High-risk STD/HIV behavior among college students.

The current sexually transmitted disease (STD) epidemic in adolescents has led to concern about the potential for spread of the human immunodeficiency virus (HIV). In 1988, a total of 5514 students in first-year community college and university classrooms across Canada were surveyed to assess STD/HIV-related knowledge, attitudes, and risk behavior. The students' mean age was 19.7 years; the male-to-female ratio was 1:1.4. Students knew more about HIV/acquired immunodeficiency syndrome than other STDs. Of the 74.3% of the men and 68.9% of the women who were coitally active, 14.3% of the men and 18.6% of the women had participated in anal intercourse and 5.5% reported a previous STD. Only 24.8% of the men and 15.6% of the women always used a condom during sexual intercourse. Among the 21.3% of the men and 8.6% of the women with 10 or more partners, regular condom use was reported in only 21% and 7.5%, respectively. In this subgroup, anal intercourse was practiced by 26.9% of the men and 34.8% of the women, and previous STD was reported by 10.6% and 24.2%, respectively. Factors associated with not using a condom included number of sexual partners, embarrassment about condom purchase, difficulty discussing condom use with a partner, use of oral contraceptives, insufficient knowledge of HIV/STDs, and the belief that condoms interfere with sexual pleasure. These factors are potentially amenable to change. Effective, behaviorally focused educational programs are needed to improve condom use and reduce STD/HIV risk.

Rehabilitation of below-knee amputees: factors influencing outcome and costs in three programmes.

The components of three different rehabilitation programmes were analysed to determine the factors that influence functional outcomes and prosthetic costs. Age and additional health problems showed little relationship to inpatient activity level while the physical health status score had a significant relationship. The level of expectation in the rehabilitation programmes for walking independently with canes or without aids at discharge was shown to have a strong influence on the activity level attained and the length of rehabilitation stay. The style of socket did not appear to affect fitting success but had some effect on the efficiency of the prosthetic fitting process and the length of stay.

Highlights from the Canada youth and AIDS study.

The identification of Acquired Immunodeficiency Syndrome (AIDS) in 1981, and the subsequent isolation of the human immunodeficiency virus (HIV) in 1983, signaled the beginning of worldwide concern over the potential impact of the disease. As the global incidence of AIDS and HIV infection increased, Canadians expressed growing apprehension about the epidemic's affect on themselves. Because adolescents potentially are at risk for HIV infection, a special need existed to determine how Canadian youth were responding to the AIDS epidemic. During the summer of 1987, the Federal Centre for AIDS, in conjunction with the National Health Research and Development Program and the Canadian Public Health Association, commissioned a nationwide study. A national sample of more than 38,000 youth in grades 7, 9, 11, and the first year of college and university were surveyed about their knowledge, attitudes, and behavior concerning AIDS and other sexually transmitted diseases (STDs). Also included in the total sample were youth who had recently dropped out of school and those who lived on the streets of large cities. In this article, the authors summarize findings from the study and offer conclusions and recommendations for action.

PIP: The Federal Center for AIDS, the National Health Research and Development Program, and the Canadian Public Health Association commissioned a study in 1987 on 38,000 adolescents 11-21 years old. The questions focused on knowledge of AIDS and attitudes and behavior about AIDS. The youth know how AIDS is transmitted but do not know how to practice prevention. Mass media has been the major purveyor of AIDS information, but are suspected of capitalizing on the situation to sell their products. Schools and physicians are regarded as reliable information sources, but these sources have not been providing the desired AIDS information on a regular basis. Education about AIDS is currently the most important preventative measure that can be implemented. Knowledge will help modify behavior only if people believe that everyone, including themselves, are at risk of contracting AIDS. Unfortunately, adolescents tend to believe in their own invincibility so they continue to be at risk for sexually transmitted infections. Surveys were conducted on adolescent attitudes toward homosexuals, AIDS infected people, and sexual intercourse in order to understand their associated behaviors. Only 14% of college students polled said they always used condoms. This type of attitude needs to be changed. Street youths are in a high risk AIDS category because they take more chances. Somehow these youths must be reached. Recommendations to improve the situation include: providing clear frank information about AIDS in Canada; educational programs for adolescents; education for parents about AIDS; counselling for college students through university health services; and an increase in AIDS survey research.