ABSTRACT: The association between suicidal ideation, friendships with delinquents, and social/parental connectedness among pre/early adolescents who reside in high-risk communities is poorly understood.
This study examined among high-risk youths: (1) the association between suicidal ideation and having delinquent friends, school connectedness, social support, and different parenting styles (i.e., caring only, supervision only, caring with supervision); and, (2) the differential associations by sex.
The associations were assessed among 2,598 pre/early adolescents using logistic regression. The analyses were adjusted for demographic, mental distress, illicit substance use, and peer/date violence victimization factors. The interaction terms determined differences by sex.
After adjusting for demographic factors and mental distress, suicidal ideation was positively associated with having delinquent friends; however, after factoring in illicit substance use and violence victimization, this association was negative for males. After adjusting for all factors, suicidal ideation was negatively associated with school connectedness and all parenting styles; however, the association between suicidal ideation and having parental caring with supervision was stronger for females.
The results suggest the potential benefits of increasing school connectedness and improving parent-child interactions, particularly among females, and the potential benefits of violence and substance-abuse prevention strategies for youths, particularly males, connected with delinquent peers.
Crisis The Journal of Crisis Intervention and Suicide Prevention 07/2011; 32(6):299-309. · 1.09 Impact Factor
ABSTRACT: The syphilis epidemic among men who have sex with men (MSM) in major US cities and concomitant increases in high-risk sexual behavior, have raised concerns of increased HIV transmission in this population. Therefore, to provide information for health promotion and disease awareness efforts, we investigated sexual behaviors, partner selection preferences and HIV serostatus disclosure practices of MSM at the White Party in Palm Springs, California. Circuit party attendees reported engaging in unprotected anal sex, however, a high proportion reported disclosing their HIV status. These findings suggest that some gay men are serosorting as a risk reduction strategy or implementing sexual risk reduction strategies to protect themselves and their partners. In our study, HIV-negative men were nine times more likely to report a preference for a seroconcordant sexual partner. The self-protecting attitudes of HIV-negative men in our sample outweighed the partner-protecting attitudes of HIV-positive men. This suggests that prevention interventions focusing on HIV-positive persons are warranted.
AIDS Care 12/2006; 18(8):1046-9. · 1.60 Impact Factor
ABSTRACT: The impact of depression on morbidity and mortality among women with human immunodeficiency virus (HIV) has not been examined despite the fact that women with HIV have substantially higher rates of depression than their male counterparts.
To determine the association of depressive symptoms with HIV-related mortality and decline in CD4 lymphocyte counts among women with HIV.
The HIV Epidemiologic Research Study, a prospective, longitudinal cohort study conducted from April 1993 through January 1995, with follow-up through March 2000.
Four academic medical centers in Baltimore, Md; Bronx, NY; Providence, RI; and Detroit, Mich.
A total of 765 HIV-seropositive women aged 16 to 55 years.
HIV-related mortality and CD4 cell count slope decline over a maximum of 7 years, compared among women with limited or no depressive symptoms, intermittent depressive symptoms, or chronic depressive symptoms, as measured using the self-report Center for Epidemiologic Studies Depression Scale.
In multivariate analyses controlling for clinical, treatment, and other factors, women with chronic depressive symptoms were 2 times more likely to die than women with limited or no depressive symptoms (relative risk [RR], 2.0; 95% confidence interval [CI], 1.0-3.8). Among women with CD4 cell counts of less than 200 x 10(6)/L, HIV-related mortality rates were 54% for those with chronic depressive symptoms (RR, 4.3; 95% CI, 1.6-11.6) and 48% for those with intermittent depressive symptoms (RR, 3.5; 95% CI, 1.1-10.5) compared with 21% for those with limited or no depressive symptoms. Chronic depressive symptoms were also associated with significantly greater decline in CD4 cell counts after controlling for other variables in the model, especially among women with baseline CD4 cell counts of less than 500 x 10(6)/L and baseline viral load greater than 10 000 copies/microL.
Our results indicate that depressive symptoms among women with HIV are associated with HIV disease progression, controlling for clinical, substance use, and sociodemographic characteristics. These results highlight the importance of adequate diagnosis and treatment of depression among women with HIV. Further research is needed to determine if treatment of depression can not only enhance the mental health of women with HIV but also impede disease progression and mortality.
JAMA The Journal of the American Medical Association 04/2001; 285(11):1466-74. · 30.03 Impact Factor
ABSTRACT: Injection drug users (IDUs) and their sex partners account for an increasing proportion of new AIDS and HIV cases in the United States, but public debate and policy regarding the effectiveness of various HIV prevention programs for them must cite data from other countries, from non-street-recruited IDUs already in treatment, or other programs, and from infection rates for pathogens other than HIV.
Participants were recruited from the street at six sites (Baltimore [Maryland], New York [two sites], Chicago [Illinois], San Jose [California], Los Angeles [California], and at a state women's correctional facility [Connecticut]), interviewed with a standard questionnaire, and located and reinterviewed at one or more follow-up visits (mean, 7.8 months later). HIV serostatus and participation in various programs and behaviors that could reduce HIV infection risk were determined at each visit.
In all, 3773 participants were recruited from the street, and 2306 (61%) were located and interviewed subsequently. Of 3562 initial serum specimens, 520 (14.6%) were HIV-seropositive; at subsequent assessment, 19 people, all from the East Coast and Chicago, had acquired HIV. Not using previously used needles was substantially protective against HIV acquisition (relative risk [RR], 0.29; 95% confidence interval [CI], 0.11-0.80 ) and, in a multivariate model, was significantly associated with use of needle and syringe exchange programs (adjusted odds ratio [ORadj], 2.08; 95% CI, 1.15-3.85). Similarly, reduction of injection frequency was very protective against seroconversion (RR, 0.33; 95% CI, 0.14-0.80), and this behavior was strongly associated with participation in drug treatment programs (ORadj, 3.54; 95% CI, 2.50-5.00). In a separate analysis, only 37.5% of study-participants had sufficient new needles to meet their monthly demand.
In this large multicity study of IDUs in the United States, several HIV prevention strategies appeared to be individually and partially effective; these results indicate the continued need for, and substantial gaps in, effective approaches to preventing HIV infection in drug users.
JAIDS Journal of Acquired Immune Deficiency Syndromes 10/2000; 25(1):63-70. · 4.43 Impact Factor