Attitudes toward using condoms and condom use: difference between sexually abused and nonabused African American female adolescents.

Rates of many sexually transmitted diseases remain higher among adolescents than among any other age group. The associations between abuse experiences and risky sexual behaviors suggest that exploring the relationships between adolescents' abuse history and condom use beliefs and behaviors is warranted. Females (N = 725) attending an adolescent clinic reported demographic characteristics, beliefs about condom use, sexual behaviors, and sexual abuse or molestation history. Those reporting sexual abuse or molestation (23%) were more likely to think condoms interfered with sexual pleasure and less likely to think condoms were important to partners. They also reported more unprotected vaginal sex and more lifetime sex partners. Beliefs were correlated with condom use consistency, number of lifetime partners, and number of unprotected sex experiences. The greater levels of behavioral risk among those reporting abuse suggest greater risk for acquisition and transmission in abused female adolescents. The authors discuss hypotheses to inform future research and intervention.

Developing an HIV behavioral surveillance system for injecting drug users: the National HIV Behavioral Surveillance System.

While disease surveillance for HIV/AIDS is now widely conducted in the United States, effective HIV prevention programs rely primarily on changing behavior; therefore, behavioral data are needed to inform these programs. To achieve the goal of reducing HIV infections in the U.S., the Centers for Disease Control and Prevention, in cooperation with state and local health departments, implemented the National HIV Behavioral Surveillance System (NHBS) for injecting drug users (IDUs) in 25 selected metropolitan statistical areas (MSAs) throughout the United States in 2005. The surveillance system used respondent-driven sampling (RDS), a modified chain-referral method, to recruit IDUs for a survey measuring HIV-associated drug use and sexual risk behavior. RDS can produce population estimates for specific risk behaviors and demographic characteristics. Formative assessment activities-primarily the collection of qualitative data-provided information to better understand the IDU population and implement the surveillance activities in each city. This is the first behavioral surveillance system of its kind in the U.S. that will provide local and national data on risk for HIV and other blood-borne and sexually transmitted infections among IDUs for monitoring changes in the epidemic and prevention programs.

Human immunodeficiency virus (HIV) risk, prevention, and testing behaviors--United States, National HIV Behavioral Surveillance System: men who have sex with men, November 2003-April 2005.

PROBLEM/CONDITION: For CDC's goal of reducing the number of new human immunodeficiency virus (HIV) infections to be achieved, data are needed to assess the prevalence of HIV-related risk behaviors at a given time, monitor trends in these behaviors, and assess the correlates of risk. These data also can be used to evaluate the extent to which current HIV-prevention programs are reaching targeted communities and direct future HIV-prevention activities to reduce HIV transmission. REPORTING PERIOD: November 2003-April 2005. DESCRIPTION OF SYSTEM: The National HIV Behavioral Surveillance (NHBS) System collects risk behavior data from three populations at high risk for HIV infection: men who have sex with men (MSM), injection-drug users, and heterosexual adults in areas in which HIV is prevalent. Data collection began in 2003 among MSM in 17 U.S. metropolitan statistical areas (MSAs), and surveys have been conducted in 25 MSAs since 2005. Participants must be aged >/= 18 years and reside in a participating MSA. RESULTS: This report summarizes data gathered during the first cycle (i.e., data collection period) of NHBS (November 2003-April 2005) from approximately 10,000 MSM. The results indicated that >90% of participants had ever been tested for HIV. Of those, 77% had been tested during the preceding 12 months. In addition to their male sex partners, 14% of participants also had at least one female sex partner during the preceding 12 months. Unprotected anal intercourse was reported by 58% with a main male partner (someone with whom the participant had sex and to whom he felt most committed [e.g., a boyfriend, spouse, significant other, or life partner]) and by 36[corrected]% with a casual male partner (someone with whom the participant had sex but who was not considered a main partner). Noninjection drugs were used by 42% of participants during the preceding 12 months; the most commonly used drugs were marijuana (77%), cocaine (37%), ecstasy (29%), poppers (28%), and stimulants (27%). A substantial proportion (80%) of participants had received free condoms during the preceding 12 months, but fewer had participated in individual- or group-level HIV prevention programs (15% and 8%, respectively). INTERPRETATION: MSM surveyed engaged in sexual and drug-use behaviors that placed them at increased risk for HIV infection. The majority of MSM surveyed had been tested for HIV infection. Although a substantial proportion of participants had received free condoms, a much smaller proportion had participated in more intensive HIV-prevention programs. PUBLIC HEALTH ACTION: NHBS data are used to assess and develop effective HIV-prevention programs and services. Continued collection and reporting of NHBS data from all targeted high-risk populations is needed to monitor behavior trends and assess future HIV prevention needs in these populations. The data are used for local HIV-prevention planning and monitoring in MSAs in which NHBS is conducted.