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PubMed1998

Relationship of HIV testing and high-risk behaviors among clients in methadone maintenance treatment.

This article reports on the association between frequency of HIV testing and high-risk behaviors among 339 individuals in the Los Angeles Enhanced Methadone Maintenance Project. Individuals who reported taking three or more HIV tests prior to entering treatment (45% of the sample) were more likely to know someone who was HIV positive, to engage in illegal activity, to perceive their risk for HIV as high, and to use condoms; they were less likely to disinfect injection equipment; and they scored higher on measures of HIV knowledge and depression as compared with less frequent testers. The strongest predictor of frequent HIV testing (three or more tests) after treatment entry, reported by 43% of the sample, was having a high number of injection-sharing partners. Although a substantial number of individuals in methadone maintenance treatment continued to take HIV tests, test taking was more strongly related to high-risk injection behavior than to sexual behavior.

Adult↗
PubMed1980

Behavioral risk factors and coronary heart disease.

After a historical review, three clusters of social psychological variables are discussed: (1) socioeconomic factors and social disorganization; (2) sustained, intensely disturbing emotions, and (3) behavioral risk factors characterized by the hard-driving, type A coronary-prone behavior pattern. Empirical evidence from the bulk of research on various aspects of these risk factors suggests that the three clusters have a significant bearing on the pathogenesis of coronary heart disease. Reduction of behavioral risk factors should concentrate on three interventions: (1) reducing the type A pattern; (2) treating emotional drain and exhaustion, and (3) treating sustained episodes of interpersonal conflict.

Adult↗
PubMed1998

The effect of entering drug treatment on involvement in HIV-related risk behaviors.

The research described here is based on a sample of 8,241 out-of-drug-treatment users of injected drugs and/or crack, aged 18 or older, recruited from 22 sites across the United States and Puerto Rico. The study divided respondents into three groups-(a) cocaine or crack users who did not also use heroin or speedball (cocaine-only users), (b) heroin injectors who did not also use cocaine or crack or speedball (heroin injectors), and (c) users of cocaine or crack and injected heroin or speedball (dual users)--and compared the efficacy of entering drug treatment for these groups' involvement in HIV-related risk behaviors. The study found that entry into treatment corresponded to greater reductions in substance abusers' frequency of drug use and involvement in risky injection practices compared to those observed in people who did not enter treatment between their baseline and 6-month follow-up interviews. Entry into drug treatment was also associated with reductions in the practice of risky sexual behaviors, but these reductions were less substantial and less consistent than those noted for drug use and injection risk behaviors.

Cocaine-Related Disorders↗
PubMed1990

AIDS risk behavior patterns among intravenous drug users in Puerto Rico and the United States.

We interviewed 385 IV drug users recruited in the streets of the San Juan metropolitan area and compared our findings with comparable results from projects in the United States. As expected, intravenous (IV) drug users, irrespectively of the race or ethnic group they belong to or the geographical setting in which they live, are still practicing HIV risk behaviors. Overall, IV drug users in this analysis are young, however, both Puerto Rican and Hispanic groups have completed less years of school than Blacks and Whites in the United States. The fact that almost half of Puerto Rican IV drug users in the United States reported illegal activities as a source of income surprised investigators. However, as hypothesized by investigators, almost half of the Island's IV drug users reported to live with parents. Puerto Rican IV drug users are still practicing HIV risk behaviors, they inject drugs and use shooting galleries to inject drugs more frequently, and are less likely to clean needles and use condoms than Puerto Ricans in the U.S., Blacks and Whites. It is a well known fact that intravenous drug users are the largest group at risk for the acquired immunodeficiency syndrome (AIDS) in Puerto Rico and among Puerto Ricans in the United States. IV drug users are also the major risk for heterosexual transmission and main source of perinatal transmission of the disease. Thus, resources for preventing AIDS in Puerto Rico are needed most among IV drug users, where 44.5 of the subjects in this study are HIV positive.

Acquired Immunodeficiency Syndrome↗
PubMed1994

Cultural factors associated with health-risk behavior among the Cheyenne River Sioux.

A field study was conducted to identify cultural factors--values, beliefs, and related characteristics--associated with health-risk behavior among adult members of the Cheyenne River Sioux Tribe. The Cultural Values Survey (CVS), an instrument for measuring cultural values and related characteristics, was developed and pilot tested in the study population. This instrument, along with the Health Risk Appraisal (HRA) (an instrument developed by the Centers for Disease Control to quantify major health-related behaviors), was administered to a random sample of 429 adults in the study community. Significant differences between females and males for both cultural characteristics and health-risk behaviors were found. Females had significantly higher HRA-calculated Health Index values than males, reflecting overall healthier behaviors. Females who scored higher on cultural factors consistent with more traditional Lakota Indian lifestyles (e.g., degree of Indian blood, Lakota language spoken in the home, traditional Lakota beliefs) had higher HRA Health Index values than females scoring lower in these characteristics. Males who scored higher in factors related to self-determination (e.g., hard work, personal control, industriousness, individual action) had higher Health Index values than those who scored lower in these areas. Further testing of the CVS instrument, as well as further research from both epidemiologic and social science perspectives is essential to elucidate the nature of the relationship between cultural factors and health-related behavior.

Adolescent↗
PubMed2006

Predictors of sexual risk behaviors among adolescent mothers in a human immunodeficiency virus prevention program.

PURPOSE: The purpose of this study was to determine the following: (1) whether adolescent mothers in a human immunodeficiency virus (HIV) prevention program had significantly greater perceived self-efficacy and perceived behavioral control to use condoms, and more favorable outcome expectancies and subjective norms regarding condom use than those in a health education control group, 3 months after intervention; and (2) the impact of the 3-month postintervention theoretical variables on intentions to use condoms at 3 months and sexual risk behaviors at 6 months. METHODS: Structural equation modeling with latent variables was used to assess the influence of theoretical variables and treatment condition using data from 496 participants (78% Latinas, 18% African-Americans) who completed questionnaires at baseline and at 3- and 6-month follow-up evaluations. RESULTS: Substantial improvements were shown by both groups, with a slight advantage for the HIV prevention group, on all theoretical variables between pretest and the follow-up evaluations. In the predictive model, the intervention group reported significantly fewer sex partners. By using intentions to use condoms as a mediator, greater self-efficacy, hedonistic beliefs, positive subjective norms, and less unprotected sex predicted intentions to use condoms, which, in turn, predicted less unprotected sex. Lower subjective norms modestly predicted multiple partners. Significant indirect paths mediated through intentions to use condoms were observed. CONCLUSIONS: These data support a relationship among several constructs from social cognitive theory and the theory of reasoned action, and subsequent sexual risk behaviors. HIV-prevention programs for adolescent mothers should be designed to include these theoretical constructs and to address contextual factors influencing their lives.

Adolescent↗
PubMed2006

Victimization, substance use, and HIV risk behaviors among gay/bisexual/two-spirit and heterosexual American Indian Men in New York City.

OBJECTIVES: secondary aims included describing condom-use attitudes, beliefs about HIV/AIDS in the Indian community, HIV knowledge, HIV status, and preference for and access to HIV prevention services in this population. METHODS: A survey was mailed to all members of an American Indian community organization in New York City. RESULTS: The 20 men self-identifying as gay, two-spirit, or bisexual (hereafter, "two-spirit") were more likely to report being victimized and engaging in HIV risk behaviors than the 51 heterosexual respondents, although they reported comparable levels of recent substance use. Overall, victimization was associated with lifetime HIV risk behaviors (even after control for sexual orientation) but not with substance use or unsafe sex in the past 12 months. The percentage of HIV infection was surprisingly high (10% of two-spirit men and 6% of heterosexual men). CONCLUSIONS: Two-spirit men are a vulnerable population whose victimization must be understood within an appropriate historical and political context.

Adult↗
PubMed2006

Multiple behavioral risk factors among adolescent survivors of childhood cancer in the Survivor Health and Resilience Education (SHARE) program.

BACKGROUND: Health-compromising behaviors among survivors of childhood cancer may increase their risks of cancer recurrence and the onset of chronic disease in adulthood. Regardless of whether such behaviors occur singly or in combination with one another, multiple behavioral risk factors must be identified and addressed early to promote better health outcomes within this special population. Adolescent survivors may be especially vulnerable, as reported rates of smoking and other risky behaviors are at or near levels of their healthy peers. The psychological literature suggests stress may play a role in risk behavior initiation and maintenance, including multiple behavioral risks, and that adolescent survivors are stress-prone. This report focuses on the prevalence and co-occurrence of three behavioral risk factors (cigarette use, insufficient physical activity, and non-adherence to sun protection recommendations) and describes stress-health behavior relationships in this special population. PROCEDURE: All patients in this study (n = 75) were adolescent survivors of childhood cancer and completed a baseline assessment of their health behaviors and stress as part of a randomized controlled trial of health promotion. RESULTS: Twenty-eight percent of the patients reported one of three risk factors, 12% reported two of three risk factors, and 7% reported all three risk factors. Non-adherence to sun protection was the single most common risk factor; physical inactivity and non-adherent sun protection were the most common co-occurring risk factors. Greater age and stress were significantly associated with the presence of more behavioral risk factors. CONCLUSIONS: The evidence suggests interventions to reduce multiple health-compromising behaviors in these patients are warranted, and that efforts to address these patients' personal and family stress levels are important as well.

Adolescent↗
PubMed1994

Reporting of HIV risk behaviors by injection drug using heterosexual couples in methadone maintenance.

This study sought to identify differences within injection drug using (IDU) couples in reporting of sexual and needle risk behavior. Subjects were thirty-nine heterosexual couples entering methadone maintenance. In 33.3% of couples, one member reported sharing needles while the other member reported no sharing. In 12.9% of couples, one member reported sharing injection equipment, while the other member reported no sharing. Agreement was 77.4% between members of monogamous couples regarding frequency of condom use, 80.7% regarding vaginal intercourse with condoms, and 25.8% regarding vaginal intercourse without condoms. Within couples, a number of differences between members of the couple in injection equipment sharing were noted, suggesting that individuals who attempt to protect themselves by not sharing injection equipment may be placed at risk by their sexual partners. Further clinical and research efforts should be directed toward reducing barriers to behavior that would protect both partners. Implications for self-report measurement of HIV risk behavior and for preventive interventions are discussed.

Adult↗
PubMed2006

A survey of female nursing students' knowledge, health beliefs, perceptions of risk, and risk behaviors regarding human papillomavirus and cervical cancer.

PURPOSE: The purpose of the study was to assess knowledge of, perceived susceptibility to, perceived seriousness of, and risk behaviors regarding human papillomavirus (HPV) and cervical cancer among female nursing students. DATA SOURCES: A 40-item survey of HPV and cervical cancer was distributed to a convenience sample of 240 female nursing students enrolled in a baccalaureate nursing program. CONCLUSIONS: Female nursing students participate in high-risk sexual behaviors and have a fairly low knowledge level, low perceived susceptibility, and low perceived seriousness regarding HPV and cervical cancer. Knowledge and perceived susceptibility were positively related to number of sexual partners. This may indicate that the women who engage in riskier behavior are more knowledgeable about HPV and their risk of contracting the disease. IMPLICATIONS FOR PRACTICE: Results indicate that all practitioners involved in the care of women should educate them about HPV and its relationship to cervical cancer. Education should include the need to use condoms to prevent HPV and other sexually transmitted diseases.

Adult↗
PubMedDate not supplied

Effects of immigration on selected health risk behaviors of Black college students.

The authors administered the National College Health Risk Behavior Survey to 1,219 college students who were attending a historically Black college located in New York City. They assessed the US-born Black students and Black students who emigrated to the United States for differences in risky sexual behaviors, risky dietary behaviors, and physical inactivity. They used bivariate and multiple regression analyses to analyze the data and observed significant differences between the US-born and non-US-born students in the behavioral domains of risky sexual behaviors (p = .003), risky dietary behaviors (p = .001), and physical inactivity (p = .010). They conclude that immigration is associated with health protective behavior in the domains of sexual behavior and physical activity among the Black college students attending this particular institution. However, in the domain of dietary intake, immigration status was associated with increased risk in these Black college students.

Adolescent↗
PubMed1998

Human immunodeficiency virus (HIV) education and HIV risk behavior: a survey of rapid deployment troops.

A paper-and-pencil questionnaire was administered to 1,377 U.S. Army troops from rapid deployment units at Fort Bragg, North Carolina. This yielded 1,368 surveys available for analysis. The primary goal of the survey was to evaluate this group's experience with the Army human immunodeficiency virus (HIV) education program and to determine their level of HIV risk behaviors as related to participation in the Army's HIV education program. Seventy-seven percent of the respondents (1,052 of 1,368) reported receiving some HIV education from the Army. Of those, 55% (578 of 1,052) reported receiving 1 hour of education within the past year. Soldiers of Asian, Native American, and "other" race/ethnicity, and to a lesser extent, Hispanic background, were more likely to report receiving no HIV education compared with whites and African Americans. Self-reported receipt of HIV education did not strongly differentiate individuals in their partner selection or in key sexual risk behaviors in which they engaged.

Adolescent↗
PubMed2004

Prevalence and co-occurrence of violence, substance use and disorder, and HIV risk behavior: a comparison of sheltered and low-income housed women in Los Angeles County.

BACKGROUND: Violence against women, substance use and disorder, and HIV represent three significant threats to the health of women, yet little is known about the extent of these epidemics among indigent women. This study investigates and documents differences in the prevalence and co-occurrence of physical and sexual violence, substance use and disorder, and HIV risk behavior in sizable probability samples of sheltered homeless and low-income housed women. METHODS: Retrospective self-reports were obtained through structured interviews with stratified random samples of women residing in shelters (N = 460) and low-income housing (N = 438) in Los Angeles County, California. RESULTS: Sheltered women were more likely than housed women to report experiencing physical and sexual violence, substance use and disorder, HIV risk behavior, and co-occurrence of these problems in the past year. Differences remained when propensity weights were used to equate the groups on demographic and background characteristics. CONCLUSIONS: Findings suggest remarkable need for services among communities of indigent women. Higher rates of problems among women in shelters highlight the importance of differentiating among subgroups of indigent women in community-based prevention and intervention activities and tentatively suggest a protective influence of housing.

Adolescent↗
PubMed1993

Sociodemographics and HIV risk behaviors of bisexual men with AIDS: results from a multistate interview project.

OBJECTIVE: To describe the sociodemographic characteristics and sexual and drug use behaviors of men with AIDS who engage in bisexual activity. METHODS: We interviewed 2120 men aged > or = 18 years who were reported with AIDS in 11 states and cities. Men were considered bisexual if they reported having had sex with a man and a woman in the previous 5 years. RESULTS: Of the 2020 men with AIDS who reported being sexually active in the previous 5 years, 1150 (57%) had had male partners only, 522 (26%) had had female partners only and 348 (17%) had had both. White men were least likely to report bisexual behavior (15%; 161 out of 1071). Men of Latin American descent were most likely to report bisexual behavior (24%; 37 out of 155), especially those born outside the United States who had lived there for < or = 10 years (38%; 11 out of 29). Bisexual Latin American men, regardless of birthplace, were more likely to be currently married than all other bisexual men (22 versus 7%; P < 0.05). HIV risk behaviors differed between men reporting bisexual and those reporting exclusively homosexual or heterosexual activity. Injecting drug use in the previous 5 years was more common among bisexual than homosexual men (12 versus 6%; P < 0.05). Bisexual men were more likely (P < 0.05) to have received money for sex (11%) than homosexual (4%) or heterosexual men (4%). This difference was even greater among injecting drug users receiving money for sex: bisexual (29%), homosexual (13%), heterosexual (3%). CONCLUSIONS: Demographics and HIV risk behaviors of bisexual men with AIDS differ from those of homosexual and heterosexual men with AIDS. These findings indicate that special efforts are needed to prevent sexual transmission of HIV among bisexual men.

Acquired Immunodeficiency Syndrome↗
PubMed1999

Lack of association between acquisition of TT virus and risk behavior for HIV and HCV infection in Vietnam.

BACKGROUND: The search for the cause of chronic hepatitis among individuals with non-A to G hepatitis has led to the discovery of a post-transfusion hepatitis-related DNA virus, designated TT virus (TTV), which, based on viral sequences, belongs to a new virus family. The principal modes of infection with TTV are poorly understood, and its role in human immunodeficiency virus type 1 (HIV-1) infection is unclear. OBJECTIVE: To determine if injection drug use (IDU) and high-risk heterosexual activity (HRHA), principal modes of acquiring HIV-1 infection, place individuals at greater risk of acquiring TTV. METHODS: The authors analyzed DNA, extracted from sera or filter paper-blotted whole blood, obtained during August 1997 and June 1998 from 324 Vietnamese (148 male; 176 female), for TTV sequences by hot-start, heminested polymerase chain reaction. RESULTS: Prevalence of TTV viremia was similar among individuals engaging in IDU or HRHA (23.4% vs. 20.2%; P > 0.5), with no age- or gender-specific differences. No association was found between TTV viremia and co-infection with HIV-1 or hepatitis C virus (HCV). Phylogenetic analysis of 30 TTV sequences revealed two distinct genotypes and four subtypes that did not segregate according to gender, HIV-1 and HCV risk behaviors, or geographic residence. CONCLUSIONS: Among HIV-1- or HCV-infected Vietnamese, who presumably acquired their infection by either the parenteral or nonparenteral route, the data indicate no clear association between acquisition of TTV infection and risk behavior for HIV-1 or HCV infection, suggesting that the usual route of TTV transmission in Vietnam is other than parenteral or sexual.

Adolescent↗
PubMed2006

Methamphetamine use and HIV risk behaviors among heterosexual men--preliminary results from five northern California counties, December 2001-November 2003.

Methamphetamine (meth) is a highly addictive stimulant that gained widespread popularity in California in the 1980s and has since spread to most regions of the United States, including rural areas. Analyses of survey data among noninjection-drug users from California in the mid-1990s determined that, among heterosexual persons and among men who had sex with men (MSM), meth users reported more sex partners, were less likely to report condom use, and were more likely to report sex in exchange for money or drugs, sex with an injection-drug user, and history of a sexually transmitted disease (STD). Subsequent studies among MSM have indicated an association between meth use and sexual risk behaviors, syphilis infection, and incidence of human immunodeficiency virus (HIV) infection. Subsequent studies among heterosexual populations have been less extensive than those among MSM and often have not used population-based samples nor adjusted for possible confounders. To further assess the association between meth use and high-risk sexual behaviors among heterosexual men, the California Department of Health Services, Office of AIDS, analyzed population-based data from five northern California counties in the HEY-Man (Health Evaluation in Young Men) Study. This report summarizes the results of that analysis, which determined that recent meth use was associated with high-risk sexual behaviors, including sex with a casual or anonymous female partner, anal intercourse, and sex with an injection-drug user. The results suggest the need for states to consider including referrals to meth prevention and treatment programs in their HIV prevention programs and for broader assessment of the relation between meth use and high-risk sexual behaviors.

Adult↗
PubMedDate not supplied

Risk behaviors for HIV infection in clients of Pennsylvania family planning clinics.

Responses from a statewide survey of risk behaviors among clients of Planned Parenthood clinics in Pennsylvania indicate that a sizable proportion of these women are at intermediate or high risk for exposure to the human immunodeficiency virus (HIV). Overall, nearly five percent of the 15,499 women in the sample reported personal behavior, or a partner's behavior, that placed them at high risk, while an additional 20 percent were at intermediate risk. Among all women surveyed, 13 percent had had three or more partners in the past year, 12 percent had had a sexually transmitted disease, four percent had partners who were intravenous (IV) drug users, two percent were either current or past IV drug users, one percent had bisexual partners and less than one percent had partners who had hemophilia or who were infected with the AIDS virus.

Adolescent↗