Search

This study examined the role of stress as a mediator of the relationship between prior drug addiction and current high ‐ risk sexual behaviour. Eight hundred twenty women aged 18 to 30   years, who received care at community ‐ based family planning clinics, were interviewed using the Composite International Diagnostic Interview and the Sexual Risk Behavior Assessment Schedule. They also completed the brief version of the Self ‐ Control Scale as a measure of problem ‐ solving strategies and measures of recent stressful events, daily hassles and ongoing chronic stress. Regardless of addiction history, stress exposure during the previous 12   months was associated with risky sexual behaviour during the previous 12   months. Structural equation modelling revealed that 12 ‐ month stress levels mediated the relationship between past drug addiction and 12 ‐ month high ‐ risk sexual behaviours, as well as the negative relationship between problem ‐ solving strategies and high ‐ risk sexual behaviours. Problem ‐ solving strategies did not moderate the relationship between drug addiction and high ‐ risk sexual behaviours. These findings suggest that stress management training may help reduce risky behaviour among young, low ‐ income women Copyright © 2014 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Background: This study was undertaken to assess the association between adult attention deficit/hyperactivity disorder (ADHD) symptoms and high-risk sexual behavior. Methods: This cross-sectional study interviewed 462 low-income women aged 18-30 years. We used the 18-item Adult ADHD Self-Report Scale (ASRS-v1.1) Symptom Checklist to assess ADHD symptoms. Risky sexual behaviors included sex before 15 years of age, risky sex partners in lifetime, number of sex partners in the last 12 months, condom use in the last 12 months, alcohol use before sex in the last 12 months, traded sex in lifetime, and diagnosed with sexually transmitted infection (STI) in lifetime. Results: Mean ADHD symptom score was 19.8 (SD±12.9), and summary index of all risky sexual behavior was 1.77 (SD±1.37). Using unadjusted odds ratios (OR), women who endorsed more ADHD symptoms reported engaging in more risky sexual behaviors of all types. However, when multivariable logistic regression was applied adjusting for various sociodemographic covariates, the adjusted ORs remained significant for having risky sex partners and having ≥3 sex partners in the prior 12 months. We observed some differences in risky sexual behavior between two domains of ADHD. Conclusions: The ADHD symptom score appears to be associated with some risky sexual behaviors and deserves further attention. A brief ADHD screening can identify this high-risk group for timely evaluation and safe sex counseling. [ABSTRACT FROM AUTHOR]

We conducted a retrospective cohort study to determine the 3-year reincarceration rate of all HIV-infected inmates ( n = 1917) released from the Texas prison system between January 2004 and March 2006. We also analyzed postrelease changes in HIV clinical status in the subgroup of inmates who were subsequently reincarcerated and had either CD4 lymphocyte counts ( n = 119) or plasma HIV RNA levels ( n = 122) recorded in their electronic medical record at both release and reincarceration. Multivariable analyses were performed to assess predictors of reincarceration and clinical changes in HIV status. Only 20% of all HIV-infected inmates were reincarcerated within 3 years of release. Female inmates (hazard ratio [HR] 0.63; 95% confidence interval [CI], 0.47, 0.84) and inmates taking antiretroviral therapy at the time of release (HR 0.31; 95% CI, 0.25, 0.39) were at decreased risk of reincarceration. African Americans (HR 1.58; 95% CI, 1.22, 2.05), inmates with a major psychiatric disorder (HR 1.82; 95% CI, 1.41, 2.34), and inmates released on parole (HR 2.86; 95% CI, 2.31, 3.55) were at increased risk of reincarceration. A subgroup of reincarcerated inmates had a mean decrease in CD4 cell count of 79.4 lymphocytes per microliter ( p < 0.0003) and a mean increase in viral load of 1.5 log10 copies per milliliter ( p < 0.0001) in the period between release and reincarceration. Our findings, although substantially limited by selection bias, highlight the importance of developing discharge planning programs to improve linkage to community-based HIV care and reduce recidivism among released HIV-infected inmates. [ABSTRACT FROM AUTHOR]

Few previous studies have reported on the overall health of drug-using women. To investigate this, 696 low-income women aged 18-31 were recruited in a cross-sectional study from gynecological care clinics in Texas between 2001 and 2003. Compared to exclusive marijuana users and non-drug users, women who used MDMA and those who used other illicit drugs but not MDMA reported more gynecological conditions, medical conditions, depressive symptoms, and physical somatic complaints. We concluded that young, low-income women who used more than one illicit drug experience significantly more physical and psychological morbidity. Generalization of this study results may be limited to young women with low income but not to other populations. [ABSTRACT FROM AUTHOR]

The article presents a retrospective cohort study which determined the proportion of inmates who filled an antiretroviral therapy (ART) prescription within 60 days of release from prison. The study was conducted to investigate the extent to which HIV-infected inmates experience ART interruption following release from prison. The main outcome was the proportion of inmates who filled an ART prescription within 10, 30, and 60 days of release from prison. Predictors of the outcome were examined. Researchers found that a small percentage of Texas prison inmates receiving ART filled an ART prescription within 60 days of their release.

This study assessed contextual risks for polydrug use in a triethnic sample (non-Hispanic white, African American, Hispanic) of young women with a low income. For the current analysis, a total of 712 young women aged 18 to 31 years who sought care in state-funded family planning clinics in southeast Texas from December 2001 to May 2003 participated in the survey. The main outcome of the study was the number of illicit drugs (including marijuana, MDMA [ecstasy], crack cocaine, and other hard drugs) used in the last 12 months. Of the 712 subjects, 198 (28%) reported using illicit drugs in the past 12 months. Neighborhood socioeconomic status was significantly associated with drug use in a bivariate model. The proportion of women living in the most advantaged neighborhoods who reported drug use was more than twice that of women living in the most disadvantaged neighborhoods. However, the significance of neighborhood socioeconomic status was eliminated after controlling for ethnicity or for personal network characteristics in a multivariate ordinal logistic regression model. In contrast, in multivariate models, personal network indicators, such as a larger number of monthly contacts with friends (odds ratio [OR] = 1.32, 95% confidence interval [CI] = 1.11, 1.56) and a larger number of friends who used illicit drugs (OR = 1.47, 95% CI = 1.33, 1.62) were associated with increased drug use. In addition, not being currently married (vs. being married) (OR = 2.73, 95% CI = 1.44, 5.16) was associated with a larger number of drugs used in the last 12 months. In conclusion, we found that neighborhood socioeconomic status was not directly associated with more drug use when controlling for ethnicity or for personal network characteristics. Personal networks may mediate the relationships between neighborhood and drug use. Strategies to reduce polydrug use should target personal networks where friends use illicit drugs. [ABSTRACT FROM AUTHOR]

Few studies have systematically evaluated whether contextual variables differ in their ability to explain the use of different drugs in the same sample. Our objective was to examine correlates of use for different illicit drugs at the individual and neighborhood level in a tri-ethnic sample of low-income women, an underrepresented sample in drug research. Women 18–31 were recruited from a low-cost family planning clinic in southeast Texas from December 2001 to May 2003. Neighborhood level indicators of disadvantage, family structure, and nativity status from U.S. Census 2000 were linked with individual survey data. Multilevel logistic regression was used to examine the effect of individual and neighborhood level measures on lifetime use of marijuana only and of other illicit drugs in 594 women. Only individual level variables (younger age, non-Hispanic White ethnicity, not being married, greater peer acceptance of substance use) increased odds of exclusive marijuana use, controlling for neighborhood level factors. However, both neighborhood and individual level variables significantly predicted other illicit drug use. Residence in less disadvantaged neighborhoods, non-Hispanic White ethnicity, higher levels of education, greater acceptance of substance use by peers, and a larger number of perceived neighborhood problems increased odds of illicit drug use. Use of other illicit drugs with or without marijuana may be more closely tied to area level factors whereas factors driving exclusive marijuana use may not rely on localized structures to the same extent. Thus, community-level interventions may need to customize their approaches according to the type of drug use targeted. The implication of using neighborhood level variables in substance use research is also discussed. [ABSTRACT FROM AUTHOR]

: Study objectiveTo describe the prevalence and correlates of sexual assault among adolescent females.: DesignA cross-sectional study.: SettingA university family planning clinic in south Texas.: ParticipantsFemale adolescents <18 years who initiated care at a university family planning clinic in south Texas between June 28, 1992, and April 28, 1994.: Main outcome measuresThe adolescents'' lifetime sexual assault experience.: ResultsOf the 791 adolescents interviewed, 167 (21%) reported a history of sexual assault. Sexual assault was found to be highly associated with multiple risky behaviors and depressive symptoms. Among assaulted adolescents, nonsexual risk behaviors (e.g., substance use) were more common among those who also experienced physical assault than among those who did not. Sexual risk behaviors (e.g., earlier age at sexual debut) and related gynecological infections (e.g., STDs) were more prevalent among women reporting forced sexual intercourse than in those who reported molestation only. Furthermore, adolescents assaulted by a stranger had participated in the most risky behaviors and reported the worst health status, while those assaulted by a date/acquaintance reported higher rates of inconsistent condom use and gynecological infections but lower rates of substance use and depressive symptoms than those assaulted by a family member.: ConclusionA deeper understanding of the links between the characteristics of assault, risk behaviors, and health conditions may provide opportunities to design more individualized interventions. [Copyright &y& Elsevier]

Campylobacter jejuni clone SA is the major cause of sheep abortion and contributes significantly to foodborne illnesses in the United States. Clone SA is hypervirulent because of its distinct ability to produce systemic infection and its predominant role in clinical sheep abortion. Despite the importance of clone SA, little is known about its distribution and epidemiological features in cattle. Here we describe a prospective study on C. jejuni clone SA prevalence in 35 feedlots in 5 different states in the United States and a retrospective analysis of clone SA in C. jejuni isolates collected by National Animal Health Monitoring System (NAHMS) dairy studies in 2002, 2007, and 2014. In feedlot cattle feces, the overall prevalence of Campylobacter organisms was 72.2%, 82.1% of which were C. jejuni Clone SA accounted for 5.8% of the total C. jejuni isolates, but its prevalence varied by feedlot and state. Interestingly, starlings on the feedlots harbored C. jejuni in feces, including clone SA, suggesting that these birds may play a role in the transmission of Campylobacter In dairy cattle, the overall prevalence of clone SA was 7.2%, but a significant decrease in the prevalence was observed from 2002 to 2014. Whole-genome sequence analysis of the dairy clone SA isolates revealed that it was genetically stable over the years and most of the isolates carried the tetracycline resistance gene tet (O) in the chromosome. These findings indicate that clone SA is widely distributed in both beef and dairy cattle and provide new insights into the molecular epidemiology of clone SA in ruminants. IMPORTANCE C. jejuni clone SA is a major cause of small-ruminant abortion and an emerging threat to food safety because of its association with foodborne outbreaks. Cattle appear to serve as a major reservoir for this pathogenic organism, but there is a major gap in our knowledge about the epidemiology of clone SA in beef and dairy cattle. By taking advantage of surveillance studies conducted on a national scale, we found a wide but variable distribution of clone SA in feedlot cattle and dairy cows in the United States. Additionally, the work revealed important genomic features of clone SA isolates from cattle. These findings provide critically needed information for the development of preharvest interventions to control the transmission of this zoonotic pathogen. Control of C. jejuni clone SA will benefit both animal health and public health, as it is a zoonotic pathogen causing disease in both ruminants and humans., (Copyright © 2017 Tang et al.)

Background: Accumulating research suggests that the gateway hypothesis of substance use may not apply equally across different race/ethnicity groups., Objectives: The current study examines racial and ethnic differences in patterns of initiation of licit and illicit substance use., Methods: A cross-sectional survey was conducted among 696 low-income women between the ages of 18 and 31 who sought gynecological care between December, 2001 and May, 2003 in southeast Texas., Results: Overall, White women fit the classic profile of drug use initiation patterns, with those initiating tobacco and beer/wine at earlier ages being more likely to use illicit drugs. Conversely, African-American and Hispanic women initiated tobacco and beer/wine at much later ages than White women, but they were as likely to use illicit drugs., Conclusions: To be optimally effective, prevention efforts may need to be tailored to fit the race/ethnicity of the audience. Further studies are suggested to investigate specific risk factors related to substance use initiation by race/ethnicity.

This study examined the association of ecstasy (methylenedioxy-methylamphethamine) use with psychopathology among young, low-income females who sought care at university family planning clinics in Texas between December 2001 and May 2003. Participants reported drug use history and eight problem behavior syndromes by using the Young Adult Self-Report. The prevalence of ecstasy use was approximately 15%. About 90% of ecstasy users reported having used other drugs. Overall, ecstasy users were more likely to have exhibited delinquent behaviors and thought problems than exclusive marijuana users. Ecstasy users who continued to use any illicit drugs showed the most severe psychopathology. These findings indicate that elevated rates of self-reported psychopathology among ecstasy users may be partly attributable to the use of multiple drugs. Furthermore, it will also be important for future studies to assess the extent to which delinquent behaviors and thought problems mediate the transition of marijuana use to ecstasy use.

Purpose: The seroprevalence of HIV infection was examined among a sample of incoming inmates in the Texas Department of Criminal Justice prison system. Rates were compared across sociodemographic factors and three types of prison facilities: substance abuse felony punishment units (SAFPs), state jails, and prisons., Methods: The study sample consisted of 4386 incoming inmates incarcerated for any duration, dating from November 1, 1998, to May 31, 1999., Results: Among males, inmates entering state jails had a higher HIV infection rate (3.7%) than either inmates entering prisons (1.9%) or those entering SAFPs (0.5%). Among females, inmates entering prisons had a higher rate of infection (9.3%) than those entering state jails (2.5%) or SAFPs (4.5%)., Conclusions: Although a number of blinded HIV seroprevalence studies have been conducted in U.S. prison systems, scarce information is currently available on HIV infection rates in alternative correctional facilities. The present study shows that HIV seropositivity varied substantially according to race, gender, and prison facility type. Given the shorter incarceration periods for inmates held in alternative facilities, understanding how infection rates vary according to type of incarceration facility holds particular public health relevance.