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Introduction: female sex workers (FSWs) are vulnerable to acquiring HIV and other sexually transmitted infections due to unprotected sex. Understanding and addressing the gaps in safer sex among FSWs can help to reduce HIV acquisition and transmission. This study described sexual practices, their correlates and use of HIV services among FSWs in Mombasa County, Kenya. Methods: participants were recruited for a baseline survey by a time-location cluster randomized design at predetermined intervals from five bars and five clubs in Mombasa County until a sample size of 160 was reached. Descriptive statistics and inferential analysis using R were conducted, and p<0.05 was regarded as statistically significant. Results: nearly all (99%) of the participants were unmarried, and 11% had tertiary education. Ninety-eight percent (98%) reported vaginal intercourse, 51% reported using alcohol/drugs before sex, and 28% practiced unprotected intercourse. About 64% had tested for HIV within three months, 14% believed that it is safe to reuse condoms, and 10% that it is safe to engage in unprotected sex. In bi-variate analysis, FSWs were more likely to engage in unprotected intercourse if they reported more frequent sex, more frequent sex with regular clients, poor HIV knowledge, alcohol/drug use, and violence. In multivariate analysis, risky sexual practices were associated with frequency of sexual intercourse, alcohol/drug use, and poor HIV knowledge. Conclusion: female sex workers engage in unprotected sex while under the influence of substances, belief in re-using condoms and have high frequency of sexual intercourse. Inadequate knowledge of HIV and substance use significantly correlated with unprotected sex. Interventions to address these modifiable factors are needed to mitigate the risk of HIV among FSWs.
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Condones , Infecciones por VIH , Trabajadores Sexuales , Conducta Sexual , Sexo Inseguro , Humanos , Kenia , Trabajadores Sexuales/estadística & datos numéricos , Femenino , Infecciones por VIH/prevención & control , Infecciones por VIH/epidemiología , Adulto , Adulto Joven , Sexo Inseguro/estadística & datos numéricos , Conducta Sexual/estadística & datos numéricos , Condones/estadística & datos numéricos , Adolescente , Conocimientos, Actitudes y Práctica en Salud , Asunción de Riesgos , Trabajo Sexual/estadística & datos numéricos , Encuestas y Cuestionarios , Sexo Seguro/estadística & datos numéricos , Prueba de VIH/estadística & datos numéricos , Trastornos Relacionados con Sustancias/epidemiologíaRESUMEN
INTRODUCTION: Road crashes are still one of the main causes of death around the world. Risky behavior has been proposed as one of the foremost predictors, with the theoretical framework of aberrant behavior emerging as a predominant approach for its examination. Sensation seeking has been pointed out as one of the main personality predictors of aberrant behavior. The current research aimed to investigate the moderated-moderation effect of both risk perception and self-esteem in the relationship between sensation seeking and aberrant behavior. METHOD: Two studies were conducted. The first study aimed to analyze the psychometric properties of the Spanish version of the Risk Perception Scale (RPS), a 10-item self-report to assess risk perception. A sample composed of 471 Spanish drivers (319 female, Mage = 29.75) completed the RPS. In the second study, a different sample of 236 Spanish drivers (129 female, Mage = 38.49) completed a set of self-reports aiming both to analyze the concurrent and divergent validity of the RPS, and to test the main moderated-moderation hypothesis. RESULTS: With respect to the first study, the confirmatory factor analysis (CFA) supported a 7-item version which fitted in a single reliable factor (α = .74). Regarding the second study, the results supported both the concurrent and divergent validity of the RPS. Likewise, it was verified the moderated-moderation effect in the case of ordinary violations (R2 = .34), aggressive violations (R2 = .20), and lapses (R2 = .12). CONCLUSIONS: The RPS is a useful self-report to assess subjective risk perception in Spanish drivers. Both self-esteem and risk perception affect the relationship between sensation seeking and aberrant driving behavior. PRACTICAL IMPLICATIONS: Intervention programs aiming to reduce aberrant driving behavior should be focused on reducing sensation seeking tendencies while simultaneously enhancing both risk perception skills and self-esteem.
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Conducción de Automóvil , Psicometría , Asunción de Riesgos , Autoimagen , Humanos , Femenino , Adulto , Masculino , Conducción de Automóvil/psicología , Psicometría/instrumentación , Accidentes de Tránsito/psicología , Adulto Joven , España , Autoinforme , Persona de Mediana Edad , Encuestas y Cuestionarios , Medición de Riesgo , Percepción , Análisis FactorialRESUMEN
INTRODUCTION: Trait driving anger is a widely studied personality variable in the field of road safety, due to its strong relationship with both risky behavior on the road and crash-related events. The Deffenbacher's Driving Anger Scale theoretical approach has underlined different situations that could provoke anger in drivers, although trait driving anger is usually analyzed as a whole. Trait general anger has been proposed as one of the most relevant predictors of trait driving anger, showing moderate relationships with it. METHOD: The current research aimed to analyze the relationship between trait general anger and each one of the situations provoking anger, as well as to search for personality variables that could moderate these relationships. Based on literature review, it was expected that self-esteem would moderate both Discourtesy and Hostile gestures, Type-A behavior pattern would moderate both Slow driving and Traffic obstructions, and conscientiousness would moderate both Police presence and Illegal driving. A sample of 417 drivers (Mage = 31.24, SDage = 13.59, 64.5% females) taken from the Spanish general population completed a set of self-reports. RESULTS: The results showed significant moderation effects in the case of Hostile gestures, Discourtesy, Illegal driving, and Slow driving. Conditional processes of these moderations were analyzed. Lastly, practical implications are discussed, allowing for tailored interventions to be implemented based on individual drivers' tendencies. Therefore, interventions should address different triggers of driving anger: boosting self-esteem for those angered by disrespect, targeting Type-A behavior reduction for those angered by traffic slowdowns, and promoting conscientiousness enhancement for those angered by others' risky driving.
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Ira , Conducción de Automóvil , Humanos , Conducción de Automóvil/psicología , Masculino , Femenino , Adulto , Adulto Joven , Persona de Mediana Edad , Asunción de Riesgos , Personalidad , Autoimagen , España , Adolescente , Accidentes de Tránsito/psicología , Accidentes de Tránsito/prevención & controlRESUMEN
Background: Drug users are a high-risk group for HIV infection and are prominent HIV carriers. Given the emergence of new drugs, we explored current drug-using behaviors, HIV infections, and the correlation between drug-using behaviors and HIV infection risk among drug users from 2014 to 2021. Objective: We aimed to identify the prevalence of HIV infection risk among drug users and explore drug use behaviors based on the updated data, which could provide evidence for the precision of HIV prevention strategies among drug users. Methods: Data were collected from sentinel surveillance of drug users in rehabilitation centers and communities in Hangzhou (2014-2021), including sociodemographic characteristics, HIV awareness, drug use, risky sexual behaviors, and HIV infection status. Multivariate logistic regression was used to identify the factors influencing HIV infection and risky sexual behaviors among drug users. Results: In total, 5623 drug users (male: n=4734, 84.19%; age: mean 38.38, SD 9.94 years) were included. New drugs dominated among the participants (n=3674, 65.34%). The main mode of drug use was noninjection (n=4756, 84.58%). Overall, for 27.45% (n=1544) of injected drugs in the last month before the investigation, the average daily injection frequency was 3.10 (SD 8.24). Meanwhile, 3.43% of participants shared needles. The incidence of sexual behaviors after drug use was 33.13% (n=1863), with 35.75% (n=666) of them using a condom in the last time. Overall, 116 participants tested positive for HIV antibodies (infection rate=2.06%). New drug users exhibited more postuse sexual behaviors than traditional drug users (odds ratio [OR] 7.771, 95% CI 6.126-9.856; P<.001). HIV-aware drug users were more likely to engage in risky sexual behaviors (OR 1.624, 95% CI 1.152-2.291; P=.006). New-type drug users were more likely to engage in unprotected sexual behavior (OR 1.457, 95% CI 1.055-2.011; P=.02). Paradoxically, drug users with greater HIV awareness were more prone to engaging in unprotected sexual behavior (OR 5.820, 95% CI 4.650-7.284; P<.001). Women engaged less in unprotected sex than men (OR 0.356, 95% CI 0.190-0.665; P=.001). HIV rates were higher among injecting drug users (OR 2.692, 95% CI 0.995-7.287; P=.04) and lower among drug users who used condoms during recent sex than those who did not (OR 0.202, 95% CI 0.076-0.537; P=.001). Higher education levels were associated with higher HIV infection rates. However, there was no significant correlation between HIV cognition level and HIV infection. Conclusions: New drug types and noninjection were the main patterns in last 7 years. Using new types of drugs, rather than traditional drugs, was associated with an increased risk of HIV infection. Injection drug use was a risk factor for HIV infection. HIV awareness among drug users was high, but the incidence of risky sexual behaviors remained high. Therefore, it is important to promote the behavioral transformation of high-risk populations from cognition to attitude, and then to taking protective measures.
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Consumidores de Drogas , Infecciones por VIH , Asunción de Riesgos , Trastornos Relacionados con Sustancias , Humanos , Masculino , China/epidemiología , Infecciones por VIH/epidemiología , Estudios Transversales , Femenino , Adulto , Consumidores de Drogas/estadística & datos numéricos , Consumidores de Drogas/psicología , Persona de Mediana Edad , Trastornos Relacionados con Sustancias/epidemiología , Prevalencia , Factores de Riesgo , Conducta Sexual/estadística & datos numéricos , Adulto Joven , Vigilancia de Guardia , AdolescenteRESUMEN
Background: The study's main objectives were to evaluate the distribution of levels of procrastination and its relationship with sleep quality, smoking status, alcohol consumption, and skipping breakfast, as a proxy measure of an unhealthy dietary pattern, among Italian university students. Methods: A cross-sectional study was conducted at the "Magna Græcia" University of Catanzaro in the Southern part of Italy, using stratified random sampling techniques. Eligible students were sent an anonymous online survey aimed at assessing sociodemographic characteristics, procrastination levels using the Pure Procrastination Scale, sleep quality using Pittsburgh Sleep Quality Index, smoking status, alcohol consumption using WHO's Alcohol Use Disorders Identification Tool, and breakfast habits. Results: The study included 518 participants with a mean age of 23 year. More than half of the sample was enrolled in medicine or life science majors and the procrastination mean score was 15 (±5.9 SD). Being procrastinators was significantly more frequently among students who were poor sleepers, hazardous alcohol consumers and breakfast skippers. When analyzing the clustering of risky behaviors, it was found that as the number of risky behaviors increased, the procrastination score exhibited an exponential increase. Conclusion: The study findings showed that university students who engage in procrastination tend to adopt risky health behaviors. The data gathered could be useful to derive targeted interventions aimed at groups more exposed to harmful health behaviors and to encourage institutional policies to promote healthy lifestyles within universities. Universities can act as hubs for cultivating a culture of well-being and promoting a healthy environment.
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Promoción de la Salud , Procrastinación , Estudiantes , Humanos , Italia , Estudios Transversales , Masculino , Femenino , Adulto Joven , Estudiantes/estadística & datos numéricos , Estudiantes/psicología , Universidades , Encuestas y Cuestionarios , Promoción de la Salud/métodos , Adulto , Consumo de Bebidas Alcohólicas/epidemiología , Conductas de Riesgo para la Salud , Calidad del Sueño , Conductas Relacionadas con la Salud , Asunción de Riesgos , Fumar/epidemiologíaRESUMEN
BACKGROUND: Sexual behaviors, particularly risky sexual behavior, has become a serious public health concern among adolescents worldwide, presenting a substantial obstacle to the prevention of sexually transmitted infections, including human immunodeficiency virus (HIV). However, there is limited research using consistent and standardized methodology to examine associations between tobacco and alcohol use frequency and both total and risky sexual behaviors among adolescents. We aimed to examine the association between tobacco and/or alcohol use with both total and risky sexual behaviors among adolescents worldwide. METHODS: Data were collected from the Global School-based Student Health Survey, which comprised 211,847 adolescents aged 12-17 years from 59 countries. The frequency of tobacco or alcohol use during the past 30 days was categorized as 0, 1-2, 3-5, 6-9, or ≥ 10 days. Tobacco and alcohol use were also categorized as non-use, tobacco use alone, alcohol use alone, and combined use. Multi-variable logistic regression analysis was used to examine both the independent and combined associations of tobacco and alcohol use with total and risky sexual behaviors. RESULTS: Compared with no tobacco use, the odds ratio of engaging in sexual intercourse increased with the frequency of tobacco use from 1 to 2 days to ≥ 10 days (total: 2.03 [95% confidence interval 1.47-2.81] to 3.98[2.63-6.03]; risky: 2.43[1.75-3.38] to 4.21[3.26-5.42]), as well as with the frequency of alcohol use. Overall, combined users had greater likelihood of both total and risky sexual behaviors than tobacco users alone, alcohol users alone, and non-users. Similarly, the association between risky sexual behaviors and tobacco use alone was more pronounced among adolescent girls (vs. adolescent boys), as were those of risky sexual behaviors with alcohol use alone among younger adolescents aged 12-14 years (vs. aged 15-17 years) and with tobacco and/or alcohol use among adolescents in the Western Pacific region (vs. Regions of Africa and Americas). CONCLUSIONS: Our findings suggest independent and combined associations between tobacco and/or alcohol use with sexual behaviors among adolescents, with variations across age, sex, and WHO region.
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Consumo de Bebidas Alcohólicas , Asunción de Riesgos , Conducta Sexual , Uso de Tabaco , Humanos , Adolescente , Masculino , Femenino , Conducta Sexual/estadística & datos numéricos , Conducta Sexual/psicología , Niño , Consumo de Bebidas Alcohólicas/epidemiología , Consumo de Bebidas Alcohólicas/psicología , Uso de Tabaco/epidemiología , Conducta del Adolescente/psicología , Encuestas Epidemiológicas , Salud Global/estadística & datos numéricosRESUMEN
Non-condom use is known as one of the risky sexual behaviors among youth and a contributing factor to the high prevalence of HIV in Nigeria. Therefore this study aimed to assess the spatial pattern and determinants of non-condom use among sexually active young people in Nigeria. The study employed a cross-sectional analysis of population-based data involving 288 males and 780 females aged 15-24 years, giving 1068 sexually active young people drawn from the 2018 NDHS. The study adopted a multi-level and spatial analysis to identify factors associated with non-condom use in Nigeria. The prevalence of non-condom use was 57.7% in this study. The spatial analysis showed that the Northeastern and South-South regions of Nigeria had a high proportion of non-condom use among young people, while the Northwest, North-Central, and Southwestern parts had low proportions of non-condom use. On multilevel analysis, the individual and community level factors associated with non-condom use included exposure to media (AOR 0.59; 95% CI 0.39-0.91) and younger age (AOR 0.72; 95% CI 0.53-0.98). Areas with a high proportion of non-condom use should receive the most attention through the promotion of condom use and education, alongside a focus on important associated factors.
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Conducta Sexual , Humanos , Adolescente , Nigeria/epidemiología , Masculino , Femenino , Estudios Transversales , Adulto Joven , Conducta Sexual/estadística & datos numéricos , Condones/estadística & datos numéricos , Prevalencia , Adulto , Infecciones por VIH/epidemiología , Análisis Espacial , Asunción de RiesgosRESUMEN
Adaptive behavior depends on appropriate responses to environmental uncertainty. Incidental sensory events might simply be distracting and increase errors, but alternatively can lead to stereotyped responses despite their irrelevance. To evaluate these possibilities, we test whether task-irrelevant sensory prediction errors influence risky decision making in humans across seven experiments (total n = 1600). Rare auditory sequences preceding option presentation systematically increase risk taking and decrease choice perseveration (i.e., increased tendency to switch away from previously chosen options). The risk-taking and perseveration effects are dissociable by manipulating auditory statistics: when rare sequences end on standard tones, including when rare sequences consist only of standard tones, participants are less likely to perseverate after rare sequences but not more likely to take risks. Computational modeling reveals that these effects cannot be explained by increased decision noise but can be explained by value-independent risky bias and perseveration parameters, decision biases previously linked to dopamine. Control experiments demonstrate that both surprise effects can be eliminated when tone sequences are presented in a balanced or fully predictable manner, and that surprise effects cannot be explained by erroneous beliefs. These findings suggest that incidental sounds may influence many of the decisions we make in daily life.
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Toma de Decisiones , Asunción de Riesgos , Sonido , Humanos , Femenino , Masculino , Toma de Decisiones/fisiología , Adulto , Adulto Joven , Estimulación Acústica , Percepción Auditiva/fisiología , Adolescente , Conducta de Elección/fisiología , IncertidumbreRESUMEN
BACKGROUND: Workforce health is one of the primary and challenging issues, especially in industrialized countries. The purpose of the present study was to evaluate the ability to predict accident-proneness among Saveh Industry workers in Iran, based on an extended Health Belief Model, that included the construct of spiritual health. METHOD: This descriptive-analytical study was conducted in 2022 on 384 workers in Saveh, Iran. The study aimed to explore relationships between accident proneness behavior, spiritual health, and health beliefs. The accident-proneness questionnaire consisted of two parts: the first part included demographic questions, and the second part comprised 9 sections covering personality traits, workplace harmful factors, miscellaneous factors, musculoskeletal disorders, safety culture, safety attitudes, job stress, organization interest, and degree of risk-taking. The Health Belief Model included 31 questions, while spiritual health was measured with the 20-question Paloutzian and Ellison questionnaire. The collected data were analyzed using SPSS version 26 software. RESULTS: In terms of accident proneness, 229 (59.6%), exhibited high levels, 148 (38.5%) had medium levels, and 7 (1.8%) showed low levels of accident-proneness. Hierarchical multiple regression analysis showed that in the first model, variables of perceived self-efficacy, vulnerability, and severity independently predicted workers accident proneness, explaining a total of 43% of variance in accident proneness behavior. In the second step, perceived self-efficacy (ß = 34%), perceived sensitivity (ß = 27%), spiritual health (ß = 16%), and perceived severity (ß = 12%) were included, respectively, which explained a total of 46% of the variance of accident-prone behavior of workers. CONCLUSION: Given the high rate of accident proneness observed in this study, there is a critical need for policymakers and health planners to design policies aimed at mitigating the risks associated with occupational accidents. Furthermore, the findings highlight the potential of integrating spiritual health into the Health Belief Model, as a conceptual framework for planning effective intervention programs to enhance workplace safety.
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Accidentes de Trabajo , Modelo de Creencias sobre la Salud , Espiritualidad , Humanos , Irán , Masculino , Adulto , Femenino , Accidentes de Trabajo/psicología , Accidentes de Trabajo/prevención & control , Persona de Mediana Edad , Encuestas y Cuestionarios , Adulto Joven , Salud Laboral , Autoeficacia , Asunción de Riesgos , Lugar de Trabajo/psicologíaRESUMEN
BACKGROUND: Sex differences in the symptomatology of adults with attention-deficit/hyperactivity disorder (ADHD) have often been overlooked when studying behavioral abnormalities. However, it is known that women exhibit considerably more stronger symptoms related to emotional competence than men. Since affective functions significantly influence the processing of risky decision-making and risk-engagement, we assume that risky behavior in ADHD is affected by sex differences. Therefore, we specifically investigated sex-specific effects on the interaction between emotionally induced changes in physiology and behavioral performance on a decision-making task. METHODS: Skin conductance responses of twenty-nine adults with ADHD (n = 16 male; n = 13 female) and thirty-three adults in the control group (n = 14 male; n = 19 female) were recorded during the performance in a modified version of the Balloon Analogue Risk Task (BART). Additional questionnaires were used to reveal insights in the self-assessment of emotional competence, risk perception, and feedback sensitivity. Emotional arousal and decision-making behavior were analyzed using linear mixed-effects models. RESULTS: Results showed different effects of sex on risk behaviors in controls and ADHD. In contrast to healthy controls, female adults with ADHD showed a significantly greater risk engagement in the BART compared to males with ADHD. This contrary sex relation was not observed in skin conductance responses and revealed a significantly different sex-dependent correlation of body response and behavioral task performance in ADHD. Comparisons with results from self-assessments furthermore indicate a reduced behavioral self-perception in women with ADHD, but not in men. CONCLUSION: In summary, we found an altered interaction between physiological activity and risky behavior in women with ADHD. Thus, the present study indicates a reduced sensitivity towards the own bodily responses in women with ADHD, which could consequently cause increased risky DM behavior in daily life. The current results suggest that more consideration needs to be given to sex-specific effects on physiological processes and behavior in adults with ADHD.
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Trastorno por Déficit de Atención con Hiperactividad , Toma de Decisiones , Respuesta Galvánica de la Piel , Asunción de Riesgos , Humanos , Femenino , Masculino , Trastorno por Déficit de Atención con Hiperactividad/fisiopatología , Trastorno por Déficit de Atención con Hiperactividad/psicología , Adulto , Toma de Decisiones/fisiología , Respuesta Galvánica de la Piel/fisiología , Factores Sexuales , Emociones/fisiología , Adulto Joven , Caracteres SexualesRESUMEN
Objective: To develop a software application for early detection of adolescent's risky behaviour, and promotion of safe reproductive health. METHODS: The multi-stage study was conducted from September 20, 2018, to April 3, 2019, at Rumbai District Pekanbaru, Riau-Indonesia. The planned software application was developed using the waterfall design model which is a sequential process. Every progress was acknowledged to be flowing downwards, like a waterfall, by going through the phases of requirements, design, implementation, verification and maintenance. The application software was pilot-tested on a group of adolescents after it was first tested for validity. The adolescents were given a questionnaire at baseline and 2 weeks after the intervention to assess the application's effectiveness. The data was analyzed using SPSS version 21. RESULTS: Validation of the tool was confirmed by Aiken's V values >0.85, with sensitivity 84.8% and specificity 75%. Of the 45 adolescents tested, majority respondens were girls 38(84,4%), early adolescent 18(40%), middle adolescent 16(35,5%) and late adolescent 11(24,4%). About 5(11.1%) were found to be positive, and 28(62.2%)were truly positive, while 3(6.7%) were found negative and 9(20%) were truly negative. There was a significant difference between the pre-test and post-test assessments (p=0.0001). Conclusion: The application proved to be effective for the early detection of risky behaviour, and for the promotion of safe reproductive health.
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Embarazo en Adolescencia , Asunción de Riesgos , Programas Informáticos , Humanos , Adolescente , Femenino , Embarazo en Adolescencia/prevención & control , Embarazo , Masculino , Conducta del Adolescente/psicología , Conducta Sexual , Encuestas y CuestionariosRESUMEN
Autism spectrum disorders (ASD) are highly heterogeneous neurodevelopmental diseases. Epidemiological data report that males have been diagnosed with autism more frequently than females. However, recent studies hypothesize that females' low incidence might be underestimated due to standard clinical measures of ASD behavioural symptoms, mostly derived from males. Indeed, up to now, ASD mouse models focused mainly on males, considering the prevalence of the diagnosis in that sex. Regarding ASD aetiopathogenesis, it has been recently reported that oxidative stress might be implicated in its onset and development, suggesting an association with ASD typical repetitive behaviours that still need to be disentangled. Here, we investigated possible behavioural and molecular sex-related differences by using the BTBR mouse model of idiopathic ASD. To this aim, animals were exposed to behavioural tests related to different ASD core symptoms and comorbidities, i.e. stereotyped repertoire, social dysfunctions, hyperlocomotion and risk-taking behaviours. Moreover, we analyzed hippocampal levels of pro-oxidant and anti-oxidant enzymes, together with biomarkers of oxidative stress and lipid peroxidation. Our results showed that BTBR females did not display the same patterns for repetitive behaviours as the male counterpart. From a biomolecular point of view, we found an increase in oxidative stress and pro-oxidant enzymes, accompanied by deficient enzymatic anti-oxidant response, only in BTBR males compared to C57BL/6 male mice, while no differences were retrieved in females. Overall, our study suggests that in females there is an urgent need to depict the distinct ASD symptomatology, accompanied by the identification of sex-specific pharmacological targets.
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Trastorno del Espectro Autista , Modelos Animales de Enfermedad , Hipocampo , Estrés Oxidativo , Caracteres Sexuales , Animales , Trastorno del Espectro Autista/metabolismo , Hipocampo/metabolismo , Femenino , Masculino , Ratones , Estrés Oxidativo/fisiología , Conducta Estereotipada/fisiología , Conducta Estereotipada/efectos de los fármacos , Oxidación-Reducción , Conducta Animal/fisiología , Ratones Endogámicos C57BL , Peroxidación de Lípido/fisiología , Asunción de RiesgosRESUMEN
BACKGROUND: The main mode of transmission of Hepatitis C in North America is through injection drug use. Availability of accessible care for people who inject drugs is crucial for achieving hepatitis C elimination. OBJECTIVE: The objective of this analysis is to compare the changes in injection drug use frequency and high-risk injection behaviors in participants who were randomized to accessible hepatitis c care versus usual hepatitis c care. METHODS: Participants who were hepatitis C virus RNA positive and had injected drugs in the last 90 days were enrolled and randomized 1:1 to an on-site, low threshold accessible care arm or a standard, referral-based usual care arm. Participants attended follow-up appointments at 3, 6, 9, and 12 months during which they answered questions regarding injection drug use frequency, behaviors, and treatment for opioid use disorder. PRIMARY OUTCOMES: The primary outcomes of this secondary analysis are the changes in the frequency of injection drug use, high-risk injection behaviors, and receiving medication for opioid use disorder in the last 30 days. RESULTS: A total of 165 participants were enrolled in the study, with 82 participants in the accessible care arm and 83 participants in the usual care arm. Participants in the accessible care arm were found to have a statistically significant higher likelihood of reporting a lower range of injection days (accessible care-by-time effect OR = 0.78, 95% CI = 0.62-0.98) and injection events (accessible care-by-time effect OR = 0.70, 95% CI = 0.56-0.88) in the last 30 days at a follow-up interview relative to those in the usual care arm. There were no statistically significant differences in the rates of decrease in receptive sharing of injection equipment or in the percentage of participants receiving treatment for opioid use disorders in the two arms. CONCLUSION: Hepatitis C treatment through an accessible care model resulted in statistically higher rates of decrease in injection drug use frequency in people who inject drugs.
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Hepatitis C , Programas de Intercambio de Agujas , Abuso de Sustancias por Vía Intravenosa , Humanos , Masculino , Femenino , Hepatitis C/tratamiento farmacológico , Hepatitis C/epidemiología , Abuso de Sustancias por Vía Intravenosa/complicaciones , Adulto , Persona de Mediana Edad , Asunción de Riesgos , Trastornos Relacionados con Opioides/terapia , Trastornos Relacionados con Opioides/epidemiologíaRESUMEN
BACKGROUND: Clustering lifestyle risk behaviors is important for predicting cardiovascular disease risk. However, it is unclear which behavior mediates other ones to influence cardiovascular disease risk. We aimed to assess the causal inference of each lifestyle risk behavior for the atherosclerotic cardiovascular disease (ASCVD) risk of the general population. METHODS: We performed a Bayesian network mediation analysis using data from the Korea National Health and Nutrition Examination Survey from 2014 to 2019. The main exposure was a combination of lifestyle risk behaviors including unhealthy weight, heavy alcohol consumption, inadequate sleep, physical inactivity, excessive sodium intake, and current smoking among subjects 40 to 79 years of age. The high risk of ASCVD (≥7.5% for the 10-year risk) was assessed using logistic regression, Bayesian networks, and structural equational models to examine the causal relationships between these six lifestyle risk behaviors. RESULTS: Among all participants, the most prevalent lifestyle risk behavior for those at high risk for ASCVD was excessive sodium intake (95.6%), followed by inadequate sleep (49.9%) and physical inactivity (43.8%). Older age (65-79 years) and male sex were directly associated with a high risk for ASCVD. Physical inactivity, current smoking, excessive sodium intake, and unhealthy weight indirectly mediated the effects of older age (8.2% of the older age) and male sex (39.9% of males) to high ASCVD risk. Physical inactivity, current smoking, excessive sodium intake, and unhealthy weight particularly mediated the high ASCVD risk sequentially. Heavy alcohol consumption and inadequate sleep were not directly associated with high ASCVD risk and did not indirectly mediate the effects of older age and males on the high ASCVD risk. CONCLUSION: Lifestyle risk behaviors mediated the atherosclerotic cardiovascular disease risk in a different manner. Especially, physical inactivity preceded current smoking, excessive sodium intake, and unhealthy weight in relation to high ASCVD risk, and this causal relationship was different according to age and sex. Therefore, tailored strategies according to specific target populations may be needed to effectively reduce the high ASCVD risk.
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Aterosclerosis , Estilo de Vida , Encuestas Nutricionales , Humanos , Masculino , Persona de Mediana Edad , Femenino , República de Corea/epidemiología , Anciano , Adulto , Aterosclerosis/epidemiología , Fumar/epidemiología , Factores de Riesgo , Consumo de Bebidas Alcohólicas/epidemiología , Teorema de Bayes , Asunción de Riesgos , Enfermedades Cardiovasculares/epidemiología , Enfermedades Cardiovasculares/etiologíaRESUMEN
Adolescents represent 16% of the global population and they are identified as a critical demographic group for promoting sexual health. Adolescents are susceptible to engaging in risky sexual behaviors (RSB) such as early sexual initiation, having multiple sexual partners, substance use during sexual encounters and practicing unsafe sex. Adolescents represent 16% of the global population and they are identified as a critical demographic group for promoting sexual health. Adolescents are susceptible to engaging in risky sexual behaviors (RSB) such as early sexual initiation, having multiple sexual partners, substance use during sexual encounters and practicing unsafe sex. To assess risky Sexual behaviors and associated factors among adolescent in Gedeo Zone, Southern Ethiopia: A community based cross-sectional study. A community based cross-sectional study was conducted in Gedeo Zone among adolescents. A total of 2780 (99.3%) adolescents were participated in the study and gave the response rate of 99.3%. A pre-tested structured questionnaire was used to gather the data and analyzed by using SPSS version 23. During analysis initially bivariable logistic regression model was used then, those variables with a level of significant at a P-value ≤ 0.25 were considered as candidate for multivariable logistic regression model. A level of significant at a P-value ≤ 0.05 was considered as statistically significant in this study. Out of 428 sexually active adolescent 334 (78%) exposed to risky sexual practice. More than half 54.3% of adolescent was protestant in religion followed by Orthodox 34.2% and Muslim 11.5%. In terms of ethnicity, Gedeo 67.4% was the dominant ethnic group in the study area. Mean age at sexual initiation was 15 ± 1.8.Residence AOR 1.14 (1.36-5.25), Sex AOR 2.77 (1.31-5.86), Age AOR 2.01 (1.41-6.39), School attending AOR 1.93 (1.27-5.75), Watching Pornographies AOR 2.51 (1.36-4.62) and Parental monitoring AOR 2.10 (1.07-4.10) were independent predictor of risky sexual practice in this study. The prevalence of risky sexual behavior was found to be alarming among adolescents aged 14-19 years, mostly rural and female adolescents and those adolescent start sexual practice earlier exposed to risky sexual practice than their counter parts. Sexual urge, watching pornography and not attending school were the major factor for risky sexual behaviors of adolescent. Parental over all control can protect risky sexual behaviors among adolescent.
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Asunción de Riesgos , Conducta Sexual , Humanos , Adolescente , Etiopía/epidemiología , Masculino , Femenino , Estudios Transversales , Conducta Sexual/psicología , Encuestas y Cuestionarios , Conducta del Adolescente , Sexo Inseguro/estadística & datos numéricos , Factores de RiesgoRESUMEN
The deleterious health effects of prolonged sitting and physical inactivity are well-established, yet these behaviors are pervasive in modern culture. To inform interventions aimed at reducing sedentary behavior and increasing lifestyle activity, this study examined psychological and behavioral economic factors that may be associated with these behaviors. This cross-sectional study was conducted among 4072 adults in Israel. Participants completed a survey pertaining to lifestyle behaviors and economic preferences using an online platform in September 2020. The psychological and behavioral economic factors of interest were patience, self-control, risk-taking, grit, and general self-efficacy. Sedentary behavior and lifestyle activity (e.g., time spent moving about) was assessed using the Rapid Assessment Disuse Index (RADI) tool (higher score indicative of more sitting and less activity). Multivariable linear and logistic regression analyses examined the association between psychological and behavioral economic factors and RADI score. Among 4072 participants, those who were impatient (vs. patient, ß: -1.13; 95% CI: -1.89, -0.38) had higher grit (ß: -1.25, 95% CI: -1.73, -0.77), and those who were more risk-seeking (ß: -0.23; 95% CI: -0.33, -0.13) had lower RADI scores (i.e., less sedentary, more active). Significant associations for grit and risk-taking were also observed when the RADI score was dichotomized, such that individuals who had higher grit or were more risk-seeking were more likely to be non-sedentary/active. No significant associations were observed for self-control or general self-efficacy. Higher grit and more risk-seeking were associated with a decreased propensity for sedentary behaviors and inactivity; these factors may provide targets for interventions aimed at reducing sedentary behavior and increasing lifestyle activity.
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COVID-19 , Conducta Sedentaria , Humanos , Masculino , Femenino , COVID-19/psicología , Estudios Transversales , Adulto , Persona de Mediana Edad , Israel/epidemiología , Ejercicio Físico/psicología , Anciano , SARS-CoV-2 , Autoeficacia , Economía del Comportamiento , Adulto Joven , Encuestas y Cuestionarios , Asunción de RiesgosRESUMEN
Suicide in young people is a public health problem. Typically, protective factors for suicide are not studied; research tends to focus on measuring risk factors. However, knowing the risk factors does not mean that we also know the opposing factors that influence a group's health problems. For this reason, we examined the relationship between developmental assets in Mexican youth aged 18 to 25 years who are not at risk for suicide, exhibit self-injurious behavior, and whose last suicide attempt had low or high lethality. A cross-sectional study of 478 young people (73% female and 27% male) from Mexico City was conducted using an online survey and correlations were tested with dummy variables (groups) and multinomial logistic regression. The no-risk group showed associations with all developmental assets, the self-injurious group had an association with the house rules variable, the low lethality group was correlated with twelve assets and the high lethality group with four assets. Four internal developmental strengths were significant in the regression model: avoidance of risk behaviors, school expectations, resistance to pressure, and expression of anger. These results suggest that PYD is a useful framework for examining suicide risk and promotes skill development in young college students.
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Intento de Suicidio , Humanos , Femenino , Masculino , México/epidemiología , Adulto Joven , Adolescente , Estudios Transversales , Adulto , Factores de Riesgo , Intento de Suicidio/estadística & datos numéricos , Suicidio/estadística & datos numéricos , Encuestas y Cuestionarios , Conducta Autodestructiva/epidemiología , Asunción de RiesgosRESUMEN
Cannabis is the most used illicit drug among youths in the United States. The objectives of this study were to identify the association between cannabis use and other risk behaviors, including suicidality, among high school students. This is a cross-sectional study using the 2021 Mississippi Youth Risk Behavior Surveillance System (YRBS). The 2021 YRBS data sets were combined for this study. The crude odds ratio (OR) and adjusted odds ratio (AOR) with a 95% confidence interval were generated using the survey packages in R to account for weights and the complex sampling design of the YRBS data. Univariate analysis identified seven risky behaviors that were significantly associated with current cannabis use, including carrying weapons on school campuses, suicidal attempts, electronic vapor use, current smoking, current drinking, sexual behaviors, and unsupervised children. In multivariable analysis, after adjusting for gender, race, students' grades, and other risky behaviors, statistically significant variables for cannabis use included current use of electronic vapor, current smoking, current drinking, and sexual behaviors. Cannabis use is evenly burdened between males and females and between all race categories among Mississippi high school students. The identified associations seem to indicate that electronic vapor, tobacco products, and alcohol use could be the forerunners for drug use and should be treated accordingly in drug use prevention programs.
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Asunción de Riesgos , Estudiantes , Humanos , Mississippi/epidemiología , Adolescente , Masculino , Femenino , Estudios Transversales , Estudiantes/estadística & datos numéricos , Estudiantes/psicología , Uso de la Marihuana/epidemiología , Conducta del Adolescente/psicología , Instituciones AcadémicasRESUMEN
The prevalence and influence of gangs on adolescents and young adults remain a concern in Western Cape, South Africa-particularly as they have one of the largest gang presence. While less attention has been focused on young women, there is a need to elucidate the relationship between gang exposure and health behaviors, such substance use, in addition to understanding whether becoming a caregiver impacts this relationship. This study uses baseline data from 496 participants enrolled in a NIDA-funded R01 trial that recruited young women aged 16 to 19 who were out of school and reported recent alcohol or other drug use and sexual risk behavior. At enrollment, a risk behavior survey was administered, and urine drug screening was conducted. Multivariable logistic regression analyses were conducted to examine baseline associations between childbirth, a gang exposure index based on eight items, and positive drug screens of the most prevalent drugs in the Western Cape (marijuana, methaqualone, and methamphetamine). At enrollment, approximately 39% of the sample had a positive urine screen for marijuana, 17% for methaqualone, and 11% for methamphetamine. Additionally, 28% had ever given birth. While only 6% reported ever being a member of a gang, most reported exposure to gangs through their physical and social environments. For all three drugs, gang exposure was associated with statistically significantly higher odds of a positive screen. Every one-point increase in the gang exposure index was associated with a 31% increase in the odds of a positive marijuana screen (p < .001), a 26% increase for methaqualone (p = 0.005) and a 37% increase in the odds of a positive methamphetamine screen (p < .001). Ever given birth was associated with lower odds of marijuana use (adjusted odds ratio [AOR]: 0.63; 95% CI: 0.42-0.96), but it was not associated with methaqualone or methamphetamine use. The findings suggest that exposure to gangs through young women's social and physical environment is positively associated with drug use. Childbirth was also protective for marijuana use, indicating there may be something unique about this type of drug, such as one's ability to more easily stop use. Although very few young women reported gang membership, a majority reported some exposure, indicating the need to address how pervasive this exposure is and the potential risk.
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Trastornos Relacionados con Sustancias , Humanos , Femenino , Sudáfrica/epidemiología , Adulto Joven , Adolescente , Trastornos Relacionados con Sustancias/epidemiología , Parto , Metanfetamina/orina , Asunción de Riesgos , Grupo Paritario , Embarazo , PrevalenciaRESUMEN
BACKGROUND: Adolescents' risky sexual behaviours (RSB) are detrimental to their sexual and reproductive health (SRH) well-being and present a serious public health threat, particularly in low- and middle-income countries (LMICs). AIM: This study aims to assess RSB among Grade 12 school-going adolescents after exposure to comprehensive sexuality education (CSE). SETTING: This study was conducted in Kitwe district, Zambia. METHODS: This cross-sectional study included 807 Grade 12 pupils at 13 selected secondary schools. Data were collected using a structured questionnaire. Proportionate probability sampling involving 13 schools was employed. Risky sexual behaviours binary outcome variables were based on transactional sex, sex while drunk, multiple sexual partners, age-disparate sexual relationships, and condomless sex. We conducted univariate and bivariate analyses to summarise sociodemographic factors and fitted binary and multivariable logistic regression models. RESULTS: The prevalence of RSB was 40.4%. Drinking alcohol (adjusted odds ratio [AOR] = 20.825; 95% CI [6.7-64.489]); ever had sex (AOR = 9.024; 95% CI [1.953-41.704]); school location (AOR = 6.50; 95% CI [1.61-26.24]); living with mother only (AOR = 4.820; 95% CI [1.328-17.493]); sex (male) (AOR = 2.632; 95% CI [1.469-4.713]), watching pornography (AOR = 1.745; 95% CI [1008-3.021]); religion (AOR = 0.472; 95% CI [0.250-0.891]) and attending religious functions (AOR = 0.317; 95% CI [0.118-0.848]) were significantly associated with RSB. Of the sexually active pupils, 221 (67.7%), 64 (19.6%) and 41 (12.5%) were in the low, medium and high-risk categories, respectively. CONCLUSION: Close to half of the respondents engaged in RSB. This is a significant number that needs intervention. The CSE programme needs to be linked with structural programmes that address the social drivers of RSB among adolescents.Contribution: The study provides a backdrop for evaluating current CSE strategies in LMICs.