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


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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Available from: Pamina M Gorbach
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    • "Strikingly, condom use occurred in only 15.0% of sexual events overall. As expected, perceptions of relationship commitment had the largest impact on condom use such that women were less likely to use condoms in a relationship they defined to be " committed, " despite perceptions of partner characteristics deemed " risky " (Ober et al., 2011). "
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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.
    Full-text · Article · Sep 2014 · AIDS Care
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    • "Condom use is a recognized strategy for effectively reducing HIV transmission by 80% [6,7]. Nevertheless, sexually active adults are known to be more resistant to using condoms in ongoing relationships with their main partners than with non-regular partners [8-11]. Likewise, consistency of condom use is known to be higher with new and casual partners than with regular partners [12,13] and is inversely proportional to relationship duration [14]. "
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    ABSTRACT: In 2009, 27% of the 48,100 estimated new cases of HIV were attributed to heterosexual contact with an infected or at-risk person. Sexually active adults are less likely to use condoms in relationships with main partners than with non-regular partners, despite general knowledge that condom use reduces HIV transmission. The purpose of this secondary qualitative analysis was to explore and contextualize perceptions of main partnerships, HIV risk, and attitudes toward condom use within main partner relationships among a subsample of intervention-arm cocaine- and/or heroin-using patients enrolled in a negative trial of brief motivational intervention to reduce the incidence of sexually transmitted disease and unsafe sexual behaviors. The open-ended portion of these interview audiotapes consisted of questions about perceptions of risk and attitudes about condom use with main partners. Enrollees were aged 18-54, English or Spanish speaking, and included in this analysis only if they reported having a main partner. We identified codes and elaborated important themes through a standard inductive three step coding process, using HyperRESEARCH™ software. Among 48 interviewees, 65% were male, half were non-Hispanic white, over 60% were 20-39 years of age, 58% had intravenous drug use (IDU), and 8% were HIV-positive. Participants defined respect, support, trust, and shared child-rearing responsibility as the most valued components of main partner relationships. Condom use was viewed occasionally as a positive means of showing respect with main partners but more often as a sign of disrespect and a barrier to intimacy and affection. Enrollees appraised their partners’ HIV risk in terms of perceptions of physical health, cleanliness, and sexual and HIV testing history. They based decisions regarding condom use mainly on perceived faithfulness, length of involvement, availability of condoms, and pregnancy desirability. Risk appraisal was commonly based on appearance and subjective factors, and condom use with main sexual partners was described most often as a demonstration of lack of trust and intimacy. Trial registration NCT01379599
    Full-text · Article · Apr 2013 · Addiction science & clinical practice
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    • "A study conducted in the US among low-income women showed that those who engaged in high-risk behaviors with their sexual partners tended not to use condoms. About half of the women believed their partners had partners at the same time as they were partners with them (partner concurrency).12 Such relationships need strong partner referral strategies after HIV testing. "
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    ABSTRACT: Human immunodeficiency virus (HIV)-positive individuals who do not disclose their HIV status to their partners are more likely to present late for HIV and acquired immune deficiency syndrome (AIDS) care than those who have disclosed their HIV status to their partners. A major area of challenge with regards to HIV counseling for clients is disclosure of their HIV status to their partners. The main methods of partner notification are patient referral, provider referral, contract referral, and outreach assistance. The emphasis on a plausible and comprehensive partner referral strategy for widespread positive case detection in resource-limited countries needs to be thought out and developed. A qualitative study was conducted among newly HIV-positive clients to identify partners for notification and acceptance of referral by their partners. Health service providers working in HIV testing and counseling clinics were also provided with semistructured questionnaires in order to assess their view towards partner notification strategies for clients testing positive for HIV. Fifteen newly diagnosed HIV-positive clients were counseled to provide referral slips to their partners. All clients agreed and took the referral card. However, only eight were willing and actually provided the card to their partners. Five of the eight partners of clients who tested HIV-positive and who were provided with referral cards responded to the referral and were tested for HIV. Three were positive and two were negative. Nine of 11 counselors did not agree to requesting partner locator information from HIV-positive clients for contractual referral and/or outreach assistance. The findings from the study were categorized by nine themes. A comprehensive and integrated approach of partner notification and a referral framework with active counselor involvement was developed. Partner notification and referral can be improved by an integrated and comprehensive framework, with active involvement of HIV counselors in the disclosure process.
    Preview · Article · Jan 2013 · HIV/AIDS - Research and Palliative Care
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