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Biomedical subjects

M W Ross

Publications and source records attributed to M W Ross.

At least 37 records · Page 2Linked to original sources
PubMed2001

Gender differences in the processes of change for condom use: patterns across stages of change in crack cocaine users.

Interventions to increase condom use in crack users have had mixed results. For interventions to achieve greater success, the mechanisms of behavior change in this population need to be understood. One mechanism, the processes of change, was examined across stages of change for condom use. Results from the analysis of variance for males and females revealed that stage of change was associated with different levels of three experiential processes: consciousness raising, social liberation and self-reevaluation. However, these analyses found that male and females seem to have different patterns of behavioral process use. Specifically, females in the preparation stage were different from those in precontemplation, whereas this difference was not pronounced in males. In general, people had high levels of experimental processes in every stage of change. The patterns of behavior process use mimicked patterns found for other behaviors with a linear increase across the stages of change. This may indicate that for maintaining condom use, more emotional and behavioral activities are required throughout the process of acquisition and maintenance than are necessary for other health-related activities. Implications of this research are that interventions for increasing condom use in drug users may target behavioral steps differently for males and females.

Adult↗
PubMed2001

Examining the direct costs and effectiveness of syphilis detection by selective screening and partner notification.

Selective screening and partner notification are two principal means of preventing and controlling syphilis in the United States, yet few studies have been undertaken to compare and evaluate the cost or effectiveness of detecting syphilis using either strategy. The objective of this paper is to assess from the perspective of a health department the cost-effectiveness of selective screening compared with the strategy of partner notification in the detection of early syphilis in Houston, Texas, in 1994 and 1995. The cost-effectiveness analysis was performed using the recurring direct costs associated with detecting syphilis by both strategies. The middle estimates for the total direct costs associated with selective screening and partner notification were $579,101 and $229,529, respectively, for the 1466 and the 567 cases of early syphilis detected. On a cost per case basis, selective screening was more cost-effective than partner notification in the detection of primary, secondary and maternal syphilis cases. However, when consideration was given to prophylactic treatment, partner notification was more cost-effective in the detection of all early stage disease. Our findings suggest that the relative benefit of partner notification over selective screening depends on prophylactic treatment and an increase in worker productivity.

Communicable Disease Control↗
PubMed2001

Characteristics of persons with syphilis in areas of persisting syphilis in the United States: sustained transmission associated with concurrent partnerships.

BACKGROUND AND GOAL: In areas with persistent syphilis, to characterize persons at higher risk for transmitting syphilis. STUDY DESIGN: Cohort study. Structured interviews of persons with early syphilis from four research centers were linked to outcomes of partner tracing. RESULTS: Of 743 persons with syphilis, 229 (31%) reported two or more partners in the previous month, and 57 (8%) received money or drugs for sex in the previous three months. Persons with at least one partner at an earlier stage of syphilis than themselves were defined as transmitters; 63 (8.5%) of persons with early syphilis met this definition. Having concurrent partners (two or more in one week in the last month) was independently associated with being a transmitter. CONCLUSION: Sexual network/behavioral characteristics of syphilis patients and their partners, such as concurrency, can help identify persons at higher risk for transmitting syphilis who should receive emphasis in disease prevention activities.

Adult↗
PubMed2001

An investigation of condom use by frequency of sex.

OBJECTIVES: To examine the association between condom use and frequency of sex across sexual partner types. METHODS: Data were collected from African American drug users residing in Washington, DC. Participants were asked to provide the first name of the last three partners with whom they had had vaginal sex, to define the type of relationship, the number of times they had had vaginal sex in the last 30 days with each partner, and whether they had used a condom during their last sexual encounter with each partner. Condom use was examined by frequency of sex in the past 30 days controlling for partner type. RESULTS: Frequency of sexual encounters varied by partner type. The largest number of sexual encounters was with casual partners, followed by commercial and primary partners, respectively. Within partner types, participants had sex most frequently with primary partners. Condom use was lowest within primary partner relationships. Regardless of partner type, condom use varied consistently depending on the frequency of sex with the same partner. CONCLUSIONS: Condom use is related to the frequency of sex between partners when partner type is controlled. The association between frequency of sex and condom use is independent of partner type, suggesting that partner type may become less influential in determining condom use as the frequency of sex increases. This finding suggests that contextual factors determining condom use go beyond partner type designations and include other relationship variables.

Adult↗
PubMed2001

Sexual behavior and illicit drug use.

Sexual behavior in drug users varies in association with the drug used, the drug subculture and setting, and the need to maintain the drug addiction. We review the literature on sexual behavior in drug-using subcultures, most of which centers on HIV risk reduction, and the drug-associated and economic pressures that influence sexual behavior. Most data available are on opioid (predominantly heroin) users and crack cocaine users. The recent phenomenon of the circuit party has led to investigation of the context in which drug use and sex have become the focus of large gay-oriented parties over long weekends. Sexual behavior in association with drugs in Western societies is important for its role in the spread of sexually transmissible pathogens, as well as injection-related pathogens.

Condoms↗
PubMed2000

Prevalence of sexually transmitted infections and associated risk factors among populations of drug abusers.

A cross-sectional survey was conducted of sexually transmitted diseases (STDs) and risky behaviors among 407 drug abusers in treatment facilities in 1998. Infections with human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), herpes simplex virus type 2 (HSV-2), and syphilis were detected by testing serum antibody levels; chlamydia and gonorrhea were detected by testing nucleic acid levels in urine. Logistic regression analysis was performed to measure associations. Prevalences of antibodies were as follows: to HSV-2, 44.4%; to HCV, 35.1%; to HBV, 29.5%; to HIV, 2.7%. The prevalence of syphilis was 3.4%; of chlamydia, 3.7%; and of gonorrhea, 1.7%. Of the 407 subjects, approximately 62% had markers for 1 of the STDs. HIV infection was associated with African American race, use of smokable freebase (crack) cocaine, and STD history. HBV infection was associated with age >30 years, injecting drugs, needle sharing, a history of treatment for drug abuse, and African American race. HCV infection was associated with an age >30 years, injecting drugs, and needle sharing, and HSV-2 infection with an age >30 years, female sex, and African American race. Syphilis was associated with a history of STDs. High prevalences of STDs among drug abusers indicate the need for integration of STD screening and treatment into drug treatment programs.

Adult↗
PubMed2000

Preventing HIV: determinants of sexual behaviour.

AIDS has Invigorated and distorted the study of sexual behaviour. Because that study began so recently, there remain many unanswered questions about why we have sex at all, why we do sex one way rather than another, or even how we define sex. Yet in every instance in which well-designed and adequately resourced behavioural Interventions have been Implemented, these have netted success in the form of falling HIV incidences or prevalences. But, despite these successes, such interventions remain patchy and poorly supported. Perhaps humankind's traditional aversion for the public discussion of sexual matters underlies this reticence. Or maybe a new era of "creeping absolutism"--in which biomedical advances are given premature credit for what they can achieve in HIV control--has arrived.

Acquired Immunodeficiency Syndrome↗
PubMed2000

Differences between Internet samples and conventional samples of men who have sex with men: implications for research and HIV interventions.

The Internet is becoming a new erotic oasis for obtaining sex online or in person. We reviewed the literature on cybersex and compared differences in data from samples of homosexually active men obtained on identical questionnaires from a conventional written questionnaire, distributed through the mailing and contact lists of a large national gay organization in Sweden, and through the same organization's website and chat room. A total of 716 written questionnaires and 678 Internet questionnaires were obtained. The Internet sample was younger, more likely to live in small towns or cities, live with parents or a girlfriend, and have lower formal education. They are less likely to have previous sexual experience solely with other men (one in three of the Internet sample vs. 1 in 14 of the written sample defined themselves as bisexual) and more likely to visit erotic oases such as bathhouses, video clubs and erotic movie houses. They also visited Internet chat rooms more frequently (86% of the Internet sample vs. 50% of the written sample). One third of the Internet sample wanted the opportunity to talk with an expert about HIV compared with a quarter of the written sample. Sexual practices between the two samples were generally similar, although the Internet sample reported significantly less body contact, kissing, hugging, mutual masturbation, and more condom use for anal intercourse with steady partners. Over four times as many of the Internet samples reported sex with women in the past year as the written sample. These data indicate that Internet data collection is feasible and that this mode of data collection, despite the nonrandom and self-selected nature of both types of samples, is likely to be more significantly oriented toward the young, geographically more isolated, and more behaviorally and self-identified bisexual respondent than conventionally distributed written questionnaires.

Adult↗
PubMed2000

The importance of psychosocial factors in the prevention of HPV infection and cervical cancer.

This article presents a review of psychosocial factors associated with the primary and secondary prevention of cervical cancer. Current research evidence convincingly links the presence of the human papillomavirus (HPV) to the development of cervical cancer suggesting that bringing together knowledge from the Papanicolau smear screening and HPV infection research may help formulate a new approach that bridges primary and secondary prevention strategies. Bringing together these 2 areas of research involves an understanding of the psychosocial factors that underlie both. This review will specifically focus on 3 areas of psychosocial research: (1) sexual behaviours associated with HPV infection; (2) knowledge, attitudes and beliefs associated with Pap smear and HPV screening; and (3) the role of the medical provider in facilitating prevention activities.

Acculturation↗
PubMed2000

HIV risks in a homeless population.

Homeless people are one of the most vulnerable with regard to HIV transmission. However, most research on this population has been carried out on samples from health clinics. We surveyed 390 homeless people in Houston at a day shelter with regard to their HIV/AIDS knowledge and risk behaviours. The sample was 76% African-American, 11% Euro-American, with small numbers of Latin-Americans, Native-Americans and Asian-Americans: half were born in Texas, and 92% were male. Data indicated that HIV/AIDS knowledge was higher in those who were at higher behavioural risk, although the direction of causality in these cross-sectional data cannot be inferred. African-Americans were at slightly higher risk. Compared with previous clinic samples, this sample was older and a higher number (one-third) slept the last night outside. Eighty per cent had had an HIV test. Condom use was low with both males and females most commonly not reporting using condoms although more than half had had sexual contact in the past month. Multivariate analysis indicated that ethnicity and HIV/AIDS knowledge were independent predictors of risk behaviour. Lifetime risks included one-third who had injected drugs (and shared needles), and nearly 10% had had sex with someone they knew to be HIV seropositive. Lack of future time perspective rather than level of knowledge may be a barrier to reducing HIV risks, and the data are discussed in terms of policy implications and homelessness.

Adult↗
PubMed2000

HIV risk evaluation.

BACKGROUND: Australia enjoys good control of human immunodeficiency virus (HIV) by world standards and HIV testing is becoming an increasingly integral part of general practice. Nevertheless, HIV testing remains charged both emotionally and medicolegally. OBJECTIVE: To outline the importance of: determining why a patient is requesting an HIV test; helping establish his or her risk of infection; and tailoring counselling interventions. CONCLUSION: Isolated high risk exposure to HIV may be grounds for postexposure prophylaxis. Other issues frequently arise out of HIV risk assessment that represent a greater hazard to the patient than HIV. The general practitioner is ideally placed to prioritise and deal with sexual health and infection issues on an individual basis.

AIDS Serodiagnosis↗
PubMed2000

Perception of reliability of human immunodeficiency virus/AIDS information sources.

The sources of human immunodeficiency virus (HIV)/AIDS information as well as the perception of reliability of information from these sources may have a significant impact on the effectiveness of HIV risk reduction messages in reaching high risk populations. We examined the sources of HIV information and the perception of reliability of information from these sources among African Americans (n = 441), Hispanic Americans (n = 456), and whites (n = 297), in Houston, Texas. The data revealed that African Americans and Hispanics were most likely to receive their HIV/AIDS information from the "media" compared with whites who received most of their information from "government agencies and professionals." Information from "family, friends and schools" were regarded as the least reliable by respondents from all three ethnic groups. The data also showed that perceptions of reliability of information sources were influenced by level of educational attainment. Implications for designing target audience-specific intervention strategies for the prevention of the spread of HIV disease are discussed.

Acquired Immunodeficiency Syndrome↗
PubMed2000

The perception of surrogate teaching patients with HIV disease of dental providers' fear and comfort.

We conducted a focus group with eight surrogate teaching patients who participate in an HIV/AIDS training program for dentists and auxiliaries. With one exception, these surrogate patients were HIV-seropositive, had taken part in eight training sessions over six months, and had been examined by about forty groups of trainees. Researchers inquired about how surrogate patients could tell if the trainees were afraid or comfortable, what negative experiences with trainees occurred or stood out, and what positive experiences were recalled or stood out. Theme analysis was used to interpret the results of the focus group. The main signifiers of clinician discomfort were related to physical distance, avoidance of physical contact, verbal interaction, and what we call "dentist interaction." The results suggest that training of dentists and other dental personnel to interact with patients with HIV/AIDS should attend to reduction of patients' psychological distress as well as management of any physical discomfort. The feedback from surrogate patients with HIV disease who have experienced a large number of dental examinations is a valuable tool for providing feedback to, and insight into, the factors that cause psychological discomfort to patients with HIV disease.

Attitude of Health Personnel↗
PubMed1999

Cecocolic and cecocecal intussusception in horses: 30 cases (1976-1996).

OBJECTIVE: To determine the prognosis in horses with cecocolic or cecocecal intussusception. DESIGN: Retrospective study. ANIMALS: 30 horses with cecocolic intussusception or cecocecal intussusception. PROCEDURE: Information on history, physical examination findings, and laboratory values was summarized from the medical records. Laboratory data included results of hematologic examination, serum biochemical analysis, and peritoneal fluid color, total nucleated cell count, and total protein concentration. A one-year follow-up via the telephone was used to determine long-term survival. RESULTS: Horses ranged from 7 months to 30 years old, but 63% were < or = 3 years. Standardbred horses were significantly overrepresented. Twenty-six horses had acute-to-subacute disease, and 4 had a chronic wasting disease. Cecal intussusceptions were suspected on the basis of finding a mass on abdominal palpation per rectum (14 of 24 horses) and positive ultrasonographic findings (2 of 3 horses). Thirteen horses with colic for > 1 day had scant, soft feces. Six horses died or were euthanatized without undergoing surgery, and 24 were treated surgically. Six of the latter horses were euthanatized during surgery because of peritonitis, rupture of the cecum, and irreducible intussusception. All 4 horses with a chronic disease were euthanatized because of irreversible changes in the cecum. Of the 18 horses allowed to recover from surgery, 15 survived long-term. Surgical treatments were reduction, with or without partial typhlectomy (6 horses), partial typhlectomy through a colotomy and reduction (6), reduction through a colotomy and partial typhlectomy (3), partial typhlectomy for a cecocecal intussusception (1) and an ileocolostomy (2). CLINICAL IMPLICATIONS: Cecal intussusception has a good prognosis with surgical correction without delay. Reduction through colotomy has a high success rate. Bypass by ileocolostomy should be used as a last resort.

Animals↗
PubMed1999

Assessing the application of HIV and AIDS related education and counselling on the Internet.

This study reviewed Internet technological capabilities for counselling and several appropriate counselling models and assessed the application of HIV/AIDS related counselling on the Internet. Sixteen health professionals in HIV/AIDS related face-to-face counselling positions were interviewed: their HIV/AIDS service background was limited to Texas-certified HIV pre/post test counsellors. Texas-licensed counsellors in HIV/AIDS service field and HIV/AIDS case managers and social workers. Duration of interviews ranged from 30 min to 60 min and were recorded on audio cassette for review and analysis. Responses were generated using an editing style of the long-interview process. Edited responses were then analyzed for content and themes. Four major themes evolved from interview responses: counsellor-client relationship, target population, ethics and operation. Major concerns included the lack of visual and verbal cues during interaction, problems of accessibility by the neediest, confidentiality, impersonal experience and increased client separation/isolation. Greater benefits may be attained by targeting the younger segment of the population and other health professionals. A majority of respondents indicated support for additional development of Internet-based HIV/AIDS related counselling.

Adult↗
PubMed1999

Predictors of dropout and burnout in AIDS volunteers: a longitudinal study.

Burnout among HIV/AIDS volunteers contributes to the loss of dedicated personnel resulting in strain on the HIV/AIDS care system. Past research has suggested that there were significant stresses and burnout associated with AIDS caregiving. We investigated the predictors of dropout in AIDS volunteers over time, and specifically, which of the variables of the stressors and rewards of being a volunteer (collected at baseline) predicted who would drop out two years later. The volunteers were the subjects of Nesbitt et al. (1996), who were members of an interfaith religious-based organization in Houston, Texas. The subjects were re-contacted by mail after two years, and 76 of the 174 respondents completed a brief questionnaire which gave details of current volunteering activity, reasons for dropout (if they had dropped out) and completed the Texas Revised Inventory of Grief (TRIG). Forty dropped-out from volunteering while 36 continued. Data show the independent variables of total stressor score, the Maslach Burnout Inventory score of Depersonalization intensity and the three subscale scores involving stress: client problems and role ambiguity, emotional overload and organizational factors as being significant in predicting dropout in HIV/AIDS volunteers over time. The best predictors of the dropping-out of HIV/AIDS volunteers can be divided into the stresses (client problems and role ambiguity, emotional overload and organizational factors) and depersonalization intensity. The results showed that volunteers who experienced more client problems and role ambiguity, more emotional overload and more problems with organizational factors are more likely to drop out from the volunteer programme. They also show that the dropout volunteers have a significantly higher level of depersonalization intensity than the continuing volunteers, with the risk of dropout increasing by almost a third in the highest tertile of depersonalization intensity scores compared with those with lower scores. These data indicate that it is the stressors of AIDS volunteering, including the intensity of depersonalization, which lead to dropout, and that rewards do not appear to have a protective effect.

Acquired Immunodeficiency Syndrome↗
PubMed1999

Complex transmission dynamics of clonally related virulent Mycobacterium tuberculosis associated with barhopping by predominantly human immunodeficiency virus-positive gay men.

Limited data suggest that measures to reduce tuberculosis transmission should be based on locations rather than on personal contacts. Molecular epidemiologic methods (analysis of IS6110 patterns, spoligotypes, variable numbers of tandem DNA repeats, and automated DNA sequence data) identified a cohort of 48 persons who were infected with progeny of the same Mycobacterium tuberculosis strain. Epidemiologic investigation documented that a large proportion of the patients were gay white human immunodeficiency virus-positive men. Most practiced barhopping, an activity that involved patronizing many bars in the same neighborhood each night. Few subjects were directly linked to more than 1 or 2 other persons by conventional investigation methods, which shows that the transmission dynamics were unusually complex compared with most previously described episodes of strain spread. The data support the concept that identification of locations where pathogen dissemination likely occurs may provide additional strategies for targeted tuberculosis control.

Alcohol Drinking↗