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PubMed2003

HIV risk behavior history of prison inmates in Hungary.

As part of an intervention in correctional facilities in Hungary, we conducted research on AIDS-related attitudes and the HIV risk behavior history of 551 male and 81 female inmates to assess needs for and to tailor AIDS education programs. Although lifetime injection drug use was uncommon (8% of men, 3% of women), many Hungarian inmates had engaged in unprotected sex and had had high-risk sex partners: a quarter of men had primary partners who sold sex, about half of them had sex with female prostitutes, 13% of women had worked as prostitutes, and 9% of all inmates indicated having had sex in prison. Because many prison inmates may constitute a potential bridge population for the sexual transmission of HIV between the general population and high-risk populations, interventions among prison inmates may provide an opportunity to reach an at-risk population and to prevent the wider spread of sexually transmitted HIV.

Adult↗

PubMedDate not supplied

Public agency collaboration: implementation of the behavioral risk factor survey in adjacent Texas communities.

This article describes a collaborative community survey project between two public agencies serving adjacent urban communities. The main purpose of the collaboration was to establish comparable baseline health risk data for each community. To meet this goal, the agencies jointly administered the Centers for Disease Control and Prevention Behavioral Risk Factor Surveillance System questionnaire in their communities. The collaborative process was manageable and conserved both time and resources. This assessment project exemplifies a collaboration that both public and private healthcare entities can model to help ensure the health of the communities they serve.

Aged↗

PubMedDate not supplied

[The prevalence of HIV and risk behavior of prostitutes living in 2 populous regions of Bujumbura (Burundi)].

This study was designed to determine the prevalence of HIV infection and associated high-risk behavior in female sex workers in two areas of Bujumbura (Bwiza and Musanga), Burundi. Between June 15th and July 15th 1993, 320 female sex workers responded to an anonymous questionnaire and gave a blood sample on filter paper for detection of HIV antibodies. The mean age of the prostitutes was 24.6 (+/- 5.9) years (range 15 to 46). The HIV infection rate was 42.2% (135 of the 320). Univariate analysis showed that the proportion of HIV-infected female sex workers was higher in the Musaga area than in Bwiza (48.3% versus 34.3%; p = 0.012). The prevalence of HIV infection increased with age (24.3% for those aged between 15 and 19; 40.8% for those aged between 20 and 24 and more than 51.4% infected in the over 25 age-group; p < 0.001). The median number of sexual partners in the preceding month was 3 (range 1 to 50) and was not correlated with HIV infection (Wilcoxon's test: p = 0.516). HIV infection was highly correlated with a previous history of STDs (62.7% versus 32.7%; p < 0.001) and was also correlated with STD symptoms (87.5% versus 51.7%; p = 0.01). The only factors correlated with HIV infection in multivariate analysis were age (p = 0.008; Trend's test) and previous history of STDs (p < 0.001). Only 40.2% (127 of 316) of the female sex workers had used condoms with their clients during the preceding month. Intervention strategies to combat HIV transmission among individuals with high levels of sexual activity in Burundi should focus on the female sex workers and their clients, particularly the manual laborers, drivers, soldiers, prisoners and other men who regularly use prostitutes. The prevention of HIV infection in individuals of high-risk groups is the best strategy to reduce HIV transmission in the general population of developing countries.

Adolescent↗

PubMed2001

Tobacco use among high school athletes and nonatieletes: results of the 1997 youth risk behavior survey.

In the United States today, the use of tobacco has become an entrenched part of teenage culture. The present study used the 1997 Youth Risk Behavior Survey (YRBS), which collected data from a nationally representative sample of 16,262 students in public and private high schools, to compare the tobacco use patterns of athletes and nonathletes. The independent variable, athletic participation, differentiated between moderately involved (1 or 2 teams) and highly involved (3 or more teams) athletes. Frequency of cigarette and cigar smoking and smokeless tobacco use served as the operational measure of tobacco use. Age, race/ethnicity, parental education, and residence were controlled. Logistic regression was used to calculate odds ratios for female and male athletes and nonathletes for each of the tobacco use variables. It was found that both male and female athletes were less likely to have ever smoked regularly, the effect being stronger for more highly involved athletes of both genders. Cigar smoking was unrelated to athlete status. Both female and male athletes were more likely to have used smokeless tobacco, the effect being stronger for more highly involved athletes of both genders. The findings are discussed in terms of access to health information, performance considerations, social status factors, the salience of an athletic identity, and the influence of the athletic subculture on its members.

Adolescent↗

PubMed2004

High-risk behavior during adolescence: comments on part I.

Cardinal and Steinberg provide evidence from both laboratory animal and human studies indicating that behavior is controlled by two distinct brain systems, one activational and the other inhibitory. This conceptual framework continues to be a useful integrative framework in developmental neurobiology and psychology. Despite the conceptual framework that posits a two-system control of high-risk behavior, it is notable that the bulk of research related to this topic has focused on one system in isolation from the other. Since the activational and inhibitory systems are constructs that are amenable to investigation using both laboratory animals and human subjects, it seems that a fruitful avenue for future interdisciplinary research would be to ascertain the interactive effect of these systems across the periadolescent period.

Adolescent↗

PubMed1992

Choice of exercise: a predictor of behavioral risks?

After controlling for differences in gender, educational achievement, and exercise duration among a sample of 7,248 Americans 18-34 years old, we found that runners-joggers-fast walkers (RJWs) and tennis players were less likely to be obese, smoke, consume large quantities of alcohol, and drive without seat belts than those who participate in team and an aggregate of other sports. These behavioral differences might be explained by imprecise data, intervening variables such as exercise intensity, or other variables that were not measured. But a more interesting explanation is that running-jogging-fast walking and playing tennis are integral components of healthy lifestyles, and team sports and some other exercise behaviors are part of riskier ways of living. No consistent association was found between duration of exercise and behavioral risk.

Adolescent↗

PubMed2005

Contraceptive use--United States and territories, Behavioral Risk Factor Surveillance System, 2002.

PROBLEM: Contraceptive use is an important determinant of unintended pregnancy. In the United States, approximately half of all pregnancies are unintended. Population-based information about contraceptive use patterns is limited at the state level. Information about contraceptive use for states can be used to guide the development of state programs and policies to decrease unintended pregnancy and the spread of sexually transmitted infections. Information about contraceptive use for specific subpopulations can be used to further refine state efforts to improve contraceptive use and subsequently decrease the occurrence of unintended pregnancy. REPORTING PERIOD: Data were collected in 2002 for men and women. DESCRIPTION OF SYSTEM: The Behavioral Risk Factor Surveillance System (BRFSS) is a random-digit--dialed, telephone survey of the noninstitutionalized U.S. population aged > or =18 years. All 50 states, the District of Columbia, Guam, the Commonwealth of Puerto Rico, and the U.S. Virgin Islands participated in BRFSS in 2002. These data can be used to track state progress towards the national health objectives for 2010 for responsible sexual behavior. The 2002 BRFSS data represent the first time state data on contraceptive use in all 50 states will be presented and examined by selected sociodemographic characteristics. The 2002 BRFSS also, for the first time, provided an opportunity to examine state-level contraceptive use patterns among men. RESULTS: Variation across states and territories was observed for the majority of contraceptive methods among the different demographics analyzed and among men and women. The percentage of men and women at risk for pregnancy who said they or their partner was using birth control was high overall and ranged from 67% (Guam) to 88% (Idaho). Oral contraceptives (i.e., the pill), vasectomy, tubal ligation, and condoms were the methods most frequently reported by both male and female respondents who said they or their partner was using birth control. Among female respondents using birth control, the pill was the most common method reported. Among men, vasectomy was the most commonly reported method. The prevalence of use for the four most commonly reported methods (pills, vasectomy, tubal ligation, condoms) varied as much as six-fold among states for vasectomy and three- to four-fold for condoms, pills, and tubal ligation. INTERPRETATION: The findings in this report document substantial differences among states and sociodemographic groups within states in contraceptive method use. PUBLIC HEALTH ACTION: These data can help states identify populations with an unmet need for birth control, barriers to birth control use, and gaps in the range of birth control methods offered by health-care providers. An analysis of the prevalence of birth control use by state and selected population characteristics can help states target contraceptive programs to best meet the needs of their population.

Adult↗

PubMed1996

Testing for HIV and other sexually transmitted diseases: implications for risk behavior in women.

A sample of 808 nonpregnant women residing in an area of high prevalence of sexually transmitted diseases (STDs) was studied with respect to sexual risk behaviors in the 4-month period before and after testing for a series of STDs. All women were tested for both Chlamydia trachomatis and Trichomonas vaginalis and were given the option of also taking a test for the HIV antibody. Neither the experience of receiving a negative HIV test result nor that of receiving a positive versus a negative diagnosis for STDs resulted in significant mean changes in self-reports of STD or HIV susceptibility, condom use consistency, or number of sexual partners during the 4 months following testing. However, perceived susceptibility was found to predict when women would decrease the consistency with which they used condoms as a function of HIV testing.

Adult↗

PubMed1992

Attitudes, norms, and self-efficacy: a model of adolescents' HIV-related sexual risk behavior.

Using data from a cross-sectional, statewide survey of 1,720 Texas ninth graders in 13 school districts, a model of psychosocial predictors of human immunodeficiency virus (HIV)-related sexual risk behavior was tested. Predictor variables in the model, based on variables from the Theory of Reasoned Action and Social Learning Theory, were attitudes, norms, self-efficacy, and behavioral intentions. Attitudes, norms, and self-efficacy predicted 36.4% of the variance in the intention to limit the number of sexual partners and the same variables plus intention predicted 24.6% of the variance in number of sexual partners in the past year. Attitudes, norms, and self-efficacy regarding condom use predicted 17.0% of the variance in condom use intentions; these variables plus intentions predicted 19.0% of the variance in condom use frequency. Attitudes, norms, and intentions were directly related to the number of sexual partners, while self-efficacy ad condom use intentions were directly related to frequency of condom use.

Adolescent↗

PubMed2004

High-risk behavior and potential transmission of drug-resistant HIV among injection drug users.

Evidence of increasing prevalence of drug resistance among recent HIV seroconverters indicates a growing public health concern and warrants an examination of the problem from a prevention perspective. Among 638 HIV-infected injection drug users (IDUs) completing 2731 visits between December 1996 and February 2000 in an ongoing cohort study in Baltimore, Maryland, factors associated with unprotected sex and needle sharing were determined. Participants were classified as being at higher or lower risk of HIV and of drug-resistant HIV transmission based on viral load, antiretroviral therapy use, and reported high-risk behavior. Stored plasma of those at higher risk of drug-resistant HIV transmission was tested for resistance by VirtualPhenotype (Vircolab, Rockville, MD). Women were nearly twice as likely as men to engage in unprotected sex, and IDUs were more likely to have unprotected sex if their sexual partners were also HIV infected. IDUs were at higher risk of HIV and drug-resistant HIV transmission at 19% and 6% of all visits, respectively. Participants were infected with drug-resistant HIV at 14% of visits when they were at higher risk of HIV transmission. Intensive risk reduction counseling is needed and must be integrated into routine HIV clinical care.

Adolescent↗

PubMed2002

Cancer risk behaviors and screening rates among homeless adults in Los Angeles County.

The homeless encounter many barriers to health care and preventive services, while having an increased prevalence of most risk factors for cancer. A group of homeless adults (221) at nine different locations within Los Angeles County were surveyed during the summers of 1998 and 1999. A portion (71%) reported that they had had at least one rectal exam, 42% had a fecal occult blood test, 24% had a skin exam, and 23% had an endoscopy (flexible sigmoidoscopy or colonoscopy), and of the men aged 50+, only 19% had a prostate-specific antigen test in their lifetime. For women aged 40+, 55% had received a Pap smear, and 53% had a breast exam, but only 32% had a mammogram within the prior year. Among the sampled homeless population, 77% believed in the benefits of cancer screening, 79% were not fatalistic about cancer, 63% believed that early detection was efficacious, and 83% did not think it would be difficult to get screened. The majority of this population demonstrated accurate knowledge of cancer screening guidelines with the exception of endoscopy. Cancer screening rates of those surveyed were lower than the rates in California for endoscopy, prostate-specific antigen, mammography, and Pap smears. Given the lower cancer screening rates compounded by higher cancer risk factors, homeless populations need increased access to cancer screening tests, as well as education on the availability of free services. Additionally, facilities for the homeless and their staff should reinforce the purposes of cancer screening, provide more screening services, and implement institutional efforts, such as providing nutritious meals and sun protection products, to reduce high-risk behaviors and increase further access to cancer screening tests.

Adult↗

PubMed2004

Using the Behavioral Risk Factor Surveillance System (BRFSS) for exposure tracking: experiences from Washington State.

One of the goals of the National Environmental Public Health Tracking Network is to link environmental data with chronic disease data as a means of improving our understanding of the environmental determinants of disease. Such efforts will rely on the ongoing collection of population exposure information, and there are few systems in place to track population exposures. In many cases, exposures can be estimated by combining environmental contaminant data with data about human behaviors. The Behavioral Risk Factor Surveillance System (BRFSS) provides a good opportunity to implement tracking of exposure-related behaviors. Washington State has used the BRFSS to collection information on environmentally related knowledge, attitudes, and behaviors. In this article we present case studies of modules covering drinking water, perceptions of environmental risk, and radon awareness and testing. Data on exposure-related behaviors have been useful for population exposure assessments and program evaluation. Questions about knowledge and attitudes and perceptions of environmental issues were not as useful because they lacked sufficient detail from which to modify existing education efforts. In some cases these data had not been used at all, indicating that the need for the data had not been well established. National development efforts should focus on compiling existing questions and developing questions on topics that are a priority at the state and national levels to be included as core questions and optional modules in future BRFSS surveys.

Data Collection↗

PubMed2004

Motorcycle helmet use and related risk behaviors among adolescents and young adults in Northern Thailand.

The objective of this study was to assess the prevalence of not wearing a helmet (unprotected) while riding a motorcycle and associated risk behaviors among adolescents and young adults in Northern Thailand. Participants were 1725 students, aged 15-21 years, from 3 vocational schools in Chiang Rai Province; 51.8% were male. Participants completed a classroom-based computer-assisted self-interview (ACASI). Of men 72.7% and of women 64.4% reported unprotected motorcycle riding 3 times or more in the past week. Logistic regression analysis showed the variables independently associated with unprotected riding to be history of ever riding after having had 3 or more alcoholic drinks (odds ratio (OR) = 2.21, 95% confidence interval (CI) = 1.76-2.21), attending technical school (OR = 2.09, 95% Cl = 1.55-2.83), living with the family (OR = 1.38, 95% CI = 1.10-1.73), and having ever had a traffic accident (OR = 1.20, 95% CI = 1.12-1.29). Being of hill tribe ethnicity (vs Thai lowlander) was associated with protected riding (OR = 0.42, 95% CI = 0.20-0.90). Adolescents and young adults in Chiang Rai are at high risk for riding a motorcycle without a helmet buckled on the head. Public education in combination with enforcement of compulsory helmet use while riding a motorcycle is recommended.

Accident Prevention↗

PubMed2002

Role models, ethnic identity, and health-risk behaviors in urban adolescents.

BACKGROUND: The assumption that role models or mentors constructively influence adolescent psychological functioning has prompted societal investment in mentoring programs. However, there has been little empirical evaluation of the relationship between role model or mentor characteristics and health behaviors. OBJECTIVES: To describe role model selection in urban adolescents and examine the relationships between role model characteristics, psychosocial functioning, and health-risk behaviors. DESIGN: Cross-sectional survey. PARTICIPANTS: A population-based, multiethnic sample of Los Angeles County adolescents aged 12 to 17 years was generated from a 3-stage, area-probability sampling frame. Of 877 adolescents identified, 749 are included in this analysis. METHODS: In-person, in-home interviews were conducted. MAIN OUTCOME MEASURES: Substance use, academic performance, and self-perception (measures of ethnic identify and self-esteem). Ethnic identity was measured by an adaptation of a scale developed by Phinney (J Adolesc Res. 1992;7:156-176) to assess commonalities across ethnic groups. RESULTS: Fifty-six percent of adolescents identified a role model. Higher levels of ethnic identity were associated with moving from identifying no role model to identifying a figure primarily available through the media to identifying a known individual, familial or nonfamilial (P<.001). Having a role model, particularly an individual known to the adolescent, was also associated with higher self-esteem (P<.001) and higher grades (P<.05). For white males without custodial fathers, having a role model was associated with decreased substance use (P<.05). CONCLUSION: Role model selection is associated with protective psychosocial characteristics.

Adolescent↗

PubMed1986

Failure to use seat belts in the United States. The 1981-1983 Behavioral Risk Factor Surveys.

Although seat belt use could prevent thousands of highway deaths and save billions of dollars annually, most Americans do not routinely buckle up. To understand better this phenomenon and other health-related behaviors, 28 states, the District of Columbia, and the Centers for Disease Control, Atlanta, surveyed over 22,000 US adults from 1981 through 1983. Overall, 76% of US adults reported not using seat belts. Blacks, 18- to 24-year-olds, persons with no more than a high school education, and persons with other risk behaviors (especially drunk driving) were least likely to use seat belts. Legislation by the states and education by physicians can increase seat belt use and reduce morbidity and mortality due to motor vehicle collisions.

Adolescent↗

PubMed1997

Individual, household and behavioral risk factors of S haematobium infection in an Egyptian village in Giza Governorate.

A survey study has been conducted in Zaweit Abu Soelum village in Giza Governorate to study and describe individual, household and behavioral risk factor related to S. haematobium infection in an area with moderate level of infection. A systematic random sample of houses was chosen, and all individuals in the selected household were invited to participate. A total number of 616 persons in 100 houses complied in the study. A primary school was present in the village. A random sample of school children were also included. Urine and stool analysis were performed for each person. Personal, household and behavioral data were collected through personal interview. Uni-varite and multivariate analysis were done to test the available risk factors. Results showed a S. haematobium prevalence of 12.3%, whereas, a prevalence of 35.9% was observed among school children. Age as a risk factor showed the highest significance to infection, followed by the history of burning micturition with f-value = 0.001.

Adolescent↗

PubMedDate not supplied

HIV infection: a retrospective analysis of adolescent high-risk behaviors.

INTRODUCTION: The purpose of this study was to retrospectively ascertain behaviors and activities that may constitute high risk during the adolescent years (ages 12-18) of young adults (ages 20-25) who are infected with human immunodeficiency virus (HIV). METHODS: Subjects (n = 44) from 1 of 5 clinics in a large midwestern city completed a survey form, developed by the investigators, which examined 6 areas of behavior and activities that the literature suggested may be associated with high-risk behaviors. RESULTS: The adolescent high-risk profile of an HIV-infected young man includes sexual abuse before the age of 12 years, heavy consumption of alcohol, heavy consumption of a variety of illicit drugs, a wide variety of sexual experiences at very young ages, and multiple sexual partners. The adolescent high-risk profile of an HIV-infected young woman in this study includes heavy consumption of alcohol, heavy consumption of a variety of illicit drugs, and unprotected vaginal intercourse at very young ages as evidenced by a high number of sexually transmitted diseases at very young ages. DISCUSSION: Although the small number of participants in this study restricts interpretation of the results, adolescent health initiatives should be examined in light of these findings. Programs and services must consider the context of psychosocial situations, as well as past experiences, and incorporate this knowledge into prevention strategies.

Adolescent↗

PubMed2006

Brief report: Behavioral risk factors for youth soccer (football) injury.

OBJECTIVES: By most reports, soccer (football) is among the most played and most popular sports in the world. This study prospectively examined behavioral risk factors for youth soccer injury. METHOD: Sixty 11- and 12-year-old boys who played on six teams in a suburban recreational soccer league were followed over the course of a season. Six predictors were assessed prior to the start of the season via self-report measures from coaches, parents, and the players themselves: inhibition, aggression, risk-taking, skill, experience playing soccer, and physical size. All games were videotaped, and tapes were reviewed to record players' collisions with other players, fouls, falls during the course of play, and injuries. RESULTS: Greater skill and less experience playing soccer best predicted injury risk. Inhibition, aggression, and risk-taking did not emerge as predictors. CONCLUSION: Results are discussed with respect to previous research in youth sport and general pediatric injury risk.

Adult↗