The identification of key health risks among the adolescent population allows Roanoke County to develop and implement a youth risk behavior prevention program that is tailored to the needs of the students. This study provides Roanoke County Schools with a large sample of student survey data regarding youth risk behavior. The final sample includes 6504 student surveys. The research tool that was used for the study is titled the Youth Risk Behavior Survey. The instrument is designed to gather data in six categories: behaviors that contribute to unintentional and intentional injuries; tobacco use; alcohol and other drugs; sexual behavior; dietary behavior; and physical activity. Roanoke County students reported participating in at risk behavior more than their national counterparts in all six categories. Injuries, violence, drugs, and behaviors related to dieting, had the highest number of responses above percents reported in national YRBS data. Additional research is needed to determine the impact of prevention programs designed to deal with these problem behaviors. / Ph. D.

Alarming S.T.I’s percentages and low condom use motivated this research. Healthcare professional’s risk-behavior and attitudes towards risk-behavior were reviewed. Three hypotheses, aimed to test whether healthcare professionals working with S.T.I’s should have a different attitude, knowledge and behavior to condom use compared to healthcare professionals that did not work with S.T.I’s. Ninety-five participants working at a hospital in middle-Sweden answered a questionnaire, based on the Swedish UNGKAB09 research. Mann-Whitney analyses showed no significant difference between the two groups on knowledge, attitude and behavior. A high percentage of steady relationships, high homogeneity between groups as well the same attitudes and intentions could have been a reliability problem. The collected data was however interesting as a base for further research

Emerging adulthood is the developmental period between adolescence and adulthood spanning ages 18-25. A central task of emerging adulthood is autonomy development, including forming stable romantic partnerships and peer support networks that will facilitate autonomy from parents. While emerging adulthood is a time of exploration and growth, this period is also associated with risk behavior including most types of substance use, risky sexual behavior and reckless driving. Research has shown strong links between earlier parenting and emerging adults’ peer and romantic relationships and problem behavior. A dearth of research has examined the impact of parenting during emerging adulthood on emerging adult outcomes. The present study drew from an ethnically and socioeconomically diverse sample of emerging adults (ages 19-20) and their parents (n = 209) from the Pacific Northwest region to examine how parenting behaviors during emerging adulthood impact low- and high-quality peer and romantic relationships, alcohol use and delinquent behavior. This study utilized observational and parent-report data to capture positive and negative parenting behaviors. Path modeling was conducted to examine associations between parenting predictors and relational and risk outcomes. Results indicated that observed parental hostility and criticism predicted emerging adult externalizing behaviors, and this relationship was partially mediated by affiliation with delinquent peers. Findings suggest that parenting may significantly contribute to youth development beyond the childhood adolescent years, and hostile and critical parenting during emerging adulthood may incur risk for emerging adult engagement with delinquent peers and delinquent behavior. This study is the first to observationally assess parenting during emerging adulthood with a population of young adults that are drawn from a representative community sample.

The thesis is focused on the experience of 6th and 9th elementary school classes with risk behavior in Dvůr Králové nad Labem. The theoretical part defines terms related to adolescence, risk behavior and prevention. This part also deals with procedures in the occurence of the risk behavior in elementary school. The practical part presents the results of own empirical investigation and bears the signs of a quantitative research. The aim of the research was to determine to which extent second grades students in Dvůr Králové nad Labem have personal experience in the risk behavior. The method of data collection tool was a questionnaire. The results of the research will be beneficial in the prevention of risk behavior in primary schools in Dvůr Králové nad Labem.

The current study uses a lottery-based paradigm to examine how risk taking is affected by two specific types of good and bad experiences, luck and fortune. Though the terms are often used interchangeably, we suggest that they refer to two separate aspects of risk. Fortune refers to the overall positivity or negativity of the overall context, whereas luck refers to the probability of a better or worse outcome. To make the lottery context fortunate or unfortunate, a set of mixed-valence control lotteries were surrounded by all gain (good fortune) or all loss lotteries (bad fortune). To make the lotteries lucky or unlucky, the proportion of better outcomes received was fixed to be well above (good luck) or well below (bad luck) 50%. Results of the study suggest that, fortune, but not luck, had a significant influence on risk taking behaviors. Participants who experienced good fortune decreased risk taking, and those who experienced bad fortune increased risk taking. When asked, however, participants were unable to differentiate between the luck and fortune manipulations. Gains and losses due to fortune were undifferentiated from gains and losses due to luck. Yet, it was found that the number of gain outcomes received, which was determined by the luck-fortune combination, largely determined subjective experiences of luck and fortune. Consistent with the somatic marker and hedonic editing hypotheses, more gain outcomes led to a heightened sense of good luck and good fortune. Following on SPA (security/ potential aspiration) theory, we suggest that these differences in risk taking behavior in response to fortune may be due to increased attention to goals emphasizing security versus potential.

The purpose of this study was to investigate relationships between four personality styles and two important indications of HIV risk behavior, at intake and 3-month follow-up, among a sample of adolescents participating in court-mandated substance abuse treatment in conjunction with an HIV prevention intervention. This study involved a secondary analysis of data from a NIDA funded project (1R01DA011875-01, R. Malow, PI). Predictor variables included levels of antisocial (unruly), dependent(submissive), avoidant (inhibited), and borderline (borderline tendency) personality styles drawn from scales of the Million Adolescent Clinical Inventory (MACI). Criterion variables included number of sexual partners and percentage of sex acts unprotected, derived from the Risk Behavior Assessment (RBA). A series of hierarchical regression analyses were conducted to test study hypotheses. Analyses controlled for age, ethnicity, education, gender, intervention status, the three personality variables not central to the hypothesis being tested, and baseline values of sexual risk behavior, when relevant. Results from the multiple regression analyses failed to support study hypotheses,indicating that adolescent personality styles were not important predictors of HIV risk behavior. Results are discussed within the context of the relevant literature. Study limitations and recommendations for future research are noted.

Objective: The current study examined conceptions of adulthood, close personal relationships, and health behaviors (dietary intake, substance use, sexual behaviors) of emerging adults aged 18-30 with horizontally-infected HIV. Emerging adults were expected to differ in levels of achievement of adulthood tasks. The quality of close relationships, and perceptions of close friends’ behaviors were hypothesized to be associated with health behaviors. Method: Utilizing a cross-sectional design, 48 emerging adults with HIV (64.6% female; M age = 22.59, SD = 3.17) from a youth-based clinic serving most of Miami-Dade County were recruited. Participants completed measures on markers of adulthood, close friend and romantic partner qualities, health behaviors, and perceptions of close peers’ health behaviors using Filemaker technology on laptops; audio computer-assisted self-interview options were available. Results: The domains of individualism and family capacities received the highest mean ratings of importance for marking adulthood. Participants rated the acceptance of responsibility for one’s actions and making independent choices as being most important for being considered an adult; other items rated highly were related to emotional control and adopting new family roles. In the domain of peer relationships, participants who had a close friend or romantic partner generally reported high levels of positive qualities in the friendship that were comparable to national samples; however, most individuals had not disclosed their HIV status to their best friend or romantic partner. A number of emerging adults (12.5%) reported having no friends, which is a higher percentage of friendless individuals than national samples. Most emerging adults with HIV reported consumption of fewer fruits and vegetables than national recommendations. In addition, comparable to rates found among adolescents and emerging adults without HIV, participants were engaged in substance use and risky sexual practices such as having multiple sexual partners. Conclusions: There was considerable variability in development among emerging adults. Conceptions of adulthood and peer relationships may be a particularly important aspect of development to examine among emerging adults with HIV. In addition, many of these individuals continue to engage in health risk behaviors that may require intervention efforts geared specifically to their developmental stage. Implications for care providers are discussed.

This thesis comprises a detailed analysis of sexual risk behavior among female sex workers participating in a prospective cohort study in Mombasa, Kenya between 1993 and 2007. To determine whether high-risk behavior has decreased over time, I examined trends in and associations with condom use and partner numbers at enrolment and over follow-up using multinomial logistic regression. While condom use increased among women enrolling into the cohort, women reduced partner numbers, rather than increasing condom use, over cohort visits. Workplace, charge for sex, duration of sex work, alcohol use, pregnancy and illness were all predictors of condom use. To evaluate the extent to which HIV risk estimates were affected by loss to follow-up, I investigated associations between sexual risk behavior, loss to follow-up, and HIV acquisition, using competing risks regression. Women reporting unprotected sex with multiple partners had the highest risk for HIV infection, and were also most likely to remain in the cohort. Finally, I used Andersen-Gill modeling to assess the impact of sexual risk behaviors on acquisition of sexually transmitted infections (STI) including gonorrhea, non-specific cervicitis, and trichomoniasis. While incident gonorrhea was closely associated with recent sexual risk behavior, incident trichomoniasis was not. Both conditions had high hazards for recurring in a 90-day window after a prior diagnosis. Non-specific cervicitis was demonstrated to be a chronic, relapsing condition associated with protected sex with multiple partners (possibly due to more frequent condom use) and with known biologic risk factors (i.e., pregnancy, hormonal contraceptive use, cervical ectopy, and genital ulcer disease). Overall, these analyses have led to a better understanding of how different sexual behavior patterns are associated with adverse outcomes, including HIV and STI acquisition, and identified specific factors associated with high-risk sexual behavior that may be amenable to intervention.

This thesis comprises a detailed analysis of sexual risk behavior among female sex workers participating in a prospective cohort study in Mombasa, Kenya between 1993 and 2007. To determine whether high-risk behavior has decreased over time, I examined trends in and associations with condom use and partner numbers at enrolment and over follow-up using multinomial logistic regression. While condom use increased among women enrolling into the cohort, women reduced partner numbers, rather than increasing condom use, over cohort visits. Workplace, charge for sex, duration of sex work, alcohol use, pregnancy and illness were all predictors of condom use. To evaluate the extent to which HIV risk estimates were affected by loss to follow-up, I investigated associations between sexual risk behavior, loss to follow-up, and HIV acquisition, using competing risks regression. Women reporting unprotected sex with multiple partners had the highest risk for HIV infection, and were also most likely to remain in the cohort. Finally, I used Andersen-Gill modeling to assess the impact of sexual risk behaviors on acquisition of sexually transmitted infections (STI) including gonorrhea, non-specific cervicitis, and trichomoniasis. While incident gonorrhea was closely associated with recent sexual risk behavior, incident trichomoniasis was not. Both conditions had high hazards for recurring in a 90-day window after a prior diagnosis. Non-specific cervicitis was demonstrated to be a chronic, relapsing condition associated with protected sex with multiple partners (possibly due to more frequent condom use) and with known biologic risk factors (i.e., pregnancy, hormonal contraceptive use, cervical ectopy, and genital ulcer disease). Overall, these analyses have led to a better understanding of how different sexual behavior patterns are associated with adverse outcomes, including HIV and STI acquisition, and identified specific factors associated with high-risk sexual behavior that may be amenable to intervention.

Black South Africans account for a majority of HIV cases in South Africa, highlighting the need for greater understanding of risks specific to this group. Within the HIV prevention and risk literature, little information exists regarding the familial and neuropsychological contributions to HIV risk in youth. The current study addressed this gap. In a group of black South African parent-child dyads, the researchers investigated the independent and interactive contributions of parenting quality and executive functioning in the prediction of HIV risk. Child report of relationship quality was negatively associated with risky sexual attitudes and externalizing behaviors. Parent report of parental monitoring/involvement was negatively associated with child pre-coital behaviors. Cognitive inflexibility interacted with child report of parental monitoring/involvement in its relation with externalizing behaviors. Results indicated that parenting may protect black South African youth with respect to HIV risk, and that executive functioning may play an indirect role in this relationship.