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OCR for page 477
Index
A
Abstinence
by adolescents, 14, 173, 174, 177 n.42, 204
predictors of, 173, 174
promotion of, 14, 20~204, 206, 207
Acute norrnovolemic hemodilution, 338
Adolescents
abortions by, 205 n.86
abstinence by, 173
AIDS cases, 141, 151-152, 157-160
anal intercourse by heterosexuals, 179-180
awareness about AIDS, 15-16, 182-183,
208-213, 21~217
blood donation by, 310315
childbearing, 15~156, 161, 166
clustering of risky behaviors, 194-197
community norms and behavior
modification among, 21~219
contraception and condom use, 12-13,
177-179
data sources on, 11-12, 150, 168-170,
184-185
delinquents, 173, 174, 185, 197-199, 216
n.98, 223, 230
deliver of programs to, 221-231
drug use and users, 13, 18~194, 199, 200,
202-203, 227-231
environmental factors in risk of AIDS, 13
epidemiology of AIDS and HIV infection
among, 148-167
fear of AIDS, 21~215
477
frequency of intercourse, 17~175
gender differences in AIDS and HIV
prevalence, 56-57, 157-160
gender differences in drug use, 189-190
geographic distribution of AIDS and HIV
prevalence, 161-166
goals of intervention programs for,
202-208
REV seroprevalence, 4, 11, 56, 147,
153-167, 200
hotlines for, 220, 222, 227
incubation period for AIDS in, 149~150
initiation of drug use, 13, 185-186
injection practices among, 186-187
knowledge levels and risky behavior,
21~217
number in U.S., 157 n.14, 233 n.ll7
member of sexual partners, 12, 175-177
in over studies, 156-157
out-of-school youth, 16, 197, 226-227
personal vulnerability messages in
prevention, 215-216
pregnancy rates, 13, 205, 207
prevalence of AIDS, 141, 151-152,
157-160
prevalence of drug use, 187-190
prevalence of HIV, 4, 11, 56, 147,
15~167, 200
prevention programs, 11, 13-15, 17, 35,
201-232
prosunluon by, 15, 17, 19~200, 270
OCR for page 478
478 ~ INDEX
raciaVethnic differences in AIDS and HIV
prevalence, 11, 16~161
raciaVethnic differences in drug use,
19~192
racialfethnic distribution of population, 160
n.20
raped/sexually abused, 200
risky behaviors, 12-13, 35, 147, 167-201
same-gender sexual behavior among, 13,
40, 18~181, 207, 216 n.98
school-based prevention programs, 224-226
services related to high-risk behaviors, 16
sexual behavior, 12-13, 147, 167-183,
199-200, 201, 203, 205, 409-412
sexually abused, 200
sexually transmitted diseases, 13, 167-168,
177, 181-182, 199, 227 n.lll
skills-related interventions, 217-218
sources of messages to, 219-221
subpopulations at higher risk, 11, 12,
14-16, 167, 184, 197-200, 208, 211,
221-222, 226-227, 234
transmission modes for AIDS, 161
vaginal intercourse by, 17~173
Age
AIDS cases by, 151, 152, 159, 163-164
and behavioral change, 40
and blood donation, 300, 314, 321-322,
337
and drug use, 192-193
and explicitness of AIDS educational
material, 225-226, 234
and HIV seroprevalence, 24, 153, 321
at initiation of sexual activity, 167-168,
181
and premarital intercourse trends, 171
and risk taking by gay men, 85
and transmission mode for HIV, 161
see also Adolescents
AIDS
asymptomatic (incubation) period, 10~109,
149-150, 151, 211
changes in character of, 38
deaths from, 43, 69 n.52, 151
dementia, 69
medical and biological aspects of, 39-40
sexual behavior after diagnosis of, 99
stigma of, 116; see also Discrimination
surrogate markers of, 291
wasting syndrome, 69
see also AIDS cases; Epidemic;
Epidemiology of AIDS
AIDS Behavioral Research Project, 82 n.1
AIDS cases
among adolescents, 148, 151-lS2, 157-166
by age at diagnosis, 151-152, 159, 164
definition for surveillance, 68-69
by exposure category and year of
diagnosis, 44, 5~51
among gay men, 4, 43, 44, 46
gender and, 3, 5~52, 157-160
geographic distribution of, 3, 161-166
among heterosexuals, 4, 40, 44, 49, 157
among hemophiliacs, 44, 291
among IV drug users, 4, 43, 44, 46, 48,
69, 157, 186
Kaposi's sarcoma with, 69 n.52
pediatric, 44
race/ethnicity and, 40, 43, 46, 54 n.24,
16~161
same-gender sexual activity and, 3
transfusion-related, 44, 49, 65
undercounting/misclassification of, 42, 48
in U.S., 1, 42-43
among women, 40, 48~9, 52, 54 n.24, 55,
60
see also Epidemiology of AIDS
Alabama, sexual behavior of gay men in
low-prevalence cities, 83 n.2
Alcohol use
by adolescents, 13, 188-190, 192, 195,
196, 199, 200, 217-218, 219, 228
and HIV infection, 64
initiation of, 193, 217 n.100
peer influences on, 2I9
prevention of, 217-218, 228
and recall on suIveys, 31
and sexual activity, 5, 8, 41, 183, 188,
19~197, 199
Alcohol, Drug Abuse, and Mental Health
Administration, 8, 36, 111, 306
American Association of Blood Banks, 293,
296
American Red Cross, 293, 297, 298 n.l3,
323
American Statistical Association,
Commission on Statistical Standards,
366
Amphetamines, 23O, 420
Amsterdam
HIV seroprevalence in, 45
OCR for page 479
INDEX l 479
needle exchange program in, 125 n.67
Anal intercourse
by heterosexual adolescents, 179-180
and HIV transmission, 66
legality of, 31, 395
by prostitutes, 260, 275 n.22
unprotected, 82, 83, 85, 87, 88 n.l2, 105
n.47, 109
Antidiscrimination legislation
Americans with Disabilities Act, 118
claims processing, 120
costs of, 117
education rights of HIV-infected children,
121
effectiveness of, 9
enforcement of, 120
Fair Housing Amendment Act of 1988, 118
federal,117-118
HIV testing and, 119
monitoring and enforcement of, 117
purpose of, 116
Rehabilitation Act of 1973, 117-118
state and local, 117, 118-121
wor}cplace-related, 119
see also Litigation
Atlanta
HIV seroprevalence in, 18, 57, 257
sexual behavior of gay men in, 83 n.2
B
Baltimore
adolescent risk behaviors in, 191, 195,
229-230
AIDS hotline for adolescents in, 220
HIV seroprevalence in, 158, 159
Behavioral research on AIDS
barriers to, 121-122, 282
cross-study comparisons, 6, 56 n.30, 70,
84, 169
of gay men, 84
IV drug users, 121
limitations of, 84
see also Behavioral surveys; Blood donor
recruitment; Blood supply protection;
Drug use; Ethnographic studies; IV
drug users; Methodological issues;
Recommendations; Research
recommendations; Sexual behavior,
Survey methods; Women
Behavioral surveys
of adolescent sexual activity, 409~12
of blood donor populations, 329-330
of drug use, 184-185, 187, 42(~428
feasibility for measuring high-risk
behaviors, 366
follow-up, 195
limitations of, 180185
Monitoring the Future, 184, 185, 189, 192
National Adolescent Student Health
Survey, 184, 209
National Household Survey on Drug
Abuse, 184-185, 188, 189
National Longitudinal Survey of the Labor
Market Experience of Youth, 168, 169
n.35, 173, 184, 185-186, 191, 193,
195, 196
National Survey of Adolescent Males, 168,
175, 178, 181
National Survey of Children, 200
National Survey of Family Growth, 168,
168 n.35, 174, 175, 177-179, 376,
377, 379
National Survey of Young Men and
Women, 168, 169 n.35, 178
National Youth Survey, 194
with probability samples, 168, 190195,
209, 212, 216, 366-367
role in AIDS research, 359, 361-362, 365
sexual behavior, 168-170, 17~175,
177-179, 181, 365~01, 401-409
targets of, 36~361
training of interviewers, 297
see also Data Collection; General
population surveys; Monitoring; Survey
methods; Treatment Outcome
Prospective Study
Behaviors, risky
see Anal intercourse; Behavioral surveys;
Cocaine use; Crack use; Drug use;
Heterosexual behavior, IV drug users;
Sexual behavior, Transmission of HIV;
Vaginal intercourse
Bisexual men
AIDS cases from, 43~5
blood donors, 24, 323, 324-325, 329
Blacks
age of initiation of intercourse, 17~171,
196
AIDS cases among, 54 n.24, 55, 160
condom use by, 178
OCR for page 480
480 ~ INDEX
drug use by, 190-192
gay men, 105
HIV antibodies in infants, 54
HIV seroprevalence among, 11, 155, 166,
292
risk factors for, 5, 43, 46, 54 n.27
see also Minorities; Race/ethnicity
Blood and blood products
age and transmission of HIV through, 161
AIDS cases from, 161, 162
decreasing patient needs for, 338-339
decreasing unnecessary use of, 26, 27,
334-336
demand for, 289-290
distribution of, 294
fresh-frozen plasma, 333-336, 339
leukocytes, 332, 339
packed red blood cells, 332-336, 339
platelets, 332-335, 339
shelf life of, 294, 337
trends in utilization, 26, 332-334
whole blood, 339
see also Blood donation; Blood donor
recruitment; Blood supply; Blood
supply protection; Blood transfusions;
Transfusion recipients
Blood donation
age and, 300, 321-322, 337
altruism and, 301, 302, 310
and attribution of responsibility, 312
autologous, 23, 26, 27, 37, 291, 33~338,
342, 343; see also Acute
norrnovolemic hemodilution
characteristics of donors, 22, 24, 293-294,
299-301, 318, 324-325
community needs and support as reasons
for, 302-303
confidentiality of information, 21, 25, 296
deferral from, 3, 21, 23-24, 294, 307-308,
321
directed, 318-319
eligibility requirements, 21, 22, 24, 289,
294, 298 n.13, 305-306, 313-314, 321,
336
fear of, 22, 305, 30~307, 316
first-time, 292, 299, 303, 307, 308, 314,
319, 320
and free ridership, 312
gender differences in, 299
health history for, 21, 25, 294, 296, 325
HIV seroprevalence among donors, 24,
292, 318, 323-324
and HIV testing at collection centers, 25,
327
ideal experience, 22-23, 309
inconvenience of, 308-309, 316, 320
inhibiting factors, 22-23, 305-309,
315-316, 322-323
and iron supplements, 299-300, 322-323,
337-338, 342
medical ineligibility for, 22, 305-306
motivations for, 22, 301-305, 316, 329
payment for, 290, 292-293, 302
perceptions and risk, 32~325, 326, 329
penoperative salvage, 27, 338
pooling of, 332
by pregnant women, 337
preoperative, 337-338
reactions to, 22, 307, 321
repeat, 292, 299, 302, 30~308, 315, 316
research on, 309, 312-313, 316, 319 n.31,
326, 327-331
screening for HIV, 21, 23, 52, 308-309,
317, 329
size of donor population, 298 n.11
staffing issues, 29~297, 330
and theory of reasoned action, 312
voluntary system, 293, 302
see also Blood donor recruitment; Blood
supply; Blood supply protection
Blood donor recruitment
"Adopt a Donor" program, 315
age factors in, 24, 314, 321-322
by appointment scheduling, 313
and attribution theory, 309-312
behavioral theory applied to, 309-317
door-in-the-face technique, 31~311
effectiveness of incentives, 302
emergency appeals, 314
families, 314-315
foot-in-the-door technique, 310-311
gender and, 24, 322-323
impediments to, 298
intention and action, 312-314
internal versus external antecedents to
action, 309-312
list of potential donors, 311
organizational and theoretical issues linked
in, 315-317
racial and ethnic minority groups, 24,
317-318, 319-322
OCR for page 481
INDEX | 48 1
research needs on, 328-329
rewards and incentives for, 22, 301-302,
305, 310
role models and, 24, 314-315, 320
safety issues in, 318-323
social pressures and, 21, 22, 29~295,
303-305, 311, 317, 319, 320
strategies for, 23, 25, 37, 318-327
targets for, 22, 300 301
temporary deferral and, 313-314
Blood supply
adequacy of, 4, 21, 22-23, 36-37, 41-42,
297-317
collection system in U.S., 292-297
effect of exclusionary policies on, 297-298
history and overview of problems, 291-292
organizations collecting blood, 293-294
recommendations for increasing, 23
shortages in, 290, 293, 298, 311
Blood supply protection
AIDS-related intonation for donors, 295
appropriate use of transfused blood and
blood components, 2~27, 37, 331-344
confidential unit exclusion procedure, 22,
295, 298 n.11, 304, 326-327, 329
decreasing patient needs for, 26, 338-339
decreasing unnecessary use of blood
products, 26, 27, 334-336
donor perspective on exclusionary
procedures, 323-327
educational materials, 325-326, 339-342,
343
effectiveness of interventions, 3-4, 9, 24,
167, 292, 295, 324
evaluation of interventions, 325, 328
exclusionary procedures, 21-22, 24, 25, 37,
291, 292, 290297, 323-327
HIV antibody testing, 291, 304
hospital audits of blood usage, 34~341
increasing autologous donation, 33~338
patient behavior modification and, 26-27,
37, 342
physician behavior modification and,
26-27, 37, 33~337, 339-342
recruitment of donors and, 318-323
research needs on, 329-330, 342-344
safety improvements, 23-25, 41
self-deferral, 292, 29~296, 305, 317,
322-324, 32~327
viral inactivation, 26, 339
see also Blood donor recruitment
Blood transfusions
autologous, 23, 26, 27, 333-334, 336-338
chronic renal failure and, 33~339
desmopressin acetate and, 26, 338
erythropoietin and, 26, 27, 338-339
and hemoglobin levels, 334-335, 337
patient behavior modification and, 2~27,
342
physician behavior modification and,
26-27, 339-342
platelet, 335
prophylactic, 335
rates, 26
red blood cell, 333, 335
risk of HIV transmission through, 292
unnecessary, 290, 291, 333
see also Transfusion recipients
Boston
sexual behavior of gay men in, 83 n.2
sterile needle programs in, 124
C
California
adolescent awareness about A~S/~V, 216
n.98
adolescent IV drug users in, 191
behavioral change among gay men in, 82
enforcement of antidiscrimination laws in,
120
REV seroprevalence in, 40 n.3, 57
Prostitutes Education Project, 274
sex for drugs in, 62-63
survey of HIV risk factors, 382-383
Centers for Disease Control
"America Responds to AIDS" media
campaign, 98, 22~221
community demonstration projects for
women, 97
counseling and testing program, 102-103
data collection systems, 5 - , 71
demonstration and education projects for
gay and bisexual men, 84 n.4
family of surveys, 12, 68, 151
"Guidelines for Effective School Health
Education to Prevent the Spread of
ADS," 204 205, 225
high school student surveys, 20~209
hotline, 222
minority youth intervention programs, 105,
22~227
OCR for page 482
482 ~ INDEX
neonatal surveillance, 11, 12, 53, 68, 70,
15~151, 155, 161
prostitute multicenter study, 18, 255, 257,
260, 263, 267
research reco~runendations for, 5-6, 12, 19
school-based education programs, 22~225
serosurveys, 372, 386-387
Chicago, clustering of adolescent risk
behaviors in, 195
Chlamydial infections, 168
see also Genital lesions; Sexually
transmitted diseases
Cigarette smoking, by adolescents, 189, 190,
193, 196, 217 n.101, 218, 219-220,
228
Cocaine use
by adolescents, 187, 188-190, 192, 193,
196, 230
changing patterns Of, 420
and HIV transmission, 41, 61 n.35
initiation of, 185-186
and sexual activity, 196, 197, 230
see also Crack use; IV drug users
Colorado
HIV seroprevalence in, 18, 45, 57, 256
restriction of HIV-infected individuals in,
278-279
Condom use
by adolescents, 12-13, 177-180, 199-201,
20~204, 216
advertisements for, 113
awareness about AIDS/~V and, 216 n.98
by clients and pamers of prostitutes, 3,
19, 26~261, 272-273, 280
crack use and, 19, 183, 270
education about, 14, 107, 111, 122 n.64,
204, 206, 207, 216, 272 n.l8
effect of interventions on, 87, 88, 97-98,
123
effectiveness of, 177 n.43, 214, 280
as evidence of prostitution, 277-278, 281
by gay men, 83 n.2, 87, 88, 123
by hemophiliacs, 66
by IV drug users, 62, 63, 95, 96
mandatory, in brothels, 275
obstacles to, 8, 14, 20, 96, 112, 113 n.55,
122 n.64, 20~204, 261, 277-278, 280,
281
predictors of, 110, 112, 219
racial/ethnic differences in, 178
risky sexual behaviors and, 180, 199
and sex roles of women, 112, 219
and skills training, 96, 107, 231, 274
in STD prevention program, 214
testing for HIV and, 97-98, 280
Confidentiality
of blood donor health history, 21, 25
and data collection, 70
Contraceptive practices
of adolescents, 177-179, 188, 207-208
age and, 167
alcohol use and, 188
education about, 207-208
of HIV-infected women, 99 n.33
see also Condom use
Council of Community Blood Centers, 293
Counseling
of adolescents, 173, 220
assessment of effectiveness of, 102-103
as intervention for women, 95, 99-103, 111
lessons from genetic counseling, 7,
10~105
peer, 220, 276
sensitivity to cultural and ethnic differences
in, 173
street, and drug treatment referral, 273
see also Education programs; Prevention
programs/strategies; Testing and
counseling for HIV
Crack use
by adolescents, 13, IS, 183, 190, 194, 200,
208, 230
and condom use, 183, 270
initiation of, 194
prostitution and, 62, 183, 208, 25~259,
262, 269-270
sexual effects of, 47, 183, 269
and sexual transrIiission of HIV, 2, 5, 15,
19, 36, 41, 46, 62-63, 69, 270, 282
and sexually transmitted diseases, 47, 183,
420
see also Cocaine use
Cystic fibrosis, 104
D
Data collection
on adolescents, 11-12, 187
aspects of, 359-360
difficulties in, 70, 84, 107, 262-263
on IV drug users, 60 n.33, 187, 256
needs, 67, 107
OCR for page 483
INDEX ~ 483
PHS funding for, 42
on prostitutes, 256, 262-263
review of current CDC programs, 5-6
on transfusion practices, 343
see also Behavioral surveys; Serosurveys;
Survey methods
Denver, behavioral change among gay men
in, 82
Desmopressin acetate, 26
Detroit, HIV seroprevalence in, 45
Discrirn~nation (AIDS-related)
defined, 115
extent of, 116-117
federal protections against, 117-118
history of, 115
as impediment to prevention, 115-121
state and local protections, 118-121
violence against gay men and lesbians,
12~121
see also Antidiscrimination legislation;
Legislation and legal issues; Litigation
Dominican Republic, health education
projects for prostitutes, 272 n.l9
The Door, 232
Down's syndrome, 104
Drug treatment programs
for adolescents, 208, 231
barriers to use by women, 93-94, 276
effectiveness of, 90-91, 92, 202-203
In health care facilities, 94
linked to needle exchange programs, 125
n.67
methadone maintenance, and HIV infection
rates, 90-91
pregnant women in, 94
prenatal care with, 94
promotion of condom use through, 107
for prostitutes, 273, 276
referral networks, 15, 94, 124, 208, 273
Treatment Outcome Prospective Study, 187
waiting lists, 276
Drug trials, pregnant women in, 101 n.37
Drug use
by adolescents, 13, 147, 183-197, 200,
202-203, 217-218, 227-231
age and, 186, 192
data sources and limitations, 32, 18~185,
191
duration of, and risk, 61 n.35
education interventions, 14, 206, 207,
214-215, 217-218, 223, 228
ethnographic studies of, 442
fear of AIDS and, 91, 230
gender differences in, 19~191
initiation of, 13, 61, 185-186
patterns of, 46, 186, 442
polydrug use, 63 n.39
prevalence of, 13, 55, 187-190, 227 n.111,
228 n.ll3
progression of, 229
by prostitutes, 17, 25~259
raciaVethnic differences in, 190-192
and recall on surveys, 31
and relapse, 89
and sexual activity, 2, 5, 8, 88-89,
195-197, 258
and sexual transmission, 17, 18, 255-2S9
social nature of, 61, 217, 229-230
sterile needle programs and, 10, 124, 203
surveys of, see Behavioral surveys; Survey
methods
and transmission of HIV, 30, 46, 442
undetTepori~ng of, 32, 185, 191; see also
Survey methods
by women, 6(}64
see also Gay men; IV drug users; Sterile
needle programs; and specific drugs
and other subpopulations
Drug withdrawal, and injection practices, 62,
95
E
Education programs
for adolescents, 14, 15-16, 17, 204 207,
215, 217-218, 223, 228, 232-233
assertiveness tr=g, 217-218
for blood donors, 295-296, 32~326,
330340, 341, 343
CDC "Guidelines for Effective School
Health Education to Prevent the
Spread of AIDS," 204 205
cognitive behavioral self-management
training, 87
about condoms and sperrnicides, 14, 107,
111, 122 n.64, 204, 206, 207, 216, 272
n.18
about drugs, 14, 20, 206, 207, 217-218
effectiveness of, 87-88, 95, 110, 111,
21~214, 221, 226
for gay men, 84 n.4, 86-88
OCR for page 484
484 ~ INDEX
gender differences in evaluation of,
223-224
for Hispanic youth, 222, 22~227
"information only" versus
"psycho-educational" programs, 110
obstacles to, 14, 19, 121, 122, 204, 232
for patients about transfusions, 27
for physician behavior modification on
transfusions, 27
planned variations in, 123, 215, 233
for prostitutes, 19, 20, 271, 272, 273, 280
on safer injection practices, 273
about same-gender sexual practices, 14
school-based, 16, 206, 223
about sexual behavior, 204, 206, 207
sexually explicity materials in, 122 n.64,
225-226
skills training in, 96, 107, 226
STAR (Students Taught Awareness and
Resistance), 228
theater groups and rap sessions, 223
see also Counseling; Prevention
programslstrategies; Testing and
counseling for HIV
E1 Puente, 232
Environmental factors, in adolescents' risk of
AIDS, 13
Epidemic
changes in risk populations, 38
data needs for tracking, 67-72; see also
Survey methods
dimensions of, 1
. . ,
progress In prevention, 0
social impacts of, 9
Epidemiology of AIDS
among adolescents, 148-167
changes in U.S., 4 6, 43-48
among prostitutes, 25~263
among women, 48~7
see also AIDS cases; Survey methods
Erythropoiet~n, 26
Ethnographic studies
of AIDS, 4421 448
on crack houses, 259
of drug use pattems, 442
examples related to HIV transmission,
441 442
of female IV drug users, 6~61, 64
of female sexual partners of IV drug users,
96 n.27, 183
gaps and deficiencies in, 448 449
of male-male sexual contacts, 441 442
methods, 442 448
of prostitutes, 269, 272
F
Fear of AIDS
and blood donation, 305, 30~307
and IV drug use, 91, 230
and prevention, 91, 213-215
and prostitution, 270
Fifth International Conference on AIDS, 89
Florida
blood donation by senior citizens in, 321
HIV seroprevalence in, 40 n.3, 54, 57
mandatory testing of prostitutes in, 279
serosurvey in, 372, 38~387
testing and counseling of gay men in, 83
n.2
Food and Drug Administration, 296
G
Gay men
age and risk taking, 85
AIDS cases, 4, 43~5, 50
behavioral change by, 40, 41, 82, 88-89,
109, 123, 218
clinical interventions, 87~8
condom use by, 83 n.2
community-level and individual
interventions, 85-88, 109
~ g users, 44, 50, 88-89, 162
high-risk subgroups, 84, 85
HIV seroprevalence, 40
impact of interventions among, 8, 82-89,
123
predictors of safer practices, 105 n.47
relapse in behaviors among, 109-110
research on, 84
safer-sex workshops, 87, 105 n.47, 123
testing and counseling of, 83 n.2
violence against, 12~121
see also Same-gender sexual behavior
Gay Men's Health Cnsis, 123
Gender differences
in adolescents, 5~57; 157-160; 189-190
in AIDS and HIV prevalence, 24, 5~52,
157-160
in blood donation, 299
and blood donor recruitment strategies,
322-323
OCR for page 485
INDEX l 485
in drug use, 19~191
in evaluation of AIDS educational
materials, 223-224
in incidence of sexually transmitted
diseases, 182
see also Women
General population surveys, 30, 203 n.83,
370-371, 376, 377
Genetic screening programs, as model for
AIDS intervention, 7, 103-105
Genital lesions, and HIV transmission, 13,
177
Geographic distribution of AIOS/~V
infection
in adolescents, 3, 161-166
in hemophiliacs and transfusion recipients,
163 n.22
in IV drug users, 45, 90
pockets of high rates of infection, 53, 56,
163, 165-166
in prostitutes, 18
in women, 53-54, 56
Georgia, HIV seroprevalence in, 57
Gonorrhea, 13, 168 n.30, 181-182, 199 n.79,
267, 280
see also Genital lesions; Sexually
transmitted diseases
Great Bntain, syringe exchange programs in,
122
H
Hallucinogens, 188, 189, 192, 193
Hashish, 188, 189
Hastings Center, 103
Health care
age and use of clinics, 182
financial barriers to, 10
for HIV-infected adolescents, 232
litigation over access to services, 119-120
Hemophiliacs
AIDS cases, 49 n.17, 52-53, 161, 163
n.22, 291
condom use by, 66
female sexual partners of infected men, 49,
52-53, 65-67, 111
programs for HIV-infected adolescents, 232
incubation period for AIDS in, 149-150
infectivity of, 83 n.3
in U.S., 52 n.l8
Hepatitis
in blood from paid donors, 290
prevalence among IV drug users, 4 n.4
racial differences in prevalence, 319 n.32
screening for, 298 n.13
Heroin, 186, 187, 189, 190, 193, 229, 230;
see also IV drug users
Heterosexual behavior
adolescent patterns of, 173-180
age of initiation of intercourse, 173-174
anal intercourse, 179-180
contraception and condom use, 88,
177-179
frequency of intercourse, 174-175
number of sexual partners, 32, 33,
175-177, 412 413
see also Vaginal intercourse; and other
specific practices
Heterosexual contacts
AIDS cases from, 3, 4, 40, 44, 45, 5~51,
55, 161
efficiency of HIV transmission in, 69
risk to women from, 49
see also IV drug users; Prostitutes; Women
High-risk populations
adolescent subpopulations, 11, 12, 14-15,
167, 184, 197-200, 208, 211, 221-222,
22~227
changes in, 2, 34
prevention strategies for, 17, 231-232
see also specific populations
Hispanics
age of initiation of intercourse, 17~171
AIDS cases among, 54 n.24, 55, 160
drug use by, 190
education/~nformation campaigns directed
to, 222, 220227
HIV antibodies in infants, 54
HIV seroprevalence among, 11, 156, 292
programs for HIV-infected adolescents, 232
risks factors for, 5, 43, 46 54 n.27, 184,
196
school dropout rates, 184, 226
sexual activity of prostitutes, 260
see also Minorities; Race/ethnicity
Hispanos Unidos Contra el SII)A/AIDS, 227
HIV infection
from antibody-negative blood, 291-292
cofactors in, 47
duration of injecting career and, 257 n.5
frequency of injection and, 257 n.5
OCR for page 486
486 ~ INDEX
infectivity associated with later stages of,
83-84
morbidity changes, 38
number of sexual partners and, 12, 18, 19,
253 n.2, 255
persistence of, 39
progression to AIDS, 39
and reproductive decision making, 99-101
saturation, 4 n.4
window period in serologic screening, 291
see also HIV seroprevalence; Serosurveys
HIV-infected populations
isolation of, 278-279
prevention program needs for, 208,
231-232
prophylactic treatment of, 116
see also Adolescents; Gay men; IV drug
users; Women; and other specific
populations
HIV seroprevalence
among adolescents, 4, 11, 56, 147, 150,
153-167, 200
among blood donors, 24, 292, 318,
323-324
among childbearing women, 155-156
in clients of prostitutes, 262
crack use and, 63
in female sexual partners of infected
hemophiliacs, 65-66
among gay men, 40, 83
gender and, 4, 154, 157-160
geographic distribution of, 3, 40, 161-166,
255-257
intervention programs and, 83
among IV drug users, 4, 45, 166, 253 n.2
in Job Corps applicants, 153, 155, 159,
163, 165
in military applicants, 153-155, 157, 159,
16~161
in other studies, 156-157
for probability samples, 150
among prostitutes, 3, 18, 253, 256-257
race/ethnicity and, 60, 16~161
survey methods, 29, 383-391
among women, 3, 4, 6-7, 53, 56-60,
65-66, 150, 153 n.l 1, 155-156
see also HIV infection; Serosurveys
Homeless people
adolescents, 13, 15, 17, 165, 189, 199-200,
208, 227, 234
extent of, 227
HIV seroprevalence among, 200
interventions for, 208
risk of HIV infection, 13, 165, 199-200,
234
women, 61
Homosexuals, see Gay men; Same-gender
sexual behavior
Hotlines, 220, 222, 227
I
Illinois, HIV seroprevalence in, 40 n.3
Infants
seroconversion in, 53 n.20
seroprevalence rates, 54-55, 56
see also Pediatric AIDS; Perinatal
transmission
Information campaigns
for adolescents, 213, 21~215, 222
"America Responds to AIDS" media
campaign, 98, 220-221
and behavioral theory of adoption and
diffusion of innovation, 123-124
for blood donation, 295-296
culturally and linguistically appropriate
messages, 106
effectiveness of, 10, 90, 94-95, 10~107,
213-214, 216
empowerment messages, 97
evaluation of, 202
for gay men, 86
health promotion campaigns, 214-215, 220
for IV drug users, 90
obstacles to, 18
personal vulnerability messages, 98,
215-216
printed materials, 98 n.31, 223, 275 n.20,
325-326, 339-340
sexually explicit material in, 10, 121,
122-124, 225
see also Education programs; Prevention
programs/strategies; Public awareness
about AIDS
Inhalants, 189, 190, 193
Interventions, see Education programs;
Information campaigns; Prevention
programs/strategies; Testing and
counseling
IV drug users
adolescents, 13, 187, 189-191, 193-194,
200, 208
OCR for page 487
INDEX ~ 487
AIDS cases, 4, 40, 43-46, 5~51, 55, 56,
69, 69 n.52, 161, 162, 186
awareness of AIDS and transmission
routes, 125 n.67
behavioral changes in, 89-92, 94-95, 110,
125 n.67
blood donation by, 318
characteristics of, 6~61, 63
condom use by, 62, 63, 95, 96 n.26
contraception by, 63
female sexual partners of, 3, 48, 49, 54
n.27, 61 n.34, 64-65, 92-96, 166, 270
fertility patterns of, 63 n.41
gateway drugs, 228-229
gay men, 44, 50
HIV seroprevalence, 4, 11 45, 5~55, 91,
166, 253 n.2, 255-257
impact of AIDS on, 187
impact of interventions among, 8, 42,
89-92, 110, 125 n.67, 229
injection practices, 32, 61-62, 89, 91, 125
n.67, 166, 186-187, 229-231, 257 n.5
minorities, 46
outreach programs for 125 n.67, 231, 273
potential for spread of HIV through,
45-46, 125
pregnancy rates in, 99 n.34
prevention programs for, 42, 60 n.33,
89-92, 208, 227-231, 273, 274; see
also Sterile needle programs
prostitutes, 18-19, 253 n.2, 255-257,
265-267, 273, 281
referral to treatment, 60 n.33
relapse in risky behaviors, 110
running buddies, 61
sexual behavior of, 2, 18, 54, 62, 89, 95
shooting galleries, 61, 230, 257 n.5, 422
women, 49, 54-55, 6~64, 93-95
works, 61
see also Drug use; Drug treatment
programs; Heroin; Sterile needle
programs
J
Job Corps applicants
HIV seroprevalence in, 153, 155, 159, 163,
165
screening for HIV, 67-68, 150, 153, 161
Joint Council of the Administration of
Healthcare Organizations, 34~341
K
Kansas City
AIDS hotline for adolescents in, 220
STAR (Students Taught Awareness and
Resistance) program, 228
Kaposi's sarcoma, 69 n.52
Koop, C. Everett, 205-206, 233
L
Latinas/Latinos, see Hispanics
Legislation (AIDS-related) and legal issues
on AIDS educational materials, 204
effects on HIV transmission, 279
mandatory HIV testing, 279-280
prostitution by HIV-infected individuals,
277
restriction of infected individuals, 278-279
on sterile needle programs, 126
see also Antidiscri~nination legislation;
_ . . . . . . .
Dlscnm~natlon; . _lugatlon
Lesbians
blood donation by, 303
violence against, 120-121
. . .
Lltlgatlon
Chalk v. Orange County Department of
Education, 118
Doe v. Centinela Hospital, 118
health care services as public
accommodation and, 119-120
legal resources for, 120
Ray v. School District of DeSoto County,
118
School Board of Nassau County v. Arline,
117
shift in nature of cases, 119
Los Angeles
AIDS cases in, 45
behavioral change among gay men in, 82
HIV seroprevalence in, 18, 57, 166, 256
cou~s~ana
HIV seroprevalence in, 45, 58
sexual behavior of gay men in
low-prevalence cities, 83 n.2
M
Marijuana use
by adolescents, 188-190, 192-193, 196,
228
initiation of, 185, 193
OCR for page 488
488 ~ INDEX
prevention of, 228
reporting of, 185
and sexual activity, 64, 195, 196
and use of other dogs, 186, 192-194, 228
Maryland, HIV seroprevalence in, 45, 58
Massachusetts
adolescent awareness about AIDS in, 209,
212, 216
IV drug use by adolescents in, 189
Mathematical models, 7~71
Methodological issues
accuracy of self-reports, 421
in blood donor studies, 319 n.31, 329
cross-study comparisons, 6, 56 n.30, 70,
84, 168
data collection and reporting, 84, 121
fallibility of measurement in other
sciences, 362-365
inconsistent age groupings, 166
measurement bias, 422~28
partner reports, 401-406
replication of measurements using same
respondents, 413~19
replication of surveys on samples of same
population, 409 413
in sexual behavior studies, 169-170
validation, 401009 see also Data
collection; Ethnographic studies;
Survey methods
Metropolitan Life Insurance Foundation,
226-227
Miami, HIV seroprevalence in, 18, 40, 56
n.30, 256
Michigan
adolescent IV drug users in, 189
HIV seroprevalence in, 45, 58
information dissemination, 98 n.32
Military applicants
HIV seroprevalence in, 153-154, 157, 159,
16{) 161, 163, 165
screening for HIV, 67~8, 150
Minnesota
blood transfusion practices in, 336
MV seroprevalence in, 45, 58
Minonties
AIDS/~V prevalence among, 34, 40, 41,
46, 54, 60, 16~161, 310320
awareness about AIDS/~V, 15, 106,
21 1-212
blood donation from, 24, 300, 317-318,
3 19-322
interventions needed for, 105-106
IV drug use by prostitutes, 18, 257, 265
see also Blacks; Hispanics; Race/ethnicity
Mississippi, sexual behavior of gay men in
Iow-prevalence cities, 83 n.2
Monitoring
behavioral change, 69
crack use and sexual transmission of HIV,
69-70
see also Behavioral surveys; Serosurveys;
Surveillance; Survey methods
Monitonug the Future, 184, 185, 189, 192
Montefiore Medical Center, Adolescent
AIDS program, 232
Mt. Sinai Hospital, Adolescent Health
Service, 232
Multicenter AIDS Cohort Studies
incidence rates among gay and bisexual
men, 45
information provided by, 68, 84 n.4
N
National Academy of Sciences, 103
National Adolescent Student Health Survey,
184, 209
National Blood Resource Education Program,
343
National Center for Health Statistics, 377,
384
National Coalition of Hispanic Health and
Human Services Organizations,
22~227
National Health Interview Survey, 98 n.32,
106, 221, 299, 377-378
National Heart, Lung, and Blood Institute,
23, 25, 37, 330, 331
National Household Sunrey on Drug Abuse,
18~18S, 188, 189
National Institute of Allergy and Infectious
Diseases' 68, 84 n.4
National Institute for Child Health and
Human Development, 103
National Institute on Drug Abuse,
demonstration projects, 6(~62, 93 n.l9,
258
National Institute of Mental Health,
behavioral studies of gay men, 84 n.4,
105
National Institutes of Health, neonatal
surveillance, 11, 12, 53
OCR for page 489
INDEX ~ 489
National Longitudinal Survey of the Labor
Market Experience of Youth, 168, 169
n.35, 173, 184, 185-186, 191, 193,
195, 196
National Network of Runaway and Youth
Services, Inc., 227
National Opinion Research Center, General
Social Survey, 30, 203 n.83, 376, 377,
39~391, 412-413
National Research Council, Committee for
Research on Problems of Sex, 366
National Survey of Adolescent Males, 168,
175, 178, 181
National Survey of Children, 200
National Survey of Family Growth, 168, 168
n.35, 174, 175, 177-179, 376, 377,
379
National Survey of Young Men and Women,
168, 169 n.35, 178
National Youth Survey, 194
Needle exchange programs, see Sterile
needle programs
Needle-stick injures, HIV infection from, 53
Nevada
HIV infection among prostitutes in, 18, 256
prostitution in, 266, 267, 277
New Jersey, HIV seroprevalence in, 18, 40,
55-56, 58, 153, 155, 25~257
New Mexico, blood donor recruitment in,
302
New York City
abortions for HIV-infected women in, 101
ADAPI (Association for Drug Abuse
Prevention and Treatment), 273-274
adolescent awareness about AIDS in, 211
n.93
AIDS cases in, 45, 49 n.13, 157, 159
behavioral change among drug users in, 92
n 17, 94-95, 229
behavioral change among gay men in, 82
blood donor population in, 298 n.ll, 321
Commission on Human Rights, 120
crack use in, 258-259, 262, 270
deaths from AIDS in, 43
enforcement of antidiscrimination laws in,
120
Gay Men's Health Crisis, 123
hepatitis prevalence in, 4 n.4
HIV seroprevalence in, 4 n.4, 11, 40, 45,
54, 58-59, 91, 153, 155, 161, 163,
165, 200, 262
IV drug use rates in, 166, 189
outreach programs, 273
programs for HIV-infected adolescents, 232
prostitution by adolescents in, 270
risk factors for blood donors in, 318
sexual activities of prostitutes in, 259-260,
261-262
sexual behaviors of adolescents in, 180
STDs among adolescents in, 199 n.79
syringe exchange pilot program in, 122
New York State
adolescent drug use in, 192
HIV seroprevalence in, 155
Newark
characteristics of street youth, 227 n.lll
HIV seroprevalence in, 40
North Carolina, HIV seroprevalence in, 59
o
Ohio, HIV seroprevalence in, 40 n.3
Opiates (other than heroin)
adolescent use of, 190, 193
and HIV transmission, 41
Oral-genital sex
condom use in, 274
legality of, 31
by prostitutes, 259-260
Oregon, sterile needle programs in, 124
p
Pediatric AIDS
by exposure category and year of
diagnosis, 44
social consequences of, 101 n.38
Pelvic inflammatory disease, 63 n.40, 182
Pennsylvania, HIV seroprevalence in, 59
Perinatal transmission
adolescent awareness of, 211 n.93
AIDS cases from, 44, 5~51, 55, 162
by ethnic group, 48, 55
IV drug use and, 63
prevention of, 9~103
risk of, 48
seroconversion rates in infants, 96
testing and, 99, 100
Pheny1ketonuria, 103-104
Physicians, behavior modification on
transfusions, 2~27, 339-342
Prenatal care, and drug treatment programs,
94
OCR for page 490
490 ~ INDEX
Presidential Commission on the Human
Immunodeficiency Virus Epidemic,
116, 120, 121
Prevention programs/strategies
access to, 271-273
adolescent involvement in design and
execution, 16
for adolescents, 11, 13-15, 17, 35, 201-232
challenges in cooling decade, 6-9, 105-108
clinical interventions, 87-88
community-level interventions, 85-88,
226-227, 282
co~Tununity norms and behavior
modification, 218-219
counseling and testing of women, 99-103
delivery venues for, 16, 17, 94, 97,
221-231, 233-234, 272
and discnmination, 115-121
drug use and behavior change, 13-14,
88-89, 202-203
effectiveness of, 4, 6-8, 82-90, 93,
101-102, 111, 282
evaluation of, 7, 16, 42, 43, 71, 81-82,
97-98, 105 n.47, 201-202, 229, 282
facts and beliefs and, 216-217
fear of AIMS and, 91, 213-215
focus groups, 97
genetic screening programs as model for,
7, 103-105
goals of, 13-14
for high-risk populations, 231-232
for noninfected populations, 15, 208,
231-232
for horizontal transmission with drug use,
92-96
impediments to, 9-11, 17-18, 20, 91, 93,
11~126, 271, 276-281
for IV drug users, 89~92, 227-231
legislation affecting, 277-280
maintenance of nsk-reduction behavior,
108-114
for multiple-high-risk-behavior populations,
208
need for, 81; see also Recommendations
peer-led, 20, 86-88, 97, 219-220, 231,
233, 271, 272 n.l9, 27~275
perceptions of risk and, 6~65, 9~96, 111
planned variations in, 35, 81-82, 108, 123,
233, 282
for populations not engaging in rislc
behaviors, 206-207
for prostitutes, 17, 19, 20, 270-281
relapse problem, 2, 8, 63, 82 n.l, 89,
108-114
school-based programs, 16, 17, 214, 217,
22~226, 233-234
for sexually active, non-drug-using
populations, 14, 207-208
skills training, 15, 86, 88, 96, 97, 107,
217-218, 220, 226, 228
and social attitudes and public policy,
121-122
sources of messages, 219-221
sterile needle programs, 12~126
transition to lower-paying legitimate jobs,
276
for vertical transmission, 96-103
voluntary contact notification procedures,
116
for women, 6-7, 67, 92-108
see also Education programs; ~fonnation
campaigns; Testing and counseling for
HIS; and other specific projects,
programs, and populations
Prostitutes and prostitution (female)
access to interventions, 271-273
adolescents, 15, 17, 199-200, 208
advocacy groups, 272
Australian Prostitutes Collective, 275
bar (B girls), 264, 265
behavioral change in, 275 n.21
brothels, 256, 257-258, 26~267, 272, 273,
27~275, 277, 281
call girls, 256, 259-260, 263, 26~269,
271-272
client-related risks, 255, 261-263
condom use by partners of, 3, 19,
26~261, 272-273
context-related risks, 259-261
and crack use, 46, 208, 25~259, 262,
269-270
defined, 253 n.l, 277
drug use and sexual transmission, 17, 18,
255-259
education interventions, 19, 20, 271,
272-275, 280
effects of marginality, 28~281
e1iniinatiOn Of, 275-276
ePidem1010gY Of AIDS and REV infection
among, 250263
eSCOrt SemCeS, 257-25S, 26~269, 272
fear Of AIDS and, 270
OCR for page 491
INDEX l 49 1
HIV seroprevalence, 3, 18, 253 n.2,
250257, 281
impediments to interventions, 265, 276-281
interventions for, 17, 19, 20, 208, 254,
263-264, 270-281
IV drug users, 18-19, 2S3 n.2, 255-258,
265-266, 267, 273, 27S n.22, 281
law enforcement efforts against, 264-265,
269, 277-278
legislation affecting, 277-280
massage parlors, 267-268, 272, 27~275
needs and options for HIV prevention,
281-282
number of nonpaying sexual partners, 18,
19, 253 n.2
outreach programs, 256, 266, 271, 272
n.18, 27~275, 278
patterns of, 263-270
personal relationships of, 260, 261
pimps, 265, 268, 277, 281
population size, 254
red light districts, 267
risk factors for, 17, 18-20, 111, 253,
255-263, 273, 274, 281
Safe House Endorsement policy, 275
sex clubs, 27~275
sexual activity of, 259-260, 275 n.22
streetwalkers, 256, 257, 258 n.7, 259, 263,
260266, 280
stroll districts, 264
studies of, 1~20, 254, 256-257, 258 n.8,
260, 262-263, 267, 269, 272, 282
subpopulations at higher risk, 18
testing for HIV, 267, 275, 278, 281-282
truck-stop, 264
Prostitutes (male), 253 n.1
Public awareness about AIDS
adolescents, 15-16, 182-183, 208-213,
216-217
and condom use, 216 n.98
IV drug users, 125 n.67
minonties, 15, 106, 210-212
see also Information campaigns
Puget Sound Blood Center, blood transfusion
practices in, 336
R
Race/ethnicity
adolescent population distribution, 160 n.20
and AIDS cases among women, 55
and AIDS and HIV prevalence among
adolescents, 160-161, 163, 165
and awareness about AIDS, 21~212
and hepatitis B infection, 319 n.32
and HIV seroprevalence among blood
donors, 24
and HIV seroprevalence among women,
54, 60
and premarital intercourse trends, 171-172
and progression of intimate relationships,
172
and sexual activity, 17~172, 174
Recommendations
adolescent prevention programs, 35,
206-207
assessment of new drug problems relevant
to HIV infection, 5, 47~8
blood supply protection, 37, 33~331
blood transfusion practices, 27, 342
counseling and testing as an intervention,
102, 105
data provision by CDC, 11-12, 71,
15~151
data summaries, 7-8, 35-36, 108
for increasing blood supplies, 23
interventions for minorities, 34, 107-108
monitoring of prostitutes, 19, 263
planned variations in intervention
programs, 35, 201
see also Research recommendations
Rehabilitation Act of 1973, 117
Relapse Prevention
in adolescents, 108-114
and drug use, 89, 110
ire gay men, 109-110
programs for, 2, 8, 63, 82 n.1, 108-114
in women, 111
Reproductive decision making
abortion, 10~101, 205 n.86
counseling and, 103-104
factors contributing to, 103-104
by IV drug users, 99-101
Research recommendations
behaviors that transmit HIV, 35
for blood supply protection, 25, 37,
327-331, 342-343
clients of prostitutes, 19-20, 263
condomuse, 8,113-114
crack use and sexual behavior, 5, 36, 70
data reported by gay men, 6, 84 85
drug use and prostitution, 19, 258
OCR for page 492
492 ~ INDEX
evaluation of interventions, 7-8, 1~11, 17,
35-36, 41, 201
HIV transmission among minorities, 5, 34,
107-108
measurement of behaviors that transmit
HIV, 33_34
multiple high-risk behaviors of adolescents,
197
protective measures other than condoms for
women, 9, 35, 112-113
relapse prevention, 8, 36, 111
survey methodologies, 33-34, 36
see also Behavioral research on AIDS
Rhode Island, HIV seroprevalence in, 59
Risk factors
see Anal intercourse; Drug use;
Heterosexual behavior, Transmission of
HIV; and specific populations
S
Safe Choices Program, 227
Same-gender sexual behavior
by adolescents, 13, 14, 40, 161, 179 n.52,
18~181, 207
age of initiation of, 181
AIDS cases from, 3, 43, 46, 162
as crimes, 31, 395
educational interventions, 14
ethnographic studies of, 441~42
and heterosexual behavior, 181
and transmission of HIV, 161, 441~42
underreporting of, 31, 33
see also Bisexual men; Gay men
San Francisco
adolescent drug use and sexual behavior
in, 183, 191
AIDS incidence rates among gay and
bisexual men, 45
behavioral change among gay men in, 82
blood donation in, 298 n.l2, 303
condom use by prostitutes in, 260, 278
crack use in, 63 n.39, 183, 270
HIV seroprevalence in, 18, 40, 45, 57,
256-256, 257, 372
Men's Health Study, 45, 68 n.51, 82 n.l9
85, 109, 372, 385-386
needle sharing and HIV infection in, 62
n.37
prostitution in, 268, 270, 275 n.22
serosurveys, 372, 385-386
sterile needle programs in, 124, 125 n.67
Stop AIDS Project, 86
surveys of sexual behavior, 372, 38~381
Youth Guidance Center, 199
Schools, prevention programs for adolescents
in, 217, 223, 22~226, 23~234
Sedatives, 190, 193
Seroprevalence, see HIV infection; HIV
seroprevalence; Serosurveys
Serosurveys
college campuses, 158, 159-160
convenience samples, 57-59, 67
of female sexual partners of hemophiliac
men, 53
of homeless youth, 158, 165
of hospital patients, 156-157, 158
in juvenile detention centers, 158, 165-166
methods and execution of sampling design,
372-373, 384
national, 384-385, 387-388
principles and purpose of, 368, 384
of prostitutes' 254-255
in STD clinics, 158, 159
see also Gay men; REV infection; HIV
seroprevalence; IV drug users; Job
Corps applicants; Military applicants;
and specific surveys
Sex education
effectiveness of, 221
by parents, 15-16, 221
by peer counselors, 220
safer sex programs for women, 274
skills training in, 217
Sexual behavior
of adolescents, 12-13, 147, 168-183, 188,
199-201, 203-204, 206, 40~12
age of initiation of intercourse, 167-168,
17~172, 195, 199, 204, 206
alcohol use and, 5, 8, 41, 183, 188
changes in, 40, 41, 82, 88~9, 95
crack use and, 5, 41, 46~7, 62-63, 183,
270, 282
data sources on, 168-170
drug use and, 2, 18, 54, 62, 89, 183,
19~197, 199, 258
empirical studies of, 401~20
explicit information and, 1~11, 14
gender and sex roles and, 219
illegal, 31
number of sexual parmers, 12, 18, 19, 62,
85, 176, 412~13
OCR for page 493
INDEX ~ 493
parent-child communication about, 15-16,
220
perceptions of risk and, 64 65, 95-96, 111
predictors of safer practices, 105 n.47
premarital intercourse trends, 170-171
reliability studies of self-reports of,
418-419
reporting of, 170
survey methods, 28-29, 30, 31-32,
369-383, 393-401, 441 442
unprotected intercourse, 62, 82, 83, 85, 87,
88 n.12, 105 n.47, 109, 201, 260, 276
see also Anal intercourse; Heterosexual
behavior, Vaginal intercourse; and
specific behaviors and populations
Sexual transmission of HIV
drug use and, 36, 255-259, 272; see also
Crack use; IV drug users
number of partners and, 12, 18, 19, 253
n.2, 255, 261, 270, 274, 275 n.22
survey methods to determine risk factors
in, 28-29
see also Gay men; Genital lesions;
Prostitutes/prostitution
Sexually transmitted diseases
age of initiation of sexual intercourse and,
167-168
among adolescents, 13, 167-168, 177,
181-182, 199, 227 n.111
crack use and, 47, 183
gender differences in incidence, 182
and HIV infection, 47, 66 n.47, 69-70
prevention programs, 213-214, 279, 280
serosurveys of clinic populations, 158,
1159
testing for, 267, 279
validation of sexual behavior surveys using
rates of, 398
see also Genital lesions; and specific
diseases
Sickle-cell anemia, 104, 320
Social attitudes
and behavior modification, 21~219
and blood donation, 21, 22, 294-295,
303-305
effect on implementation of interventions,
203-204, 232
about premarital sexual intercourse,
203-204
and public policy affecting interventions,
121-122
and reporting of behaviors, 395-396
sexually explicit information, 10, 14,
122-124, 232
Sterile needle programs
in Amsterdam, 125 n.67
approved by local jurisdictions, 122, 124
as a bridge for treatment, 125 n.67, 203
effectiveness of, 124
evaluation of, 122, 124-126
funding of, 42
in Great Britain, 122
and illicit market for sterile equipment, 125
impediments to, 10, 121, 122, 124-126,
230
and IV dmg use, 10, 124, 203, 230
need for, 125, 273
unofficial, 124
Stimulants, 190, 193
Stockholm, HIV seroprevalence in, 45
Stop AIDS Project, 86
Stress management, 88
Surveillance
case definition for, 68-69
and discriminatory policies, 116
see also Centers for Disease Control; Job
Corps applicants; Military applicants;
Serosurveys
Survey methods
for adolescents who are sexually active,
409 412
alternatives to self-reports, 431-432
aspects of, 359-360, 362
blood specimen collection with, 29, 375
cognitive research strategies, 438~40
constant bias assigned in measurements,
39~397
data collection procedures, 369-375,
440 449
for drug-using behaviors, 420~28, 442
empirical research to corroborate validity,
401 428
ethnographic data, 440~49
and execution of sampling designs in
recent surveys, 37~373
face-to-face interviews, 369, 374
and feasibility of surveys, 428-429
improving measurements, 33-34
inference in presence of bias, 39~396
limitations of, 28, 65
literacy and, 430
male-male sexual contact, 441 442
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494 ~ INDEX
measurement bias in, 422-428
nonresponse bias, 29-30, 36, 388-391
nonsampling issues, 36, 391-401
number of sexual partners reported by
adults, 412~13
parmer reports, 401~06
physical evidence, 431
pilot studies, 371, 373, 384-385, 387-388,
43W36
pretests, 437
probability sampling, 68
psychometric approaches to validity,
398~01
questions about sexual behavior, 28-29, 36
random errors, 392, 393
randomized response techniques, 433034
recruitment of respondents, 27-29, 56, 67,
71, 99, 150, 261, 365-391
replication of measurements using same
respondents, 413~19, 429
replication on samples of same population,
409013, 429
reporting biases, 31, 262
and response rates, 2~30, 367, 369-379
self-administered questionnaires, 368, 369,
374
self-report accuracy, 185, 421
for seroprevalence determinations, 29, 150,
383-391
for sexual behavior, 28-29, 30, 369-383,
393-420, 441 442
skills demonstration, 431~32
STD rates for validation, 169-170, 398
success factors, 29
surveys reviewed for this report, 368-369
systematic errors, 392-393
telephone interviews, 29, 379-383
terms and concepts, 391-393
testing of, 29, 34
validity and reliability, 3~32, 33, 191,
361, 374, 393-394, 397-428, 429~40
see also Behavioral surveys; Data
collection; Methodological issues;
Serosurveys
Syphilis, 182, 199 n.79, 214, 267, 280, 420
see also Sexually transmitted diseases;
Genital lesions
Syringe exchange programs, see Sterile
needle programs
T
Teenagers, see Adolescents
Testing and counseling for HIV
for adolescents, 208, 232
alternative sites for, 327
at blood collection centers, 25, 317, 327
blood donation screening, 21, 23
and condom use, 97-98, 280
confidential versus anonymous, 102, 208
evaluation of, 97-98, 202
fear of, 95
as intervention for gay men, 86
as intervention for women, 20, 99-105
latency period and, 291, 304, 329
mandatory, 275, 279-280, 281-282
and perinatal transmission, 99, 100
of prostitutes, 275, 279-280, 281-282
sensitivity of tests, 23, 291, 323
sources of services, 97
Texas
adolescent IV drug users in, 189
HIV seroprevalence in, 40 n.3, 54 n.26
Toronto, sexual behavior of gay men ir
low-prevalence cities, 83 n.2
Tranquilizers, 190, 193
Transfusion recipients
AIDS cases among, 44, 49, 5~52, 55, 65,
291
female sexual partners of infected men,
5~52, 55, 65 67
Transmission of HIV
and active viral replication' 65 n.47
by adolescents, 161
in black and Hispanic subpopulations, 5
data needs on, 11~115
dmg use patterns and, 442
efficiency of, 69
ethnographic studies related to, 441 442
frequency of intercourse and, 66 n.47
gender and, 161-162
genital lesions and, 13, 177
by hemophiliacs, 83 n.3
horizontal with IV drug use, 40, 92-96
infectivity associated with later stages of,
83~4
male-male sexual contacts and, 441 442
misperceptions about, 209, 212-213
modes of, 39, 161-162
risk factors for adolescents, 12-13
risk factors for prostitutes, 17, 18-20
shifts in patterns of, 3
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INDEX | 495
vertical (perinatal), 40, 48, 63~4, 96-103
Treatment Outcome Prospective Study, 187
U
United States
AIDS cases in, 1, 42-43, 159
blood collection in, 292-297
blood utilization trends in, 26
epidemiological changes in AIDS in, =6,
43-48
hemophiliacs in, 52 n.18
University of California, San Francisco,
intervention for gay men, 8~87
University of Illinois, Chicago, health
promotion program, 220
University of Mississippi, intervention for
gay men, 86
U.S. Department of Health, Education, and
Welfare, 103
V
Vaginal intercourse
by adolescents, 12, 17~173
age of initiation, 12, 32, 33
by prostitutes, 260, 261-262
unprotected, 62
see also Heterosexual behavior
Vases
inactivation in blood supplies, 339
see also Hill listings
W
Washington, D.C., adolescent IV drug users
in, 189-191
Washington State
Seattle survey of sexual behavior, 381-382
sterile needle programs in, 124
Wisconsin, blood donation in, 300, 303
Women
adolescents, 56
age of initiation of sexual intercourse,
171-172
AIDS cases among, 40, 48~49, 52, 55, 161
blood donors, 24, 322-323, 326, 337
childbearing adolescents, 155-156, 166
condom use by, 8, 112, 179
counseling and testing in intervention
program, 35, 99-103
data sources on, 150
drug users, 46, 48, 49, 60~4
epidemic among, 48-67
frequency of sexual activity, 175
health care barriers for, 10, 94
HIV seroprevalence, 3, 4, 6-7, 24, 53-54,
56-59, 150, 155-1S6, 166
horizontal transmission interventions,
92-96; see also IV drug users
information needs on, 108
military applicants, 56
minorities, 40, 48, 54, 166
number of sexual partners, 176
outreach methods for, 93
prevention strategies for, 35, 92-105
relapse prevention for, 111
reproductive decison making, 99-101
risk profile, 24, 48-49, 92, 111, 161
sexual partners of hemophiliacs and
transfusion recipients, 49 n.l7, 65~6
sexual parmers of IV drug users, 3, 48, 49,
54 n.27, 61 n.34, 6~65, 92-96
social norms shift, 175
vertical transmission interventions, 7,
96-103; see also Perinatal transmission
see also Prostitutes; IV drug users
Wyoming, HIV seroprevalence in, 362
y
Youth, see Adolescents
z
Zidovudine, prophylactic use of, 43 n.6, 101
n.37, 108
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Representative terms from entire chapter:
drug users
