Biomedical subjects

Claire E Sterk

Publications and source records attributed to Claire E Sterk.

At least 19 recordsLinked to original sources

PubMed2007

Childhood neglect and adulthood involvement in HIV-related risk behaviors.

OBJECTIVE: Much research has been done to examine the long-term effects of being victimized by sexual, physical, and/or emotional abuse in childhood, but much less research has focused on the impact of childhood neglect experiences. This study examines the role that childhood neglect has on adult women's involvement in HIV-related risky behaviors. METHODS: The data come from a study of 250 "at risk" women living in the Atlanta, GA metropolitan area, most of whom were African American. Data were collected in face-to-face interviews between 1997 and 2000. Multiple regression was used to explore the relationship between childhood neglect experiences, self-esteem, attitudes toward condom use, and involvement in HIV-related risky behaviors. RESULTS: Overall, the model tested received strong support by the study data. Childhood neglect led to reduced self-esteem. Neglect was associated with worsened attitudes toward condom use and women who experienced childhood neglect also reported more involvement in HIV risk behaviors. CONCLUSIONS: HIV intervention programs ought to target women who have experienced childhood neglect, as neglect experiences have adverse impacts upon their self-esteem, condom-related attitudes, and HIV risk behavior practices in adulthood.

Adolescent↗

PubMed2007

Criminality among female drug users following an HIV risk-reduction intervention.

The main objectives of this article are to determine the prevalence of criminality among a sample of female African American drug users and to examine change in criminality over time, including the correlates associated with this change. Data were collected from 336 adult women who participated in an HIV risk-reduction intervention focused on the context of the women's daily life. Face-to-face structured interviews were conducted at baseline, prior to enrolling in the intervention, and at follow-up, 6 months after completion of the intervention. Bivariate and correlated multivariate methods were utilized to examine changes in criminality and other behaviors over time. Both violent and nonviolent criminality declined significantly between baseline and follow-up assessments. Of the correlates considered, drug-using characteristics and victimization played the greatest role in explaining the decrease in criminality. Low self-control and depressive symptoms also contributed to the reduction in criminality. The findings suggest the importance of considering individual characteristics that may influence the women's criminal behavior as well as the impact of their routine activities.

Adolescent↗

PubMed2006

Ecstasy and gateway drugs: initiating the use of ecstasy and other drugs.

PURPOSE: The main purposes of this study are to examine whether and to what extent ecstasy use serves as a gateway to the use of such hard drugs as cocaine, heroin, and methamphetamine and compare ages of onset of alcohol and marijuana use and subsequent use of cocaine, heroin, and methamphetamine among young adult ecstasy users. METHODS: Face-to-face surveys were conducted with 268 young adult ecstasy users in Atlanta, GA. Subjects were solicited by using the community identification process, including targeted sampling and guided recruitment. Data analysis involved discrete-time event-history analysis. RESULTS: Results suggest that age of onset of ecstasy use influences the initiation of cocaine and methamphetamine use for our sample of active ecstasy users. In addition, alcohol and marijuana use precedes the initiation of cocaine and methamphetamine use, but only marijuana use influences the initiation of heroin use. CONCLUSIONS: The sequential progression of drug use proposed in the gateway literature is not immutable. Researchers must take into account the changing popularity of drugs over time, such as the emergence of ecstasy use, when identifying patterns of drug-use onset.

Adolescent↗

PubMed2006

Sex, touch, and HIV risk among ecstasy users.

We examined HIV risk among heavy and nonheavy ecstasy users, focusing specifically on touch and sexual behavior as part of the ecstasy experience. Structured interviews were conducted with 268 young adult (age 18-25) ecstasy users in Atlanta, Georgia. Heavy ecstasy users were more likely to have been tested for HIV than nonheavy users (79 vs. 68%). However, they also were more likely to perceive no chance of contracting HIV (36 vs. 26%). Touch, both sensual and sexual, was a significant part of the ecstasy experience. In addition, ecstasy use seemed to increase the sexual desire, however, not the ability to achieve an orgasm. Heavy users reported more sexual risk-taking than their nonheavy using counterparts. Results suggest that the setting of ecstasy use also may influence involvement in risk behaviors. Future longitudinal studies are needed on the relationship between ecstasy use, touch, sexual arousal and ability, and risk behavior.

Adolescent↗

PubMed2006

The impact of emotional distress on HIV risk reduction among women.

This study evaluated whether 333 seronegative African American female drug users (aged 18-59 years) participating in an HIV intervention and with higher levels of emotional distress, specifically symptoms of depression and anxiety, reduced HIV risk behaviors to a lesser extent than those with lower levels of emotional distress. Participants were recruited between June 1998 and January 2001 from inner-city Atlanta (Georgia, U.S.) neighborhoods and were randomly assigned to one of two enhanced gender-specific and culturally specific HIV intervention conditions or to the NIDA standard condition. Participants were interviewed at baseline, post-intervention and at 6-month follow-up with a structured questionnaire including information on sociodemographics, sexual and drug-using behavior, and psychosocial characteristics. Despite a significant decline in symptoms of emotional distress during the study period, the women in this sample reported high levels of depressive and anxiety symptoms at baseline and 6-month follow-up. Higher levels of emotional distress were positively associated with post-intervention sexual and drug-taking risk. Women in both enhanced intervention conditions reduced their sexual and drug-taking risks more than women in the standard intervention. Those in the motivation intervention arm experienced a greater reduction in depressive symptoms, accompanied by a greater reduction in sexual risk behavior. Findings suggest the need for effective interventions and mental health resources among subgroups of high-risk women who may be most resistant to behavioral change.

Adolescent↗

PubMed2006

Predictors of suicidal ideation among "at risk" cocaine-using African American women.

The focus of this study was to identify factors that differentiate women drug abusers who had experienced suicidal ideation from those who did not. Face-to-face interviews were conducted with 221 cocaine-using women in Atlanta, GA, 88 (39.8%) of whom reported thinking about committing suicide at least once during the 90 days prior to interview and 133 (60.2%) of whom did not. Multivariate logistic regression was used to identify predictors of suicidal ideation, and post hoc goodness-of-fit tests were conducted to assess the robustness of final models derived. Model 1 excluded all psychosocial functioning measures and Model 2 included these items. Both models showed that suicidal ideation was more common among women who were unemployed, had been abused sexually, engaged in sexual relations to cope with stresses, or had less helpful relatives. In addition, Model 1 revealed a heightened risk for women experiencing financial problems and those who had a previous mental health diagnosis, whereas Model 2 showed an elevated risk among women who experienced anxiety and those who had lower levels of self-esteem. These findings suggest the need for prevention and intervention programs that target at-risk women, and for such programs to include an emphasis on suicidal ideation in addition to focusing on risk factors that are addressed more commonly.

Black or African American↗

PubMed2005

The limits of social capital: Durkheim, suicide, and social cohesion.

Recent applications of social capital theories to population health often draw on classic sociological theories for validation of the protective features of social cohesion and social integration. Durkheim's work on suicide has been cited as evidence that modern life disrupts social cohesion and results in a greater risk of morbidity and mortality-including self-destructive behaviors and suicide. We argue that a close reading of Durkheim's evidence supports the opposite conclusion and that the incidence of self-destructive behaviors such as suicide is often greatest among those with high levels of social integration. A reexamination of Durkheim's data on female suicide and suicide in the military suggests that we should be skeptical about recent studies connecting improved population health to social capital.

Female↗

PubMed2005

African American female drug users and HIV risk reduction challenges with criminal involvement.

The main objectives of this paper are to examine the prevalence of criminal involvement among a sample of African American female drug users and to identify factors associated with that criminal involvement, where criminal involvement is defined as having been in jail or prison. Data were collected in Atlanta from 333 adult women at two points in time, namely during baseline assessments conducted prior to their enrollment in an HIV risk reduction intervention and at follow-up assessments conducted 6 months after completion of the intervention. The prevalence and period prevalence of criminal involvement were relatively high. At baseline, 86.8% of the women indicated criminal involvement at some point in their lives and over one-third (37.2%) were involved in the year prior to enrolling into the study. During follow-up interviews, 31.5% reported criminal involvement during the 6 months since enrollment. The findings revealed that victimization/abuse and drug use setting might be salient risk factors for criminal involvement. The unique needs of women such as those in this sample must be taken into account when designing intervention and prevention programs, both within and outside the criminal justice system.

Adolescent↗

PubMed2004

Partner communication and HIV risk behaviors among "at risk" women.

OBJECTIVES: This research focused on communication with one's sexual and dating partners, and addressed two main research questions: First, what is the relationship between partner communication and involvement in HIV risk behaviors? Second, which factors predict women's level of partner communication about key issues salient in their lives? METHODS: Cross-sectional interviews were conducted with 250 adult women living in the Atlanta, Georgia metropolitan area between August 1997 and August 2000. Street outreach was used to identify potential study participants, with further expansion of the sample done via targeted sampling and ethnographic mapping procedures. Path analysis was used to examine the relationships between partner communication and HIV risk taking, and to identify predictors for the extent of women's partner communication. RESULTS: The data revealed an inverse relationship between partner communication and involvement in HIV risk taking. Eight statistically significant predictors of partner communication were identified: age, marital status, length of longest marital-type relationship, level of happiness in longest relationship, knowing anyone who had died from AIDS, number of financial problems experienced, having a sexually transmitted disease during the previous year, and self-esteem level. CONCLUSIONS: Partner communication is an important variable to consider when understanding "at risk" women's HIV risk behavior practices. Finding ways to enhance women's communication with their sexual and dating partners appears to be one promising way of reducing their level of HIV risk.

Adolescent↗

PubMed2004

Drug problems and "at risk" women's involvement in HIV risk behaviors.

OBJECTIVES: This paper focuses on two research questions: is there a relationship between women's number of drug problems and the extent to which they engage in HIV risk behaviors? What factors influence the extent to which women experience drug-related problems? METHODS: This study is based on 250 adult "at risk" women (predominantly African American) in the Atlanta, Georgia metropolitan area. Street outreach efforts, targeted sampling, and ethnographic mapping procedures were used to identify potential study participants. RESULTS: The more drug problems women experienced, the greater their involvement in HIV risk behaviors was. The number of drug problems experienced was a significant contributor to the model predicting women's HIV risk involvement, along with religiosity, living with substance abusers, and age of first drug use. Depression, optimism, coping with stress, and number of different drugs used predicted the extent to which women experienced drug problems. CONCLUSIONS: Drug problems are an important predictor of women's involvement in HIV risk behaviors. Programs wishing to reduce their risk for contracting HIV should target drug-involved women and help them to stop using drugs.

Adolescent↗

PubMed2004

Past and new victimization among African American female drug users who participated in an HIV risk-reduction intervention.

This study examined to what extent a women- and culturally-specific sexual risk reduction intervention resulted in a decline of new victimization intervention. Additionally, we sought to identify factors associated with new victimization, defined as victimization during the 6 months after enrollment in the study. Female African American drug users (N = 333, ages 18-59 years) completed questionnaires. Past victimization was a major predictor of new victimization. The likelihood of new victimization, however, declined significantly when compared to past victimization. Factors associated with victimization included enhanced intervention assignment, frequency of drug use, lifestyle factors such as criminal behavior, drug use in a public setting, and living in an unstable situation. Results indicate the need to incorporate strategies to reduce victimization in HIV/AIDS and other health-related prevention and intervention programs.

Adult↗

PubMed2004

Lung cancer, chronic disease epidemiology, and medicine, 1948-1964.

Beginning in the early 1950s, a series of epidemiological, biochemical, pathological, and animal studies demonstrated a link between cigarette smoking and lung cancer. A number of reputable scientists challenged these findings, but for a variety of reasons, including the behavior of the tobacco industry, historians have assumed that these objections were insubstantial and disingenuous. Viewing these objections in scientific and medical perspective, however, suggests that there was a legitimate and reasonable scientific controversy over cigarette smoking and lung cancer in the 1950s and early 1960s. That controversy had important consequences. A new chronic disease epidemiology emerged, transforming the role and importance of epidemiology to medical research. This new epidemiology supplemented Koch's postulates, establishing a statistical method that allowed for linking environmental factors to the etiology of chronic diseases. The 1964 report to the surgeon general, Smoking and Health, represented the denouement and codification of these developments. This reexamination of the scientific controversy over smoking in the 1950s and early 1960s provides an important context for understanding the subsequent public relations battles between the tobacco industry and public health after 1964.

Causality↗

PubMed2004

Self-esteem and "at risk" women:determinants and relevance to sexual and HIV-related risk behaviors.

In this study, we describe the relationship between self-esteem and HIV-related risk behaviors, and explore what factors predict self-esteem levels of "at risk" women. Interviews were conducted with 250 (predominantly African American) women living in the Atlanta, Georgia metropolitan area between August 1997 and August 2000. A community identification process was used to identify potential study participants, with further expansion of the sample via targeted and theoretical sampling and ethnographic mapping procedures. Self-esteem was related to the number of times having oral sex, the number of times having sex with paying partners, the frequency of sexual risk-taking (all during the 90 days prior to interview), the number of different HIV risk behaviors practiced during the previous year, and condom use attitudes and self-efficacy. Greater involvement HIV risk behaviors was associated with lower self-esteem. Multivariate analyses revealed five significant predictors of women's self-esteem levels: race, religiosity, childhood experiences with emotional neglect, the number of money-related problems experienced, and the number of drug-related problems experienced. The findings indicate that self-esteem is highly relevant to "at risk" women's HIV risk behavior practices, and this has important implications for HIV intervention programs.

Adolescent↗

PubMed2003

Late-onset crack users: an emergent HIV risk group.

This article explores late-onset crack use among midlife and older adults as an emerging risk factor for HIV infection. Most research on illicit drug use and HIV infection/AIDS has focused on younger drug users, typically those who inject. The initiation into crack use during later adulthood challenges this narrow view. The analysis the authors present was drawn from qualitative and quantitative data collected as part of their ongoing research on illicit drug use. The subsample consisted of 27 men who began using crack at the age of 50 or older and 40 women who started using crack at the age of 35 or older. The findings suggest a typology of late-onset users with differing forms of HIV risk and prevention needs. The authors end the article with recommendations for effective HIV risk reduction programs for late-onset crack users.

Acquired Immunodeficiency Syndrome↗

PubMed2003

Who's getting the message? Intervention response rates among women who inject drugs and/or smoke crack cocaine.

BACKGROUND: Injection drug users (IDUs) who also smoke crack may be at greatest risk for infection with HIV as well as other blood-borne and sexually transmitted infections and in most need of positive behavioral changes. METHODS: Three hundred and thirty-three women (aged 18-59 years) were randomly assigned to one of two enhanced gender- and culturally specific HIV intervention conditions or to the NIDA standard condition. Of primary interest in this study were baseline risk and intervention response rates among three groups of drug users--IDUs who did not smoke crack, IDUs who did smoke crack, and crack smokers who did not inject. Univariate and multivariate methods were utilized, including generalized estimating equations. RESULTS: The intervention produced positive behavioral changes over time, but response rates varied according to drug using group. Overall, women falling into the crack smoking IDU category appeared to be less responsive to the intervention than those in the other drug using groups, and participants in the crack smoking only group were less responsive than those in the IDU only group. CONCLUSIONS: Results presented here indicate the continuing need to develop and target effective interventions to particular subgroups of high-risk individuals who may be most resistant to change.

Acquired Immunodeficiency Syndrome↗

PubMed2003

HIV risk reduction among African-American women who inject drugs: a randomized controlled trial.

A community-based HIV intervention for African-American women who are active injection drug users (IDUs) was evaluated. Seventy-one women (aged 20-54 years) were randomly assigned to one of two enhanced gender- and culturally specific intervention conditions or to the NIDA standard condition. Substantial decreases (p<.001) were found in the frequency of drug use and the frequency of drug injection as well as in the sharing of injection works or water and the number of injections. Trading sex for drugs or money, having sex while high, as well as other sexual risk behaviors were also reduced significantly. Furthermore, women in both enhanced intervention conditions were more likely to reduce their drug-using and sexual risk behaviors than were women in the standard condition. Results indicate the value of including additional components in interventions designed to reduce the risk of infection with HIV among women who inject drugs.

Acquired Immunodeficiency Syndrome↗

PubMed2003

Perceived condom use self-efficacy among at-risk women.

The objectives of this study are to assess the confidence in their ability to use condoms among at-risk women and identify predictors for the women's condom use self-efficacy. Structured interviews were conducted with 250 adult women in Atlanta, Georgia, between August 1997 and August 2000. Overall, the women reported feeling moderately to moderately-strongly confident in their ability to use condoms consistently. Multivariate analysis showed women with higher condom use self-efficacy were significantly younger, experienced childhood neglect, had higher self-esteem, communicated better with their sex partner, and had fewer drug problems. Findings suggest the importance of addressing condom use self-efficacy in HIV risk reduction programs with a specific focus on women and the need to be attuned to tailored needs for specific subgroups such as older women or women who encountered childhood neglect.

Adult↗

PubMed2003

"At risk" women who think that they have no chance of getting HIV: self-assessed perceived risks.

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.

Attitude to Health↗