Unsafe sexual behaviour associated with hazardous alcohol use among street-involved youth

While risky sexual behaviours related to illicit drug use among street youth have been explored, the impacts of alcohol use have received less attention. This longitudinal study examined hazardous alcohol use among a population of street-involved youth, with particular attention to sexual and drug-related risk behaviours. Data were derived from the At-Risk Youth Study, a prospective cohort of street-involved youth in Vancouver, Canada. The outcome of interest was hazardous alcohol use defined by the US National Institute on Alcohol Abuse and Alcoholism. We used generalized estimating equations (GEEs) analyses to identify factors associated with hazardous alcohol use. Between 2005 and 2014, 1149 drug-using youth were recruited and 629 (55%) reported hazardous alcohol use in the previous 6 months during study follow-up. In multivariable GEE analyses, unprotected sex (adjusted odds ratio [AOR]?=?1.28, 95% confidence interval [95% CI]?=?1.12–1.46) and homelessness (AOR?=?1.35, 95% CI?=?1.19–1.54) were independently associated with hazardous alcohol use (all p?p?相似文献   

Early-onset depressive disorders predict the use of addictive substances in adolescence: a prospective study of adolescent Finnish twins

Aims To explore the developmental relationships between early‐onset depressive disorders and later use of addictive substances. Design, setting and participants A sample of 1545 adolescent twins was drawn from a prospective, longitudinal study of Finnish adolescent twins with baseline assessments at age 14 years and follow‐up at age 17.5 years. Measurements At baseline, DSM‐IV diagnoses were assessed with a professionally administered adolescent version of Semi‐Structured Assessment for Genetics of Alcoholism (C‐SSAGA‐A). At follow‐up, substance use outcomes were assessed via self‐reported questionnaire. Findings Early‐onset depressive disorders predicted daily smoking [odds ratio (OR) 2.29, 95% confidence interval (CI) 1.49–3.50, P < 0.001], smokeless tobacco use (OR = 2.00, 95% CI 1.32–3.04, P = 0.001), frequent illicit drug use (OR = 4.71, 95% CI 1.95–11.37, P = 0.001), frequent alcohol use (OR = 2.02, 95% CI 1.04–3.92, P = 0.037) and recurrent intoxication (OR = 1.83, 95% CI 1.18–2.85, P = 0.007) 3 years later. ORs remained significant after adjustment for comorbidity and exclusion of baseline users. In within‐family analysis of depression‐discordant co‐twins (analyses that control for shared genetic and familial background factors), early‐onset depressive disorders at age 14 predicted significantly frequent use of smokeless tobacco and alcohol at age 17.5. Conclusions Our results suggest important predictive associations between early‐onset depressive disorders and addictive substance use, and these associations appear to be independent of shared familial influences.     

Complementary and alternative medicine use among people with asthma and health-related quality of life

Objective: This study investigated the relationship between complementary and alternative medicine (CAM) use and self-reported health-related quality of life among people with asthma. Method: Data from the 2010 Behavioral Risk Factor Surveillance System (BRFSS) survey and the 2010 Asthma Callback Survey (ACBS) were used. Survey respondents were men and women with asthma who were 18–99 years of age who responded to both surveys. Results: CAM use was associated with an increase in the number of days of poor mental health (OR?=?1.02, 95% CI 1.02, 1.03) and poor physical health (OR?=?1.02, 95% CI 1.01, 1.02). The odds ratios are adjusted for covariates such as asthma severity, age, sex, race/ethnicity, income, and educational attainment. CAM users report more days of poor mental health (7.2 versus 4.6) and poor physical health (9.6 versus 6.5) compared with those not using CAM therapies. Conclusions: Contrary to the hypotheses, CAM use is associated with poorer health-related quality of life. Implications for research and practice are discussed in detail.     

The impact of limited English proficiency on asthma action plan use

Objective: The goal of this study was to compare rates of asthma action plan use by limited English proficiency (LEP) caregivers to English proficient (EP) caregivers. Methods: A cross-sectional bilingual survey was distributed at an urban, academic, pediatric emergency department (PED). Surveys were completed by adult caregivers of children with asthma who sought PED care for asthma related chief complaints. LEP was defined as caregiver ability to speak English less than “very well”. Data were analyzed using Fisher’s exact test and odds ratios (OR). Results: One hundred seven surveys were completed and analyzed. Fifty-one surveys (48%) were completed by LEP caregivers and 56 (52%) by EP caregivers. A 25% difference (p?=?.01) in action plan use rates between LEP caregivers (39%) and EP caregivers (64%) was observed. EP alone was associated with action plan use (OR 2.8 [95% CI 1.3–6.1]). Variables not associated with plan use included mother acting as caregiver (OR 2.1 [95% CI 0.7–7.0]), age of child >7 years (OR 1.0 [95% CI 0.5–2.4]), caregiver education?≥?associate degree (OR 1.4 [95% CI 0.6–3.0]), private insurance (OR 0.7 [95% CI 0.3–1.8]), White race (OR 0.7 [95% CI 0.2–2.2]), Latino ethnicity (OR 0.5 [95% CI 0.2–1.3]) and a federally qualified health center (OR 0.8 [95% CI 0.3–2.0]). The main caregiver reasons for plan use were feeling that a plan works/gets results, helps with symptom management and appreciation towards physician attentiveness when a plan is prescribed. The main caregiver reasons for non plan use were they were not informed/given an action plan or perceived the child’s asthma as mild/well controlled. Conclusion: Compared with EP caregivers, those with LEP experience disparate rates of asthma action plan use.     

Prevalence of alcohol use disorders and associated factors: a population-based study using AUDIT in southern Brazil

Aims   To assess the prevalence of potential alcohol use disorders and associated factors using the Alcohol Use Disorders Identification Test (AUDIT).
Design   Cross-sectional study.
Setting   A town in southern Brazil.
Participants   A representative sample of 1260 people aged 15 and over.
Measurements   Demographic, socioeconomic, smoking habit and mental health data were collected. Logistic regression was used in the multivariate analysis, and odds ratios (ORs) and 95% confidence intervals (CIs) were calculated.
Findings   Overall prevalence of alcohol use disorder was 7.9%, with 14.5% prevalence among men and 2.4% among women. The risk of alcohol misuse increased across social class ( P linear trend = 0.03) and compared with the highest classes (A and B), groups C through E had ORs of 1.48, 1.51 and 2.36, respectively. Males had an OR of 6.89 (CI 3.61–13.16) compared with women. A linear trend was found ( P  = 0.001) between smoking categories, and smokers (OR 3.27; CI 1.91–5.58) and ex-smokers (OR 1.30; CI 0.56–2.98) were at higher risk than non-smokers. Those with minor psychiatric disorders had a 2.48 OR (CI 1.35–4.56) of presenting a positive test.
Conclusions   The AUDIT detected a high prevalence of potential alcohol use disorders in the population sampled. Those identified are potential targets for preventive measures implemented through health policies.     

The relationship between alcohol use and anxiety and retrospective attendance of primary care visits among women with human immunodeficiency virus

ABSTRACT

In this retrospective study, we sought to determine the associations between alcohol use and anxiety and RIC among WHIV. Alcohol use was assessed using the Timeline Follow-back to measure use over the 90 days preceding the interview. Anxiety symptoms scores, assessed with the Hospital Anxiety and Depression Scale- Anxiety Subscale (HADS-A). Primary care visits over twelve months prior to the interview were collected from clinic registration records. We used three logistic mixed models, adjusting for age, race, education, cocaine use, depression, viral load, and antiretroviral therapy (ART) status. Among 364 WHIV, mean attendance of primary care visits was 63.9%. Every one-day increase in drinking days (OR?=?0.99, 95% CI 0.99, 1.00) or heavy drinking days (OR?=?0.99, 95% CI 0.90, 1.00) was associated with decreased odds of attending primary care visits (P?=?0.02). Moderate/severe anxiety scores, compared to minimal anxiety scores, were associated with decreased odds of attending primary care visits (OR?=?0.69, 95% CI 0.50, 0.97). Cocaine use was associated with decreased odds of attending primary care visits (OR 0.56, 0.57). Our findings indicate that identifying and treating WHIV with alcohol use (especially heavy drinking), moderate/severe anxiety symptoms and/or cocaine use could potentially improve their RIC.     

Relationship between depression and risk behaviors in a US Military population with HIV infection

This study evaluated the relationships between depression trajectories, depression diagnosis and sexual risk behaviors in the US Military HIV Natural History Study. Risk behavior survey data, a coded diagnosis of depression, available Center for Epidemiological Studies Depression measures, and self-reported depressive symptoms (n?=?662) were utilized. Latent class analysis created 3 classes of depression trajectories, namely, low depression (LD, n?=?378), recent-onset depression (ROD, n?=?170), and high depression (HD, n?=?114) trajectories. Overall, participants with clinically diagnosed depression were less likely to report often using condoms with new sexual partners in the past 3 months than those who have never been diagnosed with depression (OR 0.15, 95% CI 0.49–2.53). Participants with ROD (OR 0.52, 95% CI 0.28–0.97) and HD (OR 0.48, 95% CI 0.24–0.96) trajectories were less likely to report often using condoms with new sexual partners in the past 3 months than those with LD trajectories. Moreover, those with either ROD (OR 2.13, 95% CI 1.19–3.80) or HD (OR 2.74, 95% CI 1.43–5.24) trajectories were more likely to have had sex with ≥2 new sexual partners in the last 3 months than those with LD trajectories. Continued efforts targeting HIV-infected persons with mental health disorders are warranted to reduce sexual risk behaviors.     

Marijuana use is associated with risky sexual behaviors in treatment-seeking polysubstance abusers

Abstract

Background: Multiple types of substance use are associated with HIV risk behaviors, but relatively little research has examined the association between marijuana use and risky sexual activities in treatment-seeking polysubstance abusing patients. Objectives: This study evaluated the relationship between marijuana use and sexual behaviors in 239 patients with cocaine, opioid or alcohol use disorders who were initiating outpatient substance use treatment. Methods: Participants completed the HIV Risk Behavior Scale and were classified into one of three groups based on their marijuana use histories: never (n?=?66), past but not current use (n?=?124) or current use (n?=?49). Results: Compared to never marijuana users, current and former marijuana users had a greater likelihood of having more than 50 lifetime sexual partners (odds ratio [OR] and 95% confidence interval [CI]?=?3.9 [1.0–15.7] and 5.2 [1.6–17.3], respectively). Former marijuana users had increased risk of low frequency condom use with casual partners relative to never users (OR [95% CI]?=?2.9 [1.1–7.6]). Moreover, current marijuana users were more likely than never users to have had more than two recent sexual partners (OR [95% CI]?=?8.1 [1.94–33.44]). Conclusion: Treatment-seeking polysubstance abusers with current or past marijuana use histories may be at greater risk of HIV infection than their counterparts who do not use marijuana. These data underscore the importance of increasing awareness about the potential association between marijuana use and increased high-risk sexual behavior among polysubstance abusing patients.     

Self-reported use of novel psychoactive substances among attendees of electronic dance music venues

Background: Novel psychoactive substances (NPSs) continue to emerge in the United States and worldwide. Few epidemiological studies have examined the prevalence and correlates of use. Objective: We examined the extent of NPS use in a high-risk population—attendees of electronic dance music (EDM) parties at nightclubs and festivals. Methods: We surveyed 682 adults (age 18–25) entering EDM events at nightclubs and festivals in New York City (NYC) in 2015. A variation of time–space sampling was used. We examined the prevalence of self-reported use of 196 NPS and correlates of any NPS use. Results: Over a third (35.1%) of participants reported lifetime use of any NPS. Self-reported use of synthetic cannabinoids was most prevalent (16.3%), followed by psychedelic phenethylamines (14.7%; 2C series: 10.3%, 2-(4-iodo-2,5-dimethoxyphenyl)-N-[(2-methoxyphenyl)methyl]ethanamine [NBOMe] series: 9.0%, Dox series: 3.5%), synthetic cathinones (“bath salts”, 6.9%), other psychedelics (6.6%), tryptamines (5.1%), and dissociatives (4.3%). 2C-I was the most prevalent 2C series drug (5.1%); methylone was the most prevalent synthetic cathinone (3.3%), 2-MeO-ketamine was the most prevalent dissociative (3.7%), and 1P-lysergic acid diethylamide (LSD) (2.9%) was the most prevalent non-phenethylamine psychedelic. Risk factors for NPS use included Ecstasy/MDMA/Molly, LSD, and ketamine use; identifying as bisexual (compared to heterosexual), reporting higher frequency of nightclub/festival attendance, and being surveyed outside of a festival (compared to those surveyed outside of nightclubs). Discussion: NPS use is prevalent in the nightclub and festival scenes in NYC. Since individuals in these scenes—especially frequent attendees—are at high risk for use, prevention and harm reduction services need to be geared toward this population.     

No association between alcohol consumption and risk of atrial fibrillation: A two-sample Mendelian randomization study

Background and aimsAlthough many observational studies have suggested that alcohol intake was associated with incident atrial fibrillation (AF), controversy remains. This study aimed to examine the causal association of alcohol intake with the risk of AF.Methods and resultsTwo-sample Mendelian randomization (MR) analysis was performed to estimate the causal effects of alcohol consumption, alcohol dependence, or alcohol use disorder identification test (AUDIT) scores on AF. Summary data on single nucleotide polymorphisms (SNPs) associated with AF were obtained from a genome-wide association study (GWAS) with up to 1,030,836 participants. The fixed- and random-effect inverse-variance weighted (IVW) methods were used to calculate the overall causal effects. MR analysis revealed nonsignificant association of genetically predicted alcohol consumption with risk of AF using fixed- and random-effect IVW approaches (odds ratio (OR) [95% confidence interval (CI)] = 1.004 [0.796–1.266], P = 0.975; OR [95% CI] = 1.004 [0.766–1.315], P = 0.979). Genetically predicted alcohol dependence was also not causally associated with AF in the fixed- and random-effect IVW analyses (OR [95% CI] = 1.012 [0.978–1.048], P = 0.490; OR [95% CI] = 1.012 [0.991–1.034], P = 0.260). There was no significantly causal association between AUDIT and AF in the fixed- and random-effect IVW analyses (OR [95% CI] = 0.889 [0.433–1.822], P = 0.748; OR [95% CI] = 0.889 [0.309–2.555], P = 0.827). Sensitivity analyses indicated no evidence of pleiotropy and heterogeneity in statistical models.ConclusionsThis MR study did not find evidence of a causal association between alcohol intake and AF.     

Trends in prevalence and risk factors of childhood asthma in Fuzhou,a city in Southeastern China

Abstract

Objective: The prevalence of asthma in children age 0–14 years in Fuzhou, a city in Southeast China, was 1.57% in 1990 and 3.28% in 2000. The aim of this study was to investigate the asthma prevalence and risk factors in children in the same city in 2010. Methods: This was a cross-sectional study with a two-stage, clustered, stratified random sample design. Parents of 12?235 children 0–14 years of age in Fuzhou were surveyed using a questionnaire. Children with history and/or symptoms of asthma were then interviewed by pediatricians in a nearby clinic to confirm the diagnosis of asthma, and a second questionnaire listing reported risk factors of asthma was completed by the parents in the clinic. Results: About 11?738 questionnaires were completed with a response rate of 95.9%. Among the responders, 648 children had history and/or symptoms of asthma but only 485 (4.13%) were confirmed with asthma. The prevalence was 1.83%, 7.64% and 6.27% in the age groups of 0–1 years, 3–4 years and 13–14 years, respectively. The most significant (binary logistic regression test) factors associated with asthma were presence of atopic or allergic diseases (OR?=?21.5, 95% CI: 12–38.5), family history of allergy or asthma (OR?=?29.4, 95% CI: 12.6–68.6), use of at least one course of antibiotics in the first year of life (OR?=?7.61, 95% CI: 3.4–17.06), supplementary protein feedings before 6 months (OR?=?1.90, 95% CI: 1.23–2.95). Natural ventilation at home (versus frequent use of air-conditioning) appeared to be a protective factor (OR?=?0.5, 95% CI: 0.3–0.8). Conclusion: The prevalence of asthma in childhood has increased significantly during the past 20 years in Fuzhou.     

Oral hygiene and dental status as factors related to asthma in high school and college students

Objective: Considering that oral microbiota might modulate immune responses, we explored if customary oral care procedures might influence immune-driven diseases such as asthma. Methods: This was a retrospective, cross-sectional analysis of responses to a self-completion medical questionnaire applied to subjects entering into college and high school programs during 2006–2011. Results: Responses from 329?780 students aged 14–24 years (97.6% of the original population) were analyzed. The prevalence of lifetime asthma was 4.01%. Subjects with asthma were slightly older, taller and heavier than subjects without asthma, and these differences were equally present in males and females. Subjects currently having two or more decayed teeth had asthma less frequently than those with one or none decayed tooth, with an odds ratio (OR)?=?0.86 and 95% confidence interval (95% CI) 0.83–0.89. In contrast, asthma was reported more frequently among students having two or more missing or filled teeth [OR?=?1.1 (95% CI 1.04–1.17) and OR?=?1.05 (95% CI 1.01–1.09), respectively]. From 2008 onwards, subjects also responded questions about oral hygiene incorporated into the core questionnaire. In these subjects, the use of toothpaste as well as the frequency and duration of toothbrushing were unrelated to asthma; regular use of mouthwash was associated with asthma in women [OR?=?1.16 (95% CI 1.07–1.25)], but not in men [OR?=?1.04 (95% CI 0.96–1.13)]. Results of multiple logistic regressions were in line with these findings. Conclusions: Our results suggested that oral hygiene and dental status could be novel factors influencing asthma development, and thus further studies to confirm and clarify this association are warranted.     

A comparison between brand-specific and traditional alcohol surveillance methods to assess underage drinkers’ reported alcohol use

Background: Adolescent alcohol consumption remains common and is associated with many negative health outcomes. Unfortunately, common alcohol surveillance methods often underestimate consumption. Improved alcohol use measures are needed to characterize the landscape of youth drinking. Objectives: We aimed to compare a standard quantity-frequency measure of youth alcohol consumption to a novel brand-specific measure. Methods: We recruited a sample of 1031 respondents across the United States to complete an online survey. Analyses included 833 male and female underage drinkers ages 13–20. Respondents reported on how many of the past 30 days they consumed alcohol, and the number of drinks consumed on an average drinking day. Using our brand-specific measure, respondents identified which brands they consumed, how many days they consumed each brand, and how many drinks per brand they usually had. Results: Youth reported consuming significantly more alcohol (on average, 11 drinks more per month) when responding to the brand-specific versus the standard measure (p?p?p?Conclusion: This study contributes to the field of alcohol and adolescent research first by investigating a potentially more accurate alcohol surveillance method, and secondly by promoting the assessment of alcohol use among adolescents vulnerable to risky alcohol use. Finally, our survey addresses the potential impact of alcohol marketing on youth and their subsequent alcohol brand preferences and consumption.     

Orphans’ perspectives on grief and loss in Botswana

This paper seeks to examine orphaned children’s experiences on grief and loss in Botswana, and its impact on their well-being and make policy recommendations. A cross sectional design which utilized survey questionnaires was employed. Data were collected from 11 districts (3 urban and 8 rural) among orphan children aged 10–18 years. Chi-squared test was used to identify variables believed to be associated with loss and grief. Unadjusted (simple) and adjusted multiple logistic regression was used to investigate factors associated with loss. Of the 732 participants (53.1%) were females and mean age was 13.5 years (SD?=?2.7); and 44.6% of these children had experienced death of a close family member in the past year which had been communicated. Children had access to education, lower primary (19.5%), upper primary (39.1%), junior secondary (32.5%), senior secondary school (6.6%), and (0.3%) in tertiary institutions. Most children (88.6%) had not experienced stigma and discrimination at school; 55.2% lived with grandparents, aunts (23.4%), siblings (11.8%), uncles (4.0%), other relatives (3.5%) and non-relatives (0.1%). Unadjusted logistic regression indicated that loss was significantly associated with having someone to talk to (OR?=?0.72, 95% CI, 0.53–0.98, p?=?0.03), change of residence (OR?=?3.08, 95% CI, 1.94–4.90, p?p?p?p?p?p?=?0.02). Age-specific interventions aimed at addressing the emotional, psychosocial and economic impacts of grief and loss are critical in preventing negative coping behaviors and improving the quality of life of orphans.     

Frequency of health service use in the year prior to asthma death

Objective: High frequency health service use (HSU) is associated with poorly controlled asthma, and is a recognized risk factor for near-fatal or fatal asthma. The objective of this study was to describe the frequency of HSU in the year prior to asthma death. Methods: Individuals aged 0–99 years who died from asthma from April 1996 to December 2011 in Ontario, Canada were identified as cases. Cases were matched to 4–5 live asthma controls by age, sex, rural/urban residence, socioeconomic status, duration of asthma and a co-diagnosis of COPD. HSU records in the year prior to death [hospitalization, emergency department (ED) and outpatient visits] were assembled. The association of prior HSU and asthma death was measured by conditional logistic regression models. Results: From 1996 to 2011, 1503 individuals died from asthma. While the majority of cases did not have increased HSU as defined in the study, compared to matched live asthma controls, the cases were 8-fold more likely to have been hospitalized two or more times (OR?=?7.60; 95% CI: 4.90, 11.77), 13-fold more likely to have had three or more ED visits (OR?=?13.28; 95% CI: 7.55, 23.34) and 4-fold more likely to have had five or more physician visits for asthma (OR?=?4.41; 95% CI: 3.58, 5.42). Conclusions: Frequency of HSU in the year prior was substantially higher in those died from asthma. Specifically, more than one asthma hospital admission, three ED visits or five physician visits increased the asthma mortality risk substantially and exponentially.     

Risk of alcohol abuse in urban versus rural DUI offenders

Background: Research concerning driving under the influence (DUI) offenses in rural populations is scarce and has often been carried out in the context of substance abuse and illicit drug use. Although previous studies have suggested that rural individuals are more likely to abstain from alcohol use, recent trends suggest that alcohol and substance abuse problems in rural areas are occurring at rates similar to urban areas. It is possible that urban and rural DUI offenders may differ on psychological and behavioral characteristics associated with heavy alcohol consumption. Objective: The aim of this study was to examine alcohol use differences between urban and rural DUI offenders. Methods: Data from 11?066 DUI offenders in a Midwestern state were used for this study. The Alcohol subscale of the Driver Risk Inventory II was used to assess the risk of problem alcohol use. Results: Higher levels of alcohol risk were associated with rural DUI offenders after adjusting for several demographic variables and blood-alcohol content level at time of arrest [Medium Risk OR?=?1.43, 95% CI: (1.20, 1.71); Problem Risk OR?=?1.43, 95% CI: (1.19, 1.72); Severe Risk OR?=?1.38, 95% CI: (1.14, 1.67)]. Conclusions: The results of this study indicate that rural DUI offenders have a significantly greater risk of heavy alcohol use when compared to urban DUI offenders. Practical implications of these results suggest that evaluators and assessors should be aware of an increased likelihood of alcohol problems in rural DUI individuals relative to those in urban areas.     

Longitudinal analysis of HIV risk behaviour patterns and their predictors among public primary care patients with tuberculosis in South Africa

The goal of this study was to identify various HIV risk behaviours among tuberculosis (TB) patients in a longitudinal study design in South Africa. In 42 public primary healthcare facilities in three districts in three provinces, adult new TB and TB retreatment patients with hazardous or harmful alcohol use were interviewed within 1 month of initiation of anti-TB treatment and were followed up at 6 months. The total sample with a complete 6-month follow-up assessment was 853. At the follow-up assessment, several HIV risk behaviours significantly reduced from baseline to follow-up. In multivariate Generalized Estimating Equations logistic regression analyses, high poverty (odds ratio (OR): 2.68, 95% confidence interval (CI): 1.56–4.62), Posttraumatic Stress Disorder (PTSD) symptoms (OR?=?1.55, 95% CI?=?1.03–2.36), and sexual partner on antiretroviral therapy (ART) (OR?=?1.84, 95% CI?=?1.09–3.10) were associated with a higher odds, and excellent/very good perceived health status (OR: 0.61, 95% CI: 0.37–0.98), severe psychological stress (OR?=?0.51, 95% CI?=?0.34–0.77), and HIV non-disclosure to most recent sexual partner (OR?=?0.40, 95% CI?=?0.25–0.65) were associated with a lower odds of inconsistent condom use. Being HIV positive (OR?=?4.18, 95% CI?=?2.68–6.53) and excellent/very subjective health status (OR?=?2.98, 95% CI?=?1.73–5.13) were associated with a higher odds, and having PTSD symptoms (OR?=?0.60, 95% CI?=?0.36–0.99), being on ART (OR?=?0.48, 95% CI?=?0.25–0.95), having a sexual partner on ART (OR?=?0.41, 95% CI?=?0.18–0.96), and HIV status non-disclosure (OR?=?0.25, 95% CI?=?0.15–0.41) were associated with a lower odds of having sex with an HIV-positive or HIV status unknown person. High poverty index (OR?=?1.97, 95% CI?=?1.19–3.25) and having a sexual partner on ART (OR?=?4.37, 95% CI?=?1.82–10.48) were associated with a higher odds, and having a partner with HIV-negative status (OR?=?0.29, 95% CI?=?0.16–0.51) and inconsistent condom use (OR?=?0.39, 95% CI?=?0.24–0.64) were associated with a lower odds of HIV status non-disclosure at last sex. The study found that among TB patients with problem drinking over a 6-month TB treatment period, the frequency of some HIV risk behaviours (inconsistent condom use) declined (OR?=?0.64, 95% CI?=?0.41–0.98), but also persisted at a high-level calling for a strengthening and integration of HIV prevention into TB management.     

Bedroom air quality and vacuuming frequency are associated with repeat child asthma hospital admissions

Objective: Indoor environment factors have been associated with risk of asthma exacerbations in children but little is known about their role on asthma hospital readmissions. As children in Western societies continually spend more time indoors, understanding the influence of these factors on asthma exacerbation is important. We examined the role of indoor environmental and lifestyle characteristics on child asthma readmissions. Methods: A hospital-based case–control study recruited 22 children readmitted for asthma and 22 controls not readmitted for asthma. Logistic regression models were used to examine the association between aeroallergens and fungi in the bedroom and indoor lifestyle characteristics factors for asthma readmissions. To determine the best possible set of predictors among a large set of risk factors, we used random forests (RF) techniques. Results: Higher levels of airborne Cladosporium and yeast in the child’s bedroom increased risk of readmission (OR?=?1.68, 95% CI 1.04–2.72 and OR?=?1.52, 95% CI 0.99–2.34, respectively). Carpeted floors in the bedroom and synthetic doonas were also associated with increase in asthma readmissions (OR?=?4.07, 95% CI 1.03–16.06 and OR?=?14.6, 95% CI 1.26–169.4, respectively). In the home, frequent vacuuming using bagged cleaners increased risk of asthma readmission OR?=?15.7 (95% CI 2.82–87.2). Conclusions: Factors in the child’s bedroom play an important role in increasing the risk of asthma hospital readmissions. These findings have major clinical implications as the identified potential risk factors may be modifiable. Further epidemiological studies with larger samples are necessary to evaluate these associations further.     

Antibiotic use in infancy and the risk of asthma in Mexican American children

Objective: This study examined the associations of antibiotic use in infancy with lifetime doctor-diagnosed asthma and current wheeze among Mexican American children. Methods: In a population-based, cross-sectional investigation, parents of 2023 children 4–18 years of age completed a questionnaire/interview addressing respiratory conditions, antibiotic use, and covariates. Results: In adjusted analyses, among children without history of ear infections in infancy, children who used antibiotics ≥3 times and 1–2 times were more likely to report doctor-diagnosed asthma compared with their peers who did not use antibiotics in infancy [adjusted odds ratio (aOR)?=?5.14, 95% confidence interval (CI): 2.88–9.17, and aOR?=?2.15, 95% CI: 1.26–3.69, respectively, p trend < 0.0001]. The respective aORs for current wheeze were 3.67 (95% CI: 1.95–6.89) and 1.63 (95% CI: 0.91–2.95). Antibiotic use in infancy was not associated with asthma or current wheeze in children who had ear infections in infancy. In additional analyses, antibiotic use in infancy was associated with asthma in children without parental history of asthma or allergies (aOR?=?2.73, 95% CI: 1.70–4.39) but not in those with parental history of asthma or allergies. Among Mexico-born participants born in rural areas, antibiotic use in infancy was associated with a seven-fold increase in risk of asthma (aOR?=?7.21, 95% CI: 1.46–35.65), while the association was non-significant in Mexico-born children born in urban areas in Mexico. Conclusions: Antibiotic use in infancy may increase the risk of asthma and wheezing, but these associations were limited to subgroups of children.     

Linking substance use with symptoms of subclinical psychosis in a community cohort over 30 years

Aims The aim of the study was to examine the temporal associations between substance use and subclinical psychosis symptoms. Design Data from a prospective community study sampled within a single cohort over 30 years (1978–2008) were analysed with discrete‐time hazard models. Setting General population‐based sample. Participants At initial sampling in 1978 males (n = 292) were 19 and females (n = 299) were 20 years old. Measurements Two psychosis syndromes representing ‘schizotypal signs’ and ‘schizophrenia nuclear symptoms’ and various substance use variables including cannabis, alcohol, tobacco and multiple‐drug use (i.e. cannabis combined with other drugs). Findings In bivariate analyses, schizotypal signs were predominantly associated with regular cannabis use in adolescence (OR = 2.29, 95% CI 1.32–3.97). Schizophrenia nuclear symptoms were mainly related to alcohol (OR = 1.84, 95% CI 1.00–3.38) and multiple‐drug use (OR = 2.35, 95% CI 1.38–4.02) during adolescence. Multivariate analyses showed that, in particular, regular cannabis use during adolescence was associated with the occurrence of subsequent schizotypal symptoms over a 30‐year period (OR = 2.60, 95% CI; 1.59–4.23), whereas multiple‐drug use in adolescence was associated predominantly with schizophrenia nuclear symptoms (OR = 1.75, 95% CI 1.01–3.03). Alcohol misuse was only slightly associated with the onset of such symptoms. Conclusions A significant portion of the occurrence of subclinical psychosis symptoms in adulthood can be attributed to excessive cannabis and multiple‐drug use during adolescence. This is in line with the hypothesis that long‐term sensitization of dopaminergic brain receptors plays a role in developing psychotic symptoms.