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PubMed2005

Alcohol use and HIV risk behaviors among HIV-infected hospitalized patients in St. Petersburg, Russia.

PURPOSE: Russia has high per capita alcohol consumption and an injection-drug-use-driven HIV epidemic. However, the role of alcohol in the spread of HIV infection in Russia is largely unexplored. Thus, we assessed recent alcohol use and associated HIV risk behaviors among HIV-infected persons in St. Petersburg, Russia. METHODS: We recruited HIV-infected hospitalized patients from the Botkin Infectious Disease Hospital between June 2001 and March 2002. Interviewers assessed alcohol and drug use with the addiction severity index (ASI) and sex- and drug-risk behaviors with the risk assessment battery (RAB). Lifetime abuse or dependence diagnoses for alcohol and drugs were established by a physician with addiction medicine training. RESULTS: Among 201 subjects, diagnoses of abuse or dependence (AB/DEP) were common: 9% (19/201) had only alcohol AB/DEP; 39% (78/201) had alcohol and drug AB/DEP; 47% (95/201) had only drug AB/DEP; and 4% (9/201) had no diagnosis of alcohol or drug AB/DEP. Sex- and drug-risk behaviors varied significantly by substance use diagnosis. Subjects with any alcohol AB/DEP had higher sex-risk RAB scores than those with drug only AB/DEP (6.1 versus 3.9, p<.0001). Among subjects with any diagnosis of drug AB/DEP, having in addition an alcohol diagnosis was associated with unclean needle use in the last six months (33% (26/78) versus 21% (20/95), p=0.08). CONCLUSIONS: Lifetime alcohol diagnoses of abuse or dependence were present in nearly one-half of hospitalized HIV-infected patients in St. Petersburg, Russia and were associated with significantly higher sex-risk behaviors and borderline significantly higher drug-risk behaviors. As HIV infection spreads rapidly in Russia and Eastern Europe, these data support the need for HIV risk-reduction interventions in alcohol abusing populations and raise the potential of benefit by addressing alcohol use in HIV-infected populations.

Adult↗
PubMed1993

HIV knowledge, communication, and risk behaviors among white, Chinese-, and Filipino-American adolescents in a high-prevalence AIDS epicenter: a comparative analysis.

We conducted a comparative analysis of human immunodeficiency virus (HIV) knowledge, communication, and risk behaviors among 1272 white, Chinese-, and Filipino-American 10th and 11th graders in San Francisco, California, a high-prevalence AIDS epicenter. We performed principal components analysis on an epidemiologic survey instrument, and we identified five factors: HIV prevention knowledge, sexual behavior risk index, drug use risk index, HIV misconceptions, and communication about HIV. White students had higher HIV prevention scores than did Chinese and Filipino students, and whites had significantly greater ability to communicate with others about HIV disease and prevention. Chinese- and Filipino-American students had fewer misconceptions about HIV than did white students. Ethnicity did not have a significant influence on sexual behavior or drug use risk indices. Findings are discussed with reference to culturally sensitive HIV education.

Adolescent↗
PubMed1999

Gender differences in risk behaviors among adolescents who experience date fighting.

OBJECTIVE: Although dating violence frequently begins during adolescence, few studies have focused on date fighting in middle and high school students. Fewer studies have studied gender differences in date violence. This study examines whether gender-specific patterns of risk behaviors exist among adolescents who report date fighting. DESIGN: The study was conducted on data collected from 21 297 students in grades 8 through 12 participating in the Vermont 1995 Youth Risk Behavior Survey. Data were analyzed on 20 724 students (females = 50.1%) who reported: 1) never having been involved in a physical fight (n = 8737); 2) that their last physical fight was with a girlfriend, boyfriend, or other dating partner (n = 432); and 3) that their last fight was with someone other than a dating partner (n = 11 555). Indicators of violence (weapon carrying, being threatened, and fighting), suicide attempts, substance use, sexual behavior, and pregnancy were analyzed with chi(2) tests. Significant variables were analyzed with stepwise logistic regression. RESULTS: Of the males, 1.8% and of the females, 4.2% reported that their last fight was with a boyfriend, girlfriend, or dating partner. Risk behaviors significantly associated among females who only experienced date fighting included the number of male sexual partners in the past 3 months (adjusted odds ratio: 1. 48; 95% confidence interval: 1.26-1.74), number of suicide attempts in the past 12 months (1.55; 1.30-1.85), riding in a car with a drinking driver (1.23; 1.10-1.37), injection of illegal drugs (2.87; 1.10-7.50), use of alcohol before last sexual encounter (1.53; 1. 27-1.86), number of pregnancies (1.66; 1.26-2.21), forced sex (2.92; 2.18-3.91), and inhalant use (1.19; 1.06-1.34). Risk behaviors significantly associated among males who experienced only date fighting were sexual activity (4.11; 2.24-7.53), number of male partners in the past 3 months (1.40; 1.12-1.75), number of times of getting someone pregnant (1.68; 1.17-2.40), experiencing forced sex (2.38; 1.11-5.13), and the number of times threatened with physical violence in past 12 months (1.82; 1.53-2.17). When compared with adolescents who reported fighting with someone other than a date, risk factors significantly associated with date fighting among females were the number of male sexual partners in the past 3 months (1.21; 1.10-1.34), older age (1.21; 1.10-1.34), carrying a weapon in the past 30 days (.77;.66-.90), experiencing forced sex (1.70; 1. 30-2.22), condom non-use (1.96; 1.60-2.41), and number of times of being threatened with physical violence in past 12 months (1.11; 1. 01-1.22). The risk factors among males were the number of male sexual partners in the past 3 months (1.43; 1.28-1.60), experiencing forced sex (1.91; 1.02-3.60), and older age (1.34; 1.14-1.57). CONCLUSIONS: The patterns of risk behaviors differed among male and female adolescents reporting dating violence. Females who reported date fighting were more likely than were nonfighters to have attempted suicide, to engage in sexual and human immunodeficiency virus risk behaviors (use of injectable drugs), to have been pregnant, experienced forced sex, and to have ridden in a car with a drinking driver. Sexual behaviors, including same-gender sexual partners, forced sex, and having been threatened with physical violence, were associated with date fighting among males. These findings are important in screening adolescents at risk for date violence.date fighting, adolescence, risk behaviors, gender.

Adolescent↗
PubMed1998

Demographic characteristics, unreported risk behaviors, and the prevalence and incidence of viral infections: a comparison of apheresis and whole-blood donors. The Retrovirus Epidemiology Donor Study.

BACKGROUND: The demographics, deferrable risk behaviors, and the prevalence and incidence of viral infections of apheresis (PH) and whole-blood (WB) donors were compared, to characterize these two populations and to evaluate the relative safety of PH and WB donors in terms of transfusion-transmitted viral infections. STUDY DESIGN AND METHODS: A comparison was made of 36,119 PH donors (> or = 1 PH donation) and 1.38 million WB donors (> or = 1 WB donation) in terms of demographics and the prevalence (/100,000 donors) and incidence (/100,000 person-years) of viral infections, by using data collected at five United States blood collection centers between 1991 and 1994. Deferrable risk behaviors were defined as those risk behaviors that would have resulted in donor deferral, had they been reported. The prevalence of deferrable risk behaviors was estimated by using data collected through an anonymous mail survey. RESULTS: PH donors were older and more likely than repeat (2+ donations) WB donors to be female, white, and United States-born and to have a higher degree of education (p < or = 0.001). The prevalence of any viral infection was 50 percent higher in WB donors than in PH donors (p = 0.04), whereas the incidence of HIV, human T-lymphotropic virus, and hepatitis B surface antigen was nonsignificantly higher in WB donors. The prevalence of deferrable risk behaviors did not differ in the two groups. CONCLUSION: Further studies will be needed to evaluate whether the difference in the prevalence of viral infections observed in this study can be explained by demographic characteristics and patterns of donation frequency.

Blood Component Removal↗
PubMed1992

Living arrangements, knowledge of health risks, and stress as determinants of health-risk behavior among college students.

The association of knowledge of health risks, living arrangements, and perceived stress with health-risk behaviors was examined in a sample of college students included in the Health Promotion and Disease Prevention Supplement of the National Health Interview Survey. Regressions of each health-risk behavior (dependent variable) were performed on the predicted correlates. Although knowledge was not associated with participation in physical activity or smoking, the study found that students who knew more about the harmful effects of alcohol drank less, and those with greater knowledge of health risks practiced fewer risky behaviors. Students living independently were more likely to smoke, and those living in residence halls were less like to do so. Drinking, however, was more common among students living in residence halls or independently than among those living at home. Hall residents engaged in more group physical activity than other students did, but their physical activity was unrelated to health-risk behaviors. Stress was associated with smoking but not with other health practices. The findings suggest that smoking may be less influenced by health knowledge and more associated than drinking is with a response to stress. Drinking appears to be a social activity associated with living among peers and is potentially modifiable by increased knowledge about the effects of alcohol on health.

Adolescent↗
PubMed2002

Associations between health risk behaviors and opposite-, same-, and both-sex sexual partners in representative samples of vermont and massachusetts high school students.

OBJECTIVE: To examine associations between health risk behaviors and sexual experience with opposite-, same-, or both-sex partners in representative samples of high school students. DESIGN: We used 1995 and 1997 data from the Vermont and Massachusetts Youth Risk Behavior Surveys. Logistic regression and multiple regression analyses were used to compare health risk behaviors among students who reported sex with opposite-sex partners only (opposite-sex students), with same-sex partners only (same-sex students), and with both male and female sexual partners (both-sex students). SETTING: Public high schools in Vermont and Massachusetts. PARTICIPANTS: Representative, population-based samples of high school students. The combined samples had 14 623 Vermont students and 8141 Massachusetts students. MAIN OUTCOME MEASURE: Violence, harassment, suicidal behavior, alcohol and other drug use, and unhealthy weight control practices. RESULTS: In both states, both-sex students were significantly more likely to report health risk behaviors than were opposite-sex students. For example, both-sex students had odds 3 to 6 times greater than opposite-sex students of being threatened or injured with a weapon at school, making a suicide attempt requiring medical attention, using cocaine, or vomiting or using laxatives to control their weight. In both states, same-sex students were as likely as opposite-sex students to report most health risk behaviors. CONCLUSION: Relative to opposite- and same-sex students, both-sex students may be at elevated risk of injury, disease, and death by experiencing serious harassment and engaging in violence, suicidal behavior, alcohol and other drug use, and unhealthy weight control practices.

Adolescent↗
PubMed2004

Adolescent sexual victimization, use of alcohol and other substances, and other health risk behaviors.

PURPOSE: To examine the relationship between substance use, other health risk behaviors, and sexual victimization among adolescent females. METHODS: A cross-sectional telephone survey of 16-20-year-olds, including 647 female "ever drinkers" (1999) and 1236 female "never drinkers" and "ever drinkers" (2000) from 17 states, was conducted as part of the National Evaluation of the Enforcing Underage Drinking Laws Program. The survey assessed underage alcohol use, sexual victimization, and other risky behaviors. Logistic regression modeling was used to measure the association among sexual victimization, substance use, and other risk behaviors. RESULTS: In 1999, 8.2% and in 2000, 7.1% of the participants reported having experienced actual or attempted sex against their will. Logistic regression analyses revealed that binge drinking in the past 2 weeks (1999), age at first drink (2000), sex without birth control (1999 and 2000), marijuana use in the past 30 days (1999 and 2000), and ever having been in a fight (2000) were associated with sexual victimization. CONCLUSIONS: Indicators of substance abuse and other health risk behaviors were strongly associated with sexual victimization among adolescent females. Implications for the direction of causal relationships are discussed.

Adolescent↗
PubMedDate not supplied

Evaluating content validity and test-retest reliability of the children's health risk behavior scale.

OBJECTIVE: Describe the instrument development process and report the validity and reliability of the Children's Health Risk Behavior Scale (CHRBS), a scale designed to screen for health risk behaviors among youth aged 10-13 Years. METHODS: Domain identification and item generation using the Youth Risk Behavior Surveillance Survey from the Centers for Disease Control and Prevention and testing relevance and test-retest reliability among a target audience sample of 77 fifth graders in their classrooms in two separate public school districts. RESULTS: Youth performed their tasks as expert item reviewers effectively. Twenty-one items comprise the CHRBS with a reading level determined to be at the third grade. CONCLUSIONS: We have developed a reliable and valid measure to assess late elementary youth's participation in health risk behavior.

Adolescent↗
PubMed2000

Prevalence of health risk behaviors among Asian American/Pacific Islander high school students.

PURPOSE: [corrected] To compare the prevalence of selected risk behaviors among Asian American/Pacific Islander (AAPI) students and white, black, and Hispanic high school students in the United States. METHODS: The national Youth Risk Behavior Survey conducted in 1991, 1993, 1995, and 1997 by the Centers for Disease Control and Prevention produced nationally representative samples of students in grades 9 through 12 in all 50 states and the District of Columbia. To generate a sufficient sample of AAPI students, data from these four surveys were combined into one dataset yielding a total sample size of 55, 734 students. RESULTS: In the month preceding the survey, AAPI students were significantly less likely than black, Hispanic, or white students to have drunk alcohol or used marijuana. AAPI students also were significantly less likely than white, black, or Hispanic students to have had sexual intercourse; however, once sexually active, AAPI students were as likely as other racial or ethnic groups to have used alcohol or drugs at last intercourse or to have used a condom at last intercourse. AAPI students were significantly less likely than white, black, or Hispanic students to have carried a weapon or fought but were as likely as any of the other groups to have attempted suicide. CONCLUSIONS: A substantial percentage of AAPI students engage in risk behaviors that can affect their current and future health. Prevention programs should address the risks faced by AAPI students using culturally sensitive strategies and materials. More studies are needed to understand the comparative prevalence of various risk behaviors among AAPI subgroups.

Adolescent↗
PubMedDate not supplied

Determinants of risk behavior for human immunodeficiency virus/acquired immunodeficiency syndrome in people with severe mental illness.

We examined the prevalence and correlates of human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) risk behaviors in a large sample of severely mentally ill (SMI) patients. Risk levels were correlated with demographic factors, diagnosis, symptom severity, trauma history, post-traumatic stress disorder (PTSD), substance use disorder (SUD), and sexual orientation. SMI clients from urban and rural settings (N = 275) were assessed regarding HIV/AIDS risk behaviors, and hypothesized risk factors. Patients exhibited substantial levels of risky behavior, particularly sexual risk. Correlates of increased risk included SUD, trauma, male homosexual orientation, younger age, and symptom severity. Structural equation modeling identified SUD and sexual orientation as the primary determinants of both drug and sexual risk behavior. We conclude that specific illness related variables appear to have less impact on risk behavior among people with SMI than previously hypothesized. Substance abuse prevention and treatment may be the most effective means of reducing HIV risk in this population.

Acquired Immunodeficiency Syndrome↗
PubMed2005

Patterns of sexual risk behavior change among sexually transmitted infection clinic patients.

Effective interventions to reduce sexually transmitted infection (STI) risk behaviors are most potent in the short term and are not uniformly effective for all people. The present study examined patterns of sexual behavior change among 238 men and 104 women who received risk reduction counseling in a public STI clinic and were followed for 9 months with a 1-year retrospective clinic chart abstraction for newly diagnosed STI. A two-stage, multivariate cluster analysis was performed on four risk behavior difference scores (follow-up - baseline) for 1-month, 3-month, 6-month, and 9-month follow-up frequencies of unprotected vaginal and anal intercourse. Cluster analysis identified three profile subgroups: Subgroup 1 had lower levels of risk behavior at all time points; Subgroup 2 had significant reductions in risk over time; and Subgroup 3 demonstrated significant increases in risk over time. Analyses on variables external to the cluster analysis found that the three profile subgroups differed on numbers of sex partners, substance use, sensation seeking, indicators of risk reduction motivation and behavioral skills, and contracting new STI. STI clinic patients with varying profiles of sexual behavior change were, therefore, differentiated by factors relevant to STI interventions.

Adult↗
PubMed1992

Risk behavior in malaria in Malaysia.

The risk behavior in malaria has been identified as one of the factors contributing to malaria in Malaysia. The occurrence of malaria among illegal immigrants and indigenous groups, staying in risk prone areas where conditions are favorable for transmission, highlights the behavior pattern of these groups. In these areas the usual anti-malarial activities are less effective and thus there is a need to identify control measures suited to that particular condition and environment and to community groups. Some of the determinants contributing to the increase in malaria cases like man-vector contact, non-compliance to drugs, complications of the disease, and factors interfering with malaria control measures, factors favoring transmission and proposals to modify risk behavior, which can be applied in an endeavor to control the diseases, have been discussed.

Communicable Disease Control↗
PubMed1996

Risk behaviors, self-efficacy, and AIDS prevention among adolescents.

This study was conducted to investigate risk behaviors and AIDS-preventive variables in high school adolescents. One hundred fifty-two students in Grades 10 through 12 were administered an AIDS-related behavior questionnaire and the Attitudes Toward AIDS Scale-High School Version (ATAS-HS; Goh, 1992). The results indicated that use of alcohol was far more common than other risk behaviors among the respondents. Rates of sexual intercourse and intravenous drug use were significantly lower than those reported in other research. Self-efficacy was significantly related to AIDS-preventive behavioral intentions, perceived knowledge, and measured knowledge about AIDS. Because the AIDS-preventive variables functioned differently in their relationships to sexual practices, the correlations suggest a pattern of co-occurrence between specific behavior intentions and actual AIDS-preventive behaviors (i.e., sexual experience, use of condoms). In addition, significant gender and grade differences were found on selected risk behaviors and AIDS-preventive variables.

Acquired Immunodeficiency Syndrome↗
PubMed2002

Reliability of the 1999 youth risk behavior survey questionnaire.

PURPOSE: To assess the test-retest reliability of the 1999 Youth Risk Behavior Survey (YRBS) questionnaire. METHODS: A sample of 4,619 male and female high school students from white, black, Hispanic, and other racial/ethnic groups completed the YRBS questionnaire on two occasions approximately two weeks apart. The questionnaire assesses a broad range of health risk behaviors. This study used a protocol that maintained anonymity yet allowed matching of Time-1 and Time-2 responses. The authors computed a kappa statistic for the 72 items measuring health risk behaviors, and compared group prevalence estimates at the two testing occasions. RESULTS: Kappas ranged from 23.6% to 90.5%, with a mean of 60.7% and a median of 60.0%. Kappas did not differ by gender, grade, or race/ethnicity of the respondent. About one in five items (22.2%) had significantly different prevalence estimates at Time 1 vs. Time 2. Ten items, or 13.9%, had both kappas below 61% and significantly different Time-1 and Time-2 prevalence estimates. CONCLUSIONS: Overall, students appeared to report health risk behaviors reliably over time, but several items need to be examined further to determine whether they should be revised or deleted in future versions of the YRBS.

Adolescent↗
PubMed2003

HIV and STD risk behavior among 18- to 25-year-old men released from U.S. prisons: provider perspectives.

Ninety-seven service providers, representing 83 agencies, were interviewed about sexual and drug use HIV/STD risk behaviors and their determinants among young men who have been released from prison. Providers believed that men frequently practiced sexual risk behavior, often in conjunction with substance use. Individual determinants of risk behavior primarily focused on "making up for lost time," being a man, degree of HIV/STD knowledge and vulnerability, desire to escape, and future orientation. Peers, partners, and family were portrayed as strong interpersonal influences on risk behavior, both positively and negatively. The dominant contextual determinant of risk behavior was the co-occurrence of sex and drug use. Structural determinants of reduced risk included stable housing, economic sufficiency, and positive community support for safer behavior (e.g., drug treatment access, needle exchange). The findings highlight the need for comprehensive, transitional case management for young men as they reintegrate into the community, including HIV/STD prevention.

Adolescent↗
PubMed2006

Family dinner meal frequency and adolescent development: relationships with developmental assets and high-risk behaviors.

PURPOSE: To examine associations between family meal frequency and developmental assets and high-risk behaviors among a national sample of adolescents. METHODS: Anonymous surveys were distributed to 99,462 sixth to 12th grade students from public and alternative schools in 213 cities and 25 states across the United States. Logistic regression analyses tested differences in assets and high-risk behaviors by family dinner frequency. RESULTS: Consistent positive associations were found between the frequency of family dinners and all developmental assets, including both external (e.g., support, boundaries and expectations; odds ratio [OR] 2.1-3.7) and internal assets (e.g., commitment to learning, positive values, social competencies, and positive identity; OR 1.8-2.6); relationships were attenuated, but remained significant after adjusting for demographics and general family communication and support. Consistent inverse relationships were found between the frequency of family dinners and all high-risk behaviors measured (i.e., substance use, sexual activity, depression/suicide, antisocial behaviors, violence, school problems, binge eating/purging, and excessive weight loss; OR .36-.58), relationships were attenuated, but remained significant after adjusting for demographics and family factors. CONCLUSIONS: The findings of the present study suggest that the frequency of family dinner is an external developmental asset or protective factor that may curtail high-risk behaviors among youth. Creative and realistic strategies for enhancing and supporting family meals, given the context within which different families live, should be explored to promote healthy adolescent development. Family rituals such as regular mealtimes may ease the stress of daily living in the fast-paced families of today's society.

Achievement↗
PubMed2006

Risk behaviors of 15-21 year olds in Mexico lead to a high prevalence of sexually transmitted infections: results of a survey in disadvantaged urban areas.

BACKGROUND: Due to the fact that adolescents are more likely to participate in high-risk behaviors, this sector of the population is particularly vulnerable to contracting sexually transmitted infections (STIs) and resultant health problems. METHODS: A survey was carried out among adolescents from poor homes in 204 small-urban areas of Mexico. Information was collected in relation to risk behaviors and socio-economic environment. A sub-group of the participants also provided blood and urine samples which were analyzed to detect sexually transmitted infections. RESULTS: The presence of Chlamydia was detected in nearly 8% of participants who had stated that they were sexually active (18%) and approximately 12% were positive for herpes type 2-specific antibodies. For both, a greater proportion of girls resulted positive compared to boys. The presence of these biological outcomes of sexual risk behavior was associated with other risk behaviors (smoking), but not with self-reported indicators of protected sex (reported use of condom during most recent sexual activity). CONCLUSION: The results presented in this study show a startlingly high prevalence of HSV-2 among sexually active Mexican adolescents in poor urban areas, suggesting that this group has participated to a great extent in risky sexual practices. The relationships between socioeconomic environment and adolescent risk behavior need to be better understood if we are to design preventive interventions that modify the determinants of risk behaviors.

Adolescent↗
PubMed1999

Changes in HIV-related risk behaviors following drug abuse treatment.

OBJECTIVES: To measure changes in HIV-related injection drug and sexual risk behaviors following drug treatment in a therapeutic community program. METHODS: We conducted a prospective cohort study of 261 drug users, randomly assigned to day or residential treatment. Participants were interviewed 2 weeks after entering treatment and 6, 12 and 18 months later (follow-up rate: 83%). RESULTS: Greater reductions in injection risk behaviors were associated with more time in treatment and the later waves of measurement. Wave was also associated with a reduction of sexual risk behavior. CONCLUSIONS: Drug abuse treatment was associated with a decrease in HIV-related risk behavior.

Adult↗