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Polysubstance use (PSU), injection drug use (IDU), and equipment sharing are associated with bloodborne infection (BBI) transmission risk, particularly Hepatitis C Virus (HCV), yet data on PSU in low- and middle-income countries (LMICs) is limited. We report on baseline PSU, medication-assisted treatment (MAT) engagement, and motivation to reduce IDU among 95 people who inject drugs (PWID) who accessed needle and syringe programs (NSP) in Nairobi and Coastal Kenya prior to HCV treatment. Bivariate and multivariate logistic regression were used to examine the associations between PSU and behaviors that confer HCV transmission and acquisition risks. Most participants (70.5%) reported PSU in the last 30 days, and one-third (35.8%) reported PSU exclusive to just heroin and cannabis use. Common combinations were heroin and cannabis (49.3%), and heroin, cannabis, and bugizi (flunitrazepam) (29.9%). Participants at baseline were receiving MAT (69.5%), already stopped or reduced IDU (30.5%), and were HIV-positive (40%). PSU was significantly associated with IDU (p = 0.008) and the number of times (p = 0.016) and days (p = 0.007) injected in the last 30 days. Participants reported high PSU and equipment sharing, despite high MAT engagement. While co-locating BBI treatment within existing harm reduction services is necessary to promote uptake and curb re-infection, tailored services may be needed to address PSU, particularly in LMICs. [ABSTRACT FROM AUTHOR]

In this study, based on Family Interactional Theory (FIT), the authors tested a longitudinal model of the intergenerational effects of the grandmothers' parent-child relationships and the grandparents' smoking on the grandchildren's externalizing behavior via parents' psychological symptoms, tobacco use, and child rearing. Using Mplus, the authors obtained a structural equation model that demonstrated generational associations from grandmothers (G1) to parents (G2) to their oldest children (G3) and thus was in accord with FIT. They identified a pathway from the grandmothers' parenting to the grandchildren's externalizing behavior via the parents' psychological symptoms, their smoking, and their child rearing. Parents' psychological symptoms in adolescence were associated with their tobacco use in their late twenties, controlling for the continuity of their psychological symptoms and their tobacco use. This 3-generational model adds to the literature on parent-child relationships (G1), smoking from adolescence to early adulthood (G2), and externalizing behavior in the G3 child. (Contains 2 tables, 1 figure, and 1 note.)

This study examined exposure to environmental tobacco smoke (ETS), a major public health problem. ETS has been found to be associated with an increased risk of adverse health effects in children. This study utilizes data from a community-based, longitudinal investigation examining the relation between children's exposure to ETS and later internalizing symptoms and externalizing behaviors. Interviews were administered to a representative community sample of participants from two New York State counties in 1983, with subsequent interviews in 1985-1986, 1992, 1997, and 2002-2003 (when the participants' mean age was 32). Data was collected on various personality and behavioral characteristics of the participants, and on internalizing symptoms and externalizing behaviors demonstrated by their children. Results indicated that children's exposure to ETS was associated with an increased risk for both internalizing symptoms and externalizing behaviors. This relationship was maintained despite control on a number of parental psychosocial risk factors (e.g., demographic variables, personality and behavioral attributes) that have been found to be associated with both parental cigarette smoking and behavior problems among children. These data, which indicate an association between exposure to ETS and internalizing symptoms and externalizing behaviors among children, support public health policies to further restrict children's exposure to ETS.

This study tested a developmental model of pathways to risky sexual behavior among South African adolescents. Participants comprised 633 adolescents, 12-17 years old, recruited from households in Durban, South Africa. Data were collected using in-person interviews. Topics included adolescents' sexual behaviors, household poverty levels, vulnerable personality and behavioral attributes, parent-child relations, and deviant peers. Structural equation modeling was used to assess the pathways to risky sexual behavior among the adolescents. The goodness-of-fit index (GFI) was 0.93. One major pathway indicated that family poverty was associated with difficulty in the parent-child relationship. This was related to vulnerable personality and behavioral attributes and to association with deviant peers, which, in turn, were related to risky sexual behavior. Findings suggest that poverty, parent-child relations, personality and behavioral vulnerabilities, and peer influences should be among factors addressed by prevention and intervention programs to reduce sexual risk behaviors by South African adolescents.

In this prospective longitudinal study, the authors investigated the association between lifetime tobacco use and subsequent health problems by age 30. The authors interviewed a community group of 749 participants from upstate New York at mean ages of 14, 16, 22, and 27 years. Daily tobacco use during any of the time periods, as well as the number of periods of daily tobacco use, were significantly associated with increased risk for respiratory ailments, neurobehavioral and cognitive problems, and general malaise. The results suggested that daily tobacco use, either during childhood, adolescence, the early 20s, or a combination of those times, predicted health problems by age 30. Effective smoking prevention programs that begin in childhood are imperative to prevent the occurrence of later health problems. (Contains 3 tables.)