Increase In High-risk Behavior Research Articles

Effect of Personality Traits and Emotion Regulation Strategies on Risky Behaviors in Adolescents.

The current study investigated the effects of personality traits and emotion regulation strategies on high-risk behaviors among adolescents (N = 1,572). This study used a cross-sectional and correlational research design. Multiple linear regression was used for analysis. A 1-unit increase in extraversion and neuroticism led to a 0.391- and 0.365-unit increase in high-risk behaviors, respectively. However, a 1-unit increase in agreeableness and conscientiousness led to a 0.307- and 0.365-unit decrease in high-risk behaviors, respectively (p < 0.05). A 1-unit increase in external and internal dysfunctional emotion regulation strategies led to a 1.34- and 0.548-unit increase in high-risk behaviors, respectively. However, a 1-unit increase in internal functional emotion regulation strategies led to a 0.641-unit decrease in high-risk behaviors (p < 0.05). Regression analysis showed that age, school type, sex, grade level, father's educational level, father's child-rearing style, and school performance were associated with more high-risk behaviors (p < 0.05). There were correlations between some personality traits, emotion regulation strategies, sociodemographic characteristics, and high-risk behaviors. Early intervention programs targeting dysfunctional personality traits and emotion regulation skills in adolescence may prevent the development of risky behaviors in adulthood. [Journal of Psychosocial Nursing and Mental Health Services, 62(2), 23-36.].

COVID-19 Vaccination, Peltzman Effect and Possible Increase in Highrisk Behaviors: A Growing Concern Related to Risk Compensation and Reduced Compliance to Public Health Protective Measures after Vaccines Rollout.

The world is still faced with widespread dissemination and many unanswered questions related to Coronavirus disease (COVID-19). Several candidate vaccines have been introduced against COVID-19, mostly requiring the injection of two doses and some with nearly 90-95% efficacy. All strategies against the spread of infection have focused on breaking the chain of virus transmission through protective public health measures and mass vaccination. The current situation emphasizes the global need for carefully designed policies to maximize vaccine access and uptake. The risk compensation theory (Peltzman Effect) states that the decrease in perceived risk through access to preventive measures may lead to increasing frequency of risky behaviors. The current pandemic has exposed people to the sense of risk compensation and behavior change in response to the perceived risk. Risk compensation phenomenon may significantly reverse the benefits of COVID-19 vaccination, especially if the vaccine is not sufficiently effective in real life or among high-risk populations. Recognition and awareness of Peltzman risk compensation are of high importance in counteracting and neutralizing the false complacency of the community, which also lends more weight to public health efforts. The public health messages and practices should be clearly expressed, straightforward, reliable and applicable. It is important to encourage mass vaccination of the population, and other NPIs must be re-established and implemented to ensure education to live with COVID-19 in parallel with daily activities and job tasks.

Pre-Exposure Prophylaxis (PrEP) for HIV Infection: Results of a Survey of HIV Healthcare Providers Evaluating Their Knowledge, Attitudes, and Prescribing Practices

Antiretroviral medications can be taken by HIV-negative persons to prevent HIV infection, also known as pre-exposure prophylaxis (PrEP). PrEP was first shown to be effective during the iPrEX study. We conducted a survey involving HIV healthcare providers to document their attitudes and prescribing practices about PrEP in response to this study. An online survey was completed by 189 members and credentialees of the American Academy of HIV Medicine between April 2011 and September 2011. Ninety percent of respondents were familiar with the results of the iPrEx study, and most (78%) were familiar with CDC's interim guidance regarding the use of PrEP in MSM. Only 19% of respondents had prescribed PrEP. The majority of PrEP prescribers were compliant with CDC interim guidance; however, only 61% screened for hepatitis B. Of PrEP prescribers, 78% prescribed to MSM, 31% to MSW, and 28% to WSM. Greatest concerns about prescribing PrEP included development of antiretroviral resistance (32%), potential increase in high-risk behavior, (22%) and poor medication adherence (21%). Fifty-eight percent stated that HIV serodiscordance within a relationship most influenced their decision to prescribe PrEP to the HIV-seronegative partner. This study demonstrates that, despite awareness of the efficacy of PrEP, its use is limited. Survey participants used PrEP most commonly in MSM; however, a significant percentage also prescribed PrEP to women. The best candidate for PrEP is felt to be individuals in an HIV-serodiscordant relationship. Limitations to our study included a low response rate, changes in the evidence base, and the novelty of PrEP.

The impact of highly active antiretroviral therapy on high-risk behaviour of HIV-infected patients in sub-Saharan Africa

High-risk sexual behaviors such as multiple sexual partners, inconsistent condom use, acquisition of sexually transmitted infection (STIs), and non-use of contraceptives persist in HIV patients undergoing care. We conducted a systematic review of studies conducted in the era of increased access to HAART (2000-2010) to assess whether wide-scale use of HAART was associated with high-risk behavior among HAART-using patients. We conducted a comprehensive search of databases (AIDSLINE, National Library of Medicine, MEDLINE, PubMed, CINHAL and EMBASE) from January 2002 to January 2010, reviewed conference proceedings and journals, and contacted the researchers involved. We analyzed the association of high-risk behaviors (non-disclosure of sero-status to sexual partners, inconsistent condom use, unprotected sexual intercourse, multiple sexual partners, non-use of contraceptives and acquisition of STIs) with using HAART. Information from eligible studies was abstracted using a standardized checklist. Fourteen English-language studies met the selection criteria of having high-risk behavior as an outcome in patients using HAART in sub-Saharan Africa. Of the 92 eligible articles screened, 14 met the criteria for inclusion as primary articles, 10 showed that HAART is not associated with increased high-risk behavior, two showed increase in acquisition of STIs among HAART-using patients, (which was inconsistent with other measures of high-risk behavior), and two studies showed short-term increase in high-risk behavior. Persistence of high-risk behavior in HAART-using patients suggests that more effort needs to be incorporated in HIV care to reduce such behavior to reduce HIV transmission to uninfected populations.

Neurological Correlates of High-Risk Behavior

Neurological impairment, traumatic brain injury, and childhood trauma and abuse are all associated with violent and high-risk behaviors among prison inmates. This case study examines the medical history of a notorious criminal--Alphonse Capone. Records suggest an association between Capone's declining neurological condition and an increase in high-risk behaviors. Prison, criminal, media, and medical records from the National Archives and other sources were studied to identify relationships to current research data describing neurological abnormalities of prison inmates. Healthcare providers can play a critical role in identifying at-risk youths, potentially reducing the incidence of high-risk behaviors associated with both crime and infectious disease transmission.

HIV Drug-resistant Strains as Epidemiologic Sentinels

Observed declines in drug resistance to nucleoside reverse transcriptase inhibitors among persons recently infected with HIV-1 in monitored subpopulations can be interpreted as a positive sign and lead public health officials to decrease efforts towards HIV prevention. By means of a mathematical model, we identified 3 processes that can account for the observed decline: increase in high-risk behavior, decrease in proportion of acutely infected persons whose conditions are treated, and change in treatment efficacy. These processes, singly or in combination, can lead to increases or decreases in disease and drug-resistance prevalence in the general population. We discuss the most appropriate public health response under each scenario and emphasize how further data collection and analyses are required to more reliably evaluate the observed time trends and the relative importance of forces shaping the epidemic. Our study highlights how drug resistance markers can be used as epidemiologic sentinels to devise public health solutions.

Impact of improved treatments on perceptions about HIV and safer sex among inner-city HIV-infected men and women.

Protease inhibitor combination therapies have significantly improved the health of many people with HIV/AIDS. Prior studies, consisting mainly of gay men, have indicated that these treatments have prompted reduced concern about HIV and an increase in high-risk behavior. This study assessed the impact of HIV treatment advances on HIV-infected individuals living in inner-city areas. A convenience sample was used (n = 196), consisting largely of heterosexual African-Americans and Hispanics. Almost the entire sample had heard of the latest HIV treatments, and 75% were currently on protease inhibitor regimens. One-third of the sample reported that AIDS was a less serious threat nowadays and that being HIV-positive was not a big deal. Fifteen percent of respondents believed that protease inhibitor combination therapies reduced the risk of HIV transmission, and 10% believed that these treatments reduced need for safer sex practices. As in previous studies of other populations, a significant percentage (23%) of respondents practiced safer sex less often since new HIV treatments arrived. HIV prevention programs need to focus more attention on HIV-infected individuals in inner city areas. Interventions for these individuals need to address changing attitudes and behaviors stemming from HIV treatment advances.

Seeking sex on the Internet and sexual risk behaviour among gay men using London gyms.

To examine the association between seeking sex on the Internet and sexual risk behaviour among gay men in London. In January-February 2000, gay men in London gyms were asked to complete self-administered questionnaires concerning use of the Internet, history of sexually transmitted diseases (STD) and recent unprotected anal intercourse (UAI). Internet sex seekers were compared with other men, also with Internet access, who did not seek sex in this way. Of 743 gay men included in the analysis (121 HIV-positive, 465 HIV-negative, 157 never-tested), 80.9% (601) had access to the Internet. Among those who had access, 34.4% (207) had used the Internet to find a sexual partner; this did not vary significantly by HIV status (P = 0.3). Internet sex seekers were more likely to have had an STD (HIV-negative men, 26.9 versus 17.5%, P = 0.04) or gonorrhoea (HIV-positive men, 22.2 versus 5.8%, P = 0.04) in the previous year than other men with Internet access. HIV-negative Internet sex seekers were also more likely to report non-concordant UAI in the previous 3 months [23.1 versus 11.8%; adjusted odds ratio (aOR), 1.9; 95% confidence interval (CI), 1.2--3.5; P = 0.01]. HIV-positive Internet sex seekers were more likely to report UAI with another positive man (37.8 versus 7.4%; aOR, 7.9; 95% CI, 1.8--34.6; P = 0.006). Seeking sex on the Internet was associated with recent STD and high-risk sexual behaviour among HIV-positive and -negative gay men in London. The contribution of seeking sex on the Internet to the recent increase in high-risk behaviour among London gay men merits further investigation.

Transected thoracic aorta: age-specific differences in incidence and possible reasons

The objective of this study was to determine the incidence of aortic transaction in relation to age, and to examine possible reasons for the observed differences. Data from the North Carolina Medical Database over a 7 year period were examined for the total number of motor vehicle accident victims and for the subset with aortic rupture, based on age at presentation. Data were then divided into 10-year intervals and the differences analyzed using chi-square analysis. Differences among various age groups were statistically significant ( P=0.0001). The highest rate was in the 21–30-year-old age group and average incidence for all ages was 0.7%. High incidence of aortic transaction in the 21–30-year-old group may be due to an increase in high-risk behaviors in such persons, to an improved survival compared with other age ranges, or to an inherent susceptibility of the aorta at this stage of life. These data have important implications for the diagnosis and treatment of aortic transaction and should be taken into account when developing practice guidelines for its management.