RESUMEN
One key component in HIV prevention is serostatus disclosure. Until recently, many studies have focused on interpersonal factors and minimally considered meeting venues as they pertain to disclosure. Using data (N = 3,309) from an online survey conducted across 16 U.S. metropolitan statistical areas, we examined whether HIV serodisclosure varies by online/offline meeting venues in both protected and unprotected anal intercourse encounters. Most of the sample (76.9 %) reported meeting men for sex (last 90 days) both online and offline, versus 12.7 % offline only and 10.4 % online only. After controlling for other variables, we found that the men who meet partners in both online and offline were 20~30 % more likely to report disclosing their HIV status prior to sex than men who met their partners exclusively either offline or online. While previous studies have identified the Internet as a risk environment, our findings suggest bi-environmental partner seeking may also have beneficial effects.
Asunto(s)
Revelación , Seropositividad para VIH/psicología , Homosexualidad Masculina , Internet , Asunción de Riesgos , Parejas Sexuales , Adulto , Estudios Transversales , Infecciones por VIH/prevención & control , Homosexualidad Masculina/estadística & datos numéricos , Humanos , Masculino , Estudios Retrospectivos , Factores de Riesgo , Autoinforme , Encuestas y Cuestionarios , Estados Unidos , Sexo Inseguro/estadística & datos numéricosRESUMEN
Following latent class analysis (LCA) approach we examined patterns of HIV risk using two related domains of behavior: drug use, and sexual activity among 523 injection drug users (IDUs) recruited into the 2009 National HIV behavioral surveillance system. Using posterior probability of endorsing six drug and sexual items, we identified three distinct classes representing underlying HIV risk. Forty percent of our participants were at highest risk, 25 % at medium risk, and 35 % at lowest risk for HIV infection. Compared to the Lowest-risk class members, the Highest-risk class members had riskier drug and sexual behaviors and had higher prevalence of HIV cases (6 vs. 4 %). This analysis underscores the merit of LCA to empirically identify risk patterns using multiple indicators and our results show HIV risk varies among IDUs as their drug and sexual behaviors. Tailored and targeted prevention and treatment interventions for the dual risk pattern are required rather than for drug or sexual risk in silos.
Asunto(s)
Consumidores de Drogas/psicología , Infecciones por VIH/prevención & control , Asunción de Riesgos , Conducta Sexual , Abuso de Sustancias por Vía Intravenosa/epidemiología , Sexo Inseguro/estadística & datos numéricos , Adulto , Estudios Transversales , Femenino , Infecciones por VIH/diagnóstico , Infecciones por VIH/epidemiología , Humanos , Modelos Logísticos , Masculino , Persona de Mediana Edad , Prevalencia , Medición de Riesgo , Parejas Sexuales , Factores Socioeconómicos , Abuso de Sustancias por Vía Intravenosa/complicaciones , Abuso de Sustancias por Vía Intravenosa/psicología , Texas/epidemiologíaRESUMEN
This study examines the association between drug and sexual HIV risk behaviours and knowledge of HIV serostatus among a sample of injection drug users, recruited into the 2009 National HIV Behavioral Surveillance project. We calculated prevalence ratios and associated 95% confidence intervals of reporting a given risk behaviour comparing injection drug users unaware of their serostatus and HIV-negative to HIV-positive injection drug users. Of 523 participants, 21% were unaware of their HIV serostatus. The three groups were not different from each other in terms of drug-use behaviours; however, injection drug users unaware of their HIV serostatus were 33% more likely to report having more than three sexual partners in the past 12 months and 45% more likely to report having unprotected sex compared to HIV-positive injection drug users. We observed markedly higher prevalence of sexual risk behaviours among injection drug users unaware of their serostatus, but drug-use risk behaviours were similar across the groups.
Asunto(s)
Consumidores de Drogas/psicología , Seropositividad para VIH/psicología , Conocimientos, Actitudes y Práctica en Salud , Asunción de Riesgos , Conducta Sexual/estadística & datos numéricos , Abuso de Sustancias por Vía Intravenosa/epidemiología , Sexo Inseguro , Adulto , Anciano , Estudios Transversales , Femenino , Infecciones por VIH/prevención & control , Infecciones por VIH/transmisión , Seropositividad para VIH/inmunología , Humanos , Masculino , Persona de Mediana Edad , Prevalencia , Factores de Riesgo , Parejas Sexuales , Factores Socioeconómicos , Abuso de Sustancias por Vía Intravenosa/complicaciones , Encuestas y Cuestionarios , Texas/epidemiología , Adulto JovenRESUMEN
Recent studies have reported a clustered pattern of high-risk drug using and sexual behaviors among younger injection drug users (IDUs), however, no studies have looked at this clustering pattern in relatively older IDUs. This analysis examines the interplay and overlap of drug and sexual HIV risk among a sample of middle-aged, long-term IDUs in Houston, Texas. Our study includes 452 eligible IDUs, recruited into the 2009 National HIV Behavioral Surveillance project. Four separate multiple logistic regression models were built to examine the odds of reporting a given risk behavior. We constructed the most parsimonious multiple logistic regression model using a manual backward stepwise process. Participants were mostly male, older (mean age: 49.5±6.63), and nonHispanic Black. Prevalence of receptive needle sharing as well as having multiple sex partners and having unprotected sex with a partner in exchange for money, drugs, or other things at last sex were high. Unsafe injecting practices were associated with high-risk sexual behaviors. IDUs, who used a needle after someone else had injected with it had higher odds of having more than three sex partners (odds ratio (OR) = 2.10, 95% confidence interval (CI): 1.40-3.12) in last year and who shared drug preparation equipment had higher odds of having unprotected sex with an exchange partner (OR = 3.89, 95% CI: 1.66-9.09) at last sex. Additionally, homelessness was associated with unsafe injecting practices but not with high-risk sexual behaviors. Our results show that a majority of the sample IDUs are practicing sexual as well as drug-using HIV risk behaviors. The observed clustering pattern of drug and sexual risk behavior among this middle-aged population is alarming and deserve attention of HIV policy-makers and planners.