Elaine Blumberg

This study explored contextual variables within strip clubs employing exotic dancers as well as dancers’ characteristics, as potential correlates of prostitution. Face-to-face anonymous interviews were conducted with exotic dancers in San Diego County (N = 123). Logistic regression revealed that nonwhite race, allowing customer touching, illegal drug use, and number of dances per shift were significant predictors of prostitution, while childhood neglect and abuse in adulthood were near-significant. Exotic dancers may be at elevated risk for engaging in prostitution, though results warrant further quantitative research, including early intervention studies for prevention/reduction of prostitution practices and sexually transmitted infections (STIs).

Objective. The purpose of this study was to determine the gaps between disclosed high-risk behaviors in low-income, mainly Hispanic youth and the identification of these risks by health care providers. Methods. This cross-sectional study included youth 13–19 years old who participated in a study on latent tuberculosis treatment. Youth were interviewed at baseline by bilingual research assistants; the provider visit was assessed by the chart review. Results. Of 221 youth, the majority (96%) were identified as Hispanic, 45% were foreign-born, and 46% were male. A total of 399 risk behaviors were revealed to research staff by the participants; only 24 risk behaviors were revealed to providers. Conclusions. The majority of risk behaviors based on the chart review were neither queried nor disclosed to the physicians. Physicians providing care to adolescents should consider strategies to improve disclosure as a necessary precursor to interventions.

Timely diagnosis of HIV is essential to improve survival rates and reduce transmission of the virus. Insufficient progress has been made in effecting earlier HIV diagnoses. The Mexican border city of Tijuana has one of the highest AIDS incidence and mortality rates in all of Mexico. This study examined the prevalence and potential correlates of late HIV testing in Tijuana, Mexico. Late testers were defined as participants who had at least one of: (1) an AIDS-defining illness within 1 year of first positive HIV test; (2) a date of AIDS diagnosis within 1 year of first positive HIV test; or (3) an initial CD4 cell count below 200 cells per microliter within 1 year of first positive HIV test. Medical charts of 670 HIV-positive patients from two HIV/AIDS public clinics in Tijuana were reviewed and abstracted; 362 of these patients were interviewed using a cross-sectional survey. Using multivariate logistic regression, we explored potential correlates of late HIV testing based on the Behavioral Ecological Model. From 342 participants for whom late testing could be determined, the prevalence of late testing was 43.2%. Multivariate logistic regression results (n = 275) revealed five significant correlates of late testing: “I preferred not to know I had HIV” (adjusted odds ratio [AOR] = 2.78, 1.46–5.31); clinic (AOR = 1.90, 1.06–3.41); exposure to peers engaging in high-risk sexual behavior (AOR = 1.14, 1.02–1.27); stigma regarding HIV-infected individuals (AOR = 0.65, 0.47–0.92); and stigma regarding HIV testing (AOR = 0.66, 0.45–0.97). These findings may inform the design of interventions to increase timely HIV testing and help reduce HIV transmission in the community at large.

To test and compare 2 predictive models of weapon carrying in youth (n = 308) recruited from 4 drop-in centers in San Diego and Imperial counties. Both models were based on the Behavioral Ecological Model (BEM). The first and second models significantly explained 39% and 53% of the variance in weapon carrying, respectively, and both full models shared the significant predictors of being black(-), being Hispanic (-), peer modeling of weapon carrying/jail time (+), and school suspensions (+). Results suggest that the BEM offers a generalizable conceptual model that may inform prevention strategies for youth at greatest risk of weapon carrying.

Objectives. We sought to determine the efficacy of coaching Latino adolescents with latent tuberculosis infection to adhere to isoniazid treatment. Methods. Participants (n = 286) were randomly assigned to adherence coaching, attention control, or usual care groups. Adherence was measured via interviews and validated with urine assays. Results. Coaching resulted in significant increases in adherence compared with attention and usual care groups. Bicultural adolescents were more likely to be adherent than those most or least acculturated. Age and risk behavior were negatively related to adherence. Conclusions. Coaching can increase Latino adolescents’ adherence to treatment for latent tuberculosis infection and should contribute to tuberculosis control for adolescents at high risk of contracting the disease.