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PubMed1999

At-risk behaviors with regard to HIV and addiction among women in prison.

The bulk of studies pertaining to addiction among delinquents have been conducted on male subjects. However, the few studies examining female inmates show that a significant proportion of them present an addictive disorder. Furthermore, the HIV infection rate is higher among these women than among incarcerated men. This study attempts to verify if women presenting a combination of criminal and addictive behaviors are at a higher risk of developing an earlier and a more severe delinquency than other delinquent women. Another goal is to determine whether women showing this comorbidity present a higher incidence of HIV-related risk behaviors. The study was conducted on a sample of 210 women from the Montreal detention center. It shows that addicted inmates present earlier onsets of both drug use and criminal behaviors compared to other female inmates. Addicted women also exhibit significantly more HIV-related risky behaviors, both in their drug use and in their sexual practices.

Adolescent↗
PubMed1998

Health risk behaviors of African American adolescents with mild mental retardation: prevalence depends on measurement method.

Health risk behaviors (e.g., substance use, violence, suicide, and car safety) of 194 14- to 17-year-old African American urban adolescents with mild mental retardation from special education classes were measured. One group was assessed using a confidential individual interview method, and an individually matched group was assessed with an anonymous group survey method. Participants completing the anonymous survey reported engaging more frequently in risk behaviors that respondents typically consider sensitive. In comparison to national and state populations of African American adolescents, urban African American adolescents with mild mental retardation appear to be at substantial elevated risk for engaging in alcohol binge drinking and weapon and gun carrying. Findings were discussed relative to cognitive and social deficits inherent in mild mental retardation.

Adolescent↗
PubMed1993

Comparison of health risk behaviors between students in a regular high school and students in an alternative high school.

Prevalence of selected health risk behaviors of students attending an alternative high school (AHS) designed as a dropout prevention/dropout recovery high school was determined using the Youth Risk Behavior Survey. The survey also was administered to a sample of students attending a regular high school (RHS) in the same school district. A larger percentage of AHS students reported being involved in a physical fight the past year, having smoked at least one cigarette the past month, having drunk at least one drink on five or more occasions the past month, having drunk five or more drinks at least once the past month, having smoked marijuana at least once the past month, having used cocaine at least once the past month, and having ever had sexual intercourse. Results indicate a need for comprehensive health education/intervention programs to address the needs of youth in alternative school settings.

Adolescent↗
PubMed2004

Age-related health risk behaviors of adolescents with physical disabilities.

OBJECTIVE: To investigate age-related differences in health risk behaviors in 11-12-, 13-14-, and 15-16-year-old adolescents with physical disabilities. METHOD: Health survey data from 319 adolescents with physical disabilities were compared with the same data from 7,020 adolescents in a national sample. RESULTS: Significant age-related differences were found for having tried smoking, smoking, having tasted an alcoholic drink, having been drunk, and using prescription drugs for recreational purposes. However, changes were modest and engagement of 15-16-year-old adolescents with physical disabilities was similar to 11-12-year-olds in the general population. Analysis of associations between disability status and health risk behaviors while controlling for age and sex showed that disability is associated with a lower likelihood of having tried smoking, smoking, having tasted an alcoholic drink, drinking, having been drunk, having used drugs, having used prescription drugs for recreational purposes, and eating sweets; a higher likelihood of not engaging in physical exercise, not eating fresh produce, and eating high-fat foods; and non-significant for seat-belt use. CONCLUSION: Health promotion programs about health risk behaviours designed for adolescents in the general population may not be appropriate for adolescents with physical disabilities.

Activities of Daily Living↗
PubMed1998

The efficacy of methadone maintenance interventions in reducing illicit opiate use, HIV risk behavior and criminality: a meta-analysis.

AIMS: To provide empirically based evaluation data regarding the efficacy of psychopharmacological interventions in opiate substance abuse, the present study employed meta-analytic statistical procedures to determine the effectiveness of methadone hydrochloride as a pharmacotherapeutic agent. DESIGN: Empirical research findings from 11 studies investigating the effect of methadone maintenance treatment (MMT) on illicit opiate use, and eight and 24 studies investigating the effect of MMT on HIV risk behaviors and criminal activities, respectively, by individuals in such treatment were addressed. FINDINGS: Results demonstrate a consistent, statistically significant relationship between MMT and the reduction of illicit opiate use, HIV risk behaviors and drug and property-related criminal behaviors. The effectiveness of MMT is most apparent in its ability to reduce drug-related criminal behaviors. MMT had a moderate effect in reducing illicit opiate use and drug and property-related criminal behaviors, and a small to moderate effect in reducing HIV risk behaviors. CONCLUSIONS: Results clarify discrepancies in the literature and are useful in predicting the outcomes of individuals in treatment. The treatment's effectiveness is evident among opiate-dependent individuals across a variety of contexts, cultural and ethnic groups, and study designs.

Crime↗
PubMedDate not supplied

Chronic disease-related behaviors in U.S. older women: Behavioral Risk Factor Surveillance System, 2003.

OBJECTIVES: To estimate the prevalence of selected behaviors related to chronic diseases among women > or =65 years old using the 2003 Behavioral Risk Factor Surveillance System (BRFSS) data. METHODS AND RESULTS: Seven behaviors were assessed: having a healthy weight, current cigarette smoking status, consumption of at least five fruits or vegetables daily, leisure time physical activity in the the past month, moderate-to-vigorous physical activity during the average week, influenza immunization in the past year, and lifetime pneumococcal immunization. With increasing age, women > or =65 years old were more likely to have a healthy weight, to be a nonsmoker, and to consume at least five fruits or vegetables daily and less likely to participate in any leisure time or moderate-to-vigorous physical activities. Women with higher incomes and educational attainment were more likely to engage in most healthful behaviors and to have a healthy weight. However, black non-Hispanic women were less likely than white women or those of other race or ethnicity to engage in most healthful behaviors and to have a healthy weight. Women who rated their health as fair or poor were more likely to receive a pneumococcal immunization, and those who rated their health as excellent were least likely to receive an influenza immunization in the past year. CONCLUSIONS: BRFSS data can be used to monitor the prevalence of behaviors related to chronic disease of women aged > or =65 years and to develop programs and polices that promote and reinforce healthful behaviors. These measures have the potential to help reduce morbidity and morality from chronic disease in older women, thereby minimizing the discrepancy between years of healthy life expectancy and life expectancy.

Aged↗
PubMed2006

The strong African American families program: prevention of youths' high-risk behavior and a test of a model of change.

In this study, the efficacy of the Strong African American Families Program (SAAF) was tested. The trial, which included 332 families, indicated that families who participated in SAAF experienced increases over time in regulated, communicative parenting; increases in targeted parenting behaviors, according to youths' reports; and low rates of high-risk behavior initiation among youths. Changes in regulated, communicative parenting mediated the intervention's impact on youths' recognition of changes in parenting, which in turn was linked to changes in youths' high-risk behavior.

Adolescent↗
PubMed2005

Housing status and HIV risk behaviors: implications for prevention and policy.

This paper examines housing as a contextual factor affecting drug and sexual risk behaviors among HIV positive people using pooled interview data from 2149 clients presenting for services at 16 medical and social service agencies participating in a multi-site evaluation study. The odds of recent drug use, needle use or sex exchange at the baseline interview was 2-4 times as high among the homeless and unstably housed compared to persons with stable housing. Follow-up data collected 6-9 months after baseline showed that change in housing status was associated with change in risk behaviors. Persons whose housing status improved between baseline and follow-up significantly reduced their risks of drug use, needle use, needle sharing and unprotected sex by half in comparison to individuals whose housing status did not change. In addition, for clients whose housing status worsened between baseline and follow-up, their odds of recently exchanging sex was over five times higher than for clients whose housing status did not change. The provision of housing is a promising structural intervention to reduce the spread of HIV.

Adolescent↗
PubMed2005

HIV prevalence and risk behaviors among men who have sex with men and inject drugs in San Francisco.

The dual risks of male-to-male sex and drug injection have put men who have sex with men and inject drugs (MSM-IDU) at the forefront of the HIV epidemic, with the highest rates of infection among any risk group in the United.States. This study analyzes data collected from 357 MSM-IDU in San Francisco between 1998 and 2002 to examine how risk behaviors differ by HIV serostatus and self-identified sexual orientation and to assess medical and social service utilization among HIV-positive MSM-IDU. Twenty-eight percent of the sample tested HIV antibody positive. There was little difference in risk behaviors between HIV-negative and HIV-positive MSM-IDU. Thirty percent of HIV-positive MSM-IDU reported distributive syringe sharing, compared to 40% of HIV negatives. Among MSM-IDU who reported anal intercourse in past 6 months, 70% of positives and 66% of HIV negatives reported unprotected anal intercourse. HIV status varied greatly by self-identified sexual orientation: 46% among gay, 24% among bisexual, and 14% among heterosexual MSM-IDU. Heterosexual MSM-IDU were more likely than other MSM-IDU to be homeless and to trade sex for money or drugs. Gay MSM-IDU were more likely to have anal intercourse. Bisexual MSM-IDU were as likely as heterosexual MSM-IDU to have sex with women and as likely as gay-identified MSM-IDU to have anal intercourse. Among MSM-IDU who were HIV positive, 15% were currently on antiretroviral therapy and 18% were currently in drug treatment, and 87% reported using a syringe exchange program in the past 6 months. These findings have implications for the development of HIV interventions that target the diverse MSM-IDU population.

Adolescent↗
PubMed2006

Reliability of the 2005 middle school Youth Risk Behavior Survey.

PURPOSE: To evaluate the reliability of the middle school version of the 2005 Youth Risk Behavior Survey (MSYRBS) questionnaire. METHODS: A convenience sample of 232 Midwestern seventh and eighth grade middle school students completed the MSYRBS questionnaire twice in a 2-week period (14 days apart). The MSYRBS questionnaire, which queries a variety of health risk behaviors, was administered in a manner that preserved anonymity but allowed Time 1 and Time 2 matching. This was accomplished by using two questionnaire scantrons coded with the same unique number, and destroying all used materials to ensure that each participant was matched with their code. Kappa statistics were calculated for individual questions and group characteristics using SAS. RESULTS: The mean kappa was 62.6% and the median was 66.5%. Kappa statistics for each item ranged from -2.4% (injection drug use) to 83.8% (suicide contemplation). Negative kappa values were found for two items that had extremely small cell sizes. Kappas did not differ by gender, grade, or race. Based on nonoverlapping confidence intervals, there were no items that had significantly different prevalence estimates at Time 1 vs. Time 2. Nine items (24.3%) and one category (alcohol-drugs) had kappas below 61.0%. CONCLUSIONS: This preliminary study suggests that the reliability of the MSYRBS is high over time. A number of items should be further examined to determine whether they should be amended or omitted from future versions of the MSYRBS. Further research with larger and more diverse samples is recommended, potentially involving children as content experts.

Adolescent↗
PubMed2000

Risk behaviors related to heterosexual transmission from HIV-infected persons. Supplement to HIV/AIDS Surveillance Study Group.

BACKGROUND: To monitor heterosexually acquired HIV infection, it is important to understand transmission from persons infected with HIV to their sex partners. GOAL: To describe sexual behaviors of persons infected with HIV that are related to transmission. STUDY DESIGN: Cross-sectional interviews were conducted from January 1995 to December 1998. RESULTS: Of 4743 heterosexual respondents who had known about their HIV infection for 1 year or longer, 42% were not sexually active and 13% had one sex partner with HIV; the remaining 2099 comprised the sample for analysis. Most respondents were male, black, and of low socioeconomic status. Approximately 60% reported one or more sexual risk behavior. Steady partner's HIV status was the strongest predictor in most models for risk behaviors; those with a partner who was not infected were significantly less likely than those with an infected partner to report any sexual transmission risk behavior (P < 0.05). CONCLUSIONS: The findings point to a continued need to focus on behavioral prevention measures that reduce the heterosexual transmission of HIV.

Adolescent↗
PubMed1998

Gender differences in risk behaviors associated with forced or pressured sex.

OBJECTIVE: To determine whether gender-specific patterns of risk behaviors are associated with a self-reported history of ever having been forced or pressured to have sexual intercourse among sexually active adolescents. SUBJECTS AND METHODS: In 1995, 21,297 eighth- through 12th-grade students in 79 public and private schools in Vermont were anonymously surveyed. Data were analyzed for 7884 sexually active students (3931 girls and 3953 boys). Demographic variables and indicators of violence, suicide, recent substance use, sexual behavior, pregnancy, and weight control behavior were assessed. Data were analyzed with multiple logistic regression. RESULTS: Of the sexually active students, 30.3% of the girls and 9.9% of the boys reported ever being forced or pressured to have sexual intercourse. Among sexually active girls, being in 1 or more physical fights in the past year (odds ratio [OR], 1.65; 95% confidence interval [CI], 1.40-1.94), seriously considering suicide (OR, 1.97; CI, 1.69-2.31), more years of sexual activity (OR, 1.52; CI, 1.43-1.61), not using a condom at last sexual intercourse (OR, 1.28; CI, 1.09-1.49), and having been pregnant more often (OR, 1.40; CI, 1.16-1.69) were associated with having been forced or pressured to have sex. For sexually active boys, seriously considering suicide (OR, 1.64; CI, 1.23-2.20), more years of sexual activity (OR, 1.21; CI, 1.12-1.31), more male partners in the past 3 months (OR, 1.30; CI, 1.14-1.48), more female partners in the past 3 months (OR, 1.09; CI, 1.01-1.18), not using a condom at last sexual intercourse (OR, 1.37; CI, 1.03-1.82), having been involved in more pregnancies (OR, 1.64; CI, 1.29-2.08), and having vomited or used laxatives (OR, 3.44; CI, 2.18-5.43) were associated with having been forced or pressured to have sex. CONCLUSIONS: Patterns of risk behaviors differed among sexually active male and female adolescents reporting being forced or pressured to have sex. Having been forced or pressured to have sex was associated with externalizing behavior, such as fighting, among girls and with internalizing behavior, such as bulimia, among boys. These unexpected associations have notable implications for screening adolescents for a history of having been forced or pressured to have sex.

Adolescent↗
PubMed1991

Independent associations of educational attainment and ethnicity with behavioral risk factors for cardiovascular disease.

The authors examined the independent associations of educational attainment and ethnicity with behavioral risk factors for cardiovascular disease using data from the 1989 baseline survey for the New York State Healthy Heart Program. This telephone survey used the Centers for Disease Control Behavioral Risk Factor Survey interview instrument and was conducted in eight communities (total population, approximately 1.24 million people) in New York State. The response rate was 65.5% (n = 4,179); 3,606 subjects aged 20-64 years with self-described ethnicity of white (n = 1,935), black (n = 1,035), or Hispanic (n = 636) and of known educational status were retained in the analysis. After adjustment for age, sex, and ethnicity, significant associations were found between educational attainment and smoking, lack of regular exercise, overweight, diet atherogenicity, and knowledge about blood pressure and cholesterol. After adjustment for age, sex, and educational attainment, associations were found between ethnicity and most of these same variables. Blacks and Hispanics generally had less favorable risk factor profiles. These data indicate that the differences in cardiovascular disease risk profiles between whites and blacks or Hispanics cannot be fully explained by underlying differences in educational attainment. The differing patterns of risk factor distribution by educational attainment within ethnic groups have implications for the segmentation of risk reduction programs.

Adult↗
PubMed2001

Adolescent cigarette smoking and health risk behavior.

During the past 30 years, tobacco use among adolescents has substantially increased, resulting in major health problems associated with tobacco consumption. The purpose of this study was to identify adolescent smoking behaviors and to determine the relationship among smoking, specific demographic variables, and health risk behaviors. The sample consisted of 93 self-selecting adolescents. An ex post facto design was used for this study and data were analyzed by using nonparametric statistics. Findings included a statistically significant relationship between lifetime cigarette use and ethnicity. Statistically significant relationships were also found among current cigarette use and ethnicity, alcohol use, marijuana use, suicidal thoughts, and age at first sexual intercourse. Nurses and other providers must recognize that cigarette smoking may indicate other risk behaviors common among adolescents.

Adolescent↗
PubMed2000

Gender Differences in HIV Risk Behaviors among Young Adults and Adolescents Entering a Massachusetts Detoxification Center.

We examined gender differences in HIV risk behaviors among young substance abusers 17 through 25 years of age. A voluntary and confidential survey inquiring about HIV-related risk behaviors was administered to clients (N = 200 respondents) on intake at a drug detoxification center in Massachusetts. Female respondents were more likely than males to report having shared their needles (p < 0.01), having had sex in exchange for drugs or money (p < 0.01), sex with an HIV-infected partner (p < 0.01), and sex with an injection-drug user (p < 0.01). They were also more likely to report having been diagnosed with an STD (p < 0.01). Nineteen percent of females (compared to 32% of males) reported always having used condoms for vaginal sex (p = 0.08), and 16% of females compared to 35% of males reported always having used condoms for anal sex (p = 0.06). In our cohort of substance-abusing youth, adolescent and young adult females were more likely than males to report unsafe injection-drug use and sexual practices. The results of this study suggest that programs designed to decrease HIV risk among high-risk substance abusers in detoxification centers should be gender specific.

Journal Article↗
PubMed2005

Youth assets and sexual risk behavior: the importance of assets for youth residing in one-parent households.

CONTEXT: Youth assets are associated with a reduction in sexual risk behavior; however, little is known about this association among youth at high risk of engaging in unsafe behavior, such as those in one-parent households. METHODS: In-home interviews were used to collect data from 1,253 inner-city teenagers and their parents. Multivariate logistic regressions were conducted separately for youth from one- and two-parent households to assess relationships between youth assets and four behaviors related to sexual risk: never having had sexual intercourse, not being currently sexually active, having delayed intercourse until age 17, and having used birth control at last intercourse. RESULTS: Among youth living in one-parent households, those with the aspirations for the future, good health practices (exercise/nutrition), peer role models and family communication assets had significantly elevated odds of reporting one of the behaviors examined (odds ratios, 1.8-7.3). The peer role models asset also interacted with parental education to significantly predict an absence of current sexual activity for youth in one-parent households (21.2). Among youth living in two-parent households, community involvement was linked to increased odds of never having had sex (1.9), but no other significant relationships were found. Youths' total number of assets significantly predicted three of the four behaviors among youth in one-parent households (1.2-1.8), but predicted only sexual inexperience among those in two-parent households (1.4). CONCLUSION: Future research should more fully investigate the role of family structure in relationships between youth assets and risk behaviors. Certain youth assets may be particularly effective in reducing sexual risk behavior among youth in one-parent households.

Adolescent↗
PubMed2005

Institutionalization of social and behavioral risk factor surveillance as a learning system.

OBJECTIVES: This paper extends further the systematic nature of social and behavioral risk factor surveillance by showing how it becomes a learning system. The authors argue that such a systematic approach will lead to a better informed public health practice and a better understanding of key public health concerns such as obesity. METHODS: This paper is based on methods developed over some 25 years of experience in designing and operating behavioral risk factor surveillance systems. Measurement issues still remain a key concern and special attention is paid to the role of time as a critical variable in developing a surveillance system. RESULTS: The paper lays out five critical areas for attention if a system is to be considered a learning system. Examples are given from ongoing surveillance systems that have developed a base for a learning system and notes how these are institutionalized. CONCLUSIONS: In the ideal case a learning system based on sociobehavioral surveillance is dependent on data being collected continuously with careful attention paid to the analytical challenges of such complex data. This is an ideal systematic approach that has not been realized in most surveillance systems now available.

Cross-Sectional Studies↗
PubMed2000

Self-efficacy and HIV-related risk behaviors among multiethnic adolescents.

A cross-sectional correlational design was used to investigate (a) self-efficacy and risk behaviors related to HIV; (b) the comparative predictiveness of self-efficacy and knowledge, attitudes, and beliefs regarding sexual activity and substance use; and (c) possible risk profiles for HIV among adolescents. High school students (N = 427), ranging in age from 12 to 20 years and attending Family Life Education classes in Alameda, California, volunteered to complete a self-administered questionnaire, resulting in a 73% response rate. Ethnic representation included African American, Chinese, Filipino, other Asian/Pacific Islander, Latino, and European American. Over half of this sample of teens were sexually active by the age of 14, with sexually active teens and substance-using teens scoring higher on HIV knowledge, attitudes, and beliefs regarding HIV-related behaviors. Ethnicity consistently appeared more significant in predicting these risk behaviors than gender, self-efficacy, and knowledge, attitudes, and beliefs. The predominance of ethnicity as the predictor for these HIV risk behaviors indicates that theoretical models for behavior change must include a dimension of culture, diversity, and ethnic identity.

Adolescent↗