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PubMed1992

Cigarette smoking among American Indians and Alaskan Natives--Behavioral Risk Factor Surveillance System, 1987-1991.

Cardiovascular disease and cancer are two of the leading causes of premature death among American Indians and Alaskan Natives. Although cigarette smoking contributes to these diseases, cigarette smoking behaviors among American Indians and Alaskan Natives have not been well characterized nationally. To better assess the impact of smoking on these populations, CDC analyzed data obtained from the Behavioral Risk Factor Surveillance System (BRFSS) during 1987-1991. This report summarizes the findings from this study.

Adolescent↗
PubMed2000

Human immunodeficiency virus-related risk behavior among African-American females.

This study draws attention to the demographic shift in the population of HIV-infected African Americans from young, low-income, unmarried homosexual, and injecting drug users to female, heterosexual, higher income, and older persons. We used data from the 1995 Survey of Family Growth, sponsored by the National Center for Health Statistics, to examine the patterns of HIV-related risk behavior (consistent condom use, number of sexual partners, sex education in birth control methods) among African-American females. We found that only 33.3% of the African-American females had indicated that their partners always used condoms; 23.8% had seven or more lifetime sexual partners; and nearly 30% did not have any sex education in birth control methods, sexually transmitted diseases, or abstinence. In addition, African-American females who had partners who had not used condoms in the last 12 months were less likely than those who reported occasional condom use to perceive that they were infected with HIV (21.1% vs. 33.1%). These risk factors were prevalent among low-income African-American females with low socioeconomic status (SES) as well as black women with higher SES who lived in smaller cities and suburbs. These results highlight the need for HIV prevention strategies that cut across socioeconomic class, gender, sexual orientation, and place of residence.

Adolescent↗
PubMed1994

Factors mediating changes in sexual HIV risk behaviors among gay and bisexual male adolescents.

OBJECTIVES: Factors mediating changes in sexual behaviors that increase the risk of human immunodeficiency virus (HIV) infection were monitored in a group of gay and bisexual male adolescents. METHODS: One hundred thirty-six males aged 14 to 19 years (Hispanic, 51%; African-American, 31%) were recruited from one gay-identified agency, were assessed at four points over a 1-year period, and participated in HIV preventive intervention sessions. RESULTS: Significant reductions occurred in the number of unprotected same-sex anal and oral acts. Those with less risk in their previous sexual history, those who did not engage in commercial sex, and those who attended more HIV intervention sessions were more likely to reduce their sexual risk. The impact of sessions varied significantly by race/ethnicity: African-American youths reduced their risk acts most dramatically. Abstinence was consistently and significantly more likely among younger youths and those who had been abstinent before enrollment. The youths significantly reduced the number of sexual partners following the intervention; this reduction in partners was maintained through the 12-month follow-up and was greatest among youths with no involvement in commercial sexual activity (prostitution). CONCLUSIONS: The efficacy of HIV prevention programs must be empirically evaluated.

Adolescent↗
PubMed1995

HIV-1 seroconversion and risk behaviors among young men in the US army. The Seroconversion Risk Factor Study Group.

OBJECTIVES: This study sought to examine risk factors associated with human immunodeficiency virus type 1 (HIV-1) seroconversion among active-duty men in the US Army. METHODS: One hundred twenty-eight men with documented HIV-1 seroconversion between 1988 and 1991 were matched to control subjects on demographic variables. Risk factor information was collected for the seroconversion period. RESULTS: Forty-nine case subjects and no control subjects reported same-gender sex; this includes 34 case subjects who also reported sex with women. Seventy case and 118 control subjects reported no risk factors other than heterosexual intercourse. Among heterosexuals, excess risk was noted for men who had sex with women in risk categories defined by the Centers for Disease Control and Prevention (odds ratio = 10.0; 95% confidence interval = 1.3, 78.1). Significant trends of increasing risk for seroconversion were found with increasing numbers of female partners, nonsteady partners, and partners with whom sex occurred on the first day of acquaintance. CONCLUSIONS: In this population, the major risk factor for HIV-1 seroconversion was same-gender sex. Among heterosexuals, sex with anonymous or causal partners increased this risk. Intervention programs should emphasize the risk of indiscriminate partner selection in addition to "safe sex" practices.

Adult↗
PubMed1995

Sexual sensation seeking and Sexual Compulsivity Scales: reliability, validity, and predicting HIV risk behavior.

Two studies are presented that evaluate newly developed scales of sensation seeking and sexual compulsivity. Results showed that the scales were reliable and correlated with convergent and divergent measures in expected directions in samples of both gay men (N = 296) and inner city low-income men and women (N = 158). Consistent with theories of sensation seeking, the scales corresponded to an attraction toward a range of sexual practices, including increased frequencies of unprotected intercourse and a greater number of sexual partners. As expected, sexual compulsivity was not related to variety and novelty in sexual practices, but was associated with lower levels of self-esteem and resistance to adopting sexual risk-reducing strategies. However important differences were observed between the gay men and heterosexual samples; scales correlated with substance use only among gay men, and sexual compulsivity was related to a range of sexual practices only among heterosexuals. The sensation seeking and Sexual Compulsivity Scales were therefore reliable, appeared valid, and useful in predicting sexual risk behaviors.

Adolescent↗
PubMed2004

An economic analysis of adult obesity: results from the Behavioral Risk Factor Surveillance System.

This paper examines the factors that may be responsible for the 50% increase in the number of obese adults in the US since the late 1970s. We employ the 1984-1999 Behavioral Risk Factor Surveillance System, augmented with state level measures pertaining to the per capita number of fast-food and full-service restaurants, the prices of a meal in each type of restaurant, food consumed at home, cigarettes, and alcohol, and clean indoor air laws. Our main results are that these variables have the expected effects on obesity and explain a substantial amount of its trend.

Adult↗
PubMed2006

Sexual risk behavior of HIV-positive methamphetamine-using men who have sex with men: the role of partner serostatus and partner type.

This study examined the role of partner serostatus and partner type in relation to the sexual risk behaviors and disclosure practices of HIV-positive methamphetamine (meth)-using men who have sex with men (MSM). The sample consisted of 132 HIV-positive meth-using MSM who reported having both serodiscordant (i.e., HIV-negative and unknown serostatus) and seroconcordant (i.e., HIV-positive) partners. HIV-positive meth-using MSM engaged in significantly fewer acts of anal sex with serodiscordant partners as compared to seroconcordant partners. However, mean levels of unprotected anal and oral sex were high, and mean levels of protected sex were low for both seroconcordant and serodiscordant partners. Oral sex was practiced twice as often as anal sex; however, both types of sex were primarily unprotected. This pattern of risky sexual behavior was reported for steady, casual, and anonymous partners, regardless of partner serostatus. Despite high rates of unprotected sex, rates of HIV serostatus disclosure were consistently high for HIV-positive and HIV-negative steady, casual, and anonymous partners. However, rates of disclosure to unknown serostatus partners were low, particularly in relation to anonymous partners. Future research should address the reasons why HIV-positive meth-using MSM engage in risky sexual activity with serodiscordant partners, and HIV prevention programs for this population should emphasize the risks associated with unprotected sex with seroconcordant partners.

Adult↗
PubMed1993

The descriptive epidemiology of selected physical activities and body weight among adults trying to lose weight: the Behavioral Risk Factor Surveillance System survey, 1989.

Few population-based studies have described the physical activity patterns of individuals trying to lose weight. We analysed cross-sectional, self-reported data from 6125 men and 12,557 women (> or = 18 years of age) from 40 states who reported in the 1989 Behavioral Risk Factor Surveillance System (BRFSS) survey that they were trying to lose weight. The BRFSS is a state-based telephone survey of non-institutionalized US adults, which utilizes a multi-stage cluster design based on the Waksberg method of random digit dialing. Walking was the most prevalent physical activity (48%), followed by aerobics (8%), gardening (5%), cycling (5%), and running (4%); however, activity choices varied by socio-demographic characteristics. Among both sexes, the prevalence of overweight (BMI > or = 30 kg/m2) decreased significantly with increasing level of activity (P < or = 0.001). Regression results showed that among both sexes and in most age groups, those who ran or jogged, performed aerobics, or cycled weighed less (P < or = 0.001) than those who reported no activity--independent of height, race, education, smoking, and caloric restriction. Walking was also associated with lower weight (P < or = 0.001) among persons aged 40 or older. Because walking is highly prevalent among persons in most socio-demographic strata and is accessible and low risk, its relative merits should be stressed in developing interventions for weight loss and maintenance.

Adult↗
PubMed1991

Cigarette smoking among reproductive-aged women--Behavioral Risk Factor Surveillance System, 1989.

Women who smoke cigarettes are at increased risk not only for chronic diseases (e.g., lung cancer and chronic obstructive pulmonary disease) but--if they use oral contraceptives--also for myocardial infarction (1). In addition, cigarette smoking during pregnancy increases the risk for low birth weight and premature infants, miscarriage, stillbirth, sudden infant death syndrome, and infant mortality (2). Because of these risks and other health problems associated with cigarette smoking, one of the national health objectives for the year 2000 is to reduce the prevalence of smoking to 12% among reproductive-aged women (18-44 years of age) (3). This report summarizes data from the 1989 Behavioral Risk Factor Surveillance System (BRFSS) on the prevalence of smoking among reproductive-aged women.

Adult↗
PubMed1995

HIV-related knowledge and risk behaviors of street youth in Belo Horizonte, Brazil. The Street Youth Study Group.

Individual interviews were conducted with 379 youth who work and/or live on the streets of a large Brazilian city to assess HIV-related knowledge, sources of information, risk behaviors, and prevention beliefs and strategies. Respondents demonstrated high levels of factual knowledge about HIV transmission (84% correct) coupled with high levels of misconceptions about casual transmission (53% correct) and intermediate levels of knowledge about prevention (64% correct). Only 54% of the respondents had heard about AIDS recently, and 37.5% said they talked to someone about AIDS. The most common sources of information about HIV/AIDS were the mass-media and friends. Over half the sample reported taking precautions to reduce their risk of HIV infection; however, the proportion of youth taking effective precautions was low. Among the 247 youth (65% of the sample) who had initiated sexual activity, lifetime condom use was reported by 18%, and condom use at last intercourse by 10%. Youth with higher levels of knowledge were more likely to report behavior changes to avoid HIV infection. These findings underscore the urgent need for prevention programs tailored to street youth in developing countries.

Acquired Immunodeficiency Syndrome↗
PubMed2006

Stimulant use and HIV risk behavior: the influence of peer support group participation.

This study examines 12-step groups for recovery from methamphetamine and cocaine use that are attended by men having sex with men and the impact of attendance on HIV risk behavior. Participants in Crystal Meth Anonymous and other 12-step groups were interviewed up to 3 months since their last substance use. Sixty-two initial interviews, and ethnographic observations, were conducted. With entry into the program, mean reported sexual partners fell from around seven to one per month and the proportion having unprotected anal intercourse declined from 70% to 24%. HIV-positive men were more likely than HIV-negative men to report unprotected anal intercourse when using stimulants but less likely in recovery. Qualitative data suggest a transition from cocaine to methamphetamine in Chicago, and that reduction in partners is due to fear of relapsing in sexual situations rather than program teachings. These programs do however facilitate discussions around drug use and sexual issues.

Adult↗
PubMed2000

Changes in injection risk behavior associated with participation in the Seattle needle-exchange program.

We studied the influence of the Seattle, Washington, needle-exchange program on sharing of drug injection equipment (syringes, drug cookers, filtration cotton) to identify potential gaps in risk reduction and to understand in greater detail the lack of an association between exchange use and risk of hepatitis B or C virus transmission. In a cohort of 2,208 injection drug users who completed a 1-year follow-up visit, we measured the association between needle-exchange use at study enrollment (ever vs. never) and injection risk behavior at the follow-up. Control for confounding was carried out using both logistic regression and propensity score analytic methods to estimate the adjusted odds ratio (AOR). In both univariate and multivariate analyses, needle-exchange use was associated with a lower likelihood of injection with a used syringe (AOR = 0.7, 95% confidence limit 0.5, 0.9). There was no association between exchange use and cooker or cotton sharing (AOR = 0.8, 95% confidence limit 0.6, 1.1) or between exchange use and use of a common syringe to divide drugs (AOR = 0.9). This analysis suggests that risk reduction measures adopted by users of the Seattle exchange may not be sufficient to prevent transmission of all blood-borne viruses, including hepatitis C virus. Greater awareness of the infection risk associated with these practices may help curb this type of equipment sharing and ultimately prevent disease transmission.

Adult↗
PubMed1993

Behavioral Risk Factor Surveillance, 1991: monitoring progress toward the nation's year 2000 health objectives.

PROBLEM/CONDITION: Risk reduction is a major focus of the national health objectives for the year 2000. Progress toward several of these objectives can be evaluated by using data from the Behavioral Risk Factor Surveillance System (BRFSS). Year 2000 objective areas measurable by BRFSS data include those for overweight, lack of physical activity, smoking, safety belt use, and medical screening for breast and cervical cancer and elevated blood cholesterol. BRFSS data have been used to guide health promotion/disease prevention programs. REPORTING PERIOD: 1991. DESCRIPTION OF SYSTEM: BRFSS is a state-based random-digit-dialing telephone survey of noninstitutionalized adults (> or = 18 years of age); 47 states and the District of Columbia participated in BRFSS in 1991. RESULTS: Some year 2000 objectives appear to be readily attainable for many states, whereas others do not. For example, among participating states, a median 57.8% (range = 45.6%-82.8%) of women ages > or = 50 years reported having had both a clinical breast examination and a mammogram in the previous 2 years (year 2000 objective: > or = 60%). In contrast, a median 37.3% (range = 22.1%-52.5%) of persons with annual family income < $20,000 reported that they did not engage in leisure-time physical activity--more than twice the year 2000 objective (> or = 17%). INTERPRETATION: BRFSS data demonstrate substantial state-to-state variation in progress toward year 2000 objectives and highlight areas (e.g., lack of leisure-time physical activity) in which substantial progress remains to be made in most states. Action taken: The BRFSS will continue to report data that relate to year 2000 health objectives. BRFSS data will enable states to monitor progress toward these objectives and develop health policies aimed at achieving them.

Adult↗
PubMedDate not supplied

Female injecting drug users: human immunodeficiency virus risk behavior and intervention needs.

Injecting drug use and heterosexual contact are the major exposure categories for women acquiring human immunodeficiency virus (HIV). The purpose of this study was to explore the relationship of acquired immunodeficiency syndrome (AIDS) risk perception, perceived seriousness of HIV, drug use self-efficacy, sexual self-efficacy, and social support for HIV/AIDS risk behavior among female injecting drug users (IDUs). A random sample of 140 female IDUs was interviewed using a structured questionnaire. The data were analyzed by descriptive statistics and logistic regression. Self-efficacy for preventive sexual behavior and social support were predictive of condom use with primary partners P = .01 and P = .001, respectively. Self-efficacy for preventive drug use was predictive of risky injection behavior (P = .004) and risky injection location (P = .003). The results suggest that HIV prevention programs targeting female IDUs should include strategies that incorporate their support networks and strengthen preventive self-efficacy. Brief intervention strategies that nurses can carry out with female IDUs are suggested.

Adult↗
PubMed1993

Adolescent risk behaviors and the potential for violence: a look at what's coming to campus.

This study analyzed the types and predictors of violent behaviors reported by students in Grades 11 and 12 in South Carolina. Results are based upon responses of 2,299 students from 57 schools, approximately 3% of the total state enrollment in those grades. The 70-item self-report Youth Risk Behavior Survey developed and piloted by the Federal Centers for Disease Control was used to collect data. The authors performed a series of logistic regression analyses to explore the relation of the demographic and potential risk variables to fighting and carrying weapons. Results from the simple logistic analyses, adjusting for race and gender, indicated that alcohol use, binge drinking, sexual activity, and use of any drugs were significantly associated (p < .05) with reported fighting. These variables and poor academic self-image were significantly associated with carrying weapons. Comprehensive multivariable models indicated that, when considered simultaneously, being black, male, sexually active, and engaging in binge drinking and drug use were significant predictors of fighting. Gender, but not race, alcohol use, drug use, or sexual activity, remained a significant predictor of carrying a weapon. Findings suggest that college risk-reduction and health-promotion programs should direct efforts at environmental modification, policy development and enforcement, as well as at personal change, including effective conflict resolution, stress management, and communication skills.

Adolescent↗
PubMed2006

Marked ethnic differences in HIV prevalence and risk behaviors among injection drug users in Dushanbe, Tajikistan, 2004.

OBJECTIVE: To examine differences by ethnicity of HIV prevalence and correlates among injection drug users (IDUs) in Dushanbe, Tajikistan. METHODS: The researchers enrolled 489 active adult IDUs in a cross-sectional risk factor study of HIV infection. Participants were provided HIV pre-and posttest counseling and risk reduction counseling and answered an interviewer-administered questionnaire. HIV-1 status was determined with rapid tests and confirmed with ELISA. RESULTS: Participants included four ethnicities: 204 Tajiks (49.1%), 145 Russians (29.7%), 58 Uzbeks (11.9%), and 46 participants of other nationalities (9.4%). Overall prevalence of HIV-1 infection was 12% and varied significantly by ethnicity: it was highest among ethnic Tajiks, at 19.2%; lowest among Russians and Uzbeks, at 3.4%; and 13% among other nationalities. Ethnic groups differed significantly in years injecting, receiving a needle from a needle exchange program (NEP), injecting in groups, having undergone drug treatment, reported condom use, and arrest history. Among Tajiks, HIV infection was significantly associated with daily injecting (OR 2.16); reporting that narcotics were very easy to obtain (OR 2.46); having undergone drug treatment (OR 2.75), and injecting "alone" (OR 3.12). CONCLUSIONS: Ethnic differences were strongly associated with HIV prevalence and risk behaviors in this multiethnic study, and prevention efforts might need to be targeted by ethnicity.

Adult↗
PubMed1994

Preparations for AIDS vaccine trials. An automated version of the Risk Assessment Battery (RAB): enhancing the assessment of risk behaviors.

Our primary objective during this pilot work has been to determine if the computerized RAB can be used in place of the paper-and-pencil version with an IDU population. As stated, reliability estimates in the form of correlations of risk scores between the two versions ranged from .82 to .94, and percentages of exact agreement of the scoreable items ranged from 88% to 100%. These correlations indicate that the C-RAB is comparable to the RAB in its psychometric properties. Further, subjects' positive ratings of the computer program and perceptions that it would better protect confidentiality indicate that this population would participate in assessments involving computer interactions. While these self-reports may be biased on clients' desire to be cooperative and the novelty of the assessment approach, the high level of approval ratings suggest that a majority of participants do prefer completing assessments on the computer. Similarly, participants' demonstrated ability to use the computer and their rating of the program as easy to use suggest that the C-RAB has potential to be a reliable and efficient tool in assessing risk behaviors among IDUs enrolled in HIV vaccine trials.

AIDS Vaccines↗
PubMed2005

Risk behaviors for varying categories of disability in NELS:88.

A large body of research shows that youth with disabilities, who comprise about 13% of the country's school-aged population, report comparable to higher incidence rates of alcohol, tobacco, and other drug (ATOD) use than their peers. Furthermore, youth with disabilities who reported ATOD use or who engaged in binge drinking had significantly more negative educational outcomes and engaged in sexual activity at a younger age than nonusers. This study describes risk factors for substance use, personal characteristics, aspects of the attitudinal environment, and educational, employment, and social outcomes among youth across 6 categories of disability. Data came from the National Center for Education Statistics' National Education Longitudinal Study of 1988-2000 (NELS:88). The findings indicate that (a) youth with varying types of disabilities are relatively homogenous with respect to risk behaviors, personal characteristics, and outcomes; (b) youth with emotional, learning, or multiple disabilities may be at heightened risk for binge drinking and marijuana use; and (c) youth with emotional and multiple disabilities may be less likely to graduate from high school or its equivalent 8 years beyond the 12th grade. Based on these results and limitations of the NELS sampling strategy, appropriate interventions are discussed as well as the need for more definitive operational definitions for disabilities, specifically the biopsychosocial approach used by the International Classification of Functioning, Disability, and Health.

Adolescent↗