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PubMed1994

Risk behavior and correlates of risk for HIV infection in the Dallas County Household HIV survey.

OBJECTIVES: The Dallas County study of a proposed national household seroprevalence survey was designed to assess the feasibility of conducting a national survey and to estimate the prevalence of human immunodeficiency virus (HIV) and hepatitis B virus infection for Dallas County. Risk behavior data were collected and correlated with HIV infection. METHODS: Participants in this survey represented a probability sample of the county. A self-administered questionnaire on demographic characteristics and HIV risk behavior was completed and a blood sample was obtained. RESULTS: Of the 1724 adults eligible for the survey, 1446 completed the questionnaire and 1374 provided a blood sample. The prevalence estimates were 0.4% for HIV and 7.3% for hepatitis B virus. A strong relationship was observed between HIV and hepatitis B status and risk behavior. CONCLUSIONS: In this study population, receptive anal intercourse and increasing numbers of male partners had the strongest correlation with the prevalence of HIV and hepatitis B virus infection in men. The high level of risk reporting for individuals positive for HIV or hepatitis B suggests that survey participants who engage in risk behaviors were willing to report those behaviors.

Adult↗
PubMed2001

Human immunodeficiency virus in semen and plasma: investigation of sexual transmission risk behavioral correlates.

Risks for sexually transmitted HIV may be related to concentrations of virus detected in semen and previous research shows a small to moderate association between viral load in blood and semen. This study examined the association between viral load in semen and plasma in a community sample of HIV-infected men and is the first study to examine semen viral load in relation to sexual transmission risk behaviors. A sample of 44 HIV-positive men recruited from community service agencies provided semen, blood, and urine samples and completed clinical interviews assessing health and behavior. We failed to find an association between viral load in semen and plasma, Spearman rho = 0.07, p > 0.1. When restricted to participants with detectable virus in semen and plasma, the correlation remained nonsignificant, rho = -0.16, p > 0.1. Men who had higher semen viral loads relative to their plasma viral load were distinguished by having engaged in significantly higher rates of unprotected intercourse as the insertive sex partner in the previous 3 months. Semen viral load was not, however, related to recent or current sexually transmitted infections (STIs). This study is among the first to examine sexual transmission risk behaviors as marker for HIV infectiousness. Results caution against inferring sexual transmission infectiousness based on plasma viral load and suggest that HIV-positive men who practice higher rates of insertive intercourse may be more infectious even in the absence of other STIs.

Adult↗
PubMedDate not supplied

A voluntary serosurvey and behavioral risk assessment for human immunodeficiency virus infection among college students.

The authors conducted a voluntary serosurvey and educational campaign among 3394 undergraduate students attending the University of Maryland at College Park to determine the prevalence of and risk factors for human immunodeficiency virus type 1 (HIV-1) infection. Two students were seropositive (0.06%, 95% confidence interval 0-0.15%). Both were homosexual men with multiple sexual partners. Despite the low prevalence of infection, potential risk factors for transmission of HIV-1 were common, as assessed by a self-administered anonymous questionnaire. These included a previous sexually transmitted disease (12.6%), male homosexual intercourse (4.8% of men), heterosexual anal intercourse (25.3%), heterosexual intercourse with a person at risk (an HIV-1 infected person, a bisexual man, a parenteral drug user, a female prostitute, or a hemophiliac) (5.2%), multiple sexual partners (21% reported 10 or more lifetime partners), and intravenous drug use (1.3%). Assessment of the efficacy of our program by comparing responses on pre- and post-test questionnaires showed gains in knowledge about heterosexual transmission of HIV-1 and an increase in the reported frequency of condom use 1-2 months after participating in the survey. The authors conclude that HIV-1 infections are occurring among college students but in our study group remain confined to persons with known high-risk behavior; however, practices that may support transmission are common, and programs designed to diminish these behaviors among college students are needed.

Adolescent↗
PubMedDate not supplied

The behavioral risk factor surveys: I. State-specific prevalence estimates of behavioral risk factors.

The prevalence of most behavioral risk factors varies substantially among states. The prevalence of current cigarette smoking ranges from 22 percent to 38 percent. Estimates of alcohol use show geographic clustering, with lower rates in the southeastern states. The prevalence of sedentary lifestyle, uncontrolled hypertension, overweight, and seatbelt use differs markedly among states. These findings represent an initial step toward the analysis of state-specific baseline risk-factor data for use in developing state programs aimed at reducing the leading causes of death in the United States.

Adult↗
PubMed1990

Towards an understanding of risk behavior: an AIDS risk reduction model (ARRM).

This report presents a three-stage model (ARRM) that characterize people's efforts to change sexual behaviors related to HIV transmission. ARRM focuses on social and psychological factors hypothesized to influence (1) labeling of high risk behaviors as problematic, (2) making a commitment to changing high risk behaviors, and (3) seeking and enacting solutions directed at reducing high risk activities. The proposed model integrates important concepts from prior behavioral medicine and human sexuality studies, specifies their differential import to achieving the goals associated with each stage of the model, and denotes factors hypothesized to influence people's motivation to continue the change process over time. Current findings are discussed within this three-stage model and directions for further research are suggested. Recent findings from our ongoing studies of gays and heterosexuals in San Francisco are presented.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

Knowledge of AIDS transmission, risk behavior, and perceptions of risk among urban, low-income, African-American and Hispanic youth.

Low-income, urban, African-American and Hispanic youth have been identified as a group that may be at risk for the spread of human immunodeficiency virus (HIV). This article evaluates general knowledge of acquired immunodeficiency syndrome (AIDS), knowledge of routes of sexual transmission of HIV, risk behaviors related to sex, and perceived susceptibility to AIDS of urban low-income youth in Detroit. We drew data from a household probability sample of 1,435 of these Detroit youth. The data indicate that, with a few exceptions, general knowledge of AIDS and routes of sexual HIV transmission was good; there were small ethnic and gender differences in knowledge. However, we found substantial ethnic and gender differences in risk behaviors. Young African-American men reported the earliest initiation of sexual activity and the most partners. Young Hispanic women reported the latest initiation of sexual activity and the fewest partners. A substantial minority of the youth were concerned about becoming infected with HIV, and these concerns were related to risk behavior. We demonstrate from these data a need for interventions in this population to correct misconceptions and to promote use of condoms and other safer sexual behaviors.

Acquired Immunodeficiency Syndrome↗
PubMed1996

Aids, violence and behavioral coding: information theory, risk behavior and dynamic process on core-group sociogeographic networks.

Elsewhere we have presented a traveling-wave analysis of HIV transmission on a tightly self-interactive, geographically-focused core group social network (Wallace R. Soc. Sci. Med. 32, 847, 1991; Soc. Sci. Med. 33, 1155, 1991; Environ. Plan. A. 26, 767, 1994; Wallace R. and Fullilove M. Environ. Plan. A. 23, 1701 1991). Here we reanalyze the problem in probability space and recover a close analog of the Shannon Coding Theorem of information theory. Subsequent direct application of information-theoretic methods provides striking insight regarding the spread of disease along the sociogeographic networks of marginalized subgroups, suggesting that 'risk behaviors' for infection may constitute essential components of a behavioral code for the transmission of information within the noisy channel of a marginalized community's social networks. The code's form, including the incorporation of risk behaviors, arises as a direct consequence of the external oppressive forces which structure marginalization. This viewpoint suggests an explanation of the sometime-observed rapid transmission of both infection and of control strategies for infection along the same network, but suggests further that if risk behaviors are indeed parts of a behavioral code for the transmission of group norms, statements of individual worth or resource sharing, then high rates of relapse are inevitable, given the persistence of the external oppression which gives those behaviors symbolic value. We suggest that violent acts in particular may emerge as key behavioral symbols for 'sending a message' in socially disorganized communities, implying that school-based or other individual-oriented harm reduction strategies for violence prevention, in the absence of a comprehensive, multifactorial reform program, cannot significantly reverse the effects of continuing economic and social constraints or of public policies of planned shrinkage and benign neglect, factors primarily responsible for the disorganization of urban minority communities within the United States.

Acquired Immunodeficiency Syndrome↗
PubMed2002

The alcohol-related psychosocial and behavioral risks of a nationally representative sample of adolescents.

This study, a secondary analysis of the National Longitudinal Study of Adolescent Health, used a representative sample of 7th-through 12th-grade students enrolled in US public schools between April and December 1995. Data were collected in respondents' homes using trained interviewers. A subset of 4,485 adolescents aged 12-17 were surveyed with regard to alcohol-use practices and related health-risk behavior, interpersonal problems, and demographic characteristics. Results showed adolescent males as significantly more likely to drink at high risk than adolescent females. Among those who drank one or more times in the past year, older adolescents were significantly more likely to report high-risk drinking than younger adolescents. Significantly more high-risk adolescents reported having a hangover, vomiting, regretting a behavior, having trouble with parents, regretting a sexual activity, having dating problems, fighting, having trouble with friends, and experiencing school trouble than did low-risk adolescents. These findings underscore the long-range significance of a coordinated school health program; in particular, school health services, school health instruction, and school health environment. Implications for school-based and community-based prevention and intervention programs are presented.

Adolescent↗
PubMed2005

[Management of behavioral risk factors for cardiovascular disease (CVD)].

Changes in many patterns of individual risk behaviors (unhealthy diet, smoking, sedentary lifestyle) are necessary in a large majority of patients with established CVD or at high risk of CVD. Make healthy food choices. Energy intake must be adjusted to maintain ideal body weight. Eating from each major food group will ensure dietary balance. The consumption of fruits and vegetables, whole grain cereals and bread, low fat dairy products, fish and lean meat should be encouraged. Oily fish and omega-3-fatty acids are specially recommended. Saturated and trans fatty acids should be replaced with MUFA's or PUFA's of vegetable and seafood origins. Totalfat intake should account for no more than 30% of energy intake, and intake of saturated fats should not exceed a third of total fat intake. The intake of cholesterol should be less than 300 mg/day. Stop smoking tobacco. All smokers should be professionally encouraged to permanently stop smoking all forms of tobacco. Increase physical activity. A lack of regular physical activity may contribute to the early onset and progression of Cardiovascular Disease. Regular physical activity and the maintenance of physical fitness is beneficial in all age groups and should be promoted as an integral part of cardiovascular prevention. Healthy people should be advised to choose enjoyable activities, which fit into their daily routine, preferably 30-40 min, 4-5 times weekly at Borg 13 or at 60-75% of the average maximum heart rate. For patients with established CVD, advice must be based on a comprehensive clinical judgement including the results of an exercise test.

Cardiovascular Diseases↗
PubMed1995

The co-morbidity of violence-related behaviors with health-risk behaviors in a population of high school students.

PURPOSE: To describe the frequency of violence-related behaviors and their association with other health behaviors among high school students. METHODS: The Youth Risk Behavior Survey was administered to all ninth and eleventh graders (n = 2075) of a school district in Texas. It provided information regarding violence-related behaviors and other health behaviors. Students were classified into four mutually exclusive, violence-related categories according to whether they were involved in a physical fight and/or carried a weapon. RESULTS: Overall, 20% of the students were involved in a physical fight but had not carried a weapon, 10% carried a weapon but had not been involved in a physical fight, and 17% had been involved in a physical fight and had carried a weapon. Prevalence of weapon-carrying and fighting were higher among males than females, and among ninth graders than eleventh graders. Among males, 48% had carried a weapon the month prior to the survey. Students who both fought and carried a weapon were 19 times more likely to drink alcohol six or more days than students who did not fight nor carried a weapon. Logistic regression analyses showed that drinking alcohol, number of sexual partners, and being in ninth grade were predictors of fighting. These three variables plus having a low self-perception of academic performance and suicidal thoughts were predictors of fighting and carrying a weapon. CONCLUSIONS: The data indicate that violence-related behaviors are frequent among high school students and that they are positively associated with certain health behaviors. Interventions designed to reduce violence should also address coexisting health-risk behaviors and target high-risk groups.

Adolescent↗
PubMed2000

Sexual risk behaviors among heterosexual HIV serodiscordant couples in the era of post-exposure prevention and viral suppressive therapy.

OBJECTIVES: To describe awareness and use of antiretroviral treatments, viral load monitoring, and post-exposure prevention; to assess changing concerns about HIV transmission; and to examine the effect of these advances on sexual behavior in HIV-serodiscordant heterosexual couples. METHODS: Cross-sectional analysis of a baseline sample of 104 couples (n = 208 individuals) from the California Partners Study II, an intervention trial for HIV-serodiscordant couples in California. Questions on sexual practices, viral load testing, HIV treatment, post-exposure prevention, and their effect on sexual behaviors, risk taking and transmission concerns were measured at intake. RESULTS: Over two-thirds of couple members surveyed reported unprotected sex with their partner in the past 6 months. Among seropositive respondents, 37% were taking protease inhibitor therapy, 92% had undergone viral load testing, and of those, 40% said it had ben undetectable at their most recent test. Most respondents, regardless of serostatus, said that viral load testing and awareness of post-exposure prevention had no effect on their condom use. In addition, perceiving that their partner had an undetectable viral load was associated with having protected sex among seronegative subjects (P < 0.05). Seropositive respondent taking protease inhibitors were 2.4 times less likely to report unprotected sex compared with those not taking protease inhibitors (P = 0.05). However, up to 33% of seropositive and 40% of seronegative respondents acknowledged decreased transmission concerns in the light of the new HIV treatments. In comparison with their seropositive partners, seronegative individuals were more likely to acknowledge increased risk taking and decreased HIV transmission concerns (P < 0.05). CONCLUSIONS: New medical advances were not associated with unprotected sex in HIV-serodiscordant couples. However, new treatment options may decrease concerns about HIV transmission, particularly among seronegative partners. Providers should discuss the effect of antiretroviral treatments on sexual transmission risk with their patients. The inclusion of seronegative partners in counseling interventions may decrease risk taking in serodiscordant couples.

Adult↗
PubMed2004

Risk behaviors and healthcare coverage among adults by frequent mental distress status, 2001.

BACKGROUND: Given the increased emphasis on chronic diseases in the United States, physicians and health survey analysts are now gathering information on patients' subjective measures of health, also known as health-related quality-of-life measures. Studies indicate that these measures can be more powerful predictors of chronic disease-related morbidity and mortality than objective measures. METHODS: The Behavioral Risk Factor Surveillance System (BRFSS) is an ongoing, state-based, random-digit-dialed telephone survey of the non-institutionalized U.S. population aged 18 years or older. This study examined frequent mental distress (FMD), defined as self-reported 14 or more mentally unhealthy days in the past 30 days, and its association with adverse health behaviors and lack of healthcare coverage. RESULTS: In 2001, approximately 10% of adults reported FMD. Persons reporting FMD had a higher prevalence of smoking, drinking heavily, physical inactivity, and obesity than did persons without FMD. They were also more often without healthcare coverage. In addition, persons with FMD were more likely to engage in multiple adverse behaviors than were persons without FMD. CONCLUSIONS: Persons reporting FMD are at higher risk of chronic diseases because they engage in risky health behaviors and lack healthcare coverage. This study provides further support that mental health screening as well as physical health screening is important in clinical practice. Further research is needed to identify therapeutic or mental health-promoting interventions to reduce mental distress and reinforce healthy behaviors.

Adolescent↗
PubMedDate not supplied

Urban seventh graders and smoking: a health risk behavior assessment.

Health risk behaviors undertaken in adolescence, such as smoking, can have a lasting impact on both short-term and long-term health developments. To better describe the health risk behaviors of an adolescent urban population, a study was conducted at two parochial middle schools in the southwest section of Philadelphia. The study purpose was to describe (1) the types of health risk behaviors being undertaken by a seventh grade student population, (2) the frequency of health risk behaviors, and (3) the age of initiation of the health risk behavior, e.g., age when they first began smoking. A descriptive, correlational study was undertaken with 106 urban seventh graders (ages of 11-13 years) from two seventh grade classes. Using the Youth Risk Behaviors Surveillance System Questionnaire, information was collected about health risk behaviors. Correlational statistics indicated significant correlations between students who smoke and alcohol use, dieting, and not feeling safe in their neighborhood. Interestingly, girls were more likely to use smoking as their primary method of weight control and dieting. Because the long-term impact of smoking is known to be negative, nurses should provide support to this at-risk population and also should be prepared to educate adolescents who come under their care.

Adolescent↗
PubMed2004

Prevalence and risk behaviors for chlamydial infection in a population-based study of female adolescents in Brazil.

BACKGROUND: Adolescents are vulnerable to sexually transmitted infections (STIs) and unplanned pregnancy. Prevention measures and assistance are of significant public health importance in this population. OBJECTIVE: The objective of this study was to identify demographic, behavioral, and clinical factors for STIs and to determine the prevalence of Chlamydia trachomatis infection (CT) among female adolescents in Vitória, Brazil. METHODS: We performed a cross-sectional study among female adolescents (15-19 years) served by the Health Family Program. Participants were screened for CT and Neisseria gonorrhoeae (GC) using ligase chain reaction applied to urine and answered a face-to-face questionnaire to assess demographic, behavioral, and clinical factors. All participants and their parents signed the informed consent. RESULTS: Four hundred sixty-four young women were sampled. The prevalence of CT was 8.9% (95% confidence interval [CI], 6.5-11.9%) overall. Among sexually active women, CT and gonorrhea prevalence were 12.2 (95% CI, 9.4-17.0%) and 1.9% (95% CI, 1.1-2.7%), respectively. Previously diagnosed STI was reported by 12.8%. Women who reported regular condom use and having condoms at home were significantly less likely to have CT, and having never purchased condoms was significantly associated with a positive CT result. CONCLUSION: A high prevalence of CT was found in this population, and behavioral risk was high despite readily available STI prevention information. Women who reported positive condom use behaviors were less likely to have CT. These results demonstrate the need for ongoing STI prevention activities, including STI screening and continued successful risk reduction activities such as condom use to further decrease CT and other STI among adolescents.

Adolescent↗
PubMed1990

Behavioral risk factors of human immunodeficiency virus infection among intravenous drug users and implications for preventive interventions.

Risk behaviors for HIV infection in relation to drug and sexual activities among 262 intravenous drug users (IVDUs) from methadone clinics in New York City were investigated using a structured questionnaire in 1986. The overall seroprevalence rate was 60.1 per cent. Intravenous heroin and cocaine users were found to be significantly more likely to be HIV positive than those who used heroin and cocaine intranasally. Among female IVDUs, excluding prostitutes (defined by self-report of sex for money or drugs), the HIV positive participants reported higher numbers of sex partners than those participants who were HIV negative. The female IVDUs who reported prostitution during the last 12 months were less likely to be HIV positive than those who did not. All males who reported passive anal and oral sex without using condoms during the last 12 months were found to be HIV positive. All female prostitutes who reported use of condoms during the last 12 months were found to be HIV negative. Interventions in methadone maintenance programs should focus on the IVDUs who are still using heroin, cocaine, and marijuana; sexually active females; and those IVDUs not using condoms (particularly among prostitutes).

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

Risk behavior, perceptions of HIV risk, and risk-reduction behavior among a small group of rural African American women who use drugs.

HIV/AIDS is a health crisis for African Americans. African American women are exposed to HIV primarily through sexual behavior, which is an increased risk for women who use drugs. The study design was a mixed method consisting of an ethnography with ongoing participant observation and in-depth interviews and a questionnaire. The purpose of the questionnaire component was to explore drug use, sexual behavior, health history, and perceptions. The questionnaire was administered at months 6 and 18. Data for this report were derived from the first questionnaire with 30 respondents. The majority of respondents (82.7%) used polysubstances consisting of cocaine, marijuana, and alcohol. Between 33% and 50% exchanged sex for drugs or money, with less than half ever using condoms. About 37% perceived that they had no risk of acquiring HIV, whereas 52% perceived a 25% chance. The pattern of HIV testing in which 33% of the women were tested 10 times or more was unexpected because of the low perception of risk. The principal conclusion was that there is great need to intervene with prevention efforts targeting rural women who use drugs in an attempt to curb increasing rates of sexually transmitted infections including HIV.

Adolescent↗
PubMed2005

Behavioral risk exposure and host genetics of susceptibility to HIV-1 infection.

BACKGROUND: Some individuals are readily infected with low human immunodeficiency virus type 1 (HIV-1) exposure, whereas others appear less susceptible, suggesting that host genetics plays a role in the viral entry pathway. The matched case-control study design with measured risk exposures provides an avenue for discovering genes involved in susceptibility to infection. METHODS: We conducted a nested case-control study of African Americans (266 HIV-1 seroconverter cases and 532 seronegative controls from the AIDS Link to Intravenous Experience cohort), to examine the association between 50 single-nucleotide polymorphisms (SNPs) in 9 candidate genes (CCR5, CCR2, RANTES, MIP1A, MCP2, IL10, IFNG, MCSF, and IL2) and susceptibility to HIV-1 infection. To account for differential exposure propensities, risk behavior self-reported during semiannual visits was used to estimate a standardized cumulative risk exposure (SCRE). Individual SNPs were evaluated using conditional logistic-regression models, and the inferred haplotypes were assessed in the haplotype trend regression analyses after adjusting for age and SCRE. RESULTS: Four SNPs (CCR2-V64I, CCR5-2459, MIP1A+954, and IL2+3896) and specific haplotypes in the IL2 and CCR2/CCR5 regions were significantly associated with HIV-1 infection susceptibility in different genetic models. CONCLUSIONS: Our results suggest that genetic variants in associated host genes may play an important role in susceptibility to HIV-1 infection.

Adult↗
PubMed2000

Risk behaviors and the prevalence of Chlamydia in a juvenile detention facility.

The prevalence of Chlamydia trachomatis, a sexually transmitted disease, and the association of selected behavioral risk factors were assessed in a population of adolescents in two juvenile detention facilities. Urine was collected for Chlamydia testing and a brief interview conducted for risk and demographic information. Almost all of the 200 participants were sexually active, many before the age of 13 years. The prevalence of Chlamydia infection was 22.2% among female and 8.7% among male participants. Injection drug use was the only statistically significant variable associated with infection. Education and community services are necessary to break the cycle of infection for this high-risk population.

Adolescent↗