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PubMed1999

Demographic and attitudinal variables related to high-risk behaviors in Asian males who have sex with other men.

Although AIDS is spreading rapidly in minority communities, little is known about attitudes, knowledge, and behavior related to AIDS and HIV in the Asian community. The purpose of this study was to examine these variables in a sample of gay Asian males, as well as to investigate the relationship between knowledge, sources of information, culturally influenced attitudes and high-risk behaviors in this population. Results from a sample of 60 young Asian men who self-identified as "having sex with other men" indicated they were generally knowledgeable about methods of transmission and prevention, and appeared linked to a large information network that included informal sources such as peers and formal sources. However, significant percentages held culturally biased views of AIDS, such as believing race of partner or one's own gender role in the sexual encounter determined level of risk; and one third of the sample did not use condoms regularly. Having been tested for HIV was associated with holding less traditional cultural beliefs and a higher sexual activity level. Open communication about safer sexual practices was associated with monogamous as opposed to multiple relationships and with decreased tendency to engage in alcohol-related unprotected sex. Variance in overall risk was predicted by demographic variables such as education, age, and level of sexual activity, rather than by the attitudinal factors measured. Limitations of this exploratory study include a time-limited subject recruitment period and consequent small sample size, a homogeneous sample weighted toward young, well-educated, and middle-class respondents, and the exclusion of non-English speaking individuals. Nevertheless, study findings suggest that educational outreach targeting Asians who have sex with other men needs to address inaccurate cultural beliefs about HIV/AIDS, emphasize consistent condom use, and encourage models of open communication with partners about safer sexual practices.

Adolescent↗
PubMedDate not supplied

Preliminary effects of brief school-based prevention approaches for reducing youth suicide--risk behaviors, depression, and drug involvement.

PROBLEM: Few empirically tested, school-based, suicide-prevention programs exist. The purpose of this study was to evaluate the postintervention efficacy of Counselors-CARE (C-CAST) and Coping and Support Training (CAST) vs. "usual care" controls for reducing suicide risk. METHODS: A randomized prevention trial; 341 potential dropouts, 14 to 19 years old, from seven high schools (52% female, 56% minorities) participated. Trend analyses using data from three time points assessed over time changes. FINDINGS: Significant decreases occurred for all youth in suicide-risk behaviors, depression, and drug involvement. Intervention-specific effects occurred for decreases in depression. CONCLUSIONS: School-based prevention approaches are feasible and show promise for reducing suicidal behaviors and related depression.

Adolescent↗
PubMed1997

Health risk behaviors among pregnant adolescents with older partners.

OBJECTIVE: To determine if pregnant adolescents with older (> or = 5 years) adult (> or = 20 years) vs same-age (+/- 2 years) male partners are at increased health risk. DESIGN: Medical charts of pregnant adolescents who participated in a structured interview as part of their prenatal care were reviewed. SETTING: Outpatient maternal and child health clinic at a university teaching hospital. PATIENTS: A total of 503 white, African American, and Mexican American adolescents, aged 12 to 17 years, who initiated prenatal care between January 19, 1992, and December 19, 1994, were consecutively sampled. MAIN OUTCOME MEASURE: We hypothesized that female adolescents paired with older-adult vs same-age partners would be more likely to report recent substance use, high-risk sexual behaviors, and partner-directed violence. RESULTS: Of the sample, 26% (n = 129) had an older adult partner, whereas 44% (n = 222) had a same-age partner. The remaining adolescents who did not fit either definition (n = 152) were excluded from further analysis. Logistic regression analyses demonstrated that girls with older-adult partners were more likely to have initiated sexual intercourse before 13 years (odds ratio [OR] = 2.1), have discontinued school (OR = 2.8), have used marijuana in the past 30 days (OR = 2.9), be married or living with their partner (OR = 3.2), and desire their current pregnancy (OR = 2.1). These young women also were more likely to report that their partner was employed (OR = 2.8), had other children (OR = 7.4), and used alcohol during the week (OR = 2.0). No association between tobacco use or partner-directed violence and partner age was observed. CONCLUSION: Pregnant adolescents with older-adult male partners report risk behaviors that may affect their health and that of their unborn child but are not more likely to experience partner-directed violence.

Adolescent↗
PubMed2007

Childhood neglect and adulthood involvement in HIV-related risk behaviors.

OBJECTIVE: Much research has been done to examine the long-term effects of being victimized by sexual, physical, and/or emotional abuse in childhood, but much less research has focused on the impact of childhood neglect experiences. This study examines the role that childhood neglect has on adult women's involvement in HIV-related risky behaviors. METHODS: The data come from a study of 250 "at risk" women living in the Atlanta, GA metropolitan area, most of whom were African American. Data were collected in face-to-face interviews between 1997 and 2000. Multiple regression was used to explore the relationship between childhood neglect experiences, self-esteem, attitudes toward condom use, and involvement in HIV-related risky behaviors. RESULTS: Overall, the model tested received strong support by the study data. Childhood neglect led to reduced self-esteem. Neglect was associated with worsened attitudes toward condom use and women who experienced childhood neglect also reported more involvement in HIV risk behaviors. CONCLUSIONS: HIV intervention programs ought to target women who have experienced childhood neglect, as neglect experiences have adverse impacts upon their self-esteem, condom-related attitudes, and HIV risk behavior practices in adulthood.

Adolescent↗
PubMed2007

[Improvement of medical care by supporting the intention to change health risk behavior].

A large proportion of disease and death cases could be prevented, if efficacious programs, particularly concerning tobacco smoking, obesity, and alcohol risk drinking, could be applied. Feasible approaches are based, among others, on the Transtheoretical Model of intentional health behavior change. This model allows to develop practical approaches to reduce risk factors of common diseases at the general population level. Evidence about the promotion of the intention to change health risk behaviors revealed successes, e. g., according to smoking cessation. The effects are growing by time. Intervention that is focused at the promotion of change of health risk behaviors can add to the improvement of health care.

Behavior Therapy↗
PubMed1998

Behavioral risk factors in emergency department patients: a multisite survey.

BACKGROUND: Many people rely on EDs for routine health care. Often, however, screening and counseling for health risks are not provided. OBJECTIVE: To determine prevalence rates of chronic disease and injury risk factors and access to routine health care in a random sample of ED patients in 3 cities. METHODS: A prospective survey was conducted at 3 hospital EDs in Akron, OH, Boston, MA, and Denver, CO. A modified version of the national Behavioral Risk Factor Surveillance Survey was administered by trained researchers to a convenience sample of non-critically ill patients during randomly selected shifts. RESULTS: Of 1,143 eligible patients, 923 (81%) agreed to participate. Their mean age was 39 (range = 17-96) years. Most were female (58%), white (60%), and unmarried (68%). Thirty-eight percent had no access to primary care. Injury-prone behaviors were prevalent: 53% of the respondents did not wear seat belts regularly; 15% had no working smoke detector; 3% kept loaded, unlocked handguns in their homes; 11% had attempted suicide; 23% had a positive CAGE screen for alcoholism; 3% had operated a motor vehicle in the preceding month while alcohol-intoxicated; and 11% had ridden in an automobile with an intoxicated driver. Cancer and chronic disease risks were also common: 48% smoked; 16% had not received a blood pressure check in the preceding year; and 4% reported unsafe sexual practices. Among women aged > 50 years, 42% had not received a Pap test in the prior 2 years and 14% had never had mammography. Many prevalence rates and access to care varied among the 3 sites. However, for most risk factors, prevalence rates did not differ in patients with and without access to primary health care. CONCLUSIONS: ED patients have high rates of injury and chronic disease risks, and many have no other source of routine health care. Research is needed to determine whether ED-based programs, designed to reduce injury and chronic disease risks, are feasible and cost-effective.

Adolescent↗
PubMed2006

Meta-analytic examination of online sex-seeking and sexual risk behavior among men who have sex with men.

OBJECTIVES: To estimate the percentage of men who have sex with men (MSM) who have used the Internet to look for sex partners and to examine the prevalence of risky sex among MSM who have and have not sought partners online. METHODS: Meta-analyses were conducted on findings from published English-language studies. High-risk sex was self-reported unprotected anal intercourse (UAI). Analyses were stratified by method of study recruitment (online versus offline venues) and participants' human immunodeficiency virus (HIV) status. RESULTS: In studies that recruited MSM offline, a weighted mean, based on 15 findings, indicated that 40% (95% confidence interval [CI], 35.2%-45.2%) of MSM had used the Internet to look for sex partners. In 3 findings from offline studies that stratified by participant HIV status, the weighted-mean percentage was higher among HIV-positive (49.6%; 95% CI, 44.9%-54.3%) than HIV-negative/unknown MSM (41.2%; 95% CI, 36.8%-45.6%). UAI with male sex partners was more likely among MSM who sought partners online than MSM who did not (odds ratio, 1.68; 95% CI, 1.18-2.40; k = 11). This group difference was observed for UAI with HIV-serodiscordant as well as HIV-seroconcordant partners, particularly among HIV-positive study participants. HIV-serodiscordant UAI was not more prevalent with partners met online than offline. CONCLUSIONS: A substantial percentage of MSM use the Internet to look for sex partners, and those who do are more likely to engage in unprotected sex. Additional research is needed to determine whether the Internet may increase risk behavior beyond that which occurs when men meet partners at offline venues.

Homosexuality↗
PubMed2002

Physical activity, TV viewing, and weight in U.S. youth: 1999 Youth Risk Behavior Survey.

OBJECTIVE: To examine the relationship between physical activity, TV watching, and weight in U.S. youth ages 14 to 18 years. RESEARCH METHODS AND PROCEDURES: Data from a nationally representative sample of 15,143 U.S. high-school students participating in the 1999 Centers for Disease Control and Prevention (CDC) Youth Risk Behavior Survey were examined. Prevalence rates of participation in moderate physical activity (MPA), vigorous physical activity (VPA), and television watching (TV) were determined. The association between MPA, VPA, TV and the body mass index (BMI) and overweight status (BMI > or =85th percentile of age- and sex-specific CDC/National Center for Health Statistics reference values) were examined by analysis of covariance and logistic regression. RESULTS: Overall, 45% reported participating in MPA > or =3 d/wk, 65% reported participating in VPA > or =3 d/wk, and 25% reported watching TV > or =4 h/school day. Boys reporting six to seven bouts of MPA had a significantly lower BMI compared with boys reporting three to five or less than two. The mean BMI differed significantly between the lowest and highest levels of MPA groups in girls. The mean BMI was significantly lower in the highest VPA group compared with the other two groups in both sexes. There was a significant graded response for BMI across all levels of TV. Decreased levels of MPA and 3 to 4 days of VPA were significantly associated with an increased risk of overweight in boys when compared with those engaging in 6 to 7 d/wk (odds ratio = 1.26 to 1.37). A graded response existed between TV and overweight in both sexes. Boys and girls were approximately 20% to 25% less likely to be classified as overweight if they reported 2 to 3 hours of TV per day and approximately 40% less likely to be classified as overweight if they reported < or =1 hour of TV per day compared with those who watched > or =4 hours of TV. In general, youth who engaged in less physical activity watched more TV per week. DISCUSSION: Increased levels of physical activity are associated with a lower BMI and less TV watching. However, the relationship between TV watching and weight status is more pronounced.

Adolescent↗
PubMed2006

Sexual risk behavior among people living with HIV/AIDS in Togo.

Since HIV in Africa is spread primarily through unprotected sex, safe sex practices such as condom use can reduce HIV spread significantly. Nevertheless, because sexual behavior involves complex dynamics, condom use is not an easy option for many people in Africa despite years of condom distribution intervention. In fact, the complex nature of sexuality complicates efforts to combat HIV spread and limits the effectiveness of many prevention efforts. This paper uses theoretical explanations--social representation theory, situated rationality theory, and social action theory--to examine the patterns of sexual risk behavior and the underlying reasons and rationalization among people living with HIV/AIDS in Lomé, Togo. Qualitative interviews were conducted with 151 people living with HIV/AIDS, recruited from 3 HIV/AIDS centers. The results of this in-depth study suggest that although people living with HIV/AIDS may be aware of the risk of infecting their sexual partners, they deliberately ignore the risk because other considerations, such as wanting a baby, take precedence. Consequently, condom access is inadequate to change risky sexual behavior that spreads HIV. It must be supplemented with adequate empowerment.

Adult↗
PubMed2003

To know that we know what we know: perceived knowledge and adolescent sexual risk behavior.

STUDY OBJECTIVE: To examine the relationship between perceived knowledge about sex and adolescent sexual behaviors. DESIGN: Secondary analysis of the 2001 Minnesota Student Survey. Bivariate and multivariate relationships between perceived knowledge about sex and sexual behaviors were examined. SETTING: Minnesota. PARTICIPANTS: 83,481 9(th) and 12(th) grade public school students. MAIN OUTCOME MEASURES: Students' report of sexual experience and sexual behaviors. RESULTS: Students with low perceived knowledge were less likely to be sexually experienced (OR=0.22, CI=0.17-0.29, females, OR=0.70, CI=0.59-0.82, males, P=0.00). Among sexually active students, those with low perceived knowledge also had significantly higher odds of engaging in risky sexual behaviors. Sexually experienced females with low perceived knowledge were more likely to report not talking with their partners about STIs (OR=1.83, CI=1.1-3.16, P=0.02), a history of pregnancy (OR=2.87, CI=1.59-5.18, P=0.00), and had higher numbers of male (P=0.03) and female (P=0.00) sexual partners. Sexually experienced males with low perceived knowledge were more likely to report not talking with their partners about pregnancy (OR=1.43, CI=1.11-1.84, P=0.01), pregnancy involvement (OR=2.22, CI=1.65-2.95, P=0.00), inconsistent use of birth control (OR=1.30, CI= 1.01-1.68, P=0.04), inconsistent use of condoms (OR=1.79, CI=1.38-2.32, P=0.00), not using a condom at last intercourse (OR=1.58, CI=1.22-2.04, P=0.00), and had a higher numbers of male (P=0.00) and female (P=0.00) sexual partners. CONCLUSIONS: Perceived knowledge may be a salient antecedent of adolescent sexual risk behavior. Health care providers and programs should incorporate the construct of perceived knowledge into their assessments of and interventions targeted at adolescents.

Adolescent↗
PubMed1992

Self-efficacy, hedonistic expectancies, and condom-use intentions among inner-city black adolescent women: a social cognitive approach to AIDS risk behavior.

The effects on condom-use intentions of an acquired immune deficiency syndrome (AIDS) prevention intervention based on social cognitive theory were investigated among 19 sexually active black adolescent women recruited from an inner-city family planning clinic. The women received the social cognitive intervention designed to increase perceived self-efficacy and favorable outcome expectancies about the hedonistic consequences of using condoms or one of two control interventions: An information-alone intervention designed to increase AIDS knowledge or a general health-promotion intervention designed to provide information about important health problems other than AIDS. All interventions lasted 105 min and involved films and small-group exercises. Participants' evaluations did not differ among conditions. As hypothesized, analysis of covariance indicated that participants in the social cognitive condition reported greater intentions to use condoms than did those in the two control conditions. In addition, participants in the social cognitive condition scored higher in perceived self-efficacy and favorable hedonistic expectancies--the two hypothesized mediators of the intervention effect. Although participants who received the information-alone intervention subsequently had greater AIDS knowledge than did those in the health promotion condition, they did not express greater intentions to use condoms. These results highlight the value of a social cognitive approach to AIDS risk behavior: outcome expectancies regarding the effects of precautionary practices on sexual enjoyment and perceived self-efficacy to implement such practices play an important role in decisions about condom use.

Acquired Immunodeficiency Syndrome↗
PubMed2006

The co-occurrence of substance use and high-risk behaviors.

Study findings suggest that alcohol and methamphetamine use heighten the risk for violence, multiple sexual partners, and unprotected sexual intercourse. Although the odds of engaging in risky behaviors increased dramatically with alcohol and methamphetamine use, the majority of subjects did not become involved in high risk behaviors even though they used alcohol and illicit drugs.

Adolescent↗
PubMed1996

Adolescents' perceptions of relative weight and self-reported weight-loss activities: analysis of 1990 YRBS (Youth Risk behavior Survey) national data.

PURPOSE: The purpose of the study was to examine, among public high school students across the United States, perceptions of relative weight-loss and its relationship to physical activity levels, time spent viewing television, and efforts to lose weight. METHODS: Self-reported data from the 1990 Youth Risk Behavior Survey (YRBS) were used to analyze these relationships. The YRBS was developed and administered by the Division of Adolescent and School Health (DASH), Centers for Disease Control and Prevention (CDC), to assess important health behaviors which contribute significantly to adverse health outcomes among American youth. A total of 10,870 black, Hispanic, and white respondents were included in this analysis. RESULTS: From this sample, 24.8% perceived themselves as being "too fat." Of that group, 76.4% were trying to lose weight. Females comprised 74.4% of those reporting that they were "too fat" and trying to lose weight. Gender differences in weight perceptions were significant (p < .001), with females (34.6%) being more likely than males (14.4%) to report being "too fat." Whites (26.0%) reported being "too fat" more often than did Hispanics (23.9%) and blacks (17.2%) (p < .001). Skipping meals and exercise were the most commonly reported weight loss strategies. Hispanics were most likely to skip meals, followed by whites and blacks. Whites were more likely than the other groups to use exercise as a means of losing weight. Adolescents who perceived themselves as "too fat" reported fewer days of strenuous activity (p < .001), fewer hours of strenuous exercise in physical education class (p < .001), and more hours spent viewing television on school days (p < .001) than others. CONCLUSIONS: One quarter of U.S. high school students perceive themselves as overweight; three-quarters of these students are trying to lose weight. Adolescents who perceive themselves as overweight are less physically active and spend more time viewing television than those who do not perceive themselves as overweight.

Adolescent↗
PubMed2004

Relationships of a brief measure of youth assets to health-promoting and risk behaviors.

PURPOSE: To test the utility of a brief measure of developmental assets for predicting risk and health-promoting behaviors. METHODS: Six "assets" questions were added to an existing school-based survey of health-related behaviors. "Asset" questions dealt with students' grades in school, their communication with parents about school, students' perceptions of their role in school decision-making, students' participation in after-school activities and volunteering, and students' perceptions that they "matter" in their community. Participants were 30,916 Vermont students in grades 8-12. The sample included approximately equal numbers of girls and boys. It was 92% white. Fifty-nine percent of students' mothers had completed at least some postsecondary education (according to student report). Data were analyzed by Chi-square techniques and logistic regression. RESULTS: Number of assets (0-6) was negatively related to students' engagement in each of seven risk behaviors, and positively related to three health-promoting behaviors. The effects of number of assets were in most cases independent of demographic variables. Among the six assets, academic success (grades in school) contributed the greatest effect for most of the outcome measures; however, each of the assets contributed significant independent effects to multiple risk- and health-behaviors. CONCLUSIONS: Students' assets, even if relatively few, may make important contributions to wellness, independent of other well-established demographic factors.

Adolescent↗
PubMed1996

Prevalence of physical inactivity during leisure time among overweight persons--Behavioral Risk Factor Surveillance System, 1994.

During 1988-1991, approximately one third of adults in the United States were overweight--an important risk factor for heart disease, diabetes, and some cancers. In addition to diet modification, initiating and maintaining regular physical activity is an important component of an effective weight-control strategy. To determine the prevalence of physical inactivity during leisure time among adults who are overweight, CDC analyzed data from the 1994 Behavioral Risk Factor Surveillance System (BRFSS). This report summarizes the results of that analysis, which indicate that more than one third (37%) of overweight persons report no physical activity during their leisure time.

Adult↗
PubMed2000

High-risk behaviors during incarceration in African-American men treated for HIV at three Los Angeles public medical centers.

OBJECTIVES: This paper describes research that examined the association between high-risk sexual and drug-using behaviors during incarceration and HIV infection for African-American men receiving HIV care at three public medical centers in Los Angeles County (LAC), California. METHODS: A case-control study was conducted in which 305 HIV-infected African-American men and 305 neighborhood controls, ages 20 to 49, were frequency-matched by age. RESULTS: After controlling for anal sex while not incarcerated, we found no association between anal sex during incarceration and HIV (odds ratio [OR], 1.1; 95% confidence interval [CI], 0.6-2.2). Among men with a history of incarceration (n = 332), the percentage reporting anal sex with men outside of incarceration (45%) was greater than those reporting anal sex while incarcerated (16%). Injection drug use (IDU) during incarceration was also not associated with HIV when controlling for IDU outside of incarceration (OR, 1.6; 95% CI, 0.5- 4.9). Increased time in jail or prison was associated with less HIV infection (p =.001). CONCLUSIONS: Although high-risk behaviors are more common in the community than in the incarcerated setting for this study group, incarcerated populations represent a high-risk group for whom access to prevention messages is limited. Periods of incarceration represent a unique opportunity to convey prevention messages that focus on high-risk behaviors outside the incarcerated setting.

Adult↗
PubMedDate not supplied

Veterans' reports of pain and associations with ratings of health, health-risk behaviors, affective distress, and use of the healthcare system.

The improved management of pain among veterans seeking care in Veterans Health Administration (VHA) facilities has been established as a priority. This study documents the high prevalence of reports of pain among a convenience sample of 685 veterans seeking care in a VHA primary care setting. Also reported are associations of pain complaints with self-rated health, an index of emotional distress, health-risk behaviors such as tobacco and alcohol use, health-related concerns about diet and weight, and perceptions of the availability of social support. The relationship between the presence of pain and use of outpatient and inpatient medical and mental health services is also examined. Nearly 50% of the sample reported that they experience pain regularly and that they were concerned about this problem at the time of the index visit to their primary care provider. Persons acknowledging the presence of pain, relative to those not reporting pain, were younger, reported worsening health over the past year, had greater emotional distress, used tobacco, had diet and/or weight concerns, and were found to use more outpatient medical, but not inpatient medical or mental health services. Results support the goals of the VHA National Pain Management Strategy designed to reduce unnecessary pain and suffering among veterans receiving care in VHA facilities.

Adult↗
PubMed2005

Changes in risk behavior and dynamics of hepatitis C virus infections among young drug users in Amsterdam, the Netherlands.

To elucidate the character and magnitude of the hepatitis C virus (HCV) epidemic among drug users in Amsterdam, 197 young drug users from the period 2000 to 2004 were compared with 215 counterparts from 1985 to 1989. Although injection risk behavior and HCV seroprevalence decreased sharply over time, HCV seroprevalence remains high (44%) among young drug users who have ever injected. Phylogenetic analysis shows that current HCV infections originate from diversification of strains already circulating in the past, but also from the recent introduction of new subtypes. HCV subtypes 1a and 3a remain the most prevalent among drug users in Amsterdam, but other subtypes such as 4d and 2b have entered the population. In conclusion, both the unpopularity of injecting drug use and the success of prevention campaigns are likely to be responsible for the decline in the seroprevalence of HCV and increased median time to seroconversion. Treatment of those infected chronically, in combination with the continuation of prevention programs, might decrease future HCV transmission.

Cohort Studies↗