HIV This Week

Magee EM, Small M, et al. Determinants of HIV/AIDS risk behaviours in expectant fathers in Haiti. J Urban Health 2006;83:625-636.

Haiti has an HIV epidemic of the highest magnitude outside of sub-Saharan Africa. Factors such as relationship power imbalances, traditional gender role acceptance, and patriarchal belief systems that devalue women's sexuality have increased Haitian women's vulnerability to HIV infection. Because of these influences and the heterosexually transmitted HIV epidemic, it is important to understand the role that men's beliefs and behaviours play in the continuing risk of young men and women in Haiti. This study gathered information from male community members through semi-structured interviews in order to describe the prevalence of HIV risk behaviours (e.g., condom use, number of sexual partners) among expectant fathers in Haiti and identify predictive psychosocial variables of HIV risk behaviours. Results showed that men who were not married (P=0.05) and men who had medium (P<0.001) and high sexual communication (P<0.001) were more likely to use condoms. This study also showed that high stigma associated with HIV (P<0.05), low HIV knowledge (P<0.01), and high decision making power (P<0.001) were predictors of multiple sex partners for the expectant fathers in the sample. Magee and colleagues conclude that HIV prevention programs should be designed to increase knowledge about HIV transmission, treatment, prevention and personal risk of contraction as well as to correct misconceptions about individuals living with HIV and promote sex communication among partners.

Harvey SM, Henderson JT. Correlates of condom use intentions and behaviors among a community-based sample of Latino men in Los Angeles. J Urban Health 2006;83:558-74.

HIV has disproportionately affected Latino communities. The majority of research addressing HIV risk behaviours within this population has focused on women. However, men who have sex with women (MSW) are a population increasingly becoming infected with HIV and heterosexual contact is the primary source of HIV transmission among Latinos diagnosed with AIDS. It has been assumed that because men are likely to control condom use, relationship factors are less likely to influence safer sex behaviour among men. However, because condom use is an interdependent behaviour, understanding factors that predict safer sex behaviour among MSW is critical. The authors examined the influence of multiple factors on condom use behaviour in a community-based sample of young Latino men. They analysed data from 191 Latino men who completed baseline interviews for an intervention to examine the association of background, intrapersonal and relationship factors with intentions to use condoms and condom use in the past three months. Findings from multivariate analyses indicated that more positive attitudes toward condoms, stronger partner condom norms and greater participation in decision-making about condom use were significantly associated with both condom use and condom use intentions. Additionally, men reporting lower expectations of negative partner reactions to condom requests were more likely to use condoms, and condom use intentions were higher among men reporting more health protective communication in the relationship. Findings suggest that programmes to prevent HIV need to include men as well as women and address the role of relationship factors and dynamics in safer sex practices.