The Role of Parenting in Alcohol and Tobacco Use Among Latino Adolescents.

Parents can impact adolescent substance use, but it is unclear which substances are most affected. This study compared associations between parenting behaviors and alcohol and tobacco use to see if parenting was equally related to both behaviors. Alcohol and tobacco use data were collected from 252 Latino adolescents living along the San Diego-Tijuana border. Logistic regression was used to test parenting behaviors' impact. Parenting was protective against alcohol use, but not related to tobacco use. Substance using peers affected both alcohol and tobacco use. Alcohol prevention efforts among Latino adolescents should target parenting behaviors.

A two-way road: rates of HIV infection and behavioral risk factors among deported Mexican labor migrants.

A large number of Mexican migrants are deported to Mexico and released in the North Mexican border region every year. Despite their volume and high vulnerability, little is known about the level of HIV infection and related risk behaviors among this hard-to-reach population. We conducted a cross-sectional, probability survey with deported Mexican migrants in Tijuana, Mexico (N = 693) and estimated levels of HIV infection and behavioral risk factors among this migrant flow. The sample and population estimated rates of HIV for deported males were 1.23 and 0.80 %, respectively. No positive cases were found among the female sample. We found high lifetime rates of reported sexually transmitted infections (22.3 %) and last 12-months rates of unprotected sex (63.0 %), sex with multiple sexual partners (18.1 %), casual partners (25.7 %), and sex workers (8.6 %), compared to U.S. and Mexico adults. HIV prevention, testing, and treatment programs for this large, vulnerable, and transnational population need to be implemented in both the U.S. and Mexico.

Latino parenting practices: a comparison of parent and child reports of parenting practices and the association with gateway drug use.

Parent and adolescent self-reports are the most common sources for measuring parenting practices. This study's purpose was to compare how parent and adolescent reports of parenting behaviors differentially predict adolescent gateway drug use. The sample consisted of 252 Latino adolescent-parent dyads. After controlling for potential confounding influences, only adolescents' reports about their parents' parenting behaviors were significant and explained 38% of the variance in gateway drug use. Practitioners may recommend to parents seeking parenting advice that they solicit feedback from their adolescent to ensure parenting efforts are received in the manner they were intended.

Engaging local businesses in HIV prevention efforts: the consumer perspective.

Participation of different community sectors, including the private business sector, is necessary to fight the HIV/AIDS epidemic. Local businesses may be reluctant to participate in HIV prevention because of fear of negative customer reactions and loss of revenue. This study examines the extent to which residents of two communities in San Diego, California, would support HIV prevention initiatives in local businesses. A population-based household survey (N = 200) is conducted in two communities with higher versus lower risk for HIV. The survey includes questions regarding the acceptability of HIV prevention activities, such as condom and brochure distribution in businesses, and history of exposure to HIV prevention activities in local businesses. Most residents agree that (a) business involvement in prevention activities would reduce HIV (92%), (b) free or low-cost condoms available in businesses could prevent the spread of HIV (90.9%) and increase condom accessibility (87%), and (c) they would prefer to shop at businesses that supported HIV prevention versus those that did not (87.4%). These findings suggest that HIV prevention in local businesses would be supported by residents and would be unlikely to adversely affect business profits. This information could be used to design interventions to engage local businesses in HIV-prevention efforts.

The reliability and practicality of the Arkansas method assay of isoniazid adherence.

The Arkansas method (AM) for isoniazid (INH) metabolite detection is a relatively inexpensive, simple, objective measure of adherence. The purpose of the study was to explore whether variations in urine sample handling and storage will produce accurate assay outcomes. Participants were a convenience sample of 28 adults and adolescents prescribed INH for latent tuberculosis infection. Participants provided one sample to test effects of the following: mixing processes; durations at room temperature, in a refrigerator, or frozen; and effects of freeze/thaw cycles on AM outcomes. No manipulations had a discernible impact on outcomes with concordant positive rates from 85% to 100%. Concordance rates of manipulated samples did not appear to differ from rates of norm samples. Results suggest that urine samples can withstand a variety of manipulations in both handling and storage without affecting the accuracy of AM assay results. These findings have important implications for providers of treatment and researchers and provide the impetus for both to examine the potential of using the AM of INH metabolite testing as a measure of medication adherence.

Determinants and prevalence of late HIV testing in Tijuana, Mexico.

Timely diagnosis of HIV is essential to improve survival rates and reduce transmission of the virus. Insufficient progress has been made in effecting earlier HIV diagnoses. The Mexican border city of Tijuana has one of the highest AIDS incidence and mortality rates in all of Mexico. This study examined the prevalence and potential correlates of late HIV testing in Tijuana, Mexico. Late testers were defined as participants who had at least one of: (1) an AIDS-defining illness within 1 year of first positive HIV test; (2) a date of AIDS diagnosis within 1 year of first positive HIV test; or (3) an initial CD4 cell count below 200 cells per microliter within 1 year of first positive HIV test. Medical charts of 670 HIV-positive patients from two HIV/AIDS public clinics in Tijuana were reviewed and abstracted; 362 of these patients were interviewed using a cross-sectional survey. Using multivariate logistic regression, we explored potential correlates of late HIV testing based on the Behavioral Ecological Model. From 342 participants for whom late testing could be determined, the prevalence of late testing was 43.2%. Multivariate logistic regression results (n = 275) revealed five significant correlates of late testing: "I preferred not to know I had HIV" (adjusted odds ratio [AOR] = 2.78, 1.46-5.31); clinic (AOR = 1.90, 1.06-3.41); exposure to peers engaging in high-risk sexual behavior (AOR = 1.14, 1.02-1.27); stigma regarding HIV-infected individuals (AOR = 0.65, 0.47-0.92); and stigma regarding HIV testing (AOR = 0.66, 0.45-0.97). These findings may inform the design of interventions to increase timely HIV testing and help reduce HIV transmission in the community at large.

Does proximity to retailers influence alcohol and tobacco use among Latino adolescents?

Despite decades of research surrounding determinants of alcohol and tobacco (A&T) use among adolescents, built environment influences have only recently been explored. This study used ordinal regression on 205 Latino adolescents to explore the influence of the built environment (proximity to A&T retailers) on A&T use, while controlling for recognized social predictors. The sample was 45% foreign-born. A&T use was associated with distance from respondents' home to the nearest A&T retailer (-), acculturation (+), parents' consistent use of contingency management (-), peer use of A&T (+), skipping school (+), attending school in immediate proximity to the US/Mexico border (+), and the interaction between the distance to the nearest retailer and parents' consistent use of contingency management (+). The association between decreasing distance to the nearest A&T retailer and increased A&T use in Latino adolescents reveals an additional risk behavior determinant in the US-Mexico border region.

Predictors of weapon carrying in youth attending drop-in centers.

OBJECTIVE: To test and compare 2 predictive models of weapon carrying in youth (n = 308) recruited from 4 drop-in centers in San Diego and Imperial counties. METHODS: Both models were based on the Behavioral Ecological Model (BEM). RESULTS: The first and second models significantly explained 39% and 53% of the variance in weapon carrying, respectively, and both full models shared the significant predictors of being black(-), being Hispanic (-), peer modeling of weapon carrying/jail time (+), and school suspensions (+). CONCLUSIONS: Results suggest that the BEM offers a generalizable conceptual model that may inform prevention strategies for youth at greatest risk of weapon carrying.

Self-report INH adherence measures were reliable and valid in Latino adolescents with latent tuberculosis infection.

BACKGROUND AND OBJECTIVE: To test the reliability and validity of 8-day and 30-day self-report measures of adherence to daily isoniazid (INH) for treatment of latent tuberculosis infection (LTBI). METHODS: Participants were 286 Latino adolescents (ages 13-18, 55.6% male) with LTBI recruited from 10 public middle and high schools in San Diego County. INH adherence was measured monthly for up to 9 months by interview and urine specimens at unannounced visits. Reliability and validity analyses were performed within 5 consecutive months. Reliability was assessed by correlating: (1) 8- and 30-day INH adherence measures within each month; and (2) each of the two adherence measures across months. Validity was assessed by correlating reported measures with biological assays within each month. RESULTS: Reliability tests yielded significant correlation coefficients (p < .05 to .001), both across measures (r = 0.71-0.93) and across time (r = 0.29-0.64 for 8-day recall; r = 0.32-0.69 for 30-day recall). Validity tests of both adherence measures were also significant (p < .05 to .001): 8-day recall (r(pb) = 0.52-0.72) and 30-day recall (r(pb) = 0.37-0.71). CONCLUSION: Results suggest that impromptu recall measures of INH adherence, combined with urine collection, are reliable and valid in Latino adolescents.

Increasing Latino adolescents' adherence to treatment for latent tuberculosis infection: a controlled trial.

OBJECTIVES: We sought to determine the efficacy of coaching Latino adolescents with latent tuberculosis infection to adhere to isoniazid treatment. METHODS: Participants (n = 286) were randomly assigned to adherence coaching, attention control, or usual care groups. Adherence was measured via interviews and validated with urine assays. RESULTS: Coaching resulted in significant increases in adherence compared with attention and usual care groups. Bicultural adolescents were more likely to be adherent than those most or least acculturated. Age and risk behavior were negatively related to adherence. CONCLUSIONS: Coaching can increase Latino adolescents' adherence to treatment for latent tuberculosis infection and should contribute to tuberculosis control for adolescents at high risk of contracting the disease.