The Cognitive Escape Scale: Measuring HIV-related Thought Avoidance

Nemeroff, Carol; Hoyt, Michael F.; Huebner, David M.; Proeschold‐Bell, Rae Jean

doi:10.1007/s10461-007-9345-1

Cited by 29 publications

(40 citation statements)

References 43 publications

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“…Additionally, despite a higher perceived seriousness of HIV among men with a greater percentage of CAI partners in the previous year in South Africa, perceived risk (Australia and Brazil) and threat (Brazil and South Africa) were lower among participants in some countries. The discordance between sexual risk taking and perceptions of HIV seriousness, risk, and threat may reflect some degree of cognitive dissonance or HIV fatalism among these participants [34,35]. The knowledge of treatment as prevention (TasP) may be another reason for a reduced risk perception among men with a higher percentage of CAI, with the assumption that an undetectable viral load equates to an inability to transmit HIV.…”

Section: Discussionmentioning

confidence: 99%

Perceptions of HIV Seriousness, Risk, and Threat Among Online Samples of HIV-Negative Men Who Have Sex With Men in Seven Countries

Chard

Metheny

Stephenson

2017

JMIR Public Health Surveill

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BackgroundRates of new HIV infections continue to increase worldwide among men who have sex with men (MSM). Despite effective prevention strategies such as condoms and pre-exposure prophylaxis (PrEP), low usage of both methods in many parts of the world hinder prevention efforts. An individual’s perceptions of the risk of acquiring HIV and the seriousness they afford to seroconversion are important drivers of behavioral risk-taking. Understanding the behavioral factors suppressing the uptake of HIV prevention services is a critical step in informing strategies to improve interventions to combat the ongoing HIV pandemic among MSM.ObjectiveThe study aimed to examine cross-national perceptions of HIV/AIDS seriousness, risk, and threat and the association between these perceptions and sociodemographic characteristics, relationships, and high-risk sexual behaviors among MSM.MethodsParticipants in Australia, Brazil, Canada, Thailand, South Africa, the United Kingdom, and the United States were recruited for a self-administered survey via Facebook (N=1908). Respondents were asked to rate their perceived seriousness from 1 (not at all serious) to 5 (very serious) of contracting HIV, their perceived risk from 1 (no risk) to 10 (very high risk) of contracting HIV based on their current behavior, and their perception of the threat of HIV—measured as their confidence in being able to stay HIV-negative throughout their lifetimes—on a scale from 1 (will not have HIV by the end of his lifetime) to 5 (will have HIV by the end of his lifetime). Covariates included sociodemographic factors, sexual behavior, HIV testing, drug use, and relationship status. Three ordered logistic regression models, one for each outcome variable, were fit for each country.ResultsContracting HIV was perceived as serious (mean=4.1-4.6), but perceptions of HIV risk (mean=2.7-3.8) and threat of HIV (mean=1.7-2.2) were relatively low across countries. Older age was associated with significantly lower perceived seriousness of acquiring HIV in five countries (Australia: odds ratio, OR 0.97, 95% CI 0.94-0.99; Brazil: OR 0.95, 95% CI 0.91-0.98; Canada: OR 0.96, 95% CI 0.93-0.98; South Africa: OR 0.96, 95% CI 0.94-0.98; United Kingdom: OR 0.95, 95% CI 0.92-0.98). Being in a male-male sexual relationship was associated with significantly lower perceived risk of HIV in four countries (Australia: OR 0.47, 95% CI 0.30-0.75; Canada: OR: 0.54, 95% CI 0.35-0.86; United Kingdom: OR 0.38, 95% CI 0.24-0.60; United States: OR 0.5, 95% CI 0.31-0.82). Drug use in the previous year was associated with greater threat of contracting HIV in two countries (Canada: OR 1.81, 95% CI 1.13-2.91; United Kingdom: OR 1.7, 95% CI 1.06-2.74).ConclusionsFew measures of behavioral or sexual risk-taking were significantly associated with perceived HIV seriousness, risk, or threat across countries. Overall, low levels of reported risk were identified, and results illustrate important gaps in the understanding of risk among MSM across societies that could be addressed through culturally-tailor...

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Section: Discussionmentioning

confidence: 99%

Perceptions of HIV Seriousness, Risk, and Threat Among Online Samples of HIV-Negative Men Who Have Sex With Men in Seven Countries

Chard

Metheny

Stephenson

2017

JMIR Public Health Surveill

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“…This study's cross-sectional assessment does not establish causality between AUDs and suboptimal ART adherence, yet it is reasonable to expect that AUDs negatively influence adherence for numerous reasons, including intoxication impairing one's capacity to plan for or remember dosing requirements [86], living in precarious conditions with lower ART access [87], alcohol consumption used to reduce ART-related side effects [88,89] and intentional “skipping” ART when drinking, due to misconceptions about drug interactions [90-92]. Additional research is needed to clarify the behavioral, environmental, and circumstantial conditions under which alcohol use is likely to influence adherence.…”

Section: Discussionmentioning

confidence: 99%

Alcohol use disorders negatively influence antiretroviral medication adherence among men who have sex with men in Peru

et al. 2014

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Objective-As international guidelines increase access to antiretroviral therapy (ART) globally, ART adherence becomes increasingly important to achieve HIV treatment as prevention (TasP) goals. In the concentrated HIV epidemic among men who have sex with men (MSM) and transgendered women (TGW) in Lima, Peru, the independent correlates of ART non-adherence were examined to inform treatment intervention priorities.Design-Cross sectional survey of HIV-infected MSM and TGW who are engaged in clinical care in Lima, Peru. Methods-FromJune to August 2012, 302 HIV-infected Peruvian MSM/TGW from three clinical care sites were recruited using convenience sampling to participate in a cross-sectional computer-assisted adherence survey. Several standardized screening measures associated with ART non-adherence were examined in order to determine the independent correlates of optimal (≥90%) and perfect (100%) adherence, which were assessed using logistic regression.Results-Of the 302 participants recruited, 263 (87.1%) were prescribed ART. Among those prescribed ART, 229 (87.1%) reported optimal and 146 (55.5%) reported perfect adherence. The prevalence of alcohol use disorders (AUD; 43.2%), alcohol dependence (5.3%), recent drug use (6.0%) and depression (44.5%) was high and most participants had some evidence of neurocognitive impairment. Meeting criteria for having an AUD and depression were collinear (p<0.001). On multivariate analysis, having an AUD was inversely related and the only Conclusions-AUDs are highly prevalent among Peruvian HIV-infected MSM and contribute significantly to ART non-adherence. These findings support the need for screening and treating underlying AUDs. In order to meet HIV TasP goals, evidence-based strategies targeting AUDs are likely to directly improve ART adherence and indirectly improve overall individual health, HIV treatment engagement and reduce transmission to sexual partners among this vulnerable and disproportionally affected population.

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“…In addition the magnitude of the effect of alcohol on adherence to ART may be affected by alcohol users having misconceptions of the possible detrimental interactions between alcohol and medications (Brigido et al, 2001;Kalichman et al, 2009;Sankar, Wunderlich, Neufeld, & Luborsky, 2007), and the use of alcohol to reduce the impact of the negative effects of HIV/AIDS (McKirnan, Ostrow, & Hope, 1996;Nemeroff, Hoyt, Huebner, & Proescholdbell, 2008). Despite the limitations in methodology used to estimate the burden of HIV/AIDS due to non-adherence to ART attributable to alcohol consumption, the finding is still valid that alcohol has a large impact on HIV/AIDS mortality due to people not adhering to ART.…”

Section: Discussionmentioning

confidence: 99%

Global burden of HIV/AIDS in 2004 resulting from alcohol attributable non-adherence to medication regimes

Shield

Shuper

Gmel

et al. 2013

IJADR

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Aims: Using novel methodology, this article aims to quantify the number of HIV/AIDS-related deaths and the potential years of life lost (PYLL) in 2004 resulting from non-adherence to antiretroviral treatment (ART) and non-adherence to ART due to alcohol consumption.Design: HIV/AIDS-related deaths and PYLL attributable to non-adherence to ART and attributable specifically to non-adherence due to alcohol consumption were calculated using attributable fractions. These fractions were based on new risk modeling methodology, which combines estimates of the mortality of those people currently adhering to ART, the mortality attributable to non-adherence to ART, and the proportion of those people not adhering to ART because of alcohol consumption.Measurements: Data on alcohol indicators were obtained from the Comparative Risk Assessment study, data on deaths and PYLL were obtained from the World Health Organization, and ART indicators were obtained from UNAIDS. Findings:In 2004, for people 15 years of age and older, 67,000 (95% CI: 62,000-72,000) deaths and 1,608,000 (95% CI: 1,491,000-1,725,000) PYLL were caused by non-adherence to ART, of which 8,000 (95% CI: 3,000-13,000) HIV/AIDS-related deaths and 187,000 (95% CI: 70,000-304,000) HIV/AIDS-related PYLL were attributable to alcohol consumption. Conclusions:As the burden of disease for HIV/AIDS-related deaths attributable to non-adherence to ART and attributable to alcohol consumption is non-trivial, additional research is required to examine the effectiveness of different interventions aimed at reducing alcohol consumption among people with HIV/AIDS and at increasing adherence to ART among both drinkers and nondrinkers.

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The Cognitive Escape Scale: Measuring HIV-related Thought Avoidance

Cited by 29 publications

References 43 publications

Perceptions of HIV Seriousness, Risk, and Threat Among Online Samples of HIV-Negative Men Who Have Sex With Men in Seven Countries

Perceptions of HIV Seriousness, Risk, and Threat Among Online Samples of HIV-Negative Men Who Have Sex With Men in Seven Countries

Alcohol use disorders negatively influence antiretroviral medication adherence among men who have sex with men in Peru

Global burden of HIV/AIDS in 2004 resulting from alcohol attributable non-adherence to medication regimes

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