Sexual Mixing Patterns and Heterosexual HIV Transmission Among African Americans in the Southeastern United States

Heterosexually transmitted HIV infection rates are disproportionately high among African Americans. HIV transmission is influenced by sexual network characteristics, including sexual partnership mixing patterns among sub-populations with different prevalences of infection

Condom Use and Duration of Concurrent Partnerships Among Men in the United States

This analysis of male respondents in the 2002 National Survey of Family Growth describes features of concurrent sexual partnerships including duration, patterns, and condom use

Event-level analyses of sex-risk and injection-risk behaviors among nonmedical prescription opioid users

Nonmedical prescription opioid use has been linked to hepatitis C virus (HCV) infection among people who inject drugs and with using high dead space syringes that retain more blood and transfer more HIV if shared. Little is known regarding its effects on sex risk behaviors

The male factor: Outcomes from a cluster randomized field experiment with a couples-based HIV prevention intervention in a South African township

This study examined the effects of the Couples Health CoOp intervention on heavy drinking, condom use, and HIV incidence

Feasibility of postpartum placement of the levonorgestrel intrauterine system more than 6 h after vaginal birth

The objective of this study was to determine the feasibility of postpartum LNG-IUS placement on the postpartum ward

Efficacy of the Young Women's CoOp: An HIV Risk-Reduction Intervention for Substance-Using African-American Female Adolescents in the South

HIV/sexually transmitted infection (STI) risk-reduction interventions are needed to address the complex risk behaviors among African-American female adolescents in disadvantaged communities in North Carolina. In a two-group randomized trial, we reached 237 sexually active, substance-using African-American female adolescents, to test a risk-reduction intervention, the Young Women’s CoOp (YWC), relative to a nutrition control. In efficacy analyses adjusting for baseline condom use, at three-month follow-up participants in the YWC were significantly less likely to report sex without a condom at last sex relative to control. There were mixed findings for within-group differences over follow-up, underscoring the challenges for intervening with substance-using female youths

Comparison of Sexual Mixing Patterns for Syphilis in Endemic and Outbreak Settings

In a largely rural region of North Carolina during 1998–2002, outbreaks occurred of heterosexually-transmitted syphilis, tied to crack cocaine use and exchange of sex for drugs and money. Sexual partnership mixing patterns are an important characteristic of sexual networks that relate to transmission dynamics of STIs

Incarceration and High-Risk Sex Partnerships among Men in the United States

Incarceration is associated with multiple and concurrent partnerships, which are determinants of sexually transmitted infections (STI), including HIV. The associations between incarceration and high-risk sex partnerships may exist, in part, because incarceration disrupts stable sex partnerships, some of which are protective against high-risk sex partnerships. When investigating STI/HIV risk among those with incarceration histories, it is important to consider the potential role of drug use as a factor contributing to sexual risk behavior. First, incarceration’s influence on sexual risk taking may be further heightened by drug-related effects on sexual behavior. Second, drug users may have fewer economic and social resources to manage the disruption of incarceration than nonusers of drugs, leaving this group particularly vulnerable to the disruptive effects of incarceration on sexual risk behavior. Using the 2002 National Survey of Family Growth, we conducted multivariable analyses to estimate associations between incarceration in the past 12 months and engagement in multiple partnerships, concurrent partnerships, and unprotected sex in the past 12 months, stratified by status of illicit drug use (defined as use of cocaine, crack, or injection drugs in the past 12 months), among adult men in the US. Illicit drug users were much more likely than nonusers of illicit drugs to have had concurrent partnerships (16% and 6%), multiple partnerships (45% and 18%), and unprotected sex (32% and 19%). Analyses adjusting for age, race, educational attainment, poverty status, marital status, cohabitation status, and age at first sex indicated that incarceration was associated with concurrent partnerships among nonusers of illicit drugs (adjusted prevalence ratio (aPR) 1.55, 95% confidence interval (CI) 1.06–2.22) and illicit drug users (aPR 2.14, 95% CI 1.07–4.29). While incarceration was also associated with multiple partnerships and unprotected sex among nonusers of illicit drugs (multiple partnerships: aPR 1.66, 95% CI 1.43–1.93; unprotected sex: aPR 1.99, 95% CI 1.45–2.72), incarceration was not associated with these behaviors among illicit drug users (multiple partnerships: aPR 1.03, 95% CI 0.79–1.35; unprotected sex: aPR 0.73, 95% CI 0.41–1.31); among illicit drug users, multiple partnerships and unprotected sex were common irrespective of incarceration history. These findings support the need for correctional facility- and community-based STI/HIV prevention efforts including STI/HIV education, testing, and care for current and former prisoners with and without drug use histories. Men with both illicit drug use and incarceration histories may experience particular vulnerability to STI/HIV, as a result of having disproportionate levels of concurrent partnerships and high levels of unprotected sex. We hypothesize that incarceration works in tandem with drug use and other adverse social and economic factors to increase sexual risk behavior. To establish whether incarceration is causally associated with high-risk sex partnerships and acquisition of STI/HIV, a longitudinal study that accurately measures incarceration, STI/HIV, and illicit drug use should be conducted to disentangle the specific effects of each variable of interest on risk behavior and STI/HIV acquisition

Coparenting and Sexual Partner Concurrency Among White, Black, and Hispanic Men in the United States

Concurrent sexual partnerships (partnerships that overlap in time) increase the spread of infection through a network. Different patterns of concurrent partnerships may be associated with varying STI risk depending on the partnership type (primary vs. non-primary) and the likelihood of condom use with each concurrent partner. We sought to evaluate co-parenting concurrency, overlapping partnerships in which at least one concurrent partner is a co-parent with the respondent, which may promote the spread of sexually transmitted infections (STIs)

Sexual Networks, Surveillance, and Geographical Space During Syphilis Outbreaks in Rural North Carolina

Sexually transmitted infections (STIs) spread along sexual networks whose structural characteristics promote transmission that routine surveillance may not capture. Cases who have partners from multiple localities may operate as spatial network bridges, thereby facilitating geographical dissemination. We investigated the relationships between surveillance, sexual networks, and spatial bridges for syphilis outbreaks in rural counties of North Carolina