587 research outputs found

    An empirical analysis of the nine Internet Gaming Disorder criteria

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    Internet Gaming Disorder (IGD) has received increased scientific attention since May 2013, and its assessment can be conducted using the nine criteria suggested by American Psychiatric Association (APA). This study examined the role of each IGD criterion using a conditional inference tree model. Methods: A total of 3,377 gamers (82.7% male, mean age 20 years, SD = 4.3 years) were recruited to the present study. In addition to collecting sociodemographic information, participants filled out the Internet Gaming Disorder Scale–Short-Form (IGDS9-SF) based on the DSM-5 criteria. Results: The conditional inference tree model revealed that endorsement of ‘withdrawal’ (criterion 2) and ‘loss of control’ (criterion 4) increased the likelihood of IGD by 77.77% (95%CI: 62.09–93.45) while endorsing ‘withdrawal’, ‘loss of control’ and ‘negative consequences’ (criterion 9) increased the likelihood of IGD by 26.66% (95%CI: 4.28–49.04). Finally, not endorsing ‘withdrawal’ but endorsing ‘preoccupation’ (criterion 1) increased the probability of IGD by 7.14% (95%CI: 1.63–12.65). Conclusions: Overall, these results suggest that not all IGD criteria carry the same diagnostic weight as each criterion can play a different role in the development of IGD. It is envisaged that these findings will help improve the assessment of IGD in the future

    Randomized community-level HIV prevention intervention trial for men who drink in South African alcohol-serving venues

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    South African alcohol-serving establishments (i.e., shebeens) offer unique opportunities to reduce HIV risks among men who drink. Purpose: To test an individual- and a social structural-level HIV prevention intervention for men who drink in shebeens. Methods: Twelve matched pairs of township neighbourhoods were randomized to receive either (i) an HIV prevention intervention (guided by Social Action Theory) to reduce sexual risk and increase risk reduction communication in social networks, or (ii) an attention-matched control intervention that focused on the prevention of relationship violence. At the individual level, the interventions delivered skills building workshops focused on sexual risk reduction. At the social structural level, the intervention aimed to increase conversations about safer sex among men in the shebeens, distributed small media and implemented community educational events. Individual-level outcomes were assessed by following the workshop cohorts for 1 year (N = 984), and community-level outcomes were examined through cross-sectional community surveys conducted for 1 year in the shebeens (N = 9,678). Results: Men in the HIV prevention workshops demonstrated greater condom use, more HIV prevention-oriented conversations and greater perceptions of safer sex norms than men in the comparison workshops. Changes at the community level demonstrated significant differences in condom use, although the pattern was not consistent over time. Conclusions: Multi-level interventions that target men who drink in South African shebeens may help reduce risks for HIV and other sexually transmitted infections.Web of Scienc

    Does Respondent Driven Sampling Alter the Social Network Composition and Health-Seeking Behaviors of Illicit Drug Users Followed Prospectively?

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    Respondent driven sampling (RDS) was originally developed to sample and provide peer education to injection drug users at risk for HIV. Based on the premise that drug users' social networks were maintained through sharing rituals, this peer-driven approach to disseminate educational information and reduce risk behaviors capitalizes and expands upon the norms that sustain these relationships. Compared with traditional outreach interventions, peer-driven interventions produce greater reductions in HIV risk behaviors and adoption of safer behaviors over time, however, control and intervention groups are not similarly recruited. As peer-recruitment may alter risk networks and individual risk behaviors over time, such comparison studies are unable to isolate the effect of a peer-delivered intervention. This analysis examines whether RDS recruitment (without an intervention) is associated with changes in health-seeking behaviors and network composition over 6 months. New York City drug users (N = 618) were recruited using targeted street outreach (TSO) and RDS (2006–2009). 329 non-injectors (RDS = 237; TSO = 92) completed baseline and 6-month surveys ascertaining demographic, drug use, and network characteristics. Chi-square and t-tests compared RDS- and TSO-recruited participants on changes in HIV testing and drug treatment utilization and in the proportion of drug using, sex, incarcerated and social support networks over the follow-up period. The sample was 66% male, 24% Hispanic, 69% black, 62% homeless, and the median age was 35. At baseline, the median network size was 3, 86% used crack, 70% used cocaine, 40% used heroin, and in the past 6 months 72% were tested for HIV and 46% were enrolled in drug treatment. There were no significant differences by recruitment strategy with respect to changes in health-seeking behaviors or network composition over 6 months. These findings suggest no association between RDS recruitment and changes in network composition or HIV risk, which supports prior findings from prospective HIV behavioral surveillance and intervention studies

    How much choice is there in housing choice vouchers? Neighborhood risk and free market rental housing accessibility for active drug users in Hartford, Connecticut

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    <p>Abstract</p> <p>Background</p> <p>Since the mid-1970s, the dominant model for U.S. federal housing policy has shifted from unit-based programs to tenant based vouchers and certificates, intended to allow recipients a choice in their housing and neighborhoods. Surprisingly little research has examined the question of where those with Section 8 housing vouchers are able to live, but some research suggests that voucher holders are more likely to reside in distressed neighborhoods than unsubsidized renter households. Further, federal housing policy has limited drug users' access to housing subsidies. In turn, neighborhood disorder has been associated with higher levels of injection drug risk behaviors, and higher drug-related mortality. This paper explores rental accessibility and neighborhood characteristics of advertised rental housing in Hartford CT.</p> <p>Methods</p> <p>Brief telephone interviews were conducted with landlords or management companies with units to rent in Hartford to explore housing accessibility measured as initial move in costs, credit and criminal background checks, and whether rental subsidies were accepted. These data were supplemented with in-depth interviews with landlords, shelter staff and active users of heroin, crack or cocaine. Apartments for rent were geocoded and mapped using <b>ArcGIS</b>. We used location quotients to identify areas where low-income rental housing is concentrated. Finally, we mapped apartments in relation to drug and violent arrest rates in each neighborhood.</p> <p>Results</p> <p>High security deposits, criminal background and credit checks limit housing accessibility even for drug users receiving vouchers. While most landlords or management companies accepted housing subsidies, several did not. Voucher units are concentrated in neighborhoods with high poverty neighborhoods. Landlords reported little incentive to accept rental subsidies in neighborhoods with low crime rates, but appreciated the guarantee provided by Section 8 in high crime neighborhoods that were less likely to attract applicants with good jobs and credit.</p> <p>Conclusion</p> <p>Housing vouchers in themselves do not greatly improve recipients' choice of neighborhood and voucher units are concentrated in the most distressed neighborhoods. Policy changes are needed to increase landlords' incentives to accept housing subsidies. Interventions to improve neighborhood conditions are needed to improve the probability of success for those recovering from drug addictions.</p

    Effects of Race, Neighborhood, and Social Network on Age at Initiation of Injection Drug Use

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    Objectives. We investigated individual- and neighborhood-level factors associated with adolescent initiation of injection drug use. Methods. Injection drug users (IDUs) who had been injecting 2 to 5 years underwent HIV testing and completed a sociobehavioral risk survey. Modeling techniques accounting for intraneighborhood correlations were used in data analyses. Results. Adolescent-initiating IDUs were less likely than adult-initiating IDUs to report high-risk sex and injection behaviors and more likely to report high-risk networks. African American IDUs from neighborhoods with large percentages of minority residents and low adult educational levels were more likely to initiate injection during adolescence than White IDUs from neighborhoods with low percentages of minority residents and high adult education levels. Conclusions. Racial segregation and neighborhood-level educational attainment must be considered when drawing inferences about age at initiation of injection drug use and related high-risk behaviors.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/40371/2/Fuller_Effects of Race, Neighborhood, and Social Network_2005.pd

    Behavioral economic methods to inform infectious disease response: Prevention, testing, and vaccination in the COVID-19 pandemic

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    The role of human behavior to thwart transmission of infectious diseases like COVID-19 is evident. Psychological and behavioral science are key areas to understand decision-making processes underlying engagement in preventive health behaviors. Here we adapt well validated methods from behavioral economic discounting and demand frameworks to evaluate variables (e.g., delay, cost, probability) known to impact health behavior engagement. We examine the contribution of these mechanisms within a broader response class of behaviors reflecting adherence to public health recommendations made during the COVID-19 pandemic. Four crowdsourced samples (total N = 1,366) completed individual experiments probing a response class including social (physical) distancing, facemask wearing, COVID-19 testing, and COVID-19 vaccination. We also measure the extent to which choice architecture manipulations (e.g., framing, opt-in/opt-out) may promote (or discourage) behavior engagement. We find that people are more likely to socially distance when specified activities are framed as high risk, that facemask use during social interaction decreases systematically with greater social relationship, that describing delay until testing (rather than delay until results) increases testing likelihood, and that framing vaccine safety in a positive valence improves vaccine acceptance. These findings collectively emphasize the flexibility of methods from diverse areas of behavioral science for informing public health crisis management

    Predictors of linkage to care following community-based HIV counseling and testing in rural Kenya

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    Despite innovations in HIV counseling and testing (HCT), important gaps remain in understanding linkage to care. We followed a cohort diagnosed with HIV through a community-based HCT campaign that trained persons living with HIV/AIDS (PLHA) as navigators. Individual, interpersonal, and institutional predictors of linkage were assessed using survival analysis of self-reported time to enrollment. Of 483 persons consenting to follow-up, 305 (63.2%) enrolled in HIV care within 3 months. Proportions linking to care were similar across sexes, barring a sub-sample of men aged 18–25 years who were highly unlikely to enroll. Men were more likely to enroll if they had disclosed to their spouse, and women if they had disclosed to family. Women who anticipated violence or relationship breakup were less likely to link to care. Enrolment rates were significantly higher among participants receiving a PLHA visit, suggesting that a navigator approach may improve linkage from community-based HCT campaigns.Vestergaard Frandse

    Depressive Symptoms at HIV Testing and Two-Year All-Cause Mortality Among Men Who Inject Drugs in Vietnam

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    People who inject drugs (PWID) with HIV experience an elevated risk of death. A potentially important determinant of survival is the high burden of depression. This study examined the relationship of depressive symptoms at HIV testing with 2-year all-cause mortality among newly diagnosed HIV-positive PWID in Vietnam. At HIV testing, 141 PWID (42%) experienced severe depressive symptoms, and over the 2 years following diagnosis, 82 PWID (24%) died. Controlling for potential confounders, the 2-year risk of death among those with depressive symptoms was 9.7% (95% CI − 1.2, 20.6%) higher than the risk among those without depressive symptoms. This increased risk of mortality for PWID with depressive symptoms was relatively consistent throughout the 2-year period: at 6, 12, and 18 months, the risk difference was 12.6% (5.5–19.7%), 13.9% (4.6–23.2%), and 11.0% (0.9–21.1%), respectively. HIV diagnosis may provide an important opportunity for depression screening and treatment, subsequently improving survival in this key population. Trial registry: ClinicalTrials.gov NCT01689545
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