%0 Journal Article %J AIDS Behav %D 2014 %T Place and sexual partnership transition among young American Indian and Alaska native women. %A Pearson, Cynthia R %A Cassels, Susan %K Adolescent %K Adult %K Alaska %K Condoms %K Cross-Sectional Studies %K Female %K Health Knowledge, Attitudes, Practice %K Humans %K Indians, North American %K Interpersonal Relations %K Life Style %K Population Surveillance %K Psychosexual Development %K Risk-Taking %K Self Efficacy %K Sexual Behavior %K Sexual Partners %K Social Behavior %K Social Class %K Social Environment %K Socioeconomic Factors %K Substance-Related Disorders %X

Multiple challenges expose American Indian and Alaska Native (AIAN) women to high-risk sexual partnerships and increased risk for HIV/STI. Using a unique sample of sexually-active young AIAN women (n = 129), we examined characteristics of last three partners and whether transitional partnerships were associated with different risk profiles, including where partners met, lived, and had sex. Respondents were more likely to have met their previous or current secondary partner (P2) at a friend's or family setting (versus work or social setting) (AOR = 3.92; 95 % CI 1.31, 11.70). Condom use was less likely when meeting a partner at friend's or family settings (AOR = 0.17; 95 % CI 0.05, 0.59). Sexual intercourse with P2 (compared to P1) usually took place in "riskier" settings such as a car, bar, or outside (AOR = 4.15; 95 % CI 1.59, 10.68). Perceived "safe" places, e.g., friend's or family's house, were identified with risky behaviors; thus, homogeneous messaging campaigns may promote a false sense of safety.

%B AIDS Behav %V 18 %P 1443-53 %8 2014 Aug %G eng %N 8 %R 10.1007/s10461-013-0667-x %0 Journal Article %J AIDS Behav %D 2011 %T Change in sexual activity 12 months after ART initiation among HIV-positive Mozambicans. %A Pearson, Cynthia R %A Cassels, Susan %A Kurth, Ann E %A Montoya, Pablo %A Micek, Mark A %A Gloyd, Stephen S %K Adult %K Anti-Retroviral Agents %K Female %K Follow-Up Studies %K HIV Infections %K Humans %K Logistic Models %K Male %K Middle Aged %K Mozambique %K Risk-Taking %K Sexual Behavior %K Sexual Partners %K Socioeconomic Factors %K Truth Disclosure %K Young Adult %X

We assessed sexual behaviors before and 12-months after ART initiation among 277 Mozambicans attending an HIV clinic. Measured behaviors included the number of sexual partners, condom use, concurrent relationships, disclosure of HIV status, alcohol use, and partners' serostatus. Compared to before ART initiation, increases were seen 12 months after ART in the proportion of participants who were sexually active (48% vs. 64% respondents, P < 0.001) and the proportion of participants with HIV-negative or unknown serostatus partners (45% vs. 80%, P < 0.001). Almost all (96%) concurrent partnerships reported at 12 months formed after ART initiation. Although reported correct and consist condom use increased, the number of unprotected sexual relationships remained the same (n = 45). Non-disclosure of HIV-serostatus to sexual partners was the only significant predictor of practicing unprotected sex with partners of HIV-negative or unknown serostatus. Sexual activity among HIV-positive persons on ART increased 12 months after ART initiation. Ongoing secondary transmission prevention programs addressing sexual activity with multiple partners, disclosure to partners and consistent condom use with serodisconcordant partners must be incorporated throughout HIV care programs.

%B AIDS Behav %V 15 %P 778-87 %8 2011 May %G eng %N 4 %R 10.1007/s10461-010-9852-3 %0 Journal Article %J Sex Transm Dis %D 2010 %T Sexual partner concurrency and sexual risk among gay, lesbian, bisexual, and transgender American Indian/Alaska natives. %A Cassels, Susan %A Pearson, Cynthia R %A Walters, Karina %A Simoni, Jane M %A Morris, Martina %K Adolescent %K Adult %K Aged %K Alaska %K Bisexuality %K Female %K Health Knowledge, Attitudes, Practice %K Healthcare Disparities %K HIV Infections %K Homosexuality, Female %K Homosexuality, Male %K Humans %K Indians, North American %K Male %K Middle Aged %K Prevalence %K Risk-Taking %K Sexual Behavior %K Sexual Partners %K Socioeconomic Factors %K Surveys and Questionnaires %K Transgender Persons %X

BACKGROUND: American Indian and Alaska Natives suffer pervasive health disparities, including disproportionately high rates of HIV. Sexual network dynamics, including concurrency and sexual mixing patterns, are key determinants of HIV disparities.

METHODS: We analyzed data from the first national study of gay, lesbian, bisexual, and transgender American Indian and Alaska Natives to examine the prevalence of concurrency, sex and race of partners, and level of risk across different partnership patterns. Egocentric network data were analyzed at the level of the respondents, who were grouped according to the sex of their last 3 partners.

RESULTS: Overall rates of HIV and concurrency were high in this population. HIV prevalence (34%) and cumulative prevalence of concurrency (55%) were highest among men who had sex with only men, while women who had sex with only women reported lower concurrency and HIV. Women who had sex with women and men also had high HIV prevalence (15%) and reported slightly higher concurrency risk and low condom use, making them effective bridge populations.

CONCLUSIONS: The uniformly high rates of Native partner selection creates the potential for amplification of disease spread within this small community, while the high rates of selecting partners of other races creates the potential for bridging to other groups in the transmission network. These findings provide some of the first insights into sexual networks and concurrency among Native gay, lesbian, bisexual, and transgender populations and suggest that both men and women deserve attention in HIV prevention efforts at individual, dyadic and population levels.

%B Sex Transm Dis %V 37 %P 272-8 %8 2010 Apr %G eng %N 4 %R 10.1097/OLQ.0b013e3181c37e3e