High-risk Behaviors Research Articles

Inside the Bell Jar of Social Media: A Descriptive Study Assessing YouTube Coverage of Psychotropic Medication Adherence.

The global mental health crisis is a longstanding one that impacts a multitude of patient populations worldwide. Within this crisis, psychiatric medication adherence is yet another complex public health challenge that continues to persist and contribute towards the chronic nature of the increased incidence and prevalence of psychiatric morbidities, which in turn result in the sequalae of substantial costs to humanity, the healthcare system, lost productivity, functioning and disability among patients with mental disorders. Psychotropic medication adherence is a significant part of psychiatric care and treatment across severity levels of mental illness. This health behavior is also filled with complexities, given the abundance of social and behavioral determinants as well as intrinsic and extrinsic factors that surround this health behavior. Examining contexts for promoting this health behavior change is crucial in determining directions for addressing it more optimally. There have been several published studies on considerations and interventions to address this health behavior; however, to date, no studies have been published on assessing coverage and directions of content across social media platforms, which trend as a rising health communication medium in our digital era. The present study is the first of its kind to dive into exploring the nature of widely viewed content and deliverers of this content on a prominent social media platform, YouTube, as the basis to determine potential directions for future intervention that can extend to reaching more patients struggling with this high-risk health behavior across the world, given the global reach of social media.

Gaps in HIV and Hepatitis C Testing Among 3486 HIV-Negative Men Who have Sex with Men in Spain in the Era of Highly Effective Antiviral Therapies.

High uptake of HIV and hepatitis C (HCV) testing in Gay, bisexual, and other men who have sex with men (GBMSM) is needed to interrupt transmission. The objective was to identify subgroups with increased probability of lack of testing among HIV-negative GBMSM in Spain. Cross-sectional study including 3486 HIV-negative GBMSM attending prevention facilities in Madrid and Barcelona, 2018-2020. Data came from self-administered online sociodemographic, health, and risk behaviors questionnaires. Outcomes were lack of HCV (lifetime) and HIV (lifetime, last year) testing. Crude and adjusted prevalences and prevalence ratios were assessed for each outcome using negative binomial regression models. Lifetime lack of HIV and HCV testing prevalence was 6.3% and 35.8%, respectively, while lack of HIV testing in the last year was 22.4%. Prevalences were also substantial in GBMSM with high-risk behaviors. After sociodemographic adjustment, the highest probability of lack of HCV testing (lifetime) and HIV (last year) was among GBMSM with insufficient viral hepatitis knowledge, no history of STI, or HCV (or HIV) testing, aged < 25, non-outness about sex life with men, and less high-risk behaviors. Lack of HCV (lifetime) and HIV testing (last year) among HIV-negative GBMSM in Spain is still high, despite high-risk behaviors.

Analysis of characteristics of types of primary sexual partners and related factors of not being tested for HIV among men who have sex with men

Objective: To compare the characteristics of MSM with different types of primary sexual partners and to analyze the factors associated with MSM not being tested for HIV in the last six months. Methods: MSM were recruited in nine cities of Shandong Province from April to July 2021, and face-to-face questionnaires were conducted to collect information on sociodemographic characteristics, high-risk behaviors, and HIV testing of MSM. Blood samples were taken for serological tests of HIV and syphilis antibodies. Results: A total of 3 008 men who had anal sex with men in the last six months were divided into three groups according to the type of primary sexual partner in the last six months: the fixed sexual partner group (36.83%, 1 108/3 008), the commercial sexual partner group (3.06%, 92/3 008), and casual sexual partner group (60.11%, 1 808/3 008). There were statistically significant differences in the distribution of age, local residence time, education level, the primary place to find male sexual partners, use of new-type drugs in the last six months, consistent condom use every time during same-sex anal sex in the last six months, group sex in the last six months, no HIV testing in the last six months, having had a sexually transmitted disease in the last year, receiving peer education in the last year, and frequency of syphilis testing in the last year among different groups (P<0.05). Multivariable logistic regression analysis showed that related factors of not being tested for HIV in the last six months in MSM were those aged less than 30 years old (aOR=1.39, 95%CI: 1.06-1.83), married/cohabiting (aOR=1.74, 95%CI: 1.39-2.16), high school education or less (aOR=1.39, 95%CI: 1.15-1.67), had not used new-type drugs in the last six months (aOR=2.27, 95%CI: 1.89-2.71), had not received peer education in the last year (aOR=1.59, 95%CI: 1.28-1.98), had never been tested for syphilis (aOR=11.30, 95%CI: 8.15-15.66), had not been tested in the last year but had been previously tested for syphilis (aOR=5.65, 95%CI: 4.19-7.62), the type of primary sexual partner in the last six months being a commercial sexual partner (aOR=1.80, 95%CI: 1.01-3.20), and the type of primary sexual partner in the last six months being a casual sexual partner (aOR=1.50, 95%CI: 1.26-1.80). Conclusions: The characteristics of MSM with different types of primary sexual partners are different, and the proportion of HIV testing still needs to be improved. In the future, we should make full use of the Internet and peer education to expand the coverage of HIV testing for MSM, targeting the characteristics of MSM with different types of primary sexual partners.

Assessment of Adverse Childhood Experiences in the South Bronx on the Risk of Developing Chronic Disease as Adults.

Background Adverse childhood experiences (ACEs) have a negative impact on health outcomes. Using a cross-sectional study design, our objective was to identify the prevalence of ACEs among residents of South Bronx and the increased relationship between such childhood stressors and the prevalence of both chronic disease and modifiable high-risk behavior in adulthood. Methods We recruited patients from a hospital-based, adult primary care clinic in the metropolitan area of the South Bronx. A prospectively designed, observational study recruited patients in a consecutive fashion to conduct a cross-sectional survey between September 2017 and January 2018. The demographic representation comprises a low socioeconomic sector of urban New York City, with low education and immigrant population. A modified ACE questionnairethat included nine ACE categories (Physical Abuse, Sexual Abuse, Household Substance Abuse, Separation from Parents, Incarcerated Household Member, Parental Separation/Divorce, and Bullying)in addition to questions on demographics, high-risk behavior, and diagnosis of chronic disease. Our primary objective was to gather the incidence of ACEs organized by domains. Secondary objectives were to demonstrate any expected increase (as odds ratios (ORs)) in chronic disease or maladaptive social habits when compared to patients with no ACEs within the cohort. The ORfor the associations was calculated with logistic regression. Individual logistic regression models for each chronic disease, high-risk behavior, and demographics were used to measure the exposure response of the nine ACE categories. Results A total of 454 patients completed the survey. The average age was 53.1±14.2 years, and females were 49% of the sample. Hispanics were at 61% followed by Blacks at 34%. Participants reported high-risk behavior at 24%, had a high prevalence of chronic illness (82%), and had ACE events at 70%. We found a significant relationship between ACE events and having a chronic disease diagnosis and engagement in high-risk behavior with higher odds of reporting chronic illnesses among participants with exposure to childhood stressors (OR 1.26, 95% confidence interval 1.1-1.5, p=0.002). Of the nine ACE categories, many were independently associated with one or more chronic diseases in adulthood. Conclusion According to our survey data, ACE events in our patient population were more prevalent (30% with four or more exposures), higher than the proposed average of one out of six Americans with four or more exposures nationally according tonational statistics. These childhood stressors appeared to have a strong association with the development of high-risk behavior and chronic illnesses.

Application of machine learning for risky sexual behavior interventions among factory workers in China.

Assessing the likelihood of engaging in high-risk sexual behavior can assist in delivering tailored educational interventions. The objective of this study was to identify the most effective algorithm and assess high-risk sexual behaviors within the last six months through the utilization of machine-learning models. The survey conducted in the Longhua District CDC, Shenzhen, involved 2023 participants who were employees of 16 different factories. The data was collected through questionnaires administered between October 2019 and November 2019. We evaluated the model's overall predictive classification performance using the area under the curve (AUC) of the receiver operating characteristic (ROC) curve. All analyses were performed using the open-source Python version 3.9.12. About a quarter of the factory workers had engaged in risky sexual behavior in the past 6 months. Most of them were Han Chinese (84.53%), hukou in foreign provinces (85.12%), or rural areas (83.19%), with junior high school education (55.37%), personal monthly income between RMB3,000 (US$417.54) and RMB4,999 (US$695.76; 64.71%), and were workers (80.67%). The random forest model (RF) outperformed all other models in assessing risky sexual behavior in the past 6 months and provided acceptable performance (accuracy 78%; sensitivity 11%; specificity 98%; PPV 63%; ROC 84%). Machine learning has aided in evaluating risky sexual behavior within the last six months. Our assessment models can be integrated into government or public health departments to guide sexual health promotion and follow-up services.

Sexual behavior and self-declaration of sexual orientation among people 18–64 years in Brazil: results from the Knowledge, Attitudes, and Practices survey, 2013 and the National Health Survey, 2019

BackgroundPopulation surveys involving the monitoring of high-risk sexual behavior have been recognized as important public health tools to control the HIV epidemic and other sexually transmitted infections (STIs).MethodsUsing data from the Knowledge, Attitudes, and Practices survey (PCAP-2013) and from the National Health Survey (PNS-2019), indicators of sexual behavior were compared according to sociodemographic characteristics among individuals aged 18–64 years, including size (%) estimates of men who have sex with men (MSM) and women who have sex with women (WSW). Specifically, the PNS-2019 prevalence estimates of homosexual, bisexual, heterosexual males and females were compared with those from the PCAP-2013. To compare PCAP and PNS proportional distributions, the Pearson's chi-square test, adjusted by the Rao-Scott’s correction, was applied.ResultsSize (%) estimates of MSM and WSW obtained by direct questions from the PCAP-2013, showed higher homosexuality prevalence estimates than those resulting from the PNS-2019 self-declared sexual orientation. Significant differences were found between the MSM proportions according to the PCAP-2013 (3.7%; 95% CI 3.1–4.4%) and to the PNS-2019 (2.2%; 95% CI 1.9–2.5), and between the WSW proportions (4.6%; 95% CI 4.0–5.4%) and (2.1%; 95% CI 1.8–2.4), respectively. Results from both surveys showed MSM and WSW prevalence estimates increase with educational level, decrease with age, and is larger among people who do not live with partner, live in urban areas and in state capitals. Regarding condom use at last sexual intercourse, no differences between the PCAP-2013 and the PNS-2019 estimates were found at the national level, but significant improvements were found for MSM, people aged 18–24 and 25–34 years, and individuals not living with a partner.ConclusionsThe underestimation of MSM and WSW prevalence by self-declared sexual orientation suggests that sexual minorities face many difficulties related to disclosing their sexuality and reinforces the importance of developing public health interventions for changing population attitudes and promoting sexual orientation disclosure. Moreover, the low use of condoms in both surveys (PCAP-2013 and PNS-2019) carried out 6 years apart highlights the need of public policies to expand prevention strategies for HIV infection and other STIs.

The Relationship between Leisure Time Physical Activity and High-risk Behaviors with Mediating Personality among the Students of University of Isfahan

Introduction The aim of this study was to investigate the relationship between leisure physical activity and high-risk behaviors with personality mediating role in students of University of Isfahan. Method The research method was descriptive-correlational and in terms of purpose was part of applied research that was conducted in the field. The statistical population of the study consisted of all students of University of Isfahan in the academic year 2020-2021(16,563 people) 375 people were selected as a sample by stratified sampling method using the Krejcie and Morgan’s table. A researcher-made checklist of leisure-time physical activity, high-risk behaviors, and personality questionnaires were used to collect data. The validity of the research tools and their reliability (by Cronbach's alpha test) were evaluated. Research data were collected in library and field sections. To analyze the research data, descriptive and inferential statistics was used. Finding The results showed that high-risk behaviors are less in the leisure time of active students. In addition, with increasing physical activity in leisure time, high-risk behaviors decrease. On the other hand, the more psychotic students are, the more high-risk behaviors are likely to happen. In addition, the separate relationships between leisure-time physical activity and personality with high-risk behaviors were significant. Discussion However, the results showed that when the personality variable was included in the relationship between leisure physical activity and high-risk behaviors, the relationship between the two variables became insignificant. Therefore, in order to reduce high-risk behaviors among students, it is better for university officials to increase the possibility of students participating in leisure-time physical activities by holding extracurricular sports classes and easy access to sports facilities.

Brief Report: How Do We Reach Men? Offering HIV Testing in Evenings and Weekends in the HPTN 071 (PopART) Community-Based Trial in South Africa.

Unknown HIV status and consequent low antiretroviral treatment coverage among men living with HIV combined with high-risk behavior is a key driver of the HIV epidemic in high-burden settings. We investigated whether conducting household visits during nontraditional shifts increased the number of men recruited for community-based HIV testing, compared with traditional weekday shifts in the HPTN 071 (PopART) trial in South Africa. We used data captured during household visits among individuals aged 15 years or older in 6 communities in South Africa from September 2016 to September 2017. Successful recruitment required community HIV care providers (CHiPs) accessing a household member and completing the study questionnaire. Linear regression analysis compared mean successful recruitments between the different shift types stratified by sex. During 187 days, 62,455 successful household visits were completed. Recruitment of men and women was higher in weekends, for men highest on Sundays (Coef: 11.2, 95% CI: 8.7 to 13.7), for women highest on Saturdays (Coef: 11.3, 95% CI: 7.6 to 15.1), indicating a mean of 11.2 more men recruited on Sunday shifts, compared with traditional weekday shifts was similar when comparing traditional weekday shifts with nontraditional weekday shifts for both men and women. Conducting household visits during the weekends led to increased recruitment for participation in the PopART intervention among both men and women. This suggests that targeting households during the weekend can be an effective and easy-to-implement strategy to increase the number of men accessed for HIV testing that can be integrated into a wide range of community-based services.

Comparison of the effectiveness of compassionate mind-based therapy and dialectical behavior therapy on cognitive deficits, emotional processing defects and impulsivity of soldiers aged 18 to 20 years with high-risk behaviors

Comparison of the effectiveness of compassionate mind-based therapy and dialectical behavior therapy on cognitive deficits, emotional processing defects and impulsivity of soldiers aged 18 to 20 years with high-risk behaviors

Relationship of psychological stress with oral health status in commercial sex workers in Makassar City

&#x0D; Background : Depression can have a negative influence on dental health and increase the chance of engaging in high-risk sexual behavior. This study aims to determine the relationship between psychological stress with oral health status in commercial sex workers in Makassar&#x0D; &#x0D; &#x0D; Methods : This study is an analytic observational study using a cross-sectional design, was conducted in January 2022. The population in this study was 36 commercial sex workers in Makassar City, using total sampling technique. Exclusion criteria consisted of commercial sex workers who experienced cognitive impairment and commercial sex workers who did not complete the questionnaire. Psychological distress status was assessed using the General Health Questions (GHQ), and Depression syndrome using DSM-IV criteria. Oral health status was assessed using OHI-S and DMF-T. &#x0D; &#x0D; &#x0D; Results : Based on the OHI-S score, the sample had an average value of 5.45 ± 6.70, the DMF-T index, the sample had an average value of 7.76 ± 5.18, the mental health score for psychological pressure had an average of 20.72 ± 8.46 and depressive symptoms had an average of 10.52 ± 6.86.&#x0D; &#x0D; &#x0D; Discussion : This study found a significant relationship between psychological stress with oral health status in commercial sex workers in Makassar. Sex workers often feel they do not need oral health services and most of the pressure is always on sexually transmitted infections (STIs)&#x0D; &#x0D; &#x0D; Conclussion : There is a significant relationship between psychological distress and depressive symptoms, with oral health status in commercial sex workers in Makassar City.&#x0D;

Heterogeneity in Adolescents' Non-Suicidal Self-Injury Behaviour Trajectories Based on the Group-Based Trajectory Model and a Decision Tree Analysis of Family-Related Determinants.

Non-suicidal self-injury (NSSI) is a global public health problem. While some studies have noted the importance of behavioural development patterns in NSSI, most NSSI research is based on cross-sectional survey data. Few studies explore the time-series heterogeneity of trajectories of NSSI symptoms and family-related influencing factors of NSSI. The purpose of the study was to identify the heterogeneity in trajectories of adolescents' NSSI behaviour and their family-related influencing factors. The group-based trajectory model (GBTM) was used to identify the heterogeneity in the NSSI behaviour trajectories of 208 adolescents in China. Next, the decision tree model (DTM) was used to analyse which family related factors influence the trajectory type. The GBTM revealed two heterogeneous trajectories of NSSI behaviour: the high-risk and low-risk NSSI behaviour groups. Next, DTM's average accuracy was 83.2%. A total of seven independent variables were used for the DTM: gender, number of NSSIs in the past month, and family economic, family structure, family conflict, parental psychological control, parental behavior control and family intimacy risks. Family conflict risk was located at the root node and was the most important factor. Heterogeneity within the population should be considered in the management of adolescents' NSSI behaviours. Further, from the perspective of family system theory and cumulative risk, focusing on the adverse effect of multiple risk factors on adolescents' NSSI addiction is more meaningful rather than the impact of single risk factors. Studies that use time series data should focus on the trend of dynamic changes in NSSI addiction characteristics over time.

Recently acquired hepatitis C: Epidemiological characteristics and treatment response in a large cohort of MSM living with HIV in Madrid

IntroductionWe analyzed epidemiological, clinical characteristics, and the response to treatment in people living with HIV (PLHIV) who recently acquired hepatitis C (RAHC) in a multicentre study in Madrid (Spain). MethodsMulticenter, ambispective, observational study of RAHC in men who have sex with men (MSM) infected with HIV. Clinical, epidemiological, and RAHC evolution were recorded prospectively in 2019 and 2020 and retrospectively in 2017 and 2018. In patients who received HCV treatment, sustained virological response (SVR) was provided 12 weeks after the end of treatment in an intention to treat analysis (ITT): all treated patients were included; and in analysis per-protocol (PP): missing patients were excluded. ResultsOverall, 133 patients were included. Median (IQR) age was 40 (34.3–46.1) years, 90.9% had at least one previous sexual transmission disease (STD), and 33.6% had previously hepatitis C. More than half of the prospective sample included patients using chemsex related drugs (57.3%), 45.7% of them intravenously. The most prevalent genotype was G1a (66.2%), followed by G4 (11.3%). Ten of 90 patients evaluated for spontaneous cure (11%) cured the infection spontaneously, and 119 had treatment after a median time of 1.8 (0.7–4.6) months: sustained virological response (SVR) was achieved in 90.7% in the ITT and 94.7% in the PP analysis, with no differences regarding the direct-acting antiviral agents (DAA) combination used. ConclusionsMSM infected by HIV with a RAHC were exposed to high-risk sexual behavior. Spontaneous cure rate was low, while SVR after treatment was achieved by more than 90%.

Impacts of Stress on Workers’ Risk-Taking Behaviors: Cognitive Tunneling and Impaired Selective Attention

Working within one of the most stressful industries, construction workers face intensive stress loads that adversely affect safety and productivity. While different factors induce stress, time pressure and mental demand are two industry characteristics that can trigger workers’ occupational stress. Although previous studies demonstrated the adverse effects of time pressure and mental demand on workers’ safety performance, no study has empirically investigated the direct impacts of such factors as task stressors on workers’ arousal and stress levels. Further, little is known about the impacts of imposed stress on workers’ situational awareness and risk decision-making. Accordingly, this study evaluates changes in individuals’ situational awareness and decision dynamics when working under stress imposed by time pressure and mental demand. The study simulated a high-risk electrical activity within a multimodel mixed-reality environment and captured participants’ physiological and cognitive responses to measure their stress levels and cognitive processes while completing the electrical task under normal and stressful conditions. Results showed high stress levels triggered by task stressors adversely affect one’s cognitive processes, including attentional distribution: Excessive stress led subjects to miss surrounding hazards, leading to impaired risk perception and increased risk-taking behaviors. The findings of this study provide valuable insights into how the occupational stress imposed by task stressors can disturb workers’ cognitive processes, reduce their situational awareness, and give rise to high-risk behaviors.

The Relationship between Drunkorexia, Alcohol, and Blackouts Among College Students: An Exploratory Study.

College drinkers commonly report blacking out (i.e., alcohol-induced amnesia), and those who drink with the intention to blackout are at risk for harmful consequences. Drunkorexia (i.e., restriction of calories on planned drinking days) is a high-risk behavior potentially associated with blacking out. Informed by the Theory of Planned Behavior (TPB), this study explores blackout experiences and intentions to blackout association with drunkorexia. College students (n=2335) who primarily identified as female and White participated via an online survey. Participants received a $3 coupon for completion of the study. Consistent with the literature, 40% and 60.7% participants reported experiencing blackouts and drunkorexia respectively in the last year. Informed by the TPB, a structural equation model assessed if more frequency blackout experiences (IV) related to drunkorexia behaviors (DV1) and alcohol behaviors (DV2), and if there was a significant indirect effect through blackout intention. The model fit the data well (CFI=.98, TLI=.95) and suggests that more frequent blackout experiences relate to more drunkorexia experiences (R2=.04) and higher levels of alcohol consumption (R2=.44). In addition, the relationship between blackout experiences and drunkorexia flows through intentions to blackout (i.e., a significant indirect effect). Findings are consistent with TPB, which suggests intentions predict health behavior. Future interventions should consider modifying intentions and other possible TPB constructs to minimize high risk alcohol consumption and drunkorexia behaviors.

Seroprevalence and Associated Risk Factors for Hepatitis B Virus among Pregnant Women Attending a Public Health Facility in Osogbo, Nigeria

BackgroundHepatitis B virus (HBV) infection among pregnant women has a high rate of vertical transmission and consequential effects on fetal and neonatal outcomes. The aim of this study was to determine the prevalence and associated risk factors of infection among pregnant women attending antenatal care services in Osogbo, Nigeria.MethodologyThis hospital based cross-sectional study was conducted among pregnant women attending routine antenatal care clinic between April and June 2021. Systematic random sampling technique was used to recruit 240 pregnant women, their data were collected by face to face interview using a pretested questionnaire, while blood sample was collected aseptically to determine hepatitis B surface antigen by enzyme linked immunosorbent assay test kit. Univariate and multivariate logistic regression were used to examine the association between explanatory variables and outcome variable.ResultsThe mean age and seroprevalence of the study population were 27.50 ± 4.4 years and 5.8% respectively. The significant risk factors for HBV infection were tattooing (aOR = 5.22; 95% CI = 0.52–8.01; p = 0.0000), history of multiple sexual partners (aOR = 2.88; 95% CI = 1.92–12.42; p = 0.0044); and past history of contact with HBV patient (aOR = 2.17; 95% CI = 1.21–15.32; p = 0.0310) were significant predictors of HBV infection.ConclusionThe seroprevalence of HBV from this study was of intermediate endemicity. We therefore, advocate for continuous health education programs on the mode of HBV transmission, high-risk behaviors and methods of preventions at antenatal care clinics to raise the awareness of mothers and limit the spread of infection.Rwanda J Med Health Sci 2023;6(2):199-207

Influence of Educational Videos on Knowledge and Attitude on Reproduktive Health in Adolescent

Aims: Reproductive health education is essential to improve knowledge and attitude to grow up and live healthily. Audiovisual media as teaching method is considered as effective way to deliver message and material for health topic in teenager. It was reported that 10-14 years-old adolescent in Jakarta has reached 874,865 people in 2020. High populated of adolescent increased higher-risk sexual behavior. Sexual and reproductive education aims to increase knowledge about the anatomy and physiology of the organs and also improve attitude to avoid high-risk sex behavior. Objective: We aim to observe the effect of educational videos on the knowledge and attitudes of adolescents about reproductive health. Method: Quasi-experimental research with pre and post-test without control group. Research sample was 100 students of 231 Junior School Jakarta using systematic random sampling. Intervention was educational videos about healthy sex behavior. Result: We found significantly increased average knowledge (15,91 vs 23,24, p= 0,0001) and attitude (34,12 vs 43,26, p= 0,0001) score after the intervention. Conclusion: There was an significant diffrence of adolescents' knowledge and attitudes about reproductive health after educational video interventions. School and teacher play an active role in reproductive health counseling activities for adolescents with the right media.

PEOPLE WITH AUTISM AND THE PROPENSITY FOR LAW-BREAKING: A SPECIAL EDUCATION TEACHERS’ PERSPECTIVE

Autism is a subtype of neuro-developmental disorders, that causes the afflicted person to have social skills deficit, which then manifests into their behaviours. Behaviours that are typical among persons with autism, such as obsessions with daily routine, difficulties in understanding abstract matters and codes of conduct may expose them to engage in indecent acts in public or exhibit other forms of risky behaviours that violate social norms and break the law. The objective of this research is to study the behaviour of persons with autism who tend to break the law based on the perspective of teachers at autism centres in Malaysia. Data were collected through focus group discussion (FGD) with 25 special education teachers who were directly involved in the process of early intervention and education of children with autism. Data obtained were then analyzed descriptively and thematic analysis was conducted to obtain the recurring themes. Results of FGD demonstrated that the frequently emerging themes of rule-breaking behaviors committed by persons with autism are physically hurting others, setting buildings on fire (arson), vandalism of public property, theft, sexual and cyber offences which are considered criminal acts under the Penal Code and the Shariah Criminal Offences State Enactment/Act. Most research participants, however, considered these behaviors to be part of the individual with autism behavior and thus do not consider them serious enough to report to law enforcement for investigation and prosecution. Thus, it is recommended that teachers, parents, and caretakers be more attentive to preventing high-risk behavior of persons with autism through ongoing early intervention programs tailored to meet the needs of persons with autism. Research findings can help society tobetter understand autistic behavior that needs timely intervention, so it will not lead to an investigation by the police or criminal prosecution.

The Extent to which student “Gold Rush” contributes to sexual risky Behaviour amongst students in the spread of HIV/AIDS in higher institutions of learning: A case of Kwame Nkrumah University in Kabwe, Zambia

Transactional sex is very common in institutions of higher learning and has continued to influence high sexual risky behaviours amongst students in Zambian. The terminology that is commonly associated with transactional sex is “gold rush,” a situation where returning students in an institutional of higher learning negotiate for relationships with new students often times with the female first year’s students. The transaction takes place as the senior students negotiate for sexual favours in return for help in terms of money, answering assignments, protection from bullying and other forms of assistance. During transactional sex, there is high sexual risk behaviour as most of the time there is unsafe sex being practiced thereby leading to a high possibility of spreading HIV/AIDS pandemic and other sexually transmitted infections. The study aimed at exploring the vulnerability of students during gold rush. In its approach, the study used a mixed research methodological design. The findings of the study showed that there was high risky sexual behaviours between returning students and the first year’s students on campus leading to high risk exposure to the spread of HIV/AIDS and other related complications. It was recommended that enough sensitizations and well-coordinated awareness programs be engaged in order to mitigate the levels of vulnerability especially amongst female new students who reported on campus.

Prevalence and determinants of hepatitis delta virus infection among HIV/hepatitis B-coinfected adults in care in the United States.

Hepatitis delta virus (HDV) infection increases the risk of liver complications compared to hepatitis B virus (HBV) alone, particularly among persons with human immunodeficiency virus (HIV). However, no studies have evaluated the prevalence or determinants of HDV infection among people with HIV/HBV in the US. We performed a cross-sectional study among adults with HIV/HBV coinfection receiving care at eight sites within the Center for AIDS Research Network of Integrated Clinical Systems (CNICS) between 1996 and 2019. Among patients with available serum/plasma specimens, we selected the first specimen on or after their initial HBV qualifying test. All samples were tested for HDV IgG antibody and HDV RNA. Multivariable log-binomial generalized linear models were used to estimate prevalence ratios (PRs) with 95% CIs of HDV IgG antibody-positivity associated with determinants of interest (age, injection drug use [IDU], high-risk sexual behaviour). Among 597 adults with HIV/HBV coinfection in CNICS and available serum/plasma samples (median age, 43 years; 89.9% male; 52.8% Black; 42.4% White), 24/597 (4.0%; 95% CI, 2.4%-5.6%) were HDV IgG antibody-positive, and 10/596 (1.7%; 95% CI, 0.6%-2.7%) had detectable HDV RNA. In multivariable analysis, IDU was associated with exposure to HDV infection (adjusted PR = 2.50; 95% CI, 1.09-5.74). In conclusion, among a sample of adults with HIV/HBV coinfection in care in the US, 4.0% were HDV IgG antibody-positive, among whom 41.7% had detectable HDV RNA. History of IDU was associated with exposure to HDV infection. These findings emphasize the importance of HDV testing among persons with HIV/HBV coinfection, especially those with a history of IDU.

How did the COVID-19 pandemic affect driver speed selection and crash risk on rural freeways?

The COVID-19 pandemic disrupted various aspects of day-to-day life in unprecedented ways. This included significant reductions in travel that corresponded with travel restrictions imposed to contain the spread of the virus. This study evaluated changes in driver speed selection and crash/injury risk over the course of the pandemic on rural freeways in Michigan. Daily speed data and monthly crash data were analyzed from 2015 to 2020 to investigate changes that corresponded to the onset of the COVID-19 pandemic. The results showed that during the initial periods of lockdown, mean speeds increased by 2.2–2.4 mph across all sites, while the total crash frequency was lower by 28%–45% compared to pre-pandemic years. Crashes also tended to be significantly more severe during the early stages of the pandemic. Interestingly, these changes were less pronounced on sites with 70-mph speed limits as compared to sites where speed limits were increased to 75 mph in 2017. However, as travel restrictions were lifted, speeds regressed towards long-term averages on the 75-mph sites while the higher speeds were maintained at sites with 70-mph limits. The increase in injury severity appears to be attributable to higher speeds, as well as increases in other high-risk behaviors during the pandemic, such as non-use of seat belts and driving under the influence of drugs or alcohol. Some of these effects are also due to differences in terms of the population of drivers that were on the road during the pandemic. The results provide important insights as to the increases in severe crashes that coincided with the onset of the pandemic.