Gemechu B. Gerbi

The correlation between alcohol consumption and risky sexual behaviours among people living with HIV/AIDS

The objectives of this study were to determine if significant correlation exists between drinking any alcoholic beverage and risky sex among 326 AIDS patients. Participants completed anonymous surveys. The result of the regression and Pearson correlation analyses revealed a significant positive correlation between drinking alcohol before sex and frequency of condom use (p<0.0001). The number of sex partners respondents reported was also correlated with the frequency of alcohol use (p = 0.003). The result shows that the quantity of alcohol consumption was correlated with two indicators of risky sex: having multiple sexual partners (p<0.0001) and having sexual intercourse without a condom (p<0.001). Interventions are that integrate HIV risk reduction with alcohol risk reduction is very useful to minimize the risk of new HIV infections and/or manage existing infections.

A comparative study of substance use before and after establishing HIV infection status among people living with HIV/AIDS

Objective: To determine if significant differences exist in substance use among people living with HIV/AIDS (PLWHA) before and after establishing their HIV infection status. Method: The study participants are HIV positive clients of a community based HIV/AIDS outreach facility located in Montgomery, Alabama. The questionnaire includes demographics, substance use and risky sexual behaviors pertaining to HIV transmission. Each participant completed an anonymous questionnaire. A total of 341 questionnaires were distributed and 326 were fully completed and returned, representing a response rate of 96%. Results: Findings revealed a statistically significant difference in alcohol consumption before sex among PLWHA before and after establishing their HIV infection status (p = .001). No significant differences were observed among participants who reported as having used drugs intravenously (p = .89), and among those sharing the same syringe/needle with another person (p = .87) before and after establishing their HIV infection status. Conclusion: There is continued substance use and alcohol consumption before sex among PLWHA after establishing their HIV status despite clear evidence of such risky behaviors that could lead to an increase in exposure to HIV.

Psychosocial factors as predictors of HIV/AIDS risky behaviors among people living with HIV/AIDS

Infection with the human immunodeficiency virus (HIV) that causes acquired immunodeficiency syndrome (AIDS) is still rising globally. In order to develop effective HIV/AIDS risky behavior reduction intervention strategies and to further decrease the spread of HIV/AIDS, it is important to assess the prevalence of psychosocial problems and HIV/AIDS risky behaviors in people living with HIV/AIDS (PLWHA). The objective of this study is to assess the relationship between psychosocial variables and HIV/AIDS risky behaviors among PLWHA. A total of 341 questionnaires were distributed and 326 were fully completed and returned, 96% response rate. The relationships between the identified psychosocial and HIV/AIDS risky behaviors among PLWHA were analyzed using The Moment Structures software version 17.0 (SPSS Inc.) The results indicate that psychosocial health problems were significant predictors of HIV/AIDS risky behaviors in PLWA. Further cross-disciplinary research that addresses the manner in which psychosocial problems and HIV/AIDS risky behaviors interact with each other among PLWHA is needed.

A quantitative risk assessment of multiple factors influencing HIV/AIDS transmission through unprotected sex among HIV-seropositive men.

Abstract The objective of this study is to conduct a quantitative risk assessment of multiple factors influencing HIV/AIDS transmission through unprotected sexual practices among HIV-seropositive men. A knowledgebase was developed by reviewing different published sources. The data were collected from different sources including Centers for Disease Control and Prevention, selected journals, and reports. The risk pathway scenario tree was developed based on a comprehensive review of published literature. The variables are organized into nine major parameter categories. Monte Carlo simulations for the quantitative risk assessment of HIV/AIDS transmission was executed with the software @Risk 4.0 (Palisade Corporation). Results show that the value for the likelihood of unprotected sex due to having less knowledge about HIV/AIDS and negative attitude toward condom use and safer sex ranged from 1.24×10−5 to 8.47×10−4 with the mean and standard deviation of 1.83×10−4 and 8.63×10−5, respectively. The likelihood of unprotected sex due to having greater anger-hostility, anxiety, less satisfied with aspects of life, and greater depressive symptoms ranged from 2.76×10−9 to 5.34×10−7 with the mean and standard deviation of 5.23×10−8 and 3.58×10−8, respectively. The findings suggest that HIV/AIDS research and intervention programs must be focused on behavior, and the broader setting within which individual risky behaviors occur.

Psychosocial responses associated with perceived risk of cancer in an African-American community.

This epidemiologic health survey study examined the association between health risk perceptions and psychosocial factors in 145 African Americans in East Montgomery, Alabama. The survey gathered information on demographics, population dynamics, health risk perceptions, and coping behaviors. Psychosocial variables measured were worries, concern, stress, and trauma associated with perceived risk of cancer. Results indicated that women were more concerned about the environmental health risks in their community than men. Compared to men, women were highly concerned about the economic effect of perceived environmental health risk. The findings indicate that an individuals health status and educational level were significant predictors of psychosocial responses.

The Association between Interrelationships and Linkages of Knowledge about HIV/AIDS and its Related Risky Behaviors in People Living with HIV/AIDS

The relationship between knowledge about HIV/AIDS and its associated risky behaviors is complex and has not been sufficiently explored. It is especially important to look at some of the aspects of this relationship among people living with HIV/AIDS (PLWHA) in order to develop effective intervention strategies to reduce HIV/AIDS risky behaviors. The objective of this study was to investigate the association between knowledge about HIV/AIDS and its risky behaviors among PLWHA. Methods Risk taking behavior among the participants was measured as the number of all risky behaviors before and after the knowledge of their HIV/AIDS positive status. Knowledge was measured by the extent to which participants answered the HIV/AIDS related questions. The relationships between the identified HIV/AIDS risky behaviors and the knowledge among PLWHA were analyzed using Structural Equation Modelling. Results 341 questionnaires were administered and 326 (96%) were completed and returned from PLWHA clients of HIV/AIDS outreach facility in Alabama. Analysis revealed that, knowledge of HIV/AIDS, and knowledge of a properly used condom in preventing the infection through sexual activity were positively related with knowledge of where to get tested for HIV/AIDS. Using drugs before sex was significantly related with having sex with prostitutes (total effects’ standardized regression coefficient (TESRC)=0.29, p<0.001). Sharing the same syringe or needle with another person or other people to inject oneself was strongly related with number of sexual partners within one year (TESRC=0.25, p<0.001), and sex with injecting drug users (TESRC=0.45, p<0.001). Conclusion A deeper understanding of HIV/AIDS and some of its transmission pathways appears to be very effective in practicing the taking of preventive measures such as using condoms or getting tested for HIV. Increasing access to HIV/AIDS education could therefore be very useful in providing further gains in HIV/AIDS awareness among PLWHA.

Epidemiology of Influenza A 2009 H1N1 Virus Pandemic in the U.S.

A novel influenza, Influenza A 2009 H1N1 virus outbreak, emerged in mid-April 2009, and by December 2009, spread across the world. This epidemiologic analysis uses the epidemiologic problem oriented approach to gather information for, and develop a quantitative risk assessment model that evaluates the likelihood of an influenza outbreak in the U.S., utilizing weekly incidence rates (WIR) and case fatality rates (CFR) stratified by age and the 10 U.S. regions. In addition ArcGIS was used to show variability regarding morbidity rate and WIR. Using data from the Centers for Disease Control and Prevention (CDC) Emerging Infections Program and applying Monte Carlo simulations with @Risk software, the analysis revealed morbidity to be highest in region 8 (1.27×10-2) and lowest in region 2 (0.13×10-2). Heat map results revealed WIR were higher in younger children, for all regions. Case fatality rates were 10 times greater in younger people than in older people and children. Using these different temporal-spatial epidemiologic methods can help decision-makers identify high-risk population clusters and help in prevention and control of pandemics.

The association between substance use and risky sexual behaviors among middle school children

Objective: The objective of the study was to determine if there was a significant association between substance use and risky sexual behaviors among middle school children. Methods: Data were collected in May 2002 using a questionnaire. A chi-square test was used for data analysis. Results: The results showed that alcohol, cocaine, marijuana, and tobacco use are strong predictors of risky sexual behaviors. Conclusions: These findings will be of use to healthcare practitioners and health educators seeking to reduce the risk of infection with HIV and other sexually transmitted diseases among the middle school children.

The association between religious affiliation and frequency of attendance at religious services on HIV risky behaviors among people living with HIV/AIDS

The purpose of this study was to examine if religious affiliation and frequency of attendance at religious services were associated with HIV risky behaviors among people living with HIV/AIDS (PLWHA). The participants are HIV positive clients of a community based HIV/AIDS outreach facility (CBHAOF) located in Montgomery, Alabama, USA. The participants completed the questionnaire during their medical visits to the clinic at their own convenience and that of the facilitys staff. A total of 341 questionnaires were distributed to PLWHA and 326 (96%) were fully completed and returned. There were more male than female participants (56 versus 42%). The majority of the respondents (67%) were between 30 and 49 years of age. Nearly two thirds of the participants (64%) were African Americans whilst 36% were other races combined (White = 29%, Hispanic = 3% and other races = 4%). A chi-square test was used to examine the association between selected variables. Findings show substantial variations of selected HIV risky behaviors according to religious affiliation and frequency of attendance at religious services (p < 0.05). The study findings suggest the importance of religious affiliation and frequency of attendance at religious services in reducing HIV risky behaviors among PLWHA. The findings have implications for HIV/AIDS prevention and we recommend that it is important to incorporate Faith-based organizations in the global fight against HIV/AIDS.

Triple Challenges of Psychosocial Factors, Substance Abuse, and HIV/AIDS Risky Behaviors in People Living with HIV/AIDS

Thirty years ago, the first cases of Human Immunodeficiency Virus (HIV) and Acquired Immunodeficiency Syndrome (AIDS) garnered the world’s attention. Since then, the lives of people living with HIV/AIDS (PLWHA), their families, communities, and the society as a whole are all affected by the HIV/AIDS pandemic. Not only does HIV/AIDS elicit detrimental physical manifestations but psychosocial health is affected negatively as well in PLWHA. Since the discovery of the Highly Active Antiretroviral Therapy (HAART) in the mid-nineties, PLWHA have overcome the fear of what previously was a certain death sentence. Their life expectancy, as a result of HAART, is now approaching that of the general population (The Antiretroviral Therapy Cohort Collaboration, 2008). However, many PLWHA confront a broad range of challenges that are multiple and chronic in nature. These challenges may yield adverse psychosocial consequences that can lead, eventually, to substance abuse and other HIV/AIDS-risky behaviors. The discovery that one is infected with the HIV is associated with reduced psychosocial health in China, the United States (U.S), and South Africa (Freeman et al., 2007; Sun, 2007; Vanable, 2006). Studies show that PLWHA have complicated histories including substance abuse, mental illness, mood disorders, and social stigma (Stoskopf, 2004; Pence, 2007a; Whetten, 2006). These negative experiences have been seen across a wide range of populations including adult men and women (Kelly, 1993), men who have sex with men (MSM) (Martin, 1998, Strathdee, 1998), HIV-positive adults (Kelly, 1993), minority women (Champion, 2002), substance users (Camacho, 1996), gay and bisexual men (Rogers, 2003), adolescents, and young adults (Ramrakha, 2000). Furthermore, these negative experiences have been associated with psychosocial disorders which in turn can contribute to increased substance abuse and HIV/AIDS-risky behaviors among PLWHA (Pence, 2007b; Leserman, 2003; Tucker, 2003). Similarly, substance abuse can contribute to numerous problems for PLWHA. For example, alcohol abuse can modify liver drug metabolism, thus complicating treatment for patients with HIV/AIDS hepatitis C virus co-infection as alcohol may