Marseille 2007
Marseille 2007
Abstract book
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Abstract #404  -  IDU risk behavior and attitudinal correlates in a sample of HIV+ patients in clinical care: Avenues for intervention.
Session:
  20.8: New tools, new toys (Parallel) on Monday @ 14.00-16.00 in PR Chaired by John De Wit, Seth Kalichman
Authors:
  Presenting Author:   Mrs Wynne Norton - University of Connecticut, United States
 
  Additional Authors:  Dr K. Rivet Amico, Dr Deborah Cornman, Dr Jeffrey  Fisher, Dr William  Fisher, Dr Gerald Friedland, Dr Michael Copenhaver, MD Michael Kozal,  
Aim:
Existing research has examined correlates of needle-sharing, including demographic and situational variables among injection drug users. However, little research has quantified the amount of IDU risk specifically in clinic samples of HIV+ patients or examined the relation between this risk and attitudes or beliefs. The current study assessed needle sharing among HIV+ IDUs in a clinical care setting and explored beliefs about needle-sharing, which are essential in developing effective behavioral interventions for positives.
 
Method / Issue:
The present study was part of a larger, outcome study of a clinic-based physician-delivered HIV risk reduction intervention for positives (The Options Project). Baseline responses to a computer administered questionnaire from 123 HIV+ patients in urban Connecticut who reported using injection drugs within the past month were analyzed. Needle sharing beliefs were assessed with a 3-item scale, where participants reported the extent to which sharing needles with HIV+, HIV-, and HIV status unknown partners would be very bad to very good on a 5-point Likert-scale. These items were summed into a needle-sharing beliefs score. A single-item assessed social norms as the degree to which participants believed important others would not want them to share needles. Beliefs and norms correlated.
 
Results / Comments:
This sub-sample of active IDUs was predominantly male (69.9%), approximately 44 years old (SD = 6.8 years), heterosexual (85.4%), and African-American (35.8%). Of the 123 active IDUs, 27 (22%) reported 1 or more sharing events over the past month. These 27 individuals engaged in a total of 256 injection drug use sharing events, 217 of which were with partners thought to be HIV- or status unknown (high-risk). In addition, these individuals shared needles with 485 partners, 410 of whom were thought to be high-risk. Response distributions for the attitudinal items suggested subtle yet significant differences between those who did and did not share needles (e.g., sharing needles would be bad versus very bad, respectively). A similar pattern was noted with the social norms item. In a logistic regression analyses, age, gender, income, high school education, attitudes towards sharing, social norms, and previous risk behavior accounted for 33.5% of the variability in needle-sharing group membership. Gender (being a woman) and less extreme negative attitudes towards needle-sharing were independently associated with being in the needle-sharing group.
 
Discussion:
There is a substantial amount of IDU HIV transmission risk in the current sample of HIV+ IDUs in clinical care, although it appears that a relatively few number of patients are producing a large number of risk events. Certainly, results support positioning interventions targeting the reduction of these kinds of risk events within a clinical care setting. Additionally, results suggest that behavioral interventions targeting IDU risk within a clinic population should address needle sharing attitudes and beliefs, which is consistent with the attitudes-behavior link that has already been well established in other risk behavior domains. These results simultaneously highlight the importance of risk reduction interventions situated within clinical care and the potential benefit of targeting attitudes towards needle-sharing within such intervention strategies.
 
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