HIV awareness: a kap study among students in Italy reveals that preventive campaigns still represent a public health priority.

BACKGROUND: Improving knowledge about HIV/AIDS among young people is crucial for preventing new infections. The aim of the study was to investigate knowledge, attitudes and practices regarding HIV infection among students attending university courses related to the healthcare professions, in order to better target future preventive and informative HIV campaigns tailored for young people. STUDY DESIGN: A knowledge, attitude and practices study was conducted among university students attending the following university courses in Bari (Southern Italy): Medicine and Surgery (MS), Dentistry and Dental Prostheses, Health Assistance, Motor Activities and Sports Sciences, Sciences and Technology of Herbal and Health Products, Nursing, Biomedical Laboratory Techniques, and Dietetics. METHODS: Students completed a self-administered questionnaire designed to assess their knowledge/attitudes re/ HIV and their own sexual practices. The general part of the questionnaire requested information about age, gender, nationality, religion and marital status. The second part included questions asking about knowledge, attitude and practices with respect to HIV, which required true/false answers or graduated answers (reported as agree, quite agree, quite disagree, and disagree). RESULTS: Four hundred students were invited to fill in the questionnaire. The response rate was 91.2% (n=365). Almost all students were aware that HIV is transmitted through sexual intercourse and blood, but only 34% knew that breastfeeding is a route of transmission. Of the respondents, 86.8% referred to previous sexual intercourse (25.8% reported using a condom in all cases of sexual intercourse, 43.5% in most cases, 18.6% rarely and 12.1 never). Sexual intercourse with casual partners was reported by 37.5% of these students and 63.9% of them did not always use a condom. CONCLUSIONS: The results of the study show that knowledge about some aspects of HIV is insufficient even though the students participating in the present study are students attending university courses related to the healthcare professions. Moreover, high-risk behaviors as the lack of the use of condom during sexual intercourse with casual partners are also common among interviewed students. Programs aimed at providing information that can prevent/reduce transmission of HIV in young people and new strategies to improve knowledge should be stressed as a public health priority.

Introducing rapid oral-fluid HIV testing among high risk populations in Shandong, China: feasibility and challenges.

BACKGROUND: This study was conducted to ascertain the feasibility of using rapid oral fluid testing as an alternative HIV testing method in China. METHOD: This is a mixed-method study among men who have sex with men (MSM), female sex workers (FSW) and VCT clients, conducted in 4 cities in Shandong Province. A pre-tested questionnaire was administered to 1137 participants through face-to-face interview to assess demographic characteristics, HIV testing histories and willingness to accept rapid oral fluid testing. VCT clients were provided with the saliva test kits for a screening test and errors in operation were recorded. Testing results were compared between oral and blood testing. Short feedback questionnaire was administered to 200 FSW who had undergone oral testing. RESULTS: The rate of willingness to take oral-fluid HIV testing among MSM, FSW and VCT clients was 72.8%, 72.1% and 67.4% respectively. Common errors recorded during test kit operation by the 229 VCT clients included: unpreparedness, wrong swab sampling, wrong dilution, wrong testing and inability to read test results. Advantages of oral testing listed by participants included: less intrusive, painlessness, easy self- testing and privacy. Disadvantages included perceived unreliable results (55.5%) and not nationally recognised (9%). Comparison of saliva and the blood testing results recorded a consistency rate of 0.970 (χ2 = 153.348, P < 0.001), implying an excellent consistency. CONCLUSION: Introduction of oral rapid fluid testing as an alternative HIV testing method in China is highly feasible but with some challenges including low recognition and operation errors.

Predictors of reporting bareback sex among a diverse sample of MSM recruited through a Swedish website.

This study aimed to understand how person, health and sexual behavior, HIV-risk cognitions, and gay community involvement relate to barebacking among 3634 men who have sex with men (MSM) recruited by way of the Swedish website QX.se. In this sample, 10% reported that they had engaged in barebacking in the past year. Variables found to be statistically significant in the bivariate analyses were incorporated into a logistic regression domain-specific model. Variables that remained significantly associated with barebacking in domain 1 were being HIV-positive and having had a sexually transmitted infection (STI) in the past year. The variable talked with someone in HIV services remained significant in domain 2, and for domain 3, the variable used the Internet to look for a bareback partner remained significant. Two variables, believing taking semen in one's mouth involves no or low risk of HIV transmission and believing that engaging in insertive unprotected anal intercourse (IUAI) involves no or low risk of HIV transmission, remained significant in domain 4. The final multivariate regression analysis included six variables (from domains 1 to 4) and had a significant fit (χ (2)(6) = 2.571, p=0.958). The likelihood of engaging in barebacking was higher for those men who reported being HIV-positive (odds ratio [OR] = 2.77), having had an STI in the past year (OR = 1.67), and having used the Internet to look for a bareback partner (OR = 12.59). This first study to explore the predictors of bareback sex among a Nordic MSM sample suggests that bareback sex among northern European MSM is less common than among other samples. The findings reconfirm that MSM who engage in bareback sex may represent a unique subset of MSM with distinct HIV prevention needs.

Do women use dental dams? Safer sex practices of lesbians and other women who have sex with women.

Dental dams are distributed and promoted in some safer sex campaigns for use in oral sex. However, whether and how often dams are used for sex between Australian women remains unknown. We investigated the use of dental dams for sex by lesbians and other women who have sex with women, and the relationship between dam use and sexual risk for this group. In 2004, a self-completion questionnaire was distributed to women attending the Sydney Gay and Lesbian Mardi Gras Fair Day and lesbian community venues and health services in Sydney (n = 543). Among the 330 women who had had oral sex with a woman in the previous 6 months, 9.7% had used a dental dam and 2.1% had used one 'often'. There was little evidence of dam use for prevention of sexually transmissible infections. Although women who practised rimming (oral-anal contact) or had fetish sex involving blood were more likely to have used a dam, dam use was not significantly more common among women who had more partners, or had casual or group sex. Some women avoided oral sex during menstruation or had oral sex with a tampon in place. Latex gloves and condoms were used by more women and more often than dams.

[Increase in the prevalence of HIV and in associated risk behaviors in men who have sex with men: 12 years of behavioral surveillance surveys in Catalonia (Spain)]. / Incremento en la prevalencia del VIH y en las conductas de riesgo asociadas en hombres que tienen sexo con hombres: 12 años de encuestas de vigilancia conductual en Cataluña.

OBJECTIVES: To describe trends in HIV prevalence, in risk behaviors associated with HIV transmission, and in knowledge and attitudes related to antiretroviral therapy (ART) among men who have sex with men (MSM) recruited in Catalonia between 1995 and 2006. METHODS: Biannual cross-sectional surveys were performed. An opportunistic sample of MSM was recruited in saunas, sex shops, bars and a cruising site in a public park. In addition, an anonymous self-administered questionnaire was sent by mail to all members of a gay and lesbian association (Coordinadora Gai-Lesbiana). Oral fluid samples were collected to determine HIV prevalence. Linear trends in proportions were assessed by the chi(2) test, stratified by age. RESULTS: The overall prevalence of HIV infection increased from 8.5% (1995) to 14.1% (2006) among men aged less than 30 years old (p=0.162) and from 18.2% (1995) to 21.2% (2006) among those aged 30 years old or more (p=0.07). Consistent condom use in anal intercourse with occasional partners decreased from 72.9% to 58.7% in men aged less than 30 years old (p <0.05) and from 77.2% to 65.6% in those aged 30 years old or more (p<0.001). The proportion of men who reported they chose riskier behaviors because of ART increased from 9.2% to 19.4% in men aged less than 30 years old and from 8.3% to 16.7% in those aged 30 years old or more (p<0.05). CONCLUSIONS: An increasing trend in the prevalence of HIV and associated risk behaviors was found in Catalonia among MSM. Therefore, preventive programs targeting this population should be intensified and should include new risk reduction strategies, as well as other educational messages about ART.

Sexual practices and dental dam use among women prisoners--a mixed methods study.

BACKGROUND: Dental dams have been distributed to women prisoners for protection against HIV and other sexually transmissible infections (STIs) in some Canadian and Australian prisons for over a decade. However, we do not know whether they serve any useful public health purpose. OBJECTIVE: To determine how dental dams are used in women's prisons in New South Wales (NSW), Australia. METHOD: Using quantitative and qualitative methods, we investigated women's sexual practices with a focus on how dental dams are used in NSW prisons. RESULTS: Although 71 of the 199 (36%) women reported having had sex with another inmate, with oral sex involved in most encounters, only eight (4%) had ever used a dental dam. The main sources of STI transmission risk among women prisoners were oral sex, manual sex and sharing dildos. Furthermore, sharing razors could also allow the transmission of blood-borne viruses, which could occur during sex in the presence of cuts or menstrual fluid. The high rates of hepatitis B and C among incarcerated women compound this risk. CONCLUSION: Dental dams are not widely used by women prisoners and we question their utility in women's prisons. Oral sex is an important risk factor for acquisition of herpes simplex virus type 1, but most women in NSW prisons (89%) are already infected. Condoms and latex gloves may have more use. Condoms could be used as a barrier on shared dildos and sex toys, while latex gloves could be used to protect cut and grazed hands from vaginal and menstrual fluids.

HIV risk practices sought by men who have sex with other men, and who use internet websites to identify potential sexual partners.

Men who have sex with men (MSM) account for the largest number of persons diagnosed with AIDS in the USA, with higher than average rates of drug use and unprotected sex being cited as the principal reasons underlying their high rates of HIV infection. Recent evidence has suggested that the use of websites specifically designed to promote unsafe sexual practices may be particularly common among MSM, thereby fostering their risky behaviours. In light of these findings, the present study is based on a content analysis of 1316 ads/profiles posted on one of the most popular MSM websites that specifically fosters unprotected sex. Ads/profiles were selected randomly based on the American ZIP code of residence. Data were collected between September 2006 and January 2007. Rates of advertised for high-risk sexual behaviours were very high, particularly for oral sex involving ejaculation into the mouth (88.0% for receptive oral sex, 77.4% for insertive oral sex), anal sex involving ejaculation into the anus (79.7% for insertive anal sex, 69.4% for receptive anal sex), multiple partner sex (77.9%) and felching (16.5%). A multivariate analysis of the correlates of sexual risk preferences identified seven factors that were related to a propensity towards enhanced sexual risk: younger age (beta = 0.12, P = 0.0001), not being African American (beta = 0.05, P = 0.0341), self-identification as a sexual 'bottom' (beta = 0.20, P = 0.0001), not caring about one's potential sex partners' HIV serostatus (beta = 0.15, P = 0.0001), preferring to have sex while under the influence of drugs (beta = 0.08, P = 0.0022), a greater involvement in and commitment to the use of the website to locate potential unprotected sex partners (beta = 0.16, P = 0.0001) and not being HIV-negative (beta = 0.08, P = 0.0081). The HIV intervention-related implications of these findings are discussed.