Study in Academy’s Journal of Urban Health Finds Condom Use Lagging in HIV-Positive Injection Drug Users

NEW YORK CITY, Oct 9— Injection drug users (IDUs) represent about one-third of people living with AIDS in the United States and therefore have an enormous potential to spread this disease. A study in the Academy’s Journal of Urban Health: Bulletin of The New York Academy of Medicine finds that male IDUs view condoms more negatively than their female counterparts, and are therefore less likely to use condoms and disclose their HIV status to partners. These two factors greatly increase the likelihood of spreading the disease to the population at large.

“Not using a condom and not discussing one’s sexual health can greatly increase the likelihood of spreading sexually transmitted diseases,” explains lead author Yuko Mizuno, PhD, of the National Center for HIV/STD/TB Prevention at the U.S. Centers for Disease Control and Prevention. “And because the U.S. HIV-infected IDU community is so large, it is important that they do engage in safer sexual practices to help reduce the risk of spreading the disease.”

The study showed that among men, the only factor that was statistically significant in influencing them not to use a condom was the perception that their sex partner was not supportive of condom use. Men in the study who were less likely to use condoms were also less likely to disclose their HIV status to their partners.

The “partner norm”—what one sex partner thinks about condom use and how much the other partner values these thoughts—is a significant deciding factor of whether both partners will use condoms, the study finds. “The question then is to come up with a strategy so that men would perceive strong normative pressure from their partners to use a condom,” writes Dr. Mizuno. One suggested strategy is to use couples-based interventions in which men and women each practice to develop norms supporting condom use. Another strategy would be providing women with skills to clearly communicate their positive beliefs about condoms and also to apply appropriate pressure on their partners to use condoms, explains Dr. Mizuno.

Researchers also found that female IDUs who were less-educated about HIV and STDs were at greater risk for violence from their sex partners. “The more knowledge and self-efficacy a woman had and the less that violence was inflicted by her sex partner, the more positive her condom beliefs were,” explains Dr. Mizuno. She also refers to a 2006 study led by Paul M. Pronyk, DTMH, a Lecturer at the University of the Witwatersrand, South Africa, which showed a reduced level of intimate-partner violence among women who were taught a curriculum of gender and HIV education.

The study, entitled “Beliefs that Condoms Reduce Sexual Pleasure???Gender Differences in Correlates Among Heterosexual HIV-Positive Injection Drug Users,” involved 348 HIV-positive IDUs (179 men and 169 women) from Baltimore, Miami, New York and San Francisco who were participating in a randomized controlled trial of an HIV prevention intervention, as well as participants recruited through community outreach. It was conducted from 2001 through 2005.

Other study authors included Mary H. Latka, Research Fellow in the Center for Urban Epidemiologic Studies (CUES) at the Academy; David W. Percell of the National Center for HIV/STD/TB Prevention at the CDC; Lisa R. Metsch of the University of Miami; Cynthia A. Gomez of the University of California???San Francisco; and, Carl A. Latkin of the Johns Hopkins University in Baltimore.

About the Journal of Urban Health
The Journal of Urban Health is a bimonthly peer-reviewed publication of The New York Academy of Medicine and focuses on the emerging fields of urban health and epidemiology. The Journal addresses health issues such as substance abuse, teenage pregnancy, HIV, tuberculosis, and violence from both clinical and policy perspectives, filling a neglected niche in medical and health literature. Published since 1847, the Journal is edited by David Vlahov, PhD, RN, Director of the Academy’s Center for Urban Epidemiologic Studies and Senior Vice President for Research.

About The New York Academy of Medicine
Founded in 1847, The New York Academy of Medicine is an independent, non-partisan, non-profit institution whose mission is to enhance the health of the public. Our research, education, community engagement, and evidence-based advocacy seek to improve the health of people living in cities, especially disadvantaged and vulnerable populations. The impact of these initiatives reaches into neighborhoods in New York City, across the country, and around the world. We work with community based organizations, academic institutions, corporations, the media, and government to catalyze and contribute to changes that promote health. Visit us online at www.nyam.org. ###

-by Sarah Rathsam

Posted on October 9, 2007

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