Sexually transmitted diseases and migration

Sexually transmitted diseases (STDs) are communicable diseases transferred mainly through sexual contact. With more than 20 pathogens known to be spread by sexual contact, STDs are the most common notifiable infectious diseases in most countries. Despite some fluctuation in their incidence, STDs continue to occur at unacceptably high levels. For most notifiable STDs, the highest rates of incidence are found in 20-24 years olds, followed by people aged 25-29 and 15-19. Among sexually active teenagers, the highest incidence of STD infection is among the youngest teens. For most STDs, the overall morbidity rate is higher for men than for women. STD control programs need to be designed and implemented with the understanding that migration has always been linked with STD. Sexual preference, marital status, socioeconomic status, place of residence, prostitution, migration, principal STDs, populations at risk, and prevention and control measures are discussed. Strategies to prevent STD transmission must remain flexible in order to adapt to prevailing conditions, with adequate clinical services being central in controlling STDs.     

Examining residence status as a risk factor for health risk behaviors among college students

Objective: The current study is aimed to evaluate college student residence as a unique risk factor for a range of negative health behaviors. Participants: We examined data from 63,555 students (66% females) from 157 campuses who completed the National College Health Assessment Survey in Spring 2011. Methods: Participants answered questions about the frequency of recent use of alcohol, tobacco, marijuana, and illicit drugs, as well as sexual risk behavior in the last 30 days. Sexual risk behaviors were operationalized as having unprotected vaginal sex (yes/no) and the number of sexual partners. Results: Logistic regression analyses revealed that living off-campus is a unique predictor of alcohol, tobacco, marijuana, and illicit drug use, as well as engaging in unprotected sex and a greater number of sexual partners (all ps <. 01). Conclusions: Students living off-campus exhibit more substance use and sexual risk behaviors than students living on-campus, independent of gender, age, or race.     

Cognitive distortions as a problem gambling risk factor in Internet gambling

The purpose of this study was to examine the role of cognitive distortions in Internet gambling. The primary objectives were to determine whether cognitive distortions predict Internet gambling and investigate whether distorted gambling-related cognitions are associated with problem gambling severity among online gamblers. Three hundred and seventy four undergraduate participants (143 online gamblers, 172 males) completed an online questionnaire looking at demographics, play-related variables (duration, frequency and expenditures of play) and cognitive distortions. Variables were entered into a logistic regression model to predict online gambling. Three variables made independent contributions to predicting Internet gambling: male gender, higher frequency of play, and cognitive distortions. A hierarchical linear regression analysis with Internet gamblers revealed that cognitive distortions accounted for a proportion of the variance in problem gambling severity beyond variance accounted for by demographic variables and level of gambling involvement. Results suggest that cognitive distortions are a risk factor in online gambling.     

Linearity and nonlinearity in HIV/STI transmission: implications for the evaluation of sexual risk reduction interventions

A mathematical model of HIV/sexually transmitted infections (STI) transmission was used to examine how linearity or nonlinearity in the relationship between the number of unprotected sex acts (or the number of sex partners) and the risk of acquiring HIV or a highly infectious STI (such as gonorrhea or chlamydia) affects the utility of sexual behavior change measures as indicators of the effectiveness of HIV/STI risk-reduction interventions. Findings indicate that the risk of acquiring HIV through vaginal intercourse is essentially a linear function of the number of unprotected sex acts and is nearly independent of the number of sex partners. Consequently, the number of unprotected sex acts is an excellent marker for the risk of acquiring HIV through vaginal intercourse, whereas the number of sex partners is largely uninformative. In general, the number of unprotected sex acts is not an adequate marker for the risk of acquiring a highly infectious STI due to the highly nonlinear per act transmission dynamics of these STIs. The number of sex partners is a reasonable indicator of STI risk only under highly circumscribed conditions. A theoretical explanation for this pattern of results is provided. The contrasting extent to which HIV and highly infectious STIs deviate from the linearity assumption that underlies sexual behavior outcome measures has important implications for the use of these measures to assess the effectiveness of HIV/STI risk-reduction interventions.     

Evaluating public health perspectives of sexually transmitted diseases: The need for further research

While sexuality is the focus of extensive research, the concept has not been adequately defined. In this paper, sexuality is defined as the individual capacity to respond to physical experiences which are capable of producing body‐centered genital excitation, that only subsequently becomes associated with cognitive constructs (either anticipatory for new experiences or reflective of past experiences) independent of ongoing physical experiences. The discussion focuses on four components of this definition: that sexuality is an individual capacity, is experiential, is body‐oriented, and is directed toward genital excitation.     

Implications of increased infectivity in early-stage HIV infection. Application of a Bernoulli-process model of HIV transmission

Recent reports suggest that the infectivity of sexually transmitted HIV (i.e., the probability of transmission on a single sexual contact) may be up to 1,000 times greater during the first few months of infection than during the long asymptomatic period that precedes the development of AIDS. Assuming the validity of this estimate, a simple Bernoulli-process model of HIV transmission indicates that, in some cases, the expected number of secondary infections is greater for the brief period of primary infection than for the much longer asymptomatic phase. The implications of these findings for current HIV/AIDS prevention practices are analyzed with particular attention to the role of condom use in preventing HIV transmission.     

Issues of Isolation and Intimacy for the HIV Infected,Sexually Addicted Gay Male in Group Psychotherapy

The pertinent issues of isolation and intimacy with sexually addicted, HIV infected gay males was researched from the perspective of group psychotherapy as a treatment modality. The purpose of the article was to highlight shame based feelings associated with being sexually addicted and HIV diagnosed with the subsequent behaviors of isolation and difficulties with intimacy. The group model is examined as a means towards alleviating isolation and helping the client form new ways towards bonding and forming intimacy. Group interventions are seen to be helpful in lessening sexual compulsivity, creating new forms of relating and providing a safe environment for an individual dealing with HIV disease.     

Occupational lifting tasks as a risk factor in low back pain: a case-control study in a Mexican population

The objective of this study was to quantify and assess whether lifting tasks in the workplace are a risk factor in lumbar spondyloarthrosis etiology. A case-control study was performed with 231 workers, 18-55 years old, insured by the Mexican Social Security Institute (IMSS, according to its designation in Spanish). A multivariate analysis using conditional logistical regression showed that lifting tasks, combined with driving tasks, are associated with this illness (OR = 7.3; 95% CI 1.7-31.4). The daily frequency of lifting as it interacts with work as a driver resulted in a greater risk (OR = 10.4; 95% CI 2.0-52.5). The load weight, daily task-hours and cumulative time showed a dose-response relationship. The attributable risk for lifting tasks was 0.83, suggesting that 83% of lumbar spondyloarthrosis development could be prevented if risk factors were eliminated by ergonomic redesign of the task.     

Improving ascertainment of risk factors for HIV infection: results of a group-randomized evaluation

To allow appropriate allocation of prevention and care funding, HIV/AIDS surveillance data must include risk factor information, currently available for less than 70% of cases reported in the United States. The authors evaluated an intervention consisting of provider training and materials to improve risk factor reporting. Facilities were matched prior to randomization to intervention or control, and generalized linear mixed models were used to test for an intervention effect. Twenty-one percent of cases from intervention facilities and 33.4% from control facilities (p = .09) were reported without any risk factor information. The pre-post difference (20.7% for intervention and 36.0% for control) was not significant among HIV cases (p = .11) nor among AIDS cases (p = .12; 21.3% for intervention and 31.1% for control). The methods the authors' evaluated may need to be combined with other approaches and/or alternative classification schemes to significantly reduce the percentage of cases reported to surveillance without risk factor information.     

Assessing the validity of a single-item HIV risk stage-of-change measure

This study examined the validity of a single-item measure of HIV risk stage of change that HIV prevention contractors were required to collect by the California State Office of AIDS. The single-item measure was compared to the more conventional University of Rhode Island Change Assessment (URICA). Participants were members of Los Angeles County-defined behavioral risk groups recruited from a mobile HIV testing program (N = 123). The study found low correspondence between participants' stage of change on the single-item and the URICA, suggesting that they do not assess the same construct, and that the single item may not provide a valid measure. The current data suggests that the single-item measure should be revised or abandoned in favor of more conventional stage-of-change measures.     

Efficacy of a Group Therapy for Sexually Abused Adolescent Girls

ABSTRACT

The effects of a group therapy program for teenage girls reporting child sexual abuse were evaluated by means of a pretest/post-test design with a control group. The psycho-educational intervention consisted of an average of 20 weekly two-hour meetings. Results of the repeated analyses of variance (ANOVA) revealed a sig-nificant improvement in youth participating in the therapy when compared with the control group on measures of post-traumatic stress, internalizing and externalizing behavior problems, coping strategies, relation- ship with the mother, and sense of empowerment. The findings suggest that the group therapy offered by the Centre d'Intervention en Abus Sexuels pour la Famille (CIASF) was effective in reducing symptoms for sexually abused teenagers.     

Treatment for Juveniles Who Sexually Offend in a Southwestern State

A 25-item questionnaire was mailed to sex offender treatment providers from counties with 60 or more reported juvenile sex offenders in a Southwestern state to determine the most effective treatment for juvenile sex offenders. Results indicated that cognitive behavioral therapy was the most successful reported approach to treatment with an average success rate of 87%. The most commonly used approach was cognitive behavioral therapy with relapse prevention. The most common sexual offense was indecency with a child involving sexual contact, contrary to studies that found that in the Probation Commission data, aggravated sexual offense was the most common. These results have ramifications for state policies on treatment for juvenile sex offenders.     

Substance use among women at risk for HIV infection.

This article reports results from a survey of culturally diverse women at risk for HIV infection in south Florida. Data concerning their substance use and its association with HIV risk behaviors are presented. Results indicate levels of consumption which exceed expectations based on general estimates of female substance use. Further, substance use was associated with specific behaviors and lifestyles which placed the women at increased risk for HIV infection.     

Prevalence of classes of risk behaviors for HIV infection in a randomly selected Australian population

A random, geographically stratified sample of over 2,600 individuals aged 16 and over was interviewed in all states and territories of Australia to determine the prevalence of classes of behaviors which are associated with HIV infection. Returns from the anonymous risk behavior questionnaire (60.2% return rate) suggested that the prevalence of both male and female homosexual behavior, and contact with prostitutes, was substantially lower than that estimated by Kinsey et al. (1948, 1953). Data suggest that prevalence of classes of behaviors which place Australian individuals at risk of HIV infection may be lower than American estimates. However, the proliferation of HIV into the Australian homosexual community may be more extensive than previously assumed. The implications of these data for HIV preventive education programs and their targeting are discussed.     

An Evaluation of a Group Treatment for Sexually Abused Young Children

ABSTRACT

The present study measured outcomes of a group treatment for five-to eight-year-old sexually abused children. Although research completed in the last 10 years has produced some outcome studies on the effectiveness of group treatment for this population, no previous research has measured the effectiveness of psychoeducational interventions, such as the teaching of sexual information and abuse prevention strategies which are often included in this type of treatment. Also, the effects of different lengths of treatment have not been studied. The results of the current study found that children improved significantly from pre-treatment to mid-treatment on measures of problematic behavior, sexual information and abuse prevention. The children also made significant improvements from mid-treatment to post-treatment and from pre-treatment to post-treatment on all of the outcome measures with the exception of mid-treatment to post-treatment changes on the maternal acceptance self-esteem subscale. These results suggest that young children do benefit from a sexual abuse group treatment and that a longer treatment may be more beneficial.     

Hope as a coping resource among parents at risk for child maltreatment

This study investigated hope as a protective factor buffering the relationships between parenting stress and well-being among a sample of parents identified at moderate to high risk for child maltreatment. Two hundred parents were recruited from a nonprofit organization providing secondary and tertiary child maltreatment prevention programs. Results of the analyses showed that parental stress was negatively associated with subjective and emotional well-being. Hope was positively correlated with well-being and negatively associated with parenting stress. Hierarchical regression analyses showed that hope had a significant incremental relationship to well-being and that the negative effects of parenting stress fell below statistical significance. These findings provide preliminary support for hope as a coping resource social workers can target when working with parents in the prevention of child maltreatment.     

Loss by suicide. A risk factor for suicidal behavior

1. Data show suicidal behavior often is precipitated by individuals' experience of loss by suicide. This article focuses on three potential links between the two phenomena (i.e., grief experienced by suicide survivors and familial risk factors for suicide; suicide clusters and pacts; consequences of mass media portrayals of suicide). 2. Suicide bereavement has certain typical characteristics that comprise the "suicide survivor syndrome" and may be linked with increased risk of suicidal ideation and behavior. 3. Individuals' suicidal behavior and ideation can lead to suicide clusters (i.e., a group of suicides or attempts occurring close together in time and space) and pacts (i.e., mutual agreements between two people who promise to kill themselves at the same time, often in the same place). 4. Mass media portrayals of suicide may lead to imitative suicides (i.e., the "Werther effect").     

Partner aggression severity as a risk marker for male and female violence recidivism

Pretreatment aggression severity was examined as a risk marker for recidivism in the treatment of partner aggression. Intact married couples experiencing husband-to-wife partner aggression were recruited from the community and participated in either conjoint group treatment or gender-specific group treatment. Elevated levels of husband and wife physical aggression and wife psychological aggression before treatment predicted the continuation and severity of physical aggression by both spouses during treatment and in the following year, with no significant differences across treatment formats. These results indicate that high levels of psychological and physical aggression signify a poor prognosis for both conjoint and gender-specific group treatment programs, suggesting the need for interventions of greater intensity, duration, and/or focus for individuals highest in psychological and physical aggression.