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PubMed1999

Factors associated with condom use in the male population of Mexico City.

Sexually transmitted diseases (STDs) are an important public health problem, due to their medical, social and economic repercussions. Therefore, more knowledge is needed about the sexual behaviour that promotes their spread, in order to improve control and prevention strategies. Our aim was to determine the frequency of male condom use associated with sexual behaviour factors, a history of and knowledge about STDs in a sample of the male population in Mexico City. During 1994 a cross-sectional epidemiological study was carried out, using multi-stage sampling with conglomerates, in 1377 men from 15 to 49 years old. The mean age was 34.5 years (SD 7.5 years). Mean age at first sexual relations was 17.7 years (SD 2.8 years). The global proportion of condom use during the last sexual relation was 24.6%; use according to type of female sex partner in the last year was 18.8% with regular partners and 62.5% with occasional partners. The principal predictors of male condom use, identified through statistical modelling, were: younger age (<25 years), middle and high education level (>9 years), middle and high socioeconomic level and type of sexual partners (occasional and regular). This population has risk factors for acquiring and transmitting some STDs, such as occasional sexual partners and a history of STDs. Characteristics which are important in relation to male condom use were identified, such as age (younger than 35), education (complete junior high school or more) and type of sexual partners (occasional and regular).

Adolescent↗
PubMed1995

Factors related to condom use with casual partners among urban African-American and Hispanic males.

Constructs from the Health Belief Model and the Theory of Reasoned Action were tested for their relationship to condom use with casual partners in a probability sample of urban African-American and Hispanic males aged 15-24. The results indicate the importance of 1) promoting a sense of male responsibility regarding condom use; 2) promoting the belief that condoms should be used with all partners; 3) developing skills for condom use and partner communication; and 4) increasing perceived susceptibility to HIV infection in design of intervention programs.

Adolescent↗
PubMed1996

AIDS-relevant condom use by gay and bisexual men: the role of person variables and the interpersonal situation.

This study examined the relative ability of selected person variables (interpersonal self-efficacy, self-control, attitudes about the effect of condoms on sex, normative beliefs) and interpersonal-situational variables (partner preference, partner serostatus) to explain gay and bisexual males' (N = 267) condom use during insertive and receptive intercourse. Partner preference accounted for a large amount of variance in condom use by itself and when controlling for the effects of the remaining variables. Exploratory hierarchical regression analyses suggested that the receptive partner's preference influenced condom use decisions to a greater extent than did the insertive partner's. Partner serostatus alone explained little variance in condom use. However, partners serostatus interacted with subject serostatus such that dyads with concordance serostatus (i.e., both partners HIV positive or both HIV negative) used condoms the least, and dyads with discordant serostatus used condoms the most. Results suggest that the interpersonal situation plays an important role in condom use decisions.

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↗
PubMed2001

Evaluating the impact of peer, nurse case-managed, and standard HIV risk-reduction programs on psychosocial and health-promoting behavioral outcomes among homeless women.

Investigators examined the 6-month impact of three cognitive-behavioral HIV risk-reduction programs on behavioral factors (substance use and sexual risk behaviors) and cognitive and psychological resources of 325 women who resided in emergency or sober-living shelters and their 308 intimate sexual partners. Participants were randomized by shelter to a peer-mentored, a nurse case-managed, or a standard care HIV risk-reduction program. Significant improvements were observed in all groups in all behavioral factors and cognitive and psychological resources except for self-esteem. Participants in the peer-mentored and nurse case-managed groups did not differ significantly from the standard group in self-esteem, life satisfaction, psychological well-being, use of noninjection drugs, sex with multiple partners, and unprotected sex at 6 months (n = 633). It was concluded that a standard approach by health care professionals appears to effectively modify HIV risk behaviors for a majority of homeless participants and may have important economic and policy implications. Further, the impact of short-term programs that address psychological vulnerabilities of impoverished populations needs to be studied further.

Adolescent↗
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↗
PubMed1996

Changes in HIV risk behavior among injecting drug users: the impact of 21 versus 90 days of methadone detoxification.

OBJECTIVE: To evaluate the hypothesis that long-term methadone detoxification would produce greater HIV risk reduction among injecting drug users (IDU) than short-term detoxification. DESIGN: Random assignment to 21 or 90 days of free detoxification. SETTING: Storefront offices in two cities, with referrals to outpatient methadone detoxification. PARTICIPANTS: Out-of-treatment IDU (n = 1803), recruited through street outreach and word of mouth, between April 1990 and March 1991. Of these, 62.6% were successfully located for 6-month follow-up. MAIN OUTCOME MEASURES: Self-reported drug injection and sexual practices at baseline and follow-up. RESULTS: Substantial reductions in risk behavior were observed at follow-up. Substantial percentages of subjects reported less frequent drug injection (54%), use of shooting galleries (85%), needle-sharing (67%), and number of sex partners (73%), and more frequent use of bleach to disinfect needles (67%) and condom use (31%). There were no significant differences in behavioral change between 21 and 90-day treatment, and subjects who entered treatment did not report significantly greater risk reduction than untreated subjects. Discriminant analyses showed a marginal effect for duration of treatment on risk reduction, although results were inconsistent. CONCLUSIONS: Large scale behavioral risk reduction appears to be occurring in this population regardless of treatment condition. In minimal service methadone detoxification, subjects treated under a longer-term detoxification protocol demonstrated no greater risk reduction than those receiving short-term detoxification.

Analgesics, Opioid↗
PubMed1996

Coronary disease risk factor reduction and behavior modification in minority adolescents: the PATH program.

PURPOSE: To evaluate the impact of a unique school-based program of exercise, health education, and behavior modification on health knowledge, health behaviors, coronary risk factors, and cardiovascular fitness in minority adolescents. METHODS: A total of 346 students from an inner-city public high school participated in health promotion intervention or regular physical education volleyball classes. Subjects were African-American (47%), Asian-American (9%), Hispanic (21%), white (3%), and other (19%). The health promotion curriculum consisted of 11 weeks of daily circuit training exercise and health lecture-discussions. RESULTS: The groups were similar in age, height, weight, ethnicity, and socioeconomic status. Following intervention both boys (P < .001) and girls (P < .006) significantly improved health knowledge test scores. Significant benefits for girls included improved dietary habits (P < .05), reduced cholesterol (P < .004), and higher estimated V(O2)max (P < .0001). There were no other significant changes in boys. CONCLUSIONS: The results suggest that a school-based health promotion program of exercise and health lecture-discussion is beneficial for multiethnic, inner-city adolescents, especially females.

Adolescent↗
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↗
PubMedDate not supplied

HIV prevention for teenage girls: relationships are the medium and the message.

HIV is a growing problem among young black and Hispanic women. Teenage girls' risk of HIV infection is primarily social in nature because sexual and/or needle-sharing behaviors typically occur in the context of relationships. Without cure or vaccine, the practice of safe or protected personal behaviors is absolutely critical to prevent new HIV infections. To optimize HIV-prevention efforts, clinicians can form caring and developmentally appropriate relationships that address HIV education. Medical HIV prevention for teenage girls is fundamentally about healthy relationships.

Adolescent↗
PubMed1999

Behavioral reduction of infection risk.

Evolutionary biologists have long postulated that there should be fitness advantages to animals that are able to recognize and avoid conspecifics infected with contact-transmitted disease. This avoidance hypothesis is in direct conflict with much of epidemiological theory, which is founded on the assumptions that the likelihood of infection is equal among members of a population and constant over space. The inconsistency between epidemiological theory and the avoidance hypothesis has received relatively little attention because, to date, there has been no evidence that animals can recognize and reduce infection risk from conspecifics. We investigated the effects of Candida humicola, a pathogen that reduces growth rates and can cause death of tadpoles, on associations between infected and uninfected individuals. Here we demonstrate that bullfrog (Rana catesbeiana) tadpoles avoid infected conspecifics because proximity influences infection. This avoidance behavior is stimulated by chemical cues from infected individuals and thus does not require direct contact between individuals. Such facultative modulations of disease infection risk may have critical consequences for the population dynamics of disease organisms and their impact on host populations.

Animals↗
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↗
PubMed2002

A lifetime portfolio of risky and risk-free sexual behaviour and the prevalence of AIDS.

A lifetime portfolio of risky and risk-free sexual activities is conceptually constructed in this paper. People's time allocation between risky and risk-free sexual activities affects, and is affected by, the prevalence of AIDS. A small satisfaction differential between risky and risk-free sex can lead to a significant prevalence of AIDS. Numerical simulations suggest that the reduction in the prevalence of AIDS generated by a 1% improvement in the sensual quality of freely distributed condoms can be 0.855% when the initial satisfaction differential between risky and risk-free sex is 50% or 0.464% when the initial satisfaction differential is 100%.

Acquired Immunodeficiency Syndrome↗
PubMed2003

Sustaining and broadening intervention impact: a longitudinal randomized trial of 3 adolescent risk reduction approaches.

OBJECTIVE: To determine whether the addition of a parental monitoring intervention (Informed Parents and Children Together [ImPACT]) alone or with "boosters" could enhance (either broaden or sustain or both) the effect of a small group, face-to-face adolescent risk reduction intervention Focus on Kids (FOK). METHODS: A longitudinal, randomized, community-based cohort study was conducted of 35 low-income, community-based, in-town settings. A total of 817 black youths aged 12 to 16 years at baseline were studied. After completion of baseline measures, youths were randomized to receive a face-to-face intervention alone (FOK only), a face-to-face intervention and a parental monitoring intervention (FOK plus ImPACT), or both of the above plus boosters (FOK plus ImPACT plus boosters). Risk and protective behaviors were assessed at 6 and 12 months after intervention. RESULTS: At 6 months' follow-up, youths in families that were assigned to FOK plus ImPACT reported significantly lower rates of sexual intercourse, sex without a condom, alcohol use, and cigarette use and marginally lower rates of "risky sexual behavior" compared with youths in families that were assigned to FOK only. At 12 months after intervention, rates of alcohol and marijuana use were significantly lower and cigarette use and overall risk intention were marginally lower among FOK plus ImPACT youths compared with FOK only youths. With regard to the boosters delivered at 7 and 10 months, 2 risk behaviors--use of crack/cocaine and drug selling--were significantly lower among the youths who were assigned to receive the additional boosters compared with youths without the boosters. The rates of the other risk behaviors and intentions did not differ significantly. CONCLUSIONS: The results of this randomized, controlled trial indicate that the inclusion of a parental monitoring intervention affords additional protection from involvement in adolescent risk behaviors 6 and 12 months later compared with the provision of an intervention that targets adolescents only. At the same time, the results of the present study do not provide sufficient evidence that booster sessions further improve targeted behaviors enough to include them in a combined parent and youth intervention.

Adolescent↗
PubMed2003

Risk-mitigating beliefs, risk estimates, and self-reported speeding in a sample of Australian drivers.

PROBLEM: Research suggests that people who engage in risk-taking behaviors often hold specific beliefs that can mitigate or reduce their perceptions of risk associated with those behaviors. METHOD: A scale was developed (Speeding Risk Belief Scale (SRBS)) to assess beliefs about speeding-related risk and predict self-reported speeding in a random-digit telephone survey of 800 South Australian drivers between the ages of 16 and 50. RESULTS: The scale was internally consistent, and path analyses showed it to be associated with self-reported speeding, both directly and indirectly through participants' estimates of speeding-related risk. DISCUSSION: Origins of risk-mitigating beliefs and the extent to which they may be causally linked with speeding are discussed, and recommendations are made for future research. IMPACT ON INDUSTRY: This research has strong implications for the conduct of countermeasure campaigns that disseminate information on speeding-related risk.

Accidents, Traffic↗