scholarly journals Travel Related Risk Behaviors and Antibiotic Use among Older Travelers

Author(s):  
Varea H Costello ◽  
David Tribble ◽  
Christa Eickhoff ◽  
D Hamilton Tilley ◽  
Gregory Utz ◽  
...  

Abstract Background Antibiotic stewardship in the pre-travel care of older adults is important to effectively treat infections while minimizing harm from side effects and unnecessary antibiotic use. The objective of this study was to compare the characteristics, risk behaviors, infectious diseases and antibiotic use between older (≥ 60 years) and younger (18-59 years) travelers. Methods TravMil is a prospective, observational cohort of United States Department of Defense beneficiaries traveling outside the continental US for ≤ 6.5 months. For this analysis, we included adults enrolled pre-travel between January 2010–August 2018 and excluded active duty personnel on deployment. Pre- and post-travel surveys captured trip characteristics, exposures, illnesses, and antibiotic use. Results 1742 travelers were analyzed: 747 (42.9%) were ≥ 60 years and 995 (57.1%) were 18-59 years. Older travelers were less likely to engage in high-risk dietary behaviors and experience travelers’ diarrhea than younger travelers (18.2% vs 22.9%; p<0.05). Influenza-like illnesses (12.5%) and febrile illness (3.4%) occurred less frequently in the older cohort. Antibiotic use for self treatment was common in both age groups (25.7% vs. 26.7%) and often inappropriate e.g. for treatment of occasional loose stool or mild travelers’ diarrhea (older adults 67.0% [67/100] vs. younger adults 57.6% [83/144]; p <0.05), and influenza-like illnesses (63.4% [64/101] vs. 58.6% [68/116]; p<0.05). Conclusions Older travelers were less likely to engage in high-risk behaviors and experience travelers’ diarrhea, and both age groups experienced mild, self-limited infections. Inappropriate use of antibiotics was common, suggesting that antimicrobial stewardship should be emphasized at pre-travel counseling with international travelers.

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S107-S107
Author(s):  
Varea H Costello ◽  
David Tribble ◽  
Christa Eickhoff ◽  
Drake H Tilley ◽  
Gregory Utz ◽  
...  

Abstract Background Older travelers (≥ 60 years) are a unique risk population for travel related infections and adverse events from antibiotics. We evaluated the differences in travel characteristics, exposures, illnesses and antibiotic use among older travelers and those between 18 – 59 y using a prospective, observational cohort of US Department of Defense (DoD) beneficiaries traveling outside the US for ≤ 6.5 months (TravMil). Methods Adult DoD beneficiaries were enrolled pre-travel. Itineraries limited to Western/Northern Europe, Canada, or New Zealand and active duty personnel on military travel were excluded. Demographics, itineraries and prescriptions were abstracted. A post-travel survey collected information on exposures and illnesses (travelers’ diarrhea (TD), influenza-like illness (ILI) or febrile illness). Categorical variables were analyzed using chi-square or Fishers exact test and the Mann-U Whitney test was used for continuous variables. Results Of the 1468 travelers, 755 were ≥ 60y and 719 were < 60y. Asia (35%) and South/Central America (28%) were the most common travel regions. Older travelers were more likely to be Caucasian (80% vs. 67%), male (52% vs. 39%) and travel for tourism (84% vs. 51%) (p< 0.05). Younger travelers were more likely engage in risk behaviors (e.g. consume poorly cooked meat or seafood (16% vs 9%) or street vendor food (26% vs 8.6%), wade in fresh water (24% vs. 18%), and non-compliance with malaria prophylaxis (22% vs 12%) (p< 0.05). Older travelers had a lower incidence of TD (18% vs 24%), and a higher proportion of cases with loose stool or mild TD that did not interfere with daily activities (63% vs. 51%) (p< 0.05). Inappropriate antibiotic use for loose stool or mild TD were similar among the two age groups (67% vs 59%). Non-significant trends of lower incidence and mild infections were observed for ILI and febrile illness in older travelers. Conclusion Older travelers were less likely to engage in risk behaviors, had a lower TD incidence and reported mild diarrheal symptoms. Inappropriate antibiotic use for loose stool or mild TD was common in both age groups. Enhancing antibiotic stewardship is important for older travelers to prevent potential side effects, drug interactions and antibiotic resistance. Disclosures All Authors: No reported disclosures


2005 ◽  
Vol 21 (4) ◽  
pp. 216-225 ◽  
Author(s):  
William L. Cook

Abstract. In family systems, it is possible for one to put oneself at risk by eliciting aversive, high-risk behaviors from others ( Cook, Kenny, & Goldstein, 1991 ). Consequently, it is desirable that family assessments should clarify the direction of effects when evaluating family dynamics. In this paper a new method of family assessment will be presented that identifies bidirectional influence processes in family relationships. Based on the Social Relations Model (SRM: Kenny & La Voie, 1984 ), the SRM Family Assessment provides information about the give and take of family dynamics at three levels of analysis: group, individual, and dyad. The method will be briefly illustrated by the assessment of a family from the PIER Program, a randomized clinical trial of an intervention to prevent the onset of psychosis in high-risk young people.


2012 ◽  
Author(s):  
Lyllymar Colon ◽  
Vivian Tamayo-Agrait ◽  
Isaedmarie Febo ◽  
Paola Piovanetti ◽  
Michelle Pico ◽  
...  

2018 ◽  
Vol 2 (1) ◽  
pp. 114-121
Author(s):  
Mohammad Reza Asadi ◽  
Zeinab Saeediaee ◽  
Mehdi Mohammadi ◽  
Mahdi Kheradmand

Heliyon ◽  
2021 ◽  
Vol 7 (5) ◽  
pp. e06987
Author(s):  
Azam Toozandehjani ◽  
Zohreh Mahmoodi ◽  
Mitra Rahimzadeh ◽  
Alireza Jashni Motlagh ◽  
Mahnaz Akbari Kamrani ◽  
...  

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Xiang Mao ◽  
Sequoia I. Leuba ◽  
Qinghai Hu ◽  
Hongjing Yan ◽  
Zhe Wang ◽  
...  

Abstract Background There is limited information about the types of recreational drugs used by men who have sex with men (MSM) in China or the consequent impact on sexual health and human immunodeficiency virus (HIV) acquisition. Methods We recruited MSM from seven cities in China between 2012 and 2013 using multiple approaches including advertisements on gay websites, collaborating with local MSM community-based organizations, peer referrals, and venues such as gay bars and bathrooms visited by MSM. We divided participants into four subgroups based on the number of recreational drugs (RDs) used in the previous 6 months. We defined use of multiple RDs as use of ≥2 types of RDs. Demographics and HIV-related high-risk behaviors were collected, and blood samples were tested for recent HIV infection by the HIV-1 subtypes B, E, and D immunoglobulin G capture enzyme immunoassay (BED-CEIA). We used multivariable logistic regression adjusted for sociodemographics to determine the adjusted odds ratios (aORs) and associated 95% confidence intervals (CIs) of the subgroups of RD use for recent or established HIV infection. Results A total of 4496 Chinese MSM participated; 28.4% used RDs, and 5% used multiple types of RDs. The prevalence of each RD use was as follows: poppers (25.9%), ecstasy (2.4%), ketamine (1.2%), amphetamine (0.6%), tramadol (0.4%), methamphetamine (3.8%), and codeine (1.9%). Users of multiple RDs commonly used poppers combined with one or more other types of RDs. Multiple RD users were likely to be aged 26–30 years (vs. 18–25 and > 30 years), live in non-local cities (vs. local cities), never married (vs. married), have a high monthly income (vs. no income and 1–599 USD), use versatile positions during anal intercourse (vs. top or bottom), and have inadequate HIV-related prevention knowledge (vs. adequate). As the number of RDs used in the previous 6 months increased, the prevalence of HIV-related high-risk behaviors increased (P < 0.05 for all). The odds of recent HIV infection were higher among those who used one type (aOR = 2.2, 95% CI: 1.5–3.0) or two types of RD (aOR=2.3, 95% CI: 1.0-5.2) in the previous 6 months compared to the odds among those who did not use RDs. Conclusion The level and pattern of multiple RD use among Chinese MSM were different from high-income countries. MSM who used more RDs are more likely to engage in high-risk sexual behaviors, and these behaviors may be associated with increases in new HIV infections.


2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Thiago S. Torres ◽  
Paula M. Luz ◽  
Luana M. S. Marins ◽  
Daniel R. B. Bezerra ◽  
Celline C. Almeida-Brasil ◽  
...  

Abstract Background Valid and reliable instruments are needed to measure the multiple dimensions of perceived risk. The Perceived Risk of HIV Scale is an 8-item measure that assesses how people think and feel about their risk of infection. We set out to perform a cross-cultural adaptation of the scale to Brazilian Portuguese among key populations (gay, bisexual and other men who have sex with men and transgender/non-binary) and other populations (cisgender heterosexual men and cisgender women). Methods Methodological study with cross-sectional design conducted online during October/2019 (key populations [sample 1] and other populations) and February–March/2020 (key populations not on pre-exposure prophylaxis [sample 2]). Cross-cultural adaptation of the Perceived Risk of HIV Scale followed Beaton et al. 2000 guidelines and included confirmatory factor analysis, differential item functioning (DIF) using the Multiple-Indicator Multiple-Cause model, and concurrent validity to verify if younger individuals, those ever testing for HIV, and engaging in high-risk behaviors had higher scores on the scale. Results 4342 participants from key populations (sample 1 = 235; sample 2 = 4107) and 155 participants from other populations completed the measure. We confirmed the single-factor structure of the original measure (fit indices for sample 1 plus other populations: CFI = 0.98, TLI = 0.98, RMSEA = 0.07; sample 2 plus other populations: CFI = 0.97, TLI = 0.95, RMSEA = 0.09). For the comparisons between key populations and other populations, three items (item 2: “I worry about getting infected with HIV”, item 4: “I am sure I will not get infected with HIV”, and item 8: “Getting HIV is something I have”) exhibited statistically significant DIF. Items 2 and 8 were endorsed at higher levels by key populations and item 4 by other populations. However, the effect of DIF on overall scores was negligible (0.10 and 0.02 standard deviations for the models with other populations plus sample 1 and 2, respectively). Those ever testing for HIV scored higher than those who never tested (p < .001); among key populations, those engaging in high-risk behaviors scored higher than those reporting low-risk. Conclusion The Perceived Risk of HIV Scale can be used among key populations and other populations from Brazil.


2007 ◽  
Vol 27 (4) ◽  
pp. 53-61 ◽  
Author(s):  
Liu Wei ◽  
Jie Chen ◽  
Michelle Rodolph ◽  
Geetha Beauchamp ◽  
Ben Masse ◽  
...  

1999 ◽  
Vol 25 (2) ◽  
pp. 109-119 ◽  
Author(s):  
Pamela A Sarigiani ◽  
Lenoraann Ryan ◽  
Anne C Petersen

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