Longitudinal Changes in Sexual Risk Behavior Among HIV+ and HIV− Male Injecting Drug Users

Dolezal, Curtis; Meyer‐Bahlburg, Heino F. L.; Liu, Xinhua; Ehrhardt, Anke Α.; Exner, Theresa M.; Rabkin, Judith G.; Gorman, Jack M.; Marder, Karen; Stern, Yaakov

doi:10.1081/ada-100101861

Cited by 33 publications

(25 citation statements)

References 56 publications

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“…While there has been a reduction in the parenteral risk of infection among IDUs due to the increasing availability of legal, sterile syringes and prevention interventions (Kral et al 2004;Nelson et al 2002;Semaan et al 2002), the risk of sexual acquisition or transmission of HIV, HBV and other sexually transmitted diseases (sexual risk) still remains high among IDUs, because unsafe sex has been more difficult to prevent (Booth et al 2000;Dolezal et al 1999;Evans et al 2003;Friedman et al 2002). Younger IDUs may be especially at risk for both acquiring and potentially transmitting HIV and HBV, because they may be more likely than older IDUs to share injecting paraphernalia, engage in unprotected sex, have concurrent sex partners (i.e., have sex with more than one partner in a given time period), and have highrisk injecting or sexual risk networks (Fennema et al 1997;Fuller et al 2003;Kral et al 2003;van Ameijden and Coutinho, 1998).…”

Section: Introductionmentioning

confidence: 99%

The Relationship of Sexual Dyad and Personal Network Characteristics and Individual Attributes to Unprotected Sex Among Young Injecting Drug Users

Gyarmathy

Neaigus

2007

AIDS Behav

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We examine in the heterosexual partnerships (dyads) of IDUs the correlates of engaging in unprotected sex on three levels: individual attributes, social network characteristics, and dyad characteristics. Unprotected sex was significantly less likely to occur in dyads where the participant injected daily or had high safe-sex attitude scores, and in dyads where both members encouraged each other to use condoms. Unprotected sex was significantly more likely to occur in dyads that smoked crack together, shared needles with each other, and where the participant knew that the sex partner had concurrent sex partners. In the sexual dyads of IDUs there is a combined risk of unsafe injecting and unsafe sex. Both injecting and sexual risk, and their combination need to be addressed in interventions that target the sexual partnerships of IDUs. Such interventions should also aim to reduce injected and non-injected crack and other stimulant use associated with high-risk sex.

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Section: Introductionmentioning

confidence: 99%

The Relationship of Sexual Dyad and Personal Network Characteristics and Individual Attributes to Unprotected Sex Among Young Injecting Drug Users

Gyarmathy

Neaigus

2007

AIDS Behav

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“…11 Studies conducted over the past decade with HIV-positive IDU men have consistently shown that, following an HIV-positive test result, many men do reduce their injection and sexual risk behaviors, although 25 to 50% continue to engage in high-risk behaviors. [12][13][14][15] Studies among HIV-positive IDU men found that more advanced HIV illness was associated with decreased sexual risk behavior 16 and that among HIV-positive IDU men and women, lack of social support, avoidant coping after an HIV-positive test, and low HIV/AIDS knowledge were associated with continued sexual and injection risk behaviors. 17 Previous studies with IDUs, regardless of serostatus, have shown that it is more difficult to change the sexual risk behaviors with main or primary partners compared with casual sex partners.…”

mentioning

confidence: 99%

Unprotected Sexual Behavior Among Heterosexual HIV-Positive Injection Drug Using Men: Associations by Partner Type and Partner Serostatus

Purcell

Mizuno²,

Metsch

et al. 2006

J Urban Health

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Few studies have examined sexual risk behaviors of HIV-positive, heterosexual, injection drug using (IDU) men. We investigated such behaviors and associations with risk among sexually active, HIV-positive IDU men who reported only female sex partners in the 3 months prior to baseline interview. We examined associations separately for four non-exclusive groups of men by crossing partner type (main or casual) and partner serostatus (HIV-positive or HIV-negative/unknown). Of 732 male participants, 469 (64%) were sexually active with only female partners. Of these 469 men, 155 (33%) reported sex with HIV-positive main partners, 127 (27%) with HIV-negative or unknown serostatus main partners, 145 (31%) with HIVpositive casual partners, and 192 (41%) with HIV-negative/unknown serostatus casual partners. Significant multivariate associations for unprotected sex with HIV-negative or unknown serostatus main partners were less self-efficacy to use condoms, weaker partner norms supporting condoms, and more negative condom beliefs. Similar correlates were found for unprotected sex with HIV-positive main and casual partners. In addition, alcohol or drug use during sex was a significant correlate of unprotected sex with HIV-positive main partners, while depression was significant for HIV-positive casual partners. For unprotected sex with HIV-negative/unknown status casual partners, self-efficacy for condom use, sex trade, and education were significant multivariate correlates. A combination of broad and tailored intervention strategies based on the relationship pattern of men's lives may provide the most benefit for reducing unprotected sex with female partners.

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“…Several studies examined different types of targeted interventions to reduce sexual risks with varying results, but most achieving some level of success (Rietmeijer et al, 1996;Sterk et al, 2003). Nevertheless, in many of the studies, levels of unprotected sex remained high even with reductions (Dolezal et al, 1999), and despite the success of specific interventions, they have not been implemented on any large scale (Metzger and Navaline, 2003;Strathdee and Sherman, 2003).…”

Section: Discussionmentioning

confidence: 99%

“…The majority of sexual risk behavior reports have focused on cross-sectional patterns, with few looking more closely at individual patterns over time (Dolezal et al, 1999;Kral et al, 2001;Nelson et al, 2002). The absence of any significant upward trends in condom use underlines the fact that more targeted sexual risk behavior interventions are needed in IDU populations.…”

Section: Discussionmentioning

confidence: 99%

Sexual Risk Behavior Among Injection Drug Users Before Widespread Availability of Highly Active Antiretroviral Therapy

et al. 2005

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HIV testing and counseling has been associated with reductions in risk behaviors in some populations. This study examined whether involvement in a long-term study, including exposure to repeated HIV testing and counseling, was associated with increased condom use among injection drug users (IDUs) through a retrospective analysis of an IDU cohort from Baltimore, MD, during 1994-1998. Eligibility included being aged 18 years or older, injecting within 10 years and not having initiated antiretroviral therapy. A logistic model of high versus low risk, based on condom use, was used. Of 322 eligible IDUs, most were male (66%) and African-American (94%). No significant change in the odds of inconsistent condom use was observed with continued study exposure. Condom use remained low, indicating a need for interventions to reduce sexual risks and HIV transmission in this population.

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Longitudinal Changes in Sexual Risk Behavior Among HIV+ and HIV− Male Injecting Drug Users

Cited by 33 publications

References 56 publications

The Relationship of Sexual Dyad and Personal Network Characteristics and Individual Attributes to Unprotected Sex Among Young Injecting Drug Users

The Relationship of Sexual Dyad and Personal Network Characteristics and Individual Attributes to Unprotected Sex Among Young Injecting Drug Users

Unprotected Sexual Behavior Among Heterosexual HIV-Positive Injection Drug Using Men: Associations by Partner Type and Partner Serostatus

Sexual Risk Behavior Among Injection Drug Users Before Widespread Availability of Highly Active Antiretroviral Therapy

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