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Addressing adolescent sexual risk behaviors in the STI/HIV prevention literature is well documented; however, intervention impacts on life satisfaction are relatively unexplored. This study is a secondary analysis of data (N = 1,658) from a randomized, multisite, multilevel safer sex media campaign (Project iMPPACS) analyzing life satisfaction across baseline and follow-up data collected from 2006 to 2008 among participants (mean age 15.08 years) who reported never having had vaginal sex at baseline (n = 787). Participants were separated into groups based on whether they reported having vaginal sex (yes/no) at baseline. Then taking into account the nested study design and controlling for confounders, a mixed model repeated measures analysis of variance assessed whether differences in mean total life satisfaction (LS) were associated across time in the media and nonmedia study conditions separately by gender. A significant interaction between time and media condition was detected (p =.039) where mean total LS increased +.065 units from baseline (M = 5.364) to last contact in media cities and decreased −.084 units from baseline (M = 5.557) to last contact in nonmedia cities when controlling for the effect of initiating vaginal sex. No significant differences in LS at baseline were observed between media and nonmedia intervention cities. Results by gender suggest most positive change in LS was observed for females with mixed findings for males. Although Project iMPPACS was not designed with the intent on improving participants' life satisfaction, results advance the LS literature by demonstrating a temporal sequence for sexual risk taking and LS over time. [ABSTRACT FROM AUTHOR]

Objective: Understanding individual level factors associated with sexual risk behaviors among African-American adolescents remains an important public health priority. The current secondary data analysis examined the longitudinal association between a baseline assessment of depressive symptoms and sexual risk behaviors reported 6 months later; the purpose was to determine whether the association of depressive symptoms to risky sex varies as a function of gender. A secondary aim was to examine self-efficacy for sex refusal and condom use assessed at a 3-month follow-up as mediators of the depressive symptoms-sexual risk relationship. Methods: The sample consisted of 782 sexually active African-American adolescents (Mage = 15.3 years, SD = 1.08; 54% female) recruited to participate in a sexual health intervention trial. Data analyses focused on vaginal sex, and outcomes included: (a) sexual activity with 2 or more partners in the previous 3 months; (b) the relative frequency of condom use in the previous 3 months; (c) noncondom use at last occasion of sex; and (d) positive sexually transmitted infection (STI) screening. Results: Depressive symptoms predicted sex with 2 more partners for female participants, but no other risk markers for the sample as a whole. However, there was a significant indirect effect of depressive symptoms on condomless sex via decreased condom use self-efficacy for both male and female adolescents. Conclusions: These findings have important implications for HIV/STI prevention, in which behavioral interventions may benefit from modules that include a focus on the influence of mood on self-efficacy for safer sex practices. [ABSTRACT FROM AUTHOR]

Objective: The use of complementary and alternative medicine (CAM) among people living with HIV and AIDS (PLWHA) may undermine other adaptive illness management behaviors, such as treatment adherence. The present study tests the hypothesis that CAM use is associated with intentional lapses in adherence (e.g., “medication vacations”), perhaps due to negative beliefs about antiretroviral therapy (ART). Method: Cross-sectional interviews with 116 PLWHA were completed using a computerized assessment of self-reported CAM use and ART adherence. Results: Almost half of participants used CAM to treat or manage HIV-related health concerns in the past month, and 78% had used CAM since being diagnosed with HIV. Seventy-one percent of participants endorsed at least one domain of intentional nonadherence since starting HIV treatment. As hypothesized, CAM users did not differ from nonusers on overall ART adherence. Contrary to hypotheses, CAM users were less likely to report taking medication vacations or having stopped taking HIV medications without their doctor's approval compared with nonusers. CAM intensity was also related to intentional nonadherence, such that patients who engaged in more CAM tended to report fewer skipped doses and fewer nonprescribed adjustments to their medication regimen in the past month. Conclusions: Findings suggest that PLWHA use CAM as an adjunct to ART and that CAM use does not undermine ART adherence. Needed now is longitudinal research to determine how a proactive, holistic approach to HIV care interacts with conventional HIV treatment over time, and whether CAM use impacts long-term quality of life and health outcomes. [ABSTRACT FROM AUTHOR]

The article presents a research paper that aims at evaluating the short-term effectiveness of the Marijuana eCHECKUP TO GO (e-TOKE), a web based program for universities, in changing marijuana involvement and perceived norms in undergraduates. The topics discussed include use of e-TOKE as an intervention to marijuana abuse and dependence symptoms, use of program for offering descriptive norm correction through educational intervention, and related statistical data involved in the study.

Abstract: Purpose: To test the long-term effects of a mass media intervention that used culturally and developmentally appropriate messages to enhance human immunodeficiency virus (HIV)-preventive beliefs and behavior of high-risk African American adolescents. Methods: Television and radio messages were delivered for more than 3 years in two cities (Syracuse, NY; and Macon, GA) that were randomly selected within each of the two regionally matched city pairs, with the other cities (Providence, RI; and Columbia, SC) serving as controls. African American adolescents, aged 14–17 years (N = 1,710), recruited in the four cities over a 16-month period, completed audio computer-assisted self-interviews at recruitment and again at 3, 6, 12, and 18-months postrecruitment to assess the long-term effects of the media program. To identify the unique effects of the media intervention, youth who completed at least one follow-up and who did not test positive for any of the three sexually transmitted infections at recruitment or at 6-and 12-month follow-up were retained for analysis (N = 1,346). Results: The media intervention reached virtually all the adolescents in the trial and produced a range of effects including improved normative condom-use negotiation expectancies and increased sex refusal self-efficacy. Most importantly, older adolescents (aged 16–17 years) exposed to the media program showed a less risky age trajectory of unprotected sex than those in the nonmedia cities. Conclusion: Culturally tailored mass media messages that are delivered consistently over time have the potential to reach a large audience of high-risk adolescents, to support changes in HIV-preventive beliefs, and to reduce HIV-associated risk behaviors among older youth. [Copyright &y& Elsevier]

Abstract: Purpose: To examine the effect of a community-based sexually transmitted infection (STI) screening program on sexual risk behavior among African American adolescents. We hypothesized that adolescents testing positive for an STI and receiving post-test counseling would reduce risky sexual practices, whereas STI-negative adolescents would show little or no change in protective sexual behavior after screening. Methods: From August 2006 to January 2008, we recruited 636 sexually active African American adolescents (age, 14–17) from community-based organizations in two mid-sized U.S. cities with high STI prevalence. Participants were screened for three STIs (gonorrhea, chlamydia, and trichomoniasis) and completed an audio computer-assisted self-interview. Youth who tested positive for an STI (6.6%) received treatment and counseling. Youth testing negative received no further intervention. Approximately 85% of participants completed 3- and 6-month follow-up assessments. Generalized estimating equations determined the effects of STI screening on adolescents'' number of sexual partners and occurrence of unprotected sex. Results: Adolescents who tested positive for an STI reduced their number of vaginal and oral sex partners and the probability of unprotected sex. STI-negative adolescents demonstrated no change for numbers of partners or unprotected sex. Conclusions: Community-based STI screening can help to reduce sexual risk behavior in youth who test positive for STIs. Alternative approaches will be needed to reduce risk behavior in youth who test negative but who are nevertheless at risk for acquiring an STI. [Copyright &y& Elsevier]

Abstract: Purpose: To evaluate the test–retest reliability of self-reported sexuality-related data in a sample of African American adolescents residing in four U.S. cities. Methods: Using audio computer-assisted self-interviewing (ACASI), 156 African American teens (mean age = 15.5 years) provided data on lifetime and recent sexual behavior, HIV/sexually transmitted disease (STD) testing, and theoretical antecedents of sexual risk behavior on two occasions separated by 2 weeks. Results: Most self-reports of lifetime sexual behavior and STD/HIV testing were stable across the two assessment points. Test–retest agreement was substantial for dichotomous indices of lifetime sexual behaviors and STD testing (kappas ranging from .61–.87), and for 3-month recall of vaginal sex (kappa = .72) and number of sexual partners (intraclass correlation coefficient [ICC] = .68). Lower reliability estimates emerged for count data of unprotected vaginal sex occasions (ICC = .44). Test–retest reliability estimates for antecedents of sexual risk behavior were highest for a validated measure of HIV-related knowledge (r = .73), but somewhat lower for peer norms (r = .58) and condom use self-efficacy (r = .50). Conclusions: Although variability in the stability of self-report data was observed, findings confirm that most sexual behavior, STD and HIV testing history, and psychosocial measures can be assessed reliably among adolescents. Research should continue to identify strategies to enhance the reliability of self-report sexual behavior data from youth at risk for HIV and other sexually transmitted infections. [Copyright &y& Elsevier]

Objective: The Centers for Disease Control and Prevention recommends that HIV testing be a standard part of medical care; however, testing is voluntary and some patients decline. We evaluated 2 brief interventions to promote rapid HIV testing among STD clinic patients who initially declined testing. Method: Using a randomized controlled trial, patients either viewed an educational digital video disc (DVD) or participated in stage-based behavioral counseling (SBC) provided by a nurse. Sixty clients presenting for care at a STD clinic who initially declined HIV testing at registration and during risk behavior screening participated in the study. Results: The primary outcome was whether patients agreed to be tested for HIV. The secondary outcomes included attitudes, knowledge, and stage-of-change regarding HIV testing. Patients receiving both interventions improved their attitudes and knowledge about testing (ps < .01). Patients receiving SBC agreed to testing more often (45%) than did patients who viewed the DVD (19%; p < .05). Conclusions: Brief interventions can increase rapid HIV testing acceptance among patients who are reluctant to be tested; counseling guided by behavioral science theory is more effective than a well-designed information-based intervention. [ABSTRACT FROM AUTHOR]

Childhood sexual abuse (CSA) is associated with a wide range of negative outcomes. The authors investigated the relation between CSA and sexual risk behavior in 827 patients recruited from a sexually transmitted disease (STD) clinic. Overall, CSA was reported by 53% of women and 49% of men and was associated with greater sexual risk behavior, including more sexual partners, unprotected sex, and sex trading. Alcohol use for men and drug use for women mediated the relation between CSA and the number of sexual partners in the past 3 months; intimate partner violence mediated the relation between CSA and the number of episodes of unprotected sex in the past 3 months for women. These results document the prevalence of CSA among patients seeking care for an STD and can be used to tailor sexual risk reduction programs for individuals who were sexually abused. [ABSTRACT FROM AUTHOR]

Most patients attending urban STD clinics can benefit from workshops designed to promote sexual health and reduce sexual risk behaviors. However, many patients do not attend such workshops when invited. The purpose of this study was to evaluate the effects of providing a financial incentive on attendance at a sexual risk reduction workshop tailored to patients at an urban STD clinic, A quasi-experimental design with two conditions (incentive vs no incentive) was implemented sequentially with 107 STD clinic patients (58 men, 49 women; 69% African American; mean age = 27 years) reporting risky sexual behavior Attendance at a subsequent sexual risk reduction workshop served as the key outcome. Results indicated that participants who were provided with a $30 cash incentive were more likely to attend the risk reduction workshop (38%) than participants who were not offered an incentive (9%), χ² (1, N = 107T) = 12.88, p < .001, Additional analyses confirmed that incentive (AOR = 7.59, p < .001) predicted attendance even after controlling for other significant predictors, namely, employment status (AOR = 3.04, p < .05) and age (AOR = 1.07, p < .05). We conclude that financial incentives are an effective way to increase attendance at sexual risk reduction workshops for at-risk urban populations. [ABSTRACT FROM AUTHOR]

Alcohol use may increase HIV sexual risk behavior, although findings have varied across study populations and methods. Using event-level data from 1,712 seronegative men who have sex with men, the authors tested the hypothesis that social context would moderate the effect of alcohol consumption on unprotected anal sex (UAS). For encounters involving a primary partner, rates of UAS did not vary as a function of alcohol use. However, consumption of 4 or more drinks tripled the likelihood of UAS for episodes involving a nonprimary partner. Thus, the effects of alcohol vary according to the context in which it is used. Interventions to reduce substance-related risk should be tailored to the demands of maintaining sexual safety with nonprimary partners. [ABSTRACT FROM AUTHOR]

This study investigated the efficacy of a 10-session, HIV-risk-reduction intervention with 221 women and 187 men receiving outpatient psychiatric care for a mental illness. Patients were randomly assigned to the HIV intervention, a structurally equivalent substance use reduction (SUR) intervention, or standard care; they were assessed pre- and postintervention and at 3- and 6-month follow-ups. Patients receiving the HIV-risk-reduction intervention reported less unprotected sex, fewer casual sex partners, fewer new sexually transmitted infections, more safer sex communications, improved HIV knowledge, more positive condom attitudes, stronger condom use intentions, and improved behavioral skills relative to patients in the SUR and control conditions. Patients receiving the SUR intervention reported fewer total and casual sex partners compared with control patients. Exploratory analyses suggested that female patients and patients diagnosed with a major depressive disorder were more likely to benefit from the HIV-risk-reduction intervention. [ABSTRACT FROM AUTHOR]

To understand the elevated smoking rates among psychiatric patients, the authors investigated whether psychiatric diagnosis, illness severity, and other substance use predicted smoking status in a diverse sample (N=2774) of psychiatric outpatients. Results indicated that 61% smoked daily and that 18% smoked heavily. Smoking was related to psychiatric diagnosis and illness severity as well as caffeine consumption and substance abuse. Diagnoses of bipolar disorder, schizoaffective disorder, and schizophrenia were independently related to smoking status, an association that was most pronounced among persons treated at clinics serving more impaired patients. Thus, diagnosis and illness severity contribute to elevated smoking rates, even after controlling for other substance use. Cessation programs are needed to reduce tobacco use in this vulnerable population. [ABSTRACT FROM AUTHOR]

Examines the factors associated with study participation and attrition among psychiatric outpatients recruited for initial phase of health promotion trial. Psychiatric and demographic characteristics of potential participants; Risk for drug problems; Link of study completion with old age and psychiatric diagnosis.

Studies the prevalence and correlates of sexual activity and HIV-risk behavior among adults with mental disorder. Use of demographic, psychiatric, sexual behavior and substance-use data; Risk markers.