Correlates of Unprotected Sex in a Sample of Young club Drug Users

OBJECTIVES: To assess the demographic characteristics, psychiatric symptoms, substance use patterns, and sexual risk behaviors in a sample of club drug users to identify factors associated with unprotected sex during the 12 months prior to the interview. METHODS: This cross-sectional study employed the targeted sampling and ethnographic mapping approaches via face-to-face interviews conducted at bars and electronic music festivals using an adapted, semi-structured version of the Global Appraisal of Individual Needs questionnaire. The sample comprised 240 male and female young adults who had used ecstasy and/or LSD in the 90 days prior to the interview and who were not receiving treatment for alcohol or drug abuse. RESULTS: Of the 240 subjects selected (mean age: 22.9±4.5 years), 57.9% were men; of the male subjects, 52.5% reported having had unprotected sex in the previous 12 months. Of the total sample, 63.33% reported having had unprotected sex. Multivariate regression analysis showed that anal sex (PR = 1.26; 95% confidence interval (CI): 1.044-1.543; p = 0.017) and the use of alcohol/drugs to make sex last longer (PR = 1.430; 95% CI: 1.181-1.732; p CONCLUSIONS: The implementation of intervention strategies aimed at reducing sexually risky behaviors should take into consideration the specific characteristics of drug users and should include the development of safer sex negotiation skills

Age of Sexual Initiation, Psychiatric Symptoms, and Sexual Risk Behavior among Ecstasy and LSD Users in Porto Alegre, Brazil: A Preliminary Analysis

Ecstasy and LSD use is widespread in large Brazilian cities, but there is limited information on their use among young, middle-class, club goers in Brazil. We conducted standardized face-to-face interviews with 200 male and female ecstasy and/or LSD users, focusing on drug use and sexual history, current risk behaviors, and psychiatric symptomatology. Participants with early sexual debut (before 14) were more likely to report lifetime use of marijuana and powder and crack cocaine than those with later sexual initiation. Early sexual debut was associated with past year sexual risk behaviors, including having sex while high (Prevalence Ratio (PR)=1.3), having two or more sex partners (PR=1.3), as well as history of sexual abuse (PR=13.6). Depression and anxiety scores were similar by age of sexual initiation. The implications of these findings are discussed

Effects of a parental program for preventing underage drinking - The NGO program strong and clear

<p>Abstract</p> <p>Background</p> <p>The present study is an evaluation of a 3-year parental program aiming to prevent underage drinking. The intervention was implemented by a non-governmental organization and targeted parents with children aged 13-16 years old and included recurrent activities during the entire period of secondary school. The program consisted of four different types of group and self-administered activities: parent meetings, family dialogues, friend meetings, and family meetings.</p> <p>Methods</p> <p>A quasi-experimental design was used following parents and children with questionnaires during the three years of secondary school. The analytic sample consisted of 509 dyads of parents and children. Measures of parental attitudes and behaviour concerning underage drinking and adolescents' lifetime alcohol consumption and drunkenness were used. Three socio-demographic factors were included: parental education, school, and gender of the child. A Latent Growth Modelling (LGM) approach was used to examine changes in parental behaviour regarding youth drinking and in young people's drinking behaviour. To test for the pre-post test differences in parental attitudes repeated measures ANOVA were used.</p> <p>Results</p> <p>The results showed that parents in the program maintained their restrictive attitude toward underage drinking to a higher degree than non-participating parents. Adolescents of participants were on average one year older than adolescents with non-participating parents when they made their alcohol debut. They were also less likely to have ever been drunk in school year 9.</p> <p>Conclusion</p> <p>The results of the study suggested that Strong and Clear contributed to maintaining parents' restrictive attitude toward underage drinking during secondary school, postponing alcohol debut among the adolescents, and significantly reducing their drunkenness.</p

Uso de drogas y riesgos relacionados con VIH/sida en diferentes muestras de Porto Alegre, Brasil

Resumen: Objetivos: Elaborar un panorama de sida/VIH (virus de la inmunodeficiencia humana) y uso de cocaína en Porto Alegre (Brasil), proporcionar una breve descripción de estudios conducidos por nuestro grupo de investigación y comentar los resultados especulando en un modelo parcial de exposición al VIH fundamentado en los datos encontrados. Material y método: Se presentan datos de corte transversal de 6 muestras con el propósito de comparar las tasas de prevalencia del VIH, así como características demográficas y uso de drogas. En estas 6 muestras se incluyeron los más variados tipos de usuarios de drogas, y las técnicas de muestreo utilizadas según el estudio muestra albo, fueron referenciales en cadena y procedimientos de bola de nieve. Los individuos fueron sometidos a test de seropositividad para VIH en los centros públicos de información y prevención hacia el VIH o en el Laboratorio del Hospital de Clínicas de Porto Alegre. La variable independiente fue el uso de drogas, con énfasis en la cocaína, que se midió con el uso de la tercera versión de la Risk Assessment Battery. Se analizaron cada una de las muestras por separado y luego se compararon las seroprevalencias con el test de la ?² y pruebas de comparaciones múltiples. Resultados: Puede observarse un dramático aumento («dosis-respuesta») en la prevalencia encontrada en estos estudios, en lo que se refiere a la seropositividad VIH, directamente relacionado con el modo de utilización de la sustancia; en las muestras en que predominan usuarios de cocaína inyectable y crack las seroprevalencias fueron claramente mayores que las muestras de usuarios recreacionales o no usuarios de drogas inyectables. Un resultado paralelo impactante fue la fuerte asociación entre una baja escolaridad, bajo salario y trabajo irregular con la alta seroprevalencia. Conclusiones: Hacemos comentarios por una perspectiva histórica, una vez que todos los estudios fueron conducidos entre 1995 y 2004, período en el que en la epidemia de sida empezó a observarse una clara disminución en el número de casos debidos al uso de droga inyectable, y un aumento en las infecciones por transmisión heterosexual, sobre todo en mujeres. Existe una gran demanda de intervenciones preventivas, especialmente para los medios más pobres, con usuarios con un nivel de educación más bajo, y en centros urbanos grandes como Porto Alegre que enfrentan diferentes riesgos asociados con la combinación de estas variables y la posibilidad de adquirir o diseminar el VIH

Changes in Method for Obtaining Better Outcomes in the Recruitment of Synthetic Drug Users

Objective: To describe the problems encountered and resolved in the course of using respondent-driven sampling (RDS), targeted canvassing (TARC), and ethnographic fieldwork (EFW) to recruit ecstasy and/or lysergic acid diethylamide (LSD) users. Method: This study is nested within a larger project designed to investigate the course of drug use, sexual risk behaviors, and psychiatric comorbidities in 240 ecstasy/LSD users. Eligible participants were males and females with ages ranging from 18 to 39 years, who reported ecstasy and/or LSD use at least once during the 90 days prior to interview and were not under treatment for drug and alcohol problems. Strategies were implemented sequentially, over four-month time frames for each method, aiming at fulfilling study objectives. Results: The final sample included 174 participants (64.36% males). Eight (4.6%) were selected using RDS, 26 (14.94%) with TARC, and 140 (80.45%) using EFW. RDS recruited participants with a higher education level, employed, and with a higher monthly income. Conversely, a higher frequency of drug usage and a higher number of drugs ever used were evident among participants selected via EFW. Conclusions: Different recruitment techniques reached different types of participants. EFW showed the best performance, granting access to the largest number of participants and with a higher number of drugs ever used. Both RDS and TARC required more time to recruit participants and yielded a lower number of eligible subjects. Participants recruited via RDS had a higher socioeconomic level but also a shorter lifetime history of drug use

Using thought mapping and structured stories to decrease HIV risk behaviors among cocaine injectors and crack smokers in the South of Brazil

Objetivos: Comparar as mudanças em conhecimento sobre AIDS e comportamentos de risco em usuários de cocaína brasileiros submetidos a uma intervenção experimental. Método: 119 sujeitos foram aleatoriamente designados para uma intervenção padrão ou uma intervenção padrão adicionada a um “mapa cognitivo”, e re-entrevistados duas e oito semanas após admissão no estudo, utilizando-se instrumentos de coleta padronizados. Os efeitos da intervenção foram examinados utilizando modelo de equações de estimação generalizadas. Resultados: Foram observados aumentos significativos no conhecimento sobre AIDS e uso de preservativos no grupo experimental, bem como modificações significativas nos subescores para risco sexual e uso de drogas. A intervenção experimental teve menos sucesso em diminuir dias de uso de cocaína quando comparada com a intervenção padrão. Conclusão: Apesar de não serem robustos, os achados sugerem que os componentes do modelo de mapa cognitivo experimentados poderiam ser úteis em combinação com outras abordagens.Objectives: To compare changes in AIDS knowledge and risk behaviors among Brazilian cocaine users in an intervention trial. Method: 119 participants were randomly assigned to either a standard or a standard plus “thought mapping” intervention, and re-interviewed 2 and 8 weeks after intake using standardized data collection instruments. Intervention effects were examined using generalized estimated equation model. Results: Significant increases in AIDS knowledge and condom use were observed in the experimental group, as well as significant changes in the subscores for sexual and drug risks. The experimental intervention was less successful in decreasing mean days of cocaine use when compared to the standard. Conclusion: Although not robust, the findings nevertheless suggest that components of the experimental thought-mapping model might be useful in combination with other approaches

Risk factors for HIV transmission in drug users from Porto Alegre, Rio Grande do Sul State, Brazil

Em um estudo transversal com uma amostra de 420 usuários de drogas de Porto Alegre, Rio Grande do Sul, Brasil, foram avaliados demografia, uso de drogas e situações de risco para contaminação pelo HIV por meio da versão brasileira do questionário Comportamentos de Risco para AIDS. A prevalência de HIV positivos foi de 22,6%; 39,3% tinham 30 anos ou mais e 69,5% eram homens. Nos trinta dias prévios à coleta, 56,8% tinham usado maconha, 43,6% cocaína inalada, 17,6% cocaína injetada e 42,4% álcool freqüentemente. As variáveis que se mantiveram associadas com infecção por HIV após regressão logística foram idade superior a trinta anos (RC: 2,89; IC95%: 1,17-7,12), ter menos de sete anos de estudo (RC: 2,10; IC95%: 1,02- 4,36), renda de menos de um salário mínimo (RC: 2,89; IC95%: 1,32-6,32) e ter usado droga injetável (DI) (RC: 5,18; IC95%: 2,89-9,28). A taxa de infecção pelo HIV encontrada foi alta, considerando que 70,0% nunca haviam usado DI. As variáveis associadas com contaminação por HIV estão de acordo com as literaturas nacional e internacional e com o modelo teórico de exposição a risco proposto pelo primeiro autor.A cross-sectional study with a sample of 420 drug users from Porto Alegre, Rio Grande do Sul State, Brazil, was utilized to assess demographic variables, drug use, and risk behaviors for HIV infection.We used the Brazilian version of the Risk Assessment Battery. Overall HIV seropositivity was 22.6%; 39.3% of the subjects infected were at least 30 years old, and 69.5% were males. In the month prior to the interview, 56.8% of the sample had used marijuana, 43.6% had sniffed cocaine, 17.6% had injected cocaine, and 42.4% had used alcohol on a frequent basis. The variables that continued to be associated with HIV infection after logistic regression were age (30 or older) (OR: 2.89; 95%CI: 1.17-7.12), having less than seven years of schooling (OR: 2.10; 95%CI: 1.02-4.36), having a monthly family income of less than one minimum wage, or approximately U$90 (OR: 2.89; 95%CI: 1.32-6.32), and having injected drugs (OR: 5.18; 95%CI: 1.32-6.32). Seroprevalence in this sample is considered high, particularly since 70.0% of the sample reported no prior drug injection.Variables associated with HIV infection are similar to the national and international literature and agree with the theoretical model of risk behavior proposed by the first author