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PubMed1992

It takes two to tango but one to infect (on the underestimation of the calculated risk for infection with HIV in sexual encounters, arising from nondisclosure of previous risk behavior or seropositivity).

The effects of nondisclosure of either HIV seropositivity or previous engagement in risk behavior on the estimation of risk in sexual intercourse is studied through the use of a probability model. Equations are utilized to derive an Underestimation Factor for three cases, which is shown to range from 2 to 20 in the case of insertive anal intercourse between an HIV+ and an HIV- man, and to 1 x 10(4) in a similar case of heterosexual insertive vaginal intercourse. This factor remains constant regardless of the number of sexual encounters between the same partners, and regardless of the protective measures as long as unawareness prevails. The discussion focuses on the implications of this formulation for education and social attitudes toward disclosure and nondisclosure in sexual encounters. It also raises the question of moral responsibility of sexual partners and some legal aspects of nondisclosure.

Attitude to Health↗
PubMed2004

Homelessness and HIV risk behaviors among injection drug users.

This article uses data from an 8-year study of injection drug users to examine whether homelessness independently influenced the likelihood of engaging in human immunodeficiency virus (HIV) risk behaviors. Fixed effects regression analyses are used to estimate the associations between four different housing contexts and four different behaviors related to transmitting HIV infections. Results showed that 16% of the study group experienced homelessness at some point during the study, and that homelessness was significantly associated with a higher likelihood of frequenting shooting galleries (odds ratio = 2.05), but did not have a significant effect on sharing syringes, sharing other injection drug paraphernalia, or participating in paid sex. These results provide limited support for positing homelessness as independently associated with increased levels of HIV-related risk behavior among injection drug users and highlights the need for more research that examines the housing dynamics among this population.

Adolescent↗
PubMed2004

HIV risk behavior among psychiatric outpatients: association with psychiatric disorder, substance use disorder, and gender.

People living with a mental illness are disproportionately vulnerable to human immunodeficiency virus. The current study sought to examine the influence of psychiatric disorder, substance use disorder, and gender on risky sexual behavior in this vulnerable population. Participants were 228 female and 202 male outpatients (66% mood disorder, 34% schizophrenia), each of whom took part in a Structured Clinical Interview for the DSM-IV and a comprehensive assessment of sexual risk behavior. Univariate and multivariate analyses tested a priori hypotheses. The results indicated that risk behavior was more frequent among patients diagnosed with a mood disorder (compared with those diagnosed with schizophrenia) or a substance use disorder (compared with those without a comorbid disorder) or both. We recommend routine human immunodeficiency virus risk screening and risk reduction programs for this vulnerable population.

Adult↗
PubMed2004

Female methamphetamine users: social characteristics and sexual risk behavior.

The primary objective of this research was to expand our knowledge regarding the personal and social characteristics of female methamphetamine (meth) users, their motivations for using meth, patterns of meth use, medical and social problems associated with meth use, and the relationship between meth use and sexual risk behaviors. The sample consisted of 98 HIV-negative, heterosexually-identified, meth-using females residing in San Diego, California. Female meth users were characterized by personal and social disadvantage, high rates of psychiatric symptomatology, and high levels of sexual risk behavior, including multiple partners, risky partner types (e.g., anonymous sex partners), and high rates of unprotected vaginal and oral sex. Meth use was also associated with the subjective positive experience of sex. These finding suggest that behavioral interventions should be tailored to the social characteristics of female meth users, and program content should reflect the intertwining of women's sexual experience and meth use.

Adult↗
PubMed1998

Behavioral risk factors among U.S. Air Force active-duty personnel, 1995.

Preventive medicine and public health policymakers need data to assess health-promotion efforts, track progress toward meeting national health goals, and focus interventions. To collect such data for U.S. Air Force (USAF) personnel, USAF's Office for Prevention and Health Services Assessment conducted a pilot project to measure the prevalence of behavioral risk factors and preventive health practices. Core questions were used from CDC's Behavioral Risk Factor Surveillance System (BRFSS). Minor changes were made to selected questions from the 1995 survey instrument. This report summarizes the results of the survey, which indicate that USAF personnel met several of the national health objectives. In addition, the report documents that a surveillance system designed to assess health behaviors and practices among the general population can be successfully adapted for a survey of a special population.

Adult↗
PubMed2000

A clinical profile to predict decision making, risk behaviors, clinical status, and health-related quality of life for cancer-surviving adolescents. Part 1.

The purpose of this two-part series is to describe a multifactorial model of clinical factors predicting decision-making quality, risk behaviors, clinical status, and health-related quality of life for cancer-surviving adolescents. This model was developed as a clinical profile to help health professionals in better identifying cancer-surviving adolescents at highest risk for substance use. Findings in the literature and results from the program of research by the author are presented to support the conceptualization of the model. In part 1, support for the antecedent predictors, both primary and secondary factors, is presented. Part 2 addresses decision making as a mediator, risk motivation as a moderator, and the expected outcomes related to risk behaviors, clinical status, and quality of life. In addition to describing the first part of the clinical profile in part 1, the background, theoretical basis of the model, and definitions of the model constructs also are provided.

Adolescent↗
PubMed1998

Young driver involvement in fatal motor vehicle crashes and trends in risk behaviors, United States, 1988-95.

OBJECTIVE: To review trends and risk factors in fatal motor vehicle crashes (MVCs) for drivers aged 15-20 years. METHODS: Fatality Analysis Reporting System data from 1988 to 1995 were used. Drivers were divided into three age strata: 15-17 years, 18-20 years, and > or = 21 years. Comparisons were made based on rates of driver involvement in fatal MVCs, the percentage of drivers involved in night time fatal MVCs, fatal MVCs without the use of restraints, and fatal MVCs with positive blood alcohol concentration. RESULTS: Over the eight years, the rate of driver involvement in fatal MVCs for those 15-17 dropped 15.5%; for those 18-20 years it dropped 22.0%, and for those > or = 21 years it declined 13.5%. When combining both age groups results were similar. In 1988, 60.4% of young drivers involved in fatal MVCs were not using restraints, but by 1995 the percentage dropped to 46.0%. Night time fatal crashes, the second most frequent risk behavior, declined from 41.7% in 1988 to 35.2% in 1995. Alcohol related traffic fatalities were responsible for 32.1% of fatal MVCs among young drivers in 1988 and for 20.3% in 1995. CONCLUSION: To accelerate these trends, implementation and evaluation of complete graduated driver licensing systems (GDLSs) is recommended. Under GDLSs, young drivers are subject to zero alcohol tolerance, curfews, and passenger restraint requirements.

Accidents, Traffic↗
PubMed2006

The effects of HIV-related thought suppression on risk behavior: cognitive escape in men who have sex with men.

This study investigated the relationship between suppressing thoughts about HIV risk and several outcomes related to HIV risk, including sexual risk behavior and HIV prevention service use, in men who have sex with men (MSM). Synthesizing the ironic processing theory (D. M. Wegner, 1994) with a cognitive escape paradigm (D. J. McKiman, D. G. Ostrow, & B. Hope, 1996), it was hypothesized that thought suppression might increase risk by leading MSM to "escape" from sexual safety norms and engage in risky sex behaviors and, via a paradoxical process, increase future use of community prevention services. Results from a sample of MSM (N = 709) indicated that thought suppression was positively related to concurrent sexual risk behavior and to future use of prevention services.

Adult↗
PubMed2001

Assessing basic HIV transmission risks and the contextual factors associated with HIV risk behavior in men who have sex with men.

HIV/AIDS remains a substantial health threat to men who have sex with men. Although new HIV medications have provided great benefits for many HIV-positive individuals, they have done little to protect HIV-negative men. Consequently, changing one's sexual practices remains the most effective way to reduce risk for HIV. However, to develop an effective intervention for reducing HIV risk, it is important to fully understand risk behavior. In this article, we detail the essential elements for conducting an HIV risk assessment as well as those contextual factors that may support risk behaviors. Further, we discuss the importance of procuring an HIV test and the critical issues that may arise because of testing for HIV as well as the critical issues that may result from testing HIV-positive. Finally, we illustrate how we integrate an HIV health risk assessment into a clinical interview.

Adult↗
PubMed1997

Human immunodeficiency virus risk behavior among white and Asian/Pacific Islander high school students in the United States: does culture make a difference?

PURPOSE: This article analyzes sexual behavior among white and Asian/Pacific Islander (API) adolescents, to determine the risk for human immunodeficiency virus (HIV) transmission from a multicultural point of view. METHODS: A total of 5,385 white and 408 API high school students were included. The national school-based Youth Risk Behavior Survey (YRBS 1991) was used. RESULTS: After controlling for academic performance, white students were 2.3 times more likely to communicate about acquired immunodeficiency syndrome (AIDS)/HIV, 2.7 times more likely to be sexually experienced, and 2.5 times more likely to use alcohol or other drugs before sex than APIs. There were no significant differences between these two groups in the age of initiating sex, the number of lifetime partners, the proportion of being currently sexually active (having had sex during the past 3 months), and condom use behavior. Although APIs had a low rate of AIDS/HIV, they have behaviors at as high a risk as white students once they became sexually experienced, and they have an even greater number of recent partners if they are currently sexually active. Use of alcohol or other drugs before sex and condom use is significantly related. CONCLUSIONS: Given the importance of attention to risks among API adolescents, this study underscores the need for more research to explore how culture values play a role among all API students, those who are sexually experienced, and those who are currently sexually active API students, to develop culturally sensitive AIDS/HIV prevention programs.

Adolescent↗
PubMed2006

Trends in physical activity and inactivity amongst US 14-18 year olds by gender, school grade and race, 1993-2003: evidence from the youth risk behavior survey.

BACKGROUND: Recent increases in the prevalence of adolescent obesity have been widely documented. Whilst there is a common lay perception that the current generation of adolescents is less active than ever before, there is little published data to support this notion. In addition, there is little published data on trends in physical activity in adolescents according to factors such as gender, age and race. METHODS: Data from the US Youth Risk Behavior Survey were used to explore time trends in physical activity (vigorous activity on three or more days in the last week) and inactivity (no vigorous activity in the last week) overall and according to gender, school grade and race amongst US adolescents between 1991 and 2003. Logistic regression was used to assess: the overall change in odds of adolescents being active or inactive per year, the change in odds of adolescents being active or inactive in each survey year compared to the first year for which data was included (1993), and the change in odds of adolescents being active or inactive in each survey year compared to the previous survey year. After analysing data for all individuals combined, separate analyses were performed by gender, school grade and race. RESULTS: There was evidence of small, but statistically significant, overall trends towards decreased physical activity and increased inactivity over time amongst boys and those in school grades 9 and 10. Whilst few consistent survey to survey trends were seen, there was a significant decrease in the odds of all adolescents, boys and those in school grades 9 and 10 being active between 1993 and 2003 and a significant increase in the odds of the same groups being inactive between 1993 and 2003. CONCLUSION: Overall changes in both activity and inactivity were generally small and are unlikely to play a significant role in reported secular trends in overweight and obesity in adolescents.

Adolescent↗
PubMed2001

Risk behavior in Norwegian blood donors.

BACKGROUND: Blood banks ensure the safety of blood components by testing them for a set of known infectious agents and by careful selection of donors based on a self-administered questionnaire and an interview. The purpose of this study is to describe the risk behavior for sexually transmitted diseases in Norwegian blood donors. STUDY DESIGN AND METHODS: A survey of the sexual habits of 5,859 blood donors in the capital of Norway was performed by using anonymous questionnaires. The results were compared with a previous survey of 10,000 randomly selected Norwegian subjects aged 18 to 60 years. The response rates were 70.3 percent and 48.4 percent, respectively. RESULTS: Blood donors had considerably more education than the general population. Their general sexual behavior was similar to that of the rest of the population, although the blood donors had later sexual debut, fewer new partners per year, and a lower frequency of intercourse. In addition, homosexual experience among males was much lower in the donor group. Blood donors were less likely to engage in risk behavior for sexually transmitted diseases than were the general population. Nevertheless, 1.5 percent of the donors reported behavior that would have led to deferral had the behavior been disclosed at the predonation interview. Deferrable donors were more likely to be male and young and to have had many partners. CONCLUSION: Anonymous questionnaires reveal information that is not given at the time of blood donation.

Adolescent↗
PubMed2006

Subjective distress from stressful events and high-risk behaviors as predictors of PTSD symptom severity in clients with severe mental illness.

Survey data collected from 257 community mental health center clients tested direct and indirect relationships among subjective distress associated with stressful/traumatic events and high-risk behaviors, substance abuse, and posttraumatic stress disorder (PTSD) symptoms. Structural equation modeling (SEM) revealed substantial direct effects of subjective distress associated with lifetime physical and sexual abuse on PTSD symptom severity. Subjective distress related to high-risk behaviors (e.g., suicide attempts) mediated subjective distress and PTSD symptom severity. Subjective distress from physical and sexual abuse was also strongly related to problem drinking. Adding gender to the model revealed greater subjective distress from physical and sexual abuse for women and greater drinking problems for men. Otherwise, gender had little effect on the model overall.

Adult↗
PubMed2000

Reducing HIV/AIDS high-risk behavior among injection drug users: peers vs. education.

This study examines the effects of peer groups and education on risk behavior for HIV among injection drug users (IDUs). The sample consisted of 682 participants in the Eastern Connecticut Health Outreach project, which compares traditional and peer-driven outreach interventions for IDUs. Participants are educated about safer injecting, subsequently administered a risk-reduction knowledge test, and given an extensive interview. Logistic regression shows that education alone is not a significant factor in reducing risky behavior in IDUs among the behaviors studied. A significant interaction was found between peer support for safer use and personal saliency of peer attitudes for both syringe and water sharing. Neither peer attitudes nor education affected cooker sharing. These results suggest that while education may be an important component in any intervention, it is not alone sufficient to reduce risky behavior. Our findings suggest that peer-directed interventions may be useful in reducing some forms of risk behavior among IDUs.

Acquired Immunodeficiency Syndrome↗
PubMed1998

Continuing high prevalence of HIV and risk behaviors among young men who have sex with men: the young men's survey in the San Francisco Bay Area in 1992 to 1993 and in 1994 to 1995.

Several recent studies have shown high rates of HIV infection and risk behavior among young men who have sex with men (MSM). To assess the direction of the epidemic in this population, we replicated a venue-based study performed in the San Francisco Bay Area during 1992 and 1993. From May 1994 to September 1995, we surveyed 675 MSM aged between 17 and 22. After statistical adjustment for age, ethnicity, residence, and site of recruitment, seroprevalence did not change significantly between the 1992 to 1993 (8.4%) and the 1994 to 1995 (6.7%) surveys. Similarly, no significant changes were found in the rates during the previous 6 months of unprotected receptive anal intercourse (23.4% versus 24.9%), injection drug use (8.0% versus 7.8%), or needle sharing among injection drug users (56.3% versus 64.5%) between the two surveys. Despite the increased attention that the problem of high risk behavior among young MSM has received, effective prevention interventions for MSM are needed as profoundly now as they had been several years ago.

Adolescent↗
PubMed1996

Sexual risk behavior and history of sexually transmitted diseases in relation to casual travel sex during different types of journeys.

OBJECTIVES: The study investigated if women with experience of casual travel sex, with a previously unknown man abroad, on different types of journeys (charter, vagabond, business and education trips), differ with regard to sexual risk behavior and history of sexually transmitted diseases (STDs). STUDY DESIGN: The study population consisted of 996 women. Of these, 27.7% admitted that they had had casual sex during journeys. The remaining women were used as a comparison group. History of STDs and sexual risk behaviors were investigated. RESULTS: The frequency of women who had more than ten lifetime sexual partners were greatly increased in all groups, as compared to the controls. A history of gonorrhea was most frequent among the charter travellers. A history of genital chlamydial infection was most common among the vagabond travellers. The lowest frequencies of a history of STDs was observed in women engaging in casual sex on 'business' journeys and they had significantly less often a history of STDs as compared to the charter travellers. A high frequency of STDs were seen in women who had experience of casual sex on different types of journeys. CONCLUSION: Women on business trips, although they had a similar sexual risk behaviour as the other groups of travellers, had less often a history of STDs.

Adolescent↗
PubMed2003

Prevalence and risk behaviors of Chinese men who seek same-sex partners via the internet in Hong Kong.

To examine the prevalence of Internet sex networking among men who have sex with men (MSM) in Hong Kong and risk behaviors associated with the behavior, a telephone survey of 15,230 Hong Kong Chinese men aged 18-60 was conducted. Of the 283 active MSM (having engaged in some MSM behaviors in the last 6 months) identified, 17.7% had networked for MSM partners via the Internet in the last 6 months. Younger age (odds ratio [OR] for age < or = 25 vs. age >25 = 4.67, 95% confidence interval [CI] = 2.35-9.28) and being an anal-sex MSM (OR = 4.72, 95% CI=2.36-9.44) were independent predictors of Internet sex networking. Being an Internet sex networker was associated with some risk behaviors such as having contracted a sexually transmitted disease (adjusted OR = 4.79, 95% CI = 1.34-17.11), having had > or = 3 MSM partners (adjusted OR = 4.74, 95% CI = 2.20-10.23), and having engaged in anal sex (adjusted OR = 3.95, 95% CI = 1.89-8.23). HIV prevention programs for MSM should thereby include Internet-based interventions.

Adolescent↗
PubMed2004

Prevalence and risk behaviors of Hong Kong males who seek cross-border same-sex partners in mainland China.

BACKGROUND: Little is known about cross-border sex-networking behaviors among men who have sex with men (MSM) GOAL: The goal of this study was to determine the prevalence of cross-border sex-networking in mainland China among MSM in Hong Kong and the associated risk behaviors STUDY: A telephone survey was conducted. A total of 15,230 Hong Kong Chinese men aged 18 to 60 participated in the study. RESULTS: Of the 283 MSM engaged in some MSM behaviors in the last 6 months, 15.2% had engaged in sexual activity with a man in mainland China in the 6 months before the survey. These "cross-border MSM" were more likely than others to have practiced risk behaviors such as having patronized male commercial sex workers, having contracted a sexually transmitted disease (STD), having had > or = 3 MSM partners, and having higher prevalence of HIV testing in the last 6 months (adjusted odds ratio, 3.32-43.83). CONCLUSIONS: There is an urgent need for a regional approach to HIV/STD prevention for MSM in southern China.

Adolescent↗