The incidence of the Human Immunodeficiency Virus (HIV) is highest in the southern states of the United States (US), with adolescents in this region being one of the most affected populations in the country. A limited amount of information is available on adolescent HIV risk behaviors in the southern states, specifically focusing on race and gender. The purpose of this study was to use the Centers for Disease Control and Prevention’s National Youth Risk Behaviors Survey (YRBS) for high school students in the southern states for 2011 and 2013 to examine the influence of race and gender on 1) early sexual initiation, 2) number of sexual partners, and 3) condom use. Descriptive statistics and multiple logistic regression was used for the analysis. A total of 6,244 (6.7%) students reported early sexual initiation, 13,121 (14.1%) reported having multiple sex partners, and 11,820 (41.1%) reported condom use in southern states for 2011 and 2013. Minority males were greater than 10 times more likely to engage in early sexual initiation compared to white females (OR-10.40; 95% Confidence Interval (CI)-9.03-11.98). Minorities and males were more likely to have multiple sex partners compared to whites and females (OR- 1.84; CI-1.73-1.95, OR-2.20; CI-2.07-2.34, respectively). Minority males were over 2 times more likely to use condoms compared to white females (OR-2.04; CI-1.87-2.23). There was a statistically significant association between the three sexual health behaviors and psychosocial factors, such as dating violence, forced sex, body weight perception, and substance use before sex. Gender and race along with psychosocial factors were associated with HIV risk behaviors for high school students in the southern states. These preliminary findings could potentially be used to target HIV/AIDS awareness and preventative actions to populations affected by the HIV burden in the southern states.

No description available.

The number of adolescents in the U.S. who engage in risk behaviors such as alcohol and drug use and unsafe sexual practices has reached alarming levels, with Hispanic adolescents in particular reporting high rates of substance use and sexual activity. This study explored risk and protective factors that influence high-risk behaviors in Hispanic adolescents. A theoretical model was developed based on an integration of Ecodevelopmental Theory and the Theory of Reasoned Action to investigate individual and social factors that affect the risk behaviors of Hispanic adolescents. This study was a cross-sectional, descriptive, secondary investigation of the baseline data of a combined sample of 493 Hispanic adolescent 7th and 8th graders and their immigrant parents who had been recruited for participation in the Familias Efficacy I and II studies. The hypothesized model of relationships included 3 direct effects variables: parent-adolescent communication about sex; adolescent condom use self-efficacy; and family functioning, which integrated 4 constructs: parental involvement; positive parenting; family communication; and parent-adolescent communication. The study model also included 3 indirect variables: parents' acculturation; differential acculturation; and parent's HIV knowledge. Three adolescent risk behaviors served as outcome variables: condom use; drinking alcohol while having sex ; and substance use. It was hypothesized that (1) family functioning, parent-adolescent communication about sex, and adolescent self efficacy would all be directly related to adolescent risk behaviors; (2) parent's acculturation would be related to adolescent risk behaviors indirectly through its association with parent's HIV knowledge and parent-adolescent communication about sex; and (3) differential acculturation would be related to adolescent risk behaviors indirectly through its association with family functioning, adolescent condom use self-efficacy, and parent-adolescent communication about sex. Cronbach's alpha computed for all measures yielded good to excellent reliability coefficients. Pearson linear correlation coefficients were calculated between all of the study variables, followed by confirmatory factor analysis to ascertain the feasibility of collapsing multiple indicators of family functioning and HIV/STIs risk behaviors into single latent variables. Finally, the hypothesized structural equation model was estimated. Beta coefficients were calculated to examine direct effects and Mackinnon's asymmetric distribution of product test was used to evaluate mediated effects. Data analysis failed to confirm any of the study hypotheses; however, post-hoc analyses yielded findings that merit further study. Family functioning emerged as the heart of the model, embedded within a web of direct and mediated relationships. Additional findings suggest that family functioning mediates the effect of parents' acculturation and of parents' HIV knowledge on adolescent risk behaviors. Study limitations include its cross-sectional design, self-report measures, convenience sample and integration of clinical and non-clinical samples. Suggestions are provided for researchers to further explore relationships among the variables, and recommendations made for community nursing practitioners to develop, implement and evaluate HIV/STIs prevention programs for Hispanic adolescents.

The purpose of the current study was to explore the relation between a culture specific theory of resiliency (TRIOS: Time, Rhythm, Improvisation, Oratory & Spirituality) and sexual health outcomes (Sexual Risk History, HIV Testing & Attitudes and Beliefs, Partner Information & Condom Self-Efficacy) among Black women. Participants were 124 Black women recruited from a larger sexual health intervention study. TRIOS was hypothesized to be correlated with outcomes and predict unique variance in outcomes beyond measures of Self-Esteem & Racial Identity. Time, Improvisation and Spirituality were hypothesized to uniquely predict limited sexual risk history, healthy HIV testing attitudes and beliefs, fewer risk indicators among sex partners, & higher condom self efficacy. The psychometric structure of TRIOS within the sample was examined. Tests included a Correlation Matrix, two sets of four Hierarchical Regressions and an Exploratory Factor Analysis. Correlations were found between TRIOS components and Sexual Risk History and Condom Self-Efficacy. Time and Improvisation uniquely predicted declines in Risky Sexual History. Rhythm uniquely predicted declines in Condom Self-Efficacy. Effects of Oratory were mixed. Methodological limitations and implications for interventions and future research were discussed.

The rates of childhood obesity remain high in spite of the enormous efforts dedicated to tackling the disease. This dissertation investigates the effect of two of its causes, including parental time and children's obesity risk behaviors. Trends in these causes have changed over time and might explain changes in obesity. The two factors are analyzed separately given the differences in impact process and concentration of literature. The data for the investigation is drawn from the Parental Time, Role Strains, Coping, and Children's Diet and Nutrition project. In examining parental time, the attention is directed towards the mother's actual time spent with the child which has been associated with reduction in child weight status. The major aim is to test and correct for the problem of endogeneity stemming from unobserved health factors that can distort any meaningful causal impact of maternal time on child weight status. Using the household production theory, parental time allocation decisions towards child health are modeled and analyzed using instrument variable (IV) methods. Results indicate that the effect of mother's time allocation reduces child weight status. Her decision to allocate time to the child is affected by unseen factors. Father's work to family spillover was found to be a valid instrument for mother's time with the child. Results were robust across different estimators. In analyzing the relationship between childhood obesity risk behaviors and weight status, this study focuses on three child practices including breakfast intake, fast food consumption and sleep patterns. The main aim was to score their joint impact, while at the same time accounting for contextual factors. This work adopted the ecological systems framework which accommodates multiple factors. Based on this theory, a simultaneous system of equations considering child weight status, risk behavior and contextual factors was set up and analyzed using 3SLS. Findings indicated that dietary behaviors remain a major factor in affecting weight status. In addition, feedback mechanism from child weight status will influence the diet pattern adopted by the child. Sleep sufficiency had no effect on child weight status.

Emerging adulthood has been emphasized as a time of exploration generally and of religious or faith-identity specifically, and successful resolution of this aspect of identity holds important consequences related to risk behaviors. The goal of this investigation was to better understand the types of faith-identities found in college, how emerging adults' relationships with parents related to their own faith-identities and how each faith-identity was related to risk behaviors. Spiritual Modeling, a type of modeling rooted in social learning theory, (Bandura; 1977; King, 2003; Oman & Thoreson, 2003) was expected to be predictive of emerging adults' faith-identities, while parent-emerging adult relationship quality and parental conflict were thought to moderate the relationship between spiritual modeling and faith-identity. Faith-Identity was expected to differentiate across binge drinking, marijuana use and number of sexual partners, and sensation seeking was thought to moderate the relationship between faith-identity and risk behaviors. Seven hundred ninety students completed an online survey across 11 large public and private religious universities. Spiritual Modeling was strongly predictive of both religious and commitment oriented faith-identities. The relationship between Spiritual Modeling and Faith-Identity was not moderated by relationship quality or parental conflict. A more religiously oriented faith-identity was predictive of fewer sexual partners and less binge drinking, while a more commitment oriented faith-identity was predictive of less marijuana use. High levels of sensation seeking amplified the relationship between a more secular faith identity and binge drinking. Commitment and Religious faith-identities significantly moderated the relationship between faith-identity and both binge drinking and number of sexual partners. Evidence is suggestive that a religiously oriented faith-identity may be more protective in combination with high levels of commitment while a faith-identity characterized by secularism and high commitment appears least protective. The potential utility of a faith-identity construct in emerging adulthood and future research directions are discussed. / text

Purpose: The purpose of this study is to evaluate and compare the extent and potential correlates of sexual risk taking behaviors related to condom use and number of sexual partners among Haitians aged 15 to 49 years old living in the urban and rural areas. Methods: Data were obtained from the 2005-2006 cross-sectional survey conducted by the Demographic Health survey. Our study population (15143) was analyzed based on the Health Belief Model (HBM) theory using a bivariate and multiple logistic regression analysis with SPSS for windows. Results: In both rural and urban areas dwellers had an accurate knowledge of the disease. However, a small proportion in both areas used condoms during their last sexual intercourse. Perceiving the disease's severity was more likely associated with condom use in the urban (OR 1.36, p ≤ .01) and in the rural areas (OR 1.45, p ≤.05). Strong associations have been found between some variables of the HBM and condom use but none have been found associated with zero or one sex partner. Findings were similar in both areas Conclusion: Holistic approach should be considered in the prevention strategy conducted in Haiti to tackle other factors that may contribute in delaying responsible sexual behavior in that country.

This study is an analysis of adolescent risk behaviors contributing to an increased rate of suicidal ideation for 12 to 18 year olds. The Youth Risk Behavior Surveillance System Survey (YRBSS) is an epidemiologic survey designed to monitor the prevalence of risky behaviors of adolescents in middle and high school1. The YRBSS is a complex sample survey with a three-stage cluster design. Multiple logistic regression is used to analyze the data, including methods of analysis to address issues in complex survey design. Results of this study indicate several different risk factors that influence the rate of suicidal ideation among adolescents, including alcohol and drug use, sexual risky behaviors, unhealthy weight loss methods, depressed mood, sex and race/ethnicity. The conclusions of this study indicate that many risk factors associated with suicidal ideation are behaviors that could be addressed with early intervention strategies to reduce the risk of suicidal ideation.

Background The role of social capital for promoting health has been extensively studied in recent years but there are few attempts to investigate the possible influence of social capital on HIV prevention,particularly in developing countries. The overall aims of this thesis are to investigate the links between social capital and HIV infection and to contribute to the theoretical framework of the role of social capital for HIV prevention. Methods Key informant interviews with leaders of organizations, networks, social groups and communities and focus group discussions with members and non-members of the social groups and networks were conducted to map out and characterize various forms of social capital that may influenceHIV prevention. A quantitative community survey was carried out in three case communities toestimate the influence of social capital on HIV risk behaviors. A cross-sectional survey was conducted to estimate the HIV prevalence in the urban district representing a high HIV prevalence zone to determine the association between social capital and HIV infection. Main findings In early 1990’s many of the social groups in Kagera region were formed because of poverty and many AIDS related deaths. This formation of groups enhanced people’s social and economic support to group members during bereavement and celebrations as well as provided loans that empowered members economically. The social groups also put in place strict rules of conduct, which helped to create new norms, values and trust, which influenced sexual health andthereby enhanced HIV prevention. Formal organizations worked together with social groups and facilitated networking and provided avenues for exchange of information including healtheducation on HIV/AIDS. Individuals who had access to high levels of structural and cognitive social capital were more likely to use condoms with their casual sex partners compared to individuals with access to low levels. Women with access to high levels of structural social capital were more likely to use condoms with casual sex partners compared to those with low levels. Individuals with access to low levels of structural social capital were less likely to be tested for HIV compared to those with access to high levels. However, there was no association between access to cognitive social capital and being tested for HIV. Individuals who had access to low levels of both structural and cognitive social capital were more likely to be HIV positive compared to individuals who had access to high levels with a similar pattern among men and women. Conclusion This thesis indicates that social capital in its structural and cognitive forms is protective to HIV infection and has played an important role in the observed decline in HIV trends in the Kagera region. Structural and cognitive social capital has enabled community members to decrease number of sexual partners, delay sexual debut for the young generation, reduce opportunities for casual sex and empower community members to demand or use condoms. It is recommended that policy makers and programme managers consider involving grassroots’ social groups and networks in the design and delivery of interventions strategies to reduce HIV transmission.

Thesis (Ph.D.)--Indiana University, 2009. / Title from screen (viewed on August 27, 2009). School of Nursing, Indiana University-Purdue University Indianapolis (IUPUI). Advisor(s): Melinda M. Swenson, Kathleen M. Russell, Deborah Stiffler, Larry J. Zimmerman. Includes vita. Includes bibliographical references (leaves 169-185).