The association between characteristics of dating relationships and condom use among heterosexual young adults.

Although there is some evidence that relationship-level factors influence sexual behavior, they have received far less attention than individual-level factors as potential correlates of condom use. This study surveyed 210 undergraduate men and women to examine the association between relationship characteristics and condom use. Higher levels of love, longer relationships and more serious and committed relationships were individually associated with less condom use. In a multiple logistic regression model controlling for HIV/sexually transmitted disease (STD) risk perception and contraceptive method, relationship length was the only relationship factor that independently predicted condom use (OR = .91; 95% CI = .84-.99). Use of a hormonal contraceptive method was negatively associated with condom use in the multivariate model (OR = .12; 95% CI = .06-.27), and mediated the association between relationship factors and condom use. Study results suggest that HIV/STD prevention interventions may be improved by addressing relationship characteristics, particularly the length of a dating relationship.     

Consistent condom use among drug-using youth in a high HIV-risk neighbourhood

The objectives of this study were to determine predictors of consistent condom use in heterosexual relationships of young adults who use hard drugs in a neighbourhood with widespread drug-use-connected HIV. We interviewed 196 18-24 year olds who injected drugs or used heroin, cocaine or crack in the prior year and lived in the Bushwick neighbourhood of New York City. Interviews covered sociodemographics, substance use and sexual networks. The unit of analysis is the relationship; the dependent variable measures consistent condom use over the prior 30 days in a given relationship. Consistent condom use was reported in 26% of 377 non-commercial relationships and in all of 22 commercial relationships. Using multiple logistic regression, consistent condom use in non-commercial relationships was more likely in relationships that are not 'very close'; for men (but not women) with peers whose norms are more favourable to condom use; and for subjects who had concurrent sex partners in the last 12 months. In conclusion, we found that: (1) the lack of relationship between the peer norms of drug-using women and their condom use suggests they may have little control over condom use in their relationships-programmes should attempt to empower young women drug users and to develop ways for their peers to influence the men in their lives; (2) epidemiologically, the positive association of concurrency to consistent condom use suggests that condom use may be restricting HIV spread through the community-the presence of consistent condom use in all of the commercial sexual relationships also may restrict HIV spread; (3) prevention efforts should attempt to change peer cultures as a way to develop self-sustaining risk reduction. These changes should include changes in gender roles and power relations.     

Power communication and condom use: patterns of HIV-relevant sexual risk management in heterosexual relationships

Combining relationship-based theories with quantitative methods is a relatively new approach in HIV prevention research. In this paper--focusing on relationship power, communication on HIV protection measures and condom use--clusters are identified which contribute to the understanding of HIV-relevant sexual risk management in heterosexual contacts. Data on 508 heterosexual contacts were collected in the German-speaking part of Switzerland using computer-assisted telephone interviews. Condom use is practised regularly among young and middle-aged couples but not among older couples. Cluster analyses show that in sexual contacts with equal or female power, communication appears to be decisive as to whether a condom is used. Male relationship power, however, is accompanied by relatively frequent condom use, regardless of whether the couple communicated about HIV protection measures. Implications for HIV prevention research and strategies, with an emphasis on aspects of relationship, gender and age, are suggested.     

Drug use patterns and infection with sexually transmissible agents among young adults in a high-risk neighbourhood in New York City

Aims To determine relationships between drug use ‘hardness’ (defined in increasing order of hardness as no drug use, marijuana use, non‐injected heroin or cocaine use, crack smoking and injection drug use) and prevalences of several sexually transmissible infections among young adults in a high‐risk neighbourhood. Drug users, particularly injection drug users and crack smokers, may be a core group for some sexually transmitted infections. Design Cross‐sectional survey and assays of young adults from (a) a household probability sample and (b) a targeted sample of youth who have used injected drugs, crack, other cocaine or heroin. Setting Bushwick, an impoverished New York City minority neighbourhood with major drug markets. Participants A total of 363 18–24‐year‐olds from a household probability sample; 165 Bushwick 18–24‐year‐olds who have used injected drugs, crack, other cocaine or heroin. Measurements Drug use by self‐report; serum‐ and urine‐based assays for HIV, hepatitis B and C, syphilis, gonorrhoea, chlamydia and herpes simplex (type 2). Findings Household‐sample prevalences: HIV, hepatitis C and syphilis, 1%; gonorrhoea 3%; chlamydia 5%; past or present hepatitis B infection 8%; herpes simplex (type 2) 18%. In combined household and targeted samples, hepatitis C and HIV were concentrated among drug injectors. Herpes simplex (type 2), syphilis and hepatitis B increased among women with ‘hardest drug ever used’. Conclusions Using ‘harder’ drugs is associated with some but not all of these infections. Prevention efforts should help youth avoid unsafe sex and higher‐risk drugs.     

Areca nut dependence among chewers in a South Indian community who do not also use tobacco

Aims Previously reported research suggests a dependence syndrome for areca nut use, though well‐designed studies are virtually non‐existent. The goal of this study was to examine evidence of areca dependence in a sample of areca‐only (i.e. no tobacco) chewers using modified measurement scales. Design A purposive sample of chewers, identified via local informants and advertisements, was surveyed from January to March of 2005. Setting Six villages in Dakshina Kannada District, Karnataka State, India. Participants Fifty‐nine daily areca chewers who do not also currently use any form of tobacco. Measurements Questionnaires included modified versions of the Fagerström Tolerance Questionnaire, Cigarette Dependence Scale (CDS‐5) and the Smokeless Tobacco Dependence Scale (STDS). Additional questions assessed demographic characteristics and patterns of use. Findings Approximately half of respondents reported 1–3 chews/day (mean = 1.9; SD = 0.98). The average number of chewing episodes/day was 4.4 (SD = 3.4) and the average number of nuts/day was 1.2 (SD = 1.1). Users’ typical chew lasts up to 20 minutes and includes spitting out the juices and rinsing the mouth with water. Overall, the levels of reported dependence symptoms were quite low, but approximately 44% of chewers endorsed at least one of the following items: continued use despite illness or mouth wounds, difficulty refraining from chewing in forbidden places, or craving during periods of abstinence. Approximately 15.4% of chewers reported at least one intentional quit attempt and a subset had summary scores indicative of dependence (13.6% had scores >16 on the CDS‐5 and 5.3% had scores >11 on the STDS). Dependence scores were positively correlated with frequency of chews/day. Conclusions The symptoms of dependence observed in a subset of areca‐only chewers warrant further investigation. Next steps should include well‐controlled laboratory evaluation of dependence features.     

Personal and partner measures in stages of consistent condom use among African-American heterosexual crack cocaine smokers

Participants' personal condom use measures and those of their last sex partner's were examined in five stages of change for consistent condom use among 449 urban sexually active, heterosexual, African-American crack smokers. The measures included participants' personal and their last sex partner's perceived responsibility, personal and perceived negative attitudes, and participants' self-efficacy to use condoms. The relationships between the measures and the stages were examined using analyses of variance and multivariate logistic regression. Over 90% of participants did not use condoms, consistently. Two-thirds of the inconsistent users were in the precontemplation stage. The rest were equally divided between the contemplation and preparation stages. Personal responsibility outperformed other measures in initial intention to become a regular condom user; partner's perceived responsibility dominated continued intention and actual consistent condom use. Negative attitudes and self-efficacies had strong relationships to the stages of consistent condom use in univariate analyses but these relationships became substantially weaker when the responsibility, attitude, and self-efficacy concepts were entered simultaneously into multivariate analyses.     

Fcgamma receptor expression levels on monocytes are elevated in rheumatoid arthritis patients with high erythrocyte sedimentation rate who do not use anti-rheumatic drugs

OBJECTIVES: Levels of immunoglobulin G (IgG) Fc receptors (FcgammaRs) affect the activity and function of monocytes/macrophages when binding IgG-containing immune complexes. Hence, the expression level of FcgammaRs on monocytic cells may influence inflammation in patients with rheumatoid arthritis (RA). In this study the expression levels of FcgammaRI, IIa and IIIa on peripheral blood monocytes of RA patients were compared with those of healthy controls and related to patient and disease characteristics and the use of disease-modifying anti-rheumatic drugs (DMARDs). In addition, FcgammaR expression levels were determined on RA synovial fluid macrophages and compared with those in RA peripheral blood. METHODS: Mononuclear cells from peripheral blood and synovial fluid were isolated and FcgammaR expression levels on CD14-positive cells were analysed by flow cytometry. The effects of patient and disease characteristics and the use of DMARDs were assessed. RESULTS: A high expression level of FcgammaRIIa and high percentages of FcgammaRIIIa-expressing monocytes were found in RA patients with a high erythrocyte sedimentation rate. DMARD-naive early RA patients had higher FcgammaRIIa expression levels but a similar amount of FcgammaRIIIa-positive monocytes compared with RA patients using DMARDs. In synovial fluid, FcgammaRIIa expression levels were lower than in RA peripheral blood, whereas the percentage of FcgammaRIIIa-positive monocytic cells was higher in synovial fluid than in peripheral blood. CONCLUSIONS: These data point to the involvement of FcgammaRs, specifically FcgammaRIIa and IIIa, in the immune response of RA and suggest that FcgammaR expression levels are susceptible to modulation by DMARD therapy.     

Depressive mood,suicide ideation and anxiety in smokers who do and smokers who do not manage to stop smoking after a target quit day

Aims The effect of successful and unsuccessful smoking cessation on depressive mood, anxiety‐ and suicide‐related outcomes is unclear. The aim of this secondary analysis was to explore the relationship between abstinence status and these outcomes. Design Cohort of adult smokers attempting to stop smoking. Smoking status was assessed by a daily diary; depressed mood, anxiety and suicidal tendencies by the Hamilton Depression Rating Scale (HDRS). The association of complete and point‐prevalence abstinence with the HDRS variables was assessed using multi‐level linear regression models. Setting Randomized trial of sertraline versus placebo for smoking cessation with weekly behavioural support provided in a clinic. Participants A total of 133 adult smokers with past major depression. Findings Pre‐quit mood scores did not predict smoking status post‐quit day. Both continuous and point‐prevalence abstainers had significantly lower total HDRS, suicide and anxiety scores, adjusted for all potential confounders, during the period following quit day than did non‐abstainers who experienced a significant mood deterioration. There was a significant effect of sertraline on post‐quit HDRS scores but not on abstinence. Conclusions Contrary to expectation, smoking abstinence among smokers with a history of major depression did not lead to increase in depression, anxiety or suicide ideation; however, failed quit attempts did. Persisting with a quit attempt while unable to achieve abstinence may be associated with mood deterioration.     

Predicting condom use in young women: demographics, behaviours and knowledge from a population-based sample in Brazil

The goal of this study was to assess condom use and related behaviour in young women in Vitória, Brazil. From March to December 2006, a cross-sectional sample of women aged 18-29 years was recruited into a population-based study. Risk behaviours for HIV and sexually transmitted infections (STIs) were surveyed. Condom use at last intercourse was assessed as a principal outcome describing protective sexual behaviour. Of 1200 eligible women identified, 1029 (85.8%) enrolled. Among them, 904 (87.9%) reported a history of sexual activity. Only 36.6% reported condom use at last intercourse; those who did were more likely to report commercial sex work (odds ratio [OR] 9.01 [1.46-55.55]), to state that STI prevention was a primary reason for using condoms (OR = 6.84 [4.81-9.71]), to have been previously diagnosed with an STI (OR = 2.39 [1.36-4.21]), to report that 'it is easy to tell a sexual partner they will not have vaginal/anal sex without a condom' (OR = 2.30 [1.56-3.39]), to report that sexual intercourse is only risky when people have anal sex (OR = 1.98 [1.22-3.22]); and less likely to be married (OR = 0.65 [0.54-0.78]), and to find it difficult to use condom consistently in all sexual encounters (OR = 0.36 [0.25-0.52]). Women who reported condom use were more concerned with preventing STIs, and to report less difficulty insisting on condom use with partners.     

Assessing the risk of marijuana use disorder among adolescents and adults who use marijuana

Background: The changing political and social climate surrounding marijuana use, coupled with the fact that available estimates of marijuana use disorder prevalence are outdated and do not adequately represent adolescents, underscore the need for up-to-date and comprehensive prevalence estimates of marijuana use disorder. Objectives: To provide recent national estimates of marijuana use disorder as a function of usage patterns, age, and other sociodemographic, substance use, and mental health variables. Methods: Analyses of data from the 2014 National Survey on Drug Use and Health examined the prevalence of marijuana use disorder among respondents (N = 55,271) with various sociodemographic, substance use, and mental health characteristics. Logistic and multinomial regression analyses examined the correlates of marijuana use disorder as a function of these variables, with a special focus on age. Results: In 2014, 3.49% of lifetime, 11.62% of past-year, and 15.32% of past-30-day marijuana users met DSM-IV criteria for a marijuana use disorder; rates among youth generally were at least double those of adults across reported time frame and intensity of use. Regression analyses indicated that young age, black race/ethnicity, greater intensity of use, current tobacco/nicotine use, and alcohol and other drug use disorders were associated with increased odds of a marijuana use disorder. Conclusions: A significant proportion of marijuana users, especially youth, are at risk for having a marijuana use disorder, even at relatively low levels of use.     

东北某市男男性接触者安全套使用情况调查

目的了解男男性接触者(MSM)的人口学特征和安全套使用状况,为制订相应艾滋病(AIDS)干预措施提供依据。方法采用定向抽样法征集MSM参加,MSM在知情同意后填写调查表。结果参加本项调查的MSM主要为青壮年、高中以上文化和未婚的城市非体力劳动者。职业、经济、出生地、婚姻等因素与安全套的使用情况无显著性差异。受教育程度与安全套的使用情况有显著性差异,大学及以上文化程度者安全套使用较受教育程度低者明显为高。结论近年来为预防AIDS采取的多种形式的积极干预,使MSM人群安全套使用情况较以往有很大提高。由于MSM中受教育程度较低者安全套使用率较低,因此,应针对MSM的人口学特征加强安全套的推广使用。     

Predictors of consistent condom use: a hierarchical analysis of adults from Kenya, Tanzania and Trinidad

The two regions hardest hit by the HIV/AIDS epidemic are sub-Saharan Africa and the Caribbean. It is estimated that more than 28 million persons within these regions are currently living with HIV/AIDS. Therefore, it is imperative that more effective models of protective behaviour change be developed and implemented. Data from 4293 adults from Kenya, Tanzania and Trinidad who agreed to participate in the Voluntary Counseling and Testing Efficacy Study were examined employing hierarchical regression modelling. Only 19% reported consistent condom use with most recent sex partner. Factors associated with consistent condom use were relation to most recent sex partner, gender, study site, perceived difficulty in requesting condom use and actually making requests for condom use. Interventions that are grounded in theory and consider the relationship between the various independent variables along with the dependent variable may be more effective in promoting HIV protective behaviour change, such as consistent condom use, than current prevention efforts.     

Patterns of condom acquisition and its association with consistent use among young men in Nigeria

There is limited information about the influence of condom acquisition patterns on consistent condom use. Research is required to identify the relative extent of consistent condom use among individuals who always obtain condoms free, or who always have mixed procurement of free and purchased condoms or who always purchase condoms. The study analysed condom acquisition and sexual behaviour practices of 372 young men and logistic regression was analysed to determine whether condom acquisition practice was a predictor of consistent condom use. Results showed that most participants (41%) had mixed procurement of free and purchased condoms, 31% always bought condoms while 28% always purchased condoms. Majority of individuals (71%) who always purchased condoms, 23% who had mixed procurement, and 12% who had free condoms consistently used condoms. The results also showed that having 2 or more partners and always purchasing condoms increased the likelihood of consistent condom use. It is recommended that programmes of free condom supply should also incorporate in it education that emphasizes consistent condom use with a partner whose HIV sero status is not known.     

Increased condom use at sexual debut in the general population of Slovenia and association with subsequent condom use

OBJECTIVES: To describe the extent of condom use at first heterosexual intercourse (FHI) in the general population of Slovenia, identify associated factors and assess the association with subsequent use. DESIGN: Cross-sectional survey comprising the first Slovenian National Survey of Sexual Lifestyles, Attitudes and Health. METHODS: Data were collected during 1999-2001 from a probability sample of the general population aged 18-49 years. Statistical methods for complex survey data were used to carry out weighted analyses. RESULTS: Condom use at FHI was reported by 23.6% of men and 21.3% of women. The more recently they experienced FHI, the more likely respondents were to report condom use (71.7% of men; 63.8% of women with FHI during 1995-1999). Men with FHI at age 18 or older and those with higher levels of education were more likely to use a condom and those who lost control (because drunk or carried away by feelings) less likely. Men seem to have more control over condom use at FHI than women. Sexually active men and women who used condom at FHI were 11 and 2.5 times more likely to consistently use condoms during the month preceding the interview. CONCLUSIONS: Currently, the majority of Slovenian men and women use protection against HIV, other sexually transmitted infections, and unplanned conception at FHI. The steep increase over time in condom use at FHI suggests that HIV-related condom use promotion has had an impact on preventive behaviours and should be sustained, especially since condom use at FHI predicts subsequent use.     

Daytime sleepiness in the healthy "old old": a comparison with young adults

OBJECTIVE: To determine if excessive daytime sleepiness is an inevitable consequence of aging. METHODS: Daytime sleepiness was measured using Multiple Sleep Latency Tests (MSLT's) before and after a night of total sleep deprivation in a sample of 22 healthy men and women in their eighties and 29 men and women in their twenties. RESULTS: Young adults were somewhat sleepier than elders, as measured by rapidity of sleep onset during daytime nap recordings using the MSLT, and showed a higher incidence of REM sleep during naps. However, recovery from the effects of acute sleep loss was slower in the elderly, judging from the presence of more daytime sleepiness 2 days after a night of total sleep deprivation. Such persistent sleepiness was absent in the young adult control group. CONCLUSIONS: Healthy persons in late old age may have a level of daytime sleepiness no greater than, and perhaps even less than, that seen in healthy young adults.     

Comparison of C-reactive protein levels in patients who do and do not develop atrial fibrillation during electrophysiologic study

C-reactive protein (CRP) was increased in patients with atrial fibrillation (AF). The aim of this study was to evaluate CRP after inducing AF in 39 patients undergoing electrophysiologic study (EPS). After a diagnostic EPS, programmed atrial stimulation with 3 extra stimuli from the right atrium was performed in all patients. CRP was measured before and 6 and 24 hours after the procedure. Patients in whom AF was induced were monitored for 24 hours. AF was induced in 18 of 39 patients. Twenty-one patients without a tachyarrhythmia constituted the control group. Groups were similar with regard to age, gender, incidences of hypertension and diabetes, and history of coronary artery disease. On average, AF lasted 4.8 hours, and spontaneous conversion to sinus rhythm was observed in all patients. There were no statistically significant differences with respect to baseline and 6-hour CRP values between groups. However, mean CRP at 24 hours was significantly higher in patients with AF compared with controls (10 +/- 11 and 3.9 +/- 4.2 mg/L; p = 0.04). In conclusion, induction of AF during EPS led to increased CRP. This finding suggested that increased CRP may be the consequence of AF.