Measurement of parenting self-efficacy and outcome expectancy related to discussions about sex.

The purpose of this study was to evaluate the psychometric properties of two scales--one to measure the self-efficacy of parents to discuss sexual health issues with their adolescents and the other to measure parents' outcome expectancy associated with such discussions. Understanding how parents feel about their confidence in talking with their children about important sexual health issues and the outcomes they expect as a result of such discussions can be useful in guiding both the development and refinement of educational programs to promote parent-child discussions. The responses of 491 mothers who participated in an HIV prevention intervention with their adolescents were used for the present analysis. Mothers ranged in age from 25 to 68 years with a mean of 37.9 years (SD = 6.9). Of mother participants, 33% were married, 96.7% were African American, and 89.2% had completed high school. Their adolescents ranged in age from 11 to 14 years, and 61.5% were male. Assessment of reliability for both scales showed that internal consistency reliability was acceptable for the total scales as well as three of the five subscales. With the exception of one item on the outcome expectancy scale, the inter-item correlations, the mean inter-item correlations, and the item-to-total correlations meet the standard criteria for scale development for both scales. Factor analysis was used to identify the underlying structure of the scales, and hypothesis testing was used to assess construct validity. The results of these analyses provide support for the construct validity of the scales.

A randomized trial of a brief HIV risk reduction counseling intervention for women.

There is an urgent need for the development and implementation of effective and feasible behavioral HIV and STD interventions. The purpose of the present randomized controlled trial was to evaluate the effectiveness of a single-session, skill-based sexual risk reduction intervention for women. Participants were assessed at baseline and at 1 month and 3 months following the intervention on measures of AIDS knowledge, behavioral intentions, self-efficacy, and sexual risk behavior. Compared with women in an AIDS-education-only condition, women receiving the skill-based intervention reported significantly higher rates of condom use at 3-month follow-up. Results suggest that brief sexual risk reduction programs are feasible and effective within a community setting.

Sexual coercion, domestic violence, and negotiating condom use among low-income African American women.

Coercion to engage in unwanted sex places women at risk for human immunodeficiency virus (HIV) infection. A survey of 125 women living in low-income housing developments in Fulton County, Georgia, showed that 53 (42%) women had engaged in unwanted sex because a male partner threatened to use force or used force to obtain sexual access. Women who had been sexually coerced were more likely to have used marijuana and crack cocaine and to have abused alcohol. Coerced women were more likely to have been physically abused by a domestic partner. These women were also more likely to perceive that requesting male partners to use condoms would create a potentially violent situation. These results suggest that women experience an interactive constellation of social problems that create risks for HIV infection and, therefore, that efforts to prevent HIV infection among women will require multifaceted intervention strategies to reach both men and women at risk.

AIDS information needs: conceptual and content analyses of questions asked of AIDS information hotlines.

Dissemination of accurate information about HIV is an essential element of national AIDS prevention strategies and AIDS telephone hotlines serve a vital function in providing such information. In this study, questions asked of two AIDS information hotlines were collected and examined to determine the AIDS information needs of the general public. Questions asked of local AIDS lines in Houston and Milwaukee (N = 1611) were independently classified into 30 content areas, with two independent raters achieving 94% agreement. The content areas were organized for analysis into 11 broader information domains. Questions about HIV antibody testing were the most frequently asked (27%), followed by questions about sexual transmission of HIV (16%), HIV-related symptoms (16%) and situations that do not confer risk for HIV infection (14%). Content analyses suggested that individuals were motivated to call hotlines by fears of contracting HIV from actual risk behaviors or to dismiss concerns about contracting HIV through casual modes. Many individuals had information needs related to their own personal experiences that could not be addressed through media campaigns or other means of mass public health education. Results suggest that HIV information dissemination to the public through hotlines and other means of direct health education serves both preventive and destigmatizing functions.

It's like a regular part of gay life: repeat HIV antibody testing among gay and bisexual men.

HIV antibody testing is a critical facet of national AIDS prevention strategies and increasing numbers of persons are tested each year. Research has shown that a significant number of men who have sex with men are repeatedly tested for HIV antibodies, and many are tested regularly every 6 months. This study investigated the prevalence of repeat testing (having been tested three or more time) and regular testing (having been tested three or more times and getting tested every 6 months), and their association to testing attitudes and sexual behaviors. We found that 66% of 253 HIV seronegative gay and bisexual men surveyed at a large gay pride festival had been repeatedly tested, and 47% were tested regularly. Repeat testing was associated with knowing people with HIV or AIDS, whereas regular testing was associated with younger age and not being in an exclusive sexual relationship. Both repeat and regular testers held more positive health-related attitudes about testing than nonrepeat and nonregularly tested men, respectively. Contrary to previous research, repeat testing was not associated with unprotected anal intercourse or unprotected oral sex. However, both repeat and regular testing were positively related to condom use during anal intercourse as well as having multiple protected anal intercourse partners. We therefore conclude that both repeat testing and higher rates of condom use reflect positive health attitudes and that repeat testing may function to meet the needs of some men who have sex with men.

Use of the cognitive assessment method to evaluate the adequacy of sexually transmitted disease history questions.

Cognitive assessment is an approach used to evaluate questions in survey interviews. This approach is useful in delineating measurement error due to participants' understanding of terms and interpretation of questions. The purpose of this study was to evaluate the quality of questionnaire items designed to evaluate history of sexually transmitted diseases (STDs) using a cognitive assessment approach. Participants recruited from an STD clinic were asked up to six questions to assess their history of STDs. Verbal probes were used after each question in an attempt to evaluate the participants' understanding of the questions and methods they used to recall episodes of having STDs. The findings revealed that respondents did not understand the medical terms for some STDs, that the wording of one question potentially interfered with respondents' comprehension of the question, and that respondents used an episodic recall method to determine their number of previous STD infections. Cognitive assessment is a useful method for identifying potential sources of respondent-induced measurement error.

Chlorobenzene degradation by bacteria isolated from contaminated groundwater.

Bacterial isolates were obtained from groundwater and soils contaminated with chlorobenzene (CB). The isolates were tested to determine whether the natural community could remove the groundwater contaminants. These isolates were identified and characterized as to their ability to grow on CB and related aromatic compounds. The complete consortium could mineralize approximately 54% of the CB within 7 days, with no accumulation of 3-chlorocatechol. Metabolic pathways were evaluated for several isolates. One phenotype was characterized by the ability to degrade CB by the modified ortho pathway. One strain also degraded p-dichlorobenzene by using the same pathway. Isolates exhibiting a second phenotype degraded p-cresol, benzene, and phenol by the classical ortho pathway and accumulated 3-chlorocatechol when grown in the presence of CB. Strains of the third phenotype grew on complex media in the presence of CB but did not transform any of the aromatic compounds tested. The results suggest that the indigenous microbial community at the contaminated site would be able to degrade CB if provided with the appropriate conditions.

Effect of circulating neutrophil depletion on lung injury induced by inhaled silica particles.

Polymorphonuclear leukocytes (PMNs) recruited into the alveolar region during inflammation may injure the lung parenchyma by releasing cytotoxic oxygen radicals and proteases. Because brief exposures to crystalline silica elicit recruitment of PMNs into the alveolar region, which is strongly correlated with parameters of cytotoxicity, increased alveolar epithelial permeability, and lysosomal enzyme release, we sought to evaluate the potential role of PMNs in silica-induced lung injury. Rats were depleted of PMNs by administration of an anti-rat PMN antiserum prior to exposure to silica. Pulmonary inflammatory responses to silica in this group were compared to responses in normal silica-exposed rats as well as sham-exposed normal or PMN-depleted rats. Bronchoalveolar lavage fluids from normal, silica-exposed rats contained 9.7 x 10(6) PMNs immediately after exposure for 3 days, compared to 0.01 x 10(6) PMNs for both normal or PMN-depleted, sham-exposed rats. Bronchoalveolar lavage fluids from successfully PMN-depleted, exposed rats contained significantly fewer (0.7 x 10(6)) PMNs compared to normal silica-exposed rats. In both groups of silica-exposed rats, a variety of biochemical indicators of lung injury were increased significantly compared to measurements from both sham-exposed groups, but there were no differences between PMN-depleted and normal silica-exposed groups. The results suggest that recruitment of PMNs into the alveolar region is not a necessary prerequisite for the observed increases in biochemical indicators of silica-induced acute lung injury.

Microbiology of chronic sinusitis in children.

To better understand the factors involved in chronic sinusitis in childhood, we cultured the sinuses, middle meatus, and nasopharynx in 39 children requiring surgical intervention. Sixty-nine percent of these patients had other medical problems, including asthma (49%) and immunologic compromise (18%). We cultured coagulase-negative staphylococcus in 18 patients, Streptococcus viridans in 14 patients, normal flora in 10 patients, Staphylococcus aureus in nine patients, group D streptococcus in five patients, Corynebacterium in five patients, Haemophilus influenzae in three patients, Neisseria in three patients, and Streptococcus pneumoniae, group A streptococcus, Escherichia coli, Pseudomonas aeruginosa, Klebsiella oxytoca, Propionibacterium acnes, Actinomyces, and an anaerobic gram-negative bacillus in one patient each. Cultures yielded no growth in nine patients. A strong association between cultures of the middle meatus obtained ipsilaterally and cultures of the maxillary (83%) and ethmoid sinuses (80%) occurred. A poor correlation was found between cultures of the nasopharynx and maxillary (45%) and ethmoid sinuses (49%). All seven patients who had both maxillary and ethmoid sinus cultures showed the same organisms in both sinuses. Only 41% of organisms were found on both sides when procedures were performed bilaterally. Cultures of the middle meatus appear to be sensitive and specific for organisms within sinuses. The presence of predominantly nonvirulent organisms in low titers suggests that additional factors other than bacterial overgrowth contribute to the pathogenesis of chronic sinusitis in children.

Phenol as an adjuvant anesthetic for tympanostomy tube insertion.

The use of inhalational anesthesia for insertion of tympanostomy tubes in children provides no postoperative pain relief. Our retrospective analysis of children following tympanostomy tube insertion previously had shown significant postoperative elevations of blood pressure and heart rate in over 70% of cases. These changes, along with behavioral findings and complaints of discomfort, are suggestive of pain. Phenol has been used in adults for local anesthesia during tympanostomy tube insertion. This study determined prospectively whether pain occurred postoperatively and whether phenol placed on the tympanic membrane just prior to myringotomy would reduce postoperative pain in children, as measured by behavioral and physiologic parameters. Results of a double-blind, randomized trial in 46 children showed that both the phenol-treated and the control groups demonstrated significant elevations in pain scores postoperatively (P = 0.0001), which then slowly diminished to baseline by 45 min to one hour. The phenol group had consistently higher pain scores than the non-phenol group (P less than 0.001). Possible reasons for these findings are discussed.