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PubMed1990

Psychological and behavioral impact among intravenous drug users of learning HIV test results.

In 1984 as part of a New York City study to examine the prevalence of HIV infection in a substance-abusing population and to test the validity of HIV screening kits, 94 patients at the New York VAMC were tested. Results were made available to 50 (35 seronegative, 15 seropositive) patients in January 1986. Psychological and behavioral impact of learning test results was assessed using standardized psychiatric rating scales. A comparison group of 31 nontested subjects were also evaluated. Ratings were done preresults, approximately 1-2 weeks after results, and 8-10 weeks after informing patients of their HIV status. No major stress reactions were observed. Seropositives experienced a higher level of anxiety 1-2 weeks after learning results but anxiety generally diminished; they made significant behavior changes which were maintained. Seronegatives experienced relief and maintained IV drug risk reduction behavior. Anxiety about contracting AIDS increased in nontested subjects as the study progressed.

AIDS Serodiagnosis↗
PubMed1991

University students and AIDS: knowledge, attitudes and behavioral adjustment.

This study addresses the relations between AIDS-related knowledge, attitudes, and behavior change among university students. A questionnaire covering such issues and personal background variables was administered to 750 students at the University of Zagreb. Over-all, 62.7% of the knowledge items were answered correctly, while functional, self-protective aspects of knowledge proved to be much better than general knowledge. On the average, attitudinal responses were moderately liberal. Both self-reported change in risk-reduction behavior and personal concern due to the appearance of AIDS were very small. Correlations of risk-reducing behavior with permissive (.15) and restrictive (.14) attitude orientations and with general and functional knowledge (.08) were modest. The level of personal concern correlated neither with permissive attitudes nor with functional knowledge, while it correlated negatively with restrictive attitudes (-.20) and with general knowledge (-.08). Substantial association was only established between functional knowledge and permissive (.51) and restrictive attitude orientations (-.23). It is concluded that, in addition to knowledge and attitudes, a number of factors which restrain desired behavioral adjustment should be considered in anti-AIDS campaigns, such as perceived level of exposure to HIV in a particular environment, young age-specific illusion of invulnerability, peer norms, and others.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

Prior episode of sexually transmitted disease and subsequent sexual risk-reduction practices. A need for improved risk-reduction interventions.

Persons with a history of a sexual transmitted disease (STD) are at increased risk for infection with human immunodeficiency virus (HIV). The extent to which women with a previous history of a STD report currently practicing protective behaviors against STD transmission is examined. Specifically, whether having experienced one or more previous episodes of an STD was related to current STD/HIV preventive practices was studied. Of the study group, 36% had at least one prior STD episode. Results of bivariate analysis show no relationship between previous STDs and current STD/HIV preventive practices: 47% of women with no previous STD episode, 64% of women with 1 previous episode, and 46% of women with 2 or more previous STD episodes reported currently practicing moderate to high levels of STD/HIV prevention methods. To adjust for potentially confounding variables, logistic regression analyses were also performed. The logistic regression model included age, alcohol use with sex, drug use with sex, marital status, and perceived risk of becoming infected with an STD in the next year. Results from the logistic regression analyses also showed no relationship between prior STD episode and current level of preventive practices against STD/HIV. Variables found to be significantly associated with level of STD/HIV preventive practices were marital status, age, and drug use with sex. These findings suggest that greater advantage should be taken of the opportunities presented when women are diagnosed with an STD to teach individuals at risk of acquiring STDs or HIV to practice risk-reduction behaviors.

Adolescent↗
PubMed1990

Knowledge about and behaviors affecting the spread of AIDS: a street survey of intravenous drug users and their associates in New York City.

An informal survey of knowledge about and behaviors relevant to the spread of AIDS was conducted on the street in New York City during October 1986. The sample (n = 204) includes IV drug users (60%) and others (40%). The informal nature of the interview suggests that respondents gave "salient" answers rather than the complete answers that would be expected in a formal interview situation. A smaller proportion of respondents reported salient knowledge about drug-related transmission of AIDS than had been found in other populations, using formal interview methods. A close association was found between any accurate knowledge about spread of AIDS and likelihood of practicing one or more risk reduction behaviors. New users (persons who had been using drugs for only 1 or 2 years) were significantly less likely than others to have salient knowledge about AIDS transmission and also less likely to practice risk reduction measures.

Acquired Immunodeficiency Syndrome↗
PubMed1992

Longitudinal sexual behavior changes in injecting drug users.

OBJECTIVE: To determine whether injection drug users (IDU) maintained sexual behavior risk reduction over an 18-month period that had been noted previously over a 4-month period. DESIGN: A repeated measures design was utilized with IDU assessed initially at study enrollment and again 18 months later. METHODS: Sexual behaviors of a group of 220 IDU (148 men and 72 women) were assessed by a structured interview at the start of an AIDS prevention project and again 18 months later. RESULTS: Having multiple sex partners during the 12 months before initial assessment was reported by 42.6% of the men and 35.7% of the women. Significantly fewer had multiple sex partners during the 10 months before follow-up assessment (men, 20.9%; women, 14.3%). Condom use for vaginal intercourse increased from a mean of 11.9% initially to 27.8% at follow-up for men. The increase in condom use was greater for those with multiple sex partners. Women did not report significant increases in condom use. Continued involvement in unsafe sexual behaviors was associated with exchanging sex for money or drugs, using drugs to help meet sexual needs, alcohol use and drug use. CONCLUSIONS: Risk reductions noted previously were maintained over 18 months for the majority of the sample. Drug-use treatment and interventions that closely examine the interplay between drug use and sexuality for individual IDU are recommended as strategies to further reduce the sexual risk of HIV transmission among IDU.

Adult↗
PubMed1989

A baseline study of AIDS in Texas: knowledge, attitudes, and behaviors.

The Texas Department of Health reports that as of March 31, 1989, Texas ranked fifth in the nation for AIDS cases, with a total of 6,312 cases and 3,829 deaths. Cited in a report from the Texas Legislative Task Force on AIDS, TDH estimates that 100,000 Texans are infected with human immunodeficiency virus (HIV), with Houston and Dallas ranking 4th and 10th respectively in the nation for AIDS cases. Since 1986, AIDS has been the leading cause of death for men 25-44 years of age in Houston, with Houston having more AIDS cases than 45 states, and Dallas more cases than 42 states, the report says. According to a preliminary announcement by the Centers for Disease Control concerning its HIV seroprevalence survey on college campuses, approximately 3/1,000 college students are HIV positive. The legislative task force estimates that by 1991, Texas will have 30,000 cases of AIDS and 250,000 Texans will be infected with HIV. The Texas death rate for AIDS is 61%, slightly higher than the national average, TDH says. Until a cure or vaccine for HIV is discovered, prevention through behavioral risk reduction will be the major focus among physicians and other health care professionals. Therefore, TDH commissioned a baseline study analyzing the knowledge, attitudes, and behaviors of Texans. This special report prepared by University of Texas researchers Demetri Vacalis, PhD, Pamela J. Shoemaker, PhD, and Alfred McAlister, PhD, highlights the study's findings.

Acquired Immunodeficiency Syndrome↗
PubMed1986

Improving risk communication.

This paper explores reasons for difficulties in communicating risks among analysts, the laypublic, media, and regulators. Formulating risk communication problems as decisions involving objectives and alternatives helps to identify strategies for overcoming these difficulties. Several strategies are suggested to achieve risk communication objectives like improving public knowledge about risks and risk management, encouraging risk reduction behavior, understanding public values and concerns, and increasing trust and credibility.

Communication↗
PubMed1992

Strategies for AIDS prevention: leadership training and peer counseling for high-risk African-American women in the drug user community.

A culturally congruent training program to promote HIV risk-reduction behaviors was implemented in a convenient sample of 9 African-American women in an urban methadone treatment program. At each of eight peer counseling and leadership training (PCLT) program sessions, the transmission and prevention of AIDS were discussed while emphasizing enhancement of participants' self-esteem, confidence, and control over high-risk behaviors. The results indicate that support of the women helped develop their sense of purpose and self-worth, reduced sexual and drug use practices associated with risk for HIV and AIDS infection, and promoted assumption of leadership roles and dissemination of accurate AIDS-related information in their communities. It was apparent that knowledge alone does not change behavior if it conflicts with established norms, values, beliefs, and life-styles and that individuals who have a sense of personal control are more willing to explore alternative lower-risk behaviors.

Acquired Immunodeficiency Syndrome↗
PubMed1989

Fear of contagion: the public response to AIDS.

The threat of Acquired Immunodeficiency Syndrome (AIDS) has triggered a specific public response: fear of contagion, an anxiety over the perceived threat of catching the disease. Four behaviors characterize this fear: avoidance, attempting extreme precautions, lack of regard for the victims, and expressions of fear of catching the disease. Social and cultural values, which attach a deep symbolic meaning to AIDS, combine with misperceptions about transmission to create this public reaction. This fear results in the isolation and rejection of AIDS and potential AIDS clients. Fear of contagion may be a useful concept in nursing interventions for motivating risk-reduction behavior and creating a more therapeutic environment for persons with AIDS. Agendas for nursing research are suggested.

Acquired Immunodeficiency Syndrome↗
PubMed1991

New Jersey high school students' knowledge, attitudes, and behavior regarding AIDS.

In 1988 a questionnaire was administered to 1,793 urban and suburban New Jersey high school students to survey their knowledge, attitudes, and behavior related to the acquisition of acquired immunodeficiency syndrome (AIDS). Knowledge about the disease was high, but exaggeration of risk from social contacts was common. Although fear was associated with misperceptions, it was not always dispelled by knowledge. Nearly half (49%) of all participants reported having used condoms, indicating that condom use is somewhat familiar and acceptable to them. Over 80% thought that condoms offer some protection against AIDS. However, knowledge did not always result in recognition or practice of risk-reduction behaviors. Student suggestions for slowing the spread of AIDS stressed personal responsibility and education. Follow-up assemblies that used survey results to address gaps in knowledge appeared necessary to counter misperceptions that might have arisen from the survey.

Acquired Immunodeficiency Syndrome↗
PubMed1989

Changing college students' lifestyles in favor of cancer prevention: a case study.

This article describes a case study in the examination of cancer risk reduction behavioral strategies chosen by 272 college students enrolled in the 1987 "How to Avoid Dying from Cancer ... Now and Later" course. The four most commonly selected cancers chosen by these students--breast, colon/colorectal, skin, and lung cancer--and the corresponding self-reported success of the various strategies are reported. The three most successful strategies were breast self-examination, use of sunscreen lotions, and increased awareness of breast cancer. We concluded that the potential of using behavioral self-contracts to induce lifestyle change in favor of cancer prevention is both cost-effective and practical.

Adult↗
PubMed1989

Education for AIDS prevention: not our only voluntary weapon.

Authorities frequently state that education is the "only" method we have to stop the AIDS (acquired immunodeficiency syndrome) epidemic until a vaccine and/or curative therapy is available. We suggest that education, while critically important to our efforts to stop transmission of the human immunodeficiency virus (HIV), needs to be bolstered by additional voluntary approaches. Control of parenteral drug use, prevention of ulcerative sexually transmitted diseases, provision of expanded contraceptive services to seropositive reproductive age women, and reinforcement of risk-reduction behaviors through extended follow-up interventions are required as well. The support of these voluntary programs is a necessary complement to educational approaches which impact on HIV transmission and eventually on the AIDS epidemic.

Acquired Immunodeficiency Syndrome↗
PubMed1990

Towards an understanding of risk behavior: an AIDS risk reduction model (ARRM).

This report presents a three-stage model (ARRM) that characterize people's efforts to change sexual behaviors related to HIV transmission. ARRM focuses on social and psychological factors hypothesized to influence (1) labeling of high risk behaviors as problematic, (2) making a commitment to changing high risk behaviors, and (3) seeking and enacting solutions directed at reducing high risk activities. The proposed model integrates important concepts from prior behavioral medicine and human sexuality studies, specifies their differential import to achieving the goals associated with each stage of the model, and denotes factors hypothesized to influence people's motivation to continue the change process over time. Current findings are discussed within this three-stage model and directions for further research are suggested. Recent findings from our ongoing studies of gays and heterosexuals in San Francisco are presented.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

Risk reduction: attitudes and behavior of family practice residents.

This study was conducted to determine the frequency of behavioral risk factor screening and counseling by family medicine residents. Patients seen for well-care visits reported that residents screened most often for smoking and alcohol abuse. Residents inquired about stress, sedentary life-style, poor nutritional habits, and obesity less often. Few patients were counseled to reduce risks, even when unhealthy behaviors had been identified. Residents provided counseling most often for obesity, smoking, and stress; sedentary life-style, poor nutritional habits, and alcohol abuse rarely received intervention. Chart documentation of screening reported by patients was done a majority of the time only for smoking and alcohol abuse. Counseling was usually not documented. Residents screened most often for those risk factors (smoking and alcohol) they considered the most important causes of chronic disease. No relationship was found, however, between resident attitudes and likelihood of counseling. Residents agreed they needed more training to counsel patients on reducing behavioral risks.

Alcohol Drinking↗
PubMed1986

AIDS risk reduction recommendations and sexual behavior patterns among gay men: a multifactorial categorical approach to assessing change.

A sample of 745 New York City gay men, aged 20-65, were interviewed in 1985 as part of a longitudinal effort to determine the behavioral, psychological, and social impact of the AIDS epidemic on the non-ill but at-risk community. Detailed sexual behavior histories were taken for the year prior to the interview (1984-1985) and the year prior to when respondents first heard about AIDS (mode = July 1981). Parallel questions were asked for each annual time period allowing pre-AIDS/post-AIDS comparisons to be conducted. A multifactorial index of sexual behavior was constructed from three categorical variables: number of different sexual partners, (0, 1, and 2 or more); engaging in sexual contact outside a private home, (0, vs. 1); and engaging in sexual acts considered to be of higher risk for exposure to disease pathogens (0 vs. 1). These three factors, representing aspects of sexual behavior targeted for change by authors of risk reduction educational materials, were combined to form a seven-level typological index of sexual behavior. Analyses are based on comparisons between pre- and post-AIDS time periods on this index. Results indicate that both substantial change and substantial lack of change have occurred in gay male sexual behavior patterns, when sexual behavior measures are scaled to reflect complete abstinence from a particular type of sexual activity, as they are here. Results are discussed in light of previously reported findings on sexual behavior changes and the ambiguity surrounding the question of how much change is needed for significant risk reduction of AIDS.

Acquired Immunodeficiency Syndrome↗
PubMed1992

Risk reduction in sexual behavior: a condom giveaway program in a drug abuse treatment clinic.

Just before and 4 months after initiation of a condom giveaway program, a questionnaire regarding sexual behavior and condom acquisition was administered to 103 men attending an outpatient drug abuse treatment clinic. Jars filled with a variety of condoms were placed in every clinic room. Condom taking varied as a function of room. Sixty percent of the subjects reported taking condoms. At follow-up, clients reported increases in condom possession and in use of condoms for vaginal intercourse.

Acquired Immunodeficiency Syndrome↗
PubMed1991

HIV, drugs, and public health in England: new worlds, old tunes.

Since 1986 there has been a major reconceptualization of drugs policy in England in response to HIV and AIDS with new ideas about risk behavior and risk reduction, and health behavior and harm minimization. The debate appears to have a new public health emphasis, but historical examination shows public health concerns have emerged in earlier periods. We examine three models of public health and their influence on drugs policy. The current drugs debate is informed by late twentieth century concern for the individual body and life-style choices. While drug policy has been given new purpose by these developments, this model of public health is essentially individualistic in focus and limited in practice.

England↗