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PubMed2005

Risk Perception and sexual risk behaviors among HIV-positive men on antiretroviral therapy.

There are reports of increased sexual risk behavior among people on highly active antiretroviral therapy (HAART) due to beliefs about risk of HIV transmission when on HAART. In a cross-sectional study (Seropositive Urban Men's Study), we examined the relationship between risk perception and sexual risk behavior among sexually active, culturally diverse HIV positive men who have sex with men (N = 456). Less than twenty-five percent engaged in unprotected anal sex (either with an HIV negative, or unknown-status partner, or an HIV positive partner) within the past 3 months. Most men believed there was significant health risk (to partner or self) associated with unprotected sex when on HAART. There was no increased risk behavior associated with being on HAART, although the perception of negative health consequences, including HIV transmission, when on HAART was significantly lower for the relatively small subset of men who reported unprotected sex. Prevention strategies need to be tailored to address risk perception associated with HAART.

Adult↗
PubMed1999

Risk behavior and HIV infection among new drug injectors in the era of AIDS in New York City.

OBJECTIVE: To examine HIV risk behavior and HIV infection among new initiates into illicit drug injection in New York City. DESIGN AND METHODS: Cross-sectional surveys of injecting drug users (IDUs) recruited from a large detoxification treatment program (n=2489) and a street store-front research site (n=2630) in New York City from 1990 through 1996. Interviews covering demographics, drug use history, and HIV risk behavior were administered; serum samples were collected for HIV testing. Subjects were categorized into two groups of newer injectors: very recent initiates (just began injecting through 3 years) and recent initiates (injecting 4-6 years); and long-term injectors (injecting > or = 7 years). RESULTS: 954 of 5119 (19%) of the study subjects were newer injectors, essentially all of whom had begun injecting after knowledge about AIDS was widespread among IDUs in the city. New injectors were more likely to be female and white than long-term injectors, and new injectors were more likely to have begun injecting at an older age (median age at first injection for very recent initiates, 27 years; median age at first injection for recent initiates, 25 years; compared with median age at first injection for long-term injectors, 17 years). The newer injectors generally matched the long-term injectors in frequencies of HIV risk behavior; no significant differences were found among these groups on four measures of injection risk behavior. HIV infection was substantial among the newer injectors: HIV prevalence was 11% among the very recent initiates and 18% among the recent initiates. Among the new injectors, African Americans, Hispanics, females, and men who engaged in male-male sex were more likely to be infected. CONCLUSIONS: The new injectors appear to have adopted the reduced risk injection practices of long-term injectors in the city. HIV infection among new injectors, however, must still be considered a considerable public health problem in New York City.

Adult↗
PubMed1996

HIV risk behaviors among women living in low-income, inner-city housing developments.

OBJECTIVES: This study describes the prevalence and predictors of human immunodeficiency virus (HIV) risk behaviors among women living in low-income, inner-city housing developments. METHODS: Anonymous questionnaires were administered to 671 women living in 10 inner-city, low-income housing developments in five US cities to determine their levels of HIV risk behavior and predictors of HIV risk practices. RESULTS: Approximately one third of women were at high risk for HIV because of the risk behavior of their sexual partners. HIV risk was highest among women who accurately perceived themselves to be at increased HIV risk, held strong beliefs about barriers to condom use, and reported weak behavioral intentions to reduce risk. Women at higher risk were also younger and reported higher rates of alcohol and substance use. CONCLUSIONS: HIV prevention efforts are needed for inner-city women. Interventions should focus on overcoming women's barriers to condom use, strengthening their intentions to change behaviors, and managing the risk related to their use of substances.

Adolescent↗
PubMed2006

Gender differences in health risk behaviors and physical activity among middle school students.

Adolescence is a period of accelerated growth and change, bridging the complex transition from childhood to adulthood. This period offers adolescents an opportunity to begin planning for their futures and to adopt healthy attitudes about risk behaviors that can continue into adulthood, thus setting the stage for a lifetime of desirable health behaviors. This study used the Youth Risk Behavior Survey on middle school students and examined the gender differences of health risk behaviors among 674 8th-graders from an urban setting. The results showed that males were more likely to be involved in fights, to initiate alcohol use, and to participate in physical activity; whereas females were more likely to try to lose weight with unhealthy practices, such as fasting and laxatives. School nurses are in a prime position to promote adolescent health in the school setting by providing health-related services and teaching to help students initiate and maintain healthy lifestyles.

Adolescent↗
PubMed2002

HIV prevention services in correctional drug treatment programs: do they change risk behaviors?

This study evaluated receipt of HIV prevention services in correctional substance abuse treatment programs and examined their impact on short-term risk behaviors. The authors performed a secondary analysis of the National Treatment Improvement Evaluation Study (NTIES), a prospective cohort study conducted during 1993 to 1995. The sample included 1,223 adult non-HIV-positive inmates, enrolled in nine correctional substance abuse treatment programs. A composite index modeled after the validated Risk Assessment Battery measured HIV risk behavior at treatment entry and at 12-month follow-up. Overall, most inmates received HIV prevention services while in treatment. Controlling for potential confounders, HIV prevention services were significantly associated with reduced risk behavior among inmates who were out of custody at follow-up, but no such association was observed among those still in custody. This analysis suggests that HIV prevention services are beneficial in reducing risk behavior among incarcerated individuals whose discharge is expected in the near future.

Adult↗
PubMed1995

Associations between diet and health behavior: results from the 1992 Rhode Island Behavioral Risk Factor Survey.

The 1992 Rhode Island Behavioral Risk Factor Surveillance System was used to assess self-reported health behaviors of consumers of finfish and raw shellfish. We hypothesized that consumers of finfish, foods considered to be healthy, were more likely than nonconsumers of finfish to partake in health-promoting behaviors. Similarly, we postulated that consumers of raw molluscan shellfish, foods linked to an elevated risk of acquiring various illnesses, were more likely than nonconsumers of raw-shellfish to partake in risk-taking behaviors. Finfish eaters were significantly more likely than abstainers to report recent exercise, efforts to lose weight, periodic monitoring of serum cholesterol, and not currently being smokers. Raw shellfish eaters were significantly more likely than abstainers to report recent acute and chronic alcohol consumption. The results suggest that inquiry into dietary patterns may be an avenue for exploring other health behaviors.

Adolescent↗
PubMed2003

Sexual at-risk behaviors of sexually abused adolescent girls.

The present study investigated sexual at-risk behaviors of sexually abused adolescent girls. Variables of interest were presence of consensual sexual activity, age at first consensual intercourse, number of sexual partners, condom use, and pregnancies. Participants were 125 sexually abused adolescent girls aged 12 to 17 years. Results showed that severity of sexual abuse (e.g., penetration, multiple perpetrators, physical coercion, multiple incidents of abuse) was related to a greater number of sexual at-risk behaviors. For instance, adolescents with a history of sexual abuse involving penetration were 13 times as likely to have been pregnant. Although family characteristics were significantly associated with being sexually active, their effect proved non-significant in the final hierarchical regression. Regression analyses clearly showed that the likelihood of engaging in sexual at-risk behaviors increased as a function of the number of severity factors.

Adolescent↗
PubMed1995

Trends in sexual risk behavior among high school students--United States, 1990, 1991, and 1993.

Since the early 1980s, adolescents in the United States have experienced high rates of unintended pregnancies (1) and sexually transmitted diseases (STDs) (2), including HIV infection (3). Since 1990, CDC's Youth Risk Behavior Surveillance System has enabled measurement of priority health-risk behaviors among high school students at the national, state, and local levels (4). This report examines data from the 1990, 1991, and 1993 national Youth Risk Behavior Survey (YRBS)* to describe trends in selected self-reported sexual risk behaviors among U.S. high school students.

Adolescent↗
PubMedDate not supplied

Profiles of self-reported HIV-risk behaviors among injection drug users in methadone maintenance treatment, detoxification, and needle exchange programs.

OBJECTIVE: Injection drug use has accounted for more than one third of acquired immune deficiency syndrome cases in the United States. The purpose of this study was to compare the demographic characteristics, types, and frequency of human immunodeficiency virus (HIV)-risk behaviors among injection drug users (IDUs) recruited from a needle exchange program (NEP), methadone maintenance treatment (MMT), and detoxification (detox) program. DESIGN: A cross-sectional, correlational design was used to determine whether the selected HIV-risk behaviors and demographic characteristics of IDUs varied by site of recruitment. SAMPLE AND MEASUREMENTS: Confidential questionnaires were completed by 445 IDUs in Philadelphia, Pennsylvania. RESULTS: Data analysis revealed that HIV sexual and injection-risk behavior varied by recruitment site. Subjects recruited from the NEP were more likely to engage in HIV-risk behaviors than subjects recruited from the MMT or detox sites. CONCLUSIONS: Interventions occurring in program and treatment sites need to be sensitive to various demographic characteristics and behaviors if they are to reach those at highest risk of HIV infection. Targeting HIV prevention interventions based upon risk group membership alone (e.g. IDUs) fails to address the distinct risk behaviors and demographic characteristics of enrollees in different programs.

Adult↗
PubMed1996

New Jersey college students' high-risk behavior: will we meet the health objectives for the year 2000?

The US Centers for Disease Control and Prevention developed the Youth Risk Behavior Survey to measure the health risk behavior of the nation's high school students and to measure progress toward meeting the national health objectives for the year 2000. The survey was adapted for college students and pilot tested in spring 1993 in 18 4-year public and private colleges in New Jersey. In this article, the authors summarize results from this survey regarding unmarried respondents' risk behavior, including sexual behavior, use of alcohol, drugs, and tobacco, and behaviors that may lead to intentional and unintentional injuries. These findings, when compared with the relevant national health objectives, suggest that New Jersey college students will meet the health objectives regarding tobacco and cocaine use but will not meet national targets set for condom and birth control use, alcohol and marijuana use, and seatbelt and bicycle helmet use.

Accidents, Traffic↗
PubMed2007

Diagnostic and other correlates of HIV risk behaviors in a probability sample of homeless adults.

OBJECTIVES: This study assessed the relationship between psychiatric disorders, including substance abuse and dependence, and risk behaviors for contracting HIV. METHODS: A probability sample of 218 homeless men and women were recruited from food programs and shelters assisting homeless individuals in an urban metropolitan community. Mood disorders, schizophrenia, and substance abuse and dependence diagnoses were assessed with the Diagnostic Interview Schedule (version 3A). Level of sexual activity and HIV risk behaviors (such as history of sexually transmitted diseases, ratio of protected sex, trading sex for money or drugs, sex with a prostitute, and sex under the influence of alcohol or drugs) also were measured. RESULTS: Substance abuse and dependence and the length of the homelessness episode at baseline were associated with the highest risk of engaging in HIV risk behaviors. However, there was no relationship between mood disorders, schizophrenia, and HIV risk behaviors. CONCLUSIONS: This study provides evidence that individuals who are homeless for extended periods and have a diagnosis of substance abuse or dependence may be especially vulnerable to engaging in risky sexual behaviors and contracting HIV. The findings highlight the importance of tailoring treatment programs to the specific needs of homeless individuals.

Adult↗
PubMed2005

An analysis of health promotion and risk behaviors of freshman college students in a rural southern setting.

This study described health promotion and risk behaviors of entering college students in a rural southern setting. A sample of 251 students completed the Health Promotion and Health Risk Survey during a testing period that included other academic surveys. Results indicated that participants believe they are in control of their health. In addition, participants reported that happiness and health were the most important personal values for them. When compared with the National College Health Risk Behavior data, participants in this study were significantly lower in many of the health risk behaviors.

Adolescent↗
PubMed2001

Dynamics of behavioral risk factors for HIV/AIDS: a 6-year prospective study of injection drug users.

This prospective study of 2960 injection drug users investigated the dynamic nature of HIV behavioral risk factors between 1988 and 1994. Behavioral risks were assessed semi-annually. Robust regression models of time-dependent covariates were used to identify longitudinal predictors of behavior change. Maintenance of risky behaviors varied over time, with risk reduction seen more among HIV infected participants than among HIV seronegatives. Those at highest risk for HIV transmission were least likely to cease engaging in these behaviors. Interventions staged according to risk behaviors, targeting incremental risk reduction rather than only promoting abstinence, may be more successful in reducing HIV transmission among drug injectors.

Acquired Immunodeficiency Syndrome↗
PubMed1995

The contribution of level of cognitive complexity and pubertal timing to behavioral risk in young adolescents.

PURPOSE: To determine the unique contributions of cognitive complexity and pubertal timing to participation in behavioral risk (substance use, sexual activity, school and legal problems) among young adolescents. DESIGN: Cross-sectional with cohort replication. METHODS: Two cohorts of middle school students in grades eight and nine in a midwestern school district completed a self-report questionnaire in 1987 and 1989. Measures of behavioral and emotional risk, cognitive complexity and pubertal timing relative to peers were included. RESULTS: Complete data were available for 817 and 796 students in each cohort year. Gender, race, level of cognitive complexity and pubertal timing each contributed significantly to the variance in behavioral risk independent of chronological age (P < .0001). Boys, whites, those at lower levels of cognitive complexity and those who began pubertal maturation earlier than peers, were at significantly greater risk. Adolescents who demonstrated higher levels of cognitive complexity and those who began puberty later compared to peers participated in a smaller array of risk behaviors, independent of chronological age. IMPLICATIONS: Pediatricians should consider adolescents at lower levels of cognitive complexity (concrete thinking) and those who begin puberty earlier at greater risk for participation in health risk behaviors. Preventive health counseling tailored to the needs of this group may be most beneficial.

Adolescent↗
PubMed1989

An objective test of AIDS risk behavior knowledge: scale development, validation, and norms.

Efforts to curtail the spread of AIDS emphasize changing risk practices. An objective measure of practical knowledge about AIDS risk behaviors can permit the more accurate assessment of the impact of such prevention programs. This paper describes the construction of a standardized 40-item test of AIDS risk behavior knowledge and presents data on the validity, reliability, and psychometric characteristics of the measure in addition to norms for several populations. Knowledge scores of risk behavior may serve as a useful dependent measure when evaluating the impact of applied or experimental AIDS prevention programs, especially with groups at potential risk for the syndrome.

Acquired Immunodeficiency Syndrome↗
PubMed2005

Trends of HIV risk behaviors in a cohort of injecting drug users and their sex partners in Miami, Florida, 1988-1998.

A cohort of 111 injection drug users (IDUs) and their sex partners was assessed in 1988 concerning risk behaviors for HIV and knowledge of HIV/AIDS. Ten years later, in 1998, the cohort was reassessed using the same instrument. All who were HIV negative in 1988 were retested by blood draw for antibodies to HIV. A paired analysis was utilized to determine individual changes in risk behaviors for three serostatus groups--those who remained HIV negative (long-term HIV negatives), seroconverters, and those positive in 1988 (long-term HIV positives). Incidence was twice as high for sex partners (37.5%) as for IDUs (18.0%). Drug and needle use risk behaviors, except crack use, showed decreases; sexual risk behaviors were less amenable to change. Knowledge significantly increased among the long-term HIV negatives and seroconverters but not among those HIV positive in 1988. This analysis demonstrates the need for continued intervention among IDUs and their sex partners.

Adult↗
PubMed2006

The dynamics of injection drug users' personal networks and HIV risk behaviors.

AIMS: While studies of the social networks of injection drug users (IDUs) have provided insight into how the structures of interpersonal relationships among IDUs affect HIV risk behaviors, the majority of these studies have been cross-sectional. The present study examined the dynamics of IDUs' social networks and HIV risk behaviors over time. DESIGN: Using data from a longitudinal HIV-intervention study conducted in Baltimore, MD, this study assessed changes in the composition of the personal networks of 409 IDUs. We used a multi-nomial logistic regression analysis to assess the association between changes in network composition and simultaneous changes in levels of injection HIV risk behaviors. Using the regression parameters generated by the multi-nomial model, we estimated the predicted probability of being in each of four HIV risk behavior change groups. FINDINGS: Compared to the base case, individuals who reported an entirely new set of drug-using network contacts at follow-up were more than three times as likely to be in the increasing risk group. In contrast, reporting all new non-drug-using contacts at follow-up increased the likelihood of being in the stable low-risk group by almost 50% and decreased the probability of being in the consistently high-risk group by more than 70%. CONCLUSIONS: The findings from this study show that, over and above IDUs' baseline characteristics, changes in their personal networks are associated with changes in individuals' risky injection behaviors. They also suggest that interventions aimed at reducing HIV risk among IDUs might benefit from increasing IDUs' social contacts with individuals who are not drug users.

Adolescent↗
PubMed2004

HIV infection and high-risk behaviors in opioid dependent patients: the Indian context.

Various risk behaviors promote the spread of HIV in drug addicts. Reflecting the substantial regional and geographic differences in the impact of HIV, its prevalence rates vary from country to country. In view of increasing reports of injection drug-uses (IDUs) from different parts of India, the study was aimed to examine and investigate the difference in prevalence rates of seropositivity between IDUs and non-IDUs in patients of drug dependence and to compare the pattern of risk behaviors due to sexual and drug use practice in IDUs and non-IDUs. A high HIV seroprevalence of 8.3% between IDUs and 1.8% in non-IDUs was found. The study findings suggest a trend towards drug-related risks being higher than sex-related risks in IDUs.

Adult↗