This study sought to determine the actual levels of condom use by female sex workers (FSW) in Thailand brothels. Specifically, it examined the influence that the country of origin of the FSW patrons exerted on usage of a condom, and it assessed the relevancy of constructs from the Health Belief Model in predicting FSW requesting condom usage by their clients. A survey was administered to a cross-sectional non-randomized convenience sample of 150 FSW in four geographic locations in Thailand, which included: Bangkok, Chang Mai, Mae Hong Son and Other (comprised mainly of brothels in small villages). Statistical interpretation of the data indicated that Thai FSW requested condom use in 63% of the cases, while the overall mean of condom use was only 51%. Condom use by patrons' country of origin was as follows: westerners 76%, foreign Asians 52% and native Thai men 27%. These results fall considerably short of the Ministry of Health's goal of 100% condom use in Thai brothels. Furthermore, public health education initiatives need to effectively target the native Thai FSW patrons since they represent the clients least likely to use a condom (27%).

Objectives: In 2009, the annual incidence of positive human immunodeficiency virus (HIV) test reports for people in the Saskatoon Health Region (SHR) was 31.3 per 100 000, when the national average was only 9.3 per 100 000. The first objective was to determine the prevalence of depressive symptomatology among injection drug users (IDUs) in the SHR. The second objective was to determine the unadjusted and adjusted risk indicators associated with depressive symptomatology among IDUs. The third objective was to determine if depressive symptomatology was associated with HIV risk behaviours. Results: Among the respondents, 81.4% reported depressive symptomatology, whereas 57.7% reported more severe depressive symptomatology. After multivariate analysis, the 4 covariates that had an independent association with depressive symptomatology included sexual assault as an adult, sexual assault as a child, attending a residential school, and having an annual income of less than $10 000 Depressive symptomatology was initially associated with 7 HIV risk behaviours. After multivariate analysis, depressive symptomatology was associated with giving sex to get money, giving drugs to get sex, and with more frequently sharing injecting equipment. Conclusions:This study found that depressive symptomatology was strongly associated with injection drug use.Can J Psychiatry. 2011;56(6):358-366. Clinical Implications• There is a need to integrate substance abuse prevention and cessation efforts with postvictimization services.• Broad public policy initiatives, such as increased social services payments and subsidized housing, to prevent poverty within IDUs would help reduce depressive symptomatology.• Offering more services where IDUs live, with mental health providers who treat both depression and drug abuse as a means to reduce HIV risk behaviour, may aid in reducing HIV incidence. Limitations• Our study was cross-sectional and therefore unable to determine causation.• Although validated instruments were used, all of the information generated was based on self-report data.• Even though our sample represented 76.6% of the known IDUs in the SHR, no attempt was made to collect information from the remaining 23.4% to determine if they were different from the study sample. Selection bias could have possibly influenced results.

In 2009, the incidence of positive HIV tests in the Saskatoon Health Region, Canada, was 31.3 per 100,000 population when the national average was only 9.3 per 100,000 population. A majority of the positive HIV tests were of Aboriginal cultural status with a majority of those associated with injection drug use (IDU). The main objective of the study was to determine the risk indicators independently associated with higher rates of IDU in the Aboriginal population in comparison to other cultural groups. It appears that there is no another study with a similar analysis. From September 2009 to April 2010, 603 current IDUs were interviewed; which represents 76.6% of the known Saskatoon IDUs. In our study population, 88.1% of the current IDUs were of Aboriginal cultural status despite making up only 9.2% of the general population. Comparing Aboriginal IDUs to non-Aboriginal IDUs, our study found that Aboriginal injection users were more likely to be female and younger, less likely to receive paid income and were more likely to attend a Residential School or had a parent or grandparent attend a Residential School. If exposure to Residential Schools is ignored, Aboriginal IDUs were also more likely to use sex trading as a source of income and witness death or experience permanent separation from a parent during youth. Our study has identified a limited number of risk indicators independently associated with higher rates of IDU in the Aboriginal population. More specifically, Residential Schools are having a significant generational impact on current IDU, which might explain higher HIV incidence rates within the Aboriginal population.

Abstract:In the United States, smoking is the leading cause of death -having a mortality rate of approximately 435,000 people in 2000-accounting for 8.1% of all US deaths recorded that year. Consequently, we analyzed the Delaware Hospital Discharge Database, and identified state and non-state residents discharged with AMI or asthma for the years 1999 to 2004. Statistical data analysis compared the incidence of AMI or asthma for each group before (1999-2002) and after (2003-2004) the amendment. As a result, we found that pre-ordinance and post-ordinance quarterly rates of AMI for Delaware residents were 451 (se = 21) and 430 (se = 21) respectively, representing a 4.7% reduction. Over the same time period, there was negligible change in the incidence of AMI for non-Delaware residents. After adjusting for population growth, the Risk Ratio (RR) for asthma in Delaware residents post-ordinance was 0.95 (95% CI, 0.90 to 0.999), which represented a significant reduction (P = 0.046). By comparison, non-Delaware residents had an increased RR for asthma post-ordinance of 1.62 (95% CI, 1.46 to 1.86; P < 0.0001).The results suggest that Delaware's comprehensive non-smoking ordinance effectively was associated with a statistically significant decrease in the incidence of AMI and asthma in Delaware residents when compared to non-Delaware residents.

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