Titilayo C. Abiona

HIV sexual risk behaviors and perception of risk among college students: implications for planning interventions

BackgroundThe college environment offers great opportunity for HIV high-risk behaviors, including unsafe sex and multiple partnerships. While the overall incidence of HIV infection has seen some decline in recent years, rates of HIV infection among young adults have not seen a proportionate decline. As in the general population, African American young adults have been disproportionately affected by the HIV/AIDS epidemic. This study examined the sexual risk behaviors and perception of HIV risk of students in a predominantly African American commuter urban university in the Midwest.MethodsStudents enrolled in randomly selected general education courses completed a paper and pencil survey. Data were collected in Fall 2007, and univariate, bivariate, and multivariate analyses were conducted using SPSS for Windows v.16.ResultsThe sample included 390 students, the majority (83%) of whom were never married and 87% were sexually experienced. Among males reporting male partnerships those who used marijuana (OR = 17.5, p = 0.01) and those who used alcohol along with illegal drugs (OR = 8.8, p = 0.03) were significantly more likely to report multiple partnerships. Among females reporting male partnerships, those 30 years and older were significantly less likely (OR = 0.09, p = 0.03) to report having multiple male partners. There were significant differences in condom use last sex (p = 0.01) and consistent condom use (p = 0.002) among the different age groups. Older students were less likely to report condom use. Females age 30 years and older (OR = 3.74, p = 0.05) and respondents age 20-29 years (OR = 2.41, p = 0.03) were more likely to report inconsistent condom use than those below 20 years. Marijuana use was correlated with inconsistent condom use (p = 0.02) and alcohol with not using condom last sex among females. Perception of HIV risk was generally poor with 54% of those age 30 years and older, 48.1% of 20-29 year olds, and 57.9% of those below the age of 20 years perceived themselves as not having any chance of being infected with HIV. Predictors of moderate/good perception of HIV risk were drug and alcohol use, inconsistent condom use, and multiple partnerships.ConclusionStudents in the study sample engaged in various HIV risk behaviors but have a poor appreciation of their risk of HIV infection. While low rates of condom use was a problem among older students (30 years and older), multiple partnerships were more common among younger students, and marijuana and alcohol use were related to low condom use among females. Our findings support the need for targeted HIV prevention interventions on college campuses.

Clinical lactation practice: 20 years of evidence

Lactation consultants depend on a vast multidisciplinary knowledge base to support their practices. To coincide with the 20-year anniversary of the International Lactation Consultant Association, the authors sought to highlight the knowledge base to demonstrate how practice has been affected. Using standard databases, they extracted English-language scientific literature related to breastfeeding and maternal and infant health outcomes; factors associated with breastfeeding initiation, exclusivity, and duration; lactation physiology; common breastfeeding challenges; breastfeeding practices within vulnerable populations; health professional support of breastfeeding; and breastfeeding practices in developing countries of Africa. Summaries of research are provided to demonstrate scientific method and knowledge evolution. As the knowledge of the biological, behavioral, and environmental factors that affect breastfeeding continues to grow, researchers and lactation consultants will identify additional research areas. Thus, the cycle of describing and explaining phenomena, testing interventions to improve practice, and ultimately improving breastfeeding outcomes worldwide will continue.

Impact of repeated four-monthly anthelmintic treatment on Plasmodium infection in preschool children: a double-blind placebo-controlled randomized trial

BackgroundHelminth infections can alter susceptibility to malaria. Studies need to determine whether or not deworming programs can impact on Plasmodium infections in preschool children.MethodsA double-blind placebo-controlled randomised trial was conducted to investigate the impact of anthelmintic treatment on Plasmodium infection in children aged 12-59 months. Children were randomly assigned to receive either albendazole or placebo every four months for 12 months with a follow-up at 14 months.Results320 children (out of 1228, 26.1%) complied with all the follow-up assessments. Plasmodium prevalence and mean Plasmodium parasite density was significantly higher in the treatment group (44.9% and 2319 ± SE 511) compared to the placebo group (33.3% and 1471 ± 341) at baseline. The odds of having Plasmodium infection increased over time for children in both the placebo and treatment groups, however this increase was significantly slower for children in the treatment group (P = 0.002). By month 14, mean Plasmodium density had increased by 156% in the placebo group and 98% in the treatment group but the rate of change in Plasmodium density was not significantly different between the groups. The change from baseline in haemoglobin had a steeper increase among children in the treatment group when compared to the placebo group but this was not statistically significant.ConclusionsRepeated four-monthly anthelminthic treatments for 14 months resulted in a significantly lower increase in the prevalence of Plasmodium infection in preschool children which coincided with a reduction in both the prevalence and intensity of A. lumbricoides infections.Trial RegistrationCurrent controlled trials ISRCTN44215995

Patterns of soil-transmitted helminth infection and impact of four-monthly albendazole treatments in preschool children from semi-urban communities in Nigeria: a double-blind placebo-controlled randomised trial

BackgroundChildren aged between one and five years are particularly vulnerable to disease caused by soil-transmitted helminths (STH). Periodic deworming has been shown to improve growth, micronutrient status (iron and vitamin A), and motor and language development in preschool children and justifies the inclusion of this age group in deworming programmes. Our objectives were to describe the prevalence and intensity of STH infection and to investigate the effectiveness of repeated four-monthly albendazole treatments on STH infection in children aged one to four years.MethodsThe study was carried out in four semi-urban villages situated near Ile-Ife, Osun State, Nigeria. The study was a double-blind placebo-controlled randomised trial. Children aged one to four years were randomly assigned to receive either albendazole or placebo every four months for 12 months with a follow-up at 14 months.ResultsThe results presented here revealed that 50% of the preschool children in these semi-urban communities were infected by one or more helminths, the most prevalent STH being Ascaris lumbricoides (47.6%). Our study demonstrated that repeated four-monthly anthelminthic treatments with albendazole were successful in reducing prevalence and intensity of A. lumbricoides infections. At the end of the follow-up period, 12% and 43% of the children were infected with A. lumbricoides and mean epg was 117 (S.E. 50) and 1740 (S.E. 291) in the treatment and placebo groups respectively compared to 45% and 45% of the children being infected with Ascaris and mean epg being 1095 (S.E. 237) and 1126 (S.E. 182) in the treatment and placebo group respectively at baseline.ConclusionResults from this study show that the moderate prevalence and low intensity of STH infection in these preschool children necessitates systematic treatment of the children in child health programmes.Trial RegistrationCurrent controlled trials ISRCTN44215995.

Body art practices among inmates: Implications for transmission of bloodborne infections

BACKGROUND Unsterile body art practices among inmates in prison have been implicated in the transmission of bloodborne viruses. The objectives of this study were to determine the prevalence of tattooing and body piercing among inmates, identify factors associated with receiving a tattoo in prison, and explore the contexts of tattooing and body piercing in prison. METHODS A cross-sectional survey was conducted among randomly selected inmates in 17 state prisons in Illinois; a convenient sample of recently released exprisoners in Chicago, IL, participated in focus group discussions (FGDs). RESULTS A total of 1819 (1293 men and 526 women) inmates participated in the survey, and 47 exprisoners participated in the FGDs. Sixty-seven percent of the survey sample had tattoos, and 60% had body piercings. More men (19.3%) than women (8.7%) had received tattoos in prison (odds ratio, 0.40; 95% confidence interval: 0.29-0.56); prevalence of body piercing in prison was low (1.3%) and similar for men and women. Factors associated with tattooing in prison include incarceration for 1 year or longer and having had sex in prison among both men and women; nonheterosexual identity for women only; and for men, being 30-39 years old; incarcerated 4 or more times; having a history of sharing needles, multiple vaginal sex partners, and inconsistent condom use in the 6 months before arrest. Focus groups provided information on body art practices in prison. Inmates had a variety of reasons for getting body art, equipment was often shared, and cleansing agents were not readily available. CONCLUSION Tattooing and body piercing practices exist in prison and could constitute risks for transmission of bloodborne viral infections. Interventions to reduce these risks are discussed.

Gender differences in HIV risk behaviors of inmates.

BACKGROUND Incarcerated men and women differ in their views on HIV prevalence rates and susceptibility and their ability to prevent HIV infection. The objective of this study was to assess sex and gender differences in HIV risk behaviors of inmates in order to better support the consideration of gender in the development of HIV prevention interventions for the incarcerated population. METHODS A survey of 1819 inmates was conducted using a structured questionnaire. Self-reported HIV risk behaviors of 526 women and 1293 men during incarceration were compared. Bivariate analyses were done to identify gender differences in demographic characteristics and HIV risk behaviors. Logistic regression was used to determine factors associated with engaging in sexual intercourse in prison. RESULTS Mean age was higher for women than men (p = 0.05), and >50% of participants were African Americans. More women than men reported that they engaged in sexual intercourse (p < 0.001); however, men were more likely to report anal sex (p < 0.001). There were no sex differences in injection drug use. Women who identified as bisexual or lesbian, those who had been currently incarcerated for at least 1 year, and those who received tattoos in prison were more likely to report sexual intercourse. The only independent risk factor identified for men was being currently incarcerated for at least 7 years. CONCLUSIONS There are gender differences in HIV risk behaviors of inmates during incarceration. The findings in this study suggest that inmates may benefit from gender-specific HIV interventions while incarcerated and in the community subsequent to release.

Soil-transmitted helminth infections in Nigerian children aged 0-25 months

The objective of this cross-sectional study was to determine the prevalence and intensity of soil-transmitted helminths (STHs) in children aged 0-25 months and to identify the associated risk factors for Ascaris lumbricoides infections. The study was conducted in three villages outside Ile-Ife, Osun state, Nigeria in May/June 2005. Stool samples (369) were processed by formol-ether concentration. Ascaris lumbricoides (12.2%) was the dominant infection. Age, fathers occupation and dog ownership were identified as the significant risk factors in the minimal adequate model for A. lumbricoides. The odds of being infected with A. lumbricoides increased as the children got older. Children aged 12-17 months and 18-25 months were 8.8 and 12.4 times, respectively, more likely to harbour Ascaris than those aged 7-11 months. The odds of harbouring Ascaris for children whose families owned a dog were 3.5 times that of children whose families did not own a dog. Children whose fathers were businessmen were 0.4 times less likely to be infected with Ascaris than those whose fathers were farmers. The findings from this study suggest that many of these young children, who are at a critical stage of development, are infected with Ascaris and that the prevalence of infection with this parasite increases with age. This study has highlighted the need to incorporate preschool children into deworming programmes in endemic regions and to investigate innovative ways of delivering cost-effective deworming treatment to this high-risk age group.

Pre‐incarceration HIV risk behaviours of male and female inmates

In most countries, HIV and AIDS rates are higher among inmates than in the general population. As part of a series of studies aimed at examining the plausible links between HIV and incarceration in a State prison system in the United States (US), the present study examined pre-incarceration sexual and injection drug use behaviours of inmates and their demographic correlates. Two-hundred-andsixteen female and 260 male inmates randomly selected from 17 Illinois State prisons completed a structured questionnaire. Findings indicate that the rate of inconsistent condom use with multiple anal and vaginal sexual partners among study participants ranged from 11 to 49%. Fourteen per cent of the women and 25% of the men reported ever injecting drugs, while 13% of the women and 7% of the men had ever shared needles. Demographic correlates of risk behaviours differed between gender and for specific behaviours. The findings indicate that persons entering prison generally exhibit risk behaviours that may increase their chances of acquiring HIV. Comprehensive HIV prevention programmes should be made available to inmates in US prisons and be accessible to them upon release. Studies are needed to examine how individual and structural factors interact to increase HIV and incarceration risk.

Relationship between incarceration frequency and human immunodeficiency virus risk behaviors of African American inmates.

OBJECTIVE We examined the relationship between frequency of incarceration and preincarceration risk behaviors and determined the demographic factors associated with risk behaviors among a sample of African American inmates. METHODS We surveyed 229 (102 female and 127 male) randomly selected inmates. Risk behaviors between inmates serving their first prison sentence and those who had been incarcerated in prison more than once were compared using the chi2 test. Multivariate logistic regression analysis was used to determine factors associated with risk behaviors. RESULTS For most risk behaviors, there were no significant differences between inmates serving their first prison sentence and inmates incarcerated more than once; however, male inmates who had been incarcerated more than once were more likely to report having had multiple vaginal sex partners (OR, 2.42; 95% CI, 1.10-5.32; P = .03). No demographic variable was found to be independently associated with risk behaviors. CONCLUSIONS Frequency of incarceration did not affect preincarceration human immunodeficiency virus (HIV) risk behaviors among this sample of African American inmates. HIV prevention efforts should be directed at addressing the individual and structural factors associated with high-risk behaviors among African Americans.

Readability and test-retest reliability of a psychometric instrument designed to assess HIV/AIDS attitudes, beliefs, behaviours and sources of HIV prevention information of young adults

Objective: This comparative study evaluated the readability and test-retest reliability of a questionnaire designed to assess the attitudes, beliefs behaviours and sources of information about HIV/AIDS among young adults recruited from universities in the United States of America (USA), Turkey and South Africa. Design/Setting: The instrument was administered on two occasions, within a two week interval, to 219 university students in the USA (n = 66), Turkey (n = 53) and South Africa (n = 100). Method: The psychometric instrument developed has five major subscales: demographic, HIV/AIDS attitudes and beliefs, HIV risk sexual behaviour, alcohol and drug use, and HIV sources of information. Results: The instrument’s readability evaluation revealed a Flesch-Kincaid score (literacy difficulty level of the questionnaire) of 8.4, indicating that respondents would need an eighth grade reading level to understand the survey. The overall test-retest reliability coefficients for the items on the demographic subscale were generally high (0.893–0.997). Similarly, high test-retest reliability was obtained for the HIV risk sexual behaviour (0.738–0.996) and the alcohol and drug use (0.562–1.000) subscales. Much lower test-retest reliability was obtained for the HIV/AIDS attitudes and beliefs (0.32–0.80), and sources of information about HIV/AIDS (0.370–0.892) subscales. Conclusion: We found no discernible difference in the reliability data among the respondents from the three countries. The instrument should be of interest to clinicians and researchers investigating the HIV risk behaviours of young adults and older age groups with an eighth grade reading level. The availability of this instrument may enhance HIV population and intervention studies internationally.