AIDS and behavior
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Higher rates of substance use have been associated with unsafe sex behavior. Male sex workers (MSW) present high rates of drug use during or after the professional sexual exchange with clients and also in their leisure. This research describes patterns of drug consumption among MSW in Spain and explores both the effect of substance use on professional and risk sexual behaviors. ⋯ Drug influence on condom use is not clear. More investigation about drug influence on sexual risk behaviors among MSW is needed. The role of steady partners and clients must be taken into account too.
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Delayed diagnosis of HIV infection is a common problem. We hypothesized that persons with less trust in physicians and in the healthcare system would be diagnosed with lower CD4 cell counts than persons with more trust because they would delay seeking healthcare. From January 2006 to October 2007, 171 newly diagnosed HIV-infected persons, not yet in HIV primary care, were recruited from HIV testing sites in Houston, Texas, that primarily serve the under- and un-insured. ⋯ Race/ethnicity was the only variable statistically significantly predictive of trust in physicians and in the healthcare system. Hispanics had the highest trust scores, followed by Blacks and Whites. Low trust is likely not a barrier to timely diagnosis of HIV infection.
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Novel strategies are needed to expand access to effective behavioral interventions for HIV prevention. Delivering effective group-based interventions to people living with HIV using video-conferencing technology is an innovative approach that may address this need, but has not been explored. ⋯ They had numerous questions about logistics, expressed concerns about safety and confidentiality, and indicated a preference for accessing video-groups via special video-phones versus computers. Findings warrant further research into the feasibility, acceptability, and effectiveness of video-group delivery of HIV prevention interventions and suggest important considerations for researchers and practitioners who may employ video-conferencing for intervention delivery.
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Although the Chinese government provides free-of-charge voluntary HIV counseling and testing, HIV testing rates among men who have sex with men (MSM) are reported to be extremely low. This study examines the association of structural and psychosocial factors and social network characteristics with HIV testing behaviors among "money boys" and general MSM in Shanghai. ⋯ Factors associated with not testing for HIV included: not knowing of a testing site, limited HIV knowledge, low perceived HIV risk, concern about HIV testing confidentiality, being a closeted gay, not using the Internet, and having a small social network or network with few members who had tested for HIV. Future efforts to promote HIV testing should focus on outreach to general MSM, confidentiality protection, decreasing the stigma of homosexuality, and encouraging peer education and support through the Internet and social networks.
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The Centers for Disease Control and Prevention recommends routine HIV screening in health care settings. Using national surveillance data, we assessed trends in HIV diagnoses and testing frequency in youth aged 13-24 diagnosed with HIV in 2005-2008. ⋯ No increases in diagnoses or differences in testing were observed among females. Intensified interventions are needed to reduce HIV infections and racial/ethnic disparities.