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Chea SK, Kazienga A, Oyugi EA, Menza I, Nasambu C, Ibrahim F, Abdullahi OA, Hassan AS, Abubakar A, Michielsen K, Abbeddou S. Associations between disordered eating behaviour and sexual behaviour amongst emerging adults attending a tertiary education institution in Coastal Kenya. PLoS One 2024; 19:e0301436. [PMID: 38861516 PMCID: PMC11166344 DOI: 10.1371/journal.pone.0301436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Accepted: 03/16/2024] [Indexed: 06/13/2024] Open
Abstract
BACKGROUND Sexual behavior (SB) is a well-documented pathway to HIV acquisition in emerging adults and remains common amongst African emerging adults. Previous research in high-income countries indicates a correlation between disordered eating behavior (DEB) and engaging in sexual behaviors. We aimed to describe the relationship between DEB and SB amongst emerging adults attending a tertiary educational institution at the Kenyan Coast. METHODS We applied a cross-sectional design nested in a young adults' cohort study. Eligibility included sexually active emerging adults aged 18-24 years. Three DEBs (emotional, restrained and external eating) were assessed using the Dutch Eating Behavior Questionnaire and analysed using exploratory factor analysis. Seven SB indicators were assessed: non-condom use, casual sex, multiple sex partners, transactional sex, group sex, age-disparate relationship and anal sex, and grouped into low vs. high SB using latent class analysis. Logistic regression was used to assess the association between DEB and SB. RESULTS Of 273 eligible participants (female, n = 110 [40.3%]), the mean of emotional, restrained and external eating was 1.9 [0.6], 2.0 [0.6] and 3.0 [0.5] respectively. Overall, 57 (20.9%) were grouped into the latent high SB class. Emotional (Adjusted odds ratio, AOR [95% confidence interval, CI]: 1.0 [0.9-1.0], p = 0.398), restrained (AOR, 1.0 [CI: 0.9-1.1], p = 0.301) and External (AOR, 1.0 [CI: 0.8-1.2], p = 0.523) eating were not independently associated with latent high SB. CONCLUSION There was no significant association between DEB and SB in this study sample. In low- and middle-income countries like Kenya, interventions targeted at DEB among emerging adults towards controlling SB are unnecessary.
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Affiliation(s)
- Stevenson K. Chea
- Department of Nursing Sciences, School of Health and Human Sciences, Pwani University, Kilifi, Kenya
- Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Adama Kazienga
- Department of Translational Physiology, Infectiology and Public Health, Ghent University, Merelbeke, Belgium
| | - Eunice A. Oyugi
- Centre for Geographic Medicine Research, Kenya Medical Research Institute, Kilifi, Kenya
| | - Isaac Menza
- Centre for Geographic Medicine Research, Kenya Medical Research Institute, Kilifi, Kenya
| | - Carophine Nasambu
- Centre for Geographic Medicine Research, Kenya Medical Research Institute, Kilifi, Kenya
| | | | - Osman A. Abdullahi
- Department of Public Health, School of Health and Human Sciences, Pwani University, Kilifi, Kenya
| | - Amin S. Hassan
- Centre for Geographic Medicine Research, Kenya Medical Research Institute, Kilifi, Kenya
- Department of Public Health, School of Health and Human Sciences, Pwani University, Kilifi, Kenya
| | - Amina Abubakar
- Centre for Geographic Medicine Research, Kenya Medical Research Institute, Kilifi, Kenya
- Department of Public Health, School of Health and Human Sciences, Pwani University, Kilifi, Kenya
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom
- Institute for Human Development, Aga Khan University, Nairobi, Kenya
| | - Kristien Michielsen
- Department of Neurosciences, Institute for Family and Sexuality Studies, Faculty of Medicine, Catholic University of Leuven (KU Leven), Leven, Belgium
| | - Souheila Abbeddou
- Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
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Rowe K, Duta M, Demeyere N, Wagner RG, Pettifor A, Kahn K, Tollman S, Scerif G, Stein A. The relationship between executive function, risky behaviour and HIV in young women from the HPTN 068 study in rural South Africa. AIDS Care 2021; 33:682-692. [PMID: 33258691 PMCID: PMC8650142 DOI: 10.1080/09540121.2020.1851016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Accepted: 11/10/2020] [Indexed: 10/22/2022]
Abstract
Executive function (EF) may predict sexual risk-taking and HIV risk in young women in rural South Africa. We tested associations between EF and seven risky behavioural outcomes: binge drinking, illicit substance use, unprotected vaginal sex, concurrent sexual relationships, transactional sex, herpes simplex virus type 2 (HSV-2) infection, and HIV infection. We compared EF in young women with HIV to matched controls. 1080 young women underwent cognitive assessments. Better verbal short-term memory was associated with a lower risk of HSV-2 (OR 0.77; 95% CI 0.69, 0.86; p < 0.001). Uncorrected trends (p < 0.05) were better verbal working memory being associated with a lower risk of concurrency, better planning with a lower risk of illicit drug use, and better affective inhibition with a lower risk of transactional sex. 78 participants with sexually acquired HIV were matched with 153 HIV-negative controls and had poorer verbal working memory than controls (Hedge's g = -0.38; 95% CI -0.66, -0.10; p = 0.0076), but this was non-significant after adjustment. EF's contribution to young women's risky behaviour in this context does not hold when stringent statistical corrections are applied, with only verbal short term memory reaching statistical significance as predictor. Replication in other samples is recommended.
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Affiliation(s)
- Kirsten Rowe
- Department of Psychiatry, University of Oxford, Oxford, UK
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa
| | - Mihaela Duta
- Department of Experimental Psychology, University of Oxford, Oxford, UK
| | - Nele Demeyere
- Department of Experimental Psychology, University of Oxford, Oxford, UK
| | - Ryan G. Wagner
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa
- Centre for Global Health Research, Umeå University, Umeå, Sweden
| | - Audrey Pettifor
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Kathleen Kahn
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa
- Centre for Global Health Research, Umeå University, Umeå, Sweden
| | - Stephen Tollman
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa
- Centre for Global Health Research, Umeå University, Umeå, Sweden
| | - Gaia Scerif
- Department of Experimental Psychology, University of Oxford, Oxford, UK
| | - Alan Stein
- Department of Psychiatry, University of Oxford, Oxford, UK
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa
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Ross JM, Granja K, Duperrouzel JC, Pacheco-Colón I, Lopez-Quintero C, Hawes SW, Gonzalez R. Risky sexual behavior among adolescents: The role of decision-making, problems from cannabis use and externalizing disorder symptoms. J Clin Exp Neuropsychol 2018; 41:300-311. [PMID: 30520343 DOI: 10.1080/13803395.2018.1550192] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
INTRODUCTION Previous research has demonstrated that externalizing symptoms, cannabis use problems, and poor decision-making abilities are each independently related to risky sexual behavior (RSB). However, few studies have examined the joint effect of these factors on RSB among a sample of adolescents. METHODS The current study addresses this gap in the literature by examining how externalizing disorder symptoms, cannabis use, and decision-making abilities interact to predict RSB among a sample of adolescents (n = 204; Mage = 15.5) at-risk for escalation in cannabis use. Poisson regression was used for all analyses, and simple slope difference tests were used for all post-hoc analyses. RESULTS A greater number of externalizing symptoms, more problems from cannabis use, and more risk disadvantageous choices on the Cups Task (CT) total trials and more risk disadvantageous choices on the CT-gain trials predicted greater RSB endorsement. Findings also highlight significant interactions between cannabis use problems and CT-total and -gain trial performance, as well as between cannabis use problems and externalizing symptoms in predicting RSB. CONCLUSION Current treatment and prevention approaches to reduce RSB among adolescents may benefit from incorporating techniques that improve decision-making skills.
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Affiliation(s)
- J Megan Ross
- a Institute for Behavioral Genetics , University of Colorado , Boulder , CO, USA.,b Center for Children and Families , Florida International University , Miami , FL, USA
| | - Karen Granja
- b Center for Children and Families , Florida International University , Miami , FL, USA
| | | | - Ileana Pacheco-Colón
- b Center for Children and Families , Florida International University , Miami , FL, USA
| | | | - Samuel W Hawes
- b Center for Children and Families , Florida International University , Miami , FL, USA
| | - Raul Gonzalez
- b Center for Children and Families , Florida International University , Miami , FL, USA
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Transition to drug co-use among adolescent cannabis users: The role of decision-making and mental health. Addict Behav 2018; 85:43-50. [PMID: 29843040 DOI: 10.1016/j.addbeh.2018.05.010] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2017] [Revised: 04/17/2018] [Accepted: 05/15/2018] [Indexed: 12/25/2022]
Abstract
BACKGROUND Co-use of cannabis and drugs other than cannabis (DOTC) influences the risk of experiencing cannabis disorders. Accordingly, we explored whether speed of transition to drug co-use, the number of DOTC used, and/or being an experimental cannabis-only user, a regular cannabis-only user, or a regular cannabis user who co-uses DOTC (i.e., cannabis-plus user) were associated with decision-making (DM), mental health disorder symptoms, or cannabis use-related characteristics. METHODS We analyzed baseline data from a sub-sample of 266 adolescent (ages 14 to 16) cannabis users (CU) participating in an ongoing longitudinal study. Assessments included semi-structured interviews, self-report questionnaires, and measures of drug use, DM (measured via the Iowa Gambling Task), mental health disorders, and cannabis use-related problems. RESULTS Endorsing a larger number of mood disorders symptoms was associated with being a regular cannabis-plus user rather than a regular cannabis-only user (AOR = 1.08, C.I.95% 1.01, 1.15). Poorer DM was associated with a faster transition to co-use, such that for each one unit increase in DM performance, the years to onset of drug co-use increased by 1% (p = 0.032). Endorsing a larger number of cannabis use-related problems was positively associated with endorsing a larger number of DOTC used (p = 0.001). CONCLUSIONS This study provides new evidence on the process of drug co-use among CU. Specifically, mood disorder symptoms were associated with use of DOTC among regular CU. Furthermore, poorer DM was associated with a faster transition to drug co-use. Poorer DM and mood disorder symptoms may aggravate or accelerate the onset of adverse consequences among adolescent CU.
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Pacheco-Colón I, Limia JM, Gonzalez R. Nonacute effects of cannabis use on motivation and reward sensitivity in humans: A systematic review. PSYCHOLOGY OF ADDICTIVE BEHAVIORS 2018; 32:497-507. [PMID: 29963875 PMCID: PMC6062456 DOI: 10.1037/adb0000380] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Reduced motivation is often noted as a consequence of cannabis use. However, prior studies examining this association have suboptimally operationalized motivation and have yielded mixed findings. This review discusses motivation and the closely related construct of reward sensitivity. We summarize the available literature examining associations between motivation and cannabis use, addressing the following questions: (a) Is there evidence for decreased motivation among cannabis users? (b) Is there evidence that lack of motivation among cannabis users is specific to their use of cannabis (rather than to use of other addictive drugs)? and (c) Is there evidence suggesting a causal relationship between cannabis use and motivation? Using PubMed, PsycINFO, and WebofScience, we conducted a literature search of studies examining nonacute effects of cannabis use on motivation, apathy, amotivation, effort, and reward sensitivity in humans. This search yielded 22 studies, which were reviewed in detail. We conclude that, although cross-sectional evidence of a cannabis-specific effect on motivation is equivocal, there is partial support from longitudinal studies for a causal link between cannabis use and reduced motivation. Additionally, we propose that reward sensitivity and motivation represent distinct yet related constructs and that reductions in one may not always lead to reductions in the other. Future work should longitudinally examine associations between cannabis use, motivation, and reward sensitivity; carefully define and operationalize these constructs; and control for the influence of potential confounding factors. (PsycINFO Database Record
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Affiliation(s)
| | - Jorge M Limia
- Department of Psychology, Florida International University
| | - Raul Gonzalez
- Department of Psychology, Florida International University
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Polimanti R, Meda SA, Pearlson GD, Zhao H, Sherva R, Farrer LA, Kranzler HR, Gelernter J. S100A10 identified in a genome-wide gene × cannabis dependence interaction analysis of risky sexual behaviours. J Psychiatry Neurosci 2017; 42:252-261. [PMID: 28418321 PMCID: PMC5487272 DOI: 10.1503/jpn.160189] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND We conducted a genome-wide gene × environment interaction analysis to identify genetic variants that interact with cannabis dependence (CaD) in influencing risky sexual behaviours (RSB). METHODS Our sample included cannabis-exposed and sexually experienced African-American and European-American participants. A DSM-IV CaD diagnosis and RSB were evaluated using the Semi-Structured Assessment for Drug Dependence and Alcoholism. We analyzed RSBs as a score that takes into account experiences of unprotected sex and multiple sexual partners. RESULTS A total of 3350 people participated in our study; 43% had a CaD diagnosis, 56% were African-American and 33% were women. We identified a genome-wide significant locus in African-American participants (S100A10 rs72993629, p = 2.73 × 10-8) and a potential transpopulation signal in women (CLTC rs12944716, p = 5.27 × 10-8). A resting-state fMRI follow-up analysis of S100A10 rs72993629 conducted in an independent cohort showed 2 significant associations: reduced power of the left paracentral lobule in amplitude of low frequency fluctuations (ALFF) analysis (p = 7.8 × 10-3) and reduced power of the right pallidum in fractional ALFF analysis (p = 4.6 × 10-3). The activity of these brain regions is known to be involved in sexual functions and behaviours. The S100A10 result functionally recapitulated our S100B finding observed in our previous genome-wide association study of CaD. The probability of identifying 2 S100 genes in 2 independent genome-wide investigations by chance is approximately 1 in 1.1 million. LIMITATIONS We were not able to identify any African-American cohort with appropriate sample size, and phenotypic assessment is available to replicate our findings. CONCLUSION The S100A10 and S100B genes, which are located on different chromosomes, encode specialized calcium-binding proteins. These data support a role for calcium homeostasis in individuals with CaD and its induced behaviours.
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Affiliation(s)
| | | | | | | | | | | | | | - Joel Gelernter
- Correspondence to: J. Gelernter, Yale University School of Medicine, Department of Psychiatry, 950 Campbell Ave., West Haven, CT 06516;
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Vidot DC, Lerner B, Gonzalez R. Cannabis Use, Medication Management and Adherence Among Persons Living with HIV. AIDS Behav 2017; 21:2005-2013. [PMID: 28456895 DOI: 10.1007/s10461-017-1782-x] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Cannabis is used to relieve nausea, trigger weight gain, and reduce pain among adults living with HIV; however, the relationship between its use and medication adherence and management is unclear. Participants (N = 107) were from an ongoing cohort study of community-dwelling HIV+ adults, stratified by cannabis (CB) use: HIV+/CB+ (n = 41) and HIV+/CB- (n = 66). CB+ participants either tested positive in a urine toxicology screen for THC or had a self-reported history of regular and recent use. HIV-status was provided by physician results and/or biomarker assessment. Adherence was measured via the Morisky scale and medication management was assessed via the Medication Management Test-Revised. After adjusting for gender, we found no association between cannabis use group and adherence nor medication management. The amount of cannabis used was also not associated with measures of adherence and management. Preliminary findings suggest that cannabis use may not adversely influence medication adherence/management among adults living with HIV.
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Affiliation(s)
- Denise C Vidot
- School of Nursing and Health Sciences, University of Miami, 5030 Brunson Ave, Coral Gables, FL, 33146, USA.
| | - Brenda Lerner
- Department of Psychology, Center for Children and Families, Florida International University, Miami, FL, USA
| | - Raul Gonzalez
- Department of Psychology, Center for Children and Families, Florida International University, Miami, FL, USA
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Brooks Holliday S, Ewing BA, Storholm ED, Parast L, D'Amico EJ. Gender differences in the association between conduct disorder and risky sexual behavior. J Adolesc 2017; 56:75-83. [PMID: 28182979 PMCID: PMC5504918 DOI: 10.1016/j.adolescence.2017.01.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2016] [Revised: 01/13/2017] [Accepted: 01/30/2017] [Indexed: 10/20/2022]
Abstract
Despite suggestions that there are gender differences in the association between conduct disorder (CD) and risky sexual behavior, limited empirical research has examined this question. Youth (N = 616) were recruited from four primary care clinics and completed questions related to risky sexual behavior, alcohol and marijuana use, and CD. Results of stratified multivariate models indicated that the association between CD and having four or more lifetime partners, having two or more partners in the last 3 months, and engaging in condomless sex was stronger among female youth. However, the association between CD and alcohol and other drug use before sex was stronger in male youth. This is an important contribution to our understanding of gender-specific manifestations of conduct disorder, and has the potential to inform screening and brief intervention efforts for this population.
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Affiliation(s)
| | - Brett A Ewing
- RAND Corporation, 1776 Main Street, Santa Monica, CA, USA
| | | | - Layla Parast
- RAND Corporation, 1776 Main Street, Santa Monica, CA, USA
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Abstract
OBJECTIVES Engagement in risky sexual behavior (RSB) is a significant public health concern. A growing body of literature is elucidating the role of brain systems and neuropsychological constructs implicated in RSB, which may pave the way for novel insights and prevention efforts. METHODS In this article, we review studies incorporating neuropsychology into the study of RSB across the lifespan. The review of the literature on the neuropsychology of RSB is separated into three different sections by age of participants. Background is presented on research associating RSB with neurocognitive processes and the brain systems involved. Given the overlap between RSBs and substance use, studies addressing these problems in tandem are also discussed. RESULTS Neurocognitive constructs are implicated in RSB, including impulsivity, decision-making, and working memory. DISCUSSION Thus far, evidence suggest that neuropsychological factors are associated with engagement in RSB. More research on the influence of neuropsychological factors on engagement in RSB is necessary and may help inform future prevention efforts. (JINS, 2016, 22, 586-594).
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