AIDS education and prevention : official publication of the International Society for AIDS Education
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Using grounded theory, 18 interviews with HIV-positive urban men were conducted to understand their sexual relationships. Analysis of the verbatim transcripts revealed that regardless of age, sexual orientation or race/ethnicity, the participants were "making choices" related to their sexual relationships. Some men were "avoiding sex" whereas others were engaging in "just sex" or having sex in a relationship that was "going somewhere." However, dependent upon the type of sexual relationship, these HIV-positive urban men struggled with issues associated with "disclosure" of serostatus, the sexual "behaviors" in which they engaged, and selecting sexual "partners." Health care providers can facilitate sexual health and well-being among HIV-positive urban men by recognizing that men may be seeking sexual intimacy for different purposes, in different types of relationships, or avoiding it entirely. By exploring these decision-making processes, it is possible to facilitate sexual relationships that prevent new infections as well as manage the dissonance associated with this decision-making associated with disclosure, behaviors and their sexual partners.
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Comparative Study
Gender, work, and HIV risk: determinants of risky sexual behavior among female entertainment workers in China.
We proposed to integrate cognitive and social factors in the study of unprotected commercial sex. Data from 159 female entertainment workers from 15 establishments in Shanghai who reported commercial sex in the month prior to interview were used to test the approach. Two-sample t tests and multivariate logistic regression were conducted to examine if and how individual cognitive and social influence factors affect the odds of consistent condom use. ⋯ Perceived easiness in condom use was the most proximate determinant of condom use. It helped to translate HIV knowledge and prevention motivation into behavior and to mediate the impact of sexual relationship power. Prevention intervention is urgently needed and should focus on self-efficacy training and promoting supportive social and working environments.
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Community-researcher partnerships can be powerful mechanisms to understand and effectively address health and social problems such as HIV/AIDS prevention. When the partnership is a positive, productive one, the combined expertise and energy of both parties result in a more effective program and a better evaluation of its effects. This article describes one such partnership and how a program challenge provided the opportunity for both partners to develop new capacities and strengthen others. ⋯ The article describes the partnership between the HIV service providers and the researchers and how the collaborative effort was key to understanding and addressing the recruitment problem, identifying potential solutions, and implementing the new social marketing strategy. This process resulted in four kinds of capacities that were built or strengthened, including program recruitment, program content and implementation, program evaluation, and the partnership itself. The article concludes with a discussion of the unexpected benefits of the capacity-building experience and of the antecedent conditions that fostered the positive partnership outcomes.
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The aim of this study was to gather data on condom use among brothel-based female sex workers in Indonesia and to study the reasons for not using condoms in order to provide new and existing condom promotion programs with information to improve their performance. Quantitative data were gathered by KABP surveys (n = 1450) and a condom diary with a sample of 204 female sex workers. Qualitative data were collected by conducting focus group discussions and in-depth interviews among female sex workers and pimps. ⋯ Condom unacceptability is an important reason for not using condoms for both clients and female sex workers, whereas pimps, who are in the best position to encourage condom use, unfortunately consider condom use as a threat to their business. For the successful introduction of consistent condom use, it is necessary to design interventions for both sex workers and clients and to provide appropriate educational materials and preferred brands of condoms. Also, pimps must be involved in intervention programs.
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Through focus group methodology, the study examines three contexts that delineate the co-occurrence of intimate partner violence and sexual risk behaviors among 68 women on methadone. First, it explores the ways in which the presence of physical abuse in an intimate relationship prevents women from asking their partners to use a condom. ⋯ The research is guided by feminist theory, which affords powerful insight into the contexts in which women are put at risk for HIV and partner violence. The study provides a discussion on the implications of the findings to HIV prevention for women who are risk for both HIV and partner violence.