Understanding Consistent Condom Use Among Homeless Men Who Have Sex with Women and Engage in Multiple Sexual Partnerships: A Path Analysis

Hsu, Hsun-Ta; Wenzel, Suzanne L.; Rice, Eric; Gilreath, Tamika D.; Kurzban, Seth; Unger, Jennifer B.

doi:10.1007/s10461-015-1051-9

Cited by 12 publications

(15 citation statements)

References 63 publications

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“…Among a cross-sectional sample of sexually active homeless adults from an understudied region in the southwestern United States, we examined the prevalence of recent sexual risk behaviors, including having condomless sex, new sexual partners, and having multiple sexual partners in the past year. We found lower rates of condomless sex than have been found in other studies of homeless adults [ 7 , 10 ]. We also found that the proportion of individuals who had condomless sex, new sexual partners, and multiple sexual partners in the past 12 months was higher among those younger than 25 years old than among those 25 years and older.…”

Section: Discussioncontrasting

confidence: 74%

“…For example, condomless sex is a prevalent HIV risk behavior among individuals experiencing homelessness. In studies of homeless men, over two-thirds of participants reported having condomless sex in the past six months [ 10 ] and each additional sex partner has been found to be associated with an increase of more than two times the odds of engaging in condomless sex [ 11 ]. In a sample of both male and female sexually active homeless adults, approximately 76% reported having condomless sex [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

“…Among heterosexual homeless men, the strongest predictors of condom use were attitudes about condom use, self-efficacy for condom use, partner type (i.e., long-term or casual), and partner communication about condom use [ 13 ]. In addition, having multiple sexual partners and depression were found to be associated with consistent condom use [ 10 ]. Predictors of condom use among homeless women include condom efficacy (i.e., belief that condoms reduce risk) and their perceived risk of getting HIV.…”

Section: Introductionmentioning

confidence: 99%

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Current Age, Age at First Sex, Age at First Homelessness, and HIV Risk Perceptions Predict Sexual Risk Behaviors among Sexually Active Homeless Adults

Maria

Hernandez

Arlinghaus

et al. 2018

IJERPH

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While HIV disproportionately impacts homeless individuals, little is known about the prevalence of HIV risk behaviors in the southwest and how age factors and HIV risk perceptions influence sexual risk behaviors. We conducted a secondary data analysis (n = 460) on sexually active homeless adults from a cross-sectional study of participants (n = 610) recruited from homeless service locations, such as shelters and drop-in centers, in an understudied region of the southwest. Covariate-adjusted logistic regressions were used to assess the impact of age at homelessness onset, current age, age at first sex, and HIV risk perceptions on having condomless sex, new sexual partner(s), and multiple sexual partners (≥4 sexual partners) in the past 12 months. Individuals who first experienced homelessness by age 24 were significantly more likely to report condomless sex and multiple sexual partners in the past year than those who had a later onset of their first episode of homelessness. Individuals who were currently 24 years or younger were more likely to have had condomless sex, new sexual partners, and multiple sexual partners in the past 12 months than those who were 25 years or older. Those who had low perceived HIV risk had lower odds of all three sexual risk behaviors. Social service and healthcare providers should consider a younger age at homelessness onset when targeting HIV prevention services to youth experiencing homelessness.

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Section: Discussioncontrasting

confidence: 74%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Current Age, Age at First Sex, Age at First Homelessness, and HIV Risk Perceptions Predict Sexual Risk Behaviors among Sexually Active Homeless Adults

Maria

Hernandez

Arlinghaus

et al. 2018

IJERPH

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“…ii) Frequency of condom use is a factor because consistent condom use is the main strategy aimed at preventing individuals from acquiring HIV through sexual intercourse [13]. …”

Section: Methodsmentioning

confidence: 99%

Factors influencing risky sexual behaviour among Mozambican miners: a socio-epidemiological contribution for HIV prevention framework in Mozambique

Martins-Fonteyn

Loquiha

Baltazar

et al. 2017

Int J Equity Health

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Background: Information dealing with social and behavioural risk factors as well as their mechanisms among Mozambican migrants working in South African mines remains undocumented. This study aims to understand the various factors influencing HIV-related risk behaviours and the resulting HIV positive status of Mozambican miners employed by South African mines. This analysis was undertaken in order to inform a broader and more effective HIV preventive framework in Mozambique. Method: This study relied upon data sourced from the first Integrated Biological and Behavioural Survey among Mozambican miners earning their living in South African mines. It employs quantitative techniques using standard statistical tools to substantiate the laid-down objectives. The primary technique applied in this paper is the multivariable statistical method used in the formulation and application of a proximate determinants framework. Results: The odds of reporting one sexual partner were roughly three times higher for miners working as perforators as opposed to other types of occupation. As well, the odds of condom use -always or sometimes -for miners in the 31-40 age group were three times higher than the odds of condom use in the 51+ age group. Miners with lower education levels were less likely to use condoms. The odds of being HIV positive when the miner reports use of alcohol or drugs (sometimes/always) is 0.32 times lower than the odds for those reporting never use of alcohol or drugs. And finally, the odds of HIV positive status for those using condoms were 2.16 times that of miners who never used condoms, controlling for biological and other proximate determinants. Conclusion: In Mozambique, behavioural theory emphasising personal behavioural changes is the main strategy to combat HIV among miners. Our findings suggest there is a need to change thinking processes about how to influence safer sexual behaviour. This is viewed to be the result of a person's individual decision, due to of the complexity of social and contextual factors that may also influence sexual behaviours. This only stresses the need for HIV prevention strategies to exclusively transcend individual factors while considering the broader social and contextual phenomena influencing HIV risk among Mozambican miners.

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“…Factors predisposing individuals to use condoms include social-demographic characteristics {e.g., age [13], gender [7, 9, 14], sexual orientation [14, 15], race [13–15], marital status [13], education level [13, 15], education backgrounds of parents [9]}, and attitudinal-belief variables such as HIV-related knowledge [8, 13] and attitudes towards condom use [7, 8, 10, 11, 14, 17]. Factors inhibiting and promoting use of condoms (i.e., enabling factors) can be measured with multiple indicators such as their own personal resources {e.g., income [15] and self-efficacy of condom use [7, 8, 11, 14, 16, 17]} and the availability of health services in their community of residence such as condom available when having sex [10] and exposure to a community-level HIV prevention intervention [13, 16].…”

Section: Conceptual Frameworkmentioning

confidence: 99%

Inequities in consistent condom use among sexually experienced undergraduates in mainland China: implications for planning interventions

Ruan

Yan

et al. 2019

BMC Public Health

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Background Since pre-exposure prophylaxis (PrEP) is mainly prescribed to high-risk uninfected individuals, consistent condom use (CCU) continues to be recommended as an inexpensive, feasible, practical and acceptable way to prevent the general population from acquiring and transmitting HIV through sexual intercourse. The objective of this cross-sectional study was to compare the relative importance of various determinants of CCU among sexually experienced undergraduates in mainland China so as to assess and subsequently to suggest ways to eliminate inequities in its use. Method From September 10, 2018, to January 9, 2019, an anonymous self-administered online questionnaire was voluntarily completed by 12,750 participants distributed across 30 provinces in mainland China (except for Tibet). The present analysis was restricted to 2054 sexually experienced undergraduates. Pearson’s chi-square test and Logistic regression models were chosen to analyze the factors associated with CCU. Results The overall rate of CCU was 61.3% [95% confidence interval (CI) = 59.2–63.4%]. CCU was inequitably distributed since enabling factors exerted greater effects than predisposing and need variables. Compared with heterosexual men, heterosexual women [adjusted odds ratio (AOR) = 0.78, 95% confidence interval (CI):0.64–0.96)], non-heterosexuals men (AOR = 0.64, 95% CI:0.45–0.92) and women (AOR = 0.68, 95% CI:0.47–0.99) were less prone to using condoms consistently. Those with more resources [i.e., higher levels of self- efficacy for condom use (AOR = 2.86, 95% CI:2.35–3.49) and being knowledgeable of the national AIDS policy (AOR = 1.50, 95% CI:1.23–1.82)], and those with lower need for condoms [i.e., late initiation of sexual activity (AOR = 1.34, 95% CI:1.09–1.64) and single sexual partner (AOR = 1.68,95% CI:1.21–2.33)] were more likely to be consistent condom users. Conclusions In order to increase consistency of condom use and simultaneously reduce the remaining inequities, a comprehensive intervention measure should be taken to target heterosexual women, non-heterosexual men and women, and those with higher need for condoms, improve their condom use self- efficacy and raise their awareness of the national AIDS policy.

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Understanding Consistent Condom Use Among Homeless Men Who Have Sex with Women and Engage in Multiple Sexual Partnerships: A Path Analysis

Cited by 12 publications

References 63 publications

Current Age, Age at First Sex, Age at First Homelessness, and HIV Risk Perceptions Predict Sexual Risk Behaviors among Sexually Active Homeless Adults

Current Age, Age at First Sex, Age at First Homelessness, and HIV Risk Perceptions Predict Sexual Risk Behaviors among Sexually Active Homeless Adults

Factors influencing risky sexual behaviour among Mozambican miners: a socio-epidemiological contribution for HIV prevention framework in Mozambique

Inequities in consistent condom use among sexually experienced undergraduates in mainland China: implications for planning interventions

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