High-risk Behaviors Research Articles

Methodology for assessing health risk behaviours among undergraduates in Sri Lanka: a literature review

It is imperative to learn more about the distinctive Health-Risk-Behaviours (HRB) that are culturally acceptable in the lower-resource settings. Therefore, the objective of this review is to identify tools measuring HRBs among undergraduates in Sri Lankan context. A literature review was conducted both manually and electronically through Google Scholar and Hinari and PubMed databases. Self-administered Questionnaires were used in National Surveys and individual studies. Youth-Risk Behaviour-Surveillance-System was the most commonly used comprehensive HRB assessment tool. The National College Health Risk Behaviour Survey, National College Health Assessment were other widely used instruments. There are few validated tools and multiple short scales or items combined like Health-Promotion-Lifestyle[1]Profile, Health-Behaviour-Questionnaire or Inventory, DOSPERT scale, Adolescent-Health-Attitude and Behaviour[1]Survey, Healthy-Lifestyle-Scale, Health-Behaviour-Scale and Health-Behaviour-Checklist. Objective methods for assessing high-risk behaviors (HRBs) include measures of personality and aggression, which have been used to critically quantify violence and accidental injury, as well as biochemical tests for alcohol, nicotine, and other drug use, mechanical or computer sensors, and biological tests such as urinary cultures for sexual risk behaviours. These tools had focused only on specific aspects of HRBs among undergraduates in Western countries and were not comprehensive assessments of HRBs of undergraduates in lower-resource settings. It was evident that there has been a deficit of choices for the adaptation of an HRB tool for undergraduates in lower-resource-settings and a new tool to be developed for Sri Lankan context.

Secondary Syphilis Can Simultaneously Mimic Cholestatic Liver Injury and Glomerular Nephropathy

ABSTRACT Syphilis, a disease affecting millions, still poses challenges for men who have sex with men in high-income countries and often presents in varying ways. It is exceedingly rare for syphilis to simultaneously cause an acute liver injury and nephropathy. This case describes the concomitant clinical presentation of these abnormalities and also describes a liver injury that mimicked cholestatic disease. Treatment of syphilis led to complete resolution of the liver and kidney injury. This case demonstrates a need to exclude syphilis in patients with high-risk behaviors who present with cholestatic liver injury in atypical fashions.

Ocular and Adnexal Diseases in Human Immunodeficiency Virus-Infected Pregnant Women Attending HIV Clinics in Ibadan, Nigeria.

Human immunodeficiency virus (HIV) is a lentivirus. It is transmitted through sexual intercourse, shared intravenous drugs, contaminated needle use, blood transfusion, and mother-to-child transmission. Of the patients with HIV, 50%-75% have ocular manifestations and this may be the primary presentation. This study was carried out in two prevention of mother-to-child transmission (PMTCT)/HIV clinics. The aim was to determine the incidence, patterns of presentation, and determinants of ocular and adnexal diseases in HIV-positive pregnant women attending HIV clinics to develop an eye care protocol for them. The study was a cross-sectional study of HIV-positive pregnant women attending the PMTCT/HIV Clinics at University College Hospital and Adeoyo Maternity Teaching Hospital, Ibadan. Patients were interviewed using a structured questionnaire. Blood samples were taken for CD4+ count and viral load. The stage of the disease, type of antiretroviral therapy (ART), and the interval between HIV diagnosis and commencement of ART were recorded. Comprehensive ocular examination, which included visual acuity check unaided and with pinhole, lid, anterior segment examination with slit lamp and posterior segment examination with dilated binocular indirect ophthalmoscopy, was conducted. Statistical Package for Social Sciences version 23 was used to analyse the data. A total of 153 pregnant women aged 23-42 years (mean, 33.5; standard deviation, ±5.6) were recruited. One hundred and fifteen (75.2%) of them were married in a monogamous setting. Multiple sexual partners (48.4%; n = 74-some women married in monogamous settings at the time of recruitment for this study had multiple sexual partners in the past) and the use of unsterilised objects (46.4%; n = 71) were major high-risk behaviours. Ocular and adnexal diseases were found in 81 (53%) participants. HIV-related ocular and adnexal diseases were found in 16 (10%) participants. Of the 16 HIV-related diseases, optic atrophy was found in seven (43.8%), presumed toxoplasmosis in three (18.7%), presumed cytomegalovirus retinitis in three (18.7%) lid warts in two (12.5%), and conjunctival microangiopathy in one (6.3%) participant. The association between HIV- related ocular and adnexal diseases and gestational age, CD4+ count, viral load and type of ART was not statistically significant. The few HIV-related findings in this study could be a result of the improved CD+ count/low viral load of most of the recruited participants. Ensuring that patients attending PMTCT/HIV clinic have at least one ocular examination during pregnancy by collaborating with eyecare professionals could ensure prompt detection and treatment of eye diseases, to improve the quality of life of HIV-positive pregnant women.

Low Level of Accurate Knowledge of Undetectable Equals Untransmittable (U = U) Among Men Who Have Sex with Men (MSM) Challenges U = U Achievement in Chengdu, Southwestern China.

The introduction of the undetectable equals untransmittable (U = U) statement significantly reduces HIV stigma and provides an empirical basis for achieving "zero transmission." U = U messaging has gained increasing support and is well-developed in several countries. However, the current status of accurate knowledge of U = U and its associated factors among men who have sex with men (MSM) in China remians unclear. We conducted a cross-sectional survey among MSM recruited in Chengdu, China, from March to May 2022 to investigate the percentage of those who knew U = U accurately and to explore associations between sexual risk behaviors, HIV testing, socio-behavioral measures, and accurate knowledge of U = U. Of 497 MSM included in our study, 23.4% (116/497) had accurate knowledge of U = U. More than half of the participants (63.2%, 314/497) reported multiple sexual partnerships, 15.7% (78/497) used substance during sex, 37.4% (186/497) reported inconsistent condom use, and 76.1% (378/497) took HIV testing in the past six months. Factors associated with accurate knowledge of U = U among MSM included substance use during sex (multivariate odds ratios ORm = 1.96; 95%CI: 1.13-3.41), HIV status tested in the last six months (ORm = 2.07; 95%CI: 1.14-3.77), HIV-related literacy (ORm = 1.41; 95%CI: 1.14-1.74) and perceived higher risk of HIV infection (ORm = 1.11; 95%CI: 1.02-1.21). The findings indicate that great challenges need to be conquered for U = U achievement among the MSM population in Chengdu, China. Intervention strategies should be prioritized in health education on high-risk behaviors such as group sex and substance use, information provision and counseling of U = U in HIV testing services, and encouraging U = U knowledge sharing among MSM with their partners in China.

Projecting the Dynamic Trends of Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome: Modeling the Epidemic in Sichuan Province, China

ObjectiveOur study aimed to provide a comprehensive overview of the current status and dynamic trends of the human immunodeficiency virus (HIV) prevalence in Sichuan, the second most heavily affected province in China, and to explore future interventions. MethodsThe epidemiological, behavioral, and population census data from multiple sources were analyzed to extract inputs for an acquired immunodeficiency syndrome (AIDS) epidemic model (AEM). Baseline curves, derived from historical trends in HIV prevalence, were used, and the AEM was employed to examine future intervention scenarios. ResultsIn 2015, the modeled data suggested an adult HIV prevalence of 0.191% in Sichuan, with an estimated 128,766 people living with HIV/AIDS and 16,983 individuals with newly diagnosed infections. Considering current high-risk behaviors, the model predicts an increase in the adult prevalence to 0.306% by 2025, projecting an estimated 212,168 people living with HIV/AIDS and 16,555 individuals with newly diagnosed infections. ConclusionHeterosexual transmission will likely emerge as the primary mode of AIDS transmission in Sichuan. Furthermore, we anticipate a stabilization in the incidence of AIDS with a concurrent increase in prevalence. Implementing comprehensive intervention measures aimed at high-risk groups could effectively alleviate the spread of AIDS in Sichuan.

Characteristic of High-Risk Behaviours Related to Alcohol and Illicit Drug Use and their Associated Factors among Adolescents in Middle and High School

<div class="WordSection1"><p><strong>Background:</strong> Use of narcotics, psychotropic and addictive substances (NPA) in adolescents has become one of the major social problems we are facing in society and it gives a negative impact. This study was done to determine the characteristics and factors that influence high-risk behaviour of NPA use in adolescents in middle and high school, also introducing CRAFFT questionnaire as an early screening tool for alcohol an illicit drugs use.</p><p><strong>Methods:</strong> Quantitative study (validated questionnaire) was conducted among 514 subjects aged 12-18 years old. CRAFFT questionnaire was used to detect a high-risk behavior of alcohol and illicit drugs use and self-reported questionnaire used to determine the risk factors of NPA.</p><p><strong>Result:</strong> Most participants (19,6%) were involved in high-risk behaviour of alcohol and illicit drugs, with the majority was males (12,4%). This study showed smoking behaviour (23,8%), drinking alcohol (15,8%) and illicit drugs use (13,6%). The type of drugs being used were cannabis (52,7%), tramadol (15,2%), dextromethorphan (10,7%) and methamphetamine (6,3%). CRAFFT questionnaire has a good internal consistency with Cronbach’s α 0,73. Education level, authoritarian parenting style, unharmonious parents, peer pressure or threat, and extracurricular activities were factors that influenced high-risk behavior of alcohol and illicit drug use</p><p><strong>Conclusions:</strong> Early detection, comprehensive treatment, and intervention of risk factors of NPA use are needed. CRAFFT can be use as one of the screening tools for detection of alcohol and illicit drugs use in adolescents.</p></div>

Prevalence of human papilloma virus infection and risk of cervical intraepithelial neoplasia among female sex workers in Mumbai, India.

Cervical cancer, mostly caused by human papilloma virus (HPV), has disproportionately high incidence in developing countries. HPV infection being essentially a sexually transmitted infection, high-risk behaviour women with multiple sexual contacts like female sex workers (FSWs) are at higher risk of co-infection with HPV and of developing cervical precancer and cancer. This study aimed to determine the prevalence and determinants of HPV infection and cervical intraepithelial neoplasia (CIN) among FSWs in Mumbai, India. A cross-sectional study was conducted among 448 FSWs, between the ages of 18-50 years, by collaborating with local non-government organizations working for the health and welfare of FSW communities at sexually transmitted diseases clinics. All FSWs were screened for HPV DNA by hybrid capture II followed by reference diagnosis of colposcopy and/or cervical biopsy. The prevalence of HPV DNA positivity was 35.5% and CIN was 2.2%. Factors significantly associated with HPV DNA positivity were age group younger than 30 years odds ratio (OR = 2.098, 95% confidence interval (CI) 1.408-3.127), Illiteracy (OR = 2.015, 95% CI 1.305-3.112), being single (OR = 2.409, 95% CI 1.558-3.724), less than 18 years of age at time of initiating work as FSW (OR = 3.718, 95% CI 3.718-2.392), having more than five clients per day (OR = 2.078, 95% CI 1.301-3.318), been working as a FSW for more than 5 years (OR = 2.321, 95% CI 1.455-3.701), not using barrier contraception methods (OR = 5.155, 95% CI 3.395-7.827) and having no exposure to human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) education program (OR = 29.153, 95% CI 15.385-55.240). FSWs with a positive HPV DNA test are substantially more likely to have CIN compared to those with a negative test (OR = 7.6, 95% CI 1.59-36.25). The prevalence of HPV infection and CIN was high among FSWs. FSWs with a positive HPV DNA test had a seven times higher risk of developing CIN. The persistence of HPV infection is expected to significantly raise the risk of cervical cancer in the future. It is suggested to have an integrated approach towards cervical cancer screening and HIV/AIDS control activities.

Deceased Organ Donor HTLV Screening Practices Postelimination of Universal Screening in the United States.

In the United States, universal screening for human T-lymphotropic virus (HTLV) in deceased organ donors was discontinued in 2009. Since then, the transplant guideline suggests considering targeted screening. However, the outcomes of this change in HTLV screening have not been evaluated. Using the Organ Procurement and Transplantation Network database between 2010 and 2022, we analyzed the HTLV antibody screening frequency and seroprevalence in potential deceased organ donors and their correlations with HTLV infection risks, including race and high-risk behaviors for blood-borne pathogen infection. Although targeted screening has not been established for HTLV, we hypothesized that screening rates should correlate with the proportions of donors with infection risk if screening is targeted. We also evaluated the organ utilization of HTLV-seropositive donors. Of 130 284 potential organ donors, 22 032 (16.9%) were tested for HTLV antibody. The proportion of donors tested for HTLV varied between Organ Procurement Organizations (median [interquartile range], 3.8% [1.0%-23.2%]; range, 0.2%-99.4%) and was not correlated to HTLV infection risks. There were 48 seropositive donors (0.22%), and at least 1 organ from 42 of these donors (87.5%) was transplanted. The number of organs recovered and transplanted per donor was significantly lower in HTLV-seropositive than in HTLV-negative donors (recovered, 2 [2-3] versus 3 [3-5], P < 0.001; transplanted, 2 [1-3] versus 3 [2-4], P < 0.001). However, HTLV-1 infection was not attributed as the cause of nonrecovery except for only 1 HTLV-seropositive donor. HTLV screening practices varied across the United States. Our findings suggest that targeted screening was not performed after the elimination of universal screening.

Viral hepatitis in persons living with HIV in the post-COVID era.

Coinfection with hepatitis viruses A to E is frequent in persons living with HIV (PLWH) and causes significant morbidity and mortality. Oro-fecal transmissible hepatitis A and E mostly produce acute self-limited episodes in poor income regions and in non-vaccinated travelers. In high-income countries, outbreaks of hepatitis A occur in men having sex with men (MSM) and chronic hepatitis E is occasionally reported among PLWH with severe immunodeficiency. Chronic hepatitis B, C, and D are frequent in PLWH in highly endemic regions and globally in persons who inject drugs (PWID) and MSM. Progression to liver cirrhosis and development of hepatocellular carcinoma (HCC) is major clinical complications in coinfected patients. Current estimates for PLWH are of 38 million worldwide. Roughly 12% have chronic viral hepatitis (5 million). Coinfection figures are of 5-10% for HBV (2-4 million), 4% for HCV (1.5 million), and 15% of HBsAg+ for HDV (0.5 million). Oral direct-acting antivirals (DAA) cure almost all treated patients with hepatitis C. However, given that there is no protective HCV immunity, PLWH with high-risk behaviors may experience HCV reinfection episodes. Tenofovir is the drug of choice in PLWH with chronic hepatitis B, given its dual effect on HIV and HBV. Lifelong oral tenofovir suppresses HBV replication and ameliorate liver damage. However, the risk of HCC persists even in the absence of cirrhosis. Finally, HDV causes the worst of viral hepatitis with faster progression to cirrhosis and HCC. An entry inhibitor, bulevirtide, has recently been approved and another drug, lonafarnib, is completing Phase 3 trials. Combination antiviral therapy for hepatitis D could improve dramatically the poor prognosis of HIV-HDV coinfected patients. The resumption of good medical practices in PLWH after the big disruption caused by COVID-19 will reduce the burden of viral hepatitis coinfections. Renewed efforts on HAV and HBV vaccination of susceptible individuals and earlier and wider prescription of antiviral therapy for HBV, HCV, and/or HDV coinfection should be prioritized in PLWH. The benefits of innovative strategies for viral hepatitis, including pre-exposure prophylaxis or use of long-acting antivirals, warrant further consideration in PLWH.

Assessing the Effects of Early Intervention on Symptom Management and Disease Progression in the Modification of High-Risk Behaviors to Prevent Rheumatoid Arthritis

Assessing the Effects of Early Intervention on Symptom Management and Disease Progression in the Modification of High-Risk Behaviors to Prevent Rheumatoid Arthritis

Sexual behavior is linked to changes in gut microbiome and systemic inflammation that lead to HIV-1 infection in men who have sex with men

Pathogenic changes in gut microbial composition precede the onset of HIV-1 infection in men who have sex with men (MSM). This process is associated with increased levels of systemic inflammatory biomarkers and risk for AIDS development. Using mediation analysis framework, in this report we link the effects of unprotected receptive intercourse among MSM prior to primary HIV-1 infection to higher levels of proinflammatory cytokines sCD14 and sCD163 in plasma and a significant decrease in the abundance of A. muciniphila, B. caccae, B. fragilis, B. uniformis, Bacteroides spp., Butyricimonas spp., and Odoribacter spp., and a potential increase in the abundance of Dehalobacterium spp. and Methanobrevibacter spp. in stools of MSM with the highest number of sexual partners. These differences in microbiota, together with a reduction in the pairwise correlations among commensal and short-chain fatty acid-producing bacteria with a number of sexual partners, support an increase in gut dysbiosis with the number of sexual partners. These results demonstrate the interconnectedness of sexual behavior, immune response, and microbiota composition, notably among MSM participating in high-risk sexual behaviors.

Assessment of High-risk Behaviors among Female Students at State Secondary Schools in Ahvaz City in 2021

Background and Objectives: Adolescence is a sensitive period of life that is characterized by changes and rapid growth. These changes are related to behaviors that affect a person's health. Therefore, this research was conducted with the aim of determining the prevalence of high-risk behaviors among female students at state secondary schools in Ahvaz City in 2021. Materials and Methods: This cross-sectional descriptive study was conducted on female students at state secondary schools in Ahvaz city by random sampling with inclusion criteria. The data were collected using a demographic form and the Iranian Adolescents Risk-Taking Scale and analyzed by SPSS software version 22 with descriptive statistical tests. Results: The average age of the subjects was 16.27 years. According to the mean and standard deviation results, the highest prevalence of risky behaviors in female students was related to dangerous driving (14.92±5.44) and drug addiction (13.13±4.70). Correlation results showed that there was a significant relationship between annual check-ups and dangerous driving, as well as between a history of physical illness and the tendency to have a relationship with the opposite sex (P&lt;0.05). There was no significant relationship between drug addiction, alcohol consumption, smoking, violence, sexual relationship and behavior, relationship with the opposite sex, and dangerous driving with a history of mental illness and the death of family members (P&gt;0.05). Conclusion: Considering the high prevalence of high-risk behaviors and the tendency to dangerous driving and drugs in female secondary school students, it seems necessary to perform psychological, educational, educational, counseling, and therapeutic interventions because prevention of high-risk behaviors is always easier, less expensive, and more effective than treatment.

The Effect of Social Media Influencer Warranting Cues on Intentions to Use Non-Hormonal Contraception

ABSTRACT Young women increasingly get sexual health information from social media influencers, who use persuasive communication and can alter attitudes, intentions, and behaviors. Contraception is a commonly discussed health topic among influencers on social media. Previous research suggests that influencers negatively frame and encourage the discontinuation of hormonal contraception. At the same time, influencers also encourage the uptake of less effective non-hormonal options, such as fertility awareness-based methods. Though descriptive content analysis work details these patterns in influencer contraceptive messaging, there is no experimental research that explains message effects. The purpose of this study was to experimentally test the effect of influencer contraceptive-related messaging on behavioral health intentions. This study introduces warranting theory as a potentially valuable model for explaining online health communication message effects. Specifically, this study tested the effect of influencer messages containing sponsorship and medical disclaimers on intentions to use non-hormonal contraception. U.S. females (n = 296) ranging in age from 18–29 years old participated in a survey. Findings suggest that the interaction led to decreased intentions to use non-hormonal contraception. However, findings did not support a relationship between influencer messaging and impressions, which highlights potential boundary conditions for warranting theory and high-risk health behaviors. Additionally, there was a positive relationship between perceived trustworthiness and expertise of the influencer and intention to use non-hormonal contraception. Future research should test influencer messaging using real social media content and consider the effect of parasocial relationships. Practical implications highlight the need for comprehensive contraceptive counseling.

The Correlation Between Self-Expression and High-Risk Behaviors in Students

Background: The increase in high-risk behaviors (HRBs) is recognized as a serious threat to the health of societies. Self-expression is one of the social skills that can have a positive effect on controlling some risky behaviors. Objectives: This study aimed to investigate the correlation between self-expression and HRBs among newly arrived students at Isfahan University of Medical Sciences. Methods: In this cross-sectional study, 402 students (166 males and 236 females) were recruited from Isfahan University of Medical Sciences in 2020. They were selected using a multi-stage random sample and answered questions from the self-expression questionnaire and the high-risk behavior questionnaire. Various statistical indicators were utilized, such as mean, standard deviation (SD), t-test for comparison between the two gender groups, ANOVA for the mean difference between three age groups, and a Pearson correlation matrix to examine the correlations between all components of HRBs. Additionally, the Pearson test and regression analysis were employed. Results: A significant negative correlation was found between the self-expression score and HRBs (r = -0.56, P &lt; 0.001). The mean score of HRBs was 15.33 ± 18.047. The mean score of self-expressions in male students was significantly lower than that of female students (74.51 ± 16.33 vs. 80.36 ± 14.30). The most common HRBs were related to smoking, hookah use (mean = 7.53 ± 8.75), and suicidal ideation (mean = 3.11 ± 3.93). Conclusions: It accentuates the significance of incorporating self-expression interventions in educational and health programs to foster healthier behaviors and promote mental health among this vulnerable population. Further research is warranted to explore additional factors influencing the link between self-expression and HRBs among university students.

Association between health-related behaviors and obstructive sleep apnea among Korean adults

We aimed to investigate the association between health-related behaviors and obstructive sleep apnea (OSA) among Korean adults. A cross-sectional design using national open data was employed. Data from 8,096 adults aged 40 years and above who participated in the Korea National Health and Nutrition Examination Survey between 2019 and 2021 were analyzed. The participants’ OSA risk level was assessed using the STOP-Bang questionnaire. A logistic regression analysis was performed to investigate the association between health-related behaviors and high risk for OSA. The association between health-related behaviors and OSA risk remained significant for former smokers (OR = 1.643) and high-risk drinking (OR = 1.365), after adjusting for variables that showed significant differences in general and metabolic characteristics. Implementing lifestyle modifications is crucial for mitigating the health and societal impact of OSA. Understanding and addressing modifiable risk factors, including high-risk drinking and smoking, should be prioritized in nursing intervention. Nursing interventions are critical for preventing and managing OSA among Korean adults. Prioritizing high-risk behaviors through cessation programs and education is essential. Vulnerability of individuals living alone must be addressed through community outreach and support services. Emphasizing routine screenings for pre-hypertension and pre-diabetes, promoting balanced nutrition, and encouraging physical activity are crucial.

Group Comparisons of the Sexual Interests and Behaviors of Assigned Males and Their Association with Genital Ablation Fantasies.

We describe here the sexual histories and characteristics of 338 individuals with interests in castration (orchiectomy) and, more broadly, genital ablation (i.e., orchiectomy, penectomy, and/or nullification), recruited from the Eunuch Archive. We compared four groups: those who only fantasize about castration (Fantasy, n = 66), those who wish to be castrated in the future (Aspiring, n = 166), and those who have been castrated (Eunuchs) both with (n = 42) or without (n = 64) androgen replacement therapy (ART). In our sample, 35.6-53.8% had sexual fantasies of castrating someone, 83.3-90.8% had fantasies of being castrated, 20.6-33.3% had fantasies of removing someone's penis, and 45.3-61.9% had fantasies of having a penectomy. The four groups had similar arousal by high-risk sex behaviors, anal sex play, attraction to people under 18, common sex behaviors, and fetishistic behaviors. Fantasy of being castrated by someone was associated with elevated high-risk sexual behaviors and attraction to individuals aged 18 to 49 after controlling for age, groups, and sexual attraction. In addition, after adjusting for age, groups, and sexual attraction, fantasy of castrating someone was associated with more attraction to individuals under the age of 18 and being aroused by interaction with a stranger, whereas fantasy of cutting off someone's penis was associated with less tendency for common sexual behaviors and digital sex communication. Fantasy of being penectomized was associated with high risk and fetishistic sexual behaviors. These results support screening for high-risk behaviors in individuals who endorse an interest in genital ablation, with treatments focused on harm reduction.

Relationship between the Presence of Human Papillomavirus in the Female Urethra and Recurrent Urinary Tract Infections.

Introduction: Recurrent urinary tract infections (rUTIs) are highly prevalent health issues among women, significantly impacting their quality of life. Urethral pain or urethritis can arise from infectious or non-infectious origins. The presence of Human Papillomavirus (HPV) in the urogenital tract has been associated with high-risk sexual behaviors, but its presence in the female urethra without such behaviors has not been thoroughly investigated. Objectives: The study aims to determine the presence of HPV in the urethra of women with recurrent urinary tract infections (rUTIs) and concomitant urethral syndrome and to compare the clinical and microbiological characteristics of women with and without urethral HPV, specifically focusing on those without high-risk sexual behaviors. Methods: This prospective multicenter study included 138 women over 18 years old with rUTIs and concomitant urethral pain syndrome. High-risk sexual behaviors, sexually transmitted infections, and vaginitis were set as exclusion criteria. Participants were divided into two groups: NHPV (n = 72) with no urethral HPV and HPV (n = 66) with urethral HPV presence. Variables analyzed included age, body mass index (BMI), follow-up duration, comorbidities, treatments, toxic habits, surgical history, main symptoms, urine sediment findings, and cultures from urine and vaginal exudate. HPV genotyping was also performed. Descriptive statistics were used, along with Student's t-test, Chi-square, Fisher's exact test, ANOVA, and multivariate cluster analysis. Results: The NHPV group was older on average (48.75 years) compared to the HPV group (39.09 years). The HPV group had a longer follow-up period (2634 days vs. 1975 days in NHPV). Urinary incontinence was significantly more common in NHPV (63.89%) compared to HPV (18.18%) (p = 0.001). HPV-positive women had a higher prevalence of verrucous lesions in the vaginal introitus (64% vs. 8% in NHPV). Additionally, the HPV group showed higher rates of pyuria (27.27%), vaginal Candida albicans (36.26%), and positive urine cultures for Escherichia coli (47.83%), Enterococcus faecalis (36.36%), and Klebsiella pneumoniae (21.74%). No significant differences were observed between the groups concerning BMI, smoking habits, diabetes, or the main symptom at consultation. The most common HPV genotypes identified were G35, G42, and G66 (each 27%). Multivariate analysis revealed that sensitivity to nitrofurantoin was the most significant variable in the HPV group (importance of 0.96), followed by fosfomycin (0.79), trimethoprim (0.79), and amoxicillin (0.71). Conclusions: HPV was present in the urethra of 47.8% of women with rUTIs and concomitant urethral syndrome who did not exhibit high-risk sexual behaviors. These women were younger and had a longer duration of symptoms compared to those without urethral HPV. The identification of Enterococcus faecalis, Escherichia coli, and Klebsiella pneumoniae was more common in the HPV group. The sensitivity of bacteria to nitrofurantoin and fosfomycin is crucial for the clinical management of these patients. The presence of urethral HPV should be considered in the evaluation and treatment of women with rUTIs and urethral syndrome.

A Comprehensive Analysis of Skin Cancer Concerns and Protective Practices in Manitoba, Canada, Highlights Lack of Skin Cancer Awareness and Predominance of High-Risk Sun Exposure Behaviors.

The rapidly increasing skin cancer rates in Canada are alarming, with current data estimating that 1/3 of Canadians will be affected in their lifetime. Thus, deeper understanding of high-risk sun exposure behaviors is needed to help counter this trend. Only limited action has been taken by federal/provincial governments to reduce skin cancer incidence. A cross-sectional survey study was conducted in Manitoba, with frequency counts, means, and percentages used to encapsulate responses. Age- and gender-adjusted odds ratios were calculated using logistic regression analyses. Our study identified worrying inadequacies in sun protective behaviors and attitudes, with the threat of such high-risk behaviors amplified by a lack of skin cancer awareness. Alarming elements were noted in participants' sun exposure history (>65% reported a history of sunburns, >50% previously used a tanning bed, and >75% recently tanned for pleasure), beliefs and attitudes (>50% believe that they look better/healthier with a tan, and >40% believe that having a base tan is protective against further sun damage), and sun protection efforts (sun protective clothing was used <60% of the time, sunscreen was used by <50%, and there was a lack of knowledge about sunscreen characteristics in ~30% of respondents), in addition to significant differences being established between demographic subgroups (based on gender, age, skin phototype, income, and education attained). This study provides worrisome insight onto the grim landscape of sun protective behaviors and attitudes in Manitoba, which will inevitably translate into higher skin cancer rates and should serve as a call to action to promote targeted public health messaging in this jurisdiction and beyond.

Understanding Peer Sexual Norms, Attitudes, and Pressure: Correlates of Risky Sexual Behaviours among Secondary School Adolescents in Anambra State, Nigeria

Aims: Sexual behaviour initiation often takes place throughout adolescence and is typically linked to engaging in unprotected sexual practices and other high-risk sexual behaviours. This research investigated the correlation between peer sexual behaviour, sexual attitudes, pressure to engage in sexual activity, and sexual risk behaviours among secondary school adolescents in Anambra State. Methodology: The study was carried out with a correlational research approach. The research included 1,200 individuals from a population of 19,048 SS2 teenagers in public secondary schools. Cronbach's Alpha statistics were used to evaluate the internal consistency of three scales: the Brief Sexual Attitudes Scale (BSAS), the Pressure to Have Sex Questionnaire (PTHSQ), and the modified Sexual Risk Behaviour Scale (SRBS). The reliability coefficients for the Adolescent Sexual Behaviour Index (ASBI) were 0.86, 0.96, and 0.80, respectively. The reliability index of the ASBI was determined using Kuder Richardson statistics, resulting in a coefficient of 0.86. The data was obtained by directly administering the instruments and processed using the Statistical Package for Social Sciences (SPSS). Pearson Product Moment Correlation is a statistical measure that quantifies the strength and direction of the linear relationship between two variables. Coefficients were used to address the research enquiries, while the null hypotheses were examined using a t-test to determine significant association. Results: The results indicated a weak positive association between the sexual conduct of peers, sexual attitudes, and pressure to engage in sexual activity, and sexual risk behaviours among secondary school teenagers in Anambra State. Furthermore, the findings demonstrated a notable association between these variables and the sexual risk behaviours of secondary school adolescents in Anambra State. Conclusion: Based on these data, it was determined that there is a weak positive link between peer sexual behaviour, sexual attitude, peer pressure to engage in sexual activity, and unsafe sexual behaviours among secondary school teenagers in Anambra State. Given this information, it is advisable for school administrators to establish health initiatives aimed at assisting young people in adopting enduring sexual habits that promote their overall health and well-being. These practices should also aim to minimise their susceptibility to HIV and other sexually transmitted diseases.

FC51: A Big BIT: Utilizing Behavioral Intervention Team Approaches to Improve the Care of Older Adults on Med-Surg Units

Background: Older adults may exhibit behavioral disturbance while medically hospitalized. Restlessness, removing medical devices, or wandering may lead to sentinel events including falls, elopements, or violence. The traditional consultation-liaison model addresses challenging or high-risk behaviors but is often reactive and may lead to missed opportunities. The interdisciplinary Behavioral Intervention Team (BIT) was implemented on the campus of Prisma Health Baptist Hospital in Columbia, SC to address and anticipate the need for behavioral health support on medical units.Methods: A pilot BIT program was implemented in September 2019. Two psychiatric nurses were embedded on med-surg units as a part of medical and psychiatric interdisciplinary teams. After obtaining approval from the Prisma Health Institutional Review Board, a retrospective review was conducted to evaluate the correlation between BIT interventions and patient safety events. Two time periods were examined: six months with early-BIT efforts and six months with expanded-BIT efforts. Medical records and safety reports were reviewed, and statistical analysis was conducted in SAS Enterprise Guide 8.3. Statistical significance was based on associated p- values (p &lt; 0.05).Results: Of admitted patients during the study period (N = 1413), almost half were age 65+. Pre- existing psychiatric diagnoses were present in 58% of cases with mood, anxiety, and neurocognitive disorders being most common. A majority of patients were on psychotropic medications during both study periods; however, there was a significant decrease in the use of psychotropic medications with expanded-BIT efforts (71.2% vs 61.3%, p &lt; 0.001). In comparing early-BIT efforts to expanded-BIT efforts, significant reductions in workplace aggression (6.7% vs 2.3%, p &lt; 0.001), use of restraints (5.8% vs 3.4%, p = 0.034) and need for security (4.2% vs 0.8%, p &lt; 0.001) were observed. Geriatric subgroup analysis demonstrated a significant decrease in the need for security only (4.6% vs 0.6%, p &lt; 0.001).Conclusions: Engaging BIT significantly reduced aggression, restraint use, and security interventions. As psychiatric comorbidities continue to impact overall treatment plans, care teams will need to prevent high-risk behaviors and events. Implementing an interdisciplinary BIT is feasible and effective in reducing negative outcomes.