The Path from Childhood Behavioural Disorders to Felony Offending: Investigating the Role of Adolescent Drinking, Peer Marginalization, and School Failure

Background

Although a pathway from childhood behavioural disorders to criminal offending is well-established, the aetiological processes remain poorly understood. Also, it is not clear if attention deficit hyperactivity disorder (ADHD) is predictive of crime in the absence of comorbid disruptive behaviour disorder (DBD).

Hypothesis

We examined two research questions: (1) Does ADHD have a unique effect on the risk of criminal offending, independently of DBD? (2) Is the effect of childhood behavioural disorders on criminal offending direct or mediated by adolescent processes related to school experience, substance misuse, and peers?

Method

Structural equation modelling, with latent variables, was applied to longitudinally collected data on 4,644 males from the 1986 Northern Finland Birth Cohort Study.

Results

Both ADHD and DBD separately predicted felony conviction risk. Most of these effects were mediated by adolescent alcohol use and low academic performance. The effect of DBD was stronger and included a direct pathway to criminal offending.

Conclusion

Findings were more consistent with the life course mediation hypothesis of pathways into crime, in that the effects of each disorder category were mediated by heavy drinking and educational failure. Preventing these adolescent risk outcomes may be an effective approach to closing pathways to criminal behaviour among behaviourally disordered children. However, as there was some evidence of a direct pathway from DBD, effective treatments targeting this disorder are also expected to reduce criminal offending.

Below:  Structural Equation Model (Standardised Path Estimates are Reported)

Full article at:   http://goo.gl/SoVWGH

  

By:  Jukka Savolainen, W. Alex Mason, Jonathan D. Bolen, Mary B. Chmelka, Tuula Hurtig, Hanna Ebeling, Tanja Nordström, and Anja Taanila

Jukka Savolainen, School of Criminology and CriminalJustice, University of Nebraska at Omaha, 321 Nebraska Hall, Lincoln, NE 68588-0561, USA, Phone 402-472-3677, FAX 402-472-6758

More at:  https://twitter.com/hiv insight

And: http://twitter.com/Prison Health

CD4 Counts at Entry to HIV Care in Mexico for Patients under the “Universal Antiretroviral Treatment Program for the Uninsured Population,” 2007–2014

In Mexico, public health services have provided universal access to antiretroviral therapy (ART) since 2004. For individuals receiving HIV care in public healthcare facilities, the data are limited regarding CD4 T-lymphocyte counts (CD4e) at the time of entry into care. Relevant population-based estimates of CD4e are needed to inform strategies to maximize the impact of Mexico’s national ART program, and may be applicable to other countries implementing universal HIV treatment programs. 

For this study, we retrospectively analyzed the CD4e of persons living with HIV and receiving care at state public health facilities from 2007 to 2014, comparing CD4e by demographic characteristics and the marginalization index of the state where treatment was provided, and assessing trends in CD4e over time. 

Our sample included 66,947 individuals who entered into HIV care between 2007 and 2014, of whom 79% were male. During the study period, the male-to-female ratio increased from 3.0 to 4.3, reflecting the country's HIV epidemic; the median age at entry decreased from 34 years to 32 years. 

Overall, 48.6% of individuals entered care with a CD4≤200 cells/μl, ranging from 42.2% in states with a very low marginalization index to 52.8% in states with a high marginalization index, and from 38.9% among individuals aged 18–29 to 56.5% among those older than 50. 

The adjusted geometric mean (95% confidence interval) CD4e increased among males from 135 (131,142) cells/μl in 2007 to 148 (143,155) cells/μl in 2014 (p-value<0.0001); no change was observed among women, with a geometric mean of 178 (171,186) and 171 (165,183) in 2007 and 2014, respectively. 

There have been important gains in access to HIV care and treatment; however, late entry into care remains an important barrier in achieving optimal outcomes of ART in Mexico. The geographic, socioeconomic, and demographic differences observed reflect important inequities in timely access to HIV prevention, care, and treatment services, and highlight the need to develop contextual and culturally appropriate prevention and HIV testing strategies and linkage programs.

Below:  CD4e counts at health care program entry decline after 2011

Full article at:   http://goo.gl/PYlXy0

By:  

Alfonso C. Hernández-Romieu, Carlos del Rio 
Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, United States of America

Alfonso C. Hernández-Romieu, Carlos del Rio 

Department of Medicine, Emory University School of Medicine, Atlanta, GA, United States of America

Carlos del Rio 

Center for AIDS Research, Emory University, Atlanta, GA, United States of America

Juan Eugenio Hernández-Ávila, Hugo Lopez-Gatell, Mauricio Hernández-Ávila 

National Institute of Public Health (INSP), Cuernavaca, Mexico

José Antonio Izazola-Licea 

National Center for Prevention and Control of HIV/AIDS (CENSIDA), Mexico City, Mexico

José Antonio Izazola-Licea, Patricia Uribe Zúñiga 

Joint United Nations Programme on HIV/AIDS (UNAIDS), Evaluation and Economics Division, Geneva, Switzerland

More at:  https://twitter.com/hiv insight

And: http://twitter.com/Prison Health

Socioeconomic Marginalisation in the Structural Production of Vulnerability to Violence among People Who Use Illicit Drugs

OBJECTIVE:

Many people who use illicit drugs (PWUD) face challenges to their financial stability. Resulting activities that PWUD undertake to generate income may increase their vulnerability to violence. We therefore examined the relationship between income generation and exposure to violence across a wide range of income generating activities among HIV-positive and HIV-negative PWUD living in Vancouver, Canada.

METHODS:

Data were derived from cohorts of HIV-seropositive and HIV-seronegative PWUD (n=1876) between December 2005 and November 2012. We estimated the relationship between different types of income generation and suffering physical or sexual violence using bivariate and multivariate generalised estimating equations, as well as the characteristics of violent interactions.

RESULTS:

Exposure to violence was reported among 977 (52%) study participants over the study period. In multivariate models controlling for sociodemographic characteristics, mental health status, and drug use patterns, violence was independently and positively associated with participation in street-based income generation activities (ie, recycling, squeegeeing and panhandling), sex work, drug dealing, and theft and other acquisitive criminal activity. Engagement in regular, self-employment or temporary employment was not associated with being exposed to violence. Strangers were the most common perpetrators of violence (46.7%) and beatings the most common type of exposure (70.8%).

CONCLUSIONS:

These results suggest that economic activities expose individuals to contexts associated with social and structural vulnerability to violence. The creation of safe economic opportunities which can minimise vulnerability to violence among PWUD is therefore urgently required.

Purchase full article at:  http://goo.gl/AVAQnj

By:  Richardson LA1, Long C2, DeBeck K3, Nguyen P4, Milloy MJ5, Wood E5, Kerr TH5.

• 1British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, Vancouver, British Columbia, Canada Department of Sociology, University of British Columbia, Vancouver, British Columbia, Canada.
• 2British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, Vancouver, British Columbia, Canada Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.
• 3British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, Vancouver, British Columbia, Canada School of Public Policy, Simon Fraser University, Burnaby, British Columbia, Canada.
• 4British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, Vancouver, British Columbia, Canada.
• 5British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, Vancouver, British Columbia, Canada Faculty of Medicine (Division of AIDS), University of British Columbia, British Columbia, Canada. 
• J Epidemiol Community Health. 2015 Jul;69(7):686-92. doi: 10.1136/jech-2014-205079. Epub 2015 Feb 17.

More at:  https://twitter.com/hiv insight

And: http://twitter.com/Prison Health

LBGTQ Populations and the Health Care System

Via:  http://goo.gl/iEaUk8

More:  http://mendingheartsinc.org/

Medical and Social Determinants of Subsequent Labour Market Marginalization in Young Hospitalized Suicide Attempters

BACKGROUND:

Individuals with a history of suicide attempt have a high risk for subsequent labour market marginalization. This study aimed at assessing the effect of individual and parental factors on different measures of marginalization.

METHODS:

Prospective cohort study based on register linkage of 5 649 individuals who in 1994 were 16-30 years old, lived in Sweden and were treated in inpatient care for suicide attempt during 1992-1994. Hazard ratios (HRs) for labour market marginalization defined as long-term unemployment (>180 days), sickness absence (>90 days), or disability pension in 1995-2010 were calculated with Cox regression.

RESULTS:

Medical risk factors, particularly any earlier diagnosed specific mental disorders (e.g., schizophrenia: HR 5.4 (95% CI: 4.2, 7.0), personality disorders: HR 3.9, 95% CI: 3.1, 4.9), repetitive suicide attempts (HR 1.6, 95% CI: 1.4, 1.9) were associated with a higher relative risk of disability pension. Individual medical factors were of smaller importance for long-term sickness absence, and of only marginal relevance to long-term unemployment. Country of birth outside Europe had an opposite effect on disability pension (HR 0.6, 95% CI: 0.4, 0.8) and long-term unemployment (HR 1.5, 95% CI: 1.3, 1.8). Female sex was positively correlated with long-term sickness absence (HR 1.6, 95% CI: 1.4, 1.7), and negatively associated with long-term unemployment (HR: 0.8, 95% CI: 0.7, 0.9).

CONCLUSIONS:

As compared to disability pension, long-term sickness absence and unemployment was more strongly related to socio-economic variables. Marginalization pathways seemed to vary with migration status and sex. These findings may contribute to the development of intervention strategies which take the individual risk for marginalization into account.

Purchase full article at: 

By:  Niederkrotenthaler T1, Tinghög P2,3, Goldman-Mellor S4, Wilcox HC5, Gould M6, Mittendorfer-Rutz E2.

• 1Medical University Vienna, Center for Public Health, Institute of Social Medicine, Suicide Research Unit, Vienna, A-1090 Vienna, Austria.
• 2Karolinska Institutet, Department of Clinical Neuroscience, Division of Insurance Medicine, 17 177 Stockholm, Sweden.
• 3The Swedish Red Cross University College, Stockholm, Sweden.
• 4University of California, Merced, Merced, CA 95343, United States of America.
• 5Johns Hopkins School of Medicine, Baltimore, MD 21205, United States of America.
• 6Columbia University, NYS Psychiatric Institute, New York, NY 10032, United States of America. 

More at:  https://twitter.com/hiv insight

And: http://twitter.com/Prison Health

A Tale of Two Epidemics: Gender Differences In Socio-Demographic Characteristics & Sexual Behaviors among HIV Positive Individuals in Mexico City

BACKGROUND:

To date, the HIV epidemic in Mexico has been concentrated mainly among men who have sex with men, but heterosexual transmission, particularly to women, is increasingly important. This study examine gender differences in socio-demographic characteristics and risk behaviors of HIV positive individuals in Mexico City.

METHODS:

We analyzed data from a cross-sectional survey of 1,490 clinic patients (male:female ratio 8:1) with HIV inMexico City in 2010. We examined socio-demographic characteristics, risk behavior, and history of HIV infection.From multivariate non-linear probability (probit) models we calculated predicted probabilities by sex of several outcomes: marginalization, demographic and sexual risk behaviors.

RESULTS:

Significant differences were found between men and women. Multivariate models suggest that women had lower schooling levels; were less likely to have been employed in the past month and earn more than the minimal wage; more likely to have children, to have been sexually abused, to never have used condoms and to report having been infected by a stable partner. Additionally, women were less likely to report having a partner with a history of migration to the USA and to have engaged in transactional sex.

CONCLUSION:

Significant differences exist between men and women with HIV in Mexico City in terms of their socioeconomicand behavioral profiles, which translate into differences in terms of exposure to HIV infection. Women face social and economic vulnerability while men tend to have riskier sexual behavior. Gender issues must be approached in prevention and treatment efforts, using diverse methods to target those most vulnerable and at risk.

Table 2

History of HIV infection among study participants

	Women	Men	p-value*
	(N = 167)	(N = 1,323)
	Percentage [CI-95 %]
Presumed route of HIV infection
Blood transfusion	6.98 [3.55,12.9]	1.53 [0.95,2.42]	<0.001
Sharing syringes	1.55 [0.07,5.83]	0.51 [0.21,1.14]
Sex without condom	84.5 [77.2,89.8]	82.5 [80.2,84.6]
Condom failure	3.10 [0.95,7.97]	12.1 [10.3,14.1]
I was forced to have sex	3.10 [0.95,7.97]	3.06 [2.21,4.22]
I forced someone to have sex	0.78 [0.00,4.69]	0.34 [0.10,0.90]
Infected by a stable partner	69.6 [61.0,77.0]	44.0 [41.0,46.9]	<0.001
Migrant/military/prison background of the person who infected you
Military or police	18.7 [12.7,26.6]	3.77 [2.64,5.35]	<0.001
Prison experience	16.8 [11.0,24.9]	3.42 [2.29,5.07]	<0.001
Migrant to the USA	17.3 [11.3,25.5]	27.4 [24.1,31.1]	0.01
Migrant, military or prison background	41.5 [33.1,50.3]	24.4 [21.6,27.4]	0.01
Reason for getting HIV test
Unprotected sex	12.6 [8.13,18.9]	19.9 [17.7,22.2]	<0.001
Tested while hospitalized	14.6 [9.76,21.1]	13.9 [12.0,15.9]
Medical advice	12.6 [8.13,18.9]	18.2 [16.1,20.4]
Requested by employer	0.66 [0.00,4.03]	1.62 [1.04,2.51]
When donating blood	3.97 [1.65,8.59]	3.57 [2.66,4.77]
HIV positive partner	25.8 [19.5,33.4]	15.5 [13.6,17.6]
Shared injecting equipment	0.66 [0.00,4.03]	0.16 [0.00,0.63]
Routine test (frequent tester)	1.32 [0.06,5.01]	7.54 [6.19,9.16]
Other	19.9 [14.2,27.0]	19.7 [17.6,22.0]
In pregnancy	7.95 [4.48,13.5]	----

Footnote: *Tests for differences in means or proportions. We used bivariate t-test for continuous variables and Chi-square test for categorical variables to compare men and women

Table 3

Sexual violence and risk behaviour history before HIV diagnosis among study participants

	Women	Men	p-value*
	(N = 167)	(N = 1,323)
	Mean or percentage [CI-95 %]
Any time in life
Frequently, almost always or always	3.85 [1.19,9.79]	19.4 [16.5,22.6]	<0.001
Sex with men only	91.7 [85.3,95.6]	80.6 [78.1,82.9]	0.01
Sex with women only	4.13 [1.53,9.56]	9.46 [7.82,11.4]
Sex with men and women	4.13 [1.53,9.56]	9.93 [8.26,11.9]
Risk behavior at sexual encounters before diagnosis
Frequency of condom use
Never	73.8 [65.3,80.8]	49.8 [46.7,52.8]	<0.001
Sometimes	11.5 [6.84,18.5]	23.1 [20.6,25.8]
Frequently, almost always or always	14.8 [9.45,22.2]	27.1 [24.5,29.9]
Frequency of alcohol use
Never	70.7 [62.1,78.1]	55.2 [52.1,58.2]	<0.001
Sometimes	18.7 [12.7,26.6]	27.9 [25.3,30.8]
Frequently, almost always or always	10.6 [6.16,17.4]	16.9 [14.7,19.3]
Frequency of drug use
Never	86.7 [79.3,91.7]	79.8 [77.2,82.1]	0.20
Sometimes	7.50 [3.82,13.8]	10.8 [9.07,12.9]
Frequently, almost always or always	5.83 [2.65,11.8]	9.38 [7.73,11.3]
Frequency of both drug and alcohol use
Never	88.5 [81.5,93.2]	80.2 [77.7,82.6]	0.06
Sometimes	4.92 [2.05,10.5]	11.4 [9.54,13.4]
Frequently, almost always or always	6.56 [3.18,12.6]	8.41 [6.86,10.3]
Sexual abuse
Sexually abused at least once	17.9 [12.7,24.6]	12.6 [10.9,14.6]	0.09
Average (sd) number of times sexually abused	11.8 [4.66,18.9]	3.69 [2.72,4.67]	0.02
Age when first sexually abused	17.9 [13.6,22.2]	13.5 [11.9,15.2]	0.05
Number of sexual encounters in the last month a	9.30 [6.57,12.0]	9.18 [8.30,10.1]	0.94
Age of first sexual intercourse	16.9 [16.3,17.6]	15.5 [15.2,15.7]	<0.001

Footnote: *Tests for differences in means or proportions. We used bivariate t-test for continuous variables and Chi-square test for categorical variables to compare men and women

a78 % of women reported having frequent sex with regular partners (42.9 % among males), the rest reported frequent sex with an occasional or one-time partner (data not shown)

Full article at:  http://goo.gl/t4YzOU

By:   Bautista-Arredondo S1, Servan-Mori E2, Beynon F3, González A4, Volkow P5.

• 1National Institute of Public Health, Cuernavaca, Mexico. sbautista@insp.mx.
• 2National Institute of Public Health, Cuernavaca, Mexico. eservan@insp.mx.
• 3National Institute of Public Health, Cuernavaca, Mexico. fenellajb@gmail.com.
• 4Mexico City's AIDS Program, Mexico City, Mexico. andrea.gonzalez.condesa@gmail.com.
• 5National Institute of Oncology, Mexico City, Mexico. pvolkowf@incan.edu.mx. 

More at:  https://twitter.com/hiv_insight

And: http://twitter.com/Prison_Health