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PubMed2005

Drug selling among high school students: related risk behaviors and psychosocial characteristics.

PURPOSE: To identify risk behaviors and psychosocial characteristics associated with high school students' selling drugs. METHODS: In 2000, an anonymous standardized survey assessed substance use, drug selling and related risk factors (e.g., friends' use; messages about use) among high school students (n = 38,999) in a large metropolitan area. The sample was 51% female and included adolescents who were white (70%), African-American (18%), Asian (3.3%), Hispanic (1.7%) or who reported other ethnicities (7%). Logistic regression analyses examined whether selling drugs was associated with variables from different explanatory models, net of risk behavior and demographic characteristics. RESULTS: Twelve percent of students reported selling drugs in the past year. In the final logistic regression model, selling drugs was associated with being male, violence, delinquency and marijuana use. Students who sold drugs were less involved in religious and family activities but did not differ in their perceptions of, or participation in, school. Friends and school adults' support of substance use was associated with selling drugs, as was daily employment. Social competence, but neither purposeful planning nor self-efficacy, was associated with selling drugs. CONCLUSIONS: Despite popular perceptions, drug selling is not limited to out-of-school youth but occurs frequently among students who attend high school. School-based prevention efforts should discourage drug selling in order to reduce students' access to drugs and protect young people from the dangers associated with drug selling.

Adolescent↗
PubMed2005

Supportive relationships and sexual risk behavior in adolescence: an ecological-transactional approach.

OBJECTIVE: To examine the longitudinal associations between supportive relationships with friends and parents and sexual risk behavior in adolescence based on an ecological-transactional perspective. METHODS: Analyses were conducted on 2,652 sexually active adolescents from the first two waves of the National Longitudinal Study of Adolescent Health (Add Health). RESULTS: African-American adolescents had lower risk for sexual risk behavior. Supportive friendships and parent connectedness interacted in predicting decreased likelihood of sexual risk behavior. Mother-child communication about sex contributed to decreased likelihood of sexual risk only for girls. There were also small reciprocal effects of sexual risk behavior on decreased relationship quality over time. CONCLUSION: To better understand the parents' role in adolescent sexual risk behavior, multiple facets of parenting, the social contexts of parenting and adolescents' peers, and the effects of adolescents' behavior on these relationships should be taken into consideration.

Adolescent↗
PubMed2000

The potential role of an adult mentor in influencing high-risk behaviors in adolescents.

BACKGROUND: While mentorship programs, which connect adolescents with adults to whom they can turn to for help and advice, are proliferating in an attempt to prevent high-risk behaviors in teenagers, there are few data to show that mentorship actually makes a difference. OBJECTIVE: To determine if there is an association between having an adult mentor and high-risk behaviors in adolescents. HYPOTHESIS: Adolescents who have an adult mentor would be less likely to engage in high-risk behaviors than those without an adult mentor. DESIGN: Cross-sectional study. A self-administered, anonymous questionnaire was developed to assess demographics, involvement in risk behaviors, and the prevalence of a mentor in the life of a young person. PARTICIPANTS: A convenience sample of 294 adolescents, seen consecutively (93% of those approached), receiving outpatient medical care. Participants were predominantly female (68%), of mixed race/ethnicity, aged between 12 and 23 years (mean +/- SD age, 16.9 +/- 2.4), and from diverse socioeconomic backgrounds. SETTING: An adolescent health service in a suburban community-based teaching hospital. MAIN OUTCOME MEASURES: Adolescent smoking, alcohol and drug use, sexual practices, and weapon carrying. RESULTS: Adolescents with mentors were significantly less likely to participate in 4 of the 5 measured risk behaviors: ever carrying a weapon (odds ratio, 0.41; P< or =.01), illicit drug use in the past 30 days (odds ratio, 0.44; P< or =.01), smoking more than 5 cigarettes per day (odds ratio, 0.54; P< or =.05), and sex with more than 1 partner in the past 6 months (odds ratio, 0.56; P< or =.05). No significant difference was found with alcohol use (> or =3 drinks in the past 30 days). CONCLUSION: A strong positive relationship was found between adolescents having an adult mentor and decreased participation in 4 of the 5 risk behaviors evaluated.

Adolescent↗
PubMed1995

Concerns and risk behaviors and the association between them among high-school students in Jerusalem.

PURPOSE: To study the distribution, prevalence, determinants, and association between the health, social, and environmental concerns and risk behaviors of high school students in Jerusalem in order to provide a better basis for preventive and health promotion services. METHODS: 1078 tenth grade high school students, 15-16 years old answered an anonymous questionnaire including, perceived concerns and risk behaviors, (e.g., smoking, alcohol, drugs, and sexual activity). Concerns were grouped into six domains. RESULTS: The most frequently reported concerns related to school, weight, coping with aggression, fatigue, war, enlistment into army, and relationships with peers. Girls had more concerns in the domains of self-image, anxiety, and relationships with peers (p < .05). Adolescents with mothers who had less education had significantly more concerns in the domains of anxiety and relationships with peers and adults (p < .05). Forty-seven percent engaged in at least one risk behavior (boys 63% and girls 34%). The Guttman scalogram indicated the following sequence of risk behaviors: alcohol, cigarettes, sex, and drugs. There were statistically significant associations between concerns and risk behaviors in the domains of anxiety, sex, and relationships with adults and peers. CONCLUSION: Many adolescent concerns are universal, although the ranking and prevalence may vary based on different regional and population characteristics (e.g., in this population a high rate of concerns relating to aggression and war were identified). The results support the need to develop prevention and health promotion programs relating to the concerns and risk behaviors in the school and community, and individual counseling programs in primary care settings.

Adolescent↗
PubMed1997

Results from the 1995 National College Health Risk Behavior Survey.

Results from the 1995 National College Health Risk Behavior Survey, which monitored health risk behaviors among US college and university undergraduates, suggest that many students' behaviors increase their likelihood of adverse health outcomes. During the 30 days preceding the survey, 34% of the participants had consumed five or more alcoholic drinks on at least one occasion, and 27% had drunk alcohol and driven a car. Thirty-one percent had smoked cigarettes regularly during their lifetimes, 49% had ever used marijuana, 30% had used a condom during their last sexual intercourse, 21% were overweight, and 38% had participated in vigorous physical activity on 3 or more of the 7 days preceding the survey. These data were analyzed by gender, age group, race and ethnicity, and institution type. They can be used by those responsible for the health and education of college students to reduce risks associated with the leading causes of mortality and morbidity.

Adolescent↗
PubMed1998

HIV sex and drug risk behavior and behavior change in a national sample of injection drug and crack cocaine using women.

This paper describes HIV sex and drug risk behavior and behavior change of injection drug and crack cocaine using women enrolled in a national multi-site Cooperative Agreement program. Baseline data on the 1,403 women who were randomly assigned to a two session intervention that was standardized across sites indicate that sex and drug risk behavior for becoming infected with HIV was considerable. Six-month post intervention follow-up data for the same sample of women show that significant reductions in sex and drug risk behavior were observed for the entire sample of women for the risk variables under study. Significant reductions were also demonstrated for various sub-groups of women enrolled in the study on most of the sex and drug risk variables. Given these findings, it appears that the standard intervention was effective in assisting drug using women reduce their behaviors that put them at risk of becoming infected with HIV. Further research in needed on the development and evaluation of HIV interventions that target specific risk behaviors and various HIV risk behavior profiles of women.

Adult↗
PubMedDate not supplied

HIV serostatus and risk behaviors in a multisite sample of drug users.

In developing HIV prevention efforts, it is critical to determine whether interventions are effective in achieving declines in risk behavior among both HIV-positive and HIV-negative individuals. Based on a multisite intervention study of injection drug users (IDUs) and crack smokers, 488 seropositive IDUs and 364 seropositive crack users were compared with randomly selected matched samples of seronegatives (with matching based on recruitment site, gender, age group and ethnicity) at baseline and six-month follow-up to compare changes in risk behaviors by serostatus. Results indicated that overall, risk behaviors declined substantially over time; significant interaction effects indicated that seropositives reported a greater decline in sex risk behaviors than seronegatives. These data support the utility of HIV testing for high-risk drug users, and indicate that interventions have produced reductions in risk behaviors of both seropositives and seronegatives. Further research on the impact of site seroprevalence, and to enhance our understanding of those who continue to engage in risky behaviors, is needed.

Adolescent↗
PubMed2000

Tobacco use and other risk behaviors: cross-sectional and predictive relationships for adolescent orthodontic patients.

BACKGROUND: The purpose of these analyses was to examine the prevalence of selected substance abuse, general and dental health risk, and scholastic risk behaviors and their cross-sectional and predictive relationships with tobacco use among 15, 179 adolescent orthodontic patients in Southern California. METHODS: Subjects were recruited through 154 orthodontists' offices and interviewed by telephone at baseline and two-year posttest. RESULTS: Results show a pattern of increasing prevalence of risk behaviors with age. In most cases, gender differences were small. There were statistically significant positive relationships between each risk behavior and tobacco use status for both boys and girls. Prevalence rates of risk behaviors other than tobacco use were highest for current smokers, intermediate for experimenters, and lowest for respondents reporting that they had never used tobacco. Baseline tobacco use predicted each posttest risk behavior in logistic regression analyses. Principle components analysis (with varimax rotation) of posttest risk practices other than tobacco use yielded three theoretically meaningful factors, all which were predicted by baseline tobacco use in multiple regressions. CONCLUSIONS: These findings show that tobacco use among adolescents can predict subsequent risk practices other than tobacco use as long as two years, and that unhealthy behaviors among teens are interrelated. Orthodontists, who have a high frequency of adolescent patient contact, may be in a unique position to deliver health promotion interventions to their patients; possibly targeting multiple risk behaviors.

Adolescent↗
PubMed2000

The relationship between sexual abuse and sexual risk among high school students: findings from the 1997 Massachusetts Youth Risk Behavior Survey.

OBJECTIVE: To assess whether adolescents with a history of sexual abuse were more likely than those with no such history to engage in sexual risk behaviors. METHODS: Data for this study were obtained through the 1997 Massachusetts Youth Risk Behavior Survey, a self-report questionnaire administered to a representative sample of 9th through 12th graders (N = 4,014) to assess a variety of adolescent risk behaviors. Only sexually experienced adolescents (n = 1,610; female = 779, male = 831) were included in the present study. Logistic regression models were constructed to examine the relationship of sexual abuse history to sexual risk behaviors. Adolescents were considered as having a history of sexual abuse if they reported ever having had sexual contact against their will. RESULTS: Almost one-third of sexually experienced adolescent girls (30.2%) and one-tenth (9.3%) of adolescent boys reported a history of sexual abuse. After controlling for related demographics and risk behaviors, sexually abused female students were significantly more likely than those without such a history to have had earlier first coitus (OR = 2.2, 95%CI = 1.46-3.47), to have had three or more sex partners ever (OR = 2.5, 95%CI = 1.71-3.68), and to have been pregnant (OR = 1.9, 95%CI = 1.21-2.92). Sexually abused male students were significantly more likely than those without such a history to have ever had multiple partners (OR = 3.2, 95%CI = 1.56-6.57), to have had multiple sex partners in the past 3 months (OR = 2.9, 95%CI = 1.71-3.68), and to have engaged in sex resulting in pregnancy (OR = 3.4, 95%CI = 1.53-7.34). CONCLUSION: Both adolescent girls and boys with a history of sexual abuse report greater sexual risk-taking than those without such a history. However, although sexual abuse is more prevalent among girls than boys, the impact of sexual abuse on sexual risk appears to be even greater for boys. Programs addressing both sexual abuse and sexual risk must be made available to all adolescents.

Adolescent↗
PubMed2004

Depression and HIV risk behaviors among patients in a sexually transmitted disease clinic.

OBJECTIVE: The authors' goal was to investigate the relationship between depression and HIV risk behaviors or sexually transmitted disease (STD) diagnosis at an urban STD clinic. METHOD: Using audio computer-assisted self-interview, 671 STD clinic patients answered questions about HIV risk behaviors and depression in a large-scale, cross-sectional study. A subset of the patients (N=201) was evaluated for current major depressive disorder by interviewers using the nonpatient edition of the Structured Clinical Interview for DSM-IV. RESULTS: Depressed patients were more likely to have sex for money or drugs, to have had sex with an intravenous drug user, to have sex when "high" on alcohol or drugs, to have a greater number of lifetime sex partners, and to abuse alcohol or drugs than were nondepressed patients. Associations of HIV risk behaviors with depression persisted after adjustment for substance abuse. CONCLUSIONS: Depression in STD clinic patients is associated with HIV risk behaviors but not STD diagnosis. Identifying depression and developing strategies to intervene effectively may reduce HIV risk behaviors and improve health outcomes.

Adolescent↗
PubMed1999

Trends in HIV-related sexual risk behaviors among high school students--selected U.S. cities, 1991-1997.

Despite recent decreases in sexual risk behaviors among high school students nationwide, human immunodeficiency virus (HIV) infection was the seventh leading cause of death among persons aged 15-24 years in the United States during 1997. To determine whether the prevalence of HIV-related sexual risk behaviors among high school students also has decreased in certain urban areas heavily affected by the epidemic, CDC analyzed data from Youth Risk Behavior Surveys (YRBS) conducted in 1991, 1993, 1995, and 1997 in eight large-city school districts: Boston, Massachusetts; Chicago, Illinois; Dallas, Texas; Fort Lauderdale, Florida; Jersey City, New Jersey; Miami, Florida; Philadelphia, Pennsylvania; and San Diego, California. This report summarizes the results of this analysis, which indicate that, from 1991 to 1997, the percentage of high school students engaging in HIV-related sexual risk behaviors decreased in some U.S. cities.

Adolescent↗
PubMed1991

Behavioral risk factor surveillance, 1986-1990.

Since 1984, an increasing number of states (including the District of Columbia) have participated in the Behavioral Risk Factor Surveillance System (BRFSS). This report provides state-specific estimates of the prevalence of selected health-risk behaviors for the years 1986 through 1990. Apparent trends and progress toward several of the year 2000 national health objectives are discussed, both for the entire adult population (persons ages greater than or equal to 18 years) and selected high-risk demographic subgroups. Now that BRFSS includes 45 states and covers over 90% of the nation's adult population, it can be used both as a measure of state-specific risk factor prevalence and an indicator of national trends.

Adolescent↗
PubMed2005

HIV risk behavior among adults with severe mental illness: a systematic review.

Adults with severe mental illness (SMI) have been disproportionately affected by the HIV/AIDS epidemic. This systematic review of the empirical literature on SMI documents the prevalence and correlates of HIV risk behaviors, discusses clinical implications for HIV prevention, and recommends directions for future research. Prevalence rates of HIV risk behaviors were estimated using weighted means, and findings on correlates were synthesized. Across reviewed studies (N=52), the majority of adults with SMI were sexually active, and many engaged in risk behaviors associated with HIV transmission (e.g., unprotected intercourse, multiple partners, injection drug use). HIV risk behaviors were correlated with factors from the following domains: psychiatric illness, substance use, childhood abuse, cognitive-behavioral factors, and social relationships. A proposed model illustrates the multiple pathways linking these domains to HIV risk behavior. Further research using improved methodologies (e.g., longitudinal designs, standardized measures, multivariate analyses) is needed to examine the broader social context in which HIV risk behavior occurs and identify underlying processes. HIV prevention efforts targeting adults with SMI must occur on multiple levels (e.g., individual, group, community, structural/policy), address several domains of influence (e.g., psychiatric illness, trauma history, social relationships), and be integrated into existing services (e.g., psychotherapy, substance abuse treatment, housing programs).

Adult↗
PubMed2004

A prospective study of the impact of polygraphy on high-risk behaviors in adult sex offenders.

This study examined whether polygraph testing would result in sex offenders engaging in fewer high-risk behaviors. Fifty adult male sex offenders taking part in community treatment programs were allocated into 2 groups: "Polygraph Aware" subjects were told they would receive a polygraph examination in 3 months regarding their high-risk behaviors, while "Polygraph Unaware" subjects were told their behavior would be reviewed in 3 months. Relevant behaviors for each subject were established at baseline interviews, following which both groups were polygraphed at 3 months. All subjects were polygraphed again at 6 months. The hypothesis was that subjects in the "Polygraph Aware" group would have engaged in fewer high-risk behaviors, based on their self-report during the examination. Thirty-two subjects (64%) attended the first polygraph examination, with 31 (97%) disclosing an average of 2.45 high-risk behaviors each previously unknown to supervising probation officers. There was no significant difference between the two groups. Because of the high failure rate, all subjects were told to expect a second polygraph. Twenty-one subjects (42%) completed the second polygraph test, with 71% disclosing an average of 1.57 behaviors, a significant decrease compared with the first test. Disclosures to treatment providers and probation officers also increased. It was concluded that polygraph testing resulted in offenders engaging in less high-risk behavior, although the possibility that offenders fabricated reports of high-risk behaviours to satisfy examiners is also considered; similarly, offenders seemed to be more honest with their supervisors, but this only occurred after experience of the test itself. Feedback from offenders who completed the study, taken together with the high drop out rate, suggested that those motivated not to reoffend found polygraphy useful, while those less motivated sought to avoid it.

Adult↗
PubMedDate not supplied

Human immunodeficiency virus-related risk behavior among Italian psychiatric inpatients.

This study evaluated at-risk behavior for human immunodeficiency virus (HIV) infection among Italian psychiatric inpatients. One hundred patients with mental disorders consecutively admitted to an acute psychiatric unit over a 1-year period were studied using a self-report questionnaire. In these patients, 53.1% reported sex with multiple partners, 35.4% with occasional partners, 57% with prostitutes, and 6.7% with intravenous (i.v.) drug users (i.v.DUs). Forty-three percent never used condoms during sexual intercourse, 23% used drugs intravenously, and 20% shared needles. Only one third of the patients were tested for HIV, and two tested seropositive ([HIV+] prevalence, 5.8%). Most patients (62%) reported no concern about the risk of HIV infection. The rate of HIV risk behaviors was higher among psychiatric patients versus a control group of 90 healthy people. These findings indicate an alarming rate of HIV risk behaviors among Italian psychiatric inpatients and the need for closer attention to HIV assessment and education in mental health settings.

Adolescent↗
PubMed1996

Japanese risk behaviors and their HIV/AIDS-preventive behaviors.

This study is to identify the risk behaviors of the Japanese that may lead to HIV infection and the behaviors that prevent such infection, as well as their background factors. Two behavioral surveys were conducted for the present study. (1) For international comparison on knowledge, attitudes, beliefs, and practices (KABP) related to HIV/AIDS, we conducted a survey on a sample of 10,000 adults, randomly selected from a nationwide population in Japan; and (2) for sexual partner relation, we conducted a survey on a sample of 10,000 adults randomly selected from a population in five major cities of Japan. Our main findings include: (1) Most of the Japanese adult did not regard AIDS as a major threat in the area where they lived; (2) People in their twenties are too casual about "having sex without using a condom with someone they've met for the first time and know little about"; (3) Thirteen percent (19% male, 8% female) of those with a steady sex partner including a spouse, on average, had sex with 2.4 non-steady partners in the previous year; and (4) Only 25 percent used condoms always when they engaged in casual sex during the previous four weeks. These risk behaviors of the Japanese adults might lead to an explosive rise in the number of HIV-infected in the near future unless steps are taken immediately to prevent it.

Adult↗
PubMed2006

Determinants of HIV/AIDS risk behaviors in expectant fathers in Haiti.

Haiti has an HIV/AIDS epidemic of the highest magnitude outside of sub-Saharan Africa. Factors such as relationship power imbalances, traditional gender role acceptance, and patriarchal belief systems that devalue women's sexuality have increased Haitian women's vulnerability to HIV infection. Because of these influences and since the HIV epidemic is largely heterosexually transmitted, it is important to understand the role that men's beliefs and behaviors play in the continuing risk of young men and women in Haiti. The purpose of this study was to gather information from male community members through semi-structured interviews in order to describe the prevalence of HIV/AIDS risk behaviors (e.g., condom use, number of sexual partners) among expectant fathers in Haiti and identify predictive psychosocial variables of HIV/AIDS risk behaviors. Results from this study showed that men who were not married (OR = 0.22, p = 0.05) and men who had medium (OR = 22.50, p < 0.001) and high sexual communication (OR = 36.51, p < 0.001) were more likely to use condoms. This study also showed that high stigma associated with HIV (OR = 16.07, p < 0.05), low HIV knowledge (OR = 0.10, p < 0.01), and high decision making power (OR = 62.52, p < 0.001) were predictors of multiple sex partners for the expectant fathers in the sample. HIV prevention programs should be designed to increase knowledge about HIV transmission, treatment, prevention and personal risk of contraction as well as correct misconceptions about individuals with HIV or AIDS and promote sex communication among partners.

Adult↗
PubMed1998

Temporal trends in HIV risk behaviors of out-of-treatment injection drug users and injection drug users who smoke crack.

This study compared the baseline sociodemographic characteristics and HIV risk behaviors of two groups of out-of-treatment injection drug users (IDUs): 366 who concurrently smoked crack (smoking IDUs) and 212 who did not smoke crack (IDUs) in the past 30 days. Temporal trends in recent risk behaviors were also assessed for each drug user group over an 18-month period, January 1992 through June 1994. Baseline data were collected in South Philadelphia before the implementation of a multisite HIV intervention research project funded by the National Institute on Drug Abuse. For the temporal trend analysis, the sample was grouped into four intake periods based on the date of the baseline interview. The results indicated that although both groups were economically disadvantaged and at high risk of HIV infection and transmission, smoking injectors had fewer economic resources and were at a moderately greater risk because of higher levels of sexual risk behaviors. Analysis of temporal trends revealed few reductions in drug risk behaviors and none in sexual risk behaviors. This study points to the need for examining differences between types of drug users, developing appropriate multidrug treatment programs and assessing the characteristics of communities so that theory-based interventions can be tailored for maximum effectiveness.

Adult↗