The HIV transmission gradient: relationship patterns of protection

Abstract

We describe a gradient of potential HIV transmission from HIV-infected persons to their partners and thence to uninfected populations. The effect of this newly discovered transmission gradient is to limit the spread of HIV. We roughly estimate a 2% long-term transmission probability for sex and 14% for drug injection for two-step transmission. Then we test theories to account for this pattern on a network sample of 267 inner city drug users and nonusers. Although HIV positive persons engaged in a high level of risk with one another, they engaged in less risk with HIV negative partners, and these partners engaged in even lower levels of risk with other HIV negative persons. Analyses suggest that the primary motivation for sexual risk reduction is partner protection, while emotional closeness is the major barrier. Hypotheses accounting for risk in terms of self protection, social norms, gender power, and drug use were weakly supported or unsupported.

Preventive service needs of young people perinatally infected with HIV in Uganda

“…Existing studies have documented poor preventive sexual practices among HIV-positive persons which include having unprotected sex especially with concordant (HIV-positive) partners and non-disclosure of HIV status to the partner (Bell, Atkinson, Mosier, Riley, & Brown, 2007;Golden, Wood, Buskin, Fleming, & Harrington, 2007;Johnson & Buzducea, 2007;Kalichman, 2000;Marks & Crepaz, 2001;Rice, Batterham, & Rotheram-Borus, 2006). These studies are, however, mostly based on clinics or intervention sites in the West.…”

Приверженность ВААРТ И Рискованное Поведение Среди Пациентов Санкт-Петербургского Центра-Спид: Стати- Стические Модели, Психологические И Социодемографические Факторы

“…Величины i p считаются известными [85]. Основная задача -измерить (оценить) величины i N , что по-зволит оценить целевые показатели Pr i и Pr на основе знаний, полученных о i N , то есть на основе ответов о последних эпизодах рискованного поведения.…”

“Is Your Man Stepping Out?” An Online Pilot Study to Evaluate Acceptability of a Guide-Enhanced HIV Prevention Soap Opera Video Series and Feasibility of Recruitment by Facebook Advertising

“…In a three city study, awareness that a male sex partner was high risk was not associated with condom use; however, main partner status was (Ober et al, 2011), signifying the importance of relationships when designing interventions to lower HIV sexual transmission. Unprotected sex with men often occurs in the context of the high value women place on relationships, for reasons that include emotional connection (Bell et al, 2007; Jones & Oliver, 2007). Therefore, it is a concern when pervasive urban sex scripts promote unprotected sex to secure relationship needs (El-Bassel, Caldeira, Ruglass, & Gilbert, 2009; Emmers-Sommer & Allen, 2005; Jones & Oliver, 2007).…”

“…However, for meaningful behavior change, critical reflection and new understanding are needed (Gesser-Edelsburg & Singhal, 2013). Contemporary urban women's sex scripts promote unprotected sex to fulfill relationship needs (Emmers-Sommer & Allen, 2005; Jones, 2006; Jones & Oliver, 2007) and to hold onto the relationship, show trust, and intimacy (Bell, Atkinson, Mosier, Riley, & Brown, 2007; Jones & Gulick, 2009). The GELSC was, therefore, produced by adding a peer video guide to the end of LSC episodes to provoke viewers to question their own sex scripts and consider their own need for change.…”