Examining Associations of Coping Strategies with Stress, Alcohol, and Substance use among College Athletes: Implications for Improving Athlete Coping

Mental health challenges and substance use are common among college athletes, yet few studies have been conducted to understand substance use as a coping strategy. The pressures of collegiate athletics - including commitments to training, travel, and competition - can contribute to maladaptive coping among college athletes, including alcohol and other substance use. An online survey was completed by 188 college athletes competing across NCAA/NJCAA divisions at six institutions in the United States to examine factors associated with substance use coping and whether specific strategies of coping were associated with risk of substance use. Alcohol and drug use were assessed using the CRAFFT Screening Test, NIDA-Modified ASSIST, and Alcohol Use Disorders Identification Test. Coping was assessed with the Coping Orientation to Problems Experienced Inventory, stress was assessed using an adapted Graduate Stress Inventory, athletics-related anxiety was assessed with the Sport Anxiety Scale, and perceived control of stress was assessed using the Perceived Control Questionnaire. Older athletes, men, and those with higher stress were more likely to use substances to cope. Higher behavioral disengagement, higher substance use coping, and lower religious coping were associated with increased likelihood of binge drinking and substance-related risk behaviors. These findings point to the importance of developing targeted interventions aimed at addressing stress and facilitating healthy coping to reduce problematic drinking and substance use among college athletes

The Relations of Identity Development and Sexual Debut to Unprotected Sex and Mental Health in Men Who Have Sex With Men

The present analysis measured recent unprotected anal intercourse (UAI), depression, and suicidality in young men who have sex with men (YMSM) to determine if these outcomes were predicted by early identity development, sexual debut, or race/ethnicity. Retrospective semi-structured interviews and self-report computer surveys were used to collect data from 598 racially diverse YMSM between the ages of 18-19 living in the New York City area. Non-parametric Spearman's correlations showed experiencing early sexual awareness was correlated with a greater number of recent UAI acts in the past 30 days. Specifically, first awareness of same-sex attractions correlated with insertive UAI acts, rs (594) = -.068, p = .045, and receptive UAI acts, rs (594) = -.115, p = .005; first realization that same-sex attractions were sexual correlated with insertive UAI acts, rs (594) = -.080), p = .021, and receptive UAI acts, rs (594) = -.106 , p = .002; and first same-sex fantasies correlated with insertive UAI acts, rs (592) = -.079), p = .023, and receptive UAI acts, rs (592) = -.091, p = .008. Additionally, experiencing first mutual masturbation, rs (449) = -.107, p = .024, first oral sex received, rs (566) = -.158, p < .000, and oral sex given, rs (571) = -.114, p = .006, at younger ages was correlated with a greater number of recent insertive UAI acts. Disclosure latency labeling positively correlated with the number of receptive acts in the past 30 days (rs (586) = .122, p = .003). Overall, it was shown that antecedents to sexual risk behaviors develop at a young age (M age of awareness = 10.47). As such, interventions should be developed for pre-adolescent MSM

Stress, Anxiety, Binge Drinking, and Substance Use Among College Student-Athletes: A Cross-Sectional Analysis

The immense pressure faced by college student-athletes to balance participation in sports with other responsibilities can contribute to unhealthy coping behaviors including alcohol and drug use. We administered online surveys to 188 college student-athletes to examine stress, athletics-related anxiety, and perceived control of stress as predictors of binge drinking, substance use, and associated risk behaviors. Participants rated athletics as the second greatest source of stress in their lives, trailing only academics. Athletics-related anxiety was a significant predictor of cannabis use and substance-related risk behaviors, and represents an understudied area in the literature. Reports of alcohol and drug use in our sample were comparable to national surveys of student-athletes, but opioid misuse was troublingly high. Participants over the age of 21 and males were more likely to report substance use and risk behaviors. Athletes are susceptible to orthopedic injury and associated pain, which may lead to early exposure to opioids with high potential for abuse. Interventions for this population must target social contributors to substance use among student-athletes, opioid prescription and misuse as a gateway to opioid use disorders, and untreated anxiety as a potential driver of substance use, including anxiety associated with athletic performance

Assessing Intravaginal Practices in HIV Prevention Research: Development and Validation of an Intravaginal Practices Questionnaire

Intravaginal practices (IVPs) refer to placing items (e.g., water, soap, commercial douches, fingers, rags) inside the vagina. IVPs have been shown to contribute to the development of bacterial vaginosis (BV) and may increase sexually transmitted infections and HIV risk. We developed the Intravaginal Practices Questionnaire (IVQ). The purpose of this study was to validate the IVQ, with the goal of establishing a consistent method of assessing IVP across studies. Women enrolled in this study (n = 180) were on average 30 years of age (SD = 8.32). Half (54%) identified as non-Hispanic, and 45% identified as Black; 41% reported lifetime IVP. Past month IVP use included commercial douches (9%), water (35%), fingers (41%), soap (21%), cloths/rags/wipes (10%), and vinegar (3%), which were placed in the vagina. No women used yogurt or herbs. An exploratory factor analysis indicated that a single-factor structure best explained the underlying constructs in participant responses in six endorsed items assessing commercial douches, water, fingers, soap, clothes/rags/ wipes, and vinegar use, suggesting that a common factor underlies these behaviors. All factor loadings were > 0.496. Cronbach's α was 0.99, suggesting that the reliability of the scale was excellent. Lastly, a total IVQ score was related to BV diagnosis (p = .007) as well as self-reported symptoms of BV (p = .034). Results illustrate that the IVQ has adequate psychometric properties. This tool may be used by public health experts and clinicians to identify IVPs that may potentially increase HIV risk

PrEP awareness and use among reproductive age women in Miami, Florida.

BackgroundMiami, Florida is an epicenter of the HIV epidemic in the US, with 20% of new HIV infections occurring in women. Despite effectiveness of Pre-Exposure Prophylaxis (PrEP) in preventing HIV, only 10% of eligible women benefit from its use.SettingThis study evaluates PrEP awareness and use, and factors associated with PrEP awareness among sexually active women in Miami, Florida.MethodsResults reported in this study included cross-sectional data that were collected as part of a baseline visit from a parent study. Cis-gender, HIV-negative, 18-45-year-old, sexually active women were recruited as part of a study evaluating recurrent bacterial vaginosis and HIV risk. Participants completed questionnaires assessing socio-demographics, HIV risk factors, prior history of HIV testing and reproductive tract infections, PrEP awareness and use. Relationships between variables and PrEP awareness were analyzed and multivariable logistic regression identified variables strongly associated with PrEP awareness.ResultsAmong the 295 women enrolled, median age was 31 (24-38) years, 49% Black, 39% White, and 34% Hispanic. Of 63% who knew about PrEP, only 5% were on PrEP. Women with income below poverty line (OR = 2.00[1.04,3.87];p = 0.04), more male sexual partners in past month (OR = 1.30[1.01,1.68];p = 0.04), lifetime HIV testing (OR = 6.42[2.83,14.52];pConclusionPrEP awareness is low among reproductive age women in a high-risk setting. Culturally tailored interventions are needed to increase PrEP awareness and uptake, especially among Black and Hispanic women with inconsistent condom use during vaginal sex with male partners

Through the Looking-Glass: Psychoneuroimmunology and the Microbiome-Gut-Brain Axis in the Modern Antiretroviral Therapy Era.

Depression, substance use disorders, and other neuropsychiatric comorbidities are common in people with HIV (PWH), but the underlying mechanisms are not sufficiently understood. HIV-induced damage to the gastrointestinal tract potentiates residual immune dysregulation in PWH receiving effective anti-retroviral therapy (ART). However, few studies among PWH have examined the relevance of microbiome-gut-brain axis: bi-directional crosstalk between the gastrointestinal tract, immune system, and central nervous system.A narrative review was conducted to integrate findings from 162 articles relevant to psychoneuroimmunology (PNI) and microbiome-gut-brain axis research in PWH.Early PNI studies demonstrated that neuroendocrine signaling via the hypothalamic-pituitary-adrenal axis and autonomic nervous system could partially account for the associations of psychological factors with clinical HIV progression. This review highlights the need for PNI studies examining the mechanistic relevance of the gut microbiota for residual immune dysregulation, tryptophan catabolism, and oxytocin release as key biological determinants of neuropsychiatric comorbidities in PWH (i.e., body-to-mind pathways). It also underscores the continued relevance of neuroendocrine signaling via the hypothalamic-pituitary-adrenal axis, autonomic nervous system, and oxytocin release in modifying microbiome-gut-brain axis functioning (i.e., mind-to-body pathways).Advancing our understanding of PNI and microbiome-gut-brain axis pathways relevant to depression, substance use disorders, and other neuropsychiatric comorbidities in PWH can guide the development of novel bio-behavioral interventions to optimize health outcomes. Recommendations are provided for bio-behavioral and neurobehavioral research investigating bi-directional PNI and microbiome-gut-brain axis pathways among PWH in the modern ART era.Copyright © 2022 by the American Psychosomatic Society.</CopyrightInformation

Adolescent girls' descriptions of dysmenorrhea and barriers to dysmenorrhea management in Moshi, Tanzania: A qualitative study.

Dysmenorrhea (menstrual pain) is common among adolescent girls globally, but many girls in Sub-Saharan Africa do not receive effective treatment. Qualitative interviews were used to describe adolescent girls' experiences of dysmenorrhea and identify sociocultural barriers to dysmenorrhea management in Moshi, Tanzania. From August to November 2018, in-depth interviews were conducted with 10 adolescent girls and 10 adult experts (e.g., teachers, medical providers) who have experience working with girls in Tanzania. Thematic content analysis identified themes related to dysmenorrhea, including descriptions of dysmenorrhea and the impact of dysmenorrhea on well-being, as well as factors influencing the use of pharmacological and behavioral pain management strategies. Potential barriers to dysmenorrhea management were identified. Dysmenorrhea negatively impacted the physical and psychological well-being of girls and hindered girls' ability to participate in school, work, and social events. The most common pain management strategies were resting, drinking hot water, engaging in physical activity, and taking paracetamol. Barriers to dysmenorrhea management included beliefs that medications are harmful to the body or can hinder fertility, limited knowledge about the benefits of hormonal contraceptives to manage menstruation, little continuing education for healthcare providers, and a lack of consistent access to effective medications, medical care, or other supplies necessary for pain management. Medication hesitancy and inconsistent access to effective medication and other menstrual supplies must be addressed to improve girls' ability to manage dysmenorrhea in Tanzania