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1,763
document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)
Despite the fact that needle exchange was introduced in Vancouver as early as 1988, needle sharing remains common. An analysis was conducted to identify determinants of borrowing used needles among subjects participating in a case-control study. IDUs had a documented HIV seroconversion after 1 January, 1994 (n = 89), or repeatedly tested HIV-seronegative after this date (n = 192). Interviewer-administered questionnaires focused on drug use, sexual behaviours, source of needles and depression. Subjects were asked if they had "ever been forced to have sex" as a child, youth or adult. Logistic regression identified determinants of borrowing needles. After controlling for HIV serostatus, factors independently associated with borrowing were injecting > 4 times/day, polydrug use, and ever experiencing non-consensual sex (
AOR
= 3.4, 95% CI: 1.8, 6.5). Depression was associated with borrowing, although not independently so. Homosexual activity was independently associated with borrowing among males, whereas living with a sexual partner was an independent predictor for females. Access or barriers to clean needle use were not associated with borrowing. Social determinants, particularly a history of
sexual abuse
, are among the most significant predictors of needle borrowing among Vancouver's IDUs. Early identification of these factors should be a component of HIV prevention programmes.
...
PMID:Social determinants predict needle-sharing behaviour among injection drug users in Vancouver, Canada. 948 50
Data from a cohort of young HIV-negative gay and bisexual men were analyzed to identify determinants of sexual risk-taking at baseline. Gay/bisexual men aged between 18 and 30 completed a self-administered questionnaire including demographics, depression, social support, substance use, and consensual versus nonconsensual sex. Risk-takers were defined as those who had unprotected anal sex with casual male sex partners in the previous year; non-risk-takers were defined as those who reported consistent condom use during anal sex with all male partners in the previous year. Logistic regression was used to identify independent predictors of sexual risk-taking. Of 439 men studied, risk-takers had less education, a higher depression score, less social support, and were more likely to report nonconsensual sex and recreational drug use relative to non-risk-takers. Independent predictors of sexual risk-taking were low education, nitrite use, low social support (adjusted odds ratio [
AOR
]=1.65; 95% CI, 1.04-2.59), and nonconsensual sex experienced as a youth or adult (AOR=1.85; 95% CI, 1.15-2.96). Young gay/bisexual men reporting nonconsensual sex, low social support, or nitrite use were significantly more likely to have recently had unprotected anal sex with casual partners. HIV prevention programs aimed at young gay/bisexual men should include
sexual abuse
counselling and foster community norms supporting safer sex practices.
...
PMID:Determinants of sexual risk-taking among young HIV-negative gay and bisexual men. 973 71
This study examined the relationship between lifetime abuse and suicidal ideation in a sample of 245 injection drug users (IDUs) who attended the Baltimore Needle Exchange Program and received a referral for opiate agonist therapy. Data were obtained from baseline interviews and HIV antibody tests. The sample mean age was 42.2 (SD = 8.1 ); 77% were African American; 69% were male. Overall, 27% reported thoughts of suicide in the last six months, and lifetime emotional, physical and
sexual abuse
was reported by 17%, 12% and 10%, respectively. In bivariate analyses, recent suicidal ideation was associated with emotional (odds ratio [OR] = 3.2; p = 0.001), physical (OR = 2.5; p = 0.026), and
sexual abuse
(OR = 5.0; p < 0.001). In multiple logistic regression models controlling for HIV status and Center for Epidemiological Studies Depression (CES-D) score, individuals who experienced emotional abuse were more than twice as likely to report recent suicidal ideation (adjusted odds ratio [
AOR
] = 2.6; p = 0.011); those who experienced
sexual abuse
were four times more likely to report suicidal ideation (
AOR
= 4.0; p = 0.004). These findings suggest that emotional and
sexual abuse
might be risk factors for suicidality among IDUs and also might suggest that suicide prevention should be an integral part of drug treatment for treatment-seeking IDUs.
...
PMID:The relationship between lifetime abuse and suicidal ideation in a sample of injection drug users. 1770 10
HIV is a chronic, life-threatening illness that necessitates regular and consistent medical care. Childhood
sexual abuse
(CSA) is a common experience among HIV-positive adults and may interfere with treatment utilization. This study examined rates and correlates of treatment utilization among HIV-positive adults with CSA enrolled in a coping intervention trial in New York City. The baseline assessment included measures of treatment utilization, mental health, substance abuse, and other psychosocial factors. In 2002-2004, participants (50% female, 69% African-American, M = 42.3 +/- 6.8 years old) were recruited. Nearly all (99%) received HIV medical care. However, 20% had no outpatient visits and 24% sought emergency services in the past 4 months. Among 184 participants receiving antiretroviral therapy (ART), 22% were less than 90% adherent in the past week. In a multivariable logistic regression model, no outpatient treatment was associated with African American race (
AOR
= 3.46 [1.42-8.40]), poor social support (
AOR
= 1.59 [1.03-2.45]), and abstinence from illicit drug use (
AOR
= 0.37 [0.16-0.85]). Emergency service utilization was associated with HIV symptoms (
AOR
= 2.30 [1.22-4.35]), binge drinking (AOR=2.92 (1.18-7.24)), and illicit drug use (
AOR
= 1.98 [1.02-3.85]). Poor medication adherence was associated with trauma symptoms (
AOR
= 2.64 [1.07-6.75]) and poor social support (
AOR
= 1.82 [1.09-2.97]). In sum, while participants had access to HIV medical care, a sizable minority did not adhere to recommended guidelines and thus may not be benefiting optimally from treatment. Interventions targeting HIV-positive adults with CSA histories may need to address trauma symptoms, substance abuse, and poor social support that interfere with medical treatment utilization and adherence.
...
PMID:Utilization of medical treatments and adherence to antiretroviral therapy among HIV-positive adults with histories of childhood sexual abuse. 1926 Jul 72
The relationship between childhood maltreatment and future threats with weapons is unknown. We examined data from the nationally representative National Comorbidity Survey Replication (n = 5692) and conducted multiple logistic regression analyses to determine the association between childhood maltreatment and lifetime behavior of threatening others with a gun or other weapon. After adjusting for sociodemographic variables, physical abuse,
sexual abuse
, and witnessing domestic violence were significantly associated with threats made with a gun (adjusted odds ratios [
AOR
] ranging between 3.38 and 4.07) and other weapons (
AOR
ranging between 2.16 and 2.83). The greater the number of types of maltreatment experienced, the stronger the association with lifetime threats made to others with guns and any weapons. Over 94% of respondents who experienced maltreatment and made threats reported that the maltreatment occurred prior to threatening others with weapons. Prevention efforts that reduce exposure to maltreatment may reduce violent behavior in later life.
...
PMID:Childhood maltreatment and threats with weapons. 1999 25
This is a prospective cohort study to identify factors associated with receipt of substance abuse treatment (SAT) among adults with alcohol problems and HIV/AIDS. Data from the HIV Longitudinal Interrelationships of Viruses and Ethanol study were analyzed. Generalized estimating equation logistic regression models were fit to identify factors associated with any service utilization. An alcohol dependence diagnosis had a negative association with SAT (adjusted odds ratio [
AOR
] = 0.36, 95% confidence interval [95% CI] = 0.19-0.67), as did identifying sexual orientation other than heterosexual (
AOR
= 0.46, CI = 0.29-0.72) and having social supports that use alcohol/drugs (
AOR
= 0.62, CI = 0.45-0.83). Positive associations with SAT include presence of hepatitis C antibody (
AOR
= 3.37, CI = 2.24-5.06), physical or
sexual abuse
(
AOR
= 2.12, CI = 1.22-3.69), social supports that help with sobriety (
AOR
= 1.92, CI = 1.28-2.87), homelessness (
AOR
= 2.40, CI = 1.60-3.62), drug dependence diagnosis (
AOR
= 2.64, CI = 1.88-3.70), and clinically important depressive symptoms (
AOR
= 1.52, CI = 1.08-2.15). While reassuring that factors indicating need for SAT among people with HIV and alcohol problems (e.g., drug dependence) are associated with receipt, nonneed factors (e.g., sexual orientation, age) that should not decrease likelihood of receipt of treatment were identified.
...
PMID:Substance abuse treatment utilization among adults living with HIV/AIDS and alcohol or drug problems. 2170 Apr 12
To assess the prevalence of sex work and its associations with substance use among female bar/spa workers in the Philippines (N = 498), workers from 54 bar or spa venues in Metro Manila (2009-2010) were surveyed on demographics, drug/alcohol use, abuse history, and sex work. Their median age was 23 years and 35% engaged in sex work. Sex work was independently associated with methamphetamine use (19% vs 4%; adjusted odds ratio [
AOR
] =2.9, 95% confidence interval [CI] = 1.3-6.2), alcohol use with patrons (49% vs. 27%;
AOR
= 1.9, 95% CI = 1.1-3.4), and alcohol intoxication during sex (50% vs. 24%;
AOR
= 2.0, 95% CI = 1.2-3.5), but inversely associated with daily alcohol use (13% vs. 16%;
AOR
= 0.2, 95% CI = 0.1-0.5). Additional significant covariates included
sexual abuse
history, younger age, and not having a higher education. Findings suggest that interventions with sex workers in bars and spas should focus on methamphetamine use, alcohol use contexts, and violence victimization, to better meet the needs of this population.
...
PMID:Sex work and its associations with alcohol and methamphetamine use among female bar and spa workers in the Philippines. 2334 41
Despite the 3:1 prevalence ratio of men versus women with Antisocial Personality Disorder (ASPD), research on sex differences on correlates of ASPD in the general population is scarce. The purpose of this study was to examine sex differences in childhood and adult adverse events, lifetime psychiatric comorbidity, and clinical correlates of DSM-IV ASPD. The sample included 819 men and 407 women with DSM-IV ASPD diagnosis. Data were derived from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) (N = 43,093). Compared to men, women with ASPD reported more frequent childhood emotional neglect (
AOR
= 2.25; 95% CI: 1.52-3.34) and
sexual abuse
(
AOR
= 4.20; 95% CI: 2.78-6.35), any parent-related adverse event during childhood (e.g., parental substance use disorder) (
AOR
= 2.47; 95% CI: 1.60-3.82), and adverse events during adulthood (
AOR
= 4.20; 95% CI: 2.78-6.35). Although women with ASPD present less violent antisocial behaviors and higher rates of aggressiveness and irritability (OR = 0.46; 95% CI: 0.31-0.67), they have higher rates of victimization, greater impairment, and lower social support. Our findings suggest increased mental health needs in women with ASPD, meriting development of different treatment programs for women and men.
...
PMID:Sex differences in antisocial personality disorder: results from the National Epidemiological Survey on Alcohol and Related Conditions. 2354 28
Childhood
sexual abuse
(CSA) occurs across the world, with a prevalence of 20% internationally. Our aim was to investigate the associations between CSA, CSA plus adult violence experiences, and selected self-reported physical and mental health in a community sample of women. Data from 7,700 women aged 28-33 years from the 1973-1978 cohort who completed Survey 4 of the Australian Longitudinal Study on Women's Health (ALSWH) were analyzed. Questions about prior abuse experience such as child
sexual abuse
, IPV, adult physical and sexual assaults, andphysical and mental health. Women who experienced CSA were 1.4 times more likely to experience bodily pain (adjusted odds ratio [
AOR
] = 1.37, confidence interval [CI] = [1.19, 1.58]), 1.3 times more likely to have poorer general health (
AOR
= 1.33, CI = [1.15, 1.54]), and 1.4 times more likely to be depressed in the past 3 years (
AOR
= 1.44, CI = [1.22, 1.71]) compared with those without abuse.. Women who experienced both CSA and adult violence were 2.4 to 3.1 times more likely to experience poor general (
AOR
= 2.35, CI = [1.76, 3.14]) and mental health (
AOR
= 2.69, CI = [1.98, 3.64]), and suffer from depression (
AOR
= 2.84, CI = [2.13, 3.78]) and anxiety (
AOR
= 3.10, CI = [2.12, 4.53]) compared with women with no abuse. This study demonstrates the importance of CSA in pain and poorer long-term mental and physical health.. It emphasizes how prior CSA may amplify pain and poorer long-term mental and physical health among women who are again exposed to violence in adulthood.
...
PMID:Childhood sexual abuse and its association with adult physical and mental health: results from a national cohort of young Australian women. 2541 Dec 33
This study evaluated whether a history of
sexual abuse
could differentiate negative health consequences among men who have sex with men (MSM; N=148) enrolled in a risk counseling program. Over half (51.4%) reported an experience of
sexual abuse
. A history of
sexual abuse
was associated with increased psychological distress, increased rates of alcohol (
AOR
= 2.91; p < .01) and/or drug abuse (
AOR
= 2; p < .01) treatment, increased risk of housing instability (
AOR
= 2.13; p < .05), and increased risk for suicidality (
AOR
= 4.3; p < .001). Findings demonstrate that screening for
sexual abuse
may be useful in determining the service needs of high-risk MSM.
...
PMID:Sexual Abuse is Associated with Negative Health Consequences among High-risk Men who have Sex with Men. 2550 31
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