Association between risky behaviors in adolescents and altered psychophysiological emotional responses / Los adolescentes con conductas de riesgo muestran respuesta psicofisiológica alterada

Abstract Introduction: The psychophysiology of emotional response in adolescence is a crucial factor for understanding risk and deviant behaviors. Objective: To compare specific characteristics of psychophysiological emotional response between risk behavior adolescents and controls. Materials and methods: Characterization of risk behaviors (RB), variations in the heart rate (HR), electromyography (EMG), skin conductance (SC) and temperature during the presentation of visual emotional stimuli. The emotional valence parameters, activation and dominance of such stimuli were qualified as well. Results: Significant differences were found among RB adolescents compared to the non-risk group, as well as signs of major psychophysiological response to emotionally loaded stimuli in RB when compared to the control group. The control group was characterized by initial bradycardia, which was more evident than in the risk behavior group. Conclusions: The control group presented more expressive initial bradycardia in comparison to the RB group. Both groups showed more pronounced cardiac deceleration when experiencing unpleasant stimuli, higher levels in EMG to pleasant stimuli in the RB group, and higher CP indicators for the three types of stimulus. A cohort study is required in order to compare current findings in RB versus physiological emotional response among adolescent groups.

Resumen Introducción. La psicofisiología de la respuesta emocional en la adolescencia es un factor clave en la comprensión de conductas de riesgo y desadaptación. Objetivo. Comparar especificidades de la reacción psicofisiológica emocional entre adolescentes con y sin conductas de riesgo. Materiales y métodos. Las medidas consistieron en la caracterización de conductas de riesgo (CR), variaciones en la frecuencia cardiaca (FC) electromiografía (EMG), conductancia de la piel (CP) y temperatura durante la presentación de estímulos emocionales visuales, así como la calificación en parámetros de valencia emocional, activación y dominancia de dichos estímulos. Resultados. Se encontraron diferencias significativas entre los adolescentes con CR comparados con aquellos que no las presentaban: se detectaron signos de mayor reacción psicofisiológica a los estímulos emocionales. Conclusiones. El grupo control se caracterizó por una bradicardia inicial más expresiva en comparación con el grupo con CR, ambos grupos mostraron desaceleración cardíaca más pronunciada ante estímulos desagradables, niveles más altos en EMG ante estímulos agradables en el grupo con RB e indicadores más elevados de CP ante los tres tipos de estímulo. Se requiere un estudio de cohorte a fin de comparar los hallazgos actuales en CR frente a la reacción fisiológica emocional entre los grupos de adolescentes.

History of abuse and psychological distress symptoms among female sex workers in two Mexico-U.S. border cities.

This study examined histories of past emotional, physical, and sexual abuse as correlates of current psychological distress using data from 916 female sex workers (FSWs) who were enrolled in a safer-sex behavioral intervention in Tijuana and Ciudad (Cd.) Juarez, Mexico. We hypothesized that histories of abuse would be associated with higher symptom levels of depression and somatization and that social support would moderate the relationship. Nonparametric correlations and a series of hierarchical regression analyses revealed that all forms of past abuse predicted higher levels of depressive symptoms, and physical and sexual abuse were significantly associated with higher levels of somatic symptoms. Social support was also significantly associated with fewer symptoms of distress; however, it was not shown to moderate the relationship between abuse history and distress.

Predictors of sexual risk reduction among Mexican female sex workers enrolled in a behavioral intervention study.

OBJECTIVE: We recently showed efficacy of an intervention to increase condom use among female sex workers (FSWs) in Tijuana and Ciudad Juarez, situated on the Mexico-United States border. We determined whether increases in condom use were predicted by social cognitive theory and injection drug user status among women randomized to this intervention. METHODS: Four hundred nine HIV-negative FSWs aged >or=18 years having unprotected sex with clients within the prior 2 months received a brief individual counseling session integrating motivational interviewing and principles of behavior change (ie, HIV knowledge, self-efficacy for using condoms, and outcome expectancies). RESULTS: Increases in self-efficacy scores were associated with increases in percent condom use (P = 0.008), whereas outcome expectancies were not. Female sex workers who inject drugs (FSW-IDUs) increased condom use with clients but not to the same extent as other FSWs (P = 0.09). Change in HIV knowledge was positively associated with change in percent condom use among FSW-IDUs (P = 0.03) but not noninjection drug users. CONCLUSIONS: Increases in self-efficacy significantly predicted increased condom use among FSWs, consistent with social cognitive theory. Increased HIV knowledge was also important among FSW-IDUs, but their changes in condom use were modest. Enhanced interventions for FSW-IDUs are needed, taking into account realities of substance use during sexual transactions that can compromise safer sex negotiation.

Efficacy of a brief behavioral intervention to promote condom use among female sex workers in Tijuana and Ciudad Juarez, Mexico.

OBJECTIVES: We examined the efficacy of a brief behavioral intervention to promote condom use among female sex workers in Tijuana and Ciudad Juarez, Mexico. METHODS: We randomized 924 female sex workers 18 years or older without known HIV infection living in Tijuana and Ciudad Juarez who had recently had unprotected sex with clients to a 30-minute behavioral intervention or a didactic control condition. At baseline and 6 months, women underwent interviews and testing for HIV, syphilis, gonorrhea, and chlamydia. RESULTS: We observed a 40% decline in cumulative sexually transmitted illness incidence (P = .049) in the intervention group. Incidence density for the intervention versus control groups was 13.8 versus 24.92 per 100 person-years for sexually transmitted illnesses combined (P = .034) and 0 versus 2.01 per 100 person-years for HIV (P < .001). There were concomitant increases in the number and percentage of protected sex acts and decreases in the number of unprotected sex acts with clients (P < .05). CONCLUSIONS: This brief behavioral intervention shows promise in reducing HIV and sexually transmitted illness risk behaviors among female sex workers and may be transferable to other resource-constrained settings.

Characteristics of female sex workers with US clients in two Mexico-US border cities.

BACKGROUND: HIV prevalence is increasing among female sex workers (FSWs) in Tijuana and Ciudad Juarez, 2 Mexican cities on the US border. Quasilegal prostitution in both cities attracts large numbers of sex tourists. We compared FSWs with and without US clients in both cities. METHODS: FSWs aged > or =18 years reporting unprotected sex with > or =1 client within the last 2 months, who were not knowingly HIV-infected, were enrolled in a behavioral intervention study. At baseline, participants underwent interviews, antibody testing for HIV and syphilis, and vaginal swabs for detecting gonorrhea and Chlamydia. Logistic regression identified factors associated with reporting >1 US client. RESULTS: Of 924 FSWs, 69% had US clients. Median age and duration in sex work were 32 and 4 years. Prevalence of HIV, infectious syphilis (titer > or =1:8), gonorrhea, Chlamydia, and any STI was 6%, 14%, 6%, 13%, and 27%, respectively. Compared with other FSWs, FSWs with US clients were more likely to have syphilis titers > or =1:8 (16% vs. 10%, P = 0.01), gonorrhea (8% vs. 2%, P <0.001) or any STI, including HIV (30% vs. 20%, P = 0.002). Factors independently associated with having US clients were: living in Tijuana, being younger, speaking English, being paid more for having sex without a condom, having >250 clients in the last 6 months, having syphilis titers > or =1:8, and injecting drugs. CONCLUSIONS: In these border cities, FSWs reporting US clients were more likely to have current STIs and to engage in higher-risk behaviors. Intensified binational prevention efforts involving both FSWs and their clients are urgently needed.

A qualitative exploration of female sex work in Tijuana, Mexico.

Previous research has documented high rates of STDs and increased risk of HIV infection among female sex workers (FSWs) in Mexico; however, little is known about the sexual risk behaviors of this population. The purpose of this study was to explore work history, context of sex work, sexual risk practices, client characteristics, attitudes toward condoms, and potential barriers to condom use in a sample of FSWs in Tijuana, Mexico. Analysis of qualitative data from 25 FSWs revealed that most women entered the sex trade at a young age ( M = 23 years), primarily as a result of financial need. Forty percent were single mothers supporting children. Women worked an average of 6-7 days per week; work shifts ranged from 4 to 13 hr per day. Clients were both Mexican and foreign (mostly American and Asian), and ranged in age from 18 to 80 years. Positive aspects of the job included flexible work hours and good income. Negative aspects of sex work included risks associated with physical assault, diseases, and unwanted pregnancies. Most clients did not want to use a condom and many offered additional money for unprotected sex. FSWs did not like to use condoms because they were perceived as uncomfortable. Most FSWs did not negotiate the use of condoms, had a low knowledge regarding the proper use of condoms, and were reticent to report their own unsafe sex practices. These results suggest the need to develop culturally appropriate safer sex interventions for FSWs in Mexican border cities.