bluuebunny/crossref_metadata_2025_split huggingface dataset:
O2-S1.02 Is concurrency the new serial monogamy? Evidence from a large survey of people attending contrasting genitourinary medicine (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

BackgroundConcurrency is an important risk behaviour for STI transmission at the population level, yet few surveys ask detailed questions about concurrency. Even if partnerships do not overlap, there is potential for STI transmission if the gap between the end of one partnership and the start of the next is short. We examined the prevalence of concurrency, quantified the gap between partners and examined gender differences in a high-risk population.MethodsCross-sectional survey of 2203 people attending four contrasting GUM clinics in England in 2009. Attendees completed a questionnaire including questions about their three most recent partnerships in the 3 months prior to attending GUM. Gaps between partners were calculated as the time between most recent sex with a previous partner and first sex with a more recent partner. Partnerships were considered concurrent if the gap was negative.Results92% of attendees reported sex partner(s) in the last 3 months, yet, while the median number of partners was 1387 men (48%) and 294 women (28%) reported 2+ partners in this time (p<0.001). For 49% of these attendees, ≥2 of their 3 most recent partners were concurrent (p=0.07 for gender difference). Among the 347 concurrent partnerships reported, the median overlap was long: 113 days (IQR: 28–460 days) with just 40 partnerships (12%) involving an overlap of <2 weeks (no significant gender difference). 40% of attendees with concurrent partners had not used condoms consistently with either partner, and a further 24% of attendees with concurrent partners reported not using condoms at all with either partner. In addition (see Abstract O2-S1.02 figure 1), while 78% of men's partners and 70% of women's were overlapping or had a brief gap (<2 weeks), just 12% and 20% respectively involved a gap between partners of >4 weeks.Abstract O2-S1.02 Figure 1Cumulative percentage distribution of the time between partners in the 3 months prior to attending GUM clinic reported by attendees with 2+ partners, by gender.ConclusionsThe majority of GUM attendees reported few partners in the last 3 months, yet half of those with 2+ partners had concurrent partnerships, such that concurrency is as common as serial monogamy in this population. These partnerships typically overlapped by a number of weeks and condoms were seldom used, if at all. Among the serially monogamous, sex with a new partner within days of last sex with a former partner was common so the potential for STI transmission is high. Understanding concurrency and the gaps experienced by high-risk individuals is important for ensuring that health promotion and partner notification are delivered appropriately and effectively.
O2-S1.03 ABC for people with HIV: a longitudinal qualitative study of responses to sexual behaviour recommendations among people receiving antiretroviral therapy in Jinja, Uganda
Authors: Allen C , Mbonye M , Seeley J , Birungi J , Wolff B , Coutinho A , Jaffar S 
Published: July 2011

BackgroundPeople living with HIV (PLHIV) taking ART are increasingly involved in positive prevention" initiatives. These are generally oriented to promoting Abstinence, “Being faithful” (partner reduction) and condom use.MethodsWe conducted a longitudinal qualitative study with PLHIV using ART, who were provided with adherence education and counselling support by a Ugandan non-governmental organisation, The AIDS Service Organisation (TASO). Participants were 40 people selected sequentially as they started ART, stratified by sex, ART delivery mode (clinic- or home-based), and HIV progression stage (early or advanced). At enrolment and 3, 6, 18 and 30 months, semi-structured interviews and home observation visits explored adherence and life changes.ResultsAt initiation of ART, participants agreed to follow TASO's positive-living (similar to ABC) recommendations. Initially poor health prevented sexual activity. As health improved, participants prioritised resuming economic production and support for their children. With further improvements, sexual desire resurfaced and people in relationships cemented these via sex. Married male participants were able to use condoms with their wives, but married female participants were unable to assure consistent condom use despite serostatus disclosure to their husbands. Several participants sought and some obtained HIV positive partners (serosorting) for emotional security, support in ART adherence, sexual fulfilment, avoidance of stigma and sometimes parenthood. Respondents used condoms in the early period of new relationships, but several did not disclose HIV status to partners at first. Male partners of female respondents stopped using condoms after a variable initial period. This contributed to continued non-disclosure, since the women feared violence or loss of economic security from disclosure.ConclusionPositive prevention interventions continue to concentrate on behavioural outcomes and education and counselling approaches. Our findings show that, as ART leads to health improvements, gender norms, economic needs, sexual desires and a wish for “normalisation” of social roles and relationships increasingly influence sexual behaviour. Positive Health, Dignity and Prevention require combinations of appropriate biological, behavioural and structural interventions tailored to the economic and cultural milieu and informed by an appreciation of the human rights of PLHIV.
O2-S2.03 Feasibility of giving HSV serological test results by mail and phone
Authors: Hayley M , Chikovani T , Rompalo A 
Published: July 2011

BackgroundAccurate serological tests for the herpes simplex virus have been commercially available since 1999. Despite this availability, they are offered infrequently. Concerns about the resources required for testing including time spent on counselling and follow-up are among the barriers to testing. The purpose of this study was to determine the feasibility of using letters and phone calls to give HSV-1 and HSV-2 serological test results and to document the resources used to deliver results and respond to subjects' concerns.MethodsSubjects were recruited from an urban STD clinic and tested for HSV-1 and HSV-2 as part of a multi-site study of HSV serological test performance (N=612). Subjects were offered the option of having an investigator mail or call with test results. Result letters included a one page hand-out on HSV-1 and HSV-2 and the phone number of an investigator who could address concerns. Number of phone calls received, time spent on the phone, level of subject distress, and request for referrals were documented. Descriptive statistics were calculated for all variables and data was examined for bivariate relationships using SPSS.ResultsSixty-seven per cent of the subjects requested that their results be mailed (n=410) and 33% requested that their results be given by phone (n=202). Approximately 6% of the subjects who received letters called for additional information. Seventy-one per cent of the calls took less than 5 min and only 2% required more than 10 min. A total of approximately 6.4 h were spent on the phone to give results and respond to questions. <1% of the subjects required multiple phone calls and less than 1% requested a referral to a clinician. Investigators rated 55% of subjects spoken to on the phone as not at all distressed, 31% as somewhat distressed, and 12% as very distressed. Distress was significantly associated with longer time on the phone, but not with testing positive for HSV-2 vs HSV-1.ConclusionsDelivery of HSV serological test results by phone or mail is feasible and requires minimum time on the part of providers.
O2-S2.04 Targeting HIV prevention efforts on HIV-infected men using conditional cash transfer (CCT): does it work?
Authors: Khan A , Qazi R , Nazim N , Khan A A 
Published: July 2011

BackgroundPreventing HIV infections in female spouses of HIV-infected men is limited by low HIV testing rates among these women who are at an increasingly high risk for HIV acquisition. We explored the effect of conditional cash transfer (CCT) on HIV-infected men for spouse testing and HIV status disclosure to their spouses.MethodsUsing medical charts we identified all eligible HIV-infected married men receiving care at the PIMS HIV clinic, Islamabad. Selection criteria for CCT were sexually active married men receiving care >6 months including at least two counselling sessions whose spouses had never been tested for HIV (HIV status unknown). CCT was cash given to cover travel/accommodation (US$14 for out-town and US$ 5 for in-town) costs for bringing the spouse to the HIV clinic for testing. All study participants underwent a brief study questionnaire looking at patient demographics, visit history, factors influencing spouse testing, barriers to care and self-disclosure. The CCT acceptance rate was 90% among HIV-infected men. Outcome of interest was spouse testing and status disclosure to spouse at 6 months post CCT.ResultsOf the 230 married men, 138 men (60%) had spouses’ never tested/unknown status. Baseline disclosure of HIV status to wife was 29%, and median duration of receiving care was 14.3 months. From these 138 men we were able to contact and enrol 94 (68%) men for CCT; 53 (56%) brought their spouses for HIV testing within 4 months; 19 (20%) self-reported getting their wives tested elsewhere, and only 22 (24%) did not comply with the CCT conditionality. CCT improved disclosure of HIV status from baseline 29% to 62% (p <0.05). Factors associated with spouse testing were men <50 years, high ART compliance score, and prior self-disclosure of status to one family member (p <0.05).ConclusionsEven within the context of a socially conservative society CCT can significantly improve HIV testing rates for female spouses and self-disclosure of HIV status by HIV-infected men. Using CCT for timely prevention of HIV infection in wives and children of HIV positive men reduces risk and can be an effective strategy to overcome socio-cultural and financial barriers. Further studies are needed to explore cost-effectiveness of this approach in preventing new infections.
O2-S2.05 Start with the social determinants of health to tailor sexual health promotion for First Nations, Inuit and Métis youth in Canada
Authors: Seto J , Asfaw T , Folz K , Clark W , Deleary M , Sheikh A 
Published: July 2011

BackgroundSexual health promotion and approaches for the prevention of sexually transmitted and blood-borne infections (STBBI) should be tailored to the needs and realities of youth. Engaging youth and building their capacity is an important step in health promotion and has proven to be critical in the development of a promising initiative aimed at engaging First Nations, Inuit and Métis youth in Canada.MethodsCommunity consultative processes were used to engage First Nations, Inuit and Métis (FN/I/M) youth in the development of sexual health promotion and STBBI prevention approaches. Engagement began in 2008 through the establishment of a steering committee, which included FN/I/M youth stakeholders, with representatives from governmental and non-governmental agencies. The steering committee aimed to make effective use of relevant technologies and social media to reach and engage FN/I/M youth in Canada. In 2009, a workshop was held to enhance the involvement of youth to identify priorities for STBBI messaging and explore the best mediums to reach youth. The outcomes of this consultation process informed the development of capacity building social media pilot projects to reach FN/I/M youth.ResultsFN/I/M youth identified the importance of taking a holistic approach by viewing sexual health through the lens of social determinants. Youth highlighted poverty, social support networks and education as major influences on sexual health outcomes for their peers. Key challenges youth noted included the lack of sexual health education and the need to strengthen social support networks. By tying in these determinants into promotion, youth identified themes such as addressing homophobia, and raising the importance of cultural relevancy to de-stigmatise sexual health within FN/I/M communities and to help youth to relate closer to messages. Youth also indicated that peer-to-peer social media methods were an ideal mechanism to convey messages. Many youth from across Canada were engaged in developing their own STBBI messages.ConclusionsEngaging FN/I/M youth as partners from concept onwards has led to an informed approach to the development of sexual health promotion and STBBI prevention messaging. Public health practitioners learnt youth need to be involved to gain credibility within this population, youth capacity building is important and taking a holistic social determinants approach in conceptualising messages is critical when reaching FN/I/M youth.
O2-S2.06 Reducing sexual risk behaviour among youth: the development and effect evaluation of an interactive online intervention for individuals and their sexual network
Authors: Davidovich U , Uhr-Dall H 
Published: July 2011

BackgroundThis study presents an intervention and its evaluation of an innovative approach to counteract barriers to safe sex and STI testing of youth aged 16–24.MethodsThe intervention—http://www.vrijlekker.nl/—has been developed based on over 200 qualitative interviews with youth investigating barriers to safe sex and STI testing. Based on these interviews, training modules were developed which participants could follow online. These modules aimed at counteracting the individual barriers for safe sex and STI testing as well as removing impeding elements in the social and sexual network. The Information-, Motivation and Behavioural Skills (IMB) model (Fisher & Fisher) was used as the theoretical basis of the intervention. The training included filmed coaches that guided users throughout the intervention, thematic films, interactive text with personal feedback and sexual network tools. The modules were offered on a tailored basis to match each user's own cognitive & behavioural risk profile. This profile was established via an automated online intake. An evaluation was conducted comparing a demographically matched control group recruited prior to the launch of the intervention and an intervention group. Behavioural outcomes were compared at 6 month follow-up.ResultsThe evaluation included 2944 participants of whom 1553 completed the follow-up (mean age 19, SD 2.4). The intervention group used condoms significantly more often with their most recent casual partner [OR=1.82 95% CI 1.08% to 3.04%] and/or with their steady partner [OR=2.17 95% CI 1.48% to 3.18%] than the control group at 6 months follow-up. Over 170 000 unique persons used the intervention already during its first year, and more than 100 new users continue to do so every day. Some schools in the Netherlands have adopted the site as part of their routine sexual education program.ConclusionsThis study has shown than offering youth an empirically and theoretically sound intervention that is interactive and which adapts itself to the individual needs of each user and its sexual network, results in a desired behavioural change and high uptake, even among the challenging target group of youth.
O2-S3.02 Assessing the validity of sexual behaviour reports in a whole population survey in rural Malawi
Authors: Glynn J , Kayuni N , Banda E , Parrott F , Floyd S , Tanton C , Hemmings J , Molesworth A , Crampin A , French N 
Published: July 2011

BackgroundSexual behaviour surveys are widely used, but under-reporting of particular risk behaviours is common, especially by women. Surveys in whole populations provide an unusual opportunity to understand the extent and nature of such under-reporting.MethodsAll consenting individuals aged between 15 and 59 within a demographic surveillance site in northern Malawi were interviewed about their sexual behaviour. Validity of responses was assessed by analysis of probing questions; by comparison of results with in-depth interviews and with Herpes simplex type-2 (HSV-2) seropositivity; by comparing reports to same sex and opposite sex interviewers; and by quantifying the partnerships within the local community reported by men and by women, adjusted for response rates.Results6796 women and 5253 men (83% and 72% of those eligible) consented and took part in sexual behaviour interviews. Probing questions and HSV-2 antibody tests in those who denied sexual activity identified under-reporting for both men and women. Reports varied little by sex or age of the interviewer. The number of marital partnerships reported was comparable for men and women, but men reported about four times as many non-marital partnerships. The discrepancy in reporting of non-marital partnerships was most marked for married women (men reported about seven times as many non-marital partnerships with married women, as were reported by married women themselves), but was only apparent in younger married women see Abstract O2-S3.02 figure 1.Abstract O2-S3.02 Figure 1Ratio of non-marital partners reported by men compared to women, by characteristics of the women and partnershipConclusionsWe have shown that the under-reporting of non-marital partnerships by women was strongly age-dependent. The extent of under-reporting of sexual activity by young men was surprisingly high. The results emphasise the importance of triangulation, including biomarkers, and the advantages of considering a whole population.
O2-S3.03 Duration of recent sexual partnerships in sexually active men and women
Authors: Leichliter Jami , Aral Sevgi 
Published: July 2011

BackgroundThe duration of partnerships and partner change rates contribute to STI transmission. Additionally, concurrent partnerships and short gaps between partnerships may be associated with STI spread. Few studies have examined the duration of sexual partnerships at the national level. We examined the duration of recent sexual partnerships reported by sexually active men and women in the US.MethodsData were from a national survey of reproductive age men and women in the US 7470 men and women reported having an opposite-sex partner in the past year and reported on their recent sex partners (up to three). Duration of partnerships was measured in months; partnerships where respondents reported only having sex once were coded as 1-month in duration. Respondents indicated whether or not the partner was a current sex partner. Bivariate analyses examined duration of partnerships (mean) by demographics. Data were analysed separately for men and women. A subset of unmarried respondents was also examined.ResultsFindings were similar for the entire sample and for those who were unmarried. Duration of most recent partnership was longer for women as compared to men, but men reported longer 2nd and 3rd most recent partnerships than women. Adolescents had the shortest duration for all three partnerships and were least likely to report that the partner was a current sex partner. There was no difference in duration of partnerships by race with the exception of black men having a shorter duration most recent partnership than other men. More black men but fewer black women reported that their most recent partner was a current partner as compared to other groups. However, black and Hispanic men were more likely to indicate that their second recent partnership was also current. For most recent and 2nd recent partnerships, married men and women reported the longest duration. For most recent partnership, unmarried men and all women with less than a high school education had a longer duration than their counterparts. There were no differences in whether the partner was current by education.ConclusionsAdolescents and black men had the shortest partnerships. Black women did not differ from white or Hispanic women in the duration of their partnerships. Men and women with short partnerships, overlapping and non-overlapping, may play a key role in the transmission of STIs.
O2-S3.04 Web-based sex diaries and young men who have sex with men: assessing feasibility, reactivity, and data agreement
Authors: Glick S , Winer R , Golden M 
Published: July 2011

BackgroundWeb-based diaries are a promising means for collecting detailed sexual behaviour and substance use data. Few studies have evaluated the feasibility and reliability of collecting these data among men who have sex with men (MSM). We compared quantitative diary data with retrospective survey data collected over 1-year in a cohort of young MSM in Seattle, WA.MethodsNinety-five MSM, age 16–30, completed web-based surveys every 3 months and were randomised to 1 of 4 diary submission schedules: every 2 weeks, once a week, twice a week, or never. The diaries asked questions about daily sexual behaviour and substance use. We assessed the agreement between diary and survey data using κ statistics for dichotomous variables and concordance correlation coefficients (CCC) for continuous variables. We used generalised estimating equations to assess for differences in survey data over time between those assigned an active diary schedule to those assigned no diary.ResultsDuring the first 6 months, 78% of participants assigned to an active diary schedule completed at least 80% of their diary days, and the 2-week schedule had the highest and most consistent completion rate. Completion rates dropped to <60% during the second 6 months. Among participants with active diary schedules, most measures had strong agreement between the diary and survey data (ie, κ or CCC≥0.8). The exceptions to this were numbers of overall and unprotected anal sex acts during the first 3 months (CCC=0.53 and 0.57, respectively) and alcohol use during the first 6 months (κ=0.57–0.59). We observed some reactivity, or a difference in reported behaviour associated with diary completion. For example, participants assigned no diary reported an average increase of 5.2 more unprotected anal sex acts over consecutive 3-month periods than those assigned an active diary schedule (p<0.01).ConclusionsThis study suggests that sexual behaviour and substance use data collected from young MSM during 3-month retrospective surveys—an interval commonly used in sexual behaviour research—are largely adequate. Web-based diaries can be used for up to 6 months to gather detailed behavioural data, and may be more appropriate than retrospective surveys for counts of anal sex acts. Furthermore, our finding that diaries may be associated with lower levels of reported sexual behaviour suggests that web-based diaries may be useful as a behavioural intervention to prevent HIV/STI among young MSM.