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PubMed2001

Ergogenic supplements and health risk behaviors.

OBJECTIVE: Our goals were to determine the prevalence of ergogenic supplement use in a young healthy population and to examine the extent to which supplement use is associated with specific health risk behaviors. STUDY DESIGN: We performed a cross-sectional survey. POPULATION: Individuals entering military service for enlisted training were included. OUTCOMES MEASURED: We recorded previous use of any nutritional ergogenic supplements and self-reported health risk behaviors. RESULTS: Of 550 eligible participants, 499 completed the survey (91% response rate). Individuals who used ergogenic supplements were more likely to drink alcohol (adjusted odds ratio [AOR]=1.8; 95% confidence interval [CI], 1.1-3.1), more likely to drink heavily (AOR=2.4; 95% CI, 1.5-3.9), more likely to ride in a vehicle with someone who had been drinking (AOR=2.2; 95% CI, 1.3-3.6), more likely to drive after drinking (AOR=2.4; 95% CI, 1.3-4.4), and more likely to have been in a physical fight (AOR=1.9; 95% CI, 1.0-3.5), compared with those who had not used supplements. Men were more likely to use supplements than women (P &lt.001). There were no differences in patterns of supplement use according to age or body mass index. CONCLUSIONS: Our study indicates an association between individuals who use ergogenic nutritional supplements and specific health risk behaviors. This represents an important opportunity for preventive counseling.

Adolescent↗
PubMed2000

Analysis of risk taking in adults with a history of high risk behavior.

Antisocial behavior often involves frequent risk-taking, e.g. excessive substance use and criminality, which may lead to destructive consequences. In the present study, adults with a history of high-risk behavior (primarily drug dependence and conduct disorder) and matched controls worked on a novel laboratory task designed to measure risk-taking. The contingencies of the task were such that choosing a 'risky' response option resulted in a net loss of monetary earnings compared to a safer, more conservative response alternative. The risky option offered a low probability of a large monetary reward or a high probability of a smaller monetary loss. The non-risky option protected current earnings. High-risk history subjects chose the risky option more often, had lower overall earnings, and were more likely to persist in making (losing) risky responses following a single gain on the risky option. The data support theories of maladaptive behavior focused on hypersensitivity to reward and insensitivity to aversive events.

Adolescent↗
PubMed2003

Evaluation of attitude, risk behavior and expectations among Thai participants in Phase I/II HIV/AIDS vaccine trials.

The Understanding of volunteers in vaccine trials about their role as study participants and their voluntary commitment during the study are always one of the important concerns apart from evaluation of safety and efficacy of vaccine trials, especially in HIV prophylactic vaccine trials. The apprehension of indirectly risky behavior encouragement and deviated expectations among volunteers should be of concern. The current prospective cohort study aimed to assess and monitor the changes of risk behaviors, attitude and expectations among 164 volunteers from 2 studies of different prophylactic HIV vaccines, the Chiron HIV Thai E gp 120/MF59 +/- the Chiron HIV SF52 gp120 and Aventis Pasteur Live Recombinant ALVAC HIV (vCP1521) priming with VaxGen gp120B/E (AIDSVAX B/E) boosting. 113 males and 51 females with a mean age (+/- SD) of 28.82 +/- 7.97 years old were enrolled from October 1997 to December 1998 and February 2000 to April 2001. Education and risk reduction counseling were regularly performed at every visit and questionnaires about risk behaviors, knowledge, attitudes, social influences and expectations were asked at baseline, 4 months and 12 months. No change of potentially HIV transmission related risk behavior was observed during the studies. There was a statistically significant decrease of risk sexual practices from the beginning of the trials (42.2% vs 1%, p < 0.0001). While 35.2 per cent from 62.2 per cent of the volunteers at the beginning of the study continued sexual practice with an identified single sexual partner at the end of the study (p < 0.0001). All of the volunteers expressed the beneficial expectations as knowledge gain, social contribution, feelings of having gained merit and self-benefits from health check-ups.

AIDS Vaccines↗
PubMed1994

AIDS knowledge and high risk behaviors in the chronic mentally ill.

Chronic mentally ill adults are a high risk group for AIDS. In the present study, we used a questionnaire to assess AIDS knowledge, attitudes, and risk behaviors in 54 men and women who were clients at a "drop in" center for mentally ill adults. Most of the subjects were suffering from schizophrenia and about one-third of them had co-existing drug problems. Results showed widespread misunderstandings about AIDS transmission, high risk groups, and practices. Many of the subjects had been treated for STDs such as syphilis and gonorrhea and were engaging in behaviors that increased their vulnerability to AIDS. These include casual sex, anal sex, sex with an IV drug user, or sex in exchange for money, drugs, or a place to sleep. Subjects expressed a moderately high level of concern about acquiring AIDS/HIV, and 15% of those tested (5/33) said they already had the illness. We observed a significant correlation between misinformation about AIDS and the frequency of high risk behaviors. We also detected ambivalence about using condoms and i.v. drugs. Although males and females did not differ in AIDS knowledge or risk behaviors, the AIDS knowledge of both groups was significantly lower than a comparison sample of public high school students. Taken together, the results underscore the immediate need for comprehensive AIDS assessment, education, and prevention in this segment of the population.

Acquired Immunodeficiency Syndrome↗
PubMed2003

Development of a youth survey to measure risk behaviors, attitudes and assets: examining multiple influences.

Currently, most surveys assessing adolescent health concerns focus primarily on risk behaviors and negative influences rather than positive influences such as assets. The purpose of this paper is to describe the development and validation of the Adolescent Health Attitude and Behavior Survey (AHABS). This instrument was developed to measure the prevalence of youth health risk behaviors, attitudes towards adolescent sexual behavior and youth assets in a statewide evaluation effort. The questionnaire was completed by 4368 public high school students in Grades 9-12. Content validity was established through an extensive review of literature, a group process and factor analyses. Reliability was established through Cronbach's alpha coefficients. Factor loadings ranged from 0.48 to 0.84 for scales measuring attitudes towards adolescent sexual behavior and alpha coefficients ranged from 0.61 to 0.81. Factor loadings ranged from 0.34 to 0.90 for scales measuring youth assets and alpha coefficients ranged from 0.69 to 0.85. Because of several limitations (e.g. construct validity was not measured), additional development work is needed. Therefore, the AHABS is still in a developing, but promising, state. Additional psychometric work will provide program practitioners and evaluators with a psychometrically sound tool to measure behaviors, attitudes and assets.

Adolescent↗
PubMed2005

Impact of gender and sex work on sexual and injecting risk behaviors and their association with HIV positivity among injecting drug users in an HIV epidemic in Togliatti City, Russian Federation.

OBJECTIVES: Togliatti City is witness to a large epidemic of human immunodeficiency virus (HIV) associated with injecting drug use (IDU). GOAL: This study sought to examine whether risk behaviors and risk factors associated with HIV differed across a sample IDUs by gender and sex work. STUDY: A sample of IDU (n = 423) comprising female sex workers (SWs) (n = 66), non-sex workers (nonSWs) (n = 89) and men (n = 268) were recruited by field workers in community settings. Behavioral and HIV prevalence data were collected. RESULTS: HIV prevalence did not differ across the groups ( approximately 56%), but gender adversely affected some risk factors. A comparison of risk behaviors indicated that SWs were more likely to engage in risky injecting behaviors than either men or nonSWs. They were also more likely to report a history of sexually transmitted infections. CONCLUSIONS: IDUs involved in sex work and IDU nonSWs require specific and targeted interventions to facilitate safer injecting and sexual behaviors.

Adolescent↗
PubMed1999

HIV-risk behaviors associated with homelessness characteristics in youth.

PURPOSE: To examine characteristics of youth homelessness associated with engaging in risk behaviors for human immunodeficiency virus (HIV). METHODS: The sample included 288 currently homeless or runaway Washington, DC youth aged 14-21 years. Measures were self-reported homelessness characteristics, unsafe sexual behavior, injection drug use, and background characteristics. Bivariate and multivariable analyses of the relationships between homelessness characteristics and HIV risk behaviors were conducted. RESULTS: Both male (n = 140) and female (n = 148) participants reported high rates of unsafe sexual behaviors, but low rates of injection drug use. HIV risk was significantly associated in bivariate analyses with severity of homelessness circumstances (i.e., spending the night in public place or with strangers, going hungry, and participating in the street economy), the duration of homelessness (i.e., greater number of episodes of homelessness, longer time length of current episode), and specific reasons for being homeless (i.e., thrown out). In addition, sexual victimization and older age were associated with increased HIV risk. In multivariable models, a smaller set of these homelessness characteristics remained significant independent correlates and explained a substantial amount of the variation in the HIV risk indices for both males and females. CONCLUSIONS: The results contribute to greater theoretical understanding of the characteristics of homelessness associated with increased risk of HIV infection within this vulnerable population of youth. The associations between homelessness characteristics and HIV risk suggest the need for HIV prevention efforts to focus directly on ameliorating the homelessness circumstances of youth.

Adolescent↗
PubMed1999

Preventing adolescent health-risk behaviors by strengthening protection during childhood.

OBJECTIVE: To examine the long-term effects of an intervention combining teacher training, parent education, and social competence training for children during the elementary grades on adolescent health-risk behaviors at age 18 years. DESIGN: Nonrandomized controlled trial with follow-up 6 years after intervention. SETTING: Public elementary schools serving high-crime areas in Seattle, Wash. PARTICIPANTS: Of the fifth-grade students enrolled in participating schools, 643 (76%) were given written parental consent for the longitudinal study and 598 (93%) were followed up and interviewed at age 18 years. INTERVENTIONS: A full intervention provided in grades 1 through 6 of 5 days of in-service training for teachers each intervention year, developmentally appropriate parenting classes offered to parents when children were in grades 1 through 3 and 5 through 6, and developmentally adjusted social competence training for children in grades 1 and 6. A late intervention, provided in grades 5 and 6 only, paralleled the full intervention at these grades. MAIN OUTCOME MEASURES: Self-reported violent and nonviolent crime, substance use, sexual activity, pregnancy, bonding to school, school achievement, grade repetition and school dropout, suspension and/or expulsion, and school misbehavior; delinquency charges from court records; grade point average; California Achievement Test scores: and disciplinary action reports from school records. RESULTS: Fewer students receiving full intervention than control students reported violent delinquent acts (48.3% vs 59.7%; P=.04), heavy drinking (15.4% vs 25.6%; P=.04), sexual intercourse (72.1% vs 83.0%; P=.02), having multiple sex partners (49.7% vs 61.5%; P=.04), and pregnancy or causing pregnancy (17.1% vs 26.4%; P=.06) by age 18 years. The full intervention student group reported more commitment (P=.03) and attachment (P=.006) to school, better academic achievement (P=.01), and less school misbehavior (P=.02) than control students. Late intervention in grades 5 and 6 only did not significantly affect health-risk behaviors in adolescence. CONCLUSIONS: A package of interventions with teachers, parents, and children provided throughout the elementary grades can have enduring effects in reducing violent behavior, heavy drinking, and sexual intercourse by age 18 years among multiethnic urban children. Results are consistent with the theoretical model guiding the intervention and support efforts to reduce health-risk behaviors through universal interventions in selected communities or schools serving high-crime neighborhoods.

Adolescent↗
PubMed2005

HIV drug resistance and HIV transmission risk behaviors among active injection drug users.

HIV(+) injection drug users in clinical care may harbor and transmit drug-resistant HIV. We performed a retrospective study of HIV drug resistance and risk behavior among HIV(+) injection drug users in care to determine the number of needle-sharing events that involved and the proportion of sharing partners exposed to drug-resistant HIV. Among 180 HIV injection drug users, 55 (31%) reported injecting drugs in the previous month, and 22 of these (40%) shared needles and/or works 148 times with 296 partners, of whom 271 (92%) were thought to be HIV(-) or status unknown. Further, 55 (31%) drug users harbored resistant HIV, including 5 (3% of total) who also shared needles and/or works a total of 27 times with 44 partners (18% of all sharing events and 15% of all exposed partners). A small proportion of injection drug users receiving clinical care engage in injection risk behavior and carry resistant HIV; however, because of multiple partners and needle-sharing events, they expose a substantial number of individuals to drug-resistant HIV. Strategies to reduce injection drug use risk behaviors among patients in clinical care are needed to reduce the transmission of sensitive and resistant HIV.

Anti-HIV Agents↗
PubMed1997

Sexual behavior risk factors associated with bacterial vaginosis and Chlamydia trachomatis infection.

BACKGROUND AND OBJECTIVES: Few studies have demonstrated that bacterial vaginosis (BV) is associated with sexual behavior risk factors similar to those for other sexually transmitted diseases. The objective of this study was to determine the prevalence of these factors in a multivariate analysis of data from women infected with BV and Chlamydia trachomatis, and noninfected control subjects. GOALS: To study detailed sexual behavior risk factors reported by women with BV versus genital C. trachomatis infection (CT) and by non-BV-infected controls. STUDY DESIGN: A cross-sectional study was conducted with 1,011 women (Swedish Women's Health Study) recruited from family planning and youth clinics in Eskilstuna and Stockholm, Sweden (November, 1989-January, 1991). Participants were evaluated for the presence of BV, CT, Neisseria gonorrhoeae, Treponema pallidum, Trichomonas vaginalis, and human immunodeficiency virus, and interviewed in detail with respect to sexual behaviors. Statistical comparisons were made using chi-square test (Pearson and likelihood ratio), t test, and logistic regression multivariate analysis. RESULTS: Of 956 women eligible for analysis, the prevalence of BV and CT was 13.7% and 8.9%, respectively. The comparison group consisted of the remaining 825 women without BV. After excluding those with concomitant CT infection, there were 118 women with BV who were compared with 72 women with CT infection only. Sexual factors associated with BV versus the comparison group were a short-term relationship before and after sexual debut, high number of lifetime sexual partners, multiple partners during the last month, high orgasm ability, and more frequent history of group sex, sexual abuse, and rape. When the BV group was compared with the CT group, there were no significant differences in sexual activity risk factors, except for a higher frequency of experience of casual sex in the CT group. CONCLUSIONS: Bacterial vaginosis is associated with sexual behavior risk factors similar to those associated with genital CT infection.

Adult↗
PubMed2006

Youth risk behavior surveillance--United States, 2005.

In the United States, 71% of all deaths among persons aged 10-24 years result from 4 causes: motorvehicle crashes, other unintentional injuries, homicide, and suicide. Results from the 2005 national Youth Risk Behavior Survey (YRBS) indicated that during the 30 days preceding the survey, many high school students engaged in behaviors that increased their likelihood of death from these 4 causes: 9.9% had driven a car or other vehicle when they had been drinking alcohol, 18.5% had carried a weapon, 43.3% had drunk alcohol, and 20.2% had used marijuana. In addition, during the 12 months preceding the survey, 35.9% of high school students had been in a physical fight and 8.4% had attempted suicide. Substantial morbidity and social problems among youth also result from unintended pregnancies and sexually transmitted diseases, including human immunodeficiency virus infection. During 2005, a total of 46.8% of high school students had ever had sexual intercourse, 37.2% of sexually active high school students had not used a condom at last sexual intercourse, and 2.1% had ever injected an illegal drug. Among adults aged > or =25 years, 61% of all deaths result from 2 causes: cardiovascular disease and cancer. Results from the 2005 national YRBS indicated that risk behaviors associated with these 2 causes of death were initiated during adolescence. During 2005, a total of 23.0% of high school students had smoked cigarettes during the 30 days preceding the survey, 79.9% had not eaten > or =5 times/day of fruits and vegetables during the 7 days preceding the survey, 67.0% did not attend physical education classes daily, and 13.1% were overweight.

Adolescent↗
PubMed2001

Are negative affective states associated with HIV sexual risk behaviors? A meta-analytic review.

This meta-analytic review examined whether negative affective states (depressive symptomatology, anxiety, anger) are associated with sexual behaviors that place people at risk for contracting or transmitting HIV. The results from 34 study samples were included in the analysis. Contrary to popular belief, the findings as a whole provide little evidence that negative affect is associated with increased sexual risk behavior. The average weighted correlation for the overall association was .05. The effect size was nonsignificantly higher for anger (r = .10) than for depressive symptoms (r = .04) or anxiety (r = .03). The variability of effect sizes was not accounted for by type of sexual risk measure, subject population, or methodological aspects of the studies. Conceptual and methodological limitations of the literature are identified and directions for future research are discussed.

Adult↗
PubMed1998

Prevalence of multiple cardiovascular disease risk factors among women in the United States, 1992 and 1995: the Behavioral Risk Factor Surveillance System.

We sought to examine the prevalence of self-reported multiple cardiovascular disease (CVD) risk factors (hypertension, high blood cholesterol, diabetes, overweight, and current smoking) among women in 1992 and 1995 in the United States using data from the Behavioral Risk Factor Surveillance System. In 1992, 37.5%, 34.4%, and 28.1% of women had zero, one, and two or more of the five risk factors, respectively. In 1995, the respective estimates were 35.5%, 34.3%, and 30%. In both years, the prevalence of two or more risk factors increased with age, decreased with educational level, was higher among black women (lowest among Hispanic women and women of other ethnic groups), and higher among women reporting cost as a barrier to healthcare. The percentage of women with two or more risk factors was higher in 1995 than in 1992 for 35 of 48 states, being statistically significant for 7 states. The percentage of women with at least two risk factors was not significantly lower in 1995 than in 1992 for any state. A higher percentage of women reported having multiple CVD risk factors in 1995 compared with 1992. A multifactorial approach to primary prevention and risk factor reduction should be encouraged to help reduce the prevalence and burden of CVD among women.

Adolescent↗
PubMed1997

Cognitive late effect factors related to decision making and risk behaviors of cancer-surviving adolescents.

The purpose of this correlational study was to examine factors related to cognitive late effects of treatment that may be predictors of decision making and risk behaviors for cancer-surviving adolescents. A convenience sample of 52 survivors (ages 14-19 years, disease-free for 5 years, no treatment for 2 years, and with all types of cancer except primary brain tumors) participated in this study at two regional survivor follow-up clinics. A medical record review, a semistructured interview with the teen, and intelligence testing on a separate day were used to collect data. A history of cancer therapy threatening cognitive function (defined as > or = 18 gy of radiotherapy, intrathecal or high-dose systemic methotrexate, or both) was a marginally significant predictor of poorer-quality decision making in the first regression model. Poorer-quality decision making was a significant predictor of one or more risk behaviors in the second model. Younger age at initial treatment and lower cognitive ability (full-scale IQ) were not significant predictors for either of the models. There were no significant differences for the Wechsler IQ subtests related to abstract and analytic ability by cognitive threat status. Post hoc analysis indicated that lack of sensitivity to change of the Wechsler IQ measure may have affected outcomes. Abstract and/or analytic ability may be important links for decision making and risk behaviors of teen survivors, thus warranting further examination within a larger sample. Intervention to improve decision making needs to be provided for teen survivors; this may be true especially when there is a history of therapy threatening cognitive function.

Adolescent↗
PubMed1997

Social network characteristics and injecting HIV-risk behaviors among street injection drug users.

As an alternative approach to individually-focused understanding of HIV risk behavior, this study explored the relationship between social network characteristics and HIV-risk injecting behaviors. Subjects were 499 inner-city injection drug users (IDUs) recruited from the streets of Baltimore, Maryland. Analysis of structural and functional network data indicates that a substantial proportion of drug sharing network members also provided social support, often because of family and sexual partner relationships. IDUs with larger drug networks which also provided social support were more likely to share needles, while IDUs with larger drug networks which did not provide social support were more likely to inject in commercial settings. The findings suggest that social support from drug network members has differential effects on injecting HIV-risk behaviors among IDUs. HIV prevention efforts should be expanded to reach drug-sharing networks and should take into account their social support relationships.

Adult↗
PubMed2006

Sexual orientation, sexual abuse, and HIV-risk behaviors among adolescents in the Pacific Northwest.

OBJECTIVES: We explored HIV risk behaviors, sexual orientation, and sexual abuse among 5 school-based cohorts in Seattle, Wash (SEA95 and SEA99:N=7477 and N=6590), and British Columbia (BC92, BC98, and BC03 [weighted]: N=239975, N=281576, and N=265132). METHODS: An HIV risk scale of 7 items assessed risky sexual behaviors and injection drug use. Self-identified sexual orientation included heterosexual, bisexual, gay/lesbian, and, in British Columbia only, mostly heterosexual. Analyses of covariance were conducted separately by gender and were adjusted for age and sexual abuse when comparing means. RESULTS: Gay/lesbian and bisexual adolescents had higher mean age-adjusted risk scores compared with heterosexual and mostly heterosexual adolescents. After we controlled for sexual abuse history, mean scores were 2 to 4 times higher among abused students than among nonabused students in each sexual orientation group. Age/abuse-adjusted models better explained the variance in risk scores (R(2)=0.10-0.31), but sexual orientation remained an independent predictor. CONCLUSION: Sexual minority adolescents who attended school reported higher HIV risk behaviors, and higher prevalence of sexual victimization may partially explain these risks.

Adolescent↗
PubMed2001

Gender attitudes and health risk behaviors in urban African American and Latino early adolescents.

OBJECTIVES: This study examines the association of beliefs about gender differences (frequently termed gender attitudes or attitudes about women in other research) and of beliefs specifically about masculinity to health risk behaviors in minority, urban, early adolescents, in light of the "gender conventionality" hypothesis. METHODS: Data from a self-administered questionnaire assessing gender attitudes and violence-related, substance use, and heterosexual health risk behaviors administered to 587 African American and Latino early adolescents are analyzed. RESULTS: With sociodemographic and family variables controlled, in males violence-related behaviors and substance use are associated with traditional beliefs about masculinity, and heterosexual activity is associated with traditional beliefs about gender differences. In females, being sexually active is positively associated with traditional beliefs about masculinity. CONCLUSIONS: Interventions to reduce health risk behaviors in minority, urban, early adolescents may be more effective if they include greater attention to ways in which gender-related attitudes may play a role in health risk taking.

Adolescent↗
PubMed2005

The relationship between violence exposure and HIV sexual risk behavior: does gender matter?

This study examined the association between violence exposures and HIV risk behaviors among 409 adolescents and whether such associations are gendered. Results indicated that adolescents exposed to either childhood sexual abuse or family or community violence were almost 3 and 4 times more likely, respectively, than peers not exposed to such violence to report a higher number of HIV-related risk behaviors. In addition, boys exposed to family violence were almost 3 times more likely than girls to report multiple partners and use of drugs during sex. Findings suggest a complex relationship among violence, gender, and HIV risks among adolescents.

Adolescent↗