The Relative Role of Perceived Partner Risks in Promoting Condom Use in a Three-City Sample of High-Risk, Low-Income Women

Integrated Substance Abuse Programs, David Geffen School of Medicine, Semel Institute for Neuroscience and Behavior, University of California, Los Angeles, 90025, USA.
AIDS and Behavior (Impact Factor: 3.49). 10/2010; 15(7):1347-58. DOI: 10.1007/s10461-010-9840-7
Source: PubMed

ABSTRACT We examined the effect of women's perceptions of sexual partner risks on condom use. Women from three US cities (n = 1,967) were recruited to provide data on HIV risks. In univariate models, increased odds of condom use were associated with perceiving that partners had concurrent partners and being unaware of partners': (a) HIV status, (b) bisexuality, (c) concurrency; and/or (d) injection drug use. In multivariate models, neither being unaware of the four partner risk factors nor perceiving a partner as being high risk was associated with condom use. Contextual factors associated with decreased odds of condom use were having sex with a main partner, homelessness in the past year, alcohol use during sex, and crack use in the past 30 days. Awareness of a partner's risks may not be sufficient for increasing condom use. Contextual factors, sex with a main partner in particular, decrease condom use despite awareness of partner risk factors.

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    ABSTRACT: Women who abuse substances are at a high-risk for contracting HIV. Condom use interventions are important in 10 reducing HIV in high-risk populations, but current interventions have small effects. The aim of this study is to examine the relative impact of substance use, personal variables (sexual impulsivity and condom expectancies), and relationship variables (perceptions of relationship commitment and partner risk, perceptions of power within the relationship) on condom use in women in court-mandated substance abuse treatment. Information was collected from 312 sexually active women in an inpatient drug and alcohol treatment facility in the Southeastern US Participants completed questionnaires 15 and were interviewed using the Timeline Follow-back method and provided information about sexual activity in the 30 days prior to intake, including type of sexual event, co-occurrence with substance use, condom use, and characteristics of sexual partners and the nature of the relationship. Multilevel logistic modeling revealed that perception of relationship commitment, condom outcome expectancies, and age significantly affected condom use for women in the sample. Specifically, condom use was least likely when women reported that the relationship was committed (odds ratio [OR] = 20 0.31, 95% confidence interval [CI]: 0.23, 0.43) or when the participant was older (OR = 0.96, 95% CI: 0.94, 0.99), and more likely when women reported more positive condom outcome expectancies (OR = 1.02, 95% CI: 1.00, 1.03). The findings suggest that perceptions of relationship commitment, regardless of perceptions of partner risk, strongly affect condom use among women court-mandated into drug and alcohol treatment. In addition, positive outcome expectancies (e.g., positive self-evaluations and perceived positive partner reactions) are associated with a greater likelihood of 25 condom use. These findings have important implications for condom use interventions, which have failed to produce large or lasting effects within this population.
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    ABSTRACT: Background Substance use is associated with HIV sexual risk behaviors, yet few studies have examined substance use patterns longitudinally. We evaluated the types and frequency of substances used over a six-month period among U.S. women at risk for HIV acquisition. Methods Women reporting unprotected sex with a man in the previous six months and at least one other personal or partner HIV risk characteristic enrolled in a multisite cohort study and completed interviews about substance use at study visits. Prevalence and frequency of substance use at the baseline and six-month visits were compared and correlates of decreased substance use at the six-month visit were assessed. Results Of 2,099 women enrolled, 1,882 had substance use data at baseline and six-months. Of these, 76.1% reported using at least one drug or binge drinking in the previous six months; 37.5% were frequent and 38.6% non-frequent substance users. Binge drinking was most frequently reported (63.3%), followed by cocaine (25.0%) and opioids (16.5%). Fifty-five percent of opiate users and 30% of cocaine users reported daily/almost daily use. At the six-month visit, 40.5% reported a decrease in frequency of use. Adjusting for income and type of drug used, poly-substance users were less likely to decrease frequency of use compared to those who only used one substance. Conclusion A substantial decrease in frequency of substance use over time was observed in this cohort. Poly-substance users were less likely to reduce frequency of use over time, suggesting that specific substance use interventions targeting these users are warranted.
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