HIV-infected and uninfected women in socially and economically disadvantaged environments experience many adverse events and high levels of depressive symptoms. HIV infection, at least during the early phase, may be less important than socio-environmental factors in predicting negative psychosocial outcomes for women.
To determine factors influencing Hispanic women's HIV-related communication and condom use with their primary male partner, 189 Dominican, Puerto Rican, and Mexican women were interviewed regarding sexual behaviour and condom use, relationship characteristics, perceived risk for HIV, and HIV-related communication with the primary male partner. Level of HIV-related communication with the primary male partner was associated with the woman's perceived risk for HIV and her rating of the openness with which she could communicate with her primary partner. Mexican women were less likely than Puerto Rican or Dominican women and women with multiple partners were less likely than those with one partner to communicate about HIV-related issues with their primary partner. Women reporting more condom use with their primary partner were younger, had discussed HIV-related issues more with the primary partner, and were less likely to expect negative reactions to requests for condom use than those reporting less condom use. These results suggest that prevention programmes that increase both general and HIV-specific communication between members of a couple may facilitate safer sex practices by the couple. Prevention programmes that encourage women to insist on condom use should consider the woman's expectations about her partner's reaction as a potential barrier to the initiation of safer sex practices.
was lost to follow-up). Therefore, the Determine combo test had a sensitivity of 0% (95% confidence interval, 0 to 28) and positive predictive value of 0% for the detection of acute infections. The ability of the 4th-generation Determine combo to detect antigen was very poor in Swaziland. Thus, the Determine combo test does not add any value to the current testing algorithm; rather, it adds additional costs and complexity to HIV diagnosis. The detection of acute HIV infections may need to rely on other testing strategies.
This study longitudinally examines the relation between a history of experiencing childhood and adult physical or sexual abuse, and male condom use by women with or at risk for HIV. Abuse history and prospective condom use data were collected from 214 HIV infected and 189 uninfected women participating in the HIV Epidemiology Research Study (HERS) who were inconsistent condom users at baseline and received two safer sex counseling sessions. Analyses were conducted to assess the association between abuse history and condom use while controlling for sociodemographic variables and other risk factors. HIV-uninfected women with a history of adult physical abuse were five times less likely to report consistent condom use at 1-year follow-up than uninfected women without a history of abuse while holding control variables constant. Expectations of a negative reaction by the partner to suggested condom use did not explain this association. Though in the same direction as in uninfected women, abuse history was not significantly related to consistent condom use among HIV-infected women. These data indicate the need to develop risk prevention strategies tailored to uninfected women with a history of adult abuse. In lieu of specialized interventions, health care providers should assess women's abuse history and supplement HIV prevention counseling with mental health counseling when indicated.
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