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1.
AIDS Behav ; 26(12): 4126-4134, 2022 Dec.
Article in English | MEDLINE | ID: mdl-35708831

ABSTRACT

This study evaluated the association between impulsivity and linkage to HIV care among Russians living with HIV recruited from an inpatient narcology hospital. Linking Infectious and Narcology Care (LINC) study participants who completed the Barratt Impulsiveness Scale (BIS) were included in these analyses. The primary independent variable was impulsivity score which was categorized as high impulsivity (BIS score > 71) vs. low impulsivity (BIS score < = 71). The primary outcome, linkage to care post recruitment, was defined as one or more HIV medical care visits at 12-month follow-up. Multiple logistic regression models were used to evaluate the association between high impulsivity and linkage to HIV care controlling for potential confounders. Participants (N = 227) were adults with a mean age of 34 years (SD = 5), and the majority were male (74%). We did not detect a significant association between impulsivity and linkage to HIV care after adjusting for respondents' age, gender, CD4 cell count, and depression score. We also found that substance use and hazardous drinking did not appear to confound the relationship. Although our study was unable to detect an association between impulsivity and linkage to HIV care, it may provide direction for future research exploring the associations between impulsivity and HIV care.


Subject(s)
HIV Infections , Substance Abuse, Intravenous , Substance-Related Disorders , Adult , Male , Humans , Female , Substance Abuse, Intravenous/diagnosis , HIV Infections/epidemiology , HIV Infections/therapy , HIV Infections/diagnosis , CD4 Lymphocyte Count , Impulsive Behavior , Substance-Related Disorders/complications , Substance-Related Disorders/epidemiology , Substance-Related Disorders/therapy , Russia/epidemiology
2.
AIDS Behav ; 26(2): 496-511, 2022 Feb.
Article in English | MEDLINE | ID: mdl-34350531

ABSTRACT

People living with HIV (PLWH) experience higher rates of comorbid chronic pain conditions compared to the general population. Managing HIV and chronic pain, two stigmatized health conditions, can exacerbate physical and psychological suffering. The current qualitative study was designed to increase our understanding of the experience of living with HIV and chronic pain. Twenty participants were recruited from a hospital-based immunology center to participate in individual in-depth qualitative interviews. The interviews focused on the experience of living with (or managing) chronic pain for PLWH. All interviews were audio recorded, transcribed and double-coded. Several themes emerged from our applied thematic analysis of the transcripts. The primary theme was that pain remained poorly managed among PLWH. Patients engaged in a variety of pain management strategies and described benefits from both traditional pain management interventions (e.g., pharmacology, physical therapy) as well as non-traditional approaches (e.g., medical marijuana, cannabidiol products, and spirituality). Other themes that emerged included barriers related to health insurance and the need to validate the patient pain experience. PLWH and chronic pain described compounding effects of managing two chronic health conditions, including perceived immune system over-activation, heightened awareness of illness, and negative mindset. More research is needed to improve care for those managing these often co-occurring health conditions.


Subject(s)
Chronic Pain , HIV Infections , Chronic Pain/therapy , HIV Infections/complications , HIV Infections/drug therapy , Health Personnel , Humans , Pain Management , Qualitative Research
3.
Psychol Serv ; 18(3): 295-309, 2021 Aug.
Article in English | MEDLINE | ID: mdl-32134305

ABSTRACT

The objective of this study was to examine the efficacy of complementary and integrative health (CIH) approaches for reducing pain intensity (primary outcome) and depressive symptoms (secondary outcome) as well as improving physical functioning (secondary outcome) among U.S. military personnel living with chronic pain. Studies were retrieved from bibliographic databases, databases of funded research, and reference sections of relevant articles. Studies that (a) evaluated a CIH approach to promote chronic pain management among military personnel, (b) used a randomized controlled trial design, and (c) assessed pain intensity were included. Two coders extracted data from each study and calculated effect sizes. Discrepancies between coders were resolved through discussion. Comprehensive searches identified 12 studies (k = 15 interventions) that met inclusion criteria. CIH practices included cognitive-behavioral therapies (k = 5), positive psychology (k = 3), yoga (k = 2), acupuncture (k = 2), mindfulness-based interventions (k = 2), and biofeedback (k = 1). Across these studies, participants who received the intervention reported greater reductions in pain intensity (d+ = 0.44, 95% CI [0.21, 0.67], k = 15) compared to controls. Statistically significant improvements were also observed for physical functioning (d+ = 0.36, 95% CI [0.11, 0.61], k = 11) but not for depressive symptoms (d+ = 0.21, 95% CI [-0.15, 0.57], k = 8). CIH approaches reduced pain intensity and improved physical functioning. These approaches offer a nonpharmacological, nonsurgical intervention for chronic pain management for military personnel. Future studies should optimize interventions to improve depressive symptoms in military populations experiencing chronic pain. (PsycInfo Database Record (c) 2021 APA, all rights reserved).


Subject(s)
Chronic Pain , Cognitive Behavioral Therapy , Military Personnel , Mindfulness , Yoga , Chronic Pain/therapy , Humans , Randomized Controlled Trials as Topic
4.
AIDS Care ; 33(5): 623-632, 2021 05.
Article in English | MEDLINE | ID: mdl-32835502

ABSTRACT

This study examined the association between symptoms of generalized anxiety disorder (GAD) and substance use among 932 people living with HIV (PLWH) in Florida. PLWH completed a 45-minute questionnaire assessing demographics, symptoms of GAD and depression, and use of substances including alcohol, cigarettes, marijuana, crack/cocaine, and injection drugs. The GAD-7 measured symptoms of anxiety and participants were categorized as experiencing none/mild anxiety (score 0-9) or moderate/severe symptoms (score ≥10). Adjusted binary logistic regressions assessed the association between moderate-severe GAD symptoms and substance use while controlling for covariates, including depressive symptoms. Approximately one-third (31.4%) of the sample reported experiencing moderate/severe symptoms of GAD. After controlling for covariates, PLWH with moderate/severe symptoms of GAD had greater odds of reporting current cigarette use (AOR = 1.70, 95% CI = 1.18-2.45 p = 0.004), past 30-day hazardous alcohol consumption (AOR = 1.50, 95% CI = 1.04-2.16, p = 0.028), and past 12-month non-injection crack/cocaine use (AOR = 1.75, 95% CI = 1.13-2.69, p = 0.011) compared to PLWH reporting none/mild symptoms. Findings demonstrate that moderate/severe GAD symptoms were common among this sample of PLWH in Florida and were associated with use of cigarettes, crack/cocaine, and hazardous alcohol consumption. Future studies should explore interventions to reduce comorbid anxiety and substance use.


Subject(s)
HIV Infections , Substance-Related Disorders , Adult , Anxiety Disorders/epidemiology , Florida/epidemiology , HIV Infections/epidemiology , Humans , Risk Factors , Substance-Related Disorders/epidemiology
5.
AIDS Care ; 33(9): 1155-1158, 2021 09.
Article in English | MEDLINE | ID: mdl-33138622

ABSTRACT

People living with HIV (PLWH) often experience mental health concerns as well as difficulties with medication adherence; they also report barriers to receipt of health services. Telephone-delivered interventions can overcome some of these barriers. To obtain patients' perspectives on telephone-delivered behavioral health services, we conducted a qualitative study with patients who participated in one of two telephone-delivered interventions (mindfulness training, health coaching) in a research trial. Patients (N = 42; M age = 46 years, 50% female, 26% Black) participated in semi-structured qualitative interviews after completing the study. They identified several advantages (e.g., being able to schedule sessions more flexibly compared to in-person appointments, ease of developing rapport with interventionists) as well as occasional challenges of phone delivery (e.g., network connectivity). Overall, PLWH view telephone-delivery as a convenient and flexible method to engage in behavioral health interventions.


Subject(s)
HIV Infections , Mindfulness , Female , HIV Infections/therapy , Humans , Male , Medication Adherence , Middle Aged , Qualitative Research , Telephone
6.
Drug Alcohol Depend ; 215: 108251, 2020 10 01.
Article in English | MEDLINE | ID: mdl-32916451

ABSTRACT

BACKGROUND: Many retired National Football League (NFL) athletes manage pain with opioids during their playing careers and in retirement, though the longitudinal association between opioid use and health outcomes pertinent to an NFL career are not yet known. This study aimed to assess the relationship between opioid use in 2010 and current use, depressive symptoms, and health related quality of life (HRQoL) among NFL retirees. METHODS: Former NFL athletes from the Retired NFL Players Association initially recruited in 2010 for a study examining risk factors of opioid use and misuse were re-contacted (N = 89) from 2018 to 2019 and administered measures of pain, opioid use, depressive symptoms, and HRQoL. Binomial regression examined the association between 2010 opioid use with current use, moderate-severe depressive symptoms, and average and above HRQoL (physical and mental) while controlling for covariates. RESULTS: Nearly 50 % of retirees using opioids in 2010 currently used. Compared to non-users, retirees who used opioids in 2010 had greater odds of current use (AOR: 3.71, 95 % CI: 1.02-13.56, p = 0.046) and experiencing moderate-severe depressive symptoms (AOR: 5.93, 95 % CI: 1.15-30.54, p = 0.033). Retirees reporting use in 2010 also evidenced lower odds of reporting average or above mental HRQoL (AOR: 0.13, 95 % CI: 0.03-0.67, p = 0.015) compared to non-users. CONCLUSIONS: This study showed that among NFL retirees, early retirement opioid use predicted current use and deleterious effects on mental health, including moderate-severe depressive symptoms approximately nine years later. This investigation further supports the importance of early intervention of pain and opioid use among this population.


Subject(s)
Athletes/psychology , Football/psychology , Mental Health , Opioid-Related Disorders/epidemiology , Adult , Analgesics, Opioid , Follow-Up Studies , Football/statistics & numerical data , Humans , Male , Pain/epidemiology , Quality of Life , Retirement , Risk Factors
7.
Community Ment Health J ; 56(2): 328-332, 2020 02.
Article in English | MEDLINE | ID: mdl-31520255

ABSTRACT

Tobacco use is rarely addressed in community mental healthcare despite high patient smoking prevalence. Community mental health centers have systems in place that could be used to comprehensively address tobacco use. This study tested feasibility of, satisfaction with, and safety of proactive tobacco treatment (tobacco outreach to offer connection to tobacco cessation treatment). Behavioral health home patients who smoke were randomly assigned to usual care (UC; N = 11) or proactive care (PC; N = 9). All participants were called 3-months post-randomization for follow-up. PC patients reported high satisfaction with the program and experienced no adverse events or mental health symptom exacerbation during treatment. PC patients reported greater reductions in cigarettes per day, more quit attempts, and more cessation medication utilization than UC patients. Proactive outreach for tobacco cessation is feasible in a behavioral health home, acceptable to patients, and may reduce smoking heaviness and promote quit attempts.


Subject(s)
Smoking Cessation , Tobacco Products , Humans , Smoking/epidemiology , Nicotiana , Tobacco Use
8.
Clin J Sport Med ; 30(6): 544-549, 2020 11.
Article in English | MEDLINE | ID: mdl-29933284

ABSTRACT

OBJECTIVE: Prescription opioid misuse has become a significant public health issue. Previous research has examined predictors of prescription opioid use and misuse among former National Football League (NFL) players. The present study aimed to describe how reasons for prescription opioid use while in the NFL corresponds to use and misuse in retirement. DESIGN: Former NFL players reporting prescription opioid use during their playing careers (N = 336) were included in this secondary data analysis. Participants reported reasons for prescription opioid use, including pain management, use "to function," to improve mood, to reduce stress, and to aid sleep. RESULTS: Among retired NFL players with exposure to prescribed pain medication during their playing career, 26.2% reported recent use of prescription opioids (past 30 days) and 73.8% reported no use. Specifically, 14.3% of retired players reported opioid use only as prescribed, whereas 11.9% reported misuse (not prescribed or use other than as prescribed). Using prescription opioids to function while in the NFL was associated with any opioid use in the past 30 days [odds ratios (OR) = 1.30, 95% CI: 1.12-1.50, P < 0.001]. Further, opioid use in the NFL to reduce stress and anxiety was associated with increased odds of past 30-day misuse of prescription opioids (OR = 1.45, 95% CI: 1.01-2.11; P = 0.048). CONCLUSIONS: The present study adds to the literature on elite athletes at high risk for pain and prescription opioid use and misuse. The findings may help to identify and provide early intervention for professional athletes most at risk for misuse of prescription opioids.


Subject(s)
Analgesics, Opioid/administration & dosage , Athletes/statistics & numerical data , Football/statistics & numerical data , Opioid-Related Disorders/epidemiology , Retirement/statistics & numerical data , Affect/drug effects , Anxiety/drug therapy , Athletes/psychology , Confidence Intervals , Humans , Logistic Models , Male , Middle Aged , Occupational Stress/drug therapy , Odds Ratio , Opioid-Related Disorders/etiology , Pain Management/methods , Risk Factors , Sleep Aids, Pharmaceutical/administration & dosage
9.
AIDS Behav ; 24(6): 1912-1928, 2020 Jun.
Article in English | MEDLINE | ID: mdl-31848765

ABSTRACT

This study explored whether telephone-delivered mindfulness training (MT) to promote medication adherence and reduce sexual risk behavior was feasible for and acceptable to people living with HIV. Participants (N = 42; 50% female; M age = 47.5 years) were randomized to MT or health coaching (HC). Pre- and post-intervention, and at 3-month follow-up, we assessed adherence to ART, sexual risk behavior, and hypothesized mediators; we also conducted individual interviews to obtain qualitative data. Results showed that 55% of patients assigned to MT completed ≥ 50% of the training calls compared with 86% of HC patients (p < .05). Most patients reported satisfaction with their intervention (MT = 88%, HC = 87%). Patients in MT and HC reported improvements in medication adherence, mindfulness, and sexual risk reduction as well as reductions in anxiety, depressive symptoms, perceived stress, and impulsivity over time; however, no between-groups differences were observed.


Subject(s)
HIV Infections , Mindfulness , Risk Reduction Behavior , Telephone , Female , HIV Infections/drug therapy , HIV Infections/prevention & control , Humans , Male , Medication Adherence , Middle Aged , Risk-Taking , Unsafe Sex
10.
Complement Ther Clin Pract ; 34: 157-164, 2019 Feb.
Article in English | MEDLINE | ID: mdl-30712721

ABSTRACT

BACKGROUND: People living with HIV/AIDS (PLWHA) often experience psychological stress associated with disease management. This meta-analysis examines the benefits of yoga interventions on psychological distress among PLWHA. METHODS: Included were studies that (a) evaluated a yoga intervention in PLWHA; (b) provided between-group or within-group changes; and (c) assessed a psychological, physiological, or biomedical outcome. RESULTS: Seven studies sampling 396 PLWHA (M age = 42 years, SD = 5 years; 40% women) met inclusion criteria. PLWHA who received yoga interventions reported significant improvements in perceived stress (d+ = 0.80, 95% Confidence Interval [CI] = 0.53, 1.07), positive affect (d + = 0.73, 95% CI = 0.49, 0.98), and anxiety (d+ = 0.71, 95% CI = 0.27, 1.14) compared to controls. CONCLUSION: Yoga is a promising intervention for stress management. However, the literature is limited by the small number of studies. Randomized controlled trials with objective measures of HIV-related outcomes are needed to further evaluate the benefits of yoga.


Subject(s)
HIV Infections , Yoga , Adult , Female , HIV Infections/psychology , HIV Infections/therapy , Humans , Male , Middle Aged
11.
J Child Adolesc Subst Abuse ; 28(2): 113-118, 2019.
Article in English | MEDLINE | ID: mdl-32952380

ABSTRACT

OBJECTIVE: African-American adolescents experience higher rates of sexually transmitted infections (STIs) compared to same-age Caucasian peers. Substance use, sensation seeking, and depression have all been linked to risky sexual practices. Theory suggests that problem-solving skills may help to buffer against these risk factors. METHOD: To test this hypothesis, we used data from African-American adolescents (N = 1018; M age = 16.7, SD = 1.1; 58% female) who participated in a prevention trial. RESULTS: Nearly half of the sample (47%) reported lifetime marijuana use, while 13% reported drug use prior to most recent sexual encounter. Sexual sensation seeking was directly associated with drug use prior to sex (ß = 1.13, b = 0.13,SE = 0.02, p < .001) and lower problem-solving skills (ß = -0.08, b = -0.06,SE = 0.02, p = .01). Problem-solving skills were associated with drug use prior to sex (ß = 0.92, b = -0.08, SE = 0.03, p = .004), such that those with greater problem-solving skills were less likely to report drug use prior to most recent sex. Lastly, problem solving skills mediated the association between sexual sensation seeking and drug use prior to sex, though the effect was small (ß = 0.01, 95% CI: .001, .01). CONCLUSIONS: Problem-solving skills can have a protective influence on risky behavior for adolescents. Future research might examine the utility of strengthening problem-solving skills in order to reduce STI/HIV risk among African American adolescents.

12.
AIDS Behav ; 23(5): 1297-1305, 2019 May.
Article in English | MEDLINE | ID: mdl-30264205

ABSTRACT

Despite advances in HIV antiretroviral medications, some patients do not achieve adequate medication adherence or suppressed viral load. The aim of this study was to identify the relationship between factors of impulsivity and medication non-adherence. It was hypothesized that impulsivity would have a direct association with non-adherence, after accounting for other known correlates. Participants included 322 HIV positive individuals (M age = 49, 56% male, 64% Black/African American). Impulsivity was measured using the Barratt Impulsiveness Scale-Brief (BIS-Brief). Factor analysis was conducted to determine if BIS-Brief resulted in a unidimensional or multi-factor solution. Results were suggestive of a two-factor solution: behavioral impulsivity and non-planning impulsivity. Structural equation modeling found non-planning impulsivity was associated with non-adherence (ß = 0.18, p = 0.016), while no significant association was observed for behavioral impulsiveness. Results suggest that strategies related to planning for future consequences may be beneficial for impulsive persons with medication adherence difficulties.


Subject(s)
HIV Infections/drug therapy , Impulsive Behavior , Medication Adherence/psychology , Medication Adherence/statistics & numerical data , Mood Disorders/epidemiology , Substance-Related Disorders/epidemiology , Adult , Aged , Female , HIV Infections/psychology , Humans , Longitudinal Studies , Male , Middle Aged
13.
Psychol Health Med ; 23(3): 360-368, 2018 03.
Article in English | MEDLINE | ID: mdl-28778126

ABSTRACT

Life satisfaction is linked to premature morbidity and mortality and it may be compromised for individuals living in economically-disadvantaged, urban neighborhoods. The present study explores how behavioral and social-environmental health factors are associated with life satisfaction among a sample of African American young adults. Participants (N = 307, Mage = 26.6 years, 53% male) were recruited from a publicly-funded clinic for a randomized controlled trial (RCT). Data from the baseline assessment of the RCT, which included measures of sleep, depression, anxiety, social support, alcohol and drug use problems, city stress, and life satisfaction, were used for the current study. Correlation analyses assessed bivariate associations between life satisfaction and the demographic and health-related factors. Linear regression using backward elimination determined the best fitting model of factors associated with life satisfaction. Backward elimination resulted in the following variables remaining as significantly associated with life satisfaction: age (b = -2.40, p = .017), anxiety (b = -5.32, p < .001), and social support (b = 2.89, p = .004). Feeling rested upon waking also remained in the best fitting model, although this association did not achieve statistical significance (p = .099). The results suggest that African American adults who are younger, less anxious, and report adequate social support are more likely to report satisfaction with life. These findings add to the literature aimed at examining health and social factors impacting the well-being of African Americans living in low-income, urban communities.


Subject(s)
Black or African American/psychology , Personal Satisfaction , Quality of Life/psychology , Reproductive Health Services , Urban Population , Adolescent , Adult , Anxiety Disorders/psychology , Depressive Disorder/psychology , Health Behavior , Humans , Male , Social Support , Substance-Related Disorders/psychology , Young Adult
14.
J Assoc Nurses AIDS Care ; 28(2): 279-288, 2017.
Article in English | MEDLINE | ID: mdl-28003102

ABSTRACT

We examined the influence of age on associations between affective states, social support, and alcohol use by age cohorts. We recruited 96 older Black adults living with HIV from the southeastern United States in 2013 and 2014. Participants completed questionnaires assessing demographics, psychological function, and substance use. Hierarchical regression analyses assessed the relationship between psychosocial factors and alcohol use in a 50- to 59-year-old group, and a 60-years-and-older age group. After controlling for covariates, trait anger, state anger, and life stress were positively associated with alcohol consumption in the younger group, while social support was negatively associated with alcohol consumption in the older group. Interventions should target negative affective states in 50- to 59-year-old adults with HIV, and preserve social support for adults with HIV as they age, as such interventions will likely have an impact on these individuals' alcohol consumption and longstanding quality of life.


Subject(s)
Alcohol Drinking/psychology , Black People/psychology , HIV Infections/psychology , Quality of Life/psychology , Social Support , Stress, Psychological/psychology , Adaptation, Psychological , Black or African American/psychology , Age Factors , Aged , Aged, 80 and over , Alcohol Drinking/epidemiology , Anger , Cohort Studies , Cross-Sectional Studies , Depression/psychology , Female , Florida/epidemiology , HIV Infections/epidemiology , Humans , Loneliness , Male , Middle Aged , Psychiatric Status Rating Scales , Regression Analysis , Socioeconomic Factors , Stress, Psychological/epidemiology
15.
AIDS Care ; 28(5): 598-602, 2016.
Article in English | MEDLINE | ID: mdl-26654243

ABSTRACT

Estimates suggest 30% of adults report the highest levels of loneliness. Though men are more likely than women to use illicit substances and engage in heavy drinking, the prevalence of substance use in women is growing and their escalation toward dependence occurs more rapidly. Loneliness and substance use have greater relevance within the HIV+ population, with higher rates of substance misuse than the general population. However, the association between loneliness and substance use within HIV+ individuals remains understudied. The purpose of the present study was to test the hypothesis that there would be an association between loneliness and substance moderated by gender in HIV+ older adults. A cross-sectional study was conducted between October 2013 and January 2014. Study participants included 96 HIV-positive Black/African American men and women recruited through the University of Florida Center for HIV/AIDS Research, Education and Service (UF CARES) in Jacksonville, Florida. Participants completed an interviewer-administered assessment examining mental and behavioral health. Pearson correlations examined associations between loneliness and substance use. Binary logistic regression analyses stratified by gender examined the association between loneliness and substance use while controlling for covariates. Among women, loneliness was associated with illicit drug use, AOR = 3.37, 95% CI: 1.23-9.21, p = .018 and heavy drinking, AOR = 2.47, 95% CI: 1.07-5.71, p = .033. No significant associations were found between loneliness and illicit drug use, and heavy drinking in men. Substance use among women in this population may be linked to loneliness. Interventions should be gender specific. Further research into this association is necessary as it will likely have important clinical implications for this population.


Subject(s)
Alcohol Drinking/epidemiology , Black or African American/psychology , HIV Infections/ethnology , Loneliness/psychology , Substance-Related Disorders/epidemiology , Black or African American/statistics & numerical data , Age Factors , Aged , Aged, 80 and over , Cross-Sectional Studies , Female , Florida/epidemiology , HIV Infections/complications , HIV Infections/psychology , Humans , Male , Middle Aged , Prevalence , Sex Factors , Social Isolation , Social Stigma , Substance-Related Disorders/psychology , Surveys and Questionnaires
16.
Subst Use Misuse ; 50(12): 1501-9, 2015.
Article in English | MEDLINE | ID: mdl-26583203

ABSTRACT

BACKGROUND: Recent studies have reported high rates of Trichomonas vaginalis among middle age and older adults. Though trichomoniasis risk factors in this age cohort remain largely unknown, illicit drug use has been associated with increased incidence of sexually transmitted infections (STIs). The number of mid-older adults using illicit drugs has increased significantly in recent years suggesting the need to understand the relationship between drug use and STIs in this age cohort. OBJECTIVES: This study examined the relationship between drug use, sexual-risk behaviors, and biologically confirmed T. vaginalis in a sample of mid-older and younger adults who reported recent drug use. METHODS: The cross-sectional design examined the relationship between past 6-month drug use, sexual risk-behaviors, and PCR-confirmed T. vaginalis in 264 adults age 18-64 who were recruited from Baltimore, Maryland. These relationships were also explored in the age-stratified sample among those 18-44 years ("younger") and individuals 45+ years ("mid-older"). RESULTS: Trichomoniasis prevalence did not differ significantly between younger (18.8%) and mid-older (19.1%) adults. Mid-older adults that tested positive for T. vaginalis were more likely to have used marijuana and crack in the past 6 months. Among younger adults, there were no associations between trichomoniasis and past 6-month drug use and sexual-risk behavior. CONCLUSIONS/IMPORTANCE: Age- and drug-related immune decline is hypothesized to contribute to increase susceptibility to T. vaginalis in mid-older adults. Broad screening for trichomoniasis, particularly among older adults who are often not regarded as at risk for STIs, is needed to control this often asymptomatic infection.


Subject(s)
Sexual Behavior/statistics & numerical data , Sexually Transmitted Diseases/epidemiology , Substance-Related Disorders/epidemiology , Trichomonas Infections/epidemiology , Trichomonas vaginalis , Adolescent , Adult , Age Factors , Alcoholism/epidemiology , Baltimore/epidemiology , Cocaine-Related Disorders/epidemiology , Condoms/statistics & numerical data , Crack Cocaine , Cross-Sectional Studies , Female , Heroin Dependence/epidemiology , Humans , Incidence , Male , Marijuana Abuse/epidemiology , Middle Aged , Prevalence , Substance Abuse, Intravenous/epidemiology , Young Adult
17.
Am J Addict ; 24(7): 676-80, 2015 Oct.
Article in English | MEDLINE | ID: mdl-26359444

ABSTRACT

BACKGROUND AND OBJECTIVES: The first aim of this study was to compare self-reported causes of homelessness between veterans and nonveterans. A second aim examined whether homeless male veterans were more likely than homeless male nonveterans to experience current problems with addictions, mental health, and physical health. Additionally, a third aim was to compare frequency of emergency room visits and treatment needs between the two groups. METHODS: Secondary data analyses compared male homeless veterans and nonveterans (N = 353) enrolled in the Alachua County Point in Time study in central Florida. Participants completed a questionnaire on demographics and health variables. Additional questions included recent emergency room visits and medical or other needs not being met. RESULTS: Veterans reported higher rates of substance use and mental health problems as a primary cause of homelessness when compared to nonveterans. Homeless veterans were more likely than nonveterans to report current problems with addictions (OR = 6.29, 95% CI: 3.43-11.53, p < .001), mental health problems (OR = 4.12, 95% CI: 2.28-7.42, p < .001), and physical problems (OR = 1.83, 95% CI: 1.08-3.67, p < .01). Finally, over half of homeless veterans (53.1%) reported an ER visit in the past year compared to only 40.9% of nonveterans (OR = 1.73, 95% CI: 1.07-2.80, p < .05). CONCLUSION AND SCIENTIFIC SIGNIFICANCE: Veterans may be more likely to become homeless due to addiction and mental health and over half of homeless veterans are presenting to hospital emergency rooms. Given the greater utilization among homeless veterans, emergency rooms may serve as a prime opportunity to provide brief treatment and referrals for needed services.


Subject(s)
Emergency Service, Hospital/statistics & numerical data , Health Status , Ill-Housed Persons/psychology , Ill-Housed Persons/statistics & numerical data , Mental Disorders/epidemiology , Substance-Related Disorders/epidemiology , Veterans/psychology , Veterans/statistics & numerical data , Adult , Cross-Sectional Studies , Florida/epidemiology , Humans , Male , Risk Factors , Surveys and Questionnaires
18.
Alcohol Alcohol ; 50(4): 393-8, 2015 Jul.
Article in English | MEDLINE | ID: mdl-25820611

ABSTRACT

AIMS: Research has shown that alcohol outcome expectancies are predictive of heavy alcohol consumption, which can lead to risky behavior. The purpose of the present study was to assess the incidence of various low-risk social behaviors while drinking among college students. Such social behaviors may later be regretted (referred to as regrettable social behaviors) and include electronic and in-person communications. METHODS: College students (N = 236) completed measures of alcohol outcome expectancies and regrettable social behaviors. RESULTS: Regrettable social behaviors were reported by 66.1% of participants, suggesting that they may occur at a much higher rate than more serious drinking-related consequences (e.g., drinking and driving, violence, etc.). Expectancies for social facilitation predicted regrettable social behavior. Further, this relationship was mediated by amount of alcohol consumed. CONCLUSION: Given the high incidence, regrettable social behaviors may be effective targets in alcohol prevention programming.


Subject(s)
Alcohol Drinking/psychology , Attitude , Emotions , Social Behavior , Students/psychology , Universities , Adolescent , Female , Humans , Male , Social Facilitation , Young Adult
19.
Addict Behav ; 39(12): 1755-8, 2014 Dec.
Article in English | MEDLINE | ID: mdl-25123341

ABSTRACT

The primary aims of the present study were to assess ADHD history as a risk factor for earlier initiation and current use of licit and illicit substances among a sample of drug using adults. It was hypothesized that ADHD history would accelerate the Gateway Theory of drug use. Participants included 941 drug-using African American and Caucasian individuals in Baltimore, Maryland. The sample consisted of 124 (13.2%) participants who reported a history of ADHD and 817 (86.8%) who reported no history of ADHD. The accelerated gateway hypothesis was supported, as a history of self-reported ADHD was significantly associated with younger ages of initiation for alcohol, cigarettes, marijuana, and cocaine use. Participants with a history of ADHD were also more likely to engage in recent HIV-risk behavior, such as injection drug use and needle sharing. This study provides compelling data in support of an accelerated gateway model for substance use related to ADHD history and increased problem severity in adulthood. Targeted substance use prevention and intervention may be beneficial for those with ADHD.


Subject(s)
Attention Deficit Disorder with Hyperactivity/epidemiology , HIV Infections/epidemiology , Substance-Related Disorders/epidemiology , Adolescent , Adult , Age Factors , Aged , Attention Deficit Disorder with Hyperactivity/psychology , Baltimore/epidemiology , Comorbidity , Female , HIV Infections/psychology , Humans , Male , Middle Aged , Risk Factors , Risk-Taking , Severity of Illness Index , Substance-Related Disorders/psychology , Young Adult
20.
AIDS Behav ; 18(7): 1288-92, 2014 Jul.
Article in English | MEDLINE | ID: mdl-24496649

ABSTRACT

Trading sex for money, drugs, goods, services, or a place to stay is prevalent among women who use drugs and has been associated with women's risk of HIV acquisition. There is evidence that trading sex for drugs only may be associated with elevated risk of HIV compared with trading sex for money. The purpose of this study was to assess whether HIV risk behaviors and HIV prevalence differ among African American drug using women (N = 92) who traded sex for drugs only, traded sex for economic resources (defined as money, shelter, or other resources) only, or traded sex for both economic resources and drugs. In this study, lower rates of condom use and higher rates of HIV were found among women who traded sex for drugs only compared to women who traded sex for economic resources or for economic resources and drugs. These findings suggest that African American women who trade sex for drugs only represent an understudied yet highly vulnerable group.


Subject(s)
HIV Seropositivity , Public Health , Sex Work , Sexual Behavior/statistics & numerical data , Substance Abuse, Intravenous/epidemiology , Adult , Female , HIV Seropositivity/epidemiology , HIV Seropositivity/psychology , Health Knowledge, Attitudes, Practice , Healthcare Disparities , Humans , Prevalence , Risk-Taking , Sex Work/ethnology , Sex Work/psychology , Sex Work/statistics & numerical data , Sexual Behavior/psychology , Sexual Partners , Substance Abuse, Intravenous/psychology , United States/epidemiology , Vulnerable Populations
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