RESUMEN
Men of Mexican descent (MMD) in the U.S. are disproportionately affected by HIV. Understanding MMD's access to HIV prevention is necessary to reduce their transmission rates. We explored disparities in access to HIV prevention among MMD of different assimilation status, healthcare access, and sexual risk behavior. 322 Midwestern MMD completed a survey assessing their access to passive interventions (e.g., lectures), interactive interventions (e.g., counseling), HIV testing, media information, and information from the Internet. 64% MMD had received passive interventions, 36% interactive interventions, 42% HIV testing, 41% information from media, and 12% from the Internet. MMD who were less assimilated to the U.S., had lower healthcare access, and were at risk for HIV, were less likely to have accessed prevention interventions but more likely to have received media information. Access to HIV prevention among Midwestern MMD is tied to their assimilation and healthcare access. Findings have implications for developing strategies of intervention delivery.
Asunto(s)
Infecciones por VIH/prevención & control , Accesibilidad a los Servicios de Salud , Americanos Mexicanos , Infecciones por VIH/etnología , Disparidades en Atención de Salud , Humanos , Masculino , Medio Oeste de Estados UnidosRESUMEN
In the USA, a high proportion of men of Mexican descent (MMD) test for HIV late in the course of the infection and miss opportunities for prevention. Given the need to promote timely HIV testing among MMD, we studied how MMD's motivations and previous experiences with disease prevention influence their intentions to seek (i.e., client-initiated HIV testing) and accept (i.e., provider-initiated HIV testing) an HIV test. We conducted a survey (N=302) at a large Mexican festival in the Midwestern USA. We elicited MMD's sexual risk behavior, social norms and culturally supported HIV testing expectations, previous experiences with disease prevention, and their intentions to seek and accept a free HIV test. Forty-one percent of MMD intended to actively seek an HIV test and 70% said they would accept it from a provider. Multivariate analyses indicated that MMD's intentions to seek and intentions to accept an HIV test were stronger when they expected desirable outcomes of an HIV test, including benefits for their family and community. Whereas MMD's intentions to actively seek an HIV test were stronger when they had more previous experiences with disease prevention and normative support, their intentions to accept an HIV test from a provider were stronger when they expected less negative outcomes from testing for HIV (e.g., stigma). Provider-initiated HIV testing may improve HIV testing access, particularly among MMD with lower experience and support. However, efforts to promote provider-initiated HIV testing among MMD should challenge negative HIV testing expectations and associate HIV testing with positive outcomes.
Asunto(s)
Serodiagnóstico del SIDA/psicología , Infecciones por VIH/diagnóstico , Conductas Relacionadas con la Salud , Americanos Mexicanos/psicología , Aceptación de la Atención de Salud/psicología , Adolescente , Adulto , Análisis de Varianza , Humanos , Intención , Masculino , Tamizaje Masivo , México/etnología , Persona de Mediana Edad , Medio Oeste de Estados Unidos , Motivación , Estados Unidos , Adulto JovenRESUMEN
Seriously mentally ill women at risk for HIV infection (n = 96) participated in structured interviews assessing sexual and substance-use behavior over a 3-month period. The majority of the women (63.5%) did not use condoms. Consistent with the theory of reasoned action, attitudes toward condom use and perceived social norms about safer sex were associated with safer sex intentions. Supplementing variables from the theory of reasoned action with safer sex self-efficacy explained additional variance in safer sex intentions. Greater safer sex intentions were related to both greater condom use and less frequent unprotected intercourse. In addition, less frequent sex after drug use and a less fatalistic outlook were associated with less frequent unprotected intercourse. Life circumstances specific to this population are particularly important to examine to improve the effectiveness of risk reduction interventions for seriously mentally ill women.
Asunto(s)
Infecciones por VIH/prevención & control , Conocimientos, Actitudes y Práctica en Salud , Enfermos Mentales/psicología , Conducta de Reducción del Riesgo , Sexo Seguro/psicología , Adulto , Condones/estadística & datos numéricos , Infecciones por VIH/epidemiología , Humanos , Intención , Modelos Logísticos , Enfermos Mentales/estadística & datos numéricos , Persona de Mediana Edad , Modelos Psicológicos , Valor Predictivo de las Pruebas , Valores Sociales , Factores Socioeconómicos , Trastornos Relacionados con Sustancias/epidemiología , Trastornos Relacionados con Sustancias/psicología , Adulto JovenRESUMEN
In structured interviews with 96 women with severe mental illness, nearly two-thirds had not used condoms during sexual intercourse in the past 3 months, more than two-thirds had sex with multiple partners, and almost one-third had been treated for a sexually transmitted infection (STI) in the past year. Women who reported fewer sexual risk context factors, such as having sex with someone the participant did not know or transactional sex, had fewer sexual partners. Larger social support networks were associated with less frequent sex after drug use. In turn, women who less often had sex after using drugs had unprotected intercourse less frequently.
Asunto(s)
Infecciones por VIH , Trastornos Mentales , Asunción de Riesgos , Apoyo Social , Trastornos Relacionados con Sustancias , Adulto , Femenino , Humanos , Entrevistas como Asunto , Persona de Mediana Edad , Medición de Riesgo , Índice de Severidad de la Enfermedad , Estados Unidos , Sexo InseguroRESUMEN
Two separate databases, one on Russian (n = 444) injection drug users (IDUs), and the other on U.S. IDUs (n = 241), were merged, and responses were compared. Results indicated that Russian IDUs perceived themselves to be at greater risk for HIV/AIDS based upon behaviors over the past 90 days. U.S. IDUs were more likely to be tested for HIV, report a negative HIV result, and know more people with HIV. U.S. IDUs consumed greater amounts of alcohol and marijuana, and made more alcohol/drug treatment attempts than Russian IDUs. Russian IDUs injected more frequently, although were more likely to recently use clean needles. Russian and U.S. IDUs responded significantly differently to eight AIDS knowledge questions. Eight condom attitude questions were asked of each group, and each revealed significantly different responses. Gender differences for Russian IDUs were also observed. There is a clear need to create culturally targeted sexual risk reduction interventions.
Asunto(s)
Síndrome de Inmunodeficiencia Adquirida/transmisión , Actitud Frente a la Salud , Condones/estadística & datos numéricos , Comparación Transcultural , Seropositividad para VIH/epidemiología , Sexo Seguro/estadística & datos numéricos , Educación Sexual , Abuso de Sustancias por Vía Intravenosa/epidemiología , Serodiagnóstico del SIDA/estadística & datos numéricos , Síndrome de Inmunodeficiencia Adquirida/epidemiología , Adulto , Bases de Datos Factuales , Seropositividad para VIH/rehabilitación , Conocimientos, Actitudes y Práctica en Salud , Humanos , Programas de Intercambio de Agujas/estadística & datos numéricos , Factores de Riesgo , Federación de Rusia , Factores Socioeconómicos , Abuso de Sustancias por Vía Intravenosa/rehabilitación , Estados UnidosRESUMEN
Injection risk practices and unprotected sex between injection drug users (IDUs) and their sexual partners are responsible for a high proportion of AIDS cases and new HIV infections in the United States. The purpose of this study was to investigate the links between drug use behaviors and psychosocial factors with high-risk sexual behaviors among male and female IDUs. Understanding the determinants of sexual risk practices among drug users can lead to the development of more effective programs to prevent sexual HIV and STD transmission. This study enrolled a community sample of 101 IDUs (males = 65, females = 36), primarily African American and unemployed, who injected drugs and had unprotected sex in the past 3 months. The sample was categorized into highest sexual risk (multiple partners and intercourse without condoms) and lower sexual risk subgroups. Univariate analyses showed that IDUs at highest sexual risk had lower sexual risk reduction self-efficacy (p =.01) and were more likely to be African American (p =.02). Drug users at highest sexual risk also used noninjected cocaine and crack more frequently (p =.05), were less likely to inject heroin (p =.04), and tended to more often inject cocaine (p =.05). IDUs at highest sexual risk also tended to more often use crack and methamphetamines. Logistic regression analyses showed that injecting cocaine or crack, sexual risk reduction self-efficacy, and race were independent predictors of sexual risk behavior levels. Sexual risk reduction programs for this population are needed, with HIV prevention programs tailored to specific IDU risk reduction needs.