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Risk reduction strategies: definitions, assumptions and the difference between concept and practice Martin Holt Jeanne Ellard
Some definitions ,[object Object],[object Object]
Some assumptions ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Conceptual variation ,[object Object],Strategic positioning defined as Rosengarten, Race & Kippax (2000) ‘ Folk belief’ that HIV+/receptive, HIV-/insertive pattern less risky during UAI Van de Ven et al (2002) HIV+/receptive, HIV-/insertive pattern for UAIR and UAIC Kalichman et al (2007) HIV+/receptive, HIV-/insertive pattern for UAIR and UAIC and oral sex Dodge, Jeffries & Sandfort (2008) Avoiding unprotected sex and practising withdrawal (a case of not reading the literature?) Jin et al (2009) HIV-negative men always taking the insertive position for UAI (no reference to status of partner)
Conceptual variation ,[object Object],Serosorting defined as Suarez & Miller (2001) HIV disclosure/discussion and then UAI only with concordant partners Truong et al (2006)  Unprotected sex only with concordant  partners (disclosure/discussion not specified) Elford (2006)  HIV-positive men having concordant UAI (HIV-negative men excluded) Parsons et al (2006)  Actual  serosorting (HIV status is known) and  perceived  serosorting (status is assumed) Xia et al (2006) Concordant UAIC and UAIR (confusing serosorting with negotiated safety) Zablotska et al (2009) Serosorting for UAIC (as Suarez & Miller) and  seroguessing  (similar to Parsons et al’s perceived serosorting)
What’s in a name? ,[object Object],[object Object],[object Object],[object Object]
The gap between concept and practice ,[object Object],[object Object]
Assumptions of the ideal case ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Messy reality ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
The challenge ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Example: responding to HIV disclosure HIV-positive men, last occasion of anal intercourse with casual partner, e-male 2008 Protected AI Unprotected AI No disclosure 60% 40% Incidental disclosure – not concordant 82% 18% Incidental disclosure – concordant 29% 71% Sero-seeking, disclosure – not concordant n=1 n=0 Sero-seeking, disclosure – concordant 6% 94% Total 52% 48%
Example: responding to HIV disclosure HIV-negative men, last occasion of anal intercourse with casual partner, e-male 2008 Protected AI Unprotected AI No disclosure 72% 28% Incidental disclosure – not concordant 54% 46% Incidental disclosure – concordant 55% 45% Sero-seeking, disclosure – not concordant n=0 n=1 Sero-seeking, disclosure – concordant 61% 39% Total 65% 35%
HIV disclosure ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
HIV disclosure ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Summary/questions ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

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Risk reduction strategies: definitions, assumptions and the difference between concept and practice

  • 1. Risk reduction strategies: definitions, assumptions and the difference between concept and practice Martin Holt Jeanne Ellard
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  • 11. Example: responding to HIV disclosure HIV-positive men, last occasion of anal intercourse with casual partner, e-male 2008 Protected AI Unprotected AI No disclosure 60% 40% Incidental disclosure – not concordant 82% 18% Incidental disclosure – concordant 29% 71% Sero-seeking, disclosure – not concordant n=1 n=0 Sero-seeking, disclosure – concordant 6% 94% Total 52% 48%
  • 12. Example: responding to HIV disclosure HIV-negative men, last occasion of anal intercourse with casual partner, e-male 2008 Protected AI Unprotected AI No disclosure 72% 28% Incidental disclosure – not concordant 54% 46% Incidental disclosure – concordant 55% 45% Sero-seeking, disclosure – not concordant n=0 n=1 Sero-seeking, disclosure – concordant 61% 39% Total 65% 35%
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