Behavioral verification and risk factors of HIV cross-population transmission in China: analysis of national surveillance data 1989-2022.

INTRODUCTION: The dynamic HIV/AIDS epidemic significantly impacts China, particularly affecting injection drug users (IDUs), former plasma donors (FPDs), men who have sex with men (MSM), and those engaging in high-risk heterosexual behavior (HRHB). This study specifically focuses on identifying the risk factors and influences that drive the spread of HIV among these population groups by performing a comprehensive analysis of contact histories of individuals diagnosed with HIV. METHODS: Data for this research were gathered from China's HIV/AIDS Comprehensive Response Information Management System (CRIMS). Contact histories were described using bar and venn diagram. Trend in engaging in HBRB among MSM were identify potential change using the Cochran-Armitage test. Logistic regression was employed to analyze the factors influencing HBRB in MSM. RESULTS: From 1989 through to 2022, a total of 1,457,218 individuals aged 15 years or older in China, who reported being infected with HIV, indicated they had one or more types of contact histories including injecting drug use, male homosexual behavior, commercial plasma donation, and high-risk heterosexual behavior. Among these, 97.0% reported a single type of contact history, while 3.0% reported having multiple contact histories. Of those with multiple contact histories, 98.0% (42,258 individuals) had engaged in HRHB. Among all HIV-infected IDUs, MSM, and FPDs, their respective proportions of engagement in HRHB were 11.8%, 5.7% and 6.2%. Prior to 2012, most were reported to be IDUs; however, subsequent to this, most reported being MSM. Factors that heightened the risk of engaging in HRHB among HIV-infected MSM included being of age between 25-34 years [adjusted odds ratio (AOR) = 1.29] or 35-44 years (AOR = 1.22), marital status such as being married (AOR = 1.23) or being divorced/widowed (AOR = 1.17), belonging to an ethnic minority (AOR = 1.29), receiving diagnosis in hospitals (AOR = 1.81), residing in rural areas (AOR = 1.12), among others. However, the risk of HRHB decreased when age ≥ 55 years (55-64 years: AOR = 0.82; ≥ 65 years: AOR = 0.64). CONCLUSION: The potential for HIV transmission among diverse populations is substantial. As such, it is imperative that strategies are implemented to mitigate the propagation of HIV to the general populace via heterosexual intercourse.

Pubertal timing and adolescent outcomes: investigating explanations for associations with a genetically informed design.

BACKGROUND: Psychopathology and risky behaviors increase during adolescence, and understanding which adolescents are most at risk informs prevention and intervention efforts. Pubertal timing relative to same-sex, same-age peers is a known correlate of adolescent outcomes among both boys and girls. However, it remains unclear whether this relation is better explained by a plausible causal process or unobserved familial liability. METHODS: We extended previous research by examining associations between pubertal timing in early adolescence (age 14) and outcomes in later adolescence (age 17) in a community sample of 2,510 twins (49% boys, 51% girls). RESULTS: Earlier pubertal timing was associated with more substance use, risk behavior, internalizing and externalizing problems, and peer problems in later adolescence; these effects were small, consistent with previous literature. Follow-up co-twin control analyses indicated that within-twin-pair differences in pubertal timing were not associated with within-twin-pair differences in most adolescent outcomes after accounting for shared familial liability, suggesting that earlier pubertal timing and adolescent outcomes both reflect familial risk factors. Biometric models indicated that associations between earlier pubertal timing and negative adolescent outcomes were largely attributable to shared genetic liability. CONCLUSIONS: Although earlier pubertal timing was associated with negative adolescent outcomes, our results suggests that these associations did not appear to be caused by earlier pubertal timing but were likely caused by shared genetic influences.

Information shocks and celebrity exposure: The effect of "Magic" Johnson on AIDS diagnoses and mortality in the U.S.

We present evidence that Earvin "Magic" Johnson's announcement that he contracted HIV served as a public-health catalyst for rapidly correcting the public's understanding of who was at risk of infection. Using a novel identification strategy, we present evidence that there was a large but temporary increase in the number of AIDS diagnoses for heterosexual men following the announcement. This effect was concentrated in areas with greater prior exposure to Johnson. We show that these men were both more likely to have been diagnosed via a formal blood test and less likely to die within 1 decade of their initial diagnosis-suggesting that Johnson's announcement caused an intertemporal substitution in testing which prolonged patients' lifespans as a result of earlier access to medical care. We estimate that Johnson's announcement caused approximately 800 additional heterosexual males in the United States in metropolitan statistical areas with National Basketball Association franchises men to discover their underlying AIDS diagnosis and, of whom, were more likely to live at least 1 decade beyond their initial diagnosis date.

Post-traumatic Stress Disorder as a Risk Factor for the Development of Risky Behavior Among Adolescent Offenders: A Systematic Review.

The purpose of this research study was to obtain greater insight into the associations of post-traumatic stress disorder (PTSD) and trauma-exposed experiences with the development of offending behavior in adolescents. Using the PubMed and Scopus databases, we performed a systematic review of recent cross-sectional studies between 2016 and 2022, investigating the associations of PTSD and trauma with the social and mental behavior of adolescents. Fifty-three articles were initially identified. Due to duplication, eight articles were excluded, leaving 45 remaining articles. In addition, 34 articles were excluded due to year of publication, review, abstract, or irrelevant title. Seven articles were included in this systematic review after excluding the remaining due to different study types or samples. Included studies primarily examined the associations of PTSD symptomatology and expression of externalizing symptoms with risky behavior and the commission of a crime. The strongest outcomes were increased levels of violent behavior, violent delinquency, and total risk in correlation with PTSD symptoms, emotional numbing, use of drugs, and in some cases maltreatment. The results of the systematic review suggest that PTSD symptoms and risky behavior, which can be also fueled by maltreatment activities in the family circle, are associated with criminal behavior. Future research is needed to confirm these findings.

Exposure to Pornography and Adolescent Sexual Behavior: Systematic Review.

BACKGROUND: Formative experiences in adolescence lay the foundation for healthy and pleasurable romantic and sexual relationships. Exposure to pornography may affect these experiences. OBJECTIVE: We aimed to synthesize evidence published in the past decade on the relationship between exposure to pornography and sexual behavior (earlier age of first sex [<16 years], condomless sex, past-year multiple partners [>1], lifetime multiple partners [>1], group sex, sexual aggression including forced sex, paid sex, teenage pregnancy, and history of sexually transmitted infection) in adolescents aged between 10 and 19 years. METHODS: We identified 19 eligible studies by searching MEDLINE, PsycINFO, Cochrane, CINAHL, Embase, and Web of Science databases from January 2010 to November 2022. RESULTS: Out of 8 studies that assessed earlier age of first sex, 5 studies, including 1 longitudinal study, found a statistically significant association with exposure to pornography. Given that most studies were cross-sectional or had substantial limitations, causal inference could not be made. Also, exposure to pornography was not measured consistently. The evidence was conflicting or insufficient to draw any conclusions regarding other outcomes. CONCLUSIONS: More quantitative research is needed to elucidate the association between pornography exposure and sexual behavior, and sex education should adopt evidence-based approaches to minimize the potential harms from pornography. TRIAL REGISTRATION: PROSPERO International Prospective Register of Systematic Reviews CRD42021227390; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=227390.

Supporting Adolescent Engagement with Artificial Intelligence-Driven Digital Health Behavior Change Interventions.

Understanding and optimizing adolescent-specific engagement with behavior change interventions will open doors for providers to promote healthy changes in an age group that is simultaneously difficult to engage and especially important to affect. For digital interventions, there is untapped potential in combining the vastness of process-level data with the analytical power of artificial intelligence (AI) to understand not only how adolescents engage but also how to improve upon interventions with the goal of increasing engagement and, ultimately, efficacy. Rooted in the example of the INSPIRE narrative-centered digital health behavior change intervention (DHBCI) for adolescent risky behaviors around alcohol use, we propose a framework for harnessing AI to accomplish 4 goals that are pertinent to health care providers and software developers alike: measurement of adolescent engagement, modeling of adolescent engagement, optimization of current interventions, and generation of novel interventions. Operationalization of this framework with youths must be situated in the ethical use of this technology, and we have outlined the potential pitfalls of AI with particular attention to privacy concerns for adolescents. Given how recently AI advances have opened up these possibilities in this field, the opportunities for further investigation are plenty.

Consequences of Victimization on Perceived Friend Support during Adolescence.

Victimization can harm youth in various ways and negatively affect their friendships with peers. Nevertheless, not all victimized youth are impacted similarly, and the literature is unclear regarding why some victims are more likely than others to experience friendship-based consequences. Using five waves of data on 901 adolescents (6th grade at wave 1; 47% male; 88% White) and a subsample of 492 victimized youth, this study assessed (1) whether victimization leads to decreases in perceived friend support, and (2) the factors that explain which victimized youth are most likely to experience decreases in perceived friend support. Explanatory factors included subsequent victimization, victims' social network status (self-reported number of friends, number of friendship nominations received), and victims' risky behaviors (affiliating with deviant friends, delinquency, aggression, binge drinking). Random effects regressions revealed that, among the full sample, victimization was linked to decreases in friend support. Among victimized youth, subsequent victimization and deviant friends decreased friend support. Having more friends was associated with increased friend support among victims, though this association weakened as the number of friends increased. The results emphasize that victimized youth are a heterogeneous group with varying risks of experiencing friendship-based consequences.

Mattering, substance use, and addictive behaviors: review, analysis, and implications for treatment and prevention.

In the current article, we examine mattering to others as a relational resource and discuss how feelings of not mattering are uniquely implicated in addiction and substance use. We describe the mattering construct and how it is conceptualized, and we comprehensively review existing evidence based primarily on research with adolescents that links feelings of not mattering with addictive tendencies in general, and specific tendencies (e.g., excessive drinking and drug use and excessive social media use). A central premise of this article is the need to take race and ethnicity into account when considering the potential link between feelings of not mattering and substance use among young people with minority status and various ethnicities who may be especially prone to feeling marginalized and insignificant as a result of adverse experiences reflecting being ostracized and not socially accepted. Potential models of drinking and addictive tendencies that can easily incorporate the mattering construct are also outlined to underscore the conceptual relevance of feelings of not mattering to others. Mattering is also considered in terms of how internalization (i.e., not mattering to oneself) potentiates impulsive and risky behavior. Our article concludes with discussion of the implications for treatment and prevention in addiction and substance use and directions for future research that should further illuminate the role of feelings of not mattering to others and not mattering to oneself.

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Objective: To investigate the status of medication adherence and various types of risky behaviors of schizophrenia patients in a certain area of western China and to explore accordingly the correlation between the two. Methods: A total of 292 667 patients with schizophrenia were enrolled in a follow-up survey between 2006 and 2018. In addition, based on the outcome-wide analysis strategy, a multivariate Cox proportional risk regression model was used to estimate and compare the impact of medication adherence on different types of risky behaviors in schizophrenia patients. Results: In this 13-year prospective cohort, 65 175 patients (31.4%) showed good medication adherence, while 142 394 patients (68.6%) showed poor medication adherence. The incidence rates of various risky behaviors during the follow-up period were as follows, minor nuisances, 12.25%, violation of the Law of the People's Republic of China on Penalties for Administration of Public Security (APS law), 3.82%, violation of criminal law, 0.94%, suicide completed, 0.28%, self-harm, 1.42%, and attempted suicide, 0.82%. Schizophrenia patients who had poor medication adherence had higher risks of committing violence against others and self-inflicted injury compared to patients with good medication adherence did, with the associated effects being minor nuisances (hazard ratio [HR]=1.31, 95% confidence interval [CI]: 1.27-1.35), violation of APS law (HR=1.47, 95% CI: 1.38-1.56), violation of criminal law (HR=1.17, 95% CI: 1.05-1.31), and self-harm (HR=1.43, 95% CI: 1.32-1.56), respectively, while the risk of suicide completed is lower in schizophrenia patients with poor medication adherence than that in patients with good medication adherence (HR=0.56, 95% CI: 0.47-0.66). There was no statistically significant association between attempted suicide and medication adherence. Conclusion: There are variations in the direction and strength of the association between medication adherence and different types of risky behaviors and further research is needed to elucidate the mechanisms of the association.

Determining the Effects of Ramadan Fasting on Risky Behaviors of Turkish Nursing Students.

The aim of this study was to determine the effect of nursing students' fasting during Ramadan on their risky behaviors. This study was conducted in a university located in 2022 using the prospective cohort study method. The data were collected from the nursing department students through face-to-face questionnaires. The sample of the study consisted of 186 nursing students. The data were obtained using a descriptive information form, which consists of questions regarding the descriptive characteristics of the nursing students, and the risky behaviors form, created by the researchers, to evaluate the effect of fasting during Ramadan on nursing students' risky behaviors. According to the findings of the research, it has been determined that the students who always fast during Ramadan have regular sahur. When the students' level of religious faith and fasting and having sahur status were compared with their risky behaviors, the mean scores of exercise and nutrition increased significantly, and the mean scores of interpersonal relationships decreased significantly. It was determined that the majority of students had a high level of religious faith, fasted and had sahur during Ramadan. Consequently, while Ramadan fasting negatively affected students' physical activity, nutrition and sleep patterns, it positively affected their interpersonal relationship status.

Prenatal exposure to organophosphate pesticides and risk-taking behaviors in early adulthood.

INTRODUCTION: Previous studies show evidence for associations of prenatal exposure to organophosphate (OP) pesticides with poorer childhood neurodevelopment. As children grow older, poorer cognition, executive function, and school performance can give rise to risk-taking behaviors, including substance abuse, delinquency, and violent acts. We investigated whether prenatal OP exposure was associated with these risk-taking behaviors in adolescence and young adulthood in a Mexican American cohort. METHODS: We measured urinary dialkyl phosphates (DAPs), non-specific metabolites of OPs, twice (13 and 26 weeks gestation) in pregnant women recruited in 1999-2000 in the Center for the Health Assessment of Mothers and Children of Salinas (CHAMACOS) study, a birth cohort set in a primarily Latino agricultural community in the Salinas Valley, California. We followed up children throughout their childhood and adolescence; at the 18-year visit, adolescent youth (n = 315) completed a computer-based questionnaire which included questions about substance use, risky sexual activity, risky driving, and delinquency and police encounters. We used multivariable models to estimate associations of prenatal total DAPs with these risk-taking behaviors. RESULTS: The prevalence of risk-taking behaviors in CHAMACOS youth ranged from 8.9% for smoking or vaping nicotine to 70.2% for committing a delinquent act. Associations of total prenatal DAPs (geometric mean = 132.4 nmol/L) with risk-taking behavior were generally null and imprecise. Isolated findings included a higher risk for smoking or vaping nicotine within the past 30 days (relative risk [RR] per 10-fold increase in prenatal DAPs = 1.89, 95% CI: 1.00, 3.56) and driving without a license (RR = 1.74, 95% CI: 1.25, 2.42). There were no consistent differences by sex or childhood adversity. DISCUSSION: We did not find clear or consistent evidence for associations of prenatal OP exposure with risk-taking behaviors in adolescence/early adulthood in the CHAMACOS population. Our small sample size may have prevented us from detecting potentially subtle associations of early life OP exposure with these risk-taking behaviors.

Risk factors of in-home unintentional injuries among 0-6-year-old children in Changsha city of China: a cross-sectional survey based on Bronfenbrenner's ecological system theory.

BACKGROUND: In-home unintentional injuries (IUIs) seriously threatened children's safety. Three factors, including risky behaviors, parental supervision, and home environmental risks, have been identified as major causes for IUIs. Studies considering the interrelations between the three were limited and no relative studies has been carried out among Chinese children. The purpose of this study is to fully explore the influences of behavioral, supervisory and environmental risk factors on IUIs and their associations among Chinese children on the bases of our self-developed scales. METHODS: Through stratified cluster sampling, a cross-sectional survey was conducted with 798 parents of children aged 0 ~ 6 years in Changsha, China. Social demographics and IUIs history in the past year were collected by self-administered questionnaires. Three IUI-related scales, which had been developed and validated by our team, aimed to measure risks from children behavior, parental supervision and in-home environment. Structural equation models were constructed to analyze the relationship of these factors and their influences on IUIs using SPSS 26.0 and AMOS 22.0. RESULTS: Seven hundred ninety-eight parents were surveyed in total, and 33.58% of them reported with IUIs history of their children. X2/df, goodness-of-fit index (GFI), adjusted goodness-of-fit index (AGFI) and the root-mean-square error of approximation (RMSEA) for the model of the whole children were 4.832, 0.879, 0.856 and 0.069 respectively, indicating an acceptable level of model fit. Direct influences were discovered between risky behaviors and children's IUIs. Home environmental risks indirectly exerted impacts on IUIs by the mediating effect of risky behaviors, while the significant effect of parental supervision only existed in children aged 4-6 and girls. CONCLUSIONS: Risky behaviors played a mediating role in IUIs among children. Supervision and environmental risks affected IUIs indirectly by the exposure to risky behaviors. Parental supervision may not be able to offset the risks posed by the environmental and behavioral factors, so effective IUIs prevention strategies should focus on behavioral and environmental interventions, with appropriate supervision strategies based on the age and sex characteristics of the child.

Integration of the Screening, Brief Intervention, and Referral to Treatment Screening Instrument Into School Nurse Practice.

Substance abuse in adolescents has been recognized as a public health problem at the national and global levels. Adolescents are at risk for experimenting with substances. School nurses in secondary schools are well positioned to screen and counsel students on substance use. In this project, school nurses' self-efficacy levels increased in using the Screening, Brief Intervention, and Referral to Treatment (SBIRT) process posteducation, and SBIRT was integrated into school nurses' practice. Initiatives aimed at stopping or preventing substance use are beneficial for a healthy society.

Relationship between risky behaviors and non-prescription opioid use among Asian American youth.

Asian Americans (AA) are a highly understudied population and are often considered the "model minority" for health. However, there is a dearth of research on risky behaviors associated with opioid use in AA teens. Data among AA youth aged 12 to 16 was collected from the 2017 Youth Risk Behavior Surveillance System. Multivariate logistic regression models were run to determine associations between opioid use and risky behaviors, controlling for age and sex. Findings showed that opioid use is significantly associated with weapon carrying, risky sexual behavior, and body image. These conclusions inform public health practice on substance abuse treatment in AA teens.

Online risky behavior and sleep quality among Chinese college students: The chain mediating role of rumination and anxiety.

This study explored the chain mediating effects of rumination and anxiety in the relationship between online risky behavior and sleep quality among Chinese college students. A sample of 1039 Chinese college students (Mage = 19.49, SD = 1.14, 53.32% males) were investigated with Online Risky Behavior Scale (ORBS), Pittsburgh Sleep Quality Index scale (PSQI), Ruminative Responses Scale (RRS) and Self-rating Anxiety Scale (SAS). The results showed that: (1) There is a significant positive correlation among online risky behavior, sleep quality, rumination and anxiety, and (2) Online risky behavior could not directly affect sleep quality, but it can affect sleep quality through the mediation of rumination and anxiety. The chain mediating effects includes three paths: The mediating role of rumination, the mediating role of anxiety, and the chain mediating role of rumination and anxiety after controlling for gender, grade, major, and network usage time. These findings contribute to a deeper understanding of how online risky behavior affects sleep quality and provide important practical guidance for improving sleep quality.

Intertwined associations among attachment styles, emotional dysregulation, and ADHD: examining unique associations with general risk-taking behavior.

Attachment insecurity, emotional dysregulation, and attention-deficit/hyperactivity disorder (ADHD) have all been implicated across the literature with various forms of negative life outcomes and increased risk-taking behavior (RTB). Furthermore, abundant research has demonstrated that the three seem to go together. Given these intercorrelations, it is unclear if any of them possess exclusive links with RTB independent of the others across multiple life domains. The present study examined the relations among attachment styles, emotional dysregulation, ADHD symptoms, and hypothetical RTBs across multiple real-life domains. Including a total of 155 mostly undergraduate students, we found in the main analysis that only ADHD symptoms were associated with RTB over and above all other variables. Specifically, the links between both attachment insecurity and emotional dysregulation with RTB disappeared when ADHD symptoms were included in the final model, but not vice versa. An exploratory analysis suggested that attachment insecurity was linked to romantic/sexual RTB over and above the others. These results further substantiate the link between ADHD symptoms and a general propensity for RTB and demonstrate that the link between the two seems to be inherent to the disorder and independent of its co-occurrence with attachment insecurity and emotional dysregulation.

Associations between the CADM2 gene, substance use, risky sexual behavior, and self-control: A phenome-wide association study.

Risky behaviors, such as substance use and unprotected sex, are associated with various physical and mental health problems. Recent genome-wide association studies indicated that variation in the cell adhesion molecule 2 (CADM2) gene plays a role in risky behaviors and self-control. In this phenome-wide scan for risky behavior, it was tested if underlying common vulnerability could be (partly) explained by pleiotropic effects of this gene and how large the effects were. Single nucleotide polymorphism (SNP)-level and gene-level association tests within four samples (25 and Up, Spit for Science, Netherlands Twin Register, and UK Biobank and meta-analyses over all samples (combined sample of 362,018 participants) were conducted to test associations between CADM2, substance- and sex-related risk behaviors, and various measures related to self-control. We found significant associations between the CADM2 gene, various risky behaviors, and different measures of self-control. The largest effect sizes were found for cannabis use, sensation seeking, and disinhibition. Effect sizes ranged from 0.01% to 0.26% for single top SNPs and from 0.07% to 3.02% for independent top SNPs together, with sufficient power observed only in the larger samples and meta-analyses. In the largest cohort, we found indications that risk-taking proneness mediated the association between CADM2 and latent factors for lifetime smoking and regular alcohol use. This study extends earlier findings that CADM2 plays a role in risky behaviors and self-control. It also provides insight into gene-level effect sizes and demonstrates the feasibility of testing mediation. These findings present a good starting point for investigating biological etiological pathways underlying risky behaviors.

Optimistic bias, risky behavior, and social norms among Indian college students during COVID-19.

Using survey data of college students in India, we investigate whether COVID-19 optimistic bias among individuals increases risky behavior. We also explore whether participants' optimistic bias differs depending on their degree of closeness with others. We found that the presence of friends instead of neighbors/strangers make participants with high COVID-19 optimistic bias inclined to take more risks. Besides, it has been found that preventive behavioral norms followed by peers minimize risky behavior among participants with high optimistic bias. Our findings offer important implications for policymakers to minimize the transmission of the disease among college students.

Life Course Transitions and Educational Trajectories: Examining Adolescents who Fall off Track Academically.

Educational interventions typically center on youth displaying early academic risk, potentially overlooking those falling off track academically later in their educational careers. The current study investigated the extent to which life course transitions experienced during adolescence were linked to falling off-track academically in high school. Data from the National Longitudinal Study of Adolescent to Adult Health (N = 4284; 53% female; Mage = 14.88) documented that 1516 students displayed no educational risk in early high school, yet 14% did not pursue 4-year college by age 24. Analyses revealed the unique life course transitions predictive of falling off-track academically (i.e., sexual intercourse, alcohol use, family transitions, residential mobility). The study's findings highlight important intervention avenues to promote adolescents' continued educational persistence.

Genetic propensity for risky behavior and depression and risk of lifetime suicide attempt among urban African Americans in adolescence and young adulthood.

Suicide attempts (SA) among African Americans have increased at a greater rate than any other racial/ethnic group. Research in European ancestry populations has indicated that SA are genetically influenced; however, less is known about the genetic contributors that underpin SA among African Americans. We examined whether genetic propensity for depression and risky behaviors (assessed via polygenic risk scores; PRS) independently and jointly are associated with SA among urban, African Americans and whether sex differences exist in these relations. Participants (N = 1,157, 45.0% male) were originally recruited as part of two first grade universal school-based prevention trials. Participants reported in adolescence and young adulthood on whether they ever attempted suicide in their life. Depression and risky behaviors PRS were created based on large-scale genome-wide association studies conducted by Howard et al. (2019) and Karlson Línner et al. (2019), respectively. There was a significant interaction between the risky behavior PRS and depression PRS such that the combination of high risky behavior polygenic risk and low/moderate polygenic risk for depression was associated with greater risk for lifetime SA among the whole sample and African American males specifically. In addition, the risky behavior PRS was significantly positively associated with lifetime SA among African American males. These findings provide preliminary evidence regarding the importance of examining risky behavior and depression polygenic risk in relation to SA among African Americans, though replication of our findings in other African American samples is needed.