1.  Peer Reviewed Title: Changes in sexual behavior following a sex education program in Brazilian public schools. Mudancas no comportamento sexual de adolescentes de escolas publicas no Brasil apos um programa de educacao sexual. Author: Andrade HH; de Mello MB; Sousa MH; Makuch MY; Bertoni N; Faundes A Source: Cadernos de Saude Publica. 2009 May;25(5):1168-1176. Abstract: This paper describes an evaluation of possible changes in sexual behavior in adolescents who participated in a school-based sex education program in selected public schools in four municipalities in the state of Minas Gerais, Brazil. The program, given within the context of reproductive rights, dealt with risks involved in unsafe sexual practices, and focused on the positive aspects of sexuality. A quasi-experimental design with pre- and post-tests and a nonequivalent control group was used to evaluate the intervention. A total of 4,795 questionnaires were included in this analysis. The program succeeded in more than doubling consistent condom use with casual partners and in increasing the use of modern contraceptives during last intercourse by 68%. The intervention had no effect on age at first intercourse or on adolescents' engagement in sexual activities. The sex education program was effective in generating positive changes in the sexual behavior of adolescents, while not stimulating participation in sexual activities. Language: Portuguese Keywords: BRAZIL | RESEARCH REPORT | SECONDARY SCHOOLS | ADOLESCENTS | SEX EDUCATION | PARTICIPATION | CHANGES | SEX BEHAVIOR | REPRODUCTIVE RIGHTS | SEXUALITY | RISK REDUCTION BEHAVIOR | CONDOM USE | PROGRAM EVALUATION | South America, Eastern | South America | Latin America | Americas | Developing Countries | Schools | Education | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Social Behavior | Behavior | Social Change | Sociocultural Factors | Human Rights | Political Factors | Personality | Psychological Factors | Programs | Organization and Administration Document Number: 340176 |
| 2. Title: Knowledge and practice of university students in Lebanon regarding contraception. Author: Barbour B; Salameh P Source: Eastern Mediterranean Health Journal. 2009 Mar-Apr;15(2):387-99. Abstract: We evaluated knowledge and practice of Lebanese university students regarding contraception in a cross-sectional, comparative study on students in public and private universities using an Arabic language self-administered questionnaire. We found low levels of knowledge of contraception. The majority of males (73.3%) and a few females (21.8%) declared previous sexual relations: the majority of males had used a condom (86.1%), but females had generally not used contraceptives (75.6%). Language: English Keywords: LEBANON | RESEARCH REPORT | COMPARATIVE STUDIES | STUDENTS | MEN | UNIVERSITIES | KNOWLEDGE | CONTRACEPTION | CONDOM USE | RISK REDUCTION BEHAVIOR | SEX BEHAVIOR | Middle East | Developing Countries | Studies | Research Methodology | Education | Demographic Factors | Population | Schools | Sociocultural Factors | Family Planning | Behavior Document Number: 341713 |
| 3. Peer Reviewed Title: Behavioral mechanisms in HIV epidemiology and prevention: past, present, and future roles. Author: Bingenheimer JB; Geronimus AT Source: Studies in Family Planning. 2009 Sep;40(3):187-204. Abstract: In the 1980’s behavioral variations across geographically and socially defined populations were the central focus of AIDS research, and behavior change was seen as the primary means of controlling HIV epidemics. Today, biological mechanisms-especially other sexually transmitted infections, antiretroviral therapy, and male circumcision-predominate in HIV epidemiology and prevention. We describe several reasons for this shift in emphasis. Although the shift is understandable, we argue for a sustained focus on behavioral mechanisms in HIV research in order to realize the theoretical promise of interventions targeting the biological aspects of HIV risk. We also provide evidence to suggest that large reductions in HIV prevalence may be accomplished by small changes in behavior. Moreover, we contend that behavioral mechanisms will find their proper place in HIV epidemiology and prevention only when investigators adopt a conceptual model that treats prevalence as a determinant as well as an outcome of behavior and that explicitly recognizes the dynamic interdependence between behavior and other epidemiological and demographic parameters. Language: English Keywords: AFRICA, SUB SAHARAN | RESEARCH REPORT | CROSS-CULTURAL COMPARISONS | EPIDEMIOLOGY | BEHAVIOR CHANGE | HIV INFECTIONS | RISK REDUCTION BEHAVIOR | HIV PREVENTION | ANTIRETROVIRAL THERAPY | MALE CIRCUMCISION | Africa | Developing Countries | Comparative Studies | Studies | Research Methodology | Public Health | Health | Behavior | Viral Diseases | Diseases | HIV | Medical Procedures | Medicine | Health Services | Delivery of Health Care Document Number: 339701 |
| 4. Title: What do sexually active adolescent females say about relationship issues? Author: Bralock A; Koniak-Griffin D Source: Journal of Pediatric Nursing. 2009 Apr;24(2):131-40. Abstract: Many sexually active teenagers face risk for contracting sexually transmitted infections (STIs) including HIV. The purpose of our study was to gain an understanding about influences on condom use among sexually active adolescents in relationships. Data were collected through semi-structured openended interviews. The findings of this study suggest that many adolescents desired the love of a male partner, and were willing to concede to his request of practicing unprotected sex. Findings support the urgent need for interventions that will promote skill-building techniques to negotiate safer sex behaviors among youth who are most likely to be exposed to STIs through risky behaviors. Language: English Keywords: UNITED STATES OF AMERICA | RESEARCH REPORT | INTERVIEWS | ADOLESCENTS | COUPLES | BLACKS | SEX BEHAVIOR | SEXUALLY TRANSMITTED DISEASES | NEEDS | CONDOM USE | RISK REDUCTION BEHAVIOR | RISK BEHAVIOR | Developed Countries | North America | Americas | Data Collection | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Family Characteristics | Family and Household | Sociocultural Factors | Ethnic Groups | Cultural Background | Behavior | Reproductive Tract Infections | Infections | Diseases | Economic Factors Document Number: 342095 |
| 5. Peer Reviewed Title: Patterns of Self-reported Behaviour Change Associated with Receiving Voluntary Counselling and Testing in a Longitudinal Study from Manicaland, Zimbabwe. Author: Cremin I; Nyamukapa C; Sherr L; Hallett TB; Chawira G; Cauchemez S; Lopman B; Garnett GP; Gregson S Source: AIDS and Behavior. 2009 Jul 22; Abstract: Voluntary counselling and testing (VCT) is promoted as a potential HIV prevention measure. We describe trends in uptake of VCT for HIV, and patterns of subsequent behaviour change associated with receiving VCT in a population-based open cohort in Manicaland, Zimbabwe. The relationship between receipt of VCT and subsequent reported behaviour was analysed using generalized linear models with random effects. At the third survey, 8.6% of participants (1,079/12,533), had previously received VCT. Women who received VCT, both those positive and negative, reduced their reported number of new partners. Among those testing positive, this risk reduction was enhanced with time since testing. Among men, no behavioural risk reduction associated with VCT was observed. Significant increases in consistent condom use, with regular or non-regular partners, following VCT, were not observed. This study suggests that, among women, particularly those who are infected, behavioural risk reduction does occur following VCT. Language: English Keywords: ZIMBABWE | RESEARCH REPORT | LONGITUDINAL STUDIES | RURAL POPULATION | HIV PREVENTION | VOLUNTARY COUNSELING AND TESTING | BEHAVIOR CHANGE | RISK REDUCTION BEHAVIOR | CONDOM USE | SEX BEHAVIOR | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Studies | Research Methodology | Population Characteristics | Demographic Factors | Population | HIV Infections | Viral Diseases | Diseases | HIV Testing | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Behavior Document Number: 342278 |
| 6. Title: Factor structure of the Condoms Barriers Scale with a sample of men at high risk for HIV. Author: Doyle SR; Calsyn DA; Ball SA Source: Assessment. 2009 Mar;16(1):3-15. Abstract: This study assesses the psychometric properties of the Condom Barriers Scale (CBS), an instrument originally designed to measure women's perceptions and attitudes regarding male condom use, with a sample of men at high risk for human immunodeficiency virus (HIV). Participants include 590 male patients in drug abuse treatment involved in a gender-specific HIV prevention intervention for teaching safer sex skills. Second-order confirmatory factor analysis generally supported the underlying four-factor subscale structure of the CBS. However, exploratory factor analysis revealed a few specific discrepancies in the factor structure between men and women. Internal consistency and test-retest reliability estimates were moderate to high in value. CBS scores correlated with use of condoms for men with high-risk sexual partners, supporting criterion-related validity. Overall, the analysis indicates that the CBS is a potentially valid and reliable instrument and has utility for assessing barriers to condom use with men, but may need some item content modifications to allow appropriate assessment of gender differences and comparisons across studies. Language: English Keywords: UNITED STATES OF AMERICA | RESEARCH REPORT | DATA ANALYSIS | RELIABILITY | PRE-POST TESTS | MEN | CONDOMS | SEX EDUCATION | RISK REDUCTION BEHAVIOR | BARRIER METHODS | PREVENTION AND CONTROL | Developed Countries | North America | Americas | Research Methodology | Measurement | Program Evaluation | Programs | Organization and Administration | Demographic Factors | Population | Contraceptive Methods | Contraception | Family Planning | Education | Behavior | Diseases Document Number: 330489 |
| 7. Peer Reviewed Title: Predicting preparatory behaviours for condom use in female undergraduate students: a one-year follow-up study. Author: Gebhardt WA; van Empelen P; van Beurden D Source: International Journal of STD and AIDS. 2009 Mar;20(3):161-4. Abstract: The objective of this study is to investigate whether the Theory of Planned Behaviour (i.e. attitude, subjective norm, perceived behavioural control and intention), fluctuations in motivation over time, and variables from the Prototype-Willingness Model (i.e. behavioural expectation and behavioural willingness to have unprotected sex) predict preparatory behaviours for condom use. Sixty-two female undergraduates completed baseline and one-year follow-up questionnaires. Having condoms at home and carrying condoms were predicted by behavioural willingness to have unsafe sex at baseline. Having bought condoms was predicted by the behavioural expectation to use condoms with new partners at baseline. Intention and fluctuations in motivation did not emerge as significant predictors of preparatory actions. Female undergraduates, who are more willing to have unprotected sex under risk-conducive circumstances, are also less likely to prepare adequately for condom use, and thereby increase their chances of encountering such situations. Overall, the findings are in support of the Prototype-Willingness Model. Language: English Keywords: NETHERLANDS | RESEARCH REPORT | PROSPECTIVE STUDIES | YOUTH | WOMEN | CONDOM USE | RISK REDUCTION BEHAVIOR | SEX EDUCATION | MOTIVATION | SEX BEHAVIOR | Developed Countries | Europe, Western | Europe | Studies | Research Methodology | Age Factors | Population Characteristics | Demographic Factors | Population | Behavior | Education | Psychological Factors Document Number: 330465 |
| 8. 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 |
| 9. Peer Reviewed Title: HIV/AIDS behavioral interventions in China: a literature review and recommendation for future research. Author: Hong Y; Li X Source: AIDS and Behavior. 2009 Jun;13(3):603-13. Abstract: In the past two decades, China has witnessed an alarming increase of HIV/AIDS epidemic. Meanwhile, a number of HIV prevention interventions have been conducted. This study reviews existing studies in literature on behavioral interventions on HIV/AIDS in China. Of 25 studies we identified, most have been concentrated in South and South-West China, mainly targeting injection drug users and female sex workers. The most commonly used intervention strategy was individual-oriented HIV-related knowledge education and behavioral skill training. All studies reported positive intervention effects including improved HIV-related knowledge, increased condom use, reduced needle sharing, and reduced STI. Literature also suggests a lack of intervention among other at-risk populations such as MSM, migrant workers, and non-injecting drug users, lack of studies with rigorous evaluation design, inadequate follow-up, limited outcome measurement, and lack of multi-faceted structural interventions. The existing intervention studies document strong evidence of controlling HIV/AIDS epidemic through effective behavioral intervention. More efforts are needed to control the growing HIV/AIDS epidemic in China. Future studies need to employ more rigorous methodology and incorporate environmental or structural factors for different populations at risk of HIV infection in China. Language: English Keywords: CHINA | LITERATURE REVIEW | IV DRUG USERS | SEX WORKERS | EPIDEMICS | HIV PREVENTION | AIDS PREVENTION | INTERVENTIONS | HEALTH EDUCATION | KNOWLEDGE | RISK REDUCTION BEHAVIOR | Asia, Eastern | Asia | Developing Countries | Drug Use and Abuse | Behavior | Sex Behavior | Diseases | HIV Infections | Viral Diseases | AIDS | Programs | Organization and Administration | Education | Sociocultural Factors Document Number: 342110 |
| 10. Peer Reviewed Title: Needle exchange and sexual risk behaviors among a cohort of injection drug users in Chicago, Illinois. Author: Huo D; Ouellet LJ Source: Sexually Transmitted Diseases. 2009 Jan;36(1):35-40. Abstract: OBJECTIVE: To examine the impact of a needle exchange program (NEP) on sexual risk behaviors of injecting drug users (IDUs). METHODS:: Between 1997 and 2000, 889 IDUs in Chicago were recruited from NEPs and an area with no NEP into a cohort study. They were interviewed and tested for HIV at baseline and 3 annual follow-up visits. Random-effect logistic models were used to compare NEP users and nonusers regarding the number of sex partners, number of unprotected sex acts, and frequency of condom use. RESULTS: Compared to NEP nonusers, NEP users had a similar number of sex partners over time, but had 49% higher odds of using condoms with their main partners (P = 0.047). At baseline, there was no difference between NEP users and nonusers in episodes of vaginal intercourse, but over time the odds of having a higher number of unprotected instances of vaginal intercourse were reduced by 26% per year for NEP users but only 10% per year for nonusers (P = 0.02). CONCLUSION: This study suggests that NEP participation may help reduce the absolute risk of HIV sexual transmission. Language: English Keywords: UNITED STATES OF AMERICA | ILLINOIS | RESEARCH REPORT | COHORT ANALYSIS | IV DRUG USERS | NEEDLE CLEANING | RISK REDUCTION BEHAVIOR | SEX BEHAVIOR | PROGRAM ACTIVITIES | Developed Countries | North America | Americas | Research Methodology | Drug Use and Abuse | Behavior | Hygiene | Public Health | Health | Programs | Organization and Administration Document Number: 329738 |
| 11. Peer Reviewed Title: Association Between Testing for Human Immunodeficiency Virus and Changes in Risk Behaviors Among Injecting Drug Users in Southern China. Author: Jin X; Smith K; Sun Y; Ding G; Yao Y; Xu J; Chang D; Wang G; Zhu Y; Wang N Source: Sexually Transmitted Diseases. 2009 May 18; Abstract: BACKGROUND:: There is growing need for research in China regarding posttest risk behavior differences among injecting drug users that explores the effect of various testing modes (nonvoluntary vs. voluntary) and other related factors on changes in posttest risk behaviors. METHODS:: One hundred seventy-two study subjects self-reported human immunodeficiency virus (HIV)-related personal risk behaviors including condom use rates and needle-sharing habits. Fisher exact test and multivariate regression analysis compared the impact of HIV testing mode on ongoing risk behaviors for HIV transmission. RESULTS:: The study found that those who received positive test results were 5.37 times more likely to increase condom use with regular sexual partners, that men were 8.8 times more likely than women to increase posttest condom use in commercial sexual activities. Needle-sharing behavior was significantly lower for subjects who tested HIV-positive (odds ratio [OR]: 4.5), who notified sexual partners of test results (OR: 0.03), and who had tested voluntarily (OR: 0.04). CONCLUSION:: Based on the study results this report concludes that voluntary HIV testing and encouragement of partner notification of test results should be incorporated into China's national testing strategy. Language: English Keywords: CHINA | RESEARCH REPORT | KAP SURVEYS | MULTIVARIATE ANALYSIS | IV DRUG USERS | SEX WORKERS | HIV TESTING | RISK REDUCTION BEHAVIOR | HIV TRANSMISSION | CONDOM USE | NEEDLE SHARING | SEX FACTORS | VOLUNTARY COUNSELING AND TESTING | NOTIFICATION | PARTNER COMMUNICATION | Asia, Eastern | Asia | Developing Countries | Surveys | Sampling Studies | Studies | Research Methodology | Data Analysis | Drug Use and Abuse | Behavior | Sex Behavior | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | HIV Infections | Viral Diseases | Diseases | Risk Behavior | Population Characteristics | Demographic Factors | Population | Political Factors | Sociocultural Factors | Interpersonal Relations Document Number: 341498 |
12.  Title: Girls’ success: Mentoring guide for life skills. Author: Kays L Source: Washington, D.C., Academy for Educational Development [AED], Center for Gender Equity, 2009. [115] p. Abstract: This guide discusses mentoring girls to help them develop important life skills. Some of the topics covered include healthy living, inner strength, making good choices, reproductive health, and sexuality. The guide provides discussion questions about each topic and learning activities that can be conducted in mentoring sessions or when girls are in school or with their families. Language: English Keywords: DEVELOPING COUNTRIES | SUMMARY REPORT | ADOLESCENTS, FEMALE | REPRODUCTIVE HEALTH | HUMAN RIGHTS | SEXUALITY | PUBERTY | NUTRITION | RISK REDUCTION BEHAVIOR | HYGIENE | DIET | SANITATION | WATER QUALITY | QUALITY OF LIFE | COUNSELING | Adolescents | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Health | Political Factors | Sociocultural Factors | Personality | Psychological Factors | Behavior | Reproduction | Public Health | Water | Natural Resources | Environment | Social Welfare | Economic Factors | Clinic Activities | Program Activities | Programs | Organization and Administration Document Number: 331823 |
| 13. Title: A pilot study of HIV education on readiness to change on substance use, AIDS knowledge, self-efficacy for risk reduction among male drug-dependent inmates. Author: Ko NY; Hsu ST; Chen CH; Tsai CY; Chu PJ; Huang CJ; Yen CF Source: Substance Use and Misuse. 2009;44(3):322-31. Abstract: Taiwan is experiencing an outbreak of human immunodeficiency virus infection among injection drug users. The purpose of the study was to determine the impact of a Transtheoretical Model-based HIV education program among drug-dependent inmates. A single group pre/post design was used to evaluate shortened impacts among 136 inmates who were arrested for illicit drug use and had attended a brief HIV education program in 2005. A repeated-measures analysis of variance indicated positive changes in AIDS knowledge (F > = 104.16, p < 0.001), self-efficacy to reduce HIV-risk behaviors (F = 26.5, p < 0.001), and readiness of change on substance use (F = 4.83, p = 0.03). The study findings showed that a brief TTM-based HIV education program can be effective for drug-dependent inmates. Language: English Keywords: TAIWAN | RESEARCH REPORT | PILOT PROJECTS | MEN | PRISONERS | IV DRUG USERS | DRUG USE AND ABUSE | AIDS | KNOWLEDGE | RISK REDUCTION BEHAVIOR | HEALTH EDUCATION | NEEDS | Asia, Eastern | Asia | Developed Countries | Studies | Research Methodology | Demographic Factors | Population | Crime | Social Problems | Sociocultural Factors | Behavior | HIV Infections | Viral Diseases | Diseases | Education | Economic Factors Document Number: 341356 |
| 14. Peer Reviewed Title: The efficacy of a network intervention to reduce HIV risk behaviors among drug users and risk partners in Chiang Mai, Thailand and Philadelphia, USA. Author: Latkin CA; Donnell D; Metzger D; Sherman S; Aramrattna A; Davis-Vogel A; Quan VM; Gandham S; Vongchak T; Perdue T; Celentano DD Source: Social Science and Medicine. 2009 Feb;68(4):740-8. Abstract: This HIV Prevention Trials Network study assessed the efficacy of a network-oriented peer education intervention promoting HIV risk reduction among injection drug users and their drug and sexual network members in Chiang Mai, Thailand and Philadelphia, USA. The study was designed to test impact on HIV infection, but the infection rate was low and the study was terminated early. This paper reports efficacy on outcomes of self-reported HIV risk behaviors. We enrolled 414 networks with 1123 participants. The experimental intervention consisted of six small group peer educator training sessions and two booster sessions delivered to the network index only. All participants in both arms received individual HIV counseling and testing. Follow-up visits occurred every six months for up to 30 months. There were 10 HIV seroconversions, 5 in each arm. The number of participants reporting injection risk behaviors dropped dramatically between baseline and follow-up in both arms at both sites. Index members in the intervention arm engaged in more conversations about HIV risk following the intervention compared to control indexes. There was no evidence of change in sexual risk as a result of the intervention. Reductions in injection risk behaviors were observed: 37%, 20%, and 26% reduction in odds of sharing cottons, rinse water and cookers, respectively, and 24% reduction in using a syringe after someone else. Analysis of the individual sites suggested a pattern of reductions in injection risk behaviors in the Philadelphia site. In both sites, the intervention resulted in index injection drug users engaging in the community role of discussing reduction in HIV injection risk behaviors. The intervention did not result in overall reductions in self-reported sexual risk behaviors, and although reductions in injection risk behaviors were observed, the overall efficacy in reducing risk was not established. Language: English Keywords: THAILAND | UNITED STATES OF AMERICA | RESEARCH REPORT | IV DRUG USERS | SEXUAL PARTNERS | PEER EDUCATORS | RISK REDUCTION BEHAVIOR | SEX BEHAVIOR | INTERVENTIONS | IMPACT | Developing Countries | Asia, Southeastern | Asia | Developed Countries | North America | Americas | Drug Use and Abuse | Behavior | Education | Programs | Organization and Administration | Communication Document Number: 341555 |
| 15. Title: Circumcision and HIV [letter] Author: Lazarus J Source: South African Medical Journal. 2009 Jan;99(1):12. Abstract: Language: English Keywords: AFRICA, SUB SAHARAN | CRITIQUE | CLINICAL TRIALS | LONGITUDINAL STUDIES | MATHEMATICAL MODEL | MEN | MALE CIRCUMCISION | HEALTH POLICY | HIV PREVENTION | RISK REDUCTION BEHAVIOR | WHO | Africa | Developing Countries | Clinical Research | Research Methodology | Studies | Theoretical Models | Demographic Factors | Population | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Policy | Political Factors | Sociocultural Factors | HIV Infections | Viral Diseases | Diseases | Behavior | UN | International Agencies | Organizations Document Number: 341057 |
| 16. 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 |
| 17. Peer Reviewed Title: Money boys, HIV risks, and the associations between norms and safer sex: a respondent-driven sampling study in Shenzhen, China. Author: Liu H; Liu H; Cai Y; Rhodes AG; Hong F Source: AIDS and Behavior. 2009 Aug;13(4):652-62. Abstract: Money boys (MBs) are male sex workers who sell sex to men who have sex with men (MSM). This study estimates the proportion of MBs in the Chinese MSM, compares HIV risks between MBs and non-MB MSM, and examines the associations between practicing safer sex and peer norms of condom use. Respondent-driven sampling (RDS) was used to sample 351 MSM in the city of Shenzhen in 2007. The RDS-adjusted proportion of MBs among MSM was 9%. Compared to non-MB MSM, more MBs reported having had multiple male and female sexual partners. Half of MBs and non-MB MSM had consistently used condoms. Both descriptive and subjective norms were positively associated with condom use. The MB proportion of 9% in MSM implies a relatively large population of MBs in China. The association between peer norms and consistent condom use can assist with the development of culturally competent HIV interventions that promote safer sex. Language: English Keywords: CHINA | RESEARCH REPORT | COMPARATIVE STUDIES | CHILD, MALE | ADOLESCENTS, MALE | SEX WORKERS | MEN HAVING SEX WITH MEN | CONDOM USE | SEX BEHAVIOR | RISK REDUCTION BEHAVIOR | RISK BEHAVIOR | HIV PREVENTION | INTERVENTIONS | Asia, Eastern | Asia | Developing Countries | Studies | Research Methodology | Child | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Adolescents | Behavior | HIV Infections | Viral Diseases | Diseases | Programs | Organization and Administration Document Number: 342723 |
| 18. Peer Reviewed Title: Behavioral and psychosocial predictors of condom use among university students in Eastern China. Author: Ma Q; Ono-Kihara M; Cong L; Pan X; Xu G; Zamani S; Ravari SM; Kihara M Source: AIDS Care. 2009 Feb;21(2):249-59. Abstract: In China the HIV epidemic has started to infiltrate into a broader population through heterosexual contact and particularly to impact young people. The purpose of this study was to identify behavioral and psychosocial correlates of condom use among Chinese university students. A self-administered questionnaire survey with cross-sectional design was conducted among all classes of undergraduate students at two universities in one municipality of Eastern China, 2003. Data obtained from 1850 sexually active students who answered the question on condom use during the previous year were used for analysis. Frequent (always/often) condom use during the previous year was reported by only about 40% of both men and women. Multivariate analysis revealed that condom use during the first sexual experience, oral contraceptive use in the previous year and higher condom self-efficacy score in both genders were potent predictors of frequent condom use, while frequent condom use was less likely practiced by men who ever had non-vaginal sex, by those with higher risk-awareness for pregnancy/HIV/sexually transmitted diseases and by women with lower scores for perceived condom benefits. Safe sex education for Chinese students should be urgently introduced and should not be limited to knowledge provision but should also address psychosocial factors, such as condom self-efficacy and gender differences adequately to effectively encourage safer behavior. Language: English Keywords: CHINA | RESEARCH REPORT | QUESTIONNAIRES | MULTIVARIATE ANALYSIS | STUDENTS | UNIVERSITIES | YOUTH | SEX BEHAVIOR | GENDER ISSUES | CONDOM USE | SEXUALLY TRANSMITTED DISEASES | HIV INFECTIONS | AIDS | RISK REDUCTION BEHAVIOR | KNOWLEDGE | SEX EDUCATION | Asia, Eastern | Asia | Developing Countries | Data Analysis | Research Methodology | Education | Schools | Age Factors | Population Characteristics | Demographic Factors | Population | Behavior | Sociocultural Factors | Reproductive Tract Infections | Infections | Diseases | Viral Diseases Document Number: 330225 |
| 19. Peer Reviewed Title: Trends in sexual experience, contraceptive use, and teenage childbearing: 1992-2002. Author: Manlove J; Ikramullah E; Mincieli L; Holcombe E; Danish S Source: Journal of Adolescent Health. 2009 May;44(5):413-23. Abstract: PURPOSE: To examine how cohort trends in family, individual, and relationship characteristics are linked to trends in adolescent reproductive health outcomes to provide a better understanding of factors behind recent declines in teenage birth rates. METHODS: We examine a sample of three cohorts of females and males aged 15-19 in 1992, 1997, and 2002, based on retrospective information from the 2002 National Survey of Family Growth. We identify how family, individual, and relationship characteristics are associated with the transition to sexual intercourse, contraceptive use at first sex, and the transition to a teen birth. RESULTS: Cohort trends and multivariate analyses indicate changes in family and relationship characteristics among American teens have been associated with positive trends in reproductive health since the early 1990s. Factors associated with improvement in adolescent reproductive health include positive changes in family environments (including increases in parental education and a reduced likelihood of being born to a teen mother) and positive trends in sexual relationships (including an increasing age at first sex and reductions in older partners). These positive trends may be offset, in part, by negative changes in family environments (including an increased likelihood of being born to unmarried parents) and the changing racial/ethnic composition of the teen population. CONCLUSIONS: Recent increases in the U.S. teen birth rate highlight the continued importance of improving reproductive health outcomes. Our research suggests that it is important for programs to take into consideration how family, individual, and relationship environments influence decision-making about sex, contraception, and childbearing. Language: English Keywords: UNITED STATES OF AMERICA | RESEARCH REPORT | KAP SURVEYS | COHORT ANALYSIS | MULTIVARIATE ANALYSIS | HEALTH SURVEYS | ADOLESCENTS, FEMALE | PREGNANT WOMEN | SEX BEHAVIOR | CONTRACEPTIVE USAGE | ADOLESCENT PREGNANCY | FAMILY RELATIONSHIPS | BIRTH RATE | REPRODUCTIVE HEALTH | RISK REDUCTION BEHAVIOR | Developed Countries | North America | Americas | Surveys | Sampling Studies | Studies | Research Methodology | Data Analysis | Health | Adolescents | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Behavior | Contraception | Family Planning | Reproductive Behavior | Fertility | Population Dynamics | Family Characteristics | Family and Household | Sociocultural Factors | Fertility Measurements Document Number: 331077 |
| 20. Peer Reviewed Title: Strategies for harm reduction among HIV-affected couples who want to conceive. Author: Matthews LT; Mukherjee JS Source: AIDS and Behavior. 2009 Jun;13(Suppl 1):S5-S11. Abstract: As effective HIV treatments become more widespread, HIV-infected individuals are living longer, healthier lives. Many HIV-affected couples (sero-discordant and sero-concordant) are considering options for safer reproduction. A large body of evidence suggests that reproductive technologies can help HIV-affected couples to safely conceive with minimal risk of HIV transmission to their partner. However, for most couples such technologies are neither geographically nor economically accessible. This paper addresses the options for safer procreation among HIV-affected couples who cannot access reproductive technologies. Language: English Keywords: GLOBAL | RECOMMENDATIONS | CASE STUDIES | COUPLES | PERSONS LIVING WITH HIV/AIDS | HIV PREVENTION | REPRODUCTIVE HEALTH | FERTILITY PREFERENCES | PREVENTION OF MOTHER-TO-CHILD TRANSMISSION | STIGMA | RISK REDUCTION BEHAVIOR | COUNSELING | REPRODUCTIVE TECHNOLOGIES | ANTIRETROVIRAL THERAPY | Studies | Research Methodology | Family Characteristics | Family and Household | Sociocultural Factors | HIV Infections | Viral Diseases | Diseases | Health | Fertility | Population Dynamics | Demographic Factors | Population | Disease Transmission Control | Prevention and Control | Social Problems | Behavior | Clinic Activities | Program Activities | Programs | Organization and Administration | Reproduction | HIV Document Number: 341889 |
| 21. Peer Reviewed Title: Heterogeneity in host HIV susceptibility as a potential contributor to recent HIV prevalence declines in Africa. Author: Nagelkerke N; de Vlas SJ; Jha P; Luo M; Plummer FA; Kaul R Source: AIDS. 2009 Jan 2;23(1):125-30. Abstract: BACKGROUND: HIV prevalence has recently declined in several African countries, and prior to this the risk of HIV acquisition per unprotected sex contact also declined in Kenyan sex workers. We hypothesized that heterogeneity in HIV host susceptibility might underpin both of these observations. METHODS: A compartmental mathematical model was used to explore the potential impact of heterogeneity in susceptibility to HIV infection on epidemic behavior, in the absence of other causative mechanisms. RESULTS: Studies indicated that a substantial heterogeneity in susceptibility to HIV infection may lead to an epidemic that peaks and then declines due to a depletion of the most susceptible individuals, even without changes in sexual behavior. This effect was most notable in high-risk groups such as female sex workers and was consistent with empirical data. DISCUSSION: Declines in HIV prevalence may have other causes in addition to behavior change, including heterogeneity in host HIV susceptibility. There is a need to further study this heterogeneity and its correlates, particularly as it confounds the ability to attribute HIV epidemic shifts to specific interventions, including behavior change. Language: English Keywords: KENYA | METHODOLOGICAL STUDIES | EPIDEMIOLOGIC METHODS | CLINICAL RESEARCH | MATHEMATICAL MODEL | SEX WORKERS | PREVALENCE | HIV TRANSMISSION | SEX BEHAVIOR | RISK REDUCTION BEHAVIOR | RISK ASSESSMENT | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Research Methodology | Theoretical Models | Behavior | Measurement | HIV Infections | Viral Diseases | Diseases | Evaluation Document Number: 330257 |
| 22. Peer Reviewed Title: Effects of micro-enterprise services on HIV risk behaviour among female sex workers in Kenya's urban slums. Author: Odek WO; Busza J; Morris CN; Cleland J; Ngugi EN; Ferguson AG Source: AIDS and Behavior. 2009 Jun;13(3):449-61. Abstract: This study assessed individual-level effects of adding micro-enterprise services to a peer-mediated HIV/AIDS intervention among 227 female sex workers (FSWs) in Kenya. Survey data were collected in May-July 2003 and July-August 2005. Two-thirds of participants had operational businesses by end-line survey. Nearly half reported to have stopped sex work. Self-reported weekly mean number of all sexual partners changed from 3.26 (SD 2.45) at baseline to 1.84 (SD 2.15) at end-line survey (P < 0.001). Weekly mean number of casual partners did not change significantly. Weekly mean number of regular partners changed from 1.96 (SD 1.86) to 0.73 (SD 0.98) over the follow-up period (P < 0.001). Consistent condom use with regular partners increased by 18.5% and remained above 90% with casual partners. Micro-enterprise services may empower FSWs by giving them an alternative livelihood when they wish to exit or reduce reliance on sex work. Determinants of successful business operation by FSWs deserve further research. Language: English Keywords: KENYA | SLUMS | RESEARCH REPORT | SEX WORKERS | HIV PREVENTION | MICROENTERPRISE DEVELOPMENT | TRAINING PROGRAMS | PROGRAM EVALUATION | RISK REDUCTION BEHAVIOR | SEX BEHAVIOR | CONDOM USE | AGE FACTORS | WOMEN'S EMPOWERMENT | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Urbanization | Urban Population Distribution | Population Distribution | Geographic Factors | Population | Behavior | HIV Infections | Viral Diseases | Diseases | Programs | Organization and Administration | Education | Population Characteristics | Demographic Factors | Women's Status | Socioeconomic Factors | Economic Factors Document Number: 342112 |
| 23. Peer Reviewed Title: Stages of consistent condom use, partner intimacy, condom use attitude, and self-efficacy in African-American crack cocaine users. Author: Pallonen UE; Timpson SC; Williams ML; Ross MW Source: Archives of Sexual Behavior. 2009 Feb;38(1):149-58. Abstract: This study examined how condom use attitude, self-efficacy, and partner intimacy related to five stages of consistent condom use. Interview data were collected from sexually active, heterosexual, African-American crack cocaine smokers (N = 366). Dependent measures assessed both the participants' own responses and their perceptions about their last sex partner's own personal condom use attitude and participants' condom use self-efficacy expectations. Partner intimacy was assessed both as a continuous attitudinal and as a discrete relationship measure. Less than 10% were classified as consistent condom users. Two thirds of inconsistent users were in the Precontemplation (PC) stage. The contemplation (C) and preparation (P) stages were equal among the remainder of the inconsistent condom users. Higher partner intimacy reduced modestly readiness for consistent condom use. The stage but not the intimacy group was related to the condom use attitudes and self-efficacy measures. Last partners' perceived own negative attitudes were significantly related to the stages of consistent condom use and was especially low in the action (A) and maintenance (M) stages. Participants' own negative attitudes were unrelated to the stages. Of the self-efficacy measures, both participants' performance and situational condom use self-efficacies increased significantly after the PC stage and were highest in the P, A, and M stages. However, situational self-efficacy accounted for most of performance self-efficacy variance. In sum, consistent condom use was rare. A partner's attitudes and the participants' own situational self-efficacy expectations, rather than intimacy, determined the readiness to adopt consistent condom use. Language: English Keywords: UNITED STATES OF AMERICA | RESEARCH REPORT | DATA COLLECTION | INTERVIEWS | BLACKS | CONDOM USE | ATTITUDES | DRUG USE AND ABUSE | CHANGES | RISK REDUCTION BEHAVIOR | Developed Countries | North America | Americas | Research Methodology | Ethnic Groups | Cultural Background | Population Characteristics | Demographic Factors | Population | Behavior | Psychological Factors | Social Change | Sociocultural Factors Document Number: 330845 |
| 24. Title: Does access to contraception raise teenage pregnancy rates? Author: Paton D Source: Nursing Times. 2009 Mar 24-30;105(11):11. Abstract: Since the government launched its Teenage Pregnancy Strategy in 1999, millions of pounds have been spent on access to 'confidential sexual health services' for young people. Many nurses are uncomfortable with providing such services to children under 16, especially without parental knowledge. Unfortunately, the latest data shows that pregnancy and abortion rates for under-16s are higher now. Given this, nurses may be questioning whether they have been right to go along with this policy. A 2007 Obstetrics and Gynecology review of the evidence relating to emergency contraception concluded that 'to date, no study has shown that increased access to [emergency contraception] reduces unintended pregnancy or abortion rates' (Raymond et al, 2007). When policy interventions have unexpected impacts that subvert the aim of the policy, economists often refer to the law of unintended consequences. In this case, by lowering the pregnancy risk, easier access to birth control may encourage more young people to engage in sexual activity. If so, pregnancies decrease among those who would have sex anyway, but increase among those who have sex when they otherwise would not have done. Overall, we end up with a similar number of pregnancies but with more sexually active underage youngsters. Many contraceptive methods offer no protection against sexually transmitted infections (STIs). Research published in Sex Education suggests increased access to emergency contraception may be associated with higher teenage STI rates (Paton, 2006). On a positive note, academic evidence is clear that involving parents in the decision-making is crucial. When the Gillick ruling was in effect in England and Wales during most of 1985, contraception could not be provided to underage girls without parental involvement. Take-up at family planning clinics dropped by about 30%, yet underage pregnancy rates decreased slightly relative to older teenagers. The ruling was overturned in late 1985. In addition, research in the Journal of Health Economics and elsewhere reveals that laws requiring parental consent before an abortion is performed on a minor lead to significant decreases in teenage abortions, pregnancies and even STIs (Levine, 2003). It is unclear why it has taken so long for the findings to filter down to nurses. Whatever the reason, nurses might remember that although the Fraser guidelines permit nurses to provide minors with access to abortion and contraception without parental knowledge if they can make informed decisions, they do not require nurses to do so. Furthermore, all health professionals-and taxpayers -should question why PCTs spend resources on measures such as school-based provision of emergency contraception that, at best, are ineffective and, at worst, may contribute to poor sexual health among teenagers. Language: English Keywords: UNITED STATES OF AMERICA | SUMMARY REPORT | ADOLESCENTS | PARENTAL INVOLVEMENT | ADOLESCENT PREGNANCY | CONTRACEPTIVE USAGE | CONTRACEPTION | DECISION MAKING | RISK REDUCTION BEHAVIOR | PROGRAM ACCESSIBILITY | Developed Countries | North America | Americas | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Child Rearing | Behavior | Reproductive Behavior | Fertility | Population Dynamics | Family Planning | Program Evaluation | Programs | Organization and Administration Document Number: 331149 |
| 25. Title: Advocacy for harm reduction in China: a new era dawns. Author: Reid G; Aitken C Source: International Journal On Drug Policy. 2009 Jul;20(4):365-70. Abstract: BACKGROUND: China's initial response to drug use and HIV was largely ineffective but has improved with recent government endorsement of harm reduction interventions. This paper examines the views of senior key informants inside China who articulated core needs and objectives for the development of a harm reduction advocacy strategy. METHODS: Thirty-nine key informants (KI) were interviewed, representing 19 stakeholder bodies selected from the Chinese government public health sector, public security sector, international agencies such as WHO, UNODC and UNAIDS, and international non-government organisations. RESULTS: The concept of harm reduction is widely understood and considered valid. Support for harm reduction is increasing, but KIs perceived an imbalance between the rapid expansion of methadone maintenance treatment programs over needle and syringe programs and other interventions. Challenges for harm reduction identified by KIs included: policy inconsistencies; lack of skilled resources, training programs and technical capacity; poor coverage of interventions; and gaps in the sharing of information. KIs suggested numerous ways to strengthen the capacity of the government and communities to reduce drug related harm. DISCUSSION: Increased acceptance of harm reduction in China, particularly among public security, implies a new level of optimism towards addressing the HIV epidemic among drug users, and parallels an impressive expansion of harm reduction interventions. Nevertheless, scaling up a response to the ongoing dual epidemic of drug use and HIV remains an enormous challenge. With appropriate technical education and training, ongoing advocacy, and a cohesive, coordinated multi-sectoral effort, the capacity of the government and community to adopt, support and promote measures to reduce HIV and other drug related harm would be markedly strengthened. Language: English Keywords: CHINA | RESEARCH REPORT | INTERVIEWS | RISK REDUCTION BEHAVIOR | POLICY | HIV INFECTIONS | ADVOCACY | DRUG USE AND ABUSE | Asia, Eastern | Asia | Developing Countries | Data Collection | Research Methodology | Behavior | Political Factors | Sociocultural Factors | Viral Diseases | Diseases | Communication Document Number: 342703 |
| 26. Peer Reviewed Title: General hygiene, sexual risk behaviour and HIV prevalence in truck drivers from Andhra Pradesh, South India: implications for prevention interventions. Author: Schneider JA; Dude A; Dinaker M; Kumar V; Laumann EO; Holloway-Beth A; Oruganti G; Saluja GS; Chundi V; Yeldandi V; Mayer KH Source: International Journal of STD and AIDS. 2009 Jan;20(1):39-45. Abstract: The relationships between hygiene, sexual behaviour and HIV infection are poorly understood. We examine these relationships in Indian truck drivers, a group at high risk for HIV infection. Truck drivers (n = 189) were recruited into an integrated HIV and hygiene Information Motivation (IM) programme. Sociodemographic characteristics, sexual and hygiene behaviour and HIV prevalence were determined. Multivariate logistic regression and linear generalized estimating equation models were utilized. At baseline, 2.1% of drivers were HIV infected and 34% who reported having contact with female sex workers (FSWs) had contact within the previous six months. Those who washed their hands postdefecation were less likely to report genital symptoms (OR 0.02; P = 0.01) and have sex with an FSW (OR [odds ratio] 0.21; P = 0.05). After an IM intervention, there were no changes in sexual risk-taking behaviour (coefficient -0.15 to -0.02; P = 0.13-0.75); however, hygiene behaviour improved from baseline (coefficient 0.09-0.31; P < 0.01 to P = 0.03). Personal hygiene habits, like handwashing, seem to be a modifiable behaviour after a modest intervention, whereas HIV risk-taking behaviour was not. The association between hygiene and HIV risk-taking suggests the need for further evaluation of the relationship and that of other hygiene practices in high-risk men in India. Language: English Keywords: INDIA | RESEARCH REPORT | EPIDEMIOLOGIC METHODS | CLINICAL RESEARCH | KAP SURVEYS | MULTIVARIATE ANALYSIS | TRUCK DRIVERS | SEX WORKERS | PREVALENCE | HYGIENE | SEX BEHAVIOR | RISK BEHAVIOR | HIV INFECTIONS | HIV PREVENTION | RISK REDUCTION BEHAVIOR | Asia, Southern | Asia | Developing Countries | Research Methodology | Surveys | Sampling Studies | Studies | Data Analysis | Labor Force | Human Resources | Economic Factors | Behavior | Measurement | Public Health | Health | Viral Diseases | Diseases Document Number: 330714 |
| 27. Peer Reviewed Title: Predictors of sexual risk reduction among Mexican female sex workers enrolled in a behavioral intervention study. Author: Strathdee SA; Mausbach B; Lozada R; Staines-Orozco H; Semple SJ; Abramovitz D; Fraga-Vallejo M; Torre Ade L; Amaro H; Martinez-Mendizabal G; Magis-Rodriguez C; Patterson TL Source: Journal of Acquired Immune Deficiency Syndromes. 2009 May 1;51 Suppl 1:S42-6. Abstract: OBJECTIVE: We recently showed efficacy of an intervention to increase condom use among female sex workers (FSWs) in Tijuana and Ciudad Juarez, situated on the Mexico-United States border. We determined whether increases in condom use were predicted by social cognitive theory and injection drug user status among women randomized to this intervention. METHODS: Four hundred nine HIV-negative FSWs aged >or=18 years having unprotected sex with clients within the prior 2 months received a brief individual counseling session integrating motivational interviewing and principles of behavior change (ie, HIV knowledge, self-efficacy for using condoms, and outcome expectancies). RESULTS: Increases in self-efficacy scores were associated with increases in percent condom use (P = 0.008), whereas outcome expectancies were not. Female sex workers who inject drugs (FSW-IDUs) increased condom use with clients but not to the same extent as other FSWs (P = 0.09). Change in HIV knowledge was positively associated with change in percent condom use among FSW-IDUs (P = 0.03) but not noninjection drug users. CONCLUSIONS: Increases in self-efficacy significantly predicted increased condom use among FSWs, consistent with social cognitive theory. Increased HIV knowledge was also important among FSW-IDUs, but their changes in condom use were modest. Enhanced interventions for FSW-IDUs are needed, taking into account realities of substance use during sexual transactions that can compromise safer sex negotiation. Language: English Keywords: MEXICO | RESEARCH REPORT | EVALUATION | WOMEN | SEX WORKERS | IV DRUG USERS | CONDOM USE | HIV | RISK REDUCTION BEHAVIOR | SEX BEHAVIOR | INTERVENTIONS | North America | Americas | Developing Countries | Demographic Factors | Population | Behavior | Drug Use and Abuse | HIV Infections | Viral Diseases | Diseases | Programs | Organization and Administration Document Number: 341322 |
| 28. Peer Reviewed Title: The context of HIV risk behaviours among HIV-positive injection drug users in Viet Nam: moving toward effective harm reduction. Author: Thanh DC; Moland KM; Fylkesnes K Source: BMC Public Health. 2009;9:98. Abstract: BACKGROUND: Injection drug users represent the largest proportion of all HIV reported cases in Viet Nam. This study aimed to explore the perceptions of risk and risk behaviours among HIV-positive injection drug users, and their experiences related to safe injection and safe sex practices. METHODS: This study used multiple qualitative methods in data collection including in-depth interviews, focus group discussions and participant observation with HIV-positive injection drug users. RESULTS: The informants described a change in the sharing practices among injection drug users towards more precautions and what was considered 'low risk sharing', like sharing among seroconcordant partners and borrowing rather than lending. However risky practices like re-use of injection equipment and 'syringe pulling' i.e. the use of left-over drugs in particular, were frequently described and observed. Needle and syringe distribution programmes were in place but carrying needles and syringes and particularly drugs could result in being arrested and fined. Fear of rejection and of loss of intimacy made disclosure difficult and was perceived as a major obstacle for condom use among recently diagnosed HIV infected individuals. CONCLUSION: HIV-positive injection drug users continue to practice HIV risk behaviours. The anti-drug law and the police crack-down policy appeared as critical factors hampering ongoing prevention efforts with needle and syringe distribution programmes in Viet Nam. Drastic policy measures are needed to reduce the very high HIV prevalence among injection drug users. Language: English Keywords: VIETNAM | RESEARCH REPORT | QUALITATIVE RESEARCH | PERSONS LIVING WITH HIV/AIDS | IV DRUG USERS | PEER EDUCATORS | HIV INFECTIONS | RISK BEHAVIOR | CONDOM USE | RISK REDUCTION BEHAVIOR | Asia, Southeastern | Asia | Developing Countries | Research Methodology | Viral Diseases | Diseases | Drug Use and Abuse | Behavior | Education Document Number: 341410 |
| 29. Peer Reviewed Title: Intervention to train physicians in rural China on HIV/STI knowledge and risk reduction counseling: preliminary findings. Author: Wang D; Operario D; Hong Q; Zhang H; Coates TJ Source: AIDS Care. 2009 Apr;21(4):468-72. Abstract: We evaluated an intervention to train physicians in rural China on knowledge of HIV/STI prevention, diagnosis, treatment options, and HIV/STI behavioral risk reduction counseling. This paper reports preliminary findings related to feasibility and acceptability of the program. Using a pre-post design, 69 physicians were recruited from rural county hospitals and participated in a 10-day group training program, followed by two months of clinical fieldwork and two additional weeks of training. Physicians completed baseline and six-month assessments. Patients' cohorts, recruited from clinic waiting areas of participating physicians, completed baseline and six-month HIV/STI risk assessments. Physicians reported increased knowledge of HIV biology and pathology, epidemiology, host immune response, opportunisitic infection and syndromic management, antiretroviral therapy, risk reduction counseling, and stigma reduction following the training. Patients reported improved knowledge of HIV, reduced HIV stigma, higher rates of HIV testing, and improved condom use at follow-up. The findings suggest that training physicians on HIV/STI-related knowledge and risk reduction counseling is a promising strategy for reducing HIV/STI epidemics in rural China. Language: English Keywords: CHINA | RURAL AREAS | EVALUATION REPORT | PROVIDERS WITH CLIENTS | PHYSICIANS | TRAINING PROGRAMS | HIV PREVENTION | SEXUALLY TRANSMITTED DISEASE PREVENTION | KNOWLEDGE | RISK REDUCTION BEHAVIOR | COUNSELING | PROGRAM ACCEPTABILITY | Asia, Eastern | Asia | Developing Countries | Geographic Factors | Population | Evaluation | Health Services | Delivery of Health Care | Health | Health Personnel | Education | HIV Infections | Viral Diseases | Diseases | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections | Sociocultural Factors | Behavior | Clinic Activities | Program Activities | Programs | Organization and Administration | Program Evaluation Document Number: 341835 |
| 30. Peer Reviewed Title: Formative study to develop the Eban treatment and comparison interventions for couples. Author: NIMH Multisite HIV/STD Prevention Trial for African American Couples Group Source: JAIDS. Journal of Acquired Immune Deficiency Syndromes. 2008 Sep 1;49 Suppl 1:S42-51. Abstract: OBJECTIVE: To describe formative and pilot-testing research that generated themes and procedures, curricula, and critical measures for a randomized clinical trial testing a Risk Reduction Intervention for HIV-serodiscordant African American couples (Project Eban). DESIGN: This article describes the themes that emerged from discussions with African American serodiscordant couples about HIV-related risks from focus groups with 11 couples and pilot study results with 32 couples across 4 sites. METHODS: In step 1, focus groups examined the need for a Risk Reduction Intervention for HIV-serodiscordant African American couples and confirmed 4 themes that formed the basis for the intervention curriculum and study format. In step 2, a pilot study refined the clinical trial procedures for this population and tested critical measures and selected portions of the curriculum for both the treatment and the comparison interventions. RESULTS: Based on these findings, stigma and psychological distress, barriers to condom use, insufficient support from community and service organizations, and the lack of skills that emphasize individual and relationship protection were ultimately integrated into the Risk Reduction Intervention. CONCLUSIONS: Pilot study findings highlighted the importance of examining gender and ethnicity in HIV-impacted couples along with factors that heightened HIV-related risk behaviors that affect couples' skills and psychological adjustment. The goal was to ensure that a skill-based, culturally congruent, relationship-centered intervention could be understood and of interest to couples. Future analyses in the main trial will be discussed. Language: English Keywords: UNITED STATES OF AMERICA | RESEARCH REPORT | FOCUS GROUPS | PILOT PROJECTS | CLINICAL TRIALS | COUPLES | BLACKS | RISK REDUCTION BEHAVIOR | SEX BEHAVIOR | HIV INFECTIONS | TREATMENT | STIGMA | PSYCHOLOGICAL FACTORS | CONDOM USE | BEHAVIOR CHANGE | CULTURE | Developed Countries | North America | Americas | Data Collection | Research Methodology | Studies | Clinical Research | Family Characteristics | Family and Household | Sociocultural Factors | Ethnic Groups | Cultural Background | Population Characteristics | Demographic Factors | Population | Behavior | Viral Diseases | Diseases | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Social Problems Document Number: 328590 |
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