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  • Title: Safe sex? Misconceptions, gender differences and barriers among injection drug users: a focus group approach.
    Author: Weiss SH, Weston CB, Quirinale J.
    Journal: AIDS Educ Prev; 1993; 5(4):279-93. PubMed ID: 8297708.
    Abstract:
    Heterosexual transmission is one factor involved in the spread of the human immunodeficiency virus (HIV) within the injection drug use (IDU) population and between IDU and non-IDU individuals. Insufficient information is currently available to reduce this heterosexual transmission. As a basis for designing a questionnaire aimed at the IDU population, we conducted 5 focus groups to collect information on knowledge of and attitudes toward safe sex as held by male and female IDUs in methadone treatment. We identified misconceptions related to HIV infection, condoms, and sexual behavior. We also found gender-based differences in knowledge and learning style. Also, while individuals felt a responsibility to prevent HIV transmission, they lacked sufficient control to do so. The wide range of responses on questions concerning sexually transmitted diseases (STDs), condoms, reproductive decisions, and methods of promoting safe sex provides a basis for developing a questionnaire designed to identify and target specific subgroups for educational intervention. Five focus groups were formed among 22 male and 16 female heterosexual intravenous drug users (IDUs) in February and March, 1991, at three methadone treatment centers in northern New Jersey. Discussion among seven to eight participants was stimulated by questions on attitudes toward and knowledge of sexual practices and sexually transmitted diseases, particularly HIV infection. The information served as part of preparations for the design of an HIV questionnaire for the IDU population. This paper reports on the focus group findings and identifies three areas of importance for questionnaire design and educational efforts: 1) misconceptions about HIV infection, condoms, and sexual terms; 2) gender differences in knowledge and learning style; and 3) the juxtaposition of awareness of responsibility with the lack of ability to use appropriate judgement. Participant characteristics were as follows: 59% Black males, 27% White males, and 14% Hispanic males, aged 20-43 years (mean of 35 years). Of the females aged 20-43 years (mean of 29 years), 44% were Black, 37% were White, and 19% were Hispanic. Most were HIV seronegative. Misconceptions existed about condoms and HIV transmission. Misconceptions traveled easily among peers. The answers to questions reflected a diversity of understanding. A variety of educational messages and approaches must be designed for specific subgroups within the drug using population. The recommendations are to use a variety of educational messages, to try to reach men, and to conduct research for finding out common characteristics of intravenous drug users who do not use condoms. Findings are reported by each of the ten questions asked. Questions pertain to why people do not use health care, what are sexual diseases, what is sexual protection, what is a condom, how to use or request use of condom, how to prevent having children, what protection is possible for couples when one member is HIV positive, what are some common sexual terms, and what can be done to prevent HIV infection.
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