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Kim SH, Park JH, Jung SY, De Gagne JC. Internet-Based Interventions for Preventing Premature Birth Among Pregnant Women: Systematic Review. JMIR Pediatr Parent 2024; 7:e54788. [PMID: 38564247 PMCID: PMC11022135 DOI: 10.2196/54788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Revised: 12/13/2023] [Accepted: 02/28/2024] [Indexed: 04/04/2024] Open
Abstract
BACKGROUND Premature birth rates have slightly increased globally, making its prevention critical for both short-term and long-term health outcomes. Various interventions have been developed in response to the multifaceted risk factors for premature birth, including internet-based programs. These programs offer accessibility and enhanced engagement; however, their overall efficacy in preventing premature births requires thorough evaluation. OBJECTIVE This systematic review aims to identify the study designs and assess the effectiveness of internet-based interventions in preventing premature birth among pregnant women. METHODS A comprehensive search of the MEDLINE, Embase, CINAHL, and Cochrane Library databases was conducted to identify randomized trials and quasi-experimental studies evaluating internet-based interventions for premature birth prevention in pregnant women. The search was inclusive, with no restrictions based on language or geographical location, allowing for a comprehensive global perspective. The time frame for the inclusion of studies extended until February 2023. The risk of bias (RoB) in each study was independently assessed by 3 authors forming pairs, using the revised Cochrane RoB tool (RoB 2) for randomized trials, as per the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Owing to heterogeneity in populations, measurements, and interventions, a meta-analysis was not conducted. RESULTS This review included 26 articles, comprising 12 intention-to-treat and 14 per-protocol studies. The overall RoB was high in most intention-to-treat studies and of some concern in most per-protocol studies. The target populations varied, including nonspecific pregnant women, those with gestational diabetes mellitus (GDM) or those at risk of GDM, individuals with anxiety or depression, and those experiencing preterm labor. Psychosocial, physiological, and wellness health outcomes were evaluated. Internet-based interventions effectively reduced stress/distress in nonspecific pregnant women but not in those experiencing preterm labor. Their effectiveness in reducing anxiety and depression varied, with inconsistent results among different groups. In women with GDM or those at risk of GDM, interventions successfully controlled fasting plasma glucose and 2-hour postprandial plasma glucose levels but did not consistently manage glycated hemoglobin levels. These interventions did not reduce the incidence of premature births across the various populations studied. The effectiveness of these internet-based interventions in addressing substance or alcohol abuse and insomnia also varied. CONCLUSIONS Internet-based interventions show promise in improving psychosocial health and managing blood sugar to prevent premature birth, highlighting variability in effectiveness across different risk factors. Further research, including clinical trials, is vital for developing, evaluating, and disseminating effective, safe internet-based interventions. Establishing standardized measurement tools and rigorous evaluation processes is crucial for enhancing these interventions' effectiveness and reliability in clinical practice, significantly contributing to preventing premature births and improving maternal health outcomes. TRIAL REGISTRATION PROSPERO CRD42021278847; https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021278847.
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Affiliation(s)
- Sun-Hee Kim
- College of Nursing, Research Institute of Nursing Science, Daegu Catholic University, Daegu, Republic of Korea
| | - Jin-Hwa Park
- College of Nursing, Research Institute of Nursing Science, Daegu Catholic University, Daegu, Republic of Korea
| | - Sun-Young Jung
- College of Nursing, Research Institute of Nursing Science, Daegu Catholic University, Daegu, Republic of Korea
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Mohamadpour F, Mohammadi N. Effectiveness of online integrative trans-diagnostic treatment on internet addiction and high-risk behaviors in female adolescents with borderline personality disorder with comorbid depressive disorder. Front Psychiatry 2024; 14:1291579. [PMID: 38250259 PMCID: PMC10797106 DOI: 10.3389/fpsyt.2023.1291579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Accepted: 12/14/2023] [Indexed: 01/23/2024] Open
Abstract
Background Based on research, borderline personality disorder is associated with many behavioral and emotional problems, including Internet addiction and high-risk behaviors. On the other hand, integrative trans-diagnostic treatment, by targeting trans-diagnostic factors in emotional pathology, is considered a suitable treatment for comorbid psychological pathologies. Also, since in adolescence, the opinion of others about oneself is more important, online therapy has the advantage of protecting them from the fear of stigma and shame in the face of others' judgments. Therefore, the aim of the current research was to investigate the effectiveness of online integrative trans-diagnostic treatment on the internet addiction and high-risk behaviors in adolescents with borderline personality disorder. Methods The current research was applied and quasi-experimental in a pre-test-post-test manner with a control group. The research sample included 40 female adolescents with borderline personality disorder who were randomly divided into two groups of 20 people, experimental and control groups. The criteria for entering the research included the age range of 12 to 18 years, female, confirmation of the disease by a psychologist, not receiving other psychological treatments in the last 3 months, and having a smartphone to participate in the online group. Substance abuse, any serious mental and physical illness/disorder that interferes with treatment, and failure to attend more than two sessions in therapy sessions were some of the exclusion criteria.The participants were tested on the scales of internet addiction and high-risk behaviors. Then, the treatment plan based on online integrative trans-diagnostic group therapy was presented to the participants of the experimental group online in 9 two-hour sessions. The control group was placed on the waiting list until the completion of the treatment sessions and the post-test implementation, and after the post-test implementation, they received the treatment. Then, their scores were measured, after completing the treatment, and a three-month follow-up period. Descriptive statistics and covariance test were used to analyze the data. Results Patients showed a clear improvement in the severity of internet addiction and high-risk behavior symptoms. So that the scores of internet addiction and high-risk behaviors in the experimental group after receiving the treatment, as well as after a three-month follow-up period, were significantly reduced (p < 0.001). Conclusion These results show that online integrative trans-diagnostic therapy can be an effective treatment option for reducing some symptoms of risky behaviors and internet addiction in adolescents with borderline personality disorder and should be studied further. It is noteworthy that the limitations of this study were the available sampling method, the use of a unisex sample of female patients, and the short-term follow-up period, which makes it difficult to generalize the results.
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Affiliation(s)
- Fahimeh Mohamadpour
- Department of Clinical Psychology, Faculty of Educational Sciences and Psychology, Shiraz University, Shiraz, Iran
| | - Nurallah Mohammadi
- Department of Clinical Psychology, Faculty of Educational Sciences and Psychology, Shiraz University, Shiraz, Iran
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3
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Eger WH, Adaralegbe A, Khati A, Azwa I, Wickersham JA, Osborne S, Shrestha R. Exploring drivers of pre-exposure prophylaxis uptake among gay, bisexual, and other men who have sex with men in Malaysia. Int J STD AIDS 2022; 33:821-828. [PMID: 35772943 PMCID: PMC10069270 DOI: 10.1177/09564624221106535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Pre-exposure prophylaxis (PrEP) is a valuable HIV prevention strategy, particularly among men who have sex with men (MSM); however, PrEP uptake is below the threshold needed to curb the HIV epidemic among this group, especially in settings like Malaysia, where same-sex sexual behavior is illegal. METHODS A sample of 355 participants completed an online survey between June and July 2020, recruited through geosocial networking apps for MSM and social networking websites (e.g. Facebook). We used descriptive and multivariable analyses to examine correlates of PrEP use within this population. RESULTS The sample was predominantly Malay (53.5%), had monthly incomes greater than RM 3000 (USD 730) (52.7%), and a tertiary level of education (84.5%). About 80% of participants heard of PrEP prior to the survey, with significantly less (18.3%) having ever taken PrEP. In the adjusted multivariable logistic model, using drugs before or during sexual intercourse ("chemsex") (AOR: 3.37; 95% CI: 1.44-7.89), being diagnosed with a sexually transmitted infection in the last 12 months (AOR: 2.08; 95% CI: 1.13-3.85), HIV testing in the previous 6 months (AOR: 3.23; 95% CI: 1.74-5.99), and disclosure of sexual orientation (AOR: 1.85; 95% CI: 1.02-3.34) were associated with having taken PrEP in the past. CONCLUSIONS This study revealed that PrEP use among Malaysian MSM is relatively low, despite high awareness, and is associated with healthcare engagement and high-risk behaviors. These results highlight the need to tailor outreach activities for individuals at increased risk for HIV and those disengaged with the health system.
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Affiliation(s)
- William H Eger
- Department of Internal Medicine, Section of Infectious Diseases, 12228Yale School of Medicine, New Haven, CT, USA
| | - Adeleye Adaralegbe
- Department of Allied Health Sciences, 7712University of Connecticut, Mansfield, CT, USA
| | - Antoine Khati
- Department of Allied Health Sciences, 7712University of Connecticut, Mansfield, CT, USA
| | - Iskandar Azwa
- Department of Medicine, Faculty of Medicine, 37447University of Malaya, Kuala Lumpur, Malaysia.,Centre of Excellence for Research in AIDS (CERiA), Faculty of Medicine, 37447University of Malaya, Kuala Lumpur, Malaysia
| | - Jeffrey A Wickersham
- Department of Internal Medicine, Section of Infectious Diseases, 12228Yale School of Medicine, New Haven, CT, USA.,Centre of Excellence for Research in AIDS (CERiA), Faculty of Medicine, 37447University of Malaya, Kuala Lumpur, Malaysia
| | - Sydney Osborne
- Department of Allied Health Sciences, 7712University of Connecticut, Mansfield, CT, USA
| | - Roman Shrestha
- Department of Internal Medicine, Section of Infectious Diseases, 12228Yale School of Medicine, New Haven, CT, USA.,Department of Allied Health Sciences, 7712University of Connecticut, Mansfield, CT, USA.,Centre of Excellence for Research in AIDS (CERiA), Faculty of Medicine, 37447University of Malaya, Kuala Lumpur, Malaysia.,Institute for Collaboration on Health, Intervention, and Policy (InCHIP), 7712University of Connecticut, Mansfield, CT, USA
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Venkatachalam BV, Thokala RP, Anandan A, Radhakrishnan K. Assessment of noncompliance in self-disclosure of deferrable risk behaviors among blood donors. Asian J Transfus Sci 2022; 16:201-208. [PMID: 36687555 PMCID: PMC9855210 DOI: 10.4103/ajts.ajts_119_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 12/25/2021] [Accepted: 05/17/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Blood transfusion services work to ensure universal accessibility of safe and effective blood products for transfusion to recipients. Failure of blood donors to disclose complete truthful information before blood donation is termed as noncompliance. Noncompliance in disclosing high-risk behaviors could compromise blood safety. This study aimed to assess the prevalence rate of noncompliance and assess the predictive factors and reasons for noncompliance. MATERIALS AND METHODS Blood donors were asked to fill a postdonation anonymous questionnaire after obtaining consent and the responses were tabulated and analyzed. Prevalence of noncompliance for both high-risk and nonhigh-risk behaviors are evaluated. Variables associated with noncompliance are analyzed by univariate analysis and logistic regression. RESULTS Total number of participants was 3001, 2850 participants gave valid responses and included in the study. There were 94 (3.30%) responses revealing noncompliance for nonhigh-risk behavior and 30 (1.05%) responses revealing noncompliance for high-risk behavior. The predictor variables for noncompliance in reporting high-risk behavior were education and adultery. The predictor variables for noncompliance in nonhigh-risk behavior reporting were presence of comorbidity and adultery. CONCLUSION Noncompliance in disclosure of high-risk behavior compromises blood safety. Blood donors must be ensured sufficient privacy while filling predonation questionnaire and while eliciting history any deferrable behaviors during blood donor medical examination. Privacy and confidence of the donors must be ensured either to share any postdonation information directly or anonymously to facilitate confidential unit exclusion.
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Affiliation(s)
- Bala Vignesh Venkatachalam
- Department of Transfusion Medicine, Sri Ramachandra Medical College and Research Institute, Sri Ramachandra Institute if Higher Education and Research, Chennai, Tamil Nadu, India
| | - Ravindra Prasad Thokala
- Department of Transfusion Medicine, Sri Ramachandra Medical College and Research Institute, Sri Ramachandra Institute if Higher Education and Research, Chennai, Tamil Nadu, India
| | - Ashwin Anandan
- Department of Transfusion Medicine, Sri Ramachandra Medical College and Research Institute, Sri Ramachandra Institute if Higher Education and Research, Chennai, Tamil Nadu, India
| | - Krishnamoorthy Radhakrishnan
- Department of Transfusion Medicine, Sri Ramachandra Medical College and Research Institute, Sri Ramachandra Institute if Higher Education and Research, Chennai, Tamil Nadu, India
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Lim AG, Trickey A, Thompson LH, Emmanuel F, Reza TE, Reynolds R, Cholette F, Melesse DY, Archibald C, Sandstrom P, Blanchard JF, Vickerman P. Elucidating Drivers for Variations in the Explosive Human Immunodeficiency Virus Epidemic Among People Who Inject Drugs in Pakistan. Open Forum Infect Dis 2021; 8:ofab457. [PMID: 34584901 PMCID: PMC8465332 DOI: 10.1093/ofid/ofab457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Accepted: 09/01/2021] [Indexed: 11/23/2022] Open
Abstract
Background Pakistan’s explosive human immunodeficiency virus (HIV) epidemic among people who inject drugs (PWID) varies widely across cities. We evaluated possible drivers for these variations. Methods Multivariable regression analyses were undertaken using data from 5 national surveys among PWID (n = 18 467; 2005–2017) to determine risk factors associated with variations in city-level HIV prevalence. A dynamic HIV model was used to estimate the population-attributable fraction (PAF; proportion of HIV infections prevented over 10 years when that risk factor is removed) of these risk factors to HIV transmission and impact on HIV incidence of reducing their prevalence. Results Regression analyses suggested that city-level HIV prevalence is strongly associated with the prevalence of using professional injectors at last injection, heroin use in last month, and injecting ≥4 times per day. Through calibrating a model to these associations, we estimate that the 10-year PAFs of using professional injectors, heroin use, and frequent injecting are 45.3% (95% uncertainty interval [UI], 4.3%–79.7%), 45.9% (95% UI, 8.1%–78.4%), and 22.2% (95% UI, 2.0%–58.4%), respectively. Reducing to lowest city-level prevalences of using professional injectors (2.8%; median 89.9% reduction), heroin use (0.9%; median 91.2% reduction), and frequent injecting (0.1%; median 91.8% reduction) in 2020 reduces overall HIV incidence by 52.7% (95% UI, 6.1%–82.0%), 53.0% (95% UI, 11.3%–80.2%), and 28.1% (95% UI, 2.7%–66.6%), respectively, over 10 years. Conclusions Interventions should focus on these risk factors to control Pakistan’s explosive HIV epidemic among PWID, including a concomitant expansion of high-coverage needle/syringe provision, opioid substitution therapy, and antiretroviral therapy.
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Affiliation(s)
- Aaron G Lim
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Adam Trickey
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Laura H Thompson
- Centre for Global Public Health, University of Manitoba, Winnipeg, Canada
| | - Faran Emmanuel
- Centre for Global Public Health, University of Manitoba, Winnipeg, Canada.,Canada-Pakistan HIV/AIDS Surveillance Project, Islamabad, Pakistan
| | - Tahira E Reza
- Canada-Pakistan HIV/AIDS Surveillance Project, Islamabad, Pakistan
| | - Rosy Reynolds
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - François Cholette
- National HIV and Retrovirology Laboratories, JC Wilt Infectious Diseases Research Centre, Public Health Agency of Canada, Winnipeg, Canada.,Department of Medical Microbiology and Infectious Diseases, University of Manitoba, Winnipeg, Canada
| | | | - Chris Archibald
- Centre for Communicable Diseases and Infection Control, Public Health Agency of Canada, Ottawa, Canada
| | - Paul Sandstrom
- National HIV and Retrovirology Laboratories, JC Wilt Infectious Diseases Research Centre, Public Health Agency of Canada, Winnipeg, Canada
| | - James F Blanchard
- Centre for Global Public Health, University of Manitoba, Winnipeg, Canada
| | - Peter Vickerman
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
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6
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Mantua J, Bessey AF, Mickelson CA, Choynowski JJ, Noble JJ, Burke TM, McKeon AB, Sowden WJ. Sleep and high-risk behavior in military service members: a mega-analysis of four diverse U.S. Army units. Sleep 2021; 44:5944093. [PMID: 33125489 DOI: 10.1093/sleep/zsaa221] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 09/29/2020] [Indexed: 11/14/2022] Open
Abstract
Experimental sleep restriction and deprivation lead to risky decision-making. Further, in naturalistic settings, short sleep duration and poor sleep quality have been linked to real-world high-risk behaviors (HRB), such as reckless driving or substance use. Military populations, in general, tend to sleep less and have poorer sleep quality than nonmilitary populations due to a number of occupational, cultural, and psychosocial factors (e.g. continuous operations, stress, and trauma). Consequently, it is possible that insufficient sleep in this population is linked to HRB. To investigate this question, we combined data from four diverse United States Army samples and conducted a mega-analysis by aggregating raw, individual-level data (n = 2,296, age 24.7 ± 5.3). A negative binomial regression and a logistic regression were used to determine whether subjective sleep quality (Pittsburgh Sleep Quality Index [PSQI], Insomnia Severity Index [ISI], and duration [h]) predicted instances of military-specific HRB and the commission of any HRB (yes/no), respectively. Poor sleep quality slightly elevated the risk for committing HRBs (PSQI Exp(B): 1.12 and ISI Exp(B): 1.07), and longer duration reduced the risk for HRBs to a greater extent (Exp(B): 0.78), even when controlling for a number of relevant demographic factors. Longer sleep duration also predicted a decreased risk for commission of any HRB behaviors (Exp(B): 0.71). These findings demonstrate that sleep quality and duration (the latter factor, in particular) could be targets for reducing excessive HRB in military populations. These findings could therefore lead to unit-wide or military-wide policy changes regarding sleep and HRB.
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Affiliation(s)
- Janna Mantua
- Behavioral Biology Branch, Walter Reed Army Institute of Research, Silver Spring, MD
| | | | - Carolyn A Mickelson
- Behavioral Biology Branch, Walter Reed Army Institute of Research, Silver Spring, MD
| | - Jake J Choynowski
- Behavioral Biology Branch, Walter Reed Army Institute of Research, Silver Spring, MD
| | | | - Tina M Burke
- Behavioral Biology Branch, Walter Reed Army Institute of Research, Silver Spring, MD
| | - Ashlee B McKeon
- Behavioral Biology Branch, Walter Reed Army Institute of Research, Silver Spring, MD
| | - Walter J Sowden
- Behavioral Biology Branch, Walter Reed Army Institute of Research, Silver Spring, MD.,Tripler Army Medical Center, Honolulu, HI
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7
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Kiragga AN, Bwanika JM, Kyenkya J, Banturaki G, Kigozi J, Musinguzi D, Namimbi F, Chander G, Reynolds SJ, Manabe YC. Point-of-care testing for HIV and sexually transmitted infections reveals risky behavior among men at gambling centers in Uganda". Int J STD AIDS 2021; 32:903-910. [PMID: 33890852 DOI: 10.1177/09564624211000973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
In sub-Saharan Africa (SSA), men are generally difficult to engage in healthcare programs. However, sports gambling centers in SSA can be used as avenues for male engagement in health programs. We offered point-of-care HIV and syphilis testing for men located at five gambling centers in Uganda and assessed HIV risky sexual behavior. Among 507 men, 0.8% were HIV-positive and 3.8% had syphilis. Risky sexual behavior included condomless sex with partner(s) of unknown HIV status (64.9%), having multiple sexual partners (47.8%), engaging in transactional sex (15.5%), and using illicit drugs (9.3%). The majority at 64.5% were nonalcohol consumers, 22.9% were moderate users, and 12.6% had hazardous consumption patterns. In 12 months of follow-up, the incidence rate of syphilis was 0.95 (95% CI: 0.82-1.06) among 178 men. Thus, men in SSA have a high prevalence of syphilis and risky sexual behavior which should be more effectively addressed to reduce the risk of HIV acquisition.
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Affiliation(s)
- Agnes N Kiragga
- Research Department, Infectious Diseases Institute, College of Health Sciences, Makerere University, Kampala, Uganda
| | - John M Bwanika
- Research Department, Infectious Diseases Institute, College of Health Sciences, Makerere University, Kampala, Uganda.,The Medical Concierge Group, Kampala, Uganda
| | - Joshua Kyenkya
- Research Department, Infectious Diseases Institute, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Grace Banturaki
- Research Department, Infectious Diseases Institute, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Joanita Kigozi
- Outreach Department, College of Health Sciences, Infectious Diseases Institute, Makerere University, Kampala, Uganda
| | | | - Florence Namimbi
- Outreach Department, College of Health Sciences, Infectious Diseases Institute, Makerere University, Kampala, Uganda
| | - Geetanjali Chander
- Division of Infectious Diseases, Department of Medicine, 1466Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Steven J Reynolds
- Division of Infectious Diseases, Department of Medicine, 1466Johns Hopkins University School of Medicine, Baltimore, MD, USA.,Division of Intramural Research, National Institute of Allergy and Infectious Diseases, 2511National Institutes of Health, Bethesda, MD, USA
| | - Yukari C Manabe
- Division of Infectious Diseases, Department of Medicine, 1466Johns Hopkins University School of Medicine, Baltimore, MD, USA
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8
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Andersson N, Ejnestrand J, Lidgren Y, Allard A, Boman J, Nylander E. Are Swedish swingers a risk group for sexually transmitted infections? Int J STD AIDS 2021; 32:427-434. [PMID: 33427085 PMCID: PMC8008433 DOI: 10.1177/0956462420973108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The aim of this study was to investigate whether Swedish swingers constitute a risk group for sexually transmitted infections (STIs). Two swinger clubs were invited to participate. At swinger meetings, members were offered an STI sampling kit and a questionnaire. Samples were analyzed for Chlamydia trachomatis, Neisseria gonorrhoeae, Mycoplasma genitalium, and Trichomonas vaginalis using a multiplex real-time polymerase chain reaction assay. In total, 235 swingers participated (118 women and 117 men). Urogenital C. trachomatis prevalence was 1.7%. Urogenital M. genitalium prevalence was 7.6% for women and 4.3% for men. No one tested positive for N. gonorrhoeae or T. vaginalis. For women, the mean number of unprotected temporary sex partners within the last 12 months was four men (range 0-35) and three women (range 0-50). Among men, the mean number of unprotected temporary sex partners within the last 12 months was five women (range 0-50) and 0 men (range 0-10). During vaginal sex, 46.6% women and 38.5% men always used protection with a temporary sex partner. Swedish swingers did not seem to have an increased prevalence of STIs. However, there was high-risk sexual behavior with unprotected sex and multiple sex partners, thereby making them a vulnerable group for acquiring STIs.
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Affiliation(s)
- Nirina Andersson
- Dermatology and Venereology, Department of Public Health and Clinical Medicine, 174459Umeå University, Umeå, Sweden
| | - Jennifer Ejnestrand
- Dermatology and Venereology, Department of Public Health and Clinical Medicine, 174459Umeå University, Umeå, Sweden
| | - Yvonne Lidgren
- Virology, Clinical Microbiology, 8075Umeå University, Umeå, Sweden
| | - Annika Allard
- Virology, Clinical Microbiology, 8075Umeå University, Umeå, Sweden
| | - Jens Boman
- Dermatology and Venereology, Department of Public Health and Clinical Medicine, 174459Umeå University, Umeå, Sweden
| | - Elisabet Nylander
- Dermatology and Venereology, Department of Public Health and Clinical Medicine, 174459Umeå University, Umeå, Sweden
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Herrijgers C, Poels K, Vandebosch H, Platteau T, van Lankveld J, Florence E. Harm Reduction Practices and Needs in a Belgian Chemsex Context: Findings from a Qualitative Study. Int J Environ Res Public Health 2020; 17:ijerph17239081. [PMID: 33291855 PMCID: PMC7730975 DOI: 10.3390/ijerph17239081] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 11/17/2020] [Accepted: 12/02/2020] [Indexed: 02/07/2023]
Abstract
Chemsex is a growing public health concern, with little evidence-based care and support available. The aim of this study is to understand current risk reduction practices, and the information and care needs of gay, bisexual, and other men who have sex with men (GBMSM) who engage in chemsex. Between January and March 2020, semi structured in-depth interviews with drug-using GBMSM (n = 20) were conducted. Data were analyzed thematically. The reported preparatory measures were: deliberately scheduling chemsex sessions, and discussing preferences regarding setting and attendees. During the event, a logbook is kept to monitor drugs taken by each participant. People try to take care of each other, but this is often counteracted. Respondents highlighted needs: reliable and easily-accessible information, anonymous medical and psychological healthcare, chemsex-specific care, and a value-neutral safe space to talk about chemsex experiences. Results imply two types of users: planned and impulsive users. Adherence to intended harm reduction practices are complicated by drug effects, peer pressure, and feelings of distrust among users.
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Affiliation(s)
- Corinne Herrijgers
- Department of Clinical Sciences, Institute of Tropical Medicine, 2000 Antwerp, Belgium; (T.P.); (E.F.)
- Correspondence:
| | - Karolien Poels
- Department of Communication Studies, Faculty of Social Sciences, University of Antwerp, 2000 Antwerp, Belgium; (K.P.); (H.V.)
| | - Heidi Vandebosch
- Department of Communication Studies, Faculty of Social Sciences, University of Antwerp, 2000 Antwerp, Belgium; (K.P.); (H.V.)
| | - Tom Platteau
- Department of Clinical Sciences, Institute of Tropical Medicine, 2000 Antwerp, Belgium; (T.P.); (E.F.)
- Department of Psychology, Open University, 6400 Heerlen, The Netherlands;
| | | | - Eric Florence
- Department of Clinical Sciences, Institute of Tropical Medicine, 2000 Antwerp, Belgium; (T.P.); (E.F.)
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10
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Aguilar G, Samudio T, Lopez G, Jimenez L, Wilson EC, McFarland W, Rios-Gonzalez C, Muñoz S. High HIV prevalence among transgender women in Paraguay. Int J STD AIDS 2020; 31:1308-1314. [PMID: 33092476 DOI: 10.1177/0956462420945550] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Transgender women have been understudied and underserved in Paraguay; data are urgently needed to understand their HIV prevention and care needs. To estimate HIV prevalence and related risk and preventive behaviors among trans women in Paraguay, we conducted a cross-sectional survey in 2017. We employed starfish sampling - a hybrid venue-based and peer-referral method combining recruitment at randomly sampled venues and randomly selected clients from program lists, followed by short-chain referrals of eligible peers. Among 304 trans women enrolled, HIV prevalence was 24.8% (95% confidence interval [CI] 18.5-31.2%), with risk increasing with age (adjusted odds ratio [AOR] 1.06 per year, 95% CI 1.03-1.10), residence in Asunción department (AOR 4.75, 95% CI 1.57-14.36), and cocaine use (AOR 2.09, 95% CI 1.11-3.95). Trans women in Paraguay need to be prioritized for interventions with high HIV prevention efficacy. Substance use interventions to address cocaine use may also yield prevention benefits for trans women in our context.
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Affiliation(s)
- Gloria Aguilar
- National Control Program for HIV/AIDS/STI, Republica del Paraguay Ministry of Public Health and Social Welfare, Asunción, Paraguay.,Center for Public Health Research, San Francisco Department of Public Health, San Francisco, CA, USA
| | - Tania Samudio
- National Control Program for HIV/AIDS/STI, Republica del Paraguay Ministry of Public Health and Social Welfare, Asunción, Paraguay
| | - Gladys Lopez
- National Control Program for HIV/AIDS/STI, Republica del Paraguay Ministry of Public Health and Social Welfare, Asunción, Paraguay
| | - Liliana Jimenez
- National Control Program for HIV/AIDS/STI, Republica del Paraguay Ministry of Public Health and Social Welfare, Asunción, Paraguay
| | - Erin C Wilson
- Center for Public Health Research, San Francisco Department of Public Health, San Francisco, CA, USA
| | - Willi McFarland
- Center for Public Health Research, San Francisco Department of Public Health, San Francisco, CA, USA
| | - Carlos Rios-Gonzalez
- Facultad de Ciencias Medicas, Universidad Nacional de Caaguazú, Coronel Oviedo, Paraguay
| | - Sergio Muñoz
- Center for Public Health Research, San Francisco Department of Public Health, San Francisco, CA, USA
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Abstract
Rectal douching (RD) may be a vector for sexually transmitted infection (STI) acquisition. The aim of this study was to describe the relationship between RD, and the prevalence of various STIs and sexual behaviors in a sample of women and men in Long Beach, California. Five hundred and forty-seven men (mean age 42.8 years) and 530 women (mean age 37 years) recruited from a community-based setting between April 2010 and August 2014 completed the Risk Behavior Assessment and a questionnaire eliciting information on use of lubricants and enemas for vaginal intercourse (VI) and anal intercourse (AI). Participants were screened for high-risk behaviors for human immunodeficiency virus infection including injection drug use. Bivariate analyses were conducted separately for women and men. Based on the empirical results, separate logistic regression models for women and men were constructed. Sensitivity analysis was conducted to assess model fit for reduced samples of only those men and women who reported AI. For men, RD was associated with a lower odds of being hepatitis C antibody positive, greater odds of being positive for hepatitis B virus surface antigen, syphilis, and using lubricants for receptive anal intercourse (RAI). RD in women was associated with higher odds of a positive test for syphilis, ever vaginally douching for VI, and using lubricants for RAI. Men and women who practice RD report positive syphilis test results and use of lubricants for RAI. RD should not be perceived as preventing STIs.
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Affiliation(s)
- Grace L Reynolds
- Department of Health Care Administration, Center for Behavioral Research and Services, California State University, Long Beach, CA, USA.,Center for Behavioral Research and Services, Psychology Department, California State University, Long Beach, CA, USA
| | - Dennis G Fisher
- Center for Behavioral Research and Services, Psychology Department, California State University, Long Beach, CA, USA.,Center for Behavioral Research and Services, Department of Health Care Administration, California State University, Long Beach, CA, USA
| | - Erlyana Erlyana
- Department of Health Care Administration, Center for Behavioral Research and Services, California State University, Long Beach, CA, USA.,Center for Behavioral Research and Services, Psychology Department, California State University, Long Beach, CA, USA
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12
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Ghazaei M, Foroughi M, Saatchi LR. Testing the High-Risk Behavior Model Among the Students Based on Religious Orientation With the Mediation of Fear of Death. Omega (Westport) 2020; 85:114-125. [PMID: 32646281 DOI: 10.1177/0030222820941277] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Adolescents are at high-risk for adverse health outcomes associated with high-risk behavior. The present study aimed to test the high-risk behavior model among the students based on religious orientation with the mediation of fear of death. This descriptive correlational study utilized structural equation modeling. The statistical population comprised all senior high school female students in Mashhad. 200 students were selected using cluster random sampling method. Data collection tools included the Iranian Adolescents Risk-taking Scale, Templer Death Anxiety Scale, and Allport and Ross Religious Orientation Scale. The result of a structural equation model suggested that the relationship between religious orientation and high-risk behavior was mediated through fear of death. Furthermore intrinsic religiosity has a negative direct relation with fear of death and high-risk behavior, and extrinsic religious orientation have a positive direct relation with fear of death and high-risk behavior. On this basis, it was concluded that religious orientation influences high-risk behavior indirectly through fear of death.
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Affiliation(s)
- Maryam Ghazaei
- Department of Psychology, Shandiz Institute of Higher Education, Mashhad, Iran
| | - Mahlegha Foroughi
- Department of Psychology, Shandiz Institute of Higher Education, Mashhad, Iran
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13
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Cochrane E, Knapper C. Audit of patient retention in pre-exposure prophylaxis (PrEP) services in an integrated sexual reproductive health service setting. Int J STD AIDS 2020; 30:1432-1435. [PMID: 31795927 DOI: 10.1177/0956462419879618] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Pre-exposure prophylaxis (PrEP) for HIV in Wales was launched in July 2017. We set up a PrEP service delivered via our integrated sexual reproductive health service in Aneurin Bevan University Health Board (ABUHB), south east Wales. Public Health Wales (PHW) data show a 22% ‘lost to follow-up’ rate amongst Welsh PrEP patients. Over 18 months, 278 patients booked into ABUHB PrEP clinics. Of these, 275 were men who have sex with men (MSM). One hundred and ninety-three patients commenced PrEP, 5 were diagnosed with HIV at baseline, 42 did not attend their first appointment. The remainder declined PrEP. Of those commenced on PrEP, 51.7% had reduced clinic attendances; all were MSM. Patients with reduced attendances were more likely to be younger (mean age 33 vs. 37 years), reside outside ABUHB catchment area (56.4% vs. 49.6%) and have mental health issues (28.6% vs. 18.8%), but were less likely to disclose substance misuse (24.2% vs. 27.1%) than those attending in line with operational guidance. Of the 63 patients who stopped attending the PrEP clinic, 32.3% (21) had documented reasons, the most common being reduced self-perceived risk. This is the first evaluation of reasons why patients stop attending as well as risk factors associated with those lost to follow-up in PrEP services in Wales.
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Affiliation(s)
| | - Carys Knapper
- Sexual and Reproductive Health, Aneurin Bevan University Health Board, Royal Gwent Hospital, Newport, UK
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14
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Lessard D, Aslan A, Zeggagh J, Morel S, Michels D, Lebouché B. Acceptability of a digital patient notification and linkage-to-care tool for French PrEPers (WeFLASH ©): Key stakeholders' perspectives. Int J STD AIDS 2019; 30:1397-1407. [PMID: 31757193 DOI: 10.1177/0956462419878043] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The objective of this study was to describe stakeholders’ perspectives on the acceptability of WeFLASH© (AADISS, Paris, France), a digital smartphone sexually transmitted infection (STI) patient notification (PN) tool to be launched among French HIV pre-exposure prophylaxis users (PrEPers). In Paris, Lyon, and Nice, we conducted 2-hour focus group discussions with PrEPers (n = 21) and community mediators (n = 10), and one-on-one interviews with PrEP-prescribing physicians (n = 5) and HIV/STI management decision-makers (n = 4). Recordings were transcribed. The analysis focused on perceived benefits and risks. Concerning benefits, participants mentioned that WeFLASH© could provide: improved PN and STI screening, by refining the notification of anonymous partners; customized linkage-to-care, by providing users with tailored information on care; and transferable epidemiological data, by filling a need for real-time data. Participants anticipated risks for: privacy and confidentiality and suggested specific security settings to protect users’ identity; sexual behavior and suggested game-like functions to improve the integration of the tool in sexual contexts; and fairness and emphasized the importance of making WeFLASH© accessible to all men who have sex with men. WeFLASH© could facilitate PN for an increasing proportion of anonymous partners met online, and empower users, including notified partners, on questions of confidentiality and consent, access to STI prevention and screening services, and access to data.
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Affiliation(s)
- David Lessard
- Centre of Health Outcomes Research, Research Institute of the McGill University Health Centre, Montreal, Canada.,Chronic and Viral Illness Service, McGill University Health Centre, Montreal, Canada
| | | | | | - Stéphane Morel
- AIDES, Pantin, France.,Community-Based Research Laboratory, Coalition Plus, Pantin, France
| | - David Michels
- AIDES, Pantin, France.,Community-Based Research Laboratory, Coalition Plus, Pantin, France
| | - Bertrand Lebouché
- Centre of Health Outcomes Research, Research Institute of the McGill University Health Centre, Montreal, Canada.,Chronic and Viral Illness Service, McGill University Health Centre, Montreal, Canada.,CIHR/SPOR Mentorship Chair in Innovative Clinical Trials, Research Institute of the McGill University Health Centre, Montreal, Canada.,Department of Family Medicine, McGill University, Montreal, Canada
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15
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Luo Q, Wu Z, Chen Z, Ma Y, Mi G, Liu X, Xu J, Rou K, Zhao Y, Scott SR. App use frequency and condomless anal intercourse among men who have sex with men in Beijing, China: a cross-sectional study. Int J STD AIDS 2019; 30:1146-1155. [PMID: 31558122 DOI: 10.1177/0956462419860293] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Gay dating applications (apps) are popular among men who have sex with men (MSM) in China. This study examined the relationship between gay dating app use frequency and condomless anal intercourse (CAI) in a sample of MSM in Beijing. In October 2017, a web-based, cross-sectional survey was conducted among MSM from Beijing, China. Demographics, frequency of app use, and sexual behaviors were collected and analyzed. Multivariable logistic regression and restricted cubic splines were used to evaluate the association between app use frequency and CAI. Of the 9280 participants, the proportion of CAI within one month prior to the survey was 43.3%, and 43.7% logged onto the app ≥11 times per week. In adjusted logistic regression analysis, logging onto the app 6–10 times per week and ≥11 times per week were inversely associated with CAI (adjusted odds ratio [AOR] =0.88 [95%CI, 0.78–0.99]; AOR = 0.88 [95%CI, 0.82–0.97], respectively). Among those 40 years of age or older, logging onto the app ≥11 times per week was associated with lower rates of CAI (AOR = 0.57 [95%CI, 0.40–0.81]). Results indicate that frequent app use was associated with lower odds of CAI among MSM in Beijing, China. Innovative interventions, which take advantage of this popular media platform, should be developed as such apps have been found to reduce the odds of CAI in Beijing.
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Affiliation(s)
- Qianqian Luo
- The National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China.,School of Nursing, Binzhou Medical University, Yantai, China
| | - Zunyou Wu
- The National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | | | - Yue Ma
- Blue City Holdings, Ltd, Beijing, China
| | - Guodong Mi
- The National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China.,Blue City Holdings, Ltd, Beijing, China
| | - Xuejiao Liu
- The National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Jie Xu
- The National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Keming Rou
- The National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yan Zhao
- The National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Sarah R Scott
- The National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
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16
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Ghahremani L, Nazari M, Changizi M, Kaveh MH. High-risk behaviors and demographic features: a cross-sectional study among Iranian adolescents. Int J Adolesc Med Health 2019; 33:/j/ijamh.ahead-of-print/ijamh-2018-0212/ijamh-2018-0212.xml. [PMID: 31532752 DOI: 10.1515/ijamh-2018-0212] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2018] [Accepted: 11/19/2018] [Indexed: 11/15/2022]
Abstract
BACKGROUND AND OBJECTIVES High-risk behaviors are considered to be a serious threat among adolescents. This study aimed to investigate the frequency of unhealthy and high-risk behaviors and their relationship with demographic features in adolescents living in Shiraz, Iran. MATERIALS AND METHODS The present descriptive, cross-sectional study was conducted on 483 students in the 10th grade of high school. The data were collected using a demographic information form and a modified adolescents high-risk behaviors questionnaire. The reliability of the questionnaire was assessed using the test-retest method. Afterwards, the data were entered into the SPSS statistical software (IBM), version 22 and were analyzed using the chi-square (χ2) test, logistic regression analysis and one-way analysis of variance (ANOVA). RESULTS High-risk health behaviors were significantly correlated to adolescents' gender, parents' occupations and education levels, length of residency in Shiraz and talking about important things with one's parents (p < 0.03). Gender predicted 52% of variance of bullying behaviors at school [Exp(B) = 0.502, p < 0.03, 95% confidence interval (CI) = 0.261-0.996]. In fact, most high-risk behaviors were associated with gender (p < 0.001). Indeed, bullying was mostly reported in boys, while being hopeless or sad, suicide attempts and appropriate weight loss behaviors were mostly reported among girls. Additionally, the frequency of smoking cigarettes and using hookahs was higher among girls compared to boys (23.1% for smoking cigarettes and 39.6% for using hookahs). However, no significant correlation was observed between gender and smoking cigarettes and using hookahs (p > 0.704 for smoking cigarettes and p > 0.118 for using hookahs). The most prevalent high-risk behaviors were physical fighting (51.1%), being sad or hopeless (35.2%), alcohol abuse (26.7%), overweight (14.7%) and obesity (8.1%) in both genders. Based on the results, only 26.5% of the adolescents had sufficient physical activity. Besides, the adolescents' weight scores were significantly correlated to eating green salads (p < 0.01), which was seen more among overweight adolescents. CONCLUSION The findings indicated that adolescents' gender and their parents' roles should be taken into consideration in designing health promotion programs, such as mental health and its related skills. This would eventually result in the prevention and reduction of unhealthy habits.
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Affiliation(s)
| | - Mahin Nazari
- Research Center for Health Sciences, Institute of health, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Mohamad Hossein Kaveh
- Research Center for Health Sciences, Institute of health, Shiraz University of Medical Sciences, Shiraz, Iran
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17
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Ghonchepour A, Sohrabi M, Golestani Z, Biabanaki F, Dehghan M. Spiritual health: is it a determinant factor for preventing risky behaviors among university students? Int J Adolesc Med Health 2019; 33:/j/ijamh.ahead-of-print/ijamh-2018-0217/ijamh-2018-0217.xml. [PMID: 30995206 DOI: 10.1515/ijamh-2018-0217] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Accepted: 11/29/2018] [Indexed: 11/17/2022]
Abstract
BACKGROUND The most common high-risk behaviors that have profound and adverse effects on the health of the community take place in the university environment. Nowadays, the necessity of exploring ways to correct and reduce the high-risk behaviors requires identification of its determinant factors. Therefore, the present study aimed to investigate the correlation between spiritual health and high-risk behaviors among university students in the southeast of Iran in 2017-2018. METHOD This survey was a cross-sectional study. The population was all students studying at three central Universities in Kerman. Eight hundred and four students participated in the survey using a quota sampling method. The research instrument was a demographic questionnaire and the 20-item spiritual well-being Palutzian and Ellison scale and the Iranian Adolescent Riskiness Scale (IARS), which includes 39 items for high-risk behaviors. RESULTS The mean total score of high-risk behaviors was 79.16 ± 24.6 which was lower than the median (117). The spiritual health of the majority of subjects (66.7%) was moderate with an average of 90.65 ± 16.64. There was a significant negative correlation between the students' spiritual health and their high-risk behaviors. CONCLUSION It is necessary and essential to plan and implement spiritual-based interventions to reduce the incidence of high-risk behaviors.
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Affiliation(s)
- Asma Ghonchepour
- School of Nursing and Midwifery, Kerman University of Medical Sciences, Kerman, Iran
| | - Mostafa Sohrabi
- School of Nursing and Midwifery, Kerman University of Medical Sciences, Kerman, Iran
| | - Zakiyeh Golestani
- School of Nursing and Midwifery, Kerman University of Medical Sciences, Kerman, Iran
| | - Fereshteh Biabanaki
- Nursing and Midwifery School, Kerman University of Medical Sciences, Kerman, Iran
| | - Mahlagha Dehghan
- Nursing Research Center, Kerman University of Medical Sciences, Kerman, Iran.,Razi Faculty of Nursing and Midwifery, Kerman University of Medical Sciences, Haft-Bagh Highway, Kerman, Iran, Phone: +983431325192, Fax: +983431325218
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18
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Balinda IG, Sugrue DD, Ivers LC. More Than Malnutrition: A Review of the Relationship Between Food Insecurity and Tuberculosis. Open Forum Infect Dis 2019; 6:ofz102. [PMID: 30949541 PMCID: PMC6441779 DOI: 10.1093/ofid/ofz102] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2018] [Accepted: 03/01/2019] [Indexed: 12/13/2022] Open
Abstract
Despite a significant reduction in tuberculosis (TB) mortality over the past decade, TB remains a leading cause of death worldwide. Food insecurity—through pathways such as malnutrition, mental health impact, and high-risk health behaviors—affects the risk of TB disease, treatment failure, and mortality. We searched the literature for studies reporting on the links between food insecurity and TB. In contrast to the well-documented interactions between food insecurity and HIV/AIDS, we found that the association between food insecurity and TB remains largely understudied—this is especially true with regard to non-nutritional correlations. Mental health and behavioral linkages between TB and food insecurity deserve further attention. An improved understanding of the pathways through which food insecurity impacts TB is crucial to inform evidence-based integration of interventions such as psychological counseling, psychiatric care, harm reduction programs, and efforts to address social determinants of disease within current TB programs.
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Affiliation(s)
- Ingabire G Balinda
- Center for Global Health, Massachusetts General Hospital, Boston, Massachusetts
| | | | - Louise C Ivers
- Center for Global Health, Massachusetts General Hospital, Boston, Massachusetts.,Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts
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19
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Abstract
CONTEXT Severity of alcohol dependence is related to the high-risk behavior of alcohol dependents. AIM To assess the high-risk behavior in patients with alcohol dependence and study the association between them. SETTINGS AND DESIGN This is a descriptive study of high-risk behavior in patients with alcohol dependence, conducted over a period of 15-month duration that is from January 2011 to April 2012 on 200 alcohol-dependent patients (178 men and 22 women) in the Department of Psychiatry, Mamata Medical College and General Hospital, Khammam (TS), India. MATERIALS AND METHODS Patients and their caregivers fulfilling the selection criteria were included in the study, and informed consent was obtained. Interview was carried out after 2 weeks to rule out the possibility of the presence of withdrawal symptoms in alcohol-dependent patients. Tools used for data collection include Sociodemographic and Clinical Profile Schedule, Clinical Institute of Withdrawal Assessment for Alcohol, Mini-Mental Status Examination, Severity of Alcohol Dependence Questionnaire, and High Risk Behavior Questionnaire. STATISTICAL ANALYSIS Descriptive statistics, Chi-square test, and logistic regression test were used. RESULTS The occurrence of high-risk behavior was substantial among patients with alcohol dependence syndrome. Event analysis method indicated that road traffic accidents associated with prior heavy drinking was the most frequently observed high-risk behavior. CONCLUSIONS The study reiterates the relationship between alcohol and sexual behavior and also highlights that individuals dependent on alcohol are a specifically vulnerable group.
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Affiliation(s)
- Anupama Korlakunta
- Department of Psychiatry, Kamineni Institute of Medical Sciences, Nalgonda, Andhra Pradesh, India
| | - C M Pavankumar Reddy
- Department of Psychiatry, Shadan Medical College, Hyderabad, India.,Department of Psychiatry, Mamata Medical College and Hospital, Khammam, Telengana, India
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20
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Gutiérrez-Velilla E, Quezada-Juárez FJ, Pérez-Sánchez IN, C Iglesias M, Reyes-Terán G, Caballero-Suárez NP. Identifying risk factors for HIV-positive test results in walk-in and hospitalized patients in a Mexico City HIV clinic: a descriptive study. Int J STD AIDS 2019; 30:569-576. [PMID: 30813862 DOI: 10.1177/0956462419828604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The objective of this study was to analyze risk factors for HIV-positive tests in walk-in users and in hospitalized patients in a Mexico City hospital. We undertook a cross-sectional study based on routine HIV testing and counseling service data in adults undergoing an HIV test from January 2015 to July 2017. Multivariate analysis was performed to determine risk factors for walk-in and hospitalized patients. The results showed that 2040 people tested during the period; hospitalized patients were more likely to test HIV-positive than walk-in users (18 versus 15%; p < 0.05). HIV risk factors for hospitalized patients included being men who have sex with men (MSM) (adjusted odds ratio [aOR] 7.2, 95% CI 2.0-26.5), divorced (aOR 4.4, 95% CI 1.3-14.4), having 3-5 lifetime sexual partners (aOR 2.7, 95% CI 1.0-7.4), and being in the emergency room (aOR 3.6, 95% CI 1.1-11.3), intensive care (aOR 27.2, 95% CI 3.4-217.2), or clinical pneumology wards (aOR 33.4, 95% CI 9.7-115.2). In the walk-in group, HIV risk factors included being male (aOR 2.8, 95% CI 1.3-5.9), being MSM (aOR 4.3, 95% CI 2.0-9.5), having sex while using drugs (aOR 2.3, 95% CI 1.3-4.0), being referred by a physician for testing (aOR 3.2, 95% CI 1.6-6.3), and perceiving oneself at risk (aOR 3.8, 95% CI 2.3-6.3). Differential risk factors found among hospitalized patients and walk-in testers can be helpful in designing better HIV testing strategies to increase early diagnosis and linkage to care.
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Affiliation(s)
- Ester Gutiérrez-Velilla
- 1 Departamento de Investigación en Enfermedades Infecciosas (CIENI), Instituto Nacional de Enfermedades Respiratorias (INER), Mexico City, Mexico
| | - Francisco J Quezada-Juárez
- 1 Departamento de Investigación en Enfermedades Infecciosas (CIENI), Instituto Nacional de Enfermedades Respiratorias (INER), Mexico City, Mexico
| | - Ivonne N Pérez-Sánchez
- 1 Departamento de Investigación en Enfermedades Infecciosas (CIENI), Instituto Nacional de Enfermedades Respiratorias (INER), Mexico City, Mexico.,2 Consejo Nacional de Ciencia y Tecnología (CONACYT), Mexico City, Mexico
| | - Maria C Iglesias
- 1 Departamento de Investigación en Enfermedades Infecciosas (CIENI), Instituto Nacional de Enfermedades Respiratorias (INER), Mexico City, Mexico
| | - Gustavo Reyes-Terán
- 1 Departamento de Investigación en Enfermedades Infecciosas (CIENI), Instituto Nacional de Enfermedades Respiratorias (INER), Mexico City, Mexico
| | - Nancy P Caballero-Suárez
- 1 Departamento de Investigación en Enfermedades Infecciosas (CIENI), Instituto Nacional de Enfermedades Respiratorias (INER), Mexico City, Mexico
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21
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Cameron AY, Erisman S, Palm Reed K. The Relationship Among Shame, Nonsuicidal Self-Injury, and Suicidal Behaviors in Borderline Personality Disorder. Psychol Rep 2019; 123:648-659. [PMID: 30654709 DOI: 10.1177/0033294118818091] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Shame has been individually linked to nonsuicidal self-injury and suicidal ideation and behavior and is highly prevalent in individuals with borderline personality disorder. The current study investigated the relationship between shame, nonsuicidal self-injury, and suicidal ideation in a sample of women with borderline personality disorder. Participants were 40 women recruited from a Women's Dialectical Behavior Therapy Partial Hospital Program in a psychiatric hospital in New England as part of a larger, six-month treatment development study. Results indicated that shame-proneness predicts nonsuicidal self-injury and suicidal ideation and behavior above and beyond the severity of borderline personality disorder symptoms, suggesting that shame may be an important treatment target for individuals with borderline personality disorder. Clinical implications, limitations, and future directions are discussed.
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Affiliation(s)
- Amy Y Cameron
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, RI, USA; Providence VA Medical Center, Providence, RI, USA
| | - Shannon Erisman
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, RI, USA; Center for Women's Behavioral Health, Women and Infants Hospital, Providence, RI, USA
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22
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Sharma V, Tun W, Sarna A, Saraswati LR, Pham MD, Thior I, Luchters S. Prevalence and determinants of unprotected sex in intimate partnerships of men who inject drugs: findings from a prospective intervention study. Int J STD AIDS 2018; 30:386-395. [PMID: 30541403 PMCID: PMC6446434 DOI: 10.1177/0956462418802142] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Unprotected sex, common among people who inject drugs, puts them and their partners at risk of sexually transmitted infections including human immunodeficiency virus (HIV). This analysis assesses the changes in sexual risk behavior with regular female partners (RFPs), among married men who inject drugs, before and after implementation of a HIV prevention intervention, and identifies correlates of unprotected sex. People who inject drugs (PWID) were assessed at three points: baseline, preintervention follow-up visit (FV)1, and postintervention FV2. Descriptive analysis was used for reporting changes in sexual behavior over time. Generalized estimating equation assessed the population-averaged change in self-reported unprotected sex with an RFP, attributable to intervention uptake. Multivariable logistic regression determined correlates of self-reported unprotected sex with an RFP at FV2. Findings suggest that the proportion of men reporting any unprotected sex remained high (baseline = 46.0%, FV1 = 43.5%, FV2 = 37.0%). A reduction was observed in unprotected sex after the intervention phase, but this could not be attributed to uptake of the intervention. Higher odds of self-reported unprotected sex with an RFP in the past three months at FV2 were associated with self-reported unprotected sex at baseline, living with family, and being HIV-negative. Married male PWID should receive counseling for safe sex with RFPs, especially those who are HIV-negative and live with their families.
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Affiliation(s)
- Vartika Sharma
- 1 Department of Obstetrics and Gynaecology, International Centre for Reproductive Health, Ghent University, Ghent, Belgium.,2 Ex-Population Council, Delhi, India
| | - Waimar Tun
- 3 Population Council, Washington, DC, USA
| | | | | | | | | | - Stanley Luchters
- 1 Department of Obstetrics and Gynaecology, International Centre for Reproductive Health, Ghent University, Ghent, Belgium.,5 Burnet Institute, Melbourne, Australia.,7 School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
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Dunne EF, Pattanasin S, Chemnasiri T, Varangrat A, Raengsakulrach B, Wichuda S, Ungsedhapand C, Sirivongrangson P, Chitwarakorn A, Holtz TH. Selling and buying sex in the city: men who have sex with men in the Bangkok men who have sex with men Cohort Study. Int J STD AIDS 2018; 30:212-222. [PMID: 30360682 DOI: 10.1177/0956462418796440] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
We describe participants in the Bangkok Men who have sex with men Cohort Study (BMCS) who sold or bought sex. Men who have sex with men (MSM) and transgender women aged ≥18 years had HIV testing and behavioral data collected at enrollment and every four months. We evaluated report of receiving money or goods for sex (selling sex) or giving money or goods for sex (buying sex) at enrollment using logistic regression models; we also describe sex work over time, and HIV and syphilis incidence among those who report sex work. At enrollment, 511 (29.3%) of 1744 participants reported buying or selling sex. Factors associated with selling sex were young age, lower education, living alone or living with a friend, being unemployed, higher HIV knowledge, binge drinking and club drug use, a higher number of casual male partners, meeting sex partners at specific venues, having a foreign sex partner, and being HSV-1 seropositive. MSM aged 18-21 years who sold sex had an HIV incidence of 11.1 per 100 person-years (95% CI: 6.7-17.4). Almost one-third of participants from BMCS reported sex work at enrollment. Young men who sold sex had high HIV incidence and HIV prevention interventions are needed for this at-risk population in Bangkok, Thailand.
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Affiliation(s)
- Eileen F Dunne
- 1 HIV/STD Research Program, Thailand Ministry of Public Health - U.S. Centers for Disease Control and Prevention Collaboration, Nonthaburi, Thailand.,2 Division of HIV/AIDS Prevention, U.S. Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Sarika Pattanasin
- 1 HIV/STD Research Program, Thailand Ministry of Public Health - U.S. Centers for Disease Control and Prevention Collaboration, Nonthaburi, Thailand
| | - Tareerat Chemnasiri
- 1 HIV/STD Research Program, Thailand Ministry of Public Health - U.S. Centers for Disease Control and Prevention Collaboration, Nonthaburi, Thailand
| | - Anchalee Varangrat
- 1 HIV/STD Research Program, Thailand Ministry of Public Health - U.S. Centers for Disease Control and Prevention Collaboration, Nonthaburi, Thailand
| | - Boonyos Raengsakulrach
- 1 HIV/STD Research Program, Thailand Ministry of Public Health - U.S. Centers for Disease Control and Prevention Collaboration, Nonthaburi, Thailand
| | - Sukwicha Wichuda
- 1 HIV/STD Research Program, Thailand Ministry of Public Health - U.S. Centers for Disease Control and Prevention Collaboration, Nonthaburi, Thailand
| | - Chaiwat Ungsedhapand
- 1 HIV/STD Research Program, Thailand Ministry of Public Health - U.S. Centers for Disease Control and Prevention Collaboration, Nonthaburi, Thailand
| | | | - Anupong Chitwarakorn
- 3 Department of Disease Control, Ministry of Public Health, Nonthaburi, Thailand
| | - Timothy H Holtz
- 1 HIV/STD Research Program, Thailand Ministry of Public Health - U.S. Centers for Disease Control and Prevention Collaboration, Nonthaburi, Thailand.,2 Division of HIV/AIDS Prevention, U.S. Centers for Disease Control and Prevention, Atlanta, GA, USA
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Davis A, Goddard-Eckrich D, Dasgupta A, El-Bassel N. Risk factors associated with sexually transmitted infections among women under community supervision in New York City. Int J STD AIDS 2018; 29:766-775. [PMID: 29471763 DOI: 10.1177/0956462418755223] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The number of women under community supervision in the United States has increased, and this population has a high risk for sexually transmitted infections (STIs). We examined STI prevalence and multiple risk factors among drug-involved women under community supervision in New York City. Data were from a randomized controlled trial testing the efficacy of a behavioral HIV/STI intervention (Women on the Road to Health [WORTH]) among drug-involved women in the community corrections system in New York City from 2009 to 2012. To be eligible for inclusion, women had to be under community supervision within the past 90 days, have used illicit drugs at least once in the past six months, and have unprotected sex at least once in the past 90 days. Participants completed a survey containing items on STI risk factors and were tested for Chlamydia trachomatis, Neisseria gonorrhoeae, and Trichomonas vaginalis. Multivariable regression was used to examine associations between risk factors and STI diagnosis. Of 333 women tested, 89 (26.7%) tested positive for an STI. Ten (3.0%) were positive for C. trachomatis, 4 (1.2%) for N. gonorrhoeae, and 77 (23.1%) for T. vaginalis. Women with any STI were more likely to be black (AOR: 2.02; 95% CI: 1.08-3.77), homeless in the past 90 days (AOR: 2.07; 95% CI: 1.01-4.26), arrested in the past 90 days (AOR: 1.97; 95% CI: 1.14-3.39), and have a greater number of sexual partners in the past 90 days (AOR: 1.24; 95% CI: 1.08-1.42). Drug-using women under community supervision have a high burden of STIs driven by multiple risk factors. Implementing STI screening, prevention, and treatment programs in community supervision settings could facilitate a reduction in STIs among this population.
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Affiliation(s)
- Alissa Davis
- 1 HIV Center, Division of Gender, Sexuality, & Health, New York State Psychiatric Institute and Columbia University Medical Center, New York, NY, USA.,2 Social Intervention Group, School of Social Work, Columbia University, New York, NY, USA
| | - Dawn Goddard-Eckrich
- 2 Social Intervention Group, School of Social Work, Columbia University, New York, NY, USA
| | - Anindita Dasgupta
- 2 Social Intervention Group, School of Social Work, Columbia University, New York, NY, USA
| | - Nabila El-Bassel
- 2 Social Intervention Group, School of Social Work, Columbia University, New York, NY, USA
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25
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Guimarães RA, Monteiro LH, Teles SA, Fernandes IL, Rodovalho AG, Silva GC, Lucchese R, Vera I, Silva AC, Gregório VD, Ferreira PM, de Almeida MM, Guimarães VA, Amorim TA, de Souza MR. Risk behaviors for sexually transmitted infections in noninjecting drug users: A cross-sectional study. Int J STD AIDS 2018; 29:658-664. [PMID: 29393006 DOI: 10.1177/0956462417750332] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
The objective of this study was to investigate risk behaviors for sexually transmitted infections (STIs) in noninjecting drug users (NIDUs), using STI diagnosis history as an indicator. A cross-sectional study was conducted in 323 NIDUs of two facilities for alcohol and/or drug dependence treatment in the Goiás State, Central Brazil. All participants were interviewed about risk behaviors and STI history. Multivariable analysis was performed in order to identify predictors of STIs. Adjusted prevalence ratio (APR) with confidence intervals of 95% was obtained using a Poisson regression model. Prevalence of self-reported STIs in the previous 12 months was 25.4% (95% confidence interval [95% CI]: 21.0-30.4%). A multivariable model verified that age (APR: 1.01; 95% CI: 1.00-1.01), sexual contact with partners diagnosed with STIs (APR: 1.27; 95% CI: 1.12-1.45) and injecting drug users (IDUs) (APR: 1.14; 95% CI: 1.14; 95% CI: 1.01-1.31), exchange sex for money and/or drugs (APR: 1.12; 95% CI: 1.02-1.21), and a history of sexual violence (APR: 1.04; 95% CI: 1.04-1.32) were predictors of STIs. Elevated rates of STI history and risk behaviors were observed in NIDUs, supporting the vulnerability of this group for these infections. Public policies and health outreach should be intensified in this population, principally regular STI testing of individuals in treatment for drug dependence and their sexual partners.
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Affiliation(s)
- Rafael A Guimarães
- 1 Institute of Tropical Pathology and Public Health, Federal University of Goiás, Goiânia, Brazil
| | - Luiz Hb Monteiro
- 2 Institute of Biotechnology, Federal University of Goiás, Catalão, Brazil
| | - Sheila A Teles
- 3 Faculty of Nursing, Federal University of Goiás, Goiânia, Brazil
| | - Inaina L Fernandes
- 2 Institute of Biotechnology, Federal University of Goiás, Catalão, Brazil
| | - Aurélio G Rodovalho
- 2 Institute of Biotechnology, Federal University of Goiás, Catalão, Brazil.,4 Municipal Secretary of Health, Catalão, Goiás, Brazil
| | - Graciele C Silva
- 2 Institute of Biotechnology, Federal University of Goiás, Catalão, Brazil
| | - Roselma Lucchese
- 2 Institute of Biotechnology, Federal University of Goiás, Catalão, Brazil
| | - Ivânia Vera
- 2 Institute of Biotechnology, Federal University of Goiás, Catalão, Brazil
| | - Andrécia C Silva
- 2 Institute of Biotechnology, Federal University of Goiás, Catalão, Brazil
| | - Valéria D Gregório
- 2 Institute of Biotechnology, Federal University of Goiás, Catalão, Brazil
| | | | | | | | - Thiago A Amorim
- 2 Institute of Biotechnology, Federal University of Goiás, Catalão, Brazil
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26
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Beymer MR, Kofron RM, Tseng CH, Bolan RK, Flynn RP, Sayles JM, Perez MJ, Jordan WC, Landovitz RJ. Results from the post-exposure prophylaxis pilot program (P-QUAD) demonstration project in Los Angeles County. Int J STD AIDS 2017; 29:557-562. [PMID: 29183270 DOI: 10.1177/0956462417743158] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Post-exposure prophylaxis (PEP) is a promising but under-utilized strategy for HIV prevention in high-risk populations. Between March 2010 and June 2011, two community-based clinics in Los Angeles County provided PEP in a pilot program to 267 unique individuals. Courses were primarily dispensed to men who have sex with men (84%) and consisted overwhelmingly of a three-drug antiretroviral therapy regimen containing two nucleoside reverse transcriptase inhibitors and either an integrase inhibitor (raltegravir) or a boosted protease inhibitor (lopinavir/ritonavir). Approximately 64% of all PEP courses were followed for at least 12 weeks, and seven individuals seroconverted. Of the seven seroconversions, six had subsequent re-exposure. The low rate of PEP failure calls for expanded funding for PEP in other jurisdictions.
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Affiliation(s)
- Matthew R Beymer
- 1 Los Angeles LGBT Center, Los Angeles, CA, USA.,2 Division of Infectious Diseases, Department of Medicine, University of California, Los Angeles, CA, USA
| | - Ryan M Kofron
- 3 Center for Clinical AIDS Research & Education, Los Angeles, CA, USA
| | - Chi-Hong Tseng
- 4 Division of General Internal Medicine and Health Services Research, Department of Medicine, University of California, Los Angeles, CA, USA
| | | | | | - Jennifer M Sayles
- 3 Center for Clinical AIDS Research & Education, Los Angeles, CA, USA
| | - Mario J Perez
- 5 Division of HIV and STD Programs, Department of Public Health, County of Los Angeles, Los Angeles, CA, USA
| | | | - Raphael J Landovitz
- 2 Division of Infectious Diseases, Department of Medicine, University of California, Los Angeles, CA, USA.,3 Center for Clinical AIDS Research & Education, Los Angeles, CA, USA
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Tognetti L, Cinotti E, Tripodi S, Garosi G, Rubegni P. Unusual presentation of secondary syphilis: membranoproliferative glomerulonephritis andmuco-cutaneous lesions. Int J STD AIDS 2017; 29:410-413. [PMID: 28950764 DOI: 10.1177/0956462417733351] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The worldwide re-emergence of secondary syphilis which happened in the last decade, has led to an increase in primary and secondary syphilis cases, along with the presentation of atypical forms. Nevertheless, reports of renal syphilis with mucosal and/or cutaneous manifestations are nowadays increasing. Typically, secondary syphilis infection in adults causes nephrotic syndrome due to a membranous glomerulonephritis. Here, we report a case of a 30-year-old immunocompetent man presenting with skin rash, oral and perianal erosions and nephritic syndrome. Laboratory investigations revealed a form of membranoproliferative glomerulonephritis secondary to Treponema pallidum infection. Therapy with benzathine penicillin brought prompt and complete remission of the disease. Although well described for congenital syphilis, this histopathologic pattern of renal involvement is very rarely reported in adult patients. In case of detection of an otherwise unexplained nephritic syndrome in sexually active patients with mucosal and/or anal lesions, an unrecognized syphilis infection should be suspected.
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Affiliation(s)
- Linda Tognetti
- 1 Division of Dermatology, Department of Medical, Surgical and Neuro-Sciences, University Hospital of Siena, Siena, Italy.,2 Department of Medical Biotechnologies, University of Siena, Siena, Italy
| | - Elisa Cinotti
- 2 Department of Medical Biotechnologies, University of Siena, Siena, Italy
| | - Sergio Tripodi
- 3 Division of Human Pathology, University of Siena, Siena, Italy
| | - Guido Garosi
- 4 Nephrology, Dialysis and Transplant Unit, University Hospital of Siena, Siena, Italy
| | - Pietro Rubegni
- 1 Division of Dermatology, Department of Medical, Surgical and Neuro-Sciences, University Hospital of Siena, Siena, Italy
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28
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Stewart J, Calderon M, Hathaway A, Winer RL, Zunt J. Human papillomavirus infection among male clients of female sex workers soliciting sex in brothels in Peru. Int J STD AIDS 2017; 29:178-184. [PMID: 28747145 DOI: 10.1177/0956462417721563] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The prevalence of high-risk human papillomavirus (HR-HPV) has been reported to be three times higher in female sex workers (FSWs) in Callao, Peru than in the general population of women in Peru. Prevalence of HR-HPV among male clients has not yet been reported. A total of 150 men soliciting intercourse in sex work venues submitted questionnaires, samples for sexually transmitted infection (STI) testing, and self-collected penile samples prior to and following intercourse for HPV genotyping. We identified variables associated with pre-coital HR-HPV, and compared HR-HPV detection pre- and post-coitus. Prior to intercourse, HR-HPV prevalence was 41.9%. Married clients were less likely than unmarried clients to have HR-HPV detected ( p = 0.03). While post-coital HR-HPV prevalence was higher (47.6%), the difference was not statistically significant. However, there was a significant increase in the mean number of HR-HPV DNA strains detected before (0.75) and after (0.94) intercourse ( p = 0.02). No cases of gonorrhoea or syphilis and six (4.1%) cases of chlamydial infection were detected. Despite low prevalence of other STIs, male clients had a high HR-HPV prevalence. The increase in detection of HR-HPV following intercourse demonstrates a potential for transmission of HR-HPV despite high self-reported condom use.
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Affiliation(s)
- Jenell Stewart
- 1 Department of Medicine, 7284 University of Washington , Seattle, WA, USA
| | | | - Alison Hathaway
- 3 16230 Yale University School of Nursing , Hartford, CT, USA
| | - Rachel L Winer
- 4 Department of Epidemiology, 7284 University of Washington , Seattle, WA, USA
| | - Joseph Zunt
- 1 Department of Medicine, 7284 University of Washington , Seattle, WA, USA.,4 Department of Epidemiology, 7284 University of Washington , Seattle, WA, USA.,5 Department of Neurology, 7284 University of Washington , Seattle, WA, USA.,6 Global Health, 7284 University of Washington , Seattle, WA, USA
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29
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Kasgary KA, Hamzehgardeshi Z, Shahhosseini Z. Factors contributing to intentional injuries in Iranian university students. Int J Adolesc Med Health 2017; 31:/j/ijamh.ahead-of-print/ijamh-2017-0002/ijamh-2017-0002.xml. [PMID: 28598802 DOI: 10.1515/ijamh-2017-0002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2017] [Accepted: 03/22/2017] [Indexed: 11/15/2022]
Abstract
Background Intentional injuries refer to injuries resulting from purposeful human action, whether directed at oneself or others. This study was performed to assess intentional injuries in Iranian university students. Methods This cross-sectional study was carried out with 430 female and male university in three higher education institutions located in the northern part of Iran in the year 2015. Samples were chosen through the stratified cluster random sampling method. They were requested to fill out the demographic data form and the Persian version of the Youth Risk Behavior Survey Questionnaire. Descriptive and inferential statistics were used for data analysis via the SPSS v.13 software. Findings Intentional injuries were more frequent in the male university students than female (p < 0.05). Also, 9.1% and 6.7% of the university students were physically injured or sexually assaulted by a boy/girl friend. No statistically significant difference was reported in dating violence between the male and female university students. The logistic regression test showed that the history of stealing money from parents without their permission, son's preferences in the family and gender are the most important predisposing factors for the university students' intentional injury. Conclusion It is suggested that health policy makers consider the role of family in programs that have been designed for improving the health of young people.
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Affiliation(s)
| | - Zeinab Hamzehgardeshi
- Department of Reproductive Health and Midwifery, Sexual and Reproductive Health Research Center,Traditional and Complementary Medicine Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Zohreh Shahhosseini
- Department of Reproductive Health and Midwifery, Sexual and Reproductive Health Research Center,Traditional and Complementary Medicine Research Center, Mazandaran University of Medical Sciences, Sari, Iran, Phone: +98-11-33367342-5, Fax: +98-11-33368915
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30
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Holcomb WR, Ivey WS. Religious Fundamentalism, Humor, and Treatment Outcomes in Individuals in Court-Mandated Substance Abuse Outpatient Treatment. Psychol Rep 2017; 120:491-502. [PMID: 28558615 DOI: 10.1177/0033294116687270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The relationship between religious fundamentalism, humor, and psychological well-being was examined with a sample of individuals ( n = 109) being treated for drug abuse in a court-mandated AA outpatient program. Three separate factors of religious fundamentalism were found through exploratory factor analysis of the Revised Religious Fundamentalism Scale, and these were named Righteous-Evil Worldview, True Religion, and Scriptural Literalism. Psychological well-being of individuals in court-mandated outpatient substance abuse treatment was found to be correlated with high levels of humor but not religious fundamentalism. Psychological well-being and humor were found to be related to satisfaction with services; no relationship was found between religious fundamentalism and satisfaction with services. One factor of religious fundamentalism, Scriptural Literalism, was found to be associated with high levels of depression and paranoia/hostility. Implications of these relationships for treatment and understanding of religious fundamentalism and psychological well-being are discussed.
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31
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Khadem-Rezaiyan M, Moallem SR, Vakili V. High-risk behaviors while driving: A population-based study from Iran. Traffic Inj Prev 2017; 18:257-261. [PMID: 27260770 DOI: 10.1080/15389588.2016.1192612] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/10/2016] [Accepted: 05/18/2016] [Indexed: 06/05/2023]
Abstract
OBJECTIVE Traffic injuries are becoming one of the most important challenges of public health systems. Because these injuries are mostly preventable, the aim of this study is to evaluate the four main high-risk behaviors while driving. METHODS This cross-sectional study was conducted on a random sample from the population of Mashhad, Iran, in 2014. A checklist and a previously validated questionnaire for the transtheoretical stages of change model (TTM) were used for data collection. Statistical analyses were performed using SPSS 11.5 software with P <.05 statistically significant. RESULTS Totally 431 individuals were included with a mean age of 30 ± 11.3 years. Forty-three percent (183) were male. The TTM model revealed that participants were mostly in pre-actional phases regarding not using a cell phone while driving (80%), fastening the driver's seat belt (66%), front seat belt (68%), and rear seat belt (85%) The penalty was a protective factor only for using cellphone (odd ratio [OR] = 0.82, 95% confidence interval [CI], 0.68-0.98). Lower education (OR = 0.12, 95% CI, 0.01-0.94) and male gender (OR = 0.35, 95% CI, 0.14-0.83) were indicative of lower rates of fastening the front and rear seat belts. CONCLUSION The stages of change model among study participants is a proper reflection of the effectiveness of the current policies. More serious actions regarding these high-risk behaviors should be considered in legislation.
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Affiliation(s)
- Majid Khadem-Rezaiyan
- a Department of Community Medicine and Public Health , Faculty of Medicine, Mashhad University of Medical Sciences , Mashhad , Iran
| | - Seyed Reza Moallem
- b Student Research Committee, Faculty of Medicine, Mashhad University of Medical Sciences , Mashhad , Iran
| | - Veda Vakili
- a Department of Community Medicine and Public Health , Faculty of Medicine, Mashhad University of Medical Sciences , Mashhad , Iran
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32
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Norris AH, Loewenberg Weisband Y, Wiles M, Ickovics JR. Prevalence of sexually transmitted infections among Tanzanian migrants: a cross-sectional study. Int J STD AIDS 2017; 28:991-1000. [PMID: 28134004 DOI: 10.1177/0956462416685486] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
For the many millions of migrants, mobility creates vulnerabilities and elevates risk for sexually transmitted infections (STIs). We document, among Tanzanian agricultural plantation residents, migrant characteristics and test associations between migrant status and prevalent STI (HSV-2, syphilis, and HIV). From 623 plantation resident participants, we limit this analysis to participants about whom we know migration status (migrants n = 242, non-migrants n = 291). We collected behavioral data via audio-computer assisted self-interview survey, and clinical data via STI testing. We used multivariate Poisson regression models, stratified by gender and controlling for behavioral risk factors, to measure associations between migrant status and STI. In men, HIV prevalence was 9% for migrants, and 6% for non-migrants. HSV-2 prevalence was 57% for migrants, and 32% for non-migrants. Syphilis prevalence was 12% for migrants, and 3% for non-migrants. Among women, there were few differences in STI prevalence by migrant status: prevalence of HIV was 6% vs. 5% (migrants vs. non-migrants); HSV-2 prevalence was 68% vs. 65%; and syphilis prevalence was 11% vs. 8%. Being a male migrant was significantly associated with increased prevalence of any STI after controlling for sociodemographic and behavioral characteristics (APR = 1.53, 95% CI 1.23-5.25). Migrant women did not have increased prevalence of STI as compared to non-migrant women (APR = 1.03, 95% CI 0.85-1.24). Amongst Tanzanian agricultural workers, male migrants experienced elevated risk for prevalent STI as compared to male non-migrants. We suggest structural interventions to reduce risks associated with migration, especially in male migrants, including workplace-based STI prevention programs, and connecting migrants to resources and support within new communities. The key messages are: migrant men experience significantly elevated risk for prevalent STI, above and beyond sociodemographic and behavioral risk factors, as compared to their non-migrant peers; women in this Tanzanian agricultural plantation community overall had higher prevalence of some STIs than men, migrant women had similar STI risk as non-migrant women; and migration for work, an economic strategy for millions, also creates vulnerabilities, so workplace-based STI prevention programs and connecting migrants to community resources are essential.
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Affiliation(s)
- Alison H Norris
- 1 Division of Epidemiology, College of Public Health, Ohio State University, Columbus, OH, USA
| | | | - Melissa Wiles
- 1 Division of Epidemiology, College of Public Health, Ohio State University, Columbus, OH, USA
| | - Jeannette R Ickovics
- 2 Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT, USA
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33
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Renn T, Golder S, Higgins G, Logan TK, Winham KM. Examining the Relationship Between Childhood Victimization, High-Risk Behaviors, and Health Among Criminal Justice-Involved Women. J Correct Health Care 2017; 23:104-121. [PMID: 28100146 DOI: 10.1177/1078345816685847] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The purpose of this study was to develop and test a conceptual model of the pathways through which childhood victimization influences adult health outcomes. Specifically, measures of high-risk behaviors, tobacco use, alcohol use, illegal substance use, and HIV risk behaviors were hypothesized to mediate the relationship between childhood victimization and adult physical health. The sample consisted of 406 women on probation and parole with a history of childhood victimization in Jefferson County, Kentucky. Structural equation modeling was used to examine the relationship between childhood victimization, high-risk behaviors, and physical health outcomes. The findings indicate partial mediation, with health risk behaviors accounting for 12.5% of the variance in the relationship between childhood victimization and health outcomes. Implications for policy and treatment practice in the health and criminal justice arena are discussed.
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Affiliation(s)
- Tanya Renn
- 1 Brown School of Social Work, Washington University in St. Louis, St. Louis, MO, USA
| | - Seana Golder
- 2 Kent School of Social Work, University of Louisville, Louisville, KY, USA
| | - George Higgins
- 3 University of Louisville, Criminal Justice, Louisville, KY, USA
| | - T K Logan
- 4 University of Kentucky, Behavioral Science, Lexington, KY, USA
| | - Katherine M Winham
- 2 Kent School of Social Work, University of Louisville, Louisville, KY, USA
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34
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Salazar LF, Crosby RA, Jones J, Kota K, Hill B, Masyn KE. Contextual, experiential, and behavioral risk factors associated with HIV status: a descriptive analysis of transgender women residing in Atlanta, Georgia. Int J STD AIDS 2017; 28:1059-1066. [PMID: 28081681 DOI: 10.1177/0956462416686722] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This study assessed the prevalence of self-reported HIV infection among a community sample of transgender women and identified associated contextual, experiential, and behavioral factors. Ninety-two transgender women completed a self-administered interview. Recruitment occurred through an LGBT service organization, a transgender support group, transgender advocates, and informal communications. Eighty-two percent were African American/Black. Of 83 who knew their status, 60% reported being HIV infected. High rates of childhood sexual abuse (52%), rape (53%), intimate partner violence (56%), and incarceration (57%) were reported. Many did not have health insurance (53%), were not employed full-time nor in school (63%) and had been recently homeless (49%). HIV-infected transgender women as compared to HIV-uninfected transgender women were more likely to be African American/Black ( P = 0.04), and older than 34 years ( P = 0.01), unemployed/not in school ( P < 0.001). HIV-infected transgender women also experienced less trans-related discrimination ( P = 0.03), perceived less negative psychosocial impact due to trans status ( P = 0.04) and had greater happiness with their physical appearance ( P = 0.01). HIV-infected transgender women may experience relatively less trans-related stress compared to their HIV-uninfected counterparts. High rates of HIV, trauma, and social marginalization raise concerns for this population and warrant the development of structural and policy-informed interventions.
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Affiliation(s)
- Laura F Salazar
- 1 Department of Health Promotion & Behavior, School of Public Health, Georgia State University, Atlanta, GA, USA
| | - Richard A Crosby
- 2 Department of Health Promotion, College of Public Health, University of Kentucky, Lexington, KY, USA.,3 Kinsey Institute for Research on Sex, Gender, and Reproduction, Indiana University, Bloomington, IN, USA
| | - Jamal Jones
- 1 Department of Health Promotion & Behavior, School of Public Health, Georgia State University, Atlanta, GA, USA
| | - Krishna Kota
- 1 Department of Health Promotion & Behavior, School of Public Health, Georgia State University, Atlanta, GA, USA
| | - Brandon Hill
- 4 Center for Interdisciplinary Inquiry and Innovation in Sexual and Reproductive Health, University of Chicago, Chicago, IL, USA
| | - Katherine E Masyn
- 5 Department of Epidemiology and Biostatistics, School of Public Health, Georgia State University, Atlanta, GA, USA
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Zamani-Alavijeh F, Narimani N, Montazeri A, Fakhri A, Mansourian M, Shafiee A, Heydarabadi AB. Self-reported risk behaviors among offender motorcyclists in Ahvaz City. Electron Physician 2015; 7:1464-9. [PMID: 26767099 PMCID: PMC4700891 DOI: 10.19082/1464] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2015] [Accepted: 11/05/2015] [Indexed: 11/20/2022] Open
Abstract
Introduction Road traffic accidents are among the most critical public health issues. Many people die on the roads each day and tens of millions sustain nonfatal injuries. The aim of this study is to describe the high-risk behaviors of motorcyclists in which police had to confiscate their motorcycles. Methods This cross-sectional study was carried out on 240 motorcyclists in Iran from December 2010 to February 2011. A researcher-created questionnaire was used to collect data on self-reported high-risk behaviors, including passing the crossroads without considering the traffic light, refusing to wear a helmet, performing stunts in the street, and driving in the opposite direction. The collected data was descriptively analyzed. Results The mean age of motorcyclists was 29.3 years (SD=8.26). Twenty-six percent (n=62) of the participants did not have a motorcycle driver’s license. The analysis of risk behaviors showed that 60.8% (n=146) of the motorcycle drivers usually passed crossroads without considering the traffic light and 20.8% (n=50) performed stunts in the street. Conclusions This study indicates that the prevalence of high-risk behaviors among motorcyclists is significant. Health education interventions may inhibit these behaviors, thus reducing the risk of injuries.
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Affiliation(s)
- Fereshteh Zamani-Alavijeh
- Ph.D. of Health Education, Assistant Professor, Department of Health Education and promotion, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Nasim Narimani
- M.Sc. Student of Health Education, Faculty of Health, Department of Public Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Ali Montazeri
- Ph.D., Professor, Mental Health Research Group, Health Metrics Research Centre, Iranian Institute for Health Sciences Research, ACECR, Tehran, Iran
| | - Ahmad Fakhri
- Ph.D. of Psychiatric, Assistant Professor, Department of Psychiatric, Faculty of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Morteza Mansourian
- Ph.D. of Health Education, Assistant Professor, Department of Health Education, School of Health, Iran University of Medical Sciences, Tehran, Iran
| | - Amir Shafiee
- Ph.D. Student, Department of Industrial Engineering, Yazd University, Yazd, Iran
| | - Akbar Babaei Heydarabadi
- Ph.D. of Health Education and Promotion, Department of Public Health, Students' Research Committee, Faculty of Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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36
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Brown MRG, Benoit JRA, Juhás M, Dametto E, Tse TT, MacKay M, Sen B, Carroll AM, Hodlevskyy O, Silverstone PH, Dolcos F, Dursun SM, Greenshaw AJ. fMRI investigation of response inhibition, emotion, impulsivity, and clinical high-risk behavior in adolescents. Front Syst Neurosci 2015; 9:124. [PMID: 26483645 PMCID: PMC4586270 DOI: 10.3389/fnsys.2015.00124] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2014] [Accepted: 08/20/2015] [Indexed: 12/27/2022] Open
Abstract
High-risk behavior in adolescents is associated with injury, mental health problems, and poor outcomes in later life. Improved understanding of the neurobiology of high-risk behavior and impulsivity shows promise for informing clinical treatment and prevention as well as policy to better address high-risk behavior. We recruited 21 adolescents (age 14–17) with a wide range of high-risk behavior tendencies, including medically high-risk participants recruited from psychiatric clinics. Risk tendencies were assessed using the Adolescent Risk Behavior Screen (ARBS). ARBS risk scores correlated highly (0.78) with impulsivity scores from the Barratt Impulsivity scale (BIS). Participants underwent 4.7 Tesla functional magnetic resonance imaging (fMRI) while performing an emotional Go/NoGo task. This task presented an aversive or neutral distractor image simultaneously with each Go or NoGo stimulus. Risk behavior and impulsivity tendencies exhibited similar but not identical associations with fMRI activation patterns in prefrontal brain regions. We interpret these results as reflecting differences in response inhibition, emotional stimulus processing, and emotion regulation in relation to participant risk behavior tendencies and impulsivity levels. The results are consistent with high impulsivity playing an important role in determining high risk tendencies in this sample containing clinically high-risk adolescents.
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Affiliation(s)
- Matthew R G Brown
- Department of Psychiatry, University of Alberta Edmonton, AB, Canada ; Department of Computing Science, University of Alberta Edmonton, AB, Canada
| | - James R A Benoit
- Department of Psychiatry, University of Alberta Edmonton, AB, Canada
| | - Michal Juhás
- Department of Psychiatry, University of Alberta Edmonton, AB, Canada
| | - Ericson Dametto
- Department of Psychiatry, University of Alberta Edmonton, AB, Canada
| | - Tiffanie T Tse
- Department of Psychiatry, University of Alberta Edmonton, AB, Canada
| | - Marnie MacKay
- Department of Psychiatry, University of Alberta Edmonton, AB, Canada
| | - Bhaskar Sen
- Department of Computing Science, University of Alberta Edmonton, AB, Canada
| | - Alan M Carroll
- Department of Psychiatry, University of Alberta Edmonton, AB, Canada
| | | | | | - Florin Dolcos
- Department of Psychiatry, University of Alberta Edmonton, AB, Canada ; Psychology Department, Neuroscience Program, and the Beckman Institute for Advanced Science and Technology, University of Illinois Urbana-Champaign Urbana, IL, USA
| | - Serdar M Dursun
- Department of Psychiatry, University of Alberta Edmonton, AB, Canada
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Abstract
The government of Botswana has been spending a lot of money in the prevention, treatment, care and support for HIV/AIDS patient for decades. This paper uses data from the third Botswana AIDS Impact Survey (BAIS III) to explore high-risk behaviors of adults and how they affect government efforts to stop the spread of HIV/AIDS. The objective of this paper is to fill in the gap on the assessment of high-risk behaviors associated with HIV/AIDS and their implications on HIV/AIDS prevention efforts. A nationally representative sample of 10,159 men and women aged 20–64 years who had successfully completed the BAIS III individual questionnaire were used in the study. Both descriptive and binary logistic regression analyses were used for analysis. Crude odds ratios were obtained from gross effects model while adjusted odds ratios (AOR) were obtained from the net effects model. Statistically significant association was observed between multiple current partners and alcohol consumption (AOR = 1.5), drug abuse (AOR = 1.7), transactional sex (AOR = 2.6) and intergenerational sex (AOR = 1.07). Furthermore, statistically significant association was seen for inconsistent condom use and having tested for HIV (AOR = 1.5). These results show a worrying tendency that despite government's efforts to stop the spread of HIV/AIDS, adults in Botswana continue to indulge in high-risk behaviors. Therefore, any programs and policies on HIV/AIDS should first target these high-risk behaviors.
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Affiliation(s)
- Mpho Keetile
- a PhD Candidate, is affiliated to the Department of Population Studies , University of Botswana , Gaborone , Botswana
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Brown MRG, Benoit JRA, Juhás M, Lebel RM, MacKay M, Dametto E, Silverstone PH, Dolcos F, Dursun SM, Greenshaw AJ. Neural correlates of high-risk behavior tendencies and impulsivity in an emotional Go/NoGo fMRI task. Front Syst Neurosci 2015; 9:24. [PMID: 25805975 PMCID: PMC4354310 DOI: 10.3389/fnsys.2015.00024] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2014] [Accepted: 02/12/2015] [Indexed: 11/13/2022] Open
Abstract
Improved neuroscientific understanding of high-risk behaviors such as alcohol binging, drug use, and unsafe sex will lead to therapeutic advances for high-risk groups. High-risk behavior often occurs in an emotionally-charged context, and behavioral inhibition and emotion regulation play important roles in risk-related decision making. High impulsivity is an important potential contributor to high-risk behavior tendencies. We explored the relationships between high-risk behavior tendencies, impulsivity, and fMRI brain activations in an emotional Go/NoGo task. This task presented emotional distractor pictures (aversive vs. neutral) simultaneously with Go/NoGo stimuli (square vs. circle) that required a button press or withholding of the press, respectively. Participants' risk behavior tendencies were assessed with the Cognitive Appraisal of Risky Events (CARE) scale. The Barratt Impulsivity Scale 11 (BIS) was used to assess participant impulsivity. Individuals with higher CARE risk scores exhibited reduced activation related to response inhibition (NoGo-Go) in right orbital frontal cortex (OFC) and ventromedial prefrontal cortex. These regions did not show a significant relationship with impulsivity scores. Conversely, more impulsive individuals showed reduced emotion-related activity (aversive-neutral distractors) in dorsomedial prefrontal cortex, perigenual anterior cingulate cortex, and right posterior OFC. There were distinct neural correlates of high-risk behavior tendency and impulsivity in terms of brain activity in the emotional Go/NoGo task. This dissociation supports the conception of high-risk behavior tendency as a distinct construct from that of impulsivity. Our results suggest that treatment for high-risk behavior may be more effective with a nuanced approach that does not conflate high impulsivity necessarily with high-risk behavior tendencies.
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Affiliation(s)
- Matthew R G Brown
- Department of Psychiatry, University of Alberta Edmonton, AB, Canada
| | - James R A Benoit
- Department of Psychiatry, University of Alberta Edmonton, AB, Canada
| | - Michal Juhás
- Department of Psychiatry, University of Alberta Edmonton, AB, Canada
| | - R M Lebel
- Department of Biomedical Engineering, University of Alberta Edmonton, AB, Canada
| | - Marnie MacKay
- Department of Psychiatry, University of Alberta Edmonton, AB, Canada
| | - Ericson Dametto
- Department of Psychiatry, University of Alberta Edmonton, AB, Canada
| | | | - Florin Dolcos
- Department of Psychiatry, University of Alberta Edmonton, AB, Canada ; Department of Psychology, Neuroscience Program, and the Beckman Institute for Advanced Science and Technology, University of Illinois Urbana-Champaign Urbana-Champaign, IL, USA
| | - Serdar M Dursun
- Department of Psychiatry, University of Alberta Edmonton, AB, Canada
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