Jennifer L Brown1, Ralph J DiClemente2,3,4, Jessica M Sales2,3, Eve S Rose2, Nicole K Gause5, Polina Safonova6, Olga Levina7, Nikolay Belyakov8, Vadim V Rassokhin9. 1. Addiction Sciences Division, Department of Psychiatry & Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, Ohio. 2. Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, Georgia. 3. Center for AIDS Research, Emory University, Atlanta, Georgia. 4. Division of Infectious Diseases, Epidemiology and Immunology, Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia. 5. Department of Psychology, University of Cincinnati, Cincinnati, Ohio. 6. St. Petersburg AIDS Center, St. Petersburg, Russia. 7. NGO Stellit, St. Petersburg, Russia. 8. North-West Regional Center for Control and Prevention of AIDS, St. Petersburg, Russia. 9. First Pavlov State Medical University, St. Petersburg, Russia.
Abstract
OBJECTIVE: Alcohol use is a prominent factor correlated with HIV risk behavior engagement. Hazardous drinking is prevalent among Russian women and may contribute to decreased condom use. Event-based studies suggest that HIV risk behaviors may vary based on situational factors including partner characteristics and alcohol use. This study investigated the effect of situational factors on condom use during the most recent sexual encounter among a sample of HIV-infected Russian women. METHOD: HIV-infected women (n = 239; mean age = 30.0 years) receiving medical care in St. Petersburg, Russia, completed an audio computer-assisted self-interview that assessed characteristics of their last sexual encounter. Multivariable logistic regression examined the associations between the following situational factors: (a) alcohol use, (b) partner type, (c) partner's serostatus, and (d) partner's alcohol use on whether a condom was used for vaginal and/or anal sex during the last sexual encounter. RESULTS: A total of 54.0% engaged in unprotected vaginal and/or anal sex during their last sexual encounter. In an adjusted logistic regression model, unprotected sex did not differ by participants' alcohol use (adjusted odds ratio [AOR] = 0.72, 95% CI [0.29, 1.8]) but was more likely with partners who had consumed alcohol (AOR = 2.3, 95% CI [1.1, 5.2]) and HIV-infected partners (AOR = 2.8, 95% CI [1.6, 4.9]) and less likely to occur in the context of nonsteady partnerships (AOR= 0.36, 95% CI [0.13, 0.99]). CONCLUSIONS: More stable, steady relationships with HIV-infected partners who consumed alcohol were associated with greater likelihood of noncondom use. Results highlight the need to address the intersection of alcohol and sexual risk engagement within the context of HIV-infected women's relationships.
OBJECTIVE:Alcohol use is a prominent factor correlated with HIV risk behavior engagement. Hazardous drinking is prevalent among Russian women and may contribute to decreased condom use. Event-based studies suggest that HIV risk behaviors may vary based on situational factors including partner characteristics and alcohol use. This study investigated the effect of situational factors on condom use during the most recent sexual encounter among a sample of HIV-infected Russian women. METHOD:HIV-infectedwomen (n = 239; mean age = 30.0 years) receiving medical care in St. Petersburg, Russia, completed an audio computer-assisted self-interview that assessed characteristics of their last sexual encounter. Multivariable logistic regression examined the associations between the following situational factors: (a) alcohol use, (b) partner type, (c) partner's serostatus, and (d) partner's alcohol use on whether a condom was used for vaginal and/or anal sex during the last sexual encounter. RESULTS: A total of 54.0% engaged in unprotected vaginal and/or anal sex during their last sexual encounter. In an adjusted logistic regression model, unprotected sex did not differ by participants' alcohol use (adjusted odds ratio [AOR] = 0.72, 95% CI [0.29, 1.8]) but was more likely with partners who had consumed alcohol (AOR = 2.3, 95% CI [1.1, 5.2]) and HIV-infected partners (AOR = 2.8, 95% CI [1.6, 4.9]) and less likely to occur in the context of nonsteady partnerships (AOR= 0.36, 95% CI [0.13, 0.99]). CONCLUSIONS: More stable, steady relationships with HIV-infected partners who consumed alcohol were associated with greater likelihood of noncondom use. Results highlight the need to address the intersection of alcohol and sexual risk engagement within the context of HIV-infectedwomen's relationships.
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