Changes in HIV risk behaviors among cocaine-using methadone patients

Cocaine use among methadone patients has been related to higher prevalence of HIV risk behaviors. HIV risk behaviors for cocaine-using patients in methadone treatment (N = 207) were examined for two time periods, the current month in-treatment and the month previous to treatment admission. All needle-related and sexually-related risk behaviors (except for needle hygiene) significantly and substantially declined over the average two year time interval. Several variables were associated with needle and sexual risks in multivariate regression analyses. Dropping apparent opiate use underreporters from the analyses did not alter the results. From a harm reduction perspective, high priority should be given to retaining cocaine-using patients in methadone maintenance, intensifying in-program services for those with anti-social personality, bipolar disorder or alcoholism, as well as increasing access to needle exchanges and free condoms.     

HIV risk behaviors: a comparison of U.S. Hispanic and Dominican Republic youth

Using 3-week-old male beagle dogs, we examined the cartilage-bone replacement processes in the mandibular condyle by means of light and electron microscopy. Calcification of the cartilage matrix occurred in the central area of the longitudinal septa, but not in the transverse septa. Perivascular mononuclear cells absorbed the transverse septa which initiated the opening of the chondrocytic lacunae. These cells phagocytosed septal cartilage fragments. Shortly thereafter, a thin bone layer was deposited on the remaining longitudinal septa by invading osteoblasts. Osteoclasts in lacunae developed neither ruffled borders nor clear zones in the cartilage matrix, but once the bone layer has been deposited in the remaining cartilage, these structures formed. Our results suggest that the cartilage-bone replacement in mandibular condyle involves three sequential processes: 1) degradation and phagocytosis of cartilage fragments in the transverse septa by mononuclear cells, 2) bone deposition over the remaining longitudinal septa, and 3) degradation of both calcified cartilage and bone by osteoclasts.     

Pathways of risk for accelerated heavy alcohol use among adolescent children of alcoholic parents

The current study examined two questions. First, do internalizing symptoms and externalizing behavior each mediate the relations between parent psychopathology (alcoholism, antisocial personality disorder, and affective disorder) and growth in adolescent heavy alcohol use? Second, are there gender differences in these mediated pathways? Using latent curve analyses, we examined these questions in a high-risk sample of 439 families (53% children of alcoholic parents; 47% female). Collapsing across gender, adolescent-reported externalizing behavior mediated both the relation between parent alcoholism and growth in heavy alcohol use and the relation between parent antisociality and growth in heavy alcohol use. Parent-reported externalizing behavior only mediated the relation between parent antisociality and growth in heavy alcohol use in males. No support was found for internalizing symptoms as a mediator of these relations. Avenues are suggested for further exploring and integrating information about different mediating processes accounting for children of alcoholics' risk for heavy alcohol use.     

Reliability of self-reported HIV risk behaviors of drug users.

In AIDS research, relatively little attention has been paid to reliability of self-report of drug users. The authors examined the test-retest reliability of the Risk Behavior Assessment (NIDA, 1991) questionnaire. This structured-interview questionnaire was administered twice to 196 drug users in 5 cities over a 48-hr period. Findings indicated that respondents consistently self-report drug use, injection practices, and sexual behaviors; discrepancies do not appear to reflect systematic decreases or increases in self-report; unreliability is associated with poorly worded questions and respondent characteristics; and discrepant reports warrant attention in analysis and interpretation of data. Measurement error has implications for estimating risks, understanding relationships between behavior and HIV transmission, and interpreting change after interventions. Items with low reliability have been revised, and further reliability studies are examining whether revisions have led to improved reliability. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Naltrexone's effects on reactivity to alcohol cues among alcoholic men.

The mechanisms of naltrexone's effects on urges to drink during abstinence are unclear. Naltrexone may suppress either urges to drink specifically or appetitive responses in general. The effects of naltrexone on cue reactivity to alcoholic and sweet nonalcoholic beverages were investigated. Alcohol-dependent men (N ?=?53) in treatment received naltrexone (50 mg) or placebo. Four hours later, they received baseline assessment, exposure to fruit juice, and exposure to their usual alcoholic beverage in 3-min trials. Naltrexone reduced urge to drink and self-reported attention to the alcohol cues, not at the initial exposure but after repeated exposures to alcohol cues. Naltrexone reduced negative affect across baseline and alcohol trials. No effects of naltrexone on responses to the nonalcoholic appetitive beverage cues were found, suggesting that general appetite suppression does not mediate the effects of naltrexone on urges. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

HIV risk behaviors among inner-city African American women. The Community Housing AIDS Prevention Study Group

This study examined the prevalence and predictors of HIV risk behaviors among a sample of 875 low-income, African American women residents of inner-city housing developments. The women completed an anonymous questionnaire that revealed that one third of them were at high risk for HIV either because they had multiple partners or because of the high-risk behaviors of their regular partner. HIV risk was highest among women who accurately perceived themselves to be at increased HIV risk, reported weak behavioral intentions to reduce risk, and held stronger beliefs about psychosocial barriers to condom use. Women at high risk were also younger, reported higher rates of substance use, and indicated that their housing development lacked social cohesiveness. These findings suggest that HIV prevention efforts for this population should focus on strengthening women's risk reduction behavioral intentions and self-efficacy through skill development, overcoming psychosocial barriers to condom use, managing the risk related to substance use, and incorporating approaches that take into account the social, psychological, and relationship barriers to change among economically impoverished African American women.     

Reducing sexual risk behaviors and alcohol use among HIV-positive men who have sex with men: A randomized clinical trial.

This randomized clinical trial (N = 253) evaluated the efficacy of a theory-based intervention designed to reduce both alcohol use and incidence of unprotected sexual behaviors among HIV-positive men who have sex with men with alcohol use disorders. An integrated, manualized intervention, using both individual counseling and peer group education/support, was compared with a control condition in which participants received resource referrals. The intervention was based on the transtheoretical model’s stages and processes of change, and motivational interviewing was used to enhance client readiness for change. Major findings include treatment effects for reduction in number of drinks per 30-day period, number of heavy drinking days per 30-day period, and number of days on which both heavy drinking and unprotected sex occurred. Practitioners employing this intervention may achieve enhanced client outcomes in reduction of both alcohol use and risky sexual behavior. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Relationship of alcohol use to other health behaviors among college students.

The present study examined whether high levels of drinking are negatively associated with the likelihood of engaging in health-enhancing behaviors and positively associated with the likelihood of engaging in health-compromising behaviors. It was hypothesized that higher levels of drinking would be associated with more negative indicators of psychological health. Health behaviors of 183 college freshmen were assessed with the Computerized Lifestyles Assessment and the Brief Symptom Inventory. Consistent with prior research, results indicated a significant positive linear trend across abstainers, light-moderate drinkers, episodic drinkers, and heavy drinkers in reports of cigarette use, other drug use, and sexual activity. However, a comparison of other health areas, including psychological health, indicated no significant trends. Implications for substance abuse prevention programs and directions for future research are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Are negative affective states associated with HIV sexual risk behaviors? A meta-analytic review.

This meta-analytic review examined whether negative affective states (depressive symptomatology, anxiety, anger) are associated with sexual behaviors that place people at risk for contracting or transmitting HIV. The results from 34 study samples were included in the analysis. Contrary to popular belief, the findings as a whole provide little evidence that negative affect is associated with increased sexual risk behavior. The average weighted correlation for the overall association was .05. The effect size was nonsignificantly higher for anger (r?=?.10) than for depressive symptoms (r?=?.04) or anxiety (r?=?.03). The variability of effect sizes was not accounted for by type of sexual risk measure, subject population, or methodological aspects of the studies. Conceptual and methodological limitations of the literature are identified and directions for future research are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Randomized trial to reduce club drug use and HIV risk behaviors among men who have sex with men.

The authors examined the effectiveness of motivational interviewing (MI) on club drug use and risky sex in non-treatment-seeking men who have sex with men (MSM). MSM (N = 150) were assessed and randomly assigned to 4 sessions of MI or an educational control intervention. Follow-up occurred at quarterly intervals for 1 year. Primary outcomes were days of any club drug use and number of unsafe sex acts. On average, club drug use declined during follow-up. A significant interaction effect showed that MI was associated with less club drug use during follow-up compared with education but only among participants with lower severity of drug dependence (p     

Changes in HIV treatment beliefs and sexual risk behaviors among gay and bisexual men, 1997-2005.

Objective: Beliefs about HIV treatment effectiveness and the impact of HIV treatments on HIV transmission risks were initially related to sexual risk-taking in the late 1990s when multidrug HIV treatments first became available. This study examined changes in beliefs about the effects of HIV treatment for preventing HIV transmission and their association to sexual risk behaviors between the years 1997 and 2005. Design: Anonymous surveys were administered to a convenience sample of gay and bisexual men attending a large community event in Atlanta, Georgia in 1997 (N = 498) and again at the same community event in 2005 (N = 448). Analyses were performed for men living with HIV/AIDS and for men who have not been diagnosed with HIV/AIDS. Main Outcome Measures: Rates of unprotected anal intercourse in the previous 3 months. Results: There were significant increases in high-risk sexual practices that coincided with increased beliefs that HIV treatments can reduce the chance of transmitting HIV. However, optimistic beliefs about the health benefits of HIV treatments decreased over the 8 years and were not related to risk behaviors. Conclusions: Beliefs about how HIV treatments impact HIV infectiousness remain associated with HIV transmission risk behavior and interventions targeting at-risk as well as HIV-positive men who have sex with men must directly address these beliefs and perceptions. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Mood and HIV risk behavior among drug-dependent veterans.

Extends prior investigations of risk behaviors for contracting and transmitting the human immunodeficiency virus (HIV) among treatment-seeking drug abusers by analyzing the relationship between HIV risk behavior and drug use and psychopathology variables. A battery of tests related to knowledge about AIDS and semistructured interviews were administered to 170 patients (aged 21–59 yrs) at a Veterans Administration drug dependence treatment unit. Ss with high anxiety and depression scores reported engaging in significantly more HIV drug-risk behaviors. In terms of drug of choice, polydrug users did not report engaging in significantly more high-risk sexual behaviors than Ss abusing solely cocaine. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Sexual risk behaviors among substance users: Relationship to impulsivity.

Recent research has suggested that trait impulsivity may predict sexual risk behavior. Few studies have examined this association directly in substance users at risk for HIV transmission. Participants were 330 primarily heroin and/or cocaine users who underwent a structured interview regarding their drug use, sexual behaviors, and impulsivity. Results from an iteratively reweighted least squares regression analysis indicate that impulsivity remained a statistically significant predictor of sexual risk after adjusting for the effects of demographic variables and substance use frequency (b=.179, p     

Relationships among HIV risk beliefs, attitudes, and behaviors in sexually active, seronegative gay men

Safer-sex guidelines established during the early days of the HIV/AIDS epidemic have undergone very little revision despite some controversy. Although these guidelines have been widely disseminated in the gay community, many gay men continue to engage in behaviors that are believed to put them at high risk for transmission of HIV. This suggests either that they have not accepted safer-sex guidelines as accurate or that other factors override personal implementation of the guidelines. The study examined seronegative gay men's beliefs about the accuracy of safer sex guidelines and the men's participation in behaviors risky for transmitting HIV. The greatest disagreement between the men's beliefs and behaviors centered on the risk of oral intercourse; this suggests a need for clarification of the safer sex message about this behavior. The findings of this study support the need to reformulate safer-sex guidelines. When unprotected oral and anal sex are classified at the same level of risk, those who engage in unprotected oral sex may proceed to unprotected anal sex with less reservation.     

Identifying and treating alcoholic medical inpatients: The psychologist's contribution.

Discusses reasons for diagnostic and treatment-related problems regarding alcoholic medical inpatients. Areas of potential contribution by psychologists include (a) increasing diagnostic precision and developing effective intervention strategies through consultation, (b) developing methods to promote patient compliance with treatment recommendations, (c) educating medical staff, and (d) contributing to the research literature. It is noted that the physician's reluctance or inability to diagnose alcoholism is related to personality and attitudes concerning alcoholism. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The influence of state and trait affect on HIV risk behaviors: A daily diary study of MSM.

Objective: To characterize the influence of state and trait affect on HIV risk behaviors. Design: Men who have sex with men (N = 155) completed reports of trait affect and daily reports of affect and sexual behaviors each night for up to 30 days. Main Outcome Measures: Analyses focused on the role of state and trait positive activation (PA), negative activation (NA), anxious arousal (AA), and sexual activation (SA) on sexual risk taking, operationalized as having a sex partner, a partner-related risk composite, and an HIV risk behavior composite. Results: State SA was positively associated with having a sex partner and HIV risk behaviors; trait SA was positively associated with partner-related risk. State AA was negatively associated with having a sex partner and positively associated with HIV risk behaviors. Trait AA had a negative association with partner-related risk and moderated the effects of state AA. State PA was negatively associated with HIV risk behaviors, and trait PA had a main effect on having a sex partner. NA had no significant trait or state effects. Conclusion: These data suggest a role for multiple affective states in sexual risk taking. Models of HIV risk-taking behaviors should be extended to include affective processes. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Adolescent admissions to residential drug treatment: HIV risk behaviors pre- and posttreatment.

HIV risk behaviors of adolescents (N?=?938) admitted to residential therapeutic communities for drug abuse and related problems are described. Approximately 95% of the sample was sexually active. The adolescents reported that they had used drugs or alcohol about half of the time that they engaged in sexual relations and that half of their sexual activity was unprotected. Males and females differed in their self-perceptions of risk for HIV infection. Three dimensions of risky behaviors were identified by factor-analytic procedures: Risky Sex With Men, Risky Sex With Women, and Risky Drug Use Behaviors. Separate regression equations for males and females identified common and unique predictors of risky behaviors. A comparison of 1-year pretreatment with 1-year posttreatment risky behaviors for a subsample of the full cohort revealed significant positive changes (i.e., reductions) on some, but not all, measures of risky behaviors. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Relationship among social and intrapersonal risk, alcohol expectancies, and alcohol usage among early adolescents

We evaluated 3 patients with biopsy-proven hypertrophic cranial pachymeningitis apparently unrelated to any systemic disease. Each patient had chronic headache, cranial neuropathy, an elevated ESR, and a mild CSF pleocytosis. Neuro-ophthalmic findings included bilateral sixth nerve palsies in two patients and the third had bilateral optic neuropathies. MR imaging revealed thickened dura that enhanced with Gd-DTPA administration. Histologic examination showed thickened, fibrotic dura with a sterile, chronic, nongranulomatous inflammation. The response to treatment was variable with corticosteroids, immunosuppressive drugs, or radiation. The distinctive MR appearance should help physicians recognize this rarely reported disease.