Dalla Lana School of Public Health
Permanent URI for this communityhttps://hdl.handle.net/1807/67751
The Dalla Lana School of Public Health (DLSPH), a Faculty of the University of Toronto, is a regional and global leader in public health education, research and service, with the largest concentrations of academic population and public health researchers in Canada and over $30 million in research funding per year.
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Browsing Dalla Lana School of Public Health by Author "Aguinaldo, Jeffrey"
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Item Delayed application of condoms with safer and unsafe sex: factors associated with HIV risk in a community sample of gay and bisexual men(2009-06) Allman, Dan; Xu, Kunyong; Myers, Ted; Aguinaldo, Jeffrey; Calzavara, Liviana; Maxwell, John; Burchell, Ann; Remis, Robert SWhile condom use remains one of the most effective measures to prevent the sexual transmission of HIV, decreasing attention appears to be given to its importance and techniques of effective use relative to potential biomedical technologies. This paper focuses on delayed condom application (DCA), one practice which has been implicated in HIV transmission among gay and bisexual men. It examines the prevalence of the practice within a gay community and explores factors associated with condom use among those who practice only safer sex and those who report at least some unprotected anal sex. Data were taken from an anonymous, cross-sectional study of a self-identified sample of gay and bisexual men (N=5080). Among 2614 men who responded to relevant questions, multivariate polytomous logistic regressions were used to identify variables associated with DCA. Nearly, half of the men reported delayed condom application for insertive anal intercourse in the previous 12 months. While the majority of this group also reported episodes of unprotected anal sex, more than 25% of those who reported delayed application only reported safer sexual practices. Most socio-demographic variables found to be associated with unsafe sex in other studies were not associated with DCA. Negative condom use experiences such as tearing, splitting and slippage were associated with delayed application among the two groups. DCA, which may be considered by men as an effective harm reduction strategy requires attention. Interventions to address this behavior need to consider the physical issues of condom use along with the complex array of social, structural, psychological, and interpersonal issues.Item The prevalence and correlates of hepatitis C virus (HCV) infection and HCV–HIV co-infection in a community sample of gay and bisexual men(2009) Myers, Ted; Allman, Dan; Xu, Kunyong; Remis, Robert S.; Aguinaldo, Jeffrey; Burchell, Ann; Calzavara, Liviana; Swantee, CarolObjective: To describe hepatitis C virus (HCV) and HIV prevalence and co-infection, and to examine variables associated with infection in a community sample of men who have sex with men (MSM). Methods: Data were from an anonymous, cross-sectional study (N = 5080) in Canada. Men self-completed a questionnaire and provided an optional saliva specimen for HCV and HIV testing. Polytomous logistic regressions identified variables associated with HCV, HIV, and HCV—HIV coinfection. Results: The prevalences of HCV, HIV, and HCV—HIV co-infection were 1.9%, 9.0%, and 0.7%, respectively. The greatest contribution to HCV (odds ratio (OR) 23.66, 95% confidence interval (CI) 9.69—57.73) and HCV—HIV co-infection (OR 26.76, 95% CI 7.97—89.80) was injection drug use. Sexual behaviors and proxies were associated with HIV but not HCV infection. Conclusions: Results suggest there are subgroups of MSM at risk for HCV. While sexual transmission of HCV was not ruled out, the predominant risk was needle sharing. The greater prevalence of HCV among HIV-positive men suggests the need for greater vigilance in the detection of HCV in this group.