RESUMEN
The AIDS epidemic in the United States continues to disproportionately affect minorities of color, especially African Americans. The purpose of this study was to explore the sexual behaviors of a sample of African American HIV positive crack smokers aware of their serostatus. Participants (100 men, 37 women) were included in this study based on the following criteria: a minimum age of 18 years, HIV positive serostatus, treatment with HIV antiretroviral medications for a minimum of 3 months prior to interview, crack cocaine use at least once in the 7 days prior to being interviewed, willingness to provide a urine sample to confirm recent drug use, and vaginal or anal sex at least once in the past 7 days. The questionnaire was a compilation of other reliable surveys and was designed to collect sociodemographic data, drug use, sexual behavior, condom use intentions and motivators, STD and HIV infection history, HIV medications, and adherence requirements. Participants reported having 1,266 different partners in the 30 days prior to the interview and had traded sex for money or drugs with 68%. A total of 79 participants had multiple partners and accounted for 1,247 partnerships. Rates of consistent condom use across partnerships were low, indicating that more interventions in this at-risk population are needed.
Asunto(s)
Negro o Afroamericano/psicología , Trastornos Relacionados con Cocaína/psicología , Cocaína Crack/efectos adversos , Consumidores de Drogas/psicología , Seropositividad para VIH/psicología , Conducta Sexual/psicología , Adulto , Estudios Transversales , Femenino , Humanos , Entrevistas como Asunto , Masculino , Persona de Mediana Edad , Factores Sexuales , Conducta Sexual/estadística & datos numéricos , Parejas Sexuales/psicología , Encuestas y Cuestionarios , Adulto JovenRESUMEN
The sample for this study consisted of 692 sexually active African-American crack cocaine users living in Houston, TX who reported more than one sexual partner in the previous 30 days. Participants were asked to describe each of their two most recent partners from a list of eight choices: spouse/like a spouse/lover; close friend/friend/acquaintance/customer you like/customer. Analyses were conducted on the 1,384 partners and 692 partnership combinations reported. Partnerships and partnership patterns were examined with respect to three risk behaviors-unprotected sex, alcohol use to accompany sex, and drug use to accompany sex-and with respect to three affective measures-partner intimacy, condom use responsibility, and condom use self-efficacy. Results indicate that while many partnerships were based on trading sex for money or drugs, many participants reported partners they considered a spouse or friend. Risk behaviors and affective measures were found to differ by partner type.
Asunto(s)
Trastornos Relacionados con Cocaína/epidemiología , Cocaína Crack , Parejas Sexuales , Fumar , Trastornos Relacionados con Sustancias/epidemiología , Adolescente , Adulto , Áreas de Influencia de Salud , Condones/estadística & datos numéricos , Humanos , Masculino , Prevalencia , Asunción de Riesgos , Conducta Sexual , Encuestas y Cuestionarios , Texas/epidemiología , Adulto JovenRESUMEN
This study examined how condom use attitude, self-efficacy, and partner intimacy related to five stages of consistent condom use. Interview data were collected from sexually active, heterosexual, African-American crack cocaine smokers (N = 366). Dependent measures assessed both the participants' own responses and their perceptions about their last sex partner's own personal condom use attitude and participants' condom use self-efficacy expectations. Partner intimacy was assessed both as a continuous attitudinal and as a discrete relationship measure. Less than 10% were classified as consistent condom users. Two thirds of inconsistent users were in the Precontemplation (PC) stage. The contemplation (C) and preparation (P) stages were equal among the remainder of the inconsistent condom users. Higher partner intimacy reduced modestly readiness for consistent condom use. The stage but not the intimacy group was related to the condom use attitudes and self-efficacy measures. Last partners' perceived own negative attitudes were significantly related to the stages of consistent condom use and was especially low in the action (A) and maintenance (M) stages. Participants' own negative attitudes were unrelated to the stages. Of the self-efficacy measures, both participants' performance and situational condom use self-efficacies increased significantly after the PC stage and were highest in the P, A, and M stages. However, situational self-efficacy accounted for most of performance self-efficacy variance. In sum, consistent condom use was rare. A partner's attitudes and the participants' own situational self-efficacy expectations, rather than intimacy, determined the readiness to adopt consistent condom use.
Asunto(s)
Negro o Afroamericano/psicología , Trastornos Relacionados con Cocaína/psicología , Condones , Cocaína Crack , Autoeficacia , Parejas Sexuales/psicología , Adolescente , Adulto , Análisis de Varianza , Actitud Frente a la Salud , Femenino , Humanos , Relaciones Interpersonales , Entrevistas como Asunto , Masculino , Sexo Seguro/psicología , Adulto JovenRESUMEN
The purpose of this cross-sectional study was to classify a sample of HIV-seropositive African-American crack cocaine smokers into homogenous HIV drug use and sexual risk groups using a two step multivariate cluster analysis. Two hundred and fifty-eight crack cocaine smokers participated in the study. Cluster analysis revealed three distinct HIV risk groups. The highest risk group, the largest one, was characterized by frequent, daily crack use, multiple sex partners, trading sex, and inconsistent condom use. The consistent condom use group, the smallest group, was characterized by consistent condom use. The inconsistent condom use group, the second largest group, was distinguished by inconsistent condom use. Comparisons of the three HIV risk groups revealed that the highest risk group had a higher proportion of illegal sources of income, higher proportion of binged crack use, frequent, daily, alcohol use, same gender sex partners, and scored higher on depressive symptoms. Members of the consistent condom use group were more likely to have been HIV diagnosed for a shorter time, to have HIV serodiscordant casual sex partners, higher psychological motivation for condom use, and a lower frequency of vaginal sex. Members of the inconsistent condom use group were more likely to have a main sex partner, to be married, to be on public assistance, to know the HIV serostatus of their casual partner, and less likely to conceal their HIV serostatus. An alarming finding was that a large number of participants inconsistently used condoms with HIV serodiscordant sex partners. Interventions aiming to prevent the secondary spread of HIV infection in African-American crack cocaine smokers should take this variability in account and focus on the differences.
Asunto(s)
Trastornos Relacionados con Cocaína/epidemiología , Trastornos Relacionados con Cocaína/psicología , Cocaína Crack , Infecciones por VIH/epidemiología , Infecciones por VIH/psicología , Sexo Inseguro/psicología , Sexo Inseguro/estadística & datos numéricos , Negro o Afroamericano , Análisis por Conglomerados , Comorbilidad , Condones , Interpretación Estadística de Datos , Femenino , Encuestas Epidemiológicas , Humanos , Masculino , Motivación , Asunción de Riesgos , Factores Socioeconómicos , Encuestas y Cuestionarios , Texas/epidemiología , Adulto JovenRESUMEN
Some male sex workers (MSWs) are also engaging in a significant amount of illicit drug use and other high risk behavior. The purpose of this study was to examine demographic characteristics, HIV risk behaviors, and sex partner characteristics in a sample of MSW. Data were collected from 179 men who were trading sex for money in Houston, TX. In the past 30 days they reported an average of 56 male partners and 5 female partners. Of the 179 men, 152 had been tested for HIV and knew their status. Twenty-six percent of those tested had tested positive.
Asunto(s)
Homosexualidad Masculina/estadística & datos numéricos , Trabajo Sexual/estadística & datos numéricos , Parejas Sexuales , Trastornos Relacionados con Sustancias/epidemiología , Adolescente , Adulto , Demografía , Infecciones por VIH/epidemiología , Humanos , Masculino , Encuestas y CuestionariosRESUMEN
This article compares demographic characteristics, sexual practices, and psychosocial status among 193 African American female crack cocaine users who currently, previously, or never traded sex for money. Current traders were less likely to have a main sexual partner, more likely to have a casual sexual partner, and more likely to smoke larger quantities of crack. There was a significant trend towards current traders reporting lower self-esteem, greater depression and anxiety, poorer decision-making confidence, more hostility, less social conformity, greater risk taking behaviors, and more problems growing up, compared to previous and never traders. These differences suggest that interventions should address self-esteem, risk-taking practices, depression and anxiety as well as other psychosocial factors.
Asunto(s)
Trastornos Relacionados con Cocaína/psicología , Trabajo Sexual/psicología , Conducta Sexual , Adolescente , Adulto , Población Negra , Femenino , Humanos , Psicología , TexasRESUMEN
The purpose of this study was to evaluate the acceptability and the comparative efficacy of brief HIV risk reduction interventions to increase condom use during paid anal sex by street-based male sex workers (MSWs). Of the 399 street-based MSWs who participated in the evaluation of acceptability, 112 participated in the evaluation of efficacy. Acceptability was evaluated by assessing completion rates. Intervention efficacy was assessed across two brief interventions, a "standard" and a "standard-plus" interventions. The primary outcome of concern was condom use during paid anal sexual encounters. In addition to this variable, changes in drug use, needle use, condom use beliefs, and condom use intention were also assessed. Results showed that almost two thirds of MSWs enrolled in a brief intervention completed it. Completion rates varied by age, race/ethnicity, sexual orientation, and HIV status. Condom use during paid anal sex increased postintervention. In addition, condom use intentions, positive condom use outcome expectations, and condom use normative expectations increased preintervention to postintervention. However, there were no significant differences between the standard and the standard-plus brief interventions in any of the outcomes measured. Brief interventions to reduce the HIV risks are acceptable to MSWs and are efficacious for reducing unprotected anal sex during paid sexual encounters.
Asunto(s)
Condones , Infecciones por VIH/prevención & control , Conducta de Reducción del Riesgo , Trabajo Sexual , Conducta Sexual , Adolescente , Adulto , Humanos , Masculino , Persona de Mediana Edad , Compartición de Agujas/psicología , Evaluación de Programas y Proyectos de Salud , Trastornos Relacionados con Sustancias/psicología , Texas , Sexo Inseguro/prevención & controlRESUMEN
The objective of this study was to quantitatively measure the nature of concurrent sex partnering in two samples of drug users having large numbers of sex partners. The purpose of this study was to measure concurrent sex partnering and overlap in concurrent sex partners in two samples of drug users in which some or all participants were trading sex-for-money. Two samples having large numbers of sex partners were used to conduct the analyses: drug-using male sex workers (MSW) and male and female crack cocaine smokers (CS) having vaginal sex. To reflect the quality of concurrent partnering, three measures were used: the proportion of the samples having concurrent partners; the proportions of the samples having intimate, casual, and sex-for-money of partners; and overlap in concurrent partners. Proportions of each sample having concurrent partners were essentially the same. However, the kinds of concurrent partners and overlap in concurrent partners were significantly different. Concurrent partners in the MSW sample were mostly sex-for-money or sex-for-drugs partners. Most concurrent partners in the CS sample were initimate or casual sex partners. Overlap in concurrent partners was also significantly different. The measure of overlap for the CS sample was three times higher than that of the MSW sample. These data suggest that concurrent sex partnering in the two samples, beyond the proportion having concurrent partners, was different. The patterns of concurrent sex partners in each sample may reflect different reasons for engaging in concurrent partnering. Different reasons for engaging in concurrent partnering may also be reflected in different overlap scores between the two samples. Efforts should be made in future studies to better capture the complexities of concurrent partnering and to examine the implications of these for disease spread and control.
Asunto(s)
Trabajo Sexual , Parejas Sexuales , Enfermedades de Transmisión Sexual/prevención & control , Trastornos Relacionados con Sustancias , Adulto , Bisexualidad , Cocaína , Femenino , Heterosexualidad , Homosexualidad , Humanos , Masculino , Trabajo Sexual/psicología , Conducta Sexual , Enfermedades de Transmisión Sexual/transmisión , Trastornos Relacionados con Sustancias/psicologíaRESUMEN
We studied the situational determinants of condom use for vaginal sex in 151 African-American crack cocaine users in Houston, Texas, using situational presentation (Sitpres) methodology, which uses hypothetical scenarios with randomly generated levels of eight variables across 10 scenarios that may impact the decision to use a condom. Multiple regression showed that variables associated with a high probability of using a condom were older age, how badly the partner wants to use a condom, and how badly the respondent wants vaginal sex. Crack craving or level of intoxication were not correlates. The Sitpres methodology was successfully used by these crack users and data indicated that it was sexual variables, rather than drug-associated variables, that were significantly associated with condom use.
Asunto(s)
Negro o Afroamericano/estadística & datos numéricos , Trastornos Relacionados con Cocaína/etnología , Condones/estadística & datos numéricos , Cocaína Crack , Acontecimientos que Cambian la Vida , Adolescente , Adulto , Áreas de Influencia de Salud , Trastornos Relacionados con Cocaína/epidemiología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Conducta Sexual/etnología , Estados Unidos/epidemiologíaRESUMEN
The purpose of this study was to investigate sexual risk behaviors and factors associated with consistent condom use of HIV+ African Americans receiving HAART who smoke crack. Participants were African Americans in Houston, Texas and over 18, being treated for HIV, and reported currently using crack. Measures included demographic variables, sexual behaviors, drug use, and nine psychosocial scales and seven escape scales. One hundred thirty seven participated in the study. Condom use was low across all partner types. Regression analyses revealed two demographic variables, and two psychosocial and one escape scale were significantly associated with intention to use condoms. One of the more alarming findings of this study concerns the large number of individuals who know they are HIV positive yet continue to have unprotected sex. The inconsistent condom use by these HIV+ individuals threatens the progress that has been made to stem the epidemic.