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High-risk Behaviors (high-risk + behavior)
Selected AbstractsHIV Transmission Risk Behaviors of Men and Women Living With HIV-AIDS: Prevalence, Predictors, and Emerging Clinical InterventionsCLINICAL PSYCHOLOGY: SCIENCE AND PRACTICE, Issue 1 2000Seth C. Kalichman This article reviews research on continued risk practices among individuals who know they are HIV infected. Across populations, one in three persons with HIV-AIDS continue practicing HIV transmission risk behaviors. Continued high-risk behaviors in persons with HIV are related to relationship factors, economic conditions, emotional states, substance abuse, and personality dispositions. High-risk behaviors are more likely with another infected person, but alarming rates of risk behaviors are observed with HIV-negative partners and partners of unknown HIV status. Risk practices are also affected by disclosure of HIV status and by perceptions of how anti-HIV medications may affect infectivity. New clinical models of intervention are needed to blend HIV prevention strategies with HIV-AIDS care services. [source] Non-medical use of prescription stimulants among US college students: prevalence and correlates from a national surveyADDICTION, Issue 1 2005Sean Esteban McCabe ABSTRACT Aims To examine the prevalence rates and correlates of non-medical use of prescription stimulants (Ritalin, Dexedrine or Adderall) among US college students in terms of student and college characteristics. Design A self-administered mail survey. Setting One hundred and nineteen nationally representative 4-year colleges in the United States. Participants A representative sample of 10 904 randomly selected college students in 2001. Measurements Self-reports of non-medical use of prescription stimulants and other substance use behaviors. Findings The life-time prevalence of non-medical prescription stimulant use was 6.9%, past year prevalence was 4.1% and past month prevalence was 2.1%. Past year rates of non-medical use ranged from zero to 25% at individual colleges. Multivariate regression analyses indicated non-medical use was higher among college students who were male, white, members of fraternities and sororities and earned lower grade point averages. Rates were higher at colleges located in the north-eastern region of the US and colleges with more competitive admission standards. Non-medical prescription stimulant users were more likely to report use of alcohol, cigarettes, marijuana, ecstasy, cocaine and other risky behaviors. Conclusions The findings of the present study provide evidence that non-medical use of prescription stimulants is more prevalent among particular subgroups of US college students and types of colleges. The non-medical use of prescription stimulants represents a high-risk behavior that should be monitored further and intervention efforts are needed to curb this form of drug use. [source] Substance Abuse by Youth and Young Adults in Rural AmericaTHE JOURNAL OF RURAL HEALTH, Issue 3 2008David Lambert PhD ABSTRACT:,Purpose:Addressing substance abuse in rural America requires extending our understanding beyond urban-rural comparisons to how substance abuse varies across rural communities of different sizes. We address this gap by examining substance abuse prevalence across 4 geographic levels, focusing on youth (age 12-17 years) and young adults (age 18-25 years). Methods: The analysis is based on 3 years (2002-2004) of pooled data from the National Survey on Drug Use and Health. We measure rurality using a four-tier consolidation of the 2003 Rural-Urban Continuum Codes: urban, rural-adjacent, rural-large, and rural-small and medium. Findings: Rural youth have higher alcohol use and methamphetamine use than urban youth and the more rural the area, the higher the use. Rural young adults living in rural-large areas have higher rates of substance abuse than their urban peers; those living in the most rural areas have nearly twice the rate of methamphetamine use as urban young adults. Rural youth are more likely than urban youth to have engaged in the high-risk behavior of driving under the influence of alcohol or other illicit drugs. Conclusions: Higher prevalence rates, coupled with high-risk behavior, place rural youth and young adults at risk of continued substance use and problems associated with this use. Rural community infrastructure should be enhanced to support substance abuse prevention and intervention for these populations. [source] Acceptance of Rapid HIV Screening in a Southeastern Emergency DepartmentACADEMIC EMERGENCY MEDICINE, Issue 11 2009Arin E. Freeman MPH Abstract Objectives:, The objective was to assess the acceptance of an emergency department (ED) human immunodeficiency virus (HIV) screening program based on the Centers for Disease Control and Prevention (CDC) recommendations for routine HIV screening in health care settings. Methods:, Rapid HIV screening was offered on an opt-out basis to patients aged 13 to 64 years presenting to the ED by trained HIV counselors. Patients were excluded if they had a history of HIV, were physically or mentally incapacitated, did not understand their right to opt-out, or did not speak English or Spanish. Statistical analyses, including logistic regression, were performed to assess the associations between the demographics of patients offered testing and their test acceptance or refusal. Results:, From March 2008 to January 2009, a total of 5,080 (91%) of the 5,585 patients offered the HIV test accepted, and 506 (9%) refused. White and married patients were less likely to accept testing than those who were African American and unmarried (p < 0.001). Adult patients were almost twice as likely to accept testing as pediatric patients (odds ratio [OR] = 1.95; 95% confidence interval [CI] = 1.50 to 2.53). As age increased among pediatric patients, testing refusal decreased (OR = 0.71; 95% CI = 0.59 to 0.85), and as age increased among adult patients, testing refusal increased (OR = 1.17; 95% CI = 1.12 to 1.22). Two percent of persons accepting the test were considered high risk. Males were more likely to report high-risk behavior than females (OR = 1.83; 95% CI = 1.23 to 2.72). Conclusions:, The opt-out approach results in high acceptance of routine HIV screening. Widespread adoption of the CDC's recommendations, although feasible, will require significant increases in resources. [source] Dating Aggression and Risk Behaviors Among Teenage Girls Seeking Gynecologic CareACADEMIC EMERGENCY MEDICINE, Issue 7 2009Lauren K. Whiteside MD Abstract Objectives:, The objective was to describe rates of dating aggression and related high-risk behavior among teens presenting to the emergency department (ED) seeking gynecologic care, compared to those seeking care for other reasons. Methods:, Female patients ages 14,18 years presenting to the ED during the afternoon/evening shift of a large urban teaching hospital over a 19-month period were approached to participate and completed a self-administered computerized survey regarding sexual risk behaviors, past-year alcohol use, dating aggression, and peer aggression. Logistic regression analysis was used to identify factors associated with the evaluation of gynecologic complaint as noted by completion of a pelvic exam. Results:, A total of 949 teens were enrolled (87% response rate), with 148 receiving gynecologic evaluation. Among girls undergoing a gynecologic evaluation, 49% reported past-year dating aggression, compared to 34% of those who did not undergo gynecologic evaluation (odds ratio [OR] = 1.81, 95% confidence interval [CI] = 1.30 to 2.62). Logistic regression analysis predicting gynecologic evaluation found statistically significant variables to be older age (OR = 1.95, 95% CI = 1.24 to 3.06), African American race (OR = 1.58, 95% CI = 1.04 to 2.40), parental public assistance (OR = 1.64, 95% CI = 1.10 to 2.45), alcohol use (OR = 2.31, 95% CI = 1.57 to 3.38), and dating aggression (OR = 1.51, 95% CI = 1.03 to 2.21). Conclusions:, Of the teens undergoing gynecologic evaluation in this urban ED, 49% reported dating aggression. These teens also reported higher rates of other sexual risk behaviors compared to their peers. Care providers in urban EDs treating all female teens and particularly those seeking gynecologic care should be aware of this high rate of dating aggression and screen for aggression in dating relationships in this high-risk group. [source] The Impact of Childhood Sexual Abuse on Later Sexual Victimization among Runaway YouthJOURNAL OF RESEARCH ON ADOLESCENCE, Issue 2 2001Kimberly A. Tyler Path analysis was used to investigate the impact of childhood sexual abuse on later sexual victimization among 372 homeless and runaway youth in Seattle. Young people were interviewed directly on the streets and in shelters by outreach workers in youth service agencies. High rates of both childhood sexual abuse and street sexual victimization were reported, with females experiencing much greater rates compared with their male counterparts. Early sexual abuse in the home increased the likelihood of later sexual victimization on the streets indirectly by increasing the amount of time at risk, deviant peer affiliations, participating in deviant subsistence strategies, and engaging in survival sex. These findings suggest that exposure to dysfunctional and disorganized homes place youth on trajectories for early independence. Subsequently, street life and participation in high-risk behaviors increases their probability of sexual victimization. [source] Developmental Assets: Profile of Youth in a Juvenile Justice FacilityJOURNAL OF SCHOOL HEALTH, Issue 2 2010Weslee Chew BACKGROUND: Possessing high numbers of developmental assets greatly reduces the likelihood of a young person engaging in health-risk behaviors. Since youth in the juvenile justice system seem to exhibit many high-risk behaviors, the purpose of this study was to assess the presence of external, internal, and social context areas of developmental assets in at-risk youth attending a northeast Missouri juvenile justice center. METHODS: Male and female middle and high school students moved to a residential juvenile justice center voluntarily completed the Developmental Assets Profile (DAP) instrument during a regularly scheduled "intake" session. RESULTS: Most respondents reported lacking risk-protective factors in the internal and social context areas. Respondents noted their lack of community involvement in the social context area and their overinvolvement with negative influences in the internal context area. Specifically in the internal and external context areas, most respondents reported having trouble with substance abuse and not having positive peer or parental support. In the social context area, many noted that they wanted to do well in activities and were encouraged to do well; however, they scored service to others and involvement in religious groups or activities as low. CONCLUSIONS: Students who lack protective qualities, especially those who do not feel committed to their community, are more likely to be involved in substance abuse and risky behaviors. School-community partnerships may provide the targeted health protective factors that encourage more community involvement and more positive health behaviors in these youth. [source] Maturity and adherence in adolescent and young adult heart recipientsPEDIATRIC TRANSPLANTATION, Issue 3 2006Carol S. Stilley Abstract: Background: Pediatric transplant (txp) teams note high rates of non-adherence and risky behaviors linked to morbidity and mortality among adolescent and young adult recipients. Clinicians and parents alike report symptoms of social immaturity and failure to appreciate consequences of risky behavior; relationships between the two have not been studied in this population. Method: This two-phase mixed method study examined adherence, high-risk behaviors, and maturity in a sample of 27 heart recipients, aged 15,31, who underwent transplantation in childhood or adolescence at Children's Hospital of Pittsburgh. All subjects completed a projective ego development measure and a questionnaire about adherence to the post-txp regimen. Nine recipients, purposely selected for good or poor adherence according to criteria determined by the transplant team and matched on age, participated in phase 2 qualitative interviews and mood assessments. Results: Sixty-three percent of the phase 1 sample missed medications, 67% missed appointments, 11% smoked, 37% had difficulty with diet, 89% exercised infrequently, 33% had tattoos, 26% had more than two body piercings, and 11% used street drugs. Six themes and a core construct of maturity were identified with qualitative methodology. Poor adherers were less mature on every theme and consistently scored at a less mature level on the projective measure of ego development. Chronological age was not related to the level of maturity in qualitative or projective data. Most interview subjects reported high levels of anxiety, and two reported clinically significant levels of depression and anger; mood was not related to adherence. Conclusions: Non-adherence and high-risk behaviors are prevalent among adolescent and young adult heart recipients. Level of maturity appears to be associated with ability to adhere to the treatment regimen and avoid high-risk behaviors. [source] The health of California's immigrant hired farmworkersAMERICAN JOURNAL OF INDUSTRIAL MEDICINE, Issue 4 2010Don Villarejo BS Abstract Background Hispanic immigrant workers dominate California's hired farm workforce. Little is known about their health status; even less is known about those lacking employment authorization. Methods The California Agricultural Workers Health Survey (CAWHS) was a statewide cross-sectional household survey conducted in 1999. Six hundred fifty-four workers completed in-person interviews, comprehensive physical examinations, and personal risk behavior interviews. Results The CAWHS PE Sample is comprised mostly of young Mexican men who lack health insurance and present elevated prevalence of indicators of chronic disease: overweight, obesity, high blood pressure, and high serum cholesterol. The self-reported, cumulative, farm work career incidence of paid claims for occupational injury under workers compensation was 27% for males and 11% for females. Conclusions The survey finds elevated prevalence of indicators of chronic disease but lack of health care access. Participants without employment authorization reported a greater prevalence of high-risk behaviors, such as binge drinking, and were less knowledgeable about workplace protections. Am. J. Ind. Med. 53:387,397, 2010. © 2010 Wiley-Liss, Inc. [source] A Brief Motivational Interview in a Pediatric Emergency Department, Plus 10-day Telephone Follow-up, Increases Attempts to Quit Drinking Among Youth and Young Adults Who Screen Positive for Problematic DrinkingACADEMIC EMERGENCY MEDICINE, Issue 8 2010Judith Bernstein RNC ACADEMIC EMERGENCY MEDICINE 2010; 17:890,902 © 2010 by the Society for Academic Emergency Medicine Abstract Objectives:, Adolescents in their late teens and early 20s have the highest alcohol consumption in the United States; binge drinking peaks at age 21-25 years. Underage drinking is associated with many negative consequences, including academic problems and risk of intentional and unintentional injuries. This study tested the effectiveness of pediatric emergency department (PED) screening and brief intervention to reduce alcohol consumption and associated risks. Methods:, A three-group randomized assignment trial was structured to test differences between intervention (I) and standard assessed control (AC) groups in alcohol consumption and alcohol-related behaviors from baseline to 12 months and to compare the AC group with a minimally assessed control (MAC) group to adjust for the effect of assessment reactivity on control group behavior. Patients aged 14,21 years were eligible if they screened positive on the Alcohol Use Disorders Identification Test (AUDIT) or for binge drinking or high-risk behaviors. The MAC group received a resource handout, written advice about alcohol-related risks, and a 12-month follow-up appointment. Patients in the AC group were assessed using standardized instruments in addition to the MAC protocol. The I group received a peer-conducted motivational intervention, referral to community resources and treatment if indicated, and a 10-day booster in addition to assessment. Measurements included 30-day self-report of alcohol consumption and alcohol-related behaviors, screens for depression and posttraumatic stress disorder, and self-report of attempts to quit, cut back, or change conditions of use, all repeated at follow-up. Motor vehicle records and medical records were also analyzed for changes from baseline to 1-year follow-up. Results:, Among 7,807 PED patients screened, 1,202 were eligible; 853 enrolled (I, n = 283; AC, n = 284; MAC, n = 286), with a 12-month follow-up rate of 72%. At 12 months, more than half of enrollees in Reaching Adolescents for Prevention (RAP) attempted to cut back on drinking, and over a third tried to quit. A significantly larger proportion of the I group made efforts to quit drinking and to be careful about situations when drinking compared to AC enrollees, and there was a numerically but not significantly greater likelihood (p = 0.065) among the I group for efforts to cut back on drinking. At 3 months, the likelihood of the I group making attempts to cut back was almost triple that of ACs. For efforts to quit, it was double, and for trying to be careful about situations when drinking, there was a 72% increase in the odds ratio (OR) for the I group. Three-month results for attempts were sustained at 12 months for quit attempts and efforts to be careful. Consumption declined in both groups from baseline to 3 months to 12 months, but there were no significant between-group differences in alcohol-related consequences at 12 months or in alcohol-related risk behaviors. We found a pattern suggestive of assessment reactivity in only one variable at 12 months: the attempt to cut back (73.3% for the I group vs. 64.9% among the AC group and 54.8% among the MAC group). Conclusions:, Brief motivational intervention resulted in significant efforts to change behavior (quit drinking and be careful about situations while drinking) but did not alter between-group consumption or consequences. [source] HIV Transmission Risk Behaviors of Men and Women Living With HIV-AIDS: Prevalence, Predictors, and Emerging Clinical InterventionsCLINICAL PSYCHOLOGY: SCIENCE AND PRACTICE, Issue 1 2000Seth C. Kalichman This article reviews research on continued risk practices among individuals who know they are HIV infected. Across populations, one in three persons with HIV-AIDS continue practicing HIV transmission risk behaviors. Continued high-risk behaviors in persons with HIV are related to relationship factors, economic conditions, emotional states, substance abuse, and personality dispositions. High-risk behaviors are more likely with another infected person, but alarming rates of risk behaviors are observed with HIV-negative partners and partners of unknown HIV status. Risk practices are also affected by disclosure of HIV status and by perceptions of how anti-HIV medications may affect infectivity. New clinical models of intervention are needed to blend HIV prevention strategies with HIV-AIDS care services. [source] |