Validity studies of the scale of positive and negative perceptions about alcohol effects.

OBJECTIVE To describe the process of elaboration and validation of the Scale of Perceptions about Alcohol Consumption in Higher Education Students in a Portuguese sample, considering the relationship between alcohol use rates and students' perceptions about the effects of this consumption. METHODS The validation study included 531 Portuguese college freshmen who answered the instrument, which is composed of five items that express positive perceptions and five items that express negative perceptions about the effects of alcohol consumption. RESULTS Evidence of content validity, internal structure and external variables were obtained. The results of the factor analysis confirm the distribution of positive and negative perceptions by two different factors according to the theoretical model. Adequate internal consistency indexes were obtained for each dimension. The data obtained showed expected correlations between the perceptions and consumption behaviors of the students, indicating evidence of criterion validity of the scale. Moreover, the study showed that different consumption patterns between men and women, with higher alcohol consumption in the students' households and restaurants or cafés by male students, in addition to the similarity in the consumption pattern between the two genders in parties and bars or nightclubs. CONCLUSION The data obtained show the validity of the instrument. In the discussion, the article presents considerations about the responsibility of higher education institutions in the prevention and reduction in consumption rates among their students.

Chemsex: por un abordaje multidisciplinar / Chemsex: for a multidisciplinary approach

El término Chemsex hace referencia al uso intencionado de drogas psicoactivas para mantener relaciones sexuales (antes o durante la actividad sexual), generalmente entre hombres que tienen sexo con hombres, y durante largos períodos de tiempo, desde varias horas a varios días, denominados sesiones. La práctica del Chemsex se asocia a un aumento del riesgo de infección por VIH y otras infecciones de transmisión sexual, así como a un incremento de los problemas de salud mental y de drogodependencia. Los usuarios de drogas recreativas presentan a menudo un funcionamiento y ajuste en su entorno socio-familiar y laboral aparentemente normal. Por tanto, ni el usuario de Chemsex ni su entorno afectivo tienen una demanda clara de ayuda profesional. Muchas de las personas que lo practican no tienen contacto con los servicios de salud, excepto en situaciones puntuales. Este fenómeno ha despertado preocupación por parte de los profesionales de la salud. En nuestro medio sanitario, actualmente, se tratan por separado a pacientes con enfermedades de transmisión sexual y a pacientes con drogodependencias. Para su cobertura resulta imprescindible un abordaje multidisciplinar

The term Chemsex refers to the intentional use of psychoactive drugs for sexual intercourse (before or during sexual activity), usually between men who have sex with men, and for long periods of time, from several hours to several days, called sessions. The practice of Chemsex is associated with an increased risk of HIV infection and other sexually transmitted infections, as well as an increase in mental health and drug dependence problems. Recreational drug users often have functioning and adjustment in their apparently normal socio-family and work environment. Therefore, neither the Chemsex user nor their emotional environment have a clear demand for professional help. Many of the people who practice it do not have contact with the health services, except in specific situations. This phenomenon has aroused concern on the part of health professionals. In our healthcare environment, currently, patients with sexually transmitted diseases and patients with drug dependence are treated separately. A multidisciplinary approach is essential for its coverage

Self-Report Data on Regular Consumption of Illicit Drugs and HIV Risk Behaviors after Kratom (Mitragyna Speciosa korth.) Initiation among Illicit Drug Users in Malaysia.

This study sought to determine the relationship between kratom (Mitragyna speciosa) initiation and regular consumption of illicit drugs and HIV risk behaviors in a cohort of illicit drug users in Malaysia. 260 illicit drug users with current kratom use were recruited through convenience sampling for this cross-sectional study. All were male, with the majority being Malays (95%, n = 246/260). Results suggest that kratom initiation was associated with significant decrease in the regular use of heroin (odds ratio (OR) = 0.50, 95% confidence interval (CI): 0.40- 0.72; p = .0001), methamphetamine (OR = 0.23, CI: 0.16- 0.35; p < .0001), and amphetamine (OR = 0.17, CI: 0.09- 0.34; p < .0001). Kratom initiation was also associated with reduction in regular HIV risk behaviors such as having sex with sex workers (OR = 0.20, CI: 0.12-0.32; p < .0001), using drugs before sexual intercourse (OR = 0.20, CI: 0.13- 0.31; p < .0001), injecting behaviors (OR = 0.10, CI: 0.04- 0.25; p < .0001), sharing of injection equipment (OR = 0.13, CI: 0.04- 0.43; p < .0001), and injecting with other injection drug users (IDUs) (OR = 0.07, CI: 0.02- 0.24; p < .0001).

Validity studies of the scale of positive and negative perceptions about alcohol effects / Estudos de validade da escala de percepções positivas e negativas sobre efeitos do álcool

ABSTRACT OBJECTIVE To describe the process of elaboration and validation of the Scale of Perceptions about Alcohol Consumption in Higher Education Students in a Portuguese sample, considering the relationship between alcohol use rates and students' perceptions about the effects of this consumption. METHODS The validation study included 531 Portuguese college freshmen who answered the instrument, which is composed of five items that express positive perceptions and five items that express negative perceptions about the effects of alcohol consumption. RESULTS Evidence of content validity, internal structure and external variables were obtained. The results of the factor analysis confirm the distribution of positive and negative perceptions by two different factors according to the theoretical model. Adequate internal consistency indexes were obtained for each dimension. The data obtained showed expected correlations between the perceptions and consumption behaviors of the students, indicating evidence of criterion validity of the scale. Moreover, the study showed that different consumption patterns between men and women, with higher alcohol consumption in the students' households and restaurants or cafés by male students, in addition to the similarity in the consumption pattern between the two genders in parties and bars or nightclubs. CONCLUSION The data obtained show the validity of the instrument. In the discussion, the article presents considerations about the responsibility of higher education institutions in the prevention and reduction in consumption rates among their students.

RESUMO OBJETIVO Considerando a relação entre as taxas de uso de álcool e as percepções dos estudantes sobre os efeitos desse consumo, descrever o processo de elaboração e validação da Escala de Percepções sobre o Consumo de Álcool em Estudantes do Ensino Superior em uma amostra portuguesa. MÉTODOS Participaram do estudo de validade 531 estudantes portugueses do primeiro ano do ensino superior que responderam ao instrumento, composto por cinco itens que expressam percepções positivas e cinco itens que expressam percepções negativas sobre os efeitos do consumo de álcool. RESULTADOS Evidências de validade de conteúdo, de estrutura interna e baseadas em variáveis externas foram obtidas. Os resultados da análise fatorial confirmam a distribuição das percepções positivas e negativas por dois fatores diferenciados em acordo com o modelo teórico de partida. Índices adequados de consistência interna foram obtidos para cada dimensão. Os dados obtidos mostraram correlações esperadas entre as percepções e os comportamentos de consumo dos estudantes, indicando evidências de validade de critério da escala. Em acréscimo, o estudo indicou haver padrões de consumo diferenciados entre os sexos, registando-se maior consumo de álcool nas residências e nos restaurantes ou cafés por parte dos homens, além de similaridade entre os dois sexos no padrão de consumo em festas e bares ou discotecas. CONCLUSÃO Os dados obtidos evidenciam a validade do instrumento. Na discussão dos dados, o artigo apresenta considerações sobre a responsabilidade das instituições de ensino superior na prevenção e redução das taxas de consumo entre a sua população estudantil.

Abordaje del fenómeno del Chemsex. una propuesta desde el Plan Nacional sobre el SIDA / No disponible

No disponible

Evaluating the impact of policies recommending PrEP to subpopulations of men and transgender women who have sex with men based on demographic and behavioral risk factors.

INTRODUCTION: Developing guidelines to inform the use of antiretroviral pre-exposure prophylaxis (PrEP) for HIV prevention in resource-limited settings must necessarily be informed by considering the resources and infrastructure needed for PrEP delivery. We describe an approach that identifies subpopulations of cisgender men who have sex with men (MSM) and transgender women (TGW) to prioritize for the rollout of PrEP in resource-limited settings. METHODS: We use data from the iPrEx study, a multi-national phase III study of PrEP for HIV prevention in MSM/TGW, to build statistical models that identify subpopulations at high risk of HIV acquisition without PrEP, and with high expected PrEP benefit. We then evaluate empirically the population impact of policies recommending PrEP to these subpopulations, and contrast these with existing policies. RESULTS: A policy recommending PrEP to a high risk subpopulation of MSM/TGW reporting condomless receptive anal intercourse over the last 3 months (estimated 3.3% 1-year HIV incidence) yields an estimated 1.95% absolute reduction in 1-year HIV incidence at the population level, and 3.83% reduction over 2 years. Importantly, such a policy requires rolling PrEP out to just 59.7% of MSM/TGW in the iPrEx population. We find that this policy is identical to that which prioritizes MSM/TGW with high expected PrEP benefit. It is estimated to achieve nearly the same reduction in HIV incidence as the PrEP guideline put forth by the US Centers for Disease Control, which relies on the measurement of more behavioral risk factors and which would recommend PrEP to a larger subset of the MSM/TGW population (86% vs. 60%). CONCLUSIONS: These findings may be used to focus future mathematical modelling studies of PrEP in resource-limited settings on prioritizing PrEP for high-risk subpopulations of MSM/TGW. The statistical approach we took could be employed to develop PrEP policies for other at-risk populations and resource-limited settings.

Cannabidiol Treatment Might Promote Resilience to Cocaine and Methamphetamine Use Disorders: A Review of Possible Mechanisms.

Currently, there are no approved pharmacotherapies for addiction to cocaine and other psychostimulant drugs. Several studies have proposed that cannabidiol (CBD) could be a promising treatment for substance use disorders. In the present work, the authors describe the scarce preclinical and human research about the actions of CBD on the effects of stimulant drugs, mainly cocaine and methamphetamine (METH). Additionally, the possible mechanisms underlying the therapeutic potential of CBD on stimulant use disorders are reviewed. CBD has reversed toxicity and seizures induced by cocaine, behavioural sensitization induced by amphetamines, motivation to self-administer cocaine and METH, context- and stress-induced reinstatement of cocaine and priming-induced reinstatement of METH seeking behaviours. CBD also potentiated the extinction of cocaine- and amphetamine-induced conditioned place preference (CPP), impaired the reconsolidation of cocaine CPP and prevented priming-induced reinstatement of METH CPP. Observational studies suggest that CBD may reduce problems related with crack-cocaine addiction, such as withdrawal symptoms, craving, impulsivity and paranoia (Fischer et al., 2015). The potential mechanisms involved in the protective effects of CBD on addiction to psychostimulant drugs include the prevention of drug-induced neuroadaptations (neurotransmitter and intracellular signalling pathways changes), the erasure of aberrant drug-memories, the reversion of cognitive deficits induced by psychostimulant drugs and the alleviation of mental disorders comorbid with psychostimulant abuse. Further, preclinical studies and future clinical trials are necessary to fully evaluate the potential of CBD as an intervention for cocaine and methamphetamine addictive disorders.

Benzo fury: A new trend in the drug misuse scene.

Benzofurans, also known by users as benzo fury or benzofury, are synthetic phenethylamines and constitute the third most prominent group of new psychoactive substances (NPS). As the use of these substances has been spread as an alternative to the classic illicit psychostimulants, such as amphetamines, their legal status was reviewed, resulting in an utter prohibition of these NPS in many countries worldwide. Herein, the prevalence of abuse, chemistry, biological effects, metabolism, and the potential harms and risky behaviors associated with the abuse of benzofurans are reviewed. The congeners of this group are mainly consumed recreationally at electronic dance music parties, in polydrug abuse settings. Benzofurans preferentially act by disturbing the functioning of serotonergic circuits, which induces their entactogenic and stimulant effects and is the reason behind the considerable number of recent benzo fury-related deaths. The slight interaction of these drugs with the dopaminergic system justifies the rewarding effects of these drugs. To date, published evidence on the mechanisms of toxicity of benzo fury is very limited but a body of research is now beginning to emerge revealing an alarming public health threat regarding the abuse of these NPS.

Adolescents who experienced negative alcohol-related consequences are willing to experience these consequences again in the future.

Alcohol use and risky single occasion drinking are common among adolescents and are associated with a higher risk of various negative social, physical, academic, or sexual consequences. Studies have shown that among college students, willingness to experience negative consequences is associated with a higher likelihood of experiencing these consequences in the future. However, it remains unclear how experiencing negative consequences influences adolescents' willingness to experience them again. Based on a representative sample of 1,333 alcohol-using 14- to 15-year-olds (47.9% female), a path model was used to examine the associations between risky drinking, negative social and physical consequences, and willingness to experience the specific consequence in the future. As hypothesized, more frequent risky drinking was positively associated with experiencing negative consequences (i.e., saying or doing embarrassing things, regretted sexual experiences, impairment of schoolwork, problems with parents/friends, accident or injury, hangover, vomiting, memory lapses). Contrary to our second hypothesis, adolescents who experienced a negative consequence were also consistently willing to experience it in the future. Findings suggest that adolescents may see the experience of negative consequences as a necessary evil to attain the positive consequences. Prevention efforts may benefit from focusing on ways of attaining positive consequences by promoting alternatives to engaging in risky drinking practices, as well as reducing negative consequences (e.g., by promoting protective behavioral strategies). (PsycINFO Database Record

Longitudinal analysis of HIV risk behaviour patterns and their predictors among public primary care patients with tuberculosis in South Africa.

The goal of this study was to identify various HIV risk behaviours among tuberculosis (TB) patients in a longitudinal study design in South Africa. In 42 public primary healthcare facilities in three districts in three provinces, adult new TB and TB retreatment patients with hazardous or harmful alcohol use were interviewed within 1 month of initiation of anti-TB treatment and were followed up at 6 months. The total sample with a complete 6-month follow-up assessment was 853. At the follow-up assessment, several HIV risk behaviours significantly reduced from baseline to follow-up. In multivariate Generalized Estimating Equations logistic regression analyses, high poverty (odds ratio (OR): 2.68, 95% confidence interval (CI): 1.56-4.62), Posttraumatic Stress Disorder (PTSD) symptoms (OR = 1.55, 95% CI = 1.03-2.36), and sexual partner on antiretroviral therapy (ART) (OR = 1.84, 95% CI = 1.09-3.10) were associated with a higher odds, and excellent/very good perceived health status (OR: 0.61, 95% CI: 0.37-0.98), severe psychological stress (OR = 0.51, 95% CI = 0.34-0.77), and HIV non-disclosure to most recent sexual partner (OR = 0.40, 95% CI = 0.25-0.65) were associated with a lower odds of inconsistent condom use. Being HIV positive (OR = 4.18, 95% CI = 2.68-6.53) and excellent/very subjective health status (OR = 2.98, 95% CI = 1.73-5.13) were associated with a higher odds, and having PTSD symptoms (OR = 0.60, 95% CI = 0.36-0.99), being on ART (OR = 0.48, 95% CI = 0.25-0.95), having a sexual partner on ART (OR = 0.41, 95% CI = 0.18-0.96), and HIV status non-disclosure (OR = 0.25, 95% CI = 0.15-0.41) were associated with a lower odds of having sex with an HIV-positive or HIV status unknown person. High poverty index (OR = 1.97, 95% CI = 1.19-3.25) and having a sexual partner on ART (OR = 4.37, 95% CI = 1.82-10.48) were associated with a higher odds, and having a partner with HIV-negative status (OR = 0.29, 95% CI = 0.16-0.51) and inconsistent condom use (OR = 0.39, 95% CI = 0.24-0.64) were associated with a lower odds of HIV status non-disclosure at last sex. The study found that among TB patients with problem drinking over a 6-month TB treatment period, the frequency of some HIV risk behaviours (inconsistent condom use) declined (OR = 0.64, 95% CI = 0.41-0.98), but also persisted at a high-level calling for a strengthening and integration of HIV prevention into TB management.

Antimicrobial stewardship: changing risk-related behaviours in the general population

This guideline covers making people aware of how to correctly use antimicrobial medicines (including antibiotics) and the dangers associated with their overuse and misuse. It also includes measures to prevent and control infection that can stop people needing antimicrobials or spreading infection to others. It aims to change people's behaviour to reduce antimicrobial resistance and the spread of resistant microbes.