Multiple Health Risk Behaviors in Young Adult Smokers: Stages of Change and Stability over Time.

BACKGROUND: Health risk behaviors (HRBs) are common, yet not well understood in young adult smokers. PURPOSE: We examined HRB profiles over 12 months in young adult smokers participating in a Facebook smoking cessation intervention clinical trial. METHODS: Participants (N = 500; age M = 20.9 years; 54.6% women) were recruited online and randomized to receive either a 3-month Facebook smoking cessation intervention or referral to Smokefree.gov (control). A Health Risk Assessment determined risk for 10 behaviors at baseline and 3, 6, and 12 months. Latent class analysis (LCA) and latent transition analysis (LTA) were used to identify patterns of HRBs and changes over time. RESULTS: At baseline, participants reported an average of 5.4 (standard deviation [SD] = 1.7) risk behaviors, including smoking (100%), high-fat diet (84.8%), poor sleep hygiene (71.6%), and low fruit and vegetable intake (69.4%). A 3-class model fit the data best at baseline and all follow-up time points: low risk (28.8% at baseline) with low likelihood of risk on all behaviors except smoking, substance use risk (14.0% at baseline) characterized by heavy episodic drinking, cannabis use, and other illicit drug use, and metabolic risk (57.2% at baseline), with a high percentage of members at risk for a low fruit and vegetable intake, high-fat diet, inactivity, stress, and poor sleep hygiene. Classes were very stable at 3, 6, and 12 months, with few participants transitioning between classes. CONCLUSIONS: Most young adult smokers engaged in multiple risk behaviors, with meaningful clustering of behaviors, and demonstrated stability over a year's time. In addition to smoking, targets for intervention are co-occurring substance use and metabolic risk behaviors. CLINICAL TRIALS REGISTRATION: NCT02207036.

Knowledge, attitudes and medical practice regarding hepatitis B prevention and management among healthcare workers in Northern Vietnam.

BACKGROUND AND AIM: Vietnam's burden of liver cancer is largely due to its high prevalence of chronic hepatitis B virus (HBV) infection. This study aimed to examine healthcare workers' (HCWs) knowledge, attitude and practices regarding HBV prevention and management. METHODS: A cross-sectional survey among health care workers working at primary and tertiary facilities in two Northern provinces in Vietnam in 2017. A standardized questionnaire was administered to randomly selected HCWs. Multivariate regression was used to identify predictors of the HBV knowledge score. RESULTS: Among the 314 participants, 75.5% did not know HBV infection at birth carries the highest risk of developing chronic infection. The median knowledge score was 25 out of 42 (59.5%). About one third (30.2%) wrongly believed that HBV can be transmitted through eating or sharing food with chronic hepatitis B patients. About 38.8% did not feel confident that the hepatitis B vaccine is safe. Only 30.1% provided correct answers to all the questions on injection safety. Up to 48.2% reported they consistently recap needles with two hands after injection, a practice that would put them at greater risk of needle stick injury. About 24.2% reported having been pricked by a needle at work within the past 12 months. More than 40% were concerned about having casual contact or sharing food with a person with chronic hepatitis B infection (CHB). In multivariate analysis, physicians scored significantly higher compared to other healthcare professionals. Having received training regarding hepatitis B within the last two years was also significantly associated with a better HBV knowledge score. CONCLUSIONS: Findings from the survey indicated an immediate need to implement an effective hepatitis B education and training program to build capacity among Vietnam's healthcare workers in hepatitis B prevention and control and to dispel hepatitis B stigma.

Definition of the profiles of hepatitis C virus patients based on the identification of risky practices in Spain

The absolute number of patients infected with the hepatitis C virus and its prevalence in Spain according to risk practices are not precise. The objective of the study was to estimate the current direct-action antiviral candidates, according to risky practices. The exposed population was determined according to each risky practice and age, based on the data obtained in two epidemiological studies and other bibliographic sources. The overall prevalence of positive serology for the Hepatitis C virus according to the analyzed data was 1.1% (41% with an active infection). The most at-risk group are intravenous drug users (60,368-82,454). It is estimated that between 37,387 to 51,065 patients would be infected via sexual transmission, between 55,505 and 75,812 patients following a blood transfusion and around 18,528 to 25,307 patients by socio-family transmission. According to these data, more than half (55-79%) of the subjects with risky practices would have significant fibrosis (≥ F2). It is estimated that more than half a million people have a positive serology for the Hepatitis C virus and 144,191 to 227,773 antiviral treatments are expected in the coming years. The identification of people with risky practices is key to increase the percentage of diagnosed cases

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Uso de drogas, prácticas de riesgo y factores asociados en la población penitenciaria en Cataluña: un estudio transversal / Substance use characteristics, health risk practices and associated factors among people imprisoned in Catalonia: a cross-sectional study

Introducción: El conocimiento disponible sobre el uso de sustancias entre personas encarceladas alberga incógnitas que nos propusimos esclarecer a fin de mejorar las intervenciones. Material y método: Se aplicó una encuesta sobre el uso de sustancias y las prácticas de riesgo, especialmente adaptada, entrevistando a 178 internos del Centro Penitenciario Brians 1, potencialmente consumidores, conformando un muestreo de bola de nieve con entrevistadores de acceso privilegiado, propicio para desvelar prácticas clandestinas. Resultados: El 74,7% de los participantes reconocieron un uso excesivo de drogas a lo largo de su vida, el 75,8% admitieron consumirlas, el 18,5% por vía endovenosa, durante los últimos seis meses en prisión. De los inyectores, el 36,4% participaron en el programa de intercambio de jeringas (PIJ) y el 54,5% las compartieron. Los españoles (con una odds ratio ajustada [ORa] de 4,79), reincidentes (ORa = 2,67), sancionados (ORa = 2,70) y con transgresiones graves de la convivencia penitenciaria (ORa=3,01) mostraron mayor probabilidad de uso. Tener mayor condena (ORa = 1,13), haber recibido tratamiento por problemas de drogas (ORa = 3,84) y ser portador del virus de la inmunodeficiencia humana (VIH) o hepatitis C (ORa = 3,95) les predisponía a inyectarse. Las personas que se inyectaban y participaban en el PIJ eran predominantemente mujeres (66,7%) y manifestaron mayor preocupación por el cuidado de su salud (90,9%). Discusión: El estudio sugiere el uso de sustancias y prácticas de riesgo en prisiones catalanas, pese a la profusión de los medios destinados a extinguirlas, prioritariamente centrados en la abstinencia; vincula la pervivencia de los comportamientos de riesgo con un estilo de vida marginalizado dentro de la propia institución; y apunta la necesidad de extender las intervenciones de reducción de daños y de aproximar el tratamiento a los reclusos, incorporando la perspectiva del usuario

Introduction: There are gaps in the available knowledge about substance use and risky practices among prison inmates witch we proposed to clarify in order to improve interventions. Material and method: We conducted a specifically adapted survey with 178 potential users imprisoned in the Brians 1 Prison of Barcelona. We applied a snowball sampling method, with peers as privileged access interviewers, which is particularly recommended to bring out hidden information. Results: 74.7% of participants admitted to excessive use of addictive substances throughout their life. In the last 6 months in prison, 75.8% accepted that they had used drugs, while 18.5% injected them. 36.4% of the latter group participated in the needle exchange program (NEP) of the facility and 54.5% acknowledged that they shared the needles. Spanish people (adjusted odds ratio (AOR = 4,79), recidivists (AOR = 2.67), penalised individuals (AOR = 2.70) and those involved in serious transgressions of prison regulations (AOR = 3.01) showed greater probability of substance use in prison. A longer sentence (AOR = 1.13), having undergone treatment for drug problems (AOR = 3.84) and being a carrier of blood-borne infections (AOR = 3.95) were linked to intravenous drug use. Injectors in the NEP were predominantly women (66.7%) and were more interested in caring for their health (90.9%). Discussion: The study reveals use of addictive substances and health risk practices among inmates in Catalonian prisons, despite their exposure to prevention policies mainly focused on abstinence; relates health risk behaviours to marginalization processes within the institution, and then consider the need to extend the scope of harm reduction interventions and to reinforce its appeal by incorporating the users' perspectives on the issue

Prevalence of sexually transmitted diseases in female sex workers in a city in the interior of São Paulo, Brazil / Prevalência de doenças sexualmente transmissíveis em mulheres profissionais do sexo, em um município do interior paulista, Brasil / Prevalencia de enfermedades sexualmente transmisibles en mujeres profesionales del sexo en un municipio del interior del estado de Sao Paulo, Brasil

Changes in the profile of sexually transmitted diseases have increased the need for their detection, particularly where there is a concentration of individuals with risk behavior, so that diagnosis and immediate treatment can be translated in the reduction of resulting problems. The objective was to identify the prevalence of sexually transmitted diseases in female sex workers in a medium-sized city in São Paulo state. This population prevalence study was conducted in 2008 on 102 females. The prevalence was 71.6 percent. When considered separately and in association, the highest values found were: HPV (67.7 percent) and Chlamydia (20.5 percent). HPV typing showed oncogenic genotypes. The prevalence of syphilis was 4.0 percent and of trichomoniasis 3.0 percent. No cases of hepatitis B or gonorrhea were identified. It was concluded that the prevalence of sexually transmitted diseases in the studied group was high, since approximately two thirds of the women showed some type of disease under this classification.

Mudanças no perfil das doenças sexualmente transmissíveis têm ampliado a necessidade de seu rastreamento, especialmente onde existe concentração de pessoas ou grupos com comportamentos de risco, para que o diagnóstico e tratamento imediato se traduzam na redução dos problemas causados. Objetivou-se identificar a prevalência de doença sexualmente transmissível entre mulheres profissionais do sexo, de município de médio porte do interior paulista. Este estudo de prevalência populacional foi realizado no ano 2008 com 102 profissionais do sexo. A prevalência geral de doença sexualmente transmissível foi 71,6 por cento. Considerados isoladamente e em associação, os maiores valores encontrados foram: HPV (67,7 por cento) e infecção clamidiana (20,5 por cento). A tipagem do HPV evidenciou genótipos oncogênicos. A prevalência de sífilis foi de 4,0 por cento e de tricomoníase 3,0 por cento. Nenhum caso de hepatite B ou gonorreia foi identificado. Conclui-se que a prevalência de doença sexualmente transmissível foi elevada, pois, aproximadamente dois terços das mulheres, apresentavam alguma doença assim classificada.

Cambios en el perfil de las enfermedades sexualmente transmisibles han ampliando la necesidad de su seguimiento, especialmente donde existe concentración de personas o grupos con comportamientos de riesgo, para que el diagnóstico y tratamiento inmediato se traduzcan en reducción de los problemas causados. El objetivo fue identificar la prevalencia de enfermedad sexualmente transmisible entre mujeres profesionales del sexo de un municipio de porte medio del interior del estado de Sao Paulo. Este estudio de prevalencia poblacional fue realizado en el año de 2008 con 102 profesionales del sexo. La prevalencia general de enfermedad sexualmente transmisible fue 71,6 por ciento. Considerados aisladamente y en asociación, los mayores valores encontrados fueron: VPH (67,7 por ciento) e infección clamidiana (20,5 por ciento). El tipaje del VPH evidenció genotipos oncogénicos. La prevalencia de sífilis fue de 4,0 por ciento y de tricomoníasis 3,0 por ciento. Ningún caso de hepatitis B o gonorrea fue identificado. Se concluye que la prevalencia de enfermedad sexualmente transmisible fue elevada, ya que aproximadamente dos tercios de las mujeres presentaban alguna enfermedad de ese tipo.