Articles tagged as "Sexual transmission and prevention"

Men who have sex with men

Smith AM, Grierson J, et al. Interpersonal and social network influences on gay men's communication about unprotected sex. Int J STD AIDS 2006;17:267-70. http://www.ingentaconnect.com/content/rsm/std/2006/00000017/00000004/art00012

This study documents gay men's communication patterns about unprotected sex. Gay men (N=206) completed a structured interview about their social networks. The 167 men who had had unprotected sex identified 1390 social relations; 32.6% had involved discussing an episode of unprotected sex. Discussions about unprotected sex were associated with the nature of the relationship, whether the other party was gay or lesbian, how often the parties spent time together, whether the relationship had been sexual, and the density of the other parties' social network. The authors conclude that social networks provide an important context for the maintenance of safer sex cultures.

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Sex Work

Gorbach PM, Sopheab H, et al. Changing behaviors and patterns among Cambodian sex workers: 1997-2003. J Acquir Immune Defic Syndr 2006 Apr 24 [Epub ahead of print]. http://gateway.ut.ovid.com/gw2/ovidweb.cgi

Gorbach and colleagues aimed to identify patterns and behaviours among direct and indirect female sex workers (DFSWs and IDFSWs, respectively) across Cambodia's five major cities from 1997 to 2003. They conducted interviews with DFSWs and IDFSWs following random selection from clusters in the five cities. They found that from 1997 to 2003, consistent condom use with clients increased from 53% to 96% among DFSWs and from 30% to 84% among IDFSWs. DFSWs reported staying in their profession longer, had fewer clients per day, stayed longer in each brothel, were in increasingly larger brothels, and were tested more for HIV. Reported condom use with clients was significantly higher among DFSWs who were never married, were in larger brothels, and charged more for sex, but lower for DFSWs with “sweethearts” and who reported abnormal vaginal discharge. For IDFSWs, reported condom use with clients was higher for those reporting abnormal vaginal discharge and HIV testing, and lower for those with “sweethearts”. The authors conclude that from 1997 to 2003, Cambodian direct and indirect sex workers increased their use of condoms each year with commercial as well as non-commercial partners, confirming that HIV prevention programmes can produce significant changes in risk behaviours.

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Sex Work

Ruan Y, Cao X, et al. Syphilis Among Female Sex Workers in Southwestern China: Potential for HIV Transmission.Sex Transm Dis 2006 May 15; [Epub ahead of print]http://www.stdjournal.com/pt/re/std/paptoc.htm;jsessionid=G14FTLCmvYgmt2Y5J6PKMnXwlthpxvhh0sW2Hms1kXtTPyhM3qLC!-801141804!-949856145!8091!-1

Ruan et al investigated the prevalence and risk factors of sexually transmitted infections among female sex workers in a southwestern Chinese city along a drug trafficking route. From December 2004 to January 2005, they recruited 343 female sex workers (FSWs) through community outreach and peer referring. Confidential questionnaire interviews were administered to collect information on sexual risk behaviours, and laboratory tests conducted to diagnose sexually transmitted infections. The prevalence of syphilis was 15.7%, HIV 0.6%, gonorrhoea 2.0%, and genital warts 1.5%. Nearly 10% of FSWs reported using illicit drugs. Among the FSWs, 53.9% reported consistent use while 7.6% never used a condom with sex clients in the previous month. Length of time in sex work (OR 1.98; 95% CI 1.08-3.62), working at low-end establishments (OR 2.03; 95% CI 1.10-3.76), and if primary sex partners had sex with other women in the past 6 months (OR 2.06; 95% CI 1.08-3.91) were independently associated with syphilis infection. Ruan and colleagues conclude that high prevalence of syphilis, unprotected commercial sex, and drug using behaviours among FSWs along a drug-trafficking route may suggest a potential for rapid spread of HIV from injecting drug users to FSWs and then to the general population and underscore the urgency of preventive interventions to break the bridge of FSWs for HIV/STI spread.

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Behaviour Change

Zablotska I, Gray RH, Serwadda D, et al. Alcohol use before sex and HIV acquisition: a longitudinal study in Rakai, Uganda. AIDS 2006;20: 1191-96

The authors examined the association between alcohol use before sex and incident HIV in a population-based cohort in Rakai, Uganda, between 1994 and 2002. In 6791 men and 8084 women they found that HIV incidence was 1.4/100 person-years and 1.5/100 person-years, respectively. After controlling for sociodemographic and behavioural factors, the relative risks for HIV when one partner consumed alcohol before sex were 1.67 (95% CI 1.17–2.40) among men, and 1.40 (95% CI 1.02–1.92) among women. When both partners consumed alcohol, the relative risks were 1.58 (95% CI 1.13–2.21) among men, and 1.81 (95% CI 1.34–2.45) among women. Alcohol use was significantly associated with inconsistent condom use and multiple sexual partners in both sexes. The authors conclude that alcohol use before sex increases HIV acquisition, and a reduction of alcohol use should be incorporated into HIV prevention programmes.

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Men who have sex with men

Mao L, Crawford JM, Hospers HJ, et al. Serosorting' in casual anal sex of HIV-negative gay men is noteworthy and is increasing in Sydney, Australia. AIDS 2006;20: 1204-06.

The authors found that ‘serosorting’ (defined as engaging in unprotected anal intercourse with casual partners who claim to be HIV negative) has been increasing among HIV-negative gay men in Sydney. They conclude that prevention and intervention programmes are urgently needed to alert HIV-negative gay men to the risks associated with ‘serosorting’, and remind them of the need for correct and consistent condom use.


Wolitski RJ, Jones KT, Wasserman JL, Smith JC. Self-Identification as "Down Low" Among Men Who Have Sex with Men (MSM) from 12 US Cities. AIDS Behav 2006 May 12 [Epub ahead of print].

Wolitski compared MSM who considered themselves to be on the "down low" (DL) with MSM who did not (non-DL MSM). 20% of the 455 MSM self-identified as DL. Blacks and Hispanics were more likely than Whites to self identify as DL. MSM who did not identify as gay were more likely than gay-identified MSM to describe themselves as DL. DL-identified MSM were less likely to have had seven or more male partners in the prior 30 days, but were more likely to have had a female sex partner and to have had unprotected vaginal sex. DL-identified MSM were less likely to have ever been tested for HIV than were non-DL MSM. The authors conclude that prevention agencies should expand existing programs for MSM to include specific efforts to reach DL MSM.

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