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PubMed2006

Ecological factors associated with STD risk behaviors among detained female adolescents.

The authors used Bronfenbrenner's conceptual framework of an ecological systems model to examine factors that are independently associated with sexually transmitted disease (STD) risk behaviors among 280 sexually active detained female adolescents. Using computer-assisted self-interviewing procedures, the authors assessed individual characteristics, peer relations, community factors, and media influences and their association to STD risk behaviors. Findings indicated that factors such as greater substance use, stronger risk-taking attitudes, lower perceived parental monitoring and familial support, gender roles supporting male dominance, risky peer norms, and lower student-teacher connectedness, were independently associated with increased STD risk behaviors. Findings suggest a multisystemic approach to STD prevention among this population.

Adolescent↗
PubMed2001

The relation between beliefs about drug treatments for HIV and sexual risk behavior in gay and bisexual men.

This study examined the relation between gay and bisexual men's (N = 575) beliefs about highly active antiretroviral therapy (HAART) and other HIV-related beliefs, intentions, and risk behaviors. Confirmatory factor analysis verified three belief factors: the extent to which HAART improves health among HIV-infected individuals, decreases the risk of HIV transmission, and is complicated and of limited efficacy. Men who endorsed the belief that HAART decreases HIV transmission risk expressed lower intentions to use condoms for anal sex and were more likely to have engaged in unprotected anal intercourse with a casual partner HIV-negative men who believed that HAART decreases transmission risk also perceived themselves to be more susceptible to HIV infection. Statistical evidence indicated that perceptions of susceptibility partially mediate the relation between sexual risk behavior and beliefs about HAART suggesting that beliefs may result from, rather than cause, increased risk behavior.

Adult↗
PubMed2001

A YRBS survey of youth risk behaviors at alternative high schools and mainstream high schools in Hong Kong.

In Hong Kong, prevocational schools serve as an alternative to mainstream schools to provide education with more emphasis on practical and technical subjects. In this paper, health-risk behaviors of prevocational school (PVS) students were identified, and comparisons of health-risk behaviors with or without adjusting the demographic factors from prevocational schools and mainstream schools were made. The PVS students were at higher risk for most categories of health-risk behaviors such as unintentional and intentional injuries, smoking, alcohol drinking, glue sniffing, inadequate physical activity, insufficient consumption of fresh fruits and vegetables, and early sexual activity with multiple partners. Female students of PVS reported higher prevalence of emotional problems and substance abuse. Findings suggest that the school environment is an influential factor on the lifestyle behavior of students. Comprehensive health education and intervention programs are needed for youth in Hong Kong prevocational schools.

Adolescent↗
PubMed2001

Association of alcohol consumption with HIV sex- and drug-risk behaviors among drug users.

The relationship between alcohol use and HIV transmission is well recognized but not fully understood. In particular, the role of alcohol abuse as a mediator of HIV risk behavior among drug users is not well documented. We hypothesized that alcohol use in drug users will result in greater HIV risk-taking behavior. Participants were 354 drug users, of whom 105 were recent injection drug users. Multiple regression models were used to characterize whether measures of sexual and injection drug use HIV risk behavior were related to alcohol consumption, controlling for other potentially associated factors. We found that sexual HIV risk-taking behavior is associated with increased alcohol consumption among women (p = 0.02), with women having more risky sexual behavior than males. However, contrary to our hypothesis, there was no significant association of alcohol consumption with risky injection drug behavior. Addressing alcohol problems among drug users, particularly women, may be an important opportunity to reduce HIV sexual risk behavior among this high-risk population.

Adult↗
PubMed2006

Methamphetamine use, impulsivity, and sexual risk behavior among HIV-positive men who have sex with men.

This study examined impulsivity as a moderator of the relationship between meth use and sexual risk behavior in a sample of HIV-positive meth-using Men who have Sex with Men (MSM). Higher impulsivity was associated with less education, lower income, being unemployed, psychiatric diagnosis, and higher Beck depression scores. Intensity of meth use and sexual risk behavior were significantly correlated. In a multiple regression analysis, more education, greater intensity of meth use and higher levels of impulsivity predicted more unprotected sex. To test for moderating effects of impulsivity, an interaction term was added to the regression. The interactive effects model was statistically significant. A plot of the interaction revealed that the relationship between intensity of meth use and total unprotected sex was strongest among participants who had higher levels of impulsivity. This suggests that targeting impulsivity in interventions may help reduce sexual risk behaviors in high intensity meth-using HIV-positive MSM.

Adult↗
PubMed2005

Acculturation and its association with health-risk behaviors in a rural Latina population.

PURPOSE: To evaluate the performance of proxy measures of acculturation and to examine the association between acculturation and selected health-risk behaviors. METHODS: Participants were 1062 Latina pregnant women who received prenatal care at clinics in San Joaquin County, California between 1999 and 2001. We used the receiver-operating characteristic (ROC) curve to characterize the sensitivity and specificity of proxy measures and regression analysis to examine health-risk behaviors. RESULTS: Using the ARSMA-II short version scale as a reference, age at immigration had the highest percentage of correctly classified individuals. Acculturation was significantly associated with a lifetime history of substance use, risky sexual behavior, low fruit consumption, and high fast-food meal consumption. CONCLUSIONS: Acculturation is an important predictor of health-risk behavior among women. Further research is needed to better understand the phenomenon and to avert associated adverse health consequences.

Acculturation↗
PubMed2001

Negative affect and sexual risk behavior: comment on Crepaz and Marks (2001).

In this commentary, the authors highlight the findings of the meta-analysis by N. Crepaz and G. Marks (2001). The role of affect in sexual risk behavior, although intuitively obvious, is not well understood and has been largely ignored by HIV prevention researchers in favor of social-cognitive models of behavior. Crepaz and Marks synthesized the results from studies that have examined the relation of negative affect (e.g., depression, anxiety, anger) to sexual risk behavior and concluded that in the literature to date, these variables appear unrelated. The authors suggest that the Crepaz and Marks findings are not surprising given the methods used in the reviewed studies and suggest methodological approaches that will allow more sensitive analyses of the association between affect and sexual risk behavior.

Acquired Immunodeficiency Syndrome↗
PubMed2006

Prevalence of overweight among elementary and middle school students in Mississippi compared with prevalence data from the Youth Risk Behavior Surveillance System.

INTRODUCTION: The purpose of the Child and Youth Prevalence of Overweight Survey was to estimate the prevalence of overweight and at risk for becoming overweight among children in Mississippi (grades 1-8) using height and weight measures instead of self-report and to compare the findings for grades 6 through 8 with data from the Youth Risk Behavior Surveillance System for middle school students (grades 6-8). METHODS: Students in randomly selected classes from 37 sampled elementary and middle schools throughout Mississippi participated in the study. School staff were trained to collect height and weight data using a standardized procedure. RESULTS: Overall, 24.0% of students in grades 1 through 8 were found to be overweight, and another 14.7% were at risk for becoming overweight. With the exception of sixth grade, there was a trend of increasing prevalence of overweight by grade (17.5% in grade 1 compared with 31.3% in grade 8). In the Child and Youth Prevalence of Overweight Survey, 25.2% of students in grades 6 through 8 were found to be overweight, compared with 18.5% in the Youth Risk Behavior Surveillance System. CONCLUSION: A high percentage of students in Mississippi are already overweight in first grade, and the prevalence tends to increase by grade. Data collected from middle school students through measured heights and weights in the Child and Youth Prevalence of Overweight Survey were higher than self-reported data from the Youth Risk Behavior Surveillance System. Our data suggest that self-reported data underestimate the prevalence of overweight among middle school students. Efforts to monitor students' body mass index and assess effectiveness of interventions should include all grades and use measured heights and weights rather than self-reports.

Child↗
PubMed1996

Reproducibility of the women's module of the Behavioral Risk Factor Surveillance System questionnaire.

The Behavioral Risk Factor Surveillance System (BRFSS) is designed to provide statewide estimates of the prevalence of preventive health practices, including screening. We assessed the reproducibility of responses to the women's health module, which covers breast and cervical cancer screening, hysterectomy, and pregnancy. A random sample of women in Massachusetts (n = 91; response rate for the repeat interview, 70.0%) and a separate random sample of minority women in the state (n = 179; response rate for the repeat interview, 69.4%) were interviewed by telephone twice, 21 to 94 days apart. Differences across administrations in mean prevalence of screening were small. Concordance exceeded 85% for almost all the variables examined, but tended to be lower for nonwhite respondents. After correction for agreement occurring by chance, moderate to excellent values of kappa (range, 0.41 to 0.86) were observed. The women's health module of the BRFSS questionnaire yields highly consistent group mean estimates of prevalence when administered repeatedly to the same individuals. Individual reproducibility is excellent, but may be reduced among minority respondents.

Adolescent↗
PubMed1999

High prevalence and incidence of sexually transmitted diseases in urban adolescent females despite moderate risk behaviors.

To better understand the prevalence, incidence, and risk factors for sexually transmitted diseases (STDs) among female adolescents, a prospective 6-month cohort study was conducted at four teen clinics in a southeastern city. At enrollment, 260 (40%) of 650 sexually active females ages 14-19 years had an STD: chlamydia, 27%; herpes simplex virus type 2 (HSV-2), 14%; gonorrhea, 6%; trichomoniasis, 3%; and hepatitis B, 2%. At follow-up, 112 (23%) of 501 participants had an incident infection: chlamydia, 18%; HSV-2, 4%; gonorrhea, 4%; and trichomoniasis, 3%. At either enrollment or follow-up, 53% had >/=1 STD; of those with 1 lifetime partner, 30% had an STD. Having a new partner (odds ratio [OR], 2.2; 95% confidence interval [CI], 1. 1-4.2) or friends who sell cocaine (OR, 1.6; CI, 1.0-2.6) was independently associated with incident infection. STD incidence and prevalence were extremely high in this population, even in teenagers with only 1 lifetime partner. Individual risk behaviors appeared less important for STD risk than population factors.

Adolescent↗
PubMed1991

AIDS knowledge and risk behaviors among culturally diverse women.

This article reports results from a survey of women at risk for HIV infection. The sample (n = 620) included black (50.6%), white (28.7%), Hispanic (13.4%), and Haitian (5.0%) adult women from south Florida. Data concerning their AIDS knowledge, prevalence of risk behaviors, and perceived vulnerability are presented. Results indicate differences in certain knowledge areas and risk behaviors by race/ethnicity and a consistent incidence of unprotected sex with their main partners across all racial/ethnic groups.

Acquired Immunodeficiency Syndrome↗
PubMed2005

HIV infection and risk behavior of Hispanic farm workers at the west Texas-Mexico border.

This study investigated the risk behaviors and HIV infection rate in a sample of 210 migrant and seasonal farm workers (MSFW) working in the border city of El Paso, Texas and nearby communities. Surveys and structured interviews collected data on sexual behavior, drug use, condom use, and other potential risk behaviors associated with HIV infection. In addition, all subjects were tested for HIV exposure by using commercial kits. The MSFW participants were all Hispanic and comprised 156 males and 54 females. Only a small minority of the subjects reported engaging in same-sex (1.4%) or bisexual relations (2.8%). Most reported vaginal intercourse (94.7%), while 9% of males and 7.4% of females also reported anal intercourse. Forty-eight percent of the sample reported having sexual activity under the influence of alcohol (44%) and/or other drugs (14%). In this study, only 3.8% admitted to intravenous drug use. Furthermore, most reported that they never used any barrier method during vaginal (71.7%), anal (72.0%), or oral intercourse (87.5%). Only one subject, a male with multiple sex and needle-sharing partners was HIV positive. Although a low level (.47%) of HIV infection was detected in the MSFW population tested, this rate is much higher than that reported for the rest of the county (.0099%) and indicates that this population is at a higher risk of HIV infection.

Adult↗
PubMed2000

Correlates of human immunodeficiency virus infection risk behavior in male attendees of a clinic for sexually transmitted disease.

Human immunodeficiency virus (HIV) infection risk behavior was evaluated in a cross-sectional survey of 400 male active-duty US Army personnel who presented at a sexually transmitted disease (STD) clinic with symptoms of acute urethritis. High-risk partners were common, and nearly one-quarter of the sample had previously had STDs. Logistic regression models examined correlates of HIV exposure risk, of inconsistent condom use, and of having partners with increased risk of HIV infection. Frequent partner turnover, sex "binging," negative attitudes toward condom use, and engaging in sex during military leaves were important correlates of risk. Individuals with HIV infection risk behavior generally were cognizant of their risk for HIV infection. Implications for intervention are discussed.

Condoms↗
PubMed1999

The role of medical problems and behavioral risks in explaining patterns of prenatal care use among high-risk women.

OBJECTIVE: To examine the associations between maternal medical conditions and behavioral risks and the patterns of prenatal care use among high-risk women. DATA SOURCE/STUDY DESIGN: Data on over 25,000 high-risk deliveries to African American and white women using multinomial logistic regression to predict the odds of adequate-plus care relative to three other categories of care. DATA COLLECTION/EXTRACTION METHODS: Data were extracted from records maintained by the University of Florida/Shands Hospital maternity clinic on all deliveries between 1987 and 1994; records for white and for African American women were subset to examine racial differences in medical conditions, health behaviors, and patterns of prenatal care use. PRINCIPAL FINDINGS: Net of sociodemographic and fertility-related characteristics, African American and white women with late antepartum conditions and hypertension problems had significantly higher odds of receiving adequate-plus care, as well as no care or inadequate care, relative to adequate care. White women with gynecological disease and medical/surgical problems were significantly less likely to receive no care or inadequate care, as were African American women with gynecological disease. CONCLUSIONS: Maternal medical conditions explain much but not all of the adequate-plus prenatal care use. More than 13 percent of African American women and 20 percent of white women with no reported medical problems or behavioral risks used adequate-plus care. Additional research is needed to understand this excess use and its possibilities in mediating birth outcomes.

Adolescent↗
PubMed2002

Temporal trends in the incidence of human immunodeficiency virus infection and risk behavior among injection drug users in Baltimore, Maryland, 1988-1998.

Although the incidence of and mortality from acquired immunodeficiency syndrome have declined recently in the United States, data are needed on the incidence of human immunodeficiency virus (HIV) and risk behaviors among injection drug users (IDUs). The authors studied the temporal trends of HIV incidence and risk behavior, ascertained through semiannual confidential interviews, between 1988 and 1998 in a cohort of 1,532 HIV-seronegative IDUs in Baltimore, Maryland. An additional 338 HIV-negative drug users were recruited in 1994 and were studied by using the same methods. Overall, 277 persons seroconverted to HIV during 8,826.45 person-years of follow-up, an incidence of 3.14 per 100 person-years. The incidence per 100 person-years declined over time from 4.45 in 1988-1990 to 3.35 in 1991-1994 to 1.84 in 1995-1998, a decline of 12% per year. HIV infections were associated with injection of cocaine, more frequent injection, needle sharing, and injection in a shooting galley. Sexual behavior variables associated with HIV incidence included a sexually transmitted infection, male homosexual behavior, and sex with another IDU. These data suggest that high-risk behavior and HIV incidence among IDUs have decreased recently in Baltimore. Nevertheless, additional prevention strategies are needed in these populations.

Adult↗
PubMed1996

Preferred sources of AIDS information, risk perceptions, and risk behaviors among inner-city community college students.

To understand preferred sources of acquired immunodeficiency syndrome (AIDS) information and level of worry about human immunodeficiency virus (HIV) among community college students, a survey of 102 students in an inner-city community college was conducted. The survey requested information on preferred sources of information about AIDS, risk behaviors, and level of worry about HIV infection compared with other life risks. Forty-six per cent of respondents had engaged in risk behaviors for AIDS. Of those who were sexually active, 81% acknowledged not always using a condom. Students noted that they were more likely to believe AIDS information from a health professional than from a friend, relative, teacher, clergy, or celebrity. Overall, getting AIDS ranked third on a list of life worries, ranking only behind getting bad grades and the death of a family member. For students who identified themselves as black or Latino, however, getting AIDS ranked first on a list of life risks. For those students who reported highrisk behavior for getting HIV, getting AIDS also ranked first on a list of life worries. We conclude that those students at whom messages about risk status have been targeted are most likely to report being more worried about getting AIDS than about other adverse life events. It remains unclear, however, whether heightened levels of worry about HIV actually translate into changes in risk behavior.

Acquired Immunodeficiency Syndrome↗
PubMed1990

AIDS-related risk behaviors among substance abusers.

Ninety-two substance abusers were surveyed about AIDS-related risk behaviors. The questionnaire administered elicited information on demographics, sexual practices, substance abuse, and risk behaviors involving the use of needles. Results indicated an appropriate base of prevention knowledge and patients' efforts to modify vulnerability to HIV exposure. Nevertheless, patients continue to engage in behaviors resulting in HIV exposure and transmission.

Acquired Immunodeficiency Syndrome↗