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Reducing HIV sexual risk behaviors among runaway adolescents.

OBJECTIVE: Reductions in runaways' sexual risk behaviors were evaluated in response to an intensive program to prevent human immunodeficiency virus (HIV) infection and the acquired immunodeficiency syndrome (AIDS). DESIGN: In a nonrandomized control trial, sexual risk behaviors among 78 runaways at one residential shelter who received up to 30 HIV/AIDS intervention sessions were compared with 67 runaways at a nonintervention shelter with sexual behaviors assessed at baseline and 3 and 6 months. SETTING: Runaways were recruited from the only two publicly funded shelters in New York, NY. PARTICIPANTS: The runaways were aged 11 to 18 years, 64% female, and predominantly black or Hispanic. INTERVENTION: The intervention addressed general knowledge about HIV/AIDS, coping skills, access to health care and other resources, and individual barriers to safer sex. MAIN OUTCOME MEASURES: Consistent condom use, a high-risk pattern of sexual behavior, and sexual abstinence over a 3-month time frame were assessed. MAIN RESULTS: As the number of intervention sessions increased, runaways' reports of consistent condom use increased significantly (at 3 months, unique R2 = .06, P less than .05; at 6 months, unique R2 = .09, P less than .05), and their reports of engaging in a high-risk pattern of sexual behavior decreased significantly (at 3 months, unique R2 = .03, P = .06; at 6 months, unique R2 = .04, P less than .05). Abstinence did not change. CONCLUSIONS: The demonstrated effectiveness of the intensive HIV/AIDS program highlights the importance of enlarging the scope of most current HIV/AIDS prevention programs.

Acquired Immunodeficiency Syndrome

Acquired immunodeficiency syndrome and adolescents. Knowledge, attitudes, and behaviors of runaway and homeless youths.

OBJECTIVE: To describe the knowledge, attitudes, and behaviors of runaway and homeless youths regarding infection with the human immunodeficiency virus (HIV). DESIGN: Cross-sectional, descriptive. SETTING: A crisis shelter for runaway and homeless youths. PARTICIPANTS: One hundred one residents, aged 13 to 20 years, of a shelter for homeless and runaway youths in Houston, Tex. INTERVENTION: None. MEASUREMENTS/MAIN RESULTS: A self-administered questionnaire was used to examine the knowledge, attitudes, and behaviors of these youths regarding infection with HIV. Nearly one fourth had injected illegal drugs; one fifth had shared needles for other purposes. Sixteen percent had had anal intercourse, 19% had engaged in prostitution, and 67% of all subjects reported having four or more sexual partners. One fifth reported that they always use condoms. While quite knowledgeable about means of transmission, they held prevalent misconceptions about casual contact and risk reduction. Youths perceive few barriers to condom use, have fairly high intentions to practice preventive behavior, and have high self-efficacy to do so. Most believe they are at little or no risk for acquiring HIV. These findings support the need for medical, educational, and social service programs to reduce the risk of HIV among these youths. CONCLUSION: Runaway and homeless youths practice behaviors that place them at high risk for acquisition of HIV infection. Risk reduction is imperative and will require programs that address the educational, psychological, social, and medical needs of these youths.

Acquired Immunodeficiency Syndrome

Runaway adolescents' perceptions of parents and self.

The purpose of the study was to investigate the relationship between runaway behavior in adolescence and an adolescent's self-concept and antecedent parental treatment. The Cornell Parent Behavior Questionnaire and the Adjective Check List were used to assess 47 runaways and a matched group of non-runaways. Analyses of the data indicated: (a) runaway adolescents report more punishment and less support from their parents; (b) runaway girls report the most and runaway boys the least degrees of parental control; (c) runaways hold a less favorable self-concept, specifically on the dimensions of anxiety, self-doubt, poor interpersonal relationships, and defensiveness; (d) runaways also manifest, as an aspect of the self, a readiness for counseling.

Adolescent

Problems of maltreated runaway youth.

Research has shown that physical and sexual maltreatment precipitate runaway behavior in adolescents. However, there have been few large-scale examinations of the family, school, and personal problems of maltreated adolescents. In the present paper, an 85-item Client Information Record was completed on 2,019 runaways by shelter staff from eight southeastern states. There were significant differences in the problems reported by physically abused and sexually abused runaways when compared to their nonabused runaway peers. Runaways who were both physically and sexually maltreated were significantly more vulnerable and much worse off than those who only experienced either physical or sexual abuse. Implications for the treatment of maltreated runaways are discussed.

Adaptation, Psychological

Sexual risk behaviors, AIDS knowledge, and beliefs about AIDS among runaways.

Sexual risk behaviors, knowledge of acquired immunodeficiency syndrome (AIDS), and beliefs about AIDS prevention were examined among 126 runaways. In the previous 3 months, 65 percent of youths had been sexually active. Among the sexually active runaways, males reported a median of 2.7 partners and females reported 1.3 partners, and only 18 percent reported consistent condom use. Runaways demonstrated moderately high AIDS knowledge and beliefs endorsing AIDS prevention. Condom use and abstinence were directly related to beliefs about preventing AIDS.

Acquired Immunodeficiency Syndrome

Lifetime sexual behaviors among predominantly minority male runaways and gay/bisexual adolescents in New York City.

Lifetime sexual behaviors were examined among two samples of predominantly minority, male adolescents in New York City aged 12 to 18 (M = 16.3), believed to be at high risk for HIV infection: 59 runaway males in two residential shelters and 60 males attending a community agency (HMI) for gay and bisexual youths. Interviews regarding psychosexual milestones indicated that 93% of these youths had engaged in oral, anal or vaginal intercourse and/or anilingus, with a median of 11.0 female partners among runaway males and a median of 7.0 male partners among HMI males. Both groups initiated sexual activity at a relatively early mean age of 12.6 years. Each group reported a unique developmental sequence of psychosexual milestones. Consistent condom use was reported by 13% of the youths. One quarter of the youths reported involvement in prostitution. These findings detail the need for AIDS prevention programs for these youths.

Adolescent

[Behavior-genetic analysis of responses in runway test as measures of emotional reactivity in rats: I.- phenotypic variations and heritability estimates based on offspring-parents regressions (author's transl)].

Individual differences of emotional reactivity were estimated from 6 kinds of responses measured in the Runway Test (modified ("Timidity Test") in 974 random-bred albino rats. 3 different estimates of heritability of these responses were calculated from the regressions of offspring on dam, sire, and midparent. The types and degree of the phenotypic variations are very different among the responses measured. Heritability estimates of 2 kinds of responses which are related to the behavior going to the remotest part of runway from starting box were relatively higher (.30-.55). Heritability estimates of starting latency, time in the starting box, and the number of sections rats traversed were medium (.20-.40). The estimates from defecation scores had lowest (.10-.30).

Animals

Jeopardy in community placement.

As part of a broader research effort, a survey of the adaptive behavior of 424 community-placed retarded persons was conducted through small group, tape-recorded interviews with their 109 caretakers. From 1252 incidents of problem behavior cited, 203 were judged to contain jeopardy. Seventy-seven percent of these incidents involved jeopardy to health and/or safety, 4 percent to general welfare, and 18 percent contained legal jeopardy. In 79 percent of incidents, the client jeopardized himself, in 12 percent he jeopardized a fellow client, and in 9 percent he jeopardized a member of the community at large. The evidence exposes need for full examination of this problem and ways to minimize it.

Adult

Psychosocial background and behavioral and emotional disorders of homeless and runaway youth.

One hundred fifty clients of a shelter for homeless youths in New York City were interviewed to obtain information about their backgrounds and the incidence of behavioral and emotional disorder. Most of the respondents came from backgrounds characterized by severe emotional deprivation and physical or sexual abuse. Of the 140 who completed the full interview, 90 percent fulfilled DSM-III-R criteria for an emotional or behavioral disorder. Fifty-nine percent had conduct disorder, three-quarters were depressed, 41 percent had considered suicide, and more than one-quarter had attempted suicide.

Adolescent

The treatment of elopement behavior in a retardate using a graduated levels program.

The present study investigated whether a levels program would effectively reduce the amount of elopement (running-away) behavior demonstrated by an adult with profound mental retardation. The subject resided in an Alternative Intermediate Services (AIS) group home. During baseline data collection, he demonstrated an average of 131 elopements per month. After implementation of the levels program, elopements decreased to 0 within 7 months. At the end of the study, the subject's elopements continued to be maintained at a very low rate.

Adult

Exploring the relationship between a continuum of care and intrusiveness of children's mental health services.

Intake data for 61 children in three types of mental health programs in Philadelphia--partial hospitalization, home-based services, and outpatient treatment--were compared to examine an assumption of the continuum-of-care concept: the level of a program's intrusiveness is positively related to a child's severity of dysfunction. Results supported the relationship between intrusiveness and dysfunction only when children in outpatient treatment were compared with those in the other two programs. Children treated in the less intrusive home-based program were more dysfunctional than those treated in the more intrusive partial hospitalization program. Factors other than degree of dysfunction, such as a history of outpatient treatment, were more predictive of treatment type. Results suggest that it may be more accurate to speak of an array of services rather than a continuum.

Adolescent

[Paradoxes in adolescence: break and continuity].

The psychopathological studies on adolescence underline the paradoxical behaviours during this period of life. After the analysis of its concept we show in which way the paradox helps to maintain the continuity of psychological life during the crisis. Thus impossible choices which are part of the contradiction in adolescents be avoided. It will be necessary to provoke the emergence of the paradox from the contradictions linked with hospitalization through on hospitalization to make the most of the letter in the therapeutic process.

Adolescent