Condom knowledge, history of use, and attitudes among chemically addicted populations

Is monogamy or committed relationship status a marker for low sexual risk among men in substance abuse treatment? Clinical and methodological considerations

BACKGROUND

HIV prevention interventions often promote monogamy to reduce sexual risk. However, there is little consensus about how to define monogamy.

OBJECTIVE

To determine the extent to which recent monogamy and/or being in a committed relationship serve as markers for low sexual risk among men in substance abuse treatment.

METHODS

Participants were 360 men enrolled in the National Institute on Drug Abuse Clinical Trials Network "Real Men Are Safe" protocol who completed all assessments (baseline, 3 months, and 6 months). Self-reported behaviors included number of sexual partners, type of relationships, frequency of vaginal/anal intercourse, and percentage of condom use.

RESULTS

The rate of self-reported monogamy in the prior 90 days was stable across assessments (54.2%, 53.1%, 58.3%). However, at each assessment 7.5-10% of monogamous men identified their partner as a casual partner, and only 123 (34.2%) reported being monogamous at every assessment. Of these, 20 (5.6%) reported being monogamous with different partners across assessments. Men with both committed relationship and casual partners reported more condom use with their committed relationship partners than men with only a committed relationship partner.

CONCLUSION

Clinicians and researchers should consider individual relationship context and behavior and avoid assuming that recent monogamy or being in a committed relationship denotes low risk.

SCIENTIFIC SIGNIFICANCE

This study provides evidence that, in male drug users, monogamy does not necessarily reflect low sexual risk. Rather, "monogamous" men actually encompass various combinations of partner types and levels of risk behavior that are unstable, even over brief time periods. Clinicians and researchers must take these variations into account.

Risk Factors for Heart Attack, Stroke, and Venous Thrombosis Associated With Hormonal Contraceptive Use

The search for a safe and effective method of contraception has been ongoing for centuries. During the last century, a variety of hormonal contraceptives, including combined hormonal oral contraceptives (COCs), have been introduced into the market. COCs have evolved through modifications of different hormonal components to minimize the risk of thrombotic events including stroke, myocardial infarction, and venous thrombosis. The evolution of COC development led to the reduction in the estrogen dose, in an attempt to lower the risk of vascular diseases. Although the risk of thrombotic events due to COC use has been substantially reduced since their inception, the quest for developing safer methods of birth control continues. It is of great interest to study coagulation effects of newer COCs, as well as progestin only, as rigorously as older COCs.

Attitudes and beliefs about HIV/AIDS behaviour and education among Tanzanian youth

BACKGROUND

Tanzania faced with an increasing problem from HIV sexual infection and vulnerability of students is a key concern. This paper explores beliefs, attitudes and behavioural perspectives on HIV/AIDS education among students in Tanzania as there has been few qualitative information on the subject.

METHODS

A total of 20 college students of both sexes were interviewed in a qualitative study. Health Belief Model and Social Cognitive Theory were used to guide the interview and constant comparative analysis on their attitudes, beliefs, behaviour and education towards HIV infection risks were utilised.

RESULTS

During the interview, the following topics emerged: misinformation and desire for HIV/AIDS education program in school curricula; perceptions of one's own and peer's susceptibility to HIV infection; social norms regarding sexual behaviour and perceptions regarding access to education and health services. Lack of accurate information and lack of education at home and at school further contributed to risk behaviour.

CONCLUSION

The study highlighted important perspectives of students towards HIV infection, risk behaviours which are important for HIV prevention programs for students. Based on the findings, recommendations for improvement in prevention programs among college students within Tanzanian schools context are discussed.

Condom attitudes and behaviors among injection drug users participating in California syringe exchange programs

This study examined condom attitudes, preferences, barriers, and use among a sample of 550 injection drug using clients of syringe exchange programs in California. In multivariate analyses, positive attitudes toward condoms were significantly associated with consistent condom use for vaginal, anal, and oral sex in the past six months, beyond the effects of confounding socio-demographic and HIV risk variables. Participants commonly cited partner-related barriers to condom use, such as reluctance to use condoms with steady partners (34%). Almost a quarter of the sample cited dislike of condoms (e.g., because of pleasure reduction). In addition, a third of respondents stated specific preferences regarding condom brands, sensitivity, sizes, and textures. Interventions that increase awareness about positive aspects of condom use and sexual risk from steady partners may be successful in increasing condom use among injection drug users.

The taking of free condoms in a drug abuse treatment clinic: the effects of location and posters

Drug abuse treatment programs can help reduce high-risk sexual behavior in drug users by promoting condom use. This study examined the influence of distribution location and poster prompts on the taking of free condoms in a drug abuse treatment clinic. Over 6 months, condoms were available alternately, with and without poster prompts, in the clinic's private restroom or public waiting area. Overall, 381% more condoms were taken from the restroom. The presence of poster prompts did not affect condom taking. These results suggest that distribution location is a critical factor in promoting condom taking in public clinic.

AIDS knowledge and risk behaviours among traumatic brain injury survivors with coexisting substance abuse

An exploratory needs assessment for AIDS education and prevention was conducted at a traumatic brain injury (TBI) rehabilitation facility among 29 clients that also experience coexisting substance abuse disorders. The results suggest that the surveyed clients possessed a moderate level of information about AIDS. Their knowledge level was variable with a major source of misinformation surrounding the use of condoms. The sample members' knowledge was not related to the type or severity of substance abuse, nor was it associated with safer sexual practices. The present results are compared to earlier findings that used an identical survey with a dual disordered population of psychiatrically impaired substance abusers. The results should help in developing an AIDS education and prevention programme for clients with the dual diagnosis of TBI and substance abuse. Clients need up-to-date information that can be comprehended and used. Education will need to be coupled with approaches that present both behavioural and attitudinal change strategies that are best suited to these clients.