Risk behaviors of youth living with HIV: pre-and post-HAART

Center for Community Health, AIDS Institute, Department of Psychiatry, University of California, Los Angeles, CA, USA.
American journal of health behavior (Impact Factor: 1.31). 03/2005; 29(2):162-71. DOI: 10.5993/AJHB.29.2.7
Source: PubMed


To examine the transmission behavior among youth living with HIV (YLH), pre- and post-HAART.
Two cohorts were recruited: (1) 349 YLH during 1994 to 1996 and (2) 175 YLH during 1999 to 2000, after the wide availability of HAART. Differences in sexual and substance-use risk acts and quality of life were examined.
Post-HAART YLH were more likely to engage in unprotected sex and substance use, to be more emotionally distressed, and to have lower quality of life than were pre-HAART YLH.
Targeted interventions for YLH that address reductions in transmission acts and aim to improve quality of life are still needed.

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Available from: Dallas Swendeman, Feb 19, 2015
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    • "Interest lies in comparing the two intervention delivery modes, comparing treatments to control, and in estimating effects of predictors known to be important. Our outcome in this paper is the self-reported number of sexual partners during the past three months, an important measure of sexual risk behavior (Rotheram-Borus et al. 2001; Lightfoot et al. 2005). "
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    ABSTRACT: We analyze longitudinal self-reported counts of sexual partners from youth living with HIV. In self-reported survey data, subjects recall counts of events or behaviors such as the number of sexual partners or the number of drug uses in the past three months. Subjects with small counts may report the exact number, whereas subjects with large counts may have difficulty recalling the exact number. Thus, self-reported counts are noisy, and mis-reporting induces errors in the count variable. As a naive method for analyzing self-reported counts, the Poisson random effects model treats the observed counts as true counts and reporting errors in the outcome variable are ignored. Inferences are therefore based on incorrect information and may lead to conclusions unsupported by the data. We describe a Bayesian model for analyzing longitudinal self-reported count data that formally accounts for reporting error. We model reported counts conditional on underlying true counts using a linear birth-death process and use a Poisson random effects model to model the underlying true counts. A regression version of our model can identify characteristics of subjects with greater or lesser reporting error. We demonstrate several approaches to prior specification.
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    • "Is the sexual behavior of HIV patients on ART safe or risky? Reports on sexual behaviors of people on ART have been inconsistent; six studies African and non-African countries have shown that patients on ART are more likely to engage in unprotected sex [5-10]; however, other cross sectional and longitudinal studies have reported a decrease in rates of risky sexual behavior after ART [11-15]. "
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    ABSTRACT: Reports on the sexual behavior of people on antiretroviral therapy (ART) are inconsistent. We selected 14 articles that compared the sexual behavior of people with and without ART for this analysis. We included both cross-sectional studies that compared different ART-naïve and ART-experienced participants and longitudinal studies examining the behavior of the same individuals pre- and post-ART start. Meta-analyses were performed both stratified by type of study and combined. Outcome variables assessed for association with ART experience were any sexual activity, unprotected sex and having multiple sexual partners. Random-effect models were applied to determine the overall odds ratios. Sub-group analyses and meta-regression analyses were performed to examine sources of heterogeneity among the studies. Sensitivity analysis was also conducted to evaluate the stability of the overall odds ratio in the presence of outliers. The meta-analysis failed to show a statistically significant association of any sexual activity with ART experience. It did, however, show an overall statistically significant reduction of any unprotected sex, having multiple sexual partners and unprotected sex with HIV negative or unknown HIV status with ART experience. Meta-regression showed no interaction between duration of ART use or recall period of sexual behavior with the sexual activity variables. However, there was an association between the percentage of married or cohabiting participants included in a study and reductions in the practice of unprotected sex with ART. In general, this meta-analysis demonstrated a significant reduction in risky sexual behavior among people on ART in sub-Saharan Africa. Future studies should investigate the reproducibility and continuity of the observed positive behavioural changes as the duration of ART lasts a decade or more.
    AIDS Research and Therapy 05/2012; 9(1):14. DOI:10.1186/1742-6405-9-14 · 1.46 Impact Factor
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    • "There is a great deal of literature describing the sexual risk behaviors of HIV+ youths who were behaviorally infected, with these youths engaging in a higher prevalence of sexual risk behaviors than the general population (Kadivar et al. 2006; Koenig et al. 2007; Lightfoot et al. 2005; Murphy et al. 2001; Naar-King et al. 2006). Extrapolating data from samples of adolescents with behaviorally acquired HIV, however, may be inadequate or insufficient to tailor harm reduction strategies for PHIV youth. "
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    ABSTRACT: A large proportion of perinatally HIV-infected (PHIV) children are becoming adolescents and exploring their sexuality. This study explored the prevalence of sexual behaviors (kissing, touching, engaging in oral sex, or having vaginal/anal intercourse) in a sample of predominantly ethnic minority youths (N = 339; 54.1% Black and 30.4% Latino; 51% female; ages 9-16) perinatally exposed to HIV (61% HIV+). Using logistic regression, we tested the association between sexual behavior and HIV status, demographic characteristics, and peer influences regarding sexual behavior. PHIV youth were less likely to be sexually active. Among sexually active youth, PHIV youth were more likely to engage in touching behavior than HIV-negative youth and were less likely to engage in penetrative sex. Youths reporting that a greater number of their peers believed that sexually active boys were "cool" or "popular" were more likely to report sexual behavior. The association between sexual behavior and peers believing sexually active girls were "cool" or "popular" varied by age, gender, and HIV status. Furthermore, friends' sexual activity was associated with sexual intercourse. Prevention programs should strengthen messages addressing peer norms regarding sexuality, as well as address specific issues related to adolescent HIV.
    Journal of Youth and Adolescence 10/2009; 38(8):1110-22. DOI:10.1007/s10964-008-9315-6 · 2.72 Impact Factor
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