The Effect of a Brief HIV Prevention Program on Risk Reduction Behaviors Among Thai Men Diagnosed With Sexually Transmitted Infections

HIV Prevention and Sexual Health Conversations Among Women in Ending the HIV Epidemic Priority Communities: A Qualitative Exploration of Experiences and Preferences

Despite significant advances in HIV prevention, women comprise ~ 20% of new HIV infections in the USA. New infections occur primarily in the South and among Black women, with research demonstrating that insufficient knowledge, inaccurate risk assessment, and HIV stigma impair HIV prevention. Understanding how cisgender women wish to communicate about sexual health and HIV prevention is vital to facilitating conversations about, and subsequent uptake of prevention methods. A total of 70 individuals who lived or worked in four HIV prevention priority counties in the state of Georgia were recruited through community-based organizations (CBOs) and flyers. Consenting participants completed 30-45-min interviews. Interviews were transcribed verbatim; transcripts were coded deductively and inductively. Participants were primarily female-identifying (91%) and were primarily Black. Overall, participants noted that community-level conversations about sexual health among women were limited due to stigma, despite endorsed comfort with conversations. Participants noted that media/community sources implied HIV prevention was unneeded for cisgender women. CBOs and informed community members were endorsed as trusted sources for information; clinicians were cited as a theoretically trusted source, particularly sexual health preventative care providers with established patient relationships, though barriers of medical mistrust, lack of cultural concordance, and stigma were noted. Suggestions for improved communication around HIV prevention included use of community members/trusted sources to facilitate conversation, promotion of non-judgment in clinical practice, and prevention awareness building. Participants' responses suggest little-to-no movement in knowledge of HIV prevention for US women. Engagement of CBOs in community education, training of community leaders, and integration of trauma-informed and patient-empowering clinical practices should be explored to promote increased HIV prevention discussion and uptake among cisgender women in the US South.

Development of a HIV Prevention Program to Promote Condom Use Among Iranian Female Sex Workers: Application of An Intervention Mapping Approach

We used an Intervention Mapping Approach (IMA) to derive multi-level HIV prevention strategies aiming to develop an HIV prevention intervention program among female sex workers (FSWs). We also aimed at pilot testing the effects of the IMA-based "HIV Prevention and Awareness Program (HIV-PAP)" on safe sex behaviors and its determinants among FSWs in Tabriz, Iran. To develop HIV-PAP, we conducted the six-step process of IMA. At Step 1, in a cross-sectional study, 140 FSWs were face-to-face interviewed. At Step 2, the program matrix was provided based on the importance and variability for identifying priority factors. At Steps 3 and 4, the methods and strategies for behavioral change were selected, and the HIV-PAP program components and materials were developed. At Steps 5 and 6, evaluation (as a pilot testing with Static-Group Comparison design) was conducted applying a pre-experimental study, in which 30 FSWs were assigned to intervention (n = 15) and control (n = 15) groups. The intervention group participated in a two-month long program, and one month later, the initial questionnaires were completed by both groups. The respondents (M age: 33.4 years, SD: 9.7) acquired low score (less than 50%) in negotiating for condom use (49.8%) only, and moderate scores (50-65%) in perceived social support (61.6%) and knowledge (60.5%). Adjusted for other variables, the factors (R2 = 32.0%) associated with safe sex behaviors among FSWs were predisposing factors [self-efficacy (β = 0.331), perceived norms (β = 0.945), and perceived barriers (β = 0.258)], condom use negotiation (β = 1.386), and environmental factors (β = 0.333). Our IM-based framework had an adequate fit index (χ2 = 130.8, CFI = 0.78). Looking for inter-group comparison after intervention, we found significant mean difference (MD) for knowledge (MD: 2.18; 95% Confidence Interval (CI) - .38 to 4.74, p < 0.05), self-efficacy to use condom (MD: 6.71; 95% CI - 1.85 to 9.29, p < 0.05), perceived risk (MD: 2.03; 95% CI 0.58, to 3.49, p < 0.05), perceived social support (MD: 4.64; 95% CI - 5.37 to 11.31, p < 0.01), and safe sexual behaviors (MD: 7.75; 95% CI - 4.19 to 9.71, p < 0.05). The HIV-PAP showed effectiveness in promoting safe sexual behaviors and their determinants among FSWs. Healthcare providers should better understand the determinants of safe sexual behaviors among FSWs in the settings with legal prohibitions for sex work. In such communities, they should try to either develop or adapt such stage-specific interventions, within which promoting the above-mentioned factors is the core priorities of the program.

Alcohol Consumption and Sexual Risk Behavior in an Aging Population in Rural South Africa

We sought to characterize the relationship between alcohol consumption and sexual risk-taking in an aging population in rural South Africa. A cross-sectional analysis was conducted using baseline data from the Health and Ageing in Africa: a Longitudinal Study of an INDEPTH Community (HAALSI) cohort. We elicited information on sexual risk behavior and self-reported frequency of alcohol consumption among 5059 adults  ≥ 40 years old. Multivariable models showed that more frequent alcohol consumption is associated with a higher number of sexual partners (β: 1.38, p < .001) and greater odds of having sex for money (OR: 42.58, p < .001) in older adults in South Africa. Additionally, daily drinkers were more likely to have sex without a condom (OR: 2.67, p = .01). Older adults who drank more alcohol were more likely to engage in sexual risk-taking. Behavioral interventions to reduce alcohol intake should be considered to reduce STI and HIV transmission.