1 / 19

Impairment of Safe Sex Behavior by Women in an STD/HIV Prevention Trial

This study examines the impact of partnering with multiple sexual partners ("Players") on safe sex behavior and infection rates among women in an STD/HIV prevention trial. The findings highlight the reduced likelihood of safe sex practices and the increased vulnerability to male control among women partnered with "Players."

robertaa
Download Presentation

Impairment of Safe Sex Behavior by Women in an STD/HIV Prevention Trial

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Partner Impairment of Safe Sex Behavior by Women Participatingin a Randomized, Controlled STD/HIV Prevention Trial Alan E. C. Holden Ph.D. Sondra T. Perdue Dr.PH. Rochelle N. Shain Ph.D. Jeffrey E. Korte Ph.D. Jeanna M. Piper M.D. Jane D. Champion Ph.D. Holden@UTHSCSA.Edu

  2. Project S.A.F.E. • Randomized, controlled trial - behavioral/cognitive intervention to reduce STD recurrence - high-risk minority women (active STD) - San Antonio, Texas (1991-1995) • Significantly reduced STD reinfection at 6 and 12 months and cumulatively by reducing high-risk sexual behavior • Shain et al. NEJM 1999; 340:93 and • Shain et al. STD 2002; 29:9

  3. Procedure • 477 Women with complete data • Information about sexual partners (up to 5) at each time point (total 893 partners) • We identified “Players”: men having sex with more than one participant in our study by matching his initials, age, ethnicity, & other characteristics • Analysis: chi-square, logistic regression “Players” is the term used in the community

  4. Identification Procedure Results • Of 893 reported sexual partners: - 78 (“Players”) partnered with 2-4 women - appear 204 times in data set - 10.2% of all men • Remaining partners: 689 men • Of 477 women: - 46 (9.2 %) partnered with Players

  5. Characteristics of Players Compared to Other Partners1 Characteristic Players Others P-Value Steady partner 20.5% 53.8% < .01 Street drug use2 79.2% 34.8% < .01 Prior STD giver 46.2% 20.5% < .01 Has other partners 66.7% 17.8% < .01 Age > 25 51.3% 38.6% < .05 1 worst-case across multiple time points when applicable 2 excludes marijuana

  6. Players vs. Others: Infection Rates During 1-Year Follow-Up Overall Infection Rate = 21.6 % OR = 3.23 (CI 1.72-6.06) p < .01

  7. Unsafe Sex: • Never uses condoms in casual sex and/or • High number of unprotected acts (5+ in last 3 months) coupled with problematic condom use

  8. Problematic Condom Use: Condom use with: • Incomplete coverage of the penis • Condom slippage • Condom breakage • Other reported problems (e.g. stuck inside her)

  9. Unsafe vs. Safe Sex: Infection Rates During 1-Year Follow-Up OR = 3.44 (CI 2.19-5.40) p < .01 Shain et al. STD 2002; 29:9

  10. Players vs. Others: Unsafe Sex, No Condom Use, and Problematic Condom Use P < .08 P < .02 P < .01 n = 46 n = 431 n = 46 n = 431 n = 15 n = 208 Overall Unsafe Sex No Condoms Problematic Use

  11. Reasons Most Frequently Given by Women for No Condom Use Others unexpected coitus 18.5 % no condoms 15.2 % mutual trust 11.7 % she loves him 8.3 % erectile problems 2.6 % Players • he said he was clean 14.4 % • she was drunk/high 9.1 % • he refused 7.2 % • he forced sex 4.6 % • he promised he 3.5 % would “pull out”

  12. Players vs. Others: Vulnerability to Male Control P = .07 P = .08 He has a lot of influence over me Usually have sex when disagree

  13. Players vs. Others: Infection Rates among Women Practicing Unsafe and Safer Sex Mantel-Haenszel Common OR = 2.89, p < .01 n = 24 n = 148 n = 22 n = 283 Unsafe Sex Safer Sex

  14. WAS THERE AN INTERVENTION EFFECT?

  15. Study vs. Control Women: Partnering with Players during One-Year Follow-Up OR = 0.61 (CI 0.40-0.96) p = .034

  16. Intervention Results: Women Infected with Gonorrhea and/or Chlamydia, 1-Year Follow-Up OR = 1.63 (CI 1.05-2.53) p = .03 Shain et al. NEJM 1999; 340:93

  17. Study vs. Control Women: Unsafe Sexwhen Partnered with Players and Others Mantel-Haenszel Common OR = 2.89, p < .01 n = 17 n = 232 n = 29 n = 199 Study Group Control Group

  18. Study vs. Control Women: Reinfection during Follow-up when Partnered with Players and Others Mantel-Haenszel Common OR = 1.52, p < .07 n = 17 n = 232 n = 29 n = 199 Study Group Control Group

  19. Conclusions: • Women partnered with “Players” are: - less likely to practice safe sex: no condom use and/or incorrect condom use - more vulnerable to his influence and control • Study women are less likely than Controls to be partnered to “Players” during one-year follow-up

More Related