Thesis (Ph. D.)--University of California, San Diego and San Diego State University, 2007. / Title from first page of PDF file (viewed March 18, 2008). Available via ProQuest Digital Dissertations. Vita. Includes bibliographical references (p. 86-98).

Thesis (Ph. D.)--University of Washington, 2000. / Vita. Includes bibliographical references (leaves 178-192).

Male sex workers (MSW) in the Dominican Republic (DR) have multiple sexual partners, including personal and client-relationships, and are disproportionately affected by human immunodeficiency virus (HIV). We examined the prevalence of condomless anal and/or vaginal intercourse (CI) among MSW in the DR as a function of social network factors. Self-report surveys and social network interviews were administered to MSW recruited through venue-based sampling (N = 220). A generalized linear model was used to complete a Poisson Regression model and identify variables significantly associated with the outcome of interest. CI was more common with female (28.3%) than with male partners (4.9%). Factors associated with CI with the last female partner included older age of MSW, CI with the last male partner, having a stable female partner (a consistent or main partner), and having ≥1 family member in the participants’ social network. Partner and social network characteristics associated with CI among MSW suggest the utility of dyadic and network interventions to reduce HIV risk. / National Institute of Mental Health / Revisión por pares

Introduction HIV remains a severe global health problem. The Republic of Chad is moderately affected (1.3%), compared to Cameroon who suffers more of the burden of the HIV/AIDS (4.5%). We described the HIV risk factors in two neighboring Central African Republics, and compared the gaps in both countries. Methods This was a retrospective cross-sectional study; data was obtained from the Demographic and Health Survey. A stratified multi-stage cluster sample design was conducted. The sample size was 5248 in Chad and 7191 in Cameroon. We used SAS to fit a multilevel logistic model, and conducted a multivariate analysis. Results The median age of respondents was 30 (IQR, 20-40) years in Chad, and 28 (IQR, 20-40) in Cameroon. Only 12.45% reported had ever been tested for HIV in Chad, (41.77% in Cameroon). In Chad, 46.40% of participants did not know a place to get HIV test, (11.15% in Cameroon). The median number of lifetime sexual partners was 2 (IQR, 1-4) in Chad, and 6 (IQR, 3-15) in Cameroon. Among Chadian participants 31.63% had only one lifetime sexual partner, (10.76% in Cameroon). In Chad 86.95% of participants reported having no sex partner other than their spouse in the last 12 months; (57.3% in Cameroon). Conclusion Condom use and HIV testing rates were very low among Chadian men comparing to Cameroonian men; however, Cameroonian men were more likely to engage in multiple sexual partners and extra-marital relationship than Chadian men.

Examined within this study were the relations between two processes within sexual identity development, sexual identity exploration and sexual identity commitment, and risky sexual behaviors. The moderating effects of sexual identity commitment, sexual self-efficacy, and positive condom use attitudes on relations between sexual identity exploration and risky sexual behaviors were also examined. Risky sexual behaviors included the frequency of substance prior to and barrier protection use during sex, multiple sex partners, and the initiation of sex prior to age sixteen. Study participants included 322 college students attending an urban university in the Southeastern United States. All were heterosexual and reported engaging in vaginal, anal or oral sex in the past 30 days. A high percentage of study participants reported at least one risky sexual behavior in the past 30 days, and most reported not using barrier protection during anal and oral sex. No direct effects were found between sexual identity exploration and any risky sexual behavior. Only one direct effect was found between higher levels of sexual identity commitment and lower frequencies of barrier protection use for oral sex. No moderating effects were found for sexual identity commitment, sexual self-efficacy, or positive condom use attitudes on relations between sexual identity exploration and any risky sexual behavior. The findings highlight the importance of examining how to get emerging adults to consistently use barrier protection during any type of sexual behavior. The results also underscore the complexity of sexual risk-taking during emerging adulthood, and the need for continued examination of the ways in which processes associated with sexual identity development may impact sexual risk-taking during emerging adulthood.

Despite an increase in interventions targeted at lowering the rate of HIV/AIDS among college students, the rate of HIV/AIDS infections has not decreased. The purpose of this study was to identify factors (i.e., HIV-sexual knowledge, self-positivity bias, peer norms, acculturation, perceived risk of HIV, HIV-related stigma, and condom use) that may affect condom use among college students who live in an area where the prevalence of HIV is relatively high. The current study utilized a sexually active sample (N=397) of diverse college students (predominantly African American and White) in an urban setting to examine the relationships. Path analysis was used to explore hypotheses. Results indicated that students who endorsed higher levels of self-positivity bias were more likely than other students to report not using condoms the last time they had sex and to perceive themselves at less risk of HIV/AIDS infection. In addition, students who reported unsupportive peer norms regarding safe sex practices perceived themselves at a higher risk of HIV/AIDS. With respect to gender differences, females reported more stigma towards individuals with HIV/AIDS than males, and males reported more perceived risk of HIV/AIDS than females. Lastly, African American college students perceived themselves to be at greater risk of contracting HIV/AIDS than other students and minority students endorsed greater stigma towards individuals with HIV/AIDS than White students. Results emphasize the need for college HIV/AIDS interventions to target peer norms and personal bias as well as cultural and gender differences that might impact condom use.

The current project involved three studies designed to examine which characteristics of persuasive communications change condom use attitudes. Study 1 investigated the effect of message type (affective versus cognitive) and source (male versus female) on attitude change among a sample of African American women attending college. In Study 1 (N = 146), the affective message and female source produced the most positive change in condom use attitudes. Study 2 examined whether message type and source were associated with favorable condom attitudes in a community sample and whether these findings differed from a college sample. Twenty-seven women participated in group discussions and completed measures of attitudes and intentions. Similar to Study 1, the pattern of means in Study 2 showed the affective message delivered by the female source resulted in the most positive condom use attitude change. These results were not significant likely due to the small sample. Focus groups were also conducted to better understand the types of condom use messages African American women find effective. Several themes emerged: condom used primarily for pregnancy prevention; negative condom use attitudes; communicating messages through internet, TV, and radio; creating fun, catchy, and informative messages; using celebrities and peers to deliver messages; and increasing the frequency of messages to equal importance of topic. The third study assessed the effectiveness of an attitude change pilot intervention that was based on the results of Studies 1 and 2. The study used a 2 (intervention vs. control) X 3 (pretest, posttest, follow-up) mixed factorial design to examine whether women’s attitudes changed after a pilot session and whether the change persisted over time. African American women (N = 115) were recruited through Craigslist and community agencies. There were no significant differences across time for the intervention and the control group. Reasons for the lack of an effect in Study 3 are discussed. Taken together, these studies provide evidence that, under certain conditions an affective message delivered by a female source can change attitudes toward using condoms. The results of these studies could potentially enhance existing interventions by renewing a focus on changing attitudes as well as behavior.

Black women in the United States disproportionately represent 64% of women with an HIV infection (CDC, 2013). Research is needed to better understand gender and culturally-specific factors that contribute to Black women’s HIV risk. The Theory of Gender and Power and the Theory of Planned behavior were used as theoretical frameworks in examining the effect of attitudinal beliefs (gender related beliefs), subjective norm beliefs (peer norms), and perceived behavioral control beliefs (relationship power) on sexual behavior in Black college women. Condom use and assertiveness in sexual communication were the dependent variables. Participants included 136 Black college women recruited through the department of psychology’s subject pool and as student volunteers. Results revealed peer norms as a significant predictor of condom use, and agency and gender ratio imbalance beliefs as significant predictors of perceived relationship power. Findings have implications for understanding social and gender related factors for HIV prevention among Black women.

Bolivia has a high STI rate and an accelerating HIV/AIDS rate. The majority of the country's newly diagnosed HIV/AIDS cases come from the province of Santa Cruz in eastern Bolivia, where this study took place. In this study, the investigator assessed the notion that Bolivian truck drivers are a bridge population of HIV transmission within heterosexual networks. This investigation determined risks of HIV/STI transmission through interviews, surveys, and workshops given to the truck drivers. Special attention was given to self reports of sexual behavior, cognitions and ego maturation stages, in order to assess risk. Mixed methodology was the research paradigm of choice, utilizing qualitative and quantitative phases. Workshops were designed, implemented, and evaluated. Analysis was completed on survey results from 246 male truckers (aged 18 to 67). More than half (56%) of these truckers admitted to having sex with casual partners. In addition, from 30% (quantitative inquiry) to 52% (qualitative inquiry) of these truck drivers have had sexually transmitted infections. Three factors predicted condom use: Age, Outcome expectancies, and Perceived social norms. Only one factor predicted STI history: Number of sex partners. Adult stage theory did not directly impact sexual behavior. A high risk of HIV/STI transmission has been detected in Bolivian truck drivers. This notion supports other studies involving truck drivers, and calls attention to the need for tailored health education programs for this population. Furthermore, younger truck drivers are at greater risk of HIV transmission than older truck drivers, in spite of their increased condom use. Sexual health workshops for Bolivian truck drivers are worthwhile and can be most effective when co-managed with truck companies or unions. Counseling, testing, and follow up research programs can best be implemented through these already-existing management structures. Future programs need to emphasize other behaviors besides condom use. Workshops should also include truckers' spouses as participants. Lastly, since casual sex partners of truck drivers rarely fit the mold of a commercial sex worker, effort should be made to describe these casual partners and design subsequent workshops for them.

Studies on sexual behaviour in Nigeria have rather been lopsided largely focussing on adolescents while neglecting the older men. This may not be unconnected with the fact that the young people are often seen as being more sexually active than the older men. In this study, the patterns and the determinants of sexual behaviour of middle-aged men were investigated. This study is based on secondary data analysis of the 2003 Nigeria Demographic and Health Survey male dataset. Data collected from a sample of 633 men whose ages fall between 40 and 59 years in Nigeria were extracted and analysed to achieve the set objectives. The variables of interest were analysed by using relevant statistical techniques with the aid of SAS enterprise guide. Sexual behaviour was measured by three variables namely: current sexual activity, extra marital partnership and condom use. Also, three hypotheses were tested. The Health Belief Model (HBM) was the theoretical model used for this study. The study shows that a high proportion of men (71.2%) aged 40-59 years in Nigeria are sexually active. The study further reveals that about 12% of Nigerian middle-aged men engage in extramarital sex and 30% are in polygynous relationships (i.e. have multiple sex partners) while condom use is very low among them. Extramarital sex is more prevalent in the rural (7.05%) than urban (4.5%) areas. The study shows that the correlates of current sexual activity among the middle-aged men in Nigeria are education and religion while engagement in extramarital sexual activity is determined by ethnicity, age at first intercourse and knowledge of HIV/AIDS. Among the sexually active ones, condom use is influenced by ethnicity, marriage type and extramarital partnership. The sexual behaviour of middle-aged men in Nigeria follows the pattern described in the HBM. That is, individual, socio-economic and HIV/AIDS factors can influence the sexual behaviour of Middle-aged men. The study concludes that in addressing the problems associated with sexual and reproductive health of Nigerian, focus should also be extended to middle-aged men, instead of the narrow focus on only adolescents and youths. Further investigation, using multiple methods of data collection is also suggested.