High Risk Sexual Behaviors for HIV among the In-School Youth in Swaziland: A Structural Equation Modeling Approach

Background

Global efforts in response to the increased prevalence of the human immunodeficiency virus (HIV) are mainly aimed at reducing high risk sexual behaviors among young people. However, knowledge regarding intentions of young people to engage in protective sexual behaviors is still lacking in many countries around the world, especially in Sub-Saharan Africa where prevalence of human immunodeficiency virus is the highest. The objective of this study was to test the theory of planned behavior (TPB) for predicting factors associated with protective sexual behaviors, including sexual abstinence and condom use, among in-school youths aged between 15 and 19 years in Swaziland.

Methods

This cross-sectional survey was conducted using a anonymous questionnaire. A two-stage stratified and cluster random sampling method was used. Approximately one hundred pupils from each of four schools agreed to participate in the study, providing a total sample size of 403 pupils of which 369 were ultimately included for data analysis. The response rate was 98%. Structural equation modeling was used to analyse hypothesized paths.

Results

The TPB model used in this study was effective in predicting protective sexual behavior among Swazi in-school youths, as shown by model fit indices. All hypothesized constructs significantly predicted intentions for abstinence and condom use, except perceived abstinence controls. Subjective norms were the strongest predictors of intention for premarital sexual abstinence; however, perceived controls for condom use were the strongest predictors of intention for condom use.

Conclusions

Our findings support application of the model in predicting determinants of condom use and abstinence intentions among Swazi in-school youths.     

Sexual Behavior and Condom Use among Gay Men,Female Sex Workers,and Their Customers: Evidence from South Korea

Background

Despite the significance for sexually transmitted diseases (STD) control in East Asia, few studies have examined the relationship between high-risk sexual behavior and condom use. We investigated how three sexually vulnerable groups for STDs show differences in condom use behaviors (CUBs) depending on their STD infection.

Methods

The source of data came from the National Survey for STD Prevalence Rate and Sexual Behavior of the High-Risk Sexual Community. The effects of behavioral determinants on CUBs were estimated by using path analysis models. An 11-item questionnaire assessing subjects’ health risk behaviors, sexual beliefs, sexual risk behaviors, and condom use.

Results

Condom use was higher for men who have sex with men (MSM; n = 108) when they were bisexuals and had high self-efficacy, for Johns (Johns; n = 118) when they had experience of STD infection, and for female sex workers (FSWs; n = 1,083) when they had high self-efficacy, did not engage in drunken sex, and were anxious about infection. Regardless of whether they were infected with STDs, FSWs always used condom when they had high sexual beliefs. On the contrary, Johns exhibited a negative relationship between sexual risk behavior and condom use when they had experience of STD infection. The variable commonly significant to all three groups was the number of sex partners; but it exhibited a positive relationship with MSMs and Johns, and a negative one with FSWs.

Conclusions

CUBs were related to sexual beliefs as well as sexual risk behavior. At the same time, the experience of STD infection mediated the relationship between the two. Therefore, we need to draw social attention to promote safer sex among STD-vulnerable groups.     

Protective Efficacy of Selenite against Lead-Induced Neurotoxicity in Caenorhabditis elegans

Background

Selenium is an essential micronutrient that has a narrow exposure window between its beneficial and toxic effects. This study investigated the protective potential of selenite (IV) against lead (Pb(II))-induced neurotoxicity in Caenorhabditis elegans.

Principal Findings

The results showed that Se(IV) (0.01 µM) pretreatment ameliorated the decline of locomotion behaviors (frequencies of body bends, head thrashes, and reversal ) of C. elegans that are damaged by Pb(II) (100 µM) exposure. The intracellular ROS level of C. elegans induced by Pb(II) exposure was significantly lowered by Se(IV) supplementation prior to Pb(II) exposure. Finally, Se(IV) protects AFD sensory neurons from Pb(II)-induced toxicity.

Conclusions

Our study suggests that Se(IV) has protective activities against Pb(II)-induced neurotoxicity through its antioxidant property.     

Socioeconomic status and health communication inequalities in Japan: a nationwide cross-sectional survey

Background

Considerable evidence suggests that communication inequality is one potential mechanism linking social determinants, particularly socioeconomic status, and health inequalities. This study aimed to examine how dimensions of health communication outcomes (health information seeking, self-efficacy, exposure, and trust) are patterned by socioeconomic status in Japan.

Methods

Data of a nationally representative cross-sectional survey of 2,455 people aged 15–75 years in Japan were used for secondary analysis. Measures included socio-demographic characteristics, subjective health, recent health information seeking, self-efficacy in seeking health information, and exposure to and trust in health information from different media.

Results

A total of 1,311 participants completed the questionnaire, giving a response rate of 53.6%. Multivariate logistic regression revealed that education and household income, but not employment, were significantly associated with health information seeking and self-efficacy. Socioeconomic status was not associated with exposure to and trust in health information from mass media, but was significantly associated with health information from healthcare providers and the Internet.

Conclusion

Health communication outcomes were patterned by socioeconomic status in Japan thus demonstrating the prevalence of health communication inequalities. Providing customized exposure to and enhancing the quality of health information by considering social determinants may contribute to addressing social disparities in health in Japan.     

“When I Was Circumcised I Was Taught Certain Things”: Risk Compensation and Protective Sexual Behavior among Circumcised Men in Kisumu,Kenya

Background

Male circumcision has been shown to reduce the transmission of HIV from women to men through vaginal sex by approximately 60%. There is concern that men may engage in risk compensation after becoming circumcised, diminishing the benefits of male circumcision.

Methods and Findings

We conducted qualitative interviews with 30 sexually active circumcised men in Kisumu, Kenya from March to November 2008. Most respondents reported no behavior change or increasing protective sexual behaviors including increasing condom use and reducing the number of sexual partners. A minority of men reported engaging in higher risk behaviors either not using condoms or increasing the number of sex partners. Circumcised respondents described being able to perform more rounds of sex, easier condom use, and fewer cuts on the penis during sex.

Conclusions

Results illustrate that information about MC''s protection against HIV has disseminated into the larger community and MC accompanied by counseling and HIV testing can foster positive behavior change and maintain sexual behavior.     

Occupational Exposure to Ultraviolet Radiation and Risk of Non-Melanoma Skin Cancer in a Multinational European Study

Background

Studies suggest that ambient sunlight plays an important role in the pathogenesis of non-melanoma skin cancers (NMSC). However, there is ongoing controversy regarding the relevance of occupational exposure to natural and artificial ultraviolet radiation (UV) radiation.

Objectives

We investigated potential associations between natural and artificial UV radiation exposure at work with NMSC in a case-control study conducted in Hungary, Romania, and Slovakia.

Methods

Occupational exposures were classified by expert assessment for 527 controls and 618 NMSC cases (515 basal cell carcinoma, BCC). Covariate information was collected via interview and multiple logistic regression models were used to assess associations between UV exposure and NMSC.

Results

Lifetime prevalence of occupational exposure in the participants was 13% for natural UV radiation and 7% for artificial UV radiation. Significant negative associations between occupational exposure to natural UV radiation and NMSC were detected for all who had ever been exposed (odds ratio (OR) 0.47, 95% confidence interval (CI) 0.27–0.80); similar results were detected using a semi-quantitative metric of cumulative exposure. The effects were modified by skin complexion, with significantly decreased risks of BCC among participants with light skin complexion. No associations were observed in relation to occupational artificial UV radiation exposure.

Conclusions

The protective effect of occupational exposure to natural UV radiation was unexpected, but limited to light-skinned people, suggesting adequate sun-protection behaviors. Further investigations focusing on variations in the individual genetic susceptibility and potential interactions with environmental and other relevant factors are planned.     

Electromyographic activity of hand muscles in a motor coordination game: effect of incentive scheme and its relation with social capital

Background

A vast body of social and cognitive psychology studies in humans reports evidence that external rewards, typically monetary ones, undermine intrinsic motivation. These findings challenge the standard selfish-rationality assumption at the core of economic reasoning. In the present work we aimed at investigating whether the different modulation of a given monetary reward automatically and unconsciously affects effort and performance of participants involved in a game devoid of visual and verbal interaction and without any perspective-taking activity.

Methodology/Principal Findings

Twelve pairs of participants were submitted to a simple motor coordination game while recording the electromyographic activity of First Dorsal Interosseus (FDI), the muscle mainly involved in the task. EMG data show a clear effect of alternative rewards strategies on subjects'' motor behavior. Moreover, participants'' stock of relevant past social experiences, measured by a specifically designed questionnaire, was significantly correlated with EMG activity, showing that only low social capital subjects responded to monetary incentives consistently with a standard rationality prediction.

Conclusions/Significance

Our findings show that the effect of extrinsic motivations on performance may arise outside social contexts involving complex cognitive processes due to conscious perspective-taking activity. More importantly, the peculiar performance of low social capital individuals, in agreement with standard economic reasoning, adds to the knowledge of the circumstances that makes the crowding out/in of intrinsic motivation likely to occur. This may help in improving the prediction and accuracy of economic models and reconcile this puzzling effect of external incentives with economic theory.     

The Effect of “In Favor of Myself”: Preventive Program to Enhance Positive Self and Body Image among Adolescents

Background

Positive self-esteem, emotional well-being, school achievements and family connectedness are considered protective factors against health-compromising behaviors.This study examined the effect of an interactive, community-based, media literacy and dissonance wellness program, In Favor of Myself, on the self-image, body image, eating attitudes and behavior of young adolescents. A preliminary cohort study was conducted among 972 program participants who did not take part in the controlled trial. Over 75% of participants said they would recommend the program to their friends.

Methods

A controlled trial was conducted to evaluate program acceptability, efficacy and effectiveness among 259 participants (210 in the intervention group and 49 in the control group), aged 12–14 years, who completed questionnaires during at least two assessment times. Program materials were provided, along with leaders'' training, in order to ensure quality program delivery and creation of a wide network of committed program leaders.

Results

The program significantly reduced drive for thinness and self-worth contingent upon others'' approval, the gap between current body figure and ideal figure, and the impact of mood on girls'' self-image. Superiority was found among those participating in the intervention group with respect to recognizing media strategies, the influence of media on desire to change, and the influence of appearance on self-confidence and drive for thinness.

Conclusions

In Favor of Myself shows promising results for strengthening adolescents'' ability to cope with the challenges of their life stage. Suggestions for improving In Favor of Myself are presented.     

Gender-Specific Effects of Depression and Suicidal Ideation in Prosocial Behaviors

Background

Prosocial behaviors are essential to the ability to relate to others. Women typically display greater prosocial behavior than men. The impact of depression on prosocial behaviors and how gender interacts with those effects are not fully understood. We explored the role of gender in the potential effects of depression on prosocial behavior.

Methods

We examined prosocial behaviors using a modified version of the Trust Game in a clinical population and community controls. Study participants were characterized on the severity of depression and anxiety, presence of suicidal ideation, history of childhood trauma, recent stressful life events, and impulsivity. We correlated behavioral outcomes with gender and clinical variables using analysis of variance and multiple regression analysis.

Results

The 89 participants comprised four study groups: depressed women, depressed men, healthy women and healthy men (n = 16–36). Depressed men exhibited reciprocity more frequently than healthy men. Depression induced an inversion of the gender-specific pattern of self-centered behavior. Suicidal ideation was associated with increased reciprocity behavior in both genders, and enhancement of the effect of depression on gender-specific self-centered behavior.

Conclusions

Depression, particularly suicidal ideation, is associated with reversal of gender-specific patterns of prosocial behavior, suggesting abnormalities in sexual hormones regulation. This explanation is supported by known abnormalities in the hypothalamus-pituitary-adrenal and hypothalamus-pituitary-gonadal axes found in depression.     

The Prevalence and Factors for Cancer Screening Behavior among People with Severe Mental Illness in Hong Kong

Objectives

Screening is useful in reducing cancer incidence and mortality. People with severe mental illness (PSMI) are vulnerable to cancer as they are exposed to higher levels of cancer risks. Little is known about PSMI''s cancer screening behavior and associated factors. The present study examined the utilization of breast, cervical, prostate, and colorectal cancer screening among PSMI in Hong Kong and to identify factors associated with their screening behaviors.

Method

591 PSMI from community mental health services completed a cross-sectional survey.

Results

The percentage of cancer screening behavior among those who met the criteria for particular screening recommendation was as follows: 20.8% for mammography; 36.5% for clinical breast examination (CBE); 40.5% for pap-smear test; 12.8% for prostate examination; and 21.6% for colorectal cancer screening. Results from logistic regression analyses showed that marital status was a significant factor for mammography, CBE, and pap-smear test; belief that cancer can be healed if found early was a significant factor for pap-smear test and colorectal screening; belief that one can have cancer without having symptoms was a significant factor for CBE and pap-smear test; belief that one will have a higher risk if a family member has had cancer was a significant factor for CBE; and self-efficacy was a significant factor for CBE and pap-smear test behavior.

Conclusions

Cancer screening utilization among PSMI in Hong Kong is low. Beliefs about cancer and self-efficacy are associated with cancer screening behavior. Health care professionals should improve the knowledge and remove the misconceptions about cancer among PSMI; self-efficacy should also be promoted.     

Preparing for the Rollout of Pre-Exposure Prophylaxis (PrEP): A Vignette Survey to Identify Intended Sexual Behaviors among Women in Kenya and South Africa if Using PrEP

Introduction

Several clinical trials have demonstrated the efficacy of pre-exposure prophylaxis (PrEP) in reducing HIV risk. One concern with introducing PrEP is whether users will engage in riskier sexual behaviors.

Methods

We assessed the effect that PrEP may have on sexual risk behaviors by administering a survey to 799 women in Bondo, Kenya, and Pretoria, South Africa. Participants were asked about their sexual behavior intentions twice — once as if they were taking PrEP and once as if they were not taking PrEP — within four risk situations (vignettes). They responded using a 5-point ordinal scale. We used a series of linear mixed effects models with an unstructured residual covariance matrix to estimate the between- and within-subject differences in the mean likelihood of engaging in risky sexual behavior across the PrEP and non-PrEP contexts. We also calculated the total percentage of participants who reported a greater likelihood of engaging in risky sexual behavior if taking PrEP than if not taking PrEP, by vignette.

Results

We found statistically significant differences in the mean likelihood of engaging in risky sexual behavior with the between-subject comparison (-0.17, p < 0.01) and with the within-subject comparison (-0.31, p < 0.001). Depending on the vignette, 27% to 40% of participants reported a greater likelihood of engaging in risky sexual behavior if taking PrEP than if not taking PrEP.

Conclusions

Our findings indicate that modest increases in risky sexual behavior could occur with PrEP. Although responses from the majority of participants suggest they would not be more likely to engage in risky sexual behavior if they took PrEP, a substantial proportion might. Programs rolling out PrEP should be prepared to assist similar women in making informed choices about reducing their risk of HIV and about their sexual health beyond HIV prevention.     

Perceptions of Audio Computer-Assisted Self-Interviewing (ACASI) among Women in an HIV-Positive Prevention Program

Background

Audio Computer-Assisted Self Interviewing (ACASI) has improved the reliability and accuracy of self-reported HIV health and risk behavior data, yet few studies account for how participants experience the data collection process.

Methodology/Principal Findings

This exploratory qualitative analysis aimed to better understand the experience and implications of using ACASI among HIV-positive women participating in sexual risk reduction interventions in Chicago (n = 12) and Philadelphia (n = 18). Strategies of Grounded Theory were used to explore participants'' ACASI experiences.

Conclusion/Significance

Key themes we identified included themes that could be attributed to the ACASI and other methods of data collection (e.g., paper-based self-administered questionnaire or face-to-face interviews). The key themes were usability; privacy and honesty; socially desirable responses and avoiding judgment; and unintentional discomfort resulting from recalling risky behavior using the ACASI. Despite both positive and negative findings about the ACASI experience, we conclude that ACASI is in general an appropriate method for collecting sensitive data about HIV/AIDS risk behaviors among HIV-positive women because it seemed to ensure privacy in the study population allowing for more honest responses, minimize socially desirable responses, and help participants avoid actual or perceived judgment.     

Improved Planning Abilities in Binge Eating

Objective

The role of planning in binge eating episodes is unknown. We investigated the characteristics of planning associated with food cues in binging patients. We studied planning based on backward reasoning, reasoning that determines a sequence of actions back to front from the final outcome.

Method

A cross-sectional study was conducted with 20 healthy participants, 20 bulimia nervosa (BN), 22 restrictive (ANR) and 23 binging anorexia nervosa (ANB), without any concomitant impulsive disorder. In neutral/relaxing, binge food and stressful conditions, backward reasoning was assessed with the Race game, promotion of delayed large rewards with an intertemporal discounting task, attention with the Simon task, and repeating a dominant behavior with the Go/No-go task.

Results

BN and to a lower extent ANB patients succeeded more at the Race game in food than in neutral condition. This difference discriminated binging from non-binging participants. Backward reasoning in the food condition was associated with lower approach behavior toward food in BN patients, and higher food avoidance in ANB patients. Enhanced backward reasoning in the food condition related to preferences for delayed large rewards in BN patients. In BN and ANB patients the enhanced success rate at the Race game in the food condition was associated with higher attention paid to binge food.

Conclusion

These findings introduce a novel process underlying binges: planning based on backward reasoning is associated with binges. It likely aims to reduce craving for binge foods and extend binge refractory period in BN patients, and avoid binging in ANB patients. Shifts between these goals might explain shifts between eating disorder subtypes.     

Repeated exposure to media violence is associated with diminished response in an inhibitory frontolimbic network

Background

Media depictions of violence, although often claimed to induce viewer aggression, have not been shown to affect the cortical networks that regulate behavior.

Methodology/Principal Findings

Using functional magnetic resonance imaging (fMRI), we found that repeated exposure to violent media, but not to other equally arousing media, led to both diminished response in right lateral orbitofrontal cortex (right ltOFC) and a decrease in right ltOFC-amygdala interaction. Reduced function in this network has been previously associated with decreased control over a variety of behaviors, including reactive aggression. Indeed, we found reduced right ltOFC responses to be characteristic of those subjects that reported greater tendencies toward reactive aggression. Furthermore, the violence-induced reduction in right ltOFC response coincided with increased throughput to behavior planning regions.

Conclusions

These novel findings establish that even short-term exposure to violent media can result in diminished responsiveness of a network associated with behaviors such as reactive aggression.     

Risk Recognition,Attachment Anxiety,Self-Efficacy,and State Dissociation Predict Revictimization

Background

Previous research has identified a number of variables that constitute potential risk factors for victimization and revictimization. However, it remains unclear which factors are associated not only with childhood or adolescent victimization, but specifically with revictimization. The aim of this study was to determine whether risk recognition ability and other variables previously associated with revictimization are specifically able to differentiate individuals with childhood victimization only from revictimized individuals, and thus to predict revictimization.

Methods

Participants were N = 85 women aged 21 to 64 years who were interpersonally victimized in childhood or adolescence only, interpersonally revictimized in another period of life, or not victimized. A logistic regression analysis was conducted to examine whether risk recognition ability, sensation seeking, self-efficacy, state dissociation, shame, guilt, assertiveness, and attachment anxiety predicted group membership.

Results

The logistic regression analysis revealed risk recognition ability, attachment anxiety, state dissociation, and self-efficacy as significant predictors of revictimization. The final model accurately classified 82.4% of revictimized, 59.1% of victimized and 93.1% of non-victimized women. The overall classification rate was 80%.

Conclusions

This study suggests that risk recognition ability, attachment anxiety, self-efficacy, and state dissociation play a key role in revictimization. Increased risk recognition ability after an interpersonal trauma may act as a protective factor against repeated victimization that revictimized individuals may lack. A lack of increased risk recognition ability in combination with higher attachment anxiety, lower self-efficacy, and higher state dissociation may increase the risk of revictimization.     

The Relationship between Trait Emotional Intelligence and Interaction with Ostracized Others' Retaliation

Background

Regulation of emotions in others is distinct from other activities related to trait emotional intelligence in that only such behavior can directly change other people''s psychological states. Although emotional intelligence has generally been associated with prosociality, emotionally intelligent people may manipulate others'' behaviors to suit their own interests using high-level capabilities to read and manage the emotions of others. This study investigated how trait emotional intelligence was related to interacting with ostracized others who attempt retaliation.

Method

We experimentally manipulated whether two people were simultaneously ostracized or not by using an online ball-tossing game called Cyberball. Eighty university students participated in Cyberball for manipulating ostracism and a “recommendation game,” a variation of the ultimatum game for assessing how to interact with others who attempt retaliation, with four participants. After the recommendation game, participants rated their intention to retaliate during the game.

Results

People with higher interpersonal emotional intelligence were more likely to recommend that the ostracized other should inhibit retaliation and maximize additional rewards when they have a weaker intention to retaliate. However, they were more likely to recommend that the ostracized other should retaliate against the ostracizers when they have a stronger intention to retaliate.

Conclusion

This is the first laboratory study that empirically reveals that people with high interpersonal emotional intelligence influence others'' emotions based on their own goals contrary to the general view. Trait emotional intelligence itself is neither positive nor negative, but it can facilitate interpersonal behaviors for achieving goals. Our study offers valuable contributions for the refinement of the trait emotional intelligence concept in the respect of its social function.     

Association between floral traits and rewards in Erysimum mediohispanicum (Brassicaceae)

Background and Aims

Floral rewards may be associated with certain morphological floral traits and thus act as underlying factors promoting selection on these traits. This study investigates whether some traits that are under pollinator-mediated selection (flower number, stalk height, corolla diameter, corolla tube length and corolla tube width) in the Mediterranean herb E. mediohispanicum (Brassicaceae) are associated with rewards (pollen and nectar).

Methods

During 2005 the phenotypic traits and the visitation rate of the main pollinator functional groups were quantified in 720 plants belonging to eight populations in south-east Spain, and during 2006 the same phenotypic traits and the reward production were quantified in 400 additional plants from the same populations.

Key Results

A significant correlation was found between nectar production rate and corolla tube length, and between pollen production and corolla diameter. Visitation rates of large bees and butterflies were significantly higher in plants exhibiting larger flowers with longer corolla tubes.

Conclusions

The association between reward production and floral traits may be a factor underlying the pattern of visitation rate displayed by some pollinators.Key words: Erysimum, floral traits, nectar, pollen, pollinator visitation rate, reward     

Parental Migration,Self-Efficacy and Cigarette Smoking among Rural Adolescents in South China

Objectives

Millions of children and adolescents in rural China are left behind as their parents move away for work. Little is known about the impact of parental migration on their smoking and self-efficacy. This study explores the associations among parental migration, self-efficacy and smoking.

Methods

A cross-sectional study was conducted among middle school students in Liangying Township, Guangdong, China. Socio-demographic and parental migration characteristics, as well as adolescent past 30-day smoking and self-efficacy level were collected using a self-administered questionnaire. Univariate and multivariate analyses were performed to estimate the risk of parental migration features for smoking and self-efficacy. Hierarchical regression was fitted to examine the relationship among parental migration, self-efficacy and smoking.

Results

2609 students (93.4%) participated into the study, 44% of who were with parents who had ever been or were currently migrating. Smoking prevalence was 9.7% in boys and 0.9% in girls. Paternal migration was protective for adolescent smoking, whilst maternal migration increased the risk. Both paternal and maternal migration had adverse effects on self-efficacy, a strong influencing factor for smoking. No significant relationship was found between other migration features and smoking and self-efficacy. The smoking risk of maternal migration was partly mediated by self-efficacy. There were no differences between boys and girls.

Conclusions

Our findings suggest that adolescents whose mothers migrate from home to work elsewhere are at elevated risk for smoking. Improving self-efficacy may be an effective means to keep adolescents away from smoking, especially for those with maternal migration.     

Serotonin differentially regulates short- and long-term prediction of rewards in the ventral and dorsal striatum

Background

The ability to select an action by considering both delays and amount of reward outcome is critical for maximizing long-term benefits. Although previous animal experiments on impulsivity have suggested a role of serotonin in behaviors requiring prediction of delayed rewards, the underlying neural mechanism is unclear.

Methodology/Principal Findings

To elucidate the role of serotonin in the evaluation of delayed rewards, we performed a functional brain imaging experiment in which subjects chose small-immediate or large-delayed liquid rewards under dietary regulation of tryptophan, a precursor of serotonin. A model-based analysis revealed that the activity of the ventral part of the striatum was correlated with reward prediction at shorter time scales, and this correlated activity was stronger at low serotonin levels. By contrast, the activity of the dorsal part of the striatum was correlated with reward prediction at longer time scales, and this correlated activity was stronger at high serotonin levels.

Conclusions/Significance

Our results suggest that serotonin controls the time scale of reward prediction by differentially regulating activities within the striatum.