Conclusions. The "bridging effect" for HIV transmission is evident. Variables predicting condom use during commercial sex are multidimensional. Integrative programs are hence required. Methadone clinics may offer a platform for offering such services to IDU-FSWs. The performance of the TPB could be enhanced by addition of external variables; its applicability varies according to the wellbeing status of the IDU-FSWs. Future randomized control studies are warranted to design effective evidence-based programs targeting IDU-FSWs. / Introduction. Injecting drug users (IDUs) drive the HIV epidemic in China. Female injecting drug users who are sex workers (IDU-FSWs) is a strategic "bridge population" for HIV transmission from the IDU to non-IDU populations. Background characteristics, health behavioral theories (e.g. the Theory of Planned Behavior, TPB), drug dependence, economic pressure, psychological problems, social support and gender power are potential predictors of condom use during commercial sex among IDU-FSWs. Most of these associations have not been investigated in China or elsewhere, and the TPB has not been applied to HIV-vulnerable populations in China. A knowledge gap exists. / Objectives. This study validated two instruments measuring severity of drug dependence. The prevalence of inconsistent condom use among IDU-FSWs and its associations with the aforementioned variables were investigated. The hypotheses that different blocks of variables would have independent effects on condom use during commercial sex, and the effects of TPB-related variables on condom use would be moderated by some external variables (e.g. severity of drug dependence) were tested. / Results. The Opiate Addiction Severity Inventory-Revised (OASI-R) was fully validated in the Study I. Around 6.8% of IDU-FSWs were HIV positive and respectively 48% and 64% of them practiced needle sharing and unprotected commercial sex (last six months). After adjusting for significant background variables, the five TPB-related variables (AOR=0.43 to 1.92, p<0.001), severity of drug dependence (AOR=1.05, p<0.01), economic pressure (AOR=1.07, p<0.05) and all studied psychosocial variables (e.g. depression, social support and gender power; AOR=0.70 to 1.67, p<0.05) were significantly associated with condom use during commercial sex. / Subjects and methods. Two cross-sectional studies were conducted. In Study I, 178 non-institutionalized drug users were interviewed in Dazhou, Sichuan. In Study II, 281 non-institutionalized IDU-FSWs were interviewed in Dazhou, Sichuan and Hengyang, Hunan, using snowballing method and face-to-face interviews. Statistical methods such as hierarchical and interaction modeling, stratification analysis, ROC method were used in this study. / The final hierarchical model predicting condom use during commercial sex included variables coming from four blocks of independent variables, with ROC area = 94% and sensitivity/specificity = 0.84/0.91. A "Wellbeing Status Index" moderated the associations between some of the TPB-related variables and condom use during commercial sex. / Gu, Jing. / Adviser: Joseph T. F. Lau. / Source: Dissertation Abstracts International, Volume: 70-06, Section: B, page: 3462. / Thesis (Ph.D.)--Chinese University of Hong Kong, 2008. / Includes bibliographical references (leaves 228-246). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Electronic reproduction. [Ann Arbor, MI] : ProQuest Information and Learning, [200-] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Abstracts in English and Chinese. / School code: 1307.

Hepatitis C (HCV) infection is associated with high rates of mortality and morbidity. Interferon alpha based treatment for HCV offers a good rate of viral clearance, however the associated neuropsychiatric side effects increase the risk of treatment interruption and disease progression. The HIV/HCV coinfection is of particular interest due to association with higher rates of HCV treatment side effects and earlier treatment discontinuation when compared with HCV mono-infection. Therefore, the aim of the thesis was to further explore the effect of coinfection on mood and cognition and how HCV interferon based treatment influences neuropsychiatric side effects in mono and co-infected samples. Firstly a meta-analysis was performed to explore cognitive impairment and depression in HIV HCV co-infection. The results suggested that there was consistent literature indicating that the coinfected group were more cognitively impaired and more likely to be depressed than the HCV and HIV monoinfected groups. Secondly empirical studies were conducted to analyse the profile of depression during interferon-based treatment, and explore potential risk factors, such as gender and immune profile. Co-infected patients appeared less vulnerable to the emergence of depressive symptoms during HCV treatment than HCV mono-infected patients. Additionally, neither female gender nor immune response were associated with increased vulnerability to depression. Finally, a longitudinal study investigating cognitive performance during interferon-based treatment was conducted. A significant effect of treatment on information processing speed level of executive function was observed. Overall the research reported in this thesis further clarifies the nature of interferon induced depression and cognitive effects differences between mono and coinfected groups. Having identified a neurovegetative symptom profile and speed of processing impairment of executive function during HCV treatment, the discussion considers the potential of targeted interventions via psychotropic medication and cognitive interventions to minimise the impact of these treatment effects and optimise outcomes in this clinical group.

Research has identified a strong correlation between HIV/AIDS and gender-based violence, yet few studies centre the experiential knowledge of HIV sero-positive women and practitioners. This thesis, based on fieldwork conducted in the Gambia, is grounded in data on HIV positive women's experiences of violence and practices of resistance, revealing context specific complexities and challenges. Data collection methods included diaries, focus groups and in-depth individual interviews with a participant group of sixty sero-positive women in six Gambian HIV Support Societies, and twenty field practitioners working in the areas of violence and HIV/AIDS. I argue in this thesis that there are intersecting underlying factors (patriarchy, gerontocracy and structural violence) that contribute to women's experiences of violence and abuse that render them vulnerable to HIV. In addition, that alongside the more visible gendered violences which intersect with HIV/AIDS. Accounts of women living with HIV revealed that stigma is discreditable and discredited attributes. It contends that stigma should be seen as an ‘everyday' practice of normalised violence, which has very harmful emotional, psychological, economic and physical effects. The research also suggests that violence against women in the context of HIV is not limited solely to male perpetrators. In the Gambia there has been limited success in the translation of women's rights agendas into concrete and effective interventions, partly due to a lack of attention to socio-cultural context and the lived experiences of HIV positive women. The thesis concludes that culturally specific, integrated health and social justice approaches are necessary, which are grounded in women's everyday practices of agency and resistance, and which in particular address the fear of dethronement (loss of power, privileges and prestige) amongst men and older members of society.

This thesis seeks to contribute to knowledge on how sameness and difference play out in personal and professional South-South relations, through an ethnography of interactions between Brazilian and Mozambican development workers, in the HIV&AIDS and gender fields, in Mozambique. The thesis is structured around nine chapters. The introduction outlines the research context, the conceptual frameworks, the key terminology used in the thesis, as well as how my personal and professional life-story inspired this research. In Chapter Two, I discuss the research methodology, sites and spaces, describe the process of multi-sited ethnography in Brazil and Mozambique and reflect about my positionality. The main body of the thesis moves from the macro to the micro level. Chapters 3 and 4 map the reproduction of development and knowledge hierarchies within South-South cooperation institutional discourses and practices and the production of a political economy of opportunities and international mobility for Brazilian development workers. The following chapters discuss how difference and sameness, proximity and distance, and horizontality and verticality are experienced in interactions between Brazilian and Mozambican development workers. Chapter 5 explores principal ways in which the notion of kinship structure relations and imaginaries. Chapter 6 examines affinities, hierarchy and power in an International Non-Governmental Organisation office in Maputo, while Chapter 7 discusses political affinities in feminist knowledge practices. I then analyse the interconnections between the personal, professional and political (Chapter 8) through examining the potential for professional relationships to evolve into something more personal. Chapter 9 concludes the thesis with a review of my findings in the light of the main research question and outlines this thesis' contribution to academic debates on feminist organising, aid ethnographies and South-South relations.

Submitted by Suzana Dias (suzana.dias@famerp.br) on 2018-10-31T18:37:25Z No. of bitstreams: 1 LudmilaMoreiraVasconcelos_dissert.pdf: 1613747 bytes, checksum: af77415c21324e1dbbeddf59d74195ea (MD5) / Made available in DSpace on 2018-10-31T18:37:25Z (GMT). No. of bitstreams: 1 LudmilaMoreiraVasconcelos_dissert.pdf: 1613747 bytes, checksum: af77415c21324e1dbbeddf59d74195ea (MD5) Previous issue date: 2017-04-17 / early detection of latent tuberculosis infection is one of the TB control strategy recommended by the World Health Organization. Objective: to analyze the association of latent tuberculosis infection with sociodemographic, clinical and risk factors for active TB cases chemoprophylaxis. Material and Methods: A retrospective cross-sectional epidemiological study, based on secondary data chemoprophylaxis notification form of tuberculosis of the state information system (TBWEB) of Epidemiological Surveillance Group XXIX (GVE 29) of São José do Rio Preto. They considered all reported cases from 2009 to 2013. The selected variables were sociodemographic and clinical. For the analysis, all statistical tests were applied with a 0.05 significance level. The software used for analysis were Minitab® 17 (Minitab Inc.) and Statistica 10 (StatSoft Inc.). Results: predominance of females, mean age 37.51 years and median of 40.00 years. Smear the day with negative sputum was associated significantly with cough (P = 0.001) and occupation (P <0.001). Few HIV / AIDS and health care professionals made the smear and sputum culture. Conclusion: The study found it hard both in screening latent tuberculosis, as in diagnosis and treatment, which may contribute to the spread of TB and multidrug resistance, increasing the morbidity and mortality rates from the disease, particularly among co-infected with HIV. / a detecção precoce da tuberculose infecção latente é uma das estratégias de controle da tuberculose recomendada pela Organização Mundial de Saúde. Objetivo: analisar a associação da tuberculose de infecção latente com variáveis sociodemográficas, clínicas e fatores de risco para tuberculose ativa de casos de quimioprofilaxia. Material e Método: estudo epidemiológico transversal retrospectivo, a partir de dados secundários da ficha de notificação de quimioprofilaxia da tuberculose do sistema de informação estadual (TBWEB) do Grupo de Vigilância Epidemiológica XXIX (GVE 29) de São José do Rio Preto. Foram considerados todos os casos notificados de 2009 a 2013. As variáveis selecionadas foram as sociodemográficas e clínicas. Para a análise, todos os testes estatísticos foram aplicados com nível de significância de 0,05. Os softwares utilizados para análise foram o Minitab® 17 (Minitab Inc.) e Statistica 10 (StatSoft Inc.). Resultados: predomínio do sexo feminino, idade média 37,51 anos e mediana de 40,00 anos. Realização da baciloscopia com resultado negativo do escarro se associou de forma significativa com a tosse (P=0,001) e ocupação (P<0,001). Poucos portadores de HIV/Aids e profissionais de saúde realizaram a baciloscopia e cultura do escarro. Conclusão: O estudo mostrou dificuldades tanto no rastreio de tuberculose infecção latente, como no diagnóstico e tratamento, o que pode contribuir para a multirresistência e disseminação da TB, aumentando as taxas de morbimortalidade pela doença, principalmente entre os coinfectados pelo HIV.

Background: Though there continues to be a significant amount of research aimed at understanding factors associated with participating in sexual risk behavior in populations of YBMSM, there has been far less research concerned with understanding how psychological distress may influence sexual risk behaviors and how emotional bond formation may affect the relationship between psychological distress and sexual risk behavior. This study aims to better understand the relationship between psychological distress and sexual risk behavior as well as the moderating effect of adult attachment insecurity on this relationship. Methods: Three data collection strategies were utilized to address the study aims: 1) cross-sectional (n = 228), 2) eight-week structured diary (n = 153), and 3) semi-structured interview (n = 30). The cross-sectional survey provided measurement information on adult attachment style using a modified version of the Experiences in Close Relationships Scale (ECR) that consists of the attachment avoidance and anxiety subscales, the Brief Symptoms Inventory (BSI) and the Kessler-10 (K10). Sexual risk was measured by assessing unprotected anal intercourse (UAI) and serodiscordant UAI in the last two months. The eight-week structured diary utilized weekly reports of UAI encounter vs. no UAI encounter, and serodiscordant UAI encounter vs. no serodiscordant UAI encounter. The K10 and the Profile of Moods (POMS) anxiety and depression subscales measured psychological distress. The semi-structured interview assessed childhood attachment. Regression analyses were used to analyze the cross-sectional data. Random effects and population average regression models were used to analyze the structured diary data. A thematic inductive analysis technique was utilized to analyze the qualitative data. Results: Overall, participants reported slightly elevated mean scores on the attachment anxiety subscale while scores on the attachment avoidance subscale remained low. Participants reported an average of two UAI partners in the last month and an average of 1.3 UAI encounters over the eight-week diary period. Psychological distress scores were slightly elevated in the cross-sectional survey and depression scores were elevated in the diary component. For Aim 1, men higher on attachment insecurity (anxiety and avoidance) had higher levels of general psychological distress, depression, and anxiety in comparison to men who were more secure. The qualitative data supported the quantitative findings and showed that subjective appraisal of traumatic events and sexual orientation disclosure may mediate the relationship between childhood attachment and adult mental health. For Aim 2, the quantitative findings suggested that attachment insecurity was not related to sexual risk behavior. However, the qualitative component suggested that participants who were anxious used sex as a means to try to create an emotional bond, while participants who were avoidant used sex as a means to feel good without wanting to create an emotional bond. Both anxious and avoidant men seemed to participate in more concurrent sexual relationships which could increase their likelihood of HIV/STI transmission. For Aim 3, men who were more depressed and had higher levels of general psychological distress were more likely to report a serodiscordant UAI encounter in a given week. The qualitative data supported the quantitative findings and suggested that men might use sex as a means of escape their negative mood. This model of "escapism" could have lead to participation in sexual practices that increased men's risk of HIV/STI transmission. For Aim 4, adult attachment insecurity did not moderate the relationship between psychological distress and sexual risk. The qualitative data suggested that secure attachment in childhood was important to adequately coping with stressful situations, which in turn promoted overall well-being. Conclusion: Study findings suggest that understanding adult attachment may lead to a better understanding of psychological distress and sexual risk behavior among YBMSM. The results highlight the importance of considering childhood and young adult emotional bond formation in the development of HIV/STI prevention intervention activities aimed at addressing the heightened rates of sexual risk behavior among YBMSM. This research could have valuable implications for the development of HIV/STI and mental health prevention interventions aimed at reducing sexual risk behaviors and promoting well-being in populations of YBMSM

Aside from sub-Saharan Africa, the Caribbean is the only region where the number of women and girls living with human immunodeficiency virus (HIV) is greater than that of men and boys. In the Dominican Republic (DR), the number of all diagnosed HIV cases that were women increased from 27% in 2003 to 51% in 2013, which indicates a shift in the burden of HIV from men to women. Women in stable relationships in the DR have risk for HIV and other sexually transmitted infections (STIs) related to high rates of multiple concurrent partners and low condom use among stable partners. Past HIV prevention efforts in the DR have largely focused on encouraging consistent condom use. However, this may not be a feasible solution for women in relationships. In this dissertation, I sought to examine safe sex communication (SSC) as a possible alternative to consistent condom use for HIV/STI prevention among women in stable heterosexual relationships in DR. I began by conducting an integrative literature review and identified multiple relationship, individual, and partner factors related to SSC among Latina women in stable relationships. Then I conducted a mixed methods study guided by the Theory of Gender and Power with women in stable heterosexual relationships who seek care at Clínica de Familia La Romana in the DR. First, I conducted a qualitative descriptive study to describe SSC. Emergent content analysis of eleven interview transcripts following Colaizzi’s method revealed two main themes: (1) Context of sexual risk (i.e., the meaning of safe sex for stable partners, behaviours related to sexual risk, beliefs and attitudes related to sexual risk, confianza (trust) between stable partners, economic power within relationships, and learning to manage safe sex within a stable relationship) and (2) SSC (i.e., reasons to talk about safe sex, methods, content, and outcomes, influential factors, and ideas for improvement). Second, I conducted a cross sectional survey with 100 women to identify psychosocial correlates of SSC. The mean age of women was 35.72 years, average relationship length was 8.5 years, and 46.91% were living with HIV. Logistic regression analysis revealed that lower SSC self-efficacy (OR = 0.20, 95% confidence interval = 0.08 – 0.50) and greater difference in age between partners (OR = 0.91, 95% confidence interval = 0.85 – 0.98) were both significantly related to less SSC. Information from this dissertation can be used to help identify women in the DR who are at risk for poor SSC with their stable partners and guide researchers, health care providers, and other individuals involved in efforts to reduce HIV/STI risk among this population to develop more effective interventions for this population. Future research should determine which safe sex behaviors SSC is related to among Latina women with stable partners, as well as which aspects of SSC can be generalized to women of all Latino subcultures and nationalities. Additionally, more information is needed about the male partner’s role in SSC within their stable relationship and what factors influence partner SSC among Latino men in stable relationships.

This dissertation is among the first ethnographic investigations of HIV/AIDS programs in the Middle East and North Africa (MENA) region. Contemporary representations of the region’s HIV/AIDS epidemic often recycle simplistic orientalist tropes, lumping together diverse countries, communities, and histories under the rubric of a shared socio-cultural and religious context. This cultural heritage is presumed to explain both the region’s seemingly unique epidemiological dynamics and its reportedly extreme forms of stigma and taboo. Public health efforts in the region aim to ‘lift the veil’ on HIV risk, and efforts are currently underway across the MENA to bring groups like sex workers and men who have sex with men – considered to be ‘at risk’ by virtue of their sexual behaviors – “out of the shadows” (UNAIDS 2010). Drawing on 26 months (2009 – 2013) of ethnographic research in Morocco, I approach internationally circulating best practices in HIV prevention as technologies of visibility that seek to expose particular bodies to forms of surveillance and management. In the process, I argue, they also serve to highlight certain narratives about risk and vulnerability, and spotlight particular fault-lines in the Moroccan social terrain. What is unique and notable about HIV transmission and prevention in the MENA region, I argue, is not a singular ‘Muslim culture’ steeped in stigma and taboo. Rather, what is remarkable about HIV/AIDS in the region is the way that epidemiological markers of sexual risk, as well as efforts to make that risk visible, become entangled in historically important debates about cultural authenticity, distinctions between public and private, and processes and pressures for social and political change. This research explores tensions between a focus on individual-level HIV risk, on the one hand, and the potential for political action to address the structural factors of collective HIV- related vulnerability, on the other. I ask, how do the new visibilities of HIV/AIDS prevention open up or foreclose possibilities for politicizing risk and vulnerability? Here, my research foregrounds the narratives of women recruited by AIDS organizations, who are largely from precarious socio-economic backgrounds and are often single heads of households. My interlocutors used a variety of discursive strategies to frame their vulnerability in ways that challenged the limited lens of individual sexual risk that HIV/AIDS organizations tended to promote; for example, these women drew on religious discourses to highlight a failed social contract, in which a corrupt class of rich Muslims neglected their duties to the Muslim poor. In this context, my interlocutors attempted to de-exceptionalize sex work by highlighting commonalities with the arduous and exploitative aspects of other forms of low-wage labor, at the intersection of gendered and class-based inequalities. And they spoke about the inadequacies of a healthcare system and a social service sector – which included AIDS organizations – that was not equipped to care for the poorest and most vulnerable. Importantly, this research itself might be understood as a technology of visibility with the power to uncover a particular, socially situated story about HIV/AIDS work in Morocco. Here, I seek to provide, not a sensational tale about Arab-Muslim culture, nor a melodramatic representation of sexual exploitation, but a story of how public health best practices render (in)visible and (de)politicize particular social fault lines in the process of reading and responding to the spread of HIV/AIDS. Through a comparison of the everyday labor of two AIDS organizations, I show how incorporating an ‘ethnographic’ view of the lives of ‘at-risk’ groups can help elucidate socio-structural aspects of risk and vulnerability. Thus, under the right conditions, I suggest that particular institutional forms may, in fact, produce visibilities that harbor the seeds of meaningful participation, activism, and political change.

Conclusion. The significance of risk perception in predicting behavioral intention, hence actual future behaviors, is therefore evident. Conditional measures need to be used. HIV prevention can employ conditional risk perception approaches. Health behavioral theories can be strengthened by using such conditional measures on risk perceptions. The results add to this new and growing area of risk behavior research. / Introduction. Risk perception, a core element of key health behavioral theories and health interventions, is assumed to motivate people to avoid risk behaviors. Mixed findings however prevail in the literature due to methodological issues. Many of such studies are cross-sectional, using global risk perception measures that do not condition on type of risk behavior or partnership which may affect the level of risk. / Male injecting drug users (IDU) are driving the HIV epidemic in China and bridge HIV transmission to non-IDU female populations; they may be at risk of both unprotected sex and syringe sharing. HIV prevention targeting male IDU is greatly warranted and would benefit from understanding of the relationships between risk perceptions and behaviors, in the context of health behavioral theories such as the Health Action Process Approach (HAPA) model, which had not been applied to studies targeting IDU. / Objectives. This study refined the concepts and measures of HIV-related risk perception, conditioning on different types of behaviors and partners, and extended it to include others-directed risk perceptions. The relationship between such conditional risk perception measures and both prior risk behaviors and behavioral intention to avoid sex-related and drug-related risk behaviors in the future were investigated and were compared to those involving global unconditional risk perception measures. The nature of the aforementioned relationships, being motivational or reflective was investigated. A longitudinal component validated the predictive power of behavioral intention over actual future behaviors. / Results. Almost 90% of the respondents had had unprotected sex though &lt;20% shared syringes with others in the last 6 months. Prior syringe sharing but not unprotected sex in the last 6 months was significantly associated with global unconditional risk perception measures. The picture is totally different when risk perception measures conditioned on type of sex partner and unprotected sex or syringe sharing were used instead of the global measures---higher levels of the conditional risk perception measures were significantly associated with higher levels of behavioral intention for consistent condom use and avoidance of syringe sharing, thus supporting the motivational hypothesis. Conditional others-directed risk perceptions (perceived risk of transmitting HIV to others via unprotected sex and syringe sharing) were also associated with the aforementioned behavioral intentions to avoid risk behaviors. A pilot longitudinal study showed that behavioral intentions strongly predict actual future behaviors. Other HAPA-based variables such as self-efficacy and outcome expectancies had predictive effects on behavioral intentions, independent from those of risk perceptions. / Subjects and methods. A total of 456 sexually active male IDU were recruited from Dazhou, Sichuan and Hengyang, Hunan, via snowball sampling. With informed consent, anonymous face-to-face interviews were conducted by trained and experienced staff of the local CDC in privacy settings. / Tsui, Hi Yi. / Adviser: Joseph Lau. / Source: Dissertation Abstracts International, Volume: 72-04, Section: B, page: . / Thesis (Ph.D.)--Chinese University of Hong Kong, 2010. / Includes bibliographical references (leaves 118-130). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Electronic reproduction. Ann Arbor, MI : ProQuest Information and Learning Company, [200-] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Abstract also in Chinese; appendix in Chinese.

Li, Huizhen. / "March 2008." / Thesis (M.Phil.)--Chinese University of Hong Kong, 2008. / Includes bibliographical references (leaves 139-150). / Abstracts in English and Chinese. / Abstract --- p.ii / Acknowledgement --- p.vii / Abbreviations --- p.ix / Introduction --- p.1 / Chapter 1.1 --- HIV and AIDS --- p.4 / Chapter 1.1.1 --- HIV Transmission Routes --- p.5 / Chapter 1.1.2 --- HIV Related Risk Behaviors --- p.6 / Chapter 1.2 --- HIV Burden --- p.7 / Chapter 1.2.1 --- HIV Infection in China --- p.7 / Chapter 1.2.2 --- HIV Infection in Hong Kong --- p.9 / Chapter 1.2.3 --- Methadone Treatment in Hong Kong --- p.10 / Chapter 1.3 --- Objectives and Hypothesis --- p.14 / Chapter 1.4 --- Organization of This Thesis --- p.15 / Literature Review --- p.16 / Chapter 2.1 --- Search Methods --- p.18 / Chapter 2.1.1 --- Formulating Review Questions --- p.18 / Chapter 2.1.2 --- Search Strategy --- p.19 / Chapter 2.1.3 --- Inclusion and Exclusion Criteria --- p.21 / Chapter 2.2 --- Assessing the Quality of Studies --- p.22 / Chapter 2.3 --- Search Results --- p.23 / Chapter 2.3.1 --- Descriptive Summary --- p.25 / Chapter 2.3.2 --- Critique of Reviewed Articles --- p.33 / Chapter 2.4 --- Implication on Planning of Current Study --- p.37 / Chapter 2.4.1 --- Summary of Reviewed Articles --- p.37 / Methods for Exploring Predictors of HIV Risk --- p.40 / Chapter 3.1 --- Data Source --- p.42 / Chapter 3.1.1 --- Data Management in Methadone Clinics --- p.42 / Chapter 3.1.2 --- Source of Data --- p.43 / Chapter 3.2 --- Data Transformation --- p.45 / Chapter 3.3 --- Framework for assessing outcome --- p.48 / Chapter 3.3.1 --- Study population in different analyses --- p.48 / Chapter 3.3.2 --- Risk Score --- p.49 / Chapter 3.3.3 --- Independent Variables --- p.50 / Chapter 3.4 --- Generalized Linear Model --- p.52 / Chapter 3.5 --- Logistic Regression Model --- p.54 / Chapter 3.6 --- Multilevel Analyses --- p.55 / Chapter 3.6.1 --- Variables --- p.56 / Chapter 3.6.2 --- Definition of 'Neighborhood' --- p.56 / Chapter 3.6.3 --- Individual Variables --- p.60 / Chapter 3.6.4 --- Framework for Analyses --- p.60 / Chapter 3.7 --- Field Study --- p.63 / Results: Community Variation of HIV Risk --- p.65 / Chapter 4.1 --- Demographic Description --- p.67 / Chapter 4.1.1 --- Age distribution --- p.67 / Chapter 4.1.2 --- Gender Distribution --- p.68 / Chapter 4.1.3 --- Proportion of New Admission --- p.72 / Chapter 4.2 --- Drug Taking Profile --- p.74 / Chapter 4.2.1 --- Heroin Use --- p.74 / Chapter 4.2.2 --- Injecting Heroin Users --- p.77 / Chapter 4.3 --- HIV related risk behaviors --- p.81 / Chapter 4.3.1 --- Injection History --- p.81 / Chapter 4.3.2 --- Risky Injection Practices --- p.87 / Chapter 4.3.3 --- Sexual Behaviors --- p.93 / Chapter 4.4 --- Correlation between Demographics and Risk Score --- p.94 / Chapter 4.4.1 --- General Linear Regression Model Coefficient --- p.94 / Chapter 4.4.2 --- Risk Predictors in Logistic Regressions --- p.95 / Chapter 4.5 --- Neighborhood Effect --- p.100 / Chapter 4.6 --- On-site Observation --- p.103 / Chapter 4.6.1 --- Demographic Variations --- p.103 / Chapter 4.6.2 --- Drug Use Variations --- p.104 / Chapter 4.6.3 --- Social Background --- p.105 / Discussion --- p.111 / Chapter 5.1 --- Neighborhood Effect --- p.113 / Chapter 5.1.1 --- Variation across Communities --- p.113 / Chapter 5.1.2 --- Implication on Social Network of IDUs --- p.115 / Chapter 5.2 --- Decline of Admissions --- p.117 / Chapter 5.2.1 --- Decrease of New Admissions --- p.117 / Chapter 5.2.2 --- Decline of Readmission in 2003 --- p.119 / Chapter 5.3 --- Female IDU Population --- p.121 / Chapter 5.4 --- Limitations --- p.125 / Chapter 5.4.1 --- Importance of Individual Level Variables and Community Level Variables --- p.125 / Chapter 5.4.2 --- Reliability of Self-reported Data --- p.126 / Chapter 5.4.3 --- Duplicates of Readmissions --- p.126 / Chapter 5.4.4 --- Definition of Syringe Reuse --- p.127 / Chapter 5.4.5 --- Choice of Models --- p.129 / Conclusion and Future Directions --- p.131 / Chapter 6.1 --- Summary of Results --- p.133 / Chapter 6.2 --- Implication of results --- p.134 / Chapter 6.3 --- Future Directions --- p.136 / Bibliography --- p.139