HIV Seropositivity: Stall R

Stall R, Hart G. · No affiliation provided · Sex Transm Infect. · Pubmed #19028935 No free full text.

This publication has no abstract.

Friedman MS, Marshal MP, Stall R, Cheong J, Wright ER. · Graduate School of Public Health, University of Pittsburgh, 130 DeSoto Street, Pittsburgh, PA 15261, USA. · AIDS Behav. · Pubmed #17990094 links to  free full text

Abstract: This study examined relationships between timing of gay-related developmental milestones, early abuse, and emergence of poor health outcomes in adulthood among 1,383 gay/bisexual men in the Urban Men's Health Study. Latent Profile Analysis grouped participants as developing early, middle or late based on the achievement of four phenomena including age of first awareness of same-sex sexual attractions and disclosure of sexual orientation. Participants who developed early were more likely, compared to others, to experience forced sex and gay-related harassment before adulthood. They were more likely to be HIV seropositive and experience gay-related victimization, partner abuse and depression during adulthood. Early forced-sex, gay-related harassment and physical abuse were associated with several negative health outcomes in adulthood including HIV infection, partner abuse, and depression. This analysis suggests that the experience of homophobic attacks against young gay/bisexual male youth helps to explain heightened rates of serious health problems among adult gay men.

Plankey MW, Ostrow DG, Stall R, Cox C, Li X, Peck JA, Jacobson LP. · Department of Medicine, Division of Infectious Diseases, Georgetown University Medical Center, Washington, DC 20007, USA. · J Acquir Immune Defic Syndr. · Pubmed #17325605 No free full text.

Abstract: BACKGROUND: The association between methamphetamine use and HIV seroconversion for men who have sex with men (MSM) was examined using longitudinal data from the Multicenter AIDS Cohort Study. METHODS: Seronegative (n = 4003) men enrolled in 1984 to 1985, 1987 to 1991, and 2001 to 2003 were identified. Recent methamphetamine and popper use was determined at the current or previous visit. Time to HIV seroconversion was the outcome of interest. Covariates included race/ethnicity, cohort, study site, educational level, number of sexual partners, number of unprotected insertive anal sexual partners, number of unprotected receptive anal sexual partners, insertive rimming, cocaine use at the current or last visit, ecstasy use at the current or last visit, any needle use since the last visit, Center for Epidemiologic Study of Depression symptom checklist score >16 since the last visit, and alcohol consumption. RESULTS: After adjusting for covariates, there was a 1.46 (95% confidence interval [CI]: 1.12 to 1.92) increased relative hazard of HIV seroconversion associated with methamphetamine use. The relative hazard associated with popper use was 2.10 (95% CI: 1.63 to 2.70). The relative hazard of HIV seroconversion increased with the number of unprotected receptive anal sexual partners, ranging from 1.87 (95% CI: 1.40 to 2.51) for 1 partner to 9.32 (95% CI: 6.21 to 13.98) for 5+ partners. The joint relative hazard for methamphetamine and popper use was 3.05 (95% CI: 2.12 to 4.37). There was a significant joint relative hazard for methamphetamine use and number of unprotected receptive anal sexual partners of 2.71 (95% CI: 1.81 to 4.04) for men with 1 unprotected receptive anal sexual partner, which increased in a dose-dependent manner for >1 partners. CONCLUSIONS: Further examination of the mechanisms underlying the synergism of drug use and sexual risk behaviors on rates of HIV seroconversion is necessary for the development of new targeted HIV prevention strategies for non-monogamous drug-using MSM.

Duru OK, Collins RL, Ciccarone DH, Morton SC, Stall R, Beckman R, Miu A, Kanouse DE. · Division of General Internal Medicine/Health Services Research, University of California, Los Angeles, CA 90024, USA. · AIDS Behav. · Pubmed #16779659 links to  free full text

Abstract: We examined potential correlates of sex without HIV disclosure within a sample of 875 participants from the HIV Cost and Services Utilization Study. Interviews with each participant assessed sexual activities with up to six recent partners, and this study included both respondent and partnership characteristics. Compared with marriage and/or primary same-sex relationships, occasional partnerships and one-time encounters were associated with sex with disclosure, and shorter relationships were more likely to involve sex without disclosure. Knowledge of partner serostatus was also associated with sex without disclosure. Women were less likely to have sex without disclosure than men having sex with men. We found an association between the perceived duty to disclosure to all partners and sex without disclosure, while we found no association in multivariate analyses between outcome expectancies and sex without disclosure.

Mansergh G, Naorat S, Jommaroeng R, Jenkins RA, Stall R, Jeeyapant S, Phanuphak P, Tappero JW, van Griensven F. · Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, 1600 Clifton Road, Mailstop E-37, Atlanta, GA 30333, USA. · AIDS Behav. · Pubmed #16715348 No free full text.

Abstract: HIV/STD risk behavior has not been examined in community samples of men who have sex with men (MSM) in Thailand. The sexually-active sample (n=927) was recruited from bars, saunas, and parks; 20% identified as bisexual and 17% tested HIV-positive. Inconsistent (<100%) condom use was reported by 45% of those with steady partners and 21% of those with casual partners in the prior three months. 21% had heard of effective HIV treatments (n=194), among whom 44% believed HIV was less serious and 36% said their risk behavior had increased after hearing about the treatments. In multivariate analysis, HIV-positive status, gay-identification, getting most HIV information from the radio, believing HIV can be transmitted by mosquito bite, and concern about acquiring an STD were associated with inconsistent condom use during anal sex; slightly older age (25-29 vs. 18-24 years) was associated with more consistent condom use. HIV/STD risk-reduction strategies for MSM in Bangkok should clearly state sexual risk to individuals in this population.

Ibañez GE, Purcell DW, Stall R, Parsons JT, Gómez CA. · Divisions of HIV/AIDS Prevention, National Center for HIV, STD, and TB Prevention, Centers for Disease Control and Prevention, 1600 Clifton Road, MS E-37, Atlanta, GA 30333, USA. · AIDS. · Pubmed #15838194 No free full text.

Abstract: OBJECTIVES: Gay and bisexual men and injection drug users (IDU) are the two main groups at risk of HIV exposure in the United States, but few studies have focused on the intersection of these two groups. Little is known about HIV-positive gay and bisexual IDU. The aim of this study is to identify and compare differences in HIV transmission risk behaviors and psychological distress in HIV-positive gay and bisexual men by injection versus non-injection drug use. METHODS: Data were from the baseline assessment of a randomized controlled trial of an HIV prevention intervention for HIV-positive gay and bisexual men. RESULTS: Of the 1168 men, 236 (20%) reported injection drug use, 500 (43%) reported only non-injection drug use, and 422 (36%) reported no drug use. More of the IDU reported having sex with women, and identified themselves as "barebackers" (i.e. men who intentionally have unprotected anal intercourse). IDU reported more unprotected sexual behaviors than men who did not use drugs, but their sexual risk behaviors were similar to those of men who used non-injection drugs. IDU, compared with other drug users, reported more use of non-injected methamphetamine, amphetamine, barbiturates, and gamma hydroxybutyrate. More IDU, compared with the other two groups, reported sexual abuse, anxiety, and hostility. CONCLUSION: HIV-positive gay and bisexual IDU are a distinct group from other HIV-positive gay and bisexual men. Prevention case management and interventions that help men cope with multiple health concerns and prevent HIV transmission are needed for this population.

Stall R, van Griensven F. · Divisions of HIV/AIDS Prevention, National Center for HIV, STD, and TB Prevention, Centers for Disease Control and Prevention, 1600 Clifton Road, MS E-37, Atlanta, GA 30333, USA. · AIDS. · Pubmed #15838190 No free full text.

This publication has no abstract.

Mills TC, Paul J, Stall R, Pollack L, Canchola J, Chang YJ, Moskowitz JT, Catania JA. · Department of Psychiatry, University of California at San Francisco, USA. · Am J Psychiatry. · Pubmed #14754777 links to  free full text

Abstract: OBJECTIVE: This study estimates the prevalence of depression and describes the correlates and independent associations of distress and depression among U.S. men who have sex with men. METHOD: A household-based probability sample of men who have sex with men (N=2,881) was interviewed between 1996 and 1998 in four large American cities. With cutoff points of 15 and 22 for the Center for Epidemiological Studies Depression Scale, individual correlates and predictors of distress and depression were examined, and multinomial logistic regression was performed. RESULTS: The 7-day prevalence of depression in men who have sex with men was 17.2%, higher than in adult U.S. men in general. Both distress and depression were associated with lack of a domestic partner; not identifying as gay, queer, or homosexual; experiencing multiple episodes of antigay violence in the previous 5 years; and very high levels of community alienation. Distress was also associated with being of other than Asian/Pacific Islander ethnicity and experiencing early antigay harassment. Depression was also associated with histories of attempted suicide, child abuse, and recent sexual dysfunction. Being HIV positive was correlated with distress and depression but not significantly when demographic characteristics, developmental history, substance use, sexual behavior, and current social context were controlled by logistic regression. CONCLUSIONS: Rates of distress and depression are high in men who have sex with men. These high rates have important public health ramifications. The predictors of distress and depression suggest prevention efforts that might be effective when aimed at men who have sex with men.

Ciccarone DH, Kanouse DE, Collins RL, Miu A, Chen JL, Morton SC, Stall R. · Urban Health Study, Department of Family and Community Medicine, University of California San Francisco, 94110, USA. · Am J Public Health. · Pubmed #12773361 links to  free full text

Abstract: OBJECTIVES: We estimated the proportion of HIV-positive adults who have any sexual contact without disclosure and the proportion of their sexual partnerships that involve unprotected sex without disclosure. METHODS: We drew participants from the HIV Cost and Services Utilization Study (n = 1421). Interviews assessed disclosure and sexual activities with up to 5 recent partners. RESULTS: Overall, 42% of the gay or bisexual men, 19% of the heterosexual men, and 17% of all the women reported any sex without disclosure, predominately within nonexclusive partnerships (P <.001). Across all groups, 13% of serodiscordant partnerships involved unprotected anal or vaginal sex without disclosure, with no significant difference between groups. CONCLUSIONS: Risky sex without disclosure of serostatus is not uncommon among people with HIV.

Alves RN, Kovacs MJ, Stall R, Paiva V. · Núcleo de Estudos e Prevenção da Aids, Instituto de Psicologia, Universidade de São Paulo, São Paulo, SP, Brasil. · Rev Saude Publica. · Pubmed #12364898 links to  free full text

Abstract: OBJECTIVE: To analyze the risk perception among HIV-positive women before getting a positive test result. METHODS: An exploratory study using in-depth interviews was conducted among 26 women who attended the outpatient clinic of a regional health center in Maringá, Brazil. The sample was drawn according to the women's availability. The interviews were carried out using a semi-structured questionnaire with open and closed questions on social-demographics, knowledge of primary and secondary prevention, risk perception before getting the test results, and impact of the diagnosis on their lives and sexual activity. Data was assessed using content analysis. RESULTS: Though the participants were aware that anyone could get infected, none of them believed they could actually be infected. Psychological mechanisms such as denial, avoidance, thought omnipotence, and projection are encouraged by practices and gender-dominant relationships in the Brazilian culture, which increases women's vulnerability to HIV infection. They feel helpless and many have unprotected sex with their partners, and are prone to unwanted pregnancies and re-infection. CONCLUSION: HIV prevention programs should take into account psychological, social, economical and cultural aspects that impact on women's vulnerability before and after being infected. For a wider outreach of actions, programs cannot to be restricted to massive information diffusion and need to apply psychoeducational strategies to small groups of women not only to increase their medical knowledge but also to enhance their awareness.

Stall R, Paul JP, Greenwood G, Pollack LM, Bein E, Crosby GM, Mills TC, Binson D, Coates TJ, Catania JA. · Division of HIV/AIDS Prevention, Behavioural Intervention Research Branch, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA. · Addiction. · Pubmed #11784456 No free full text.

Abstract: AIMS: To measure the prevalence and independent associations of heavy and problematic use of alcohol and recreational drugs among a household-based sample of urban MSM (men who have sex with men). DESIGN: Cross-sectional survey. PARTICIPANTS: Men who identified as being gay or bisexual or who reported sex with another man in the prior 5 years were included in this analysis (n = 2172). SETTING: A probability telephone sample of MSM was taken within Zip Codes of four large American cities (Chicago, Los Angeles, New York and San Francisco) estimated to have total concentrations of at least 4% of all households with one resident MSM. MEASUREMENTS: Standard measures of alcohol use, problems associated with alcohol use, and recreational drug use were administered by trained telephone interviewers. FINDINGS: Both recreational drug (52%) and alcohol use (85%) were highly prevalent among urban MSM, while current levels of multiple drug use (18%), three or more alcohol-related problems (12%), frequent drug use (19%) and heavy-frequent alcohol use (8%) were not uncommon. The associations of heavy and/or problematic substance use are complex, with independent multivariate associations found at the levels of demographics, adverse early life circumstances, current mental health status, social and sexual practices and connection to gay male culture. CONCLUSIONS: The complex pattern of associations with heavy and/or problematic substance use among urban MSM suggests that heavy and/or problematic substance use is grounded in multiple levels: the individual, the interpersonal and the socio-cultural.