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PubMed2007

Prevalence of treatment optimism-related risk behavior and associated factors among men who have sex with men in 11 states, 2000-2001.

Sustainable behavior change among men who have sex with men (MSM) may be threatened by optimistic beliefs about HIV treatments: treatment optimism has been associated with high risk sexual behaviors. We used data from behavioral surveys of MSM attending gay bars in 11 states from 2000-2001 to describe the prevalence and correlates of being less careful with sex or drugs because of treatment optimism (optimism-related risk behavior). Fifteen percent of 1477 HIV-negative or -untested MSM reported optimism-related risk behavior. Optimism-related risk behavior was reported more often by Black and Hispanic MSM (versus white), more often by MSM with a high school education or less (versus college), and less often by MSM in some states. HIV prevention programs should address treatment optimism and related behavioral risks by providing culturally appropriate information, accessible to MSM with lower educational attainment, about the limitations of current therapies.

AIDS Serodiagnosis↗
PubMedDate not supplied

[Trends in the prevalence of HIV infection and risk behaviors in homo- and bisexual men].

OBJECTIVES: To describe trends in the prevalence of HIV infection, in risk behaviors and in knowledge and attitudes related to antiretroviral therapy (ART) among men who have sex with men (MSM) recruited in Barcelona (Spain) between 1995 and 2002. METHODS: Cross-sectional surveys were conducted twice yearly from 1993. MSM were recruited in saunas, sex-shops, a cruising site in a public park and by a mailing sent to all members of a gay organization, using an anonymous self-administered questionnaire. From 1995 saliva samples were requested to determine the prevalence of HIV infection. RESULTS: The prevalence of HIV infection remained stable from 14.2% in 1995 to 18.3% in 2002 (p > 0.05). The proportion of men who had more than 10 sexual partners in the previous 12 months showed an increasing trend (from 45.2% in 1995 to 55.7% in 2002, p < 0.0001). Unprotected anal intercourse (UAI) with casual partners did not change significantly between 1995 and 2002 (25.8% en 2002). In 2002, 55.8% of steady couples in which one or both members did not know their serological status and 27.5% of serodiscordant couples reported UAI. The proportion of men who believed that "HIV-positive persons taking ART (7.7% in 2002) or with undetectable viral load (6.4% in 2002) cannot transmit the virus" remained steady since 1998 (p > 0.05). CONCLUSIONS: The prevalence of HIV and risk behaviors continues to be high among MSM in Barcelona. A strategic objective in the control of the HIV epidemic must be to continue the decrease in the number of occasions on which UAI takes place between men with discordant serological status.

Adult↗
PubMed2002

Ethnic and gay community attachments and sexual risk behaviors among urban Latino young men who have sex with men.

Culturally relevant prevention programs are required to reduce HIV risk exposure of Latino young men who have sex with men (YMSM). As part of Hermanos Jóvenes, 465 Latino YMSM were surveyed at community venues of New York City outside the gay-identified area of lower Manhattan. We examined factors that influence ethnic and gay community attachments; the association between community attachments and social support in sexual matters; and the relationship between levels of attachment, social support in sexual matters, and sexual risk behaviors. Sixty-eight percent felt closely connected to their ethnic community; about 34% were highly attached to both neighborhood and New York City gay communities. Greater social support in sexual matters was associated with ethnic and gay community attachments. Latino YMSM connected to their ethnic community were about 40% less likely to report recent unprotected anal intercourse (UAI) with a male partner, and 60% less likely to have engaged in UAI during the last sexual contact with a nonmain male partner. Gay community attachment was not significantly related to risk behaviors. Findings point to the importance of ethnic ties and involving ethnic community organizations in HIV prevention efforts.

Acculturation↗
PubMed1996

Sexual risk behavior among urban women of childbearing age: implications for clinical practice.

Cox's interaction model of client health behavior was used as an organizing framework to describe the demographic characteristics, motivation, problem-solving, self-esteem, and sexual risk behaviors among urban women of childbearing age (N = 125; average age = 32 years). Eighty-five percent of the women were African American. Sexual risk behaviors were defined as more than one sex partner and not using a condom. Eight women were at the highest risk in that they reported having more than one sex partner and not using condoms. Participants reported low self-esteem, intrinsic motivation, and adequate problem-solving abilities. Motivation scores were significantly different based on number of sex partners (t = 2.26, p = .03). Women with more than one partner had lower scores compared to women with only one partner. There was a significant variation in reported self-esteem among women who used condoms (t = 2.36; p = .22). Women who did not use condoms reported lower self-esteem than women who said that they used condoms.

Adult↗
PubMed2004

Assessing health risk behaviors among adolescents: the effect of question wording and appeals for honesty.

PURPOSE: To understand how methodological factors influence prevalence estimates of health-risk behaviors obtained from surveys, we examined the effect of varying question wording and honesty appeals while holding other aspects of the surveys constant. METHODS: A convenience sample of students (n = 4140) in grades 9 through 12 was randomly assigned to complete one of six versions of a paper-and-pencil questionnaire in classrooms. Each questionnaire version represented a different combination of honesty appeal (standard vs. strong) and questionnaire type. The questionnaire types varied in wording and in the number of questions assessing particular types of behaviors. The questionnaires were based on those used in three national surveys--the Youth Risk Behavior Survey, Monitoring the Future, and the National Household Survey on Drug Abuse. Logistic regression analyses examined how responses to each survey question assessing behavior were associated with questionnaire type, honesty appeal, and the interaction of those two variables. RESULTS: Among 32 behaviors with different question wording across questionnaire types, 12 showed a significant effect of questionnaire type. Among 45 behaviors with identical question wording across questionnaire types, five showed a significant main effect of questionnaire type. Among all 77 behaviors, one showed a significant main effect for honesty appeal and two showed a significant interaction between honesty appeal and questionnaire type. CONCLUSIONS: When population, setting, questionnaire context, mode of administration, and data-editing protocols are held constant, differences in question wording can create statistically significant differences in some prevalence estimates. Varying honesty appeals does not have an effect on prevalence estimates.

Adolescent↗
PubMed2004

Long-term effects of syringe exchange on risk behavior and HIV prevention.

The purpose of this study was to assess stability of population-level injection risk behavior over time among participants in a syringe exchange program and compare factors affecting syringe sharing at two points in time. Participants of the Tacoma Syringe Exchange Program were interviewed in 1997 and 2001 using audio computer assisted self-interviewing technology. In each wave of data collection, a random cross section of participants was recruited and interviewed, with no attempt made to follow respondents over time. Rates of injection risk behavior remained stable across the 4-year period, despite increases in factors associated with syringe sharing. Homelessness, rates of depression symptoms, and injection of amphetamines all increased from 1997 to 2001. The central factors associated with syringe sharing in both 1997 and 2001 were depression symptoms and the interaction of younger age with amphetamine injection. The data indicate that the exchange has been able to stabilize risk among a high-risk population for a substantial period of time. This study confirms previous findings that SEPs can play a significant role in the prevention of HIV in marginal and impoverished communities in the United States.

Adult↗
PubMed2005

Health status, arthritis risk factors, and medical care use among respondents with joint symptoms or physician diagnosed arthritis: findings from the 2001 Behavioral Risk Factor Surveillance System.

OBJECTIVE: . The Behavioral Risk Factor Surveillance System (BRFSS) telephone interview study provides estimates indicating that approximately one-third of US adults meet the Centers for Disease Control and Prevention (CDC) case definition for arthritis. However, this population includes very diverse groups with major differences in health status, risk factors and disability. METHODS: BRFSS data for 2001 were compared for 4 roughly equal size groups of respondents reporting joint symptoms or a physician's diagnosis of arthritis: those with transient joint symptoms (TJS), chronic joint symptoms (CJS), a physician diagnosis of arthritis (PDA), and those with both PDA and CJS. RESULTS: By far the greatest burden of arthritis related disability is concentrated among individuals reporting both CJS and PDA. After controlling for age, sex, race, ethnicity, and education, this group had over 7 times the likelihood of fair to poor health status compared to the general adult population without arthritis. About one-third of those with undiagnosed CJS reported activity limitations, one-quarter were without health insurance at some point during the previous year, and this group had over 3 times the likelihood of reporting fair to poor health compared to the general population. Obesity was an even more prevalent arthritis risk factor than physical inactivity. CONCLUSION: The results support the validity of the CDC case definition of arthritis, which excludes TJS. However, a previous PDA in the absence of current symptoms was in itself a poor predictor of activity limitations due to arthritis. Findings will be useful in evaluating subsequent revisions of the CDC arthritis case definition and monitoring the burden of arthritis.

Adult↗
PubMed2004

Associations between youth risk behavior and exposure to violence: implications for the provision of mental health services in urban schools.

This article assesses the relation between health risk behaviors and varying levels of exposure to violence in an effort to inform assessment and intervention efforts of a school-based mental health program serving inner-city youth. Health risk behaviors such as involvement in violence, risky sexual behavior, and substance use are clearly associated, both with each other and with violence exposure. However, differential relationships were observed depending on the nature of violence exposure. Knowledge of violence was associated with substance use and sexual behavior variables. Witnessing violence was associated with violence involvement, substance use, and exercise variables. Finally, violent victimization was associated with violence involvement and sexual behavior variables. A more complete understanding of the associations among health risk factors and violence exposure variables has the potential to improve implementation of school mental health services for urban youth.

Adolescent↗
PubMed2006

Strong HIV and hepatitis disclosure norms and frequent risk behaviors among Hungarian drug injectors.

Ethnographic interviews and focus groups were conducted between May 2003 and January 2004 among injection drug users (IDUs; n=29) in Budapest, Hungary, to assess knowledge related to HIV, hepatitis B (HBV), and hepatitis C (HCV) and norms, attitudes, and behaviors. Participants perceived themselves at low risk for infection with HIV but at high risk for hepatitis through injection but not sexual exposure. They reported strong disclosure norms for HIV and hepatitis infections, while sexual and injection risk behaviors were influenced by trust about partners' self-report of infection status. Injection networks were small, with infrequent syringe sharing among a few close friends. Cookers and drug filters often were shared, and filters were reused as a backup drug supply. Most sexual relationships were monogamous, and condoms were used rarely. Although participant norms supported HIV/HBV/HCV testing, the lack of available behaviors with injection and sex partners who are close friends. Network interventions among IDUs in Hungary should build on disclosure norms and trust to reduce injection and sex risk. Testing services should be expanded and access increased so that IDUs can act on and reinforce their norms for testing.

Adult↗
PubMed2001

Substance use and sexual transmission risk behavior of HIV-positive men who have sex with men.

We examined substance use in relationship to transmission risk behavior (unprotected insertive, UIAI, or receptive anal intercourse, URAI) between HIV-positive men who have sex with men (MSM) and their HIV-negative or unknown serostatus partners. Men who engaged in transmission risk behavior with casual partners were more likely than men who did not engage in such behavior to have used various substances. Users of certain drugs were specifically less likely to use condoms with HIV-negative or unknown status partners than users. Of men who drank alcohol, those who drank more frequently before or during sex engaged in significantly more UIAI with casual partners. Of men who used drugs, those who used more frequently before or during sex were more likely to engage in URAI with casual partners. In multivariate analyses, use of inhalants as well as drinking before or during sex predicted UIAI, while use of inhalants as well as noninjection drug use before or during sex predicted URAI. HIV prevention programs for HIV-positive MSM should focus on decreasing substance use and use specifically before or during sex. Developing prevention programs for substance-using MSM is critical to improve community health and decrease HIV transmissions.

Adult↗
PubMed2005

Project PREVENT: a randomized trial to reduce multiple behavioral risk factors for colon cancer.

BACKGROUND: This report examines the outcome data for Project PREVENT, a two-site randomized control trial designed to reduce behavioral risk factors for colorectal cancer among individuals who have been diagnosed with adenomatous colon polyps. METHODS: The study sample included 1,247 patients with recent diagnosis of adenomatous colorectal polyps. Within 4 weeks following the polypectomy, participants completed a baseline survey by telephone, and were randomized to either Usual Care (UC) or the PREVENT intervention, which was designed to target multiple risk factors. The intervention consisted of a telephone-delivered intervention plus tailored materials, and focused on the six primary behavioral risk factors for colorectal cancer, including red meat consumption, fruit and vegetable intake, multivitamin intake, alcohol, smoking, and physical inactivity. RESULTS: Participation in the PREVENT intervention was associated with a significantly greater reduction in prevalence of multiple risk factors for colorectal cancer compared with UC. Only about one third of UC participants dropped any risk factors during the study period, compared with almost half of the PREVENT participants. PREVENT participants were also significantly more likely to change more than one behavior than UC participants. CONCLUSIONS: The PREVENT intervention was effective in helping patients change multiple risk factors. These results provide further support that more comprehensive interventions that move beyond emphasis on a single risk factor are acceptable to patient populations, can result in improvements, and are cost effective.

Adenomatous Polyposis Coli↗
PubMedDate not supplied

High-risk behaviors for HIV: a comparison between crack-abusing and opioid-abusing African-American women.

High rates of unprotected sexual behaviors and the exchange of sex for crack have been reported among female crack cocaine users. This subpopulation of drug users is at significant risk for contracting and transmitting HIV and AIDS. To date, there has been no research comparing crack- and opioid-abusing women, particularly regarding their involvement in high-risk behaviors and other key background indicators for different subgroups of drug-abusing women. Sixty-one crack-abusing African-American women who recently entered an intensive outpatient treatment program were compared to 64 matched women whose primary drug of abuse was heroin. The opioid subgroup represented both those who were involved in methadone maintenance and those who were out of treatment. Higher rates of high-risk sexual behaviors were reported by the crack subgroup, including prostitution, number of sexual partners, and infrequency of condom use. As expected, i.v. drug use and high-risk behaviors associated with needle use were much higher among the opioid subgroup. Other significant differences were found between the two groups across key indicators. Individuals in the crack subgroup were younger, cared for more children, were less employable, were less likely to be married, and had more extensive lifetime substance abuse. Quantitative and qualitative background and clinical data are also presented. The nature of crack versus heroin abuse is also discussed, particularly in relation to high-risk sexual behaviors. Finally, the impact of the findings on developing appropriate treatment interventions for both groups is addressed.

Adolescent↗
PubMedDate not supplied

Raw shellfish consumption in California: the 1992 California Behavioral Risk Factor Survey.

We used the 1992 California Behavioral Risk Factor Surveillance System to study the prevalence of raw shellfish consumption in California and the demographic and behavioral characteristics of raw shellfish consumers. We used the logistic regression analysis of the weighted survey data with PC SAS and SUDAAN to adjust for the effects of age and gender. Twenty-three percent of the respondents in the survey reported that they ate raw shellfish; one third of these reported eating raw shellfish once a month. Higher prevalences of raw shellfish consumption were reported by men, persons 18-49 years old, those with income above $25,000 and education beyond high school than by women, individuals older than 49 years, and those with an income of $25,000 or less per year and 12 or fewer years of school. A higher percentage of persons with liver disease, stomach surgery, and a history of chronic alcohol drinking reported consumption of raw shellfish than did individuals without liver disease, previous stomach surgery, or a history of alcohol abuse. After adjustment for gender and age, those who reported acute (P < .01) and chronic (P < .01) drinking and driving while intoxicated (P < .01) were more likely to report consumption of raw shellfish. Two variables (lack of seat belt usage [P = 2] and cigarette smoking [P = .13]) were not significantly associated statistically with raw shellfish consumption.

Adult↗
PubMed1994

Prevalence of adults with no known major risk factors for coronary heart disease--behavioral risk factor surveillance system, 1992.

Although the death rate for coronary heart disease (CHD) in the United States has declined approximately 50% since 1970, CHD remains the leading cause of death for both men and women and, in 1990, accounted for 489,340 deaths. National strategies and programs have targeted individual risk factors for death attributed to CHD. However, an alternative approach may be to measure the prevalence of adults who have no known risk factors for CHD. This report provides state-specific estimates of and characterizes adults who report having no known major risk factors for CHD.

Adult↗
PubMed1999

HIV-risk behaviors in adolescent substance abusers.

Thirty adolescents aged 12-18 years from each group (substance use disorders, psychiatric disorders, and controls) were assessed to explore HIV-risk behaviors and knowledge about HIV/AIDS. Semi-structured instruments for psychiatric and substance use disorders were also administered. There were no significant differences between groups in knowledge of HIV/AIDS. However, chi-square analysis of risk behaviors revealed significant differences between the substance use disorders group and the controls. The knowledge-behavior gap was greater for the substance users than all other groups, in that while they knew an equal amount about HIV/AIDS, they actually engaged in more risky sexual behaviors than the other two groups. It may be that the impulsivity associated with substance use disorders accounts for this difference. It is recommended that HIV/AIDS prevention education and impulse control strategies are included in the treatment of adolescents with substance use disorders.

Acquired Immunodeficiency Syndrome↗
PubMed2003

Contribution of socioeconomic status to the association between hostility and cardiovascular risk behaviors: a prospective cohort study.

The authors examined the contribution of childhood and early adulthood socioeconomic status (SES) to the association between adulthood cynical hostility and cardiovascular risk behaviors. Participants from the population-based, prospective Cardiovascular Risk in Young Finns Study were 531 males and 688 females, aged 12-21 years at the baseline in 1983 and 21-30 years at the follow-up in 1992. Cardiovascular risk behaviors comprised the number of cigarettes smoked per day, physical inactivity, the type of fat used in the diet, and the frequency of alcohol consumption. The general linear models showed socioeconomic variation in cynical hostility, butter use in the diet, and smoking. In regression analyses, hostility was positively associated with smoking in men and women (beta coefficients = 0.16 and 0.09; p values = 0.000 and 0.019, respectively) and with frequency of alcohol use (beta coefficients = 0.10 and 0.03; p values = 0.024 and 0.03, respectively). Adding parents' and participants' SES to the model marginally attenuated these associations. The authors conclude that the association of cynical hostility with smoking and alcohol use seems to be independent of intergenerational social mobility and childhood and adulthood SES.

Adolescent↗
PubMed1987

Changes in AIDS risk behaviors among homosexual male physicians and university students.

Two samples of homosexual men, 64 physicians and 58 university students, reported profound decreases in several sexual practices linked to transmission of acquired immune deficiency syndrome (AIDS). The physicians showed the greater reduction. When sociodemographic variables, health beliefs, feeling of control over outcome, mood, sexual interest before the AIDS epidemic, and medical care utilization were correlated with decrease and/or increase in AIDS risk behaviors, the clusters of variables most strongly correlated with change in risk behaviors differed between the physicians and students. Interventions designed to change behaviors in AIDS high-risk groups should be tailored for specific subgroups.

Acquired Immunodeficiency Syndrome↗
PubMed2001

Prevalence of HIV and hepatitis B and self-reported injection risk behavior during detention among street-recruited injection drug users in Los Angeles County, 1994-1996.

AIMS: To describe injection risk behaviors while in detention in a sample of injection drug users (IDUs) in Los Angeles County. DESIGN AND SETTING: Cross-sectional, interviewer-administered, face-to-face risk survey, and serological screening for HIV and hepatitis B conducted at four street locations in Los Angeles County between 1994 and 1996. All interviews were conducted in a non-institutionalized setting. MEASUREMENTS: Ascertainment of self-reported risk behavior during detention and screening for HIV and hepatitis B surface antigen (HBsAg) and antibody to the core (HBcAb) seromarkers. PARTICIPANTS: Six hundred and forty-two participants were street-recruited during the study period. Seventy-one per cent of the sample was male, the median age was 43 years, 61% were African-American, 27% were Latino, 8% were white and 36% considered themselves homeless. FINDINGS: Overall HIV prevalence was 3.0%; 3.1% tested positive for the hepatitis B surface antigen marker (HBsAg), and 80.3% for antibody to hepatitis B core antigen (HBcAb). After adjustment for length of injection drug use and recency of release from detention, HIV seroreactivity was significantly associated with history of detention due to possession of IDU paraphernalia (OR = 1.9). The presence of the hepatitis B HBcAb seromarker was associated with injection drug use while in detention, (OR = 1.7), and having been ever arrested for possession of IDU paraphernalia (OR = 1.8). CONCLUSIONS: IDU detainees constitute a high risk group for blood-borne infections. Comprehensive prevention and health promotion efforts in the community need to include correctional facilities.

AIDS Serodiagnosis↗