Rates Of Risky Behaviors Research Articles

An approach to comparison of threatening behavior parameters between social groups based upon incomplete and imprecise date

The paper proposes a way to estimate risky behavior rates ratio in two groups. These groups can be either the same group but considered a priori and a posteriori a behavioral intervention, or two groups/two samples from different populations to be compared simultaneously. A similar estimation is proposed to cumulative risk ratio (odds ratio). The risky behavior rate can be estimated either with data about several last episodes of the behavior or with the data on extreme intervals between the episodes during a certain period of time. For these two estimations may be different; a measure of their consistency is introduced.

Health status of women with intended and unintended pregnancies

Unintended pregnancy may have negative impacts on maternal health. However, no comprehensive studies have been undertaken on the health of women with intended and unintended pregnancies. This study aimed to compare the health status of women with intended and unintended pregnancies in Iran. Comparative study. Two hundred women were included in this study: of these, 100 had intended pregnancies and 100 had unintended pregnancies. The participants were recruited using a multi-stage sampling method from the health centres of Kerman, Iran in 2010. The tools for data collection included: a questionnaire to assess demographic characteristics and fertility history; the Short Form-36 (SF-36) questionnaire to assess general physical and mental health status; and a questionnaire to assess pregnancy-related health status. Validity and reliability of the questionnaires were assessed before use. In comparison with women with intended pregnancies, women with unintended pregnancies had lower scores for physical and mental health status; less prenatal care; lower scores for self-care behaviours such as use of supplements, vaccination and nutrition; lower scores for personal health; and higher rates of risky behaviours such as smoking, drinking alcohol and drug abuse during pregnancy (P<0.05). Unintended pregnancy is a threat to the physical and mental health of women. As unintended pregnancy is associated with lower self-care behaviours and higher rates of risky behaviours during pregnancy, special care and counselling are recommended.

HIV rapid testing in drug treatment: comparison across treatment modalities

Despite high rates of risky behavior among patients, many drug abuse treatment programs do not provide on-site HIV testing. This secondary analysis examined differences in outcome by program modality from a multi-site trial in which 1281 HIV-negative patients in three methadone programs, seven non-methadone outpatient programs, and three residential programs were randomly assigned to: (1) off-site referral for HIV risk reduction counseling and testing; or on-site rapid testing (2) with or (3) without risk reduction counseling. The parent study using generalized estimating equations with site as a cluster variable found significantly higher rates of HIV testing and feedback of results by 1month post-enrollment for the combined on-site conditions compared to the offsite condition [RR=4.52, 97.5% CI (3.57, 5.72)]. Utilizing the same statistical approach, we found neither significant treatment modality nor significant treatment modality by testing condition interaction effects either for receipt of HIV test results at 1month or for sexual or drug use HIV-risk behaviors at 6-month follow-up. On-site HIV testing is effective across treatment modalities for achieving high rates of testing and results feedback. All programs should be encouraged to adopt or expand this service.

Country-level correlations between school experience and health behaviour: the Health Behaviour in School-aged Children survey 2005-6

Aims The World Health Organisation has said that liking school is a protective factor against sexual risk taking and substance use. In the Health Behaviour in School-aged Children survey (HBSC) 2005-6, English children reported high rates of risky behaviour, despite a high percentage liking school. We investigated the correlation at country level between 3 measures of school experience and 4 measures of health behaviour. Methods The HBSC study (2005-6) surveyed 204534 children aged 11, 13, and 15 from 41 countries. We accessed the country-level HBSC data from the WHO-Europe website. For each age group, we calculated Pearson9s r for correlations between 3 measures of school experience (liking school a lot, feeling pressured by schoolwork and classmates being kind and helpful) and 4 measures of risk behaviour (smoking, having been drunk at least twice (all ages), having tried cannabis and condom use (15 year olds only)). Results Age 11: Classmates being kind and friendly correlated with lower rates of having been drunk twice (Male: r=.35, p=.03; Female: r=.33, p=.04) and, for males, with significantly lower rates of smoking (M: r=.43, p Age 13: Females liking school correlated with lower rates of having been drunk twice (r=.314, p=.048)). Classmates being kind and helpful correlated with lower rates of drunkenness (M: r=.475, p Age 15: Males liking school correlated with lower rates of having tried cannabis (r=.326, p=.04), and male reporting of friendly classmates correlated with lower rates of smoking (r=.408, p No other significant correlations were found. Conclusions The strongest correlate of healthy behaviour was having friendly and helpful classmates, which was linked to some measures of reduced smoking/alcohol use at all ages. Liking school was not a consistent correlate of healthy behaviour at country level.

Sexual risk behaviour in young people with first episode psychosis

Previous studies have consistently reported high rates of risky behaviour for sexually transmitted infections (STIs) amongst individuals with persistent psychosis. Whether such behaviours are evident from the first presentation or relate to a chronic illness course remains largely undetermined, with limited research conducted amongst young people with first episode psychosis. The aim of the current study was to compare engagement in sexual risk behaviour amongst young people with first episode psychosis with their peers. Sixty-seven sexually active young people with first episode psychosis and 48 healthy control participants (aged 18-29 years) closely matched on sociodemographic characteristics completed a detailed questionnaire assessing a comprehensive range of sexual risk behaviours. There were few differences in the rates of sexual risk behaviour reported by the first episode sample and their peers. Compared with control participants, young people with first episode psychosis reported significantly more inconsistent condom use, less condom-related preparatory behaviour, more concern about HIV/STIs when sex was unprotected, less confidence discussing condom use and increased substance use by their last sexual partner. The sexual behaviour of young people with first episode psychosis appears similar to their peers. However, group differences, particularly increased frequency of unprotected sex amongst the first episode sample, suggest that those with psychosis are at increased STI risk and have distinct needs. The findings support the call for early intervention strategies that target reduction of sexual risk behaviour in the context of persistent mental illness.

Men who have sex with men and women in Bangalore, South India, and potential impact on the HIV epidemic

The aim of this study was to quantify differences in patterns of sexual behaviour among men who have sex with men and women (MSMW) compared with men who have sex with men only (MSMO), and to examine the extent to which bisexual behaviour may act as a bridge for introducing HIV infection into the general population. A cross-sectional survey in Bangalore city in 2006, which sampled men seeking sex with men in public places and hammams (bath houses where transgender individuals sell sex to men). Among a sample of 357 men reporting same-sex behaviour; 41% also reported sex with a woman in the past year and 14% were currently married to a woman, only two of whom had informed their wives about having sex with men. Condom use was very inconsistent with all male partners, while 98% reported unprotected vaginal sex with their wives. MSMW reported lower rates of risky behaviour with other men than MSMO: fewer reported selling sex (17% vs 58%), or receptive anal sex with known (28% vs 70%) or unknown (30% vs 59%) non-commercial partners. Bisexual behaviour was common among men seeking sex with men sampled in this survey. Although MSMW reported lower rates of risky sexual behaviour with male partners than MSMO, inconsistent condom use with both male and female partners indicates a potential means of HIV transmission into the general population. HIV prevention programmes and services should reach bisexual men who potentially expose their male and female partners to HIV.

Study on factors in frequency and degree of risky behaviors in adolescents

Objective To explore the factors in frequency and degree of risk behavior in adolescents,as well find the way to cope with adolescent mental health. Methods 1369 middle students and college students were measured by Risky Behavior Questionnaire for Adolescents (RBQ-A) ,and analyzed the data. Results (1) There were statistically significant among the different age in difference of risky behaviors except aggressive and/or violent behaviors. Males scored higher than females in unsafe sexual practices, aggressive and/or violent behaviors, dangerous,destructive,and/or illegal behaviors,alcohol and/or drug use and smoking(P<0.05 orP<0.01). Students in city scored higher than rural students in dangerous,destructive,and/or illegal behaviors and alcohol and/or drug use(P<0.05 or P< 0.01). Families with high income scored higher than low income in unsafe sexual practices and rule breaking(P< 0.05 or P< 0.01). Families with low income scored higher than high income residences in dangerous,destructive,and/or illegal behaviors and alcohol and/or drug use(P < 0.05 or P < 0.01). (2) The significant differences were existed in unsafe sexual practices,aggressive and/or violent behaviors,dangerous, destructive,and/or illegal behaviors,alcohol and/or drug use and smoking between males and females (P<0.05 or P<0.01).The significant differences were existed in dangerous,destructive,and/or illegal behaviors and alcohol and/or drug use between groups of 16 years old and 14 ～ 15 years old (P < 0. 05 or P < 0. 01). The significant differences were existed in dangerous,destructive,and/or illegal behaviors between urban and rural students (P< 0.05 orP<0.01).The significant differences were existed in total scores in gender and urban and rural(P<0.05 or P<0.01). Conclusion The significant differences are existed in rate of risky behaviors in gender,age,urban and rural. But there is different degree existed in it. Key words: Risky behaviors; Adolescent; Psychological measurement

Reduction in risk-taking behaviors among MSM in Senegal between 2004 and 2007 and prevalence of HIV and other STIs. ELIHoS Project, ANRS 12139

An epidemiological survey conducted in Senegal in 2004 among men having sex with men (MSM) revealed high HIV prevalence and a high rate of risky behaviors within this population. Consequently, several prevention campaigns targeting MSM were implemented. A second survey was carried out in 2007 to assess the impact of these measures. This paper aims to examine trends in HIV and STI prevalence and in sexual behaviors between 2004 and 2007. The two surveys were conducted in four urban sites among 440 and 501 MSM – recruited using the snowball sampling method – in 2004 and 2007, respectively. A similar methodology was applied for both surveys. This consisted of a closed-ended questionnaire concerning socio-demographic, behavioral, and biomedical information plus a clinical examination including urine and blood tests to detect STIs and HIV infection. Between 2004 and 2007, the frequency of different sexual practices reported by MSM remained stable, but condom use for each type of sexual practice rose. The percentage of men who reported consistent condom use during previous-month anal sex has increased by about 35% (p<0.01). The percentage of men who reported consistent condom use during previous-month non-commercial sex with women has increased by 14% (p<0.01). HIV prevalence remained stable from 22.4% [95% CI: 18.6–26.8] in 2004 to 21.8% [95% CI: 18.3–25.7] in 2007 (adjusted OR = 1.05, p=0.8). Gonorrhea prevalence decreased from 5.5% [95% CI: 3.6–8.3] in 2004 to 2.6% [95% CI: 1.5–4.5] in 2007 (adjusted OR=0.5, p=0.07). The prevention campaigns, STI and HIV care and support programs conducted in Senegal among MSM have been followed by a reduction of risk-taking behaviors and STI prevalence among this population. Specific targeting of this group within HIV/STI prevention programs seems to be effective in decreasing sexual infections.

A randomized trial of computer-based reminders and audit and feedback to improve HIV screening in a primary care setting

Despite recommendations for voluntary HIV screening, few medical centres have implemented screening programmes. The objective of the study was to determine whether an intervention with computer-based reminders and feedback would increase screening for HIV in a Department of Veterans Affairs (VA) health-care system. The design of the study was a randomized controlled trial at five primary care clinics at the VA Palo Alto Health Care System. All primary care providers were eligible to participate in the study. The study intervention was computer-based reminders to either assess HIV risk behaviours or to offer HIV testing; feedback on adherence to reminders was provided. The main outcome measure was the difference in HIV testing rates between intervention and control group providers. The control group providers tested 1.0% (n = 67) and 1.4% (n = 106) of patients in the preintervention and intervention period, respectively; intervention providers tested 1.8% (n = 98) and 1.9% (n = 114), respectively (P = 0.75). In our random sample of 753 untested patients, 204 (27%) had documented risk behaviours. Providers were more likely to adhere to reminders to test rather than with reminders to perform risk assessment (11% versus 5%, P < 0.01). Sixty-one percent of providers felt that lack of time prevented risk assessment. In conclusion, in primary care clinics in our setting, HIV testing rates were low. Providers were unaware of the high rates of risky behaviour in their patient population and perceived important barriers to testing. Low-intensity clinical reminders and feedback did not increase rates of screening.

Youth Living With HIV and Partner-Specific Risk for the Secondary Transmission of HIV

Secondary transmission remains a significant concern among HIV-infected youth. Little is known, however, about how partner-specific sexual risk behaviors for the secondary transmission of HIV may differ between the 2 largest subgroups of HIV-positive youth, women-who-have-sex-with-men (WSM) and men-who-have-sex-with-men (MSM), METHODS: During 2003-2004, a convenience sample of HIV-infected youth, 13 to 24 years of age, were recruited from 15 Adolescent Medicine Trials Network clinical sites. Approximately 10 to 15 youth were recruited at each site. Participants completed an ACASI survey including questions about sex partners in the past year. Cross-sectional data analyses, including bivariate and multivariable regressions, using generalized estimating equations, were conducted during 2008 to compare recent partner-specific sexual risk behaviors between WSM and MSM. Of 409 participants, 91% (371) were included in this analysis, including 176 WSM and 195 MSM. Ninety-two percent (163 WSM, 177 MSM) provided information on characteristics of their sexual partners. There were significant differences between the 2 groups in recent partner-specific sexual risk behaviors including: lower rates of condom use at last sex among WSM (61% WSM vs. 78% MSM; P = 0.0011); a larger proportion of the sex partners of MSM reported as concurrent (56% MSM vs. 36% WSM; P = 0.0001); and greater use of hard drugs at last sex by MSM and/or their partner (18% MSM vs. 4% WSM; P = 0.0008). When measuring risk as a composite measure of sexual risk behaviors known to be associated with HIV transmission, both groups had high rates of risky behaviors, 74.7% among young MSM compared to 68.1% of WSM. These data suggest that recent partner-specific sexual risk behaviors for HIV transmission are high among young infected MSM and WSM. These findings suggest the need to offer interventions to reduce the secondary transmission of HIV to all HIV-positive youth in care. However, differences in risk behaviors between young MSM and WSM supports population-specific interventions.

Sex-Related Differences in Neural Activity during Risk Taking: An fMRI Study

This study explored sex effects on the process of risk-taking. We observed that the female participants (n = 10) showed stronger activation in the right insula and bilateral orbitofrontal cortex (OFC) than did the male participants (n = 12) while they were performing in the Risky-Gains task. The female participants also showed stronger activations in the precentral, postcentral, and paracentral regions after receiving punishment feedback. In addition, the strength of neural activity in the insula correlated with the rate of risky behaviors for the female participants but not for the male participants. Similarly, the percent signal changes in the right OFC correlated negatively with the rate of selecting risky choices for the female group. These findings strongly suggest a sex-related influence modulating brain activity during risk-taking tasks. When taking the same level of risk, relative to men, women tend to engage in more neural processing involving the insula and the OFC to update and valuate possible uncertainty associated with risk-taking decision making. These results are consistent with the value-based decision-making model and offer insights into the possible neural mechanisms underlying the different risk-taking attitudes of men and women.

Detained Adolescents' Attitudes about Pregnancy and Parenthood

Introduction The purpose of this study was to examine attitudes and behaviors associated with parenthood and pregnancy among adolescents in the juvenile justice system. Method A cross-sectional survey of attitudes and behaviors about parenthood was conducted with 300 adolescents residing in three juvenile detention centers. Results Data revealed high rates of risky behaviors that resulted in parenthood/pregnancy and generally positive attitudes about being an adolescent parent. Positive attitudes about parenthood ( P = .000) and lower self-efficacy to not have sex ( P = .021) were significantly correlated with having been pregnant or having fathered a child. Logistic regression showed positive attitudes about parenthood and the combination of drinking and driving together were significant predictors of pregnancy ( P ≤ .05). Discussion Pediatric nurse practitioners working with adolescents in the juvenile justice system who routinely provide prevention counseling and implement health promotion programs must take into account the reality that many adolescents in this population are or will become parents and do not consider pregnancy as an outcome to be necessarily avoided. Moving beyond primary and secondary prevention strategies to implement programs to prevent second pregnancies and enhance parenting skills will provide needed health benefits to these adolescent parents.

Gesundheits- und Risikoverhalten unter Arbeitsuchenden: Ein Screening am Arbeitsamt

The purpose of this study was to investigate the distribution of health behaviours and health-risk behaviours among three groups of job-seeking persons at employment agencies: short-term unemployed, long-term unemployed, and non-unemployed (e.g., threatened by job loss) persons. A related aim was to identify the general willingness of persons recruited at employment agencies to participate in a study regarding health behaviours. At the employment agency Greifswald (Western Pomerania, Germany), over a period of two weeks, all job-seeking persons while waiting were personally asked to participate in a screening regarding health behaviours. A total of 1672 persons (M=34 years, 54% women), that is 74.3% of all job-seekers, participated in the screening. Regarding physical activity, fruit and vegetable intake, smoking, at-risk drinking, drug use and overweight, all three groups showed a lack of health behaviour and increased risky behaviour compared to the general population or nation-wide guidelines. ANOVAs, chi (2) tests and logistic regressions showed significant differences among the three groups. Non-unemployed persons were more likely to report a healthier life style compared to both unemployed groups. Long-term unemployed persons had a higher risk of smoking (OR=1.56; CI 95%=1.14-2.12) and of using drugs (OR=2.79; CI 95%=1.30-5.98) compared to short-term unemployed persons. The high participation rate, along with the high rates of risky behaviour and lack of health behaviour indicate the demand for intervention programs for job-seekers and the opportunity of using this setting for proactive interventions that could reach more than 70% of all job-seekers.

Risky behavior regarding drug use and HIV infection: an Internet questionnaire coupled with short education texts for Portuguese speakers

Surveys of risky behavior relating to HIV/AIDS are generally made for groups at risk of infection, for which HIV/AIDS prevalence is usually expected to be higher than in the general population. Therefore, an educational homepage in Portuguese was created on the Internet to inform/ask internauts regarding knowledge and behavior. The internauts were classified as adolescents (13 to 25 years) and adults (>25 years). The number of STDs was reported as 1. 8 +/- 2. 6 infections (range: 1 to 20 infections); 43% used condoms during sexual intercourse. Alcohol consumption was reported by 63% and illicit drug use by 32% (marijuana 24% and inhalants 15%). Among the adolescents, 31% did not classified alcohol as a drug. The adults more frequently reported homosexuality, anal intercourse and STDs, although the adolescents also presented high rates of risky behavior. These results show the need to reach out to internauts through better control strategies. Different types of strategies must be encouraged, in order to reach people that use this means of communication and entertainment.

Health Interventions With Girls in the Juvenile Justice System

Girls today make up 25% of youth in the juvenile justice system (JJS). To address the interrelated sexual and dating violence risk behaviors of this population, we compared the relative impact of a 6-hour, peer-led group intervention, Girl Talk-2, whose goal was to decrease sexual and dating violence risk behaviors, with the impact of a comparison group in which the same information was presented in a standard lecture and video format. A cyclic cohort study with alternating intervention and comparison programs were implemented with 539 girls at 6 sites of a county JJS. Data were collected on relevant knowledge, attitudes and practices pre-intervention, immediately postintervention, and 6 months postintervention. Although all participants had high rates of risky behaviors, knowledge and attitudes about sexual protective behaviors were worse as girls' level of involvement in the JJS increased. At 6 month follow-up, the Girl Talk-2 intervention group had significantly higher use of condoms and communication skills to defuse potentially violent situations than girls in the comparison group. Both groups had improvement in knowledge and attitudes over time, and the intervention group reported higher use of newly acquired communication skills. The Girl Talk-2 intervention showed significant changes in 2 out of 3 key protective behaviors for participants when compared with a comparison group. Effective behavioral interventions are essential to assist girls in the JJS safeguard their future health.

Family context and HIV risk among youth in psychiatric care: what pediatricians can do

The HIV/AIDS epidemic is one of the most widespread public health problems today. Teens with mental health concerns are particularly vulnerable to infection because they engage in higher rates of risky behaviors than their peers. Families are vital influences in protecting teens from HIV exposure, but parents often feel unprepared to discuss sexual behavior with teens. This review provides an overview of the role of teens' mental illness in HIV risk and suggests guidelines for pediatricians to facilitate parents' ability to keep teens safe from risky behaviors. Young people account for more than 50% of new infections each year, and mental health problems are related to increased risk taking via inconsistent condom use, multiple partners, and decreased assertiveness. Parents can protect youth from engaging in HIV risk behaviors through supervision, providing support, and communicating effectively about sexual topics. Pediatricians can support parents in keeping youth safe from HIV infection by openly discussing ways to reduce teens' risk of exposure. Talking to families about risks, empowering parents to address issues with teens, and providing referrals for parents to build a network of support can reduce mental health problems and HIV risk among teens.

The impact of community risks and resources on adolescent risky behavior and health care expenditures

Purpose To examine a nested model that predicts adolescent risky behavior, health care use, and health care expenditures from individual characteristics, such as age and gender, and community characteristics such as social capital and community-level risky behavior rates. Methods Claims and encounter data were used to classify adolescents enrolled in Florida’s Healthy Kids Program into two groups: those who engaged in risky behavior (ARB) and those who did not (NRB). Hierarchical linear modeling techniques were used to predict the odds of risky behavior, the odds of health care use, and health care expenditures based on individual and community characteristics. Results ARB consumed significantly more health care services than NRB, and their higher use and charges were attributable not only to individual level factors (i.e., age, gender, presence of special health care need, metropolitan residence status), but also to community level factors (i.e., social capital, risky behavior rates, violence, and ethnic/racial composition) as well. In particular, community investment in social capital predicted lower levels of risky behavior as well as lower health care expenditures. Conclusions This information is important in terms of policy efforts at providing health care for this vulnerable group of individuals, as well as in developing prevention and intervention programs that can be delivered through the health care system and via links to community supports.

“At Risk” Women Who Think That They Have No Chance of Getting HIV: Self-Assessed Perceived Risks

ABSTRACT During the past two decades, a fair amount of inconclusive research has been conducted to examine the relationship between perceived risk of contracting HIV and actual HIV risk behavior practices. The present study examines HIV risk perceptions among a sample of 250 urban, economically-disadvantaged, primarily minority women. In particular, we focus on differences between those saying that they have no chance whatsoever of contracting HIV and those who indicated at least some possibility of becoming HIV-infected. Three research questions are addressed: (1) Are there differences between these groups attributable to their risk behavior practices? (2) To what extent do women who think that they are not at risk for HIV engage in risky behaviors that could expose them to HIV? (3) What are the most salient predictors of the women's perceived risk classification? Results showed that women perceiving themselves to have at least some HIV risk engaged in higher rates of risky behaviors than their counterparts who perceived themselves to have no possibility of contracting HIV. Despite this finding, more than one-half of the “no perceived risk of HIV” sample had engaged in at least one risky practice during the preceding year and more than one-quarter had engaged in at least two such behaviors. Age, childhood maltreatment experiences, self-esteem, number of HIV risk behaviors practiced, amount of illegal drug use reported, and number of times having sex were significant predictors of women's perception of having some HIV risk versus having no HIV risk.

Do clinical preventive services make a difference in adolescent behavior?

Conclusions: Overall results suggest that intervention adolescents report lower rates of risky behaviors compared to those in the baseline sample. While further evaluation of the efficacy of clinical preventive services is necessary initial longitudinal results show promise that screening and counseling for risky health behaviors may favorably influence adolescent behavior. (excerpt)

College Health Needs to Participate in the National STD Debate

We have a window of opportunity in which events are coming together, and we in ACHA can make a significant impact on STDs/STIs. College health professionals can choose to become actively involved or we can be bystanders. Our population, our tradition, and our moral imperatives all urge us to become engaged at all levels. We work with one of the most highly educated of all groups--a group that also shows some of the highest rates of risky behaviour--and we should be able to demonstrate the highest levels of successful intervention.