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Sample records for hiv serodiscordant heterosexual

  1. Absence of transmission from HIV-infected individuals with HAART to their heterosexual serodiscordant partners.

    Science.gov (United States)

    Del Romero, Jorge; Río, Isabel; Castilla, Jesús; Baza, Begoña; Paredes, Vanessa; Vera, Mar; Rodríguez, Carmen

    2015-12-01

    Further studies are needed to evaluate the level of effectiveness and durability of HAART to reduce the risk of HIV sexual transmission in serodiscordant couples having unprotected sexual practices. A cross-sectional study was conducted with prospective cohort of heterosexual HIV serodiscordant couples where the only risk factor for HIV transmission to the uninfected partner (sexual partner) was the sexual relationship with the infected partner (index case). HIV prevalence in sexual partners at enrolment and seroconversions in follow-up were compared by antiretroviral treatment in the index partner, HIV plasma viral load in index cases and sexual risk exposures in sexual partners. In each visit, an evaluation of the risks for HIV transmission, preventive counselling and screening for genitourinary infections in the sexual partner was performed, as well as the determination of the immunological and virological situation and antiretroviral treatment in the index case. At enrolment no HIV infection was detected in 202 couples where the index case was taking HAART. HIV prevalence in sexual partners was 9.6% in 491 couples where the index case was not taking antiretroviral treatment (ptreatment, over 13,000 risky sexual exposures and 5 HIV seroconversions of sexual partners were recorded. The percentage of seroconversion among couples having risky sexual intercourse was 2.5 (95% confidence interval [CI]: 1.1-5.6) when the index case did not undergo antiretroviral treatment and zero (95% CI: 0-3.2) when the index case received HAART. The risk of sexual transmission of HIV from individuals with HAART to their heterosexual partners can become extremely low. Copyright © 2014. Published by Elsevier España, S.L.U.

  2. A cross-sectional analysis ofTrichomonas vaginalisinfection among heterosexual HIV-1 serodiscordant African couples.

    Science.gov (United States)

    Bochner, Aaron F; Baeten, Jared M; Rustagi, Alison S; Nakku-Joloba, Edith; Lingappa, Jairam R; Mugo, Nelly R; Bukusi, Elizabeth A; Kapiga, Saidi; Delany-Moretlwe, Sinead; Celum, Connie; Barnabas, Ruanne V

    2017-11-01

    Trichomonas vaginalis is the most prevalent curable STI worldwide and has been associated with adverse health outcomes and increased HIV-1 transmission risk. We conducted a cross-sectional analysis among couples to assess how characteristics of both individuals in sexual partnerships are associated with the prevalence of male and female T. vaginalis infection. African HIV-1 serodiscordant heterosexual couples were concurrently tested for trichomoniasis at enrolment into two clinical trials. T. vaginalis testing was by nucleic acid amplification or culture methods. Using Poisson regression with robust standard errors, we identified characteristics associated with trichomoniasis. Among 7531 couples tested for trichomoniasis, 981 (13%) couples contained at least one infected partner. The prevalence was 11% (n=857) among women and 4% (n=319) among men, and most infected individuals did not experience signs or symptoms of T. vaginalis . Exploring concordance of T. vaginalis status within sexual partnerships, we observed that 61% (195/319) of T. vaginalis -positive men and 23% (195/857) of T. vaginalis -positive women had a concurrently infected partner. In multivariable analysis, having a T. vaginalis -positive partner was the strongest predictor of infection for women (relative risk (RR) 4.70, 95% CI 4.10 to 5.38) and men (RR 10.09, 95% CI 7.92 to 12.85). For women, having outside sex partners, gonorrhoea, and intermediate or high Nugent scores for bacterial vaginosis were associated with increased risk of trichomoniasis, whereas age 45 years and above, being married, having children and injectable contraceptive use were associated with reduced trichomoniasis risk. Additionally, women whose male partners were circumcised, had more education or earned income had lower risk of trichomoniasis. We found that within African HIV-1 serodiscordant heterosexual couples, the prevalence of trichomoniasis was high among partners of T. vaginalis -infected individuals, suggesting

  3. Oral Pre-Exposure Prophylaxis (PrEP) for Prevention of HIV in Serodiscordant Heterosexual Couples in the United States: Opportunities and Challenges

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    Myers, Julie E.; Kurth, Ann E.; Cohen, Stephanie E.; Mannheimer, Sharon B.; Simmons, Janie; Pouget, Enrique R.; Trabold, Nicole; Haberer, Jessica E.

    2014-01-01

    Abstract Oral HIV pre-exposure prophylaxis (PrEP) is a promising new biomedical prevention approach in which HIV-negative individuals are provided with daily oral antiretroviral medication for the primary prevention of HIV-1. Several clinical trials have demonstrated efficacy of oral PrEP for HIV prevention among groups at high risk for HIV, with adherence closely associated with level of risk reduction. In the United States (US), three groups have been prioritized for initial implementation of PrEP—injection drug users, men who have sex with men at substantial risk for HIV, and HIV-negative partners within serodiscordant heterosexual couples. Numerous demonstration projects involving PrEP implementation among MSM are underway, but relatively little research has been devoted to study PrEP implementation in HIV-serodiscordant heterosexual couples in the US. Such couples face a unique set of challenges to PrEP implementation at the individual, couple, and provider level with regard to PrEP uptake and maintenance, adherence, safety and toxicity, clinical monitoring, and sexual risk behavior. Oral PrEP also provides new opportunities for serodiscordant couples and healthcare providers for primary prevention and reproductive health. This article provides a review of the critical issues, challenges, and opportunities involved in the implementation of oral PrEP among HIV-serodiscordant heterosexual couples in the US. PMID:25045996

  4. Optimal Uses of Antiretrovirals for Prevention in HIV-1 Serodiscordant Heterosexual Couples in South Africa: A Modelling Study

    Science.gov (United States)

    Hallett, Timothy B.; Baeten, Jared M.; Heffron, Renee; Barnabas, Ruanne; de Bruyn, Guy; Cremin, Íde; Delany, Sinead; Garnett, Geoffrey P.; Gray, Glenda; Johnson, Leigh; McIntyre, James; Rees, Helen; Celum, Connie

    2011-01-01

    Background Antiretrovirals have substantial promise for HIV-1 prevention, either as antiretroviral treatment (ART) for HIV-1–infected persons to reduce infectiousness, or as pre-exposure prophylaxis (PrEP) for HIV-1–uninfected persons to reduce the possibility of infection with HIV-1. HIV-1 serodiscordant couples in long-term partnerships (one member is infected and the other is uninfected) are a priority for prevention interventions. Earlier ART and PrEP might both reduce HIV-1 transmission in this group, but the merits and synergies of these different approaches have not been analyzed. Methods and Findings We constructed a mathematical model to examine the impact and cost-effectiveness of different strategies, including earlier initiation of ART and/or PrEP, for HIV-1 prevention for serodiscordant couples. Although the cost of PrEP is high, the cost per infection averted is significantly offset by future savings in lifelong treatment, especially among couples with multiple partners, low condom use, and a high risk of transmission. In some situations, highly effective PrEP could be cost-saving overall. To keep couples alive and without a new infection, providing PrEP to the uninfected partner could be at least as cost-effective as initiating ART earlier in the infected partner, if the annual cost of PrEP is ART and PrEP is >70% effective. Conclusions Strategic use of PrEP and ART could substantially and cost-effectively reduce HIV-1 transmission in HIV-1 serodiscordant couples. New and forthcoming data on the efficacy of PrEP, the cost of delivery of ART and PrEP, and couples behaviours and preferences will be critical for optimizing the use of antiretrovirals for HIV-1 prevention. Please see later in the article for the Editors' Summary PMID:22110407

  5. Optimal uses of antiretrovirals for prevention in HIV-1 serodiscordant heterosexual couples in South Africa: a modelling study.

    Directory of Open Access Journals (Sweden)

    Timothy B Hallett

    2011-11-01

    Full Text Available Antiretrovirals have substantial promise for HIV-1 prevention, either as antiretroviral treatment (ART for HIV-1-infected persons to reduce infectiousness, or as pre-exposure prophylaxis (PrEP for HIV-1-uninfected persons to reduce the possibility of infection with HIV-1. HIV-1 serodiscordant couples in long-term partnerships (one member is infected and the other is uninfected are a priority for prevention interventions. Earlier ART and PrEP might both reduce HIV-1 transmission in this group, but the merits and synergies of these different approaches have not been analyzed.We constructed a mathematical model to examine the impact and cost-effectiveness of different strategies, including earlier initiation of ART and/or PrEP, for HIV-1 prevention for serodiscordant couples. Although the cost of PrEP is high, the cost per infection averted is significantly offset by future savings in lifelong treatment, especially among couples with multiple partners, low condom use, and a high risk of transmission. In some situations, highly effective PrEP could be cost-saving overall. To keep couples alive and without a new infection, providing PrEP to the uninfected partner could be at least as cost-effective as initiating ART earlier in the infected partner, if the annual cost of PrEP is 70% effective.Strategic use of PrEP and ART could substantially and cost-effectively reduce HIV-1 transmission in HIV-1 serodiscordant couples. New and forthcoming data on the efficacy of PrEP, the cost of delivery of ART and PrEP, and couples behaviours and preferences will be critical for optimizing the use of antiretrovirals for HIV-1 prevention. Please see later in the article for the Editors' Summary.

  6. Characteristics of HIV-1 Serodiscordant Couples Enrolled in a Clinical Trial of Antiretroviral Pre-Exposure Prophylaxis for HIV-1 Prevention

    OpenAIRE

    Andrew Mujugira; Baeten, Jared M.; Deborah Donnell; Patrick Ndase; Mugo, Nelly R.; Linda Barnes; Campbell, James D.; Jonathan Wangisi; Tappero, Jordan W.; Elizabeth Bukusi; Cohen, Craig R.; Elly Katabira; Allan Ronald; Elioda Tumwesigye; Edwin Were

    2011-01-01

    Introduction Stable heterosexual HIV-1 serodiscordant couples in Africa have high HIV-1 transmission rates and are a critical population for evaluation of new HIV-1 prevention strategies. The Partners PrEP Study is a randomized, double-blind, placebo-controlled trial of tenofovir and emtricitabine-tenofovir pre-exposure prophylaxis to decrease HIV-1 acquisition within heterosexual HIV-1 serodiscordant couples. We describe the trial design and characteristics of the study cohort. Methods HIV-1...

  7. Stakeholders perception of HIV sero-discordant couples in western ...

    African Journals Online (AJOL)

    Objective: To describe the perceptions of key stakeholders regarding the counselling needs of HI V sero-discordant couples as part of preparation for a clinical trial involving HIV sero-discordant couples. Design: Qualitative study using key informant and couple interviews. Setting: Moi Teaching and Referral Hospital (MTRH) ...

  8. Sexual and Reproductive Health in HIV Serodiscordant Couples

    African Journals Online (AJOL)

    AJRH Managing Editor

    AIDS); 17(4): 99. REVIEW ARTICLE. Sexual and Reproductive Health in HIV Serodiscordant Couples. Christian C. Makwe*. 1 and Osato F. Giwa-Osagie. 1. 1Department of Obstetrics and Gynaecology, College of Medicine, University of ...

  9. “Since both of us are using antiretrovirals, we have been supportive to each other”: facilitators and barriers of pre-exposure prophylaxis use in heterosexual HIV serodiscordant couples in Kisumu, Kenya

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    Rena C Patel

    2016-12-01

    Full Text Available Introduction: Since 2015, the World Health Organization recommends pre-exposure prophylaxis (PrEP for all persons at substantial risk for HIV, including HIV-uninfected partners in serodiscordant relationships in resource-limited settings. As PrEP moves from clinical trials to real-world use, understanding facilitators of and barriers to PrEP initiation and adherence is critical to successful PrEP implementation and rollout. Methods: We conducted 44 in-depth individual or couple interviews with 63 participants (30 without HIV and 33 with HIV enrolled in the Partners Demonstration Project in Kisumu, Kenya, between August and September 2014. The semi-structured interviews discussed the following: 1 perceived advantages and disadvantages of antiretroviral therapy (ART/PrEP; 2 reasons for accepting or declining ART/PrEP and 3 influence of prevention of transmission to partner or infant on ART/PrEP use. Transcripts from the interviews were iteratively analyzed using inductive content analysis. Results: Our study identified three key factors that may facilitate initiation of PrEP in this population. First, participants using PrEP felt reduced stress and increased trust in their HIV serodiscordant relationships. Second, greater community-wide knowledge of PrEP was thought to likely increase PrEP acceptance. Third, greater education and counselling by providers on PrEP use was also considered to likely increase the adoption of PrEP. We also identified three key barriers to initiation of and adherence to PrEP. First, most participants who declined PrEP expressed doubts about the relative additional effectiveness of PrEP in combination with other prevention tools. Second, perceived stigma related to PrEP use was an important barrier to PrEP initiation. Third, many struggled with overcoming perceived side effects or logistical challenges of taking daily PrEP, particularly when they themselves were not ill. Conclusions: Leveraging the facilitators and

  10. Circumcision of male children for reduction of future risk for HIV: acceptability among HIV serodiscordant couples in Kampala, Uganda.

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    Kenneth K Mugwanya

    Full Text Available The ultimate success of medical male circumcision for HIV prevention may depend on targeting male infants and children as well as adults, in order to maximally reduce new HIV infections into the future.We conducted a cross-sectional study among heterosexual HIV serodiscordant couples (a population at high risk for HIV transmission attending a research clinic in Kampala, Uganda on perceptions and attitudes about medical circumcision for male children for HIV prevention. Correlates of willingness to circumcise male children were assessed using generalized estimating equations methods.318 HIV serodiscordant couples were interviewed, 51.3% in which the female partner was HIV uninfected. Most couples were married and cohabiting, and almost 50% had at least one uncircumcised male child of ≤18 years of age. Overall, 90.2% of male partners and 94.6% of female partners expressed interest in medical circumcision for their male children for reduction of future risk for HIV infection, including 79.9% of men and 87.6% of women who had an uncircumcised male child. Among both men and women, those who were knowledgeable that circumcision reduces men's risk for HIV (adjusted prevalence ratio [APR] 1.34 and 1.14 and those who had discussed the HIV prevention effects of medical circumcision with their partner (APR 1.08 and 1.07 were significantly (p≤0.05 more likely to be interested in male child circumcision for HIV prevention. Among men, those who were circumcised (APR 1.09, p = 0.004 and those who were HIV seropositive (APR 1.09, p = 0.03 were also more likely to be interested in child circumcision for HIV prevention.A high proportion of men and women in Ugandan heterosexual HIV serodiscordant partnerships were willing to have their male children circumcised for eventual HIV prevention benefits. Engaging both parents may increase interest in medical male circumcision for HIV prevention.

  11. Risky sexual behaviours among HIV Sero-discordant individuals ...

    African Journals Online (AJOL)

    Backgound: HIV/AIDS pandemic is a great public health concern hence the need to identify interventions to prevent new infections among risk groups. Objective: To determine risky sexual behaviours among HIV sero-discordant individuals attending Defence Forces Memorial Hospital (DFMH). Design: A descriptive ...

  12. Strategies to prevent HIV transmission to serodiscordant couples.

    Science.gov (United States)

    Hallal, Ronaldo Campos; Raxach, Juan Carlos; Barcellos, Nêmora Tregnago; Maksud, Ivia

    2015-09-01

    The use antiretroviral reduces the sexual transmission of HIV, expanding interventions for serodiscordant couples. This article aims to review the use of antiretroviral and other prevention interventions among serodiscordant couples and to analyze its use in Brazil. A retrospective review was performed through the MEDLINE database and bases included in the Biblioteca Virtual em Saúde. The articles recovered exhibit four main strategies: (1) condom; (2) reduction of risks in sexual practices; (3) use of antiretrovirals, particularly early initiation of antiretroviral therapy (TASP) and pre-exposure prophylaxis (PrEP); (4) risk reduction in reproduction. TASP is highly effective in reducing sexual transmission, PrEP was tested in serodiscordant couples and both reduce the sexual transmission risk in different sexual practices, enabling individualized prevention strategies. When used in combination, antiretrovirals and sexual practices with condoms offer greater efficacy than any single strategy. The combined use of new and old strategies allows us to build a prevention policy for all.

  13. A Scoring Tool to Identify East African HIV-1 Serodiscordant Partnerships with a High Likelihood of Pregnancy.

    Science.gov (United States)

    Heffron, Renee; Cohen, Craig R; Ngure, Kenneth; Bukusi, Elizabeth; Were, Edwin; Kiarie, James; Mugo, Nelly; Celum, Connie; Baeten, Jared M

    2015-01-01

    HIV-1 prevention programs targeting HIV-1 serodiscordant couples need to identify couples that are likely to become pregnant to facilitate discussions about methods to minimize HIV-1 risk during pregnancy attempts (i.e. safer conception) or effective contraception when pregnancy is unintended. A clinical prediction tool could be used to identify HIV-1 serodiscordant couples with a high likelihood of pregnancy within one year. Using standardized clinical prediction methods, we developed and validated a tool to identify heterosexual East African HIV-1 serodiscordant couples with an increased likelihood of becoming pregnant in the next year. Datasets were from three prospectively followed cohorts, including nearly 7,000 couples from Kenya and Uganda participating in HIV-1 prevention trials and delivery projects. The final score encompassed the age of the woman, woman's number of children living, partnership duration, having had condomless sex in the past month, and non-use of an effective contraceptive. The area under the curve (AUC) for the probability of the score to correctly predict pregnancy was 0.74 (95% CI 0.72-0.76). Scores ≥ 7 predicted a pregnancy incidence of >17% per year and captured 78% of the pregnancies. Internal and external validation confirmed the predictive ability of the score. A pregnancy likelihood score encompassing basic demographic, clinical and behavioral factors defined African HIV-1 serodiscordant couples with high one-year pregnancy incidence rates. This tool could be used to engage African HIV-1 serodiscordant couples in counseling discussions about fertility intentions in order to offer services for safer conception or contraception that align with their reproductive goals.

  14. A Scoring Tool to Identify East African HIV-1 Serodiscordant Partnerships with a High Likelihood of Pregnancy.

    Directory of Open Access Journals (Sweden)

    Renee Heffron

    Full Text Available HIV-1 prevention programs targeting HIV-1 serodiscordant couples need to identify couples that are likely to become pregnant to facilitate discussions about methods to minimize HIV-1 risk during pregnancy attempts (i.e. safer conception or effective contraception when pregnancy is unintended. A clinical prediction tool could be used to identify HIV-1 serodiscordant couples with a high likelihood of pregnancy within one year.Using standardized clinical prediction methods, we developed and validated a tool to identify heterosexual East African HIV-1 serodiscordant couples with an increased likelihood of becoming pregnant in the next year. Datasets were from three prospectively followed cohorts, including nearly 7,000 couples from Kenya and Uganda participating in HIV-1 prevention trials and delivery projects.The final score encompassed the age of the woman, woman's number of children living, partnership duration, having had condomless sex in the past month, and non-use of an effective contraceptive. The area under the curve (AUC for the probability of the score to correctly predict pregnancy was 0.74 (95% CI 0.72-0.76. Scores ≥ 7 predicted a pregnancy incidence of >17% per year and captured 78% of the pregnancies. Internal and external validation confirmed the predictive ability of the score.A pregnancy likelihood score encompassing basic demographic, clinical and behavioral factors defined African HIV-1 serodiscordant couples with high one-year pregnancy incidence rates. This tool could be used to engage African HIV-1 serodiscordant couples in counseling discussions about fertility intentions in order to offer services for safer conception or contraception that align with their reproductive goals.

  15. Successful increase in contraceptive uptake among Kenyan HIV-1-serodiscordant couples enrolled in an HIV-1 prevention trial.

    Science.gov (United States)

    Ngure, Kenneth; Heffron, Renee; Mugo, Nelly; Irungu, Elizabeth; Celum, Connie; Baeten, Jared M

    2009-11-01

    To evaluate a multipronged approach to promote dual contraceptive use by women within heterosexual HIV-1-serodiscordant partnerships. For 213 HIV-1-serodiscordant couples in Thika, Kenya, participating in an HIV-1 prevention clinical trial, contraceptive promotion was initiated through a multipronged intervention that included staff training, couples family planning sessions, and free provision of hormonal contraception on-site. Contraceptive use and pregnancy incidence were compared between two time periods (before versus after June 2007, when the intervention was initiated) and between Thika and other Kenyan trial sites (Eldoret, Kisumu, and Nairobi). Generalized estimating equations and Andersen-Gill proportional hazards modeling were used. Nonbarrier contraceptive use increased after implementation of the intervention: from 31.5 to 64.7% of visits among HIV-1-seropositive women [odds ratio 4.0, 95% confidence interval (CI) 3.0-5.3] and from 28.6 to 46.7% of visits among HIV-1-seronegative women (odds ratio 2.2, 95% CI 1.4-3.5). In comparison, at the other Kenyan sites, where the intervention was not implemented, contraceptive use changed minimally, from 15.6 to 22.3% of visits for HIV-1-seropositive women and from 13.6 to 12.7% among HIV-1-seronegative women. Self-reported condom use remained high during follow-up. Pregnancy incidence at the Thika was significantly lower after compared with before June 2007 (hazard ratio 0.2, 95% CI 0.1-0.6) and was approximately half that at other Kenyan sites during the intervention period (hazard ratio 0.5, 95% CI 0.3-0.8). A multipronged family planning intervention can lead to high nonbarrier contraceptive uptake and reduced pregnancy incidence among women in HIV-1-serodiscordant partnerships.

  16. Successful increase in contraceptive uptake among Kenyan HIV-1 serodiscordant couples enrolled in an HIV-1 prevention trial

    Science.gov (United States)

    Ngure, Kenneth; Heffron, Renee; Mugo, Nelly; Irungu, Elizabeth; Celum, Connie; Baeten, Jared

    2016-01-01

    Objective To evaluate a multi-pronged approach to promote dual contraceptive use by women within heterosexual HIV-1 serodiscordant partnerships. Methods For 213 HIV-1 serodiscordant couples in Thika, Kenya participating in an HIV-1 prevention clinical trial, contraceptive promotion was initiated through a multi-pronged intervention that included staff training, couples family planning sessions, and free provision of hormonal contraception on-site. Contraceptive use and pregnancy incidence were compared between two time periods (before versus after June 2007, when the intervention was initiated) and between Thika and other Kenyan trial sites (Eldoret, Kisumu, and Nairobi). Generalized estimating equations and Andersen-Gill proportional hazards modeling were used. Results Non-barrier contraceptive use increased after implementation of the intervention: from 31.5% to 64.7% of visits among HIV-1 seropositive women (odds ratio [OR] 4.0, 95% confidence interval [CI] 3.0–5.3) and from 28.6% to 46.7% of visits among HIV-1 seronegative women (OR 2.2, 95% CI 1.4–3.5). In comparison, at the other Kenyan sites, where the intervention was not implemented, contraceptive use changed minimally, from 15.6% to 22.3% of visits for HIV-1 seropositive women and from 13.6% to 12.7% among HIV-1 seronegative women. Self-reported condom use remained high during follow-up. Pregnancy incidence at the Thika was significantly lower after compared with before June 2007 (hazard ratio [HR] 0.2, 95% CI 0.1–0.6), and was approximately half that at other Kenyan sites during the intervention period (HR 0.5, 95% CI 0.3–0.8). Conclusions A multi-pronged family planning intervention can lead to high non-barrier contraceptive uptake and reduced pregnancy incidence among women in HIV-1 serodiscordant partnerships. PMID:20081393

  17. Characteristics of HIV-1 serodiscordant couples enrolled in a clinical trial of antiretroviral pre-exposure prophylaxis for HIV-1 prevention.

    Science.gov (United States)

    Mujugira, Andrew; Baeten, Jared M; Donnell, Deborah; Ndase, Patrick; Mugo, Nelly R; Barnes, Linda; Campbell, James D; Wangisi, Jonathan; Tappero, Jordan W; Bukusi, Elizabeth; Cohen, Craig R; Katabira, Elly; Ronald, Allan; Tumwesigye, Elioda; Were, Edwin; Fife, Kenneth H; Kiarie, James; Farquhar, Carey; John-Stewart, Grace; Kidoguchi, Lara; Panteleeff, Dana; Krows, Meighan; Shah, Heena; Revall, Jennifer; Morrison, Susan; Ondrejcek, Lisa; Ingram, Charlotte; Coombs, Robert W; Lingappa, Jairam R; Celum, Connie

    2011-01-01

    Stable heterosexual HIV-1 serodiscordant couples in Africa have high HIV-1 transmission rates and are a critical population for evaluation of new HIV-1 prevention strategies. The Partners PrEP Study is a randomized, double-blind, placebo-controlled trial of tenofovir and emtricitabine-tenofovir pre-exposure prophylaxis to decrease HIV-1 acquisition within heterosexual HIV-1 serodiscordant couples. We describe the trial design and characteristics of the study cohort. HIV-1 serodiscordant couples, in which the HIV-1 infected partner did not meet national guidelines for initiation of antiretroviral therapy, were enrolled at 9 research sites in Kenya and Uganda. The HIV-1 susceptible partner was randomized to daily oral tenofovir, emtricitabine-tenofovir, or matching placebo with monthly follow-up for 24-36 months. From July 2008 to November 2010, 7920 HIV-1 serodiscordant couples were screened and 4758 enrolled. For 62% (2966/4758) of enrolled couples, the HIV-1 susceptible partner was male. Median age was 33 years for HIV-1 susceptible and HIV-1 infected partners [IQR (28-40) and (26-39) respectively]. Most couples (98%) were married, with a median duration of partnership of 7.0 years (IQR 3.0-14.0) and recent knowledge of their serodiscordant status [median 0.4 years (IQR 0.1-2.0)]. During the month prior to enrollment, couples reported a median of 4 sex acts (IQR 2-8); 27% reported unprotected sex and 14% of male and 1% of female HIV-1 susceptible partners reported sex with outside partners. Among HIV-1 infected partners, the median plasma HIV-1 level was 3.94 log(10) copies/mL (IQR 3.31-4.53) and median CD4 count was 496 cells/µL (IQR 375-662); the majority (64%) had WHO stage 1 HIV-1 disease. Couples at high risk of HIV-1 transmission were rapidly recruited into the Partners PrEP Study, the largest efficacy trial of oral PrEP. (ClinicalTrials.gov NCT00557245).

  18. Characteristics of HIV-1 serodiscordant couples enrolled in a clinical trial of antiretroviral pre-exposure prophylaxis for HIV-1 prevention.

    Directory of Open Access Journals (Sweden)

    Andrew Mujugira

    Full Text Available Stable heterosexual HIV-1 serodiscordant couples in Africa have high HIV-1 transmission rates and are a critical population for evaluation of new HIV-1 prevention strategies. The Partners PrEP Study is a randomized, double-blind, placebo-controlled trial of tenofovir and emtricitabine-tenofovir pre-exposure prophylaxis to decrease HIV-1 acquisition within heterosexual HIV-1 serodiscordant couples. We describe the trial design and characteristics of the study cohort.HIV-1 serodiscordant couples, in which the HIV-1 infected partner did not meet national guidelines for initiation of antiretroviral therapy, were enrolled at 9 research sites in Kenya and Uganda. The HIV-1 susceptible partner was randomized to daily oral tenofovir, emtricitabine-tenofovir, or matching placebo with monthly follow-up for 24-36 months.From July 2008 to November 2010, 7920 HIV-1 serodiscordant couples were screened and 4758 enrolled. For 62% (2966/4758 of enrolled couples, the HIV-1 susceptible partner was male. Median age was 33 years for HIV-1 susceptible and HIV-1 infected partners [IQR (28-40 and (26-39 respectively]. Most couples (98% were married, with a median duration of partnership of 7.0 years (IQR 3.0-14.0 and recent knowledge of their serodiscordant status [median 0.4 years (IQR 0.1-2.0]. During the month prior to enrollment, couples reported a median of 4 sex acts (IQR 2-8; 27% reported unprotected sex and 14% of male and 1% of female HIV-1 susceptible partners reported sex with outside partners. Among HIV-1 infected partners, the median plasma HIV-1 level was 3.94 log(10 copies/mL (IQR 3.31-4.53 and median CD4 count was 496 cells/µL (IQR 375-662; the majority (64% had WHO stage 1 HIV-1 disease.Couples at high risk of HIV-1 transmission were rapidly recruited into the Partners PrEP Study, the largest efficacy trial of oral PrEP. (ClinicalTrials.gov NCT00557245.

  19. Strategies to prevent HIV transmission to serodiscordant couples

    Directory of Open Access Journals (Sweden)

    Ronaldo Campos Hallal

    2015-09-01

    Full Text Available ABSTRACTIntroduction:The use antiretroviral reduces the sexual transmission of HIV, expanding interventions for serodiscordant couples.Objective:This article aims to review the use of antiretroviral and other prevention interventions among serodiscordant couples and to analyze its use in Brazil.Methods:A retrospective review was performed through the MEDLINE database and bases included in the Biblioteca Virtual em Saúde.Results:The articles recovered exhibit four main strategies: (1 condom; (2 reduction of risks in sexual practices; (3 use of antiretrovirals, particularly early initiation of antiretroviral therapy (TASP and pre-exposure prophylaxis (PrEP; (4 risk reduction in reproduction.Discussion:TASP is highly effective in reducing sexual transmission, PrEP was tested in serodiscordant couples and both reduce the sexual transmission risk in different sexual practices, enabling individualized prevention strategies.Conclusions:When used in combination, antiretrovirals and sexual practices with condoms offer greater efficacy than any single strategy. The combined use of new and old strategies allows us to build a prevention policy for all.

  20. Reclaiming fertility awareness methods to inform timed intercourse for HIV serodiscordant couples attempting to conceive.

    Science.gov (United States)

    Liao, Caiyun; Wahab, Maybel; Anderson, Jean; Coleman, Jenell S

    2015-01-01

    Increased life expectancy of HIV-positive individuals during recent years has drawn attention to their quality of life, which includes fulfillment of fertility desires. In particular, heterosexual HIV serodiscordant couples constitute a special group for whom the balance between desired pregnancy and the risk of viral transmission should be carefully considered and optimized. Although advanced assisted reproductive technologies are available, such treatments are expensive and are often unavailable. Moreover, standard viral load testing and antiretroviral therapy may not be accessible due to structural or individual barriers. To reduce the risk of HIV transmission, a lower cost alternative is timed condomless sex combined with other risk-reduction strategies. However, timed condomless sex requires specific knowledge of how to accurately predict the fertile window in a menstrual cycle. The aim of this study was to summarize inexpensive fertility awareness methods (FAMs) that predict the fertile window and may be useful for counselling HIV-positive couples on lower cost options to conceive. Original English-language research articles were identified by a detailed Medline and Embase search in July 2014. Relevant citations in the included articles were also retrieved. Calendar method, basal body temperature and cervicovaginal mucus secretions are the most accessible and sensitive FAMs, although poor specificity precludes their independent use in ovulation detection. In contrast, urinary luteinizing hormone testing is highly specific but less sensitive, and more expensive. To maximize the chance of conception per cycle, the likelihood of natural conception needs to be assessed with a basic fertility evaluation of both partners and a combination of FAMs should be offered. Adherence to other risk-reduction strategies should also be advised, and timely referral to reproductive medicine specialists is necessary when sub/infertility is suspected. FAMs provide effective

  1. Possibilities of care for serodiscordant couples for HIV who got pregnant

    Directory of Open Access Journals (Sweden)

    Tassiane Ferreira Langendorf

    Full Text Available ABSTRACT Objective: Understanding the meaning of pregnancy for heterosexual couples facing serodiscordant situation for HIV, aiming at construction of care possibilities based on subjectivity. Method: Phenomenological research, theoretical-philosophical-methodological framework by Martin Heidegger. Research was conducted in a University Hospital in the countryside of Southern Brazil, from September 2013 to May 2014 through a phenomenological interview, with participation of eleven couples. Results: For the couples, pregnancy is part of life when they wish to have a child, even when one or both of them already have children from previous relationships. In addition, it is part of life when they consider the risks and do not want to have children in such circumstances anymore, but it happened unexpectedly. Conclusion: Understanding reproductive needs and demands of these couples is an aid for qualification and improvement of care as a contribution to nursing care planning towards reproductive health of these couples.

  2. Contraceptive method and pregnancy incidence among women in HIV-1-serodiscordant partnerships.

    Science.gov (United States)

    Ngure, Kenneth; Heffron, Renee; Mugo, Nelly R; Celum, Connie; Cohen, Craig R; Odoyo, Josephine; Rees, Helen; Kiarie, James N; Were, Edwin; Baeten, Jared M

    2012-02-20

    Effective contraception reduces unintended pregnancies and is a central strategy to reduce vertical HIV-1 transmission for HIV-1-infected women. Among 2269 HIV-1-seropositive and 1085-seronegative women from seven African countries who were members of HIV-1-serodiscordant heterosexual partnerships and who were participating in an HIV-1 prevention clinical trial, we assessed pregnancy incidence according to contraceptive method using multivariate Andersen-Gill analysis. Compared with women using no contraceptive method, pregnancy incidence was significantly reduced among HIV-1-seropositive and HIV-1-seronegative women using injectable contraception [adjusted hazard ratio (aHR) 0.24, P = 0.001 and aHR 0.25, P pregnancy risk only among HIV-1-seropositive women (aHR 0.51, P = 0.004) but not seronegative women (aHR 0.64, P = 0.3), and, for both seropositive and seronegative women, oral contraceptive pill users were more likely to become pregnant than injectable contraceptive users (aHR 2.22, P = 0.01 for HIV-1-seropositive women and aHR 2.65, P = 0.09 for HIV-1-seronegative women). Condoms, when reported as being used as the primary contraceptive method, marginally reduced pregnancy incidence (aHR 0.85, P = 0.1 for seropositive women and aHR 0.67, P = 0.02 for seronegative women). There were no pregnancies among women using intrauterine devices, implantable methods or who had undergone surgical sterilization, although these methods were used relatively infrequently. Family planning programs and HIV-1 prevention trials need innovative ways to motivate uptake and sustained use of longer acting, less user-dependent contraception for women who do not desire pregnancy.

  3. Sexual and Reproductive Health in HIV Serodiscordant Couples

    African Journals Online (AJOL)

    AJRH Managing Editor

    described as “homosexual”1. The report of the first. AIDS cases in California2 in 1981 prompted additional case reports in other US cities1,3 and in. Europe4,5, among men who have sex with men. HIV infection has now become a global epidemic and the mode of spread predominantly through heterosexual intercourse,.

  4. High Proportion of HIV Serodiscordance among HIV-Affected Married Couples in Northern Vietnam

    Science.gov (United States)

    Sawada, Ikumi; Tanuma, Junko; Do, Cuong Duy; Doan, Tra Thu; Luu, Quynh Phuong; Nguyen, Lan Anh Thi; Vu, Tuong Van Thi; Nguyen, Tuan Quang; Tsuchiya, Naho; Shiino, Teiichiro; Yoshida, Lay-Myint; Pham, Thanh Thuy Thi; Ariyoshi, Koya; Oka, Shinichi

    2015-01-01

    Introduction Little is known about the state of HIV transmission among married couples in Vietnam. This study aims to clarify HIV serostatus in this group and elucidate risk factors for intra-marital HIV transmission. Methods In 2012, we enrolled a group of HIV-positive married men registered at the HIV outpatient clinic of a referral hospital in northern Vietnam, along with their wives. Sociodemographic, behavioural and clinical data were collected from men and wives. HIV serodiscordant couples were followed until March 2014 to determine seroconversion rate. A phylogenetic analysis was performed based on env V3 sequence to detail cluster formation among men. Results Of the 163 HIV-positive men enrolled in the study, 101 (62.0%) had wives testing HIV-negative. Half of men reported injecting drug use (IDU) as a likely transmission route. Couples reported a high incidence of unprotected sexual intercourse prior to diagnosis; the median (inter quartile range) was 4 (4–8) times per month. Only 17 couples (10.4%) reported using condoms during at least half these instances. Multivariable analysis revealed IDU history among men was independently associated with HIV-negative wives (adjusted OR 0.31; 95% CI 0.10–0.95, p=0.041). Phylogenetic analysis of 80 samples indicated CRF01_AE. Of these, 69 (86.3%) clustered with IDU-associated viruses from Vietnam. No HIV seroconversion was identified during a follow-up of 61 serodiscordant couples, with 126.5 person-years of observation during which HIV-infected men were on antiretroviral drug therapy (ART). Conclusion High HIV serodiscordance was observed among HIV-affected married couples in northern Vietnam. A large number of at-risk wives therefore remain HIV-negative and can be protected with measures including proper use of ART if couples are made aware of the serodiscordance through screening. PMID:25898138

  5. Contraceptive method and pregnancy incidence among African women in HIV-1 serodiscordant partnerships

    Science.gov (United States)

    NGURE, Kenneth; HEFFRON, Renee; MUGO, Nelly R.; CELUM, Connie; COHEN, Craig R.; ODOYO, Josephine; REES, Helen; KIARIE, James N.; WERE, Edwin; BAETEN, Jared M.

    2014-01-01

    Background Effective contraception reduces unintended pregnancies and is a central strategy to reduce vertical HIV-1 transmission for HIV-1 infected women. Methods Among 2269 HIV-1 seropositive and 1085 seronegative women from 7 African countries who were members of HIV-1 serodiscordant heterosexual partnerships and who were participating in an HIV-1 prevention clinical trial, we assessed pregnancy incidence for women using various contraceptive methods using multivariate Andersen-Gill analysis. Results Compared with women using no contraceptive method, pregnancy incidence was significantly reduced among HIV-1 seropositive and seronegative women using injectable contraception (adjusted hazard ratio (aHR) 0.24, p=0.001 and aHR 0.25, ppregnancy risk only among HIV-1 seropositive women (aHR 0.51, p=0.004) but not seronegative women (aHR 0.64, p=0.3), and, for both seropositive and seronegative women, oral contraceptive pill users were more likely to become pregnant than injectable contraceptive users (aHR 2.22, p=0.01 for HIV-1 seropositive women and aHR 2.65, p=0.09 for HIV-1 seronegative women). Condoms, when reported as being used as the primary contraceptive method, marginally reduced pregnancy incidence (aHR 0.85, p=0.1 for seropositive women and aHR 0.67, p=0.02 for seronegative women). There were no pregnancies among women using intrauterine devices, implantable methods or who had undergone surgical sterilization, although these methods were used relatively infrequently. Conclusions Family planning programs and HIV-1 prevention trials need innovative ways to motivate uptake and sustained use of longer acting, less user-dependent contraception for women who do not desire pregnancy. PMID:22156966

  6. Natural Conception May Be an Acceptable Option in HIV-Serodiscordant Couples in Resource Limited Settings.

    Science.gov (United States)

    Sun, Lijun; Wang, Fang; Liu, An; Xin, Ruolei; Zhu, Yunxia; Li, Jianwei; Shao, Ying; Ye, Jiangzhu; Chen, Danqing; Li, Zaicun

    2015-01-01

    Many HIV serodiscordant couples have a strong desire to have their own biological children. Natural conception may be the only choice in some resource limited settings but data about natural conception is limited. Here, we reported our findings of natural conception in HIV serodiscordant couples. Between January 2008 and June 2014, we retrospectively collected data on 91 HIV serodiscordant couples presenting to Beijing Youan Hospital with childbearing desires. HIV counseling, effective ART on HIV infected partners, pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP) in negative female partners and timed intercourse were used to maximally reduce the risk of HIV transmission. Of the 91 HIV serodiscordant couples, 43 were positive in male partners and 48 were positive in female partners. There were 196 unprotected vaginal intercourses, 100 natural conception and 97 newborns. There were no cases of HIV seroconversion in uninfected sexual partners. Natural conception may be an acceptable option in HIV-serodiscordant couples in resource limited settings if HIV-positive individuals have undetectable viremia on HAART, combined with HIV counseling, PrEP, PEP and timed intercourse.

  7. Adherence to antiretroviral prophylaxis for HIV prevention: a substudy cohort within a clinical trial of serodiscordant couples in East Africa.

    Directory of Open Access Journals (Sweden)

    Jessica E Haberer

    Full Text Available Randomized clinical trials of oral antiretroviral pre-exposure prophylaxis (PrEP for HIV prevention have widely divergent efficacy estimates, ranging from 0% to 75%. These discrepancies are likely due to differences in adherence. To our knowledge, no studies to date have examined the impact of improving adherence through monitoring and/or intervention, which may increase PrEP efficacy, or reported on objective behavioral measures of adherence, which can inform PrEP effectiveness and implementation.Within the Partners PrEP Study (a randomized placebo-controlled trial of oral tenofovir and emtricitabine/tenofovir among HIV-uninfected members of serodiscordant couples in Kenya and Uganda, we collected objective measures of PrEP adherence using unannounced home-based pill counts and electronic pill bottle monitoring. Participants received individual and couples-based adherence counseling at PrEP initiation and throughout the study; counseling was intensified if unannounced pill count adherence fell to 80% adherence. Study limitations include potential shortcomings of the adherence measures and use of a convenience sample within the substudy cohort.The high PrEP adherence achieved in the setting of active adherence monitoring and counseling support was associated with a high degree of protection from HIV acquisition by the HIV-uninfected partner in heterosexual serodiscordant couples. Low PrEP adherence was associated with sexual behavior, alcohol use, younger age, and length of PrEP use. Please see later in the article for the Editors' Summary.

  8. Reclaiming fertility awareness methods to inform timed intercourse for HIV serodiscordant couples attempting to conceive

    Directory of Open Access Journals (Sweden)

    Caiyun Liao

    2015-01-01

    Full Text Available Introduction: Increased life expectancy of HIV-positive individuals during recent years has drawn attention to their quality of life, which includes fulfilment of fertility desires. In particular, heterosexual HIV serodiscordant couples constitute a special group for whom the balance between desired pregnancy and the risk of viral transmission should be carefully considered and optimized. Although advanced assisted reproductive technologies are available, such treatments are expensive and are often unavailable. Moreover, standard viral load testing and antiretroviral therapy may not be accessible due to structural or individual barriers. To reduce the risk of HIV transmission, a lower cost alternative is timed condomless sex combined with other risk-reduction strategies. However, timed condomless sex requires specific knowledge of how to accurately predict the fertile window in a menstrual cycle. The aim of this study was to summarize inexpensive fertility awareness methods (FAMs that predict the fertile window and may be useful for counselling HIV-positive couples on lower cost options to conceive. Methods: Original English-language research articles were identified by a detailed Medline and Embase search in July 2014. Relevant citations in the included articles were also retrieved. Results and discussion: Calendar method, basal body temperature and cervicovaginal mucus secretions are the most accessible and sensitive FAMs, although poor specificity precludes their independent use in ovulation detection. In contrast, urinary luteinizing hormone testing is highly specific but less sensitive, and more expensive. To maximize the chance of conception per cycle, the likelihood of natural conception needs to be assessed with a basic fertility evaluation of both partners and a combination of FAMs should be offered. Adherence to other risk-reduction strategies should also be advised, and timely referral to reproductive medicine specialists is necessary

  9. Estimating the cost-effectiveness of pre-exposure prophylaxis to reduce HIV-1 and HSV-2 incidence in HIV-serodiscordant couples in South Africa.

    Directory of Open Access Journals (Sweden)

    Britta L Jewell

    Full Text Available To estimate the cost-effectiveness of daily oral tenofovir-based PrEP, with a protective effect against HSV-2 as well as HIV-1, among HIV-1 serodiscordant couples in South Africa.We incorporated HSV-2 acquisition, transmission, and interaction with HIV-1 into a microsimulation model of heterosexual HIV-1 serodiscordant couples in South Africa, with use of PrEP for the HIV-1 uninfected partner prior to ART initiation for the HIV-1 1infected partner, and for one year thereafter.We estimate the cost per disability-adjusted life-year (DALY averted for two scenarios, one in which PrEP has no effect on reducing HSV-2 acquisition, and one in which there is a 33% reduction. After a twenty-year intervention, the cost per DALY averted is estimated to be $10,383 and $9,757, respectively--a 6% reduction, given the additional benefit of reduced HSV-2 acquisition. If all couples are discordant for both HIV-1 and HSV-2, the cost per DALY averted falls to $1,445, which shows that the impact is limited by HSV-2 concordance in couples.After a 20-year PrEP intervention, the cost per DALY averted with a reduction in HSV-2 is estimated to be modestly lower than without any effect, providing an increase of health benefits in addition to HIV-1 prevention at no extra cost. The small degree of the effect is in part due to a high prevalence of HSV-2 infection in HIV-1 serodiscordant couples in South Africa.

  10. A Case Study of Sexual Abuse and Psychological Correlates among an HIV-Serodiscordant Couple.

    Science.gov (United States)

    Wyatt, Gail E; Loeb, Tamra B; Williams, John K; Davis, Teri D; Zhang, Muyu

    2012-06-01

    Childhood sexual abuse (CSA), adult sexual abuse (ASA) and intimate partner violence (IVP) are documented risk factors for HIV infection and are often implicated in the presentation of mental health disorders in both males and females, including those who are vulnerable to HIV-infection (African-Americans; trauma survivors). As such, these issues may contribute to health-related challenges among couples, particularly if the individuals are impacted by histories of trauma and HIV. Presented here is a case study of one couple with self-reported histories of CSA and clinically significant symptoms of posttraumatic stress disorder (PTSD) and depression. This couple was selected from a larger National Institute of Mental Health (NIMH)-funded study of 535 African-American HIV-serodiscordant heterosexual couples (see El Bassel, 2010). The study couple completed 8 sessions of an HIV sexual risk reduction intervention program to increase condom use. Although the couple reported an initial increase in condom use at the immediate post intervention assessment, condom use decreased to baseline assessment levels at the 12-month post intervention assessment. The decrease in HIV-transmission protective behaviors over time (i.e., condom use), in part, may be attributable to the clinically significant psychological distress symptoms of PTSD and depression that were maintained from baseline, throughout the trial, and at follow-up assessments. We propose that the success of sexual risk reduction interventions may be attenuated and compromised over time by the presence of sexual trauma histories and the residual mental health issues. We discuss clinical implications for health care professionals in their work with couples, especially those from racially diverse groups.

  11. StakeholderS perception of hiV Sero-diScordant coupleS in weStern ...

    African Journals Online (AJOL)

    2008-07-07

    Jul 7, 2008 ... Objective: to describe the perceptions of key stakeholders regarding the counselling needs of hiV sero-discordant couples as part of preparation for a clinical trial involving hiV sero-discordant couples. Design: Qualitative study using key informant and couple interviews. Setting: Moi teaching and referral ...

  12. StakeholderS perception of hiV Sero-diScordant coupleS in weStern ...

    African Journals Online (AJOL)

    2008-07-07

    Jul 7, 2008 ... the need for education on the meaning of hiV sero-discordancy including potential sources of infection; assistance ... the meaning, mechanisms and implications of sero-discordancy. culturally appropriate hiV- disclosure and safer .... Data collection: Each data collection team consisted of a moderator and a ...

  13. Evaluating Safer Conception Options for HIV-Serodiscordant Couples (HIV-Infected Female/HIV-Uninfected Male: A Closer Look at Vaginal Insemination

    Directory of Open Access Journals (Sweden)

    Okeoma Mmeje

    2012-01-01

    Full Text Available HIV serodiscordant couples represent at least half of all HIV-affected couples worldwide. Many of these couples have childbearing desires. Safer methods of conception may allow for pregnancy while minimizing the risk of sexual transmission of HIV. In serodiscordant partnerships with an HIV-infected female and HIV-uninfected male, vaginal insemination of a partner's semen during the fertile period coupled with 100% condom use may be the safest method of conception.

  14. Quantifying sexual exposure to HIV within an HIV-serodiscordant relationship: development of an algorithm.

    Science.gov (United States)

    Fox, Julie; White, Peter J; Weber, Jonathan; Garnett, Geoff P; Ward, Helen; Fidler, Sarah

    2011-05-15

    The risk of acquiring HIV from a single sexual contact varies enormously reflecting biological and behavioural characteristics of both infected and uninfected partners. Accurate information on HIV transmission risk is required to construct evidence-based risk reduction practices for individuals, to direct the provision of prevention strategies at the population level, and enable the definition, quantification and comparison of true exposure in individuals termed 'exposed uninfected' within clinical trials. Following a systematic review of current literature on HIV transmission estimates, an HIV risk score was developed, incorporating weighted risk factors into a Bernoulli mathematical model, allowing quantification of overall risk of HIV acquisition within HIV-serodiscordant partnerships. The HIV risk score enumerates the relative risk of HIV acquisition from HIV-positive partners incorporating the type and frequency of specific sex acts, the index case HIV plasma viral load and stage of disease, and the presence of genital ulcer disease in either partner and pregnancy, HSV-2 seropositivity, and circumcision status (men only) in the HIV-negative partner. Key determinants of HIV exposure risk can be incorporated into a mathematical model in order to quantify individual relative risks of HIV acquisition. Such a model can facilitate comparisons within clinical trials of exposed uninfected individuals and facilitate interventions to reduce HIV transmission.

  15. A flexible method to model HIV serodiscordance among couples in Mozambique.

    Directory of Open Access Journals (Sweden)

    Adelino J C Juga

    Full Text Available Whereas the number of people newly infected by HIV is continuing to decline globally, the epidemic continues to expand in many parts of the world. As the HIV/AIDS epidemic has matured in many countries, it is believed that the proportion of new infections occurring within couples has risen. Across countries, including Mozambique, a sizeable proportion of couples with HIV infection are discordant. A serodiscordant couple is a couple in which one partner has tested positive for HIV and the other has not. To describe the HIV serodiscordance among couples, a variety of association measures can be used. In this paper, we propose the serodiscordance measure (SDM as a new alternative measure. Focus is on the specification of flexible marginal and random effects models for multivariate correlated binary data together with a full-likelihood estimation method, to adequately and directly describe the measure of interest. Fitting joint models allows examining the effects of different risk factors and other covariates on the probability to be HIV positive for each member within a couple, and estimating common effects for both probabilities more efficiently, while accounting for the association between their infection status. Moreover, the interpretation of the proposed association parameter SDM is more direct and relevant and effects of covariates can be studied as well. Results show that the HIV prevalence for the province where a couple was located as well as the union number for the woman within a couple are factors associated with HIV serodiscordance. These findings are important for the Mozambican public health policy makers to design national prevention plans, which include policies to stimulate regular HIV testing for couples as well as adolescents and young adults, prior to getting married or living together as a couple.

  16. Achieving pregnancy safely for HIV-serodiscordant couples: a social ecological approach

    Directory of Open Access Journals (Sweden)

    Haneefa T Saleem

    2017-02-01

    Full Text Available The recognition and fulfilment of the sexual and reproductive health and rights (SRHR of all individuals and couples affected by HIV, including HIV-serodiscordant couples, requires intervention strategies aimed at achieving safe and healthy pregnancies and preventing undesired pregnancies. Reducing risk of horizontal and vertical transmission and addressing HIV-related infertility are key components of such interventions. In this commentary, we present challenges and opportunities for achieving safe pregnancies for serodiscordant couples through a social ecological lens. At the individual level, knowledge (e.g. of HIV status, assisted reproductive technologies and skills (e.g. adhering to antiretroviral therapy or pre-exposure prophylaxis are important. At the couple level, communication between partners around HIV status disclosure, fertility desires and safer pregnancy is required. Within the structural domain, social norms, stigma and discrimination from families, community and social networks influence individual and couple experiences. The availability and quality of safer conception and fertility support services within the healthcare system remains essential, including training for healthcare providers and strengthening integration of SRHR and HIV services. Policies, legislation and funding can improve access to SRHR services. A social ecological framework allows us to examine interactions between levels and how interventions at multiple levels can better support HIV-serodiscordant couples to achieve safe pregnancies. Strategies to achieve safer pregnancies should consider interrelated challenges at different levels of a social ecological framework. Interventions across multiple levels, implemented concurrently, have the potential to maximize impact and ensure the full SRHR of HIV-serodiscordant couples.

  17. Love and HIV serodiscordance in gay men's accounts of life with their regular partners.

    Science.gov (United States)

    Davis, Mark; Flowers, Paul

    2011-08-01

    This paper examines discourse on serodiscordant relationships in interviews with 16 HIV-positive and 3 HIV-negative gay men living in Scotland. Drawing on critiques concerning love, reason and HIV serostatus normativity, this paper supplies a much-needed insight into how gay men in serodiscordant relationships negotiate HIV prevention. Among other matters, some HIV-negative men were said to knowingly request risky sex with their HIV-positive partners as an expression of love. In some situations, the person without HIV claimed a normative serostatus that implied they could 'invest' more in the relationship by offering to have sexual intercourse that may expose them to HIV. Such dynamics expressed devotion on the part of the HIV-negative man, but implied obligation for the HIV-positive man. Based on these and other perspectives we argue for closer attention to gay men's subjectivity in the present circumstances of proliferating biomedical forms of HIV prevention; more thoroughly reflexive public health engagements with gay men's sexual cultures; and a research agenda for gay men that challenges HIV-serostatus normativity.

  18. Sperm washing to prevent HIV transmission from HIV-infected men but allowing conception in sero-discordant couples.

    Science.gov (United States)

    Eke, Ahizechukwu C; Oragwu, Chikelue

    2011-01-19

    Sperm washing is a term used to describe the process in which individual spermatozoa are separated from the seminal fluid. Sperm washing is used to prevent HIV transmission but allow conception in sero-discordant couples, where the male is HIV positive, but the female is HIV negative. This procedure is based on the observation that HIV cannot attach itself to spermatozoa, but it can be found in the fluid and cells surrounding spermatozoa. To determine the benefits and harms of sperm washing of HIV-infected males when used to prevent the transmission of HIV but allowing conception in the HIV-negative female. We searched the Cochrane HIV/AIDS Group Controlled Trials Register, the Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, SCORPUS, AIDsearch, AJOL, LILACS and INDEX MEDICUS. We also searched the following conference proceedings for relevant abstracts:The International AIDS Conference; The Conference on Retroviruses and Opportunistic Infections (CROI); The British HIV Association (BHIVA) Conference; The International Conference of Obstetricians and Gynecologists (FIGO); The American Academy of HIV Medicine Conference; The Australasian HIV/AIDS Conference; The American Society for Reproductive Medicine (ASRM) conferences and website; The European Society for Human Reproduction and Embryology (ESHRE) conferences and websites, and the British Fertility Society (BFS) conferences and website. We also conducted a search of the website: www.ClinicalTrials.gov. The date of the most recent Cochrane HIV/AIDS Group Controlled Trials Register search was on the 10th of November, 2010. We preferentially looked for randomised or quasi-randomised controlled trials on sperm washing, aimed at preventing HIV transmission from HIV infected men but allowing conception in sero-discordant couples, irrespective of publication status, year of publication, or language in the review. No relevant trials were identified for inclusion in this review. Forty four studies were

  19. Effectiveness of ART and Condom Use for Prevention of Sexual HIV Transmission in Serodiscordant Couples: A Systematic Review and Meta-Analysis

    Science.gov (United States)

    Liu, Huixin; Su, Yingying; Zhu, Lin; Xing, Jiannan; Wu, Jing; Wang, Ning

    2014-01-01

    Background Consistent and correct condom use and suppressive antiretroviral therapy for the infected partner are two of the primary strategies recommended for prevention of heterosexual HIV transmission in serodiscordant couples today. The applied effectiveness of treatment as a prevention strategy in China is still under investigation, and much less is known about its effects in the presence of other prevention strategies such as consistent condom use. Methods We conducted a systematic search in PubMed and three Chinese language databases to identify relevant articles for the estimation of relative effectiveness of a) consistent condom use and b) ART use by index partners for preventing HIV transmission in serodiscordant couples. We also estimated the prevention effectiveness of ART stratified by condom use level and the prevention effectiveness of consistent condom use stratified by ART use level. Results Pooled results from the eleven eligible studies found a pooled HIV seroconversion incidence of 0.92 cases per 100 person years (PY) among HIV-negative spouses whose index partners were taking ART versus 2.45 cases per 100 PY in untreated couples. The IRR comparing seroconversion in couples where the index-partner was on ART versus not on ART was 0.47 (95%CI: 0.43, 0.52), while stratified by condom use, the IRR was 0.33(0.17,0.64). The IRR comparing incidence in couples reporting “consistent condom use” versus those reporting otherwise was 0.02(95%CI:0.01,0.04), after stratified by ART use level, the IRR was 0.01(95%CI: 0.00, 0.06). Conclusions ART use by index partners could reduce HIV transmission in serodiscordant couples, and the effectiveness of this prevention strategy could be further increased with consistent condom use. PMID:25369471

  20. Effectiveness of ART and condom use for prevention of sexual HIV transmission in serodiscordant couples: a systematic review and meta-analysis.

    Directory of Open Access Journals (Sweden)

    Huixin Liu

    Full Text Available BACKGROUND: Consistent and correct condom use and suppressive antiretroviral therapy for the infected partner are two of the primary strategies recommended for prevention of heterosexual HIV transmission in serodiscordant couples today. The applied effectiveness of treatment as a prevention strategy in China is still under investigation, and much less is known about its effects in the presence of other prevention strategies such as consistent condom use. METHODS: We conducted a systematic search in PubMed and three Chinese language databases to identify relevant articles for the estimation of relative effectiveness of a consistent condom use and b ART use by index partners for preventing HIV transmission in serodiscordant couples. We also estimated the prevention effectiveness of ART stratified by condom use level and the prevention effectiveness of consistent condom use stratified by ART use level. RESULTS: Pooled results from the eleven eligible studies found a pooled HIV seroconversion incidence of 0.92 cases per 100 person years (PY among HIV-negative spouses whose index partners were taking ART versus 2.45 cases per 100 PY in untreated couples. The IRR comparing seroconversion in couples where the index-partner was on ART versus not on ART was 0.47 (95%CI: 0.43, 0.52, while stratified by condom use, the IRR was 0.33(0.17,0.64. The IRR comparing incidence in couples reporting "consistent condom use" versus those reporting otherwise was 0.02(95%CI:0.01,0.04, after stratified by ART use level, the IRR was 0.01(95%CI: 0.00, 0.06. CONCLUSIONS: ART use by index partners could reduce HIV transmission in serodiscordant couples, and the effectiveness of this prevention strategy could be further increased with consistent condom use.

  1. Pregnancy Desire, Partner Serodiscordance, and Partner HIV Disclosure among Reproductive Age HIV-Infected Women in an Urban Clinic.

    Science.gov (United States)

    Rhodes, Corinne M; Cu-Uvin, Susan; Rana, Aadia I

    2016-01-01

    Women comprise 25% of the US HIV epidemic, with many women of reproductive age. There is a need for providers to address the reproductive needs and desires of women with HIV given that effective antiretroviral therapy has transformed HIV into a chronic disease. This cross-sectional study shows high rates of partner serodiscordance (61%) and moderate HIV disclosure to partners (61%). Patients surveyed reported practitioners discuss condoms (94%) and contraception (71%) more often than pregnancy desire (38%). In our sample, 44% of the surveyed women intended future pregnancy, whereas women who did not intend future pregnancy cited HIV/health and serodiscordance as the most common reasons (56% and 35%, resp.). There was no difference in the knowledge of mother-to-child transmission risk between women who intended or did not intend future pregnancy (p = 0.71). These results underline the need for provider training in reproductive counseling to promote risk reduction and education.

  2. A scoping review and thematic analysis of social and behavioural research among HIV-serodiscordant couples in high-income settings.

    Science.gov (United States)

    Mendelsohn, Joshua B; Calzavara, Liviana; Daftary, Amrita; Mitra, Sanjana; Pidutti, Joel; Allman, Dan; Bourne, Adam; Loutfy, Mona; Myers, Ted

    2015-03-13

    While HIV incidence has stabilized in many settings, increases in health and wellbeing among many people living with HIV/AIDS suggest that the number of HIV-serodiscordant relationships is growing. Given the deficit of reviews addressing social and behavioural characteristics of HIV-serodiscordant couples within high-income settings, our objective was to understand the scope of the published literature, identify evidence gaps, and suggest future research needs. Ten electronic databases were searched. Studies were included if they were reported in English, used primary data, were from the combination antiretroviral (cART) era (>1996), reported on social or behavioural aspects, included any fraction of primary (i.e., stable) relationships, and were conducted in high-income settings. Studies that identified their unit of analysis as either the dyad or individual member of the couple were included. Studies were coded according to a thematic framework. Included studies (n = 154) clustered into eight themes: risk behaviours (29%), risk management (26%), reproductive issues (12%), relationship quality (9%), serostatus disclosure (7%), adherence to antiretroviral therapy (7%), vulnerability (5%), and social support (3%). The proportion of studies conducted among heterosexual couples, same-sex male couples, and mixed cohorts were 42%, 34%, and 24%, respectively. Most studies (70%) were conducted in the United States, 70% of all studies were quantitative (including interventions), but only one-third were focused on couples (dyads) where both partners are recruited to a study. Over 25% of studies focused on sexual risk among same-sex male couples. Future research efforts should focus on the interrelationship of risk management strategies and relationship quality, social determinants of health and wellbeing, HIV testing, vulnerable populations, reproductive issues among same-sex couples, disclosure of serodiscordant status to social networks, dyadic studies, population

  3. Contraception and family planning among HIV-seroconcordant and -serodiscordant couples in the US and Zambia

    Directory of Open Access Journals (Sweden)

    Deborah L Jones

    2010-05-01

    Full Text Available Deborah L Jones1, Olga Villar-Loubet1, Chipepo Kankasa2, Ndashi Chitalu2, Miriam Mumbi2, Stephen M Weiss11Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, FL, USA; 2Department of Paediatrics, University of Zambia School of Medicine, Lusaka, ZambiaAbstract: With the advent of antiretroviral therapy, remarkable progress has been made in the reduction of morbidity and mortality associated with the human immunodeficiency virus (HIV. As a result, in both the developed and developing world, reproductive decision-making and family planning has re-emerged as an important health issue among HIV-seroconcordant and -serodiscordant couples. This study sought to explore contraceptive attitudes and practices among HIV-seropositive and -serodiscordant couples in the US and Zambia and to compare contraceptive decision-making between seroconcordant and discordant couples. Study results suggest that while most participants expressed a willingness to use protection to prevent pregnancy, the majority were not using protection consistently. Similarly, among seropositive younger men in both the US and Zambia, more men expressed a desire to have children than women of either serostatus group. Study outcomes also suggest that male and female condom use to reduce HIV transmission within couples is limited. Thus, as males are largely the sexual decision makers regarding condom use, women’s attitudes or plans regarding child bearing may be eclipsed by those of their male partners, and recent reductions in provision of female condoms in the developing world may further reduce women’s options to protect themselves and prevent pregnancy. Education and counseling on vertical and horizontal transmission of HIV among both seropositive and serodiscordant couples should be an element of family planning efforts. Conversely, family planning should be a critical element of HIV counseling and testing strategies to

  4. HIV sero-discordance among Nigerian couples: challenges and ...

    African Journals Online (AJOL)

    Socio-demographic data of age, gender, occupation, risk group assessment and informed consent were obtained from all subjects. Hepatitis B status of the spouses, sero-positive for HIV was determined. Among the 100 couples tested for HIV sero-positivity, 52% were discordant while 48% were cordant. HIV-I was the ...

  5. The Challenges to Intimacy and Sexual Relationships for Gay Men in HIV Serodiscordant Relationships: A Pilot Study.

    Science.gov (United States)

    Palmer, Robert; Bor, Robert

    2001-01-01

    HIV creates imbalance in long term, HIV-serodiscordant, gay male relationships, particularly in sexual relations and issues of physical and emotional intimacy. Partners employ a range of coping strategies and techniques. This article explores these issues and how partners preserve their relationships in the face of these unique challenges. (BF)

  6. Increased Risk of HIV-1 Transmission in Pregnancy: A Prospective Study among African HIV-1 Serodiscordant Couples

    Science.gov (United States)

    MUGO, Nelly R.; HEFFRON, Renee; DONNELL, Deborah; WALD, Anna; WERE, Edwin O.; REES, Helen; CELUM, Connie; KIARIE, James N.; COHEN, Craig R.; KAYINTEKORE, Kayitesi; BAETEN, Jared M.

    2011-01-01

    Background Physiologic and behavioral changes during pregnancy may alter HIV-1 susceptibility and infectiousness. Prospective studies exploring pregnancy and HIV-1 acquisition risk in women have found inconsistent results. No study has explored the effect of pregnancy on HIV-1 transmission risk from HIV-1 infected women to male partners. Methods In a prospective study of African HIV-1 serodiscordant couples, we evaluated the relationship between pregnancy and the risk of 1) HIV-1 acquisition among women and 2) HIV-1 transmission from women to men. Results 3321 HIV-1 serodiscordant couples were enrolled, 1085 (32.7%) with HIV-1 susceptible female partners and 2236 (67.3%) with susceptible male partners. HIV-1 incidence in women was 7.35 versus 3.01 per 100 person-years during pregnant and non-pregnant periods (hazard ratio [HR] 2.34, 95% confidence interval [CI] 1.33–4.09). This effect was attenuated and not statistically significant after adjusting for sexual behavior and other confounding factors (adjusted HR 1.71, 95% CI 0.93–3.12). HIV-1 incidence in male partners of infected women was 3.46 versus 1.58 per 100 person-years when their partners were pregnant versus not pregnant (HR 2.31, 95% CI 1.22–4.39). This effect was not attenuated in adjusted analysis (adjusted HR 2.47, 95% CI 1.26–4.85). Conclusions HIV-1 risk increased two-fold during pregnancy. Elevated risk of HIV-1 acquisition in pregnant women appeared in part to be explained by behavioral and other factors. This is the first study to show pregnancy increased the risk of female-to-male HIV-1 transmission, which may reflect biological changes of pregnancy that could increase HIV-1 infectiousness. PMID:21785321

  7. Fertility Intentions, Pregnancy, and Use of PrEP and ART for Safer Conception Among East African HIV Serodiscordant Couples.

    Science.gov (United States)

    Heffron, Renee; Thomson, Kerry; Celum, Connie; Haberer, Jessica; Ngure, Kenneth; Mugo, Nelly; Bukusi, Elizabeth; Katabira, Elly; Odoyo, Josephine; Bulya, Nulu; Asiimwe, Stephen; Tindimwebwa, Edna; Baeten, Jared M

    2017-09-11

    African HIV serodiscordant couples often desire pregnancy, despite sexual HIV transmission risk during pregnancy attempts. Pre-exposure prophylaxis (PrEP) and antiretroviral therapy (ART) reduce HIV risk and can be leveraged for safer conception but how well these strategies are used for safer conception is not known. We conducted an open-label demonstration project of the integrated delivery of PrEP and ART among 1013 HIV serodiscordant couples from Kenya and Uganda followed quarterly for 2 years. We evaluated fertility intentions, pregnancy incidence, the use of PrEP and ART during peri-conception, and peri-conception HIV incidence. At enrollment, 80% of couples indicated a desire for more children. Pregnancy incidence rates were 18.5 and 18.7 per 100 person years among HIV-uninfected and HIV-infected women, and higher among women who recently reported fertility intention (adjusted odds ratio 3.43, 95% CI 2.38-4.93) in multivariable GEE models. During the 6 months preceding pregnancy, 82.9% of couples used PrEP or ART and there were no HIV seroconversions. In this cohort with high pregnancy rates, integrated PrEP and ART was readily used by HIV serodiscordant couples, including during peri-conception periods. Widespread scale-up of safer conception counseling and services is warranted to respond to strong desires for pregnancy among HIV-affected men and women.

  8. Quantifying Ongoing HIV-1 Exposure in HIV-1–Serodiscordant Couples to Identify Individuals With Potential Host Resistance to HIV-1

    Science.gov (United States)

    Mackelprang, Romel D.; Baeten, Jared M.; Donnell, Deborah; Celum, Connie; Farquhar, Carey; de Bruyn, Guy; Essex, Max; McElrath, M. Juliana; Nakku-Joloba, Edith; Lingappa, Jairam R.

    2012-01-01

    Background. Immunogenetic correlates of resistance to HIV-1 in HIV-1–exposed seronegative (HESN) individuals with consistently high exposure may inform HIV-1 prevention strategies. We developed a novel approach for quantifying HIV-1 exposure to identify individuals remaining HIV-1 uninfected despite persistent high exposure. Methods. We used longitudinal predictors of HIV-1 transmission in HIV-1 serodiscordant couples to score HIV-1 exposure and define HESN clusters with persistently high, low, and decreasing risk trajectories. The model was validated in an independent cohort of serodiscordant couples. We describe a statistical tool that can be applied to other HESN cohorts to identify individuals with high exposure to HIV-1. Results. HIV-1 exposure was best quantified by frequency of unprotected sex with, plasma HIV-1 RNA levels among, and presence of genital ulcer disease among HIV-1–infected partners and by age, pregnancy status, herpes simplex virus 2 serostatus, and male circumcision status among HESN participants. Overall, 14% of HESN individuals persistently had high HIV-1 exposure and exhibited a declining incidence of HIV-1 infection over time. Conclusions. A minority of HESN individuals from HIV-1–discordant couples had persistent high HIV-1 exposure over time. Decreasing incidence of infection in this group suggests these individuals were selected for resistance to HIV-1 and may be most appropriate for identifying biological correlates of natural host resistance to HIV-1 infection. PMID:22926009

  9. Attitudes of serodiscordant couples towards antiretroviral-based HIV prevention strategies in Kenya: a qualitative study

    Directory of Open Access Journals (Sweden)

    Nikola Fowler

    2014-11-01

    Full Text Available Introduction: Transmission in serodiscordant couples (SDCs accounts for approximately half of all new HIV infections, both in Kenya and the wider sub-Saharan region (1. With evidence to suggest inconsistent condom use within this population (2, the World Health Organization has recommended two new methods of HIV prevention for SDCs: Treatment as Prevention (TasP and Pre-Exposure Prophylaxis (PrEP. However, there has been little research about the attitudes of SDCs towards these strategies (3, 4; knowledge that is paramount for successfully predicting the acceptability and efficacy of each method, as well as for informing decisions regarding HIV policy changes in Kenya. Methods: An exploratory, qualitative study was conducted in the Muhoroni constituency of Nyando district, Kenya from January to March 2013. Purposive sampling was predominately used to recruit 21 HIV-positive and 17 HIV-negative individuals in a serodiscordant relationship from four hospitals and health centres. During face-to-face semi-structured interviews, topic guides were used to elicit information about participants’ attitudes and preferences towards TasP and PrEP. Collected data underwent framework analysis, allowing the development of overarching categories, sub-themes and inductive interpretation. Results: The majority of participants, irrespective of gender and HIV status, found TasP more acceptable than PrEP. A key factor influencing this decision was HIV-negative participants’ limited motivation to take and adhere to antiretrovirals (ARVs, primarily due to a predominantly external health locus of control, a lack of cultural acceptance of prophylactic medication and concerns about side effects. In addition to this, the likely health improvements TasP offers HIV-positive partners, as well as the attitude that the sick individual should be the first to receive HIV medication, also contributed to this conclusion. Issues of risk compensation were raised, with some HIV

  10. Delivering safer conception services to HIV serodiscordant couples in Kenya: perspectives from healthcare providers and HIV serodiscordant couples

    Directory of Open Access Journals (Sweden)

    Kenneth Ngure

    2017-02-01

    Conclusions: Antiretroviral-based HIV prevention is acceptable and accessible to meet the growing demand for safer conception services in Kenya, since medically assisted interventions are currently cost prohibitive. Cross-disciplinary training for health providers would expand confidence in all prevention options and foster the tailoring of counselling to couples’ preferences.

  11. Brief Report: Medication Sharing Is Rare Among African HIV-1 Serodiscordant Couples Enrolled in an Efficacy Trial of Oral Pre-exposure Prophylaxis (PrEP) for HIV-1 Prevention.

    Science.gov (United States)

    Thomson, Kerry A; Haberer, Jessica E; Marzinke, Mark A; Mujugira, Andrew; Hendrix, Craig W; Celum, Connie; Ndase, Patrick; Ronald, Allan; Bangsberg, David R; Baeten, Jared M

    2017-06-01

    Sharing of pre-exposure prophylaxis (PrEP) medications is a concern for PrEP implementation. For HIV-1 serodiscordant couples, sharing may undermine the HIV-1 prevention benefit and also cause antiretroviral resistance if taken by HIV-1 infected partners. Within a PrEP efficacy trial among HIV-1 serodiscordant couples, we assessed the occurrence of PrEP sharing by self-report and plasma tenofovir concentrations in HIV-1 infected partners. PrEP sharing was self-reported at PrEP sharing within HIV-1 serodiscordant couples was extremely rare.

  12. Antiretroviral Therapy Initiation Is Not Associated With Risky Sexual Behavior Among Heterosexual Human Immunodeficiency Virus-Infected Persons in Serodiscordant Partnerships.

    Science.gov (United States)

    Mujugira, Andrew; Celum, Connie; Ngure, Kenneth; Thomas, Katherine K; Katabira, Elly; Baeten, Jared M

    2017-01-01

    Few prospective studies have assessed whether antiretroviral therapy (ART) use is associated with changes in sexual risk behavior of human immunodeficiency virus (HIV)-infected persons in known HIV-serodiscordant partnerships. We conducted a longitudinal analysis of HIV-infected persons with known uninfected partners enrolled in the Partners Pre-Exposure Prophylaxis Study in Kenya and Uganda. Antiretroviral therapy use and self-reported sexual behavior were ascertained every 3 months. We assessed the effect of ART on sexual risk behaviors using zero-inflated negative binomial regression. Primary outcomes were condomless vaginal sex acts, pregnancy incidence and new sexually transmitted infection diagnoses. We followed 1817 HIV-infected persons (58% women) for 864 person-years before ART initiation and 771 person-years after ART. Median CD4 and plasma viral load at ART initiation were 277 cells/μL and 4.18 log10 copies/mL. Antiretroviral therapy use was associated with a significant decrease in condomless vaginal sex acts with HIV-uninfected partners (0.65 vs 0.39 per month; rate ratio, 0.64; 95% confidence interval [CI], 0.55-0.75; P sexually transmitted infection diagnoses were similar (odds ratio, 1.05; 95% CI, 0.86-1.29; P = 0.63). Substantial risk compensation did not occur after ART initiation among East African HIV-infected persons with known HIV-uninfected partners. These data inform modelling studies of ART for HIV prevention by suggesting that risky sexual behavior did not appear to offset decreased HIV infectiousness in this key population.

  13. PrEP Use During Periods of HIV Risk Among East African Women in Serodiscordant Relationships.

    Science.gov (United States)

    Pyra, Maria; Haberer, Jessica E; Heffron, Renee; Kidoguchi, Lara; Brown, Elizabeth R; Bukusi, Elizabeth A; Asiimwe, Stephen; Celum, Connie; Katabira, Elly; Mugo, Nelly R; Baeten, Jared M

    2017-09-29

    PrEP is efficacious for African women at risk for HIV, but data on adherence outside of clinical trials are sparse. We describe the persistence and execution of PrEP use among women participating in a large open-label PrEP demonstration project, particularly during periods of HIV risk. & Methods: 310 HIV-uninfected women in HIV serodiscordant couples in Kenya and Uganda were offered and accepted PrEP. Electronic monitoring caps were used to measure daily PrEP adherence. Time on PrEP while at risk for HIV (when the HIV-infected partner was on ART PrEP were calculated and compared among older and younger (PrEP during their entire risk period and 24% stopped but re-started PrEP during their risk period. While on PrEP, women took ≥6 doses/week for 78% of weeks (67% of weeks for women PrEP successfully over sustained periods of risk. While young women had lower adherence than older women, they achieved strong protection, suggesting women can align PrEP use to periods of risk and imperfect adherence can still provide substantial benefit.This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial License 4.0 (CCBY-NC), where it is permissible to download, share, remix, transform, and buildup the work provided it is properly cited. The work cannot be used commercially without permission from the journal.

  14. Estimating the impact of universal antiretroviral therapy for HIV serodiscordant couples through home HIV testing: insights from mathematical models

    Directory of Open Access Journals (Sweden)

    Sarah T Roberts

    2016-05-01

    Full Text Available Introduction: Antiretroviral therapy (ART prevents HIV transmission within HIV serodiscordant couples (SDCs, but slow implementation and low uptake has limited its impact on population-level HIV incidence. Home HIV testing and counselling (HTC campaigns could increase ART uptake among SDCs by incorporating couples’ testing and ART referral. We estimated the reduction in adult HIV incidence achieved by incorporating universal ART for SDCs into home HTC campaigns in KwaZulu-Natal (KZN, South Africa, and southwestern (SW Uganda. Methods: We constructed dynamic, stochastic, agent-based network models for each region. We compared adult HIV incidence after 10 years under three scenarios: (1 “Current Practice,” (2 “Home HTC” with linkage to ART for eligible persons (CD4 <350 and (3 “ART for SDCs” regardless of CD4, delivered alongside home HTC. Results: ART for SDCs reduced HIV incidence by 38% versus Home HTC: from 1.12 (95% CI: 0.98–1.26 to 0.68 (0.54–0.82 cases per 100 person-years (py in KZN, and from 0.56 (0.50–0.62 to 0.35 (0.30–0.39 cases per 100 py in SW Uganda. A quarter of incident HIV infections were averted over 10 years, and the proportion of virally suppressed HIV-positive persons increased approximately 15%. Conclusions: Using home HTC to identify SDCs and deliver universal ART could avert substantially more new HIV infections than home HTC alone, with a smaller number needed to treat to prevent new HIV infections. Scale-up of home HTC will not diminish the effectiveness of targeting SDCs for treatment. Increasing rates of couples’ testing, disclosure, and linkage to care is an efficient way to increase the impact of home HTC interventions on HIV incidence.

  15. Sexual behaviour of heterosexual men and women receiving antiretroviral pre-exposure prophylaxis for HIV prevention: a longitudinal analysis.

    Science.gov (United States)

    Mugwanya, Kenneth K; Donnell, Deborah; Celum, Connie; Thomas, Katherine K; Ndase, Patrick; Mugo, Nelly; Katabira, Elly; Ngure, Kenneth; Baeten, Jared M

    2013-12-01

    Scarce data are available to assess sexual behaviour of individuals using antiretroviral pre-exposure prophylaxis for HIV prevention. Increased sexual risk taking by individuals using effective HIV prevention strategies, like pre-exposure prophylaxis, could offset the benefits of HIV prevention. We studied whether the use of pre-exposure prophylaxis in HIV-uninfected men and women in HIV-serodiscordant couples was associated with increased sexual risk behaviour. We undertook a longitudinal analysis of data from the Partners PrEP Study, a double-blind, randomised, placebo-controlled trial of daily oral pre-exposure prophylaxis among HIV-uninfected partners of heterosexual HIV-serodiscordant couples (n=3163, ≥18 years of age). Efficacy for HIV prevention was publicly reported in July 2011, and participants continued monthly follow-up thereafter. We used regression analyses to compare the frequency of sex-unprotected by a condom-during the 12 months after compared with the 12 months before July 2011, to assess whether knowledge of pre-exposure prophylaxis efficacy for HIV prevention caused increased sexual risk behaviour. We analysed 56 132 person-months from 3024 HIV-uninfected individuals (64% male). The average frequency of unprotected sex with the HIV-infected study partner was 59 per 100 person-months before unmasking versus 53 after unmasking; we recorded no immediate change (p=0·66) or change over time (p=0·25) after July, 2011. We identified a significant increase in unprotected sex with outside partners after July, 2011, but the effect was small (average of 6·8 unprotected sex acts per year vs 6·2 acts in a predicted counterfactual scenario had patients remained masked, p=0·04). Compared with before July, 2011, we noted no significant increase in incident sexually transmitted infections or pregnancy after July, 2011. Pre-exposure prophylaxis, provided as part of a comprehensive prevention package, might not result in substantial changes in risk

  16. The Predominant Relationship Between Sexual Environment Characteristics and HIV-Serodiscordant Condomless Anal Sex Among HIV-Positive Men Who Have Sex with Men (MSM)

    OpenAIRE

    Perry, Nicholas S.; Taylor, S. Wade; Elsesser, Steven; Safren, Steven A.; O���Cleirigh, Conall

    2016-01-01

    In some studies, situational factors have been shown to be stronger predictors of condomless sex than individual risk factors. Cross-sectional relationships between condomless anal sex (CAS) with HIV-serodiscordant partners and risk factors across ecological levels (individual, sexual environment) were examined using a sample (N = 60) of HIV-positive men who have sex with men (MSM) who reported multiple recent episodes of CAS. Negative binomial regressions were used to evaluate the associatio...

  17. Intimate partner violence and self-reported pre-exposure prophylaxis (PrEP) interruptions among HIV-negative partners in HIV serodiscordant couples in Kenya and Uganda.

    Science.gov (United States)

    Cabral, Alejandra; Baeten, Jared; Ngure, Kenneth; Velloza, Jennifer; Odoyo, Josephine; Haberer, Jessica; Celum, Connie; Muwonge, Timothy; Asiimwe, Stephen; Heffron, Renee

    2017-10-23

    Oral pre-exposure prophylaxis (PrEP) is effective for HIV prevention and PrEP delivery studies are investigating ways to deliver PrEP with high adherence. However, in many settings with high HIV burden, intimate partner violence (IPV) is reported often and could be a barrier to effective PrEP use. We examined the association between IPV and interruptions in PrEP use. We analyzed data from 1,013 serodiscordant heterosexual couples enrolled in a large PrEP demonstration project in Kenya and Uganda, the Partners Demonstration Project. At quarterly study visits, HIV-negative participants receiving PrEP were asked about interruptions in their PrEP use and experiences with IPV. The association between IPV and PrEP interruptions was analyzed using multivariable generalized estimating equations. At baseline and follow-up there were 53 visits with reports of abuse by 49 HIV-negative partners, including physical, economic, and verbal IPV. Interruptions in PrEP use were reported at 328 visits (7.1% of all visits) by 249 people. The median length of PrEP interruption was 28 days (interquartile range [IQR]: 7-45). The frequency of PrEP interruptions among those reporting IPV was 23.8% and those without IPV was 6.9%. PrEP interruption was significantly associated with IPV after adjustment for age and frequency of sexual intercourse (adjusted OR=2.6, 95% CI 1.2-6.0). IPV was more likely to be reported at visits when PrEP interruptions were also reported, which may have implications for sustained adherence to PrEP. Within PrEP delivery programs, there may be opportunities to assess individual safety and well-being in order to bolster adherence.This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial License 4.0 (CCBY-NC), where it is permissible to download, share, remix, transform, and buildup the work provided it is properly cited. The work cannot be used commercially without permission from the journal.

  18. Geographical Patterns of HIV Sero-Discordancy in High HIV Prevalence Countries in Sub-Saharan Africa

    National Research Council Canada - National Science Library

    Cuadros, Diego F; Abu-Raddad, Laith J

    2016-01-01

    .... We described the spatial patterns of sero-discordancy among stable couples by analyzing Demographic and Health Survey data from Cameroon, Kenya, Lesotho, Tanzania, Malawi, Zambia, and Zimbabwe...

  19. Sexual risk behaviors and acceptability of HIV pre-exposure prophylaxis among HIV-negative gay and bisexual men in serodiscordant relationships: a mixed methods study.

    Science.gov (United States)

    Brooks, Ronald A; Landovitz, Raphael J; Kaplan, Rachel L; Lieber, Eli; Lee, Sung-Jae; Barkley, Thomas W

    2012-02-01

    The objective of this mixed methods study was to examine current sexual risk behaviors, acceptability and potential adoption of pre-exposure prophylaxis (PrEP) for HIV prevention, and sexual behavior intentions with PrEP adoption among HIV-negative gay and bisexual men (GBM) in HIV serodiscordant relationships. A multiracial/ethnic sample of 25 HIV-negative GBM in serodiscordant relationships completed a qualitative interview and a brief interviewer-administered survey. A modified grounded theory approach was used to identify key themes relating to acceptability and future adoption of PrEP. Participants reported engaging in sexual risk behaviors that place them at risk for HIV infection. Participants also reported a high level of acceptability for PrEP and willingness to adopt PrEP for HIV prevention. Qualitative themes explaining future PrEP adoption included: (1) the opportunity to engage in sex using a noncondom HIV prevention method, (2) protection from HIV infection, and (3) less anxiety when engaging in sex with an HIV-positive partner. Associated with the future adoption of PrEP, a majority (64%) of participants indicated the likelihood for an increase in sexual risk behaviors and a majority (60%) of participants also indicated the likelihood for a decrease or abandonment of condom use, both of which are in contrast to the findings from the large iPrEx study. These findings suggest that the use of PrEP by HIV-negative GBM in serodiscordant relationships carries with it the potential for risk compensation. The findings suggest that PrEP only be offered as part of a comprehensive HIV prevention strategy that includes ongoing risk reduction counseling in the delivery of PrEP to help moderate risk compensation.

  20. Brief Report: Context Matters: PrEP Adherence is Associated With Sexual Behavior Among HIV Serodiscordant Couples in East Africa.

    Science.gov (United States)

    Haberer, Jessica E; Ngure, Kenneth; Muwonge, Timothy; Mugo, Nelly; Katabira, Elly; Heffron, Renee; Musinguzi, Nicholas; Bangsberg, David R; Celum, Connie; Baeten, Jared M

    2017-12-15

    Short message service (SMS) surveys are a promising tool for understanding whether preexposure prophylaxis (PrEP) adherence aligns with risk for HIV acquisition-a concept known as prevention-effective adherence. The Partners Demonstration Project was an open-label study of integrated PrEP and antiretroviral therapy (ART) delivery among high-risk HIV serodiscordant couples in East Africa. HIV-uninfected partners were offered PrEP until their HIV-infected partner had taken ART for ≥6 months. At 2 study sites, HIV-uninfected partners were offered enrollment into the Partners Mobile Adherence to PrEP (PMAP) substudy based on ongoing PrEP use, personal cell phone ownership, and ability to use SMS. SMS surveys asked about PrEP adherence and sexual activity in the previous 24 hours; these surveys were sent daily for the 7 days before and 7 days after routine study visits in the Partners Demonstration Project. The PMAP substudy enrolled 373 HIV-uninfected partners; 69% were men and mean age was 31 years. Participants completed 17,030 of 23,056 SMS surveys sent (74%) with a mean of 47 surveys per participant over 9.8 months of follow-up. While HIV-infected partner use of ART was PrEP adherence was 92% on surveys concurrently reporting sex within the serodiscordant partnership, and 84% on surveys reporting no sex (P PrEP adherence and sexual behavior. Higher PrEP adherence was temporally associated with increased risk for HIV acquisition.

  1. Mortality in members of HIV-1 serodiscordant couples in Africa and implications for antiretroviral therapy initiation: Results of analyses from a multicenter randomized trial

    Science.gov (United States)

    2012-01-01

    Background The risk of HIV-1 related mortality is strongly related to CD4 count. Guidance on optimal timing for initiation of antiretroviral therapy (ART) is still evolving, but the contribution of HIV-1 infection to excess mortality at CD4 cell counts above thresholds for HIV-1 treatment has not been fully described, especially in resource-poor settings. To compare mortality among HIV-1 infected and uninfected members of HIV-1 serodiscordant couples followed for up to 24 months, we conducted a secondary data analysis examining mortality among HIV-1 serodiscordant couples participating in a multicenter, randomized controlled trial at 14 sites in seven sub-Saharan African countries. Methods Predictors of death were examined using Cox regression and excess mortality by CD4 count and plasma HIV-1 RNA was computed using Poisson regression for correlated data. Results Among 3295 HIV serodiscordant couples, we observed 109 deaths from any cause (74 deaths among HIV-1 infected and 25 among HIV-1 uninfected persons). Among HIV-1 infected persons, the risk of death increased with lower CD4 count and higher plasma viral levels. HIV-1 infected persons had excess mortality due to medical causes of 15.2 deaths/1000 person years at CD4 counts of 250 – 349 cells/μl and 8.9 deaths at CD4 counts of 350 – 499 cells/μl. Above a CD4 count of 500 cells/μl, mortality was comparable among HIV-1 infected and uninfected persons. Conclusions Among African serodiscordant couples, there is a high rate of mortality attributable to HIV-1 infection at CD4 counts above the current threshold (200 – 350 cells/μl) for ART initiation in many African countries. These data indicate that earlier initiation of treatment is likely to provide clinical benefit if further expansion of ART access can be achieved. Trial Registration Clinicaltrials.gov (NCT00194519) PMID:23130818

  2. Mortality in members of HIV-1 serodiscordant couples in Africa and implications for antiretroviral therapy initiation: Results of analyses from a multicenter randomized trial

    Directory of Open Access Journals (Sweden)

    de Bruyn Guy

    2012-10-01

    Full Text Available Abstract Background The risk of HIV-1 related mortality is strongly related to CD4 count. Guidance on optimal timing for initiation of antiretroviral therapy (ART is still evolving, but the contribution of HIV-1 infection to excess mortality at CD4 cell counts above thresholds for HIV-1 treatment has not been fully described, especially in resource-poor settings. To compare mortality among HIV-1 infected and uninfected members of HIV-1 serodiscordant couples followed for up to 24 months, we conducted a secondary data analysis examining mortality among HIV-1 serodiscordant couples participating in a multicenter, randomized controlled trial at 14 sites in seven sub-Saharan African countries. Methods Predictors of death were examined using Cox regression and excess mortality by CD4 count and plasma HIV-1 RNA was computed using Poisson regression for correlated data. Results Among 3295 HIV serodiscordant couples, we observed 109 deaths from any cause (74 deaths among HIV-1 infected and 25 among HIV-1 uninfected persons. Among HIV-1 infected persons, the risk of death increased with lower CD4 count and higher plasma viral levels. HIV-1 infected persons had excess mortality due to medical causes of 15.2 deaths/1000 person years at CD4 counts of 250 – 349 cells/μl and 8.9 deaths at CD4 counts of 350 – 499 cells/μl. Above a CD4 count of 500 cells/μl, mortality was comparable among HIV-1 infected and uninfected persons. Conclusions Among African serodiscordant couples, there is a high rate of mortality attributable to HIV-1 infection at CD4 counts above the current threshold (200 – 350 cells/μl for ART initiation in many African countries. These data indicate that earlier initiation of treatment is likely to provide clinical benefit if further expansion of ART access can be achieved. Trial Registration Clinicaltrials.gov (NCT00194519

  3. Motivators, concerns, and barriers to adoption of preexposure prophylaxis for HIV prevention among gay and bisexual men in HIV-serodiscordant male relationships.

    Science.gov (United States)

    Brooks, Ronald A; Kaplan, Rachel L; Lieber, Eli; Landovitz, Raphael J; Lee, Sung-Jae; Leibowitz, Arleen A

    2011-09-01

    The purpose of this study was to identify factors that may facilitate or impede future adoption of preexposure prophylaxis (PrEP) for HIV prevention among gay and bisexual men in HIV-serodiscordant relationships. This qualitative study utilized semistructured interviews conducted with a multiracial/-ethnic sample of 25 gay and bisexual HIV-serodiscordant male couples (n=50 individuals) recruited from community settings in Los Angeles, CA. A modified grounded theory approach was employed to identify major themes relating to future adoption of PrEP for HIV prevention. Motivators for adoption included protection against HIV infection, less concern and fear regarding HIV transmission, the opportunity to engage in unprotected sex, and endorsements of PrEP's effectiveness. Concerns and barriers to adoption included the cost of PrEP, short- and long-term side effects, adverse effects of intermittent use or discontinuing PrEP, and accessibility of PrEP. The findings suggest the need for a carefully planned implementation program along with educational and counseling interventions in the dissemination of an effective PrEP agent.

  4. Condomless Sex Among Virally Suppressed Women With HIV With Regular HIV-Serodiscordant Sexual Partners in the Era of Treatment as Prevention.

    Science.gov (United States)

    Patterson, Sophie; Carter, Allison; Nicholson, Valerie; Webster, Kath; Ding, Erin; Kestler, Mary; Ogilvie, Gina; de Pokomandy, Alexandra; Loutfy, Mona; Kaida, Angela

    2017-12-01

    Sexual HIV transmission does not occur with sustained undetectable viral load (VL) on antiretroviral therapy (ART). Awareness of ART prevention benefits and its influence on condom use among women with HIV (WWH) remain unexplored. We estimated prevalence and correlates of condomless sex with regular HIV-serodiscordant partners among WWH with undetectable VL on ART. We used baseline questionnaire data from the community-based longitudinal Canadian HIV Women's Sexual and Reproductive Health Cohort Study (CHIWOS). We included WWH self-reporting vaginal/anal sex with ≥1 HIV-negative/unknown status regular partner within 6 months, and undetectable VL (sex was defined as sex. Of 271 participants (19% of the CHIWOS cohort), median age was 41 (interquartile range: 34-47), 51% were in a relationship, 55% reported condomless sex, and 75% were aware of ART prevention benefits. Among women aware, 63% reported condomless sex compared with 32% of women not aware (P sex included being aware of ART prevention benefits (adjusted odds ratio: 4.08; 95% confidence interval: 2.04 to 8.16), white ethnicity, ≥high-school education, residing in British Columbia, and being in a relationship. Virally suppressed women aware of ART prevention benefits had 4-fold greater odds of condomless sex. Advancing safer sex discussions beyond condoms is critical to support women in regular serodiscordant partnerships to realize options for safe and satisfying sexuality in the Treatment-as-Prevention era.

  5. Alignment of adherence and risk for HIV acquisition in a demonstration project of pre-exposure prophylaxis among HIV serodiscordant couples in Kenya and Uganda: a prospective analysis of prevention-effective adherence

    Directory of Open Access Journals (Sweden)

    Jessica E. Haberer

    2017-01-01

    Conclusions: Over three-quarters of participant-visits by HIV-uninfected partners in serodiscordant couples achieved prevention-effective adherence with PrEP. Greater adherence was observed during months with HIV risk and the strongest predictor of achieving sufficient adherence was sexual activity.

  6. Heterosexuals and HIV transmission: where do we go from here?

    Science.gov (United States)

    Kippax, S; Crawford, J

    1991-07-01

    A number of reports from Australia and abroad, detailing the results of surveys of heterosexuals' sexual practice, have indicated that most heterosexuals are not changing their sexual behavior despite the present context of a global HIV/AIDS pandemic, and despite there being a reasonably accurate knowledge of HIV transmission among survey respondents. However, it does appear that safe sex messages are getting through to and bringing about the gradual adoption of risk reduction behavior among young university students. Findings are reported from surveys of 18-19-year-old male and female students at Macquarie and Sydney Universities during 1987-90. 55 and 66 students were surveyed in 1987 and 1989, respectively, at the University of Sydney, while 700, 564, and 709 students were surveyed in 1988, 1989, and 1990, respectively, at Macquarie University. 45-55% of students had experienced oral/genital sex, 45-60% vaginal intercourse, and 4-7% anal sex. The students generally know that kissing and masturbation are safe sex practices, and they also appear to accept that condom use decreases the risk of exposure to HIV. The most dangerous sex practices were judged to be unprotected intercourse with regular and casual partners, but especially with casual partners, and withdrawal and oral/genital sex with casual partners. When compared with older students, these 18-19 year old students were significantly more likely to use condoms in vaginal intercourse with both regular and casual partners.

  7. Relationship between heterosexual anal sex, injection drug use and HIV infection among black men and women.

    Science.gov (United States)

    Risser, J M H; Padgett, P; Wolverton, M; Risser, W L

    2009-05-01

    US blacks carry a disproportionate risk of heterosexually transmitted HIV. This study aimed to evaluate the association between self-reported heterosexual anal intercourse and HIV. Using respondent-driven sampling (RDS), we recruited and interviewed 909 blacks from areas of high poverty and HIV prevalence in Houston, Texas, and who reported heterosexual sex in the last year. All individuals were tested for HIV. Weighted prevalence values were calculated to account for non-random recruitment associated with RDS. The weighted population prevalence of HIV infection was 2.4% and 2.5% among men and women, respectively. Education, employment status, income and crack cocaine use were not associated with HIV infection. Lifetime injection drug use (odds ratio [OR] 3.31, 95% confidence interval [CI] 1.31-8.33%) and heterosexual anal intercourse (OR 2.41, 95% CI 1.02-5.73%) were associated with HIV infection. Individuals who reported both injection drug use and heterosexual anal intercourse had 6.21 increased odds of HIV (95% CI 2.47-15.61%). Our results suggest that heterosexual anal sex may be a vector for HIV transmission, especially in the context of injection drug use. Prevention strategies directed at curbing the HIV epidemic among black heterosexuals require that we correctly identify the risks so that appropriate interventions can be developed.

  8. Community-based implementation and effectiveness in a randomized trial of a risk reduction intervention for HIV-serodiscordant couples: study protocol.

    Science.gov (United States)

    Hamilton, Alison B; Mittman, Brian S; Williams, John K; Liu, Honghu H; Eccles, Alicia M; Hutchinson, Craig S; Wyatt, Gail E

    2014-06-20

    The HIV/AIDS epidemic continues to disproportionately affect African American communities in the US, particularly those located in urban areas. Despite the fact that HIV is often transmitted from one sexual partner to another, most HIV prevention interventions have focused only on individuals, rather than couples. This five-year study investigates community-based implementation, effectiveness, and sustainability of 'Eban II,' an evidence-based risk reduction intervention for African-American heterosexual, serodiscordant couples. This hybrid implementation/effectiveness implementation study is guided by organizational change theory as conceptualized in the Texas Christian University Program Change Model (PCM), a model of phased organizational change from exposure to adoption, implementation, and sustainability. The primary implementation aims are to assist 10 community-based organizations (CBOs) to implement and sustain Eban II; specifically, to partner with CBOs to expose providers to the intervention; facilitate its adoption, implementation and sustainment; and to evaluate processes and determinants of implementation, effectiveness, fidelity, and sustainment. The primary effectiveness aim is to evaluate the effect of Eban II on participant (n = 200 couples) outcomes, specifically incidents of protected sex and proportion of condom use. We will also determine the cost-effectiveness of implementation, as measured by implementation costs and potential cost savings. A mixed methods evaluation will examine implementation at the agency level; staff members from the CBOs will complete baseline measures of organizational context and climate, while key stakeholders will be interviewed periodically throughout implementation. Effectiveness of Eban II will be assessed using a randomized delayed enrollment (waitlist) control design to evaluate the impact of treatment on outcomes at posttest and three-month follow-up. Multi-level hierarchical modeling with a multi

  9. Reproductive Counseling by Clinic Healthcare Workers in Durban, South Africa: Perspectives from HIV-Infected Men and Women Reporting Serodiscordant Partners

    Directory of Open Access Journals (Sweden)

    L. T. Matthews

    2012-01-01

    Full Text Available Background. Understanding HIV-infected patient experiences and perceptions of reproductive counseling in the health care context is critical to inform design of effective pharmaco-behavioral interventions that minimize periconception HIV risk and support HIV-affected couples to realize their fertility goals. Methods. We conducted semistructured, in-depth interviews with 30 HIV-infected women (with pregnancy in prior year and 20 HIV-infected men, all reporting serodiscordant partners and accessing care in Durban, South Africa. We investigated patient-reported experiences with safer conception counseling from health care workers (HCWs. Interview transcripts were reviewed and coded using content analysis for conceptual categories and emergent themes. Results. The study findings indicate that HIV-infected patients recognize HCWs as a resource for periconception-related information and are receptive to speaking to a HCW prior to becoming pregnant, but seldom seek or receive conception advice in the clinic setting. HIV nondisclosure and unplanned pregnancy are important intervening factors. When advice is shared, patients reported receiving a range of information. Male participants showed particular interest in accessing safer conception information. Conclusions. HIV-infected men and women with serodiscordant partners are receptive to the idea of safer conception counseling. HCWs need to be supported to routinely initiate accurate safer conception counseling with HIV-infected patients of reproductive age.

  10. "I Did Not Want to Give Birth to a Child Who has HIV": Experiences Using PrEP During Pregnancy Among HIV-Uninfected Kenyan Women in HIV-Serodiscordant Couples.

    Science.gov (United States)

    Pintye, Jillian; Beima-Sofie, Kristin M; Kimemia, Grace; Ngure, Kenneth; Trinidad, Susan Brown; Heffron, Renee A; Baeten, Jared M; Odoyo, Josephine; Mugo, Nelly; Bukusi, Elizabeth A; Kelley, Maureen C; John-Stewart, Grace C

    2017-11-01

    The perceptions, motivations, and beliefs of HIV-uninfected women about pre-exposure prophylaxis (PrEP) use during pregnancy can influence its uptake and adherence. This study elicited the views of HIV-uninfected women with personal experience taking PrEP during pregnancy. Qualitative interviews were conducted with HIV-uninfected women who had personal experience taking PrEP while pregnant. Semistructured interviews were conducted with 21 HIV-uninfected Kenyan women in HIV-serodiscordant couples enrolled in an open-label PrEP demonstration project who became pregnant while using PrEP and continued PrEP through their pregnancy. Interviews were audio-recorded and transcribed into English. A qualitative descriptive analysis was performed, using a constant comparison approach to identify key themes related to PrEP use in pregnancy. Desire to remain HIV uninfected and have an HIV-free infant were strong motivators influencing continued use of PrEP during pregnancy. Supporting HIV-infected partners and childbearing within an HIV-serodiscordant relationship were also motivators. Women had challenges distinguishing normal pregnancy symptoms from PrEP side effects and were concerned that observed side effects could be signs of danger for the infant related to PrEP exposure. Health care providers were important conduits of knowledge about PrEP, and continuity of PrEP providers throughout pregnancy facilitated adherence. HIV-uninfected women in HIV-serodiscordant couples were motivated to use PrEP during pregnancy to remain HIV uninfected and to have an HIV-free child but had concerns about side effects. Health care providers will be important for PrEP messaging and adherence support in this unique population.

  11. Contribution of Anal Sex to HIV Prevalence Among Heterosexuals: A Modeling Analysis.

    Science.gov (United States)

    O'Leary, Ann; DiNenno, Elizabeth; Honeycutt, Amanda; Allaire, Benjamin; Neuwahl, Simon; Hicks, Katherine; Sansom, Stephanie

    2017-10-01

    Anal intercourse is reported by many heterosexuals, and evidence suggests that its practice may be increasing. We estimated the proportion of the HIV burden attributable to anal sex in 2015 among heterosexual women and men in the United States. The HIV Optimization and Prevention Economics model was developed using parameter inputs from the literature for the sexually active U.S. population aged 13-64. The model uses differential equations to represent the progression of the population between compartments defined by HIV disease status and continuum-of-care stages from 2007 to 2015. For heterosexual women of all ages (who do not inject drugs), almost 28% of infections were associated with anal sex, whereas for women aged 18-34, nearly 40% of HIV infections were associated with anal sex. For heterosexual men, 20% of HIV infections were associated with insertive anal sex with women. Sensitivity analyses showed that varying any of 63 inputs by ±20% resulted in no more than a 13% change in the projected number of heterosexual infections in 2015, including those attributed to anal sex. Despite uncertainties in model inputs, a substantial portion of the HIV burden among heterosexuals appears to be attributable to anal sex. Providing information about the relative risk of anal sex compared with vaginal sex may help reduce HIV incidence in heterosexuals.

  12. Sexual life and fertility desire in long-term HIV serodiscordant couples in Addis Ababa, Ethiopia: a grounded theory study

    Directory of Open Access Journals (Sweden)

    Hailemariam Tewodros G

    2012-10-01

    Full Text Available Abstract Background Even though remarkable progress has been achieved, HIV/AIDS continues to be a major global health priority. HIV discordant relationship is one of the emerging issues in HIV prevention endeavour. In Ethiopia, very little is known about HIV-serodiscordant couples particularly how they manage their sexual relationship and fertility desire. Therefore, we conduct this study with the aim of exploring the experiences of HIV discordant couples about their sexual life, and fertility desire in the context of long-term relationships in Addis Ababa, Ethiopia. Methods A grounded theory approach was employed using in-depth interviews among 36 informants in ART/PMTCT centers of three public hospitals, a health center and one PLHIV association in Addis Ababa. Theoretical sampling was used to recruit 28 clients who lived in a discordant relationship and eight health care providers as key informants. Data collection and analysis were undertaken simultaneously using a constant comparison. The analysis was facilitated using OpenCode software. Results A grounded theory pertaining to sexual life and desire to have a child among HIV discordant couples emerged as “maintaining the relationship” as a core category. Couples pass through a social process of struggle to maintain their relationship. The causal conditions for couples to enter into the process of struggle to maintain their relationship were collectively categorized as “Entering in-to a transition” (knowing HIV serostatus and this includes mismatch of desire to have a child, controversy on safe sex versus desire to have a child, and undeniable change in sexual desire and practice through time were the features in entering into-transition. Then after the transition, couples engaged in certain actions/strategies that are categorized as “dealing with discordancy” such as entertaining partner’s interest by scarifying once self interest to maintain their relationship. Conclusions

  13. Attitudes of Heterosexual Men and Women Toward HIV Negative and Positive Gay Men

    OpenAIRE

    Pala, Andrea Norcini; Villano, Paola; Clinton, Lauren

    2016-01-01

    Attitudes of Italian heterosexual men and women toward gay men, both HIV positive and negative, are poorly investigated. Italian culture is still extremely conservative and provides limited support to the gay community (e.g., lack of same-sex marriage recognition). Consequently, gay men experience social exclusion and disparities. The present study explores the association between homophobia and closeness with sexual orientation and HIV status. 261 heterosexual Italian men and women were asse...

  14. Attitudes of Heterosexual Men and Women Toward HIV Negative and Positive Gay Men.

    Science.gov (United States)

    Norcini Pala, Andrea; Villano, Paola; Clinton, Lauren

    2017-01-01

    Attitudes of Italian heterosexual men and women toward gay men, both HIV positive and negative, are poorly investigated. Italian culture is still extremely conservative and provides limited support to the gay community (e.g., lack of same-sex marriage recognition). Consequently, gay men experience social exclusion and disparities. The present study explores the association between homophobia and closeness with sexual orientation and HIV status. 261 heterosexual Italian men and women were assessed for feelings of closeness and homophobia after reading a vignette where the character was C1: heterosexual and HIV negative; C2: gay and HIV negative; or C3: gay and HIV positive. Experiences of homophobia and closeness varied depending on gender of participant and condition assigned, and higher levels of homophobia were correlated with lower levels of closeness regardless of HIV status. Implications and future directions are discussed.

  15. Convivendo com a diferença: o impacto da sorodiscordância na vida afetivo-sexual de portadores do HIV/AIDS Conviviendo con la diferencia: el impacto de la serodiscordancia en la vida afectiva-sexual de portadores del VIH/SIDA Living with the difference: the impact of serodiscordance on the affective and sexual life of HIV/AIDS patients

    Directory of Open Access Journals (Sweden)

    Renata Karina Reis

    2010-09-01

    en altera-ciones de la respuesta sexual humana y favoreciendo hasta la propia abstinencia sexual. Se pone de manifiesto la necesidad de atención por parte de equipos interdisciplinarios para los portadores de HIB/aids y también de sus parejas, a fin de proporcionarles asistencia integral, contemplando la sexualidad y las dificultades derivadas de la serodiscordancia.The purpose of this descriptive-exploratory qualitative study was to describe and analyze the impact of serodiscordance on the affective-sexual life of HIV/AIDS patients who have HIV seronegative heterosexual partners. Eleven HIV/AIDS carriers in outpatient clinic follow-up were interviewed, in a reference university-hospital in the state of São Paulo. Data were collected through recorded individual interviews and analyzed according to Prose analysis. Living with HIV/AIDS serodiscordance implies these couples have to deal with several intimacy-related difficulties, due to the possibility of HIV transmission to the seronegative partner. This has a negative effect on serodiscordant partners, reflecting in chan-ges in human sexual response, which could lead to sexual abstinence. Interdisciplinary care should be provided to HIV/AIDS carriers and their partners, thus providing comprehensive care regarding their sexuality and difficulties caused by serodiscordance.

  16. Rethinking Gender, Heterosexual Men, and Women's Vulnerability to HIV/AIDS

    Science.gov (United States)

    Hoffman, Susie; Dworkin, Shari L.

    2010-01-01

    Most HIV prevention literature portrays women as especially vulnerable to HIV infection because of biological susceptibility and men's sexual power and privilege. Conversely, heterosexual men are perceived as active transmitters of HIV but not active agents in prevention. Although the women's vulnerability paradigm was a radical revision of earlier views of women in the epidemic, mounting challenges undermine its current usefulness. We review the etiology and successes of the paradigm as well as its accruing limitations. We also call for an expanded model that acknowledges biology, gender inequality, and gendered power relations but also directly examines social structure, gender, and HIV risk for heterosexual women and men. PMID:20075321

  17. Further research needed to support a policy of antiretroviral therapy as an HIV prevention initiative

    DEFF Research Database (Denmark)

    Rodger, Alison J; Bruun, Tina; Vernazza, Pietro

    2013-01-01

    The results from the HPTN 052 trial have increased the focus on use of antiretroviral therapy (ART) for prevention of HIV transmission; however, condom use also effectively prevents HIV transmission. Studies in heterosexual serodiscordant couples with viral suppression have so far only reported...

  18. Straight talk: HIV prevention for African-American heterosexual men: theoretical bases and intervention design.

    Science.gov (United States)

    Frye, Victoria; Bonner, Sebastian; Williams, Kim; Henny, Kirk; Bond, Keosha; Lucy, Debbie; Cupid, Malik; Smith, Stephen; Koblin, Beryl A

    2012-10-01

    In the United States, racial disparities in HIV/AIDS are stark. Although African Americans comprise an estimated 14% of the U.S. population, they made up 52% of new HIV cases among adults and adolescents diagnosed in 2009. Heterosexual transmission is now the second leading cause of HIV in the United States. African Americans made up a full two-thirds of all heterosexually acquired HIV/AIDS cases between 2005 and 2008. Few demonstrated efficacious HIV prevention interventions designed specifically for adult, African-American heterosexual men exist. Here, we describe the process used to design a theory-based HIV prevention intervention to increase condom use, reduce concurrent partnering, and increase HIV testing among heterosexually active African-American men living in high HIV prevalence areas of New York City. The intervention integrated empowerment, social identity, and rational choices theories and focused on four major content areas: HIV/AIDS testing and education; condom skills training; key relational and behavioral turning points; and masculinity and fatherhood.

  19. Factors Associated with Recent HIV Testing among Heterosexuals at High-Risk for HIV Infection in New York City

    Directory of Open Access Journals (Sweden)

    Marya eGwadz

    2016-04-01

    Full Text Available Background. The CDC recommends persons at high-risk for HIV infection in the United States receive annual HIV testing to foster early HIV diagnosis and timely linkage to health care. Heterosexuals make up a significant proportion of incident HIV infections (>25%, but test for HIV less frequently than those in other risk categories. Yet factors that promote or impede annual HIV testing among heterosexuals are poorly understood. The present study examines individual/attitudinal-, social-, and structural-level factors associated with past-year HIV testing among heterosexuals at high-risk for HIV. Methods. Participants were African American/Black and Hispanic heterosexual adults (N=2307 residing in an urban area with both high poverty and HIV prevalence rates. Participants were recruited by respondent-driven sampling (RDS in 2012-2015 and completed a computerized structured assessment battery covering background factors, multi-level putative facilitators of HIV testing, and HIV testing history. Separate logistic regression analysis for males and females identified factors associated with past-year HIV testing.Results. Participants were mostly male (58%, African American/Black (75%, and 39 years old on average (SD = 12.06 years. Lifetime homelessness (54% and incarceration (62% were common. Half reported past-year HIV testing (50% and 37% engaged in regular, annual HIV testing. Facilitators of HIV testing common to both genders included sexually transmitted infection (STI testing or STI diagnosis, peer norms supporting HIV testing, and HIV testing access. Among women, access to general medical care and extreme poverty further predicted HIV testing, while recent drug use reduced the odds of past-year HIV testing. Among men, past-year HIV testing was also associated with lifetime incarceration and substance use treatment.Conclusions. The present study identified gaps in rates of HIV testing among heterosexuals at high-risk for HIV, and both common and

  20. The risk of HIV transmission within HIV-1 sero-discordant couples appears to vary across sub-Saharan Africa

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    Hiam Chemaitelly

    2014-03-01

    Conclusions: Empirical measures from cohort studies appear to underestimate HIV infectiousness in SSA. The risk of HIV transmission among SDCs appears also to vary across SSA, and this may have contributed to the contrasting HIV epidemic trajectories in this continent.

  1. The role of family planning in achieving safe pregnancy for serodiscordant couples: commentary from the United States government's interagency task force on family planning and HIV service integration.

    Science.gov (United States)

    Mason, Jennifer; Medley, Amy; Yeiser, Sarah; Nightingale, Vienna R; Mani, Nithya; Sripipatana, Tabitha; Abutu, Andrew; Johnston, Beverly; Watts, D Heather

    2017-03-08

    People living with HIV (PLHIV) have the right to exercise voluntary choices about their health, including their reproductive health. This commentary discusses the integral role that family planning (FP) plays in helping PLHIV, including those in serodiscordant relationships, achieve conception safely. The United States (US) President's Emergency Plan for AIDS Relief (PEPFAR) is committed to meeting the reproductive health needs of PLHIV by improving their access to voluntary FP counselling and services, including prevention of unintended pregnancy and counselling for safer conception. Inclusion of preconception care and counselling (PCC) as part of routine HIV services is critical to preventing unintended pregnancies and perinatal infections among PLHIV. PLHIV not desiring a current pregnancy should be provided with information and counselling on all available FP methods and then either given the method onsite or through a facilitated referral process. PLHIV, who desire children should be offered risk reduction counselling, support for HIV status disclosure and partner testing, information on safer conception options to reduce the risk of HIV transmission to the partner and the importance of adhering to antiretroviral treatment during pregnancy and breastfeeding to reduce the risk of vertical transmission to the infant. Integration of PCC, HIV and FP services at the same location is recommended to improve access to these services for PLHIV. Other considerations to be addressed include the social and structural context, the health system capacity to offer these services, and stigma and discrimination of providers. Evaluation of innovative service delivery models for delivering PCC services is needed, including provision in community-based settings. The US Government will continue to partner with local organizations, Ministries of Health, the private sector, civil society, multilateral and bilateral donors, and other key stakeholders to strengthen both the policy and

  2. Clinical efficacy of a combination of Percoll continuous density gradient and swim-up techniques for semen processing in HIV-1 serodiscordant couples

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    Osamu Inoue

    2017-01-01

    Full Text Available To evaluate the clinical efficacy of a procedure comprising a combination of Percoll continuous density gradient and modified swim-up techniques for the removal of human immunodeficiency virus type 1 (HIV-1 from the semen of HIV-1 infected males, a total of 129 couples with an HIV-1 positive male partner and an HIV-1 negative female partner (serodiscordant couples who were treated at Keio University Hospital between January 2002 and April 2012 were examined. A total of 183 ejaculates from 129 HIV-1 infected males were processed. After swim-up, we successfully collected motile sperms at a recovery rate as high as 100.0% in cases of normozoospermia (126/126 ejaculates, oligozoospermia (6/6, and asthenozoospermia (36/36. The recovery rate of oligoasthenozoospermia was 86.7% (13/15. In processed semen only four ejaculates (4/181:2.2% showed viral nucleotide sequences consistent with those in the blood of the infected males. After using these sperms, no horizontal infections of the female patients and no vertical infections of the newborns were observed. Furthermore, no obvious adverse effects were observed in the offspring. This protocol allowed us to collect HIV-1 negative motile sperms at a high rate, even in male factor cases. We concluded that our protocol is clinically effective both for decreasing HIV-1 infections and for yielding a healthy child.

  3. Resourceful masculinities: exploring heterosexual Black men's vulnerability to HIV in Ontario, Canada.

    Science.gov (United States)

    Husbands, Winston; Oakes, Wesley; Mbulaheni, Tola; Ongoïba, Fanta; Pierre-Pierre, Valérie; Luyombya, Henry

    2017-10-29

    Heterosexually active Black men are alleged to endorse masculine norms that increase their and their female partners' vulnerability to HIV. These norms include Black men's inability or reluctance to productively engage their own health-related personal and interpersonal vulnerabilities. We draw on data from the iSpeak research study in Ontario, Canada, to assess whether and how heterosexual Black men cope with personal and inter-personal vulnerability, namely that heterosexual Black men: avoid emotionally supportive relationships with other men (and women), which diminishes their capacity to productively acknowledge and resolve their health-related challenges; are reticent to productively acknowledge and address HIV and health on a personal level; and are pathologically secretive about their health, which compounds their vulnerability and precipitates poor health outcomes. iSpeak was implemented in 2011 to 2013, and included two focus groups with HIV-positive and HIV-negative self-identified heterosexual men (N = 14) in Toronto and London, a focus group with community-based health promotion practitioners who provide HIV-related services to Black communities in Ontario (N = 6), and one-on-one interviews with four researchers distinguished for their scholarship with/among Black communities in Toronto. Participants in the men's focus group were recruited discretely through word-of-mouth. Focus groups were audiotaped and transcribed verbatim. Team members independently read the transcripts, and then met to identify, discuss and agree on the emerging themes. We demonstrate that iSpeak participants (a) engage their personal and interpersonal vulnerabilities creatively and strategically, (b) complicate and challenge familiar interpretations of Black men's allegedly transgressive masculinity through their emotional and practical investment in their health, and (c) demonstrate a form of resourceful masculinity that ambiguously aligns with patriarchy. We conclude

  4. Estimating the Number of Heterosexual Persons in the United States to Calculate National Rates of HIV Infection.

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    Amy Lansky

    Full Text Available This study estimated the proportions and numbers of heterosexuals in the United States (U.S. to calculate rates of heterosexually acquired human immunodeficiency virus (HIV infection. Quantifying the burden of disease can inform effective prevention planning and resource allocation.Heterosexuals were defined as males and females who ever had sex with an opposite-sex partner and excluded those with other HIV risks: persons who ever injected drugs and males who ever had sex with another man. We conducted meta-analysis using data from 3 national probability surveys that measured lifetime (ever sexual activity and injection drug use among persons aged 15 years and older to estimate the proportion of heterosexuals in the United States population. We then applied the proportion of heterosexual persons to census data to produce population size estimates. National HIV infection rates among heterosexuals were calculated using surveillance data (cases attributable to heterosexual contact in the numerators and the heterosexual population size estimates in the denominators.Adult and adolescent heterosexuals comprised an estimated 86.7% (95% confidence interval: 84.1%-89.3% of the U.S. population. The estimate for males was 84.1% (CI: 81.2%-86.9% and for females was 89.4% (95% CI: 86.9%-91.8%. The HIV diagnosis rate for 2013 was 5.2 per 100,000 heterosexuals and the rate of persons living with diagnosed HIV infection in 2012 was 104 per 100,000 heterosexuals aged 13 years or older. Rates of HIV infection were >20 times as high among black heterosexuals compared to white heterosexuals, indicating considerable disparity. Rates among heterosexual men demonstrated higher disparities than overall population rates for men.The best available data must be used to guide decision-making for HIV prevention. HIV rates among heterosexuals in the U.S. are important additions to cost effectiveness and other data used to make critical decisions about resources for

  5. Dating, marriage, and parenthood for HIV-positive heterosexual Puerto Rican men: normalizing perspectives on everyday life with HIV.

    Science.gov (United States)

    Sastre, Francisco; Sheehan, Diana M; Gonzalez, Arnaldo

    2015-03-01

    HIV-positive men are living long and healthier lives while managing HIV as a chronic illness. Although research has extensively documented the experiences of illness of people living with HIV, dating, marriage, and fatherhood among heterosexual Latino men has not been examined. To address this gap, this study used a qualitative study design to examine patterns and strategies for dating, marriage, and parenthood among 24 HIV-positive heterosexual Puerto Rican men living in Boston. The findings in our study indicate that an HIV diagnosis does not necessarily deter men from having an active sexual life, marrying, or having children. In fact, for some of the men, engaging in these social and life-changing events is part of moving on and normalizing life with HIV; these men planned for, achieved, and interpreted these events in the context of establishing normalcy with HIV. Although the HIV diagnosis discouraged some men from engaging in sexual relations, getting married, or having children, others fulfilled these desires with strategies aimed to reconciling their HIV status in their personal life, including dating or marrying HIV-positive women only. Additional important themes identified in this study include the decision to disclose HIV status to new sexual partners as well as the decision to accept the risk of HIV transmission to a child or partner in order to fulfill desires of fatherhood. Understanding the personal struggles, decision-making patterns, and needs of HIV-positive heterosexual men can aid in designing interventions that support healthy living with HIV. © The Author(s) 2014.

  6. Marriage is not a safe place : Heterosexual marriage and HIV-related vulnerability in Indonesia

    NARCIS (Netherlands)

    Jacubowski, Nadja

    2008-01-01

    This paper examines the link between heterosexual marriage and women's vulnerability to HIV in Indonesia. In this country, gender relations are currently dominated by traditional beliefs and practices and by religious morality. Data for the current study were collected by means of documentary

  7. Molecular phylodynamics of the heterosexual HIV epidemic in the United Kingdom.

    Directory of Open Access Journals (Sweden)

    Gareth J Hughes

    2009-09-01

    Full Text Available The heterosexual risk group has become the largest HIV infected group in the United Kingdom during the last 10 years, but little is known of the network structure and dynamics of viral transmission in this group. The overwhelming majority of UK heterosexual infections are of non-B HIV subtypes, indicating viruses originating among immigrants from sub-Saharan Africa. The high rate of HIV evolution, combined with the availability of a very high density sample of viral sequences from routine clinical care has allowed the phylodynamics of the epidemic to be investigated for the first time. Sequences of the viral protease and partial reverse transcriptase coding regions from 11,071 patients infected with HIV of non-B subtypes were studied. Of these, 2774 were closely linked to at least one other sequence by nucleotide distance. Including the closest sequences from the global HIV database identified 296 individuals that were in UK-based groups of 3 or more individuals. There were a total of 8 UK-based clusters of 10 or more, comprising 143/2774 (5% individuals, much lower than the figure of 25% obtained earlier for men who have sex with men (MSM. Sample dates were incorporated into relaxed clock phylogenetic analyses to estimate the dates of internal nodes. From the resulting time-resolved phylogenies, the internode lengths, used as estimates of maximum transmission intervals, had a median of 27 months overall, over twice as long as obtained for MSM (14 months, with only 2% of transmissions occurring in the first 6 months after infection. This phylodynamic analysis of non-B subtype HIV sequences representing over 40% of the estimated UK HIV-infected heterosexual population has revealed heterosexual HIV transmission in the UK is clustered, but on average in smaller groups and is transmitted with slower dynamics than among MSM. More effective intervention to restrict the epidemic may therefore be feasible, given effective diagnosis programmes.

  8. Characteristics of HIV-1 discordant couples enrolled in a trial of HSV-2 suppression to reduce HIV-1 transmission: the partners study.

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    Jairam R Lingappa

    Full Text Available The Partners HSV-2/HIV-1 Transmission Study (Partners Study is a phase III, placebo-controlled trial of daily acyclovir for genital herpes (HSV-2 suppression among HIV-1/HSV-2 co-infected persons to reduce HIV-1 transmission to their HIV-1 susceptible partners, which requires recruitment of HIV-1 serodiscordant heterosexual couples. We describe the baseline characteristics of this cohort.HIV-1 serodiscordant heterosexual couples, in which the HIV-1 infected partner was HSV-2 seropositive, had a CD4 count >or=250 cells/mcL and was not on antiretroviral therapy, were enrolled at 14 sites in East and Southern Africa. Demographic, behavioral, clinical and laboratory characteristics were assessed.Of the 3408 HIV-1 serodiscordant couples enrolled, 67% of the HIV-1 infected partners were women. Couples had cohabitated for a median of 5 years (range 2-9 with 28% reporting unprotected sex in the month prior to enrollment. Among HIV-1 susceptible participants, 86% of women and 59% of men were HSV-2 seropositive. Other laboratory-diagnosed sexually transmitted infections were uncommon (500 relative to <350, respectively, p<0.001.The Partners Study successfully enrolled a cohort of 3408 heterosexual HIV-1 serodiscordant couples in Africa at high risk for HIV-1 transmission. Follow-up of this cohort will evaluate the efficacy of acyclovir for HSV-2 suppression in preventing HIV-1 transmission and provide insights into biological and behavioral factors determining heterosexual HIV-1 transmission.ClinicalTrials.gov NCT00194519.

  9. Characteristics of HIV-1 Discordant Couples Enrolled in a Trial of HSV-2 Suppression to Reduce HIV-1 Transmission: The Partners Study

    Science.gov (United States)

    Lingappa, Jairam R.; Kahle, Erin; Mugo, Nelly; Mujugira, Andrew; Magaret, Amalia; Baeten, Jared; Bukusi, Elizabeth A.; Cohen, Craig R.; Katabira, Elly; Ronald, Allan; Kiarie, James; Farquhar, Carey; Stewart, Grace John; Makhema, Joseph; Essex, M.; Were, Edwin; Fife, Kenneth; deBruyn, Guy; Gray, Glenda; McIntyre, James; Manongi, Rachel; Kapiga, Saidi; Coetzee, David; Allen, Susan; Inambao, Mubiana; Kayitenkore, Kayitesi; Karita, Etienne; Kanweka, William; Delany, Sinead; Rees, Helen; Vwalika, Bellington; Coombs, Robert W.; Morrow, Rhoda; Whittington, William; Corey, Lawrence; Wald, Anna; Celum, Connie

    2009-01-01

    Background The Partners HSV-2/HIV-1 Transmission Study (Partners Study) is a phase III, placebo-controlled trial of daily acyclovir for genital herpes (HSV-2) suppression among HIV-1/HSV-2 co-infected persons to reduce HIV-1 transmission to their HIV-1 susceptible partners, which requires recruitment of HIV-1 serodiscordant heterosexual couples. We describe the baseline characteristics of this cohort. Methods HIV-1 serodiscordant heterosexual couples, in which the HIV-1 infected partner was HSV-2 seropositive, had a CD4 count ≥250 cells/mcL and was not on antiretroviral therapy, were enrolled at 14 sites in East and Southern Africa. Demographic, behavioral, clinical and laboratory characteristics were assessed. Results Of the 3408 HIV-1 serodiscordant couples enrolled, 67% of the HIV-1 infected partners were women. Couples had cohabitated for a median of 5 years (range 2–9) with 28% reporting unprotected sex in the month prior to enrollment. Among HIV-1 susceptible participants, 86% of women and 59% of men were HSV-2 seropositive. Other laboratory-diagnosed sexually transmitted infections were uncommon (500 relative to <350, respectively, p<0.001). Conclusions The Partners Study successfully enrolled a cohort of 3408 heterosexual HIV-1 serodiscordant couples in Africa at high risk for HIV-1 transmission. Follow-up of this cohort will evaluate the efficacy of acyclovir for HSV-2 suppression in preventing HIV-1 transmission and provide insights into biological and behavioral factors determining heterosexual HIV-1 transmission. Trial Registration ClinicalTrials.gov NCT00194519 PMID:19404392

  10. Anal intercourse and HIV risk among low-income heterosexual women: findings from Chicago HIV behavioral surveillance.

    Science.gov (United States)

    Livak, Britt S; Prachand, Nikhil G; Benbow, Nanette

    2012-01-01

    Anal intercourse (AI) is a highly efficient route for HIV transmission and has not been well elucidated among heterosexual (HET) women. Heterosexual women living in impoverished urban areas in the US are at increased risk for HIV acquisition. We aim to describe rates of AI and characteristics associated with AI among heterosexual women at increased risk for HIV acquisition living in Chicago. The Chicago Department of Public Health conducted a survey of HET during 2007 as part of the National HIV Behavioral Surveillance System. Venue-based, time-location sampling was used to select participants from venues in high-risk areas (census tracts with concurrently high rates of heterosexual AIDS and household poverty). Eligible participants were interviewed anonymously and offered a HIV test. In total, 407 heterosexual women were interviewed. Seventy-one (17%) women reported having AI in the past 12 months, with 61 of the 71 (86%) reporting unprotected AI. In multivariate analysis, women who engaged in AI were more than three times as likely to have three or more sex partners in the past 12 months (OR=3.27, 95% CI 1.53-6.99). AI was also independently associated with STI diagnosis in the past 12 months (2.13, 95% CI 1.06-4.26), and having sexual intercourse for the first time before the age of 15 years (2.23, 95% CI 1.28-3.89). AI was associated with multiple high risk behaviors including a greater number of sexual partners, STI diagnosis, and earlier age at first sex. The combination of risk factors found to be associated with AI call for new HIV prevention services tailored to the needs of women and young girls living in poverty.

  11. Conceptualizations of heterosexual anal sex and HIV risk in five East African communities.

    Science.gov (United States)

    Duby, Zoe; Colvin, Christopher

    2014-01-01

    Heterosexual anal sex is underresearched and little understood, particularly in the African context. Existing prevalence data indicate that heterosexual anal sex is a widespread practice, yet little is known about the way in which it is conceptualized and understood. Describing findings from qualitative research conducted in Kenya, Tanzania, and Uganda, we shed light on conceptualizations of heterosexual anal sex and its relation to human immunodeficiency virus (HIV). These findings suggest that penile-anal sex is practiced by men and women in Africa for a range of reasons, including virginity maintenance, contraception, fulfillment of male pleasure, relationship security, menstruation, in the presence of vaginal complications, financial gain, fidelity, and prestige. Despite anal sex being the most efficient way to transmit HIV sexually, there is widespread lack of knowledge about its risks. These findings describe the ways in which anal sex is conceptualized in five East African communities, highlighting how penile-anal intercourse is often not considered "sex" and how the omission of anal sex in safe-sex messaging is interpreted as meaning that anal sex is safe. In light of its frequency and risks, greater attention must be paid to heterosexual anal sex in Africa to ensure a comprehensive approach to HIV prevention.

  12. 'You are not yourself': exploring masculinities among heterosexual African men living with HIV in London.

    Science.gov (United States)

    Doyal, Lesley; Anderson, Jane; Paparini, Sara

    2009-05-01

    It is now clear that gender is an essential factor shaping the narratives of men as well as women. However, there have been few studies of the daily lives or sexual activities of heterosexual men. Hence, strategies developed to prevent the spread of the HIV virus are rarely based on detailed knowledge of the men whose behaviours they are intended to change; this is especially evident in the developing world where the epidemic is most severe. Nor do we know very much about those men who have already been diagnosed as HIV positive. Around 13 million men are now living with HIV of whom around 96% are in low or middle income countries. Migrants from developing countries also make up the majority of positive people in a number of developed countries. In the UK, for example, heterosexual activity is now responsible for about half of all new HIV diagnoses with the majority of those involved being of African origin. But almost nothing is known about the ways in which different constructions of masculinity affect their experiences of illness. This study used qualitative methods to explore the experiences of a sample of black African men who defined themselves as heterosexual and were receiving treatment for HIV and/or AIDS in London. It explored their feelings, their needs, their hopes and their desires as they negotiated their lives in the diaspora.

  13. Estimating PMTCT's Impact on Heterosexual HIV Transmission: A Mathematical Modeling Analysis.

    Directory of Open Access Journals (Sweden)

    Aditya S Khanna

    Full Text Available Prevention of mother-to-child HIV transmission (PMTCT strategies include combined short-course antiretrovirals during pregnancy (Option A, triple-drug antiretroviral treament (ART during pregnancy and breastfeeding (Option B, or lifelong ART (Option B+. The WHO also recommends ART for HIV treatment and prevention of sexual transmission of HIV. The impact of PMTCT strategies on prevention of sexual HIV transmission of HIV is not known. We estimated the population-level impact of PMTCT interventions on heterosexual HIV transmission in southwestern Uganda and KwaZulu-Natal, South Africa, two regions with different HIV prevalence and fertility rates.We constructed and validated dynamic, stochastic, network-based HIV transmission models for each region. PMTCT Options A, B, and B+ were simulated over ten years under three scenarios: 1 current ART and PMTCT coverage, 2 current ART and high PMTCT coverage, and 3 high ART and PMTCT coverage. We compared adult HIV incidence after ten years of each intervention to Option A (and current ART at current coverage.At current coverage, Options B and B+ reduced heterosexual HIV incidence by about 5% and 15%, respectively, in both countries. With current ART and high PMTCT coverage, Option B+ reduced HIV incidence by 35% in Uganda and 19% in South Africa, while Option B had smaller, but meaningful, reductions. The greatest reductions in HIV incidence were achieved with high ART and PMTCT coverage. In this scenario, all PMTCT strategies yielded similar results.Implementation of Options B/B+ reduces adult HIV incidence, with greater effect (relative to Option A at current levels in Uganda than South Africa. These results are likely driven by Uganda's higher fertility rates.

  14. Homogenous HIV-1 subtype B quasispecies in Brazilian men and women recently infected via heterosexual transmission.

    Science.gov (United States)

    Gouveia, Nancy Lima; Camargo, Michelle; Caseiro, Marcos Montani; Janini, Luiz Mario Ramos; Sucupira, Maria Cecilia Araripe; Diaz, Ricardo Sobhie

    2014-06-01

    HIV has extraordinary genetic mutability, both among individuals and at the population level. However, studies of primary HIV-1 infection and serum-converters indicate that the viral population is homogeneous at the sequence level, which suggests clonal HIV transmission. It remains unclear whether this feature applies to the female population. Ten single genome amplification sequences were generated from ten individuals (five females) with recent heterosexually acquired HIV infection as determined by the serologic testing algorithm for recent HIV seroconversion. Intra-individual genetic diversity was equally low in both genders (selection for sexual transmission of HIV-1 in both genders. Future studies that generate a larger number of clones, preferably by next generation deep sequencing, are needed to confirm these results.

  15. Antibodies to mycoplasma fermentans in HIV-positive heterosexual patients: seroprevalence and association with AIDS.

    Science.gov (United States)

    Horowitz, S; Horowitz, J; Hou, L; Fuchs, E; Rager-Zisman, B; Jacobs, E; Alkan, M

    1998-01-01

    There are conflicting reports concerning the prevalence of Mycoplasma fermentans in HIV-positive patients and its association with AIDS. Serum antibodies to M. fermentans were measured by a modified immunoblotting technique in 48 HIV-positive heterosexual patients and in 30 HIV-negative heterosexual controls. Antibodies to M. fermentans were detected in 19 (40%) of HIV-positive patients and in three (10%) of the HIV-negative controls (P = 0.01). The prevalence of antibodies to Mycoplasma hominis and to Ureaplasma urealyticum was similar in both groups. In the HIV-positive group, 16/19 (84%) M. fermentans-positive patients developed AIDS, compared to eight of 29 (28%) M. fermentans-negative patients (P = 0.0004). The HIV-positive patients with antibodies to M. fermentans had a lower CD4+ cell count and a higher prevalence of antibodies to the other mycoplasma tested (P = 0.007 and P = 0.03, respectively), as compared to the patients without antibodies to M. fermentans. These findings may suggest that the presence of antibodies to M. fermentans indicate an opportunistic infection. Of the 19 M. fermentans-positive patients, 11 were positive on the first examination, and eight became positive during the follow-up period. Seven out of these eight patients developed antibodies to M. fermentans before the development of AIDS. Therefore, the possibility exists that M. fermentans might influence the development of AIDS.

  16. Heterosexual anal sex reported by women receiving HIV prevention services in Los Angeles County.

    Science.gov (United States)

    Reynolds, Grace L; Fisher, Dennis G; Napper, Lucy E; Fremming, Brent W; Jansen, Michael A

    2010-01-01

    This study examined reported heterosexual receptive anal intercourse (HRAI) in a sample of women recruited from HIV prevention providers in Los Angeles County. The majority of women surveyed were Latina and the modal age was 19 years. Women reporting HRAI were more likely to use both injected and non injected drugs and to have sexual partners who injected drugs. Factors associated with HRAI in a multivariate regression model included use of methamphetamine; use of alcohol before, during, or after sex; and use of dental services at the interview agency. Factors inversely associated with heterosexual anal sex were being African American (compared with Latina) and endorsing the use of condoms for episodes of vaginal sex from start to finish. HIV prevention providers in Los Angeles County should be aware of the need for basic prevention messages concerning condom use and injection behavior in young Latina women. Copyright © 2010 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.

  17. Qualitative analysis of an educational intervention with HIV-discordant heterosexual Latino couples.

    Science.gov (United States)

    Pérez-Jiménez, David; Orengo-Aguayo, Rosaura E

    2011-12-01

    This qualitative analysis elucidates the potential elements of the intervention that may be effective in terms of a) increasing knowledge about HIV/ AIDS in the members of this population; b) increasing the use of male condoms and the practice of mutual masturbation; and c) changing opinions toward male condom use and mutual masturbation. Five heterosexual HIV-discordant couples participated in the adapted intervention, which consisted of four three-hour-long sessions. One month after the intervention, we conducted a qualitative semi-structured interview with every participant to evaluate issues related to the process and content of the activities comprising the intervention, the impact of the intervention, logistics, and recruitment and retention as well as to make a more general evaluation. The information was submitted to qualitative content analysis. After the intervention, participants reported having better attitudes regarding safer sex, particularly in terms of condom use. A reason given by the participants to feel more positive toward condom use and mutual masturbation was that these practices could prevent the infection of the HIV-negative partner. This study provides important evidence of an intervention that promises to be efficacious in preventing some high-risk sexual behaviors among Latino HIV-discordant heterosexual couples. The evidence presented seems to suggest that an intervention that includes basic relevant information about HIV/AIDS, that explains the benefits of condom use and other safer sex options, and that provides effective negotiation and communication strategies could significantly reduce HIV transmission among these couples.

  18. Correlates of Unprotected Sex Among Adult Heterosexual Men Living with HIV

    OpenAIRE

    Milam, Joel; Richardson, Jean L.; Espinoza, Lilia; Stoyanoff, Sue

    2006-01-01

    The correlates of unprotected sex among a sample of heterosexual men living with HIV (n = 121) were examined to determine whether patient characteristics can be used as a basis for tailoring safer sex counseling in the clinic setting. Potential correlates of self-reported unprotected oral sex (fellatio) and vaginal sex included participant demographics (e.g., age, ethnicity), disease status (CD4 counts, viral load, years since diagnosis), safer sex beliefs (e.g., condom attitudes), substance ...

  19. It’s a Process: Reactions to HIV Diagnosis and Engagement in HIV Care among High-Risk Heterosexuals

    Directory of Open Access Journals (Sweden)

    Alexandra H. Kutnick

    2017-05-01

    Full Text Available After HIV diagnosis, heterosexuals in high-poverty urban areas evidence delays in linkage to care and antiretroviral therapy initiation compared to other groups. Yet barriers to/facilitators of HIV care among these high-risk heterosexuals are understudied. Under the theory of triadic influence, putative barriers to HIV care engagement include individual/attitudinal-level (e.g., fear, medical distrust, social-level (e.g., stigma, and structural-level influences (e.g., poor access. Participants were African-American/Black and Hispanic adults found newly diagnosed with HIV (N = 25 as part of a community-based HIV testing study with heterosexuals in a high-poverty, high-HIV-incidence urban area. A sequential explanatory mixed-methods design was used. We described linkage to HIV care and clinical outcomes [CD4 counts, viral load (VL levels] over 1 year, and then addressed qualitative research questions about the experience of receiving a new HIV diagnosis, its effects on timely engagement in HIV care, and other barriers and facilitators. Participants were assessed five times, receiving a structured interview battery, laboratory tests, data extraction from the medical record, a post-test counseling session, and in-person/phone contacts to foster linkage to care. Participants were randomly selected for qualitative interviews (N = 15/25 that were recorded and transcribed, then analyzed using systematic content analysis. Participants were 50 years old, on average (SD = 7.2 years, mostly male (80%, primarily African-American/Black (88%, and low socioeconomic status. At the first follow-up, rates of engagement in care were high (78%, but viral suppression was modest (39%. Rates improved by the final follow-up (96% engaged, 62% virally suppressed. Two-thirds (69% were adequately retained in care over 1 year. Qualitative results revealed multi-faceted responses to receiving an HIV diagnosis. Problems accepting and internalizing one

  20. Characteristics of late presentation of HIV infection in MSM and heterosexual adults in Portugal 2011–2013

    Directory of Open Access Journals (Sweden)

    Tara Shivaji

    2014-11-01

    Full Text Available Introduction: It is estimated that over half of newly diagnosed HIV infections in Europe present late. An HIV positive individual presenting late to care represents a missed opportunity to benefit from treatment, increasing the risk of morbidity and mortality at an individual level, and onward disease transmission at population level. Reducing late presentation is a strategic priority of the Portuguese HIV/AIDS program. We set out to describe the characteristics of late presentation in the two largest transmission risk groups currently in Portugal to inform HIV prevention and treatment. Methods: We extracted details of all notified cases from individuals over 15 years with a laboratory confirmed HIV diagnosis made between January 2011 and December 2013 from the Portuguese HIV surveillance database and selected cases from heterosexuals and men who have sex with men (MSM. We defined late presentation as an initial CD4 count <350 cells/mm3 or presence of AIDS-defining disease at time of HIV diagnosis. We calculated adjusted odds ratios (aOR with 95% confidence intervals (CI for characteristics associated with late presentation in separate logistic regression for heterosexuals and MSM. Results: Of 4219 HIV positive cases notified, 2589 (61% were heterosexuals and 1220 (29% were MSM. A total of 1586 (38% cases presented late of which 1037 (40% were heterosexual and 328 (27% were MSM. The median age at late presentation was 40 in heterosexual women, 46 in heterosexual men and 35 in MSM. A total of 1446 (55% of heterosexual HIV positive adults were unaware of having had a high risk sexual contact. Late presentation among heterosexuals was associated with being male (aOR=1.58 95% CI 1.29–1.93, not knowing a partners’ HIV status (OR=1.59 95% CI 1.35–1.87 and age, increasing the odds of late presentation by a factor of 1.02 per year (95% CI 1.01–1.03. Among MSM, only age was associated with late presentation, increasing by 1.04 (95% CI 1.03–1

  1. Silêncios e segredos: aspectos (não falados da conjugalidade face à sorodiscordância para o HIV/AIDS Secrets and silences: unspoken aspects of conjugal life for HIV/AIDS serodiscordant couples

    Directory of Open Access Journals (Sweden)

    Ivia Maksud

    2012-06-01

    Full Text Available Uma das situações atuais colocada pela epidemia de HIV/AIDS é o fenômeno da "sorodiscordância". Este artigo aborda temas que não podem ser falados em relações constituídas entre esses casais e/ou desses com familiares, amigos e redes de vizinhança. São discutidas duas dimensões dos segredos contidos em relações sorodiscordantes: (1 segredos individuais que estabelecem silêncios para cada membro da díade; e (2 segredos de casal, estabelecidos e guardados pelo par frente a outras pessoas. O artigo deriva de pesquisa com casais sorodiscordantes para o HIV/AIDS em que foram realizadas 26 entrevistas em profundidade. A análise foi realizada a partir de um quadro de sistematização comparada, que permitiu observar como os mesmos conteúdos temáticos variavam de acordo com o gênero e a sorologia dos entrevistados. Os dados mostram que cotidianamente os sujeitos realizam estratégias para manutenção de aspectos da vida privada que podem ser ameaçados pela dinâmica da fofoca, entendida não como fenômeno independente, mas em função de normas e crenças coletivas em determinados espaços sociais.One of the current issues raised by HIV/AIDS is the phenomenon of serodiscordance: affective-sexual relations between partners with different HIV serology. The article analyzes issues that cannot be discussed within established relationships in these couples and/or with family, friends, and neighborhood networks. The article discusses two dimensions of silences and secrets in serodiscordant relationships: (1 individual secrets and silences that are established for each member of the couple and (2 double secrets, established by the couple in relation to others. The article is based on in-depth interviews with 26 serodiscordant couples. The analysis was based on comparative systematization, which allowed observing how the same thematic contents varied according to the interviewee's gender and HIV status. The data show how the subjects

  2. Why Take an HIV Test? Concerns, Benefits, and Strategies to Promote HIV Testing among Low-Income Heterosexual African American Young Adults

    Science.gov (United States)

    Wallace, Scyatta A.; McLellan-Lemal, Eleanor; Harris, Muriel J.; Townsend, Tiffany G.; Miller, Kim S.

    2011-01-01

    A qualitative study examined perceptions of HIV testing and strategies to enhance HIV testing among HIV-negative African American heterosexual young adults (ages 18-25 years). Twenty-six focus groups (13 male groups, 13 female groups) were conducted in two low-income communities (urban and rural). All sessions were audio-recorded and transcribed.…

  3. Quality of life and related factors among HIV-positive spouses from serodiscordant couples under antiretroviral therapy in Henan Province, China.

    Directory of Open Access Journals (Sweden)

    Duo Shan

    Full Text Available OBJECTIVE: To describe the quality of life and related factors in HIV-positive spouses undergoing ART from discordant couples. METHODS: A cross-sectional study was conducted among 1,009 HIV-positive spouses from serodiscordant couples in Zhumadian, Henan Province, between October 1, 2008 and March 31, 2009. HIV-positive spouses were interviewed by local health professionals. Quality of life was evaluated by WHOQOL (Chinese Version. A multiple linear regression model was used to analyze the related factors. RESULTS: The majority of subjects were female (56.39%, had received a high school education (44%, were of Han ethnicity (98.41%, and were farmers (90.09%; the median time period of receiving ART was 3.92 years. The physical, psychological, social, and environmental QOL scores of the subjects were 12.91±1.95, 12.35±1.80, 13.96±2.43, and 12.45±1.91 respectively. The multiple linear regression model identified the physical domain related factors to be CD4 count, educational level, and occupation; psychological domain related factors include age, educational level, and reported STD symptom; social domain related factors included education level; and environmental domain related factors included education level, reported STD symptoms, and occupation. CONCLUSION: Being younger, a farmer, having a lower level of education, a reported STD symptom, or lower CD4 count, could decrease one's quality of life, suggesting that the use of blanket ART programs alone may not necessarily improve quality of life. Subjects received lower scores in the psychological domain, suggesting that psychological intervention may also need to be strengthened.

  4. Human immunodeficiency type-1 virus (HIV-1) infection in serodiscordant couples (SDCs) does not have an impact on embryo quality or intracytoplasmic sperm injection (ICSI) outcome.

    Science.gov (United States)

    Melo, Marco Antonio Barreto; Meseguer, Marcos; Bellver, José; Remohí, José; Pellicer, Antonio; Garrido, Nicolás

    2008-01-01

    To evaluate the embryo quality in our program for human immunodeficiency type-1 virus (HIV-1) serodiscordant couples (SDCs) with the male infected in comparison with a tubal-factor infertility control group. Retrospective case-control study. Instituto Valenciano de Infertilidad, Valencia, Spain. Thirty SDC and 79 control couples without HIV-1 infection attending for intracytoplasmic sperm injection (ICSI). Only first cycles were considered. Controlled ovarian hyperstimulation and ICSI in both groups; sperm wash, nested polymerase chain reaction (PCR) in semen sample, and capacitation by swim-up after thawing the semen sample in the SDC group; and sperm capacitation by swim-up after thawing the semen sample in the control group. ICSI procedure and embryo characteristics (fertilization, cleavage, embryo morphology, and development) and cycle outcome (ongoing pregnancy and miscarriage rates). Fertilization and cleavage rates were similar between the groups. On days 2 and 3 of embryo development, very similar embryo features were found between the groups. There was no difference in mean number of optimal embryos on day 3. When embryos were cultured up to 5-6 days, a significant increase in embryo blockage was found in the SDC group compared with the control group. The mean number of optimal blastocysts on day 6 was comparable in both groups. No difference was found regarding the number of cryopreserved and transferred embryos or implantation, pregnancy, multiple pregnancy, or miscarriage rates between the groups. HIV-1 infection in SDCs with infected males does not appear to have a significantly negative impact on embryo development or ICSI outcome.

  5. Correlates of unprotected sex among adult heterosexual men living with HIV.

    Science.gov (United States)

    Milam, Joel; Richardson, Jean L; Espinoza, Lilia; Stoyanoff, Sue

    2006-07-01

    The correlates of unprotected sex among a sample of heterosexual men living with HIV (n = 121) were examined to determine whether patient characteristics can be used as a basis for tailoring safer sex counseling in the clinic setting. Potential correlates of self-reported unprotected oral sex (fellatio) and vaginal sex included participant demographics (e.g., age, ethnicity), disease status (CD4 counts, viral load, years since diagnosis), safer sex beliefs (e.g., condom attitudes), substance use, psychological characteristics (depressive symptoms, dispositional optimism and pessimism), and sex partner characteristics (main/casual partner, HIV status of partner, and duration of relationship). A series of logistic regression analyses were used to determine significant relationships. Correlates of reported levels of prior 3-month unprotected fellatio (24%) and vaginal (21%) sex were not associated with the type of relationship (main or casual) or perceived HIV serostatus of the partner (positive, negative, or unknown). Unprotected fellatio was positively associated with age and CD4 count and inversely associated with optimism and positive condom attitudes (all p's < 0.05). Unprotected vaginal sex was positively associated with duration of relationship and inversely associated with positive condom attitudes. Prevention efforts among sexually active adult heterosexual men living with HIV may benefit from focusing on improving attitudes towards condom use regardless of partner relationship status.

  6. Intimate partner sexual and physical violence among women in Togo, West Africa: Prevalence, associated factors, and the specific role of HIV infection

    OpenAIRE

    Burgos-Soto, Juan; Orne-Gliemann, Joanna; Encrenaz, Gaëlle; Patassi, Akouda; Woronowski, Aurore; Karyiyare, Benjamin; Lawson-Evi, Annette K.; Leroy, Valériane; Dabis, François; Didier K Ekouevi; BECQUET, Renaud

    2014-01-01

    Background: A substantial proportion of newly diagnosed HIV infections in sub-Saharan Africa occur within serodiscordant cohabiting heterosexual couples. Intimate partner violence is a major concern for couple-oriented HIV preventive approaches. This study aimed at estimating the prevalence and associated factors of intimate partner physical and sexual violence among HIV-infected and -uninfected women in Togo. We also described the severity and consequences of this violence as well as care-se...

  7. Functional characteristics of HIV-1 subtype C compatible with increased heterosexual transmissibility

    DEFF Research Database (Denmark)

    Walter, Brandon L; Armitage, Andrew E; Graham, Stephen C

    2009-01-01

    BACKGROUND: Despite the existence of over 50 subtypes and circulating recombinant forms of HIV-1, subtype C dominates the heterosexual pandemic causing approximately 56% of all infections. OBJECTIVE: To evaluate whether viral genetic factors may contribute to the observed subtype-C predominance...... mononuclear cell and cell lines with low CCR5 expression. Structural modeling suggested the formation of an additional hydrogen bond between V3 and CCR5. Moreover, we found preferential selection of HIV with 316T and/or extremely short V1-V2 loops in cervices of three women infected with subtypes A/C, B or C....... CONCLUSION: As CD4-CCR5-T cells are key targets for genital HIV infection and cervical selection can favor compact V1-V2 loops and 316T, which increase viral infectivity, we propose that these conserved subtype-C motifs may contribute to transmission and spread of this subtype....

  8. Two variants of HIV-1 B serotype are transmitted heterosexually in São Paulo, Brazil

    Directory of Open Access Journals (Sweden)

    Casseb J.

    1998-01-01

    Full Text Available HIV-1 variability may have an important impact on transmission and pathogenicity. Better characterization of the HIV epidemic in Brazil is necessary for the development of vaccine trials in this country. We analyzed sera from 108 HIV-1-infected volunteers from São Paulo City to determine serotype and reactivity for V3 motifs of HIV in this population, and the relationship to transmission mode. We concluded that the HIV-1 B serotype is frequent among heterosexually infected women, even in the absence of anal sex, and that two major V3 motifs, GPGR and GWGR, had similar prevalence among women (48% and 52%, respectively and men (56% and 44%, respectively. We also observed an equal distribution of these strains regardless of their CD4+ T cell counts, clinical status, and mode of transmission. Even though V3 serology for HIV-1 subtyping is an inexpensive tool for use in developing countries, additional methods, such as heteroduplex mobility assay and direct DNA sequencing, should be included to determine HIV-1 genetic diversity.

  9. Qualitative Analysis of an Educational Intervention with HIV-Discordant Heterosexual Latino Couples

    Science.gov (United States)

    Pérez-Jiménez, David; Orengo-Aguayo, Rosaura E.

    2012-01-01

    Objective This qualitative analysis elucidates the potential elements of the intervention that may be effective in terms of a) increasing knowledge about HIV/AIDS in the members of this population; b) increasing the use of male condoms and the practice of mutual masturbation; and c) changing opinions toward male condom use and mutual masturbation. Methods Five heterosexual HIV-discordant couples participated in the adapted intervention, which consisted of four three-hour-long sessions. One month after the intervention, we conducted a qualitative semi-structured interview with every participant to evaluate issues related to the process and content of the activities comprising the intervention, the impact of the intervention, logistics, and recruitment and retention as well as to make a more general evaluation. The information was submitted to qualitative content analysis. Results After the intervention, participants reported having better attitudes regarding safer sex, particularly in terms of condom use. A reason given by the participants to feel more positive toward condom use and mutual masturbation was that these practices could prevent the infection of the HIV-negative partner. Conclusion This study provides important evidence of an intervention that promises to be efficacious in preventing some high-risk sexual behaviors among Latino HIV-discordant heterosexual couples. The evidence presented seems to suggest that an intervention that includes basic relevant information about HIV/AIDS, that explains the benefits of condom use and other safer sex options, and that provides effective negotiation and communication strategies could significantly reduce HIV transmission among these couples. PMID:22263299

  10. Barriers and facilitators of HIV prevention with heterosexual Latino couples: beliefs of four stakeholder groups.

    Science.gov (United States)

    Pérez-Jiménez, David; Seal, David W; Serrano-García, Irma

    2009-01-01

    Although HIV prevention interventions for women are efficacious, long-term behavior change maintenance within power-imbalanced heterosexual relationships has been difficult. To explore the feasibility, content, and format of an HIV intervention for Latino couples, the authors conducted 13 focus groups with HIV/AIDS researchers, service providers, and heterosexual men and women in Puerto Rico, the Dominican Republic, and Mexico. Reasons that participants thought that men should be involved in prevention efforts included promotion of shared responsibility, creation of a safe environment for open conversation about sex, and increased sexual negotiation skills. Perceived barriers to men's involvement included cultural taboos, sexual conservatism associated with Catholicism and machismo, and power-imbalanced relationships. Participants stressed the need for recruitment of men within naturally occurring settings or by influential community leaders. Participants indicated that couples-level interventions would be successful if they used strong coed facilitators, included both unigender and mixed-gender discussion opportunities, and addressed personally meaningful topics. Implications of these findings are discussed.

  11. Sexual behavior patterns and HIV risks in bisexual men compared to exclusively heterosexual and homosexual men.

    Science.gov (United States)

    Izazola-Licea, José Antonio; Gortmaker, Steven L; de Gruttola, Víctor; Tolbert, Kathryn; Mann, Jonathan

    2003-01-01

    To compare patterns of sexual behavior among bisexual, heterosexual and homosexual men. A household probability survey was carried out in Mexico City in 1992-1993 using the national health surveys sampling frame. Information from 8,068 men was obtained; however, the main analysis of this paper refers only to men sexually active in the previous 5 years. Bisexuals reported more prevalent anal intercourse with women (16% vs. 3%, p = 0.01), and more sexual encounters with female sex workers than exclusive heterosexuals (10% vs. 4%; p = 0.04). Bisexuals used condoms more often with sex workers than did heterosexuals (p = 0.01). Most of the bisexuals (79%) did not engage in anal receptive or insertive intercourse with males in the previous year, practicing instead oral insertive sex or only masturbation; 35% of homosexuals did not report practicing anal sex. Bisexuals who engaged in anal intercourse had less anal receptive behavior than homosexuals (13% vs. 60%, p sexual behavior with males than exclusive homosexuals. This finding may imply that bisexual men in Mexico are an ineffective epidemiological bridge for HIV transmission. The English version of this paper is available too at:http://www.insp.mx/salud/index.html.

  12. The Preliminary Findings of a Study Exploring the Perceptions of a Sample of Young Heterosexual Males regarding HIV Prevention Education Programming in Nova Scotia, Canada

    Science.gov (United States)

    Gahagan, Jacqueline; Rehman, Laurene; Barbour, Laura; McWilliam, Susan

    2007-01-01

    Despite the increasing numbers of young Canadian females becoming infected with HIV through heterosexual transmission with an infected male sexual partner, the majority of current HIV prevention programs and services in Canada continue to ignore the needs of young heterosexual males. This research is derived from 30 in-depth interviews, 9 focus…

  13. High rates of anal dysplasia in HIV-infected men who have sex with men, women, and heterosexual men.

    Science.gov (United States)

    Gaisa, Michael; Sigel, Keith; Hand, Jonathan; Goldstone, Stephen

    2014-01-14

    To determine rates of anal dysplasia in a cohort of HIV-infected men who have sex with men (MSM), women, and heterosexual men with abnormal anal cytology. We evaluated histologic findings in 728 HIV-infected MSM, women, and heterosexual men referred for high-resolution anoscopy (HRA) after abnormal anal cytology in a single-center cohort study. Using multivariable logistic regression, we evaluated predictors of high-grade squamous intraepithelial lesion (HSIL) histology or invasive carcinoma including age, sexual behavior, receptive anal intercourse (RAI), anogenital warts, smoking status, antiretroviral therapy, CD4 T-cell count, and HIV-1 plasma viral load. A total of 2075 HIV-positive patients were screened with anal cytology and 62% of MSM, 42% of women, and 29% of heterosexual men had abnormal findings (P anal cytology who underwent HRA, 71% were MSM, 23% women, and 6% heterosexual men. HSIL/cancer was found in 32% of MSM, 26% of women, and 23% of heterosexual men (P = 0.3). There were five cases of anal squamous cell carcinoma (0.7%), four in MSM and one in a heterosexual man. In a multivariable adjusted analysis, biopsy-proven HSIL/cancer was associated with RAI [odds ratio (OR) 2.2; 95% confidence interval (CI) 1.3-3.7]. CD4 T-cell counts more than 500/μl conferred a lower risk of HSIL/cancer (OR 0.5; 95% CI 0.3-0.9). Rates of anal HSIL histology are high in HIV-infected patients of all sexual risk groups with abnormal anal cytology. Consequently, all HIV-infected patients may warrant anal cancer screening.

  14. Low HIV-testing rates and awareness of HIV infection among high-risk heterosexual STI clinic attendees in The Netherlands.

    Science.gov (United States)

    Van der Bij, Akke K; Dukers, Nicole H T M; Coutinho, Roel A; Fennema, Han S A

    2008-08-01

    Since 1999, HIV testing is routinely offered to all attendees of the sexually transmitted infections (STI) outpatient clinic in Amsterdam, the Netherlands. This study evaluates whether this more active HIV-testing policy increased uptake of HIV testing and awareness of an HIV-positive serostatus among heterosexual attendees. In addition to routine data collected at each STI consultation, data from half-yearly HIV surveys were used from 1994 to 2004. During each survey period, 1000 consecutive attendees are enrolled voluntary and anonymously for HIV testing and are interviewed on previous HIV testing and outcome. Trends in and predictors for uptake of HIV testing as offered during routine STI consultation were analysed by logistic regression. Trends in awareness of an HIV-positive serostatus as obtained from the anonymous HIV surveys were likewise analysed. The percentage of heterosexual attendees opting for an HIV test during consultation increased from 13% in 1996 to 56% in 2004. However, the proportion of individuals aware of their HIV infection did not change over time and only a minority (19%) of the 108 attendees found HIV-positive in the anonymous surveys were aware of their HIV infection. Persons being or visiting a commercial sex worker, having a non-Dutch ethnicity, lacking health insurance and having an STI diagnosed were less likely to opt for an HIV test. Although heterosexual attendees increased their uptake of HIV testing during STI consultation over time, uptake of testing by attendees at risk for HIV infection, such as those infected with an STI, remained low. As a result, the percentage of persons aware of their HIV infection remained low, posing a risk for their individual health and for ongoing HIV transmission. Current testing strategies, therefore, misses the group that most needs testing. Based on these results, 'opt-out' HIV testing is now the standard procedure at the Amsterdam STI clinic.

  15. [Exercising sexual and reproductive rights: a qualitative study of heterosexual people with HIV in Mexico].

    Science.gov (United States)

    Campero, Lourdes; Kendall, Tamil; Caballero, Marta; Mena, Ana Lorena; Herrera, Cristina

    2010-01-01

    To analyze experiences of heterosexual Mexican people living with HIV (PLWHA) related to the exercise of their sexual and reproductive rights. Qualitative study based on 40 in-depth interviews with PLWHA in four Mexican States. Lack of support and counseling limits the exercise of sexual and reproductive rights by PLWHA, especially women. Principal limitations include feelings of frustration and confusion, fear of re-infection, scanty information, lack of power to negotiate condom use, social stigma and discrimination, and limited access to services and adequate technologies. To increase awareness and exercise of rights by PLWHA it is necessary to: improve sexual education; promote processes of cultural change to combat gender inequality and stigma and discrimination; and provide timely and scientific information about HIV prevention.

  16. HIV Risk Behavior and Access to Services: What Predicts HIV Testing among Heterosexually Active Homeless Men?

    Science.gov (United States)

    Wenzel, Suzanne L.; Rhoades, Harmony; Tucker, Joan S.; Golinelli, Daniela; Kennedy, David P.; Zhou, Annie; Ewing, Brett

    2012-01-01

    HIV is a serious epidemic among homeless persons, where rates of infection are estimated to be three times higher than in the general population. HIV testing is an effective tool for reducing HIV transmission and for combating poor HIV/AIDS health outcomes that disproportionately affect homeless persons, however, little is known about the HIV…

  17. Fertility care interventions should be provided as the first line options for HIV+ serodiscordant couples who desire children in settings with affordable access to care, regardless of their fertility status.

    Science.gov (United States)

    Zakarin Safier, Lauren; Sauer, Mark V

    2017-03-08

    With increasing life expectancy, couples with at least one partner afflicted with HIV are more commonly pursuing the opportunity to have biologic offspring. Currently, there are no universally accepted recommendations regarding first line reproductive treatments for HIV serodiscordant couples lacking a history of infertility. We strongly believe that fertility care intervention should be the first line treatment, when affordably accessible, over natural conception for HIV serodiscordant couples to achieve pregnancy in a safe and efficacious manner. In the era of highly active anti-retroviral therapy, in combination with timed intercourse and pre-exposure prophylaxis for the HIV negative partner, some members of the medical community are arguing in favour of natural conception as a means of achieving pregnancy in this patient population. In our opinion, laboratory assisted fertility methods, including intrauterine insemination, in vitro fertilization, and intracytoplasmic sperm injection with semen washing should be the first line treatment recommendation for HIV serodiscordant couples desiring pregnancy for the following reasons: (1) abundance of evidence in the medical literature supporting the safety profile and efficacy of fertility care intervention in couples with HIV; paucity of data addressing safety of natural conception in comparison to fertility intervention techniques (2) unknown public health impact of promoting natural conception as a safe means of achieving pregnancy (3) ethical implications: patients should be offered the available and accessible treatment option posing the lowest possible known risk to the uninfected partner. We believe that physician assisted fertility care, when affordably accessible, should be the treatment of choice over natural conception. While the preliminary data on natural conception in couples using highly active anti-retroviral therapy/pre-exposure prophylaxis/timed intercourse appears promising, we believe that this

  18. High-risk human papillomavirus viral load and persistence among heterosexual HIV-negative and HIV-positive men.

    Science.gov (United States)

    Grabowski, Mary K; Gray, Ronald H; Serwadda, David; Kigozi, Godfrey; Gravitt, Patti E; Nalugoda, Fred; Reynolds, Steven J; Wawer, Maria J; Watya, Stephen; Quinn, Thomas C; Tobian, Aaron A R

    2014-06-01

    High-risk human papillomavirus (HR-HPV) viral load is associated with HR-HPV transmission and HR-HPV persistence in women. It is unknown whether HR-HPV viral load is associated with persistence in HIV-negative or HIV-positive men. HR-HPV viral load and persistence were evaluated among 703 HIV-negative and 233 HIV-positive heterosexual men who participated in a male circumcision trial in Rakai, Uganda. Penile swabs were tested at baseline and 6, 12 and 24 months for HR-HPV using the Roche HPV Linear Array, which provides a semiquantitative measure of HPV shedding by hybridisation band intensity (graded: 1-4). Prevalence risk ratios (PRR) were used to estimate the association between HR-HPV viral load and persistent detection of HR-HPV. HR-HPV genotypes with high viral load (grade:3-4) at baseline were more likely to persist than HR-HPV genotypes with low viral load (grade: 1-2) among HIV-negative men (month 6: adjPRR=1.83, 95% CI 1.32 to 2.52; month 12: adjPRR=2.01, 95% CI 1.42 to 3.11), and HIV-positive men (month 6: adjPRR=1.33, 95% CI 1.06 to 1.67; month 12: adjPRR=1.73, 95% CI 1.18 to 2.54). Long-term persistence of HR-HPV was more frequent among HIV-positive men compared with HIV-negative men (month 24: adjPRR=2.27, 95% CI 1.47 to 3.51). Persistence of newly detected HR-HPV at the 6-month and 12-month visits with high viral load were also more likely to persist to 24 months than HR-HPV with low viral load among HIV-negative men (adjPRR=1.67, 95% CI 0.88 to 3.16). HR-HPV genotypes with high viral load are more likely to persist among HIV-negative and HIV-positive men, though persistence was more common among HIV-positive men overall. The results may explain the association between high HR-HPV viral load and HR-HPV transmission. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  19. Intimate partner violence perpetration, risky sexual behavior, and STI/HIV diagnosis among heterosexual African American men.

    Science.gov (United States)

    Raj, Anita; Reed, Elizabeth; Welles, Seth L; Santana, Maria Christina; Silverman, Jay G

    2008-09-01

    Evidence indicates that abusive male partners pose increased risk for sexually transmitted infection (STI)/HIV among females. However, research with males on this issue is limited. The objective of this study was to assess the associations between intimate partner violence (IPV) perpetration and recent STI/HIV diagnosis, unprotected sex, and sex trade involvement among heterosexual African American men. In this cross-sectional study, heterosexual African American males aged 18 to 65 years who reported two or more sex partners in the past year were recruited from urban health clinics to complete a computerized survey assessing sociodemographic characteristics, IPV perpetration history, risky sexual behaviors, and substance use. Multivariate logistic regression analyses assessed associations between IPV perpetration and STI/HIV risk. More than half of participants in this sample (61%) were unemployed; 28.2% had less than a high school education and 23.1% were homeless. One-fifth of the sample (21.2%) reported IPV perpetration in their current relationship. IPV perpetration was significantly associated with recent STI/HIV diagnosis, unprotected anal sex, and buying sex. IPV perpetration is pervasive among heterosexually at-risk African American men presenting for clinical care, and those perpetrating IPV are at heightened risk for STI/HIV.

  20. Heterosexual anal intercourse and HIV infection risks in the context of alcohol serving venues, Cape Town, South Africa

    Directory of Open Access Journals (Sweden)

    Carey Kate B

    2011-10-01

    Full Text Available Abstract Background The most efficient sexual behavior for HIV transmission is unprotected receptive anal intercourse. However, it is unclear what role heterosexual unprotected anal sex is playing in the world's worst HIV epidemics of southern Africa. The objective is to examine the prevalence of heterosexual unprotected anal intercourse among men and women who drink at informal alcohol serving establishments (shebeens in South Africa. Methods Cross-sectional surveys were collected from a convenience sample of 5037 patrons of 10 shebeens in a peri-urban township of Cape Town, South Africa. Analyses concentrated on establishing the rates of unprotected anal intercourse practiced by men and women as well as the factors associated with practicing anal intercourse. Results We found that 15% of men and 11% of women reported anal intercourse in the previous month, with 8% of men and 7% of women practicing any unprotected anal intercourse. Multiple logistic regression showed that younger age, having primary and casual sex partners, and meeting sex partners at shebeens were independently associated with engaging in anal intercourse. Mathematical modeling showed that individual risks are significantly impacted by anal intercourse but probably not to the degree needed to drive a generalized HIV epidemic. Conclusions Anal intercourse likely plays a significant role in HIV infections among a small minority of South Africans who patronize alcohol serving establishments. Heterosexual anal intercourse, the most risky sexual behavior for HIV transmission, should not be ignored in HIV prevention for South African heterosexuals. However, this relatively infrequent behavior should not become the focus of prevention efforts.

  1. Heterosexual anal intercourse and HIV infection risks in the context of alcohol serving venues, Cape Town, South Africa

    Science.gov (United States)

    2011-01-01

    Background The most efficient sexual behavior for HIV transmission is unprotected receptive anal intercourse. However, it is unclear what role heterosexual unprotected anal sex is playing in the world's worst HIV epidemics of southern Africa. The objective is to examine the prevalence of heterosexual unprotected anal intercourse among men and women who drink at informal alcohol serving establishments (shebeens) in South Africa. Methods Cross-sectional surveys were collected from a convenience sample of 5037 patrons of 10 shebeens in a peri-urban township of Cape Town, South Africa. Analyses concentrated on establishing the rates of unprotected anal intercourse practiced by men and women as well as the factors associated with practicing anal intercourse. Results We found that 15% of men and 11% of women reported anal intercourse in the previous month, with 8% of men and 7% of women practicing any unprotected anal intercourse. Multiple logistic regression showed that younger age, having primary and casual sex partners, and meeting sex partners at shebeens were independently associated with engaging in anal intercourse. Mathematical modeling showed that individual risks are significantly impacted by anal intercourse but probably not to the degree needed to drive a generalized HIV epidemic. Conclusions Anal intercourse likely plays a significant role in HIV infections among a small minority of South Africans who patronize alcohol serving establishments. Heterosexual anal intercourse, the most risky sexual behavior for HIV transmission, should not be ignored in HIV prevention for South African heterosexuals. However, this relatively infrequent behavior should not become the focus of prevention efforts. PMID:21999574

  2. Gendered constructions of the impact of HIV and AIDS in the context of the HIV-positive seroconcordant heterosexual relationship.

    Science.gov (United States)

    Bhagwanjee, Anil; Govender, Kaymarlin; Reardon, Candice; Johnstone, Leigh; George, Gavin; Gordon, Sarah

    2013-05-15

    This article explores the complex, dynamic and contextual frameworks within which men working in a mining community and their live-in long-term partners or spouses (termed "couples" in this study) respond to the introduction of HIV into their heterosexual relationships; the way in which partners adopt gendered positions in enabling them to make sense of their illness; how they negotiate their respective masculine and feminine roles in response to the need for HIV-related lifestyle changes; as well as the gendered nature of partner support in relation to antiretroviral therapy (ARV) adherence. We conducted an in-depth qualitative study with a sample of 12 HIV-positive seroconcordant heterosexual couples in a South African mining organization. Transcripts based on semi-structured couple's interviews were analyzed using an inductive emergent thematic analytical method. The findings present compelling evidence that the impact of HIV and AIDS is mitigated, in the main, by the nature of the dyadic relationship. Where power and agency were skewed in accordance with traditional gender scripts, the impact of HIV and AIDS was deleterious in terms of negotiating disclosure, meeting expectations of care and support, and promoting treatment adherence. As a corollary, the study also revealed that where the relational dynamic evidenced a more equitable distribution of power, the challenge of negotiating illness was embraced in a way that strengthened the couples' affiliation in profound ways, manifested not simply in a reduction in risk behaviours, but in both partner's courage to re-visit sensitive issues related to managing their relationship in the context of a debilitating illness. Gendered positioning (by self and others) was found to play a crucial role in the way couples experienced HIV and ARV treatment, and underscored the positive role of a couples-counselling approach in the negotiation of the illness experience. However, as part of a broader social project, the

  3. Gendered constructions of the impact of HIV and AIDS in the context of the HIV-positive seroconcordant heterosexual relationship

    Directory of Open Access Journals (Sweden)

    Anil Bhagwanjee

    2013-05-01

    Full Text Available Introduction: This article explores the complex, dynamic and contextual frameworks within which men working in a mining community and their live-in long-term partners or spouses (termed “couples” in this study respond to the introduction of HIV into their heterosexual relationships; the way in which partners adopt gendered positions in enabling them to make sense of their illness; how they negotiate their respective masculine and feminine roles in response to the need for HIV-related lifestyle changes; as well as the gendered nature of partner support in relation to antiretroviral therapy (ARV adherence. Methods: We conducted an in-depth qualitative study with a sample of 12 HIV-positive seroconcordant heterosexual couples in a South African mining organization. Transcripts based on semi-structured couple's interviews were analyzed using an inductive emergent thematic analytical method. Results: The findings present compelling evidence that the impact of HIV and AIDS is mitigated, in the main, by the nature of the dyadic relationship. Where power and agency were skewed in accordance with traditional gender scripts, the impact of HIV and AIDS was deleterious in terms of negotiating disclosure, meeting expectations of care and support, and promoting treatment adherence. As a corollary, the study also revealed that where the relational dynamic evidenced a more equitable distribution of power, the challenge of negotiating illness was embraced in a way that strengthened the couples’ affiliation in profound ways, manifested not simply in a reduction in risk behaviours, but in both partner's courage to re-visit sensitive issues related to managing their relationship in the context of a debilitating illness. Conclusions: Gendered positioning (by self and others was found to play a crucial role in the way couples experienced HIV and ARV treatment, and underscored the positive role of a couples-counselling approach in the negotiation of the illness

  4. The IWG (Interagency Working Group) model for the heterosexual spread of HIV and the demographic impact of the AIDS epidemic

    Energy Technology Data Exchange (ETDEWEB)

    Stanley, E.A. (Los Alamos National Lab., NM (USA)); Seitz, S.T. (Illinois Univ., Urbana, IL (USA)); Way, P.O.; Johnson, P.D. (Bureau of the Census, Washington, DC (USA)); Curry, T.F. (Air Force Academy, CO (USA))

    1990-01-01

    This paper presents the State Department's Interagency Working Group (IWG) model for the spread of HIV. The model is fully operational for Pattern 2 (heterosexual blood transmission) and Pattern 3 (heterosexual, homosexual, and IV drug transmission) countries. This model was developed for various uses, including technical research, policy analysis, and support for decision making. Research uses include studying patterns of HIV spread, assessing the relative effect of different processes on the spread of HIV, examining the demographic impact of HIV infections, and comparing the potential impact of behavioral versus medical intervention strategies. The model will be used in workshops where policy makers and health officials can do hands-on scenario analyses, gain qualitative insights into the possible long-term-epidemiological and demographic impact of HIV, gauge the uncertainties in predictions for the future, and study the impact of HIV, gauge the uncertainties in predictions for the future, and study the impact that intervention strategies are likely to have. The computational model uses a deterministic system of differential equations and runs on a 286- or a 386-based IBM-compatible machine under Microsoft Windows. The program requires an input ASCII (text) file to run; all parameters used by the model are input through this file and, therefore, are user-accessible. The software is user-friendly, mouse-driven, and allows for interactive manipulation of input data and visualization and processing of model outputs. 15 refs., 13 figs., 1 tab.

  5. Risk for Heterosexual HIV Transmission Among Non-Injecting Female Partners of Injection Drug Users in Estonia.

    Science.gov (United States)

    Uusküla, A; McMahon, J M; Kals, M; Talu, A; Abel-Ollo, K; Rüütel, K; Des Jarlais, D C

    2013-03-01

    The HIV epidemic in Estonia, as with other eastern European countries, is currently concentrated among injection drug users (IDUs). Non-IDUs who have IDU sex partners could serve as a potential bridge in an expanding epidemic. We applied HIV transmission modelling to data collected from non-IDU/IDU heterosexual couples in Kohtla-Järve, Estonia to estimate HIV risk from IDUs to their sex partners based on self-reported sexual behaviors shared by the couple. IDUs and their current main non-injecting sex partners were recruited for an interviewer-administered survey and HIV testing. Bernoulli modelling techniques were applied to estimate the risk of HIV transmission (incidence) among HIV negative non-injecting female partners of male IDUs. The estimated HIV incidence in this population of non-injecting women with only main sexual partners in the last 6 months ranged from 3.24 to 4.94 HIV seroconversions per 100 person years depending on the value used in the models for the per act transmission rate during acute stage infection. Non-IDUs who have IDU sex partners are at high risk for HIV and could serve as a potential bridge to a more generalized epidemic. Whether this might lead to an expansion of the HIV epidemic beyond core groups in Estonia or other Eastern European countries warrants closer study.

  6. Correlates of trading sex for methamphetamine in a sample of HIV-negative heterosexual methamphetamine users.

    Science.gov (United States)

    Semple, Shirley J; Strathdee, Steffanie A; Zians, Jim; Patterson, Thomas L

    2011-01-01

    While many studies have examined correlates of trading sex for money, few have examined factors associated with exclusive trading of sex for drugs. We identified sociodemographic, behavioral, and psychological correlates of trading sex for methamphetamine in a sample of HIV-negative heterosexual men and women who were enrolled in a sexual risk reduction intervention in San Diego, California. Of 342 participants, 26% overall (21% of males and 31% of females) reported trading sex for methamphetamine in the past two months. Multiple logistic regression analysis revealed that recently trading sex for methamphetamine was independently associated with being female, homeless, binging on methamphetamine, sexual victimization in the past two months, engaging in anal sex 24 or more times in the past two months, and higher sexual compulsivity scores. Effective interventions for this high-risk population should consider gender-focused counseling for sexual abuse, motivational enhancement therapy, social-cognitive skills training, as well as enhanced access and utilization of social services, including drug treatment.

  7. Partial protective effect of CCR5-Delta 32 heterozygosity in a cohort of heterosexual Italian HIV-1 exposed uninfected individuals

    Directory of Open Access Journals (Sweden)

    Cauda Roberto

    2006-09-01

    Full Text Available Abstract Despite multiple sexual exposure to HIV-1 virus, some individuals remain HIV-1 seronegative (exposed seronegative, ESN. The mechanisms underlying this resistance remain still unclear, although a multifactorial pathogenesis can be hypothesised. Although several genetic factors have been related to HIV-1 resistance, the homozigosity for a mutation in CCR5 gene (the 32 bp deletion, i.e. CCR5-Delta32 allele is presently considered the most relevant one. In the present study we analysed the genotype at CCR5 locus of 30 Italian ESN individuals (case group who referred multiple unprotected heterosexual intercourse with HIV-1 seropositive partner(s, for at least two years. One hundred and twenty HIV-1 infected patients and 120 individuals representative of the general population were included as control groups. Twenty percent of ESN individuals had heterozygous CCR5-Delta 32 genotype, compared to 7.5% of HIV-1 seropositive and 10% of individuals from the general population, respectively. None of the analysed individuals had CCR5-Delta 32 homozygous genotype. Sequence analysis of the entire open reading frame of CCR5 was performed in all ESN subjects and no polymorphisms or mutations were identified. Moreover, we determined the distribution of C77G variant in CD45 gene, which has been previously related to HIV-1 infection susceptibility. The frequency of the C77G variant showed no significant difference between ESN subjects and the two control groups. In conclusion, our data show a significantly higher frequency of CCR5-Delta 32 heterozygous genotype (p = 0.04 among the Italian heterosexual ESN individuals compared to HIV-1 seropositive patients, suggesting a partial protective role of CCR5-Delta 32 heterozygosity in this cohort.

  8. Self-reported altruistic and reciprocal behaviors among homosexually and heterosexually experienced adults: implications for HIV/AIDS service organizations.

    Science.gov (United States)

    Cochran, Susan D; Mays, Vickie; Corliss, Heather; Smith, Tom W; Turner, Joseph

    2009-06-01

    Prior studies find that gay men and lesbians volunteer in HIV/AIDS service organizations at high rates. However, no population-based study has investigated the mechanisms involved. Using data from the General Social Survey, a nationally representative biennial survey that in 2002 and 2004 interviewed 2031 sexually experienced adults, the authors examine levels of empathic concern, altruistic values, and the past year occurrence of altruistic and reciprocal behaviors among homosexually and exclusively heterosexually experienced adults. Overall, women reported higher levels of empathic concern and stronger altruistic values relative to men while men reported engaging in a wider variety of altruistic behaviors than did women. In gender-specific comparisons, homosexually experienced men reported stronger altruistic values than did exclusively heterosexual men but levels of empathic concern and the range of altruistic and reciprocal behaviors engaged in did not vary appreciable. Among women, homosexually experienced women reported engaging in a wider range of altruistic behaviors than exclusively heterosexual women, but did not differ in their levels of empathic concern or strength of altruistic values. Findings support the existence of some small sexual orientation-related differences in altruistic values and altruistic and reciprocal behaviors. These have implications for HIV-related volunteerism. One surprising finding in this study was that approximately 17% of homosexually experienced men had donated blood in the year prior to interview despite the prohibition against doing so.

  9. Trends in risk behavior and HIV seroprevalence in heterosexual injection drug users in San Francisco, 1986-1992.

    Science.gov (United States)

    Watters, J K

    1994-12-01

    We examine changes and stability in risk behaviors and HIV-1 seroprevalence among heterosexual injection drug users (IDUs) over 13 cross-sectional surveys, 1986-1992. Interviews (n = 5,956) were conducted with IDUs in street settings and drug detoxification clinics over 6.5 years, and respondents were tested for HIV-1 antibody. Trends in use of condoms and bleach and HIV seroprevalence were assessed using multiple logistic and linear regression analyses. The percentage of time condoms were reportedly used during intercourse among men increased from 4.5% to 31.0%. Among the declining population of IDUs who reported needle sharing, reported use of bleach increased from 3% to 89%. Significant changes in use of bleach 100% of the time were reported: 29.8% in 1988, 52.8% in 1990, and 40.0% in 1992. HIV seroprevalence doubled from 7% in 1986 to 14% in 1987. Post-1987 fluctuations in HIV seroprevalence were not significant. Significant changes in risk behaviors among IDUs were reported over the study period. These changes coincided with the implementation of HIV prevention in San Francisco, including outreach programs, HIV testing and counseling, bleach distribution, and syringe exchange. The moderate and stable rate of HIV seroprevalence beginning in 1987 parallels self-reported reductions in risk behavior.

  10. Expression of CCR5, CXCR4 and DC-SIGN in Cervix of HIV-1 Heterosexually Infected Mexican Women

    Science.gov (United States)

    Rivera-Morales, Lydia Guadalupe; Lopez-Guillen, Paulo; Vazquez-Guillen, Jose Manuel; Palacios-Saucedo, Gerardo C; Rosas-Taraco, Adrian G; Ramirez-Pineda, Antonio; Amaya-Garcia, Patricia Irene; Rodriguez-Padilla, Cristina

    2012-01-01

    Background: A number of studies have demonstrated that receptor and co-receptor expression levels which may affect viral entry, promoting cervical HIV infection. The aim was to evaluate the expression levels of CCR5, CXCR4and DC-SIGN mRNA in a sample of heterosexually HIV infected Mexican women. Methods: We enrolled twenty-six HIV heterosexual infected women attending a local infectious diseases medical unit.RNA was isolated from the cervix and gene expression analysis was performed using real-time PCR. Results: Expression rates for mRNA of CCR5 (median 1.82; range 0.003–2934) were higher than those observed for CXCR4 (0.79; 0.0061–3312) and DC-SIGN (0.33; 0.006–532) receptors (p < 0.05). A high correlation was found between the mRNA expression levels of these three receptors (rs = 0.52 to 0.85, p < 0.01). Conclusion: Levels of expression of the tested chemokine receptors in the cervix are different from each other and alsovary from woman to woman, and seem to support the suggestion that chemokine receptor expression in genital tissues may be playing a role in the HIV transmission. PMID:23115608

  11. A little thing called love: condom use in high-risk primary heterosexual relationships.

    Science.gov (United States)

    Corbett, A Michelle; Dickson-Gómez, Julia; Hilario, Helena; Weeks, Margaret R

    2009-12-01

    Condoms are less likely to be used in primary relationships than in other relationship types. An understanding of what women and men expect when entering into these relationships, as well as how they make decisions about condom use and other prevention behaviors, is essential to efforts to curb the spread of HIV. Qualitative in-depth interviews were conducted with 25 high-risk heterosexual couples, including HIV-serodiscordant couples, participating in a trial of the female condom in Hartford in 2004-2007. Data were coded and analyzed in an iterative inductive and deductive process. Participants described nonuse of condoms as a strategy to fi nd and maintain a primary relationship, establish trust and increase intimacy. Many had unprotected intercourse while recognizing their risk of HIV and other STDs, placing their love for their partner and other emotional needs over concerns about their health. Several couples reduced their STD risk by practicing negotiated safety (i.e., using condoms until their serostatus had been determined) or similar strategies, including sharing sexual or drug use history, disclosing HIV test results and using condoms until they decided that their relationship would be monogamous. HIV prevention approaches must recognize the importance of love and the needs that primary relationships satisfy if they are to be considered relevant by those at greatest risk. Negotiated safety and similar strategies may be an important risk reduction tool for heterosexuals, particularly those in HIV-affected relationships, but their potential effectiveness may vary.

  12. Higher rates of triple-class virological failure in perinatally HIV-infected teenagers compared with heterosexually infected young adults in Europe

    DEFF Research Database (Denmark)

    Judd, A; Lodwick, R; Noguera-Julian, A

    2017-01-01

    OBJECTIVES: The aim of the study was to determine the time to, and risk factors for, triple-class virological failure (TCVF) across age groups for children and adolescents with perinatally acquired HIV infection and older adolescents and adults with heterosexually acquired HIV infection. METHODS:...

  13. Public Health Benefit of Peer-Referral Strategies for Detecting Undiagnosed HIV Infection Among High-Risk Heterosexuals in New York City.

    Science.gov (United States)

    Gwadz, Marya; Cleland, Charles M; Perlman, David C; Hagan, Holly; Jenness, Samuel M; Leonard, Noelle R; Ritchie, Amanda S; Kutnick, Alexandra

    2017-04-15

    Identifying undiagnosed HIV infection is necessary for the elimination of HIV transmission in the United States. The present study evaluated the efficacy of 3 community-based approaches for uncovering undiagnosed HIV among heterosexuals at high-risk (HHR), who are mainly African American/Black and Hispanic. Heterosexuals comprise 24% of newly reported HIV infections in the United States, but experience complex multilevel barriers to HIV testing. We recruited African American/Black and Hispanic HHR in a discrete urban area with both elevated HIV prevalence and poverty rates. Approaches tested were (1) respondent-driven sampling (RDS) and confidential HIV testing in 2 sessions (n = 3116); (2) RDS and anonymous HIV testing in one session (n = 498); and (3) venue-based sampling (VBS) and HIV testing in a single session (n = 403). The main outcome was newly diagnosed HIV infection. RDS with anonymous testing and one session reached HHR with less HIV testing experience and more risk factors than the other approaches. Furthermore, RDS with anonymous (4.0%) and confidential (1.0%) testing yielded significantly higher rates of newly diagnosed HIV than VBS (0.3%). Thus peer-referral approaches were more efficacious than VBS for uncovering HHR with undiagnosed HIV, particularly a single-session/anonymous strategy, and have a vital role to play in efforts to eliminate HIV transmission.

  14. Heterosexual anal sex among female sex workers in high HIV prevalence states of India: need for comprehensive intervention.

    Science.gov (United States)

    Alexander, Mallika; Mainkar, Mandar; Deshpande, Sucheta; Chidrawar, Shweta; Sane, Suvarna; Mehendale, Sanjay

    2014-01-01

    Role of vaginal sex in heterosexual transmission of HIV has been investigated but that of heterosexual anal sex (HAS) is not fully understood. This paper examines practice of HAS among Female Sex Workers (FSWs) and its correlates in India where the HIV epidemic is being primarily driven by core groups like FSWs. Data for this paper are drawn from Round I survey of 9667 FSWs in the Integrated Biological and Behavioral Assessment (IBBA) from 23 districts of 4 high HIV prevalent states of India. Bivariate and multivariate analysis identified factors associated with HAS. Ever having anal sex was reported by 11.9% FSWs (95% CI: 11.3%-12.6%). Typology (AOR 2.20, 95% CI 1.64-2.95) and literacy (AOR 1.28, 95% CI 1.10-1.49) were positively associated with practice of HAS. Longer duration in sex trade (AOR 1.69, 95% CI 1.44-1.99), entertaining larger number of clients the previous week (AOR 1.78, 95% CI 1.47-2.15), alcohol consumption (AOR 1.21, 95% CI 1.03-1.42) and inability to negotiate condom use (AOR 1.53, 95% CI 1.28-1.83) were also correlated with HAS. Self-risk perception for HIV (AOR 1.46, 95% CI 1.25-1.71) did not impede HAS. Although symptoms of sexually transmitted infections (STIs) in the last 12 months were associated with anal sex (AOR 1.39, 95% CI 1.13-1.72) there was no significant association between laboratory confirmed HIV and other STIs with HAS. Practice of HAS by FSWs might significantly contribute to HIV transmission in India. This study also shows that despite self-risk perception for HIV, even literate FSWs with longer duration in sex work report HAS. General messages on condom use may not influence safe HAS. FSWs need to be targeted with specific messages on HIV transmission during anal sex. Women controlled prevention methods, such as rectal microbicides and vaginal microbicides are needed.

  15. Heterosexual anal sex among female sex workers in high HIV prevalence states of India: need for comprehensive intervention.

    Directory of Open Access Journals (Sweden)

    Mallika Alexander

    Full Text Available INTRODUCTION: Role of vaginal sex in heterosexual transmission of HIV has been investigated but that of heterosexual anal sex (HAS is not fully understood. This paper examines practice of HAS among Female Sex Workers (FSWs and its correlates in India where the HIV epidemic is being primarily driven by core groups like FSWs. METHODS: Data for this paper are drawn from Round I survey of 9667 FSWs in the Integrated Biological and Behavioral Assessment (IBBA from 23 districts of 4 high HIV prevalent states of India. Bivariate and multivariate analysis identified factors associated with HAS. RESULTS: Ever having anal sex was reported by 11.9% FSWs (95% CI: 11.3%-12.6%. Typology (AOR 2.20, 95% CI 1.64-2.95 and literacy (AOR 1.28, 95% CI 1.10-1.49 were positively associated with practice of HAS. Longer duration in sex trade (AOR 1.69, 95% CI 1.44-1.99, entertaining larger number of clients the previous week (AOR 1.78, 95% CI 1.47-2.15, alcohol consumption (AOR 1.21, 95% CI 1.03-1.42 and inability to negotiate condom use (AOR 1.53, 95% CI 1.28-1.83 were also correlated with HAS. Self-risk perception for HIV (AOR 1.46, 95% CI 1.25-1.71 did not impede HAS. Although symptoms of sexually transmitted infections (STIs in the last 12 months were associated with anal sex (AOR 1.39, 95% CI 1.13-1.72 there was no significant association between laboratory confirmed HIV and other STIs with HAS. CONCLUSION: Practice of HAS by FSWs might significantly contribute to HIV transmission in India. This study also shows that despite self-risk perception for HIV, even literate FSWs with longer duration in sex work report HAS. General messages on condom use may not influence safe HAS. FSWs need to be targeted with specific messages on HIV transmission during anal sex. Women controlled prevention methods, such as rectal microbicides and vaginal microbicides are needed.

  16. Marketing HIV prevention for heterosexually identified Latino men who have sex with men and women: the Hombres Sanos campaign.

    Science.gov (United States)

    Fernández Cerdeño, Araceli; Martínez-Donate, Ana P; Zellner, Jennifer A; Sañudo, Fernando; Carrillo, Héctor; Engelberg, Moshe; Sipan, Carol; Hovell, Melbourne

    2012-01-01

    This article describes the development process of Hombres Sanos, a social marketing campaign to promote HIV testing and condom use for heterosexually identified Latino men who have sex with men and women. The steps included qualitative formative research and a social marketing analytic framework to understand our target audience better, identify incentives and barriers to risk reduction, guide product development, define an optimal promotional campaign, and inform the selection of campaign platforms. A better grasp of the authors' target beneficiaries' needs and values led to an innovative dual strategy for audience segmentation and targeting. The campaign had consumer-centered, culturally sensitive, and theory-driven communication materials. The authors found communication materials and events to be appealing and effective. The campaign was well received among the wider community, and evaluation showed promising results among Latino men in general and among heterosexually identified Latino men who have sex with men and women in particular. The authors provide a step-by-step overview of the project's formative research, including research methods and findings, and how these were translated into a social marketing campaign. In addition, the authors discuss the challenges encountered in this process and the potential of social marketing to reduce HIV risk among Latinos.

  17. 'What does it take to be a man? What is a real man?': ideologies of masculinity and HIV sexual risk among Black heterosexual men.

    Science.gov (United States)

    Bowleg, Lisa; Teti, Michelle; Massie, Jenné S; Patel, Aditi; Malebranche, David J; Tschann, Jeanne M

    2011-05-01

    Research documents the link between traditional ideologies of masculinity and sexual risk among multi-ethnic male adolescents and White male college students, but similar research with Black heterosexual men is scarce. This exploratory study addressed this gap through six focus groups with 41 Black, low- to middle-income heterosexual men aged 19 to 51 years in Philadelphia, PA. Analyses highlighted two explicit ideologies of masculinity: that Black men should have sex with multiple women, often concurrently, and that Black men should not be gay or bisexual. Analyses also identified two implicit masculinity ideologies: the perception that Black heterosexual men cannot decline sex, even risky sex, and that women should be responsible for condom use. The study's implications for HIV prevention with Black heterosexual men are discussed. © 2011 Taylor & Francis

  18. Microbicides to prevent heterosexual transmission of HIV: ten years down the road

    NARCIS (Netherlands)

    van de Wijgert, Janneke; Coggins, Christiana

    2002-01-01

    The development of topical microbicides for HIV prevention originated in response to the unabated spread of HIV despite the availability of an effective HIV prevention tool (condoms), as well as the lack of an effective HIV vaccine. Initially, hopes were pinned on existing over-the-counter

  19. HIV/STI Prevention Among Heterosexually Active Black Adolescents With Mental Illnesses: Focus Group Findings for Intervention Development.

    Science.gov (United States)

    Brawner, Bridgette M; Jemmott, Loretta Sweet; Wingood, Gina; Reason, Janaiya; Mack, Niya

    Heterosexually active Black adolescents with mental illnesses are at increased risk for sexually transmitted infections (STIs), including HIV. However, few HIV/STI prevention interventions exist for this demographic. We held seven focus groups (N = 33) to elucidate social, cultural, and psychological factors that influence HIV/STI risk-related sexual behaviors in this understudied population. Seven themes emerged: (a) Blackness and media portrayals, (b) Blackness as a source of cultural resilience and pride, (c) psychosocial determinants of condom use, (d) consequences of engaging in sexual activity, (e) attitudes and beliefs toward sexual behaviors, (f) benefits of sexual activity, and (g) coping mechanisms. Participants also supported the feasibility of and interest in HIV/STI prevention programs integrated with mental health treatment. Transportation, potential breaches of confidentiality, and time were noted barriers to participation. Psychoeducational, skills-based programs are needed to address the sequelae of mental illnesses as they relate to the sexual decision-making process in adolescents. Copyright © 2017 Association of Nurses in AIDS Care. Published by Elsevier Inc. All rights reserved.

  20. Pre-exposure prophylaxis for HIV-negative persons with partners living with HIV: uptake, use, and effectiveness in an open-label demonstration project in East Africa.

    Science.gov (United States)

    Heffron, Renee; Ngure, Kenneth; Odoyo, Josephine; Bulya, Nulu; Tindimwebwa, Edna; Hong, Ting; Kidoguchi, Lara; Donnell, Deborah; Mugo, Nelly R; Bukusi, Elizabeth A; Katabira, Elly; Asiimwe, Stephen; Morton, Jennifer; Morrison, Susan; Haugen, Harald; Mujugira, Andrew; Haberer, Jessica E; Ware, Norma C; Wyatt, Monique A; Marzinke, Mark A; Frenkel, Lisa M; Celum, Connie; Baeten, Jared M

    2017-11-06

    Introduction : Pre-exposure prophylaxis (PrEP) can provide high protection against HIV infection and is a recommended intervention for HIV-negative persons with substantial HIV risk, such as individuals with a partner living with HIV.  Demonstration projects of PrEP have been conducted in diverse settings worldwide to illustrate practical examples of how PrEP can be delivered.  Methods : We evaluated delivery of PrEP for HIV-negative partners within heterosexual HIV serodiscordant couples in an open-label demonstration project in East Africa.  The delivery model integrated PrEP into HIV treatment services, prioritizing PrEP for HIV-negative partners within serodiscordant couples prior to and during the first 6 months after the partner living with HIV initiated antiretroviral therapy (ART).  We measured adherence to PrEP through medication event monitoring system (MEMS) bottle caps and quantification of tenofovir in plasma among a random sample of participants. We estimated HIV infections prevented using a counterfactual cohort simulated from the placebo arm of a previous PrEP clinical trial. Results : We enrolled 1,010 HIV serodiscordant couples that were naïve to ART and PrEP.  Ninety-seven percent (97%) of HIV-negative partners initiated PrEP, and when PrEP was dispensed, objective measures suggest high adherence: 71% of HIV-negative participants took ≥80% of expected doses, as recorded via MEMS, and 81% of plasma samples had tenofovir detected.  A total of 4 incident HIV infections were observed (incidence rate=0.24 per 100 person-years), a 95% reduction (95% CI 86-98%, p<0.0001) in HIV incidence, relative to estimated HIV incidence for the population in the absence of PrEP integrated into HIV treatment services.   Conclusions : PrEP uptake and adherence were high and incident HIV was rare in this PrEP demonstration project for African HIV-negative individuals whose partners were known to be living with HIV.  Delivery of PrEP to HIV-negative partners

  1. Using Intervention Mapping to develop a programme to prevent sexually transmittable infections, including HIV, among heterosexual migrant men.

    Science.gov (United States)

    Wolfers, Mireille E G; van den Hoek, Caty; Brug, Johannes; de Zwart, Onno

    2007-07-05

    There is little experience with carefully developed interventions in the HIV/STI prevention field aimed at adult heterosexual target groups in the Netherlands. The ability to apply intervention development protocols, like Intervention Mapping, in daily practice outside of academia, is a matter of concern. An urgent need also exists for interventions aimed at the prevention of STI in migrant populations in the Netherlands. This article describes the theory and evidence based development of HIV/STI prevention interventions by the Municipal Public Health Service Rotterdam Area (MPHS), the Netherlands, for heterosexual migrant men with Surinamese, Dutch-Caribbean, Cape Verdean, Turkish and Moroccan backgrounds. First a needs assessment was carried out. Then, a literature review was done, key figures were interviewed and seven group discussions were held. Subsequently, the results were translated into specific objectives ("change objectives") and used in intervention development for two subgroups: men with an Afro-Caribbean background and unmarried men with a Turkish and Moroccan background. A matrix of change objectives was made for each subgroup and suitable theoretical methods and practical strategies were selected. Culturally-tailored interventions were designed and were pre-tested among the target groups. This development process resulted in two interventions for specific subgroups that were appreciated by both the target groups and the migrant prevention workers. The project took place in collaboration with a university center, which provided an opportunity to get expert advice at every step of the Intervention Mapping process. At relevant points of the development process, migrant health educators and target group members provided advice and feedback on the draft intervention materials. This intervention development project indicates that careful well-informed intervention development using Intervention Mapping is feasible in the daily practice of the MPHS

  2. Using Intervention Mapping to develop a programme to prevent sexually transmittable infections, including HIV, among heterosexual migrant men

    Directory of Open Access Journals (Sweden)

    van den Hoek Caty

    2007-07-01

    Full Text Available Abstract Background There is little experience with carefully developed interventions in the HIV/STI prevention field aimed at adult heterosexual target groups in the Netherlands. The ability to apply intervention development protocols, like Intervention Mapping, in daily practice outside of academia, is a matter of concern. An urgent need also exists for interventions aimed at the prevention of STI in migrant populations in the Netherlands. This article describes the theory and evidence based development of HIV/STI prevention interventions by the Municipal Public Health Service Rotterdam Area (MPHS, the Netherlands, for heterosexual migrant men with Surinamese, Dutch-Caribbean, Cape Verdean, Turkish and Moroccan backgrounds. Methods First a needs assessment was carried out. Then, a literature review was done, key figures were interviewed and seven group discussions were held. Subsequently, the results were translated into specific objectives ("change objectives" and used in intervention development for two subgroups: men with an Afro-Caribbean background and unmarried men with a Turkish and Moroccan background. A matrix of change objectives was made for each subgroup and suitable theoretical methods and practical strategies were selected. Culturally-tailored interventions were designed and were pre-tested among the target groups. Results This development process resulted in two interventions for specific subgroups that were appreciated by both the target groups and the migrant prevention workers. The project took place in collaboration with a university center, which provided an opportunity to get expert advice at every step of the Intervention Mapping process. At relevant points of the development process, migrant health educators and target group members provided advice and feedback on the draft intervention materials. Conclusion This intervention development project indicates that careful well-informed intervention development using

  3. Heterosexual Anal Sex Among Men and Women in Substance Abuse Treatment: Secondary Analysis of Two Gender-Specific HIV-Prevention Trials.

    Science.gov (United States)

    Hatch-Maillette, Mary A; Beadnell, Blair; Campbell, Aimee N C; Meade, Christina S; Tross, Susan; Calsyn, Donald A

    2017-01-01

    Receptive anal sex has high human immunodeficiency virus (HIV) transmission risk, and heterosexual substance-abusing individuals report higher anal sex rates compared to their counterparts in the general population. This secondary analysis evaluated the effectiveness of two gender-specific, evidence-based HIV-prevention interventions (Real Men Are Safe, or REMAS, for men; Safer Sex Skill Building, or SSSB, for women) against an HIV education (HIV-Ed) control condition on decreasing unprotected heterosexual anal sex (HAS) among substance abuse treatment-seeking men (n = 171) and women (n = 105). Two variables, engagement in any HAS and engagement in unprotected HAS, were assessed at baseline and three months postintervention. Compared to the control group, women in the gender-specific intervention did not differ on rates of any HAS at follow-up but significantly decreased their rates of unprotected HAS. Men in both the gender-specific and the control interventions reported less HAS and unprotected HAS at three-month follow-up compared to baseline, with no treatment condition effect. The mechanism of action for SSSB compared to REMAS in decreasing unprotected HAS is unclear. More attention to HAS in HIV-prevention interventions for heterosexual men and women in substance abuse treatment is warranted.

  4. Modelling the Effects of Condom Use and Antiretroviral Therapy in Controlling HIV/AIDS among Heterosexuals, Homosexuals and Bisexuals

    Directory of Open Access Journals (Sweden)

    Noble Malunguza

    2010-01-01

    Full Text Available A deterministic compartmental sex-structured HIV/AIDS model for assessing the effects of homosexuals and bisexuals in heterosexual settings in which homosexuality and bisexuality issues have remained taboo is presented. We extend the model to focus on the effects of condom use as a single strategy approach in HIV prevention in the absence of any other intervention strategies. Initially, we model the use of male condoms, followed by incorporating the use of both the female and male condoms. The model includes two primary factors in condom use to control HIV which are condom efficacy and compliance. Reproductive numbers for these models are computed and compared to assess the effectiveness of male and female condom use in a community. We also extend the basic model to consider the effects of antiretroviral therapy as a single strategy. The results from the study show that condoms can reduce the number of secondary infectives and thus can slow the development of the HIV/AIDS epidemic. Further, we note from the study that treatment of AIDS patients may enlarge the epidemic when the treatment drugs are not 100% effective and when treated AIDS patients indulge in risky sexual behaviour. Thus, the treatment with amelioration of AIDS patients should be accompanied with intense public health educational programs, which are capable of changing the attitude of treated AIDS patients towards safe sex. It is also shown from the study that the use of condoms in settings with the treatment may help in reducing the number of secondary infections thus slowing the epidemic.

  5. Mortality in HIV-infected women, heterosexual men, and men who have sex with men in Rio de Janeiro, Brazil: an observational cohort study.

    Science.gov (United States)

    Coelho, Lara; Grinsztejn, Beatriz; Castilho, Jessica L; De Boni, Raquel; Quintana, Marcel S B; Campos, Dayse P; Ribeiro, Sayonara R; Pacheco, Antonio G; Veloso, Valdilea G; Luz, Paula M

    2016-10-01

    Mortality in HIV-infected individuals might differ by sex and mode of HIV acquisition. We aimed to study mortality in HIV-infected women, heterosexual men, and men who have sex with men (MSM) in a cohort from Rio de Janeiro, Brazil. In this observational cohort study, we included HIV-infected women, heterosexual men, and MSM (aged ≥18 years) from the Instituto Nacional de Infectologia Evandro Chagas database who were enrolled between Jan 1, 2000, and Oct 30, 2011, and who had at least 60 days of follow-up. Causes of deaths, defined with the Coding of Death in HIV protocol, were documented. Cox proportional hazards models accounting for competing risks were used to explore risk factors for AIDS-related and non-AIDS-related deaths. We had 10 142 person-years of follow-up from 2224 individuals: 817 (37%) women, 554 (25%) heterosexual men, and 853 (38%) MSM. Of 103 deaths occurred, 64 were AIDS related, 31 were non-AIDS related, and eight were of unknown causes. In unadjusted analyses, compared with women, the hazard of AIDS-related deaths was higher for heterosexual men (hazard ratio [HR] 3·52, 95% CI 1·30-9·08; p=0·009) and for MSM (2·30, 0·89-5·94; p=0·084). After adjustment for age, CD4 cell counts, last HIV viral load, antiretroviral therapy use, and AIDS-defining infection, AIDS-defining malignant disease, and hospital admission during follow-up, the excess risk of AIDS-related death decreased for heterosexual men (adjusted HR 1·99, 0·75-5·25; p=0·163) but was unchanged for MSM (2·24, 0·82-6·11; p=0·114). Non-AIDS-related mortality did not differ by group. Compared with women, increased risk of AIDS-related death in heterosexual men was partly mitigated by risk factors for AIDS mortality, whereas the excess risk in MSM was unchanged. Further study of reasons for disparity in AIDS-related mortality by mode of transmission is needed. US National Institutes of Health, Brazilian National Council of Technological and Scientific Development (CNPq

  6. The HIV epidemic in Greenland - a slow spreading infection among adult heterosexual Greenlanders

    DEFF Research Database (Denmark)

    Bjørn-Mortensen, Karen; Ladefoged, Karin; Obel, Niels

    2013-01-01

    We aimed to characterise the HIV epidemic in Greenland and to determine incidence, prevalence, mortality rates (MR) and specific causes of deaths.......We aimed to characterise the HIV epidemic in Greenland and to determine incidence, prevalence, mortality rates (MR) and specific causes of deaths....

  7. Sexual scripting of heterosexual penile-anal intercourse amongst participants in an HIV prevention trial in South Africa, Uganda and Zimbabwe

    Science.gov (United States)

    Duby, Zoe; Hartmann, Miriam; Montgomery, Elizabeth T.; Colvin, Christopher J.; Mensch, Barbara; van der Straten, Ariane

    2015-01-01

    Sexual risk-taking is influenced by individual, interpersonal and social factors. This paper presents findings from a qualitative followup study to a clinical trial evaluating biomedical HIV prevention products among African women, explored participants’ perceptions and experiences of heterosexual penile-anal intercourse, as well as the gendered power dynamics and relationship contexts in which this sexual behaviour occurs. In-depth interviews were conducted with 88 women from South Africa, Uganda and Zimbabwe. Findings reveal that despite its social stigmatisation, women engage in penile-anal intercourse for reasons including male pleasure, relationship security, hiding infidelity, menstruation, vaginal infections, money and beliefs that it will prevent HIV transmission. In addition, participants described experiences of non-consensual penile-anal intercourse. We used sexual scripting theory as an analytical framework with which to describe the sociocultural and relationship contexts and gendered power dynamics in which these practices occur. These data on the distinct individual, dyadic and social contexts of heterosexual penile-anal intercourse, and the specific factors that may contribute to women’s HIV risk, make a unique contribution to our understanding of heterosexual behaviour in these sub-Saharan countries, thereby helping to inform both current and future HIV prevention efforts for women in the region. PMID:26223703

  8. Herpes simplex virus 2 infection: A risk factor for HIV infection in heterosexuals

    Directory of Open Access Journals (Sweden)

    Anuradha K

    2008-01-01

    Full Text Available Background: Genital ulcerative disease is one of the risk factors for acquisition of HIV. As HSV-2 infection is currently the most common cause of genital ulcerative disease, it acts as a potential risk factor for HIV infection. The present study was undertaken to know the seroprevalence of antibodies to HSV-2 in HIV seropositive individuals and in the general population, and to ascertain if HSV-2 is a risk factor for developing HIV infection. Methods: The study group included one hundred new HIV seropositive persons irrespective of active genital herpes or history of genital herpes. Fifty age- and sex- matched healthy volunteers were included as controls. In all patients and controls, diagnostic serology was done for HSV-2 using HSV-2-specific glycoprotein IgG2 by indirect immunoassay using the ELISA test. Statistical value ′P′ was calculated using the Chi-squared test. Results: Out of the 100 HIV seropositives, 66 were males and 34 were females with an age range of 20-54 years. In only 22 (19 males and 3 females of these, positive history of genital herpes was obtained. In 49 out of the 100 HIV seropositives, IgG2 antibodies against HSV-2 were detected. In the control group, 11 out of 50 controls were seropositive for HSV-2 IgG2 antibody. There was a statistically significant association between HSV-2 and HIV seropositivity with ′P′ value < 0.005. Conclusion: The high prevalence of HSV-2 seropositivity in the HIV-infected group (49% as compared to normal controls (22% was statistically significant. Prior HSV-2 infection could be an important risk factor for acquisition of HIV in our patients.

  9. Mortality among HIV-infected women, heterosexual men, and men who have sex with men: insights from an observational cohort study

    Science.gov (United States)

    Coelho, Lara; Grinsztejn, Beatriz; Castilho, Jessica L.; De Boni, Raquel; Quintana, Marcel S. B.; Campos, Dayse P.; Ribeiro, Sayonara R.; Pacheco, Antonio G.; Veloso, Valdilea G.; Luz, Paula M.

    2016-01-01

    Background Mortality among HIV-infected individuals may differ by sex and mode of HIV acquisition. We studied mortality among women, heterosexual men, and men who have sex with men (MSM) in a cohort from Rio de Janeiro, Brazil. Methods HIV-infected adults followed at Instituto Nacional de Infectologia Evandro Chagas from 2000–2011 were included. Cox proportional hazards models accounting for competing risks were used to explore risk factors for AIDS and non-AIDS related deaths. Findings 2224 individuals were included (36·7%[817/2224] women, 24·9%[554/2224] heterosexual men, and 38·4%[853/2224] MSM). Throughout the study period, 103 deaths occurred: 64 due to AIDS-related causes, 31 due to non-AIDS related causes and 8 of unknown causes. In unadjusted analyses, compared to women, hazard of AIDS-related deaths was higher for heterosexual men (hazard ratio [HR] 3·52, 95% confidence interval [95%CI] 1·30–9·08) and for MSM (HR 2·30, 95%CI 0·89–5·94). After adjusting for confounders, excess risk of AIDS-related death observed for heterosexual men was attenuated (aHR 1·99, 95%CI 0·75–5·25, p-value=0.163), but unchanged for MSM (aHR 2·24, 95%CI 0·82–6·11, p-value=0.114). Non-AIDS related mortality did not differ by group. Interpretation Compared to women, increased risk of AIDS-related death among heterosexual men was partially mitigated by risk factors for AIDS mortality while excess risk observed among MSM was unchanged. Further study of reasons for AIDS-related mortality disparity by mode of transmission is needed. PMID:27658875

  10. Gender-transformative interventions to reduce HIV risks and violence with heterosexually-active men: a review of the global evidence.

    Science.gov (United States)

    Dworkin, Shari L; Treves-Kagan, Sarah; Lippman, Sheri A

    2013-11-01

    Emerging out of increased attention to gender equality within HIV and violence prevention programming has been an intensified focus on masculinities. A new generation of health interventions has attempted to shift norms of masculinity to be more gender equitable and has been termed "gender-transformative." We carried out a systematic review of gender-transformative HIV and violence prevention programs with heterosexually-active men in order to assess the efficacy of this programming. After reviewing over 2,500 abstracts in a systematic search, a total of 15 articles matched review criteria. The evidence suggests that gender-transformative interventions can increase protective sexual behaviors, prevent partner violence, modify inequitable attitudes, and reduce STI/HIV, though further trials are warranted, particularly in establishing STI/HIV impacts. In the conclusion, we discuss the promises and limitations of gender-transformative work with men and make suggestions for future research focused on HIV and/or violence prevention.

  11. Impact of targeted interventions on heterosexual transmission of HIV in India

    Directory of Open Access Journals (Sweden)

    Risbud Arun

    2011-07-01

    Full Text Available Abstract Background Targeted interventions (TIs have been a major strategy for HIV prevention in India. We evaluated the impact of TIs on HIV prevalence in high HIV prevalence southern states (Tamil Nadu, Karnataka, Andhra Pradesh and Maharashtra. Methods A quasi-experimental approach was used to retrospectively compare changes in HIV prevalence according to the intensity of targeted intervention implementation. Condom gap (number of condoms required minus condoms supplied by TIs was used as an indicator of TI intensity. Annual average number of commercial sex acts per female sex worker (FSW reported in Behavioral Surveillance Survey was multiplied by the estimated number of FSWs in each district to calculate annual requirement of condoms in the district. Data of condoms supplied by TIs from 1995 to 2008 was obtained from program records. Districts in each state were ranked into quartiles based on the TI intensity. Primary data of HIV Sentinel Surveillance was analyzed to calculate HIV prevalence reductions in each successive year taking 2001 as reference year according to the quartiles of TI intensity districts using generalized linear model with logit link and binomial distribution after adjusting for age, education, and place of residence (urban or rural. Results In the high HIV prevalence southern states, the number of TI projects for FSWs increased from 5 to 310 between 1995 and 2008. In high TI intensity quartile districts (n = 30, 186 condoms per FSW/year were distributed through TIs as compared to 45 condoms/FSW/year in the low TI intensity districts (n = 29. Behavioral surveillance indicated significant rise in condom use from 2001 to 2009. Among FSWs consistent condom use with last paying clients increased from 58.6% to 83.7% (p Conclusion Targeted interventions are associated with HIV prevalence decline.

  12. Higher rates of triple-class virological failure in perinatally HIV-infected teenagers compared with heterosexually infected young adults in Europe.

    Science.gov (United States)

    Judd, A; Lodwick, R; Noguera-Julian, A; Gibb, D M; Butler, K; Costagliola, D; Sabin, C; van Sighem, A; Ledergerber, B; Torti, C; Mocroft, A; Podzamczer, D; Dorrucci, M; De Wit, S; Obel, N; Dabis, F; Cozzi-Lepri, A; García, F; Brockmeyer, N H; Warszawski, J; Gonzalez-Tome, M I; Mussini, C; Touloumi, G; Zangerle, R; Ghosn, J; Castagna, A; Fätkenheuer, G; Stephan, C; Meyer, L; Campbell, M A; Chene, G; Phillips, A

    2017-03-01

    The aim of the study was to determine the time to, and risk factors for, triple-class virological failure (TCVF) across age groups for children and adolescents with perinatally acquired HIV infection and older adolescents and adults with heterosexually acquired HIV infection. We analysed individual patient data from cohorts in the Collaboration of Observational HIV Epidemiological Research Europe (COHERE). A total of 5972 participants starting antiretroviral therapy (ART) from 1998, aged start of ART for those with perinatal infection and 15-29 years for those with heterosexual infection, with ART containing at least two nucleoside reverse transcriptase inhibitors (NRTIs) and a nonnucleoside reverse transcriptase inhibitor (NNRTI) or a boosted protease inhibitor (bPI), were followed from ART initiation until the most recent viral load (VL) measurement. Virological failure of a drug was defined as VL > 500 HIV-1 RNA copies/mL despite ≥ 4 months of use. TCVF was defined as cumulative failure of two NRTIs, an NNRTI and a bPI. The median number of weeks between diagnosis and the start of ART was higher in participants with perinatal HIV infection compared with participants with heterosexually acquired HIV infection overall [17 (interquartile range (IQR) 4-111) vs. 8 (IQR 2-38) weeks, respectively], and highest in perinatally infected participants aged 10-14 years [49 (IQR 9-267) weeks]. The cumulative proportion with TCVF 5 years after starting ART was 9.6% [95% confidence interval (CI) 7.0-12.3%] in participants with perinatally acquired infection and 4.7% (95% CI 3.9-5.5%) in participants with heterosexually acquired infection, and highest in perinatally infected participants aged 10-14 years when starting ART (27.7%; 95% CI 13.2-42.1%). Across all participants, significant predictors of TCVF were those with perinatal HIV aged 10-14 years, African origin, pre-ART AIDS, NNRTI-based initial regimens, higher pre-ART viral load and lower pre-ART CD4. The results

  13. Child Sexual Abuse and Negative Affect as Shared Risk Factors for Sexual Aggression and Sexual HIV Risk Behavior in Heterosexual Men.

    Science.gov (United States)

    Peterson, Zoё D; Janssen, Erick; Goodrich, David; Fortenberry, J Dennis; Hensel, Devon J; Heiman, Julia R

    2017-10-31

    Previous research has suggested that sexually aggressive behavior and sexual HIV risk behavior are associated. Childhood sexual abuse (CSA) is a well-established risk factor for both types of problematic sexual behavior. Negative affect (i.e., anxiety, depression, and anger) is a less well-studied risk factor, but it has been theorized to relate to both sexual aggression and HIV risk behavior. Thus, this study sought to (1) confirm the relationship between sexual aggression and HIV risk behavior, (2) establish CSA and negative affect as shared risk factors for sexual aggression and HIV risk behavior, and (3) evaluate whether negative affect mediates the relationship between CSA and sexual aggression and between CSA and HIV sexual risk in a sample of heterosexual men. We recruited 18- to 30-year-old heterosexual men (N = 377) from urban sexually transmitted infection clinics. Men completed measures of sexual HIV risk history (number of partners and condom use), sexual aggression history, CSA history, and trait negative affect (anger, anxiety, and depression). Structural equation modeling was used to examine hypothesized direct and indirect relationships. In the final SEM model, sexual aggression history and sexual HIV risk behavior were correlated. CSA was associated with both types of problematic sexual behavior. Anxiety significantly mediated the relationship between CSA and sexual aggression and between CSA and sexual HIV risk behavior (χ 2[1300] = 2121.79, p Sexual aggression appears to be part of a constellation of sexual risk behaviors; thus, it may be possible to develop prevention programs that target both sexual HIV risk and sexual aggression. CSA is a shared risk factor for sexual aggression and HIV risk behavior through the pathway of anxiety. Thus, anxiety might be one promising target for intervention.

  14. Strategies to prevent HIV transmission among heterosexual African-American women

    Directory of Open Access Journals (Sweden)

    Peters Ronald J

    2005-03-01

    Full Text Available Abstract Background African-American women are disproportionately affected by HIV, accounting for 60% of all cases among women in the United States. Although their race is not a precursor for HIV, the socioeconomic and cultural disparities associated with being African American may increase their risk of infection. Prior research has shown that interventions designed to reduce HIV infection among African-American women must address the life demands and social problems they encounter. The present study used a qualitative exploratory design to elicit information about strategies to prevent HIV transmission among young, low-income African-American women. Methods Twenty five low income African American women, ages 18–29, participated in five focus groups of five women each conducted at a housing project in Houston, Texas, a large demographically diverse metropolitan area that is regarded as one of the HIV/AIDS epicenters in the United States. Each group was audiotaped, transcribed, and analyzed using theme and domain analysis. Results The participants revealed that they had most frequently placed themselves at risk for HIV infection through drugs and drinking and they also reported drug and alcohol use as important barriers to practicing safer sex. The women also reported that the need for money and having sex for money to buy food or drugs had placed them at risk for HIV transmission. About one-third of the participants stated that a barrier to their practicing safe sex was their belief that there was no risk based on their being in a monogamous relationship and feeling no need to use protection, but later learning that their mate was unfaithful. Other reasons given were lack of concern, being unprepared, partner's refusal to use a condom, and lack of money to buy condoms. Finally, the women stated that they were motivated to practice safe sex because of fear of contracting sexually transmitted diseases and HIV, desire not to become pregnant, and

  15. Impact of targeted interventions on heterosexual transmission of HIV in India.

    Science.gov (United States)

    Kumar, Rajesh; Mehendale, Sanjay M; Panda, Samiran; Venkatesh, S; Lakshmi, Pvm; Kaur, Manmeet; Prinja, Shankar; Singh, Tarundeep; Virdi, Navkiran K; Bahuguna, Pankaj; Sharma, Arun K; Singh, Samiksha; Godbole, Sheela V; Risbud, Arun; Manna, Boymkesh; Thirumugal, V; Roy, Tarun; Sogarwal, Ruchi; Pawar, Nilesh D

    2011-07-11

    Targeted interventions (TIs) have been a major strategy for HIV prevention in India. We evaluated the impact of TIs on HIV prevalence in high HIV prevalence southern states (Tamil Nadu, Karnataka, Andhra Pradesh and Maharashtra). A quasi-experimental approach was used to retrospectively compare changes in HIV prevalence according to the intensity of targeted intervention implementation. Condom gap (number of condoms required minus condoms supplied by TIs) was used as an indicator of TI intensity. Annual average number of commercial sex acts per female sex worker (FSW) reported in Behavioral Surveillance Survey was multiplied by the estimated number of FSWs in each district to calculate annual requirement of condoms in the district. Data of condoms supplied by TIs from 1995 to 2008 was obtained from program records. Districts in each state were ranked into quartiles based on the TI intensity. Primary data of HIV Sentinel Surveillance was analyzed to calculate HIV prevalence reductions in each successive year taking 2001 as reference year according to the quartiles of TI intensity districts using generalized linear model with logit link and binomial distribution after adjusting for age, education, and place of residence (urban or rural). In the high HIV prevalence southern states, the number of TI projects for FSWs increased from 5 to 310 between 1995 and 2008. In high TI intensity quartile districts (n = 30), 186 condoms per FSW/year were distributed through TIs as compared to 45 condoms/FSW/year in the low TI intensity districts (n = 29). Behavioral surveillance indicated significant rise in condom use from 2001 to 2009. Among FSWs consistent condom use with last paying clients increased from 58.6% to 83.7% (p < 0.001), and among men of reproductive age, the condom use during sex with non-regular partner increased from 51.7% to 68.6% (p < 0.001). A significant decline in HIV and syphilis prevalence has occurred in high prevalence southern states among FSWs and

  16. Heterosexual transmission of HIV in the Dominican Republic: gendered indicators are associated with disparities in condom use.

    Science.gov (United States)

    Jimenez, Michelle M; Andrade, Flavia C D; Raffaelli, Marcela; Iwelunmor, Juliet

    2015-11-23

    Gendered dynamics in heterosexual relationships compromise women's self-efficacy and increase their vulnerability to acquiring HIV. This study examines the impact of socioeconomic determinants, media exposure, and sexual expectations on sexual behaviors of men and women in the Dominican Republic (DR). We analyzed cross-sectional data from 51,018 adults in the Dominican Republic age 15 to 45 years collected by the Demographics and Health Survey (DHS) in 2007. Measures included demographic and socioeconomic indicators, social exposures, sexual expectations and sexual behaviors. Logistic regression models explored gender differences in condom use. Study findings indicated that women were less likely to use a condom at last intercourse than men (odds ratio [OR] = 0.29; 95 % CI = 0.27, 0.31). Among men, secondary (OR = 1.43; 95 % CI = 1.16, 1.76) and higher education (OR = 1.58; 95 % CI = 1.25, 2.00), being in the richest quintile (OR = 1.25; 95 % CI = 1.07, 1.47), and living in a female-headed household (OR = 1.13; 95 % CI 1.03, 1.23) increased the likelihood of condom use. Compared to never married men, currently and formerly married men were less likely to use condoms (OR = 0.03; 95 % CI = 0.03, 0.04 and OR = 0.67; 95 % CI = 0.60, 0.75, respectively). The odds of condom use increased for young women 15-19 years old in comparison with women age 30-34 years, but decreased as they grew older. For women, being in the richer quintile (OR = 1.28; 95 % CI = 1.06, 1.54), living in a female-headed household (OR = 1.26; 1.12, 1.41), and having good access to media (OR = 1.24; 95 % CI = 1.12, 1.42) increased the likelihood of condom use. Being currently married or formerly married and living in rural areas decreased such likelihood among women. Study findings provide evidence that, in the DHS, socioeconomic and cultural differences between men and women affects condom use. Efforts to reduce HIV transmission

  17. Sexuality, gendered identities and exclusion: the deployment of proper (hetero)sexuality within an HIV-prevention text from South Africa.

    Science.gov (United States)

    Gacoin, Andrée

    2010-05-01

    HIV prevention discourses concern lives, the protection of bodily rights and people's active involvement in the policies and programmes that affect them. HIV prevention discourses also create lives, relying upon the deployment of normative sexual identities at the same time as they invite complex and fluid youth identities to embody the norms of prevention. This paper examines a particular HIV prevention text that is available to teachers in the Western Cape province of South Africa to support the implementation of the national Life Orientation programme. Rather than considering this text as a neutral 'scaffold' upon which teachers and students add cultural meanings, it is important to interrogate the ways in which texts rely upon and reiterate particular discursive constructions of the youth sexual subject. This paper argues that the text deploys a particular discursive framework in order to construct a 'normal' (and hetero) sexuality that validates, rather than questions, social constructions of masculine privilege within heterosexuality. This is achieved through the deployment of a scientific expertise of sexuality; the mobilisation of a valued hetero/homosexual binary to create a 'safe' heterosexuality; the normalisation of bourgeois sexuality through the ideology of marriage; and the naturalisation of heterosexual masculine and feminine identities.

  18. HIV-1 transmission linkage in an HIV-1 prevention clinical trial

    Energy Technology Data Exchange (ETDEWEB)

    Leitner, Thomas [Los Alamos National Laboratory; Campbell, Mary S [UNIV OF WASHINGTON; Mullins, James I [UNIV OF WASHINGTON; Hughes, James P [UNIV OF WASHINGTON; Wong, Kim G [UNIV OF WASHINGTON; Raugi, Dana N [UNIV OF WASHINGTON; Scrensen, Stefanie [UNIV OF WASHINGTON

    2009-01-01

    HIV-1 sequencing has been used extensively in epidemiologic and forensic studies to investigate patterns of HIV-1 transmission. However, the criteria for establishing genetic linkage between HIV-1 strains in HIV-1 prevention trials have not been formalized. The Partners in Prevention HSV/HIV Transmission Study (ClinicaITrials.gov NCT00194519) enrolled 3408 HIV-1 serodiscordant heterosexual African couples to determine the efficacy of genital herpes suppression with acyclovir in reducing HIV-1 transmission. The trial analysis required laboratory confirmation of HIV-1 linkage between enrolled partners in couples in which seroconversion occurred. Here we describe the process and results from HIV-1 sequencing studies used to perform transmission linkage determination in this clinical trial. Consensus Sanger sequencing of env (C2-V3-C3) and gag (p17-p24) genes was performed on plasma HIV-1 RNA from both partners within 3 months of seroconversion; env single molecule or pyrosequencing was also performed in some cases. For linkage, we required monophyletic clustering between HIV-1 sequences in the transmitting and seroconverting partners, and developed a Bayesian algorithm using genetic distances to evaluate the posterior probability of linkage of participants sequences. Adjudicators classified transmissions as linked, unlinked, or indeterminate. Among 151 seroconversion events, we found 108 (71.5%) linked, 40 (26.5%) unlinked, and 3 (2.0%) to have indeterminate transmissions. Nine (8.3%) were linked by consensus gag sequencing only and 8 (7.4%) required deep sequencing of env. In this first use of HIV-1 sequencing to establish endpoints in a large clinical trial, more than one-fourth of transmissions were unlinked to the enrolled partner, illustrating the relevance of these methods in the design of future HIV-1 prevention trials in serodiscordant couples. A hierarchy of sequencing techniques, analysis methods, and expert adjudication contributed to the linkage

  19. Hybrid STTR intervention for heterosexuals using anonymous HIV testing and confidential linkage to care: a single arm exploratory trial using respondent-driven sampling.

    Science.gov (United States)

    Gwadz, Marya; Cleland, Charles M; Leonard, Noelle R; Kutnick, Alexandra; Ritchie, Amanda S; Banfield, Angela; Hagan, Holly; Perlman, David C; McCright-Gill, Talaya; Sherpa, Dawa; Martinez, Belkis Y

    2015-11-16

    An estimated 14 % of the 1.2 million individuals living with HIV in the U.S. are unaware of their status. Yet this modest proportion of individuals with undiagnosed HIV is linked to 44-66 % of all new infections. Thus innovative intervention approaches are needed to seek out and test those with undiagnosed HIV, and link them to HIV treatment with high retention, an approach referred to as "Seek, Test, Treat, and Retain" (STTR). The present protocol describes a creative "hybrid" STTR approach that uses anonymous HIV testing followed by confidential care linkage, focused on heterosexuals at high risk (HHR) for HIV, who do not test as frequently as, and are diagnosed later, than other risk groups. This is a single-arm exploratory intervention efficacy trial. The study has two phases: one to seek out and test HHR, and another to link those found infected to HIV treatment in a timely fashion, with high retention. We will recruit African American/Black and Latino adult HHR who reside in urban locations with high poverty and HIV prevalence. Participants will be recruited with respondent-driven sampling, a peer recruitment method. The "Seek and Test" phase is comprised of a brief, convenient, single-session, anonymous HIV counseling and testing session. The "Treat and Retain" component will engage those newly diagnosed with HIV into a confidential research phase and use a set of procedures called care navigation to link them to HIV primary care. Participants will be followed for 6 months with objective assessment of outcomes (using medical records and biomarkers). Undiagnosed HIV infection is a major public health problem. While anonymous HIV testing is an important part of the HIV testing portfolio, it does not typically include linkage to care. The present study has potential to produce an innovative, brief, cost-effective, and replicable STTR intervention, and thereby reduce racial/ethnic disparities in HIV/AIDS. ClinicalTrials.gov, NCT02421159 , Registered April 15

  20. Human Immunodeficiency Virus (HIV) Testing and False Disclosures in Heterosexual College Students

    Science.gov (United States)

    Marelich, William D.; Clark, Tonya

    2004-01-01

    The authors assessed factors that motivate individuals to report negative human immunodeficiency virus (HIV) antibody test results, although they had never been tested. In particular, they investigated sexual intimacy motives associated with the needs for affiliation, sex, and dominance as contributing factors for faulty disclosures. Participants…

  1. Binge Use and Sex and Drug Use Behaviors among HIV(−), Heterosexual Methamphetamine Users in San Diego

    OpenAIRE

    Cheng, W. Susan; Richard S. Garfein; Semple, Shirley J.; Steffanie A Strathdee; Zians, James K.; Patterson, Thomas L.

    2010-01-01

    This study identified sociodemographic factors, drug using practices, sexual behaviors, and motivational factors associated with binge (a period of uninterrupted) methamphetamine (MA) use among heterosexual MA users.

  2. Sexual practices of people living with HIV in South Eastern Nigeria.

    Science.gov (United States)

    Ikechebelu, J; Mbamara, S U; Joe-Ikechebebelu, N N; Ezenwabachili, A O

    2009-12-01

    Couples could be in serodiscordant or seroconcordant sexual relationship. The seroconcordant could be seroconcrdant positive or negative in a heterosexual or homosexual or bisexual relationship. The various sexual practices include vaginal sex; anal sex fisting; oral sex fellatio, cunnilingus; masturbation mutual or exclusive and a host of others. These sexual practices outside safer sex guidelines will lead to HIV transmission among couples. The study is set to determine the sexual practices of people living with HIV (PLWHA) in Southeast Nigeria. This is an analytical epidemiological study. A total of 300 subjects were studied using interviewer administered questionnaires. Data is presented in tables and figures. Analysis was done using SPSS 11.0 statistical package. Most respondents were in heterosexual relationship (97%). The married couples in serodiscordant relationship were 25.3% while the singles in serodiscordant relationship were 20%. About 56% do not use condom for the adopted sexual practice although 65% believe that condom use would protect against HIV transmission. Couples in seroconcordant seronegative relationship have it as a challenge to remain so. This study suggests that the PLWHA are very important in the spread of HIV infection as they are still sexually active, in non-cohabiting conjugal unstable relationship, and they do not use the condom consistently. There is an urgent need to target this population with effective behavioural change communications that will translate to safer sexual behaviour. The practice of safer sex should be taught in every health care center, in schools and in village gatherings by qualified health care workers. This will help curb the transmission of HIV.

  3. Preexposure prophylaxis is efficacious for HIV-1 prevention among women using depot medroxyprogesterone acetate for contraception.

    Science.gov (United States)

    Heffron, Renee; Mugo, Nelly; Were, Edwin; Kiarie, James; Bukusi, Elizabeth A; Mujugira, Andrew; Frenkel, Lisa M; Donnell, Deborah; Ronald, Allan; Celum, Connie; Baeten, Jared M

    2014-11-28

    To evaluate preexposure prophylaxis (PrEP) efficacy for HIV-1 prevention among women using depot medroxyprogesterone acetate (DMPA) for contraception and men whose HIV-1-infected partners use DMPA. Secondary analysis of data from a randomized placebo-controlled trial of daily oral tenofovir and emtricitabine/tenofovir PrEP among heterosexual Kenyan and Ugandan HIV-1 serodiscordant couples. PrEP efficacy for HIV-1 prevention was compared among HIV-1-uninfected women using DMPA versus no hormonal contraception and among HIV-1 uninfected men whose HIV-1-infected female partners used DMPA versus no hormonal contraception. Of 4747 HIV-1 serodiscordant couples, 901 HIV-1-uninfected women used DMPA at some point during follow-up, 1422 HIV-1-uninfected women used no hormonal contraception, 1568 HIV-1-uninfected men had female partners who used DMPA, and 2626 men had female partners who used no hormonal contraception. PrEP efficacy estimates for HIV-1 prevention, compared with placebo, were similar among women using DMPA and those using no hormonal contraception (64.7 and 75.5%, adjusted interaction P = 0.65). Similarly, for men whose female partners used DMPA, PrEP efficacy did not differ from men whose partners used no hormonal contraception (90.0 versus 81.7%, adjusted interaction P = 0.52). PrEP is efficacious for HIV-1 prevention among women using DMPA and men whose partners use DMPA, suggesting PrEP could mitigate the potential increased HIV-1 acquisition and transmission risks that have been associated with DMPA use. Women at risk for HIV-1 choosing DMPA could maintain this contraceptive method and add PrEP to achieve prevention of unintended pregnancy and HIV-1.

  4. Viral linkage in HIV-1 seroconverters and their partners in an HIV-1 prevention clinical trial.

    Directory of Open Access Journals (Sweden)

    Mary S Campbell

    2011-03-01

    Full Text Available Characterization of viruses in HIV-1 transmission pairs will help identify biological determinants of infectiousness and evaluate candidate interventions to reduce transmission. Although HIV-1 sequencing is frequently used to substantiate linkage between newly HIV-1 infected individuals and their sexual partners in epidemiologic and forensic studies, viral sequencing is seldom applied in HIV-1 prevention trials. The Partners in Prevention HSV/HIV Transmission Study (ClinicalTrials.gov #NCT00194519 was a prospective randomized placebo-controlled trial that enrolled serodiscordant heterosexual couples to determine the efficacy of genital herpes suppression in reducing HIV-1 transmission; as part of the study analysis, HIV-1 sequences were examined for genetic linkage between seroconverters and their enrolled partners.We obtained partial consensus HIV-1 env and gag sequences from blood plasma for 151 transmission pairs and performed deep sequencing of env in some cases. We analyzed sequences with phylogenetic techniques and developed a Bayesian algorithm to evaluate the probability of linkage. For linkage, we required monophyletic clustering between enrolled partners' sequences and a Bayesian posterior probability of ≥ 50%. Adjudicators classified each seroconversion, finding 108 (71.5% linked, 40 (26.5% unlinked, and 3 (2.0% indeterminate transmissions, with linkage determined by consensus env sequencing in 91 (84%. Male seroconverters had a higher frequency of unlinked transmissions than female seroconverters. The likelihood of transmission from the enrolled partner was related to time on study, with increasing numbers of unlinked transmissions occurring after longer observation periods. Finally, baseline viral load was found to be significantly higher among linked transmitters.In this first use of HIV-1 sequencing to establish endpoints in a large clinical trial, more than one-fourth of transmissions were unlinked to the enrolled partner

  5. Percepções de alunas de graduação em enfermagem sobre parcerias sorodiscordantes para o HIV/AIDS Percepciones de alumnos de enfermería sobre parejas serodiscordantes para el VIH/SIDA Nursing students' perceptions on HIV serodiscordant partnerships

    Directory of Open Access Journals (Sweden)

    Hugo Fernandes

    2005-08-01

    nursing students' perceptions on mixed-HIV-status couples. Social Representation Theory was used to get to know how the students feel, think and act towards HIV/aids serodiscordance. Six fourth-year nursing students were interviewed. Participants were between 20 and 26 years old. The "Projective Thematic Drawing" and a structure interview were used for data collection. Data were analyzed by means of "Thematic Content Analysis". The obtained data revealed the students' perceptions on serodiscordant couples. This study triggered future reflections/discussions on health education for mixed-HIV-status couples and nursing care.

  6. Economic evaluations of adult male circumcision for prevention of heterosexual acquisition of HIV in men in sub-Saharan Africa: a systematic review.

    Directory of Open Access Journals (Sweden)

    Olalekan A Uthman

    Full Text Available BACKGROUND: There is conclusive evidence from observational data and three randomized controlled trials that circumcised men have a significantly lower risk of becoming infected with the human immunodeficiency virus (HIV. The aim of this study was to systematically review economic evaluations on adult male circumcision (AMC for prevention of heterosexual acquisition of HIV in men. METHODS AND FINDINGS: Studies were identified from the following bibliographic databases: MEDLINE (Ovid, EMBASE (Ovid, Cochrane Library (Wiley's internet version, NHS EED and DARE Office of Health Economics HEED. The searches were conducted in November 2009. The Drummond 10-point checklist was used for methodological critique of the economic evaluations. Cost data were inflated and converted to 2008 US dollars (US$. Of 264 identified papers, only five met the inclusion criteria and were included in the review. The studies were published between 2006 and 2009. Most of the studies were carried out from the perspective of government healthcare payer. The time horizon ranged from 10 to 20 years. All studies reported that AMC is cost-effective. The reported cost per HIV infection averted ranged from US$174 to US$2808. The key driver of the cost-effectiveness models was circumcision efficacy. CONCLUSIONS: All published economic evaluations offered the same conclusion that AMC is cost-effective and potentially cost-saving for prevention of heterosexual acquisition of HIV in men. On these grounds, AMC may be seen as a promising new form of strategy for prevention of HIV and should be implemented in conjunction with other evidence-based prevention methods.

  7. Heterosexual Partnerships and the Need for HIV Prevention and Testing for Men Who Have Sex With Men and Women in China: A Qualitative Study.

    Science.gov (United States)

    Wang, Sijia; Song, Dandan; Huang, Wen; He, Huan; Wang, Min; Manning, David; Zaller, Nickolas; Zhang, Hongbo; Operario, Don

    2015-04-01

    Previous studies have reported that approximately 30% of men who have sex with men (MSM) in China have concurrent female partners. Men who have sex with men and women (MSMW) might "bridge" HIV transmission to their female sex partners. This study aimed to explore (a) motivations for why MSMW in China engage in relationships and sexual behaviors with female partners; (b) patterns of sexual behaviors and condom use between MSMW and their female partners; and (c) barriers to and strategies for encouraging MSMW and their female partners to undergo HIV testing. The authors conducted in-depth interviews with 30 MSMW in two urban cities in China, Guangzhou and Chengdu, and used thematic analysis methods to code and interpret the data. MSMW described family, social, and workplace pressures to have a female partner, and expressed futility about their ability to form stable same-sex relationships. Although participants reported concern about the risk of personally acquiring and transmitting HIV or other sexually transmitted infections (STIs) to their female partners, they described the challenges to using condoms with female partners. HIV-positive participants described how stigma restricted their ability to disclose their HIV status to female partners, and HIV-negative participants displayed less immediate concern about the need for female partners to undergo HIV testing. Participants described a range of possible strategies to encourage HIV testing among female partners. These findings highlight the urgent need for HIV risk reduction and testing interventions for Chinese MSMW in the context of heterosexual partnerships, and they also underscore the additional need for privacy and cultural sensitivity when designing future studies.

  8. Prevalence of Chlamydia trachomatis infection in women, heterosexual men and MSM visiting HIV counselling institutions in North Rhine-Westphalia, Germany - should Chlamydia testing be scaled up?

    Directory of Open Access Journals (Sweden)

    Anne Lallemand

    2016-10-01

    Full Text Available Abstract Background Patients asking for a free anonymous HIV test may have contracted other sexually transmitted infections (STIs such as Chlamydia trachomatis, yet Chlamydia prevalence in that population is unknown. This study aimed to assess the prevalence and factors associated with Chlamydia infection in patients seeking HIV testing at local public health authorities (LPHA in order to evaluate whether Chlamydia testing should be routinely offered to them. Methods We conducted a cross-sectional study among patients (≥18 years attending 18 LPHA in North Rhine-Westphalia from November 2012 to September 2013. LPHA collected information on participants’ socio-demographic characteristics, sexual and HIV testing behaviours, previous STI history and clinical symptoms. Self-collected vaginal swabs and urine (men were analysed by Transcription-Mediated Amplification. We assessed overall and age-stratified Chlamydia prevalence and 95 % confidence intervals (95 % CI. Using univariate and multivariable binomial regression, we estimated adjusted prevalence ratios (aPR to identify factors associated with Chlamydia infection. Results The study population comprised 1144 (40.5 % women, 1134 (40.1 % heterosexual men and 549 (19.4 % men who have sex with men (MSM; median age was 30 years. Chlamydia prevalence was 5.3 % (95 % CI: 4.1–6.8 % among women, 3.2 % (95 % CI: 2.2–4.4 in heterosexual men and 3.5 % (95 % CI: 2.1–5.4 in MSM. Prevalence was highest among 18–24 year-old women (9 %; 95 % CI: 5.8–13 and heterosexual men (5.7 %; 95 % CI: 3.0–9.8 %, respectively. Among MSM, the prevalence was highest among 30–39 year-olds (4.4 %; 95 % CI: 1.9–8.5 %. Among those who tested positive, 76.7 % of women, 75.0 % of heterosexual men and 84.2 % of MSM were asymptomatic. Among women, factors associated with Chlamydia infection were young age (18–24 years versus ≥ 40 years, aPR: 3.0, 95 % CI: 1.2–7.8, having had more than 2

  9. Masculinidade e vulnerabilidade ao HIV de homens heterossexuais, São Paulo, SP Masculinity and vulnerability to HIV among heterosexual men in São Paulo, Brazil

    Directory of Open Access Journals (Sweden)

    Iara Guerriero

    2002-08-01

    Full Text Available OBJETIVO: Identificar aspectos da masculinidade relacionados à vulnerabilidade dos homens à infecção pelo HIV. MÉTODOS: Pesquisa qualitativa realizada com homens motoristas de ônibus e integrantes de uma Comissão Interna de Prevenção de Acidentes (Cipa em uma empresa de transportes coletivos na cidade de São Paulo, SP. Foram gravadas e transcritas dez entrevistas individuais e quatro oficinas de sexo seguro. Seu conteúdo foi disposto e discutido em blocos temáticos relacionados à sexualidade, à infidelidade, ao preservativo, às doenças sexualmente transmissíveis e à Aids. RESULTADOS: São aspectos que tornam os homens mais vulneráveis: sentir-se forte, imune a doenças; ser impetuoso, correr riscos; ser incapaz de recusar uma mulher; considerar que o homem tem mais necessidade de sexo do que a mulher e de que esse desejo é incontrolável. A infidelidade masculina é considerada natural; a feminina é atribuída a deficiências do parceiro. A decisão por usar ou não camisinha é feita pelo homem; a mulher só pode solicitá-la para evitar gravidez. A não-utilização da camisinha é atribuída a: estética, alto custo, medo de perder a ereção, perda de sensibilidade no homem e na mulher. Os entrevistados não se consideram vulneráveis ao HIV nem a doenças sexualmente transmissíveis (DST e confundem suas formas de transmissão. CONCLUSÕES: A idéia de que ser homem é ser um bom provedor para a família e ter responsabilidade pode constituir um aspecto que favoreça a prevenção, já que pode levá-los a usar camisinha como contraceptivo e para não trazer doenças para casa. É importante conhecer e intervir sobre as concepções de masculinidade, não só porque elas podem contribuir para aumento da vulnerabilidade ao HIV, mas também porque podem apontar caminhos mais efetivos para a prevenção.OBJECTIVE: To identify aspects of masculinity that could be associated with vulnerability to HIV among heterosexual men

  10. Working "upstream": why we shouldn't use heterosexual women as health promotion change agents in HIV-prevention interventions aimed at heterosexual men.

    Science.gov (United States)

    Drake, Carly; Gahagan, Jacqueline

    2015-01-01

    The use of cognitive-behavioral interventions that aim to improve men's health-seeking behaviors via women-a trend that grows increasingly troublesome as gender inequality persists-cannot address the deep-seated social, economic, and political inequalities contributing to the spread of HIV/AIDS, such as sexism and poverty. Such methods often rely on generalizations about men and women and regard female empowerment as a key goal, despite employing shaky definitions of the concept. Here we use the principles of health promotion, particularly determinants of health, to reflect upon and critique current interventions and present alternative programming models that engage both men and women in changing men's health-seeking behaviors and working "upstream" rather than "downstream" of the epidemic.

  11. Vulnerabilidade ao HIV/AIDS e a prevenção da transmissão sexual entre casais sorodiscordantes Vulnerabilidad al VIH/SIDA y la prevención de la transmisión sexual entre parejas donde solo un sujeto está contaminado por el VIH Vulnerability and prevention of sexual HIV transmission among HIV/AIDS serodiscordant couples

    Directory of Open Access Journals (Sweden)

    Renata Karina Reis

    2009-09-01

    influencia en la manutención del sexo seguro son factores de vulnerabilidad para el compañero sexual no contaminado. Los servicios especializados en la atención a individuos con VIH/SIDA necesitan incluir al compañero sexual en las acciones educativas/preventivas promovidas por los profesionales de la salud.This exploratory, descriptive study aimed to describe and analyze the vulnerability of HIV serodiscordant couples. The research was developed at an Aids Outpatient Service in a city in the State of Sao Paulo. Data were collected through individual interviews with 11 HIV/AIDS carriers who had a known serodiscordant partner. Prose analysis was applied for data organization and analyses, and the concept of vulnerability was used as a theoretical reference. The naturalization of HID/AIDS related to an undetectable viral load, the invulnerability feeling that stems from the time spent together by the couple, and its influence in the maintenance of safe sex are vulnerability factors for seronegative sexual partners. Specialized services to assist HIV/AIDS carriers need to include sexual partners in actions promoted by healthcare professionals targeting prevention and/or education.

  12. Sorodiscordância na atenção às pessoas com HIV/AIDS: implicações para o enfermeiro Serodiscordance in care for people with HIV/AIDS: implications for nurses

    Directory of Open Access Journals (Sweden)

    Vinicius Lino de Souza Neto

    2016-10-01

    Full Text Available Objetivo: analisar a produção científica sobre a prática sexual em casais sorodiscordantes e destacar as implicações para a prática do enfermeiro. Método: trata-se de uma revisão integrativa realizada nas bases de dados da Biblioteca Virtual em Saúde, Lilacs, SciELO, PubMED, CINAHL, sendo selecionados 12 artigos que atenderam aos critérios de inclusão, publicados de 2009 a 2014. Resultados: a maioria dos artigos foram publicados por enfermeiros em 2011 e 2013 nas revistas Caderno de Saúde Pública, Temas em Psicologia e Revista da Escola de Enfermagem USP; sendo prevalente o descritor, casamento. As publicações foram agrupadas em duas categorias temáticas: Práticas sexuais após o diagnóstico do HIV; e Sorodiscordância na vida afetivo-sexual de portadores do HIV/AIDS: implicações para o enfermeiro. Conclusões: ações de enfermagem pautadas na orientação sexual contribuam para melhorar a qualidade de vida dos sorodiscordantes.

  13. Low HIV-testing rates and awareness of HIV infection among high-risk heterosexual STI clinic attendees in The Netherlands

    NARCIS (Netherlands)

    van der Bij, Akke K.; Dukers, Nicole H. T. M.; Coutinho, Roel A.; Fennema, Han S. A.

    2008-01-01

    OBJECTIVES: Since 1999, HIV testing is routinely offered to all attendees of the sexually transmitted infections (STI) outpatient clinic in Amsterdam, the Netherlands. This study evaluates whether this more active HIV-testing policy increased uptake of HIV testing and awareness of an HIV-positive

  14. Relation between HIV viral load and infectiousness: a model-based analysis.

    Science.gov (United States)

    Wilson, David P; Law, Matthew G; Grulich, Andrew E; Cooper, David A; Kaldor, John M

    2008-07-26

    A consensus statement released on behalf of the Swiss Federal Commission for HIV/AIDS suggests that people receiving effective antiretroviral therapy-ie, those with undetectable plasma HIV RNA (<40 copies per mL)-are sexually non-infectious. We analysed the implications of this statement at a population level. We used a simple mathematical model to estimate the cumulative risk of HIV transmission from effectively treated HIV-infected patients (HIV RNA <10 copies per mL) over a prolonged period. We investigated the risk of unprotected sexual transmission per act and cumulatively over many exposures, within couples initially discordant for HIV status. Assuming that each couple had 100 sexual encounters per year, the cumulative probability of transmission to the serodiscordant partner each year is 0.0022 (uncertainty bounds 0.0008-0.0058) for female-to-male transmission, 0.0043 (0.0016-0.0115) for male-to-female transmission, and 0.043 (0.0159-0.1097) for male-to-male transmission. In a population of 10 000 serodiscordant partnerships, over 10 years the expected number of seroconversions would be 215 (80-564) for female-to-male transmission, 425 (159-1096) for male-to-female transmission, and 3524 (1477-6871) for male-to-male transmission, corresponding to an increase in incidence of four times compared with incidence under current rates of condom use. Our analyses suggest that the risk of HIV transmission in heterosexual partnerships in the presence of effective treatment is low but non-zero and that the transmission risk in male homosexual partnerships is high over repeated exposures. If the claim of non-infectiousness in effectively treated patients was widely accepted, and condom use subsequently declined, then there is the potential for substantial increases in HIV incidence. Australian Research Council.

  15. Predictors of bisexual behaviour among MSM attending intervention sites may help in prevention interventions for this bridge to the heterosexual epidemic in India: data from HIV sentinel surveillance.

    Directory of Open Access Journals (Sweden)

    Sheela Godbole

    Full Text Available Indian cultural tradition demanding marriage, many MSM howsoever they self-identify are likely to be married or have sex with women. To consolidate India's HIV prevention gains, it is important to understand and address the interaction between the MSM and heterosexual epidemics in India and create specific interventions for bisexual MSM. The challenge is to identify and intervene this hard to reach population. Data from HIV Sentinel Surveillance 2011 among MSM in four Indian states were analyzed to assess predictors and prevalence of bisexual behaviour in MSM.Between March-May 2011, 4682 men (15-49 years who had anal/oral sex with a male partner in the past month, attending intervention sites and consenting for an un-linked anonymous survey answered an 11- item questionnaire and provided blood for HIV test by finger stick at 19 designated surveillance sites.Of 4682 MSM tested overall, 5% were illiterate, 51% reported only receptive anal intercourse, 21% only penetrative and 28% both. 36% MSM had ever received money for sex. Overall 6.8% were HIV infected. 44% MSM were bisexual in the last six months. On multivariate analysis, 'being bisexual' was found to be independently associated with 'older age': 26-30 years [AOR = 3.1, 95% CI(2.7, 3.7], >30 years [AOR = 6.5, 95% CI(5.5, 7.7]; 'reporting penetrative behaviour alone' with other men [AOR = 5.8, 95% CI(4.8, 7.0, p<0.01] and 'reporting both penetrative and receptive behaviour' [AOR = 2.7, 95% CI(2.3, 3.1 p<0.01]. Those who both paid and received money for sex [AOR = 0.49, 95% CI (0.38, 0.62] were significantly less likely to be bisexual.A substantial proportion of men receiving services from Targeted Intervention programs are bisexual and the easy opportunity for intervention in this setting should be capitalised upon. Focusing on older MSM, as well as MSM who show penetrative behaviour with other men, could help in reaching this population.

  16. Gender and sexuality: emerging perspectives from the heterosexual epidemic in South Africa and implications for HIV risk and prevention

    Directory of Open Access Journals (Sweden)

    Jewkes Rachel

    2010-02-01

    Full Text Available Abstract Research shows that gender power inequity in relationships and intimate partner violence places women at enhanced risk of HIV infection. Men who have been violent towards their partners are more likely to have HIV. Men's behaviours show a clustering of violent and risky sexual practices, suggesting important connections. This paper draws on Raewyn Connell's notion of hegemonic masculinity and reflections on emphasized femininities to argue that these sexual, and male violent, practices are rooted in and flow from cultural ideals of gender identities. The latter enables us to understand why men and women behave as they do, and the emotional and material context within which sexual behaviours are enacted. In South Africa, while gender identities show diversity, the dominant ideal of black African manhood emphasizes toughness, strength and expression of prodigious sexual success. It is a masculinity women desire; yet it is sexually risky and a barrier to men engaging with HIV treatment. Hegemonically masculine men are expected to be in control of women, and violence may be used to establish this control. Instead of resisting this, the dominant ideal of femininity embraces compliance and tolerance of violent and hurtful behaviour, including infidelity. The women partners of hegemonically masculine men are at risk of HIV because they lack control of the circumstances of sex during particularly risky encounters. They often present their acquiescence to their partners' behaviour as a trade off made to secure social or material rewards, for this ideal of femininity is upheld, not by violence per se, by a cultural system of sanctions and rewards. Thus, men and women who adopt these gender identities are following ideals with deep roots in social and cultural processes, and thus, they are models of behaviour that may be hard for individuals to critique and in which to exercise choice. Women who are materially and emotionally vulnerable are least

  17. Evaluation of polycaprolactone matrices for sustained vaginal delivery of nevirapine in the prevention of heterosexual HIV transmission.

    Science.gov (United States)

    Dang, Nhung; Sivakumaran, Haran; Harrich, David; Shaw, P Nicholas; Coombes, Allan G A

    2014-07-01

    Nevirapine (NVP) was loaded in polycaprolactone (PCL) matrices to produce vaginal inserts with the aim of preventing HIV transmission. NVP dispersions in PCL were prepared, at 10% (w/w) theoretical loading, measured with respect to the PCL content of the matrices, in the form of (1) NVP only, (2) a physical mixture of NVP with polyethylene glycol (PEG) 6000 or (c) a solid dispersion (SD) with PEG produced by co-dissolution in ethanol. Characterisation of SD by differential scanning calorimetry and attenuated total reflectance-Fourier transform infrared spectroscopy suggested transformation of the crystalline structure of NVP to an amorphous form which consequently increased the dissolution rate of drug. A low-loading efficiency of 13% was obtained for NVP-loaded matrices and less than 20% for matrices prepared using physical mixtures of drug and PEG. The loading efficiency was improved significantly to around 40% when a 1:4 NVP-PEG SD was used for matrix production. After 30 days, 40% of the drug content was released from NVP-loaded matrices, 55% from matrices containing 1:4 NVP-PEG physical mixtures and 60% from matrices loaded with 1:4 NVP-PEG SDs. The in vitro anti-viral activity of released NVP was assessed using a luciferase reporter gene assay following the infection of HeLa cells with pseudo-typed HIV-1. NVP released from PCL matrices in simulated vaginal fluid retained over 75% anti-HIV activity compared with the non-formulated NVP control. In conclusion, 1:4 NVP-PEG SDs when loaded in PCL matrices increase drug loading efficiency and improve release behaviour. © 2014 Wiley Periodicals, Inc. and the American Pharmacists Association.

  18. Cost-effectiveness of pre-exposure prophylaxis targeted to high-risk serodiscordant couples as a bridge to sustained ART use in Kampala, Uganda

    Directory of Open Access Journals (Sweden)

    Roger Ying

    2015-07-01

    Full Text Available Introduction: Despite scale-up of antiretroviral therapy (ART for treating HIV-positive persons, HIV incidence remains elevated among those at high risk such as persons in serodiscordant partnerships. Antiretrovirals taken by HIV-negative persons as pre-exposure prophylaxis (PrEP has the potential to avert infections in individuals in serodiscordant partnerships. Evaluating the cost-effectiveness of implementing time-limited PrEP as a short-term bridge during the first six months of ART for the HIV-positive partner to prevent HIV transmission compared to increasing ART coverage is crucial to informing policy-makers considering PrEP implementation. Methods: To estimate the real world delivery costs of PrEP, we conducted micro-costing and time and motion analyses in an open-label prospective study of PrEP and ART delivery targeted to high-risk serodiscordant couples in Uganda (the Partners Demonstration Project. The cost (in USD, in 2012 of PrEP and ART for serodiscordant couples was assessed, with and without research components, in the study setting. Using Ministry of Health costs, the cost of PrEP and ART provision within a government programme was estimated, as was the cost of providing PrEP in addition to ART. We parameterized an HIV transmission model to estimate the health and economic impacts of 1 PrEP and ART targeted to high-risk serodiscordant couples in the context of current ART use and 2 increasing ART coverage to 55% of HIV-positive persons with CD4 ≤500 cells/µL without PrEP. The incremental cost-effectiveness ratios (ICERs per HIV infection and disability-adjusted life year (DALY averted were calculated over 10 years. Results: The annual cost of PrEP and ART delivery for serodiscordant couples was $1058 per couple in the study setting and $453 in the government setting. The portion of the programme cost due to PrEP was $408 and $92 per couple per year in the study and government settings, respectively. Over 10 years, a

  19. Pre-exposure prophylaxis does not affect the fertility of HIV-1-uninfected men.

    Science.gov (United States)

    Were, Edwin O; Heffron, Renee; Mugo, Nelly R; Celum, Connie; Mujugira, Andrew; Bukusi, Elizabeth A; Baeten, Jared M

    2014-08-24

    There is a paucity of data on the effect of antiretroviral medications on male fertility. Couples affected by HIV-1 often have fertility intentions, and antiretroviral medications, as both treatment of HIV-1-infected persons and pre-exposure prophylaxis (PrEP) for uninfected persons, are part of peri-conception risk reduction. Within a randomized, placebo-controlled trial of daily oral tenofovir disoproxil fumarate (TDF) and combination emtricitabine (FTC)/TDF PrEP for HIV-1 prevention conducted among heterosexual HIV-1-serodiscordant couples, we assessed the impact of TDF and FTC/TDF use on male fertility, measured as incident pregnancy in female partners of men assigned to PrEP vs. placebo. Of the 2962 HIV-1-uninfected men partners, 986 were randomized to TDF, 1013 to FTC/TDF, and 963 to placebo. The overall pregnancy incidence in their HIV-1-infected female partners was 12.9 per 100 person-years and did not differ significantly across the study arms (13.2 TDF, 12.4 FTC/TDF, 13.2 placebo). The frequency of live births, pregnancy losses, and gestational age at birth or loss was also statistically similar in the three randomization groups. TDF and FTC/TDF, when used as PrEP by HIV-1-uninfected men, did not adversely affect male fertility or pregnancy outcomes.

  20. Vulnerabilidade ao HIV/Aids de pessoas heterossexuais casadas ou em união estável Vulnerability to HIV/AIDS in married heterosexual people or people in a common-law marriage

    Directory of Open Access Journals (Sweden)

    Christiane Maia

    2008-04-01

    Full Text Available OBJETIVO: Estudar conhecimentos, comportamentos preventivos e percepções em relação ao HIV/Aids de homens e mulheres heterossexuais casados ou em união consensual. MÉTODOS: Estudo exploratório realizado no Distrito Federal, entre 2001 e 2002. Foram entrevistados 200 homens e mulheres heterossexuais (18 e 49 anos em união civil ou estável, divididos em dois grupos: (I 50 casais abordados em locais públicos, e (II 100 usuários de Unidade Básica de Saúde, sendo 50 mulheres e 50 homens. O instrumento para coleta de dados consistiu de questionário semi-estruturado acerca de características demográficas, socioeconômicas e comportamentais dos entrevistados, com 38 perguntas, das quais duas eram abertas. RESULTADOS: A distribuição etária entre os grupos foi semelhante, contudo o grupo I apresentou maior escolaridade e renda, enquanto o grupo II mostrou menor conhecimento sobre as formas de transmissão do HIV. Uso de preservativo foi igualmente citado pelos grupos como uma das formas de prevenção, 14% dos entrevistados relataram seu uso regular no último ano. As principais justificativas para não usar o preservativo foram "confiança no companheiro" e "incompatibilidade com parceria sexual fixa". A percepção de risco à infecção foi mais freqüente entre as mulheres. CONCLUSÕES: A população estudada encontrava-se em situação de vulnerabilidade frente ao risco de contrair a doença, embora os entrevistados possuíssem conhecimento satisfatório sobre o HIV/Aids. Suas percepções conjugais refletiam sua aculturação sobre os papéis de gênero e hierarquização da relação efetivo-sexual, que podem colaborar para que os comportamentos preventivos sejam pouco adotados.OBJECTIVE: To study knowledge, preventive behavior, and perception regarding HIV/AIDS of heterosexual men and women that are married or in a common-law marriage. METHODS: Exploratory study carried out in the Federal District of Brazil, between 2001 and

  1. Heterosexually acquired human immunodeficiency virus infection in women in Copenhagen: sexual behavior and other risk factors

    DEFF Research Database (Denmark)

    Smith, E; Kroon, S; Gerstoft, J

    1990-01-01

    In order to describe the risk pattern including sexual behaviour among HIV-infected women in Copenhagen we studied the charts of all women tested seropositive between January 1985 and August 1988 in the three main hospitals handling HIV/AIDS. One hundred and fifteen women were positive for HIV...... antibodies: 35 (31%) were infected by heterosexual contact and 63 (55%) were intravenous drug users. Among the heterosexually transmitted cases 25 (71%) had intercourse with a man from a high risk group and nine women had intercourse with a known HIV antibody positive man without known risk factors. Use...... of condoms was claimed by 31% of the heterosexually-transmitted women before the HIV test, and by 74% (P = 0.002) after the test. In 1988 73% of the women tested HIV positive were infected by heterosexual contact, in 1985 only 14%. We conclude that among HIV infected women in Copenhagen heterosexual...

  2. “What Does it Take to be a Man? What is a Real Man?”: Ideologies of masculinity and HIV sexual risk among Black heterosexual men

    OpenAIRE

    Bowleg, Lisa; Teti, Michelle; Massie, Jenné S.; Patel, Aditi; Malebranche, David J.; Tschann, Jeanne M.

    2011-01-01

    Research documents the link between traditional ideologies of masculinity and sexual risk among multi-ethnic male adolescents and White male college students, but similar research with Black heterosexual men is scarce. This exploratory study addressed this gap through six focus groups with 41 Black, low to middle income heterosexual men aged 19 to 51 years in Philadelphia, PA. Analyses highlighted two explicit ideologies of masculinity: that Black men should have sex with multiple women, ofte...

  3. Concordant and discordant reports on shared sexual behaviors and condom use among African American serodiscordant couples in four cities.

    Science.gov (United States)

    2010-10-01

    This paper examines the concordance of reported shared sexual behaviors, including condom use, among 535 heterosexual, African American, serodiscordant couples and identifies factors that might predict discordant reports. Percentages of agreement, Kappa and McNemar's statistics and conditional probability indices are used to measure concordance. Logistic regression models identify predictors of couples' discordant sexual reports. Analyses revealed Kappa statistics for reporting anal sex, fellatio and cunnilingus indicated moderate to substantial agreement. The effects of demographics and the couples' relationship contexts on concordance of reported sexual behaviors were found to vary somewhat by gender and type of sexual behavior. Findings showed that concordance of reporting between the couples was consistent for the past 90 and 30 days. Findings from this paper provide new scientific insights into the knowledge base of self-reported couples' data and suggest that these data can be used to evaluate their accuracy and serve as a proxy for validity.

  4. Polymorphisms in major cytokine genes: A study among human immunodeficiency Virus-1 serodiscordant couples in Mumbai, India

    Directory of Open Access Journals (Sweden)

    D V Chaudhari

    2013-01-01

    Full Text Available Purpose: Polymorphism in cytokine genes may affect its production, which play an important role in modulation of human immunodeficiency virus (HIV infection. Evaluation of these polymorphisms might help to understand why some individuals remain uninfected in spite of several exposures to HIV infection, such as the negative spouses of discordant couples. The aim of this study was to evaluate the association of 22 single nucleotide polymorphisms (SNPs in 13 cytokine genes and their receptors with HIV infection in serodiscordant couples, attending the Integrated Counselling and Testing Centre of a Municipality Hospital. Materials and Methods: At the end of at least 2 years of follow up, 42 couples were confirmed as being serodiscordant. Genotyping was carried out in blood samples of these couples using the polymerase chain reaction-sequence-specific amplification method. Results: Significantly high frequency of interleukin-1 receptor antagonist IL-1RA mspa 11100 CC ( P = 0.04, tumor necrosis factor-alpha TNF-α −238 AG ( P = 0.01 and IL-4 −33 TT ( P = 0.01 was observed in HIV seropositives (HSP while frequency of TNF-α −238 GG ( P = 0.02 was significantly high among the exposed uninfected (EU. However, application of Bonferroni correction identified only two SNPs i.e., TNF-α −238 AG and IL-4 −33 TT to be significantly associated with the acquisition of HIV. In remaining cytokine genes, no significant association was observed. Conclusion: Our study highlighted possible association of certain specific polymorphisms with HIV transmission, whereas presence or absence of certain other polymorphism in EU individuals might be offering protection from HIV infection. These variations at the genetic level might help to explore new insights into treatment and HIV prevention strategies.

  5. Contexts of vulnerability and the acceptability of new biomedical HIV prevention technologies among key populations in South Africa: A qualitative study.

    Science.gov (United States)

    Atujuna, Millicent; Newman, Peter A; Wallace, Melissa; Eluhu, Megan; Rubincam, Clara; Brown, Ben; Bekker, Linda-Gail

    2018-01-01

    New biomedical prevention technologies (NPTs) may contribute to substantially reducing incident HIV infections globally. We explored acceptability and preferences for NPTs among key and other vulnerable populations in two South African townships. We conducted six focus groups and 12 in-depth interviews with adolescents, and adult heterosexual men, women, and men who have sex with men (MSM) (n = 48), and eight in-depth interviews with key informant healthcare workers. The interview guide described pre-exposure prophylaxis (PrEP), vaginal rings, rectal microbicides and HIV vaccines, and explored acceptability and product preferences. Focus groups and in-depth interviews (45-80 minutes) were conducted in Xhosa, audiotaped, and transcribed and translated into English. Data were coded and reviewed using framework analysis with NVivo software. Overall, initial enthusiasm and willingness to use NPTs evolved into concerns about how particular NPTs might affect or require alterations in one's everyday lifestyle and practices. Different product preferences and motivations emerged by population based on similarity to existing practices and contexts of vulnerability. Adult women and female adolescents preferred a vaginal ring and HIV vaccine, motivated by longer duration of protection to mitigate feared repercussions from male partners, including threats to their marriage and safety, and a context of ubiquitous rape. Male adolescents preferred an HIV vaccine, seen as protection in serodiscordant relationships and convenient in obviating the HIV stigma and cost involved in buying condoms. Adult men preferred PrEP, given familiarity with oral medications and mistrust of injections, seen as enabling serodiscordant couples to have a child. MSM preferred a rectal microbicide given familiarity with gel-based lubricants, with concerns about duration of protection in the context of unplanned consensual sex and rape. Biomedical interventions to prevent HIV transmission, rather than

  6. HIV status awareness, partnership dissolution and HIV transmission in generalized epidemics.

    Directory of Open Access Journals (Sweden)

    Georges Reniers

    Full Text Available HIV status aware couples with at least one HIV positive partner are characterized by high separation and divorce rates. This phenomenon is often described as a corollary of couples HIV Testing and Counseling (HTC that ought to be minimized. In this contribution, we demonstrate the implications of partnership dissolution in serodiscordant couples for the propagation of HIV.We develop a compartmental model to study epidemic outcomes of elevated partnership dissolution rates in serodiscordant couples and parameterize it with estimates from population-based data (Rakai, Uganda.Via its effect on partnership dissolution, every percentage point increase in HIV status awareness reduces HIV incidence in monogamous populations by 0.27 percent for women and 0.63 percent for men. These effects are even larger when the assumption of monogamy can be relaxed, but are moderated by other behavior changes (e.g., increased condom use in HIV status aware serodiscordant partnerships. When these behavior changes are taken into account, each percentage point increase in HIV status awareness reduces HIV incidence by 0.13 and 0.32 percent for women and men, respectively (assuming monogamy. The partnership dissolution effect exists because it decreases the fraction of serodiscordant couples in the population and prolongs the time that individuals spend outside partnerships.Our model predicts that elevated partnership dissolution rates in HIV status aware serodiscordant couples reduce the spread of HIV. As a consequence, the full impact of couples HTC for HIV prevention is probably larger than recognized to date. Particularly high partnership dissolution rates in female positive serodiscordant couples contribute to the gender imbalance in HIV infections.

  7. HIV status awareness, partnership dissolution and HIV transmission in generalized epidemics.

    Science.gov (United States)

    Reniers, Georges; Armbruster, Benjamin

    2012-01-01

    HIV status aware couples with at least one HIV positive partner are characterized by high separation and divorce rates. This phenomenon is often described as a corollary of couples HIV Testing and Counseling (HTC) that ought to be minimized. In this contribution, we demonstrate the implications of partnership dissolution in serodiscordant couples for the propagation of HIV. We develop a compartmental model to study epidemic outcomes of elevated partnership dissolution rates in serodiscordant couples and parameterize it with estimates from population-based data (Rakai, Uganda). Via its effect on partnership dissolution, every percentage point increase in HIV status awareness reduces HIV incidence in monogamous populations by 0.27 percent for women and 0.63 percent for men. These effects are even larger when the assumption of monogamy can be relaxed, but are moderated by other behavior changes (e.g., increased condom use) in HIV status aware serodiscordant partnerships. When these behavior changes are taken into account, each percentage point increase in HIV status awareness reduces HIV incidence by 0.13 and 0.32 percent for women and men, respectively (assuming monogamy). The partnership dissolution effect exists because it decreases the fraction of serodiscordant couples in the population and prolongs the time that individuals spend outside partnerships. Our model predicts that elevated partnership dissolution rates in HIV status aware serodiscordant couples reduce the spread of HIV. As a consequence, the full impact of couples HTC for HIV prevention is probably larger than recognized to date. Particularly high partnership dissolution rates in female positive serodiscordant couples contribute to the gender imbalance in HIV infections.

  8. Predictors of AIDS-preventive behavioral intentions among adult heterosexuals at risk for HIV-infection : Extending current models and measures

    NARCIS (Netherlands)

    Buunk, BP; Bakker, AB; Siero, FW; van den Eijnden, RJJM; Yzer, MC

    This study examined the predictors of the intention to use condoms with new sexual partners. A sample of heterosexual adult females and males (n = 711) was recruited through various channels. A substantial part of the sample had engaged in risky sexual behavior. Predictors were based on various

  9. Sexual risk behaviour among HIV-positive persons in Kumasi ...

    African Journals Online (AJOL)

    David Ofori-Adjei

    2012-03-01

    Mar 1, 2012 ... tics, HIV/AIDS knowledge, attitudes, and beliefs and sexual risk behaviours. Results: Forty-four percent of the sample reported having sex after testing positive for HIV. Of the 175 participants with regular sex partners, 24% had HIV- positive partners. Majority (67%) had HIV-negative partners (serodiscordant ...

  10. Southern African guidelines on the safe use of pre-exposure prophylaxis in persons at risk of acquiring HIV-1 infection

    Directory of Open Access Journals (Sweden)

    Linda-Gail Bekker

    2016-03-01

    Full Text Available The Southern African HIV Clinicians Society published its first set of oral pre-exposure prophylaxis (PrEP guidelines in June 2012 for men who have sex with men (MSM who are at risk of HIV infection. With the flurry of data that has been generated in PrEP clinical research since the first guideline, it became evident that there was a need to revise and expand the PrEP guidelines with new evidence of safety and efficacy of PrEP in several populations, including MSM, transgender persons, heterosexual men and women, HIV-serodiscordant couples and people who inject drugs. This need is particularly relevant following the World Health Organization (WHO Consolidated Treatment Guidelines released in September 2015. These guidelines advise that PrEP is a highly effective, safe, biomedical option for HIV prevention that can be incorporated with other combination prevention strategies in Southern Africa, given the high prevalence of HIV in the region. PrEP should be tailored to populations at highest risk of HIV acquisition, whilst further data from studies in the region accrue to guide optimal deployment to realise the greatest impact regionally. PrEP may be used intermittently during periods of perceived HIV acquisition risk, rather than continually and lifelong, as is the case with antiretroviral treatment. Recognition and accurate measurement of potential risk in individuals and populations also warrants discussion, but are not extensively covered in these guidelines.

  11. Southern African guidelines on the safe use of pre-exposure prophylaxis in persons at risk of acquiring HIV-1 infection

    Directory of Open Access Journals (Sweden)

    Linda-Gail Bekker

    2016-02-01

    Full Text Available The Southern African HIV Clinicians Society published its first set of oral pre-exposure prophylaxis (PrEP guidelines in June 2012 for men who have sex with men (MSM who are at risk of HIV infection. With the flurry of data that has been generated in PrEP clinical research since the first guideline, it became evident that there was a need to revise and expand the PrEP guidelines with new evidence of safety and efficacy of PrEP in several populations, including MSM, transgender persons, heterosexual men and women, HIV-serodiscordant couples and people who inject drugs. This need is particularly relevant following the World Health Organization (WHO Consolidated Treatment Guidelines released in September 2015. These guidelines advise that PrEP is a highly effective, safe, biomedical option for HIV prevention that can be incorporated with other combination prevention strategies in Southern Africa, given the high prevalence of HIV in the region. PrEP should be tailored to populations at highest risk of HIV acquisition, whilst further data from studies in the region accrue to guide optimal deployment to realise the greatest impact regionally. PrEP may be used intermittently during periods of perceived HIV acquisition risk, rather than continually and lifelong, as is the case with antiretroviral treatment. Recognition and accurate measurement of potential risk in individuals and populations also warrants discussion, but are not extensively covered in these guidelines.

  12. HIV transmission risk through anal intercourse: systematic review, meta-analysis and implications for HIV prevention

    National Research Council Canada - National Science Library

    Baggaley, Rebecca F; White, Richard G; Boily, Marie-Claude

    2010-01-01

    ...) and its potential contribution to heterosexual spread. We assessed the per-act and per-partner HIV transmission risk from AI exposure for heterosexuals and MSM and its implications for HIV prevention...

  13. Intimate partner sexual and physical violence among women in Togo, West Africa: Prevalence, associated factors, and the specific role of HIV infection

    Science.gov (United States)

    Burgos-Soto, Juan; Orne-Gliemann, Joanna; Encrenaz, Gaëlle; Patassi, Akouda; Woronowski, Aurore; Kariyiare, Benjamin; Lawson-Evi, Annette K.; Leroy, Valériane; Dabis, François; Ekouevi, Didier K.

    2014-01-01

    Background A substantial proportion of newly diagnosed HIV infections in sub-Saharan Africa occur within serodiscordant cohabiting heterosexual couples. Intimate partner violence is a major concern for couple-oriented HIV preventive approaches. This study aimed at estimating the prevalence and associated factors of intimate partner physical and sexual violence among HIV-infected and -uninfected women in Togo. We also described the severity and consequences of this violence as well as care-seeking behaviors of women exposed to intimate partner violence. Methods A cross-sectional survey was conducted between May and July 2011 within Sylvanus Olympio University Hospital in Lomé. HIV-infected women attending HIV care and uninfected women attending postnatal care and/or children immunization visits were interviewed. Intimate partner physical and sexual violence and controlling behaviors were assessed using an adapted version of the WHO Multi-country study on Women’s Health and Life Events questionnaire. Results Overall, 150 HIV-uninfected and 304 HIV-infected women accepted to be interviewed. The prevalence rates of lifetime physical and sexual violence among HIV-infected women were significantly higher than among uninfected women (63.1 vs. 39.3%, pviolence. Among injured women, only one-third had ever disclosed real causes of injuries to medical staff and none of them had been referred to local organizations to receive appropriate psychological support. Regardless of HIV status and after adjustment on potential confounders, the risk of intimate partner physical and sexual violence was strongly and significantly associated with male partner multi-partnership and early start of sexual life. Among uninfected women, physical violence was significantly associated with gender submissive attitudes. Discussion and conclusions The prevalence rates of both lifetime physical and sexual violence were very high among HIV-uninfected women and even higher among HIV-infected women

  14. Prevalence and social drivers of HIV among married and cohabitating heterosexual adults in south-eastern Tanzania: analysis of adult health community cohort data

    NARCIS (Netherlands)

    Mtenga, Sally M.; Pfeiffer, Constanze; Merten, Sonja; Mamdani, Masuma; Exavery, Amon; Haafkens, Joke; Tanner, Marcel; Geubbels, Eveline

    2015-01-01

    In sub-Saharan Africa, the prevalence of HIV among married and cohabiting couples is substantial. Information about the underlying social drivers of HIV transmission in couples is critical for the development of structural approaches to HIV prevention, but not readily available. We explored the

  15. Sexual repertoires of heterosexuals: implications for HIV/sexually transmitted disease risk and prevention. The ACSF Group, Analyse des Comportements Sexuels en France.

    Science.gov (United States)

    Messiah, A; Blin, P; Fiche, V

    1995-12-01

    To provide a quantitative and population-based analysis of sexual repertoires among heterosexuals. The French National Survey of Sexual Behaviour (ACSF), conducted between September 1991 and February 1992 on a representative sample of the population aged 18-69 years. Sexual practices of the last heterosexual encounter were investigated among 4261 individuals; we measured the combinations of different practices and their correlations with age, and calculated frequencies for the main repertoires and their correlations with the interpartner relationship. Vaginal penetration and caressing were almost systematic, self-masturbation and anal penetration were rare, while mutual masturbation and orogenital practices had intermediate levels of occurrence. Examination of the correlations revealed (1) a very high correlation between practices which are reciprocal or symmetrical, (2) a strong association between genito-manual and genito-oral practices, (3) an association between anal penetration and fellatio, and (4) no clear correlation between any set of practices and vaginal sex or condom use. A small number of repertoires accounted for the vast majority of encounters. Younger people tended to have a more diversified repertoire. Repertoire types and diversity were strongly correlated to the pattern of interpartner relationship, independently of age. Reciprocity seems a standard feature of the heterosexual repertoire. The absence of a negative correlation between vaginal or anal penetration and other practices argues against promotion of the latter as substitute for the former. By contrast, the independence between condom use and any specific repertoire argues for its promotion as a universal means of protection.

  16. Community Cultural Norms, Stigma and Disclosure to Sexual Partners among Women Living with HIV in Thailand, Brazil and Zambia (HPTN 063).

    Science.gov (United States)

    Ojikutu, Bisola O; Pathak, Subash; Srithanaviboonchai, Kriengkrai; Limbada, Mohammed; Friedman, Ruth; Li, Shuying; Mimiaga, Matthew J; Mayer, Kenneth H; Safren, Steven A

    2016-01-01

    Serostatus disclosure may facilitate decreased HIV transmission between serodiscordant partners by raising risk awareness and heightening the need for prevention. For women living with HIV (WLWH), the decision to disclose may be influenced by culturally determined, community-level stigma and norms. Understanding the impact of community HIV stigma and gender norms on disclosure among WLWH in different countries may inform intervention development. HPTN063 was a longitudinal, observational study of sexually active HIV-infected individuals, including heterosexual women, in care in Zambia, Thailand and Brazil. At baseline, a questionnaire measuring community HIV stigma and gender norms, anticipated stigma, demographic, partner/relationship characteristics, and intimate partner violence was administered. Longitudinal HIV disclosure to sexual partners was determined via audio-computer assisted self-interview (ACASI) at the baseline and quarterly during the one year following up. Logistic regression was conducted to identify the predictors of disclosure. Almost half (45%) of women living with HIV acknowledged perceived community HIV stigma (the belief that in their community HIV infection among women is associated with sex work and multiple sexual partners). Many women (42.9%) also acknowledged perceived community gender norms (the belief that traditional gender norms such as submissiveness to husbands/male sexual partners is necessary and that social status is lost if one does not procreate). HIV disclosure to current sex partners was reported by 67% of women. In multivariate analysis, among all women, those who were older [OR 0.16, 95%CI(0.06,0.48)], reported symptoms of severe depression [OR 0.53, 95%CI(0.31, 0.90)], endorsed anticipated stigma [OR 0.30, 95%CI(0.18, 0.50)], and were unmarried [OR 0.43, 95%CI(0.26,0.71)] were less likely to disclose to current partners. In an analysis stratified by marital status and cohabitation, unmarried [OR 0.41, 95%CI(0

  17. Community Cultural Norms, Stigma and Disclosure to Sexual Partners among Women Living with HIV in Thailand, Brazil and Zambia (HPTN 063.

    Directory of Open Access Journals (Sweden)

    Bisola O Ojikutu

    Full Text Available Serostatus disclosure may facilitate decreased HIV transmission between serodiscordant partners by raising risk awareness and heightening the need for prevention. For women living with HIV (WLWH, the decision to disclose may be influenced by culturally determined, community-level stigma and norms. Understanding the impact of community HIV stigma and gender norms on disclosure among WLWH in different countries may inform intervention development.HPTN063 was a longitudinal, observational study of sexually active HIV-infected individuals, including heterosexual women, in care in Zambia, Thailand and Brazil. At baseline, a questionnaire measuring community HIV stigma and gender norms, anticipated stigma, demographic, partner/relationship characteristics, and intimate partner violence was administered. Longitudinal HIV disclosure to sexual partners was determined via audio-computer assisted self-interview (ACASI at the baseline and quarterly during the one year following up. Logistic regression was conducted to identify the predictors of disclosure.Almost half (45% of women living with HIV acknowledged perceived community HIV stigma (the belief that in their community HIV infection among women is associated with sex work and multiple sexual partners. Many women (42.9% also acknowledged perceived community gender norms (the belief that traditional gender norms such as submissiveness to husbands/male sexual partners is necessary and that social status is lost if one does not procreate. HIV disclosure to current sex partners was reported by 67% of women. In multivariate analysis, among all women, those who were older [OR 0.16, 95%CI(0.06,0.48], reported symptoms of severe depression [OR 0.53, 95%CI(0.31, 0.90], endorsed anticipated stigma [OR 0.30, 95%CI(0.18, 0.50], and were unmarried [OR 0.43, 95%CI(0.26,0.71] were less likely to disclose to current partners. In an analysis stratified by marital status and cohabitation, unmarried [OR 0.41, 95%CI(0

  18. My partner wants a child: A cross-sectional study of the determinants of the desire for children among mutually disclosed sero-discordant couples receiving care in Uganda

    Directory of Open Access Journals (Sweden)

    Mirembe Florence

    2010-05-01

    Full Text Available Abstract Background The percentages of couples in HIV sero-discordant relationships range from 5 to 31% in the various countries of Africa. Given the importance of procreation and the lack of assisted reproduction to avoid partner transmission, members of these couples are faced with a serious dilemma even after the challenge of disclosing their HIV status to their spouses. Identifying the determinants of the decision to have children among sero-discordant couples will help in setting reproductive intervention priorities in resource-poor countries. Methods We conducted a survey among 114 mutually disclosed sero-discordant couples (228 individuals receiving HIV care at four centres in Greater Kampala, between June and December 2007. The data we collected was classified according to whether the man or the woman was HIV-positive. We carried out multivariate logistic regression modelling to determine factors (age, gender, and the influences of relatives and of health workers, ART knowledge, and disclosure that are independently associated with a desire for children. Results The majority, 59%, of the participants, desired to have children. The belief that their partner wanted children was a major determinant of the desire to have children, irrespective of the HIV sero-status (adjusted odds ratio 24.0 (95% CI 9.15, 105.4. Among couples in which the woman was HIV-positive, young age and relatives' expectations for children were significantly associated with increased fertility desire, while among couples in which the man was positive; knowledge of ART effectiveness was associated with increased fertility desire. Availability of information on contraception was associated with decreased fertility desire. Conclusions The gender of the positive partner affects the factors associated with a desire for children. Interventions targeting sero-discordant couples should explore contraceptive choices, the cultural importance of children, and partner

  19. Prevalence and predictors of HIV sero-discordance among ...

    African Journals Online (AJOL)

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  20. Extra-couple HIV transmission in sub-Saharan Africa: a mathematical modelling study of survey data.

    Science.gov (United States)

    Bellan, Steve E; Fiorella, Kathryn J; Melesse, Dessalegn Y; Getz, Wayne M; Williams, Brian G; Dushoff, Jonathan

    2013-05-04

    The proportion of heterosexual HIV transmission in sub-Saharan Africa that occurs within cohabiting partnerships, compared with that in single people or extra-couple relationships, is widely debated. We estimated the proportional contribution of different routes of transmission to new HIV infections. As plans to use antiretroviral drugs as a strategy for population-level prevention progress, understanding the importance of different transmission routes is crucial to target intervention efforts. We built a mechanistic model of HIV transmission with data from Demographic and Health Surveys (DHS) for 2003-2011, of 27,201 cohabiting couples (men aged 15-59 years and women aged 15-49 years) from 18 sub-Saharan African countries with information about relationship duration, age at sexual debut, and HIV serostatus. We combined this model with estimates of HIV survival times and country-specific estimates of HIV prevalence and coverage of antiretroviral therapy (ART). We then estimated the proportion of recorded infections in surveyed cohabiting couples that occurred before couple formation, between couple members, and because of extra-couple intercourse. In surveyed couples, we estimated that extra-couple transmission accounted for 27-61% of all HIV infections in men and 21-51% of all those in women, with ranges showing intercountry variation. We estimated that in 2011, extra-couple transmission accounted for 32-65% of new incident HIV infections in men in cohabiting couples, and 10-47% of new infections in women in such couples. Our findings suggest that transmission within couples occurs largely from men to women; however, the latter sex have a very high-risk period before couple formation. Because of the large contribution of extra-couple transmission to new HIV infections, interventions for HIV prevention should target the general sexually active population and not only serodiscordant couples. US National Institutes of Health, US National Science Foundation, and J S

  1. Cost-Effectiveness of Peer- Versus Venue-Based Approaches for Detecting Undiagnosed HIV Among Heterosexuals in High-Risk New York City Neighborhoods.

    Science.gov (United States)

    Stevens, Elizabeth R; Nucifora, Kimberly A; Zhou, Qinlian; Braithwaite, Ronald Scott; Cleland, Charles M; Ritchie, Amanda S; Kutnick, Alexandra H; Gwadz, Marya V

    2018-02-01

    We used a computer simulation of HIV progression and transmission to evaluate the cost-effectiveness of a scale-up of 3 strategies to seek out and test individuals with undiagnosed HIV in New York City (NYC). Hypothetical NYC population. We incorporated the observed effects and costs of the 3 "seek and test" strategies in a computer simulation of HIV in NYC, comparing a scenario in which the strategies were scaled up with a 1-year implementation or a long-term implementation with a counterfactual scenario with no scale-up. The simulation combined a deterministic compartmental model of HIV transmission with a stochastic microsimulation of HIV progression, calibrated to NYC epidemiological data from 2003 to 2015. The 3 approaches were respondent-driven sampling (RDS) with anonymous HIV testing ("RDS-A"), RDS with a 2-session confidential HIV testing approach ("RDS-C"), and venue-based sampling ("VBS"). RDS-A was the most cost-effective strategy tested. When implemented for only 1 year and then stopped thereafter, using a societal perspective, the cost per quality-adjusted life-year (QALY) gained versus no intervention was $812/QALY, $18,110/QALY, and $20,362/QALY for RDS-A, RDS-C, and VBS, respectively. When interventions were implemented long term, the cost per QALY gained versus no intervention was cost-saving, $31,773/QALY, and $35,148/QALY for RDS-A, RDS-C, and VBS, respectively. When compared with RDS-A, the incremental cost-effectiveness ratios for both VBS and RDS-C were dominated. The expansion of the RDS-A strategy would substantially reduce HIV-related deaths and new HIV infections in NYC, and would be either cost-saving or have favorable cost-effectiveness.

  2. Heterosexual men's attitudes toward the female condom.

    Science.gov (United States)

    Seal, D W; Ehrhardt, A A

    1999-04-01

    This article addresses heterosexual men's familiarity with the female condom and their attitudes toward this barrier method. Qualitative interviews were conducted with 71 ethnically diverse and heterosexually active men who were recruited in sexually transmitted disease (STD) clinics or through word of mouth in communities with high HIV/STD seroprevalence in New York City during fall 1994 to fall 1995. Only one man reported previous experience with the female condom. The large majority of men had no or limited knowledge of the female condom. Men's reactions to learning about this method ranged from positive to negative, although most men reported willingness to have sex with a partner who wanted to use the female condom. Positive reactions included: endorsement of a woman-controlled condom and her right to use it, the potential for enhancing one's sexual pleasure, and an eagerness to have a new sexual experience. Negative reactions centered on the "strangeness" and "bigness" of the female condom, concerns about prevention efficacy, and concerns about reductions in sexual pleasure. Our findings highlight the need for HIV prevention programs that target heterosexual men and promote the use of the female condom.

  3. a reflection on the impact of HIV discordance on child HIV infection

    African Journals Online (AJOL)

    cqq1a

    2010-05-09

    May 9, 2010 ... This is an opinion piece based on data and experience from Rwanda. The authors believe this opinion piece may help improve current programs on prevention of HIV transmission from mother to child in Africa taking into account the prevalent of HIV sero-discordance in couples. The authors recommend ...

  4. Particle infectivity of HIV-1 full-length genome infectious molecular clones in a subtype C heterosexual transmission pair following high fidelity amplification and unbiased cloning

    Energy Technology Data Exchange (ETDEWEB)

    Deymier, Martin J., E-mail: mdeymie@emory.edu [Emory Vaccine Center, Yerkes National Primate Research Center, 954 Gatewood Road NE, Atlanta, GA 30329 (United States); Claiborne, Daniel T., E-mail: dclaibo@emory.edu [Emory Vaccine Center, Yerkes National Primate Research Center, 954 Gatewood Road NE, Atlanta, GA 30329 (United States); Ende, Zachary, E-mail: zende@emory.edu [Emory Vaccine Center, Yerkes National Primate Research Center, 954 Gatewood Road NE, Atlanta, GA 30329 (United States); Ratner, Hannah K., E-mail: hannah.ratner@emory.edu [Emory Vaccine Center, Yerkes National Primate Research Center, 954 Gatewood Road NE, Atlanta, GA 30329 (United States); Kilembe, William, E-mail: wkilembe@rzhrg-mail.org [Zambia-Emory HIV Research Project (ZEHRP), B22/737 Mwembelelo, Emmasdale Post Net 412, P/BagE891, Lusaka (Zambia); Allen, Susan, E-mail: sallen5@emory.edu [Zambia-Emory HIV Research Project (ZEHRP), B22/737 Mwembelelo, Emmasdale Post Net 412, P/BagE891, Lusaka (Zambia); Department of Pathology and Laboratory Medicine, Emory University, Atlanta, GA (United States); Hunter, Eric, E-mail: eric.hunter2@emory.edu [Emory Vaccine Center, Yerkes National Primate Research Center, 954 Gatewood Road NE, Atlanta, GA 30329 (United States); Department of Pathology and Laboratory Medicine, Emory University, Atlanta, GA (United States)

    2014-11-15

    The high genetic diversity of HIV-1 impedes high throughput, large-scale sequencing and full-length genome cloning by common restriction enzyme based methods. Applying novel methods that employ a high-fidelity polymerase for amplification and an unbiased fusion-based cloning strategy, we have generated several HIV-1 full-length genome infectious molecular clones from an epidemiologically linked transmission pair. These clones represent the transmitted/founder virus and phylogenetically diverse non-transmitted variants from the chronically infected individual's diverse quasispecies near the time of transmission. We demonstrate that, using this approach, PCR-induced mutations in full-length clones derived from their cognate single genome amplicons are rare. Furthermore, all eight non-transmitted genomes tested produced functional virus with a range of infectivities, belying the previous assumption that a majority of circulating viruses in chronic HIV-1 infection are defective. Thus, these methods provide important tools to update protocols in molecular biology that can be universally applied to the study of human viral pathogens. - Highlights: • Our novel methodology demonstrates accurate amplification and cloning of full-length HIV-1 genomes. • A majority of plasma derived HIV variants from a chronically infected individual are infectious. • The transmitted/founder was more infectious than the majority of the variants from the chronically infected donor.

  5. Adaptation and implementation of HoMBReS: a community-level, evidence-based HIV behavioral intervention for heterosexual Latino men in the midwestern United States.

    Science.gov (United States)

    Martinez, Omar; Roth, Alexis M; Kelle, Guadalupe; Downs, Mario; Rhodes, Scott D

    2014-02-01

    Over the past decade, the midwestern United States has witnessed a dramatic increase in its Latino population. The lack of culturally and linguistically congruent resources coupled with high incidence and prevalence rates of HIV among Latinos living in the Midwest merits attention. HoMBReS: Hombres Manteniendo Bienestar y Relaciones Saludables (Men Maintaining Wellbeing and Healthy Relationships) is a community-level social network intervention designed for Latino men. We describe the adaptation and implementation of HoMBReS for Latino men living in Indianapolis, Indiana, the second largest city in the Midwest. Five Navegantes (lay health educators) were trained; they provided a total of 34 educational charlas (small group didactic sessions). A total of 270 Latino men attended the charlas and were offered no-cost screening for HIV and sexually transmitted infections (STI). Three participants tested HIV positive and 15 screened positive for STI. The charlas coupled with the testing initiative, served as a successful method to increase sexual health knowledge among Latino men and to link newly-diagnosed HIV/STI-positive individuals to treatment and care. The adaptation and implementation of HoMBReS respond to the CDC and NIH call to increase HIV testing and service provision among vulnerable populations.

  6. Modeling the impact of social discrimination and financial hardship on the sexual risk of HIV among Latino and Black men who have sex with men

    National Research Council Canada - National Science Library

    Ayala, George; Bingham, Trista; Kim, Junyeop; Wheeler, Darrell P; Millett, Gregorio A

    2012-01-01

    We examined the impact of social discrimination and financial hardship on unprotected anal intercourse with a male sex partner of serodiscordant or unknown HIV status in the past 3 months among 1081...

  7. El ejercicio de los derechos sexuales y reproductivos: un estudio cualitativo de personas heterosexuales con VIH en México Exercising sexual and reproductive rights: a qualitative study of heterosexual people with HIV in Mexico

    Directory of Open Access Journals (Sweden)

    Lourdes Campero

    2010-02-01

    Full Text Available OBJETIVO: Analizar experiencias relacionadas con el ejercicio de los derechos sexuales y reproductivos de personas heterosexuales que viven con VIH (PVVIH en México. MATERIAL Y MÉTODOS: Estudio cualitativo donde se realizaron 40 entrevistas en profundidad a PVVIH en cuatro estados del país. Resultados. Vivir con VIH sin apoyo ni consejería limita el ejercicio de los derechos sexuales y reproductivos, especialmente en las mujeres. Las principales limitantes son sentimientos de frustración, falta de claridad en la información, temor a la reinfección, falta de poder para negociar el uso del condón, estigma, discriminación y falta de acceso a servicios y tecnología adecuados. CONCLUSIÓN: Para una mayor conciencia y ejercicio de los derechos de las PVVIH se necesita promover la educación sexual, cambios culturales que combatan la desigualdad de género, el estigma y la discriminación, e información oportuna y científica sobre prevención del VIH.OBJECTIVE: To analyze experiences of heterosexual Mexican people living with HIV (PLWHA related to the exercise of their sexual and reproductive rights. MATERIAL AND METHODS: Qualitative study based on 40 in-depth interviews with PLWHA in four Mexican States. RESULTS: Lack of support and counseling limits the exercise of sexual and reproductive rights by PLWHA, especially women. Principal limitations include feelings of frustration and confusion, fear of re-infection, scanty information, lack of power to negotiate condom use, social stigma and discrimination, and limited access to services and adequate technologies. CONCLUSION: To increase awareness and exercise of rights by PLWHA it is necessary to: improve sexual education; promote processes of cultural change to combat gender inequality and stigma and discrimination; and provide timely and scientific information about HIV prevention.

  8. Disparate associations of HLA class I markers with HIV-1 acquisition and control of viremia in an African population.

    Directory of Open Access Journals (Sweden)

    Wei Song

    Full Text Available Acquisition of human immunodeficiency virus type 1 (HIV-1 infection is mediated by a combination of characteristics of the infectious and the susceptible member of a transmission pair, including human behavioral and genetic factors, as well as viral fitness and tropism. Here we report on the impact of established and potential new HLA class I determinants of heterosexual HIV-1 acquisition in the HIV-1-exposed seronegative (HESN partners of serodiscordant Zambian couples.We assessed the relationships of behavioral and clinically documented risk factors, index partner viral load, and host genetic markers to HIV-1 transmission among 568 cohabiting couples followed for at least nine months. We genotyped subjects for three classical HLA class I genes known to influence immune control of HIV-1 infection. From 1995 to December 2006, 240 HESNs seroconverted and 328 remained seronegative. In Cox proportional hazards models, HLA-A*68:02 and the B*42-C*17 haplotype in HESN partners were significantly and independently associated with faster HIV-1 acquisition (relative hazards = 1.57 and 1.55; p = 0.007 and 0.013, respectively after controlling for other previously established contributing factors in the index partner (viral load and specific class I alleles, in the HESN partner (age, gender, or in the couple (behavioral and clinical risk score. Few if any previously implicated class I markers were associated here with the rate of acquiring infection.A few HLA class I markers showed modest effects on acquisition of HIV-1 subtype C infection in HESN partners of discordant Zambian couples. However, the striking disparity between those few markers and the more numerous, different markers found to determine HIV-1 disease course makes it highly unlikely that, whatever the influence of class I variation on the rate of infection, the mechanism mediating that phenomenon is identical to that involved in disease control.

  9. Disparate Associations of HLA Class I Markers with HIV-1 Acquisition and Control of Viremia in an African Population

    Science.gov (United States)

    Song, Wei; He, Dongning; Brill, Ilene; Malhotra, Rakhi; Mulenga, Joseph; Allen, Susan; Hunter, Eric; Tang, Jianming; Kaslow, Richard A.

    2011-01-01

    Background Acquisition of human immunodeficiency virus type 1 (HIV-1) infection is mediated by a combination of characteristics of the infectious and the susceptible member of a transmission pair, including human behavioral and genetic factors, as well as viral fitness and tropism. Here we report on the impact of established and potential new HLA class I determinants of heterosexual HIV-1 acquisition in the HIV-1-exposed seronegative (HESN) partners of serodiscordant Zambian couples. Methodology/Principal Findings We assessed the relationships of behavioral and clinically documented risk factors, index partner viral load, and host genetic markers to HIV-1 transmission among 568 cohabiting couples followed for at least nine months. We genotyped subjects for three classical HLA class I genes known to influence immune control of HIV-1 infection. From 1995 to December 2006, 240 HESNs seroconverted and 328 remained seronegative. In Cox proportional hazards models, HLA-A*68:02 and the B*42-C*17 haplotype in HESN partners were significantly and independently associated with faster HIV-1 acquisition (relative hazards = 1.57 and 1.55; p = 0.007 and 0.013, respectively) after controlling for other previously established contributing factors in the index partner (viral load and specific class I alleles), in the HESN partner (age, gender), or in the couple (behavioral and clinical risk score). Few if any previously implicated class I markers were associated here with the rate of acquiring infection. Conclusions/Significance A few HLA class I markers showed modest effects on acquisition of HIV-1 subtype C infection in HESN partners of discordant Zambian couples. However, the striking disparity between those few markers and the more numerous, different markers found to determine HIV-1 disease course makes it highly unlikely that, whatever the influence of class I variation on the rate of infection, the mechanism mediating that phenomenon is identical to that involved in

  10. Is there a legacy of the U.S. Public Health Syphilis Study at Tuskegee in HIV/AIDS-related beliefs among heterosexual African-Americans and Latinos?

    Science.gov (United States)

    Mays, Vickie M.; Coles, Courtney N.; Cochran, Susan D.

    2012-01-01

    Knowledge of the US Public Health Syphilis Study at Tuskegee is sometime cited as a principal reason for the relatively low participation rates seen among racial/ethnic minorities, particularly African Americans, in biomedical research. However, only a few studies have actually explored this possibility. We use data from a random digit dial telephone survey of 510 African-Americans and 253 Latinos, age 18 to 45 years, to investigate associations between knowledge of the USPHS Syphilis Study at Tuskegee and endorsement of HIV/AIDS conspiracy theories. All respondents were drawn from an area of low-income, predominantly race-segregated inner city households in Los Angeles. Results indicate that African Americans were significantly more likely than Latinos to endorse HIV/AIDS conspiracy theories. Further, African Americans were more aware of the USPHS Syphilis Study at Tuskegee (SST). Nevertheless, 72% of African Americans and 94% of Latinos reported that they have never heard of the Syphilis Study at Tuskegee. Further, while awareness of the Syphilis Study at Tuskegee was a significant predictor of endorsing HIV/AIDS conspiracy theories, results suggest that other factors may be more important in accounting for low biomedical and behavioral study participation rates. PMID:23308036

  11. When one can infect two: a reflection on the impact of HIV ...

    African Journals Online (AJOL)

    The authors believe this opinion piece may help improve current programs on prevention of HIV transmission from mother to child in Africa taking into account the prevalent of HIV sero-discordance in couples. ... The lives of three individuals have the potential to be changed from HIV testing and counseling. Morally, this ...

  12. Management of HIV infected patients with assisted reproductive ...

    African Journals Online (AJOL)

    Many couples who are infected with HIV (sero-discordant and sero-concordant) seek assistance with conception. The objective of the paper is to address the options available to these couples using artificial reproductive techniques (ART), in order to decrease the risk of transmission of HIV to the uninfected partner and the ...

  13. Hombres Sanos: evaluation of a social marketing campaign for heterosexually identified Latino men who have sex with men and women.

    Science.gov (United States)

    Martínez-Donate, Ana P; Zellner, Jennifer A; Sañudo, Fernando; Fernandez-Cerdeño, Araceli; Hovell, Melbourne F; Sipan, Carol L; Engelberg, Moshe; Carrillo, Hector

    2010-12-01

    We evaluated the effectiveness of Hombres Sanos [Healthy Men] a social marketing campaign to increase condom use and HIV testing among heterosexually identified Latino men, especially among heterosexually identified Latino men who have sex with men and women (MSMW). Hombres Sanos was implemented in northern San Diego County, California, from June 2006 through December 2006. Every other month we conducted cross-sectional surveys with independent samples of heterosexually identified Latino men before (n = 626), during (n = 752), and after (n = 385) the campaign. Respondents were randomly selected from 12 targeted community venues to complete an anonymous, self-administered survey on sexual practices and testing for HIV and other sexually transmitted infections. About 5.6% of respondents (n = 98) were heterosexually identified Latino MSMW. The intervention was associated with reduced rates of recent unprotected sex with both females and males among heterosexually identified Latino MSMW. The campaign was also associated with increases in perception of HIV risk, knowledge of testing locations, and condom carrying among heterosexual Latinos. Social marketing represents a promising approach for abating HIV transmission among heterosexually identified Latinos, particularly for heterosexually identified Latino MSMW. Given the scarcity of evidence-based HIV prevention interventions for these populations, this prevention strategy warrants further investigation.

  14. Prevalence and Correlates of Heterosexual Anal Intercourse Among Men and Women, 20 U.S. Cities.

    Science.gov (United States)

    Hess, Kristen L; DiNenno, Elizabeth; Sionean, Catlainn; Ivy, Wade; Paz-Bailey, Gabriela

    2016-12-01

    Heterosexual anal intercourse (HAI) is not an uncommon behavior and it confers a higher risk of HIV transmission than vaginal intercourse. We examined data from heterosexuals recruited in 20 US cities for the 2013 National HIV Behavioral Surveillance system. We assessed correlates of reporting HAI in the previous year. Then, among people reporting HAI in the past year, we assessed what event-level factors are associated with having HAI at last sex. Thirty percent of women and 35 % of men reported HAI in the past year. Among people who had HAI in the past year, those who had HAI at last sex were more likely to have a partner who was HIV-positive or of unknown status or to have exchanged money or drugs for sex at last sex. Information that highlights the risk of HIV transmission associated with HAI would complement existing HIV prevention messages focused on heterosexuals in the U.S.

  15. Adolescent pre-exposure prophylaxis for HIV prevention: current perspectives

    Directory of Open Access Journals (Sweden)

    Machado DM

    2017-11-01

    Full Text Available Daisy Maria Machado,1 Alexandre Machado de Sant’Anna Carvalho,2 Rachel Riera3 1Disciplina de Infectologia Pediátrica, Departamento de Pediatria, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, 2Universidade Federal do Rio de Janeiro, Rio de Janeiro, 3Disciplina de Medicina Baseada em Evidências, Departamento de Medicina, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil Abstract: Adolescents are a critical population that is disproportionately impacted by the HIV epidemic. More than 2 million adolescents between the age group of 10 and 19 years are living with HIV, and millions are at risk of infection. HIV risks are considerably higher among girls, especially in high-prevalence settings such as eastern and southern Africa. In addition to girls, there are other vulnerable adolescent subgroups, such as teenagers, who use intravenous (IV drugs, gay and bisexual boys, transgender youth, male sex workers, and people who fall into more than one of these categories. Pre-exposure prophylaxis (PrEP is a new intervention for people at high risk for acquiring HIV, with an estimated HIV incidence of >3%. Recent data from trials show evidence of the efficacy of PrEP as a powerful HIV prevention tool in high-risk populations, including men who have sex with men, HIV-1-serodiscordant heterosexual couples, and IV drug users. The reported efficacy in those trials of the daily use of oral tenofovir, alone or in combination with emtricitabine, to prevent HIV infection ranged from 44% to 75% and was heavily dependent on adherence. Despite the proven efficacy of PrEP in adult trials, concerns remain about its feasibility in real-life scenarios due to stigma, cost, and limited clinician experience with PrEP delivery. Recent studies are attempting to expand the inquiry into the efficacy of such HIV prophylaxis approaches in adolescent populations, but there are still many gaps in knowledge, and no

  16. "Sikker sex" blandt hiv-smittede heteroseksuelle par

    DEFF Research Database (Denmark)

    Weis, N M; Skinnes, L; Vesterdal, B

    1999-01-01

    To investigate the use of condoms ("safe sex") as prevention of transmission with human immuno deficiency virus (hiv) among heterosexual couples, 57 hiv-positive heterosexual patients and their partners if there was one interviewed. Forty-three of the 57 patients were heterosexually infected. Fiv...

  17. Sexual dysfunctions in non-heterosexual men - literature review.

    Science.gov (United States)

    Grabski, Bartosz; Kasparek, Krzysztof

    2017-02-26

    The paper aims to present results and discuss methodology of research conducted so far on sexual dysfunction in non-heterosexual men, as well as to form suggestions for future research and clinical practice. The present paper is a continuation of our earlier paper, which discussed the specific context of the issue connected with the characteristics of gay sexual orientation and the social situation those men face. There is little research on dysfunctions and sexual problems in non-heterosexual men, and none has been conducted in Poland. The research that has been done is characterized by inconsistent methodology that is far from perfect, and varied results which cannot be compared. There are still many unanswered questions in the field. The issues connected with research that require attention include the choice of samples and their representativeness, and the accuracy of the methods used for identifying sexual dysfunctions. It is also still not clear whether sexual problems occur more often in non-heterosexual than heterosexual men, how non-heterosexual men deal with those problems, and how the problems influence their functioning. Another issue that requires a deeper understanding is the connections between sexual dysfunctions in this group and various aspects of the so-called minority stress, such as internalized homophobia and experiencing discrimination, psychoactive substance abuse, HIV infection, and the sexual and partnership lifestyle.

  18. HIV Status Discordance: Associated Factors Among HIV Positive Pregnant Women in Lagos, Southwest Nigeria.

    Science.gov (United States)

    Uah, Innocent A O; Ezechi, Oliver C; Ohihoin, Aigbe Gregory

    2015-06-01

    The HIV negative partner in a HIV serodiscordant relationship is at high risk of becoming HIV infected. The annual risk of HIV infection for a partner of a person with HIV is about 10%, with higher annual transmission rates of 20-25% per year reported in Rwanda and Zambia. Although there is considerable variation across countries, recent studies in southern and east Africa countries with mature epidemics reported that up to two-thirds of infected persons in stable relationship are discordant. HIV serodiscordance is thus a recognized priority for HIV prevention intervention. In Nigeria only few studies have studied the burden of serodiscordance, making planning difficult. In this study HIV serodiscordance rate and associated factors among pregnant women were assessed in a large PMTCT clinic in Lagos Nigeria over a 9 years period. Information on HIV status disclosure, partners HIV status (confirmed by HIV test results), sociodemographic characteristics and reproductive information were obtained from the women after enrollment and entered into the case file. In the study, relevant information was managed with SPSS for windows version 19.0. The variables independently associated with HIV status discordance were determined in both univariate and multivariate analysis. P values and Odd ratio with their confidence intervals were calculated. Out of the 4435 women enrolled during the study period, 3712 (83.7%) had disclosed their status to their partner. Partner's HIV status among the women with confirmed HIV status was negative in 2065 (66.8%) women, thus a discordant rate of 66.8%. HIV status disclosure rate was 83.7%; with significantly higher disclosure rate in concordant couple (83.3%) compared to 76.8% among women in serodiscordant relationship (p = 0.00; OR: 1.5; 95% CI: 1.25-1.82). Discordant HIV status in a female positive relationship was found to be associated with history of at least two termination of pregnancy (OR: 3.05; 95% CI: 2.91-3.89) and five or more

  19. Heterosexual and homosexual partners practising unprotected sex may develop allogeneic immunity and to a lesser extent tolerance.

    Science.gov (United States)

    Kingsley, Cherry; Peters, Barry; Babaahmady, Kaboutar; Pomeroy, Laura; Rahman, Durdana; Vaughan, Robert; Lehner, Thomas

    2009-11-23

    Epidemiological studies suggest that allogeneic immunity may inhibit HIV-1 transmission from mother to baby and is less frequent in multiparous than uniparous women. Alloimmune responses may also be elicited during unprotected heterosexual intercourse, which is associated ex vivo with resistance to HIV infection. The investigation was carried out in well-defined heterosexual and homosexual monogamous partners, practising unprotected sex and a heterosexual cohort practising protected sex. Allogeneic CD4(+) and CD8(+) T cell proliferative responses were elicited by stimulating PBMC with the partners' irradiated monocytes and compared with 3(rd) party unrelated monocytes, using the CFSE method. Significant increase in allogeneic proliferative responses was found in the CD4(+) and CD8(+) T cells to the partners' irradiated monocytes, as compared with 3(rd) party unrelated monocytes (pparty monocytes was consistent with tolerization, in both the heterosexual and homosexual partners (psex (psex (p = 0.02). Both heterosexual and homosexual monogamous partners practising unprotected sex develop allogeneic CD4(+) and CD8(+) T cell proliferative responses to the partners' unmatched cells and a minority may be tolerized. However, a greater proportion of homosexual rather than heterosexual partners developed CD4(+)CD25FoxP3(+) regulatory T cells. These results, in addition to finding greater inhibition of HIV-1 infectivity in PBMC ex vivo in heterosexual partners practising unprotected, compared with those practising protected sex, suggest that allogeneic immunity may play a significant role in the immuno-pathogenesis of HIV-1 infection.

  20. Top Questions in ID: Pre-exposure Prophylaxis for HIV

    OpenAIRE

    Krakower, Douglas S.; Cohen, Stephanie E.; Mayer, Kenneth H.

    2017-01-01

    Abstract HIV pre-exposure prophylaxis (PrEP) is highly efficacious at preventing HIV acquisition. This review discusses ways to identify candidates for PrEP, recommended PrEP regimens, baseline and follow-up evaluations, applications of PrEP for HIV-serodiscordant couples, resources to address financial barriers, investigational strategies for PrEP, and educational resources for clinicians and patients.

  1. Pregnancy Incidence and Outcomes among Women Receiving Pre-Exposure Prophylaxis for HIV Prevention: A Randomized Clinical Trial

    Science.gov (United States)

    Mugo, Nelly R.; Hong, Ting; Celum, Connie; Donnell, Deborah; Bukusi, Elizabeth A.; John-Stewart, Grace; Wangisi, Jonathan; Were, Edwin; Heffron, Renee; Matthews, Lynn T.; Morrison, Susan; Ngure, Kenneth; Baeten, Jared M.

    2015-01-01

    Importance Antiretroviral pre-exposure prophylaxis (PrEP), using tenofovir disoproxil fumarate and combination tenofovir disoproxil fumarate / emtricitabine, is efficacious for prevention of HIV acquisition. PrEP could reduce periconception HIV risk, but the effect on pregnancy outcomes is not well defined. Objective To assess pregnancy incidence and outcomes among women using PrEP during the periconception period. Design Randomized trial among 1785 HIV serodiscordant heterosexual couples (the Partners PrEP Study) in which the female partner was HIV uninfected that demonstrated that PrEP was efficacious for HIV prevention, conducted between July 2008 and June 2013 at 9 sites in Kenya and Uganda. Intervention Daily oral tenofovir disoproxil fumarate (TDF) (n=598), combination tenofovir disoproxil fumarate and emtricitabine (TDF-FTC) (n=566), or placebo (n=621) through July 2011, when PrEP demonstrated efficacy for HIV prevention; thereafter, participants continued receiving active PrEP, without placebo. Pregnancy testing occurred monthly and study medication was discontinued upon pregnancy detection. Main Outcomes Pregnancy incidence, birth outcomes (pregnancy loss, preterm birth, congenital anomalies), infant growth. Results A total of 431 pregnancies occurred. Pregnancy incidence was 10.0 per 100 person-years among women assigned placebo, 11.9 among those assigned TDF (incidence difference 1.9, 95% confidence interval [CI] −1.1–4.9, p=0.22 versus placebo), and 8.8 among those assigned TDF-FTC (incidence difference −1.3, 95% CI −4.1–1.5, p=0.39 versus placebo). Prior to discontinuation of the placebo treatment group in July 2011, the occurrence of pregnancy loss (96 of 288 pregnancies), was 42.5% for women receiving TDF-FTC compared with 32.3% for those receiving placebo (difference for TDF-FTC versus placebo 10.2%, 95% CI −5.3–25.7, p=0.16) and was 27.7% for those receiving TDF alone (difference versus placebo −4.6%, 95% CI −18.1–8.9, p=0

  2. Pregnancy and transmission of Human Immunodefiency Virus (HIV ...

    African Journals Online (AJOL)

    Conclusion: The incidence of HIV transmission to the male uninfected partner in a serodiscodant setting in Jos during pregnancy is low but its occurrence in this study suggests the need to re-test the seronegative male partners after every pregnancy. Keywords: pregnancy, human immunodeficiency virus, serodiscordance, ...

  3. Heterosexual Allies: A Descriptive Profile

    Science.gov (United States)

    Goldstein, Susan B.; Davis, Denise S.

    2010-01-01

    Forty-six heterosexual members of a college-based gay/straight alliance organization were surveyed to investigate characteristics of students who commit to acting as allies in reducing sexual prejudice. Assessment focused on the students' history of intergroup contact and exposure to sexual prejudice prior to joining the gay/straight alliance,…

  4. HIV sexual transmission is predominantly driven by single individuals rather than discordant couples: a model-based approach.

    Directory of Open Access Journals (Sweden)

    David Champredon

    Full Text Available Understanding the relative contribution to HIV transmission from different social groups is important for public-health policy. Information about the importance of stable serodiscordant couples (when one partner is infected but not the other relative to contacts outside of stable partnerships in spreading disease can aid in designing and targeting interventions. However, the overall importance of within-couple transmission, and the determinants and correlates of this importance, are not well understood. Here, we explore how mechanistic factors - like partnership dynamics and rates of extra-couple transmission - affect various routes of transmission, using a compartmental model with parameters based on estimates from Sub-Saharan Africa. Under our assumptions, when sampling model parameters within a realistic range, we find that infection of uncoupled individuals is usually the predominant route (median 0.62, 2.5%-97.5% quantiles: 0.26-0.88, while transmission within discordant couples is usually important, but rarely represents the majority of transmissions (median 0.33, 2.5%-97.5% quantiles: 0.10-0.67. We find a strong correlation between long-term HIV prevalence and the contact rate of uncoupled individuals, implying that this rate may be a key driver of HIV prevalence. For a given level of prevalence, we find a negative correlation between the proportion of discordant couples and the within-couple transmission rate, indicating that low discordance in a population may reflect a relatively high rate of within-couple transmission. Transmission within or outside couples and among uncoupled individuals are all likely to be important in sustaining heterosexual HIV transmission in Sub-Saharan Africa. Hence, intervention policies should be broadly targeted when practical.

  5. "Sikker sex" blandt hiv-smittede heteroseksuelle par

    DEFF Research Database (Denmark)

    Weis, N M; Skinnes, L; Vesterdal, B

    1999-01-01

    To investigate the use of condoms ("safe sex") as prevention of transmission with human immuno deficiency virus (hiv) among heterosexual couples, 57 hiv-positive heterosexual patients and their partners if there was one interviewed. Forty-three of the 57 patients were heterosexually infected. Five...... at being given the possibility of talking about problems regarding hiv-transmission and sexuality. In conclusion a discrepancy was found between knowledge about transmission of hiv and the use of condoms among heterosexual couples. Udgivelsesdato: 1999-Jun-14...

  6. Condom use and concurrent partnering among heterosexually active, African American men: a qualitative report.

    Science.gov (United States)

    Frye, Victoria; Williams, Kim; Bond, Keosha T; Henny, Kirk; Cupid, Malik; Weiss, Linda; Lucy, Debbie; Koblin, Beryl A

    2013-10-01

    African Americans are overrepresented among heterosexual cases of HIV/AIDS in the USA. Inconsistent condom use and concurrent partnering are two sexual behaviors driving the heterosexual HIV epidemic in the African American community. To inform the development of an HIV prevention behavioral intervention to decrease concurrent partnering and increase condom use among African American heterosexual men, we conducted formative research, including 61 structured interviews, 5 focus groups with 25 men, and 30 in-depth qualitative interviews between July and December 2009. We used a grounded theoretical approach and categorizing strategies to code and analyze the qualitative data. Results around condom use confirmed earlier findings among heterosexual men in general: condoms diminish pleasure, interfere with erection, and symbolize infidelity. Although valued by some as a form of disease prevention and pregnancy prevention, condoms are often used only with specific types of female partners, such as new or casual partners, or due to visual risk assessment. Sex partner concurrency was described as normative and ascribed to men's "natural" desire to engage in a variety of sexual activities or their high sex drive, with little recognition of the role it plays in the heterosexual HIV epidemic. Fatherhood emerged among many men as a crucial life event and compelling motivation for reducing sexual risk behavior. Based on these results, we conclude that existing HIV prevention efforts to improve attitudes towards and motivate use of condoms either have not reached or have not been successful with African American heterosexual men. In designing behavioral interventions to decrease concurrent partnering and increase condom use, addressing negative attitudes towards condoms and partner risk assessment is critical, as is integrating novel motivational approaches related to identity as fathers and men in the African American community.

  7. Identifying risk: a comparison of risk between heterosexual-identifying bisexual men and other bisexual men in Vientiane, Laos.

    Science.gov (United States)

    Bowring, Anna; van Gemert, C; Vongsaiya, K; Hughes, C; Sihavong, A; Phimphachanh, C; Chanlivong, N; Toole, M; Hellard, M

    2014-04-01

    Men who have sex with men are a priority population for HIV control in Laos, but encompass men diverse in sexual orientation, gender identification, and behavior. Behaviorally bisexual men and their sexual partners were recruited in Vientiane, Laos, in 2010 using modified snowball sampling. Heterosexual-identifying bisexual men identified as exclusively/predominantly heterosexual and other bisexual men identified as bisexual or predominantly/exclusively homosexual. Sixty (68%) heterosexual-identifying and 38 (32%) other bisexual men were recruited; the median number of sex partners in the past year was eight and seven, respectively. Consistent condom use was low with regular (7%) and casual (35%) partners and did not differ by identity. More heterosexual-identifying (53%) than other bisexual (29%) men reported weekly alcohol consumption. Twelve (20%) heterosexual-identifying and 15 (54%) other bisexual men correctly answered all HIV-knowledge questions. High-risk behaviors for STI and HIV transmission were common. Targeted HIV prevention initiatives are needed, particularly to reach heterosexual-identifying bisexual men.

  8. The geography of heterosexual partnerships in Baltimore city adults.

    Science.gov (United States)

    Gindi, Renee M; Sifakis, Frangiscos; Sherman, Susan G; Towe, Vivian L; Flynn, Colin; Zenilman, Jonathan M

    2011-04-01

    Human immunodeficiency virus/sexually transmitted disease (HIV/STD) risk is determined in part by sexual network characteristics, which include spatial parameters. Geography and proximity of partner selection are important factors, which may explain neighborhood-level differences in HIV/STD morbidity. To study the effects of neighborhood factors on HIV/STD transmission in high-density urban areas, the geography of partner selection must be understood. The Baltimore site of the National HIV Behavioral Surveillance system surveyed adults reporting one or more heterosexual partnerships. Spatial assortativity was defined as both partners residing in the same or adjacent census tracts and based on participant report. HIV core areas were defined as the census tracts in the top quartile for standardized HIV/AIDS case rates. Participants (n = 307) provided data on 776 recent sexual partnerships, and geographic information were obtained for 510 partnerships (66%). Almost half (47%) reported choosing spatially assortative partners. Participants who lived in high HIV-prevalence areas were more likely to choose spatially assortative partners than residents of lower prevalence areas after adjusting for partnership type, gender, and number of partners. Although this population exhibited assortative mixing in all types of partnerships, racial and age assortativities were not associated with choosing spatially assortative partners. Over 15 years ago, STD clinic patients in Baltimore were found to seek partners within close proximity. We confirm these results in a non-STD clinic population, indicating a continuing need for neighborhood approaches to intervention programs in urban areas.

  9. A Pilot Intervention to Promote Safer Sex in Heterosexual Puerto Rican Couples

    OpenAIRE

    Pérez-Jiménez, David; Seal, David Wyatt; Ronis, David L

    2014-01-01

    Although the sexual transmission of HIV occurs in the context of an intimate relationship, preventive interventions with couples are scarce, particularly those designed for Hispanics. In this article, we present the effect of a pilot intervention directed to prevent HIV/AIDS in heterosexual couples in Puerto Rico. The intervention was theory-based and consisted of five three-hour group sessions. Primary goals included increasing male condom use and the practice of mutual masturbation as a saf...

  10. Values and Preferences on the Use of Oral Pre-exposure Prophylaxis (PrEP) for HIV Prevention Among Multiple Populations: A Systematic Review of the Literature.

    Science.gov (United States)

    Koechlin, Florence M; Fonner, Virginia A; Dalglish, Sarah L; O'Reilly, Kevin R; Baggaley, Rachel; Grant, Robert M; Rodolph, Michelle; Hodges-Mameletzis, Ioannis; Kennedy, Caitlin E

    2017-05-01

    Daily oral pre-exposure prophylaxis (PrEP) is the use of antiretroviral drugs by HIV-negative people to prevent HIV infection. WHO released new guidelines in 2015 recommending PrEP for all populations at substantial risk of HIV infection. To prepare these guidelines, we conducted a systematic review of values and preferences among populations that might benefit from PrEP, women, heterosexual men, young women and adolescent girls, female sex workers, serodiscordant couples, transgender people and people who inject drugs, and among healthcare providers who may prescribe PrEP. A comprehensive search strategy reviewed three electronic databases of articles and HIV-related conference abstracts (January 1990-April 2015). Data abstraction used standardised forms to categorise by population groups and relevant themes. Of 3068 citations screened, 76 peer-reviewed articles and 28 conference abstracts were included. Geographic coverage was global. Most studies (N = 78) evaluated hypothetical use of PrEP, while 26 studies included individuals who actually took PrEP or placebo. Awareness of PrEP was low, but once participants were presented with information about PrEP, the majority said they would consider using it. Concerns about safety, side effects, cost and effectiveness were the most frequently cited barriers to use. There was little indication of risk compensation. Healthcare providers would consider prescribing PrEP, but need more information before doing so. Findings from a rapidly expanding evidence base suggest that the majority of populations most likely to benefit from PrEP feel positively towards it. These same populations would benefit from overcoming current implementation challenges with the shortest possible delay.

  11. HIV Transmission Patterns Among The Netherlands, Suriname, and The Netherlands Antilles: A Molecular Epidemiological Study

    NARCIS (Netherlands)

    Kramer, Merlijn A.; Cornelissen, Marion; Paraskevis, Dimitrios; Prins, Maria; Coutinho, Roel A.; van Sighem, Ard I.; Sabajo, Lesley; Duits, Ashley J.; Winkel, Cai N.; Prins, Jan M.; van der Ende, Marchina E.; Kauffmann, Robert H.; Op de Coul, Eline L.

    2011-01-01

    We aimed to study patterns of HIV transmission among Suriname, The Netherlands Antilles, and The Netherlands. Fragments of env, gag, and pol genes of 55 HIV-infected Surinamese, Antillean, and Dutch heterosexuals living in The Netherlands and 72 HIV-infected heterosexuals living in Suriname and the

  12. Implementation of Couples' Voluntary HIV Counseling and Testing ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Implementation of Couples' Voluntary HIV Counseling and Testing Services in Durban, South Africa, for HIV Prevention and Intervention. Heterosexual couples represent the largest HIV risk group in sub-Saharan Africa. Couples' Voluntary HIV Counseling and Testing (CVCT) is an effective HIV prevention strategy because ...

  13. Concurrent partnering and condom use among rural heterosexual African-American men.

    Science.gov (United States)

    Ricks, Janelle M; Geter, Angelica; Crosby, Richard A; Brown, Emma

    2014-03-01

    Background Limited research has targeted HIV risk among heterosexual African-American men in the rural south-eastern United States. A cross-sectional survey was administered to 538 men to assess HIV knowledge, attitudes towards HIV testing and sexual risk behaviour. Fifty-one percent reported consistent condom use in the past 3 months. Monogamous men reported more consistent condom use (t=3.47, d.f.=536, Ppartners (AOR=1.49, 95% CI=1.26-1.76, Ppartnering in rural settings.

  14. Sexual behavior patterns and HIV risks in bisexual men compared to exclusively heterosexual and homosexual men Patrones de comportamiento sexual y de riesgo al VIH en hombres bisexuales comparados con hombres heterosexuales y homosexuales exclusivos

    Directory of Open Access Journals (Sweden)

    José Antonio Izazola-Licea

    2003-01-01

    Full Text Available OBJECTIVE: To compare patterns of sexual behavior among bisexual, heterosexual and homosexual men. MATERIAL AND METHODS:A household probability survey was carried out in Mexico City in 1992-1993 using the national health surveys sampling frame. Information from 8 068 men was obtained; however, the main analysis of this paper refers only to men sexually active in the previous 5 years. RESULTS: Bisexuals reported more prevalent anal intercourse with women (16% vs. 3%, p=0.01, and more sexual encounters with female sex workers than exclusive heterosexuals (10% vs. 4%; p=0.04. Bisexuals used condoms more often with sex workers than did heterosexuals (p=0.01. Most of the bisexuals (79% did not engage in anal receptive or insertive intercourse with males in the previous year, practicing instead oral insertive sex or only masturbation; 35% of homosexuals did not report practicing anal sex. Bisexuals who engaged in anal intercourse had less anal receptive behavior than homosexuals (13% vs. 60%, pOBJETIVO: Comparar los patrones de comportamiento sexual entre hombres bisexuales, heterosexuales y homosexuales. MATERIAL Y MÉTODOS: Se llevó a cabo una encuesta probabilística en hogares de la Ciudad de México en 1992-1993, utilizando el marco muestral de las Encuestas Nacionales de Salud; se obtuvo información de 8 068 hombres entre 15 y 60 años de edad. El análisis principal de este trabajo se centra en hombres sexualmente activos en los cinco años previos a la encuesta. RESULTADOS: Los hombres bisexuales notificaron con mayor frecuencia relaciones sexuales anales con mujeres (16% vs. 3%, p=0.01, y mayor frecuencia de relaciones sexuales con trabajadoras sexuales que los heterosexuales exclusivos (10% vs. 4%, p=0.04. Los bisexuales usaron condones más frecuentemente con trabajadoras sexuales que los heterosexuales (p=0.01. La mayoría de los bisexuales (79% no mantuvieron relaciones sexuales anales (receptivas o insertivas con otros hombres en el a

  15. Heterosexual and homosexual partners practising unprotected sex may develop allogeneic immunity and to a lesser extent tolerance.

    Directory of Open Access Journals (Sweden)

    Cherry Kingsley

    Full Text Available BACKGROUND: Epidemiological studies suggest that allogeneic immunity may inhibit HIV-1 transmission from mother to baby and is less frequent in multiparous than uniparous women. Alloimmune responses may also be elicited during unprotected heterosexual intercourse, which is associated ex vivo with resistance to HIV infection. METHODOLOGY/PRINCIPAL FINDINGS: The investigation was carried out in well-defined heterosexual and homosexual monogamous partners, practising unprotected sex and a heterosexual cohort practising protected sex. Allogeneic CD4(+ and CD8(+ T cell proliferative responses were elicited by stimulating PBMC with the partners' irradiated monocytes and compared with 3(rd party unrelated monocytes, using the CFSE method. Significant increase in allogeneic proliferative responses was found in the CD4(+ and CD8(+ T cells to the partners' irradiated monocytes, as compared with 3(rd party unrelated monocytes (pheterosexual and homosexual partners (p<0.01. Examination of CD4(+CD25(+FoxP3(+ regulatory T cells by flow cytometry revealed a significantly greater proportion of these cells in the homosexual than heterosexual partners practising unprotected sex (p<0.05. Ex vivo studies of infectivity of PBMC with HIV-1 showed significantly greater inhibition of infectivity of PBMC from heterosexual subjects practising unprotected compared with those practising protected sex (p = 0.02. CONCLUSIONS/SIGNIFICANCE: Both heterosexual and homosexual monogamous partners practising unprotected sex develop allogeneic CD4(+ and CD8(+ T cell proliferative responses to the partners' unmatched cells and a minority may be tolerized. However, a greater proportion of homosexual rather than heterosexual partners developed CD4(+CD25FoxP3(+ regulatory T cells. These

  16. When Heterosexuality is Questioned: Stifling Suspicion Through Public Displays of Heterosexual Identity.

    Science.gov (United States)

    Davis-Delano, Laurel R; Morgan, Elizabeth M; Gillard, Ann; Davis, Coralynn V

    2017-10-02

    This study examined public heterosexual identity management practices of heterosexual-identified young adults in the United States. Analysis of 415 participants' written narratives indicated that 41% (n = 169) described consciously engaging in public displays of their heterosexual status in relation to suspicion about their sexual orientation. This article describes our findings regarding five aspects of these narratives of suspicion: types of suspicion, causes of suspicion, reasons for concern about suspicion, the types of public displays of heterosexual status employed to quell suspicion, and intended audiences for these displays. Overall, the results indicated that heterosexual identity suspicion is multifaceted, this suspicion serves as a catalyst for public displays of heterosexual status, and the climate of suspicion described by our participants reflects and reinforces contemporary heterosexism.

  17. Heterosexual Attitudes towards Same-Sex Marriage

    OpenAIRE

    Moskowitz, David A.; Rieger, Gerulf; Roloff, Michael E.

    2010-01-01

    Negative attitudes of heterosexual people toward same-sex marriage relate to the degree to which they are homophobic. However, it has been understudied whether there exists a gender difference in this association. Our results indicated that homophobia was the best predictor of attitudes toward gay male and lesbian marriage, and this was equally true for both heterosexual men and women. However, the attitudinal difference between gay male and lesbian marriage was related to homophobia in men b...

  18. Predictors of HIV Sexual Risk Behavior among Men Who Have Sex with Men, Men Who Have Sex with Men and Women, and Transgender Women

    OpenAIRE

    Bowers, Jane Rohde; Branson, Catherine M.; Fletcher, Jesse B.; Reback, Cathy J.

    2012-01-01

    Men who have sex with men, men who have sex with men and women, and transgender women are at high risk for HIV infection. This study seeks to clarify which known HIV risk factors (partner type, sex location, serodiscordance, multiple sex partners, substance use during sex) contribute to engagement in high-risk (unprotected receptive anal) sex in each population. Data collected from June 2005 through June 2008 indicate all three populations display different HIV sexual risk profiles. The data ...

  19. How common and frequent is heterosexual anal intercourse among South Africans? A systematic review and meta-analysis

    Directory of Open Access Journals (Sweden)

    Branwen N. Owen

    2017-01-01

    Discussion: Reported heterosexual AI is common but variable among South Africans. Nationally and regionally representative sexual behaviour studies that use standardized recall periods and confidential interview methods, to aid comparison across studies and minimize reporting bias, are needed. Such data could be used to estimate the extent to which AI contributes to South Africa’s HIV epidemic.

  20. HIV

    African Journals Online (AJOL)

    Introduction. The·human immunodeficiency virus (HIV) can be transmiHed from one person to onother through the use of non-sterile nee- dles, syringes, and other skin-piercing and invasive instruments. Proper .sterilization of all such instruments is therefore important to prevent its transmission. HIV is very sensitive to ...

  1. hiv

    African Journals Online (AJOL)

    2016-03-31

    Mar 31, 2016 ... Indexed By: African Journal Online (AJOL); Texila American University; Genamics; Scholarsteer; EIJASR; CAS-American Chemical. Society; and IRMS Informatics India (J-Gate). ABSTRACT. This study evaluated the effect of HIV infection on CD4 T-lymphocyte depletion in people living with HIV/AIDS.

  2. Differences between matched heterosexual and non-heterosexual college students on defense mechanisms and psychopathological symptoms.

    Science.gov (United States)

    Biernbaum, Mark A; Ruscio, Michele

    2004-01-01

    Differences between heterosexual and non-heterosexual college students on measures of defense mechanisms and psychopathological symptoms were examined. Fifty-six (28 heterosexual, 28 non-heterosexual) subjects were drawn from a larger study of college student adjustment. Non-heterosexual subjects were matched to a heterosexual peer on several demographic variables as well as on attachment security/insecurity. Differences between the two groups on the Defense Mechanism Inventory and the Brief Symptom Inventory were tested. Contrary to traditional psychoanalytic conceptions of homosexuality, no differences were found between the two groups on any subscale of the Defense Mechanism Inventory, thereby repudiating one important aspect of traditional psychoanalytic theories on the development of homosexuality. Non-heterosexual students reported significantly higher levels of anxiety, depression, somaticization, paranoid ideation, general symptom severity, and suicidal ideation. These students appear to be at increased risk for psychopathology and suicidal ideation, despite similar defense profiles, when compared to matched heterosexual peers. Additional research is needed to determine the origins of this increased risk, and comprehensive and targeted prevention and intervention programs must be established to ameliorate such risks.

  3. The Attitudes of Australian Heterosexual University Students toward the Suicide of Gay, Lesbian and Heterosexual Peers

    Science.gov (United States)

    Molloy, Mari; McLaren, Suzanne

    2004-01-01

    This study sought to examine the attitudes of heterosexual university students to peer suicide when that peer was gay, lesbian, or heterosexual. University students (n = 206) completed several questionnaires, including The Suicide Attitude Vignette Experience. Results indicated that the suicide act was seen as more justified, acceptable, and…

  4. Contraceptive options for women living with HIV.

    Science.gov (United States)

    Phillips, Sharon; Steyn, Petrus; Temmerman, Marleen

    2014-08-01

    Women living with HIV are often of reproductive age, and many desire effective contraceptive options to delay or prevent pregnancy. We review the safety of various hormonal and non-hormonal contraceptive methods for women living with human immunodeficiency virus (HIV). Additionally, we discuss drug interactions between contraceptive methods and antiretrovirals and the safety of methods with respect to onward transmission to HIV-negative partners for women in sero-discordant partnerships. In general, most methods are safe for most women living with HIV. An understanding of the reproductive goals of each individual patient, as well as her medical condition and medication, should be taken into account when counselling women on their contraceptive options. Further research is needed to understand drug interactions between contraceptives and antiretrovirals better and how to fulfil the contraceptive needs of HIV-positive women. Copyright © 2014. Published by Elsevier Ltd.

  5. [Characteristics of heterosexual love in alcoholics].

    Science.gov (United States)

    Sugawara, Tazuko; Morita, Nobuaki; Tagami, Fujio; Nakatani, Youji

    2008-12-01

    Heterosexual love has many negative impacts on the process of recovery from dependency in a clinical setting; therefore, the present study investigated the characteristics of heterosexual love in alcoholics. Semi-structured interviews were conducted on 23 alcoholics and 14 healthy volunteers in order to ascertain their experiences with heterosexual love, and episodes were compared between the two groups (39 episodes for the alcoholics and 22 episodes for the healthy volunteers). When compared to the healthy volunteers, the length of time from meeting to dating was shorter for the alcoholics, and the measures to deepen relationships were more limited and tended to cause difficulties during the period. In addition, during the period of maintaining relationships, the alcoholics tended to have fewer daily conversations and had more regrets of having started dating. Furthermore, when compared to the healthy volunteers, the mean score for heterosexuality-related satisfaction and the mean score for needing the partner was significantly lower for the alcoholics. These findings suggest that among alcoholics heterosexual love has an element of instability that reflects a lower degree of self-acceptance; therefore, it is necessary to remain aware of this point when providing support.

  6. Detection of HIV and HCV RNA in semen from Brazilian coinfected men using multiplex PCR before and after semen washing

    OpenAIRE

    Cynthia Liliane Motta do Canto; Segurado, Aluisio C; Cláudio Pannut; Agnaldo Cedenho; Miguel Srougi; Deborah Spaine; Silvana Fernandes; Nadily Carretiero; Maria Carolina Bernal; José Eduardo Levi

    2006-01-01

    INTRODUCTION: Prolonged survival of patients under HAART has resulted in new demands for assisted reproductive technologies. HIV serodiscordant couples wish to make use of assisted reproduction techniques in order to avoid viral transmission to the partner or to the newborn. It is therefore essential to test the effectiveness of techniques aimed at reducing HIV and HCV loads in infected semen using molecular biology tests. METHODS: After seminal analysis, semen samples from 20 coinfected pati...

  7. Genital human papillomavirus prevalence and human papillomavirus concordance in heterosexual couples are positively associated with human immunodeficiency virus coinfection.

    Science.gov (United States)

    Mbulawa, Zizipho Z A; Coetzee, David; Marais, Dianne J; Kamupira, Mercy; Zwane, Eugene; Allan, Bruce; Constant, Deborah; Moodley, Jennifer R; Hoffman, Margaret; Williamson, Anna-Lise

    2009-05-15

    This study examined the concordance of genital human papillomavirus (HPV) infection in 254 heterosexually active couples and the impact of HIV coinfection. Genital HPV detection was significantly more common among HIV-infected women than among HIV-seronegative women (99 [68%] of 145 women vs. 33 [31%] of 107 women; P HPV detection was significantly more common among HIV-infected men than among HIV-seronegative men (67 [72%] of 93 and 65 [43%] of 150 men, respectively; P women had a significantly greater prevalence of HPV infection than did HIV-seronegative male partners of HIV-seronegative women (38 [58%] of 65 men vs. 27 [32%] of 85 men; P = .001), indicating that HIV coinfection in one partner has a significant impact on the prevalence of HPV genital infection in the other partner. HPV concordance between couples was associated with HIV infection status (P HPV was associated with HIV concordance status (P = .024). HIV-seronegative couples were more likely to share 1 HPV type and were unlikely to share >1 type, whereas HIV-infected or HIV-discordant couples were more likely to share >1 HPV type. Women with a high HPV load frequently shared HPV types with their male partners, suggesting that a high HPV load may play a role in HPV transmission between partners. In conclusion, HIV coinfection in one or both sexually active partners increased HPV prevalence and HPV type-specific concordance.

  8. The consequences of the heterosexual norm

    Directory of Open Access Journals (Sweden)

    Anna Johansson

    2008-04-01

    Full Text Available Librarians may exclude people accidentally. This is so because there is a widespread use of classifications and subject headings reflecting the heterosexual norm. Critical classification theory tackles this norm for the reason that it affects the retrieval of gay literature. In order to allow a reconsideration of this exclusive practice in the LIS community I challenge two main questions: Firstly, how does the heterosexual norm appear in classification systems and subject headings lists? And secondly, what are the consequences of that practice for the retrieval of gay literature?This paper focuses on the professional practise in Swedish public libraries. If subject cataloguing prevents Lesbians, Gays, Bisexuals and Transgender (LGBT finding their literatures, then Swedish public libraries are upholders of the exclusive heterosexual norm in society.

  9. Single-agent tenofovir versus combination emtricitabine plus tenofovir for pre-exposure prophylaxis for HIV-1 acquisition: an update of data from a randomised, double-blind, phase 3 trial.

    Science.gov (United States)

    Baeten, Jared M; Donnell, Deborah; Mugo, Nelly R; Ndase, Patrick; Thomas, Katherine K; Campbell, James D; Wangisi, Jonathan; Tappero, Jordan W; Bukusi, Elizabeth A; Cohen, Craig R; Katabira, Elly; Ronald, Allan; Tumwesigye, Elioda; Were, Edwin; Fife, Kenneth H; Kiarie, James; Farquhar, Carey; John-Stewart, Grace; Kidoguchi, Lara; Coombs, Robert W; Hendrix, Craig; Marzinke, Mark A; Frenkel, Lisa; Haberer, Jessica E; Bangsberg, David; Celum, Connie

    2014-11-01

    Antiretroviral pre-exposure prophylaxis (PrEP), with daily oral tenofovir disoproxil fumarate or tenofovir disoproxil fumarate in combination with emtricitabine, has been shown to be efficacious for HIV-1 prevention. Although the use of more than one antiretroviral agent is essential for effective HIV-1 treatment, more than one agent might not be required for effective prophylaxis. We assessed the efficacy of single-agent tenofovir disoproxil fumarate relative to combination emtricitabine plus tenofovir disoproxil fumarate as PrEP. We did a randomised, double-blind, placebo-controlled three-group phase 3 trial of daily oral tenofovir disoproxil fumarate and emtricitabine plus tenofovir disoproxil fumarate PrEP in HIV-1 uninfected individuals in heterosexual HIV-1 serodiscordant couples from Kenya and Uganda. After an interim review, the trial's placebo group was discontinued and thereafter the active groups were continued, and participants initially randomly assigned to placebo were offered rerandomisation in a 1:1 ratio to tenofovir disoproxil fumarate or emtricitabine plus tenofovir disoproxil fumarate as PrEP. The primary endpoints were HIV-1 seroconversion and safety. This trial is registered with ClinicalTrials.gov, number NCT00557245. 4410 (99·6%) of 4427 couples received tenofovir disoproxil fumarate or emtricitabine plus tenofovir disoproxil fumarate and were followed up for HIV-1 acquisition. Of 52 incident HIV-1 infections, 31 occurred in individuals assigned tenofovir disoproxil fumarate (incidence 0·71 cases per 100 person-years) and 21 were in those assigned emtricitabine plus tenofovir disoproxil fumarate (0·48 cases per 100 person-years); HIV-1 incidence in the placebo group until discontinuation was two cases per 100 person-years. HIV-1 prevention efficacy with emtricitabine plus tenofovir disoproxil fumarate was not significantly different from that of tenofovir disoproxil fumarate alone (hazard ratio [HR] 0·67, 95% CI 0·39-1·17; p=0·16

  10. Anxiety and Depressive Symptoms Among People Living with HIV and Childhood Sexual Abuse: The Role of Shame and Posttraumatic Growth.

    Science.gov (United States)

    Willie, Tiara C; Overstreet, Nicole M; Peasant, Courtney; Kershaw, Trace; Sikkema, Kathleen J; Hansen, Nathan B

    2016-08-01

    There is a critical need to examine protective and risk factors of anxiety and depressive symptoms among people living with HIV in order to improve quality of life. Structural equation modeling was used to examine the associations between HIV-related shame, sexual abuse-related shame, posttraumatic growth, and anxiety and depressive symptoms among a cohort of 225 heterosexual women and men who have sex with men (MSM) living with HIV who have experienced childhood sexual abuse (CSA). Higher sexual abuse-related shame was related to more anxiety and depressive symptoms for heterosexual women. Higher posttraumatic growth predicted less anxiety symptoms for only heterosexual women. Higher posttraumatic growth predicted less depressive symptoms for heterosexual women and MSM, but the magnitude of this effect was stronger for heterosexual women than MSM. Psychosocial interventions may need to be tailored to meet the specific needs of heterosexual women and MSM living with HIV and CSA.

  11. Non-Heterosexuality, Relationships, and Young Women's Contraceptive Behavior.

    Science.gov (United States)

    Ela, Elizabeth J; Budnick, Jamie

    2017-06-01

    Non-heterosexual young women have a higher rate of unintended pregnancy than their heterosexual peers, but their fertility behaviors are understudied. We use longitudinal data from the Relationship Dynamics and Social Life study to investigate mechanisms contributing to non-heterosexual women's higher pregnancy risk. These data include weekly reports of relationships, sex, and contraceptive use over 30 months. We compare the relationships and fertility behaviors of three groups: exclusively heterosexual (consistent heterosexual behavior, identity, and attraction); mostly heterosexual (heterosexual identity with same-sex behavior and/or same-sex attraction); and LGBTQ (any non-heterosexual identity). We find that mostly heterosexual and LGBTQ women behave differently from exclusively heterosexual women in ways likely to elevate their risk of unintended pregnancy: more distinct partners during the study period, more sexual intercourse with men, less frequent contraceptive use, less use of a dual method (condom plus hormonal method), and more gaps in contraceptive coverage. Mostly heterosexual women resemble LGBTQ women in their contraceptive behavior but have significantly more intercourse with men, which may increase their pregnancy risk relative to both LGBTQ and exclusively heterosexual women. We conclude by considering implications for LGBTQ health and the measurement of sexual minority populations.

  12. Conceptions of heterosexuality and attitudes toward non-heterosexuals of Psychology students from Córdoba

    Directory of Open Access Journals (Sweden)

    Imhoff, Débora

    2012-12-01

    Full Text Available The study analyzes the conceptions of heterosexuality of Psychology students at Universidad Nacional de Córdoba, and explores its associations with attitudes towards homosexuality. An exploratory research design was conducted, mixing qualitative and quantitative approaches, with a non probabilistic sample, 89 students (64 of the initial section of the career and 25 of the final section. Students answered a written self-report about the question: "Heterosexuality, is it natural? Why?". Seven types of conceptions of heterosexuality were identified, four of them based on essentialists views, and three presented socio-constructionist arguments. Data suggests an association between negative attitudes toward homosexuals and essentialists conceptions of heterosexuality, especially in lower grades students. This study generated questions and reflections about future therapist sexualities and gender-blind training.

  13. Homotolerance and Heterosexuality as Norwegian Values

    Science.gov (United States)

    Rothing, Ase; Svendsen, Stine Helena Bang

    2010-01-01

    In recent years, equality between homosexual and heterosexual relationships has increasingly been presented as a marker for Norwegian values. Norwegian schooling encourages tolerance toward homosexuals, and the state shows active interest in counteracting bullying against LGBT (lesbian, gay, bisexual, and transgender) youth by supporting research…

  14. Conceptualizing Heterosexual Identity Development: Issues and Challenges

    Science.gov (United States)

    Hoffman, Rose Marie

    2004-01-01

    This article summarizes the work of R. L. Worthington and J. J. Mohr (2002); R. L. Worthington, H. B. Savoy, F. R. Dillon, and E. R. Vernaglia (2002); and J. J. Mohr (2002) on heterosexual identity development that constituted the Major Contribution section of the July 2002 issue of The Counseling Psychologist. The author provides an overview of…

  15. Young Children, Gender and the Heterosexual Matrix

    Science.gov (United States)

    Paechter, Carrie

    2017-01-01

    In this paper I consider the adult focus of current mainstream gender theory. I relate this to how the concept of the heterosexual matrix originates in a social contract which excludes children from civil society. I argue that this exclusion is problematic both for theoretical reasons and from the perspective of children themselves. I start by…

  16. Update on HIV in Western Europe.

    OpenAIRE

    Nakagawa, F.; Phillips, A N; Lundgren, J. D.

    2014-01-01

    HIV infection in Western Europe is mainly concentrated among men who have sex with men, heterosexuals who acquired HIV from sub-Saharan African countries, and in people who inject drugs. The rate of newly diagnosed cases of HIV has remained roughly stable since 2004 whereas the number of people living with HIV has slowly increased due to new infections and the success of antiretroviral therapy in prolonging life. An ageing population is gradually emerging that will require additional care. Th...

  17. HIV testing among Portuguese men who have sex with men--results from the European MSM Internet Survey (EMIS).

    Science.gov (United States)

    Carvalho, C; Fuertes, R; Lucas, R; Martins, A; Campos, M J; Mendão, L; Schmidt, A J; Barros, H

    2013-10-01

    To describe HIV testing behaviour and context of MSM in Portugal participating in the European MSM Internet Survey (EMIS). Data for the Portuguese sample were extracted and those for 5187 participants were analysed. Multivariate logistic regression models were fitted to quantify the association between participants' characteristics and HIV testing behaviour and context. Seventy-two percent of the participants had ever been tested for HIV and among those ever tested, 11% were diagnosed with HIV. Primary care was the most common testing setting for HIV-negative men (37%). Compared to those never tested, men who had ever taken an HIV test had higher educational level (aOR 1.89, 95% CI 1.67-2.14) and identified themselves as gay/homosexual more frequently (aOR 1.94 , 95% CI 1.70-2.20). HIV testing odds significantly increased with the number of sexual partners in the previous 12 months. Those who reported unprotected anal intercourse (UAI) with a partner of unknown or serodiscordant HIV status in the previous 12 months were less likely to report an HIV test (aOR 0.38, 95% CI 0.33-0.44). Among those never tested or who tested negative, 41% and 22% reported UAI with a partner of unknown or serodiscordant status in the previous 12 months, respectively. Among men with diagnosed HIV, 72% were currently on antiretroviral therapy and 58% reported an undetectable viral load. More than one third (38%) of those who had detectable or unknown/undisclosed viral load reported at least one episode of UAI with a partner of unknown or serodiscordant HIV status in the last 12 months. Actual interventions should focus on: improving testing uptake and counselling; increasing treatment coverage; achieving and maintaining an undetectable viral load; and intensifying prevention efforts focused on consistent condom use. © 2013 British HIV Association.

  18. Measurement Noninvariance of Safer Sex Self-Efficacy Between Heterosexual and Sexual Minority Black Youth.

    Science.gov (United States)

    Gerke, Donald; Budd, Elizabeth L; Plax, Kathryn

    2016-01-01

    Black and lesbian, gay, bisexual, or questioning (LGBQ) youth in the United States are disproportionately affected by HIV and other sexually transmitted diseases (STDs). Although self-efficacy is strongly, positively associated with safer sex behaviors, no studies have examined the validity of a safer sex self-efficacy scale used by many federally funded HIV/STD prevention programs. This study aims to test factor validity of the Sexual Self-Efficacy Scale by using confirmatory factor analysis (CFA) to determine if scale validity varies between heterosexual and LGBQ Black youth. The study uses cross-sectional data collected through baseline surveys with 226 Black youth (15 to 24 years) enrolled in community-based HIV-prevention programs. Participants use a 4-point Likert-type scale to report their confidence in performing 6 healthy sexual behaviors. CFAs are conducted on 2 factor structures of the scale. Using the best-fitting model, the scale is tested for measurement invariance between the 2 groups. A single-factor model with correlated errors of condom-specific items fits the sample well and, when tested with the heterosexual group, the model demonstrates good fit. However, when tested with the LGBQ group, the same model yields poor fit, indicating factorial noninvariance between the groups. The Sexual Self-Efficacy Scale does not perform equally well among Black heterosexual and LGBQ youth. Study findings suggest additional research is needed to inform development of measures for safer sex self-efficacy among Black LGBQ youth to ensure validity of conceptual understanding and to accurately assess effectiveness of HIV/STD prevention interventions among this population.

  19. [HIV sero-conversion rate and risk factors among HIV discordant couples in Zhumadian city, Henan province].

    Science.gov (United States)

    Chen, Fang-fang; Wang, Lan; Han, Juan; Wang, Li-yan; He, Wen-sheng; Guo, Wei; Zhou, Jian-ping; Wang, Lu

    2013-01-01

    To analyze the sero-conversion rate and risk factors among HIV discordant couples in Zhumadian. Sero-discordant couples had been followed up during 2006 - 2011. Information were collected from the National Comprehensive HIV/AIDS Information Management System and the HIV discordant couples Follow-up Management Information System including demographic characteristics of sero-negative spouses, the characteristics of infection and antiretroviral therapy information of index spouses, marital sexual behavior and social support etc., on a biannual basis. Blood specimens of sero-negative spouses were also collected and tested. Cox proportional-hazard model was used to analyze the related risk factors on HIV sero-conversion. Among 4813 sero-discordant couples, 127 HIV sero-conversion spouses were identified, with a total sero-conversion rate as 0.63 per 100 person-years. The one-year sero-conversion rate in 2006 - 2011 ranged from 0.29 to 1.28 per 100 person-years. Factors that associated with increased risk of HIV sero-conversion were: sero-negative spouses with lower education level (RR = 1.50, 95%CI: 1.02 - 2.21, P = 0.04), index spouses not received ART (RR = 3.16, 95%CI: 2.20 - 4.56, P sexual contacts in the past 6 months with frequency of ≥ 4 times per month (RR = 4.27, 95%CI: 2.89 - 6.30, P conversion rate among sero-negative spouses in Zhumadian had been stabilized and the rate was lower than it was in the last years. The increase of ART acceptance and its adherence and social support should be improved and focused on the follow-up management towards the serodiscordant couples.

  20. Body image satisfaction in heterosexual, gay, and lesbian adults.

    Science.gov (United States)

    Peplau, Letitia Anne; Frederick, David A; Yee, Curtis; Maisel, Natalya; Lever, Janet; Ghavami, Negin

    2009-10-01

    Does the prevalence and degree of body dissatisfaction differ among heterosexual and homosexual men and women? Some theorists have suggested that, compared to their heterosexual peers, gay men are at greater risk for body dissatisfaction and lesbians at lower risk. Past studies examining this issue have generally relied on small samples recruited from gay or lesbian groups. Further, these studies have sometimes produced conflicting results, particularly for comparisons of lesbian and heterosexual women. In the present research, we compared body satisfaction and comfort with one's body during sexual activity among lesbian women, gay men, heterosexual women, and heterosexual men through two large online studies (Ns = 2,512 and 54,865). Compared to all other groups, heterosexual men reported more positive evaluations of their appearance, less preoccupation with their weight, more positive effects of their body image on their quality of life and the quality of their sex life, more comfort wearing a swimsuit in public, and greater willingness to reveal aspects of their body to their partner during sexual activity. Few significant differences were found among gay men, lesbian women, and heterosexual women. Many gay men (42%) reported that their feelings about their body had negative effects on the quality of their sex life, as did some lesbian women (27%), heterosexual women (30%), and heterosexual men (22%). Overall, the findings supported the hypothesis that gay men are at greater risk than heterosexual men for experiencing body dissatisfaction. There was little evidence that lesbian women experience greater body satisfaction than heterosexual women.

  1. Assessment of the utilization of pre-marital HIV testing services and ...

    African Journals Online (AJOL)

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    Counseling is important to help HIV discordant couples accept safer sex practices to prevent. HIV transmission to the un-infected partner. Couple counseling on HIV can, thus, be provided as part of pre- marital counseling (1). Most HIV infection in sub-Saharan Africa occurs due to heterosexual intercourse between couples ...

  2. Heterosexual Attitudes towards Same-Sex Marriage

    Science.gov (United States)

    Moskowitz, David A.; Rieger, Gerulf; Roloff, Michael E.

    2016-01-01

    Negative attitudes of heterosexual people toward same-sex marriage relate to the degree to which they are homophobic. However, it has been understudied whether there exists a gender difference in this association. Our results indicated that homophobia was the best predictor of attitudes toward gay male and lesbian marriage, and this was equally true for both heterosexual men and women. However, the attitudinal difference between gay male and lesbian marriage was related to homophobia in men but not in women. That is, for men only, being less homophobic towards lesbians than towards gay men was associated with favoring lesbian over gay men marriage. Considering these results, the role of gender in attitudes toward same-sex marriage seems to be as an important moderator of homophobia. PMID:20390996

  3. Heterosexual attitudes toward same-sex marriage.

    Science.gov (United States)

    Moskowitz, David A; Rieger, Gerulf; Roloff, Michael E

    2010-01-01

    Negative attitudes of heterosexual people toward same-sex marriage relate to the degree to which they are homophobic. However, it has been understudied whether there exists a gender difference in this association. Our results indicated that homophobia was the best predictor of attitudes toward gay male and lesbian marriage, and this was equally true for both heterosexual men and women. However, the attitudinal difference between gay male and lesbian marriage was related to homophobia in men but not in women. That is, for men only, being less homophobic toward lesbians than toward gay men was associated with favoring lesbian over gay men marriage. Considering these results, the role of gender in attitudes toward same-sex marriage seems to be as an important moderator of homophobia.

  4. "Sikker sex" blandt hiv-smittede heteroseksuelle par

    DEFF Research Database (Denmark)

    Weis, N M; Skinnes, L; Vesterdal, B

    1999-01-01

    out of 30 patients involved in a relationship (defined as living together for at least three months) used condoms inconsistently. One of these couples was still discordant. Of the remaining 27 patients without steady partners two used condoms inconsistently. The patients expressed great satisfaction......To investigate the use of condoms ("safe sex") as prevention of transmission with human immuno deficiency virus (hiv) among heterosexual couples, 57 hiv-positive heterosexual patients and their partners if there was one interviewed. Forty-three of the 57 patients were heterosexually infected. Five...

  5. Anal high-risk human papillomavirus infection and high-grade anal intraepithelial neoplasia detected in women and heterosexual men infected with human immunodeficiency virus

    OpenAIRE

    Gandra S; Azar A; Wessolossky M

    2015-01-01

    Sumanth Gandra, Aline Azar, Mireya WessolosskyDivision of Infectious Disease and Immunology, University of Massachusetts Medical School, Worcester, MA, USABackground: Although anal high-risk human papillomavirus (HR-HPV) infection and anal cytological abnormalities are highly prevalent among human immunodeficiency virus (HIV)-infected men who have sex with men (MSM), there are insufficient data on these abnormalities among HIV-infected heterosexual men (HSM) and women. In this study, we evalu...

  6. Heterosexual identity and heterosexism: recognizing privilege to reduce prejudice.

    Science.gov (United States)

    Simoni, J M; Walters, K L

    2001-01-01

    We propose that heterosexuals' attitudes toward their own heterosexual identity evolve in a manner similar to the development of racial identity attitudes among Whites-another dominant group with privileged social status. A more developed heterosexual identity, we hypothesized, would be associated with diminished levels of negative attitudes toward non-heterosexuals. To test our hypotheses, we administered to 154 heterosexual students Herek's (1988) Attitudes Toward Gays and Lesbians scale measuring heterosexist (i.e., anti-gay) attitudes and a version of Helms and Carter's (1990) White Racial Identity Attitude Scale (WRIAS) modified to assess heterosexual identity attitudes. Hierarchical regression analyses controlling demographic indicators partially confirmed the hypothesized associations between evolving identity stages and less heterosexist attitudes. The role of recognizing one's social privilege is proposed (though not empirically examined) as a potential mediator between developing a dominant group identity and decreasing prejudicial attitudes towards non-privileged groups. Finally, implications and recommendations for future research and addressing heterosexism are presented.

  7. Heterosexual Rejection and Mate Choice: A Sociometer Perspective.

    Science.gov (United States)

    Zhang, Lin; Liu, Shen; Li, Yue; Ruan, Lu-Jun

    2015-01-01

    Previous studies about the effects of social rejection on individuals' social behaviors have produced mixed results and tend to study mating behaviors from a static point of view. However, mate selection in essence is a dynamic process, and therefore sociometer theory opens up a new perspective for studying mating and its underlying practices. Based on this theory and using self-perceived mate value in the relationship between heterosexual rejection and mate choice as a mediating role, this current study examined the effects of heterosexual rejection on mate choice in two experiments. Results showed that heterosexual rejection significantly reduced self-perceived mate value, expectation, and behavioral tendencies, while heterosexual acceptance indistinctively increased these measures. Self-perceived mate value did not serve as a mediator in the relationship between heterosexual rejection and mate expectation, but it mediated the relationship between heterosexual rejection and mating behavior tendencies toward potential objects. Moreover, individuals evaded both rejection and irrelevant people when suffering from rejection.

  8. Sexual Exposure to Blood and Increased Risks for Heterosexual HIV ...

    African Journals Online (AJOL)

    A total of 224 men and 276 women living in a Black township in Cape Town, South Africa, were interviewed using a structured questionnaire. Information was elicited on demographic characteristics and sexual behaviours over the three months preceding the interview including engaging in sexual contact that involved ...

  9. Gender inequality dynamics in the prevention of a heterosexual HIV ...

    African Journals Online (AJOL)

    More emphasis could be given to the harm caused to both men and women by certain norms related to masculinity and sexuality, and the subsequent need for combined efforts in reducing intimate partner violence and concurrency. The empowerment and engagement of both women and men as agents of change would ...

  10. Non-heterosexual disclosure at the workplace

    DEFF Research Database (Denmark)

    Voergård-Olesen, Rikke Karen; Eskerod, Pernille

    2013-01-01

    Many organizations state that they would like to develop a more inclusive culture when it comes to sexual orientation. In order to do this insight into non-heterosexual behaviors and considerations concerning disclosure is a prerequisite. As sexual orientation generally is invisible each person has...... a strategic choice concerning (non-)disclosure. Based on an empirical study, we contribute to the understanding of non-heterosexuals’ disclosure strategies and experiences at the workplace. Individual, semi-structured interviews on personal experiences and thoughts were conducted. The interviewees were eight...

  11. Body image, compulsory heterosexuality, and internalized homophobia.

    Science.gov (United States)

    Pitman, G E

    1999-01-01

    ABSTRACT Body dissatisfaction in lesbians is a subject which has traditionally been ignored in the psychological literature on body image and eating disorders. Early feminist theorists and researchers argued that body dissatisfaction in women developed as a way of dealing with the oppression and misogyny they are faced with on a daily basis. However, these theories failed to take issues of race, class, and sexual orientation into account, thereby excluding the experiences of a diversity of women. This article focuses specifically on the lesbian experience and explores how cultural messages about thinness, femininity, and heterosexuality shape lesbians' feelings about their sexuality and about their bodies. Through the inevitable process of internalizing homophobia and fat hatred, both of which are institutionalized ways of keeping heterosexuality and female oppression in place, lesbians may begin to believe that there is something inherently wrong with them and with their bodies. This article explores how the impact of racism, classism, sexism, and homophobia on women may provide a more comprehensive understanding of the cultural forces behind women's dissatisfaction with their bodies.

  12. Normalizing Heterosexuality: Mothers' Assumptions, Talk, and Strategies with Young Children

    Science.gov (United States)

    Martin, Karin A.

    2009-01-01

    In recent years, social scientists have identified not just heterosexism and homophobia as social problems, but also heteronormativity--the mundane, everyday ways that heterosexuality is privileged and taken for granted as normal and natural. There is little empirical research, however, on how heterosexuality is reproduced and then normalized for…

  13. A Qualitative Examination of Heterosexual Consciousness among College Students

    Science.gov (United States)

    Mueller, John A.; Cole, Jennifer C.

    2009-01-01

    The purpose of this study was to explore how heterosexual college students understand and make meaning of their life experiences and how they incorporate those into their sexual orientation consciousness. We interviewed 14 undergraduate and graduate self-identified heterosexual students, ten women and four men, ranging in age from 20 to 24.…

  14. Consistent condom use among Thai heterosexual adult males in Bangkok, Thailand.

    Science.gov (United States)

    Janepanish, Poolsuk; Dancy, Barbara L; Park, Chang

    2011-04-01

    Thai heterosexual males between 20 and 39 years old are at increased risk for HIV infection. Consistent condom use is effective against HIV transmission, but little is known about determinants of consistent condom use for these males. The purpose of this study is to explore determinants of consistent condom use for this population. The determinants of interest are age, educational level, marital status, income, and concepts from the theory of planned behavior: attitude toward condom use, subjective norm about consistent condom use, perceived behavioral control (PBC) of consistent condom use, and intention to use condoms consistently. We used a cross-sectional descriptive research design with a convenience sample of 400 heterosexual Thai males between 20 and 39 years. Our sample had a mean age of 28.71 years (SD = 6.33). During the last three months, 39.5% reported using condoms consistently, 23% reported using condoms inconsistently, and 37.5% reported never using condoms. The results from the regression analyses revealed that marital status, income, subjective norm about consistent condom use, PBC of consistent condom use, and intention to use condoms consistently were determinants of consistent condom use. Also the effect of subjective norm about consistent condom use and PBC of consistent condom use on consistent condom use was mediated by intention to use condoms consistently. These results suggest that interventions to increase consistent condom use should focus on enhancing intention to use condoms consistently by promoting subjective norm about consistent condom use and PBC of consistent condom use.

  15. Influence of human immunodeficiency virus and CD4 count on the prevalence of human papillomavirus in heterosexual couples.

    Science.gov (United States)

    Mbulawa, Zizipho Z A; Marais, Dianne J; Johnson, Leigh F; Boulle, Andrew; Coetzee, David; Williamson, Anna-Lise

    2010-12-01

    This study investigated the impact of human immunodeficiency virus (HIV) infection on genital human papillomavirus (HPV) in heterosexual couples. More HIV-positive men and women had genital HPV compared with HIV-negative men (77 vs 49%; Pwomen (74 vs 36%; Pmen and women with partners who were HPV positive had HPV genital infection compared with those with HPV-negative partners (for men, 72% compared with 40%; PMen with HIV-positive female partners were at greater risk of high-risk HPV and low-risk HPV (LR HPV) infection compared with men with HIV-negative female partners. This risk increased with decreasing CD4 count { ≥ 350 ml⁻¹: odds ratio [OR ], 2.37 [95% confidence interval (CI), 1.47-3.83]; HPV of any type was not found to differ between women with an HIV-positive or HIV-negative male partner. In men, HIV infection and female partner HIV-positive status were both associated with a higher risk of type-specific HPV concordance with their sexual partner, though the associations were not significant for LR HPV. In women, HIV infection and low CD4 count were significantly associated with increased risk of type-specific HPV concordance, but male partner HIV-positive status was not significantly associated with this concordance. In conclusion, male genital HPV prevalence and type-specific sharing were influenced by their own HIV-positive status and that of their female partner. In contrast, female genital HPV prevalence and HPV type-specific sharing were determined by their own HIV-positive status and not by that of their male partner.

  16. Treatment as prevention: are Argentinean HIV care providers willing to adopt earlier antiretroviral therapy?

    Science.gov (United States)

    Socías, María Eugenia; Sued, Omar; Pryluka, Daniel; Patterson, Patricia; Fink, Valeria; Cesar, Carina; Cahn, Pedro

    2014-01-01

    HIV guidelines increasingly recommend antiretroviral therapy (ART) initiation at a higher CD4 levels. The extent to which these evolving standards are translated into routine clinical care has not been evaluated in Argentina. During October 2012, we conducted an online survey among Argentinean HIV clinicians to assess their attitudes and practices toward ART initiation and its potential use for HIV prevention. Of the 280 physicians included, 61% would prescribe ART at CD4 ≤ 500 cells/µL for asymptomatic patients. Although, only 11% would recommend ART irrespective of CD4 cell count, 72% would do it for serodiscordant couples, and 75% for sex workers. Most participants agreed that they would consider earlier initiation of ART if transmission risk exists, and that expansion of ART could help decrease HIV incidence. These results suggest that a large proportion of Argentinean HIV care providers are willing to adopt the recently updated Argentinean guidelines recommending earlier ART, especially when high HIV transmission risk exists.

  17. Assessment of the utilization of pre-marital HIV testing services and ...

    African Journals Online (AJOL)

    Background: Pre-marital HIV testing contributes to the prevention of HIV infection by diminishing heterosexual transmission between partners and indirectly also protects any potential child from contracting the virus. Objectives: To assess the utilization and determinants of pre-marital HIV testing in civil marriages taking ...

  18. Lack of HIV testing and dissatisfaction with HIV testing and counselling among men having sex with men in Hungary.

    Science.gov (United States)

    Nyitray, Alan G; Bagyinszky, Ferenc; Ross, Michael W; Schmidt, Axel J

    2017-11-22

    Using data from a large internet-based survey of European men having sex with men (MSM), we assessed factors associated with HIV testing and reasons for dissatisfaction with HIV testing and counselling among Hungarian MSM. A total of 2052 Hungarian MSM provided evaluable data for the European MSM Internet Survey (EMIS) in 2010. χ2 tests and Poisson regression with a robust variance estimator were used to assess factors associated with HIV testing and dissatisfaction with HIV testing and counselling. A total of 42.1% of MSM reported never being testing for HIV. Over one-half of men (54.1%) who reported condomless anal intercourse (CAI) in the prior 12 months with a person of unknown or sero-discordant HIV status reported no lifetime HIV testing. The factor most strongly associated with dissatisfaction with HIV testing and counselling was test site with increased dissatisfaction with inpatient hospital settings vs. community-based organizations. Both lack of HIV testing and dissatisfaction with testing were independently associated with MSM who reported that no one, or only a few people, knew they were attracted to men. Lack of HIV testing was strongly associated with CAI. MSM reported that community-based organizations better supported confidentiality and were more respectful during HIV testing.

  19. Misclassification of men with reported HIV infection in Ukraine.

    Science.gov (United States)

    Čakalo, Jurja-Ivana; Božičević, Ivana; Vitek, Charles; Mandel, Jeffrey S; Salyuk, Tetyana; Rutherford, George W

    2015-10-01

    We analyzed data on reported mode of transmission in case reports of HIV-infections among men in Ukraine. The number of men who were reported to have acquired HIV through heterosexual transmission increased substantially in 2006-2011. However, we estimate that up to 40 % of reported cases of heterosexual transmission among men may actually represent misclassified men who have sex with men or persons who inject drugs. These findings indicate a need to improve the quality of data on reported mode of HIV transmission. Accurate information has important public health implications in planning prevention and treatment services.

  20. The interstitial nuclei of the human anterior hypothalamus: an investigation of variation with sex, sexual orientation, and HIV status.

    Science.gov (United States)

    Byne, W; Tobet, S; Mattiace, L A; Lasco, M S; Kemether, E; Edgar, M A; Morgello, S; Buchsbaum, M S; Jones, L B

    2001-09-01

    The interstitial nuclei of the human anterior hypothalamus (INAH1-4) have been considered candidates for homology with the sexually dimorphic nucleus of the preoptic area of the rat. Volumetric sexual dimorphism has been described for three of these nuclei (INAH1-3), and INAH3 has been reported to be smaller in homosexual than heterosexual men. The current study measured the INAH in Nissl-stained coronal sections in autopsy material from 34 presumed heterosexual men (24 HIV- and 10 HIV+), 34 presumed heterosexual women (25 HIV- and 9 HIV+), and 14 HIV+ homosexual men. HIV status significantly influenced the volume of INAH1 (8% larger in HIV+ heterosexual men and women relative to HIV- individuals), but no other INAH. INAH3 contained significantly more neurons and occupied a greater volume in presumed heterosexual males than females. No sex difference in volume was detected for any other INAH. No sexual variation in neuronal size or density was observed in any INAH. Although there was a trend for INAH3 to occupy a smaller volume in homosexual men than in heterosexual men, there was no difference in the number of neurons within the nucleus based on sexual orientation. Copyright 2001 Academic Press.

  1. Care of women with HIV infection - a gynaecologist/obstetrician's ...

    African Journals Online (AJOL)

    Women, especially those in the reproductive age group, make up more than 50% of people living with HIV/AIDS worldwide. Most of these infections are acquired via heterosexual transmission, and therefore the interaction between HIV infection and most of the gynaecological conditions is to be expected. Further research is ...

  2. Sexual Dysfunction among HIV Patients: Three Case Reports and ...

    African Journals Online (AJOL)

    This may affect individuals' quality of life, interpersonal relationships and HIV treatment. The sub-Saharan Africa (SSA) region is the epicentre of the HIV epidemic, majority of the patients being young (< 30 years old) and in long-term heterosexual relationships. With increased life expectancy due to expanded access to ...

  3. Using Molecular HIV Surveillance Data to Understand Transmission Between Subpopulations in the United States.

    Science.gov (United States)

    Oster, Alexandra M; Wertheim, Joel O; Hernandez, Angela L; Ocfemia, Marie Cheryl Bañez; Saduvala, Neeraja; Hall, H Irene

    2015-12-01

    Studying HIV transmission networks provides insight into the spread of HIV and opportunities for intervention. We identified transmission dynamics among risk groups and racial/ethnic groups in the United States. For HIV-1 pol sequences reported to the US National HIV Surveillance System during 2001-2012, we calculated pairwise genetic distance, identified linked pairs of sequences (those with distance ≤1.5%), and examined transmission category and race/ethnicity of these potential transmission partners. Of 40,950 sequences, 12,910 (32%) were linked to ≥1 other sequence. Of men who have sex with men (MSM) who were linked to ≥1 sequence, 88% were linked to other MSM and only 4% were linked to heterosexual women. Of heterosexual women for whom we identified potential transmission partners, 29% were linked to MSM, 21% to heterosexual men, and 12% to persons who inject drugs. Older and black MSM were more likely to be linked to heterosexual women. Assortative mixing was present for all racial/ethnic groups; 81% of blacks/African Americans linked to other blacks. This analysis is the first use of US surveillance data to infer an HIV transmission network. Our data suggest that HIV infections among heterosexual women predominantly originate from MSM, followed by heterosexual men. Although few MSM were linked to women, suggesting that a minority of MSM are involved in transmission with heterosexual women, these transmissions represent a substantial proportion of HIV acquisitions by heterosexual women. Interventions that reduce transmissions involving MSM are likely to also reduce HIV acquisition among other risk groups.

  4. Processes of sexual orientation questioning among heterosexual women.

    Science.gov (United States)

    Morgan, Elizabeth M; Thompson, Elisabeth Morgan

    2011-01-01

    Because very little is known about heterosexual identity development, this study assesses and describes sexual orientation questioning processes of heterosexual-identified women and offers a comparison of these processes with those employed by their sexual-minority counterparts. Participants included 333 female college students (ages 18-23; M = 19.2): 228 participants primarily identified as "exclusively straight/heterosexual," and 105 participants indicated a sexual-minority identity. Sixty-seven percent of exclusively heterosexual respondents (n = 154) indicated having thought about or questioned their sexual orientation. The processes by which heterosexual participants described questioning their sexual orientation were coded for the presence of five emergent categories using an inductive thematic coding methodology. These five categories included unelaborated questioning (19%), other-sex experiences (16%), exposure to sexual minorities (26%), assessment of same-sex attraction (48%), and evaluations of same-sex behavior (26%). Several unifying and differentiating themes emerged between sexual orientation groups. Results from this study suggest that contemporary young women's heterosexuality is not necessarily an unexamined identity; indeed, the large majority of young women in this sample were deliberately identifying as heterosexual after contemplating alternative possibilities.

  5. [Development of the Heterosexual Love Assessment Scale for Alcoholics].

    Science.gov (United States)

    Sugawarai, Tazuko; Morita, Noriaki; Nakatani, Youji

    2013-10-01

    The purpose of this study was to develop a scale for assessing the attributes of the heterosexual love of alcoholics. Using the characteristics and categories related to the heterosexual love of alcoholics found in previous research, we created a "Heterosexual Love Assessment Scale for Alcoholics" and conducted a survey among 110 alcoholics (80 men and 30 women). The following three factors were extracted from the results: "mutual respect", "superficial intimacy", and "fear of being disliked", A high level of reliability was obtained on the scales indicated below (alpha = 63-82), and concurrent validity was confirmed between these and the Adult Attachment Scale (ECR: Experiences in Close Relationships inventory). Further, correlations were found between "mutual respect" and the benefit of heterosexual love in recovery, and between the other two factors and the impediment of heterosexual love, and between the Denial & Awareness Scale (for alcoholic). As this scale can be used to assess the type of heterosexual love of alcoholics, we predict that it will be useful in examining the effects of heterosexual love on recovery and as a tool for offering advice.

  6. The potential impact of an HIV vaccine with limited protection on HIV incidence in Thailand: a modeling study.

    NARCIS (Netherlands)

    Nagelkerke, N.J.; Hontelez, J.A.; Vlas, S.J. de

    2011-01-01

    BACKGROUND: The RV144 trial on the ALVAC/AIDSVAX candidate HIV vaccine, carried out in Thailand, showed short-lived protection against infection. METHODS: Using a deterministic compartmental model we explored the potential impact of this vaccine on heterosexual HIV transmission in Thailand. Both

  7. Heterosexual masculinity and homophobia: a reaction to the self?

    Science.gov (United States)

    Theodore, P S; Basow, S A

    2000-01-01

    Heterosexual masculinity is the cultural pressure exerted on males to be masculine in traits and heterosexual in orientation or else be viewed as feminine and socially unacceptable. The current study investigated the link between heterosexual masculinity and homophobia in 74 college males. Specifically, gender self-discrepancy (how well males think they fit cultural expectations of how they should act as a man), attribute importance (perceived importance of possessing masculine attributes), and self-esteem were examined as predictors of homophobia. Attribute importance, self-discrepancy along masculine traits, and their interaction significantly predicted degree of homophobia in this sample.

  8. Unprotected anal intercourse and sexually transmitted diseases in high-risk heterosexual women.

    Science.gov (United States)

    Jenness, Samuel M; Begier, Elizabeth M; Neaigus, Alan; Murrill, Christopher S; Wendel, Travis; Hagan, Holly

    2011-04-01

    We examined the association between unprotected anal intercourse and sexually transmitted diseases (STDs) among heterosexual women. In 2006 through 2007, women were recruited from high-risk areas in New York City through respondent-driven sampling as part of the National HIV Behavioral Surveillance study. We used multiple logistic regression to determine the relationship between unprotected anal intercourse and HIV infection and past-year STD diagnosis. Of the 436 women studied, 38% had unprotected anal intercourse in the past year. Unprotected anal intercourse was more likely among those who were aged 30 to 39 years, were homeless, were frequent drug or binge alcohol users, had an incarcerated sexual partner, had sexual partners with whom they exchanged sex for money or drugs, or had more than 5 sexual partners in the past year. In the logistic regression, women who had unprotected anal intercourse were 2.6 times as likely as women who had only unprotected vaginal intercourse and 4.2 times as likely as women who had neither unprotected anal nor unprotected vaginal intercourse to report an STD diagnosis. We found no significant association between unprotected anal intercourse and HIV infection. Increased screening for history of unprotected anal intercourse and, for those who report recent unprotected anal intercourse, counseling and testing for HIV and STDs would likely reduce STD infections.

  9. A Pilot Intervention to Promote Safer Sex in Heterosexual Puerto Rican Couples.

    Science.gov (United States)

    Pérez-Jiménez, David; Seal, David Wyatt; Ronis, David L

    2014-09-01

    Although the sexual transmission of HIV occurs in the context of an intimate relationship, preventive interventions with couples are scarce, particularly those designed for Hispanics. In this article, we present the effect of a pilot intervention directed to prevent HIV/AIDS in heterosexual couples in Puerto Rico. The intervention was theory-based and consisted of five three-hour group sessions. Primary goals included increasing male condom use and the practice of mutual masturbation as a safer sex method, and promoting favorable attitudes toward these behaviors. Twenty-six couples participated in this study. Fifteen were randomly assigned to the intervention group and eleven to a control group. Retention rates at post-intervention and follow-up were 82% for the whole sample. Results showed that there was a significant increase in the use of male condoms with main partners in the intervention group when compared with the control group. Couples in the intervention group also had better scores on secondary outcomes, such as attitudes toward condom use and mutual masturbation, HIV information, sexual decision-making, and social support. We found that these effects persisted over the three month follow up. A significant effect was also observed for the practice of mutual masturbation, but not for sexual negotiation. These results showed that promoting male condom use in dyadic interventions among heterosexual couples in Puerto Rico is feasible. Our findings suggest that because vaginal penetration has been constructed as the sexual script endpoint among many Hispanic couples, promoting other non-penetrative practices, such as mutual masturbation, may be difficult.

  10. Dyadic dynamics of HIV risk among transgender women and their primary male sexual partners: the role of sexual agreement types and motivations.

    Science.gov (United States)

    Gamarel, Kristi E; Reisner, Sari L; Darbes, Lynae A; Hoff, Colleen C; Chakravarty, Deepalika; Nemoto, Toru; Operario, Don

    2016-01-01

    Transgender women - individuals assigned a male sex at birth who identify as women, female, or on the male-to-female trans feminine spectrum - are at high-risk of HIV worldwide. Prior research has suggested that transgender women more frequently engage in condomless sex with primary cisgender (i.e., non-transgender) male partners compared with casual or paying partners, and that condomless sex in this context might be motivated by relationship dynamics such as trust and intimacy. The current study examined sexual agreement types and motivations as factors that shape HIV risk behaviors in a community sample of 191 transgender women and their cisgender primary male partners who completed a cross-sectional survey. Overall, 40% of couples had monogamous, 15% open, and 45% discrepant sexual agreements (i.e., partners disagreed on their type of agreement). Actor-partner interdependence models were fit to examine the influence of sexual agreement type and motivations on extra-dyadic HIV risk (i.e., condomless sex with outside partners) and intra-dyadic HIV serodiscordant risk (i.e., condomless sex with serodiscordant primary partners). For male partners, extra-dyadic risk was associated with their own and their partners' sexual agreement motives, and male partners who engaged in extra-dyadic HIV risk had an increased odds of engaging in HIV serodiscordant intra-dyadic risk. Study findings support inclusion of the male partners of transgender women into HIV prevention efforts. Future research is warranted to explore the interpersonal and social contexts of sexual agreement types and motivations in relationships between transgender women and their male partners to develop interventions that meet their unique HIV prevention needs.

  11. Prevalence of Physical and Psychological Violence among Heterosexual Couples

    National Research Council Canada - National Science Library

    Laura López Angulo; Yenisley Fundora Quintero; Anais Valladares González; Yamila Ramos Rangel; Yanet Blanco Fleites

    2015-01-01

    .... This study demonstrated the reality of this phenomenon in our context. Objective: to determine the prevalence of psychological and physical violence among heterosexual couples in the city of Cienfuegos in 2010. Methods...

  12. The Impact of Prior Heterosexual Experiences on Homosexuality in Women

    Directory of Open Access Journals (Sweden)

    Marissa A. Harrison

    2008-04-01

    Full Text Available An abundance of unwanted sexual opportunities perpetrated by insensitive, physically and sexually abusive men may be a factor in the expression of homosexuality in some women. In the present study, we examined self-reports of dating histories, sexual experiences, and physical and sexual abuse among lesbians and heterosexual women. Lesbians with prior heterosexual experience reported more severe and more frequent physical abuse by men. Lesbians also reported more instances of forced, unwanted sexual contact perpetrated by men, and this sexual abuse occurred at a significantly earlier age. These data show that adverse experiences with the opposite sex are more common in lesbians than heterosexual women, and therefore negative heterosexual experiences may be a factor in the expression of a same-sex sexual orientation in women. We propose an evolutionary psychological interpretation of this phenomenon based on the cardinally different mating strategies of women and men that have evolved for maximizing the likelihood of reproduction.

  13. Comparing Measures of Late HIV Diagnosis in Washington State

    Directory of Open Access Journals (Sweden)

    Laura Saganic

    2012-01-01

    Full Text Available As more US HIV surveillance programs routinely use late HIV diagnosis to monitor and characterize HIV testing patterns, there is an increasing need to standardize how late HIV diagnosis is measured. In this study, we compared two measures of late HIV diagnosis, one based on time between HIV and AIDS, the other based on initial CD4+ results. Using data from Washington's HIV/AIDS Reporting System, we used multivariate logistic regression to identify predictors of late HIV diagnosis. We also conducted tests for trend to determine whether the proportion of cases diagnosed late has changed over time. Both measures lead us to similar conclusions about late HIV diagnosis, suggesting that being male, older, foreign-born, or heterosexual increase the likelihood of late HIV diagnosis. Our findings reaffirm the validity of a time-based definition of late HIV diagnosis, while at the same time demonstrating the potential value of a lab-based measure.

  14. The Impact of Prior Heterosexual Experiences on Homosexuality in Women

    OpenAIRE

    Marissa A. Harrison; Susan M. Hughes; Rebecca L. Burch; Gordon G. Gallup

    2008-01-01

    An abundance of unwanted sexual opportunities perpetrated by insensitive, physically and sexually abusive men may be a factor in the expression of homosexuality in some women. In the present study, we examined self-reports of dating histories, sexual experiences, and physical and sexual abuse among lesbians and heterosexual women. Lesbians with prior heterosexual experience reported more severe and more frequent physical abuse by men. Lesbians also reported more instances of forced, unwanted ...

  15. Contesting 'straights': 'lesbians', 'queer heterosexuals' and the critique of heteronormativity.

    Science.gov (United States)

    Schlichter, Annette

    2007-01-01

    The essay explores interrelations between Lesbian Theory and Queer Straight Theory. It provides a brief genealogy and an interrogation of the "discourse of queer heterosexuality." I argue that Queer Straight Theory is certainly indebted to lesbian (and) feminist critiques of institutional heterosexuality and their denaturalizations of straight and lesbian sexualities. Lesbian and Queer Straight Theories remain in disagreement, however, about notions of power and identity that shape their theoretical and political stances.

  16. Spontaneous otoacoustic emissions in heterosexuals, homosexuals, and bisexuals.

    Science.gov (United States)

    McFadden, D; Pasanen, E G

    1999-04-01

    Click-evoked otoacoustic emissions (CEOAEs) were previously shown to be significantly less strong in homosexual and bisexual females than in heterosexual females. Here it is reported that the spontaneous otoacoustic emissions (SOAEs) of those same 60 homosexual and bisexual females were less numerous and weaker than those in 57 heterosexual females. That is, the SOAEs of the homosexual and bisexual females were intermediate to those of heterosexual females and heterosexual males. The SOAE and CEOAE data both suggest that the cochleas of homosexual and bisexual females have been partially masculinized, possibly as part of some prenatal processes that also masculinized whatever brain structures are responsible for sexual orientation. For males of all sexual orientation, the SOAEs were less numerous and weaker than for the females, and there were no significant differences among the 56 heterosexual, 51 homosexual, and 11 bisexual males. All subjects passed a hearing screening test. When all SOAEs above 3000 Hz were excluded (as a control against incipient, undetected hearing loss) the same results were obtained as with the full range of data (550-9000 Hz). The differential use of oral contraceptives by the heterosexual and nonheterosexual females also could not explain the differences in their OAEs.

  17. Heterosexual Rejection and Mate Choice: A Sociometer Perspective

    Directory of Open Access Journals (Sweden)

    Lin eZHANG

    2015-12-01

    Full Text Available Previous studies about the effects of social rejection on individuals’ social behaviors have produced mixed results and tend to study mating behaviors from a static point of view. However, mate selection in essence is a dynamic process, and therefore sociometer theory opens up a new perspective for studying mating and its underlying practices. Based on this theory and using self-perceived mate value in the relationship between heterosexual rejection and mate choice as a mediating role, this current study examined the effects of heterosexual rejection on mate choice in two experiments. Results showed that heterosexual rejection significantly reduced self-perceived mate value, expectation, and behavioral tendencies, while heterosexual acceptance indistinctively increased these measures. Self-perceived mate value did not serve as a mediator in the relationship between heterosexual rejection and mate expectation, but it mediated the relationship between heterosexual rejection and mating behavior tendencies towards potential objects. Moreover, individuals evaded both rejection and irrelevant people when suffering from rejection.

  18. High rates of HIV seroconversion in pregnant women and low reported levels of HIV testing among male partners in Southern Mozambique: results from a mixed methods study.

    Directory of Open Access Journals (Sweden)

    Caroline De Schacht

    Full Text Available INTRODUCTION: Prevention of acute HIV infections in pregnancy is required to achieve elimination of pediatric HIV. Identification and support for HIV negative pregnant women and their partners, particularly serodiscordant couples, are critical. A mixed method study done in Southern Mozambique estimated HIV incidence during pregnancy, associated risk factors and factors influencing partner's HIV testing. METHODS: Between April 2008 and November 2011, a prospective cohort of 1230 HIV negative pregnant women was followed during pregnancy. A structured questionnaire, HIV testing, and collection of dried blood spots were done at 2-3 scheduled visits. HIV incidence rates were calculated by repeat HIV testing and risk factors assessed by Poisson regression. A qualitative study including 37 individual interviews with men, women, and nurses and 11 focus group discussions (n = 94 with men, women and grandmothers explored motivators and barriers to uptake of male HIV testing. RESULTS: HIV incidence rate was estimated at 4.28/100 women-years (95%CI: 2.33-7.16. Significant risk factors for HIV acquisition were early sexual debut (RR 3.79, 95%CI: 1.04-13.78, p = 0.04 and living in Maputo Province (RR 4.35, 95%CI: 0.97-19.45, p = 0.05. Nineteen percent of women reported that their partner had tested for HIV (93% knew the result with 8/213 indicating an HIV positive partner, 56% said their partner had not tested and 19% did not know their partner test status. Of the 14 seroconversions, only one reported being in a serodiscordant relationship. Fear of discrimination or stigma was reported as a key barrier to male HIV testing, while knowing the importance of getting tested and receiving care was the main motivator. CONCLUSIONS: HIV incidence during pregnancy is high in Southern Mozambique, but knowledge of partners' HIV status remains low. Knowledge of both partners' HIV status is critical for maximal effectiveness of prevention and treatment services to reach

  19. Predictors of advanced disease and late presentation in new HIV diagnoses reported to the surveillance system in Spain

    Directory of Open Access Journals (Sweden)

    Jesús Oliva

    2014-03-01

    Conclusions: Despite universal health care coverage in Spain, men, immigrants and people infected through drug use or heterosexual contact seem to be experiencing difficulties in gaining timely access to HIV care.

  20. Risky sexual behaviour in context: qualitative results from an investigation into risk factors for seroconversion among gay men who test for HIV.

    Science.gov (United States)

    Elam, G; Macdonald, N; Hickson, F C I; Imrie, J; Power, R; McGarrigle, C A; Fenton, K A; Gilbart, V L; Ward, H; Evans, B G

    2008-11-01

    The INSIGHT case-control study confirmed that HIV serodiscordant unprotected anal intercourse (SdUAI) remains the primary risk factor for HIV infection in gay men in England. This paper uses qualitative follow-up data to examine the contexts of SdUAI and other risk factors among the case-control study participants. In-depth interviews were conducted with 26 recent HIV seroconverters and 22 non-converters. Purposive selection was used to provide diversity in demographics and sexual behaviour and to facilitate exploration of risk factors identified in the case-control study. Condoms were perceived as barriers to intimacy, trust and spontaneity. The potential consequences of the loss of these were traded off against the consequences of HIV infection. Previous negative HIV tests and the adoption of risk reduction strategies diminished the perceived threat of HIV infection, supporting beliefs that HIV was something that happened to others. Depression and low self-esteem, often combined with use of alcohol or other drugs, led to further risk taking and loss of control over risk reduction strategies. A range of psychosocial reasons led some men to engage in UAI with serodiscordant or unknown partners, despite high levels of risk awareness. Men in their mid-life, those in serodiscordant relationships and men that had experienced bereavement or other significant, negative, life events revealed factors related to these circumstances that contributed to increases in risky UAI. A diverse portfolio of interventions is required to build confidence and control over safer sex practices that are responsive to gay men's wider emotional needs.

  1. Where You Live Matters: Structural Correlates of HIV Risk Behavior Among Young Men Who Have Sex with Men in Metro Detroit.

    Science.gov (United States)

    Bauermeister, José A; Eaton, Lisa; Andrzejewski, Jack; Loveluck, Jimena; VanHemert, William; Pingel, Emily S

    2015-12-01

    Structural characteristics are linked to HIV/STI risks, yet few studies have examined the mechanisms through which structural characteristics influence the HIV/STI risk of young men who have sex with men (YMSM). Using data from a cross-sectional survey of YMSM (ages 18-29) living in Detroit Metro (N = 328; 9 % HIV-positive; 49 % Black, 27 % White, 15 % Latino, 9 % Other race), we used multilevel modeling to examine the association between community-level characteristics (e.g., socioeconomic disadvantage; distance to LGBT-affirming institutions) and YMSM's HIV testing behavior and likelihood of engaging in unprotected anal intercourse with serodiscordant partner(s). We accounted for individual-level factors (race/ethnicity, poverty, homelessness, alcohol and marijuana use) and contextual factors (community acceptance and stigma regarding same-sex sexuality). YMSM in neighborhoods with greater disadvantage and nearer to an AIDS Service Organization were more likely to have tested for HIV and less likely to report serodiscordant partners. Community acceptance was associated with having tested for HIV. Efforts to address YMSM's exposure to structural barriers in Detroit Metro are needed to inform HIV prevention strategies from a socioecological perspective.

  2. Gender-Specificity in Viewing Time Among Heterosexual Women.

    Science.gov (United States)

    Xu, Yin; Rahman, Qazi; Zheng, Yong

    2017-07-01

    Measures of sexual interest tend to be more gender-specific in heterosexual men than in heterosexual women. Cognitive measures, such as viewing time to attractive stimuli, may also show similar patterns of gender-specificity or nonspecificity among men and women and thus serve as useful adjuncts to more direct measures of sexual interest. The objectives of the present research were to determine the extent of gender-specificity in women's viewing times for female pictures (varying in their perceived physical attractiveness) and explore the influence of social comparison of physical appearance on these patterns of responses. In Study 1, we recorded only women's viewing times for pictures of both genders, measured self-reported menstrual cycle phase, and manipulated the waist-to-hip ratio of the women in the female pictures. In Study 2, we recorded women's and men's viewing times, self-reported sexual attraction to pictures of males and females, and physical appearance social comparison. Study 1 found that heterosexual women's viewing time toward female pictures was not associated with manipulation of the perceived attractiveness of those pictures. Study 2 found that heterosexual men were more gender-specific than heterosexual women in their viewing time patterns. We also found that reported sexual attraction and physical appearance social comparison were associated with heterosexual women's viewing times for female pictures, while heterosexual men's viewing times were associated with sexual attraction only. Our results are discussed in relation to the utility of viewing time as an indicator of visual attention toward attractive or sexually appealing visual stimuli.

  3. Characteristics of HIV diagnoses in Australia, 1993-2006.

    Science.gov (United States)

    Guy, Rebecca J; McDonald, Ann M; Bartlett, Mark J; Murray, Jo C; Giele, Carolien M; Davey, Therese M; Appuhamy, Ranil D; Knibbs, Peter; Coleman, David; Hellard, Margaret E; Grulich, Andrew E; Kaldor, John M

    2008-06-01

    To describe recent trends in the diagnosis of HIV infection in Australia. National HIV surveillance data from 1993 to 2006 were analysed with a focus on geographic differences by HIV exposure route and late presentation (HIV within 3 months of a first AIDS-defining illness or a CD4 count of less than 200 cells muL(-1)). In 1993-99, the number of HIV diagnoses declined by 32%, and then increased by 39% from 1999 to 2006. From 2000 onwards, rates increased significantly in Victoria, Queensland, South Australia and Western Australia. The most frequently reported routes of HIV exposure were male to male sex (71%) and heterosexual contact (18%), and the population rate of diagnoses have increased in both categories. Among the cases reported as heterosexually acquired (n = 2199), 33% were in people born in a high-prevalence country and 19% in those with partners from a high-prevalence country. Late presentation was most frequent in heterosexually acquired infections in persons who had a partner from a high-prevalence country: 32% compared with 20% overall. Recent increases in annual numbers of HIV diagnoses in Australia underline the continuing need for HIV-prevention programs, particularly among men having male to male sex. Early diagnosis and access to care and treatment should also be emphasised, as a substantial proportion of people with HIV infection are unaware of their status until late in the course of disease.

  4. Gender difference in the characteristics of and high-risk behaviours among non-injecting heterosexual methamphetamine users in Qingdao, Shandong Province, China

    Directory of Open Access Journals (Sweden)

    Liu Dianchang

    2013-01-01

    Full Text Available Abstract Background Despite the increasing risk of HIV infections, few studies concerning the characteristics of non-injecting heterosexual methamphetamine (MA users and related risk behaviours have been conducted in China. Methods Gender differences in socio-demographic characteristics, perception of MA and STD/HIV, MA use practices, and sexual behaviours related to MA use were examined among 398 non-injecting heterosexual MA users (288 males, 110 females. Results Male MA users were more likely to be married, local, and self-employed; female MA users were more likely to be young, single, engaged in commercial service or unemployed. Female MA users usually start MA use at an earlier age than males (24.3 vs. 31.3 years old, with shorter abuse durations (2.6 vs. 2.9 years, higher frequency of MA use (3.6 vs. 2.4 times per week, and higher likelihood of using MA with heterosexual partners (100% vs. 78.1%. More male MA users have had multiple sex partners (96.9% vs. 77.3% and sex exchanges (72.9% vs. 46.4%. Among 277 males who had had sex with commercial sex workers (CSW, 69.4% never used condoms, and among 77 males who had had sex with multiple partners who are commercial sex workers and always or usually used condoms, 87.0% never changed condoms when changing partners. Conclusion There may be gender difference in the characteristics of high-risk behaviours among non-injecting heterosexual MA users. The findings suggest the integration of specific risk reduction strategies into intervention programs for non-injecting heterosexual MA user populations may significantly improve program goals.

  5. The characteristics of heterosexual STD clinic attendees who practice oral sex in Zhejiang Province, China.

    Directory of Open Access Journals (Sweden)

    Qiaoqin Ma

    Full Text Available BACKGROUND: The characteristics of heterosexual attendees who visit sexually transmitted disease (STD clinics and practice oral sex have not been revealed in China. This information is important for the development of targeted STD prevention programmes for this population. STUDY DESIGN: A self-administered questionnaire survey with a cross-sectional design was administered to consecutive attendees at four STD clinics in Zhejiang Province, China, between October and December in 2007. Demographic, psychosocial, and behavioural factors associated with oral sex over a lifetime were identified using univariate and multivariate analyses. RESULTS: Of the 872 attendees, 6.9% engaged in oral sex over their lifetimes. Of the oral-sex group, 96.6% also engaged in vaginal sex. The correlates for oral sex over a lifetime as determined by the multivariate analysis were high income (odds ratio [OR] = 2.53, 95% confidence interval [CI] 1.39-4.59, high human immunodeficiency virus (HIV-related knowledge (OR = 2.71, 95% CI 1.26-5.81, early sex initiation (OR = 2.42, 95% CI 1.37-4.27, multiple sexual partners (OR = 3.09, 95% CI 1.58-6.06, and sexually active in the previous 6 months (OR = 7.73, 95% CI 1.04-57.39. CONCLUSIONS: Though the prevalence of oral sex is low, the heterosexual STD clinic attendees practicing oral sex was found to have higher risks associated with STD/HIV transmission than those not. Behavioural and medical interventions conducted by clinicians in Chinese STD clinics should take into account the characteristics and related risks of those who practice oral sex.

  6. Preconception Counseling and Care in the Setting of HIV: Clinical Characteristics and Comorbidities

    Directory of Open Access Journals (Sweden)

    Rupsa C. Boelig

    2015-01-01

    Full Text Available Objective. To describe the demographic and clinical characteristics of HIV-infected individuals and HIV-affected couples who were referred for preconception counseling (PCC at a large urban US-based HIV clinic. Methods. Electronic medical records were reviewed for HIV-infected individuals and HIV-affected couples. Medical, reproductive, surgical, psychosocial, and family history data were abstracted. Univariate analyses were done. Results. There were 8 single HIV-infected women and 100 HIV-affected couples who underwent PCC. HIV-infected women were older (mean age 35 years versus 32 years, P=0.06, were more likely to smoke (23% versus 0%, P<0.01, and had more medical comorbidities (57% versus 33%, P=0.04 than HIV-uninfected women. The majority of couples were serodiscordant (77%, and of these couples, 32% had a detectable plasma viral load and 33% report inconsistent condom use. Conclusions. HIV-infected women have a number of medical and psychosocial issues, including those related to HIV that may increase the risk of adverse pregnancy outcomes and HIV perinatal and sexual transmission. PCC is an important intervention to optimize maternal management to improve perinatal outcomes and minimize transmission risks.

  7. Serosorting Is Associated with a Decreased Risk of HIV Seroconversion in the EXPLORE Study Cohort

    Science.gov (United States)

    Philip, Susan S.; Yu, Xuesong; Donnell, Deborah; Vittinghoff, Eric; Buchbinder, Susan

    2010-01-01

    Background Seroadaptation strategies such as serosorting and seropositioning originated within communities of men who have sex with men (MSM), but there are limited data about their effectiveness in preventing HIV transmission when utilized by HIV-negative men. Methodology/Principal Findings Data from the EXPLORE cohort of HIV-negative MSM who reported both seroconcordant and serodiscordant partners were used to evaluate serosorting and seropositioning. The association of serosorting and seropositioning with HIV seroconversion was evaluated in this cohort of high risk MSM from six U.S. cities. Serosorting was independently associated with a small decrease in risk of HIV seroconversion (OR = 0.88; 95%CI, 0.81–0.95), even among participants reporting ≥10 partners. Those who more consistently practiced serosorting were more likely to be white (p = 0.01), have completed college (p = <0.0002) and to have had 10 or more partners in the six months before the baseline visit (p = 0.01) but did not differ in age, reporting HIV-infected partners, or drug use. There was no evidence of a seroconversion effect with seropositioning (OR 1.02, 95%CI, 0.92–1.14). Significance In high risk HIV uninfected MSM who report unprotected anal intercourse with both seroconcordant and serodiscordant partners, serosorting was associated with a modest decreased risk of HIV infection. To maximize any potential benefit, it will be important to increase accurate knowledge of HIV status, through increased testing frequency, improved test technology, and continued development of strategies to increase disclosure. PMID:20844744

  8. The Role of Relationship Dynamics and Gender Inequalities As Barriers to HIV-Serostatus Disclosure: Qualitative Study among Women and Men Living with HIV in Durban, South Africa

    Directory of Open Access Journals (Sweden)

    Divya S. Bhatia

    2017-07-01

    Full Text Available BackgroundThis qualitative study investigated gender power inequalities as they contribute to relationship dynamics and HIV-serostatus disclosure among men and women living with HIV in Durban, South Africa. HIV serodiscordance among men and women within stable partnerships contributes to high HIV incidence in southern Africa, yet disclosure rates remain low. Given the emphasis on prevention for HIV-serodiscordant couples, this research supports the urgent need to explore how best to support couples to recognize that they are part of this priority population and to access appropriate prevention and treatment.MethodsThirty-five in-depth individual interviews were conducted with 15 HIV-positive men and 20 HIV-positive women (not couples receiving care at public-sector clinics near Durban. A structured coding scheme was developed to investigate men’s and women’s attitudes toward HIV-serostatus disclosure and behaviors of sharing (or not sharing HIV serostatus with a partner. Narratives were analyzed for barriers and facilitators of disclosure through the lens of sociocultural gender inequality, focusing on reasons for non-disclosure.ResultsAmong 35 participants: median age was 33 years (men and 30 years (women; average years since HIV diagnosis was 1 (men and 1.5 (women. Four themes related to gender inequality and HIV-serostatus disclosure emerged: (1 Men and women fear disclosing to partners due to concerns about stigma and relationship dissolution, (2 suspicions and mistrust between partners underlies decisions for non-disclosure, (3 unequal, gendered power in relationships causes differential likelihood and safety of disclosure among men and women, and (4 incomplete or implicit disclosure are strategies to navigate disclosure challenges. Findings illustrate HIV-serostatus disclosure as a complex process evolving over time, rather than a one-time event.ConclusionPartner communication about HIV serostatus is infrequent and complicated

  9. HIV incidence in the Estonian population in 2013 determined using the HIV-1 limiting antigen avidity assay.

    Science.gov (United States)

    Soodla, P; Simmons, R; Huik, K; Pauskar, M; Jõgeda, E-L; Rajasaar, H; Kallaste, E; Maimets, M; Avi, R; Murphy, G; Porter, K; Lutsar, I

    2017-08-01

    Estonia has one the highest number of new HIV diagnoses in the European Union, mainly among injecting drug users and heterosexuals. Little is known of HIV incidence, which is crucial for limiting the epidemic. Using a recent HIV infection testing algorithm (RITA) assay, we aimed to estimate HIV incidence in 2013. All individuals aged ≥18 years newly-diagnosed with HIV in Estonia January- December 2013, except blood donors and those undergoing antenatal screening, were included. Demographic and clinical data were obtained from the Estonian Health Board and the Estonian HIV-positive patient database. Serum samples were tested for recent infection using the LAg-avidity EIA assay. HIV incidence was estimated based on previously published methods. Of 69,115 tested subjects, 286 (0.41%) were newly-diagnosed with HIV with median age of 33 years (IQR: 28-42) and 65% male. Self-reported routes of HIV transmission were mostly heterosexual contact (n = 157, 53%) and injecting drug use (n = 62, 21%); 64 (22%) were with unknown risk group. Eighty two (36%) were assigned recent, resulting in estimated HIV incidence of 0.06%, corresponding to 642 new infections in 2013 among the non-screened population. Incidence was highest (1.48%) among people who inject drugs. These high HIV incidence estimates in Estonia call for urgent action of renewed targeted public health promotion and HIV testing campaigns. © 2017 British HIV Association.

  10. Update on HIV in Western Europe

    DEFF Research Database (Denmark)

    Nakagawa, Fumiyo; Phillips, Andrew N; Lundgren, Jens D

    2014-01-01

    living with HIV has slowly increased due to new infections and the success of antiretroviral therapy in prolonging life. An ageing population is gradually emerging that will require additional care. There are large differences across countries in HIV testing rates, proportions of people who present......HIV infection in Western Europe is mainly concentrated among men who have sex with men, heterosexuals who acquired HIV from sub-Saharan African countries, and in people who inject drugs. The rate of newly diagnosed cases of HIV has remained roughly stable since 2004 whereas the number of people...... to care with low CD4+ cell counts, accessibility to treatment and care, and rates of retention once in care. Improved collection of HIV surveillance data will benefit countries and help to understand their epidemic better. However, social inequalities experienced by people with HIV still remain in some...

  11. Update on HIV in Western Europe.

    Science.gov (United States)

    Nakagawa, Fumiyo; Phillips, Andrew N; Lundgren, Jens D

    2014-06-01

    HIV infection in Western Europe is mainly concentrated among men who have sex with men, heterosexuals who acquired HIV from sub-Saharan African countries, and in people who inject drugs. The rate of newly diagnosed cases of HIV has remained roughly stable since 2004 whereas the number of people living with HIV has slowly increased due to new infections and the success of antiretroviral therapy in prolonging life. An ageing population is gradually emerging that will require additional care. There are large differences across countries in HIV testing rates, proportions of people who present to care with low CD4+ cell counts, accessibility to treatment and care, and rates of retention once in care. Improved collection of HIV surveillance data will benefit countries and help to understand their epidemic better. However, social inequalities experienced by people with HIV still remain in some regions and urgently need to be addressed.

  12. Update on HIV in Western Europe

    DEFF Research Database (Denmark)

    Nakagawa, Fumiyo; Phillips, Andrew N; Lundgren, Jens D

    2014-01-01

    HIV infection in Western Europe is mainly concentrated among men who have sex with men, heterosexuals who acquired HIV from sub-Saharan African countries, and in people who inject drugs. The rate of newly diagnosed cases of HIV has remained roughly stable since 2004 whereas the number of people...... living with HIV has slowly increased due to new infections and the success of antiretroviral therapy in prolonging life. An ageing population is gradually emerging that will require additional care. There are large differences across countries in HIV testing rates, proportions of people who present...... to care with low CD4+ cell counts, accessibility to treatment and care, and rates of retention once in care. Improved collection of HIV surveillance data will benefit countries and help to understand their epidemic better. However, social inequalities experienced by people with HIV still remain in some...

  13. Homicides between heterosexual intimates: Criminological and victimological characteristics

    Directory of Open Access Journals (Sweden)

    Simeunović-Patić Biljana J.

    2002-01-01

    Full Text Available In this paper the problem of homicidal violence between heterosexual intimates is analyzed, and the need for its treatment as a specific criminological issue denoted, having in mind many of its distinctive etiological and victimological dimensions. The presented findings of an empirical research on intimate homicides committed in Belgrade from 1985 to 1993 allowed for a testing of some hypotheses related to the factors of homicidal criminalization and victimization within the context of the intimate heterosexual relationships. The evidence on history and dynamics of deeply disturbed intimate relations, as well as some typical characteristics of male intimate partners in violent heterosexual relationships, are particularly considered. On the bases of research findings, it seems possible that the plausible preventive strategies can be developed.

  14. A difference in hypothalamic structure between heterosexual and homosexual men.

    Science.gov (United States)

    LeVay, S

    1991-08-30

    The anterior hypothalamus of the brain participates in the regulation of male-typical sexual behavior. The volumes of four cell groups in this region [interstitial nuclei of the anterior hypothalamus (INAH) 1, 2, 3, and 4] were measured in postmortem tissue from three subject groups: women, men who were presumed to be heterosexual, and homosexual men. No differences were found between the groups in the volumes of INAH 1, 2, or 4. As has been reported previously, INAH 3 was more than twice as large in the heterosexual men as in the women. It was also, however, more than twice as large in the heterosexual men as in the homosexual men. This finding indicates that INAH is dimorphic with sexual orientation, at least in men, and suggests that sexual orientation has a biological substrate.

  15. Comparing the Rates of Early Childhood Victimization across Sexual Orientations: Heterosexual, Lesbian, Gay, Bisexual, and Mostly Heterosexual.

    Directory of Open Access Journals (Sweden)

    Christopher Zou

    Full Text Available Few studies have examined the rates of childhood victimization among individuals who identify as "mostly heterosexual" (MH in comparison to other sexual orientation groups. For the present study, we utilized a more comprehensive assessment of adverse childhood experiences to extend prior literature by examining if MH individuals' experience of victimization more closely mirrors that of sexual minority individuals or heterosexuals. Heterosexual (n = 422 and LGB (n = 561 and MH (n = 120 participants were recruited online. Respondents completed surveys about their adverse childhood experiences, both maltreatment by adults (e.g., childhood physical, emotional, and sexual abuse and childhood household dysfunction and peer victimization (i.e., verbal and physical bullying. Specifically, MH individuals were 1.47 times more likely than heterosexuals to report childhood victimization experiences perpetrated by adults. These elevated rates were similar to LGB individuals. Results suggest that rates of victimization of MH groups are more similar to the rates found among LGBs, and are significantly higher than heterosexual groups. Our results support prior research that indicates that an MH identity falls within the umbrella of a sexual minority, yet little is known about unique challenges that this group may face in comparison to other sexual minority groups.

  16. Sexual discordance and sexual partnering among heterosexual women.

    Science.gov (United States)

    Nield, Jennifer; Magnusson, Brianna; Brooks, Christopher; Chapman, Derek; Lapane, Kate L

    2015-05-01

    This study examined characteristics of self-identified heterosexual women who were concordant or discordant in their sexual behavior and the association of discordance and sexual partnering among those aged 15-44 years from the 2006-2010 National Survey of Family Growth (n = 7,353). Sexual concordance was defined as reporting a heterosexual identity and no female partners in the past year; discordance was reporting a heterosexual identity and having at least one female partner in the past year. Sexual partnering was defined as being concurrent, serially monogamous or monogamous with a male partner in the previous year. Polytomous logistic regression models evaluated the association between sexual discordance and sexual partnering. Among self-identified heterosexual, sexually active women, 11.2 % reported ever having had a same sex partner. Heterosexually discordant women who had both male and female partners in the previous year were 5.5 times as likely to report having a concurrent relationship (95 % CI 2.77-11.09) and 2.4 times as likely to report engaging in serially monogamous relationships (95 % CI 1.19-4.97) with male partners. Discordance between heterosexual identity and same sex behavior is a factor in risky behaviors. Women who have sex with women and men may act as bridges for the transmission of STDs, particularly to their female partners. Sexual education should include information inclusive of non-heteronormative behaviors and identities to provide sexual minorities with the tools and information they need. Clinical guidelines should ensure that all women are offered counseling and screening for reproductive and sexual health.

  17. Children's gender identity in lesbian and heterosexual two-parent families

    NARCIS (Netherlands)

    Bos, H.; Sandfort, T.G.M.

    2010-01-01

    This study compared gender identity, anticipated future heterosexual romantic involvement, and psychosocial adjustment of children in lesbian and heterosexual families; it was furthermore assessed whether associations between these aspects differed between family types. Data were obtained in the

  18. The Community-based Participatory Intervention Effect of “HIV-RAAP”

    Science.gov (United States)

    Yancey, Elleen M.; Mayberry, Robert; Armstrong-Mensah, Elizabeth; Collins, David; Goodin, Lisa; Cureton, Shava; Trammell, Ella H.; Yuan, Keming

    2012-01-01

    Objectives To design and test HIV-RAAP (HIV/AIDS Risk Reduction Among Heterosexually Active African American Men and Women: A Risk Reduction Prevention Intervention) a coeducational, culture- and gender-sensitive community-based participatory HIV risk reduction intervention. Methods A community-based participatory research process included intervention development and implementation of a 7-session coeducational curriculum conducted over 7 consecutive weeks. Results The results indicated a significant intervention effect on reducing sexual behavior risk (P=0.02), improving HIV risk knowledge (P=0.006), and increasing sexual partner conversations about HIV risk reduction (P= 0.001). Conclusions The HIV-RAAP intervention impacts key domains of heterosexual HIV transmission. PMID:22488405

  19. The Gender Context of HIV Risk and Pregnancy Goals in Western ...

    African Journals Online (AJOL)

    Background: Intentional childbearing may place heterosexual couples at risk of HIV infection in resource-limited settings with high HIV prevalence areas where society places great value on having children. Objective: To explore cognitive, cultural, and spatial mapping of sexual and reproductive health domains and services ...

  20. Age and HIV Risk and Protective Behaviors among African American Women

    Science.gov (United States)

    Corneille, Maya A.; Zyzniewski, Linda E.; Belgrave, Faye Z.

    2008-01-01

    Though HIV prevention efforts have focused on young adult women, women of all ages may engage in HIV risk behaviors and experience barriers to condom use. This article examines the effect of age on sexual risk and protective attitudes and behaviors among African American women. Unmarried heterosexual African American women between the ages of 18…

  1. HIV prevalence, sexual risk behaviour and sexual mixing patterns among migrants in Amsterdam, The Netherlands

    NARCIS (Netherlands)

    Gras, M. J.; Weide, J. F.; Langendam, M. W.; Coutinho, R. A.; van den Hoek, A.

    1999-01-01

    To study (1) HIV prevalence; (2) sexual risk behaviour; (3) sexual mixing patterns; (4) determinants of disassortative (between-group) mixing among migrant groups in Amsterdam, the Netherlands and to gain insight into the potential for heterosexual spread of HIV/sexually transmitted diseases.

  2. Self-reported sexual and psychosocial health among non-heterosexual Danes

    DEFF Research Database (Denmark)

    Graugaard, Christian; Giraldi, Annamaria; Frisch, Morten

    2015-01-01

    INTRODUCTION: Little is known about the sexual and psychosocial health of non-heterosexual Danes. Based on a large population study, the aim of this article was to compare quality-of-life-related key variables of heterosexual and non-heterosexual men and women, aged 16-66. MATERIALS AND METHODS: ...

  3. Social Support and Psychological Well-Being in Lesbian and Heterosexual Preadoptive Couples

    Science.gov (United States)

    Goldberg, Abbie E.; Smith, JuliAnna Z.

    2008-01-01

    This study examines predictors of social support and mental health among 36 lesbian and 39 heterosexual couples who were waiting to adopt. Lesbian preadoptive partners perceived less support from family than heterosexual partners but similar levels of support from friends. Lesbian and heterosexual partners reported similar levels of well-being.…

  4. Sexual-Minority and Heterosexual Youths' Peer Relationships: Experiences, Expectations, and Implications for Well-Being

    Science.gov (United States)

    Diamond, Lisa M.; Lucas, Sarah

    2004-01-01

    The current study compared the peer relationships and well-being of 60 sexual-minority (i.e., non-heterosexual) and 65 heterosexual youths between the ages of 15 and 23. Sexual-minority youths had comparable self-esteem, mastery, and perceived stress as did heterosexuals, but greater negative affect. Younger sexual-minority male adolescents had…

  5. Mucocutaneous disorders in Hiv positive patients

    Directory of Open Access Journals (Sweden)

    Kar H

    1996-01-01

    Full Text Available Twenty eight HIV positive patients were included in this study. They were evaluated for their mucocutaneous disorders, sexually transmitted diseases and other systemic disorders between 1994-95 in the department of Dermatology and STD Dr R M L Hospital of New Delhi. The heterosexual contact with commercial sex workers (CSWs was the most common route of HIV transmission. Chancroid, syphilis and genital warts were common STDs found in HIV positive patients. Oral thrush (67.9% was the commonest mucocutaneous disorder found in these patients followed by herpes zoster (25% and seborrhoeic dermatitis (21.4%. There was no unusual clinical presentation seen in mucocutaneous disorders and STDs.

  6. Predictors of Heterosexual College Students' Attitudes toward LGBT People

    Science.gov (United States)

    Woodford, Michael R.; Silverschanz, Perry; Swank, Eric; Scherrer, Kristin S.; Raiz, Lisa

    2012-01-01

    This study identifies the predictors of U.S. heterosexual undergraduate and graduate college students' attitudes toward lesbian, gay, bisexual, and transgender (LGBT) people as a group rather than toward individual identities. Findings suggest that affirming LGBT attitudes are most strongly associated with liberal political ideology and whether…

  7. Recollections of Sexual Socialisation among Marginalised Heterosexual Black Men

    Science.gov (United States)

    Dunlap, Eloise; Benoit, Ellen; Graves, Jennifer L.

    2013-01-01

    This paper describes the sexual socialisation process of marginalised, drug-using heterosexual black men, focusing primarily on the sources and content of sexual information. Analysing qualitative interview data, we discovered that the men in our sample both learn about sex and become sexually active at an early age. They most often learn about…

  8. Reasons for Living in Homosexual and Heterosexual Older Adolescents.

    Science.gov (United States)

    Hirsch, Jameson K.; Ellis, Jon B.

    Suicide rates among older adolescents is a major concern for researchers. A homosexual lifestyle, with its additional stresses, may erode one's adaptive characteristics. This study sought to identify and compare suicidal behavior and adaptive characteristics in homosexual and heterosexual adolescents. Sixty-two individuals were divided into two…

  9. Psychological Abuse among College Women in Exclusive Heterosexual Dating Relationship.

    Science.gov (United States)

    Pipes, Randolph B.; LeBov-Keeler, Karen

    1997-01-01

    Identifies possible predictors of psychological abuse in nonmarital heterosexual romantic relationships. Responses from 175 undergraduate women reveal 11% claiming psychological abuse as well as more instances of partner behaviors characteristic of psychological abuse. Abused individuals were more likely to have lower self-esteem, had parents'…

  10. Effects of Associating with Musical Genres on Heterosexual Attraction.

    Science.gov (United States)

    Zillman, Dolf; Bhatia, Azra

    1989-01-01

    Studies the effect of musical preferences on undergraduate students' estimation of numerous behavioral traits and the desirability of a potential heterosexual date. Finds that such disclosure influences attraction, as well as the perception and evaluation of pertinent traits, the effects being a function of genre-specific stereotypes and…

  11. Association between serosorting and bacterial sexually transmitted infection among HIV-negative men who have sex with men at an urban lesbian, gay, bisexual, and transgender health center.

    Science.gov (United States)

    Hotton, Anna L; Gratzer, Beau; Mehta, Supriya D

    2012-12-01

    Serosorting, selecting sex partners of the same HIV status, may be associated with increased risk of sexually transmitted infection (STI). We examined the association between unprotected anal intercourse (UAI) with a seroconcordant partner and STIs among HIV-negative men who have sex with men (MSM) at an urban lesbian, gay, bisexual, and transgender STI clinic. Subjects reported how they assessed their most recent sex partner's HIV status. Those who reported getting tested together or asking were classified as known concordant; those who determined their partner's serostatus based on appearance, age, or social aspects were classified as assumed concordant. Generalized estimating equations generated prevalence ratios for associations between seroconcordance and STIs. From May 2010 through October 2011, 961 HIV-negative MSM were screened for gonorrhea, chlamydia, and syphilis at 1110 visits. Sexually transmitted infection prevalence was 20.1%: 20.2% at visits with known seroconcordant UAI, 35.3% at visits with assumed seroconcordant UAI, 29.5% at visits where UAI with an unknown status partner was reported, 34.8% at visits with serodiscordant UAI, and 16.1% at visits with no reported UAI. Assumed serodiscordant UAI (adjusted prevalence ratio [aPR], 2.51; 95% confidence interval [CI], 1.79-3.51), unknown status partner (aPR, 1.76; 95% CI, 1.31-2.38), and serodiscordant UAI (aPR, 2.57; 95% CI, 1.76-3.75) were significant predictors of STI after controlling for age and race/ethnicity, STI history, alcohol use, substance use, and multiple sex partners. Known seroconcordant UAI was not associated with STI. Assumed seroconcordant UAI was associated with increased STI prevalence, although known seroconcordant UAI was not. The risk associated with UAI with a partner of assumed seroconcordance should be emphasized for HIV-negative MSM.

  12. Suspected dog bite associated HIV horizontal transmission in Swaziland

    Directory of Open Access Journals (Sweden)

    Ganizani Mlawanda

    2013-01-01

    Full Text Available Background: Dog bites may lead to transmission of bacteria and viruses over and above tetanus and rabies. Theoretically human immunodeficiency virus (HIV, Hepatitis B and Hepatitis C may be transmitted after dog bites where transfer of blood from one victim to another occur in clinical practice HIV, Hepatitis B and Hepatitis C are not considered when making treatment decisions, nor adequate patient history taken to consider all potential risks after dog bites in succession.Objective: To present case of suspected HIV transmission after dog bites in close succession involving two HIV sero-discordant victims.Management and outcome: HIV rapid test and/or HIV Ribonucleic acid (RNA polymerasechain reaction (PCR results for the victim(s at presentation and a month later.Results: Two night patrol guards presented to casualty after dog bites in close succession by the same dog. They were managed according to the dog bite protocol. Thinking out of the box, the first victim was found to be HIV positive by rapid test whilst the second victim was negative based on both HIV rapid test and HIV RNA PCR. One month after the dogbites, a case of HIV sero-conversion was confirmed in the second victim despite post-exposure prophylaxis (PEP.Discussion: Although an isolated case, shouldn’t clinicians re-think the significance of HIV transmission after animal bites where there is repeated blood exposure in several people insuccession?Conclusion: Clinicians should be aware of the potential of HIV, Hepatitis B and C transmission, when faced with dog bites in succession. 

  13. What is the benefit of the biomedical and behavioral interventions in preventing HIV transmission?

    Directory of Open Access Journals (Sweden)

    Ricardo Kuchenbecker

    2015-09-01

    Full Text Available ABSTRACTIntroduction:Scientific evidence supports the sinergy between biomedical and behavioral interventions aimed at preventing the transmission of HIV as a strategy to eradicate AIDS.Objective:To characterize comparatively the benefits from biomedical and behavioral interventions to prevent HIV transmission.Methods:Narrative review. We performed a comparative analysis of the benefits of studied interventions by means of estimating the number needed to treat (NNT. Evaluated interventions: counseling activities for behavior change to prevent exposure to HIV; antiretroviral pre-exposure prophylaxis (PrEP and antiretroviral post-exposure prophylasis (PEP for HIV and treatment of serodiscordant couples as a strategy for prevention of HIV transmission (TasP.Results:counseling interventions and TasP have smaller NNTs, equal to, respectively, 11 (95%CI 9 - 18 at 12 months and 34 (95%CI 23 - 54 in 42 months comparatively to PrEP interventions, that resulted in 41 (95%CI 28 - 67 individuals receiving antiretrovirals in order to prevent one case of HIV infection at 36 months for men and serodiscordant couples. PEP interventions are associated with protective effects estimated at 81%. Lack of trials evaluating PEP prevents estimate of NNT.Conclusion:The estimate of the NNT can be a helpful parameter in the comparison between the effectiveness of different behavioral and biomedical HIV prevention strategies. Studies evaluating the benefit and safety of combined behavioral and biomedical interventions are needed, especially considering the attributable fraction of each component. Integration of behavioral and biomedical interventions is required to achieve complete suppression of the virus, and thus reducing viral replication, infectivity and the number of cases.

  14. Cost-effectiveness of newborn circumcision in reducing lifetime HIV risk among U.S. males.

    Directory of Open Access Journals (Sweden)

    Stephanie L Sansom

    Full Text Available BACKGROUND: HIV incidence was substantially lower among circumcised versus uncircumcised heterosexual African men in three clinical trials. Based on those findings, we modeled the potential effect of newborn male circumcision on a U.S. male's lifetime risk of HIV, including associated costs and quality-adjusted life-years saved. METHODOLOGY/PRINCIPAL FINDINGS: Given published estimates of U.S. males' lifetime HIV risk, we calculated the fraction of lifetime risk attributable to heterosexual behavior from 2005-2006 HIV surveillance data. We assumed 60% efficacy of circumcision in reducing heterosexually-acquired HIV over a lifetime, and varied efficacy in sensitivity analyses. We calculated differences in lifetime HIV risk, expected HIV treatment costs and quality-adjusted life years (QALYs among circumcised versus uncircumcised males. The main outcome measure was cost per HIV-related QALY saved. Circumcision reduced the lifetime HIV risk among all males by 15.7% in the base case analysis, ranging from 7.9% for white males to 20.9% for black males. Newborn circumcision was a cost-saving HIV prevention intervention for all, black and Hispanic males. The net cost of newborn circumcision per QALY saved was $87,792 for white males. Results were most sensitive to the discount rate, and circumcision efficacy and cost. CONCLUSIONS/SIGNIFICANCE: Newborn circumcision resulted in lower expected HIV-related treatment costs and a slight increase in QALYs. It reduced the 1.87% lifetime risk of HIV among all males by about 16%. The effect varied substantially by race and ethnicity. Racial and ethnic groups who could benefit the most from circumcision may have least access to it due to insurance coverage and state Medicaid policies, and these financial barriers should be addressed. More data on the long-term protective effect of circumcision on heterosexual males as well as on its efficacy in preventing HIV among MSM would be useful.

  15. Discrimination against HIV-infected people and the spread of HIV: some evidence from France.

    Directory of Open Access Journals (Sweden)

    Patrick Peretti-Watel

    Full Text Available BACKGROUND: Many people living with HIV/AIDS (PLWHA suffer from stigma and discrimination. There is an ongoing debate, however, about whether stigma, fear and discrimination actually fuel the persisting spread of HIV, or slow it down by reducing contacts between the whole population and high-risk minorities. To contribute to this debate, we analysed the relationship between perceived discrimination and unsafe sex in a large sample of French PLWHAs. METHODOLOGY/PRINCIPAL FINDINGS: In 2003, we conducted a national cross-sectional survey among a random sample of HIV-infected patients. The analysis was restricted to sexually active respondents (N = 2,136. Unsafe sex was defined as sexual intercourse without a condom with a seronegative/unknown serostatus partner during the prior 12 months. Separate analyses were performed for each transmission group (injecting drug use (IDU, homosexual contact, heterosexual contact. Overall, 24% of respondents reported experiences of discrimination in their close social environment (relatives, friends and colleagues and 18% reported unsafe sex during the previous 12 months. Both prevalences were higher in the IDU group (32% for perceived discrimination, 23% for unsafe sex. In multivariate analyses, experience of discrimination in the close social environment was associated with an increase in unsafe sex for both PLWHAs infected through IDU and heterosexual contact (OR = 1.65 and 1.80 respectively. CONCLUSIONS: Our study clearly confirms a relationship between discrimination and unsafe sex among PLWHAs infected through either IDU or heterosexual contact. This relationship was especially strong in the heterosexual group that has become the main vector of HIV transmission in France, and who is the more likely of sexual mixing with the general population. These results seriously question the hypothesis that HIV-stigma has no effect or could even reduce the infection spread of HIV.

  16. Current perspectives in HIV post-exposure prophylaxis

    Directory of Open Access Journals (Sweden)

    Sultan B

    2014-10-01

    Full Text Available Binta Sultan,1,2 Paul Benn,1 Laura Waters1 1Department of Genitourinary Medicine, Mortimer Market Centre, Central and North West London NHS Foundation Trust, London, UK; 2Centre for Sexual Health and HIV Research, University College London, London, UK Abstract: The incidence of human immunodeficiency virus (HIV infection continues to rise among core groups and efforts to reduce the numbers of new infections are being redoubled. Post-exposure prophylaxis (PEP is the use of short-term antiretroviral therapy (ART to reduce the risk of acquisition of HIV infection following exposure. Current guidelines recommend a 28-day course of ART within 36–72 hours of exposure to HIV. As long as individuals continue to be exposed to HIV there will be a role for PEP in the foreseeable future. Nonoccupational PEP, the vast majority of which is for sexual exposure (PEPSE, has a significant role to play in HIV prevention efforts. Awareness of PEP and its availability for both clinicians and those who are eligible to receive it are crucial to ensure that PEP is used to its full potential in any HIV prevention strategy. In this review, we provide current evidence for the use of PEPSE, assessment of the risk of HIV transmission, indications for PEP, drug regimens, and management of patients started on PEP. We summarize national and international guidelines for the use of PEPSE. We explore the place of PEP within the wider strategy of reducing HIV incidence rates in the era of treatment as prevention and pre-exposure prophylaxis. We also consider the implications of recent data from interventional and observational studies demonstrating significant reductions in the risk of HIV transmission within a serodiscordant relationship if the HIV-positive partner is taking effective ART upon PEP guidelines. Keywords: post-exposure prophylaxis, pre-exposure prophylaxis, treatment as prevention, human immunodeficiency virus

  17. Prevalence of HIV and discordant rate and their associated factors ...

    African Journals Online (AJOL)

    Background: Understanding and monitoring the prevalence of Human Immunodeficiency Virus (HIV) infection among premarital clients and determining discordant rate and applying specific interventions targeted at this group could bring dual benefits as it prevents both heterosexual and vertical transmission of the disease.

  18. How do HIV-negative individuals in sub-Saharan Africa change their sexual risk behaviour upon learning their serostatus? A systematic review.

    Science.gov (United States)

    Ramachandran, Sanjeev; Mishra, Sharmistha; Condie, Natalie; Pickles, Michael

    2016-12-01

    To determine whether, and how, sexual behaviour of HIV-negative individuals in sub-Saharan Africa (SSA) changes upon learning their serostatus. We systematically reviewed the published literature using EMBASE and Medline to search for publications between 2004 and 2014. We included studies that quantified behaviour change (condom use, number of sexual partners or sex acts) following an HIV test in HIV-negative adults in SSA, and extracted relevant data including study characteristics and measurement type. From 2185 unique citations, n=14 studies representing 22 390 participants met our inclusion criteria. We did not pool data due to marked heterogeneity in study outcome measures. The proportion of participants reporting consistent condom use (n=6) post-testing ranged from 7.6% greater, to 10.6% fewer, while 'no condom use' (n=5) ranged from 40.0% less, to 0.7% more. Condom use in serodiscordant couples increased (n=3). Five studies measured the proportion reporting abstinence, finding an increase of 10.9% to a decrease of 5.3% post-testing. The post-testing change in the mean number of sex acts (n=3) ranged from a relative decrease of 15.7% to a relative increase of 9.4%. Two studies reported relative decreases in the mean number of sexual partners of 35.2% and 14.0%. Three studies examining serodiscordant primary relationships specifically all showed increases in extrarelational sex. With the exception of serodiscordant couples, there is variable evidence that awareness of one's serostatus leads to substantial changes in risk behaviour among HIV-negative individuals. Further research is needed to estimate the behavioural impact of learning one's serostatus in SSA. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  19. Antiretroviral therapy during pregnancy and early neonatal life: consequences for HIV-exposed, uninfected children

    OpenAIRE

    Patrícia El Beitune; Geraldo Duarte; Silvana Maria Quintana; Figueiró-Filho,Ernesto A.; Alessandra Cristina Marcolin; Renata Abduch

    2004-01-01

    Women have emerged as the fastest growing human immunodeficiency virus (HIV) infected population worldwide, mainly because of the increasing occurrence of heterosexual transmission. Most infected women are of reproductive age and one of the greatest concerns for both women and their physicians is that more than 1,600 infants become infected with HIV each day. Almost all infections are a result of mother-to-child transmission of HIV. With the advent of combination antiretroviral therapies, tra...

  20. Anal intercourse among female sex workers in East Africa is associated with other high-risk behaviours for HIV

    NARCIS (Netherlands)

    Veldhuijzen, Nienke J.; Ingabire, Chantal; Luchters, Stanley; Bosire, Wilkister; Braunstein, Sarah; Chersich, Matthew; van de Wijgert, Janneke

    2011-01-01

    Introduction: Epidemiological and HIV prevention studies in sub-Saharan Africa have almost exclusively focussed on vaginal transmission of HIV, the primary mode of transmission in the region. Little is known about the prevalence of heterosexual anal intercourse (AI), its correlates and its role in

  1. Physical victimization and high-risk sexual partners among illicit drug-using heterosexual men in New York City.

    Science.gov (United States)

    Turner, Alezandria K; Jones, Kandice C; Rudolph, Abby; Rivera, Alexis V; Crawford, Natalie; Lewis, Crystal Fuller

    2014-10-01

    Physical victimization has been linked to high-risk sexual partnerships in women. Although illicit drug-using heterosexual men are at high-risk of physical victimization, the association between violence and high-risk partners in heterosexual men has received little attention in the published literature. We examined the association between experience of severe physical victimization and acquisition of a high-risk sexual partner (i.e., a partner who injected drugs or participated in transactional sex) 1 year later among illicit drug-using men in New York City (2006-2009) using secondary cross-sectional data. Injection and non-injection drug-using men (n = 280) provided a retrospectively recalled history of risk behavior and violence for each year over the past 4 years. Our primary outcome was acquisition of a high-risk sexual partner in any year following the baseline year. Our primary exposure was severe physical victimization (i.e., threatened with a knife or gun, beaten up, shot, or stabbed) in the prior year. Frequency of cocaine, heroin, and crack use and sexual victimization were also assessed. Log-binomial logistic regression with generalized estimating equation (GEE) methods was used to account for repeated measures for up to four time points. After adjustment for important covariates, participants that experienced physical victimization were significantly more likely to have acquired a high-risk sexual partner 1 year later (relative risk (RR), 3.73; 95 % confidence interval (CI), 1.55-8.97). Our study challenges gender-based stereotypes surrounding physical victimization and provides support for multidisciplinary programs that address both violence and HIV risk among illicit drug-using heterosexual men.

  2. The children of homosexual and heterosexual single mothers.

    Science.gov (United States)

    Javaid, G A

    1993-01-01

    Children reared in homes headed by homosexual and heterosexual mothers were compared with respect to the mothers' and children's attitudes towards marriage, procreation and homosexuality. The mothers did not prefer their children to be homosexual; they desired them to marry and procreate. This was expressed more unambiguously for their sons. The children mirrored these expectations, boys with greater frequency than the girls. Most of the children expressed reservations about having a homosexual mother.

  3. Lectura y crítica del discurso heterosexual

    OpenAIRE

    Martín, Sofía

    2017-01-01

    La heterosexualidad actualmente se presenta como algo natural, lógico e incuestionable. Es importante que se analice el discurso heterosexual y se responda a la pregunta: ¿realmente es algo natural? A partir del estudio de su discurso y escritos provenientes de la Iglesia, el Estado y otras áreas de la sociedad occidental actual, se llega a la conclusión de que la heterosexualidad es una invención más.

  4. Homophobia and physical aggression toward homosexual and heterosexual individuals.

    Science.gov (United States)

    Bernat, J A; Calhoun, K S; Adams, H E; Zeichner, A

    2001-02-01

    This study examined the relationship between homophobia (defined as self-reported negative affect, avoidance, and aggression toward homosexuals) and homosexual aggression. Self-identified heterosexual college men were assigned to homophobic (n = 26) and nonhomophobic (n = 26) groups on the basis of their scores on the Homophobia Scale (HS; L. W. Wright, H. E. Adams, & J. A. Bernat, 1999). Physical aggression was examined by having participants administer shocks to a fictitious opponent during a competitive reaction time (RT) task under the impression that the study was examining the relationship between sexually explicit material and RT. Participants were exposed to a male homosexual erotic videotape, their affective reactions were assessed, and they then competed in the RT task against either a heterosexual or a homosexual opponent. The homophobic group reported significantly more negative affect, anxiety, and anger-hostility after watching the homosexual erotic videotape than did the nonhomophobic group. Additionally, the homophobic group was significantly more aggressive toward the homosexual opponent, but the groups did not differ in aggression toward the heterosexual opponent.

  5. Gay and lesbian couples in Italy: comparisons with heterosexual couples.

    Science.gov (United States)

    Antonelli, Paolo; Dèttore, Davide; Lasagni, Irene; Snyder, Douglas K; Balderrama-Durbin, Christina

    2014-12-01

    Assessing couple relationships across diverse languages and cultures has important implications for both clinical intervention and prevention. This is especially true for nontraditional relationships potentially subject to various expressions of negative societal evaluation or bias. Few empirically validated measures of relationship functioning have been developed for cross-cultural applications, and none have been examined for their psychometric sufficiency for evaluating same-sex couples across different languages and cultures. The current study examined the psychometric properties of an Italian translation of the Marital Satisfaction Inventory - Revised (MSI-R), a 150-item 13-scale measure of couple relationship functioning, for its use in assessing the intimate relationships of gay and lesbian couples in Italy. Results for these couples were compared to data from heterosexual married and unmarried cohabiting couples from the same geographical region, as well as to previously published data for gay, lesbian, and unmarried heterosexual couples from the United States. Findings suggest that, despite unique societal pressures confronting Italian same-sex couples, these relationships appear resilient and fare well both overall and in specific domains of functioning compared to heterosexual couples both in Italy and the United States. © 2014 Family Process Institute.

  6. Prevalence of Physical and Psychological Violence among Heterosexual Couples

    Directory of Open Access Journals (Sweden)

    Laura López Angulo

    2015-09-01

    Full Text Available Background: there are few studies at the population level on the prevalence of violence in heterosexual relationships. This study demonstrated the reality of this phenomenon in our context. Objective: to determine the prevalence of psychological and physical violence among heterosexual couples in the city of Cienfuegos in 2010. Methods: a cross-sectional study of adults aged 15 to 74 years was conducted in six health areas. An equal probability sample of 1873 subjects was selected. The variables included psychological and physical violence, sex, age, skin color, marital status, educational level and history of living in troubled homes. The results were processed using SPSS 15.0. Results: prevalence of psychological and physical violence among couples was approximately six out of ten with different frequency levels. Psychological violence rose to 82.3 % and physical violence to 96.3 % when the couple lived together. Women reported being victims of violence from age 35 to 44 and men from age 25 to 34. Seventy point eight percent of couples who had middle school education reported suffering physical violence while 63 % of those with university education reported psychological violence. Fifty-one point eight percent of the study population was victim of physical violence during childhood. Conclusions: prevalence of psychological and physical violence among heterosexual couples in the sample studied in Cienfuegos is higher than the mean in the general population.

  7. Practicing vaginistic femininity: Doing bodies, enacting normative heterosexuality

    Directory of Open Access Journals (Sweden)

    Stephanie Stelko

    2015-12-01

    Full Text Available Vaginismus is a female sexual pain disorder, characterized by contractions of the pubococcygeus (PC muscle that surrounds the outer third of the vagina, which makes penetrative penile-vaginal intercourse (coitus, insertion of a finger or tampon and gynecological examinations hard or impossible, and painful for the woman. The condition is believed to be associated with negative beliefs, attitudes or experiences related to sex. Vaginismus has important social repercussions in everyday life, which acquire meaning in the context of hegemonic heterosexuality. In line with theories of performativity, heterosexuality and gender are normatively and performatively linked sets of practices, with coitus being the central practice of heterosexuality and thus defining for one’s gender. Thus, the inability of vaginistic women to perform coitus impairs their performance of normative heterogender. In this article I address gender experiences of women with primary vaginismus, by looking at social and bodily practices they engage in. In the first part of the article, I explore how women with primary vaginismus do (vaginistic heterogender. In the second part I address the practices they do in order to ‘overcome’ vaginismus, thus improving their performance of normative heterogender, and argue that these practices are gendering themselves.

  8. O discurso da prevenção da Aids frente às lógicas sexuais de casais sorodiscordantes: sobre normas e práticas The speech of Aids prevention in face of sexual logics of serodiscordant couples: on norms and practices

    Directory of Open Access Journals (Sweden)

    Ivia Maksud

    2009-01-01

    Full Text Available O artigo aborda práticas sexuais e representações sociais de casais sorodiscordantes para o HIV/Aids. Argumenta-se que em situação de conjugalidade há uma suspensão do chamado sexo seguro e um processo de rotinização da intimidade. A partir de entrevistas realizadas com homens e mulheres envolvidos em relacionamentos considerados estáveis, destrinça-se o repertório de práticas sexuais exercidas segundo o gênero, investigam-se as representações associadas ao elenco destas práticas e se discute como as mensagens de prevenção muitas vezes não acompanham estas lógicas, forjando-se a partir de discursos normativos e distantes das realidades cotidianas vividas pelos sujeitos.This paper reflects on sexual practices and social representations of Aids serodiscordant couples. In conjugal situation there is the suspension of "safe sex" and a process of routine of intimacy. The method adopted was in-deep interviews with men and women involved in stable conjugal relationships. The analysis describes male and female sexual scripts so as the social representations related to them. The paper show that prevention messages many times have normative speech, very distant of the daily realities lived by the subjects.

  9. Association Between Depression and Condom Use Differs by Sexual Behavior Group in Patients with HIV.

    Science.gov (United States)

    Brickman, Cristina; Propert, Kathleen J; Voytek, Chelsea; Metzger, David; Gross, Robert

    2017-06-01

    Identifying a relationship between depression and sexual risk behavior in HIV-infected patients could establish a mechanism to enhance prevention efforts. We conducted a cross-sectional analysis using data from the University of Pennsylvania Center for AIDS Research and used ordinal logistic regression to measure the association between depression and non-condom use. 716 men who have sex with men (MSM), 262 heterosexual men and 277 heterosexual women were included. The association between depression and non-condom use was strongest in heterosexual men with and without HIV-infected regular partners (OR 8.53, 95% CI 1.18-61.89 and OR 2.30, 95% CI 0.99-5.36 respectively), but absent in heterosexual women regardless of partner. Although the OR was low in MSM overall, an association was detected in MSM without HIV-infected regular partners (OR 2.44, 95% CI 1.39-4.31). In conclusion, we demonstrated an association between depression and non-condom use driven by heterosexual men and MSM without HIV-infected regular partners. Sexual risk should be addressed when intervening on depressive symptoms in these subgroups.

  10. Surveying Indian gay men for coping skills and HIV testing patterns using the internet

    Directory of Open Access Journals (Sweden)

    K S Jethwani

    2014-01-01

    Full Text Available Background: Surveying vulnerable and incarcerated populations is often challenging. Newer methods to reach and collect sensitive information in a safe, secure, and valid manner can go a long way in addressing this unmet need. Homosexual men in India live with inadequate social support, marginalization, and lack legal recognition. These make them less reachable by public health agencies, and make them more likely to continue with high-risk behaviors, and contract human immunodeficiency virus (HIV. Aims: To understand coping skills and HIV testing patterns of homosexual men versus heterosexual men. Materials and Methods: An internet based study using a secure web platform and an anonymised questionnaire. The brief COPE Inventory was used to assess coping styles. Results: A total of 124 respondents were studied. Homosexual men used negative coping skills such as behavioral disengagement and tested for HIV significantly more often than heterosexual men. Heterosexual respondents used positive coping skills more often. The most commonly used coping skill by heterosexual men was instrumental coping and by homosexual men was acceptance. Discussion: Overall, homosexual men used negative coping mechanisms, like behavioral disengagement more often. The Indian family structure and social support is probably responsible for heterosexual men′s over-reliance on instrumental coping, while resulting in disengagement in homosexuals. Conclusion: The lack of legal and social recognition of homosexuality has negatively impacted lives of gay men in India. This is strongly linked to harmful psychological and public health implications for HIV prevention and mental health for homosexual men.

  11. Surveying Indian gay men for coping skills and HIV testing patterns using the internet.

    Science.gov (United States)

    Jethwani, K S; Mishra, S V; Jethwani, P S; Sawant, N S

    2014-01-01

    Surveying vulnerable and incarcerated populations is often challenging. Newer methods to reach and collect sensitive information in a safe, secure, and valid manner can go a long way in addressing this unmet need. Homosexual men in India live with inadequate social support, marginalization, and lack legal recognition. These make them less reachable by public health agencies, and make them more likely to continue with high-risk behaviors, and contract human immunodeficiency virus (HIV). To understand coping skills and HIV testing patterns of homosexual men versus heterosexual men. An internet based study using a secure web platform and an anonymised questionnaire. The brief COPE Inventory was used to assess coping styles. A total of 124 respondents were studied. Homosexual men used negative coping skills such as behavioral disengagement and tested for HIV significantly more often than heterosexual men. Heterosexual respondents used positive coping skills more often. The most commonly used coping skill by heterosexual men was instrumental coping and by homosexual men was acceptance. Overall, homosexual men used negative coping mechanisms, like behavioral disengagement more often. The Indian family structure and social support is probably responsible for heterosexual men's over-reliance on instrumental coping, while resulting in disengagement in homosexuals. The lack of legal and social recognition of homosexuality has negatively impacted lives of gay men in India. This is strongly linked to harmful psychological and public health implications for HIV prevention and mental health for homosexual men.

  12. Correlates of Heterosexual Anal Intercourse among Women in the 2006-2010 National Survey of Family Growth.

    Science.gov (United States)

    Benson, Lyndsey S; Martins, Summer L; Whitaker, Amy K

    2015-08-01

    Heterosexual anal intercourse (HAI) is common among U.S. women. Receptive anal intercourse is a known risk factor for HIV, yet there is a paucity of data on HAI frequency and distribution in the United States. Condom use is lower with HAI vs. vaginal intercourse, but little is known regarding of correlates of HAI with and without condoms. The aims of this study were to describe recent (past 12 months) and lifetime HAI among sexually active reproductive-aged U.S. women, and to characterize women who engage in HAI with and without condoms. We analyzed a sample of 10,463 heterosexually active women aged 15-44 years for whom anal intercourse data were available in the 2006-2010 National Survey of Family Growth. Weighted bivariate and multivariable analyses were used to determine HAI prevalence and correlates. Primary outcomes were lifetime HAI, recent (last 12 months) HAI, and condom use at last HAI. In our sample, 13.2% of women had engaged in recent HAI and 36.3% in lifetime HAI. Women of all racial and ethnic backgrounds and religions reported recent anal intercourse. Condom use was more common at last vaginal intercourse than at last anal intercourse (28% vs. 16.4%, P Women of all ages and ethnicities engage in HAI, at rates higher than providers might realize. Condom use is significantly lower for HAI vs. vaginal intercourse, putting these women at risk for acquisition of sexually transmitted infections. © 2015 International Society for Sexual Medicine.

  13. Sexual Activity Without Condoms and Risk of HIV Transmission in Serodifferent Couples When the HIV-Positive Partner Is Using Suppressive Antiretroviral Therapy

    DEFF Research Database (Denmark)

    Rodger, Alison J; Cambiano, Valentina; Bruun, Tina

    2016-01-01

    condomless sex and HIV-1 RNA load less than 200 copies/mL. Anonymized phylogenetic analysis compared couples' HIV-1 polymerase and envelope sequences if an HIV-negative partner became infected to determine phylogenetically linked transmissions. EXPOSURES: Condomless sexual activity with an HIV......IMPORTANCE: A key factor in assessing the effectiveness and cost-effectiveness of antiretroviral therapy (ART) as a prevention strategy is the absolute risk of HIV transmission through condomless sex with suppressed HIV-1 RNA viral load for both anal and vaginal sex. OBJECTIVE: To evaluate the rate...... of within-couple HIV transmission (heterosexual and men who have sex with men [MSM]) during periods of sex without condoms and when the HIV-positive partner had HIV-1 RNA load less than 200 copies/mL. DESIGN, SETTING, AND PARTICIPANTS: The prospective, observational PARTNER (Partners of People on ART-A New...

  14. Enhancing masculinity by slandering homosexuals: the role of homophobic epithets in heterosexual gender identity.

    Science.gov (United States)

    Carnaghi, Andrea; Maass, Anne; Fasoli, Fabio

    2011-12-01

    The current studies investigate the effects of homophobic labels on the self-perception of heterosexual males, hypothesizing that when exposed to homophobic epithets, they are motivated to underline their masculinity and claim a distinctly heterosexual identity by taking distance from homosexuals and, to a lesser degree, from women. Heterosexual male participants were subliminally (Study 1) and supraliminally (Study 2) primed either by a homophobic epithet or by a category label, and completed the Traditional Beliefs About Gender and Gender Identity scale. Participants stressed their heterosexual identity, but not their gender distinctiveness, when exposed to homophobic epithets, compared to category labels. Study 2 demonstrated that the relation between the homophobic label and the participants' heterosexual identity was mediated by how negatively they reacted to the antigay label. Heterosexual identity was enhanced in reaction to homophobic labels but not to an equally derogatory label referring to regional identity. Results are discussed within an intergroup framework.

  15. Overestimation of heterosexually attributed AIDS deaths is associated with immature psychological defence mechanisms and clitoral masturbation during penile-vaginal intercourse.

    Science.gov (United States)

    Brody, S; Costa, R M

    2009-12-01

    Research shows that (1) greater use of immature psychological defence mechanisms (associated with psychopathology) is associated with lesser orgasmic consistency from penile-vaginal intercourse (PVI), but greater frequency of other sexual behaviours and greater condom use for PVI, and (2) unlike the vectors of receptive anal intercourse and punctures, HIV acquisition during PVI is extremely unlikely in reasonably healthy persons. However, the relationship between overestimation of AIDS deaths due to 'heterosexual transmission' (often misunderstood as only PVI), sexual behaviour and mental health has been lacking. Two hundred and twenty-one Scottish women completed the Defense Style Questionnaire, reported past month frequencies of their various sexual activities, and estimated the total number of women who died from AIDS in Scotland nominally as a result of heterosexual transmission in the UK from a partner not known to be an injecting drug user, bisexual or infected through transfusion. The average respondent overestimated by 226,000%. Women providing lower estimates were less likely to use immature psychological defences, and had a lower frequency of orgasms from clitoral masturbation during PVI and from vibrator use. The results indicate that those who perceive 'heterosexual transmission' led to many AIDS deaths have poorer psychological functioning, and might be less able to appreciate PVI.

  16. Partner-specific sexual practices among heterosexual men and women with multiple partners: results from the French national survey, ACSF. Analyse des Comportements Sexuel en France.

    Science.gov (United States)

    Messiah, A; Pelletier, A

    1996-06-01

    Heterosexual men and women with several partners are at risk of acquiring and transmitting sexually transmitted diseases and HIV. Risk depends on parameters such as the sexual practices themselves which may vary according to the type of partner (regular vs. casual). It is therefore important to describe the sexual practices and identify the correlations between the type of partner and these practices among heterosexuals with multiple partners. A subsample of all subjects having had at least two sexual partners during the previous year (n = 1644) was obtained from the ACSF survey (n = 20,055), the French national telephone survey on sexual behavior conducted between September 1991 and February 1992. Questions concerned in particular sexual practices of the last encounter as well as type of partner. Petting and vaginal penetration were almost systematic, mutual manual stimulation and orogenital sex were common, while self-masturbation and anal sex were infrequent. On average, a condom was seldom used. However, it was used more often when the partner was occasional. Nonpenetrative and oral practices were also more frequent with occasional partners. Women tended to report lower frequencies of practices and of condom use than men. A subset of heterosexuals with multiple partners engaged in safe sex. Practices tend to be partner-specific, with safer sex practices more likely to occur with occasional partners, although the magnitude of the difference is moderate.

  17. Sexually transmitted infections among heterosexual male clients of female sex workers in China: a systematic review and meta-analysis.

    Directory of Open Access Journals (Sweden)

    Megan M McLaughlin

    Full Text Available Female sex workers have been the target of numerous sexually transmitted infection (STI prevention strategies in China, but their male clients have attracted considerably less public health attention and resources. We sought to systematically assess the prevalence of HIV, syphilis, gonorrhea, and chlamydia among heterosexual male clients of female sex workers in China.Original research manuscripts were identified by searching Chinese and English language databases, and 37 studies analyzing 26,552 male clients were included in the review. Client STI prevalence across studies was heterogeneous. Pooled prevalence estimates and 95% confidence intervals were 0.68% (0.36-1.28% for HIV, 2.91% (2.17-3.89% for syphilis, 2.16% (1.46-3.17% for gonorrhea, and 8.01% (4.94-12.72% for chlamydia.The pooled prevalence estimates of HIV, syphilis, gonorrhea, and chlamydia among clients in this review exceed the prevalences previously reported among population-representative samples and low-risk groups in China. However, heterogeneity across studies and sampling limitations prevent definitive conclusions about how the prevalence of STIs in this population compares to the general population. These findings suggest a need for greater attention to clients' sexual risk and disease prevalence in China's STI research agenda in order to inform effective prevention policies.

  18. Gender differences in heterosexual anal sex practices among women and men in substance abuse treatment.

    Science.gov (United States)

    Calsyn, Donald A; Hatch-Maillette, Mary A; Meade, Christina S; Tross, Susan; Campbell, Aimee N C; Beadnell, Blair

    2013-09-01

    Heterosexual anal intercourse (HAI) is an understudied risk behavior among women and men in substance abuse treatment. Rates of HAI for women (n = 441) and men (n = 539) were identified for any, main and casual partners. More men (32.8 %) than women (27.1 %) reported engaging in HAI in the previous 90 days. These rates are higher than those reported for both men (6.0-15.9 %) and women (3.5-13.0 %) ages 25-59 in the National Survey of Sexual Health and Behavior. Men were significantly more likely to report HAI with their casual partners (34.1 %) than women (16.7 %). In a logistic regression model generated to identify associations between HAI and variables previously shown to be related to high risk sexual behavior, being younger, bisexual, and White were significantly associated with HAI. For men, having more sex partners was also a significant correlate. HAI is a logical target for increased focus in HIV prevention interventions.

  19. Associations Between Sex Education and Contraceptive Use Among Heterosexually Active, Adolescent Males in the United States.

    Science.gov (United States)

    Jaramillo, Nicole; Buhi, Eric R; Elder, John P; Corliss, Heather L

    2017-05-01

    This study examined associations between reports of receiving education on topics commonly included in sex education (e.g., abstinence only, comprehensive) prior to age 18 years and contraceptive use at the last sex among heterosexually active, 15- to 20-year-old males in the United States. Cross-sectional data from 539 males participating in the 2011-2013 National Survey of Family Growth were analyzed. Bivariate and multinomial logistic regression analyses adjusting for confounding estimated associations between receipt of seven sex education topics (e.g., information on HIV/AIDS, how to say no to sex) and contraceptive use at the last sex (i.e., dual barrier and female-controlled effective methods, female-controlled effective method only, barrier method only, and no method). Nearly, all participants (99%) reported receiving sex education on at least one topic. Education on sexually transmitted diseases (94.7%) and HIV/AIDS (92.0%) were the most commonly reported topics received; education on where to get birth control was the least common (41.6%). Instruction about birth control methods (adjusted odds ratio [AOR] = 3.01; 95% confidence interval [CI] = 1.32-6.87) and how to say no to sex (AOR = 3.39; CI = 1.33-8.64) were positively associated with dual contraception compared to no use. For each additional sex education topic respondents were exposed to, their odds of using dual methods compared to no method was 47% greater (AOR = 1.47; CI = 1.16-1.86). Exposure to a larger number of sex education topics is associated with young men's report of dual contraception use at the last sex. Comprehensive sex education, focusing on a range of topics, may be most effective at promoting safer sex among adolescent males. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  20. Associations Between Family Factors and Premarital Heterosexual Relationships Among Female College Students in Tehran

    National Research Council Canada - National Science Library

    Farideh Khalaj Abadi Farahani; John Cleland; Amir Hooshang Mehryar

    2011-01-01

    CONTEXT: Although premarital heterosexual relationships, especially those involving sexual contact, are discouraged in Iran, particularly for females, a considerable minority of young people are involved in such relationships...

  1. Men's experiences viewing an HIV/AIDS prevention education film by and for women.

    Science.gov (United States)

    DeMarco, Rosanna F; Minnich, Chad A

    2007-09-01

    The purpose of this study is to understand (a) the experience of men viewing the film Women's Voices Women's Lives (WVWL), a prevention education film for and by heterosexual African American women living with HIV/AIDS in the United States, and (b) the perceived needs of male viewers on how to best access effective HIV/AIDS prevention messages. A postviewing structured written survey was completed addressing the experience of viewing the film and HIV prevention services in the community, respectively (N = 16). Responses include stunning realization and anger that motivated viewers to get immediately screened for HIV. In addition, the men felt they were informed about HIV risk through the courage and candidness of the women describing their experience. Participants reported that a film similar to WVWL should be made for heterosexual/bisexual men. The authors conclude film prevention messages are a powerful means to convey health education ideas.

  2. HIV late presenters in Denmark: need for increased diagnostic awareness among general practitioners.

    Science.gov (United States)

    Leutscher, Peter Derek Christian; Laursen, Tinne; Andersen, Berit; Ostergaard, Lars; Laursen, Alex; Larsen, Carsten Schade

    2011-04-01

    The study objective was to describe demographic and clinical characteristics among HIV late presenters in a Danish university hospital. Patients > 15 years of age were enrolled in this retrospective study. Data from the medical patient records were analyzed in accordance with the CD4 count at the time of HIV diagnosis. Among 194 HIV patients (138 men and 56 women), 63 (33%) were diagnosed with a CD4 count below 200 cells/microlitre (late presenters). Heterosexuals constituted a larger proportion of patients in the late presenter group than did homosexual men (MSM) (p = 0.02), whereas a higher proportion of MSM than heterosexuals were diagnosed with HIV during primary infection (p HIV diagnosis. HIV antibody testing had not been performed although complaints consistent with possible underlying immune deficiency had been reported. Twenty per cent of the late presenters had a persistently low CD4 count below 200 cells/microlitre at follow-up despite having received HAART therapy for more than two years. One third of the HIV patients in this study were diagnosed as late presenters, and this group featured a higher proportion of heterosexuals than of MSM. The HIV antibody test should be performed more consistently on solid clinical ground by general practitioners.

  3. Measuring heterosexual LGBT ally development: a Rasch analysis.

    Science.gov (United States)

    Ji, Peter; Fujimoto, Ken

    2013-01-01

    An instrument was developed that measured heterosexual persons' level of lesbian, gay, bisexual, and transgender (LGBT) ally identity. Using a Rasch analysis, 2 dimensions were observed: (a) internal and interpersonal and (b) activity. Persons with high levels of LGBT ally identities endorsed items about having LGBT knowledge, attitudes, and skills; having interpersonal experiences with LGBT communities; and including LGBT ally as part of their identities. The instrument met criteria for the content, substantive, structural, generalizability, and responsiveness validity. The instrument can be used to assist persons to develop their abilities to support and advocate for equality for LGBT communities.

  4. Poder heterosexual y movimientos socio-sexuales: tensiones no resueltas

    OpenAIRE

    Granados Barco, Adriana

    2012-01-01

    Desde la década de 1980 feministas lesbianas, afro-americanas y latino-americanas, desarrollan planteamientos críticos en torno al racismo, clasismo e imposición heterosexual mantenido dentro del movimiento feminista anglo-europeo. Algunos de estos planteamientos conciben la heterosexualidad como una norma, un régimen político, una institución, y especialmente una ideología asentada sobre la diferencia sexual. Teniendo en cuenta estas críticas, el presente trabajo aborda las tensiones y las d...

  5. HIV-related discrimination reported by people living with HIV in London, UK.

    Science.gov (United States)

    Elford, Jonathan; Ibrahim, Fowzia; Bukutu, Cecilia; Anderson, Jane

    2008-03-01

    The objective was to examine the extent to which people living with HIV in London reported being discriminated against because of their infection. In 2004-2005, people living with HIV attending NHS outpatient HIV clinics in north east London were asked: "Have you ever been treated unfairly or differently because of your HIV status-in other words discriminated against?". Of the 1,687 people who returned a questionnaire (73% response rate), data from 1,385 respondents were included in this analysis; 448 heterosexual women and 210 heterosexual men of black African origin, 727 gay/bisexual men (621 white, 106 ethnic minority). Overall, nearly one-third of respondents (29.9%, 414/1,385) said they had been discriminated against because of their HIV infection. Of those who reported experiencing HIV-related discrimination, almost a half (49.6%, 200/403) said this had involved a health care worker including their dentist (n = 102, 25.3%) or primary care physician (n = 70, 17.4%).

  6. HIV Transmission

    Science.gov (United States)

    ... Abroad Treatment Basic Statistics Get Tested Find an HIV testing site near you. Enter ZIP code or city Follow HIV/AIDS CDC HIV CDC HIV/AIDS See RSS | ... on HIV Syndicated Content Website Feedback HIV/AIDS HIV Transmission Language: English (US) Español (Spanish) Recommend on ...

  7. Partner Human Papillomavirus Viral Load and Incident Human Papillomavirus Detection in Heterosexual Couples.

    Science.gov (United States)

    Grabowski, Mary K; Kong, Xiangrong; Gray, Ronald H; Serwadda, David; Kigozi, Godfrey; Gravitt, Patti E; Nalugoda, Fred; Reynolds, Steven J; Wawer, Maria J; Redd, Andrew D; Watya, Stephen; Quinn, Thomas C; Tobian, Aaron A R

    2016-03-15

    The association between partner human papillomavirus (HPV) viral load and incident HPV detection in heterosexual couples is unknown. HPV genotypes were detected in 632 human immunodeficiency virus (HIV)-negative couples followed for 2 years in a male circumcision trial in Rakai, Uganda, using the Roche HPV Linear Array. This assay detects 37 genotypes and provides a semiquantitative measure of viral load based on the intensity (graded 1-4) of the genotype-specific band; a band intensity of 1 indicates a low genotype-specific HPV load, whereas an intensity of 4 indicates a high load. Using Poisson regression with generalized estimating equations, we measured the association between partner's genotype-specific viral load and detection of that genotype in the HPV-discordant partner 1 year later. Incident detection of HPV genotypes was 10.6% among men (54 of 508 genotype-specific visit intervals) and 9.0% among women (55 of 611 genotype-specific visit intervals). Use of male partners with a baseline genotype-specific band intensity of 1 as a reference yielded adjusted relative risks (aRRs) of 1.14 (95% confidence interval [CI], .58-2.27]) for incident detection of that genotype among women whose male partner had a baseline band intensity of 2, 1.75 (95% CI, .97-3.17) among those whose partner had an intensity of 3, and 2.52 (95% CI, 1.40-4.54) among those whose partner had an intensity of 4. Use of female partners with a baseline genotype-specific band intensity of 1 as a reference yielded an aRR of 2.83 (95% CI, 1.50-5.33) for incident detection of that genotype among men whose female partner had a baseline band intensity of 4. These associations were similar for high-risk and low-risk genotypes. Male circumcision also was associated with significant reductions in incident HPV detection in men (aRR, 0.53 [95% CI, .30-.95]) and women (aRR, 0.42 [95% CI, .23-.76]). In heterosexual couples, the genotype-specific HPV load in one partner is associated with the risk of new

  8. High levels of post-migration HIV acquisition within nine European countries.

    Science.gov (United States)

    Alvarez-Del Arco, Debora; Fakoya, Ibidun; Thomadakis, Christos; Pantazis, Nikos; Touloumi, Giota; Gennotte, Anne-Francoise; Zuure, Freke; Barros, Henrique; Staehelin, Cornelia; Göpel, Siri; Boesecke, Christoph; Prestileo, Tullio; Volny-Anne, Alain; Burns, Fiona; Del Amo, Julia

    2017-06-23

    We aimed to estimate the proportion of post-migration HIV acquisition among HIV-positive migrants in Europe. To reach HIV positive migrants we designed a cross sectional study performed in HIV clinics. The study was conducted from July 2013-July 2015 in 57 clinics (9 European countries, targeting individuals over 18 years diagnosed in the preceding 5 years and born abroad. Electronic questionnaires supplemented with clinical data were completed in any of 15 languages. Post-migration HIV acquisition was estimated through Bayesian approaches combining extensive information on migration and patients' characteristics. CD4 counts and HIV-RNA trajectories from seroconversion were estimated by bivariate linear mixed models fitted to natural history data. Post-migration acquisition risk factors were investigated with weighted logistic regression. Of 2009 participants, 46% were men who have sex with men (MSM) and a third originated from Sub-Saharan Africa (SSA) and Latin America & Caribbean (LAC), respectively. Median time in host countries was 8 years. Post-migration HIV acquisition was 63% (95% CI: 57%-67%); 72% among MSM, 58% and 51% in heterosexual men and women, respectively. Post-migration HIV acquisition was 71% for LAC migrants and 45% for people from SSA. Factors associated with post-migration HIV acquisition among heterosexual women and MSM were age at migration, length of stay in host country and HIV diagnosis year and among heterosexual men, length of stay in host country, and HIV diagnosis year. A substantial proportion of HIV-positive migrants living in Europe acquired HIV post-migration. This has important implications for European public health policies.

  9. Neural correlates of sexual arousal in homosexual and heterosexual men.

    Science.gov (United States)

    Safron, Adam; Barch, Bennett; Bailey, J Michael; Gitelman, Darren R; Parrish, Todd B; Reber, Paul J

    2007-04-01

    Men exhibit much higher levels of genital and subjective arousal to sexual stimuli containing their preferred sex than they do to stimuli containing only the nonpreferred sex. This study used event-related functional magnetic resonance imaging to investigate how this category-specific pattern would be reflected in the brains of homosexual (n = 11) and heterosexual (n = 11) men. Comparisons of activation to preferred sexual stimuli, nonpreferred sexual stimuli, and sports stimuli revealed large networks correlated with sexual arousal, spanning multiple cortical and subcortical areas. Both homosexual and heterosexual men exhibited category-specific arousal in brain activity. Within the amygdala, greater preference-related activity was observed in homosexual men, but it is unclear whether this is a cause or a consequence of their sexuality. In a subsequent analysis of regions hypothesized to support arousal, both participant groups demonstrated widespread increases in evoked activity for preferred stimuli. Aggregate data from these regions produced significant differences between stimulus types in 16 out of 22 participants. Significant activational differences matched reported sexual orientation in 15 of these 16 participants, representing an advance in psychophysiological measures of arousal. (c) 2007 APA, all rights reserved

  10. Predictors of Heterosexual Casual Sex Among Young Adults

    Science.gov (United States)

    Manning, Wendy; Giordano, Peggy; Longmore, Monica

    2013-01-01

    Casual sex is often associated with the young adult stage in the life course. Most recent research on the prevalence, motives, and consequences of heterosexual casual sex has relied on samples of college students, yet students are only a small and advantaged subset of the young adult population. The current study drew on the Toledo Adolescent Relationships Study, which was collected in 2006–2007 and included young adults (ages 18–24 years) whose trajectories reflected a wider spectrum of educational experiences (N = 1,023). We moved beyond prior work by examining both frequency and type of heterosexual casual sex: lifetime vaginal, lifetime oral, and recent vaginal sex. We found that young adults enrolled or who graduated from 4-year educational institutions reported fewer casual sex partners on all three measures compared to participants with-out a high school degree and those with some college experience. Sexual attitudes were key factors mediating the association between educational status and casual sex behavior. These results indicate that programs aimed at encouraging healthy sexual behavior should target individuals who are at risk of not graduating high school because they are at greatest risk of frequent casual sex partners. PMID:23297151

  11. Polypharmacy, Infectious Diseases, Sexual Behavior, and Psychophysical Health Among Anabolic Steroid-Using Homosexual and Heterosexual Gym Patrons in San Francisco's Castro District.

    Science.gov (United States)

    Ip, Eric J; Yadao, Michael A; Shah, Bijal M; Doroudgar, Shadi; Perry, Paul J; Tenerowicz, Michael J; Newsom, Lindsay; Mann, Amber A; Mkrtchyan, Hermine; Pope, Harrison G

    2017-06-07

    Limited studies based in England and Australia reported misuse of anabolic-androgenic steroids (AAS) among homosexual men to enhance body image. Anecdotally, AAS are also being misused by homosexual men in the United States. Since many AAS and certain performance enhancing drugs (PEDs) are administered via injection, this poses a potential vector for the spread of infectious disease in an already at-risk population. This study compared and contrasted homosexual and heterosexual male gym clients regarding use of AAS and PEDs, use of alcohol and illicit drugs, seroprevalence of infectious disease, engagement in risky injection practices and sexual behaviors, and presence of psychiatric conditions. Recruitment and data collection occurred outside four exercise gyms in the San Francisco Castro District area between October 25, 2014 and March 10, 2015. Two hundred and twenty homosexual men and 73 heterosexual men completed the 114-item cross-sectional survey. Ten percent of homosexual men reported lifetime AAS use. Homosexual men had almost four times more sexual partners and were over 14 times more likely to knowingly have unprotected intercourse with a known HIV positive person than heterosexual men. In addition, a quarter of homosexual men who injected drugs admitted to sharing used syringes or needles with another person. Conclusions/Importance: The current study is the first to confirm AAS use among homosexual men in the United States. Homosexual men partook in high-risk sexual behaviors and injection practices which may place them at greater risks for contracting and spreading HIV and other infectious diseases.

  12. Effects of attractiveness and status in dating desire in homosexual and heterosexual men and women

    NARCIS (Netherlands)

    Ha, P.T.; Berg, J.E.M. van den; Engels, R.C.M.E.; Lichtwarck-Aschoff, A.

    2012-01-01

    The present study examined partner preferences of homosexual and heterosexual men and woman, focusing on attractiveness and status. Homosexual (N = 591 men; M age = 28.87 years, SD = 10.21; N = 249 women; M age = 33.36 years, SD = 13.12) and heterosexual participants (N = 346 men; M age = 39.74

  13. The Effects of Premarital Heterosexual and Homosexual Experience on Dating and Marriage Desirability.

    Science.gov (United States)

    Williams, John D.; Jacoby, Arthur P.

    1989-01-01

    Surveyed 365 college students to investigate their attitudes toward the effects of past sexual behavior, both heterosexual and homosexual, on one's acceptability as a dating or marriage partner. Results showed that both men and women prefer partners without previous coital or oral heterosexual experience, and both strongly rejected those with any…

  14. A Comparison of Lesbian, Bisexual, and Heterosexual College Undergraduate Women on Selected Mental Health Issues

    Science.gov (United States)

    Kerr, Dianne L.; Santurri, Laura; Peters, Patricia

    2013-01-01

    Objective: To investigate selected mental health characteristics of lesbians and bisexual undergraduate college women as compared with heterosexual college women. Participants: Self-identified lesbians and bisexual and heterosexual female college students who took part in the American College Health Association National College Health Assessment…

  15. Poverty among Cohabiting Gay and Lesbian, and Married and Cohabiting Heterosexual Families

    Science.gov (United States)

    Prokos, Anastasia H.; Keene, Jennifer Reid

    2010-01-01

    Using a subsample ( N = 1,365,145) of the 2000 Census 5% Public Use Microdata Sample, the authors investigate explanations for differing poverty chances of cohabiting gay and lesbian, and married and cohabiting heterosexual families. Gay and lesbian couples fare worse than married couples, but better economically than cohabiting heterosexuals.…

  16. Changes in Diversity Course Student Prejudice and Attitudes toward Heterosexual Privilege and Gay Marriage

    Science.gov (United States)

    Case, Kim A.; Stewart, Briana

    2010-01-01

    This study examined diversity course influence on student prejudice against lesbians and gay men, awareness of heterosexual privilege, and support for gay marriage. The study included heterosexual female students in psychology of women, introduction to women's studies, and nondiversity psychology courses. Students in diversity courses expressed…

  17. Effect of Psychopathy on Physical Aggression Toward Gay and Heterosexual Men

    Science.gov (United States)

    Parrott, Dominic J.; Zeichner, Amos

    2006-01-01

    The purpose of this investigation was to examine the effect of psychopathy on antigay aggression. Participants were 84 heterosexual men who competed in an aggression paradigm in which electric shocks were received from and administered to a randomly determined fictitious opponent (heterosexual male, gay male) during a competitive reaction time…

  18. Disparities in Depressive Symptoms Between Heterosexual and Lesbian, Gay, and Bisexual Youth in a Dutch Cohort : The TRAILS Study

    NARCIS (Netherlands)

    la Roi, Chaïm; Kretschmer, Tina; Dijkstra, Jan Kornelis; Veenstra, René; Oldehinkel, Albertine J.

    Lesbian, gay, and bisexual (LGB) youth experience elevated levels of depressive symptoms compared to heterosexual youth. This study examined how differences in depressive symptoms between heterosexual and LGB youth developed from late childhood to early adulthood. The association between sexual

  19. Number of Psychosocial Strengths Predicts Reduced HIV Sexual Risk Behaviors Above and Beyond Syndemic Problems Among Gay and Bisexual Men.

    Science.gov (United States)

    Hart, Trevor A; Noor, Syed W; Adam, Barry D; Vernon, Julia R G; Brennan, David J; Gardner, Sandra; Husbands, Winston; Myers, Ted

    2017-10-01

    Syndemics research shows the additive effect of psychosocial problems on high-risk sexual behavior among gay and bisexual men (GBM). Psychosocial strengths may predict less engagement in high-risk sexual behavior. In a study of 470 ethnically diverse HIV-negative GBM, regression models were computed using number of syndemic psychosocial problems, number of psychosocial strengths, and serodiscordant condomless anal sex (CAS). The number of syndemic psychosocial problems correlated with serodiscordant CAS (RR = 1.51, 95% CI 1.18-1.92; p = 0.001). When adding the number of psychosocial strengths to the model, the effect of syndemic psychosocial problems became non-significant, but the number of strengths-based factors remained significant (RR = 0.67, 95% CI 0.53-0.86; p = 0.002). Psychosocial strengths may operate additively in the same way as syndemic psychosocial problems, but in the opposite direction. Consistent with theories of resilience, psychosocial strengths may be an important set of variables predicting sexual risk behavior that is largely missing from the current HIV behavioral literature.

  20. Children's Gender Identity in Lesbian and Heterosexual Two-Parent Families.

    Science.gov (United States)

    Bos, Henny; Sandfort, Theo G M

    2010-01-01

    This study compared gender identity, anticipated future heterosexual romantic involvement, and psychosocial adjustment of children in lesbian and heterosexual families; it was furthermore assessed whether associations between these aspects differed between family types. Data were obtained in the Netherlands from children in 63 lesbian families and 68 heterosexual families. All children were between 8 and 12 years old. Children in lesbian families felt less parental pressure to conform to gender stereotypes, were less likely to experience their own gender as superior and were more likely to be uncertain about future heterosexual romantic involvement. No differences were found on psychosocial adjustment. Gender typicality, gender contentedness and anticipated future heterosexual romantic involvement were significant predictors of psychosocial adjustment in both family types.

  1. [Different patterns of aversive emotion regulation in homosexual and heterosexual men].

    Science.gov (United States)

    Hu, Shao-hua; Xu, Yi; Li, Peng; Wang, Qi-dong; Hu, Jian-bo; Wei, Ning; Zhang, Min-ming

    2008-09-01

    To compare the differences between homosexual and heterosexual men in the pattern of induced aversive emotion regulation. Ten healthy homosexual men and 10 heterosexual men were investigated by functional magnetic resonance imaging under three types of visual sexual stimuli designed by Block. SPM2 software was used for data analysis. Same levels of negative emotions of homosexual men and heterosexual were induced by female-female and male-male erotic stimuli respectively. Activations of same brain regions including prefrontal gyrus, temporal gyrus, occipital gyrus and cerebellum were observed in two groups. However, there were significant differences in the side of hippocampus and precuneus. Activations of right cingulate cortex were observed in homosexual men, but not in heterosexual men. There are some differences in the patterns of aversive emotion regulation between homosexual and heterosexual men.

  2. Haemodynamic brain response to visual sexual stimuli is different between homosexual and heterosexual men.

    Science.gov (United States)

    Hu, S-H; Wang, Q-D; Xu, Y; Liao, Z-L; Xu, L-J; Liao, Z-L; Xu, X-J; Wei, E-Q; Yan, L-Q; Hu, J-B; Wei, N; Zhou, W-H; Huang, M-L; Zhang, M-M

    2011-01-01

    The underlying neurobiological factors involved in sexual orientation are largely unknown. This study investigated whether neural circuits or different cognitive processes accounted for differences in brain activation in 14 heterosexual and 14 homosexual males. Brain scans were undertaken in each subject using functional magnetic resonance imaging while they viewed different sexual stimuli, i.e. heterosexual couple stimuli (HCS), gay couple stimuli (GCS), lesbian couple stimuli (LCS) and neutral stimuli (NS). Ratings of sexual attractiveness of the stimuli were assessed. Subjective sexual arousal was induced by HCS and GCS in heterosexual and homosexual men, respectively. Sexual disgust was induced by GCS and LCS in heterosexual and homosexual men, respectively. Compared with viewing NS, viewing sexual stimuli induced significantly different brain activations, most of which had the characteristics of cognitive processes. These observations suggest that different cognitive patterns may be the major cause of different subjective responses to sexual stimuli between heterosexual and homosexual men.

  3. Extending the Minority Stress Model to Incorporate HIV-Positive Gay and Bisexual Men's Experiences: a Longitudinal Examination of Mental Health and Sexual Risk Behavior.

    Science.gov (United States)

    Rendina, H Jonathon; Gamarel, Kristi E; Pachankis, John E; Ventuneac, Ana; Grov, Christian; Parsons, Jeffrey T

    2017-04-01

    Minority stress theory represents the most plausible conceptual framework for explaining health disparities for gay and bisexual men (GBM). However, little focus has been given to including the unique stressors experienced by HIV-positive GBM. We explored the role of HIV-related stress within a minority stress model of mental health and condomless anal sex. Longitudinal data were collected on a diverse convenience sample of 138 highly sexually active, HIV-positive GBM in NYC regarding sexual minority (internalized homonegativity and gay-related rejection sensitivity) and HIV-related stressors (internalized HIV stigma and HIV-related rejection sensitivity), emotion dysregulation, mental health (symptoms of depression, anxiety, sexual compulsivity, and hypersexuality), and sexual behavior (condomless anal sex with all male partners and with serodiscordant male partners). Across both sexual minority and HIV-related stressors, internalized stigma was significantly associated with mental health and sexual behavior outcomes while rejection sensitivity was not. Moreover, path analyses revealed that emotion dysregulation mediated the influence of both forms of internalized stigma on symptoms of depression/anxiety and sexual compulsivity/hypersexuality as well as serodiscordant condomless anal sex. We identified two targets of behavioral interventions that may lead to improvements in mental health and reductions in sexual transmission risk behaviors-maladaptive cognitions underlying negative self-schemas and difficulties with emotion regulation. Techniques for cognitive restructuring and emotion regulation may be particularly useful in the development of interventions that are sensitive to the needs of this population while also highlighting the important role that structural interventions can have in preventing these disparities for future generations.

  4. [Introduction to LGBT: definitions, some historical facts, and evolution of thinking in the era of HIV/AIDS--hopes and challenges].

    Science.gov (United States)

    Tritt, Remigiusz Jarosław

    2010-01-01

    This article deals with the subject matter of LGBT (lesbians, gays, bisexuals, transgenders), i.e. individuals who are not heterosexual, presenting definitions, some historical facts, and evolution of thinking in 2010. Attention is drawn to discrimination and stigmatization of members of the LGBT community. Problems related to the prevention of HIV/AIDS among men having sexual contacts with other men are discussed. A concise presentation of the functioning of the LGBT community in the heterosexual society is included. Emphasis is placed on equality of non-heterosexual orientations with reference to important ideas such as homo- and binormativity.

  5. Childhood Sexual Abuse Is Highly Associated With HIV Risk–Taking Behavior and Infection Among MSM in the EXPLORE Study

    Science.gov (United States)

    Mimiaga, Matthew J.; Noonan, Elizabeth; Donnell, Deborah; Safren, Steven A.; Koenen, Karestan C.; Gortmaker, Steven; O’Cleirigh, Conall; Chesney, Margaret A.; Coates, Thomas J.; Koblin, Beryl A.; Mayer, Kenneth H.

    2012-01-01

    Background Previous studies have found high rates of childhood sexual abuse (CSA) among US men who have sex with men (MSM). CSA history has been associated with a variety of negative effects later in life including behaviors that place MSM at greater risk for HIV acquisition and transmission. The present analysis is the first to examine the longitudinal association between CSA and HIV infection, unprotected anal sex, and serodiscordant unprotected anal sex, as well as mediators of these relationships among a large sample of HIV-uninfected MSM. Methods The EXPLORE Study was a behavioral intervention trial conducted in 6 US cities over 48 months with HIV infection as the primary efficacy outcome. Behavioral assessments were done every 6 months via confidential computerized assessments. Longitudinal regression models were constructed, adjusting for randomization arm, geographical location of study site, age at enrollment, education, and race/ethnicity. Results Of the 4295 participants enrolled, 39.7% had a history of CSA. Participants with a history of CSA [adjusted hazards ratio = 1.30, 95% confidence interval (CI): 1.02 to 1.69] were at increased risk for HIV infection over study follow-up. A significant association was seen between history of CSA and unprotected anal sex (adjusted odds ratio = 1.24, 95% CI: 1.12 to 1.36) and serodiscordant unprotected anal sex (adjusted odds ratio = 1.30, 95% CI: 1.18 to 1.43). Among participants reporting CSA, the EXPLORE intervention had no effect in reducing HIV infection rates. Participants reporting CSA were significantly more likely to have symptoms of depression and use nonprescription drugs. Conclusions A predictive relationship between a history of CSA and subsequent HIV infection was observed among this large sample of HIV-uninfected MSM. Findings indicate that HIV-uninfected MSM with CSA histories are at greater risk for HIV infection, report higher rates of HIV sexual risk behavior, and may derive less benefit from

  6. How partnership type and HIV seroconcordance affect HIV transmission risk in regular sexual partnerships: a cross-sectional survey of Australian gay and bisexual men.

    Science.gov (United States)

    Bavinton, Benjamin R; Grulich, Andrew E; Duncan, Duane; Zablotska, Iryna B; Prestage, Garrett P

    2017-06-22

    Background: Regular sexual partnerships among gay and bisexual men (GBM) who practice condomless anal intercourse (CLAI) have not been well characterised in terms of partnership type, HIV seroconcordance and risk of HIV transmission. Primarily sexual regular partnerships, although commonly reported by gay men, have largely been ignored in research and HIV prevention. Among regular partners reporting CLAI with each other, we determined factors differentiating romantic or committed relationships from partnerships organised primarily around sex ('fuckbuddies') and estimated the proportion of CLAI presenting risk for HIV transmission. Methods: An online, cross-sectional survey of Australian GBM was conducted. Univariate and multivariate generalised estimating equations were used to determine statistical associations. Results: Men reported on 2250 regular sexual partnerships. Over half the partnerships were romantic or committed relationships. Over half the partnerships were HIV-negative seroconcordant (54.9%), 3.1% were HIV-positive seroconcordant, 5.2% were serodiscordant and 36.8% were of unknown seroconcordance. Potential risks presented by CLAI were sometimes mitigated by protective factors, such as having a clear spoken agreement about sex with outside partners, having fewer outside partners, openly discussing HIV risk and having an agreement to reduce risk from outside partners. These protective factors were more often found in romantic or committed relationships than among primarily sexual partnerships, and were less often found in partnerships of unknown seroconcordance. Conclusion: CLAI is more common among regular sexual partnerships considered to be of a romantic, committed nature. However, factors associated with such romantic or committed partnerships can also protect against HIV transmission risk. Unknown seroconcordance, particularly lack of communication about HIV status among primarily sexual partnerships, is a key risk factor that needs to be

  7. Anal high-risk human papillomavirus infection and high-grade anal intraepithelial neoplasia detected in women and heterosexual men infected with human immunodeficiency virus

    Directory of Open Access Journals (Sweden)

    Gandra S

    2015-01-01

    Full Text Available Sumanth Gandra, Aline Azar, Mireya WessolosskyDivision of Infectious Disease and Immunology, University of Massachusetts Medical School, Worcester, MA, USABackground: Although anal high-risk human papillomavirus (HR-HPV infection and anal cytological abnormalities are highly prevalent among human immunodeficiency virus (HIV-infected men who have sex with men (MSM, there are insufficient data on these abnormalities among HIV-infected heterosexual men (HSM and women. In this study, we evaluated the prevalence of anal HR-HPV, cytological abnormalities, and performance of these screening tests in detecting high-grade anal intraepithelial neoplasia (AIN2+ among our cohort of HIV-infected MSM and non-MSM (HSM and women.Methods: A single-center, retrospective cohort study was conducted with HIV-infected individuals who underwent anal cancer screening with anal cytology and HR-HPV testing from January 2011 to January 31, 2013.Results: Screening of 221 HIV-infected individuals for both HR-HPV and anal cytology showed the presence of HR-HPV in 54% (abnormal anal cytology 48% of MSM, 28% (abnormal anal cytology 28% of HSM, and 27% (abnormal anal cytology 34% of women. Among 117 (53% individuals with abnormal results (HR-HPV-positive and/or cytology was atypical squamous cells of undetermined significance or above, 67 underwent high resolution anoscopy. Of these 67 individuals, 22 individuals had AIN2+ (17 MSM, four women, and one HSM. HR-HPV correlated better with AIN2+ than with anal cytology on biopsy in both MSM (r=0.29 versus r=0.10; P=0.05 versus P=0.49 and non-MSM (r=0.36 versus r=-0.34; P=0.08 versus P=0.09.Conclusion: Given the presence of AIN2+ in screened HIV-infected HSM and women, routine anal cancer screening in all HIV-infected individuals should be considered. HR-HPV merits further evaluation for anal cancer screening among non-MSM.Keywords: human immunodeficiency virus, anal human papillomavirus, heterosexual men, women, anal cancer

  8. Adolescents Living with HIV: An Indian Profile

    Directory of Open Access Journals (Sweden)

    Sravya Kurapati

    2012-01-01

    Full Text Available Purpose. Although there have been studies on the presence of Human Immunodeficiency Virus (HIV among the adult and even pediatric population, the adolescent population has been neglected. The main objective of this study was to understand and describe the profile of adolescents accessing the Integrated Counseling and Testing Centre (ICTC at a tertiary healthcare centre in north India. This was a retrospective analysis of the data collected where, in addition to the analysis of the presence of HIV among the target population, a comparative analysis of HIV-positive and negative individuals was also carried out. Methods. Counselors at the ICTC of All India Institute of Medical Sciences recorded responses of the patients, and pre- and posttest counseling was performed appropriately. Also, HIV testing was performed using rapid tests (EIA and ELISA. Both pre- and posttest counseling was performed for most of the patients. Also, the data collected from 2005 to May, 2011 was then retrospectively analyzed using various statistical tests, such as, Chi-square test and odds ratios. Results. Out of 979, 84 tested HIV positive. Discrimination at multiple levels was observed.The 10–14 years age group was 0.56 times more likely to be HIV positive than 15–19 year old. HIV serostatus was strongly associated with risk behavior (P=0.003 with heterosexual transmission being the most common. Conclusion. These findings highlight the profile of adolescents in India and their equation with HIV on demographic and psychosocial levels.

  9. Comparisons among heterosexual, bisexual, and homosexual male sadomasochists.

    Science.gov (United States)

    Breslow, N; Evans, L; Langley, J

    1986-01-01

    Between 1982 and 1984 a questionnaire designed to elicit demographic and behavioral information concerning individuals who participate in sadomasochism (S&M) was distributed nationally. Data from 136 heterosexual, 45 bisexual, and 91 homosexual male sadomasochists (N = 272) were analyzed. Similarities and differences among these three groups in response to 15 of the 40 questions asked concerning age and manner of first S&M interest, openness with others concerning those interests, self image and adjustment, sexual behavior, and sex role orientation are reported and compared to findings previously reported by Spengler (1977), Lee (1979), Kamel (1980), Weinberg & Falk (1980) and Weinberg, Williams, & Moser (1984). Issues concerning the categorization of the respondents into appropriate S&M sex role types are also discussed.

  10. Heterosexual gender relations in and around childhood risk and safety.

    Science.gov (United States)

    Brussoni, Mariana; Olsen, Lise L; Creighton, Genevieve; Oliffe, John L

    2013-10-01

    Injuries are a leading cause of child death, and safety interventions frequently target mothers. Fathers are largely ignored despite their increasing childcare involvement. In our qualitative study with 18 Canadian heterosexual couples parenting children 2 to 7 years old, we examined dyadic decision making and negotiations related to child safety and risk engagement in recreational activities. Parents viewed recreation as an important component of men's childcare, but women remained burdened with mundane tasks. Most couples perceived men as being more comfortable with risk than women, and three negotiation patterns emerged: fathers as risk experts; mothers countering fathers' risk; and fathers acknowledging mothers' safety concerns but persisting in risk activities. Our findings suggest that contemporary involved fathering practices privilege men in the outdoors and can erode women's control for protecting children from unintentional injury. We recommend promoting involved fathering that empowers both parents and developing injury-prevention strategies incorporating both fathers' and mothers' perspectives.

  11. Heterosexual students' experiences in sexual orientation intergroup dialogue courses.

    Science.gov (United States)

    Dessel, Adrienne B; Woodford, Michael R; Routenberg, Robbie; Breijak, Duane P

    2013-01-01

    Heterosexism contributes to an unsafe campus climate for lesbian, gay, and bisexual (LGB) college students. Intergroup dialogue courses about sexual orientation seek to build awareness, cross-group relationships, and commitment to social action to address anti-LGB prejudice and discrimination. Although dialogue courses are growing in popularity, few courses address sexual orientation. To advance knowledge of these dialogues, this qualitative study explores heterosexual students' motivations and expectations, challenges, and learning outcomes related to their participation in intergroup dialogue courses on sexual orientation. Core themes include desire to learn about the LGB community, concerns about offending classmates, anxiety around LGB stigma, conflict with classmates around controversial topics, affirming LGB people, and learning about heterosexism, privilege, and intersectionality of identity. Implications for intergroup dialogue pedagogy and research are discussed.

  12. Gender differences in pornography consumption among young heterosexual Danish adults

    DEFF Research Database (Denmark)

    Hald, Gert Martin

    2006-01-01

    a representative sample of 688 young heterosexual Danish adult men and women. The study found large gender differences in prevalence rates of pornography consumption and consumption patterns. Compared to women, men were exposed to pornography at a younger age, consumed more pornography as measured by time......The aims of the study were (1) to investigate gender differences in pornography consumption among Danish adults aged 18-30 and (2) to examine gender differences in situational, interpersonal, and behavioral characteristics of pornography consumption. A national survey study was conducted using...... or with friends (non-sexual partners) than women. For both men and women, the usual place of use was home and no significant gender difference was found in this regard. Men and women were found to vary in their preferences in pornographic materials, with men both preferring a wider range of hardcore pornography...

  13. Social Capital and HIV Risks among Acculturating Asian Indian Men in New York City

    Science.gov (United States)

    Bhattacharya, Gauri

    2005-01-01

    This community-based, qualitative study explored social capital resources and their influences upon HIV risk behaviors in a sample of 17 heterosexual Asian Indian immigrant men residing in New York City. Our study defined social capital as the resources available to individuals and society through social relationships. At the family, peer, and…

  14. HIV and Sexually Transmitted Infections in the Netherlands in 2004 An update: November 2005

    NARCIS (Netherlands)

    Laar MJW van de; Boer IM de; Koedijk FDH; Op de Coul ELM; HIV Monitoring Foundation and; STI sentinel surveillance network; ISIS laboratory surveillance; ISIS/Osiris - Inspectorate of Health; Healthcare Insurance Board; CIE

    2005-01-01

    The increasing trend of Sexually Transmitted Infections (STI) has continued further in 2004, despite a slight levelling off in 2003. The rise was observed both in the number of consultations and STI among heterosexuals and men having sex with men (MSM). In 2004, the number of new HIV diagnoses in

  15. Migrants travelling to their country of origin: a bridge population for HIV transmission?

    NARCIS (Netherlands)

    Kramer, Merlijn A.; van Veen, Maaike G.; Op de Coul, Eline L. M.; Geskus, Ronald B.; Coutinho, Roel A.; van de Laar, Marita J. W.; Prins, Maria

    2008-01-01

    Background: By having unprotected heterosexual contact in both The Netherlands and their homeland, migrants who travel to their homeland might form a bridge population for HIV and sexually transmitted infection (STI) transmission. We studied the determinants for such a population in two large

  16. stability results of a mathematical model for the control of hiv/aids ...

    African Journals Online (AJOL)

    DJFLEX

    Once a sexually active HIV infected person is introduced into a heterosexual population, the virus begins to spread in the population due to interactions between ... A. R. Kimbir, Department of Mathematics/Statistics/Computer Science, Federal University of Agriculture, Makurdi. D. K. Igobi, Department of Mathematics and ...

  17. Demographic characteristics of HIV/AIDS patients at the University of ...

    African Journals Online (AJOL)

    Results: The result showed that the commonest route of transmission remains heterosexual contact, but the infection appears to be more common among married couples. People living with HIV/AIDS are more likely to divulge information about their status when they need support of relatives. Condom use is still abhorred.

  18. No predictive value of GC phenotypes for HIV infection and progression to AIDS

    NARCIS (Netherlands)

    Pronk, J. C.; Frants, R. R.; Crusius, B.; Eriksson, A. W.; de Wolf, F.; Boucher, C. A.; Bakker, M.; Goudsmit, J.

    1988-01-01

    The genetic polymorphism of group-specific component (GC) was investigated with isoelectric focusing in 351 homosexual men at risk for HIV infection, 96 male patients with AIDS, and 86 heterosexual controls. No significant differences in GC phenotype distribution were seen between controls and any

  19. Anal high-risk human papillomavirus infection and high-grade anal intraepithelial neoplasia detected in women and heterosexual men infected with human immunodeficiency virus.

    Science.gov (United States)

    Gandra, Sumanth; Azar, Aline; Wessolossky, Mireya

    2015-01-01

    Although anal high-risk human papillomavirus (HR-HPV) infection and anal cytological abnormalities are highly prevalent among human immunodeficiency virus (HIV)-infected men who have sex with men (MSM), there are insufficient data on these abnormalities among HIV-infected heterosexual men (HSM) and women. In this study, we evaluated the prevalence of anal HR-HPV, cytological abnormalities, and performance of these screening tests in detecting high-grade anal intraepithelial neoplasia (AIN2+) among our cohort of HIV-infected MSM and non-MSM (HSM and women). A single-center, retrospective cohort study was conducted with HIV-infected individuals who underwent anal cancer screening with anal cytology and HR-HPV testing from January 2011 to January 31, 2013. Screening of 221 HIV-infected individuals for both HR-HPV and anal cytology showed the presence of HR-HPV in 54% (abnormal anal cytology 48%) of MSM, 28% (abnormal anal cytology 28%) of HSM, and 27% (abnormal anal cytology 34%) of women. Among 117 (53%) individuals with abnormal results (HR-HPV-positive and/or cytology was atypical squamous cells of undetermined significance or above), 67 underwent high resolution anoscopy. Of these 67 individuals, 22 individuals had AIN2+ (17 MSM, four women, and one HSM). HR-HPV correlated better with AIN2+ than with anal cytology on biopsy in both MSM (r=0.29 versus r=0.10; P=0.05 versus P=0.49) and non-MSM (r=0.36 versus r=-0.34; P=0.08 versus P=0.09). Given the presence of AIN2+ in screened HIV-infected HSM and women, routine anal cancer screening in all HIV-infected individuals should be considered. HR-HPV merits further evaluation for anal cancer screening among non-MSM.

  20. Effects of attractiveness and status in dating desire in homosexual and heterosexual men and women.

    Science.gov (United States)

    Ha, Thao; van den Berg, Judith E M; Engels, Rutger C M E; Lichtwarck-Aschoff, Anna

    2012-06-01

    The present study examined partner preferences of homosexual and heterosexual men and woman, focusing on attractiveness and status. Homosexual (N=591 men; M age=28.87 years, SD=10.21; N=249 women; M age=33.36 years, SD=13.12) and heterosexual participants (N=346 men; M age=39.74 years, SD=14.26; N=400 women; M age=35.93 years, SD=13.72) rated the importance of attractiveness and social status of potential partners and then, in a vignette test, expressed their desire to date hypothetical potential partners based on photographs that varied in attractiveness and status-related profiles. With ratings, heterosexual men valued attractiveness the most, followed by homosexual men, heterosexual women, and homosexual women. Heterosexual women rated social status as most important. When status profiles were manipulated and accompanied with photographs of faces, the pattern of differences between homosexuals and heterosexuals supported the self-reported results. Overall, homosexual men and women have similar mate preferences to heterosexual men and women by showing more dating desire for attractive and high social status persons. Compared to attractiveness, status played a smaller role in dating desire.

  1. Effects of patient load and travel distance on HIV transmission in rural China: Implications for treatment as prevention.

    Science.gov (United States)

    Smith, M Kumi; Miller, William C; Liu, Huixin; Ning, Chuanyi; He, Wensheng; Cohen, Myron S; Wang, Ning

    2017-01-01

    Sustained viral suppression through ART reduces sexual HIV transmission risk, but may require routine access to reliable and effective medical care which may be difficult to obtain in resource constrained areas. We investigated the roles of patient load and travel distance to HIV care clinic on transmission risk in HIV serodiscordant couples in Henan Province, China. Cox proportional hazard models were used to compare HIV transmission events across couples living near, medium, or farther distances from their assigned HIV care clinics, as well as those attending clinics where clinicians bore high versus low patient loads. Most (84·4%) of the 3695 serodiscordant couples lived within 10 kilometers of their assigned HIV clinic, and most (73·5%) attended clinics with patient-to-provider ratios of at least 100:1. In adjusted Cox models, attending clinics where clinicians bore average patient loads of 100 or more elevated HIV transmission risk (aHR, 1·50, 95% CI, 1·00-4·84), an effect amplified in village tier clinics (aHR = 1·55; 95% CI, 1·23-6·78). Travel distance was associated with HIV transmission only after stratification; traveling medium distances to village clinics (5-10km) increased transmission risk (aHR = 1·83, 95% CI, 1·04-3·21) whereas traveling longer distances to township or county level clinics lowered transmission risk (aHR = 0·10, 95% CI, 0·01-0·75). Higher patient loads at HIV clinics was associated with risk of HIV transmission in our population, particularly at village level clinics. Farther travel distance had divergent effects based on clinic tier, suggesting unique mechanisms operating across levels of resource availability. The resource intensity of long-term HIV treatment may place significant strains on small rural clinics, for which investments in additional support staff or time-saving tools such as point-of-care laboratory testing may bring about impactful change in treatment outcomes.

  2. Strategies of people with HIV to confront the stigma associated with HIV/aids. Patients of the general hospital of Huixtla, Chiapas

    Directory of Open Access Journals (Sweden)

    Francisco Chong Villarreal

    2012-01-01

    Full Text Available This article presents results from a study conducted with HIV patients from the General Hospital of Huixtla, Chiapas. Taking conceptual elements from structuration theory, the investigation explores strategies used by people with HIV infection in order to tackle consequences of stigma associated with HIV/aids. For the analysis, we consider three different groups whose experiences and ways to deal with stigmatization associated to HIV/aids differ from each other: women, homosexual men and heterosexual men. The results show that an important strategy used by people with HIV is that, while keeping the diagnosis hidden, they reconstruct within their community the representation of HIV/aids without stigma by means of information about HIV.

  3. Health care students' reactions towards HIV patients: examining prejudice, emotions, attribution of blame and willingness to interact with HIV/AIDS patients.

    Science.gov (United States)

    Philip, Jannel; Chadee, Derek; Yearwood, Rosana Patricia

    2014-01-01

    One of the most pervasive stigmatising conditions in society today is HIV/AIDS. In Trinidad and Tobago, stigma and discrimination are still pervasive especially against persons living with HIV/AIDS (PLHIV) and at-risk groups. HIV stigmatisation takes place at all levels including health care institutions, and is a major obstacle to effective HIV/AIDS prevention and care. This study examined health care students' reactions towards HIV patients. A stratified random sample of 339 health care students from Trinidad was used. A 2 × 2 factorial design using vignettes manipulated a male patient's sexual orientation (heterosexual/homosexual) and HIV onset controllability (high/low). Multivariate analysis of variance and discriminant function analysis were used to analyse the data. There was a significant main effect of HIV onset controllability on participants' attribution of blame, emotions, prejudicial evaluation and willingness to interact with PLHIV, Λ (.64) F(6, 330) = 31.44, p towards PLHIV.

  4. Distribution of HIV-1 and HSV-2 epidemics in Chad revealing HSV-2 hot-spot in regions of high-risk HIV spread.

    Science.gov (United States)

    Charpentier, Charlotte; Koyalta, Donato; Ndinaromtan, Montana; Tchobkréo, Bagamla; Jenabian, Mohammad-Ali; Day, Nesrine; Si-Mohamed, Ali; Weiss, Helen; Bélec, Laurent

    2011-02-01

    Herpes Simplex Virus-2 (HSV-2) is known to be a potent co-factor of Human Immunodeficiency type 1 virus (HIV-1) heterosexual transmission. We were interested in assessing the distribution of HIV-1 and HSV-2 epidemics at the national level in Chad. In 2007, a population-based anonymous serosurvey for HIV-1 and HSV-2 infections, using dried blood spots, was conducted. The study included 548 adults living in 15 regions of Chad. After specimen elution, serological testing for HIV and HSV-2 infections was performed. Countrywide, the HIV-1 and HSV-2 seroprevalences were 11.1% and 15.7%, respectively. A positive correlation was observed with the highest HIV-1 prevalence seen in regions of the highest HSV-2 prevalence, especially in two conflict-affected eastern provinces of Darfur. Urgent public health interventions are needed in regions of Chad where high HSV-2 prevalence may be increasing the risk of HIV propagation.

  5. [Epidemiology of HIV infection in the world and in France].

    Science.gov (United States)

    Semaille, Caroline; Lot, Florence

    2006-05-15

    All continents are affected by HIV at various degrees and the situation of Africa is certainly one of the most serious with HIV prevalence over 20% in Austral Africa, and accounting for half of all HIV cases in the world. Eastern Europe has been recently affected by HIV mainly among IDU. In Asia, the spread of epidemic on general population follows HIV transmission linked to drug use and commercial sex. Similar trends have been observed in Western Europe: relapse of safer sex among men wich have sex with men (MSM) with new HIV contamination, decrease of HIV transmission among drug users and increase of new HIV diagnosis among heterosexuals originating from countries with high prevalence of HIV/AIDS, notably sub-Saharan Africa. Since the introduction of potent anti-retroviral agents in 1996, the numbers of AIDS cases and mortality due to AIDS have sharply decreased in Western Europe. The number of new HIV diagnosis in 2004 is around 7 000 cases in France. The two mostly affected populations in 2003-2004 are homosexuals and sub-Saharan Africans. The harm reduction policies conducted has markedly reduced HIV transmission among injecting drug users.

  6. Transmission route and reasons for HIV testing among recently diagnosed HIV patients in HIV-TR cohort, 2011–2012

    Directory of Open Access Journals (Sweden)

    Basak Dokuzoguz

    2014-11-01

    Full Text Available Introduction: Routes of transmission and reasons for HIV testing are important epidemiologic data to analyze the epidemic and to tailor the response to AIDS. The aim of this study was to analyze reasons for testing and transmission ways of HIV among recently diagnosed HIV patients registered in the multicenter HIV-TR cohort in Turkey. Methods: Transmission ways and reasons for testing of all patients diagnosed in 2011 and 2012 were recorded on a web-based data collection system and were analyzed retrospectively. Results: The study included 693 patients (561 male, 132 female from 24 sites. Reason for HIV testing was available in 640 patients (92%. The most common reason for HIV testing was diagnostic workout for other conditions or illness followed by patient-initiated testing. The reasons for testing were listed in Table 1. The most common routes of HIV transmission were heterosexual intercourse (62.7% and sex among men who have sex with men (MSM (22.6%. At the time of HIV diagnosis, the mean CD4 lymphocyte cell count was 355/mm3 (3–1433/mm3. Primary HIV infection was determined in 42/693 (6% patients and 9/693 (% 1, 2 cases were considered “probable primary HIV infection.” The majority of the cases presented to a clinic for follow-up right after the diagnosis. On the other hand 32/616 (5.2% patients delayed their presentation for more than 3 months. The longest delay was 11 months. Conclusions: The results of the database suggest that targeted testing is lacking in the country. The shift toward homosexual transmission during the last 2 years emphasizes the need for targeted interventions. Patients present relatively late and HIV infection could only be diagnosed when immunosuppression related findings appeared. Patient-initiated testing,an indicator of awareness, was very low suggesting a need to scale-up awareness raising interventions.

  7. [Pregnancy: a model of prevention of HIV transmission].

    Science.gov (United States)

    Mandelbrot, Laurent

    2014-01-01

    Antiretroviral drugs are primarily used to treat people living with HIV but can also reduce the risk of transmission. The first application of this prophylactic approach was in the prevention of mother-to-child transmission, which comprises three components: 1) antiretroviral therapy during pregnancy to reduce maternal viral load, 2) pre-exposure prophylactic treatment of the fetus in utero and intrapartum, and 3) postexposure neonatal treatment. This has resulted in a sharp reduction in mother-to-child transmission, to well below 1 % in France today. "Treatment as prevention" (TASP) is now widely recommended to prevent sexual transmission to partners of people living with HIV articularly when a couple wishes to have children. Achieving and sustaining undetectable viral load is an important means of reducing the risk of sexual transmission in serodiscordant couples and also of controlling the pandemic worldwide. The other uses of antiretroviral drugs to protect HIV-negative people at risk include post-exposure prophylaxis (PEP) and pre-exposure prophylaxis (PrEP). Prevention has both individual and collective dimensions and involves several components, including behavioral changes, serological testing, and use of antiretrovirals.

  8. "A man's gonna do what a man wants to do": African American and Hispanic women's perceptions about heterosexual relationships: a qualitative study.

    Science.gov (United States)

    McLellan-Lemal, Eleanor; Toledo, Lauren; O'Daniels, Christine; Villar-Loubet, Olga; Simpson, Cathy; Adimora, Ada A; Marks, Gary

    2013-05-24

    HIV prevention efforts have given limited attention to the relational schemas and scripts of adult heterosexual women. These broader schemas and scripts of romantic and other sexual liaisons, partner selection, relationship dynamics, and power negotiations may help to better understand facilitators and barriers to HIV risk-reduction practices. We conducted exploratory qualitative interviews with 60 HIV-uninfected heterosexual African-American women from rural counties in North Carolina and Alabama, and Hispanic women from an urban county in southern Florida. Data were collected for relationship expectations; relationship experiences, and relationship power and decision-making. Interview transcripts underwent computer-assisted thematic analysis. Participants had a median age of 34 years (range 18-59), 34% were married or living as married, 39% earned an annual income of $12,000 or less, 12% held less than a high school education, and 54% were employed. Among the Hispanic women, 95% were foreign born. We identified two overarching relationship themes: contradictions between relationship expectations and desires and life circumstances that negated such ideals, and relationship challenges. Within the contradictions theme, we discovered six subthemes: a good man is hard to find; sex can be currency used to secure desired outcomes; compromises and allowances for cheating, irresponsible, and disrespectful behavior; redefining dating; sex just happens; needing relationship validation. The challenges theme centered on two subthemes: uncertainties and miscommunication, and relationship power negotiation. Gender differences in relationship intentions and desires as well as communication styles, the importance of emotional and financial support, and the potential for relationships to provide disappointment were present in all subthemes. In examining HIV risk perceptions, participants largely held that risk for HIV-infection and the need to take precautions were problems of

  9. “A man’s gonna do what a man wants to do”: African American and Hispanic women’s perceptions about heterosexual relationships: a qualitative study

    Science.gov (United States)

    2013-01-01

    Background HIV prevention efforts have given limited attention to the relational schemas and scripts of adult heterosexual women. These broader schemas and scripts of romantic and other sexual liaisons, partner selection, relationship dynamics, and power negotiations may help to better understand facilitators and barriers to HIV risk-reduction practices. Methods We conducted exploratory qualitative interviews with 60 HIV-uninfected heterosexual African-American women from rural counties in North Carolina and Alabama, and Hispanic women from an urban county in southern Florida. Data were collected for relationship expectations; relationship experiences, and relationship power and decision-making. Interview transcripts underwent computer-assisted thematic analysis. Results Participants had a median age of 34 years (range 18–59), 34% were married or living as married, 39% earned an annual income of $12,000 or less, 12% held less than a high school education, and 54% were employed. Among the Hispanic women, 95% were foreign born. We identified two overarching relationship themes: contradictions between relationship expectations and desires and life circumstances that negated such ideals, and relationship challenges. Within the contradictions theme, we discovered six subthemes: a good man is hard to find; sex can be currency used to secure desired outcomes; compromises and allowances for cheating, irresponsible, and disrespectful behavior; redefining dating; sex just happens; needing relationship validation. The challenges theme centered on two subthemes: uncertainties and miscommunication, and relationship power negotiation. Gender differences in relationship intentions and desires as well as communication styles, the importance of emotional and financial support, and the potential for relationships to provide disappointment were present in all subthemes. In examining HIV risk perceptions, participants largely held that risk for HIV-infection and the need to take

  10. The Transmission Dynamics of Human Immunodeficiency Virus (HIV)

    Science.gov (United States)

    May, R. M.; Anderson, R. M.

    1988-10-01

    The paper first reviews data on HIV infections and AIDS disease among homosexual men, heterosexuals, intravenous (IV) drug abusers and children born to infected mothers, in both developed and developing countries. We survey such information as is currently available about the distribution of incubation times that elapse between HIV infection and the appearance of AIDS, about the fraction of those infected with HIV who eventually go on to develop AIDS, about time-dependent patterns of infectiousness and about distributions of rates of acquiring new sexual or needle-sharing partners. With this information, models for the transmission dynamics of HIV are developed, beginning with deliberately oversimplified models and progressing - on the basis of the understanding thus gained - to more complex ones. Where possible, estimates of the model's parameters are derived from the epidemiological data, and predictions are compared with observed trends. We also combine these epidemiological models with demographic considerations to assess the effects that heterosexually-transmitted HIV/AIDS may eventually have on rates of population growth, on age profiles and on associated economic and social indicators, in African and other countries. The degree to which sexual or other habits must change to bring the `basic reproductive rate', R_0, of HIV infections below unity is discussed. We conclude by outlining some research needs, both in the refinement and development of models and in the collection of epidemiological data.

  11. Future of phylogeny in HIV prevention.

    Science.gov (United States)

    Brenner, Bluma G; Wainberg, Mark A

    2013-07-01

    The success of the HIV Prevention Trials Network 052 trial has led to revisions in HIV-1 treatment guidelines. Antiretroviral therapy may reduce the risk of HIV-1 transmissions at the population level. The design of successful treatment as prevention interventions will be predicated on a comprehensive understanding of the spatial, temporal, and biological dynamics of heterosexual men who have sex with men and intravenous drug user epidemics. Viral phylogenetics can capture the underlying structure of transmission networks based on the genetic interrelatedness of viral sequences and cluster networks that could not be otherwise identified. This article describes the phylogenetic expansion of the Montreal men who have sex with men epidemic over the last decade. High rates of coclustering of primary infections are associated with 1 infection leading to 13 onward transmissions. Phylogeny substantiates the role of primary and recent stage infection in transmission dynamics, underlying the importance of timely diagnosis and immediate antiretroviral therapy initiation to avert transmission cascades.

  12. Chlamydia trachomatis Infection in HIV-Infected Women: Need for Screening by a Sensitive and Specific Test

    Directory of Open Access Journals (Sweden)

    Sonali Bhattar

    2013-01-01

    Full Text Available Reproductive tract infection (RTIs/sexually transmitted infections (STIs are recognized as a major public health problem, particularly due to their relationship with HIV infection. Early detection and treatment of Chlamydia trachomatis infection (CTI among HIV-infected and HIV-uninfected women may impact heterosexual HIV transmission. A total of 120 participants were enrolled: 30 HIV seropositive women with symptoms of RTIs, 30 HIV seropositive women without symptoms of RTIs, 30 HIV seronegative women with symptoms of RTIs, and 30 HIV seronegative women without symptoms of RTIs. One endocervical swab was collected from all participants and CTI was detected by real-time PCR (COBAS TaqMan CT Test, v2.0. CTI was detected in 4 (6.67% HIV-infected women and in 1 (1.67% HIV-uninfected woman (OR 4.214; 95% CI 0.457–38.865. Vaginal discharge was present in almost half of HIV-infected and HIV-uninfected women; lower abdominal pain was present in 11 (18.3% of HIV-infected and in 9 (15% of HIV-uninfected women. This study showed that CTI is more prevalent among HIV-infected females as compared to HIV-uninfected females. As the use of real-time PCR is not feasible in most hospitals, efforts should be made to develop a simple, sensitive, and specific test to identify women with CTI for prevention of sequelae and HIV transmission.

  13. Outcome predictors of internet-based brief sex therapy for sexual dysfunctions in heterosexual men

    NARCIS (Netherlands)

    Blanken, I.; Leusink, P.; van Diest, S.; Gijs, L.; van Lankveld, J.J.D.M.

    2014-01-01

    The authors investigated whether baseline and therapy process characteristics of 82 heterosexual men participating in an Internet-based sex therapy study predict posttreatment sexual functioning. Problem severity, baseline sexual desire and baseline sexual satisfaction, but also partner problems and

  14. Heterosexual and nonheterosexual young university students' involvement in traditional and cyber forms of bullying.

    Science.gov (United States)

    Wensley, Kate; Campbell, Marilyn

    2012-12-01

    Research has consistently found that school students who do not identify as self-declared completely heterosexual are at increased risk of victimization by bullying from peers. This study examined heterosexual and nonheterosexual university students' involvement in both traditional and cyber forms of bullying, as either bullies or victims. Five hundred twenty-eight first-year university students (M=19.52 years old) were surveyed about their sexual orientation and their bullying experiences over the previous 12 months. The results showed that nonheterosexual young people reported higher levels of involvement in traditional bullying, both as victims and perpetrators, in comparison to heterosexual students. In contrast, cyberbullying trends were generally found to be similar for heterosexual and nonheterosexual young people. Gender differences were also found. The implications of these results are discussed in terms of intervention and prevention of the victimization of nonheterosexual university students.

  15. Heterosexuals attitudes toward bisexual men and women in the United States.

    Science.gov (United States)

    Herek, Gregory M

    2002-11-01

    This paper examines heterosexual adults attitudes toward bisexual men and women using data from a 1999 national RDD survey (N = 1,335). Ratings on 101-point feeling thermometers were lower (less favorable) for bisexual men and bisexual women than for all other groups assessed--including religious, racial, ethnic, and political groups--except injecting drug users. More negative attitudes toward bisexuals were associated with higher age, less education, lower annual income, residence in the South and rural areas, higher religiosity, political conservatism, traditional values concerning gender and sexual behavior, authoritarianism, and lack of contact with gay men or lesbians. White heterosexual women expressed significantly more favorable attitudes than other women and all men. A gender difference was observed in attitudes toward bisexuals and homosexuals: Heterosexual women rated bisexuals significantly less favorably than they rated homosexuals, regardless of gender, whereas heterosexual men rated male targets less favorably than female targets, regardless of whether the target was bisexual or homosexual.

  16. Life Satisfaction, Self-Esteem, and Loneliness Among LGB Adults and Heterosexual Adults in China.

    Science.gov (United States)

    Hu, Jingchu; Hu, Jize; Huang, Gang; Zheng, Xifu

    2016-01-01

    Low levels of life satisfaction have been linked to low self-esteem and loneliness, but this association has never been tested directly in LGB (lesbian/gay/bisexual) populations. We compared 275 Chinese LGB adults to 275 demographic-matched Chinese heterosexual controls on life satisfaction, self-esteem, and loneliness. LGB adults reported lower levels of self-esteem and higher levels of loneliness than heterosexuals, but similar levels of overall life satisfaction. Self-esteem partially mediated (but did not moderate) the relationship between loneliness and life satisfaction in both groups. Hierarchical regressions indicated that demographic variables, loneliness, and self-esteem can predict life satisfaction in both LGB and heterosexual adults, but explained more variance of life satisfaction in the LGB group. Thus self-esteem and loneliness play a more important role in life satisfaction for LGB rather than heterosexual Chinese adults.

  17. Psychological adjustment of homosexual and heterosexual men: a cross-national replication.

    Science.gov (United States)

    Siegelman, M

    1978-01-01

    The present investigation of British subjects replicated an investigation conducted in the United States. There was considerable agreement in the findings of the two studies. A multidimensional evaluation of adjustment, based on questionnaire data, indicated that the total sample of British homosexuals described themselves as less well adjusted than the heterosexuals on four factors, better adjusted on two factors, and not different on six factors. There was a significant difference on only one dimension, however, for selected groups of masculine homosexuals vs. heterosexuals. Homosexuals and heterosexuals low on feminity, in addition, tended to be better adjusted than homosexuals and heterosexuals high on femininity. The possible confusion between adjustment and masculinity-femininity, as well as the importance of using a multidimensional approach when considering adjustment, is discussed.

  18. HIV incidence and risk factors for acquisition in HIV discordant couples in Masaka, Uganda: an HIV vaccine preparedness study.

    Directory of Open Access Journals (Sweden)

    Eugene Ruzagira

    Full Text Available To determine the incidence of and risk factors for HIV acquisition in a cohort of HIV-uninfected partners from HIV discordant couples in Masaka, Uganda, and to establish its suitability for HIV vaccine trials.HIV-uninfected adults living in HIV discordant couple relationships were enrolled and followed for 2 years. Interviews, medical investigations, HIV counseling and testing, syphilis and urine pregnancy (women tests were performed at quarterly visits. Sexual risk behaviour data were collected every 6 months.495 participants were enrolled, of whom 34 seroconverted during 786.6 person-years of observation (PYO. The overall HIV incidence rate [95% confidence interval (CI] was 4.3 [3.1-6]; and 4.3 [2.8-6.4] and 4.4 [2.5-8] per 100 PYO in men and women respectively. Independent baseline predictors for HIV acquisition were young age [18-24 (aRR = 4.1, 95% CI 1.6-10.8 and 25-34 (aRR = 2.7, 95% CI 1.2-5.8 years]; alcohol use (aRR = 2.6, 95% CI 1.1-6; and reported genital discharge (aRR = 3.4, 95% CI 1.6-7.2 in the past year. Condom use frequency in the year preceding enrolment was predictive of a reduced risk of HIV acquisition [sometimes (aRR = 0.4, 95% CI 0.2-0.8; always (aRR = 0.1, 95% CI 0.02-0.9]. In the follow-up risk analysis, young age [18-24 (aRR = 6.2, 95% CI 2.2-17.3 and 25-34 (aRR = 2.3, 95% CI 1.1-5.0 years], reported genital discharge (aRR = 2.5, 95% CI 1.1-5.5, serological syphilis (aRR 3.2, 95% CI 1.3-7.7 and the partner being ART naïve (aRR = 4.8, 95% CI 1.4-16.0 were independently associated with HIV acquisition. There were no seroconversions among participants who reported consistent condom use during the study.The study has identified important risk factors for HIV acquisition among HIV discordant couples. HIV-uninfected partners in discordant couples may be a suitable population for HIV vaccine efficacy trials. However, recent confirmation that ART reduces heterosexual HIV transmission may

  19. Was an epidemic of gonorrhoea among heterosexuals attending an Adelaide sexual health services associated with variations in sex work policing policy?

    Science.gov (United States)

    Li, Bin; Bi, Peng; Waddell, Russell; Chow, Eric Pf; Donovan, Basil; McNulty, Anna; Fehler, Glenda; Loff, Bebe; Shahkhan, Hana; Fairley, Christopher K

    2016-08-01

    A review of historical trends in gonococcal diagnoses made at the Adelaide Sexual Health Clinic (ASHC), South Australia, identified a substantial rise in diagnoses among heterosexuals between 2006 and 2010. Sex work is illegal in South Australia, regulated in Victoria and legal in New South Wales. This and other factors that could have influenced the epidemic were explored in this analysis. Retrospective analyses of gonorrhoea diagnoses made by sexual health services between 1990 and 2012 in three Australian state capitals, Melbourne (Victoria) and Sydney (New South Wales) were undertaken. At the ASHC the proportion of gonorrhoea diagnoses was higher between 2006 and 2010 among heterosexual men (5.34% vs 0.84%, p<0.001), non-sex worker women (0.64% vs 0.28%, p<0.001) and female sex workers (FSWs) (1.75% vs 0.24%, p<0.001) compared with other years. This relationship was not seen at the Melbourne Sexual Health Clinic and corresponding data from the Sydney Sexual Health Centre showed that FSWs were less likely to have gonorrhoea between 2006 and 2010 than the other groups (p=0.746, p=0.522, p=0.024, respectively). At ASHC FSWs were significantly more likely to be diagnosed between 2006 and 2010 (OR 2.8, 95% CI 1.48 to 5.27, p=0.002). Charges against sex workers peaked in 2007/2008. A substantial, self-limiting rise in diagnoses of heterosexual gonorrhoea was seen in Adelaide FSWs between 2006 and 2010. Removing barriers to condom use is vital to the prevention of HIV and STI transmission. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  20. Homosexual Women Have Less Grey Matter in Perirhinal Cortex than Heterosexual Women

    OpenAIRE

    Ponseti, Jorge; Siebner, Hartwig R.; Klöppel, Stefan; Wolff, Stephan; Granert, Oliver; Jansen, Olav; Mehdorn, Hubertus M.; Bosinski, Hartmut A.

    2007-01-01

    Is sexual orientation associated with structural differences in the brain? To address this question, 80 homosexual and heterosexual men and women (16 homosexual men and 15 homosexual women) underwent structural MRI. We used voxel-based morphometry to test for differences in grey matter concentration associated with gender and sexual orientation. Compared with heterosexual women, homosexual women displayed less grey matter bilaterally in the temporo-basal cortex, ventral cerebellum, and left v...

  1. Premarital Heterosexual Relationships and its Association with Marital Satisfaction among Married College Students in Tehran

    OpenAIRE

    فریده خلج‌آبادی فراهانی; علی زاده‌محمدی

    2015-01-01

    Despite increasing trends towards premarital heterosexual relationships among youth and marital dissatisfaction among couples, few studies have examined the association between these two phenomena. This paper aims to assess the relationship between experience or premarital heterosexual relationships (both friendship & sexual) with marital satisfaction. This paper is based on the survey data of a mix method study conducted in 2011-2012. In this paper, 299 married college students, both males a...

  2. HIV Prevention

    Science.gov (United States)

    ... Abroad Treatment Basic Statistics Get Tested Find an HIV testing site near you. Enter ZIP code or city Follow HIV/AIDS CDC HIV CDC HIV/AIDS See RSS | ... Collapse All Is abstinence the only 100% effective HIV prevention option? Yes. Abstinence means not having oral, ...

  3. HIV Testing

    Science.gov (United States)

    ... Abroad Treatment Basic Statistics Get Tested Find an HIV testing site near you. Enter ZIP code or city Follow HIV/AIDS CDC HIV CDC HIV/AIDS See RSS | ... All Collapse All Should I get tested for HIV? CDC recommends that everyone between the ages of ...

  4. Effect of variable transmission rate on the dynamics of HIV in sub-Saharan Africa

    Directory of Open Access Journals (Sweden)

    Stewart Sarah L

    2011-08-01

    Full Text Available Abstract Background The cause of the high HIV prevalence in sub-Saharan Africa is incompletely understood, with heterosexual penile-vaginal transmission proposed as the main mechanism. Heterosexual HIV transmission has been estimated to have a very low probability; but effects of cofactors that vary in space and time may substantially alter this pattern. Methods To test the effect of individual variation in the HIV infectiousness generated by co-infection, we developed and analyzed a mathematical sexual network model that simulates the behavioral components of a population from Malawi, as well as the dynamics of HIV and the co-infection effect caused by other infectious diseases, including herpes simplex virus type-2, gonorrhea, syphilis and malaria. Results The analysis shows that without the amplification effect caused by co-infection, no epidemic is generated, and HIV prevalence decreases to extinction. But the model indicates that an epidemic can be generated by the amplification effect on HIV transmission caused by co-infection. Conclusion The simulated sexual network demonstrated that a single value for HIV infectivity fails to describe the dynamics of the epidemic. Regardless of the low probability of heterosexual transmission per sexual contact, the inclusion of individual variation generated by transient but repeated increases in HIV viral load associated with co-infections may provide a biological basis for the accelerated spread of HIV in sub-Saharan Africa. Moreover, our work raises the possibility that the natural history of HIV in sub-Saharan Africa cannot be fully understood if individual variation in infectiousness is neglected.

  5. Extradyadic involvement and relationship dissolution in heterosexual women university students.

    Science.gov (United States)

    Negash, Sesen; Cui, Ming; Fincham, Frank D; Pasley, Kay

    2014-04-01

    This study examined the role of extradyadic involvement (EDI) in heterosexual dating relationships among young adult females (N = 539). A considerable percentage of participants (36 %) reported that they had engaged in an extradyadic emotional or sexual relationship within the last 2 months. Results from logistic regression analyses supported the general hypothesis that emotional and sexual EDI were both significantly associated with relationship dissolution. These associations remained strong even after controlling for participants' age, relationship duration, and relationship quality. The findings also showed that the strength of the association between acts of emotional or sexual extradyadic behaviors and relationship dissolution was linked to relationship quality, gender of the actor, and type of EDI (emotional vs. sexual). Specifically, compared to participants who reported poor relationship quality, those who reported high relationship quality were more likely to end the partnership if they reported emotional or sexual EDI. Findings suggest that individuals in higher quality relationships appear to have considerably more to lose in their relationship when emotional or sexual EDI occurs. This, in part, may be because the more satisfactory the relationship the more disillusionment one may feel when betrayed by their romantic partner. Overall, the present findings underscore the multifaceted nature of the relationships between EDI and relationship dissolution. We call for more research that rigorously examines what contextual factors influence young adults in dating relationships to dissolve relationships following EDI.

  6. Heterosexual Seduction in the Urban Night Context: Behaviors and Meanings.

    Science.gov (United States)

    Brak-Lamy, Guadalupe

    2015-01-01

    This article presents an anthropological analysis of heterosexual seduction behaviors of men and women (from 18 to 65 years old, with varying civil status) who attended nightclubs located in the movida areas of Lisbon, Portugal. These behaviors were analyzed according to structure versus communitas theories. Nighttime seduction behaviors were observed and recorded in a field diary, and in-depth semistructured interviews with 60 men and 60 women were conducted. Interviews were analyzed using the thematic content analysis model. Results suggested that the communitas domain was evinced in the various seduction strategies. These courtship behaviors tended to follow a specific pattern: nonverbal seduction, visual seduction, verbal seduction, and acting-consisting of caresses, touches, and kisses. When this escalation process evoked positive responses, it generally culminated in the complete synchrony of movements between the two bodies. The seduction process encompassed both masculine and feminine initiatives: Women engaged primarily in nonverbal and visual seduction, while men appeared to orchestrate verbal courtship and acting. However, sometimes men and women did not want to seduce or be seduced because they were married (especially women) or were with their partners (especially young men) and did not want to endanger the structure domain.

  7. The relationship of homophobia to intimacy in heterosexual men.

    Science.gov (United States)

    Monroe, M; Baker, R C; Roll, S

    1997-01-01

    Interpersonal intimacy is more difficult to achieve for American men than women. Research has shown that men disclose less, have fewer close friendships, and are viewed by their wives as low in intimacy. Among the barriers to intimacy among men, Tognoli (1980) suggested that homophobia is the most powerful. The present study tested this idea by asking men to disclose a personal secret to either a male confidant, a female confidante, or by writing the secret. It was expected that the presence of a male confidant would stimulate homophobic feelings and inhibit disclosure, while the other two conditions would result in more personal disclosure. A correlation between intimacy of disclosure and level of homophobia was also expected. Subjects were 75 heterosexual men, 31 to 50 years of age, randomly assigned to one of the three conditions. They also completed the Miller Social Intimacy Scale, the Jourard Self-Disclosure Questionnaire, the Index of Homophobia, and the Marlowe-Crowne Social Desirability Scale. Results showed that homophobia was inversely related to level of social intimacy. There was some indication that homophobia does relate to less intimate disclosure to other males. Thus this study found some support for the idea that homophobia is an obstacle to intimacy for men.

  8. The Symbolic Nature of Trust in Heterosexual Adolescent Romantic Relationships.

    Science.gov (United States)

    Norona, Jerika C; Welsh, Deborah P; Olmstead, Spencer B; Bliton, Chloe F

    2017-08-01

    Trust contributes to young people's capacity for sustaining current and future successful relationships. To date, research has yet to examine the meaning of trust in early dating relationships and reasons for its deterioration. The present study focused on video-recorded conversations about trust between 34 heterosexual adolescent couples in dating relationships living in the U.S. Transcripts from these conversations were qualitatively analyzed using thematic analysis to identify adolescents' meanings of trust and reasons they provided for a lack of trust in their romantic partners. All 34 couples identified concerns specifically related to infidelity. Six major themes for not trusting romantic partners emerged. Results suggested that the lack of trust in romantic relationships might stem from several areas that are directly and indirectly related to the current relationship, including low self-esteem, the experience of betrayal in past romantic relationships, partners' extradyadic behaviors, and gossip among peers. Importantly, peers can play a defining role in influencing young people's perceptions of their romantic partners and developing or sustaining trust in their romantic relationships.

  9. Lesbian, Gay, and Heterosexual Adoptive Parents' Experiences in Preschool Environments.

    Science.gov (United States)

    Goldberg, Abbie E

    2014-01-01

    Little research has examined the school experiences of lesbian/gay (LG) parent families or adoptive parent families. The current exploratory study examined the experiences of 79 lesbian, 75 gay male, and 112 heterosexual adoptive parents of preschool-age children with respect to their (a) level of disclosure regarding their LG parent and adoptive family status at their children's schools; (b) perceived challenges in navigating the preschool environment and advocating on behalf of their children and families; and (c) recommendations to teachers and schools about how to create affirming school environments with respect to family structure, adoption, and race/ethnicity. Findings revealed that the majority of parents were open about their LG and adoptive family status, and had not encountered challenges related to family diversity. Those parents who did experience challenges tended to describe implicit forms of marginalization, such as insensitive language and school assignments. Recommendations for teachers included discussing and reading books about diverse families, tailoring assignments to meet the needs of diverse families, and offering school community-building activities and events to help bridge differences across families.

  10. Intimacy and Emotion Work in Lesbian, Gay, and Heterosexual Relationships.

    Science.gov (United States)

    Umberson, Debra; Thomeer, Mieke Beth; Lodge, Amy C

    2015-04-01

    Knowledge about how gender shapes intimacy is dominated by a heteronormative focus on relationships involving a man and a woman. In this study, the authors shifted the focus to consider gendered meanings and experiences of intimacy in same-sex and different-sex relationships. They merged the gender-as-relational perspective-that gender is co-constructed and enacted within relationships-with theoretical perspectives on emotion work and intimacy to frame an analysis of in-depth interviews with 15 lesbian, 15 gay, and 20 heterosexual couples. They found that emotion work directed toward minimizing and maintaining boundaries between partners is key to understanding intimacy in long-term relationships. Moreover, these dynamics, including the type and division of emotion work, vary for men and women depending on whether they are in a same-sex or different-sex relationship. These findings push thinking about diversity in long-term relationships beyond a focus on gender difference and toward gendered relational contexts.

  11. Power, gender stereotypes and perceptions of heterosexual couples.

    Science.gov (United States)

    Smoreda, Z

    1995-12-01

    This paper examines the relation between power attributed to members of heterosexual couples and the perception of their personalities in terms of gender stereotyped traits. Three-hundred and fifty adults, native French subjects (women and men) participated in the study. They attributed daily family tasks and decisions to the target persons; then, they described them on the Bem Sex-Role Inventory. The results indicated strong correlations between observers' representations of power distribution in the couple and the gender related personality descriptions of the couple. The attribution of 'instrumental' traits increased (and 'expressive' traits decreased) according to the degree of power assigned to the target person of either sex. On the 'instrumentality' dimension, accentuation of perceptions of people in gender role inconsistent positions was also observed. The simultaneous influences of general gender stereotypes and specific relations between the gender roles in dyads on the perception of individuals are discussed. It is proposed that social relations of dominance provide a model for the construction of gender stereotypes and their contextual applications.

  12. Understanding HIV Care Provider Attitudes Regarding Intentions to Prescribe PrEP

    Science.gov (United States)

    Castel, Amanda D.; Feaster, Daniel J.; Tang, Wenze; Willis, Sarah; Jordan, Heather; Villamizar, Kira; Kharfen, Michael; Kolber, Michael A.; Rodriguez, Allan; Metsch, Lisa

    2015-01-01

    Introduction Pre-exposure prophylaxis (PrEP) is a promising approach to reducing HIV incidence. Thus garnering the support of HIV providers, who are most familiar with antiretrovirals and likely to encounter patients in HIV serodiscordant relationships, to scale-up PrEP implementation is essential. We sought to determine whether certain subgroups of HIV providers were more likely to intend to prescribe PrEP. Methods Surveys were administered to HIV providers in Miami, Florida and Washington, DC. Composite scores were developed to measure PrEP knowledge, experience, and likelihood of prescribing. Latent class analysis (LCA) was used to stratify provider attitudes toward PrEP. Results Among 142 HIV providers, 73.2% had cared for more than 20 HIV-infected patients in the prior 3 months; 17% had ever prescribed PrEP. LCA identified two classes of providers (entropy 0.904); Class 1 (n=95) found PrEP less effective and perceived barriers to prescribing it; Class 2 (n=47) perceived PrEP as moderately effective and perceived fewer barriers to prescribing it. Compared to Class 2, Class 1 had significantly less experience with PrEP delivery (t(22.7)=2.88, p=0.009) and was significantly less likely to intend to prescribe to patients with multiple sex partners (20% vs. 43%, p=0.04) and those with a drug use history (7% vs. 24%, p=0.001). Conclusions While most HIV providers found PrEP to be effective, those considering it less effective had limited knowledge and experience with PrEP and had lesser intentions to prescribe. Provider training regarding whom should receive PrEP and addressing potential barriers to PrEP provision are needed if this HIV prevention method is to be optimized. PMID:26247895

  13. HIV Testing Among Teens Attending Therapeutic Schools: Having a Personal Source of Information About HIV/AIDS Matters!

    Science.gov (United States)

    Swenson, Rebecca R; Houck, Christopher; Sarfati, David; Emerson, Erin; Donenberg, Geri; Brown, Larry K

    2015-06-01

    Being informed and using positive coping strategies are associated with engaging in health-promoting behaviors. We assessed whether the type of information source about HIV (personal or impersonal) and coping strategies (optimism, avoidance, or emotion-focused) are associated with HIV testing among adolescents attending therapeutic schools. Participants were 417 adolescents, ages 13-19, who attended one of 20 therapeutic day schools for emotionally/behaviorally disordered youth in two US cities (Providence, RI and Chicago, IL) and completed a baseline assessment for an HIV prevention study. Among adolescents in the study, 29% reported having been tested for HIV. Adolescents were more likely to have been tested if they were older, female, Hispanic, identified as non-heterosexual, came from lower SES households, and had recently had unprotected sex. Additionally, youth who endorsed greater use of optimistic thinking and emotion-focused coping, and who reported having been informed about HIV by more personal sources, were also more likely to have been tested for HIV. In a multivariate analysis, having had recent unprotected sex and having more personal sources of information about HIV/AIDS were independently associated with HIV testing. Study findings suggest that, controlling for sociodemographic background, sexual risk behavior, and coping strategy, HIV testing among adolescents with emotional and behavioral problems may be increased when adolescents learn about HIV/AIDS from personal sources such as their healthcare providers, family, and friends.

  14. Sexual behavior and HIV transmission risk of Ugandan adults taking antiretroviral therapy: 3 year follow-up.

    Science.gov (United States)

    Apondi, Rose; Bunnell, Rebecca; Ekwaru, John Paul; Moore, David; Bechange, Stevens; Khana, Kenneth; King, Rachel; Campbell, James; Tappero, Jordan; Mermin, Jonathan

    2011-06-19

    Long-term impact of antiretroviral therapy (ART) on sexual HIV-transmission risk in Africa is unknown. We assessed sexual behavior changes and estimated HIV transmission from HIV-infected adults on ART in Uganda. Between 2003 and 2007, we enrolled and followed ART-naive HIV-infected adults in a home-based AIDS program with annual counseling and testing for cohabitating partners, participant transmission risk-reduction plans, condom distribution and prevention support for cohabitating discordant couples. We assessed participants' HIV plasma viral load and partner-specific sexual behaviors. We defined risky sex as intercourse with inconsistent/no condom use with HIV-negative or unknown serostatus partners in previous 3 months. We compared rates using Poisson regression models, estimated transmission risk using established viral load-specific transmission estimates, and documented sero-conversion rates among HIV-discordant couples. Of 928 participants, 755 (81%) had 36 months data: 94 (10%) died and 79 (9%) missing data. Sexual activity increased from 28% (baseline) to 41% [36 months (P sexually active participants, 22% reported risky sex at baseline, 8% at 6 months (P conversion occurred among 62 cohabitating sero-discordant partners (0.5 sero-conversions/100 person-years). At 36 months, consistent condom use was 74% with discordant partners, 55% with unknown and 46% with concordant partners. Estimated HIV transmission risk reduced 91%, from 47.3 to 4.2/1000 person-years. Despite increased sexual activity among HIV-infected Ugandans over 3 years on ART, risky sex and estimated risk of HIV transmission remained lower than baseline levels. Integrated prevention programs could reduce HIV transmission in Africa.

  15. Uptake of HIV testing and counseling, risk perception and linkage to HIV care among Thai university students

    Directory of Open Access Journals (Sweden)

    Thana Khawcharoenporn

    2016-07-01

    Full Text Available Abstract Background HIV testing and counseling (HTC with linkage to care after known infection are key components for HIV transmission prevention. This study was conducted to assess HTC uptake, HIV risk perception and linkage to care among Thai university students. Methods An outreach HTC program was conducted in a large public university in Thailand from January 2013 to December 2014. The program consisted of brief HIV knowledge assessment, free HTC, HIV risk assessment and education provided by the healthcare personnel. Students were categorized into low, moderate and high-risk groups according to the pre-defined HIV risk characteristics. Results One-thousand-eight-hundred-one students participated in the program, 494 (27 % underwent HTC. Independent characteristics associated with no HTC uptake included female sex (P < 0.001, lower HIV knowledge score (P < 0.001, younger age (P < 0.001 and students from non-health science faculties (P = 0.02. Among the 494 students undergoing HTC, 141 (29 % were categorized into moderate or high-risk group, of whom 45/141 (32 % had false perception of low HIV risk. Being heterosexual was independently associated with false perception of low HIV risk (P = 0.04. The rate of new HIV infection diagnosis was 4/494 (0.8 %. Of these 4 HIV-infected students, 3 (75 % were men who have sex with men and only 2 of the 4 students (50 % showed up for HIV continuity care. Conclusions An outreach HIV prevention program with HTC was feasible and beneficial in detecting HIV risk and infection among the university students. However, interventions to improve HTC uptake, HIV risk perception and linkage to care are needed.

  16. Psychopathologic features among drug addicts and homosexuals with HIV infection.

    Science.gov (United States)

    Cazzullo, C L; Gala, C; Martini, S; Pergami, A; Rossini, M; Russo, R

    1990-01-01

    Personal and familial psychopathological histories and information about early losses were collected and the results of the locus of control test and tests for psychological responses were determined for a series of ninety-two HIV-infected subjects (58 drug addicts; 26 homosexuals; 8 heterosexuals, partners of drug addicts). A higher percentage of drug addicts reported past histories of attempted suicide than the homosexuals. Early loss events were more frequent for homosexuals than for drug addicts. There was a higher psychopathological risk for asymptomatic HIV seropositivity in homosexuals, drug addicts who had attempted suicide, subjects that acknowledged that they have serious illness and subjects with external coping mechanisms rather than internal.

  17. Molecular epidemiology of HIV-1 infection in Taiwan from 2005 to 2008: further spread of CRF07_BC and emergence of CRF07_BC/subtype B dual infection.

    Science.gov (United States)

    Chen, Yen-Ju; Lee, Cheng-Ming; Chen, Marcelo; Chuang, Shao-Yuan; Liu, Hsin-Fu; Wong, Wing-Wai; Lin, Yu-Hui; Tsai, Hung-Chin; Wang, Jen-Hsien; Chen, Yi-Ming Arthur

    2012-04-15

    In 2004, HIV-1 infection among Taiwanese injection drug users (IDUs) started to surge. In 2007, a resurgence of HIV-1 epidemic among men having sex with men (MSM) occurred. We conducted a molecular epidemiological study of HIV-1 among different risk groups in Taiwan from 2005 to 2008. In total 1133 HIV-1-infected adults including 576 IDUs, 464 MSM, and 93 heterosexuals were recruited. HIV-1 subtypes were determined using nested multiplex polymerase chain reaction and phylogenetic analysis. Dual infection was confirmed using cloning, sequencing, and heteroduplex mobility assay. Among HIV-1/AIDS subjects, 96.1% MSM and 62.5% heterosexual males were infected with subtype B, whereas 66.7% female heterosexuals were infected with CRF01_AE. Most IDUs (84.5%) were infected with CRF07_BC. Four heterosexual males, 2 females and 2 MSM who were not IDUs had CRF07_BC. Forty-nine patients had CRF07_BC/subtype B dual infection and 44 (89.8%) were IDUs. Multivariate logistic regression showed that the odds ratio for dual infection among IDUs who shared syringes >5 times per month was 4.7 (95% confidence interval = 1.3 to 17.7). Phylogenetic analyses revealed that there were 2 main groups of CRF07_BC strains with sporadic transmission between different risk groups. Among 10 IDUs infected with CRF01_AE, 7 cases were clustered with an outbreak happened in 2005 and 3 cases were clustered with other strains from heterosexual population. In Taiwan, 7.8% of HIV-1-infected IDUs had dual infection. It may have important impact to their clinical management. Although CRF07_BC was still remained in IDUs, it has spread to MSM and heterosexual populations.

  18. Understanding Women's Risk for HIV Infection Using Social Dominance Theory and the Four Bases of Gendered Power

    Science.gov (United States)

    Rosenthal, Lisa; Levy, Sheri R.

    2010-01-01

    Theoretical models to date have fallen short of accounting for the alarming worldwide rates of HIV infection in women through heterosexual contact. In this article, social dominance theory and the four bases of gendered power--force, resource control, social obligations, and consensual ideologies--are used to organize and explain international…

  19. "Gay Boy Talk" Meets "Girl Talk": HIV Risk Assessment Assumptions in Young Gay Men's Sexual Health Communication with Best Friends

    Science.gov (United States)

    Mutchler, Matt G.; McDavitt, Bryce

    2011-01-01

    Young adults, particularly young gay men (YGM), are vulnerable to human immunodeficiency virus (HIV). Yet, little is known about how YGM discuss sexual health issues with their friends ("gay boy talk"). We conducted semi-structured interviews with YGM and their best friends (11 YGM/YGM dyads and 13 YGM/heterosexual female dyads). In this paper, we…

  20. ‘We keep her status to ourselves’: Experiences of stigma and discrimination among HIV-discordant couples in South Africa, Tanzania and Ukraine

    Science.gov (United States)

    Rispel, Laetitia C.; Cloete, Allanise; Metcalf, Carol A.

    2015-01-01

    Abstract In HIV-discordant relationships, the HIV-negative partner also carries the burden of a stigmatised disease. For this reason, couples often hide their HIV-discordant status from family, friends and community members. This perpetuates the silence around HIV-discordant relationships and impacts on targeted HIV prevention, treatment and counselling efforts. This article reports on experiences of stigma and discrimination among HIV-discordant couples in South Africa, Tanzania and Ukraine. During 2008, HIV-discordant couples who had been in a relationship for at least one year were recruited purposively through health-care providers and civil society organisations in the three countries. Participants completed a brief self-administered questionnaire, while semi-structured interviews were conducted with each partner separately and with both partners together. Interviews were analysed using thematic content analysis. Fifty-one couples were recruited: 26 from South Africa, 10 from Tanzania, and 15 from Ukraine. Although most participants had disclosed their HIV status to someone other than their partner, few were living openly with HIV discordance. Experiences of stigma were common and included being subjected to gossip, rumours and name-calling, and HIV-negative partners being labelled as HIV-positive. Perpetrators of discrimination included family members and health workers. Stigma and discrimination present unique and complex challenges to couples in HIV sero-discordant relationships in these three diverse countries. Addressing stigmatisation of HIV-discordant couples requires a holistic human rights approach and specific programme efforts to address discrimination in the health system. PMID:25778765

  1. 'We keep her status to ourselves': experiences of stigma and discrimination among HIV-discordant couples in South Africa, Tanzania and Ukraine.

    Science.gov (United States)

    Rispel, Laetitia C; Cloete, Allanise; Metcalf, Carol A

    2015-01-01

    In HIV-discordant relationships, the HIV-negative partner also carries the burden of a stigmatised disease. For this reason, couples often hide their HIV-discordant status from family, friends and community members. This perpetuates the silence around HIV-discordant relationships and impacts on targeted HIV prevention, treatment and counselling efforts. This article reports on experiences of stigma and discrimination among HIV-discordant couples in South Africa, Tanzania and Ukraine. During 2008, HIV-discordant couples who had been in a relationship for at least one year were recruited purposively through health-care providers and civil society organisations in the three countries. Participants completed a brief self-administered questionnaire, while semi-structured interviews were conducted with each partner separately and with both partners together. Interviews were analysed using thematic content analysis. Fifty-one couples were recruited: 26 from South Africa, 10 from Tanzania, and 15 from Ukraine. Although most participants had disclosed their HIV status to someone other than their partner, few were living openly with HIV discordance. Experiences of stigma were common and included being subjected to gossip, rumours and name-calling, and HIV-negative partners being labelled as HIV-positive. Perpetrators of discrimination included family members and health workers. Stigma and discrimination present unique and complex challenges to couples in HIV sero-discordant relationships in these three diverse countries. Addressing stigmatisation of HIV-discordant couples requires a holistic human rights approach and specific programme efforts to address discrimination in the health system.

  2. Implicit sexual attitude of heterosexual, gay and bisexual individuals: disentangling the contribution of specific associations to the overall measure.

    Directory of Open Access Journals (Sweden)

    Pasquale Anselmi

    Full Text Available The article aims to measure implicit sexual attitude in heterosexual, gay and bisexual individuals. A Many-Facet Rasch Measurement analysis was used to disentangle the contribution of specific associations to the overall IAT measure. A preference for heterosexuals relative to homosexuals is observed in heterosexual respondents, driven most by associating positive attributes with heterosexuals rather than negative attributes with homosexuals. Differently, neither the negative nor the positive evaluation of any of the target groups play a prominent role in driving the preference for homosexuals observed in gay respondents. A preference for heterosexuals relative to homosexuals is observed in bisexual respondents, that results most from ascribing negative attributes to homosexuals rather than positive attributes to heterosexuals. The results are consistent with the expression of the need for achieving a positive self-image and with the influence of shared social norms concerning sexuality.

  3. Human immunodeficiency virus and chlamydia/gonorrhea testing among heterosexual college students: who is getting tested and why do some not?

    Science.gov (United States)

    Moore, Erin W

    2013-01-01

    This study explored college students' reported history of human immunodeficiency virus (HIV) and chlamydia/gonorrhea and characteristics of students reporting testing. Additionally, it assessed their motivation regarding future testing and reasons for lack of motivation. The sample consisted of 292 sexually experienced college students self-identifying as heterosexual at a midwestern university. Participants completed a 26-item survey during the 2010-2011 academic year. Demographics (sex, age, race/ethnicity), behaviors (higher numbers of sex partners, currently not using condoms), and motivation for future testing distinguished those who had been tested ever and those who had not. Half of participants were not motivated to seek testing in the next 3 months; the most common reason for no motivation being perceived lack of risk. Interventions promoting testing can use these findings to target those likely to never have been tested. These results also highlight the need to find ways to motivate students to get tested.

  4. Dangerous girls and cheating boys: Zulu-speaking disabled young peoples' constructs of heterosexual relationships in Kwazulu-Natal, South Africa.

    Science.gov (United States)

    Chappell, Paul

    2017-05-01

    Across South Africa there is a growing body of work that explores gender dynamics in heterosexual relationships between young people aged 15-24 years. This is mainly influenced by the high prevalence of HIV and the incidence of intimate partner violence in this age group. Most studies to date have been based upon non-disabled young people, with limited focus on young disabled people. In an attempt to address this gap, this paper describes findings from a study conducted with 22 Zulu-speaking young people with visual and physical disabilities in KwaZulu-Natal. Throughout the findings, young disabled participants appeared to downplay their disability with respect to intimate relationships and accentuated the interweaving of complementary and contentious discourses of gender and cultural identity. Taking cognisance of the intersectionality of gender and cultural discourses, the paper extend constructs of disabled sexualities beyond an exclusive gaze on disability in the South African context.

  5. Upset Over Sexual versus Emotional Infidelity Among Gay, Lesbian, Bisexual, and Heterosexual Adults.

    Science.gov (United States)

    Frederick, David A; Fales, Melissa R

    2016-01-01

    One hypothesis derived from evolutionary perspectives is that men are more upset than women by sexual infidelity and women are more upset than men by emotional infidelity. The proposed explanation is that men, in contrast to women, face the risk of unwittingly investing in genetically unrelated offspring. Most studies, however, have relied on small college or community samples of heterosexual participants. We examined upset over sexual versus emotional jealousy among 63,894 gay, lesbian, bisexual, and heterosexual participants. Participants imagined which would upset them more: their partners having sex with someone else (but not falling in love with them) or their partners falling in love with someone else (but not having sex with them). Consistent with this evolutionary perspective, heterosexual men were more likely than heterosexual women to be upset by sexual infidelity (54 vs. 35 %) and less likely than heterosexual women to be upset by emotional infidelity (46 vs. 65 %). This gender difference emerged across age groups, income levels, history of being cheated on, history of being unfaithful, relationship type, and length. The gender difference, however, was limited to heterosexual participants. Bisexual men and women did not differ significantly from each other in upset over sexual infidelity (30 vs. 27 %), regardless of whether they were currently dating a man (35 vs. 29 %) or woman (28 vs. 20 %). Gay men and lesbian women also did not differ (32 vs. 34 %). The findings present strong evidence that a gender difference exists in a broad sample of U.S. adults, but only among heterosexuals.

  6. Pharyngeal Gonorrhoea in Women: An Important Reservoir for Increasing Neisseria gonorrhoea Prevalence in Urban Australian Heterosexuals?

    Directory of Open Access Journals (Sweden)

    M. Josephine Lusk

    2013-01-01

    Full Text Available We aim to characterize sexual behavioral aspects of heterosexual Neisseria gonorrhoea (NG acquisition in two Sexually Transmitted Diseases clinics in Sydney, Australia, in 2008–2012. Of 167 NG cases, 102 were heterosexually acquired with a trend of increasing NG prevalence in heterosexuals from 1.1% (95% CI 0.6–2.1 in 2008 to 3.0% (95% CI 2.0–4.0 in 2012 (P=0.027. Of heterosexual male cases, unprotected fellatio was the likely sexual activity for NG acquisition in 21/69 (30.4% and commercial sex work (CSW contact the likely source in 28/69 (40.6%. NG prevalence overall in CSW (2.2% was not significantly higher than in non-CSW (1.2% (P=0.15, but in 2012 there was a significant increase in NG prevalence in CSW (8.6% compared to non-CSW (1.6% (P<0.001. Pharyngeal NG was found in 9/33 (27.3% female cases. Decreased susceptibility to ceftriaxone (MIC ≥ 0.03 mg/L occurred in 2.5% NG isolates, none heterosexually acquired. All were azithromycin susceptible. A significant trend of increasing prevalence of heterosexual gonorrhoea in an urban Australian STD clinic setting is reported. We advocate maintenance of NG screening in women, including pharyngeal screening in all women with partner change who report fellatio, as pharyngeal NG may be an important reservoir for heterosexual transmission. Outreach to CSW should be enhanced.

  7. A Latent Class Analysis of Heterosexual Young Men's Masculinities.

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    Casey, Erin A; Masters, N Tatiana; Beadnell, Blair; Wells, Elizabeth A; Morrison, Diane M; Hoppe, Marilyn J

    2016-07-01

    Parallel bodies of research have described the diverse and complex ways that men understand and construct their masculine identities (often termed "masculinities") and, separately, how adherence to traditional notions of masculinity places men at risk for negative sexual and health outcomes. The goal of this analysis was to bring together these two streams of inquiry. Using data from a national, online sample of 555 heterosexually active young men, we employed latent class analysis (LCA) to detect patterns of masculine identities based on men's endorsement of behavioral and attitudinal indicators of "dominant" masculinity, including sexual attitudes and behaviors. LCA identified four conceptually distinct masculine identity profiles. Two groups, termed the Normative and Normative/Male Activities groups, respectively, constituted 88 % of the sample and were characterized by low levels of adherence to attitudes, sexual scripts, and behaviors consistent with "dominant" masculinity, but differed in their levels of engagement in male-oriented activities (e.g., sports teams). Only eight percent of the sample comprised a masculinity profile consistent with "traditional" ideas about masculinity; this group was labeled Misogynistic because of high levels of sexual assault and violence toward female partners. The remaining four percent constituted a Sex-Focused group, characterized by high numbers of sexual partners, but relatively low endorsement of other indicators of traditional masculinity. Follow-up analyses showed a small number of differences across groups on sexual and substance use health indicators. Findings have implications for sexual and behavioral health interventions and suggest that very few young men embody or endorse rigidly traditional forms of masculinity.

  8. HIV-Related Stigma and HIV Prevention Uptake Among Young Men Who Have Sex with Men and Transgender Women in Thailand.

    Science.gov (United States)

    Logie, Carmen H; Newman, Peter A; Weaver, James; Roungkraphon, Surachet; Tepjan, Suchon

    2016-02-01

    HIV-related stigma is a pervasive structural driver of HIV. With an HIV epidemic among young men who have sex with men (MSM) and transgender women (TG) in Thailand characterized as explosive, we conducted a cross-sectional survey among MSM and TG aged 18-30 years. From April-August 2013, participants recruited using venue-based sampling from gay entertainment sites and community-based organizations completed a tablet-assisted survey interview in Thai language. We conducted multiple logistic regression to assess correlations between HIV-related stigma (felt-normative, vicarious domains) and socio-demographic variables, HIV vulnerabilities (gay entertainment employment, sex work, forced sex history), and HIV prevention uptake (condom use, HIV testing, rectal microbicide acceptability). Among participants (n = 408), 54% identified as gay, 25% transgender, and 21% heterosexual. Two-thirds (65.7%) were employed at gay entertainment venues, 67.0% had more than three male partners (past month), 55.6% had been paid for sex, and 4.5% were HIV-positive. One-fifth (21.3%) reported forced sex. Most participants reported experiencing felt-normative and vicarious HIV-related stigma. Adjusting for socio-demographics, participants with higher total HIV-related stigma scores had significantly lower odds of HIV testing and rectal microbicide acceptability, and higher odds of having experienced forced sex. Both vicarious and felt-normative dimensions of HIV-related stigma were inversely associated with HIV testing and rectal microbicide acceptability. Our findings suggest that HIV-related stigma harms the health of HIV-negative MSM and TG at high risk for HIV infection. HIV-related interventions and research among young MSM and TG in Thailand should address multiple dimensions of HIV-related stigma as a correlate of risk and a barrier to accessing prevention.

  9. Social and psychological correlates of unprotected anal intercourse among Hispanic-American women: implications for STI/HIV prevention.

    Science.gov (United States)

    Villar-Loubet, Olga; Weiss, Stephen M; Marks, Gary; O'Daniels, Christine; Jones, Deborah; Metsch, Lisa R; McLellan-Lemal, Eleanor

    2016-11-01

    Heterosexual anal intercourse is associated with increased risk for HIV and other sexually transmitted infections. Research on the social and psychological risk factors associated with heterosexual unprotected anal intercourse among Hispanic women in the USA is limited. We examined demographic, mental health, relationship power, sexual self-efficacy, self-esteem, acculturation and HIV knowledge as correlates of unprotected anal intercourse among 514 HIV-negative Hispanic women, 18 to 59 years of age, residing in one urban county in southern Florida. In both unadjusted and adjusted results, the likelihood of engaging in unprotected anal intercourse was associated with food insecurity in the past 30 days (adjusted odds ratio [AOR] = 1.57, 95% confidence interval [CI] 1.03, 2.40) and more interpersonal power attributed to the male partner (AOR = 1.63, 95%CI 1.08, 2.45). Not significant, yet of possible importance, were ever having engaged in exchange sex (AOR = 1.96, 95%CI = 0.97, 3.98) and lower HIV knowledge (AOR = 0.80, 95%CI = 0.63, 1.01). Interventions aimed at reducing heterosexual unprotected anal intercourse risk for HIV infection among Hispanic women may benefit by addressing socioeconomic and interpersonal issues, and assessing HIV knowledge and comprehension.

  10. HIV/AIDS knowledge, attitudes and beliefs based prediction models for practices in prison inmates, Sindh, Pakistan.

    Science.gov (United States)

    Akhtar, S; Luby, S P; Rahbar, M H; Azam, I

    2001-06-01

    This study was conducted on prison inmates in Sindh to determine whether HIV/AIDS related knowledge, attitudes and beliefs can predict their practices which risk HIV infection. A pre-designed questionnaire was administered in this cross-sectional study to collect the data on HIV/AIDS related knowledge, attitudes, beliefs, practices and demographic variables in a systematic sample of 3,395 prison inmates during July 1994. The data on responses of inmates to HIV/AIDS related knowledge, attitudes, and beliefs were analyzed and a clear interpretable factor structure emerged for each set of questions labeled as knowledge, attitude and beliefs. Similarly based on responses of inmates to practice questions, three factors emerged and were labeled as heterosexuality, homosexuality and drugs. The standardized factor scores of inmates for each of these six factors were computed and used in further analyses. Multiple linear regression analyses were carried out separately using heterosexuality, homosexuality and drugs factors score as dependent variables to identify if any of the independent variables (demographic variables, knowledge beliefs and attitude) predict these practice factors. The model for heterosexuality explained 23% of the variance and included HIV/AIDS related knowledge, beliefs, age, ethnicity and marital status and duration of imprisonment (F = 84.33, p HIV/AIDS related beliefs, marital status and ethnicity (F = 20.10, p < 0.001; R2= 0.03). Implications of prevention program based on these results are considered.

  11. Informed recruitment in partner studies of HIV transmission: an ethical issue in couples research.

    Science.gov (United States)

    McNutt, Louise-Anne; Gordon, Elisa J; Uusküla, Anneli

    2009-08-27

    Much attention has been devoted to ethical issues related to randomized controlled trials for HIV treatment and prevention. However, there has been less discussion of ethical issues surrounding families involved in observational studies of HIV transmission. This paper describes the process of ethical deliberation about how best to obtain informed consent from sex partners of injection drug users (IDUs) tested for HIV, within a recent HIV study in Eastern Europe. The study aimed to assess the amount of HIV serodiscordance among IDUs and their sexual partners, identify barriers to harm reduction, and explore ways to optimize intervention programs. Including IDUs, either HIV-positive or at high risk for HIV, and their sexual partners would help to gain a more complete understanding of barriers to and opportunities for intervention. This paper focuses on the ethical dilemma regarding informed recruitment: whether researchers should disclose to sexual partners of IDUs that they were recruited because their partner injects drugs (i.e., their heightened risk for HIV). Disclosing risks to partners upholds the ethical value of respect for persons through informed consent. However, disclosure compromises the IDU's confidentiality, and potentially, the scientific validity of the research. Following a brief literature review, we summarize the researchers' systematic evaluation of this issue from ethical, scientific, and logistical perspectives. While the cultural context may be somewhat unique to Eastern Europe and Central Asia, the issues raised and solutions proposed here inform epidemiological research designs and their underlying ethical tensions. We present ethical arguments in favor of disclosure, discuss how cultural context shapes the ethical issues, and recommend refinement of guidance for couples research of communicable diseases to assist investigators encountering these ethical issues in the future.

  12. Pre-exposure prophylaxis for conception (PrEP-C) as a risk reduction strategy in HIV-positive men and HIV-negative women in the UK.

    Science.gov (United States)

    Whetham, J; Taylor, S; Charlwood, L; Keith, T; Howell, R; McInnes, C; Payne, E; Home, J; White, D; Gilleece, Y

    2014-01-01

    Couples wishing to have biological children when one partner is HIV positive and the other is HIV negative present clinicians with complex clinical, social and ethical considerations. We established two multidisciplinary pre-conception services for HIV-positive individuals and their partners. We report the first UK use of pre-exposure prophylaxis for conception (PrEP-C) as part of an overall risk reduction strategy. Couples were counselled and written informed consent for PrEP-C was obtained. Patient demographics, HIV and medical histories were recorded. Males underwent baseline semen analysis and seminal HIV viral load testing. Females had full fertility screens. Both partners were screened for sexually transmitted infections. All couples used timed ovulatory intercourse (TOI). Tenofovir±emtricitabine was taken by the female at protocol designated times before±after TOI. Thirty-two male positive/female negative couples used the services. Thirteen couples have used PrEP-C (median age of male 41 years (range 32-56), female 31 (28-43); median CD4 533 (236-1194); all male plasma and seminal HIV viral loads were undetectable). Eleven pregnancies in 10 couples have resulted in 7 live births, 1 ongoing pregnancy and 4 miscarriages (5/40, 6/40, 10/40 and 1 twin 17/40) after a median of 2.5 attempts (range 1-5). PrEP-C was well tolerated with no discontinuations and no HIV transmissions. These data suggest that PrEP-C is a safe and effective option for serodiscordant couples wishing to conceive; a standardised protocol has been developed; data collection via a central database is under way.

  13. Higher prevalence of oral human papillomavirus infection in HIV-positive than HIV-negative Thai men and women.

    Science.gov (United States)

    Vacharotayangul, Piamkamon; Rungsiyanont, Sorasun; Lam-Ubol, Aroonwan; Pankam, Tippawan; Rodbamrung, Piyanee; Naorungroj, Supawadee; Phanuphak, Nittaya

    2015-12-01

    This study was designed to investigate the prevalence of oral human papillomavirus (HPV) infection among HIV-positive and HIV-negative Thai men and women. Participants including men who have sex with men (MSM) and heterosexual women were enrolled at the Thai Red Cross Anonymous Clinic in Bangkok. History taking and oral examination were performed by three independent dentists after calibration. HPV infection was evaluated from oral rinse with mouthwash collected at the time of examination. HPV typing was performed by PCR and nucleic acid hybridization to detect thirty-seven HPV DNA genotypes using Linear Array(®) HPV Genotyping Test (Roche Molecular System, Inc.). 244 subjects were enrolled in the study, consisted of 187 HIV-positive (51.9% women and 48.1% MSM) and 57 HIV-negative (21.0% women and 79.0% MSM) Thai subjects. The prevalence of oral HPV infection was 17.2% in HIV-positive subjects whereas only 5.3% of HIV-negative cases had HPV detected in their oral rinses (p=0.0346). Among HIV positive subjects, MSM had higher chance of having HPV infection than females (25% vs. 9.4%, p=0.0074). HIV-positive Thai MSM and women had higher prevalence of oral HPV infection than those without HIV. Copyright © 2015 Elsevier Ltd. All rights reserved.

  14. Increasing trend of HIV seropositivity in a sexually transmitted diseases centre and epidemiology of HIV seropositive individuals.

    Science.gov (United States)

    Ray, K; Ramesh, V; Karmakar, S N; Misra, R S

    1996-01-01

    11,539 STD clinic attenders and 20,897 antenatal clinic (ANC) attenders at a New Delhi hospital were screened for HIV antibodies by ELISA over a 3-year period. Results were confirmed by Western Blot. A low HIV seropositivity rate (1 per 1000) with an increasing trend in 1993 (4 per 1000) was observed in the STD attenders as against 0.1 per 1000 in the normal control populations. Most of the STD attenders including all the HIV seropositives had heterosexual contact with female sex workers. Both the HIV seropositive ANC attenders acquired the infection through blood transfusion. Thirteen of 23 HIV positive STD attenders had genital lesions, 5 having ulcerative and 8 having nonulcerative STD. Their clinical presentation did not differ from the HIV negative cases but the therapeutic response in 4 was altered. None had signs of symptoms of ARC/AIDS. Two out of 6 spouses and a 2-year-old child of HIV seropositive patients were seropositive. Increasing HIV seropositivity observed in this study reflects the changing situation in the country and highlights the importance of improvement of surveillance, early diagnosis and combined approaches to the management and control of STDs and HIV.

  15. Childhood family correlates of heterosexual and homosexual marriages: a national cohort study of two million Danes.

    Science.gov (United States)

    Frisch, Morten; Hviid, Anders

    2006-10-01

    Children who experience parental divorce are less likely to marry heterosexually than those growing up in intact families; however, little is known about other childhood factors affecting marital choices. We studied childhood correlates of first marriages (heterosexual since 1970, homosexual since 1989) in a national cohort of 2 million 18-49 year-old Danes. In multivariate analyses, persons born in the capital area were significantly less likely to marry heterosexually, but more likely to marry homosexually, than their rural-born peers. Heterosexual marriage was significantly linked to having young parents, small age differences between parents, stable parental relationships, large sibships, and late birth order. For men, homosexual marriage was associated with having older mothers, divorced parents, absent fathers, and being the youngest child. For women, maternal death during adolescence and being the only or youngest child or the only girl in the family increased the likelihood of homosexual marriage. Our study provides population-based, prospective evidence that childhood family experiences are important determinants of heterosexual and homosexual marriage decisions in adulthood.

  16. "I Want to Feel Like a Full Man": Conceptualizing Gay, Bisexual, and Heterosexual Men's Sexual Difficulties.

    Science.gov (United States)

    McDonagh, Lorraine K; Nielsen, Elly-Jean; McDermott, Daragh T; Davies, Nathan; Morrison, Todd G

    2017-12-20

    Current understandings of sexual difficulties originate from a model that is based on the study of heterosexual men and women. Most research has focused on sexual difficulties experienced by heterosexual men incapable of engaging in vaginal penetration. To better understand men's perceptions and experiences of sexual difficulties, seven focus groups and 29 individual interviews were conducted with gay (n = 22), bisexual (n = 5), and heterosexual (n = 25) men. In addition, the extent to which difficulties reported by gay and bisexual men differ from heterosexual men was explored. Data were analyzed using thematic analysis applying an inductive approach. Two intercorrelated conceptualizations were identified: penis function (themes: medicalization, masculine identity, psychological consequences, coping mechanisms) and pain (themes: penile pain, pain during receptive anal sex). For the most part, gay, bisexual, and heterosexual men reported similar sexual difficulties; differences were evident regarding alternative masculinity, penis size competition, and pain during receptive anal sex. The results of this study demonstrate the complexity of men's sexual difficulties and the important role of sociocultural, interpersonal, and psychological factors. Limitations and suggested directions for future research are outlined.

  17. Brain response to visual sexual stimuli in heterosexual and homosexual males.

    Science.gov (United States)

    Paul, Thomas; Schiffer, Boris; Zwarg, Thomas; Krüger, Tillmann H C; Karama, Sherif; Schedlowski, Manfred; Forsting, Michael; Gizewski, Elke R

    2008-06-01

    Although heterosexual and homosexual individuals clearly show differences in subjective response to heterosexual and homosexual sexual stimuli, the neurobiological processes underlying sexual orientation are largely unknown. We addressed the question whether the expected differences in subjective response to visual heterosexual and homosexual stimuli may be reflected in differences in brain activation pattern. Twenty-four healthy male volunteers, 12 heterosexuals and 12 homosexuals, were included in the study. BOLD signal was measured while subjects were viewing erotic videos of heterosexual and homosexual content. SPM02 was used for data analysis. Individual sexual arousal was assessed by subjective rating. As compared to viewing sexually neutral videos, viewing erotic videos led to a brain activation pattern characteristic for sexual arousal in both groups only when subjects were viewing videos of their respective sexual orientation. Particularly, activation in the hypothalamus, a key brain area in sexual function, was correlated with sexual arousal. Conversely, when viewing videos opposite to their sexual orientation both groups showed absent hypothalamic activation. Moreover, the activation pattern found in both groups suggests that stimuli of opposite sexual orientation triggered intense autonomic response and may be perceived, at least to some extent, as aversive. Copyright 2007 Wiley-Liss, Inc.

  18. Brain differentiation and preferred partner characteristics in heterosexual and homosexual men and women.

    Science.gov (United States)

    Muscarella, Frank; Elias, Vanessa A; Szuchman, Lenore T

    2004-08-01

    The current study examined and compared the preferred partner characteristics of heterosexual and homosexual men and women in relation to speculated patterns of brain differentiation underlying the preferences. Further, the study compared the preferences of butch versus femme homosexual women. Two hundred twelve heterosexual and homosexual men and women completed questionnaires on which they rated themselves and their idealized sexual partners on various morphological and behavioral characteristics. Results of within-subjects multivariate analyses of variance (MANOVAs) showed that the pattern of preferred partner characteristics of heterosexual women is most consistent with the theorized brain differentiation underlying those preferences. There was varying support for the theory as it applies to the other three groups. Between-subjects MANOVAs provided evidence to support some of the predictions generated by theory on the differences in brain differentiation between heterosexual and homosexual men and women and between homosexual women categorized as butch and femme. The overall pattern of preferred partner characteristics among and between heterosexual and homosexual men and women does not support theory that holds that underlying brain differentiation between the groups is discrete and categorical. Rather, it supports theory that holds that differentiation manifests itself on a continuum leading to a variety of patterns of sexual orientation, and by extension, preferred partner characteristics.

  19. Posttraumatic Stress Disorder Symptom Severity and Relationship Functioning Among Partnered Heterosexual and Lesbian Women Veterans.

    Science.gov (United States)

    Caska-Wallace, Catherine M; Katon, Jodie G; Lehavot, Keren; McGinn, Meghan M; Simpson, Tracy L

    2016-06-01

    Few studies have examined associations of posttraumatic stress disorder (PTSD) and relationship satisfaction among women Veterans, and no research has explored these factors in lesbian women Veterans, a large subgroup that may have unique concerns. This study examined the link between PTSD and relationship satisfaction in partnered heterosexual and lesbian women Veterans and evaluated potential moderation by sexual orientation, partner support, and conflict. Women Veterans (heterosexual n = 260; lesbian n = 128) were recruited nationally to complete a cross-sectional online survey. Multiple linear regression models were used to evaluate moderation, using two- and three-way interactions. Partner support moderated the association between PTSD symptoms and relationship satisfaction to a different degree for heterosexual and lesbian women Veterans, playing a more prominent role in this association for lesbian women. Specifically, for lesbians with low partner support, as PTSD symptoms worsened, relationship satisfaction decreased at a steeper rate than for heterosexual women with low partner support. On the other hand, for lesbians with high partner support, as PTSD symptoms worsened, relationship satisfaction decreased less sharply than for heterosexual women with high partner support. Degree of conflict was highly correlated with relationship satisfaction and also appeared to moderate these relations differently by sexual orientation. These findings suggest that women Veterans with PTSD experience impairments in their romantic relationships, which vary by sexual orientation, partner support, and conflict. Partner support and conflict may be important targets in assessment and therapy for women Veterans with PTSD, and especially so for sexual minorities.

  20. Disparities in Health Risk Behavior and Psychological Distress Among Gay Versus Heterosexual Male Cancer Survivors.

    Science.gov (United States)

    Kamen, Charles; Palesh, Oxana; Gerry, Arianna Aldridge; Andrykowski, Michael A; Heckler, Charles; Mohile, Supriya; Morrow, Gary R; Bowen, Deborah; Mustian, Karen

    2014-06-01

    Gay men have been found to have higher rates of cancer diagnoses than heterosexual men and poorer outcomes postcancer diagnosis. The two aims of this study were to examine rates of cancer diagnosis in a national sample of gay and heterosexual men, and to examine disparities in health risk behavior between gay and heterosexual men and gay and heterosexual cancer survivors. The current study utilized data from a total sample of 14,354 men, including 373 gay men, collected as part of the Behavioral Risk Factor Surveillance System survey conducted in 2009 in the states of Arizona, California, Massachusetts, Ohio, and Wisconsin. This study replicated the finding that prevalence of self-reported cancer diagnoses differed significantly between gay and heterosexual men, with gay men 82% more likely to report a lifetime history of cancer diagnosis (pperspective on behavioral risk factors previously shown to be higher among gay men that may continue postcancer diagnosis. Future research should test the degree to which these disparities are caused by minority stress, as previous studies have indicated that increased health risk behaviors among sexual minority populations may result from exposure to chronic stress and discrimination. Developing behavior change interventions to address these risk behaviors is vital for improving cancer outcomes among gay men.

  1. Pharyngeal Gonorrhoea in Women: An Important Reservoir for Increasing Neisseria gonorrhoea Prevalence in Urban Australian Heterosexuals?

    Science.gov (United States)

    Lusk, M Josephine; Uddin, Ruby N N; Lahra, Monica M; Garden, Frances L; Kundu, Ratan L; Konecny, Pam

    2013-01-01

    We aim to characterize sexual behavioral aspects of heterosexual Neisseria gonorrhoea (NG) acquisition in two Sexually Transmitted Diseases clinics in Sydney, Australia, in 2008-2012. Of 167 NG cases, 102 were heterosexually acquired with a trend of increasing NG prevalence in heterosexuals from 1.1% (95% CI 0.6-2.1) in 2008 to 3.0% (95% CI 2.0-4.0) in 2012 (P = 0.027). Of heterosexual male cases, unprotected fellatio was the likely sexual activity for NG acquisition in 21/69 (30.4%) and commercial sex work (CSW) contact the likely source in 28/69 (40.6%). NG prevalence overall in CSW (2.2%) was not significantly higher than in non-CSW (1.2%) (P = 0.15), but in 2012 there was a significant increase in NG prevalence in CSW (8.6%) compared to non-CSW (1.6%) (P fellatio, as pharyngeal NG may be an important reservoir for heterosexual transmission. Outreach to CSW should be enhanced.

  2. High HIV Prevalence and Risk Among Male Clients of Female Sex Workers in Hanoi and Ho Chi Minh City, Vietnam.

    Science.gov (United States)

    Nadol, Patrick; Hoang, Tran Vu; Le, Linh-Vi; Nguyen, Tuan Anh; Kaldor, John; Law, Matthew

    2017-08-01

    In Vietnam's concentrated HIV epidemic, female sex workers (FSWs) are at increased risk for acquiring and transmitting HIV, largely through their male clients. A high proportion of males in Vietnam report being clients of FSWs. Studying HIV-related risk factors and prevalence among male clients is important, particularly given the potential for male clients to be a 'bridge' of HIV transmission to the more general population or to sex workers. Time-location sampling was used to identify FSW in Hanoi and Ho Chi Minh City, Vietnam's largest cities, in 2013-2014. Recruited FSWs were asked to refer one male client to the study. Demographic and risk behavior data were collected from FSWs and male clients by administered questionnaires. Biologic specimens collected from male clients were tested for HIV and opiates. Sampling weights, calculated based on the FSWs probability of being selected for enrolment, were applied to prevalence estimates for both FSWs and male clients. Logistic regression models were developed to obtain odds ratios for HIV infection among male clients. A total of 804 male clients were enrolled. Overall, HIV prevalence among male clients was 10.2%; HIV prevalence was 20.7% (95% confidence interval (CI) 15.0-27.9%) among those reporting a history of illegal drug use and 32.4% (95% CI 20.2-47.7%) among those with opioids detected in urine. HIV prevalence among male clients did not differ across 'bridging' categories defined by condom use with FSWs and regular partners over the previous 6 months. HIV among male clients was associated with a reported history of illegal drug use (OR 3.76; 95% CI 1.87-7.56), current opioid use (OR 2.55; 95% CI 1.02-6.36), and being referred by an FSW who self-reported as HIV-positive (OR 5.37; 95% CI 1.46-19.75). Self-reported HIV prevalence among enrolled FSWs was 2.8%. Based on HIV test results of male clients and self-reported status from FSWs, an estimated 12.1% of male client-FSW pairs were sero-discordant. These

  3. Factors associated with HIV-1 virological failure in an outpatient clinic for HIV-infected people in Haiphong, Vietnam

    DEFF Research Database (Denmark)

    Huong, D T M; Bannister, W; Phong, P T

    2011-01-01

    The objective of our study was to investigate factors associated with virological failure in 100 consecutive HIV-1 infected Vietnamese adults who initiated antiretroviral therapy (ART) from June 2007 to June 2008. Data were collected from medical records, and a structured questionnaire was used...... in individual interviews to investigate factors associated with adherence to ART. Plasma HIV viral load was measured at the time of the interview. The median age was 35 years, 35% were women and heterosexual intercourse was the most common mode of HIV transmission (61%). After a median of 14 months since...... starting ART, 23% had detectable HIV-1 viral load (= 400 copies/mL). Patients who had developed a World Health Organization (WHO) clinical stage 4 condition at the time of initiation of ART were more likely to experience virological failure than those in stages 1-3, odds ratio (OR): 5.20 (95% confidence...

  4. Sex parties among urban MSM: an emerging culture and HIV risk environment.

    Science.gov (United States)

    Mimiaga, Matthew J; Reisner, Sari L; Bland, Sean E; Driscoll, Maura A; Cranston, Kevin; Isenberg, Deborah; VanDerwarker, Rodney; Mayer, Kenneth H

    2011-02-01

    Private sex parties are an emerging risk environment for HIV among men who have sex with men (MSM). In 2009, 103 participants who reported attending at least one sex party in Massachusetts in the prior 12 months completed an in-depth, interviewer-administered quantitative assessment. Multivariable logistic regression analyses were conducted to examine associations with having engaged in one or more serodiscordant unprotected anal sex (SDUAS) acts at the most recent sex party attended. Nearly one-third (32%) of the sample reported engaging in SDUAS at the most recent sex party attended. Adjusting for age, race/ethnicity, and educational attainment, variables associated with an increased odds of engaging in SDUAS at the most recent sex party were: total number of unprotected anal receptive sex acts at sex parties in the past 12 months, self-perception of being at-risk for transmitting or acquiring HIV, and sexual sensation seeking. Examined in the same model, if condoms were provided/available at the most recent sex party attended, participants were at a decreased odds of engaging in SDUAS at that sex party. The majority (80%) expressed an interest in HIV prevention activities for MSM who attend sex parties. HIV prevention interventions are needed to reach MSM who attend sex parties and should take into account individual and contextual factors that may contribute to sexual risk. Environmental factors in the sex party setting, in particular the presence and availability of condoms, may potentially mitigate individual-level factors such as unprotected anal sex.

  5. Housing status and HIV risk behaviors among transgender women in Los Angeles.

    Science.gov (United States)

    Fletcher, Jesse B; Kisler, Kimberly A; Reback, Cathy J

    2014-11-01

    Due to social stigma, lack of social support, and minimal legal employment opportunities, transgender women (transwomen) face elevated rates of unstable housing. This study examined the association between housing status and HIV risk behaviors among 517 transwomen encountered through street outreach. Seven variables (including sociodemographics, HIV status, housing status, and sexual partner type) were used to estimate partial associations during multivariable analyses; housing status was coded trichotomously (housed, marginally housed, and homeless) for these analyses. Results demonstrated that homeless and marginally housed transwomen engaged in significantly higher rates of illicit drug use than housed transwomen; however, marginally housed and housed transwomen engaged in significantly higher rates of illegal hormone injections than homeless transwomen. Rates of sex work were high in the sample as a whole, though sex with an exchange partner was most common among the marginally housed transwomen. Multivariate logistic regression revealed that unstable housing moderated the association between HIV status and engagement in unprotected serodiscordant anal intercourse. The marginally housed transwomen exhibited the greatest risk profile for HIV acquisition or transmission.

  6. Muestras del conflicto heterosexual en cine iraní

    Directory of Open Access Journals (Sweden)

    Farshad Zahedi

    2011-08-01

    Full Text Available Normal 0 false false false EN-US X-NONE AR-SA /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Tabla normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin:0in; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:Arial; mso-bidi-theme-font:minor-bidi;} Desde las primeras manifestaciones de un cine de corte realista en Irán, en la década de los 60, hasta la actualidad, las escenas de un conflicto heterosexual aparecen periódicamente en los textos fílmicos. Este estudio es un esfuerzo de realizar un análisis sintomático a esta imagen a través de las muestras significativas, las que de alguna manera han jugado un papel importante en la reconstrucción del imaginario colectivo del pueblo iraní en esta encrucijada histórica del contacto con la modernidad. Estas muestras, en gran medida dialogan con su contexto histórico, y a la vez, con un carácter transhistórico formado por las fobias y miedos a la vigilancia y al aparato de control del Padre-Estado. Estas fobias y por tanto este conflicto crean una atmósfera de incomunicación total, que darán lugar a una falta de creatividad y en ocasiones incluso a la esterilidad.

  7. HIV Testing and Diagnosis Rates in Kiev, Ukraine: April 2013 - March 2014

    Science.gov (United States)

    Simmons, Ruth; Malyuta, Ruslan; Medoeva, Antonia; Kruglov, Yuri; Yurchenko, Alexander; Copas, Andrew; Porter, Kholoud

    2015-01-01

    Objective Data from Ukraine on risk factors for HIV acquisition are limited. We describe the characteristics of individuals testing for HIV in the main testing centres of the Ukrainian capital Kiev, including HIV risk factors, testing rates, and positivity rates. Methods As part of a larger study to estimate HIV incidence within Kiev City, we included questions on possible risk factors for HIV acquisition and testing history to existing systems in 4 infectious disease clinics. Data were provided by the person requesting an HIV test using a handheld electronic tablet. All persons (≥16yrs) presenting for an HIV test April 2013–March 2014 were included. Rates per 100,000 were calculated using region-specific denominators for Kiev. Results During the study period 6370 individuals tested for HIV, equivalent to a testing rate of 293.2 per 100,000. Of these, 467 (7.8%) were HIV-positive, with the highest proportion positive among