Changing patterns of HIV transmission and better targeting for intervention strategies

Predictors of sexual risk-taking among new drug users

We studied predictors of HIV-related sexual risk-taking among individuals who initiated the use of heroin or methamphetamine during the past 5 years. Many studies have linked drug use to HIV risk and most research has been based on samples of users with long-established drug careers. We conducted face-to-face interviews with 153 adult new drug users in Atlanta, GA. Drug use was not a statistically significant predictor of sexual risk, but gender, age, race, homelessness status, childhood neglect, level of paranoia, and level of (dys)functionality in handling disagreements were associated with the frequency of sexual risk-taking. We discuss the need to incorporate new drug users in HIV/AIDS and other health-related prevention and intervention programs.

Predictors of Condom-Related Attitudes among At-Risk Women

BACKGROUND

Negative attitudes toward using male condoms tend to be associated with higher rates of sexual risk. Little has been written about the factors that influence women's attitudes toward condom use, and this has implications for HIV intervention efforts.

METHODS

Two hundred fifty adult women considered to be at risk based on demographic and family characteristics and residing in the Atlanta, Georgia, metropolitan area were interviewed between August 1997 and August 2000. Street outreach efforts were used to identify potential study participants, with further expansion of the sample done via targeted sampling and ethnographic mapping procedures.

RESULTS

Women held ambivalent to weakly positive attitudes toward condoms. Multivariate analysis revealed that five factors were associated with a greater frequency of engaging in seven specific types of sexual activities known to be associated with HIV transmission: condom-related attitudes (negative condom attitudes), marital status (being married vs. other marital status classification), religiosity (lesser), childhood physical abuse (greater), and the amount of illegal drug use (greater). Four significant predictors of condom attitudes were also identified: age (better condom attitudes among younger women), childhood neglect (more conductive condom attitudes among nonneglected women), self-esteem (more self-esteem = more favorable condom attitudes), and the number of drug problems experienced (more drug problems = more negative condom attitudes).

CONCLUSIONS

The more negative at-risk women's attitudes were regarding condom use, the more often they tended to engage in risky sex. Specific backgrounds and characteristics of the women were associated with greater/lesser condom use. To increase condom use, programs should consider targeting specific types of women as well as their specific attitudes toward condom use.