北京市2014年高中生饮酒行为及其影响因素分析

了解北京市高中生饮酒相关行为现状及其影响因素,为预防青少年过早饮酒和过量饮酒提供依据.方法 2014年3-5月,采用分层整群随机抽样方法,抽取北京市18个区县的15 726名高中生进行健康危险行为自填问卷调查.结果 北京市高中生曾饮酒率为67.9%,13岁前饮酒率为35.2%,现在饮酒率为41.0%,过量饮酒率为16.6%.“与家人朋友喝”是北京市高中生饮酒的最主要原因.职业技术学校、男生、高二、母亲高中文化水平、重组家庭、人均月收入高和学习成绩差的高中生各项饮酒率均较高.有健康危险行为的高中生更容易出现饮酒相关行为,如有吸烟行为的学生更容易发生现在饮酒行为(OR=4.41,95%CI=3.90~4.98),有打架行为的学生更容易出现过量饮酒行为(OR=2.00,95%CI=1.77~2.26),有性行为的学生更容易出现13岁前饮酒行为(OR=1.58,95%CI=1.36~1.84),有尝试自杀行为的学生更容易出现过量饮酒行为(OR=1.67,95%CI=1.27~2.19).结论 在预防青少年饮酒相关行为时,应考虑年龄、家庭、性别等因素,并重视其他健康危险行为因素的影响,家庭和学校需尽早积极开展预防青少年饮酒行为的综合性健康教育.     

Use of dietary supplements among women at high risk of hereditary breast and ovarian cancer (HBOC) tested for cancer susceptibility

Although use of dietary supplements among women with breast cancer is high, use among women at high risk of hereditary breast and ovarian cancer (HBOC) is unknown. This study assesses the prevalence of use of dietary supplements and identifies characteristics associated with use among women at high risk of HBOC who underwent genetic testing for cancer susceptibility. Participants were 303 women who underwent BRCA1/2 testing as part of Interdisciplinary Health Research International Team on Breast Cancer Susceptibility. Dietary supplements use was measured 12 mo post-disclosure. Potential determinants of use included personal cancer history, test result, psychological distress, cancer genetics knowledge, and health-related behaviors. Globally, 51% of participants used at least one dietary supplement. Calcium (26%), multivitamins (17%), vitamins D (14%), E (12%), and C (10%) were most frequently reported. Women > or = 50 yr were more likely to be using dietary supplements (P < 0.0001). Women with an inconclusive test result were more likely to use mineral supplements than noncarriers [odds ratio (OR) = 2.6; 95% confidence interval (CI) = 1.3-5.3]. Cigarette smoking was negatively associated with use of vitamin supplements (OR = 0.3; 95% CI = 0.1-0.7). Use of dietary supplements among women at high risk of HBOC who underwent BRCA1/2 testing is as frequent as use among patients with other types of tumors or use among individuals from the general population.     

Parental concerns and medical-seeking behavior after immunization

OBJECTIVE: To examine demographics and immunization attitudes, beliefs, and behaviors of parents who sought medical attention for a child due to an adverse event following immunization (AEFI). METHODS: A sample of households that participated in the National Immunization Survey was re-contacted during 2001. This analysis was conducted in 2004 and 2005. RESULTS: Of 2286 respondents, 223 (6.9%, weighted) sought medical attention for a child due to an AEFI. Compared with parents reporting no adverse event, parents who sought medical attention were less likely to be African American (adjusted odds ratio [AOR]=0.34, 95% confidence interval [CI]=0.16-0.75) or Hispanic (AOR=0.16, 95% CI=0.07-0.39) versus white, aged 35 years or older versus 25 to 34 (AOR=0.35, 95% CI=0.17-0.72), more likely to believe that immunizations cause minor side effects (AOR=5.74, 95% CI=2.99-11.00), report unwanted yet required childhood immunizations (AOR=3.54, 95% CI=1.45-8.66), not want a new baby to be fully immunized (AOR=3.48, 95% CI=1.25-9.67), report concern about immunization safety (AOR=2.08, 95% CI=1.07-4.05), believe that immunizations are dangerous (AOR=3.56, 95% CI=1.14-11.13), and have a child missing two or more doses of three immunizations (measles-containing vaccine, DTaP/DTP, or hepatitis B) (AOR=2.30, 95% CI=1.17-4.55). CONCLUSIONS: This study suggests that research is needed to determine whether negative parental attitudes associated with a child's AEFI might be lessened by improving vaccine safety communication between physician and parent.     

Demographic and health-related correlates of herbal and specialty supplement use

BACKGROUND: By broadening the definition of a dietary supplement, the 1994 Dietary Supplements Health and Education Act opened the market to many herbals, botanicals, and other food ingredients that would have otherwise needed safety testing before being sold. Information regarding patterns and correlates of herbal and specialty supplement use can help nutritionists understand which compounds are most commonly used, who are likely to use these supplements, and whether the choice of herbal supplements appears motivated by specific health concerns. METHODS: Data are from 61,587 participants, aged 50 to 76 years, who completed a self-administered mailed questionnaire in 2000-2002 on current dietary supplement use (20 herbal/specialty supplements, multivitamins, and 17 individual vitamins or minerals), demographic and lifestyle characteristics, and medical history. RESULTS: When compared with no supplement use, herbal/specialty supplement use was significantly higher among respondents who were older, female, educated, had a normal body mass index, were nonsmokers, engaged in exercise, and ate a diet lower in fat and higher in fruits and vegetables (all P<.001). Similar trends were observed when herbal/specialty supplement users were compared with vitamin/mineral users. For specific supplements and medical conditions, the strongest associations were cranberry pills and multiple bladder infections (odds ratio [OR], 4.66; 95% confidence interval [CI], 4.03-5.38), acidophilus pills and lactose intolerance (OR, 3.37; 95% CI, 2.96-3.84), and saw palmetto and enlarged prostate (OR, 3.33; 95% CI, 3.00-3.72). CONCLUSIONS: Odds of supplement use are high for certain demographic and lifestyle characteristics. Additionally, persons with specific medical conditions are using supplements promoted to reduce risk for their particular conditions.     

Risk factors associated with severe underweight among young children reporting to a diarrhoea treatment facility in Bangladesh

Protein-energy malnutrition (PEM) is a serious health problem among young children in Bangladesh. PEM increases childhood morbidity and mortality. Information is needed on the major risk factors for PEM to assist with the design and targeting of appropriate prevention programmes. To compare the underlying characteristics of children, aged 6-24 months, with or without severe underweight, reporting to the Dhaka Hospital of ICDDR,B in Bangladesh, a case-control study was conducted among 507 children with weight-for-age z-score (WAZ) < -3 and 500 comparison children from the same communities with WAZ > -2.5. There were no significant differences between the groups in age [overall mean+standard deviation (SD) 12.6 +/- 4.1 months] or sex ratio (44% girls), area of residence, or year of enrollment. Results of logistic regression analysis revealed that severely-underweight children were more likely to have: undernourished mothers [body mass index (BMI) < 18.5, adjusted odds ratio (AOR) = 3.8, 95% confidence interval (CI) 2.6-5.4] who were aged < 19 years (AOR = 3.0, 95% CI 1.9-4.8) and completed < 5 years of education (AOR = 2.7, 95% CI 1.9-3.8), had a history of shorter duration of predominant breastfeeding (< 4 months, AOR = 2.3, 95% CI 1.6-3.3), discontinued breastfeeding (AOR = 2.0, 95% CI 1.1-3.5), and had higher birth-order (> 3 AOR = 1.8, 95% CI 1.2-2.7); and fathers who were rickshaw-pullers or unskilled day-labourers (AOR = 4.4; 95% CI 3.1-6.1) and completed < 5 years of education (AOR = 1.5; 95% CI 1.1-2.2), came from poorer families (monthly income of Tk < 5,000, AOR = 2.7, 95% CI 1.9-3.8). Parental education, economic and nutritional characteristics, child-feeding practices, and birth-order were important risk factors for severe underweight in this population, and these characteristics can be used for designing and targeting preventive intervention programmes.     

The Relationship between Hostility and Behavioral Risk Factors for Poor Health in Women Veterans

BACKGROUND: While previous research has generally supported a relationship between hostility and health risk behaviors, the majority of this research has been conducted in predominately male, highly educated, Caucasian samples. The current study was designed to further examine the relationship between hostility and health risk behaviors in a sample of women. METHODS: Measures of health risk behavior and scores from the Cook-Medley hostility scale were obtained from 409 women veterans. Linear and logistic regression analyses were used to examine the relationship between hostility and health behaviors including tobacco smoking, alcohol use, body-mass index, caffeine use, and level of physical activity, after sociodemographic factors were accounted for. RESULTS: In a cohort of women veterans using VA health care, ages 35-81, hostility was significantly associated with tobacco smoking (OR = 2.10; 95% CI = 1.34 to 3.30), caffeine use (OR = 2.12; 95% CI = 1.16 to 3.85), and the number of alcoholic beverages consumed by women who drink alcohol. Hostility was not associated with body mass index (OR = 1.15; 95% CI = 0.77 to 1.72) or a lack of physical exercise (OR = 0.89; 95% CI = 0.55 to 1.43). CONCLUSIONS: Results are generally consistent with previous research and support the relationship between hostility and health risk behaviors. Awareness that hostility contributes to risk behaviors and disease may help in the design of interventions aimed at risk reduction.     

Does Preconception Health Differ by Nativity?: Findings from the Los Angeles Mommy and Baby (LAMB) Study

Objectives To compare certain preconception health (PCH) behaviors and conditions among US-born (USB) and foreign-born (FB) mothers in Los Angeles County (LAC), regardless of race/ethnicity, and to determine if any identified differences vary among Asian/Pacific Islanders (API’s) and Hispanics. Methods Data are from the 2012 Los Angeles Mommy and Baby study (n = 6252). PCH behaviors included tobacco use, multivitamin use, unintended pregnancy, and contraception use. PCH conditions comprised being overweight/obese, diabetes, asthma, hypertension, gum disease, and anemia. The relationship between nativity and each PCH behavior/condition was assessed using multivariable logistic regression models. Results USB women were more likely than FB women to smoke (AOR 2.12, 95 % CI 1.49–3.00), be overweight/obese (AOR 1.57, 95 % CI 1.30–1.90), and have asthma (AOR 2.04, 95 % CI 1.35–3.09) prior to pregnancy. They were less likely than FB women to use contraception before pregnancy (AOR 0.59, 95 % CI 0.49–0.72). USB Hispanics and API’s were more likely than their FB counterparts to be overweight/obese (AOR 1.57, 95 % CI 1.23–2.01 and AOR 2.37, 95 % CI 1.58–3.56, respectively) and less likely to use contraception (AOR 0.58, 95 % CI 0.45–0.74 and AOR 0.46, 95 % CI 0.30–0.71, respectively). USB Hispanic mothers were more likely than their FB counterparts to smoke (AOR 2.47, 95 % CI 1.46–4.17), not take multivitamins (AOR 1.30, 95 % CI 1.02–1.66), and have asthma (AOR 2.35, 95 % CI 1.32–4.21) before pregnancy. Conclusions US nativity is linked to negative PCH among LAC women, with many of these associations persisting among Hispanics and API’s. As PCH profoundly impacts maternal and child health across the lifecourse, culturally-appropriate interventions that maintain positive behaviors among FB reproductive-aged women and encourage positive behaviors among USB women should be pursued.     

Prevalence, family history, and prevention of reported osteoporosis in U.S. women

BACKGROUND: Osteoporosis is a major public health concern and has been associated with a family history positive for the condition. However, data on the behaviors of individuals with such a family history are scarce. The objectives of this study were to assess the relationship between the prevalence of reported physician-diagnosed osteoporosis and family history in a representative sample of U.S. women, examine whether osteoporosis risk factors account for this relationship, and evaluate the likelihood that women at high risk of osteoporosis due to family history report preventive behaviors. METHODS: The prevalence of reported osteoporosis was estimated in 8073 women aged>or=20 years in the National Health and Nutrition Examination Survey, 1999-2004. Information on osteoporosis in first-degree relatives and grandparents was obtained during interviews. RESULTS: The prevalence of osteoporosis in participants was 7.94%. In 19.8% of them, a positive family history was reported and was significantly and independently associated with osteoporosis (AOR 2.35, 95% CI=1.87, 2.96). This association was stronger when two or more relatives were affected (AOR 8.48, 95% CI=4.50, 15.99). After stratification by age, the association was observed only in women aged>or=35 years. Women with a family history of osteoporosis were more likely than those with none to report preventive behavior, such as taking supplements of calcium, vitamin D, or both; physical activity; and estrogen use. CONCLUSIONS: These findings indicate that family history is a significant, independent risk factor for osteoporosis in U.S. women aged>or=35 years. Further studies are warranted to evaluate family history as a convenient and inexpensive tool for identifying women at risk of osteoporosis and for promoting the adoption of preventive behaviors.     

Prevalence and Risk Factors of Undernutrition among Children Less than 2 Years in Urban Slums of Pune,Maharashtra, India

ABSTRACT

Undernutrition and its risk factors among children aged 0-23 months in urban slums of Pune was studied. Maternal and child characteristics, household food security and anthropometric measurements of 400 children were recorded. Results identified prevalence of stunting to be 34%, wasting 15.3% and underweight 21.8%. Odds of stunting was higher among children 7 to 12 months of age (AOR=7.064, 95% CI: 1.908-26.150). Odds of wasting was higher among children 7 to 12 months (AOR=3.144, 95% CI: 1.631-6.060), age < 6 months (AOR=2.546, 95% CI: 1.259-5.149) and not feeding colostrum (AOR=2.806, 95% CI=1.059 -7.478). Birth weight < 2500gm increased the risk of all three manifests of undernutrition. Children who were not immunised or received partial immunization had 1.5 times greater risk of being underweight (AOR=1.933, 95% CI: 1.118-3.342). Age specific interventions to address specific risk factors is a priority to address this public health issue.     

Factors associated with geographic migration among a cohort of injection drug users

We sought to determine factors associated with migration among injection drug users in Vancouver, Canada. We examined migration patterns among participants in the Vancouver Injection Drug Users Study. All participants were residents of Vancouver at the time of recruitment. Correlates of migration, defined as living outside of Greater Vancouver between June 1999 and May 2005, were identified using generalized estimating equations. Various factors were negatively associated with migration including frequent crack cocaine smoking (AOR = 0.44, 95% CI: 0.37-0.52), current methadone use (AOR = 0.50, 95% CI: 0.40-0.63), frequent heroin injection (AOR = 0.51, 95% CI: 0.41-0.64), requiring help injecting (AOR = 0.60, 95% CI: 0.47-0.77), sex trade involvement (AOR = 0.64, 95% CI: 0.51-0.82), living in unstable housing (AOR = 0.69, 95% CI: 0.58-0.83), public injecting (AOR = 0.75, 95% CI: 0.60-0.94), and incarceration (AOR = 0.77, 95% CI: 0.61-0.96). Alcohol use was positively associated with migration in this analysis (AOR = 1.25, 95% CI: 1.05-1.48). Our findings suggest that participants who migrated were less at risk for HIV infection, given lower levels of reported risk-taking.     

Women Who Use Drugs and Have Sex with Women in a Canadian Setting: Barriers to Treatment Enrollment and Exposure to Violence and Homelessness

Individuals who use illicit drugs and belong to a sexual minority group often contend with elevated risks for adverse health outcomes. However, little is known about women who use drugs and have sex with women. We therefore sought to identify sociodemographic, substance use patterns, and exposures to social-structural factors associated with reporting sexual activity among women participating in three open prospective cohort studies of individuals who use illicit drugs in Vancouver, Canada. Generalized estimating equations were used to identify substance use patterns, violence, and other social and structural drivers of health-related harm among women who reported having sex with women (WSW) between December 2005 and May 2012. In multivariate analyses, younger age (adjusted odds ratio [AOR] 2.89; 95 % confidence interval [CI] 1.81, 4.60), violence (AOR 1.78; 95 % CI 1.22, 2.59), and homelessness (AOR 1.42; 95 % CI 1.00, 2.02) were associated with WSW. WSW were also less likely to report enrollment in addiction treatment (AOR 0.68; 95 % CI 0.46, 0.99). In a second model, sexual violence (AOR 3.47; 95 % CI 2.08, 5.78) in the previous 6 months was also found to be positively associated with WSW. These findings indicate a critical need for more thorough understandings of the intersections between sexual relationships, exposure to violence, and enrollment in addiction treatment among women who use illicit drugs, as well as the development of programs to address the unique needs of this population.     

State of transition: Marijuana use among young adults in the San Francisco Bay Area

BackgroundCalifornia may vote on marijuana legalization in 2016. Young adults have the highest rates of marijuana use, but little is known about the correlates of use in this age group, including factors that may be affected by policy change. We investigated whether there are differences in marijuana use by sociodemographic characteristics, psychological distress, loneliness and social support, controlling for risk factors such as alcohol and cigarette use as well as perceived harm of marijuana.MethodsBivariate and multivariable analysis of past 30 day marijuana use using the 2014 San Francisco Bay Area Young Adult Health Survey, a probabilistic multi-mode survey of (N = 1324) young adults (aged 18–26 years) residing in Alameda and San Francisco Counties, stratified by race/ethnicity.Results291 (27%) sample participants reported current marijuana use. Compared to non-Hispanic Whites (referent) Asian/Pacific Islander respondents were less likely to use marijuana (AOR, 0.42; 95% CI, 0.22–0.80) while multiracial participants were twice as likely (AOR, 2.27; 95% CI, 1.06–4.85). Psychological distress was not related to marijuana use, but social support (AOR, 1.42; 95% CI, 1.08–1.88) and loneliness (AOR, 1.42; 95% CI, 1.09–1.86) were. Perceived harm of marijuana was inversely related to marijuana use (AOR, 0.60; 95% CI, 0.51–0.70), while smoking cigarettes (AOR, 3.95; 95% CI, 2.28–6.84) and binge drinking (AOR, 1.13; 95% CI, 1.03–1.24) were positively related.ConclusionsLegalization policies should include public education campaigns addressing potential harms of marijuana use particularly targeting multiracial young adults who also engage in other risk behaviors, such as cigarette smoking and binge drinking.     

High-risk behaviors in women who use crack: knowledge of HIV serostatus and risk behavior

PURPOSE: To determine whether crack cocaine-using women who are aware of their HIV serostatus have made modifications in risk behaviors, we compared known HIV-positive (HIV+) and HIV-negative (HIV-) users with respect to sexual risk behaviors, prevalence of sexually transmitted infections (STIs) and vaginitis, and correlates of unprotected sex. METHODS: We used a cross-sectional design with street outreach, recruitment, and interviews of sexually active crack cocaine using women. Women received testing for HIV, STIs, and vaginitis. RESULTS: Sixty-one HIV+ and 117 HIV- women were enrolled. HIV+ women were significantly more likely to be African-American. There were no significant differences in drug use, types of sexual partners, number of paying partners, attitudes regarding condoms, or STI diagnoses. HIV+ women were less likely to engage in unprotected sex compared with HIV- women (56% vs. 75%, adjusted odds ratio [AOR], 0.36; 95% confidence interval [CI], 0.13-0.99). Among HIV+ women, unprotected sex was negatively associated with stronger beliefs regarding the protective value of condoms (AOR, 0.07; 95% CI, 0.01-0.67) and concurrent injection-drug use (AOR, 0.19; 95% CI, 0.04-0.99). CONCLUSIONS: Although the majority of crack using HIV+ crack using women in this sample continued to engage in high-risk sexual activities, they were less likely to do so than HIV- women. Interventions targeting this population are needed.     

南京市白下区中学生抑郁障碍与健康危险行为的关系

目的了解南京市白下区中学生人群中主要健康危险行为的发生率及其与抑郁障碍的关系。方法采用横断面调查，研究对象来自南京白下区9个学校的27个班级1102名在校的初一至高三的中学生，其中初中生占63．6％，高中生占36．4％；男生为45．0％，女生为55．0％。调查的有效应答率为94．2％。结果该样本人群中5种健康危险行为：吸烟、饮酒、网吧上网、逃学、离家出走的发生率分别为4．3％、33．6％、8．0％、6．5％和4．5％，男生均高于女生，高三学生的发生率为最高，高中学生的健康危险行为的发生率高于初中学生，18岁以上年龄组的学生中，各种健康危险行为的发生率均为最高。罹患抑郁障碍的学生发生健康危险行为的可能性均大于非抑郁障碍患者，针对上述5种健康危险行为的OR值分别为3．30（95％CI=1．67～6．55），1．86（95％CI=1．27～2．73），2．78（95％CI=1．57～4．93），3．82（95％CI=2．15～6．81）和5．53（95％CI=2．95～10．40）。发生健康危险行为者（网吧上网者、逃学者和离家出走者）寻求心理医生进行疏导的比例显著高于未发生健康危险行为者，但两类学生与老师交流沟通的比例则无差异。结论健康危险行为的发生、抑郁障碍已成为中学生人群中一个越来越重要的公共卫生问题，有关职责部门应制定有针对性的预防控制措施。     

Differences in Substance Use, Psychosocial Characteristics and HIV-Related Sexual Risk Behavior Between Black Men Who Have Sex with Men Only (BMSMO) and Black Men Who Have Sex with Men and Women (BMSMW) in Six US Cities

We assessed associations in substance use, psychosocial characteristics, and HIV-related sexual risk behaviors, comparing characteristics of Black men who only have sex with other men only (BMSMO; n = 839) to Black men who have sex with men and women (BMSMW; n = 590). The study analyzed baseline data from the HIV Prevention Trials Network Brothers Study (HPTN 061), a feasibility study of a multi-component intervention for Black MSM in six US cities. Bivariate analyses compared BMSMO to BMSMW along demographics, substance use, psychosocial characteristics, and HIV-related sexual risk behaviors. Logistic regression models then assessed multivariable associations between being BMSMW and the odds of engaging in HIV-related sexual risk behaviors. Adjusted analyses revealed that BMSMW remained more likely to have unprotected anal intercourse while under the influence of alcohol (AOR: 1.45; 95 % CI:1.11–1.90) and were more likely to receive money/drugs for sex (AOR: 2.11; 95 % CI:1.48–3.03), compared to BMSMO. Substance use is an important factor to be considered when developing risk-reduction interventions for BMSMW. Structural interventions that address factors that may contribute to exchange sex among these men are also warranted.     

A prospective study of vitamin supplement intake and cataract extraction among U.S. women.

We prospectively examined the association between vitamin supplement intake and the incidence of cataract extraction during 12 years of follow-up in a cohort of 47,152 female nurses. Women were 45 years or older and free of diagnosed cancer in 1980; others were added as they reached 45 years of age, for a total of 73,956 women. During 720,082 years of follow-up, 1,377 senile cataracts were diagnosed and extracted. Those who used multivitamins or separate supplements of vitamin C, E, or A did not have decreased risks of cataract as compared with nonusers even for use of 10 or more years. After adjusting for cataract risk factors, including cigarette smoking, body mass index, and diabetes mellitus, users of vitamin C supplements for 10 or more years had a relative risk (RR) of 0.95 [95% confidence interval (CI) = 0.76-1.20]. Associations were stronger among long-term vitamin C supplement users who were never-smokers (RR = 0.71; 95% CI = 0.47-1.08) and less than 60 years of age (RR = 0.72; 95% CI = 0.49-1.04). These findings suggest that there is little overall benefit of long-term use of vitamin supplements for risk of cataracts requiring extraction.     

Bridging Sexual Boundaries: Men Who Have Sex with Men and Women in a Street-Based Sample in Los Angeles

The purpose of the study was to determine the potential contribution of bisexual men to the spread of HIV in Los Angeles. We compare the characteristics and behaviors of men who have sex with men and women (MSMW) to men who have sex with only women (MSW) and men who have sex with only men (MSM) in Los Angeles. Men (N = 1,125) who participated in one of the two waves of data collection from 2005 to 2007 at the Los Angeles site for NIDA’s Sexual Acquisition and Transmission of HIV—Cooperative Agreement Program were recruited using Respondent Driven Sampling. Participants completed Audio Computer Assisted Self Interviews and received oral HIV rapid testing with confirmatory blood test by Western Blot and provided urine specimens for detection of recent powder cocaine, crack cocaine, methamphetamine, or heroin use. MSM, MSW, or MSMW were defined by the gender of whom they reported sex with in the past 6 months. Chi-square tests and ANOVAs were used to test independence between these groups and demographic characteristics, substance use, and sexual behaviors. We fit generalized linear random intercept models to predict sexual risk behaviors at the partner level. Men were mostly of low income, unemployed, and minority, with many being homeless; 66% had been to jail or prison, 29% had ever injected drugs, and 25% had used methamphetamine in the past 30 days. The sample had high HIV prevalence: 12% of MSMW, 65% of MSM, and 4% of MSW. MSMW were behaviorally between MSW and MSM, except that more MSMW practiced sex for trade (both receiving and giving), and more MSMW had partners who are drug users than MSW. Generalized linear random intercept models included a partner-level predictor with four partner groups: MSM, MSMW-male partners, MSMW-female partners, and MSW. The following were significantly associated with unprotected anal intercourse (UAI): MSW (AOR 0.15, 95% CI 0.08, 0.27), MSMW-female partners (AOR 0.4, 95% CI 0.27, 0.61), HIV-positive partners (AOR 2.03, 95% CI 1.31, 3.13), and being homeless (AOR 1.37, 95% CI 1.01, 1.86). The factors associated with giving money or drugs for sex were MSMW-female partners (AOR 1.70, 95% CI 1.09, 2.65), unknown HIV status partners (AOR 1.72, 95% CI 1.29, 2.30), being older (AOR 1.02, 95% CI 1.00, 1.04), history of incarceration (AOR 1.64, 95% CI 1.17, 2.29), and being homeless (AOR 1.73, 95% CI 1.27, 2.36). The following were associated with receiving money or drugs for sex: MSW (AOR 0.53, 95% CI 0.32, 0.89), African American (AOR 2.42, 95% CI 1.56, 3.76), Hispanic (AOR 1.85, 95% CI 1.12, 3.05), history of incarceration (AOR 1.44, 95% CI 1.04, 2.01), history of injecting drugs (AOR 1.57, 95% CI 1.13, 2.19), and had been recently homeless (AOR 2.14, 95% CI 1.57, 2.94). While overall HIV-positive MSM had more UAI with partners of any HIV status than MSMW with either partner gender, among HIV-positive MSMW, more had UAI with HIV-negative and HIV status unknown female partners than male partners. Findings highlight the interconnectedness of sexual and drug networks in this sample of men—as most have partners who use drugs and they use drugs themselves. We find a concentration of risk that occurs particularly among impoverished minorities—where many men use drugs, trade sex, and have sex with either gender. Findings also suggest an embedded core group of drug-using MSMW who may not so much contribute to spreading the HIV epidemic to the general population, but driven by their pressing need for drugs and money, concentrate the epidemic among men and women like themselves who have few resources.     

Dietary magnesium and C-reactive protein levels

OBJECTIVE: Current dietary guidelines recommend adequate intake of magnesium (310-420 mg daily) in order to maintain health and lower the risk of cardiovascular disease. Recent evidence from animal and clinical studies suggests that magnesium may be associated with inflammatory processes. The objective of this study was to determine whether dietary magnesium consumption is associated with C-reactive protein (CRP), a marker of inflammation, in a nationally representative sample. METHODS: Analysis of adult (> or =17 years) participants in a cross-sectional nationally representative survey (National Health and Nutrition Examination Survey 1999-2000 [NHANES]) who were not taking magnesium or magnesium-containing supplements. The primary outcome measure was high sensitivity CRP (elevated > or =3.0 mg/L). RESULTS: Among US adults, 68% consumed less than the recommended daily allowance (RDA) of magnesium, and 19% consumed less than 50% of the RDA. After controlling for demographic and cardiovascular risk factors, adults who consumed or =RDA (Odds Ratio [OR] for intake <50% RDA = 1.75, 95% Confidence Interval [CI] 1.08-2.87). Adults who were over age 40 with a BMI >25 and who consumed <50% RDA for magnesium were 2.24 times more likely to have elevated CRP (95% CI 1.13-4.46) than adults > or =RDA. CONCLUSIONS: Most Americans consume magnesium at levels below the RDA. Individuals with intakes below the RDA are more likely to have elevated CRP, which may contribute to cardiovascular disease risk.     

Cardiovascular Disease Risk in Sexual Minority Women (18-59 Years Old): Findings from the National Health and Nutrition Examination Survey (2001-2012)

Objective

Sexual minority women (lesbian and bisexual) experience significant stigma, which may increase their cardiovascular disease (CVD) risk. The purpose of this study was to examine the prevalence of modifiable risk factors for CVD (including mental distress, health behaviors, blood pressure, glycosylated hemoglobin, and total cholesterol) and CVD in sexual minority women compared with their heterosexual peers.