The Role of Psychiatric Disorders in HIV Transmission and Prevention

2017 ◽  
Author(s):  
Andréa L. Hobkirk ◽  
Seth C. Kalichman ◽  
David M. Stoff ◽  
Christina S. Meade
Keyword(s):  
Hiv Infection ◽  
Psychiatric Disorders ◽  
Hiv Risk ◽  
Hiv Transmission ◽  
Psychiatric Symptoms ◽  
The United States ◽  
Hiv Risk Behavior ◽  
Traumatic Experience ◽  
Outpatient Mental Health ◽  
Hiv Risk Reduction Interventions

Adults with severe mental illness (SMI) have been disproportionately affected by the HIV/AIDS epidemic, with prevalence estimates ranging from 1% to 8% in the United States and up to 27% internationally. Compared to the general population, adults with SMI tend to engage in higher rates of sexual and drug use behaviors associated with HIV transmission. In addition, psychiatric illness can develop secondary to HIV infection and contribute to further transmission on HIV to others. HIV risk behavior is driven by several direct and indirect factors, including psychiatric symptoms, substance use, traumatic experience, socioeconomic status, and HIV infection itself. This chapter addresses the complex multidimensional relationship between psychiatric disorders and transmission of HIV as well as its prevention. This chapter also presents several HIV risk reduction interventions designed for vulnerable men and women in outpatient mental health clinics and the community.

scholarly journals HIV Risk Behavior and Beliefs of HIV-Seropositive Drug Users

1992 ◽  
Vol 22 (4) ◽  
pp. 833-847 ◽  
Author(s):  
Christina Hartgers ◽  
Pieta Krijnen ◽  
Johanna A.R. van den Hoek ◽  
Roel A. Coutinho ◽  
Joop van der Pligt
Keyword(s):  
Risk Behavior ◽  
Hiv Risk ◽  
Drug Users ◽  
Hiv Transmission ◽  
Hiv Risk Behavior ◽  
Unsafe Sex ◽  
Response Efficacy ◽  
Female Prostitute ◽  
Hiv Seropositive ◽  
Hiv Negative

To assess HIV risk behavior, beliefs, attitudes and intentions among HIV-seropositive drug users (DUs), we studied 122 HIV-positive DUs (including ninety-five current injectors) participating in a longitudinal HIV-study among DUs in Amsterdam. All were familiar with their serostatus. Over a period of four months, 20% of the sample put others at risk of HIV infection, mainly through unsafe sex. Forty-nine percent think they might infect someone with HIV in the future, again mainly through unsafe sex. Although the majority intends to use condoms, self-efficacy and response efficacy is low; that is, many do not think they are able to use condoms when necessary and many have limited confidence in the efficacy of condoms in preventing HIV transmission. Correlates of HIV risk behavior were non-Dutch nationality and being a female prostitute. The results suggest that, next to efforts which aim to prevent new infections among HIV-negative injectors or sexual partners of injectors, prevention efforts should focus on HIV-seropositive DUs or former DUs.

Men Who Have Sex With Men and HIV Risk Behavior: Exploring the Influence of Masculinity Within the Social Ecological Model

2021 ◽  
Vol 33 (6) ◽  
pp. 511-533
Author(s):  
Kenneth C. Hergenrather ◽  
Diona Emmanuel ◽  
Robert J. Zeglin ◽  
David J. Ruda ◽  
Scott D. Rhodes
Keyword(s):  
Risk Behavior ◽  
Hiv Risk ◽  
Ecological Model ◽  
The United States ◽  
Social Ecological Model ◽  
Hiv Risk Behavior ◽  
Bisexual Men ◽  
Social Ecological ◽  
The Social ◽  
Sex With Men

In the United States, gay, bisexual men, and men who have sex with men (MSM) represent 86% of new HIV infections among males. Approximately 1 in 7 men with HIV are unaware of their HIV status (CDC, 2017, 2019a, 2020a). To explore influences on MSM HIV risk behavior, the authors performed a systematic review of quantitative studies conducted in the U.S. assessing what is purported as masculinity. From 30 identified studies, significant findings were framed within the Social Ecological Model (SEM) levels (e.g., Individual, Relationship, Community). SEM level themes were applied to create the Masculinity 10, a preliminary 10-item assessment to explore the influence of masculinity on MSM HIV risk behavior. To increase MSM engagement in HIV prevention and treatment, the influences of masculinity (e.g., attitude toward sexual minorities, appearance, emotion, temperament, substance use, sexual activity, social support, intimate relationships, health care) on HIV risk behavior should be further explored.

scholarly journals Policing Practices and Risk of HIV Infection Among People Who Inject Drugs

2020 ◽  
Author(s):  
Pieter Baker ◽  
Leo Beletsky ◽  
Liliana Avalos ◽  
Christopher Venegas ◽  
Carlos Rivera ◽  
...  
Keyword(s):  
Hiv Infection ◽  
Risk Behaviors ◽  
Hiv Risk ◽  
People Who Inject Drugs ◽  
Methadone Maintenance ◽  
The United States ◽  
Knowledge Generation ◽  
Physical Assault ◽  
Drug Law ◽  
Meta Analyses

Abstract Drug-law enforcement constitutes a structural determinant of health among people who inject drugs (PWID). Street encounters between police and PWID (e.g., syringe confiscation, physical assault) have been associated with health harms, but these relationships have not been systematically assessed. We conducted a systematic literature review to evaluate the contribution of policing to risk of human immunodeficiency virus (HIV) infection among PWID. We screened MEDLINE, sociological databases, and gray literature for studies published from 1981 to November 2018 that included estimates of HIV infection/risk behaviors and street policing encounters. We extracted and summarized quantitative findings from all eligible studies. We screened 8,201 abstracts, reviewed 175 full-text articles, and included 27 eligible analyses from 9 countries (Canada, China, India, Malaysia, Mexico, Russia, Thailand, Ukraine, and the United States). Heterogeneity in variable and endpoint selection precluded meta-analyses. In 5 (19%) studies, HIV infection among PWID was significantly associated with syringe confiscation, reluctance to buy/carry syringes for fear of police, rushed injection due to a police presence, fear of arrest, being arrested for planted drugs, and physical abuse. Twenty-one (78%) studies identified policing practices to be associated with HIV risk behaviors related to injection drug use (e.g., syringe-sharing, using a “shooting gallery”). In 9 (33%) studies, policing was associated with PWID avoidance of harm reduction services, including syringe exchange, methadone maintenance, and safe consumption facilities. Evidence suggests that policing shapes HIV risk among PWID, but lower-income settings are underrepresented. Curbing injection-related HIV risk necessitates additional structural interventions. Methodological harmonization could facilitate knowledge generation on the role of police as a determinant of population health.

scholarly journals Association Between HIV-Related Tweets and HIV Incidence in the United States: Infodemiology Study

10.2196/17196 ◽  
2020 ◽  
Vol 22 (6) ◽  
pp. e17196 ◽  
Author(s):  
Robin Stevens ◽  
Stephen Bonett ◽  
Jacqueline Bannon ◽  
Deepti Chittamuru ◽  
Barry Slaff ◽  
...  
Keyword(s):  
United States ◽  
Social Media ◽  
Hiv Infection ◽  
Language Processing ◽  
Hiv Risk ◽  
Intraclass Correlation ◽  
Hiv Infections ◽  
The United States ◽  
Infection Rates ◽  
Age Range

Background Adolescents and young adults in the age range of 13-24 years are at the highest risk of developing HIV infections. As social media platforms are extremely popular among youths, researchers can utilize these platforms to curb the HIV epidemic by investigating the associations between the discourses on HIV infections and the epidemiological data of HIV infections. Objective The goal of this study was to examine how Twitter activity among young men is related to the incidence of HIV infection in the population. Methods We used integrated human-computer techniques to characterize the HIV-related tweets by male adolescents and young male adults (age range: 13-24 years). We identified tweets related to HIV risk and prevention by using natural language processing (NLP). Our NLP algorithm identified 89.1% (2243/2517) relevant tweets, which were manually coded by expert coders. We coded 1577 HIV-prevention tweets and 17.5% (940/5372) of general sex-related tweets (including emojis, gifs, and images), and we achieved reliability with intraclass correlation at 0.80 or higher on key constructs. Bivariate and multivariate analyses were performed to identify the spatial patterns in posting HIV-related tweets as well as the relationships between the tweets and local HIV infection rates. Results We analyzed 2517 tweets that were identified as relevant to HIV risk and prevention tags; these tweets were geolocated in 109 counties throughout the United States. After adjusting for region, HIV prevalence, and social disadvantage index, our findings indicated that every 100-tweet increase in HIV-specific tweets per capita from noninstitutional accounts was associated with a multiplicative effect of 0.97 (95% CI [0.94-1.00]; P=.04) on the incidence of HIV infections in the following year in a given county. Conclusions Twitter may serve as a proxy of public behavior related to HIV infections, and the association between the number of HIV-related tweets and HIV infection rates further supports the use of social media for HIV disease prevention.

Settings and Models of AIDS Psychiatric Care

2010 ◽  
Author(s):  
Harold W. Goforth ◽  
Sami Khalife
Keyword(s):  
Hiv Infection ◽  
Mental Health Professionals ◽  
Hiv Transmission ◽  
The United States ◽  
Hiv And Aids ◽  
Easy Access ◽  
Full Description ◽  
Psychiatric Illnesses ◽  
Adolescents And Adults ◽  
Primary Physicians

From primary prevention to end-of-life care, AIDS psychiatry can make significant contributions to preventing risk behaviors and HIV transmission, mitigating suffering, and improving adherence to risk reduction and medical care. Early in the epidemic, stigma and discrimination magnified suffering and excluded persons known to have HIV and AIDS from many settings in the United States and throughout the world. Such treatment of persons with AIDS was described (Cohen, 1989) as a new form of discrimination called “AIDSism.” As we approach the end of the third decade of the HIV pandemic, in most countries education, training, and experience have mitigated AIDSism, and persons with HIV and AIDS are now seen in varieties of medical and nonmedical settings. The multimorbid medical and psychiatric illnesses associated with HIV infection have complicated the care of persons with HIV and AIDS. A primary care guideline for the care of persons with HIV is available in print (Aberg et al., 2009) and online and is updated regularly at: http://www.journals.uchicago.edu/page/cid/IDSAguidelines.html. AIDS psychiatrists, psychosomatic medicine psychiatrists, as well as child, adult, and geriatric psychiatrists and other mental health professionals are in a unique position to intervene and provide both preventive and treatment interventions for children, adolescents, and adults who are vulnerable to, infected with, or affected by HIV infection. Psychiatrists generally make long-term and trusting relationships with their patients and take complete histories including sexual histories and substance use histories. Primary physicians, pediatricians, obstetricians, and HIV specialists as well as parents and teachers may also have unique opportunities to intervene throughout the life cycle. In this chapter, we provide a list of settings where educational opportunities abound and can lead to an improved understanding of how to prevent HIV transmission. These settings are summarized in Table 1.1. Since a full description of every setting with potential for intervention is beyond the scope of this chapter, we provide more specific descriptions of settings where providing education and easy access to testing, condoms, and drug and alcohol treatment can be therapeutic and lifesaving.

scholarly journals Epidemiology of Human Immunodeficiency Virus in the United States

2007 ◽  
Vol 20 (3) ◽  
pp. 478-488 ◽  
Author(s):  
Susan Hariri ◽  
Matthew T. McKenna
Keyword(s):  
United States ◽  
Human Immunodeficiency Virus ◽  
Hiv Infection ◽  
Hiv Transmission ◽  
The United States ◽  
Population Based ◽  
True Incidence ◽  
Immunodeficiency Virus ◽  
Sex With Men ◽  
Fundamental Shift

SUMMARY The human immunodeficiency virus (HIV) epidemic emerged in the early 1980s with HIV infection as a highly lethal disease among men who have sex with men and among frequent recipients of blood product transfusions. Advances in the treatment of HIV infection have resulted in a fundamental shift in its epidemiology, to a potentially chronic and manageable condition. However, challenges in the prevention of this infection remain. In particular, increasing evidence suggests that transmission of drug-resistant virus is becoming more common and that the epidemic is having a profound impact on morbidity and mortality in ethnic and racial minority subgroups in the United States. New population-based data collection systems designed to describe trends in behaviors associated with HIV transmission and better methods for measuring the true incidence of transmission will better elucidate the characteristics of HIV infection in the United States and inform future public health policies.

scholarly journals 1961. Grindr™ on Screen Activity on iPhones Correlates with HIV Risk and Substance Use in Men Who Have Sex with Men, San Diego

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S63-S64 ◽  
Author(s):  
Martin Hoenigl ◽  
Susan J Little ◽  
Jamila K Stockman ◽  
Britt Skaathun ◽  
David Grelotti ◽  
...  
Keyword(s):  
Substance Use ◽  
Risk Behavior ◽  
Hiv Risk ◽  
San Diego ◽  
Screening Program ◽  
Objective Measure ◽  
The United States ◽  
Hiv Risk Behavior ◽  
Substance Users ◽  
Sex With Men

Abstract Background Technology has changed the way men-who-have-sex-with-men (MSM) seek sex; ≥60% of MSM in the United States use the internet to find sex partners, primarily via Grindr™ which is the most used dating app among MSM. Studies to date have mostly evaluated Grindr™ use as a dichotomous variable and found inconsistent results regarding associations with increased HIV risk behavior. Importantly, Grindr™ “on-screen” activity is monitored by phones and can provide an objective measure of app usage. Here we aimed to assess Grindr™ “on-screen” activity in MSM undergoing community-based HIV and sexually transmitted infection (STI) screening in San Diego, and to correlate activity with sexual risk behavior and substance use. Methods This nested cohort study was conducted between December 2018 and April 2019 and leveraged our “Good to Go” (AI106039) screening program for participant recruitment. During their testing encounter participants not on HIV PrEP were provided with surveys on demographics, substance use and risk behavior during previous 3 months, and Grindr™ usage. Participants with iPhones were instructed on how to assess Grindr™ on-screen activity (i.e., time on-screen during last 7 days) on their phones (Figure 1). Risk behavior was classified using the validated San Diego Early Test (SDET) Score (Figure 2). Results Overall 378/784 (48%) MSM participants indicated that they had opened Grindr™ during the previous 7 days. Grindr™ users had higher SDET scores than those not using Grindr™ (median SDET 2, IQR 0–5; mean 2.29) while there was no difference in proportion of substance users (alcohol and marijuana excluded, 21% vs. 17%; P = 0.14). Of 231 MSM who indicated recent Grindr™ use (61%) had iPhones; median on-screen activity during the previous 7 days was 144 minutes (range 1–2,640 minutes). Participants with high Grindr™ utilization (>80th percentile of time on screen corresponding to >480 minutes), had significantly higher SDET scores (median 5 vs. 2; mean 4.02 vs. 3.26; P < 0.001) and a tendency toward a higher proportion of substance users (29% vs. 20%) than those with lower Grindr™ utilization. Conclusion This study introduces Grindr™ on-screen activity as an objective measure that can help identify MSM at high risk for HIV. Disclosures All Authors: No reported Disclosures.

scholarly journals Episodic HIV Risk Behavior Can Greatly Amplify HIV Prevalence and the Fraction of Transmissions from Acute HIV Infection

2012 ◽  
Vol 4 (1) ◽  
Author(s):  
Xinyu Zhang ◽  
Lin Zhong ◽  
Ethan Romero-Severson ◽  
Shah Jamal Alam ◽  
Christopher J. Henry ◽  
...  
Keyword(s):  
Hiv Infection ◽  
Risk Behavior ◽  
Hiv Risk ◽  
Hiv Prevalence ◽  
Hiv Risk Behavior ◽  
Acute Hiv Infection ◽  
Acute Hiv

scholarly journals Are HIV-Negative Men Who Have Sex with Men and Who Bareback Concerned About HIV Infection? Implications for HIV Risk Reduction Interventions

2012 ◽  
Vol 42 (2) ◽  
pp. 279-289 ◽  
Author(s):  
Iván C. Balán ◽  
Alex Carballo-Diéguez ◽  
Ana Ventuneac ◽  
Robert H. Remien ◽  
Curtis Dolezal ◽  
...  
Keyword(s):  
Hiv Infection ◽  
Risk Reduction ◽  
Hiv Risk ◽  
Hiv Risk Reduction ◽  
Sex With Men ◽  
Hiv Risk Reduction Interventions ◽  
Hiv Negative

scholarly journals Association Between HIV-Related Tweets and HIV Incidence in the United States: Infodemiology Study (Preprint)

2019 ◽  
Author(s):  
Robin Stevens ◽  
Stephen Bonett ◽  
Jacqueline Bannon ◽  
Deepti Chittamuru ◽  
Barry Slaff ◽  
...  
Keyword(s):  
United States ◽  
Social Media ◽  
Hiv Infection ◽  
Language Processing ◽  
Hiv Risk ◽  
Intraclass Correlation ◽  
Hiv Infections ◽  
The United States ◽  
Infection Rates ◽  
Age Range

BACKGROUND Adolescents and young adults in the age range of 13-24 years are at the highest risk of developing HIV infections. As social media platforms are extremely popular among youths, researchers can utilize these platforms to curb the HIV epidemic by investigating the associations between the discourses on HIV infections and the epidemiological data of HIV infections. OBJECTIVE The goal of this study was to examine how Twitter activity among young men is related to the incidence of HIV infection in the population. METHODS We used integrated human-computer techniques to characterize the HIV-related tweets by male adolescents and young male adults (age range: 13-24 years). We identified tweets related to HIV risk and prevention by using natural language processing (NLP). Our NLP algorithm identified 89.1% (2243/2517) relevant tweets, which were manually coded by expert coders. We coded 1577 HIV-prevention tweets and 17.5% (940/5372) of general sex-related tweets (including emojis, gifs, and images), and we achieved reliability with intraclass correlation at 0.80 or higher on key constructs. Bivariate and multivariate analyses were performed to identify the spatial patterns in posting HIV-related tweets as well as the relationships between the tweets and local HIV infection rates. RESULTS We analyzed 2517 tweets that were identified as relevant to HIV risk and prevention tags; these tweets were geolocated in 109 counties throughout the United States. After adjusting for region, HIV prevalence, and social disadvantage index, our findings indicated that every 100-tweet increase in HIV-specific tweets per capita from noninstitutional accounts was associated with a multiplicative effect of 0.97 (95% CI [0.94-1.00]; <i>P</i>=.04) on the incidence of HIV infections in the following year in a given county. CONCLUSIONS Twitter may serve as a proxy of public behavior related to HIV infections, and the association between the number of HIV-related tweets and HIV infection rates further supports the use of social media for HIV disease prevention.

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