HIV Exposure through Heterosexual Contacts: Analysis of Demographic, Behavioral and Structural Risk Factors among Black Men in Ottawa and Windsor, Ontario
##plugins.themes.bootstrap3.article.main##
We determined the association of demographic, behavioral, and structural factors with risk of HIV exposure through heterosexual contact among Black men in Ottawa (n=210) and Windsor (n=156), Ontario. We applied hierarchical linear regression model in the analysis. Mean HIV exposure risk scores were Windsor (12.08±8.42) and Ottawa (17.16±11.80) in Ottawa (Scale = 48). Age, marriage, employment, masculinity, and condom attitudes were statistically significant (p <0.05). Age groups (15-29 years and 40-49 years), traditional masculine ideology, and negative condom attitudes associated with increased risk of HIV exposure by heterosexual contact. Marriage and full-time employment associated with reduced risk of exposure the ACB heterosexual men.
Downloads
Download data is not yet available.
References
-
“The Epidemiology of HIV in Canada.” https://www.catie.ca/en/fact-sheets/epidemiology/epidemiology-hiv-canada (accessed Jan. 06, 2021).
Google Scholar
1
-
E. Maticka-Tyndale, J. Kerr, and R. Mihan, “A profile of the sexual experiences of African, Caribbean and Black Canadian youth in the context of Canadian youth sexuality,” Can. J. Hum. Sex., vol. 25, no. 1, pp. 41–52, Feb. 2016, doi: 10.3138/cjhs.251-A1.
Google Scholar
2
-
M.-C. Boily, M. Alary, and R. F. Baggaley, “Neglected issues and hypotheses regarding the impact of sexual concurrency on HIV and sexually transmitted infections,” AIDS Behav., vol. 16, no. 2, pp. 304–311, Feb. 2012, doi: 10.1007/s10461-011-9887-0.
Google Scholar
3
-
O. Dosekun and J. Fox, “An overview of the relative risks of different sexual behaviours on HIV transmission,” Curr. Opin. HIV AIDS, vol. 5, no. 4, pp. 291–297, Jul. 2010, doi: 10.1097/COH.0b013e32833a88a3.
Google Scholar
4
-
J. Kerr, T. Northington, T. Sockdjou, and E. Maticka-Tyndale, “Perceived Neighborhood Quality and HIV-related Stigma among African Diasporic Youth; Results from the African, Caribbean, and Black Youth (ACBY) Study,” J. Health Care Poor Underserved, vol. 29, no. 2, pp. 651–663, 2018, doi: 10.1353/hpu.2018.0049.
Google Scholar
5
-
Centre for Infectious Disease Prevention and Control (Canada) and Public Health Agency of Canada, HIV transmission risk: a summary of the evidence. Ottawa, Ont.: Public Health Agency of Canada, 2013.
Google Scholar
6
-
M. S. Cohen and C. D. Pilcher, “Amplified HIV transmission and new approaches to HIV prevention,” J. Infect. Dis., vol. 191, no. 9, pp. 1391–1393, May 2005, doi: 10.1086/429414.
Google Scholar
7
-
D. P. Wilson, M. G. Law, A. E. Grulich, D. A. Cooper, and J. M. Kaldor, “Relation between HIV viral load and infectiousness: a model-based analysis,” Lancet Lond. Engl., vol. 372, no. 9635, pp. 314–320, Jul. 2008, doi: 10.1016/S0140-6736(08)61115-0.
Google Scholar
8
-
M.-C. Boily et al., “Heterosexual risk of HIV-1 infection per sexual act: systematic review and meta-analysis of observational studies,” Lancet Infect. Dis., vol. 9, no. 2, pp. 118–129, Feb. 2009, doi: 10.1016/S1473-3099(09)70021-0.
Google Scholar
9
-
T. C. Quinn et al., “Viral load and heterosexual transmission of human immunodeficiency virus type 1. Rakai Project Study Group,” N. Engl. J. Med., vol. 342, no. 13, pp. 921–929, Mar. 2000, doi: 10.1056/NEJM200003303421303.
Google Scholar
10
-
P. Patel, C. B. Borkowf, J. T. Brooks, A. Lasry, A. Lansky, and J. Mermin, “Estimating per-act HIV transmission risk: a systematic review,” AIDS, vol. 28, no. 10, pp. 1509–1519, Jun. 2014, doi: 10.1097/QAD.0000000000000298.
Google Scholar
11
-
P. H. A. of Canada, “HIV Surveillance report, 2018, CCDR 45(12),” aem, Dec. 06, 2019. https://www.canada.ca/en/public-health/services/reports-publications/canada-communicable-disease-report-ccdr/monthly-issue/2019-45/issue-12-december-5-2019/article-1-2018-hiv-survellance-report.html (accessed Jan. 06, 2021).
Google Scholar
12
-
D. P. Kennedy, R. A. Brown, D. Golinelli, S. L. Wenzel, J. S. Tucker, and S. R. Wertheimer, “Masculinity and HIV Risk among Homeless Men in Los Angeles,” Psychol. Men Masculinity, vol. 14, no. 2, pp. 156–167, 2013, doi: 10.1037/a0027570.
Google Scholar
13
-
E. J. Silver and L. J. Bauman, “Association of ‘Macho Man’ Sexual Attitudes and Behavioral Risks in Urban Adolescents,” Am. J. Sex. Educ., vol. 9, no. 2, pp. 176–187, Apr. 2014, doi: 10.1080/15546128.2014.900466.
Google Scholar
14
-
J. L. Peterson, R. Rothenberg, J. M. Kraft, C. Beeker, and R. Trotter, “Perceived condom norms and HIV risks among social and sexual networks of young African American men who have sex with men,” Health Educ. Res., vol. 24, no. 1, pp. 119–127, Feb. 2009, doi: 10.1093/her/cyn003.
Google Scholar
15
-
“HIV Transmission | HIV Basics | HIV/AIDS | CDC,” Oct. 28, 2020. https://www.cdc.gov/hiv/basics/transmission.html (accessed Jan. 06, 2021).
Google Scholar
16
-
R. M. Anderson, R. M. May, M. C. Boily, G. P. Garnett, and J. T. Rowley, “The spread of HIV-1 in Africa: sexual contact patterns and the predicted demographic impact of AIDS,” Nature, vol. 352, no. 6336, pp. 581–589, Aug. 1991, doi: 10.1038/352581a0.
Google Scholar
17
-
H. R. Barrett and B. Mulugeta, “Human Immunodeficiency Virus (HIV) and migrant ‘risk environments’: the case of the Ethiopian and Eritrean immigrant community in the West Midlands of the UK,” Psychol. Health Med., vol. 15, no. 3, pp. 357–369, May 2010, doi: 10.1080/13548501003653192.
Google Scholar
18
-
J. R. Hargreaves et al., “Systematic review exploring time trends in the association between educational attainment and risk of HIV infection in sub-Saharan Africa,” AIDS Lond. Engl., vol. 22, no. 3, pp. 403–414, Jan. 2008, doi: 10.1097/QAD.0b013e3282f2aac3.
Google Scholar
19
-
W. M. Msisha, S. H. Kapiga, F. Earls, and S. V. Subramanian, “Socioeconomic status and HIV seroprevalence in Tanzania: a counterintuitive relationship,” Int. J. Epidemiol., vol. 37, no. 6, pp. 1297–1303, Dec. 2008, doi: 10.1093/ije/dyn186.
Google Scholar
20
-
R. Vivancos, I. Abubakar, and P. R. Hunter, “Foreign travel, casual sex, and sexually transmitted infections: systematic review and meta-analysis,” Int. J. Infect. Dis. IJID Off. Publ. Int. Soc. Infect. Dis., vol. 14, no. 10, pp. e842-851, Oct. 2010, doi: 10.1016/j.ijid.2010.02.2251.
Google Scholar
21
-
S. Baidoobonso, G. R. Bauer, K. N. Speechley, E. Lawson, and BLACCH Study Team, “HIV risk perception and distribution of HIV risk among African, Caribbean and other Black people in a Canadian city: mixed methods results from the BLACCH study,” BMC Public Health, vol. 13, p. 184, Mar. 2013, doi: 10.1186/1471-2458-13-184.
Google Scholar
22
-
I. Konkor, “HIV vulnerabilities among heterosexual African, Caribbean and other Black men in London, Ontario,” Electron. Thesis Diss. Repos., Jun. 2019, [Online]. Available: https://ir.lib.uwo.ca/etd/6243.
Google Scholar
23
-
R. P. Kerani et al., “Evidence of Local HIV Transmission in the African Community of King County, Washington,” J. Immigr. Minor. Health, vol. 19, no. 4, pp. 891–896, Aug. 2017, doi: 10.1007/s10903-016-0458-3.
Google Scholar
24
-
J. Ross, C. O. Cunningham, and D. B. Hanna, “HIV outcomes among migrants from low-income and middle-income countries living in high-income countries: a review of recent evidence,” Curr. Opin. Infect. Dis., vol. 31, no. 1, pp. 25–32, Feb. 2018, doi: 10.1097/QCO.0000000000000415.
Google Scholar
25
-
F. Omorodion, K. Gbadebo, and P. Ishak, “HIV vulnerability and sexual risk among African youth in Windsor, Canada,” Cult. Health Sex., vol. 9, no. 4, pp. 429–437, Aug. 2007, doi: 10.1080/13691050701256721.
Google Scholar
26
-
C. Magazine, “Sexual Behavior and Attitudes among White, Black, Latinx, and Asian College Students - Contexts.” https://contexts.org/blog/sexual-attitudes-among-college-students-similarities-between-white-black-latinx-and-asian-students/ (accessed Jan. 06, 2021).
Google Scholar
27
-
“Community-level influences of behavior change,” OUPblog, Jan. 02, 2013. https://blog.oup.com/2013/01/community-level-influences-of-behavior-change/ (accessed Jan. 06, 2021).
Google Scholar
28
-
E. Reed, M. C. Santana, L. Bowleg, S. L. Welles, C. R. Horsburgh, and A. Raj, “Experiences of racial discrimination and relation to sexual risk for HIV among a sample of urban black and African American men,” J. Urban Health Bull. N. Y. Acad. Med., vol. 90, no. 2, pp. 314–322, Apr. 2013, doi: 10.1007/s11524-012-9690-x.
Google Scholar
29
-
N. Madise, E. Zulu, and J. Ciera, “Is poverty a driver for risky sexual behaviour? Evidence from national surveys of adolescents in four African countries,” Afr. J. Reprod. Health, vol. 11, no. 3, pp. 83–98, Dec. 2007.
Google Scholar
30
-
V. Agadjanian, C. Arnaldo, and B. Cau, “Health Costs of Wealth Gains: Labor Migration and Perceptions of HIV/AIDS Risks in Mozambique,” Soc. Forces Sci. Medium Soc. Study Interpret., vol. 89, no. 4, pp. 1097–1117, Jun. 2011, doi: 10.1093/sf/89.4.1097.
Google Scholar
31
-
K. Awusabo-Asare and S. K. Annim, “Wealth status and risky sexual behaviour in Ghana and Kenya,” Appl. Health Econ. Health Policy., vol. 6, no. 1, pp. 27–39, 2008, doi: 10.2165/00148365-200806010-00003.
Google Scholar
32
-
CDC, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention Division of HIV/AIDS Prevention., “Deaths among persons with AIDS through December 2000.” 2002, Accessed: Apr. 14, 2021. [Online].
Google Scholar
33
-
J. A. Bauermeister, L. Eaton, J. Andrzejewski, J. Loveluck, W. VanHemert, and E. S. Pingel, “Where You Live Matters: Structural Correlates of HIV Risk Behavior Among Young Men Who Have Sex with Men in Metro Detroit,” AIDS Behav., vol. 19, no. 12, pp. 2358–2369, Dec. 2015, doi: 10.1007/s10461-015-1180-1.
Google Scholar
34
-
I. Konkor et al., “An Intersectional Approach to HIV Vulnerabilities and Testing Among Heterosexual African Caribbean and Black Men in London, Ontario: Results From the weSpeak Study,” J. Racial Ethn. Health Disparities, vol. 7, Mar. 2020, doi: 10.1007/s40615-020-00737-3.
Google Scholar
35
-
D. R. Williams, null Yan Yu, J. S. Jackson, and N. B. Anderson, “Racial Differences in Physical and Mental Health: Socio-economic Status, Stress and Discrimination,” J. Health Psychol., vol. 2, no. 3, pp. 335–351, Jul. 1997, doi: 10.1177/135910539700200305.
Google Scholar
36
-
W. P. Hammond, D. Matthews, D. Mohottige, A. Agyemang, and G. Corbie-Smith, “Masculinity, medical mistrust, and preventive health services delays among community-dwelling African-American men,” J. Gen. Intern. Med., vol. 25, no. 12, pp. 1300–1308, Dec. 2010, doi: 10.1007/s11606-010-1481-z.
Google Scholar
37
-
M. P. Carey and K. E. E. Schroder, “Development and Psychometric Evaluation of the Brief HIV Knowledge Questionnaire,” AIDS Educ. Prev. Off. Publ. Int. Soc. AIDS Educ., vol. 14, no. 2, pp. 172–182, Apr. 2002.
Google Scholar
38
-
K. E. Baruth and J. J. Caroll, “A formal assessment of resilience: The Baruth Protective Factors Inventory,” J. Individ. Psychol., vol. 58, no. 3, pp. 235–244, 2002.
Google Scholar
39
-
O. Friborg, O. Hjemdal, J. H. Rosenvinge, and M. Martinussen, “A new rating scale for adult resilience: what are the central protective resources behind healthy adjustment?” Int. J. Methods Psychiatr. Res., vol. 12, no. 2, pp. 65–76, 2003, doi: 10.1002/mpr.143.
Google Scholar
40
-
T. Roy, C. Anderson, C. Evans, M. S. Rahman, and M. Rahman, “Cross-cultural adaptation of the short-form condom attitude scale: validity assessment in a sub-sample of rural-to-urban migrant workers in Bangladesh,” BMC Public Health, vol. 13, no. 1, p. 240, Mar. 2013, doi: 10.1186/1471-2458-13-240.
Google Scholar
41
-
C. M. Grello, D. P. Welsh, and M. S. Harper, “No Strings Attached: The Nature of Casual Sex in College Students,” J. Sex Res., vol. 43, no. 3, pp. 255–267, 2006.
Google Scholar
42
-
Omorodion, F. I., Etowa, E.B., Kerr, J., Ghose, B., and Etowa, J., “Correlates of Casual Sex Amidst Vulnerability to HIV Among ACB Heterosexual Men in Ottawa and Windsor, Ontario Canada,” J. Racial Ethn. Health Disparities, 2021, doi: 10.1007/s40615-021-00975-z.
Google Scholar
43
-
National Institute on Drug Abuse (NIDA), Who Is at Risk for HIV Infection and Which Populations Are Most Affected?. 2020.
Google Scholar
44
-
B. Tlou, “The influence of marital status on HIV infection in an HIV hyperendemic area of rural South Africa, 2000-2017,” Afr. J. AIDS Res. AJAR, vol. 18, no. 1, pp. 65–71, Mar. 2019, doi: 10.2989/16085906.2018.1559209.
Google Scholar
45
-
O. Shisana et al., “Does marital status matter in an HIV hyperendemic country? Findings from the 2012 South African National HIV Prevalence, Incidence and Behaviour Survey,” AIDS Care, vol. 28, no. 2, pp. 234–241, Feb. 2016, doi: 10.1080/09540121.2015.1080790.
Google Scholar
46
-
A. M. Nabukenya, A. Nambuusi, and J. K. B. Matovu, “Risk factors for HIV infection among married couples in Rakai, Uganda: a cross-sectional study,” BMC Infect. Dis., vol. 20, no. 1, p. 198, Mar. 2020, doi: 10.1186/s12879-020-4924-0.
Google Scholar
47
-
J. A. Pellowski, S. C. Kalichman, K. A. Matthews, and N. Adler, “A pandemic of the poor: social disadvantage and the U.S. HIV epidemic,” Am. Psychol., vol. 68, no. 4, pp. 197–209, 2013, doi: 10.1037/a0032694.
Google Scholar
48
-
E. D. Riley, M. Gandhi, C. Hare, J. Cohen, and S. Hwang, “Poverty, unstable housing, and HIV infection among women living in the United States,” Curr. HIV/AIDS Rep., vol. 4, no. 4, pp. 181–186, Dec. 2007, doi: 10.1007/s11904-007-0026-5.
Google Scholar
49
-
S. C. Kalichman et al., “Food insufficiency and medication adherence among people living with HIV/AIDS in urban and peri-urban settings,” Prev. Sci. Off. J. Soc. Prev. Res., vol. 12, no. 3, pp. 324–332, Sep. 2011, doi: 10.1007/s11121-011-0222-9.
Google Scholar
50
-
M.-L. G. Buot et al., “Beyond Race and Place: Distal Sociological Determinants of HIV Disparities,” PLOS ONE, vol. 9, no. 4, p. e91711, Apr. 2014, doi: 10.1371/journal.pone.0091711.
Google Scholar
51
-
M. Maruthappu, C. Zhou, C. Williams, T. Zeltner, and R. Atun, “Unemployment and HIV mortality in the countries of the Organisation for Economic Co-operation and Development: 1981–2009,” JRSM Open, vol. 8, no. 7, Jul. 2017, doi: 10.1177/2054270416685206.
Google Scholar
52
-
D. Paraskevis et al., “HIV-1 outbreak among injecting drug users in Greece, 2011: a preliminary report,” Euro Surveill. Bull. Eur. Sur Mal. Transm. Eur. Commun. Dis. Bull., vol. 16, no. 36, Sep. 2011, doi: 10.2807/ese.16.36.19962-en.
Google Scholar
53
-
A. B. Nguyen, T. T. Clark, K. B. Hood, M. A. Corneille, A. Y. Fitzgerald, and F. Z. Belgrave, “Beyond traditional gender roles and identity: does reconceptualisation better predict condom-related outcomes for African-American women?,” Cult. Health Sex., vol. 12, no. 6, pp. 603–617, Aug. 2010, doi: 10.1080/13691051003658127.
Google Scholar
54
-
N. F. Sanchez, J. P. Sanchez, and A. Danoff, “Health Care Utilization, Barriers to Care, and Hormone Usage Among Male-to-Female Transgender Persons in New York City,” Am. J. Public Health, vol. 99, no. 4, pp. 713–719, Apr. 2009, doi: 10.2105/AJPH.2007.132035.
Google Scholar
55
-
S. Baidoobonso, G. R. Bauer, K. N. Speechley, E. Lawson, and BLACCH Study Team, “Social and Proximate Determinants of the Frequency of Condom Use Among African, Caribbean, and Other Black People in a Canadian City: Results from the BLACCH Study,” J. Immigr. Minor. Health, vol. 18, no. 1, pp. 67–85, Feb. 2016, doi: 10.1007/s10903-014-9984-z.
Google Scholar
56
-
L. Bowleg, M. Teti, D. J. Malebranche, and J. M. Tschann, “‘It’s an Uphill Battle Everyday’: Intersectionality, Low-Income Black Heterosexual Men, and Implications for HIV Prevention Research and Interventions,” Psychol. Men Masculinity, vol. 14, no. 1, pp. 25–34, Jan. 2013, doi: 10.1037/a0028392.
Google Scholar
57
-
L. F. O’Sullivan, S. Hoffman, A. Harrison, and C. Dolezal, “Men, Multiple Sexual Partners, and Young Adults’ Sexual Relationships: Understanding the Role of Gender in the Study of Risk,” J. Urban Health Bull. N. Y. Acad. Med., vol. 83, no. 4, pp. 695–708, Jul. 2006, doi: 10.1007/s11524-006-9062-5.
Google Scholar
58
-
J. K. Ganle, “Hegemonic Masculinity, HIV/AIDS Risk Perception, and Sexual Behavior Change Among Young People in Ghana,” Qual. Health Res., vol. 26, no. 6, pp. 763–781, May 2016, doi: 10.1177/1049732315573204.
Google Scholar
59
-
Barker, D. and Ricardo, C., “Young Men and the Construction of Masculinity in Sub-Saharan Africa: Implications for HIV/AIDS, Conflict, and Violence.” The World Bank, 2005, Accessed: Feb. 03, 2021. [Online]. Available: https://promundoglobal.org/wp-content/uploads/2015/01/Young-Men-and-the-Construction-of-Masculinity-in-Sub-Saharan-Africa-Implications-for-HIV-AIDS-Conflict-and-Violence.pdf.
Google Scholar
60
-
L. Bowleg, “When Black + Lesbian + Woman ≠ Black Lesbian Woman: The Methodological Challenges of Qualitative and Quantitative Intersectionality Research,” Sex Roles, vol. 59, no. 5, pp. 312–325, Sep. 2008, doi: 10.1007/s11199-008-9400-z.
Google Scholar
61
-
M. Corneille, J. E. Fife, F. Z. Belgrave, and B. C. Sims, “Ethnic identity, masculinity, and healthy sexual relationships among African American men,” Psychol. Men Masculinity, vol. 13, no. 4, pp. 393–399, 2012, doi: 10.1037/a0026878.
Google Scholar
62
-
Fishbein, M. and Ajzen, I., Understanding Attitudes and Predicting Social Behavior. Englewood Cliffs, N.J.; Prentice Hall, 1980.
Google Scholar
63
-
I. Ajzen, “The theory of planned behavior,” Organ. Behav. Hum. Decis. Process., vol. 50, no. 2, pp. 179–211, Dec. 1991, doi: 10.1016/0749-5978(91)90020-T.
Google Scholar
64
-
S. D. Pinkerton and P. R. Abramson, “Effectiveness of condoms in preventing HIV transmission,” Soc. Sci. Med., vol. 44, no. 9, pp. 1303–1312, May 1997, doi: 10.1016/S0277-9536(96)00258-4.
Google Scholar
65
-
S. C. Weller, “A meta-analysis of condom effectiveness in reducing sexually transmitted HIV,” Soc. Sci. Med. 1982, vol. 36, no. 12, pp. 1635–1644, Jun. 1993, doi: 10.1016/0277-9536(93)90352-5.
Google Scholar
66
-
G. A. Millett, S. A. Flores, J. L. Peterson, and R. Bakeman, “Explaining disparities in HIV infection among black and white men who have sex with men: a meta-analysis of HIV risk behaviors,” AIDS Lond. Engl., vol. 21, no. 15, pp. 2083–2091, Oct. 2007, doi: 10.1097/QAD.0b013e3282e9a64b.
Google Scholar
67