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PubMed2000

Highway cowboys, old hands, and Christian truckers: risk behavior for human immunodeficiency virus infection among long-haul truckers in Florida.

This paper reports the results of ethnographic research to describe risk for human immunodeficiency virus (HIV) infection among long-haul truck drivers and the contexts and factors that influence risk and protective behaviors. Drivers were selected using purposive and snowball sampling at trucking-related businesses along major truck routes in Florida. Interview information was used to categorize truckers' levels of potential risk, describe behavioral characteristics of each group, identify sex partners, and assess perceptions of the risk of HIV infection. One-third of the 71 men interviewed had frequent sexual intercourse on the road with multiple partners, but few ever used condoms. Commercial sex workers were their most frequent partners for on-the-road sex. The risk was compounded by occupational conditions, which motivated truckers to drive long hours, often using drugs to stay alert. Sex, alcohol, and drugs were perceived as quick, effective stress relievers during downtime on long, lonely trips. Despite their high-risk behaviors, truckers tended to consider themselves at low risk for HIV infection and expressed a number of misconceptions regarding HIV transmission. For example, many truckers did not associate HIV risk with heterosexual contact or think that condoms were effective in preventing HIV transmission. In addition, many truckers maintained strong homophobic and anti-government opinions that reinforced their suspicion of safe-sex messages. These findings suggest that high-risk sexual behavior is common among long-haul truckers in the US, who may be at risk for HIV infection primarily because of unprotected sexual intercourse with multiple sex partners. Also, drug use may be associated with HIV risk behavior. The authors recommend establishing prevention programs that are developed by and for truckers, determining HIV seroprevalence rates of truckers, addressing drug and alcohol abuse among truckers, and altering industry policy that keeps truckers on the road too long for their own and others' safety.

Adult↗
PubMed2004

Sad, blue, or depressed days, health behaviors and health-related quality of life, Behavioral Risk Factor Surveillance System, 1995-2000.

BACKGROUND: Mood disorders are a major public health problem in the United States as well as globally. Less information exists however, about the health burden resulting from subsyndromal levels of depressive symptomatology, such as feeling sad, blue or depressed, among the general U.S. population. METHODS: As part of an optional Quality of Life survey module added to the U.S. Behavioral Risk Factor Surveillance System, between 1995-2000 a total of 166,564 BRFSS respondents answered the question, "During the past 30 days, for about how many days have you felt sad, blue, or depressed?" Means and 95% confidence intervals for sad, blue, depressed days (SBDD) and other health-related quality of life (HRQOL) measures were calculated using SUDAAN to account for the BRFSS's complex sample survey design. RESULTS: Respondents reported a mean of 3.0 (95% CI = 2.9-3.1) SBDD in the previous 30 days. Women (M = 3.5, 95% CI = 3.4-3.6) reported a higher number of SBDD than did men (M = 2.4, 95% CI = 2.2-2.5). Young adults aged 18-24 years reported the highest number of SBDD, whereas older adults aged 60-84 reported the fewest number. The gap in mean SBDD between men and women decreased with increasing age. SBDD was associated with an increased prevalence of behaviors risky to health, extremes of body mass index, less access to health care, and worse self-rated health status. Mean SBDD increased with progressively higher levels of physically unhealthy days, mentally unhealthy days, unhealthy days, activity limitation days, anxiety days, pain days, and sleepless days. CONCLUSION: Use of this measure of sad, blue or depressed days along with other valid mental health measures and community indicators can help to assess the burden of mental distress among the U.S. population, identify subgroups with unmet mental health needs, inform the development of targeted interventions, and monitor changes in population levels of mental distress over time.

Adolescent↗
PubMed2005

Acculturation, health protective sexual communication, and HIV/AIDS risk behavior among Hispanic women in a large midwestern city.

The relationships among acculturation, health protective sexual communication, and HIV/AIDS risk behaviors of Hispanic women are examined. Respondents represented 14 Latin American countries, a mean age of 29.5 years, and relatively low education and income levels. A significant correlation was found between higher non-Hispanic acculturation level and higher sexual communication with new partners. Higher non-Hispanic acculturation levels were also correlated with higher number of sexual partners in the prior 12 months. The higher the score for health protective sexual communication, the higher the reported frequency of condom use with new sexual partners in the past 12 months. Given the low number of sexual partners, HIV/AIDS risk for this group of women appears to be related to not knowing whether their partners had other sexual partners and to low frequency of condom use. Implications for health education are discussed.

Acculturation↗
PubMed1995

HIV seroprevalence and risk behaviors among lesbians and bisexual women in San Francisco and Berkeley, California.

Few data are available on human immunodeficiency virus (HIV) infection and risk behaviors among lesbians and bisexual women. A total of 498 lesbians and bisexual women was sampled from public venues in San Francisco and Berkeley, Calif, during 1993. The overall HIV seroprevalence was 1.2%. Ten percent of participants reported injecting drugs since 1978. Forty percent of the participants reported unprotected vaginal or anal sex with men during the past 3 years, including unprotected sex with gay and bisexual men and male injection drug users. The high rates of injection drug use and unsafe sexual behaviors suggest that lesbians and bisexual women frequenting public venues in San Francisco and Berkeley are at risk for HIV infection.

Adolescent↗
PubMed2000

Sport participation, risk taking, and health risk behaviors.

Adolescents participate in sports for a variety of reasons. Some seem to enjoy participating in what some might consider very-high-risk or "extreme" sports activities. For some adolescents risk taking becomes pervasive and can be detrimental to normal health and development. The majority of adolescents will do well in the context of athletics, and the many positive benefits of regular physical activity and sports participation should be appropriately emphasized. However, a subset of adolescents may be at greater risk for adverse consequences. This article reviews the reasons for participation and attrition from sports, the phenomenon of thrill seeking in sports, certain risk-taking behaviors of athletes, and studies comparing health risk behaviors in athletes and non-athletes.

Adolescent↗
PubMed2000

HIV risk behaviors among Asian drug users in San Francisco.

This study identified patterns of drug use and HIV risk behaviors in relation to cultural factors among Asian drug users in San Francisco. A sample of 92 Asian drug users (35 Chinese, 31 Filipino, 26 Vietnamese) who were not currently enrolled in drug treatment programs were recruited through targeted sampling methods and interviewed using a questionnaire with open-ended questions. The study evaluated responses of the participants based on content analyses. Compared with Chinese and Vietnamese, Filipino drug users had engaged in riskier behaviors in terms of injection drug use, having sex while on drugs, and having sex with injection drug users (IDUs). Cultural factors such as stigma of injection drug use and fear of needles were cited as reasons for not injecting drugs. Among IDUs, half cited trust as a reason for having shared needles. AIDS prevention programs targeting Asian drug users should consider specific cultural factors among high-risk groups (i.e., Filipinos, immigrants, women, and IDUs).

Adult↗
PubMed2002

HIV and AIDS risk behaviors among female jail detainees: implications for public health policy.

OBJECTIVES: We examined the sexual and injection drug use HIV and AIDS risk behaviors of female jail detainees. METHODS: The sample (n = 948) was stratified by charge type (felony vs misdemeanor) and race/ethnicity (African American, non-Hispanic White, Hispanic, other). RESULTS: Non-Hispanic White women, women arrested for less serious charges, women who had prior arrests, women arrested on drug charges, and women with severe mental disorders were at especially high risk for sexual and injection drug transmission of HIV and AIDS. CONCLUSIONS: Many women at risk for HIV and AIDS--women who use drugs, women who trade sex for money or drugs, homeless women, and women with mental disorders--eventually will cycle through jail. Because most jail detainees return to their communities within days, providing HIV and AIDS education in jail must become a public health priority.

Acquired Immunodeficiency Syndrome↗
PubMed1997

A comparison of AIDS-related sexual risk behaviors among African-American college students.

This article compares the sexual practices and risk-taking behaviors of African-American male and female college students (n = 649) attending 4-year institutions in a major southeastern metropolitan area. It is a descriptive study of the kinds of practices that put African-American college students at a high risk of contracting the human immunodeficiency virus (HIV). Overall, the reported practices indicate that the college students studied are exposed to risk by certain sexual behaviors, with males reporting significantly higher frequency of risk behaviors than females. The percentages of male students reporting they engage in an array of risky sexual practices (including sex without condoms and anal intercourse) suggest the invulnerability to HIV apparently perceived by this group. Although the students overall adhere to some HIV-preventive behaviors, they also violate important HIV prevention practices. The findings illuminate the need for designing and conveying messages for African-American college students, and particularly for males, that impress the realities of acquired immunodeficiency syndrome (AIDS) as an indiscriminant disease on this group.

Acquired Immunodeficiency Syndrome↗
PubMed2003

Social capital as a predictor of adolescents' sexual risk behavior: a state-level exploratory study.

This exploratory study assessed the state-level association between social capital, poverty, and income inequality and adolescents' sexual risk and protective behaviors. A cross-sectional design using state-level correlations was employed. Seven outcome measures from the national 1999 Youth Risk Behavior Surveillance Survey were used. For females and males, social capital was significantly associated with five of the seven outcome measures (all associations p < 01). For females, the amount of variance explained by these correlations ranged from 23% to 45%; the range for males was 20% to 52%. Poverty was not a significant predictor of any outcome variable. Income inequality was a significant predictor of birth control usage among females, but in multivariate regression analyses, only social capital retained significance. Findings provide preliminary evidence that social capital may have a profound influence of adolescents' sexual risk and protective behaviors. Social capital was inversely correlated with sexual risk behaviors and positively correlated with protective sexual behaviors. Further and more comprehensive research involving social capital and adolescents is warranted.

Adolescent↗
PubMed2000

Mothers' responses to sons and daughters engaging in injury-risk behaviors on a playground: implications for sex differences in injury rates.

Videotapes of children engaging in injury-risk activities on a playground were shown to mothers, who were asked to intervene by stopping the tape and saying whatever they would to their child in the situation shown. Results revealed that mothers of daughters were more likely to judge behaviors as posing some degree of injury risk, and they intervened more frequently and quickly than mothers of sons. Mothers' speed to intervene positively correlated with both children's injury history and their risk-taking tendencies, indicating that mothers of children who were previously injured and who often engaged in injury-risk behaviors had a higher degree of tolerance for children's risk taking than mothers of children who experienced fewer injuries and less frequently engaged in injury-risk behaviors. Mothers' verbalizations to children's risk taking revealed that daughters received more cautions and statements communicating vulnerability for injury, whereas sons received more statements encouraging risk-taking behavior.

Child↗
PubMed2001

Hepatitis C prevalence and risk behavior of injecting drug users in Sydney: a continuing concern.

This study examines patterns of injecting drug use and hepatitis C (HCV) risk behavior among injecting drug users. A survey of injecting drug users attending needle and syringe programs (NSPs) in the Sydney metropolitan area and members of NSW Users and AIDS Association (NUAA) yielded 336 responses. Demographic, behavioral and drug-use information was collected from injecting drug users aged from 14 to 64 years. The majority of respondents (66%) were HCV positive, 28% had tested negative and 5% did not know their status. Prevalence was higher among men than among women (54% vs 44%). Two thirds of respondents (72%) reported frequent heroin injection. Multivariate analysis identified the following significant risk factors for hepatitis C: being more than 30 years of age, an injecting history of five years or more, and having shared drug injecting equipment with a HCV positive user. The most significant factor associated with needle sharing was having unprotected sex with sexual partners and having a positive hepatitis C test result. Early identification of these factors should be a component of HCV prevention programs. Our data indicate that the promotion of safer injecting continues to be an important public health issue with regard to reducing HCV infections.

Adolescent↗
PubMedDate not supplied

Health professionals' advice to Iowa adults with hypertension using the 2002 Behavioral Risk Factor Surveillance System.

PURPOSE: We investigated the prevalence of hypertension-lowering lifestyle-modification advice given to adults living in Iowa. We sought to determine if persons with high blood pressure and those who are overweight receive more advice than do persons with normal blood pressure and a desirable body weight. METHODS: By using the 2002 Behavioral Risk Factor Surveillance System, we asked Iowa adults with (N=1050) and without (N=2514) high blood pressure five questions relating to the most recent Joint National Committee guidelines on lowering blood pressure. Respondents with high blood pressure were placed into normal weight and overweight categories. Chi-square analysis revealed group differences in amount of advice received. To reflect the true Iowa population, data were weighted by SPSS software. RESULTS: Compared with persons without high blood pressure, those with high blood pressure received more lifestyle-modification advice (p < .001) for eating less high-fat or high-cholesterol foods (28.3% vs. 12.5%), eating more fruits and vegetables (35.7% vs. 20.0%), exercising more (37.6% vs. 20.8%), losing weight (19.3% vs. 9.3%), and quitting smoking (80.5% vs. 64.6%). CONCLUSIONS: Although persons with multiple chronic-disease risk factors are given more advice, the prevalence of advice given to individuals when lifestyle changes may reduce risk factors is still very low. Methods of translating research on lifestyle modifications into practice are discussed.

Adult↗
PubMed1993

AIDS-related risk behavior, knowledge, and beliefs among women and their Mexican-American sexual partners who used intravenous drugs.

OBJECTIVE: To assess the risk behaviors, knowledge, and beliefs regarding human immunodeficiency virus (HIV) infection and acquired immunodeficiency syndrome (AIDS) among women and their sexual partners who were Mexican-American men who used intravenous drugs. DESIGN: Survey of male methadone users and their female sexual partners. PARTICIPANTS AND SETTING: Mexican-American male clients at a methadone clinic in Los Angeles, Calif, were consecutively recruited for the study. A method similar to partner contact tracing was used to identify female subjects. One hundred subjects, representing 50 male-female pairs of sexual partners, answered identical questionnaires. The responses from females were compared with those from their male partners. RESULTS: Seventy-four percent of the females disclosed that they used intravenous drugs, and 88% knew that their male partners were intravenous drug users. Of subjects who used intravenous drugs, 73% (27/37) of females and 88% (44/50) of males currently injected themselves and shared uncleaned needles. Seventy-six percent of females and 84% of males never used a condom during the previous year, and about 20% of both sexes had more than one sexual partner. Even though most of the females understood how HIV was transmitted and recognized themselves as at risk for AIDS, they continued to share needles unsafely and place themselves at risk for acquiring HIV infection through sex. CONCLUSION: This group of females and their male sexual partners engaged in multiple behaviors that may contribute to the further propagation of HIV infection.

Acquired Immunodeficiency Syndrome↗
PubMed2006

Psychiatric and psychosocial correlates of sexual risk behavior among adults with severe mental illness.

Persons with severe mental illness (SMI) are disproportionately affected by HIV/AIDS. This study examined multivariate correlates of sexual risk among 152 adults with SMI receiving outpatient psychiatric treatment. Structured interviews assessed psychiatric, psychosocial, and behavioral risk factors. The majority was sexually active (65%), and many reported unprotected intercourse (73%), multiple partners (45%), and sex trading (21%) in the past year. Logistic regression models found that sexual behaviors were differentially associated with non-psychotic disorder, psychiatric symptoms, substance abuse, childhood sexual abuse, romantic partnership, and social support (all ps < .05). Findings underscore the need for targeted HIV prevention interventions that address psychiatric and psychosocial risk factors.

Acquired Immunodeficiency Syndrome↗
PubMed2005

Smoking status and mammography among women aged 50-75 in the 2002 behavioral risk factor surveillance system.

BACKGROUND: Since the late 1980's, data show an association between smoking status and mammography. Women smokers reported 12-15% lower rates than non-smokers. This study investigated whether an association persists in a recent national-level database. METHODS: The sample was women aged 50-75 years from the 2002 Behavioral Risk Factor Surveillance System (N = 52,300). Analyses used two definitions of recent mammography, one based on a one-year interval between exams, the other on a two-year interval. Smoking was classified as current, former, or never. Other covariates included sociodemographic variables, health practices, insurance status and usual source of care. RESULTS: The rate of mammography for current smokers was 16% lower than for never smokers for the past-year interval, and 14.0% lower for the two-year interval. Multiple logistic regression supported the smoking/mammography association. Other covariates associated with lower mammography on both dependent variables were recent Pap test, health insurance/usual source of care, recent dental visit, seat belt use, marital status and age. CONCLUSIONS: Reasons for the persistent association between smoking and mammography must be determined. These variables will inform interventions with women who smoke. A key question is whether to intervene on smoking directly or whether mediating variables are sufficient targets of intervention.

Aged↗
PubMed2006

Racial disparities in diabetes-related preventive care: results from the Missouri Behavioral Risk Factor Surveillance System.

INTRODUCTION: Racial disparities exist in the rates of diabetes complications in the United States and in the state of Missouri. It is unclear to what degree such disparities involve diabetes-related preventive care. We sought evidence for racial disparities in diabetes-related preventive care between non-Hispanic blacks and whites in Missouri. METHODS: We analyzed data from the Missouri Behavioral Risk Factor Surveillance System from 1994 through 2002. This state-specific survey is conducted annually among a representative sample of Missourians. We examined data from 842 Missourians who reported a diagnosis of type 1 or type 2 diabetes and who had consulted a health professional in the 12 months before they were interviewed. We analyzed reported receipt of glycosylated hemoglobin testing, foot examinations, and dilated eye examinations in the year before interview. RESULTS: Non-Hispanic blacks were significantly less likely than whites to report having had glycosylated hemoglobin testing (odds ratio [OR], 0.47; 95% confidence interval [CI], 0.22-0.99) but more likely to report having received foot examinations (OR, 1.99; 95% CI, 1.21-2.39). There was no difference between blacks and whites in the probability of dilated eye examinations (OR, 1.49; 95% CI, 0.94-2.36). CONCLUSION: Compared with whites, non-Hispanic blacks in Missouri receive adequate screening for diabetic complications but not for glycemic control. Further studies are needed to investigate whether these disparities are linked to differences in the rate of diabetes complications in Missouri.

Black or African American↗
PubMed1999

Reducing employee injuries through preventing at-risk behaviors: how to make such programs work.

Hospitals that have adopted successful "behavior-based" programs aimed at reducing employee injuries and preventing at-risk behaviors find that enlisting worker support is key to the effectiveness of such efforts. In this report, we'll present the experiences of officials at two medical centers in successfully reducing and preventing injuries. We'll also provide some guidance from psychologists and employee safety experts on ways to approach the problem.

Ergonomics↗
PubMed2005

Relationship of abuse and pelvic inflammatory disease risk behavior in minority adolescents.

PURPOSE: Little is known about the relationship between minority adolescent's experiences of sexual or physical abuse and the pathology of gynecological symptoms that might have an impact on the diagnosis of sexually transmitted disease (STD) or risk for pelvic inflammatory disease (PID). The objective of this study was to determine the relationship of sexual or physical abuse to the pathology of genitourinary symptoms that impact diagnoses of STD and risk for PID among Mexican American and African American adolescent women with a current STD. METHODS: Mexican American and African American adolescent women (n = 373) with an STD underwent a targeted physical exam and questioning regarding sexual or physical abuse, current genitourinary symptomatology, and risk behaviors known to be associated with PID to determine the relationship of sexual or physical abuse to the pathology of genitourinary symptoms that impact diagnoses of STD and risk for PID. RESULTS: Bivariate comparisons found that abused adolescents (n = 232) reported more behaviors associated with increased risk for PID, including earlier coitus, more sex partners, higher STD recurrence, and delayed health-seeking behavior. Multivariate comparisons found that abused adolescents were more likely to report pathologic genitourinary symptomatology than those who were not abused. Clinicians reported more abnormal physical exams but did not make any more presumptive diagnoses of PID for abused than nonabused adolescents. CONCLUSIONS: Delayed treatment for PID dramatically worsens future fertility and chronic pelvic pain. These findings demonstrate that abused adolescent women are at high risk for PID. Because of its considerable impact on risk for PID, an assessment for abuse is essential in clinical management of adolescent women with STD and diagnosis of PID.

Adolescent↗