bluuebunny/crossref_metadata_2025_split huggingface dataset:
P2-S3.03 Exploring perceptions of the social determinants of STIs in African American communities of the USA
Authors: Friedman A , Forsythe A , Poehlman J , Harris S , Smith J , Uhrig J 
Published: July 2011

BackgroundAfrican Americans (AAs) make up 12% of the US population, yet they account for about half of all reported chlamydia and syphilis cases, and 70% of gonorrhoea cases. Targeted, culturally sensitive interventions are needed to address these disparities. This study sought to explore how AAs perceive STIs in their communities, and what they feel should be done to address the problem.MethodsTriads (n=31) and individual interviews (n=64) were conducted with sexually active, heterosexual AA adults, ages 18-45, in four communities with high STI incidence. Triads were segmented by age, gender, and urban/rural residence. Interviewers (gender/race-matched) used a semi-structured guide to explore awareness and importance of the STI problem in AA communities, perceptions of contributing factors and high-risk groups, and suggested solutions. Discussions were audio-taped and transcribed. A team of three analysts coded transcripts using QSR NVivo8, based on a codebook developed from identified themes.ResultsA total of 158 adults participated. Overall, STDs were believed or presumed to be very common in AA communities. Many had heard about the disparate STD/HIV rates on the news/TV or in school. Men were more likely to challenge this, reasoning that AAs are heterogeneous and that STIs are more likely influenced by socioeconomic status (SES) than race. Participants identified youth, low SES groups, drug addicts, Sex workers, homosexuals, and men on the down low as highest-risk groups. Promiscuity and a lack of sexual-health education, care for self/others/future, and health-care access were seen as major causes. Other contributing factors were teen pregnancy/family disintegration, gangs, drugs, school dropouts, unemployment, poverty, boredom, hopelessness, male/female ratio, partner concurrency, and the media. Overall, STIs were seen as a relatively low priority. Yet most felt that change is critical and could be promoted through music, mass media, faith-based/community/organizational, electronic and interpersonal channels. Increasing information, education, and healthcare access; and developing parenting, self-esteem boosting, and mentoring programs were suggested.ConclusionsSTDs among AAs are recognised as a likely consequence of many underlying social, structural and community ills, which must be addressed to reduce STD disparities. Traditional STD prevention efforts must be supported by non-traditional social/structural interventions.
P2-S3.04 Condom use among US adults at last sexual intercourse, 1996-2008: an analysis of general social survey (GSS) data
Authors: Warner L , Anderson J , Macaluso M 
Published: July 2011

BackgroundPublic health programs have sought to increase the use of condoms among persons at risk for transmitting or acquiring sexually transmitted infection. Although data from national health surveys have indicated increasing trends in condom use among adults since the onset of the HIV epidemic, little is known about recent national trends in usage.MethodsQuestions on condom use at last sexual intercourse were added to the General Social Survey, a nationally representative survey of US adults 18 and older conducted in alternating years, beginning in 1996. Using data from 1996 to 2008, the prevalence of condom use at last intercourse was estimated, and trends and correlates of this measure were evaluated.ResultsAcross the 13-year period, condom use was reported by 20.2% of respondents during their most recent intercourse. Use was significantly higher for sex outside ongoing relationships as compared to within relationships, (46.4% vs 18.1%, respectively) and among those with 2 or more past-year sex partners as compared to one partners (44.7% vs 15.6%). A statistically significant increasing 1996–2008 trend in condom use was detected overall, but not for use within partnership type or by number of partners.ConclusionsSimilar to other studies, condom use was more likely to be reported by persons most at risk; however, even among those at increased risk, fewer than half used condoms during most recent sexual intercourse.
P2-S3.05 Association of STI-related stigma and shame to STI testing and partner notification among young black men in San Francisco
Authors: Lippman S , Morris J , Lightfoot M , Philip S 
Published: July 2011

BackgroundYoung minority men in the US bear a disproportionate burden of STI, but comprise one of the population groups least likely to access services. STI service utilisation is not only constrained by access to quality care but also potentially impacted by socio-cultural factors, including STI-related stigma and shame, which can undermine efforts to promote testing and treatment. STI-related stigma and shame may also provide a disincentive for young men to participate in partner notification programs, including partner-delivered therapy. We hypothesised that young men who perceive increasing levels of social stigma related to STI would be less likely to seek out STI-related services or notify their sexual partners about STI.MethodsBetween June and July, 2010, 108 African American young men (15—24 years) responded to a brief, self-administered intercept survey on a hand-held device. Recruitment was conducted on the street and in residential areas of a low income urban neighbourhood with elevated STI rates. The survey included socio-demographic questions, an 11 item scale measuring STI-related stigma and shame, and questions regarding STI testing history, preferences for notifying partners, and interest in partner delivered therapy. The association between stigma and shame scores and STI testing and partner notification preferences was evaluated with multivariate logistic regression, adjusting for age and education.ResultsThe median (range) STI-stigma score was 12 (5–25) and the shame score was 15 (6–30); higher scores indicate more stigma or shame. Most participants had ever been tested for STI (73%), indicated willingness to personally notify their main partners (72%) or other partners (66%), and said they would deliver STI therapy to a partner (68%). Increasing STI-related stigma was significantly associated with a history of STI testing, such that every SD increase in stigma score was associated with 50% decreased odds of having been tested (OR: 0.5, 95% CI 0.3 to 1.0). Participants with higher levels of stigma and shame were also significantly less likely to be willing to personally notify their partners of STI or to deliver therapy.ConclusionsSTI-related stigma and shame, common in this population, could undermine STI testing, treatment, and partner notification programs. Efforts to expand access to care should be accompanied by efforts to change socio-cultural attitudes and norms around STI testing and treatment.
P2-S3.08 Selling sex on the doorstep: development work for the third British National Survey of sexual attitudes and lifestyles (Natsal 3)
Authors: Tanton C , Phelps A , Nicholson S , Mercer C , Sonnenberg P , Datta J , Macdowall W , Erens B , Wellings K , Johnson A 
Published: July 2011

BackgroundThe Third British National Survey of Sexual Attitudes & Lifestyles (Natsal 3) builds upon groundbreaking research undertaken for Natsal 1 and Natsal 2 in 1990 and 2000, respectively. Natsal 3 aims to interview 15 000 men and women aged 16–74 years during 2010–2012. However, the first pilot (Pilot 1) for Natsal 3 achieved a response rate of only 38.4%, leading us to explore ways to maximise survey participation.MethodsFollowing Pilot 1, we consulted widely with interviewers, survey methodologists and communications experts to improve documents sent to households in advance of the interviewer calling, and the survey branding. This included simplifying the advance letter language and removing specific references to “sex”; developing a more detailed information leaflet to send with the letter; developing a study logo and respondent website. In Pilot 2, households were randomised to be sent the leaflet with the advance letter or to be given it when the interviewer called. We also examined the effect of the token of appreciation on participation rates by randomising households to receive either a £15 or a £30 voucher for participation.ResultsThe overall response rate increased to 50.3% (218/434 eligible addresses) in Pilot 2. This did not vary by whether or not households received the information leaflet in advance (50.8% and 49.6%, respectively), but interviewers felt that households sent the leaflet were more informed about the study and they were more confident approaching these households. Interviewers preferred the improved advance letter and some respondents reported that the website was a key factor encouraging them to participate. Pilot 2 response rates differed by token of appreciation (47.1% vs 53.4% for £15 vs £30) but the sample size was too small to conclude that the difference was significant, so randomisation continued during the first wave of fieldwork. Response rates in wave 1 before reissuing were 48.4% vs 50.6% for £15 and £30, respectively (p=0.2).ConclusionsDespite survey response rates declining generally, Natsal 3 development work has shown that it is possible to attain an adequate response in a population-based survey of sexual behaviour. Careful wording of participant documents, attractive survey branding and a participant website all contributed to increasing response rates. Response rates were slightly higher for the larger token of appreciation but increasing the value was not considered cost-effective.
P2-S3.09 Mobility as predictor of involvemnet in high risk sexual risk behaviour
Authors: Kwena Z , Obuya C 
Published: July 2011

BackgroundPopulation mobility has long been associated with frequency and variety of sexually transmitted infections including HIV. People's mobility tends to disrupt their traditional social constraints and control of sexual behaviour by giving them opportunity, isolation and the desire for unique experiences. Fishermen being one of the highly mobile populations, we sought to evaluated the extent to their mobility predicts their involvement in high risk sexual behaviour.MethodsDuring a Phase I randomised double-blind placebo-controlled cross over trial evaluating the safety and acceptability of ethanol in emollient gel as a topical male microbicide, we collected data on fishermen's socio-economic and demographic characteristics, mobility patterns and sexual practices including extra-marital partnerships. We pre- and post-test counselled for STIs, obtained blood samples for HIV, HSV-2 and syphilis serologies and provided appropriate treatment and referrals. We analysed the data using descriptive statistics and then bivariate and multivariate logistic regression.ResultsOf the 167 fishermen screened, over a half (52%) were mobile defined as travelling and spending at least one night away from home in the month preceding the study). Two-thirds (63%) had active extra-marital relationships with only 5% consistently using condoms in these sexual encounters. During travel, a quarter (24%) drank alcohol and a similar number (25%) had sex with a third (32%) reporting new casual sex partners. At bivariate level, those travelling in the month preceding the study were more likely to be HIV+ (OR 2.08; 95% CI 1.01 to 4.28), have an active extra-marital relationship (OR 3.69; 95% CI 1.57 to 8.68), and have multiple sex partners in the six month preceding the study (OR 2.04; 95% CI 1.06 to 3.95). Mobility among fishermen was independently associated with having an active extra-marital relationship (AOR 3.64; 95% CI 1.11 to 12.00).ConclusionMobile fishermen exhibit high risk sexual behaviour that include extra-marital sex and low condom use. This population is likely to benefit from STI/HIV prevention intervention.
P2-S3.10 HSV-2 serologic testing and psychosocial harm: a systematic review
Authors: Ross K , Wald A , Johnston C 
Published: July 2011

BackgroundSerologic testing for herpes simplex virus type-2 (HSV-2) in persons without a history of genital herpes is currently not recommended partly due to the concern that HSV-2 diagnosis would lead to negative psychosocial sequelae, such as anxiety and depression. We conducted a systematic review to assess the evidence as to whether HSV-2 serologic testing among asymptomatic persons results in persistent negative psychosocial consequences.MethodsEight electronic databases and unpublished data sources were searched to identify studies measuring the psychosocial impact of HSV-2 serologic testing in persons without a history of genital herpes. To be included, studies had to test for HSV-2 using an HSV type-specific serologic test and to perform at least one psychosocial assessment of participants after they received HSV serologic results. We compared psychosocial responses in HSV-2 positive persons over time and vsHSV-2 negative persons (when available).ResultsNine studies satisfied the inclusion criteria. Studies were published from the years 2000–2008 and were conducted in the USA (N=6), Australia (N=2), and the UK (N=1). In total, 1355 participants were included; 596 (44%) participants were HSV-2 positive, and of these 341 (57%) lacked prior history of genital herpes. Participants were recruited from a variety of settings (ie, STD clinics, HMO enrollees, college campuses). Follow-up ranged from immediately after diagnosis to 1 year afterwards. Seven studies reported that HSV-2 diagnosis by serologic test did not have a persistent negative impact on participants' mental health (anxiety, depression, self-esteem) or sexual attitude and satisfaction. Two studies reported a negative impact of testing; one found that 5 HSV-2 seropositive college students had increased distress 3 months post-testing as compared to HSV-2 negatives, and the other found self-reports of sexual undesirability up to one year after diagnosis. A genital herpes diagnosis was perceived as moderately severe for participants prior to testing; however, after HSV-2 testing, the perceived severity of a herpes diagnosis was lower among those testing HSV-2 positive.ConclusionsDiagnosis of HSV-2 by type-specific serologic testing did not result in long-term psychosocial harm in most asymptomatic persons. Concerns about sustained emotional impact should not deter clinicians from testing individuals without a history of genital herpes for HSV-2.
P2-S3.12 Culture and research: how do you mix them?
Authors: Gesink D , McGilvery P , Tilley T , Saganiuk K 
Published: July 2011

BackgroundCommunity-based participatory research principles partner community and academics through all stages of the research process. Our purpose is to describe how we have been combining traditional Cree cultural practices (culture) and Western academic research processes (research) to facilitate a restorative research experience.MethodsCulture and research were given equal emphasis in the structure and content of meetings, governance structure of the project, knowledge exchange activities, project development and ethics. To begin this sexual health project, the Health Director invited academic and government partners to the community. Statistics on rates of sexually transmitted infections were shared with community partners. Since then, emphasis has been placed on face-to-face meetings in the community. Elders and community leadership have attended meetings and provided guidance on research activities. The governance structure was organised so primary decision makers are from the community and are guided by a community working group, cultural advisor and scientific advisor. Knowledge exchange was achieved through mutual participation in traditional Cree cultural activities and research emersion at an academic institution. Key community informants, Elders and research assistants led project development. The local First Nations College provided primary ethical review.ResultsFace-to-face meetings helped build strong, sustainable relationships between community and outside researchers. Knowledge exchange activities, like cultural teachings and research trainings, contributed to mutual respect, understanding and trust between community and outside team members. Participation in community events and traditional ceremonies combined with formal and informal discussions with the community working group, Elders, and key community informants led to the identification of a priority research area of importance to the community. Following community led ways of knowing and doing has led to the development of innovative research methods for data collection. Ethics review held in ceremony provided a supportive, holistic environment from which to proceed with research activities.ConclusionsBuilding trust and nurturing the relationship between community and outside research partners has been integral for restoring confidence in the potential benefits of research for this First Nations community.
P2-S4.01 Epidemiological profile and motivations for HIV screening among people attending an anonymous HIV voluntary testing service in Cotonou, Benin
Authors: Zannou D M , Azon-Kouanou A , Alaye O M , Akakpo J , Azon D , Akinocho E , Anagonou-Y S 
Published: July 2011

BackgroundThe creation of the only free anonymous HIV voluntary counselling and testing (VCT) center in Cotonou (named SIDAG) is an HIV prevention strategy that allows to reach those who decide, for themselves, to know their HIV status. Knowledge of the epidemiological profile and motivations of these volunteers will help tailoring services offered to them.Objectivesi) To describe practices at risk for HIV infection among the SIDAG's clientele ii) To analyse the motivations bringing these people for HIV screening; iii) To identify factors associated with HIV infection in this group. MethodsThis cross-sectional survey, carried out from April to June 2010, included all subjects attending SIDAG for HIV anonymous VCT who provided consent for participation. HIV testing was carried out immediately using an algorithm with two rapid tests (Determine and SD Bioline), and results were communicated on site to the participants before they leave.Results280 subjects participated in the study (149 men, 53% and 131 women, 47%). Their mean age was 28 years [range: 17–66 years]; 32% were college or university students, 53% had attained a higher educational level and 76% were single. 22% of the subjects had a history of STI. All subjects reported being heterosexual; 274 (98%) had sexual partners (regular partners: 73%; casual partners only: 25%). 27% always used condoms for casual sex. 13% of the men reported sex with sex workers. The main motivations for getting tested were the desire to know their HIV status: 43.6%; exposure to HIV through sexual contact: 20% (unprotected sex, condom failure, prolonged relation with HIV-infected partner); and peer pressure from family or friends: 11.2%. The HIV serology was positive in 6.8% of the 280 tested subjects. Factors associated with seropositivity were: a low education level (p<0.001), current or previous cohabitation with a sexual partner (p<0.01), lack of condom use (p<0.001) and motivation for testing because of clinical suspicion (p<0.001).ConclusionCandidates for anonymous HIV VCT in Cotonou are mainly young patients concerned by the risk behaviours they had. Services like SIDAG should be decentralised to serve the greatest number.
P2-S4.02 Don't look at your patients, look at their partners: Characteristics of sexual partnerships reported by people attending GUM clinics in England
Authors: Mercer C H , Aicken C R H , Low N , Estcourt C S , White P J , Keane F , Brook G , Rait G , Cassell J A 
Published: July 2011

BackgroundPartnership characteristics, for example, their length, timing, and whether or not condoms are used, may be more important for assessing STI transmission risk than partnership numbers. However, data routinely collected by GUM clinics in the UK are limited in terms of such measures of partnership risk. We sought to measure this in a high-risk population and consider the implications for STI transmission and partner notification (PN).MethodsCross-sectional survey of 2203 people attending 4 sociodemographically and geographically contrasting GUM clinics in England in 2009. Attendees completed a questionnaire that was linked to their clinical records for data on acute STI diagnoses. Questions asked about their three most recent partnerships in the 3 months prior to attending GUM and the total number of partners in this period. We used a novel statistical approach to weight the data to represent the partnerships for which these questions were not asked. This enables us to describe the population of partnerships reported by GUM attendees, rather than the population of attendees.ResultsMost patients had few partners: median: 1 partner, IQRs: 1–3 (men) and 1–2 (women). However, the 1941 attendees reporting partners reported a total of 3576 partners: 1953 by 846 men, 1623 by 1095 women. Men's partnerships were shorter than women's: 73% vs 54% (p<0.01) were <3 months “old” (49% vs 27%, respectively, were one-off encounters), and were more likely to be considered as ended: 64% vs 41%, respectively, p<0.01, see Abstract P2-S4.02 figure 1 Inconsistent condom use was high, especially in women's partnerships: 81% vs 65% among men's partnerships, p=0.002. Men (but not women) were more likely to have acute STIs diagnosed if they had never used condoms with their partners than if they had at least once: 33% vs 27%, p=0.001. 24% of men vs 14% of women had recent concurrent partnerships based on the dates of their 3 most recent partners (p<0.01), but this was not associated with having acute STI diagnoses.Abstract P2-S4.02 Figure 1Distribution of partnership length by partnership status and gender of GUM clinic attendee.ConclusionsDespite low median partner numbers, GUM attendees have a large population of partnerships, of which only a small minority involve consistent condom use, thus the potential for STI transmission is high. These partnerships are often casual in nature being short in duration and unlikely to be ongoing. Research is needed to develop and test alternative methods for reaching such partners to ensure that PN achieves both individual and public health benefit.