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

Thesis (MPH.) -- University of Limpopo, 2016 / BACKGROUND: In Botswana, women and girls continue to be disproportionately affected by HIV/AIDS. According to the UNAIDS in 2009, 170 000 of the estimated 300000 adults living with HIV or one quarter of the population aged 15 and over were women. HIV prevalence trend among pregnant women (Botswana Sentinel Surveillance 2001-2009) aged 15-49 years attending antenatal in public clinics is 31.8%. The national HIV prevalence amongst the women surveyed has shown a decline of prevalence from 36.2% in 2001 to 30.4% in 2011. AIM OF THE STUDY: The aim of the study was to determine the perceptions of women of reproductive age in Nkoyaphiri clinic, Mogoditshane village towards the use of female condom (FC). METHODS: A descriptive cross-sectional design was used on a sample of 125 women of reproductive age in Nkoyaphiri clinic in Botswana. A self-administered questionnaire written in both English and Setswana were given to 125 women of reproductive age. Their responses were coded, cleaned and entered into SPSS version 21.0 software for analysis. FINDINGS: About 92% of women of reproductive age heard about FC, more than half (64.8%) of respondents reported that they do not know how to use FC, and 88% have never used FC. The results had shown that a higher percentage (88%) of respondents have never ever used FC compared to (12%) that have used it. Most participants 46.4% believed that FC can prevent unwanted pregnancies, the Sexually Transmitted Infections (STI) and HIV/AIDS 42.4%. The results also show that 18.4% of respondents often use female condom inconsistently, while 3.3% cited it as their current contraceptive method. CONCLUSION: The results of this study shows that the level of FC use is lower (12%) among respondents, compared to 88% who never used FC. This shows that majority of women had never used FC. This results show that a lot still needs to be done in promoting the use of FC and strategies should be designed to send information to all individuals. Lack of knowledge on the use of FC contributes to lack of use of FC among women.

Introduction: Intimate Partner Violence (IPV), also called domestic violence, is defined as any physical, psychological, or sexual violence, and emotional violence perpetrated by an intimate partner (CDC, 2016). Sexual violence or rape is defined as a sexual act committed against someone without that person’s freely-given consent (CDC, 2017). IPV is experienced among heterosexual women globally, although this phenomenon is not unique to this population. IPV also disproportionately affects young gay, bisexual, and other men who have sex with men (MSM) (Stults et al., 2016). The purpose of this study is to examine the association between IPV victimization and the increased risk of HIV and other health outcomes among YBMSM. Methods: The 6-month follow-up was conducted in Jackson, MS. A total 600 YBMSM were eligible to participant in the study. The participants were recruited from two local clinics that were focused on diagnosing and treating STI’s. Also, recruiters promoted the opportunity to enroll in the study through social media, attending bars, and nightclubs. Inclusion criteria were: 1) assigned male at birth; 2) self-identification as Black/African American; 3) 15-29 years of age; 4) attending the clinic to be tested for HIV or other STIs, 5) having engaged in anal sex with a male partner at least once in the past 6 months, and 6) the ability to speak and comprehend English. Results: The overall study sample consisted of 600 YMSM. All participants were identified as African–American. The average age of the sample was 22.6 years (SD=±3.2). Bottoms were more likely to experience rape (AOR=1.7,CI 1.1,2.6; p=.02). YBMSM who experienced IPV since enrolling in the study, as compared to those who did not experience IPV, were more likely to use marijuana, alcohol, crack, and painkillers (AOR=7.7 ,CI 5.1,11.7; p= Conclusion: These findings suggest that IPV and Rape shows a significant association with decreased condom use, decreased condom negotiation, sexual position, drug use and HIV risk among YBMSM in Jackson, MS.

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 study investigated if condom outcomes vary as a function of perceived group support (from members of the group) and ethnic identity among participants in an HIV prevention intervention. The peer-led intervention consisted of an empirically supported curriculum, Sisters Informing Sisters on Topics about AIDS (SISTA) with an additional component that addressed the role of alcohol/drugs in risky sexual behavior. Participants included 263 unmarried, heterosexual, African American women who were recruited from three universities. At post-test, perception of a supportive group environment was associated with positive attitudes towards condom use. In addition, ethnic identity was associated with positive attitudes toward condom use and with higher condom negotiation efficacy. However, the study hypotheses were not supported because after controlling for pre-test scores, partner status, and relationship length these associations were no longer significant. The findings also indicated that participants reported more consistent condom use and condom protective attitudes at post- than at pre-test. Findings suggest that further research is needed to understand the role that support and ethnic identity plays in interventions for African American women.

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.