1.  Peer Reviewed Title: Is sexual risk taking behaviour changing in rural south-west Uganda? Behaviour trends in a rural population cohort 1993 2006. Author: Biraro S; Shafer LA; Kleinschmidt I; Wolff B; Karabalinda A; Nalwoga A; Musinguzi J; Kirungi W; Opio A; Whitworth J; Grosskurth H Source: Sexually Transmitted Infections. 2009 Apr;85(Suppl 1):i3-i11. Abstract: Objective: To describe sexual behaviour trends in a rural Ugandan cohort in the context of an evolving HIV epidemic, 1993-2006. Methods: Sexual behaviour data were collected annually from a population cohort in which HIV serological surveys were also conducted. Behaviour trends were determined using survival analysis and logistic regression. Trends are reported based on the years in which the respective indicators were collected. Results: Between 1993 and 2006, median age at first sex increased from 16.7 years to 18.2 years among 17-20-year-old girls and from 18.5 years to 19.9 years among boys. Both sexes reported a dip in age at sexual debut between 1998 and 2001. One or more casual partners in the past 12 months among men rose from 11.6% in 1997 to 12.7% in 2004 and then declined to 10.2% in 2006. Among women it increased from 1.4% in 1997 to 3.7% in 2004 and then reduced to 1.4% in 2006. The rise in casual partners between 1997 and 2004 was driven mainly by older age groups. Trends in condom use with casual partners varied by age, increasing among those aged 35+ years, declining in the middle age groups and presenting a dip and then a rise in the youngest aged group (13-19 years). Conclusion: Among youth, risky behaviour declined but increased in the late 1990s/early 2000s. Among those aged 35+ years, condom use rose but casual partners also rose. Several indicators portrayed a temporary increase in risk taking behaviour from 1998 to 2002. Language: English Keywords: UGANDA | RESEARCH REPORT | KAP SURVEYS | COHORT ANALYSIS | LONGITUDINAL STUDIES | EPIDEMIOLOGIC METHODS | RURAL POPULATION | MULTIPLE PARTNERS | SEX BEHAVIOR | RISK BEHAVIOR | HIV INFECTIONS | SEX FACTORS | FIRST INTERCOURSE | AGE FACTORS | CONDOM USE | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Surveys | Sampling Studies | Studies | Research Methodology | Population Characteristics | Demographic Factors | Population | Sexual Partners | Behavior | Viral Diseases | Diseases | Risk Reduction Behavior Document Number: 340101 |
| 2. Peer Reviewed Title: AIDS and the stigma of sexual promiscuity: Thai nurses' risk perceptions ofoccupational exposure to HIV. Author: Chan KY; Rungpueng A; Reidpath DD Source: Culture, Health and Sexuality. 2009 May;11(4):353-368. Abstract: This paper examines the culturally shaped meanings of AIDS and perceptions of accidental occupational exposure to HIV among a group of twenty nurses in Bangkok, Thailand. The findings are based on data collected as a part of a larger mixed-methods study that examined how perceptions of risk behaviours (including sexual promiscuity) shape health workers' perceptions of patients living with HIV/AIDS. Nurses' narratives revealed that despite acknowledgement of the low probability of occupational exposure to HIV, the fear of HIV infection remained and was largely driven by the enormity of the anticipated social (rather than the health) consequences of being HIV-positive. The perceived certainty of social ostracism was reinforced by participants' observations of the social rejection experienced by people living with HIV/AIDS both within and outside clinical settings. For female nurses, the dominant social perception that women living with HIV/AIDS were violators of gender norms, and thus 'guilty' victims, was an issue central to their self-identities. Ways of improving care for people living with HIV in the light of the nurses concerns and future research are discussed. Language: English Keywords: THAILAND | RESEARCH REPORT | KAP SURVEYS | MULTIPLE PARTNERS | NURSES AND NURSING | WOMEN IN DEVELOPMENT | PERSONS LIVING WITH HIV/AIDS | STIGMA | SEX BEHAVIOR | RISK BEHAVIOR | HIV TRANSMISSION | PERCEPTION | CULTURAL BACKGROUND | OCCUPATIONAL HEALTH | Developing Countries | Asia, Southeastern | Asia | Surveys | Sampling Studies | Studies | Research Methodology | Sexual Partners | Behavior | Health Personnel | Delivery of Health Care | Health | Economic Development | Economic Factors | HIV Infections | Viral Diseases | Diseases | Social Problems | Sociocultural Factors | Psychological Factors | Population Characteristics | Demographic Factors | Population Document Number: 341088 |
| 3. Peer Reviewed Title: Estimating HIV prevalence and risk behaviors among high-risk heterosexual men with multiple sex partners: use of respondent-driven sampling. Author: Chopra M; Townsend L; Johnston L; Mathews C; Tomlinson M; O'bra H; Kendall C Source: Journal of Acquired Immune Deficiency Syndromes. 2009 May 1;51(1):72-7. Abstract: OBJECTIVES: To collect HIV data from high-risk men who have multiple, younger, female sex partners in a periurban township in South Africa. DESIGN: Unlinked anonymous cross-sectional survey using respondent-driven sampling. METHODS: Survey conducted among men aged 18 years or older who reported having had sex with more than 1 female partner in the previous 3 months (one of whom was either 3 or more years younger than the participant or below the age of 24) and lived in the area of recruitment. RESULTS: The median age of the 421 recruited men was 28 years (range: 18-62 years). They reported a median of 6 sexual partners (range: 2-39) during the past 3 months, and 51% (confidence interval: 45.0 to 59.6) reported inconsistent condom use with their casual partners. During the 3 months before the survey, 98% of men reported having concurrent sexual relationships. HIV prevalence was 12.3% (confidence interval: 8.3% to 16.9%). Being older than 24 years and not using a condom during the last sexual intercourse with a 1-time sexual partner were significantly associated with HIV infection. CONCLUSIONS: This group of heterosexual urban men practice high levels of risky sexual behavior and are an important group that require more targeted HIV surveillance and prevention interventions. Language: English Keywords: SOUTH AFRICA | RESEARCH REPORT | SAMPLING STUDIES | HETEROSEXUALS | MEN | URBAN POPULATION | HIV INFECTIONS | PREVALENCE | MULTIPLE PARTNERS | CONDOM USE | RISK BEHAVIOR | SEX BEHAVIOR | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Studies | Research Methodology | Behavior | Demographic Factors | Population | Population Characteristics | Viral Diseases | Diseases | Measurement | Sexual Partners | Risk Reduction Behavior Document Number: 342370 |
| 4. Peer Reviewed Title: Multiple sexual partnership mediates the association between early sexual debut and sexually transmitted infection among adolescent and young adult males in Nigeria. Author: Fatusi A; Wang W Source: European Journal of Contraception and Reproductive Health Care. 2009 Apr;14(2):134-43. Abstract: The study was cross-sectional analytical in design and involved 1,278 Nigerian males aged 15-24 years. Logistic regression was used in assessing the statistical relationship between early sexual debut (<16 years) and self-reported STIs (history of at least one of three symptoms-painful urination, genital discharge, and genital ulcer/sore within the past 12 months), with demographic factors, sexual behaviors, and psychosocial measures controlled for. The prevalence of self-reported symptoms was 4.2% for genital discharge, 4.1% for painful urination, and 2.0% for genital sore/ulcer. Overall, 6.8% had STI symptoms. At bivariate analysis, early sexual debut (p = 0.021), multiple partners (p < 0.001), concurrent partners (p = 0.002), and sex with casual/commercial partners (p = 0.013) were associated with STIs. At multivariate analysis, early sexual debut (odds ratio [OR] = 2.12, 95% confidence interval [CI] = 1.17-3.84) remained significantly associated with STIs. Multiple sexual partnership (OR = 2.00, 95% CI = 1.13-3.52) was also significantly associated with STIs and is a mediator of the association between early debut and STI. Language: English Keywords: NIGERIA | RESEARCH REPORT | HEALTH SURVEYS | STATISTICAL REGRESSION | ADOLESCENTS, MALE | YOUTH | MULTIPLE PARTNERS | FIRST INTERCOURSE | SEXUALLY TRANSMITTED DISEASES | SIGNS AND SYMPTOMS | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Health | Data Analysis | Research Methodology | Adolescents | Age Factors | Population Characteristics | Demographic Factors | Population | Sexual Partners | Sex Behavior | Behavior | Reproductive Tract Infections | Infections | Diseases Document Number: 341447 |
| 5. Peer Reviewed Title: Alcohol abuse, sexual risk behaviors, and sexually transmitted infections in women in Moshi urban district, northern Tanzania. Author: Ghebremichael M; Paintsil E; Larsen U Source: Sexually Transmitted Diseases. 2009 Feb;36(2):102-7. Abstract: BACKGROUND: To assess the covariates of alcohol abuse and the association between alcohol abuse, high-risk sexual behaviors and sexually transmitted infections (STIs). METHODS: Two thousand and nineteen women aged 20 to 44 were randomly selected in a 2-stage sampling from the Moshi urban district of northern Tanzania. Participant's demographic and socio-economic characteristics, alcohol use, sexual behaviors, and STIs were assessed. Blood and urine samples were drawn for testing of human immunodeficiency virus, herpes simplex virus, syphilis, chlamydia, gonorrhea, trichomonas, and mycoplasma genitalium infections. RESULTS: Adjusted analyses showed that a history of physical (OR = 2.05; 95% CI: 1.06-3.98) and sexual violence (OR = 1.63; 95% CI: 1.05-2.51) was associated with alcohol abuse. Moreover, alcohol abuse was associated with number of sexual partners (OR = 1.66; 95% CI: 1.01-2.73). Women who abused alcohol were more likely to report STIs symptoms (OR = 1.61; 95% CI: 1.08-2.40). Women who had multiple sexual partners were more likely to have an STI (OR = 2.41; 95% CI: 1.46-4.00) compared to women with 1 sexual partner. There was no direct association between alcohol abuse and prevalence of STIs (OR = 0.86; 95% CI: 0.55-1.34). However, alcohol abuse was indirectly associated with STIs through its association with multiple sexual partners. CONCLUSIONS: The findings of alcohol abuse among physically and sexually violated women as well as the association between alcohol abuse and a history of symptoms of STIs and testing positive for STIs have significant public health implications. In sub-Saharan Africa, where women are disproportionately affected by the HIV epidemic screening for alcohol use should be part of comprehensive STIs and HIV prevention programs. Language: English Keywords: TANZANIA | RESEARCH REPORT | KAP SURVEYS | CLINICAL RESEARCH | EPIDEMIOLOGIC METHODS | WOMEN IN DEVELOPMENT | URBAN POPULATION | MULTIPLE PARTNERS | SEXUALLY TRANSMITTED DISEASES | SEX BEHAVIOR | RISK BEHAVIOR | ALCOHOL USE AND ABUSE | PREVALENCE | RAPE | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Surveys | Sampling Studies | Studies | Research Methodology | Economic Development | Economic Factors | Population Characteristics | Demographic Factors | Population | Sexual Partners | Behavior | Reproductive Tract Infections | Infections | Diseases | Measurement | Crime | Social Problems | Sociocultural Factors Document Number: 330387 |
| 6. Peer Reviewed Title: A framework of sexual partnerships: risks and implications for HIV prevention in Africa. Author: Green EC; Mah TL; Ruark A; Hearst N Source: Studies In Family Planning. 2009 Mar;40(1):63-70. Abstract: The global diversity of HIV epidemics can be explained in part by types and patterns of sexual partnerships. We offer a typology of sexual partnerships that corresponds to varying levels of HIV-transmission risk to help guide thinking about appropriate behavioral interventions, particularly in the epidemics of sub-Saharan Africa. Declines in HIV prevalence have been associated with reductions in numbers of sex partners, whereas many other prevention strategies have not been demonstrated to reduce HIV transmission at a population level. We suggest a reorientation of current prevention efforts, based on the epidemiology of sexually transmitted HIV epidemics and trends in sexual behavior change. Concurrent sexual partnerships are likely to play a large role in transmission dynamics in the generalized epidemics of East and Southern Africa, and should be addressed through improved behavior-change interventions. Language: English Keywords: AFRICA | RESEARCH REPORT | SEXUAL PARTNERS | MULTIPLE PARTNERS | HIV TRANSMISSION | SEXUALLY TRANSMITTED DISEASES | RISK REDUCTION BEHAVIOR | BEHAVIOR CHANGE | PROGRAM EVALUATION | Developing Countries | Sex Behavior | Behavior | HIV Infections | Viral Diseases | Diseases | Reproductive Tract Infections | Infections | Programs | Organization and Administration Document Number: 341337 |
| 7. Peer Reviewed Title: A framework of sexual partnerships: Risks and implications for HIV prevention in Africa. Author: Green EC; Mah TL; Ruark A; Hearst N Source: Studies in Family Planning. 2009 Mar;40(1):63-70. Abstract: The global diversity of HIV epidemics can be explained in part by types and patterns of sexual partnerships. We offer a typology of sexual partnerships that corresponds to varying levels of HIVtransmission risk to help guide thinking about appropriate behavioral interventions, particularly in the epidemics of sub-Saharan Africa. Declines in HIV prevalence have been associated with reductions in numbers of sex partners, whereas many other prevention strategies have not been demonstrated to reduce HIV transmission at a population level. We suggest a reorientation of current prevention efforts, based on the epidemiology of sexually transmitted HIV epidemics and trends in sexual behavior change. Concurrent sexual partnerships are likely to play a large role in transmission dynamics in the generalized epidemics of East and Southern Africa, and should be addressed through improved behavior-change interventions. Language: English Keywords: AFRICA, SUB SAHARAN | METHODOLOGICAL STUDIES | CLASSIFICATION | EPIDEMIOLOGIC METHODS | SEXUAL PARTNERS | MULTIPLE PARTNERS | HIV PREVENTION | RISK ASSESSMENT | BEHAVIOR CHANGE COMMUNICATION | EPIDEMIOLOGY | SEX BEHAVIOR | SAFER SEX | HUMAN GEOGRAPHY | Africa | Developing Countries | Studies | Research Methodology | Behavior | HIV Infections | Viral Diseases | Diseases | Evaluation | Communication Programs | Communication | Behavior Change | Public Health | Health | Geography | Social Sciences | Science | Sociocultural Factors Document Number: 341082 |
| 8. Title: Knowledge about AIDS/HIV infection among women attending obstetrics and gynaecology clinic at a university hospital. Author: Haider G; Zohra N; Nisar N; Munir AA Source: JPMA. Journal of the Pakistan Medical Association. 2009 Feb;59(2):95-8. Abstract: OBJECTIVE: To determine the level of awareness about Human Immune-deficiency Virus Infection and Auto Immune Deficiency Syndrome (HIV/AIDS) among women attending obstetrics and gynaecology clinic. METHODS: A descriptive cross-sectional study was conducted in the obstetric and gynaecology clinic at Isra University Hospital Hyderabad Pakistan from April to June 2007. A total of 189 women attending the obstetric and gynaecology clinic between ages 20 and 50 years were included. Informed consent was taken and information was collected by a pre-designed questionnaire to assess the level of awareness about HIV/AIDS. Data analysis was done by computer software, SPSS version 11. RESULTS: Out of the total, 86.8% women had heard about HIV/AIDS. A large majority of women knew that it is transmitted by close sexual relationship, through infected blood, can be transmitted from mother to baby and knew that it is transmitted by reuse of infected needles while only 40.7% knew that it can be transmitted during delivery. The respondents had the knowledge that multiple sexual partners (79.4%), prostitutes and homosexual males (49.7%), drug addicts (49.7%) were high risk groups. Regarding prevention of AIDS, 70.9% mentioned avoiding homosexuality, 58.7% knew the use of condoms and 74.7% women knew that screening of blood in laboratories before transfusion can prevent AIDS. CONCLUSION: The level of awareness regarding HIV/AIDS transmission and prevention was satisfactory among women attending the out-patient department of a gynaecology and obstetrics department. However, number of misconceptions needs to be corrected. Language: English Keywords: PAKISTAN | RESEARCH REPORT | KAP SURVEYS | CROSS SECTIONAL ANALYSIS | WOMEN IN DEVELOPMENT | MEN HAVING SEX WITH MEN | SEX WORKERS | MULTIPLE PARTNERS | KNOWLEDGE | HIV TRANSMISSION | SEX BEHAVIOR | RISK BEHAVIOR | BLOOD TRANSFUSION | MOTHER-TO-CHILD TRANSMISSION | CHILDBIRTH | NEEDLE SHARING | Developing Countries | Asia, Southern | Asia | Surveys | Sampling Studies | Studies | Research Methodology | Economic Development | Economic Factors | Behavior | Sexual Partners | Sociocultural Factors | HIV Infections | Viral Diseases | Diseases | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Transmission | Infections | Pregnancy Outcomes | Pregnancy | Reproduction Document Number: 330906 |
| 9. Peer Reviewed Title: Risk factors for incidence of sexually transmitted infections among women in South Africa, Tanzania, and Zambia: results from HPTN 055 study. Author: Kapiga S; Kelly C; Weiss S; Daley T; Peterson L; Leburg C; Ramjee G Source: Sexually Transmitted Diseases. 2009 Apr;36(4):199-206. Abstract: OBJECTIVE: To determine risk factors for sexually transmitted infections (STIs) among women in Durban and Hlabisa (South Africa), Moshi (Tanzania), and Lusaka (Zambia). STUDY DESIGN: Between 2003 and 2004, 958 women at risk of STIs were enrolled in a 1-year prospective study. They were interviewed at each monthly visit, and samples for STI testing were collected during quarterly and other visits when clinically indicated. RESULTS: The incidence of infections as measured in person-years at risk (PYAR) was as follows: overall trichomoniasis, 31.9/100 PYAR; chlamydial infection in South Africa, 19.5/100 PYAR; chlamydial infection in Tanzania and Zambia, 4.9/100 PYAR; gonorrhea in South Africa, 16.5/100 PYAR; gonorrhea in Tanzania and Zambia, 5.3/100 PYAR; overall syphilis, 7.5/100 PYAR; and overall HIV, 3.8/100 PYAR. The incidence of most STIs was highest among the South African sites, where chlamydial infection and gonorrhea were detected by using a more sensitive assay. Independent risk factors included age, hormonal contraceptive methods, and measures of sexual behavior, including number of sex partners and occurrence of anal sex in the past 3 months. Women with incident HIV infection were at increased risk of chlamydial infection [odds ratio (OR) = 5.5, 95% confidence interval (CI): 2.0-15.2]and gonorrhea (OR = 5.7, 95% CI: 1.9-17.0) in South African sites. Despite ongoing counseling during the study, high-risk sexual behaviors were common, and consistent condom use remained low. CONCLUSIONS: The incidence of STIs, including HIV, was high among women in this study. These findings highlight the urgent need for effective HIV/STI prevention programs in this population. Language: English Keywords: AFRICA, SOUTHERN | RESEARCH REPORT | KAP SURVEYS | PROSPECTIVE STUDIES | EPIDEMIOLOGIC METHODS | CLINICAL RESEARCH | WOMEN IN DEVELOPMENT | MULTIPLE PARTNERS | SEXUALLY TRANSMITTED DISEASES | PREVALENCE | RISK FACTORS | AGE FACTORS | CONTRACEPTIVE USAGE | SEX BEHAVIOR | RISK BEHAVIOR | Developing Countries | Africa, Sub Saharan | Africa | Surveys | Sampling Studies | Studies | Research Methodology | Economic Development | Economic Factors | Sexual Partners | Behavior | Reproductive Tract Infections | Infections | Diseases | Measurement | Health | Population Characteristics | Demographic Factors | Population | Contraception | Family Planning Document Number: 341157 |
| 10. Title: Risk-taking behaviour is more frequent in teenage girls with multiple sexual partners. Author: Kuortti M; Kosunen E Source: Scandinavian Journal of Primary Health Care. 2009;27(1):47-52. Abstract: OBJECTIVE: To investigate associations between sexual behaviour and risk-taking health behaviour among adolescent females in our changing sexual culture. DESIGN: A questionnaire study. Girls who had had multiple sexual partners (at least five in their lifetime or four during the last six months) were compared with those with fewer partners. Logistic regression was applied. SETTING: The Adolescent Clinic, a primary healthcare unit in the city of Tampere, Finland. SUBJECTS: A sample of 247 female clients aged 15-18 years who had experienced sexual intercourse. MAIN OUTCOME MEASURES: Contraceptive practices, substance use, and sexual attitudes. RESULTS: Girls with multiple sexual partners (n = 69) and the reference group (n = 178) did not differ from each other significantly by age, age at menarche, or educational status. In univariate analysis, age at sexual debut, contraceptive practices, and various substance uses were strongly associated with having multiple sexual partners. Ever-use of emergency contraception was marginally associated, while ever-use of conventional hormonal contraception or condoms was not. In multivariate analysis, low age at sexual debut (OR 8.75 for age 11-13), omitting contraception at the most recent intercourse (OR 3.48), ever-use of withdrawal as a contraceptive method (OR 2.34), and repeated use of drugs (OR 4.10) were associated with having multiple sexual partners. CONCLUSION: Different types of risk-taking behaviour are still interlinked. In discussions with adolescents showing one type of risk behaviour health service providers should make an effort to identify other modes of risk-taking. Language: English Keywords: FINLAND | RESEARCH REPORT | KAP SURVEYS | STATISTICAL REGRESSION | MULTIVARIATE ANALYSIS | CASE CONTROL STUDIES | ADOLESCENTS, FEMALE | MULTIPLE PARTNERS | SEX BEHAVIOR | RISK BEHAVIOR | FIRST INTERCOURSE | ATTITUDES | DRUG USE AND ABUSE | CONTRACEPTIVE USAGE | CONDOM USE | Europe, Northern | Europe | Developed Countries | Surveys | Sampling Studies | Studies | Research Methodology | Data Analysis | Adolescents | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Sexual Partners | Behavior | Psychological Factors | Contraception | Family Planning | Risk Reduction Behavior Document Number: 330352 |
| 11. Peer Reviewed Title: Cultural scripts for multiple and concurrent partnerships in southern Africa: Why HIV prevention needs anthropology. Author: Leclerc-Madlala S Source: Sexual Health. 2009;6(2):103-110. Abstract: Background: Multiple and concurrent sexual partnerships have been identified as southern Africa's key behavioural driver of HIV, resulting in calls to make partner reduction programming central to an intensified HIV prevention focus. Various efforts are currently being made in the region in response to this call. Such efforts will likely have as limited success as past prevention efforts if the cultural milieu in which sexual partnering practices are located and reproduced remains poorly understood, unaccounted for, and unaddressed in prevention programming. Methods: Focussed ethnographic discussions were held between October 2007 and November 2008 with 228 members of southern African non-government organisations representing seven countries. Discussions formed part of follow-up activities to a high level regional meeting and were aimed at exploring contextual factors in HIV transmission, most especially the role of culture in relation to multiple and concurrent partnerships. Results: Common patterns in cultural scripts for the performance of sexuality were discernable. Several predominant scripts that tend to affirm and lend cultural legitimacy to multiple and concurrent partnering were identified, discussed and analysed. Conclusion: Effectuating change at the level of cultural scripting to discourage multiple and concurrent partnerships is required for sustainable long-term protection of people and communities against HIV. The success of partner reduction programs will be largely determined by the extent to which they are informed by anthropological knowledge and work with cultural logics to allow people to envision how they can transform obstacles into support for risk reduction. (author's) Language: English Keywords: AFRICA, SOUTHERN | CRITIQUE | NONGOVERNMENTAL ORGANIZATIONS | MULTIPLE PARTNERS | CULTURE | HIV PREVENTION | ANTHROPOLOGY, CULTURAL | SEXUALITY | INFIDELITY | SEXUAL ABUSE | RISK REDUCTION BEHAVIOR | WORKSHOPS | Developing Countries | Africa, Sub Saharan | Africa | Organizations | Political Factors | Sociocultural Factors | Sexual Partners | Sex Behavior | Behavior | HIV Infections | Viral Diseases | Diseases | Anthropology | Social Sciences | Science | Personality | Psychological Factors | Crime | Social Problems | Education Document Number: 342231 |
| 12. Peer Reviewed Title: Prevalence and risk factors for Chlamydia trachomatis infection among cross-border truck drivers in Hong Kong. Author: Leung PH; Boost MV; Lau JT; Wong AT; Pang M; Ng TK; Tong ET Source: Sexually Transmitted Infections. 2009 Feb;85(1):27-29. Abstract: Objectives: To determine the prevalence and risk factors for chlamydial infection in cross-border truck drivers. Methods: 225 Hong Kong-based cross-border truck drivers were screened for chlamydial infection. Associations between infection and potential risk factors were determined by questionnaire. Results: 8.5% of drivers were positive for chlamydial infection. Of 62% of drivers reporting recent sex with commercial sex workers (CSW), 39% had not used condoms. 75% of drivers with extramarital sex partners (ESP) also frequented CSW and 47% of this group had not used condoms with CSW. 43.3% PCR-positive cases reported symptoms. No risk factor was associated with chlamydial infection after adjustment, although "had sex with ESP" approached significance. Conclusions: The prevalence of chlamydial infection among cross-border truck drivers was not strikingly high, although drivers engaged in sex with both ESP and CSW, with many admitting unprotected intercourse. The findings highlight the importance of promoting safe sex to truck drivers. Language: English Keywords: HONG KONG | RESEARCH REPORT | EPIDEMIOLOGIC METHODS | CLINICAL RESEARCH | TRUCK DRIVERS | SEX WORKERS | MULTIPLE PARTNERS | BORDER CROSSING | CHLAMYDIA | PREVALENCE | RISK FACTORS | SCREENING | EXTRAMARITAL SEX BEHAVIOR | CONDOM USE | Developed Countries | Asia, Eastern | Asia | Research Methodology | Labor Force | Human Resources | Economic Factors | Sex Behavior | Behavior | Sexual Partners | International Migration | Migration | Population Dynamics | Demographic Factors | Population | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections | Diseases | Measurement | Health | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Risk Reduction Behavior Document Number: 340111 |
| 13. Peer Reviewed Title: Role of widows in the heterosexual transmission of HIV in Manicaland, Zimbabwe, 1998 2003. Author: Lopman BA; Nyamukapa C; Hallett TB; Mushati P; Spark-du Preez N; Kurwa F; Wambe M; Gregson S Source: Sexually Transmitted Infections. 2009 Apr;85(Suppl 1):i41-i48. Abstract: Background: AIDS is the main driver of young widowhood in southern Africa. Methods: The demographic characteristics of widows, their reported risk behaviours and the prevalence of HIV were examined by analysing a longitudinal populationbased cohort of men and women aged 15-54 years in Manicaland, eastern Zimbabwe. The results from statistical analyses were used to construct a mathematical simulation model with the aim of estimating the contribution of widow behaviour to heterosexual HIV transmission. Results: 413 (11.4%) sexually experienced women and 31 (1.2%) sexually experienced men were reported to be widowed at the time of follow-up. The prevalence of HIV was exceptionally high among both widows (61%) and widowers (male widows) (54%). Widows were more likely to have high rates of partner change and engage in a pattern of transactional sex than married women. Widowers took partners who were a median of 10 years younger than themselves. Mathematical model simulations of different scenarios of sexual behaviour of widows suggested that the sexual activity of widow(er)s may underlie 8-17% of new HIV infections over a 20-year period. Conclusions: This combined statistical analysis and model simulation suggest that widowhood plays an important role in the transmission of HIV in this rural Zimbabwean population. High-risk partnerships may be formed when widowed men and women reconnect to the sexual network. Language: English Keywords: ZIMBABWE | RESEARCH REPORT | KAP SURVEYS | COHORT ANALYSIS | MATHEMATICAL MODEL | EPIDEMIOLOGIC METHODS | FOLLOW-UP STUDIES | WIDOWED | WOMEN IN DEVELOPMENT | HETEROSEXUALS | SEX WORKERS | MULTIPLE PARTNERS | HIV INFECTIONS | PREVALENCE | SEX BEHAVIOR | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Surveys | Sampling Studies | Studies | Research Methodology | Theoretical Models | Marital Status | Nuptiality | Demographic Factors | Population | Economic Development | Economic Factors | Behavior | Sexual Partners | Viral Diseases | Diseases | Measurement Document Number: 340106 |
14.  Title: Concurrent sexual partnerships and HIV infection: Evidence from national population-based surveys. Author: Mishra V; Bignami-Van Assche S Source: Calverton, Maryland, Macro International, Demographic and Health Research Division, MEASURE DHS, 2009 Mar. 129 p. (DHS Working Papers No. 62USAID Contract No. CPO-C-00-03-00002-00) Abstract: Knowing the prevalence and correlates of multiple and concurrent sexual partnerships is important for understanding the dynamics of HIV transmission, and thus for developing effective prevention interventions. Although at least a few theoretical models of multiple and concurrent partnerships have been developed, there is little agreement about how to derive empirical measures and how to assess the relationship of multiple and concurrent sexual partnerships with HIV infection. This study takes advantage of self-reported data on sexual partnerships and biomarker data on HIV serostatus that have been collected in recent years from adult women and men (age 15-49) by nationally representative Demographic and Health Surveys (DHS) and AIDS Indicator Surveys (AIS). Using information on up to three of the respondents' most recent sexual partners, we evaluate and compare the prevalence of concurrent sexual partnerships across countries-defining concurrent partnerships as having two or more sexual partners that overlapped in time in the year preceding the survey. We also examine key characteristics of respondents reporting concurrent partnerships in pooled samples for sub-Saharan Africa, and we evaluate the association between concurrency and HIV serostatus at the individual level, after controlling for educational level, wealth status, condom use, male circumcision, and other factors. Finally, we assess the relationship between prevalence of concurrency and HIV prevalence at the community and country levels. We find that men are much more likely than women to have concurrent partners. Our analysis also shows that many reported multiple partnerships in the 12 months preceding the survey interview were not concurrent ones. Finally, very few men had overlapping partners for one year or longer. In the pooled samples for sub-Saharan Africa, we find that urban, more-educated, and wealthier women and men are more likely to have concurrent partnerships than their rural, less-educated, and poorer counterparts. Circumcised men are also more likely to have concurrent partners than uncircumcised men. Those who had concurrent partners are more likely to report using condoms than those who did not have concurrent partners; yet only one-fifth of women and less than one-tenth of men with concurrent partners reported using condoms at last sex. In most countries, at the individual level women and men who had concurrent sexual partners in the previous 12 months were more likely to be HIV-positive than those who had only one lifetime partner, or those who had multiple lifetime partners but no overlapping partners in the previous 12 months. Yet the duration of overlap in concurrent sexual relationships does not seem correlated with the likelihood of HIV infection. At the individual level, in the pooled samples for sub-Saharan Africa, a positive and significant relationship between concurrent sexual partnerships and HIV-positive status is observed for both women (aOR=3.32; 95%CI: 2.22-4.97) and men (aOR=2.87; 95%CI: 1.85-4.45), after adjusting for other factors such as educational level, wealth status, urban/rural residence, and condom use. Among men, controlling for male circumcision has virtually no effect on the adjusted association between sexual concurrency and HIV serostatus (aOR=2.85; 95%CI: 1.84-4.42). In multivariate models, associating one's concurrency behavior with his/her HIV serostatus reveals that the likelihood of HIV infection is only slightly greater among individuals with concurrent partnerships in the previous 12 months (aOR=3.32 for women; aOR=2.87 for men) than among those with multiple lifetime partnerships that were not concurrent in the previous 12 months (but could have been previously) (aOR=2.86 for women; aOR=2.63 for men). This is to be expected because having concurrent partners increases the risk of transmitting HIV infection to the partners, not necessarily one's own risk of infection above the risk of having multiple serial partners. One's own risk may be greater only to the extent his/her concurrency behavior is a proxy for partners' concurrency behavior or belonging to a higher-risk sexual network. The prevalence of sexual concurrency does not seem correlated with HIV prevalence at the community level or at the country level, neither among women nor among men. The associations are even weaker when the prevalence of HIV among women is correlated with the prevalence of concurrency among men, and when the prevalence of HIV among men is correlated with the prevalence of concurrency among women. The lack of a relationship between the prevalence of concurrency and HIV prevalence among men at the community level does not seem due to varying prevalence levels of male circumcision. However, at the country level a stronger association between prevalence of concurrency among men and HIV prevalence emerges in countries with lower prevalence of male circumcision. The study identifies a number of measurement issues and data constraints that limited the scope of our analysis and that should be kept in mind when interpreting the findings and planning future studies. Some of the major limitations of the study include the cross-sectional and self-reported nature of the survey data, the lack of data on complete sexual histories, and the lack of data on sexual networks. Some of these data limitations have already been addressed in more recent DHS and AIS surveys by systematically including questions about the number of the respondent's lifetime sexual partners, and about consistent condom use with all partners (up to three) in the previous 12 months. The measurement of concurrency could be further improved by collecting information on the duration of the sexual relationship with each of the respondent's sexual partners in the previous 12 months, including his/her spousal partners, and by collecting information on the frequency of sexual intercourse during each relationship. Despite the limitations inherent to the measurement of concurrency using self-reported data from cross-sectional population-based surveys, the findings of this study shed new light on the prevalence and correlates of concurrency, as well as on the association between concurrency and HIV. Language: English Keywords: AFRICA, SUB SAHARAN | RESEARCH REPORT | KAP SURVEYS | DEMOGRAPHIC AND HEALTH SURVEYS | EPIDEMIOLOGIC METHODS | MULTIPLE PARTNERS | PERSONS LIVING WITH HIV/AIDS | COMMUNITY | HIV INFECTIONS | PREVALENCE | POLYGAMY | TIME FACTORS | CONDOM USE | Africa | Developing Countries | Surveys | Sampling Studies | Studies | Research Methodology | Demographic Surveys | Population Dynamics | Demographic Factors | Population | Sexual Partners | Sex Behavior | Behavior | Viral Diseases | Diseases | Residence Characteristics | Population Distribution | Geographic Factors | Measurement | Marriage Patterns | Marriage | Nuptiality | Risk Reduction Behavior Document Number: 341092 |
| 15. Title: The role of partner reduction and faithfulness in HIV prevention in Sub-Saharan Africa: evidence from Cameroon, Rwanda, Uganda, and Zimbabwe. Author: Mishra V; Hong R; Assche SB; Barrere B Source: Calverton, Maryland, Macro International, MEASURE DHS, 2009 Jan. 31 p. (USAID Contract No. GPO-C-00-03-00002-00DHS Working Papers No. 61) Abstract: Objectives. We examine patterns of multiple sexual partnerships and partner faithfulness among men, women, and cohabiting couples in four countries in sub-Saharan Africa and assess the association between these behaviors and the risk of HIV infection. Methods. Our data are from nationally-representative surveys conducted during 2004-2006 in Cameroon, Rwanda, Uganda, and Zimbabwe that included HIV testing of adult men and women, using blood specimens analyzed with standard laboratory and quality control procedures. Men and women in a marital/cohabiting union who reported never having had sex with any person other than their current partner(s) are defined as lifetime faithful. Men and women in a marital/cohabiting union who ever had sex with a person other than current their partner(s) but not in the previous 12 months are defined as recently faithful. Lifetime and recent mutual faithfulness among cohabiting couples are similarly defined. Data are analyzed using descriptive and multivariate statistical methods after adjusting for potential confounding factors. Results. Multiple sexual partnerships are common in sub-Saharan Africa. In all four countries considered, the adjusted odds of being HIV-infected increase with the number of lifetime sexual partners and decrease with the level of spousal faithfulness. Similarly, in couples where the partners are not mutually faithful, either or both partners are more likely to be HIV-infected than in couples where both partners are lifetime faithful. Our study finds that men report having more lifetime partners and being less faithful to their spouse(s) than women report. Conclusions. Having fewer lifetime sexual partners and being faithful to spousal partner(s) are strongly associated with reduced risk of HIV infection. Thus, in addition to promoting abstinence until marriage and condom use, especially in higher-risk sex, HIV prevention programs should focus more on promoting partner reduction and partner faithfulness, especially for men. KEYWORDS: faithfulness, multiple sexual partnerships, partner reduction, HIV, AIDS, sub-Saharan Africa. Language: English Keywords: AFRICA, SUB SAHARAN | RESEARCH REPORT | KAP SURVEYS | CROSS-CULTURAL COMPARISONS | DEMOGRAPHIC AND HEALTH SURVEYS | MULTIPLE PARTNERS | SEXUAL PARTNERS | EXTRAMARITAL SEX BEHAVIOR | SAFER SEX | HIV PREVENTION | SEX BEHAVIOR | RISK ASSESSMENT | RISK BEHAVIOR | Africa | Developing Countries | Surveys | Sampling Studies | Studies | Research Methodology | Comparative Studies | Demographic Surveys | Population Dynamics | Demographic Factors | Population | Behavior | HIV Infections | Viral Diseases | Diseases | Evaluation Document Number: 329991 |
| 16. Peer Reviewed Title: Local differences in human immunodeficiency virus prevalence: a comparison of social venue patrons, antenatal patients, and sexually transmitted infection patients in eastern kinshasa. Author: Mwandagalirwa K; Jackson EF; McClamroch K; Bollinger R; Ryder RW; Weir SS Source: Sexually Transmitted Diseases. 2009 Jul;36(7):406-12. Abstract: BACKGROUND: This study compares the sexual behavior and HIV prevalence of men and women at social venues where people meet new sexual partners in Eastern Kinshasa with that of sexually transmitted infection (STI) treatment and antenatal clinic (ANC) patients in the same area. METHODS: ANC patients, STI clinic patients, and social venue patrons were interviewed, asked to provide a blood sample on-site, and provided with information about obtaining test results. Every patron at identified social venues in the study area was invited to participate. RESULTS: One thousand one hundred sixteen pregnant women; 66 male and 229 female STI clinic patients; and 952 male and 247 female patrons of social venues were interviewed and tested for HIV. HIV prevalence differed by group: ANC patients (4%); female venue patrons (12%); female STI patients (16%); male venue patrons (2%); and male STI patients (23%). HIV prevalence among sex workers at social venues (29%) was higher than HIV prevalence among other female patrons with new or multiple partnerships in the past four weeks (19%) and higher than HIV prevalence among female patrons denying sex work (6%). However, the absolute number of infected women was higher among women reporting recent new or multiple partnerships than among the smaller group of sex workers (23 vs. 18). Two-thirds of the infected female STI patients (24/36) reported no more than one and no new sexual partner in the past year. CONCLUSION: Improving prevention programs in Kinshasa is essential. Prevention efforts should not neglect women at social venues who do not self-identify as sex workers but who have high rates of new sexual partnership formation. Language: English Keywords: DEMOCRATIC REPUBLIC OF THE CONGO | RESEARCH REPORT | COMPARATIVE STUDIES | CLIENTS | MULTIPLE PARTNERS | HIV INFECTIONS | PREVALENCE | ANTENATAL CARE | SEXUALLY TRANSMITTED DISEASES | CLINICS | VOLUNTARY COUNSELING AND TESTING | INTERVIEWS | CONDOM USE | Developing Countries | Africa, Central | Africa, Sub Saharan | Africa | Studies | Research Methodology | Program Activities | Programs | Organization and Administration | Sexual Partners | Sex Behavior | Behavior | Viral Diseases | Diseases | Measurement | Maternal Health Services | Maternal-Child Health Services | Primary Health Care | Health Services | Delivery of Health Care | Health | Reproductive Tract Infections | Infections | Health Facilities | HIV Testing | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Data Collection | Risk Reduction Behavior Document Number: 342831 |
| 17. Peer Reviewed Title: Disco funerals: a risk situation for HIV infection among youth in Kisumu, Kenya. Author: Njue C; Voeten HA; Remes P Source: AIDS. 2009 Feb 20;23(4):505-9. Abstract: OBJECTIVE: We investigated the so-called 'disco funeral' phenomenon in Kisumu, Kenya, whereby community members including adolescents congregate at the home of the deceased for several days, accompanied by music and dancing. We explored whether disco funerals are a risk situation for HIV/sexually transmitted infection infection among youth. DESIGN:: Cross-sectional qualitative study. METHODS: We conducted 44 in-depth interviews with male and female adolescents aged 15-20 years in Kisumu municipality in Nyanza Province, Kenya. We also made observations during six disco funerals. RESULTS: Disco funerals were an important place for young people to hang out; they increased the opportunities to meet and engage in (risky) sexual activities. Many adolescents reported having casual sex on these occasions, sometimes with multiple partners, and mostly without condoms. Some girls were forced into sex, and there were several accounts of gang rape. Sex in exchange for money was reported frequently. Drugs and alcohol seemed to facilitate unprotected, multiple-partner, coerced, and transactional sex. CONCLUSION: In Kisumu, a town with a generalized HIV/AIDS epidemic, the high AIDS mortality leads to frequent disco funerals. Because many adolescents are having unprotected, transactional, or coerced sex at these occasions, disco funerals might contribute to the high HIV prevalence among youth, especially among adolescent girls. HIV interventions urgently need to include outreach actions to youth who hang out at disco funerals and link up with parents and funeral organizers to reduce risk situations. Language: English Keywords: KENYA | RESEARCH REPORT | KAP SURVEYS | CROSS SECTIONAL ANALYSIS | ADOLESCENTS | SEX WORKERS | MULTIPLE PARTNERS | DANCING | MUSIC | DEATH | SEX BEHAVIOR | RISK BEHAVIOR | RAPE | CONDOM USE | DRUG USE AND ABUSE | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Surveys | Sampling Studies | Studies | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Behavior | Sexual Partners | Culture | Sociocultural Factors | Mortality | Population Dynamics | Crime | Social Problems | Risk Reduction Behavior Document Number: 341131 |
| 18. Peer Reviewed Title: Efficacy of computer technology-based HIV prevention interventions: a meta-analysis. Author: Noar SM; Black HG; Pierce LB Source: AIDS. 2009 Jan 2;23(1):107-15. Abstract: OBJECTIVES: To conduct a meta-analysis of computer technology-based HIV prevention behavioral interventions aimed at increasing condom use among a variety of at-risk populations. DESIGN: Systematic review and meta-analysis of existing published and unpublished studies testing computer-based interventions. METHODS: Meta-analytic techniques were used to compute and aggregate effect sizes for 12 randomized controlled trials that met inclusion criteria. Variables that had the potential to moderate intervention efficacy were also tested. RESULTS: The overall mean weighted effect size for condom use was d = 0.259 (95% confidence interval = 0.201, 0.317; Z = 8.74, P < 0.001; N = 4639), indicating a statistically significant impact of the interventions. This effect size compares favorably to previously tested interventions delivered by human facilitators. Statistically significant effect sizes were also found for frequency of sexual behavior, number of partners, and incident sexually transmitted diseases. In addition, interventions were significantly more efficacious when they were directed at men or women (versus mixed sex groups), utilized individualized tailoring, used a Stages of Change model, and had more intervention sessions. CONCLUSION: Computer technology-based HIV prevention interventions have similar efficacy to more traditional human-delivered interventions. Given their low cost to deliver, ability to customize intervention content, and flexible dissemination channels, they hold much promise for the future of HIV prevention. Language: English Keywords: UNITED STATES OF AMERICA | LITERATURE REVIEW | CLINICAL RESEARCH | MULTIPLE PARTNERS | COMPUTERS | CONDOM USE | HIV PREVENTION | PROGRAM EFFECTIVENESS | PROGRAM EVALUATION | SAFER SEX | SEX BEHAVIOR | COITAL FREQUENCY | SEXUALLY TRANSMITTED DISEASES | BEHAVIOR CHANGE COMMUNICATION | Developed Countries | North America | Americas | Research Methodology | Sexual Partners | Behavior | Information Processing | Information | Risk Reduction Behavior | HIV Infections | Viral Diseases | Diseases | Programs | Organization and Administration | Reproductive Tract Infections | Infections | Communication Programs | Communication | Behavior Change Document Number: 330258 |
| 19. Title: Risk of sexual HIV transmission among wives left behind and wives of nonmigrant men in rural areas of China. Author: Qin QR; Ji GP; Xu J; Jiang QC; Hong H; Chu XY; Chen R; Ye DQ Source: Journal of the Association of Nurses In AIDS Care. 2009 Jul-Aug;20(4):308-15. Abstract: In rural areas of China where commercial plasma donation used to be common, little is known about sexual behaviors and condom use among wives left behind by migrating husbands and wives of nonmigrant men. This study investigated sexual behaviors and condom use among married women in rural areas of China. A cross-sectional survey was conducted with 1,873 participants recruited by a cluster-sampling method. Study results showed that wives left behind had a significantly lower mean frequency of sexual intercourse with their husbands in the previous month, a higher rate of multiple sexual partners, a higher rate of self-reported HIV infection, and a lower rate of condom use when compared with wives of nonmigrant men. Also, HIV-infected wives left behind who were infected by their husbands had multiple sex partners and did not use condoms consistently. This research provides additional insight that may be used to develop effective HIV prevention strategies in rural areas of China. Language: English Keywords: CHINA | RURAL AREAS | RESEARCH REPORT | COMPARATIVE STUDIES | SAMPLING STUDIES | CURRENTLY MARRIED | WOMEN | MULTIPLE PARTNERS | LABOR MIGRATION | HIV TRANSMISSION | RISK FACTORS | SEX BEHAVIOR | CONDOM USE | SOCIOECONOMIC STATUS | Asia, Eastern | Asia | Developing Countries | Geographic Factors | Population | Studies | Research Methodology | Marital Status | Nuptiality | Demographic Factors | Sexual Partners | Behavior | Migration | Population Dynamics | HIV Infections | Viral Diseases | Diseases | Health | Risk Reduction Behavior | Socioeconomic Factors | Economic Factors Document Number: 342813 |
| 20. Peer Reviewed Title: Correlates of any condom use among Russian narcology patients reporting recent unprotected sex. Author: Raj A; Cheng DM; Krupitsky EM; Coleman S; Bridden C; Samet JH Source: AIDS and Behavior. 2009 Apr;13(2):310-317. Abstract: The purpose of this study was to assess whether HIV/sexually transmitted infection (STI) risk factors: risky sex (multiple sex partners and sex trade involvement), past HIV or STI diagnosis and substance use (at risk drinking and injection drug use) are associated with the outcome any condom use in the past 6 months among Russian narcology hospital patients. Participants (N = 178) included only those who reported unprotected sex in the past 6 months and were aged 18-55 years and 76% male. Any condom use in the past 6 months was reported by 55% of the sample. History of STIs was reported by 43% of participants; 15% were HIV-infected. Regression analyses adjusted for demographics demonstrated that those reporting multiple sex partners (ORadj = 4.2, 95% CI = 2.0-8.7) and sex trade involvement (ORadj = 2.4, 95% CI = 1.1-5.1) in the past 6 months had significantly higher odds of reporting any condom use in this same timeframe. HIV/STI and substance use were not associated with increased odds of condom use. Language: English Keywords: RUSSIA | RESEARCH REPORT | KAP SURVEYS | STATISTICAL REGRESSION | MULTIPLE PARTNERS | SEX WORKERS | IV DRUG USERS | SEX BEHAVIOR | RISK BEHAVIOR | CONDOM USE | DRUG USE AND ABUSE | ALCOHOL USE AND ABUSE | SEX FACTORS | Developing Countries | Asia, Northern | Asia | Surveys | Sampling Studies | Studies | Research Methodology | Data Analysis | Sexual Partners | Behavior | Risk Reduction Behavior | Population Characteristics | Demographic Factors | Population Document Number: 340132 |
| 21. Title: HIV transmission networks. Author: Rothenberg R Source: Current Opinion In HIV and AIDS. 2009 Jul;4(4):260-5. Abstract: PURPOSE OF REVIEW: Over the past several years, one segment of the complex field of HIV transmission dynamics - heterosexual networks - has dominated theoretical and empirical investigation. This review provides an overview of recent work on HIV risks and networks, with a focus on recent findings in heterosexual network dynamics. RECENT FINDINGS: Qualitative (ethnographic) assessments have demonstrated the heterogeneity and complexity of heterosexual connections, particularly in Africa, where tradition, official polygamy, and unofficial multiperson arrangements have lead to concurrency of sexual partnerships. A large, quantitative study on Likoma Island, Malawi, demonstrated the considerable, interlocking sexual connections that arise from a high-concurrency sexual setting, even with a low average number of partnerships (low degree) of long duration. Such settings, as suggested by ethnographic studies, may be common in Africa and, coupled with newer information about transmissibility during acute and early infection, may provide a plausible explanation for endemic transmission and possibly for rapid HIV propagation. SUMMARY: Recognition of high-concurrency, low-degree networks is an important development for understanding HIV transmission dynamics. Their relevance to heterosexual transmission, and possible extension to other epidemiologic settings, reinforces the heterogeneity and complexity of HIV transmission dynamics. Language: English Keywords: GLOBAL | LITERATURE REVIEW | THEORETICAL MODELS | HETEROSEXUALS | HIV TRANSMISSION | EPIDEMIOLOGY | PREVALENCE | RISK FACTORS | SEX BEHAVIOR | MULTIPLE PARTNERS | Research Methodology | Behavior | HIV Infections | Viral Diseases | Diseases | Public Health | Health | Measurement | Sexual Partners Document Number: 342341 |
| 22. Peer Reviewed Title: Demographic and behavioral factors associated with HIV testing in China [letter] Author: Rou K; Guan J; Wu Z; Li L; Rotheram MJ; Detels R; Wen Y; Lin C; Cao H Source: JAIDS. Journal of Acquired Immune Deficiency Syndromes. 2009 Apr 1;50(4):432-4. Abstract: Language: English Keywords: CHINA | RESEARCH REPORT | KAP SURVEYS | MULTIVARIATE ANALYSIS | MULTIPLE PARTNERS | HIV TESTING | VOLUNTARY COUNSELING AND TESTING | DEMOGRAPHIC FACTORS | RISK BEHAVIOR | SEX BEHAVIOR | ALCOHOL USE AND ABUSE | STIGMA | PREVALENCE | SOCIOECONOMIC FACTORS | Asia, Eastern | Asia | Developing Countries | Surveys | Sampling Studies | Studies | Research Methodology | Data Analysis | Sexual Partners | Behavior | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Population | Social Problems | Sociocultural Factors | Measurement | Economic Factors Document Number: 330980 |
| 23. Peer Reviewed Title: Commentary on "Prevalence and risk factors for Chlamydia trachomatis infection among cross-border truck drivers in Hong Kong". Author: Sorensen W Source: Sexually Transmitted Infections. 2009 Feb;85(1):29-30. Abstract: The report by Leung et al1 highlights many dimensions of concern from the global perspective of sexually transmitted infection (STI) control, while investigating only Chlamydia trachomatis infection among Hong Kong truckers. This is the only truck driver study, to my knowledge, focused solely on chlamydia infection and its determinants. Because of their screening procedure, one third of the truckers accessed their results-unprecedented for men in this occupation. Of course, the problematical characteristic of chlamydia infection is its asymptomatic status, thereby reducing the impetus to seek testing. This probably contributes to the moderate to high rates of infection (estimated at 89 million new cases annually)2 experienced globally. .... The report by Leung et al1 failed to uncover any significant behavioural or demographic information associated with chlamydia infection among truckers. Yet this null finding informs us, for China is the latest and largest theatre under the spotlight of global STI concern. Chlamydia infection in China "is both a danger in itself and a marker of possible paths of the HIV/AIDS epidemic as it moves into heterosexual transmission networks".5 The chlamydia epidemic in China may already be generalised to the point that risk categories can be misinterpreted if they do surface from analysis. A more fundamental question is whether the traditional categories of FSW or MSM are oversimplified. The challenge to health experts is to continue to tease apart this complexity in order to address prevention efforts. (excerpt) Language: English Keywords: HONG KONG | RESEARCH REPORT | CRITIQUE | EPIDEMIOLOGIC METHODS | CLINICAL RESEARCH | TRUCK DRIVERS | SEX WORKERS | MULTIPLE PARTNERS | BORDER CROSSING | CHLAMYDIA | PREVALENCE | RISK FACTORS | SCREENING | EXTRAMARITAL SEX BEHAVIOR | CONDOM USE | Developed Countries | Asia, Eastern | Asia | Research Methodology | Labor Force | Human Resources | Economic Factors | Sex Behavior | Behavior | Sexual Partners | International Migration | Migration | Population Dynamics | Demographic Factors | Population | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections | Diseases | Measurement | Health | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Risk Reduction Behavior Document Number: 340112 |
| 24. Peer Reviewed Title: Prevalence, correlates, and sexually transmitted infection risk related to coitus interruptus among African-American adolescents. Author: Sznitman SR; Romer D; Brown LK; DiClemente RJ; Valois RF; Vanable PA; Carey MP; Stanton B Source: Sexually Transmitted Diseases. 2009 Apr;36(4):218-20. Abstract: "Coitus interruptus" or withdrawal that involves the male partner "pulling out" before ejaculation, has received relatively little research attention, particularly in adolescents. The limited data that exist suggest that it is practiced among adolescents, yet its prevalence remains unclear. In a research trial developed to test the efficacy of a sexually transmitted infection (STI)/HIV prevention program among black adolescents, we were surprised to see extensive use of withdrawal (60% prevalence). Because black adolescents are disproportionately affected by the intersecting epidemics of HIV and other STIs, the practice of withdrawal may pose a particular risk practice for this population. Therefore, we examined 3 questions: (1) what are the correlates of withdrawal use among black adolescents, (2) how widespread is the combined use of withdrawal and condoms, and (3) what is the contribution of withdrawal to STI acquisition? (excerpt) Language: English Keywords: UNITED STATES OF AMERICA | RESEARCH REPORT | EPIDEMIOLOGIC METHODS | CLINICAL RESEARCH | BLACKS | ADOLESCENTS | MULTIPLE PARTNERS | PREVALENCE | SEXUALLY TRANSMITTED DISEASES | WITHDRAWAL | SEX FACTORS | CONDOM USE | Developed Countries | North America | Americas | Research Methodology | Ethnic Groups | Cultural Background | Population Characteristics | Demographic Factors | Population | Youth | Age Factors | Sexual Partners | Sex Behavior | Behavior | Measurement | Reproductive Tract Infections | Infections | Diseases | Family Planning, Behavioral Methods | Family Planning | Risk Reduction Behavior Document Number: 341120 |
| 25. Peer Reviewed Title: Reported number of sexual partners: comparison of data from four African longitudinal studies. Author: Todd J; Cremin I; McGrath N; Bwanika JB; Wringe A; Marston M; Kasamba I; Mushati P; Lutalo T; Hosegood V; Zaba B Source: Sexually Transmitted Infections. 2009 Apr;85(Suppl 1):i72-i80. Abstract: Objective: To compare reported numbers of sexual partners in Eastern and Southern Africa. Methods: Sexual partnership data from four longitudinal population-based surveys (1998-2007) in Zimbabwe, Uganda and South Africa were aggregated and overall proportions reporting more than one lifetime sexual partner calculated. A lexis-style table was used to illustrate the average lifetime sexual partners by site, sex, age group and birth cohort. The male-to-female ratio of mean number of partnerships in the last 12 months was calculated by site and survey. For each single year of age, the proportion sexually active in the past year, the mean number of partners in the past year and the proportion with more than one partner in the past year were calculated. Results: Over 90% of men and women between 25 and 45 years of age reported being sexually active during the past 12 months, with most reporting at least one sexual partner. Overall, men reported higher numbers of lifetime sexual partners and partners in the last year than women. The male-to-female ratio of mean partnerships in the last year ranged from 1.41 to 1.86. In southern African cohorts, individuals in later birth cohorts reported fewer sexual partners and a lower proportion reported multiple partnerships compared with earlier birth cohorts, whereas these behavioural changes were not observed in the Ugandan cohorts. Across the four sites, reports of sexual partnerships followed a similar pattern for each sex. Conclusions: The longitudinal results show that reductions in the number of partnerships were more evident in southern Africa than in Uganda. Language: English Keywords: AFRICA, SUB SAHARAN | RESEARCH REPORT | KAP SURVEYS | LONGITUDINAL STUDIES | COHORT ANALYSIS | CROSS-CULTURAL COMPARISONS | SEXUAL PARTNERS | MULTIPLE PARTNERS | SEX FACTORS | AGE FACTORS | Africa | Developing Countries | Surveys | Sampling Studies | Studies | Research Methodology | Comparative Studies | Sex Behavior | Behavior | Population Characteristics | Demographic Factors | Population Document Number: 340110 |
| 26. Peer Reviewed Title: Multiple sex partner behavior in female undergraduate students in China: a multi-campus survey. Author: Yan H; Chen W; Wu H; Bi Y; Zhang M; Li S; Braun KL Source: BMC Public Health. 2009;9(305):1-11. Abstract: A total of 4,769 unmarried female undergraduates completed anonymous questionnaires. These students were recruited using randomized cluster sampling by type of university and students' major and grade. Data gathered included information about how demographics, families, peers, work, and other factors (major, academic performance, and sex-related knowledge and attitudes) influence risk behavior. Approximately 18% (n=863) of the students reported ever having sexual intercourse, and 5.3% reported having multiple sex partners (29.3% of all women having sexual intercourse). Several demographic, family, peer and work influences, and student factors were risk factors for ever having sex. However, risk factors for multiple sex partners only included working in a place of entertainment, having current close friends that were living with boyfriends, poor academic performance, and positive attitudes toward multiple partners. These women also were more likely to practice masturbation, start having sex at a younger age, have sex with married men or men not their "boyfriends" at first coitus, and not use condoms consistently. Language: English Keywords: CHINA | RESEARCH REPORT | SAMPLING STUDIES | STUDENTS | MULTIPLE PARTNERS | SEX BEHAVIOR | CONDOM USE | ATTITUDES | QUESTIONNAIRES | Asia, Eastern | Asia | Developing Countries | Studies | Research Methodology | Education | Sexual Partners | Behavior | Risk Reduction Behavior | Psychological Factors Document Number: 339910 |
| 27. Peer Reviewed Title: Influence of timing of sexual debut and first marriage on sexual behaviour in later life: findings from four survey rounds in the Kisesa cohort in northern Tanzania. Author: Zaba B; Isingo R; Wringe A; Marston M; Slaymaker E; Urassa M Source: Sexually Transmitted Infections. 2009 Apr;85(Suppl 1):i20-i26. Abstract: The authors evaluated reports on age at first sex (AFS) and age at first marriage (AFM) from a Kisesa cohort study, 1994-2004, for consistency and for trends in median age-at-event and time spent single but sexually active in different birth cohorts. The association of these variables with marital stability and numbers of partners at later ages was explored using statistical regression techniques. Age at first sex and AFM were inconsistently reported by 32% and 33% of respondents, respectively, but there was no general tendency to report lower or higher ages at a later report date. In 10-year birth cohorts born between 1950-1959 and 1980-1989, male median AFS declined from 18.1 to 17.0 years and female median AFM rose from 16.2 to 16.6 years. Young people of both sexes currently spend longer time sexually active but unmarried than previously. Early marriage is statistically associated with remarriage and polygamy; longer time between sexual debut and marriage is associated with higher numbers of partners at later stages of life. Inconsistent reporting of age-at-event introduces noise but does not bias estimates of population-level indicators. Lengthening time spent single and sexually active suggests that men and women entering first marriage will have been exposed to increased numbers of non-marital partners. Successful youth interventions may also influence adult behavior. Language: English Keywords: TANZANIA | RESEARCH REPORT | METHODOLOGICAL STUDIES | STATISTICAL REGRESSION | KAP SURVEYS | COHORT ANALYSIS | YOUTH | MULTIPLE PARTNERS | SEX BEHAVIOR | FIRST INTERCOURSE | MARRIAGE | AGE FACTORS | DATA QUALITY | MARRIAGE AGE | TIME FACTORS | Developing Countries | Africa, Eastern | Africa, Sub Saharan | Africa | Studies | Research Methodology | Data Analysis | Surveys | Sampling Studies | Population Characteristics | Demographic Factors | Population | Sexual Partners | Behavior | Nuptiality | Marriage Patterns | Population Dynamics Document Number: 340103 |
| 28. Peer Reviewed Title: Survey of motivation for use of voluntary counseling and testing services for HIV in a high risk area of Shenyang, China. Author: Zhou L; Guo J; Fan L; Tian J; Zhou B Source: BMC Health Services Research. 2009;9:23. Abstract: BACKGROUND: HIV voluntary counseling and testing (VCT) is considered an effective prevention method of HIV infection. In order to understand the VCT environment and enhance the effective delivery of VCT services in a country, an accurate assessment of the current status of VCT services is very important. METHODS: From July 2006 to June 2007, we conducted a cross-sectional survey using a face to face interview among 2676 VCT clients from a high risk area in Shenyang city, China. RESULTS: The major demographic characteristics among 2,676 VCT clients were: 41.1% were in the age range 20 to 30 years; 73.1% were males; and 67.1% had attained the level of junior high school education. The primary information source for VCT services was mass media like television (TV) and newspaper in 88.9%. 34.3% were afraid of the result of infection which was the main barrier to accept VCT services among 540 participants answering the question. 75.2% were motivated by recently acquired knowledge about HIV. 47.9% had 3 or more male sex partners, 62.3% had used condoms sometimes, and 14.5% had been infected with a STD. 2.8% of the participants identified themselves as men who have sex with men (MSM). The main demographic characteristics of MSM did not differ from the total group of participants except with respect to age: 63.5% reported having one male sex partner in the preceding 12 months, 44.6% reported never using condoms in the preceding 12 months, and only 2.7% reported a history of sexually transmitted disease. CONCLUSION: Public education offered by health workers in hospitals, private clinics and other medical institutions needs to be strengthened. Given the results from this study, we recommend: (1) making VCT a routine part of health services, especially in areas where many high-risk individuals live; (2) improving the information sources and increasing the understanding of HIV and HIV-infected individuals; (3) enhancing international collaboration in strategic planning, technical assistance, and protocols to translate policy into effective action; (4) supporting Chinese non-government organizations (NGOs) in playing a significant role in the battle against AIDS. Language: English Keywords: CHINA | RESEARCH REPORT | KAP SURVEYS | CROSS SECTIONAL ANALYSIS | MEN HAVING SEX WITH MEN | MULTIPLE PARTNERS | MOTIVATION | VOLUNTARY COUNSELING AND TESTING | MASS MEDIA | INFORMATION SOURCES | FEAR | KNOWLEDGE | CONDOM USE | Asia, Eastern | Asia | Developing Countries | Surveys | Sampling Studies | Studies | Research Methodology | Sex Behavior | Behavior | Sexual Partners | Psychological Factors | HIV Testing | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Communication | Information | Emotions | Sociocultural Factors | Risk Reduction Behavior Document Number: 330989 |
| 29. Title: HIV / AIDS in Haiti: Key findings of the Mortality, Morbidity, and Utilization of Services Survey, EMMUS-IV, 2005-2006. VIH / sida en Haiti. Resultats de Enquete Mortalite, Morbidite et Utilisation des Services, EMMUS-IV, 2005-2006. Author: Macro International. MEASURE DHS Source: Calverton, Maryland, Macro International, MEASURE DHS, [2008]. [26] p. Abstract: The Mortality, Morbidity, and Utilization of Services Survey (Enquete Mortalite, Morbidite et Utilisation des Services en Haiti), or EMMUS-IV, was carried out on a nationally representative sample. It is the fourth survey of its kind in Haiti and it updates the health and demographic indicators collected during the previous surveys of 1994-1995 and 2000. EMMUS-IV field staff interviewed approximately 10,000 households between October 2005 and June 2006, including 10,000 women between the ages of 15 and 49 and 5,000 men between the ages of 15 and 59. The data are representative at the national level, for urban and rural residence, for the Capital Area, and for all administrative departments (North, North-East, North-West, Center, Artibonite, South, South-East, Grande-Anse, Nippes, and West excluding the Capital Area of greater Port-au-Prince). In the course of the EMMUS-IV, approximately 10,000 respondents agreed to provide a small blood sample for an anonymous HIV test. The results of this test were used to estimate HIV prevalence in the general population. This report presents survey findings on HIV prevalence in Haiti and other related results, including knowledge of HIV/AIDS, attitudes toward people living with HIV, and sexual behavior. (excerpt) Language: EnglishFrench Keywords: HAITI | TECHNICAL REPORT | DEMOGRAPHIC AND HEALTH SURVEYS | HIV INFECTIONS | PREVALENCE | HIV | AIDS | KNOWLEDGE | PERSONS LIVING WITH HIV/AIDS | ATTITUDES | STIGMA | SEX BEHAVIOR | RISK BEHAVIOR | MULTIPLE PARTNERS | CONDOM USE | VOLUNTARY COUNSELING AND TESTING | ORPHANS AND VULNERABLE CHILDREN | Developing Countries | Caribbean | Americas | Demographic Surveys | Population Dynamics | Demographic Factors | Population | Viral Diseases | Diseases | Measurement | Research Methodology | Sociocultural Factors | Psychological Factors | Behavior | Social Problems | Sexual Partners | Risk Reduction Behavior | HIV Testing | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Family and Household Document Number: 327001 |
| 30. Title: HIV risk behaviors of Latin American and Caribbean men who have sex with men in Miami, Florida, USA. Author: Akin M; Fernandez MI; Bowen GS; Warren JC Source: Revista Panamericana de Salud Pública / Pan American Journal of Public Health. 2008 May 20;23(5):341-348. Abstract: The goal of this study is to describe the sexual practices, drug use behaviors, psychosocial factors, and predictors of unprotected anal intercourse (UAI) in a sample of Hispanic men who have sex with men (MSM) born in Latin American and Caribbean (LAC) countries who currently reside in Miami-Dade County, Florida. Hispanic MSM (N = 566) recruited from community and Internet venues completed a computer-assisted self-interview assessing sociodemographic factors, drug use, sexual behaviors, and psychosocial factors. We focused on the 470 men who were born in LAC countries, including Puerto Rico. We first examined separately, by country of origin, the sexual practices, drug use behaviors, and psychosocial factors of the sample. We then collapsed the groups and examined the factors associated with UAI in the previous 6 months for the entire sample of Hispanic MSM from LAC countries. In the previous 6 months, 44% of the sample engaged in UAI, and 41% used club drugs. At the multivariate level, psychological distress, higher number of sexual partners, club drug use, HIV-positive status at the time of immigration, and greater orientation to American culture were significantly associated with UAI in the previous 6 months. Many MSM born in LAC countries engage in HIV-related risk behaviors in the AIDS epicenter of Miami-Dade County, Florida. Culturally appropriate interventions should address these risk behaviors in this underserved population. (author's) Language: English Keywords: FLORIDA | CARIBBEAN | |