Correlates of human immunodeficiency virus infection risk behavior in male attendees of a clinic for sexually transmitted disease.

Human immunodeficiency virus (HIV) infection risk behavior was evaluated in a cross-sectional survey of 400 male active-duty US Army personnel who presented at a sexually transmitted disease (STD) clinic with symptoms of acute urethritis. High-risk partners were common, and nearly one-quarter of the sample had previously had STDs. Logistic regression models examined correlates of HIV exposure risk, of inconsistent condom use, and of having partners with increased risk of HIV infection. Frequent partner turnover, sex "binging," negative attitudes toward condom use, and engaging in sex during military leaves were important correlates of risk. Individuals with HIV infection risk behavior generally were cognizant of their risk for HIV infection. Implications for intervention are discussed.

Reducing risk of sexually transmitted disease (STD) and human immunodeficiency virus infection in a military STD clinic: evaluation of a randomized preventive intervention trial.

Three single-session preventive interventions for reducing sexually transmitted disease (STD) and human immunodeficiency virus infection risk behaviors were evaluated with a sample of 400 men who attended a large military STD clinic. A quasi-experimental, pre-evaluation/postevaluation design was used, comparing standard clinic care alone versus standard care combined with 1 of 3 experimental interventions: health-risk appraisal, interactive video, and targeted situational behaviors. Questionnaire data were collected at baseline and during follow-up visits at 2 weeks and 2 months. Findings indicated that the health-risk appraisal and interactive video increased adherence with clinic recommendations to abstain from sex (chi(2)3199=19.67; P<.001) and increased readiness to change "risky" partner-selection behavior (chi(2)2194=6.42; P<.04). Follow-up data suggested that STD-related risk behavior was particularly resistant to change but that the single-session intervention had some impact, which could be viewed as a "priming" effect that enhances multisession interventions.

Features of urethritis in a cohort of male soldiers.

Of 400 cases of urethritis in male soldiers enrolled in a behavioral intervention project, the etiology of 69% was defined at study enrollment, as well as the etiology of 72% of 25 repeated episodes involving 21 men during the first 78 days of active follow-up (5% of the cohort). Chlamydia trachomatis (36%), Neisseria gonorrhoeae (34%), and Ureaplasma urealyticum (19%) were the most common causes of infection identified at enrollment and during subsequent visits (44%, 28%, and 12%, respectively). By univariate analysis, patients with repeated infection ("repeaters") were significantly more likely to report a history of sexually transmitted disease (STD; relative risk [RR], 3) and sex with sex workers (RR, 4) than were nonrepeaters. By multivariate analysis, only STD history was significant (RR, 2.8). Characteristics of repeaters in this cohort suggest that specific patterns may be used to establish screening "profiles" of potential repeaters, by which such individuals might be targeted for aggressive intervention at the time of the initial diagnosis.

Human immunodeficiency virus (HIV) education and HIV risk behavior: a survey of rapid deployment troops.

A paper-and-pencil questionnaire was administered to 1,377 U.S. Army troops from rapid deployment units at Fort Bragg, North Carolina. This yielded 1,368 surveys available for analysis. The primary goal of the survey was to evaluate this group's experience with the Army human immunodeficiency virus (HIV) education program and to determine their level of HIV risk behaviors as related to participation in the Army's HIV education program. Seventy-seven percent of the respondents (1,052 of 1,368) reported receiving some HIV education from the Army. Of those, 55% (578 of 1,052) reported receiving 1 hour of education within the past year. Soldiers of Asian, Native American, and "other" race/ethnicity, and to a lesser extent, Hispanic background, were more likely to report receiving no HIV education compared with whites and African Americans. Self-reported receipt of HIV education did not strongly differentiate individuals in their partner selection or in key sexual risk behaviors in which they engaged.

Coping with HIV disease among seropositive women: psychosocial correlates.

With HIV becoming more of a chronic illness, and with a shift in the demographics of the HIV pandemic to women, it is important to understand which psychosocial factors relate to positive coping behaviors in HIV-infected women. Additionally, socioeconomic factors have frequently confounded the interpretation of results of many other studies of stress and coping in HIV-infected individuals. In the present study, 58 HIV-infected women were assessed. These women were generally well-educated, employed women and therefore did not suffer from socioeconomic factors associated with inner city living, commercial sex work, or drug use. We performed a discriminant function analysis to determine which of five psychosocial variables could discriminate between those who strongly self-identified with each of three coping styles from those with low self-identification. The three coping styles included an active, problem solving style, a hopeless, given-up style, and a stoic style. Different patterns of psychosocial variables discriminated between those who strongly identified with a coping style from those who did not. For fighting spirit, the best combination of predictors (loadings > .25) were: strong social support, lower loneliness, depression, and anger, and a belief in a chance locus of control. The best combination of predictors for identification with a helpless coping style were: loneliness, depression, and anger, lower social support and less belief in a chance locus of control. Stronger identification with a stoic coping style were belief in a chance locus of control and lower social support, loneliness, and anger. Results of the study point to areas of psychosocial functioning which need to be strengthened or diminished in order to maintain effective coping for HIV-infected women and enhance their quality of life.

Reaction time slowing in HIV-1-infected individuals: role of the preparatory interval.

Psychomotor speed and directed attention were evaluated in 83 human immunodeficiency virus-1-infected individuals (HIV+) and 50 HIV-1 seronegative (HIV-) control participants using simple and choice reaction time (RT) tasks. The simple RT task included 1- and 3-s, irregularly varied preparatory intervals (PI) between the warning and target lights. Relative to the HIV- group, simple and choice RT were significantly slowed in the HIV+ group. Further, again relative to the HIV- controls, the HIV+ group did not show expected faster RT with increased response preparation time in the simple RT task. This also occurred in some HIV+ subjects who did not have psychomotor slowing. These findings suggest that RT performance in HIV-1-infected individuals may reflect separate processes associated with psychomotor slowing and impaired ability to direct attention. Possible neural mechanisms associated with control of these processes are discussed.

The effects of prophylactic treatment of the central nervous system on the intellectual functioning of children with acute lymphocytic leukemia.

The effect of central nervous system prophylaxis (cranial radiation and intrathecal chemotherapy) on intellectual function was studied in 24 children with acute lymphocytic leukemia. The Wechsler Intelligence tests were administered to these children and to a sample of their healthy siblings, who served as a comparison group. The mean Full Scale lQ was 98.6 for the patients and 112.5 for the sibling controls (p less than 0.001 level). Those patients who received central nervous system preventive treatment at a young age exhibited a greater decrement in intellectual abilities than did patients who were older when they received this treatment. In contrast, leukemia patients who had not received central nervous system prophylaxis had IQs that did not differ statistically from those of their siblings. These data suggest that central nervous system prophylaxis may have an adverse effect on the intellectual capability of children with acute lymphocytic leukemia.

Children with serious illness: behavioral correlates of separation and isolation.

The deleterious effects of separation have been demonstrated in experimental animal studies and in naturalistic case studies of children. In this study extensive observational and physiological records were obtained on four preschool children who were receiving chemotherapy for childhood cancer. The findings generally parallel those reported in the subhuman primate literature. The children's behavior followed a sequence of agitation followed by behavioral depression. The findings underscore the seriousness of parent-child separation and the need to develop intervention strategies to ameliorate these deleterious effects.