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Bruno Spire - One of the best experts on this subject based on the ideXlab platform.
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prevalence of Unsafe Sex with one s steady partner either hiv negative or of unknown hiv status and associated determinants in cameroon eval anrs12 116 survey
Sexually Transmitted Infections, 2010Co-Authors: Aissata Dia, Sylvie Boyer, Anne-déborah Bouhnik, Fabienne Marcellin, Reneececile Bonono, Camelia Protopopescu, Sinata Koullashiro, Maria Patrizia Carrieri, Claude Abe, Bruno SpireAbstract:Objective Our study aimed at estimating the prevalence of inconsistent condom use and at identifying its determinants in steady partnerships among people living with HIV/AIDS (PLWHA) in Cameroon. Methods Analyses were based on data collected during the national cross-sectional multicentre survey EVAL (ANRS 12-116), which was conducted in Cameroon between September 2006 and March 2007 among 3151 adult PLWHA diagnosed HIV-positive for at least 3 months. The study population consisted of the 907 survey participants who reported Sexual activity during the previous 3 months, with a steady partner either HIV-negative or of unknown HIV status. Logistic regression was used to identify factors associated with individuals9 report of inconsistent condom use during the previous 3 months. Results Inconsistent condom use was reported by 35.3% of Sexually active PLWHA. In a multivariate analysis adjusted for socio-demographic characteristics, not receiving antiretroviral therapy (OR (95% CI): 2.28 (1.64 to 3.18)) was independently associated with inconsistent condom use. Conclusions The prevalence of Unsafe Sex remains high among Sexually active PLWHA in Cameroon. Treatment with antiretroviral therapy is identified as a factor associated with safer Sex, which further encourages the continuation of the national policy for increasing access to HIV treatment and care, and underlines the need to develop counselling strategies for all patients.
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hiv disclosure and Unsafe Sex among hiv infected women in cameroon results from the anrs eval study
Social Science & Medicine, 2009Co-Authors: Sandrine Loubiere, Patrick Perettiwatel, Sylvie Boyer, Jerome Blanche, Severincecile Abega, Bruno SpireAbstract:Encouraging seropositive people to voluntarily disclose their serostatus has been promoted as a key component of HIV prevention. Among other reasons, HIV disclosure to one's main partner is believed to be an incentive for serodiscordant couples to practice safe Sex. The present article investigated this issue by conducting a cross-sectional survey of a large sample of HIV-infected women attending HIV care centers in Cameroon (N=1014). Overall, 86.3% of these women had disclosed their serostatus to their main partner. With respect to Sexual activity with their main partner during the previous three months, 35.0% had practiced abstinence and 47.4% only safe Sex, whereas 17.6% had engaged in Unsafe Sex at least once. HIV disclosure to one's main partner was related to safe Sexual practices in multivariate analysis. Some of the factors associated with disclosure and safe Sex were illustrative of the positive roles of improved access to care and women's empowerment. On the contrary, beliefs overestimating the effectiveness of antiretroviral therapies were quite widespread among respondents and predictive of both concealment of HIV status and Unsafe Sex.
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Unsafe Sex in regular partnerships among heteroSexual persons living with hiv evidence from a large representative sample of individuals attending outpatients services in france anrs en12 vespa study
AIDS, 2007Co-Authors: A D Bouhnik, Patrick Perettiwatel, Yolande Obadia, Marie Préau, Marie-ange Schiltz, Bruno SpireAbstract:Objective:Risky Sexual behaviour remains frequent among people living with HIV. We analysed factors associated with Unsafe Sex within serodiscordant couples among heteroSexual individuals living with HIV in France.Methods:In 2003, a face-to-face survey was conducted among individuals selected in a r
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Unsafe Sex with casual partners and quality of life among HIV-infected gay men: evidence from a large representative sample of outpatients attending French hospitals (ANRS-EN12-VESPA).
Journal of Acquired Immune Deficiency Syndromes, 2006Co-Authors: Anne-déborah Bouhnik, Bruno Spire, Yolande Obadia, Marie Préau, Marie-ange Schiltz, Patrick Peretti-watel, France Lert, Vespa GroupAbstract:INTRODUCTION: The introduction of highly active antiretroviral therapy has relaunched the debate on risky Sexual behavior among HIV-infected gay men. It was proposed to study the influences of lifestyle characteristics and health-related quality of life (HRQL) on Unsafe Sex with casual partners in a representative sample of HIV-infected gay men. METHODS: In 2003, a national survey based on face-to-face interviews was conducted among a representative sample of patients selected in a random stratified sample of 102 French hospital departments delivering HIV care. The patients selected for this analysis were gay men who reported having had Sex with casual partners during the previous 12 months. Unsafe Sex was defined as at least 1 episode of anal Sexual intercourse without a condom with a casual partner during the previous 12 months. Health-related quality of life was assessed using the SF-36 Scale. Patients who declared that they had engaged in Unsafe Sex were compared with those who declared that they had not done so, using the chi test and logistic regressions. RESULTS: Among the 1,117 gay men who participated in the study, 607 declared having had casual partners during the previous 12 months, and 140 (20%) of this latter group had engaged in Unsafe Sex. Poor mental HRQL was encountered in 68% of the patients and found to be independently associated with Unsafe Sex, even after multiple adjustment for number of partners, occurrences of binge drinking, use of anxiolytics, use of the Internet, and use of outdoor and commercial venues for Sexual encounters. CONCLUSIONS: Risky Sexual behavior with casual partners is frequent among HIV-infected gay men. In addition to other well-known factors, behavior of this kind was found in this study to be related to poor mental HRQL. A more comprehensive approach to care designed to improve mental quality of life might therefore make for more effective secondary prevention.
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vulnerability Unsafe Sex and non adherence to haart evidence from a large sample of french hiv aids outpatients
Social Science & Medicine, 2006Co-Authors: Patrick Perettiwatel, Bruno Spire, M A Schiltz, A D Bouhnik, I Heard, F Lert, Yolande ObadiaAbstract:Current socio-behavioural research in HIV-infected people has tried to identify patients with "high-risk" profiles, i.e. who simultaneously exhibit non-adherence to highly active anti-retroviral therapy (HAART) and Unsafe Sex with serodiscordant partners. We challenged this approach by investigating the correlates of both behaviours, for homoSexual men, heteroSexual men and heteroSexual women separately, among a representative sample of 4963 HIV-infected people in France. Variables introduced in the analysis dealt with patients' background and daily life, with a focus on situations of economic, social and personal vulnerability. Overall, 2932 patients agreed to participate, and 1809 were both receiving HAART and Sexually active. Among heteroSexual women, non-adherence and Unsafe Sex appeared as joint outcomes of similar situations of vulnerability. Among heteroSexual men, these behaviours were weakly correlated and shared some predictors related to situations of vulnerability. Among homoSexual men, non-adherence and Unsafe Sex were not correlated and had distinct determinants. Situations of vulnerability, the context and the motives of Unsafe Sex, as well as factors associated with non-adherence and Unsafe Sex varied greatly with gender and Sexual preference. Theoretical models used for designing behavioural interventions should take into account this diversity.
Nicole Crepaz - One of the best experts on this subject based on the ideXlab platform.
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attributions about one s hiv infection and Unsafe Sex in seropositive men who have Sex with men
Aids and Behavior, 2001Co-Authors: Cherilyn R Bingman, Gary Marks, Nicole CrepazAbstract:This study of 71 Sexually active HIV-positive men who have Sex with men found that the likelihood of engaging in unprotected anal intercourse (UAI) with partners at risk for HIV was directly associated with the strength with which the men attributed blame and responsibility for their HIV infection to other persons. Men who believed that another person intentionally tried to infect them were at especially high risk for engaging in UAI. Self-attributions were not associated with Sexual risk behavior. Conceptual explanations and directions for future research are discussed.
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hiv positive men s Sexual practices in the context of self disclosure of hiv status
Journal of Acquired Immune Deficiency Syndromes, 2001Co-Authors: Gary Marks, Nicole CrepazAbstract:Objective To examine whether disclosure of HIV-positive status to Sex partners at risk for HIV infection is associated with safer Sex practices and to examine the prevalence and correlates of specific disclosure/Sexual behavior patterns. Methods Cross-sectional assessment of 206 HIV-positive men (41% homoSexual, 35% biSexual, 24% heteroSexual) sampled randomly at an outpatient HIV clinic in Los Angeles, who reported that their most recent Sex partner was HIV-negative or of unknown serostatus. Unsafe Sex was defined as unprotected anal or vaginal intercourse with that partner. Results Twenty-five percent of the men engaged in Unsafe Sex, and 48% of the total sample withheld disclosure from the partner. The prevalence of safer Sex was not significantly higher among disclosers than among nondisclosers (unadjusted odds ratio = 1.29; 95% confidence interval: 0.69-2.45), and disclosure was not significantly associated with safer Sex in any of 25 demographic or partner subgroups examined in the study. In the full sample, 40% of the men disclosed and engaged in safer Sex (informed protection), 35% withheld disclosure and engaged in safer Sex (uninformed protection), 12% informed their partner and engaged in Unsafe Sexual behavior (informed exposure), and 13% withheld disclosure and engaged in Unsafe Sex (uninformed exposure). Risky behavior patterns were associated with using alcohol/drugs before Sex, having an HIV-unknown partner, being less emotionally involved with one's partner, and testing seropositive in the previous 3 years. Conclusions Interventions for seropositive men that focus primarily on increasing disclosure of serostatus to Sex partners may not reduce the prevalence of Unsafe Sex. Interventions are needed to address the social and psychologic processes that give rise to risky behavior patterns in HIV-infected men. Improved substance abuse counseling also may be needed.
Gary Marks - One of the best experts on this subject based on the ideXlab platform.
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attributions about one s hiv infection and Unsafe Sex in seropositive men who have Sex with men
Aids and Behavior, 2001Co-Authors: Cherilyn R Bingman, Gary Marks, Nicole CrepazAbstract:This study of 71 Sexually active HIV-positive men who have Sex with men found that the likelihood of engaging in unprotected anal intercourse (UAI) with partners at risk for HIV was directly associated with the strength with which the men attributed blame and responsibility for their HIV infection to other persons. Men who believed that another person intentionally tried to infect them were at especially high risk for engaging in UAI. Self-attributions were not associated with Sexual risk behavior. Conceptual explanations and directions for future research are discussed.
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hiv positive men s Sexual practices in the context of self disclosure of hiv status
Journal of Acquired Immune Deficiency Syndromes, 2001Co-Authors: Gary Marks, Nicole CrepazAbstract:Objective To examine whether disclosure of HIV-positive status to Sex partners at risk for HIV infection is associated with safer Sex practices and to examine the prevalence and correlates of specific disclosure/Sexual behavior patterns. Methods Cross-sectional assessment of 206 HIV-positive men (41% homoSexual, 35% biSexual, 24% heteroSexual) sampled randomly at an outpatient HIV clinic in Los Angeles, who reported that their most recent Sex partner was HIV-negative or of unknown serostatus. Unsafe Sex was defined as unprotected anal or vaginal intercourse with that partner. Results Twenty-five percent of the men engaged in Unsafe Sex, and 48% of the total sample withheld disclosure from the partner. The prevalence of safer Sex was not significantly higher among disclosers than among nondisclosers (unadjusted odds ratio = 1.29; 95% confidence interval: 0.69-2.45), and disclosure was not significantly associated with safer Sex in any of 25 demographic or partner subgroups examined in the study. In the full sample, 40% of the men disclosed and engaged in safer Sex (informed protection), 35% withheld disclosure and engaged in safer Sex (uninformed protection), 12% informed their partner and engaged in Unsafe Sexual behavior (informed exposure), and 13% withheld disclosure and engaged in Unsafe Sex (uninformed exposure). Risky behavior patterns were associated with using alcohol/drugs before Sex, having an HIV-unknown partner, being less emotionally involved with one's partner, and testing seropositive in the previous 3 years. Conclusions Interventions for seropositive men that focus primarily on increasing disclosure of serostatus to Sex partners may not reduce the prevalence of Unsafe Sex. Interventions are needed to address the social and psychologic processes that give rise to risky behavior patterns in HIV-infected men. Improved substance abuse counseling also may be needed.
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negative affect and Unsafe Sex in hiv positive men
Aids and Behavior, 1998Co-Authors: Gary Marks, Cherilyn R Bingman, Shelley T DuvalAbstract:This cross-sectional study of 155 Sexually active HIV-positive men (48% homoSexual, 39% biSexual, 13% heteroSexual) sampled at an outpatient clinic in Los Angeles found that negative affective states (depression-dejection, tension-anxiety, confusion-bewilderment, anger arousal, and keeping anger inward) were significantly associated with having engaged in unprotected anal intercourse in the most recent Sexual encounter with a male partner. Negative affect was not associated with unprotected vaginal or anal intercourse with most recent female partners. Path analyses suggested that the association of negative affect (composite score) and Unsafe Sex with male partners was mediated by participants' use of alcohol/drugs in the 3 hours before the Sexual encounter. Additionally, the association of depression-dejection and Unsafe Sex tended to be mediated by attributions of responsibility for protecting Sex partners (i.e., more responsibility attributed to partners than to self). The findings support a psychological escape model of Sexual risk behavior in seropositive men and demonstrate the need for secondary prevention programs for HIV-positive persons.
Yolande Obadia - One of the best experts on this subject based on the ideXlab platform.
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Unsafe Sex in regular partnerships among heteroSexual persons living with hiv evidence from a large representative sample of individuals attending outpatients services in france anrs en12 vespa study
AIDS, 2007Co-Authors: A D Bouhnik, Patrick Perettiwatel, Yolande Obadia, Marie Préau, Marie-ange Schiltz, Bruno SpireAbstract:Objective:Risky Sexual behaviour remains frequent among people living with HIV. We analysed factors associated with Unsafe Sex within serodiscordant couples among heteroSexual individuals living with HIV in France.Methods:In 2003, a face-to-face survey was conducted among individuals selected in a r
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Unsafe Sex with casual partners and quality of life among HIV-infected gay men: evidence from a large representative sample of outpatients attending French hospitals (ANRS-EN12-VESPA).
Journal of Acquired Immune Deficiency Syndromes, 2006Co-Authors: Anne-déborah Bouhnik, Bruno Spire, Yolande Obadia, Marie Préau, Marie-ange Schiltz, Patrick Peretti-watel, France Lert, Vespa GroupAbstract:INTRODUCTION: The introduction of highly active antiretroviral therapy has relaunched the debate on risky Sexual behavior among HIV-infected gay men. It was proposed to study the influences of lifestyle characteristics and health-related quality of life (HRQL) on Unsafe Sex with casual partners in a representative sample of HIV-infected gay men. METHODS: In 2003, a national survey based on face-to-face interviews was conducted among a representative sample of patients selected in a random stratified sample of 102 French hospital departments delivering HIV care. The patients selected for this analysis were gay men who reported having had Sex with casual partners during the previous 12 months. Unsafe Sex was defined as at least 1 episode of anal Sexual intercourse without a condom with a casual partner during the previous 12 months. Health-related quality of life was assessed using the SF-36 Scale. Patients who declared that they had engaged in Unsafe Sex were compared with those who declared that they had not done so, using the chi test and logistic regressions. RESULTS: Among the 1,117 gay men who participated in the study, 607 declared having had casual partners during the previous 12 months, and 140 (20%) of this latter group had engaged in Unsafe Sex. Poor mental HRQL was encountered in 68% of the patients and found to be independently associated with Unsafe Sex, even after multiple adjustment for number of partners, occurrences of binge drinking, use of anxiolytics, use of the Internet, and use of outdoor and commercial venues for Sexual encounters. CONCLUSIONS: Risky Sexual behavior with casual partners is frequent among HIV-infected gay men. In addition to other well-known factors, behavior of this kind was found in this study to be related to poor mental HRQL. A more comprehensive approach to care designed to improve mental quality of life might therefore make for more effective secondary prevention.
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vulnerability Unsafe Sex and non adherence to haart evidence from a large sample of french hiv aids outpatients
Social Science & Medicine, 2006Co-Authors: Patrick Perettiwatel, Bruno Spire, M A Schiltz, A D Bouhnik, I Heard, F Lert, Yolande ObadiaAbstract:Current socio-behavioural research in HIV-infected people has tried to identify patients with "high-risk" profiles, i.e. who simultaneously exhibit non-adherence to highly active anti-retroviral therapy (HAART) and Unsafe Sex with serodiscordant partners. We challenged this approach by investigating the correlates of both behaviours, for homoSexual men, heteroSexual men and heteroSexual women separately, among a representative sample of 4963 HIV-infected people in France. Variables introduced in the analysis dealt with patients' background and daily life, with a focus on situations of economic, social and personal vulnerability. Overall, 2932 patients agreed to participate, and 1809 were both receiving HAART and Sexually active. Among heteroSexual women, non-adherence and Unsafe Sex appeared as joint outcomes of similar situations of vulnerability. Among heteroSexual men, these behaviours were weakly correlated and shared some predictors related to situations of vulnerability. Among homoSexual men, non-adherence and Unsafe Sex were not correlated and had distinct determinants. Situations of vulnerability, the context and the motives of Unsafe Sex, as well as factors associated with non-adherence and Unsafe Sex varied greatly with gender and Sexual preference. Theoretical models used for designing behavioural interventions should take into account this diversity.
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concealment of hiv and Unsafe Sex with steady partner is extremely infrequent
AIDS, 2005Co-Authors: Bruno Spire, Anne-déborah Bouhnik, Yolande ObadiaAbstract:In France, in January 2005, a heteroSexual male, who had hidden his positive status from his steady female partner and transmitted HIV to her, was sentenced to prison. As in other western countries, prison sentences against individuals who hid their positive status from their steady partner and transmitted HIV to him/her, have generated huge controversy concerning the acceptability of defining HIV transmission as a specific offence [1-3]. In such prosecutions, those professionals and activists who are committed to the fight against AIDS see a threat to the principle of shared responsibility, which has been acknowledged as an effective prevention strategy since the earlier AIDS era [4]. People living with HIV AIDS (PLWHA) would have to bear the burden of prevention alone and HIV-positive status would be associated with a possible penal sentence. It also may increase stigma and discrimination against PLWHA.
Patrick Rawstorne - One of the best experts on this subject based on the ideXlab platform.
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is it really crystal clear that using methamphetamine or other recreational drugs causes people to engage in Unsafe Sex
Sexual Health, 2013Co-Authors: Erol Digiusto, Patrick RawstorneAbstract:Many studies have found associations between Unsafe Sexual behaviour and use of crystal methamphetamine (and many other recreational drugs). Researchers and authors of relevant articles in popular media have often interpreted these associations as meaning that using 'crystal' directly causes people to engage in Unsafe Sex, and that interventions should aim to reduce crystal use in order to reduce the prevalence of Sexually transmissible infections such as HIV. There is consistent evidence that crystal users are a high-risk group in terms of Sexual behaviour. However, most relevant studies have provided only circumstantial evidence regarding a causal relationship. Promoting the idea that a particular recreational drug is a major direct cause of Unsafe Sex may have the unintended adverse effect of creating an excuse for engaging in Unsafe Sex, thereby increasing its use, and may incur opportunity costs by preventing limited available health promotion resources from being directed more usefully. This paper examines the limitations, in terms of demonstrating causality, of various types of study that have been published on this topic in relation to crystal use in particular. Researchers who investigate relationships between recreational drug use and behaviour, including Sexual behaviour, should be careful about the wording of their conclusions and recommendations, and should consider the possibly counterproductive ways in which their findings might be represented in the media.
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crystallizing the hiv epidemic methamphetamine Unsafe Sex and gay diseases of the will
Archives of Sexual Behavior, 2005Co-Authors: Heather Worth, Patrick RawstorneAbstract:In the past few years, there has been increasing concern in Europe, North America, and Australia about the rates of recreational methamphetamine use (among other terms, called “P,” “ice,” “crystal,” and “crystal meth”) in the gay community. Gay media headlines, such as “The party drug crystal meth is fueling a new epidemic of Unsafe Sex and . . . some experts fear the party’s only just begun” (Brown, 2002), have kindled anxieties around methamphetamine and Sexual risk in gay men’s health professionals and HIV educators. In the U.S. and other countries, numerous community forums have been held to discuss the “epidemic of crystal,” methamphetamineoriented HIV education programs have been put in place, and “crystal meth anonymous” chapters and specialist rehabilitation centers have sprung up. Further, the associations between methamphetamine use and risky Sex are most often mediated through a psychobiological explanatory framework (Rhodes, 1996). Drug use and Sex are both exceedingly social practices, historically and culturally embedded. The almost universal uptake of condoms in the early 1980s among the gay community represented much more than individual behavior change; rather, it was a social phenomenon, embedded within a community which took action against the HIV epidemic (Kippax & Kinder, 2002). And HIV prevention in the gay community was predicated not on reducing the numbers of casual partners—it assumed that Sexual liberation and multiple partnering were a keystone of gay community. However, since the beginning of the epidemic, there has been an often conservative counterargument that these gay community Sexual noms are, in fact, pathological (e.g., Signorile, 1997) and, recently, that many gay men are Sexually compulsive and addicted (see
