, viewing homosexual sex sites, and having bought or sold sex. It is necessary to work with individual behaviors that draw individuals close to infection.

Experiential learning of HIV self-test among student nurses: A qualitative study

BackgroundThere is increasing demand for HIV self-tests, and nurses play an important role in counselling and assisting in the testing process. Traditional lecture-based nursing education has not typically focused on self-testing procedures, and there is little understanding of clients' experiences of self-testing. ObjectivesTo understand the experiential learning (EL) of student nurses during the process of self-testing for HIV. DesignThis study used a qualitative design. SettingsA college in northern Taiwan. ParticipantsWe recruited a purposive sample of 30 nursing students. MethodsThe OraQuick self-test was used as the self-testing tool in this study. After participants used the OraQuick self-test, they underwent a semi-structured interview during the post-test counselling period. All interview data were subjected to line-by-line content analysis. ResultsWe extracted nine themes of nursing students' experiences during experiential learning of HIV self-test. In the pre-test stage, they recalled possible risk behaviors for HIV infection, decided to complete the self-test alone or asked for significant others to accompany them, and endured emotional fluctuations immediately prior to the test. When waiting for the test results, they felt isolated from the outside world. Some participants also began questioning the accuracy and safety of the test, and either viewed the results immediately or later on. In the post-test stage, some participants reported being uncertain about the results. Participants reported a greater understanding of the personal impact of testing and revealed their needs for support. Some identified a sense of loss and linked this to the rapid and direct delivery of test results. ConclusionsOur results can be used to guide HIV-related education courses and prevention programs. Experiential learning has the potential to improve HIV pre and post-test counselling, as nurses develop both clinical knowledge and personal insight of the testing process.

Neighborhood Environments and Sexual Risk Behaviors for HIV Infection Among U.S. Women: A Systematic Review.

Empirical evidence indicates that aspects of the neighborhood environment may affect HIV prevention efforts. Therefore, the neighborhood environment should be considered when implementing prevention interventions. However, much of the empirical evidence is derived from studies conducted among drug users, men, or adolescents. Such evidence may not be as applicable to adult women whose primary risk for HIV infection is via heterosexual sexual behavior. Therefore, a systematic review examining the relationship between neighborhood environments and HIV sexual risk behaviors among adult U.S. women was conducted. Three databases were searched for articles published in English in peer-reviewed journals between 1/1/1980 and 12/31/2016 meeting relevant criteria. Seven articles identified from the three databases or additional hand searches met inclusion criteria and were summarized. Findings were mixed with several studies indicating associations between neighborhood environments and HIV sexual risk behaviors. However, all summarized studies were cross-sectional. Longitudinal studies conducted among women are needed.

A Review of Risk Behaviors for HIV Infection by Men Who Have Sex With Men Through Geosocial Networking Phone Apps

The purpose of our review was to analyze the relationship between the use of geosocial networking phone apps and risk behaviors for HIV infection in men who have sex with men (MSM). The review was guided by the question: Does the use of geosocial networking apps to find sex partners increase risk behaviors for HIV infection by MSM? We searched the databases PubMed, Web of Science, CINAHL, and LILACS, considering primary studies published up to December 2015, without any time restraint. All 14 studies that met our search criteria analyzed sexual behaviors in relation to sociocultural and economic characteristics, number of partners, unprotected anal sex, drug use, HIV testing, risk management measures, and the presence of other sexually transmitted diseases. The results indicated that use of geosocial networking apps to find sex partners may lead to new patterns of behavior and relationships that place MSM at risk for HIV.

Prevalence and Associations of Psychological Distress, HIV Infection and HIV Care Service Utilization in East Zimbabwe

The correlation between mental health and sexual risk behaviours for HIV infection remains largely unknown in low and middle income settings. The present study determined the prevalence of psychological distress (PD) in a sub-Saharan African population with a generalized HIV epidemic, and investigated associations with HIV acquisition risk and uptake of HIV services using data from a cross-sectional survey of 13,252 adults. PD was measured using the Shona Symptom Questionnaire. Logistic regression was used to measure associations between PD and hypothesized covariates. The prevalence of PD was 4.5% (95% CI 3.9–5.1%) among men, and 12.9% (95% CI 12.2–13.6%) among women. PD was associated with sexual risk behaviours for HIV infection and HIV-infected individuals were more likely to suffer from PD. Amongst those initiated on anti-retroviral therapy, individuals with PD were less likely to adhere to treatment (91 vs. 96%; age- and site-type-adjusted odds ratio = 0.38; 95% CI 0.15, 0.99). Integrated HIV and mental health services may enhance HIV care and treatment outcomes in high HIV-prevalence populations in sub-Saharan Africa.

Risk behaviours for HIV infection among travelling Mexican migrants: The Mexico–US border as a contextual risk factor

ABSTRACTThe Mexico–US border region is a transit point in the trajectory of Mexican migrants travelling to and from the USA and a final destination for domestic migrants from other regions in Mexico. This region also represents a high-risk environment that may increase risk for HIV among migrants and the communities they connect. We conducted a cross-sectional, population-based survey, in Tijuana, Mexico, and compared Mexican migrants with a recent stay on the Mexico–US border region (Border, n = 553) with migrants arriving at the border from Mexican sending communities (Northbound, n = 1077). After controlling for demographics and migration history, border migrants were more likely to perceive their risk for HIV infection as high in this region and regard this area as a liberal place for sexual behaviours compared to Northbound migrants reporting on their perceptions of the sending communities (p < .05). Male border migrants were more likely to engage in sex, and have unprotected sex, with female sex workers during their recent stay on the border compared to other contexts (rate ratio = 3.0 and 6.6, respectively, p < .05). Binational and intensified interventions targeting Mexican migrants should be deployed in the Mexican border region to address migration related HIV transmission in Mexico and the USA.

P4.051 Vulnerability to HIV and Prevention Needs of Female Post-Secondary Students Engaged in Transactional Sex in Kumasi, Ghana - A Qualitative Study

BackgroundThis was a qualitative study on the vulnerability to HIV of female post-secondary students engaging in transactional sex (TS) - defined as engaging in sex for the purpose of obtaining...

S6.2 Dangerous liaisons: risk in MSM in developed countries

Although there has been a reduction in incident HIV infection in some MSM communities in developed countries, in others new diagnoses and incident infections are increasing. Helping those who are...

Sexual Risk Behaviors for HIV Infection in Spanish Male Sex Workers: Differences According to Educational Level, Country of Origin and Sexual Orientation

The stigma associated with male sex workers (MSW) hinders the prevention, treatment, and care of HIV infection in this population. These factors make social and public health resources less accessible to MSW. To improve the effectiveness of prevention strategies, this study examines social factors such as educational level, country of origin, and sexual orientation. Semi-structured interviews of 100 MSW in Castellón and Valencia (Spanish cities) indicate that knowledge of HIV transmission is good; nevertheless, MSW significantly overestimate or underestimate some sexual practices. Levels of condom use are high; notably, they are higher during anal sex. Levels of condom use are lower with intimate partners than with clients. MSW do not present differences in terms of the socio-demographic variables analyzed and sexual orientation. Furthermore, regression analyses are not significant. These results offer more accurate profiles of MSW than were previously available, which will ultimately help improve the effectiveness of prevention programs.

HIV Seroprevalence among High-Risk Groups in Kohgiloyeh and Boyerahmad Province, Southwest of Iran, a Behavioral Surveillance Survey

We conducted a survey to assess the seroprevalence and risk behaviors for HIV infection in 2,009 individuals in Kohgiloyeh and Boyerahmad province, in Southwest of Iran. Blood samples were drawn from each participant and tested for anti-HIV1/2 antibodies. HIV antibodies were detected in 36 (1.8%) blood samples among a total of 2,009 participants. The rate of infection in inmates was 2.7% while this rate was 9.9% in injection drug users. Correlation between HIV infection and sex, age, marital status, history of imprisonment, injection drug use, and place of residence were significant. Improving of the surveillance in this community through supervision and monitoring of infected people is needed.

Missed opportunities for earlier HIV testing and diagnosis at the health facilities of Dessie town, North East Ethiopia

BackgroundFor patients in all health-care settings HIV screening is recommended after the patient is notified that testing will be performed unless the patient declines. The nation's physicians and other health care providers should assume a much more active role in promoting HIV testing. The aim of this study was to investigate the extent to which missed opportunities for earlier HIV testing and diagnosis occur in the health facilities of north east Ethiopia.MethodsA confidential client exit interview and medical record review was made on 427 clients who attended health facilities of Dessie town between November-December 2008. Data collection was done by counselors trained on Provider Initiated Counseling and Testing (PICT) and data collection tool included demographics, reason for visit to health facilities, HIV test initiation by service providers, clients self risk perception, clients willingness and acceptance of HIV test, HIV test result and review of client medical records.ResultsAmong 427 clients, missed opportunities for HIV testing were found in 76.1% (325) of clients. HIV test initiation was made by data collecting counselors during interview period and 80.0% (260) of clients not initiated by service providers were found to be willing to have HIV test. Large number, 43.0% (112), of the willing clients actually tested for HIV. Of the tested clients, 13.4% (15) were found to be HIV positive. Most, 60% (9), of HIV positive clients who lost the opportunities of diagnosis felt themselves as having no risk for HIV infection. Missed opportunities for HIV diagnosis of 51.7% (15), overall HIV test acceptance rate of 36.5% (154) and positivity rate of 6.9% (29) were found.ConclusionsThe missed opportunities for earlier HIV test and diagnosis of patients attending health facilities were found to be high and frequent. Testing only clients with HIV risk misses large number of HIV positive patients. Asking clients' willingness for HIV testing should be conducted by all service providers irrespective of the clients' risk behaviors for HIV infection or the type of services they need.

Controlled trial of prescribed heroin in the treatment of opioid addiction

Aim This study aimed to assess the efficacy of the prescription of intravenous diacetylmorphine (DAM) versus oral methadone with medical and psychosocial support, with a view of improving physical and mental health as well as social integration among socially excluded, opioid-dependent individuals for whom standard treatments have failed. Design This study used an open, randomized controlled trial. Setting This study took place in Granada, Spain. Participants Sixty-two opioid-dependent participants were randomized, 31 in each treatment group, and 50 of them were analyzed. The participants were recruited directly from the streets, through peer outreach, in well-known meeting places for drug-addicted individuals. Interventions Participants in the experimental group received injected DAM, twice a day, plus oral methadone, once a day, for 9 months. The control group received only oral methadone, once a day. The two groups received an equivalent opioid dosage. The average DAM dosage was 274.5 mg/day (range: 15–600 mg), and an average methadone dosage was 42.6 mg/day (range: 18–124 mg). The daily methadone dosage in the control group was 105 mg/day (range: 40–180 mg). Comprehensive clinical, psychological, social, and legal support was given to both groups. Measurements The following were measured in this study: general health, quality of life, drug-addiction-related problems, nonmedical use of heroin, risk behavior for HIV and HCV, and psychological, family, and social status. Findings Both groups improved with respect to the total domain assessed. Those in the experimental group showed greater improvement in terms of physical health (the improvement was 2.5 times higher; p = .034) and risk behavior for HIV infection (the improvement was 1.6 times higher; p = .012). In addition, this group decreased its street heroin use from 25 days/month to 8 days/month as seen on the Addiction Severity Index ( p = .020), as well as the number of days free from drug-related problems (the improvement was 2.1 times higher; p = .004) or involvement in crime (from 11 days/month to <1 day/month; p = .096 between groups). Conclusions These findings support the hypothesis that, under the same conditions, DAM could be safely delivered, in our context. Also, in physical health, HIV risk behavior, street heroin use, and days involved in crime, DAM plus methadone was more efficacious than methadone alone. This implies that this treatment could provide an effective alternative for the treatment of socially excluded, opioid-dependent patients with severe physical and mental health problems because of drug addiction, when all available previous treatments have failed.

Khat chewing habit as a possible risk behaviour for HIV infection: a case-control study

Background: The use/abuse of psychoactive drugs such as khat leaves (Catha edulis) are believed to alter one's moods or emotional state either through the sustained release or inhibition of neurotransmitters, thereby enhancing or dampening the response of the individual. Most people whose thinking are warped by continued drug use may not be able to see the harm resulting from their actions. Thus, there has been a strong linkage between drug use and casual or unsafe sexual practice despite the serious concern about HIV infection. Objective: Khat chewing is known to be a widespread habit in Ethiopia. This study is, thus, aimed at investigating whether or not the use of this psychostimulant alone or in conjunction with other behaviors associated with its use constitutes a risk behavior that accelerates the spread of HIV infection. Methods: A case-control study involving 850 human subjects, i.e. 425 HIV positives (cases) and 425 HIV negatives (controls) was conducted using rapid test algorithm and/or western blot method for determination of HIV status. Both groups were interviewed about their probable khat chewing habits, alcohol intake, multiple sexual practice, and the like, using a structured questionnaire. The data were analysed using SPSS/PC + statistical software.Results: Risk behaviors for HIV infection such as khat chewing in conjunction with alcohol intake and casual sex were observed more in people with HIV than in the control group. Khat chewing was significantly associated with multiple sexual practice (OR = 4.03, 95% CI = 3.02, 5.39), which in turn was strongly linked with HIV cases (OR = 3.52, 95% CI = 2.64, 4.69). Thus, more than the non-chewers, khat chewers constituted significantly higher number of HIV cases (OR =2.32, 95% CI = 1.75, 3.07).Conclusion/Recommendations: Khat chewing is a risk behavior for the spread of HIV infection. Mainstreaming of khat control into national development planning initiatives is recommended.The Ethiopian Journal of Health Development Vol. 19(3) 2005: 174-181