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Charoensakulchai S, Onwan M, Kanchanasurakit S, Flaherty G, Matsee W. Recreational substance use among international travellers. J Travel Med 2024; 31:taae012. [PMID: 38236178 DOI: 10.1093/jtm/taae012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Revised: 01/11/2024] [Accepted: 01/16/2024] [Indexed: 01/19/2024]
Abstract
BACKGROUND Drug tourism reflects the expanding illicit drug market, posing health risks in unfamiliar travel settings. Existing knowledge specifically addressing substance use among international travellers is sparse and has not been reviewed to date. This review aimed to describe the recreational substance abuse in international travellers. METHODS A literature search was conducted on PubMed, Google Scholar and Scopus using keywords related to recreational substances and international travellers. A total of 11 021 articles were reviewed, charted and summarized for the evidence on prevalence, patterns and characteristics of substance abuse and their health- and non-health-related problems on international travellers. RESULTS A total of 58 articles were included. Most were cross-sectional studies and review articles. In total, 20 articles addressed the prevalence of substance abuse in travellers, 33 looked at characteristics and patterns of substance abuse in travellers and 39 investigated the health- and non-health-related problems from substance abuse. Estimated prevalence of recreational substances abuse varied from 0.7% to 55.0%. Rates of substances abuse were 9.45-34.5% for cannabis, 20.4-35.9% for alcohol intoxication, 2.82-40.5% for MDMA, 2-22.2% for cocaine, 2-15% for psychedelic agents and 2% for methamphetamine. The prevalence varied according to travellers' characteristics and travel destinations. Direct health problems included neuropsychiatric problems. Indirect problems included accident and unintentional injuries, crime and violence, risky sexual behaviours and sexual violence and blood-borne infections. Non-health-related problems included air rage, deportation and violation of local laws. CONCLUSION Substance abuse among international travellers is an underestimated problem that requires intervention. These findings emphasize the importance of addressing this issue to mitigate both health and well-being problems among travellers whilst promoting safer and more responsible travel experiences. In the context of travel health practices, practitioners should counsel travellers whose itineraries may include substance abuse, informing them about associated risks and consequences.
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Affiliation(s)
- Sakarn Charoensakulchai
- Thai Travel Clinic, Hospital for Tropical Diseases, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand
| | - Manasvin Onwan
- Department of Preventive and Social Medicine, Faculty of Medicine, Srinakharinwirot University, Ongkarak, Nakorn-nayok 26120, Thailand
| | - Sukrit Kanchanasurakit
- Division of Clinical Pharmacy, Department of Pharmaceutical Care, School of Pharmaceutical Sciences, University of Phayao, Phayao 56000, Thailand
- Center of Health Outcomes Research and Therapeutic Safety (Cohorts), School of Pharmaceutical Sciences, University of Phayao, Phayao 56000, Thailand
- Unit of Excellence on Clinical Outcomes Research and Integration (UNICORN), School of Pharmaceutical Sciences, University of Phayao, Phayao 56000, Thailand
- Division of Pharmaceutical Care, Department of Pharmacy, Phrae Hospital, Phrae 54000, Thailand
| | - Gerard Flaherty
- School of Medicine, University of Galway, Galway, Ireland
- School of Medicine, International Medical University, Kuala Lumpur 57000, Malaysia
- Travel Medicine Research Unit, Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand
| | - Wasin Matsee
- Thai Travel Clinic, Hospital for Tropical Diseases, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand
- Travel Medicine Research Unit, Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand
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Ramón-Cardona J, Sánchez-Fernández MD, Durán-Sánchez A, Álvarez-García J. Music as an Element of Tourism Innovation: Types of Nightlife Premises in Ibiza (Spain). Front Psychol 2022; 13:890847. [PMID: 35795411 PMCID: PMC9252451 DOI: 10.3389/fpsyg.2022.890847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Accepted: 03/14/2022] [Indexed: 12/02/2022] Open
Abstract
The island of Ibiza is a western Mediterranean destination known internationally for its nightlife. The aim of this paper is to make a proposal to classify the different types of premises in the Ibiza nightlife offer. This involves making a first definition that allows to delimit which businesses are parts of the sector. The methodology used is based on the case study and specifically, on the review of the promotional actions and activities carried out, completed with the visit to the premises. The classification has been made based on the offer marketed and not only on the legal forms used, as innovation goes ahead of the existing legal classifications. Although it is a particular application, due to the international importance of Ibiza, it is a good starting point to classify the nightlife offer of many other tourist destinations. The resulting typology divides the sector into two large groups: nightclubs and other premises. While nightclubs have musical parties as their main activity declared, the other premises have accommodation or catering as their main activity, with music being an element of differentiation. Nightclubs are divided into several subgroups, depending on their size and relevance. The other premises are subdivided into Beach Clubs, Hotel Clubs, Party Boats, Lounge Clubs, Disco Pubs, among others.
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Affiliation(s)
- José Ramón-Cardona
- Escuela Universitaria de Turismo del Consell Insular de Ibiza, Universidad de las Islas Baleares, Palma, Spain
| | | | - Amador Durán-Sánchez
- Departamento de Economía Financiera y Contabilidad, Facultad de Empresa Finanzas y Turismo, Instituto Universitario de Investigación para el Desarrollo Territorial Sostenible (INTERRA), Universidad de Extremadura, Avenida de la Universidad, Cáceres, Spain
| | - José Álvarez-García
- Departamento de Economía Financiera y Contabilidad, Facultad de Empresa Finanzas y Turismo, Instituto Universitario de Investigación para el Desarrollo Territorial Sostenible (INTERRA), Universidad de Extremadura, Avenida de la Universidad, Cáceres, Spain
- *Correspondence: José Álvarez-García,
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Martinotti G, Merino Del Villar C, Garcia Cordoba A, Andrés Tubau L, Castro Sánchez I, Di Carlo F, Chiappini S, Pettorruso M, Schifano F, Di Giannantonio M. Club Drugs and Psychiatric Sequelae: An Issue of Vulnerability and Previous Psychiatric History. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18136944. [PMID: 34209645 PMCID: PMC8297170 DOI: 10.3390/ijerph18136944] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 06/26/2021] [Accepted: 06/27/2021] [Indexed: 11/16/2022]
Abstract
The pursuit of pleasure among clubbers and disco-goers often involves drug use. However, whether substance use may represent a relevant risk factor contributing to the development of psychiatric symptoms and of mental illness remains debated. The purposes of this study were to evaluate the percentage of subjects who developed long-lasting psychiatric symptoms in a sample of subjects reporting use of substances in nightclubs, and to evaluate the role of a previous psychiatric diagnosis in these subjects. Data were collected during three consecutive years in dedicated nursing units inside all the nightclubs of Ibiza, in emergency hospital rooms at the Can Misses Hospital and inside the psychiatric ward. A total of 10,163 subjects required medical assistance inside discos in the medical-nursing units, of which 223 required transfers to hospital emergency rooms. Of these, 110 required subsequent psychiatric hospitalization. Ninety-one (82.7%) of these patients had a positive psychiatric history, which was also found in thirty-one of the 113 subjects (27.4%) not requiring psychiatric hospitalization. Negative psychiatric history was negatively associated with hospitalization (Coefficient = −2.574; p = 0.000) and for subjects with a negative psychiatric history the odds to be hospitalized changed by a factor of 0.076. Gender, age, civil status and nationality were not significant predictors of hospitalization. Overall, the number of subjects who developed major psychiatric disorders appeared to be limited. However, the presence of a psychiatric history here played a crucial role. Club drugs are therefore able to induce psychiatric sequelae requiring hospitalization mainly in subjects who are already vulnerable from a psychopathological point of view.
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Affiliation(s)
- Giovanni Martinotti
- Department of Neuroscience, Imaging, Clinical Sciences, University G. d’Annunzio, 66100 Chieti-Pescara, Italy; (F.D.C.); (S.C.); (M.P.); (M.D.G.)
- Psychopharmacology, Drug Misuse and Novel Psychoactive Substances Research Unit, School of Life and Medical Sciences, University of Hertfordshire, Hertfordshire AL10 9EU, UK;
- Correspondence:
| | | | - Andrés Garcia Cordoba
- Emergency Staff Group, Calle Pere Francés 43, 07800 Eivissa, Illes Balears, Spain; (A.G.C.); (L.A.T.); (I.C.S.)
| | - Lluís Andrés Tubau
- Emergency Staff Group, Calle Pere Francés 43, 07800 Eivissa, Illes Balears, Spain; (A.G.C.); (L.A.T.); (I.C.S.)
| | - Ivan Castro Sánchez
- Emergency Staff Group, Calle Pere Francés 43, 07800 Eivissa, Illes Balears, Spain; (A.G.C.); (L.A.T.); (I.C.S.)
- Plan Municipal Sobre Drogas, Ayuntamiento de Ibiza, Carrer de Canàries, 35-Edif. CETIS, 1r piso, 07800 Eivissa, Illes Balears, Spain
| | - Francesco Di Carlo
- Department of Neuroscience, Imaging, Clinical Sciences, University G. d’Annunzio, 66100 Chieti-Pescara, Italy; (F.D.C.); (S.C.); (M.P.); (M.D.G.)
| | - Stefania Chiappini
- Department of Neuroscience, Imaging, Clinical Sciences, University G. d’Annunzio, 66100 Chieti-Pescara, Italy; (F.D.C.); (S.C.); (M.P.); (M.D.G.)
- Psychopharmacology, Drug Misuse and Novel Psychoactive Substances Research Unit, School of Life and Medical Sciences, University of Hertfordshire, Hertfordshire AL10 9EU, UK;
| | - Mauro Pettorruso
- Department of Neuroscience, Imaging, Clinical Sciences, University G. d’Annunzio, 66100 Chieti-Pescara, Italy; (F.D.C.); (S.C.); (M.P.); (M.D.G.)
| | - Fabrizio Schifano
- Psychopharmacology, Drug Misuse and Novel Psychoactive Substances Research Unit, School of Life and Medical Sciences, University of Hertfordshire, Hertfordshire AL10 9EU, UK;
| | - Massimo Di Giannantonio
- Department of Neuroscience, Imaging, Clinical Sciences, University G. d’Annunzio, 66100 Chieti-Pescara, Italy; (F.D.C.); (S.C.); (M.P.); (M.D.G.)
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Martinotti G, Schiavone S, Negri A, Vannini C, Trabace L, De Berardis D, Pettorruso M, Sensi SL, Di Giannantonio M. Suicidal Behavior and Club Drugs in Young Adults. Brain Sci 2021; 11:brainsci11040490. [PMID: 33921484 PMCID: PMC8069608 DOI: 10.3390/brainsci11040490] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 04/09/2021] [Accepted: 04/11/2021] [Indexed: 12/17/2022] Open
Abstract
Psychoactive drugs play a significant role in suicidality when used for intentional overdose or, more frequently, when the intoxication leads to disinhibition and alterations in judgment, thereby making suicide more likely. In this study, we investigated suicidality prevalence among drug users and evaluated the differences in suicide ideation, taking into account the substance categories and the association of suicide ideation intensity with other psychiatric symptoms. Subjects admitted to the Can Misses Hospital's psychiatry ward in Ibiza were recruited during summer openings of local nightclubs for four consecutive years starting in 2015. The main inclusion criterium was an intake of psychoactive substances during the previous 24 h. The Columbia Suicide Severity Rating Scale (C-SSRS) was used to assess the suicide risk. Suicidality was present in 39% of the study cohort. Suicide Ideation Intensity overall and in the previous month was higher in users of opioids and in general of psychodepressors compared to psychostimulants or psychodysleptics. Suicidality was not correlated with alterations in any of the major psychopathological scales employed to assess the psychiatric background of the study subjects. The presence of high levels of suicidality did not specifically correlate with any major symptom indicative of previous or ongoing psychopathological alterations. These findings suggest that impulsivity and loss of self-control may be determinants of the increased suicidality irrespectively of any major ongoing psychiatric background.
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Affiliation(s)
- Giovanni Martinotti
- Department of Neuroscience, Imaging and Clinical Sciences, University G. d’Annunzio of Chieti-Pescara, 66100 Chieti-Pescara, Italy; (G.M.); (C.V.); (M.P.); (S.L.S.); (M.D.G.)
| | - Stefania Schiavone
- Department of Clinical and Experimental Medicine, University of Foggia, 71122 Foggia, Italy; (S.S.); (L.T.)
| | - Attilio Negri
- S.C Area Ser.D Mantova—U.O. Ser.T Alto Mantovano, 46100 Mantova, Italy;
- Department of Clinical and Pharmaceutical Sciences, School of Life and Medical Science, University of Hertfordshire, Hatfield AL10 9AB, UK
| | - Chiara Vannini
- Department of Neuroscience, Imaging and Clinical Sciences, University G. d’Annunzio of Chieti-Pescara, 66100 Chieti-Pescara, Italy; (G.M.); (C.V.); (M.P.); (S.L.S.); (M.D.G.)
| | - Luigia Trabace
- Department of Clinical and Experimental Medicine, University of Foggia, 71122 Foggia, Italy; (S.S.); (L.T.)
| | - Domenico De Berardis
- NHS, Department of Mental Health, Psychiatric Service for Diagnosis and Treatment, Hospital “G. Mazzini”, 64100 Teramo, Italy
- Correspondence: ; Tel.: +39-0861429708
| | - Mauro Pettorruso
- Department of Neuroscience, Imaging and Clinical Sciences, University G. d’Annunzio of Chieti-Pescara, 66100 Chieti-Pescara, Italy; (G.M.); (C.V.); (M.P.); (S.L.S.); (M.D.G.)
| | - Stefano L. Sensi
- Department of Neuroscience, Imaging and Clinical Sciences, University G. d’Annunzio of Chieti-Pescara, 66100 Chieti-Pescara, Italy; (G.M.); (C.V.); (M.P.); (S.L.S.); (M.D.G.)
- Center for Advanced Studies and Technology (CAST) University G. d’Annunzio of Chieti-Pescara, 66100 Chieti-Pescara, Italy
| | - Massimo Di Giannantonio
- Department of Neuroscience, Imaging and Clinical Sciences, University G. d’Annunzio of Chieti-Pescara, 66100 Chieti-Pescara, Italy; (G.M.); (C.V.); (M.P.); (S.L.S.); (M.D.G.)
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Sun, sea and sex: a review of the sex tourism literature. TROPICAL DISEASES TRAVEL MEDICINE AND VACCINES 2020; 6:24. [PMID: 33292661 PMCID: PMC7691961 DOI: 10.1186/s40794-020-00124-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Accepted: 11/16/2020] [Indexed: 01/24/2023]
Abstract
Background Sex tourism is defined as travel planned specifically for the purpose of sex, generally to a country where prostitution is legal. While much of the literature on sex tourism relates to the commercial sex worker industry, sex tourism also finds expression in non-transactional sexual encounters. This narrative review explores current concepts related to travel and sex, with a focus on trans-national sex tourism. Methods The PubMed database was accessed to source relevant literature, using combinations of pertinent search terms. Only articles published in the English language were selected. Reference lists of published articles were also examined for relevant articles. Results With regard to preferred destinations, South/Central America and the Caribbean were more likely to receive tourists looking for casual sex. Longer duration of travel, travelling alone or with friends, alcohol or drug use, being younger and being single were factors associated with higher levels of casual sex overseas. The majority of literature retrieved on sex workers focused on risk behaviours, sexually transmitted infections (STI), mobility of sex workers and how these factors affected their lives. Sex tourists require better access to effective methods of preventing HIV, such as pre-exposure prophylaxis, and better education on HIV prevention. Drugs and alcohol play a major role as risk factors for and cofactors in casual sexual behaviour while abroad. Conclusions Travellers need to be informed of the increased risks of STI before travel. They should be aware of the local prevalence of STIs and the risks associated with their sexual practices when they travel, including engaging with commercial sex workers, having unprotected sexual intercourse and becoming victims of sexual violence.
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Martinotti G, Negri A, Schiavone S, Montemitro C, Vannini C, Baroni G, Pettorruso M, De Giorgio F, Giorgetti R, Verrastro V, Trabace L, Garcia A, Castro I, Iglesias Lopez J, Merino Del Villar C, Schifano F, di Giannantonio M. Club Drugs: Psychotropic Effects and Psychopathological Characteristics of a Sample of Inpatients. Front Psychiatry 2020; 11:879. [PMID: 33110412 PMCID: PMC7488956 DOI: 10.3389/fpsyt.2020.00879] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Accepted: 08/11/2020] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Growing evidence supports the possibility of significant psychiatric consequences related to novel and traditional psychoactive substance consumption. The problem of differential diagnosis has hampered research on specific psychopathologies with unclear outcomes. The aim of our study was to report psychiatric and clinical features of subjects admitted to a psychiatric ward in Ibiza, Spain, with a clinical diagnosis of substance abuse or intoxication. METHODS A survey was administered to a sample of inpatients hospitalized due to psychiatric symptoms related to recent use of psychoactive substances. The questionnaire investigated sociodemographic factors, familiar and personal anamnesis, substance use habits, general and psychopathological features. Urine samples were collected and analyzed in a toxicology laboratory using gas chromatography and mass spectrometry. RESULTS A total of 110 patients were included in the study. Most patients (70%) declared multiple substance use, and 33% of patients reported more than two substances; nevertheless, it was possible to identify 17 (15%) depressor users, 44 (40%) stimulant users and 49 (45%) psychodysleptics users. A positive association with a lifetime diagnosis of bipolar disorder was found (two-tailed Fisher's exact test: p = 0.013). Psychomotor agitation, reference, and paranoid delusions, affective symptoms, consciousness disorders, and aggressiveness represented some of the most frequent symptoms at entry evaluation. CONCLUSIONS In this study, we described the acute psychiatric presentations related to recreational drug use in subjects on holiday in Ibiza. The use of psychoactive substances was characterized by poly-use of both traditional and novel substances, with several psychopathological consequences. Future research should focus on a better understanding of the psychopathological effects of specific substances, defining signs and symptoms to help make a differential diagnosis and prospectively examine long-term effects.
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Affiliation(s)
- Giovanni Martinotti
- Department of Neuroscience, Imaging, Clinical Sciences, University G.d'Annunzio Chieti-Pescara, Chieti, Italy.,Department of Pharmacy, Pharmacology and Clinical Science, University of Hertfordshire, Hatfield, United Kingdom
| | - Attilio Negri
- Department of Pharmacy, Pharmacology and Clinical Science, University of Hertfordshire, Hatfield, United Kingdom.,Postgraduate School of Clinical Pharmacology and Toxicology, University of Milan, Milan, Italy
| | - Stefania Schiavone
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Chiara Montemitro
- Department of Neuroscience, Imaging, Clinical Sciences, University G.d'Annunzio Chieti-Pescara, Chieti, Italy
| | - Chiara Vannini
- Department of Neuroscience, Imaging, Clinical Sciences, University G.d'Annunzio Chieti-Pescara, Chieti, Italy
| | - Gaia Baroni
- Department of Neuroscience, Imaging, Clinical Sciences, University G.d'Annunzio Chieti-Pescara, Chieti, Italy
| | - Mauro Pettorruso
- Department of Neuroscience, Imaging, Clinical Sciences, University G.d'Annunzio Chieti-Pescara, Chieti, Italy
| | - Fabio De Giorgio
- Section of Legal Medicine, Department of Health Care Surveillance and Bioethics, Università Cattolica del Sacro Cuore, Rome, Italy.,Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy
| | - Raffaele Giorgetti
- Section of Legal Medicine, Department of Excellence SBSP, University "Politecnica delle Marche" of Ancona, Ancona, Italy
| | - Valeria Verrastro
- Department of Medical and Surgical Sciences, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - Luigia Trabace
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | | | | | | | | | - Fabrizio Schifano
- Department of Pharmacy, Pharmacology and Clinical Science, University of Hertfordshire, Hatfield, United Kingdom
| | - Massimo di Giannantonio
- Department of Neuroscience, Imaging, Clinical Sciences, University G.d'Annunzio Chieti-Pescara, Chieti, Italy
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di Giannantonio M, Negri A, Schiavone S, Vannini C, Pettorruso M, De-Giorgio F, Verrastro V, Trabace L, Corbo M, Gottardo R, Camuto C, Mazzarino M, Barra A, De Berardis D, Lopez JI, Del Villar CM, Schifano F, Martinotti G. Prescription Drug Misuse in "Clubbers" and Disco Goers in Ibiza. Front Psychiatry 2020; 11:592594. [PMID: 33384628 PMCID: PMC7770108 DOI: 10.3389/fpsyt.2020.592594] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Accepted: 11/16/2020] [Indexed: 12/31/2022] Open
Abstract
Background: Prescription drug misuse and its related risks are considered a worldwide public health issue. Current trends show that the extent of such phenomenon may not be limited to subjects with psychiatric disorders, as it also spreads to dance party and nightclub attendees, who often consume prescription drugs in combination with alcohol and psychoactive substances. This study aims to report the sociodemographic data and the psychiatric and clinical features of a sample of clubbers reporting prescription drugs use. Methods: Patients admitted to the psychiatry ward of the Can Misses Hospital in Ibiza were recruited for the study during a span of four consecutive years (2015-2018). The inclusion criteria were age 18-75 years old and the intake of psychoactive substances or more than five alcohol units during the previous 24 h. Substance use habits, psychopathological features, and use of unprescribed pharmaceuticals were investigated. Urine samples were collected and analyzed using gas chromatography/mass spectrometry. Results: A total of 110 subjects with psychoactive substance intoxication were recruited for the study. Among these, 37 (40%) disclosed the use of prescription drugs without medical supervision. The most common compounds were benzodiazepines (66%), antiepileptic drugs (8%), antidepressants (6%), opioids (6%), antipsychotics (6%), stimulants (6%), and non-steroidal anti-inflammatory drugs (NSAIDs, 2%). Prescription drug misuse was negatively associated with the use of psychodysleptics (two-tailed Fisher's exact test p = 0.018, ρ = -0.262). Conclusions: The use of prescription drugs is also common among clubbers, usually characterized by low propensity to be prescribed benzodiazepines, antipsychotics, or antidepressants. Prescription drugs may be an alternative to classic and novel psychoactive compounds or may be used to tamper and self-medicate the effects determined by the use of substances. Party goers should be adequately informed about possible risks of co-intake of psychoactive substances and prescription drugs to prevent serious medical and psychiatric consequences.
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Affiliation(s)
- Massimo di Giannantonio
- Department of Neuroscience, Imaging, Clinical Sciences, University G.d'Annunzio, Chieti-Pescara, Italy
| | - Attilio Negri
- Department of Clinical, Pharmaceutical and Biological Sciences, School of Life & Medical Sciences, University of Hertfordshire, Hatfield, United Kingdom.,Postgraduate School of Clinical Pharmacology and Toxicology, University of Milan, Milan, Italy
| | - Stefania Schiavone
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Chiara Vannini
- Department of Neuroscience, Imaging, Clinical Sciences, University G.d'Annunzio, Chieti-Pescara, Italy
| | - Mauro Pettorruso
- Department of Neuroscience, Imaging, Clinical Sciences, University G.d'Annunzio, Chieti-Pescara, Italy
| | - Fabio De-Giorgio
- Department of Health Care Surveillance and Bioethics, Section of Legal Medicine, University Cattolica del Sacro Cuore, Rome, Italy.,Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Valeria Verrastro
- Department of Medical and Surgical Sciences, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - Luigia Trabace
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Mariangela Corbo
- Department of Neuroscience, Imaging, Clinical Sciences, University G.d'Annunzio, Chieti-Pescara, Italy
| | - Rossella Gottardo
- Unit of Forensic Medicine, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Cristian Camuto
- Department of Health Care Surveillance and Bioethics, Section of Legal Medicine, University Cattolica del Sacro Cuore, Rome, Italy.,Laboratorio Antidoping FMSI, Rome, Italy
| | | | - Andrea Barra
- Azienda Sanitaria Locale Potenza, Potenza, Italy
| | - Domenico De Berardis
- NHS, Department of Mental Health, Psychiatric Service for Diagnosis and Treatment, Hospital "G. Mazzini," ASL 4, Teramo, Italy
| | | | | | - Fabrizio Schifano
- Psychopharmacology, Drug Misuse & Novel Psychoactive Substances Research Unit, School of Life & Medical Sciences, University of Hertfordshire, Hatfield, United Kingdom
| | - Giovanni Martinotti
- Department of Neuroscience, Imaging, Clinical Sciences, University G.d'Annunzio, Chieti-Pescara, Italy.,Psychopharmacology, Drug Misuse & Novel Psychoactive Substances Research Unit, School of Life & Medical Sciences, University of Hertfordshire, Hatfield, United Kingdom
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Svensson P, Sundbeck M, Persson KI, Stafström M, Östergren PO, Mannheimer L, Agardh A. A meta-analysis and systematic literature review of factors associated with sexual risk-taking during international travel. Travel Med Infect Dis 2018; 24:65-88. [PMID: 29567294 DOI: 10.1016/j.tmaid.2018.03.002] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2017] [Revised: 02/23/2018] [Accepted: 03/12/2018] [Indexed: 11/27/2022]
Abstract
BACKGROUND International travel facilitates global spread of sexually transmitted infections (STI). Travellers could contribute to onward transmission of pathogens rarely encountered at home and export new strains to the destination. The aim was to systematically examine evidence regarding determinants of travel-related sexual risk-taking and identify knowledge gaps and areas for targeted interventions. METHOD Articles published in peer-reviewed journals from 2000 to 2017 were screened in 6 databases and assessed for relevance against criteria. Data was extracted for factors associated with travel-related STI or proxies. Meta-analyses estimated pooled prevalence of casual sex and non-condom use. Adjusted odds ratios of predictors were pooled to generate a combined estimate. RESULT Forty-nine articles qualified for inclusion. A heterogeneity test indicated variation across studies. The pooled prevalence of casual travel sex was 35% and prevalence of non-condom use 17%. Expectations of casual sex strongly predicted sex with a new partner when travelling abroad. Planning to have sex indicated condom use. CONCLUSION The studies largely represented sub-groups of risk-taking populations from a European context, indicating substantial knowledge gaps. Studies investigating migrants travelling to visit friends and relatives, older travellers, and female travelers are needed. Post-travel harm reduction activities may serve as a focus for future interventions.
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Affiliation(s)
- Pia Svensson
- Social Medicine and Global Health, Department of Clinical Sciences, Lund University, Malmö, Sweden.
| | - Mats Sundbeck
- Social Medicine and Global Health, Department of Clinical Sciences, Lund University, Malmö, Sweden
| | - Kristina Ingemarsdotter Persson
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden; Public Health Agency, Health and Sexuality, Stockholm, Sweden
| | - Martin Stafström
- Social Medicine and Global Health, Department of Clinical Sciences, Lund University, Malmö, Sweden
| | - Per-Olof Östergren
- Social Medicine and Global Health, Department of Clinical Sciences, Lund University, Malmö, Sweden
| | - Louise Mannheimer
- Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden; Public Health Agency, Health and Sexuality, Stockholm, Sweden
| | - Anette Agardh
- Social Medicine and Global Health, Department of Clinical Sciences, Lund University, Malmö, Sweden
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Decraene V, Kühlmann Berenzon S, Andersson Franko M, Veličko I. Differences in travel-related incidence of chlamydia by age groups, gender and destination: Sweden 2000-2013. Travel Med Infect Dis 2018; 25:42-49. [PMID: 29476910 DOI: 10.1016/j.tmaid.2018.02.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2017] [Revised: 02/17/2018] [Accepted: 02/20/2018] [Indexed: 10/18/2022]
Abstract
BACKGROUND The absolute number of travel-related Chlamydia cases in Sweden has consistently increased between 2000 and 2013. Given the growth in international travel, we aimed to study the trends of travel-related Chlamydia incidence to determine differences and identify high-risk groups and destinations. METHODS For 2000-2013 we calculated annual Chlamydia incidence per 100,000 travels by dividing the number of notified travel-related cases by the number of travels; the latter were collected from a yearly survey among Swedish residents. For specific destinations 95% confidence intervals were calculated and monotonic yearly trends tested. RESULTS The overall median annual travel-related Chlamydia incidence was higher for women than for men, but the opposite was true in age groups >25 years. For men, Thailand had the highest incidence, which was 3-7 times higher than the next highest destination in each age group. Spain, Turkey and Thailand had the highest incidence among women, but differences between countries were smaller than for men. For most destinations the yearly trends were stable. CONCLUSIONS We showed different profiles for men and women and age groups in terms of high incidence destinations. This specific information could allow to better tailor safe sex messages and advocate post-travel Chlamydia testing to target groups travelling to certain destinations.
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Affiliation(s)
- Valérie Decraene
- European Programme for Intervention Epidemiology Training (EPIET), European Centre for Disease Prevention and Control, Stockholm, Sweden; Public Health England North West, Liverpool, United Kingdom; The Public Health Agency of Sweden, Solna, Sweden
| | | | | | - Inga Veličko
- The Public Health Agency of Sweden, Solna, Sweden
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10
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Berdychevsky L. Toward the Tailoring of Sexual Health Education Messages for Young Women: A Focus on Tourist Experiences. JOURNAL OF SEX RESEARCH 2017; 54:1171-1187. [PMID: 28276937 DOI: 10.1080/00224499.2017.1280720] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Perceived anonymity and decreased influence of sexual double standards in tourism provide female travelers with opportunities for sexual experimentation and risk taking. The purpose of this study was (a) to identify the clusters of risk takers among young women based on their perceptions of and motivations for sexual risk taking in tourism and (b) to profile the clusters with respect to the psychological, sexual, demographic, and tourist characteristics. The data were collected through an online survey of 853 women (age in years: M = 23.5, SD = 6.67). Five clusters of sexual risk takers emerged based on their factor-analyzed risk perceptions and motivations. These clusters were interpreted as (a) diversely motivated broad risk perceivers; (b) fun-seeking broad risk perceivers; (c) diversely motivated physical risk perceivers; (d) anonymity- and empowerment-seeking risk disregarders; and (e) unmotivated broad risk perceivers. Women in these clusters differed in their intentions to engage in sexual risk taking in tourism, sensation-seeking propensities, perceptions of tourist characteristics, levels of sexual experience, and demographic backgrounds. Results suggest tailoring sexual health promotion messages based on cluster affiliation, leveraging cluster-specific risk perceptions, motivations, and personal characteristics. This study provides recommendations for individually tailored, context-specific, age-appropriate, and gender-sensitive sexual health education programs.
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Affiliation(s)
- Liza Berdychevsky
- a Department of Recreation, Sport, and Tourism , University of Illinois at Urbana-Champaign
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11
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Flaherty GT, Maxemous KK, Nossier RE, Bui YG. The highs and lows of drug tourism: a travel medicine perspective. J Travel Med 2017; 24:4191323. [PMID: 29088481 DOI: 10.1093/jtm/tax068] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2017] [Accepted: 08/24/2017] [Indexed: 11/13/2022]
Affiliation(s)
- Gerard T Flaherty
- School of Medicine, National University of Ireland Galway, Galway, Ireland.,School of Medicine, International Medical University, Kuala Lumpur, Malaysia
| | - Karl K Maxemous
- School of Medicine, National University of Ireland Galway, Galway, Ireland
| | - Ramez E Nossier
- School of Medicine, National University of Ireland Galway, Galway, Ireland
| | - Yen-Giang Bui
- Department of Public Health, CISSS Montérégie-Centre, Longueuil, Canada
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12
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Warne M, Sinadinovic K, Berman AH, Källmén H, Vinberg S. Risky consumption of alcohol and drugs among employees at ski resorts. NORDIC STUDIES ON ALCOHOL AND DRUGS 2017; 34:201-216. [PMID: 32934485 PMCID: PMC7450871 DOI: 10.1177/1455072517707879] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2017] [Accepted: 04/07/2017] [Indexed: 12/03/2022] Open
Abstract
AIM To evaluate risky consumption of alcohol and drugs among Swedish men and women who are employed at ski resorts. METHODS A cross-sectional sample of 611 employees in 48 small and medium-sized enterprises responded to a questionnaire covering alcohol and drug use, social aspects around work and working conditions. Consumption of alcohol and drugs in the study sample was compared to population data. Data were analysed using Mann-Whitney U-tests and logistic regression analyses. RESULTS Compared to the general population, the study group of ski resort employees had higher scores on the Alcohol Use Disorders Identification Test (AUDIT) in all age groups except 35+ for men. Regarding the Drug Use Disorders Identification Test (DUDIT) scores, only men in the 18-24 age group had higher scores compared to the general population. The prevalence of risky alcohol and drug use was higher among seasonally employed individuals; 82.9%, compared to 58.0% among other employees for alcohol; 8.3% compared to 2.8% for drugs. The regression analysis indicated that social aspects such as living together with colleagues and having co-workers/friends who are frequently inebriated were the most significant explanatory variables for explaining risk consumption of alcohol (OR 16.82 and OR 4.33). Risky use of drugs was associated with being younger (OR 0.15) and male (OR 0.86), as well as with having co-workers/friends who are frequently inebriated (OR 4.25). CONCLUSIONS The study showed a high prevalence of risky alcohol consumption among ski resort employees compared to the general population, with higher risky drug consumption found only among younger men. Social aspects such as living with colleagues and having co-workers or friends who are often inebriated, were identified as important explanatory factors. Preventive measures should be introduced, targeting norms and work culture surrounding alcohol and drug use among ski resort employees.
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Affiliation(s)
| | | | | | - Håkan Källmén
- STAD, Centre for Psychiatry Research, Stockholm, Sweden
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13
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Santacroce R, Ruiz Bennasar C, Sancho Jaraiz JR, Fiori F, Sarchione F, Angelini F, Catalano G, Carenti ML, Corkery JM, Schifano F, Di Giannantonio M, Martinotti G. A matter of life and death: substance-caused and substance-related fatalities in Ibiza in 2015. Hum Psychopharmacol 2017; 32. [PMID: 28657183 DOI: 10.1002/hup.2592] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2016] [Revised: 03/08/2017] [Accepted: 03/13/2017] [Indexed: 11/09/2022]
Abstract
OBJECTIVES AND METHODS In the framework of the EU-funded project "EU-Madness," we collected and analysed all the reports of fatalities directly or indirectly related to substances of abuse registered in Ibiza from January to September 2015, in order to analyse the characteristics of the sample, the identified substances, and the nature of deaths associated with their consumption. RESULTS A significant increase of substance-caused deaths with respect to the previous 4 years has been highlighted. Most of the subjects were young males, more than half were not Spanish. Males prevailed also amongst the victims of traffic accidents and suicides. The most commonly involved substances included MDMA, alcohol, cocaine, THC, opiates and prescription drugs. CONCLUSIONS Although the use of NPS is rapidly increasing in Europe, according to the results from our sample, alcohol and well-known stimulants (MDMA and cocaine) are still the substances of abuse mainly involved in the cases of substance-caused and substance-related fatalities. The significant increase of fatalities in Ibiza in the last 5 years is an issue that must be taken into account and should be better investigated, as other theories besides NPS-increased diffusion should be proposed, and therefore, targeted prevention strategies should be designed.
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Affiliation(s)
- Rita Santacroce
- Department of Neuroscience, Imaging and Clinical Sciences, University "G. d'Annunzio", Chieti, Italy.,Department of Pharmacy, Pharmacology and Postgraduate Medicine, University of Hertfordshire, Hatfield, UK
| | | | | | - Federica Fiori
- Department of Neuroscience, Imaging and Clinical Sciences, University "G. d'Annunzio", Chieti, Italy
| | - Fabiola Sarchione
- Department of Neuroscience, Imaging and Clinical Sciences, University "G. d'Annunzio", Chieti, Italy
| | - Federica Angelini
- Department of Neuroscience, Imaging and Clinical Sciences, University "G. d'Annunzio", Chieti, Italy
| | | | | | - John Martin Corkery
- Department of Pharmacy, Pharmacology and Postgraduate Medicine, University of Hertfordshire, Hatfield, UK
| | - Fabrizio Schifano
- Department of Pharmacy, Pharmacology and Postgraduate Medicine, University of Hertfordshire, Hatfield, UK
| | - Massimo Di Giannantonio
- Department of Neuroscience, Imaging and Clinical Sciences, University "G. d'Annunzio", Chieti, Italy
| | - Giovanni Martinotti
- Department of Neuroscience, Imaging and Clinical Sciences, University "G. d'Annunzio", Chieti, Italy.,Department of Pharmacy, Pharmacology and Postgraduate Medicine, University of Hertfordshire, Hatfield, UK
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14
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Martinotti G, Cinosi E, Santacroce R, Papanti D, Pasquini A, Mancini V, Corbo M, Fiori F, Sarchione F, Marchetti D, Verrocchio MC, Di Giannantonio M, Torrens M, Schifano F, Morlan Coarasa MJ, Merino Del Villar C. Substance-related psychopathology and aggressiveness in a nightlife holiday resort: Results from a pilot study in a psychiatric inpatient unit in Ibiza. Hum Psychopharmacol 2017; 32. [PMID: 28557062 DOI: 10.1002/hup.2586] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2016] [Revised: 03/03/2017] [Accepted: 03/06/2017] [Indexed: 11/07/2022]
Abstract
OBJECTIVES We aimed to describe a sample of subjects admitted to a psychiatric unit after the intake of psychoactive substances for recreational purposes. METHODS Between June and September 2015, 49 subjects were included. Sociodemographic characteristics and psychopathological aspects were investigated, and urine samples for further analysis were collected. Three subgroups (cannabinoids, stimulants, and depressors users) were identified, according to the structured interview regarding substance use and urinalysis. RESULTS Level of aggressiveness was found to be significantly higher (p < .05) in the cannabinoids subgroup. Self-reported symptom severity was comparable among groups, but trends could be identified: SCL-90 results showed a prevalence of anxiety symptoms among depressors users, hostility or aggression in the tetrahydrocannabinol subgroup, and psychoticism in the stimulants subgroup. CONCLUSIONS The use of psychoactive substances was be characterised by poly-use of both traditional and novel substances. The presence of aggressiveness emerged as a main feature associated with the use of cannabis and other cannabinoids. Binge drinking and sleep deprivation also represented a relevant component in almost all the evaluated subjects.
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Affiliation(s)
- Giovanni Martinotti
- Department of Neuroscience, Imaging and Clinical Sciences, University "G.d'Annunzio", Chieti, Italy.,Department of Pharmacy, Pharmacology, Postgraduate Medicine, University of Hertfordshire, Hatfield, Herts, UK
| | - Eduardo Cinosi
- Department of Neuroscience, Imaging and Clinical Sciences, University "G.d'Annunzio", Chieti, Italy
| | - Rita Santacroce
- Department of Neuroscience, Imaging and Clinical Sciences, University "G.d'Annunzio", Chieti, Italy.,Department of Pharmacy, Pharmacology, Postgraduate Medicine, University of Hertfordshire, Hatfield, Herts, UK
| | - Duccio Papanti
- Department of Medical, Surgical, and Health Sciences, University of Trieste, Italy
| | - Anna Pasquini
- Department of Neuroscience, Imaging and Clinical Sciences, University "G.d'Annunzio", Chieti, Italy
| | - Valerio Mancini
- Department of Neuroscience, Imaging and Clinical Sciences, University "G.d'Annunzio", Chieti, Italy
| | - Mariangela Corbo
- Department of Neuroscience, Imaging and Clinical Sciences, University "G.d'Annunzio", Chieti, Italy
| | - Federica Fiori
- Department of Neuroscience, Imaging and Clinical Sciences, University "G.d'Annunzio", Chieti, Italy
| | - Fabiola Sarchione
- Department of Neuroscience, Imaging and Clinical Sciences, University "G.d'Annunzio", Chieti, Italy
| | - Daniela Marchetti
- Department of Psychological, Health, and Territorial Sciences, University "G. d'Annunzio", Chieti, Italy
| | - Maria Cristina Verrocchio
- Department of Psychological, Health, and Territorial Sciences, University "G. d'Annunzio", Chieti, Italy
| | - Massimo Di Giannantonio
- Department of Neuroscience, Imaging and Clinical Sciences, University "G.d'Annunzio", Chieti, Italy
| | - Marta Torrens
- Institut de Neuropsiquiatria i Addicions, Hospital del Mar, Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Barcelona, Spain
| | - Fabrizio Schifano
- Department of Pharmacy, Pharmacology, Postgraduate Medicine, University of Hertfordshire, Hatfield, Herts, UK
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15
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Crawford G, Lobo R, Brown G, Macri C, Smith H, Maycock B. HIV, Other Blood-Borne Viruses and Sexually Transmitted Infections amongst Expatriates and Travellers to Low- and Middle-Income Countries: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2016; 13:E1249. [PMID: 27999275 PMCID: PMC5201390 DOI: 10.3390/ijerph13121249] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/12/2016] [Revised: 12/01/2016] [Accepted: 12/12/2016] [Indexed: 11/23/2022]
Abstract
In some high-income countries, a proportion of human immunodeficiency virus (HIV), other blood-borne virus (BBV) or sexually transmitted infection (STI) diagnoses have been reported as acquired overseas in low- and middle-income countries. A review was conducted to explore HIV, other BBV or STI related knowledge, risk behavior and acquisition amongst expatriates and travelers, particularly males, travelling from high to low- and middle-income countries. Seven academic databases were searched for 26 peer reviewed articles that met inclusion criteria. Significant variability in the studies was noted, in age, travel duration and frequency and outcomes/risk factors measured and reported on. Risk factors described included longer duration of stay; being single; travel for romance or sex; alcohol and other drug use; lack of travel advice; being male; higher number of sexual partners; and inconsistent condom use. Vaccination, pre-travel health advice, and having fewer sexual partners were described as protective. Studies are needed focusing on the social context in which risk-taking occurs. Better collaboration is essential to deliver comprehensive health promotion interventions alongside more consistent pre- and post- travel testing and advice. Policy measures are crucial, including consistent evaluation indicators to assess impacts of HIV, other BBVs or STIs in the context of mobility. Risks and responses for these epidemics are shared globally.
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Affiliation(s)
- Gemma Crawford
- Collaboration for Evidence, Research and Impact in Public Health, School of Public Health, Curtin University, Perth 6845, Australia.
| | - Roanna Lobo
- Collaboration for Evidence, Research and Impact in Public Health, School of Public Health, Curtin University, Perth 6845, Australia.
| | - Graham Brown
- Collaboration for Evidence, Research and Impact in Public Health, School of Public Health, Curtin University, Perth 6845, Australia.
- Australian Research Centre in Sex Health and Society, La Trobe University, Melbourne 3083, Australia.
| | - Chloe Macri
- School of Public Health, Curtin University, Perth 6845, Australia.
| | - Hannah Smith
- School of Public Health, Curtin University, Perth 6845, Australia.
| | - Bruce Maycock
- Collaboration for Evidence, Research and Impact in Public Health, School of Public Health, Curtin University, Perth 6845, Australia.
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16
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Milhausen RR, Crosby RA, Yarber WL, Graham CA, Sanders SA, Ingram H, Barr VM, Macdonald IR. An intervention study assessing a peer outreach model to promote safer-sex for tourism workers. THE CANADIAN JOURNAL OF HUMAN SEXUALITY 2016. [DOI: 10.3138/cjhs.253-a5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Tourism destinations provide unique social contexts which foster sexual risk-taking. Banff, Alberta, Canada is one such destination with high rates of STI and risk-taking, particularly among tourism workers (TWs).Twenty-five TWs (14 women and 11 men) completed a single session intervention designed to promote the consistent and correct use of condoms. The intervention, comprised of motivational and skills-based training and the provision of a range of high-quality condoms and lubricants, was delivered in a one-to-one format in community settings. Pre- and post-intervention (three weeks following) paper and pencil questionnaires were administered. Sexual experience barriers to condom use significantly decreased (P<.001) after the intervention and confidence in condom use negotiation (P=.005) significantly increased. Confidence in using condoms without loss of pleasure (P=.001) also significantly increased. The number of condom use errors significantly decreased (P<.001). All except two of the behavioral outcomes were also significant: TWs were more likely to discuss condom use before having sex (P=.025), more likely to report condom use the last time sex occurred (P=.005), and more likely to add lubrication to condoms for penile-vaginal sex (P=.027). Significant changes in frequency of unprotected penile-anal sex and frequency of unprotected penile-vaginal sex were not observed; however a large effect size was observed relative to decreases in unprotected penile-vaginal sex. Together the behavioural outcomes and psychosocial outcomes suggest the potential utility for this single session program to be applied in other tourist destinations.
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Affiliation(s)
- Robin R. Milhausen
- Department of Family Relations and Applied Nutrition, University of Guelph, Guelph, ON
- The Kinsey Institute, Indiana University, Bloomington, IN
- Rural Center for AIDS/STD Prevention, Indiana University, Bloomington, IN
| | - Richard A. Crosby
- The Kinsey Institute, Indiana University, Bloomington, IN
- Rural Center for AIDS/STD Prevention, Indiana University, Bloomington, IN
- Department of Health Behavior, College of Public Health, University of Kentucky, Lexington, KY
| | - William L. Yarber
- The Kinsey Institute, Indiana University, Bloomington, IN
- Rural Center for AIDS/STD Prevention, Indiana University, Bloomington, IN
- Department of Applied Health Science, Indiana University, Bloomington, IN
- Department of Gender Studies, Indiana University, Bloomington, IN
| | - Cynthia A. Graham
- The Kinsey Institute, Indiana University, Bloomington, IN
- Rural Center for AIDS/STD Prevention, Indiana University, Bloomington, IN
- Department of Psychology, University of Southampton, Southampton, UK
| | - Stephanie A. Sanders
- The Kinsey Institute, Indiana University, Bloomington, IN
- Rural Center for AIDS/STD Prevention, Indiana University, Bloomington, IN
- Department of Gender Studies, Indiana University, Bloomington, IN
| | - Hailey Ingram
- Department of Applied Psychology and Human Development, Ontario Institute for Studies in Education, University of Toronto, Toronto, ON
| | | | - Ian R. Macdonald
- Alpine Medical Clinic, Banff, AB
- Mineral Spring Hospital, Banff, AB
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17
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Berdychevsky L. Antecedents of Young Women's Sexual Risk Taking in Tourist Experiences. JOURNAL OF SEX RESEARCH 2016; 53:927-941. [PMID: 26575307 DOI: 10.1080/00224499.2015.1069783] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
The purpose of this phenomenological exploration was to shed light on the constellation of factors anteceding young women's sexual risk taking during their tourist experiences. A total of 15 in-depth interviews (1.5 to 2.5 hours each) with 13 women were conducted and analyzed through the lens of transcendental phenomenology. An analysis of antecedent factors revealed a confluence of sociopersonal characteristics (e.g., sexual definitions, attitudes, double standards, and age) and touristic attributes (e.g., the sense of temporariness/ephemerality, anonymity, and fun-oriented mentality depending on length, destination, and type of tourist experience) that underlie women's proclivity for and perceptions of sexual risk taking in certain travel scenarios. These result in myriad effects on physical, sexual health, sociocultural, mental, and emotional aspects of women's health and well-being. While the sociopersonal antecedents highlight the cross-pollination between sex-related perceptions in everyday life and touristic environments, the touristic antecedents emphasize the uniqueness of tourist experiences as the contexts for sexual risk taking. The findings address an underresearched topic in sex and tourism scholarship and offer implications for health education and intervention programs, pointing to the value of constructing the context-specific and gender-sensitive sexual health messages underpinned by the ideas of women's empowerment and sexual agency.
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Affiliation(s)
- Liza Berdychevsky
- a Department of Recreation, Sport and Tourism, College of Applied Health Sciences , University of Illinois at Urbana-Champaign
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18
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"That's cool, you're a musician and you drink": Exploring entertainers' accounts of their unique workplace relationship with alcohol. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2016; 36:85-94. [PMID: 27598722 DOI: 10.1016/j.drugpo.2016.07.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2016] [Revised: 06/20/2016] [Accepted: 07/01/2016] [Indexed: 11/23/2022]
Abstract
This qualitative research investigates the alcohol experiences of entertainers who perform within licensed premises. Previous, mainly quantitative, studies have found that entertainers, specifically musicians, are an occupational group who drink excessively. This qualitative study draws on a wider sample of entertainers to examine their accounts of drinking in the workplace and the explanations they provide for this. We conducted individual semi-structured interviews (n=24) with band-members, variety acts and DJs in Glasgow, Scotland. This revealed a workplace characterised by continual opportunities for often free alcohol consumption. Unlike most occupations, for entertainers 'drinking-on-the-job' was normative, expected, and sometimes encouraged by peers, the public, employers or sponsors. Entertainers also experienced performance-related incentives to drink before, during and/or after a show; including anxiety, matching their intoxication level to the audience's, and 'reward-drinking'. This qualitative research confirms the unique nature of the entertainer-alcohol link, even in comparison to that found within other leisure industry occupations. While providing some explanation as to why entertainers might drink excessively, participants' accounts also suggested potential strategies for avoiding the negative outcomes of workplace drinking.
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19
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Meader N, King K, Moe-Byrne T, Wright K, Graham H, Petticrew M, Power C, White M, Sowden AJ. A systematic review on the clustering and co-occurrence of multiple risk behaviours. BMC Public Health 2016; 16:657. [PMID: 27473458 PMCID: PMC4966774 DOI: 10.1186/s12889-016-3373-6] [Citation(s) in RCA: 307] [Impact Index Per Article: 38.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2015] [Accepted: 07/26/2016] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Risk behaviours, such as smoking and physical inactivity account for up to two-thirds of all cardiovascular deaths, and are associated with substantial increased mortality in many conditions including cancer and diabetes. As risk behaviours are thought to co-occur in individuals we conducted a systematic review of studies addressing clustering or co-occurrence of risk behaviours and their predictors. As the main aim of the review was to inform public health policy in England we limited inclusion to studies conducted in the UK. METHODS Key databases were searched from 1990 to 2016. We included UK based cross-sectional and longitudinal studies that investigated risk behaviours such as smoking, physical inactivity, unhealthy diet. High heterogeneity precluded meta-analyses. RESULTS Thirty-seven studies were included in the review (32 cross-sectional and five longitudinal). Most studies investigated unhealthy diet, physical inactivity, alcohol misuse, and smoking. In general adult populations, there was relatively strong evidence of clustering between alcohol misuse and smoking; and unhealthy diet and smoking. For young adults, there was evidence of clustering between sexual risk behaviour and smoking, sexual risk behaviour and illicit drug use, and sexual risk behaviour and alcohol misuse. The strongest associations with co-occurrence and clustering of multiple risk behaviours were occupation (up to 4-fold increased odds in lower SES groups) and education (up to 5-fold increased odds in those with no qualifications). CONCLUSIONS Among general adult populations, alcohol misuse and smoking was the most commonly identified risk behaviour cluster. Among young adults, there was consistent evidence of clustering found between sexual risk behaviour and substance misuse. Socio-economic status was the strongest predictor of engaging in multiple risk behaviours. This suggests the potential for interventions targeting multiple risk behaviours either sequentially or concurrently particularly where there is evidence of clustering. In addition, there is potential for intervening at the social or environmental level due to the strong association with socio-economic status.
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Affiliation(s)
- Nick Meader
- Centre for Reviews and Dissemination, University of York, York, YO10 5DD UK
| | - Kristelle King
- Centre for Reviews and Dissemination, University of York, York, YO10 5DD UK
| | - Thirimon Moe-Byrne
- Centre for Reviews and Dissemination, University of York, York, YO10 5DD UK
| | - Kath Wright
- Centre for Reviews and Dissemination, University of York, York, YO10 5DD UK
| | - Hilary Graham
- Department of Health Sciences, University of York, York, UK
| | - Mark Petticrew
- Department of Social and Environmental Health Research, London School of Hygiene and Tropical Medicine, London, UK
| | - Chris Power
- Population, Policy and Practice, UCL Institute of Child Health, London, UK
| | - Martin White
- UKCRC Centre for Diet and Activity Research (CEDAR), MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - Amanda J. Sowden
- Centre for Reviews and Dissemination, University of York, York, YO10 5DD UK
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20
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Simkhada PP, Sharma A, van Teijlingen ER, Beanland RL. Factors Influencing Sexual Behaviour Between Tourists and Tourism Employees: A Systematic Review. Nepal J Epidemiol 2016; 6:530-8. [PMID: 27152234 PMCID: PMC4850236 DOI: 10.3126/nje.v6i1.14735] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2015] [Revised: 03/25/2016] [Accepted: 03/29/2016] [Indexed: 11/18/2022] Open
Abstract
Background: Increased travel abroad has a significant impact on the incidence and prevalence of Sexually Transmitted Infections (STIs). Previous reviews have focused on the knowledge, attitudes and behaviour of tourists and acquisition of STIs. Less is known about the impact on tourism operators in countries visited by tourists. The aim of this review is to ascertain factors influencing sexual behaviour between workers in the tourism industry and tourists; exploring the prevalence of sexual behaviour between the two populations, their perceptions of sexual risk while engaging in sexual activities and the knowledge of tourism operators regarding STIs. Methods: A systematic review was conducted. Database searches were performed in Medline/Ovid, EMBASE, Cochrane library and CINAHL for studies published between 2000 and March 2016. Grey literature searches were completed in the NHS database and Google Scholar between 2000 and December 2013. Papers were independently selected by two researchers. Data were extracted and critically appraised using a pre-designed extraction form and adapted CASP checklist. Results: The search identified 1,602 studies and 16 were included after review of the full text. Studies were conducted in nine countries. Findings suggest that STI knowledge, attitude and practice were fairly good among tourists and tourism workers, but there is a need for pre-travel advice for travellers, especially those travelling to low and middle-income countries. Greater importance was given to tourists than to tourism operators and locals interacting with tourists. Studies suggest that as a group both tourist and tourist workers were likely to engage in sexual activities. Overall, both condom use and STI screening were low, among tourists as well as tourism operators. Furthermore, studies reported links between drug and alcohol use and sexual behaviour and risk taking. Conclusion: Although less research appeared to have been conducted among tourism workers than tourists, it does demonstrate the need for education, training and promotion of travel medicine. STI screening, pre-travel advice, travel history in terms of contracting STIs and safe-sex awareness-raising are needed. More and better sexual health education and relevant tourism policies are needed globally.
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