HIV infection, high-risk behaviors and substance use in homeless men sheltered in therapeutic communities in Central Brazil

2018 ◽  
Vol 29 (11) ◽  
pp. 1084-1088 ◽  
Author(s):  
Sandra M Brunini ◽  
Cleiciane V de Lima Barros ◽  
Rafael Alves Guimarães ◽  
Hélio Galdino Júnior ◽  
Giovanni Rezza ◽  
...  
Keyword(s):  
Substance Use ◽  
Hiv Infection ◽  
Hiv Testing ◽  
Risk Behaviors ◽  
Illicit Drug ◽  
High Rate ◽  
Therapeutic Communities ◽  
Factors Associated ◽  
Central Brazil ◽  
Homeless Men

Homeless men present high vulnerability to HIV infection, mainly due to sexual risk behaviors and substance use. The objective was to estimate the prevalence of HIV infection, risk behaviors and substance use in homeless men. A cross-sectional study was conducted in 481 homeless men recruited in four therapeutic communities in the Goiás State, Central Brazil. All were interviewed about sociodemographic characteristics, substance use, and risk behaviors. Furthermore, all were tested for HIV. Poisson regression was used to verify factors associated with HIV infection. HIV prevalence was 1.24% (95.0% CI: 0.57 to 2.69%). Previous HIV testing (adjusted prevalence ratio [APR]: 10.0; 95.0% CI: 1.86–55.8) and years of education (APR: 0.76; 95.0% CI: 0.60–0.97) were factors associated with HIV infection. Participants had high rates of hazardous alcohol use and illicit drug use. The prevalence of HIV infection among homeless men was higher than that found in the Brazilian male population and we identified a high rate of risk behaviors for HIV among the homeless men investigated. Thus, it is necessary to expand HIV prevention measures in Brazil, such as health education, condom availability, regular HIV testing and increased testing coverage in this population, and treatment for alcohol and/or illicit drug dependence/abuse.

Substance Use among Women at Risk for HIV Infection

1992 ◽  
Vol 22 (2) ◽  
pp. 131-146 ◽  
Author(s):  
K. G. Wambach ◽  
Joseph B. Byers ◽  
Dianne F. Harrison ◽  
Philippa Levine ◽  
Allen W. Imershein ◽  
...  
Keyword(s):  
At Risk ◽  
Substance Use ◽  
Hiv Infection ◽  
Risk Behaviors ◽  
Hiv Risk ◽  
Culturally Diverse ◽  
Hiv Risk Behaviors ◽  
South Florida ◽  
Increased Risk

This article reports results from a survey of culturally diverse women at risk for HIV infection in south Florida. Data concerning their substance use and its association with HIV risk behaviors are presented. Results indicate levels of consumption which exceed expectations based on general estimates of female substance use. Further, substance use was associated with specific behaviors and lifestyles which placed the women at increased risk for HIV infection.

scholarly journals Substance Use Disorder, Intravenous Injection, and HIV Infection: A Review

2019 ◽  
Vol 28 (12) ◽  
pp. 1465-1471
Author(s):  
Shao-Cheng Wang ◽  
Brion Maher
Keyword(s):  
Substance Use ◽  
Hiv Infection ◽  
Risk Behaviors ◽  
Intravenous Injection ◽  
Substance Use Disorder ◽  
Hiv Risk ◽  
Risk Taking ◽  
Hiv Risk Behaviors ◽  
Unprotected Sex ◽  
Impaired Control

DSM-V-defined substance use disorder comprises four groups of symptoms: impaired control, social impairment, risky use, and pharmacological reactions. Behavioral patterns of impaired control, including impulsivity and risk taking, are associated with HIV risk behaviors. Substance users with stronger craving symptoms are more likely to use drugs via intravenous injection than other routes because of the faster drug effect and the higher bioavailability; thus, they are at high risk of HIV infection. HIV risk behaviors such as unprotected sex and intravenous injection facilitate HIV disease spread. Public health policies such as Needle and Syringe Exchange Programs and medication-assisted treatment are proven to reduce HIV risk behaviors such as the frequency of intravenous injection and even the incidence of HIV infection, but both of them have limitations. While intravenous injection is a frequently discussed issue in public policies and the HIV-related literature, it is a much less frequent topic in the addiction literature. We believed that understanding the mental substrate behind impulsivity/risk taking and the possible biological mechanism of intravenous injection may help in creating more effective strategies to slow down HIV infection.

Verbal Performances and Addict Conversion: An Interactionist Perspective on Therapeutic Communities

1983 ◽  
Vol 13 (3) ◽  
pp. 281-298 ◽  
Author(s):  
J. David Hawkins ◽  
Norman Wacker
Keyword(s):  
Illicit Drug ◽  
Peer Group ◽  
High Rate ◽  
Institutional Setting ◽  
Street Crime ◽  
Therapeutic Communities ◽  
Value System ◽  
Interactionist Perspective ◽  
Treatment Philosophy

Verbal interaction in therapeutic communities (TC's) for the treatment of drug addictions are explored here as a source of both the high rate of “conversion” among residents and the reported high rates of relapse to street crime and illicit drug use after leaving treatment. Residents enter TC's with values radically opposed to those of the TC's treatment philosophy but are gradually drawn into behavioral conformity with the TC code. Certain verbal performances demanded of clients appear instrumental to a conversion process in which clients develop self-concepts along the lines of program models, in spite of their frequent early efforts to “game” their way through therapy. In verbal performances, clients are pressured to use the distinctive language (argot) and implicit value system of the TC treatment philosophy to characterize their own and their fellow clients' behavior before the group. Major vehicles are confessions, confrontations and rituals of stigmatization mounted with the active participation of resident peers. The ways in which residents are drawn into actively playing expected roles in the resocialization of fellow clients are described. In TC's, dramatic verbal performances are highly compartmentalized in recurring discrete frames or occasions (Goffman, 1974). Each occasion is governed by a particularistic code which is learned experientially through the prompting of the TC peer group and staff. Specific codes of behavior are “learned by rote.” Behaviors appropriate on one occasion meet with censure on different occasions. In TC's the elaborated code or “concept” which joins the dramatic occasions is described as unknowable and not reducible to intellectual understanding. As a result, the resocialization process in TC's appears to be a conversion to this specific institutional setting itself. Such context-tried resocialization is not likely to guarantee the long-term rehabilitation of clients when they leave the TC setting.

scholarly journals Risk Behaviors of Homeless Men in India: A Potential Bridge Population for HIV Infection

2007 ◽  
Vol 12 (4) ◽  
pp. 613-622 ◽  
Author(s):  
Arunansu Talukdar ◽  
Krishnendu Roy ◽  
Indrajit Saha ◽  
Jayashree Mitra ◽  
Roger Detels
Keyword(s):  
Hiv Infection ◽  
Risk Behaviors ◽  
Homeless Men

scholarly journals Pilot Study of a Multilevel Mobile Health App for Substance Use, Sexual Risk Behaviors, and Testing for Sexually Transmitted Infections and HIV Among Youth: Randomized Controlled Trial (Preprint)

2019 ◽  
Author(s):  
David Cordova ◽  
Jaime Munoz-Velazquez ◽  
Frania Mendoza Lua ◽  
Kathryn Fessler ◽  
Sydni Warner ◽  
...  
Keyword(s):  
Substance Use ◽  
Drug Use ◽  
Hiv Testing ◽  
Sexual Risk ◽  
Risk Behaviors ◽  
Controlled Trial ◽  
Sexual Risk Behaviors ◽  
Small Scale ◽  
Usual Practice ◽  
Sexually Transmitted

BACKGROUND Preventing and reducing substance use disorders, sexually transmitted infections (STIs)/HIV, and teen pregnancy, and the associated risk behaviors (ie, substance use and sexual risk behaviors) among youth remain public health priorities in the United States. Equally important is improving the uptake of STI/HIV testing among the youth. Mobile health (mHealth) apps may be a solution to ameliorate these public health concerns; however, few mHealth preventive interventions have demonstrated efficacy in reducing substance use or sexual risk behaviors or improving the uptake of STI/HIV testing among the youth, particularly in clinic settings. OBJECTIVE This small-scale study aimed to examine the feasibility of conducting a pilot randomized controlled trial (RCT). We evaluated the effects of Storytelling 4 Empowerment (S4E), relative to enhanced usual practice, on the potential mechanisms by which behavior change occurs, namely clinician-youth risk communication, prevention knowledge, and substance use and sexual risk refusal self-efficacy. We also assessed the ability to measure targeted outcomes of past 30-day substance use (ie, alcohol, tobacco, and other drug use), condomless sex, and alcohol or drug use before sex, as well as the uptake of STI/HIV testing. METHODS Employing community-based participatory research principles, 50 youths aged 13 to 21 years were recruited from a youth-centered community health clinic in Southeast Michigan, randomized sequentially to either S4E or enhanced usual practice, and assessed at baseline, immediately postintervention, and 30 days postintervention. S4E consists of 3 modules, including alcohol and drug use, tobacco, and STI/HIV. RESULTS Relative to youth in the enhanced usual practice group, S4E participants demonstrated higher youth-clinician risk communication (mean 3.22, SD 1.67) and increases in prevention knowledge (∆ score mean 0.36, SD 0.51) and self-efficacy (∆ score mean 0.16, SD 0.47). In addition, youth in the S4E group showed reductions in the proportions of past 30-day overall substance use (Cohen <i>h</i>=0.71, 95% CI 0.15 to 1.27), as well as past 30-day alcohol (Cohen <i>h</i>=0.71, 95% CI 0.15 to 1.27), tobacco (Cohen <i>h</i>=0.17, 95% CI −0.39 to 0.73), and drug use (Cohen <i>h</i>=1.28, 95% CI 0.72 to 1.84). The results also suggest a reduction in the proportion of youths who reported past 30-day condomless sex (Cohen <i>h</i>=0.18, 95% CI −0.38 to 0.74) and alcohol use before sex (Cohen <i>h</i>=0.44, 95% CI −0.12 to 1.00). Finally, the findings also demonstrated an increase in the proportion of youths who reported STI/HIV testing over time (Cohen <i>h</i>=0.16, 95% CI −0.39 to 0.72). CONCLUSIONS The findings suggest the feasibility of a small-scale pilot RCT. S4E demonstrated shifts in the hypothesized direction, reducing substance use, sexual risk behaviors, and improving the uptake of STI/HIV testing among youth in a clinic setting. The findings suggest that a larger RCT may be warranted. CLINICALTRIAL ClinicalTrails.gov NCT03855410, https://clinicaltrials.gov/ct2/show/NCT03855410.

scholarly journals HIV Risk Behaviors and Testing History in Historically Black College and University Settings

2008 ◽  
Vol 123 (3_suppl) ◽  
pp. 115-125 ◽  
Author(s):  
Peter E. Thomas ◽  
Andrew C. Voetsch ◽  
Binwei Song ◽  
Denyce Calloway ◽  
Carolyn Goode ◽  
...  
Keyword(s):  
Hiv Infection ◽  
Hiv Testing ◽  
Historically Black ◽  
Risk Behaviors ◽  
Perceived Risk ◽  
Care Facility ◽  
Black College ◽  
Future Research ◽  
Convenience Sample ◽  
Increased Risk

Objectives. From 2001 through 2005, African Americans accounted for the largest percentage of new cases of human immunodeficiency virus (HIV)/ acquired immunodeficiency syndrome (AIDS) in all age categories, especially among people aged 13 to 24 years. Although students attending historically black colleges and universities (HBCUs) report many of the behaviors that promote HIV transmission, their risk behaviors and HIV testing practices have not been well-characterized. We compared the demographic and behavioral characteristics of people who have been previously tested for HIV with those of people tested for the first time in this demonstration project to increase HIV testing at HBCUs. Methods. The Centers for Disease Control and Prevention and collaborating partners conducted rapid HIV testing and behavioral surveys at HBCUs in Arkansas, Georgia, Mississippi, and Washington, D.C., from January 2005 to April 2007. We recruited a convenience sample of students and community members at different campus venues including student health centers, dormitories, and student activity centers. Results. Our analysis included 5,291 people, 42% of whom reported they had never been tested for HIV. People who had been tested in the past were more likely to be older, believe they were at high risk for infection, have visited a health-care facility, and report behaviors that increased their risk of HIV infection. Conclusion. Respondents who believed they were at increased risk for HIV infection or reported behaviors that increased their risk for infection were more likely to have been tested for HIV. Future research should compare actual vs. perceived risk for HIV infection and contrast how each impacts HIV testing.

scholarly journals HIV Testing and Risks of Sexual Behavior among HIV-Negative Men Who Have Sex with Men in Ningbo, China

2020 ◽  
Vol 17 (4) ◽  
pp. 1322 ◽  
Author(s):  
Haibo Jiang ◽  
Hang Hong ◽  
Hongjun Dong ◽  
Jun Jiang ◽  
Lin He
Keyword(s):  
High Risk ◽  
Hiv Testing ◽  
Psychiatric Disorders ◽  
Risk Behaviors ◽  
Protective Factor ◽  
Preventive Strategy ◽  
High Risk Behaviors ◽  
Factors Associated ◽  
Sex With Men ◽  
Hiv Negative

Human immunodeficiency virus (HIV) testing is confirmed as a preventive strategy for HIV control. However, the testing rate and risk behaviors of HIV-negative men who have sex with men (MSM) remain unclear. We aimed to examine factors associated with HIV testing and high-risk behaviors among HIV-negative MSM. From July 2016 to June 2017, participants were recruited by snowball sampling from WeChat groups, bars, and other venues. HIV testing was performed to exclude HIV-positive MSM. Face-to-face questionnaires regarding HIV testing and high-risk behaviors were conducted; 988 MSM were included, and 57.1% of participants underwent HIV testing in the past year. The proportion of high-risk behaviors was 49.9%. Factors associated with HIV testing were bisexual orientation, substance use to adjust psychiatric disorders, and receiving acquired immune deficiency syndrome (AIDS) interventions. Being married, bisexual orientation, and receiving AIDS interventions were risk factors for high-risk sexual behaviors, while college or higher degree was a protective factor. We determined that HIV transmission factors are widespread, and the rate of HIV testing is relatively low. Attention should be given to marital status, using substances to adjust psychiatric disorders, or bisexual HIV-negative MSM, and AIDS interventions should be strengthened to promote HIV testing and reduce high-risk behaviors.

scholarly journals Sex-on-Premise Venues, Associated Risk Behaviors, and Attitudes toward Venue-Based HIV Testing among Men Who Have Sex with Men in Lima, Perú

2020 ◽  
Author(s):  
Alexander Lankowski ◽  
Hugo Sánchez ◽  
José Hidalgo ◽  
Robinson Cabello ◽  
Ann Duerr
Keyword(s):  
Hiv Testing ◽  
Sexual Risk ◽  
Risk Behaviors ◽  
Online Survey ◽  
Sexual Risk Behaviors ◽  
Hiv Infections ◽  
High Rate ◽  
Access To Treatment ◽  
Cross Sectional ◽  
Sex With Men

Abstract Background. In Perú, HIV disproportionately affects men who have sex with men (MSM). Despite widespread access to treatment, the high rate of new HIV infections has remained unchanged over the last decade. Low knowledge of HIV status associated with late diagnosis is a key factor underlying the high HIV incidence observed in this setting, creating conditions for efficient onward transmission. Improving access to HIV testing and prevention services for those at highest risk is an important public health priority. Sex-on-premise venues (SOPVs) – saunas, sex clubs, pornographic movie theaters, hourly hotels, and bars/discos with areas where sex is permitted – may be opportune sites for outreach; however, further research on SOPVs and the populations who frequent them is needed to inform such efforts. Methods . We conducted a cross-sectional online survey of adult MSM in Lima, Perú to evaluate patterns of SOPV attendance, associated sexual risk behaviors, and attitudes toward SOPV-based interventions. Participants were recruited through outreach to social media networks affiliated with local LGBTQ-aligned community groups. Our primary analytic objective was to estimate the association of HIV-related sexual risk behaviors and SOPV attendance. Additionally, we performed exploratory analyses to describe risk behavior stratified by SOPV category and to examine the relationship between SOPV attendance and the use of online platforms to meet sex partners. Results. Overall, 389 MSM completed the survey from November 2018 through May 2019, of whom 68% reported attending an SOPV in the last three months. SOPV attendance was associated with multiple sexual risk behaviors, including transactional sex, group sex, substance use around the time of sex, and higher number of partners. Over two thirds of SOPV attendees indicated they would accept HIV testing if offered at SOPVs. Conclusions. SOPV attendance was common among MSM in Lima who participated in our survey, and SOPV attendees reported significantly greater engagement in sexual risk behaviors related to HIV transmission. Attitudes toward hypothetical SOPV-based interventions were generally favorable. These findings suggest that outreach at SOPVs may be an effective mechanism for reaching a particularly high-risk sub-population of MSM in Perú to deliver targeted HIV testing and prevention interventions.

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