Tuberculosis Knowledge, Perceived Risk and Risk Behaviors Among Homeless Adults: Effect of Ethnicity and Injection Drug Use

Abstract

The objectives of this study were to investigate Tuberculosis (TB) knowledge, perceived risk, and risk behaviors in a sample of homeless persons with latent TB in the Skid Row district of Los Angeles. Particular emphasis was given to comparing these variables among homeless persons of varying ethnic backgrounds and among those who did and did not report a history of injection drug use (IDU). Baseline data were collected from 415 homeless individuals recruited to participate in a Tuberculosis chemoprophylaxis intervention. Areas of interest relative to TB knowledge and perceived risk for infection were behavioral factors surrounding substance use and abuse; personal factors measured in terms of current depression; and sociodemographic and situational factors, such as age, ethnicity, history of incarceration, and duration of homelessness. Findings revealed differences in substance abuse. IDUs were more likely to have histories of daily drug use and alcohol dependency, but were less apt to report recent use of crack cocaine. TB knowledge deficits centered on ignorance with respect to modes of transmission and risk factors for TB infection. IDU was also associated with depression. Latinos and IDUs were most likely to lack TB knowledge. There is a pressing need for accessible, available, culturally acceptable and sustained TB screening and intervention programs designed to address multiple risk factors and knowledge deficits with respect to TB infection in homeless populations.

Applying the Health Belief Model to Analyze Intention to Participate in Preventive Pulmonary Tuberculosis Chest X-Ray Examinations Among Indigenous Nursing Students

“…Study findings revealed that ethnic Malayo-Polynesians in Taiwan, similar to findings in previous studies of at-risk population in the United States, were somewhat less likely than the general population to perceive themselves as at-risk of contracting TB (Ailinger et al, 2004;Nyamathi et al, 2004). Lack of knowledge about TB and a low perceived risk of infection elevate the risk of TB infection and transmission to others (Nyamathi et al, 2004). Therefore, one significant component of TB education should focus on increasing perceived susceptibility from the viewpoint of epidemiological data and then helping at-risk populations to discuss related concerns.…”

“…With appropriate TB education, erroneous knowledge related to routes of TB transmission (e.g., tableware) could be corrected. Study findings revealed that ethnic Malayo-Polynesians in Taiwan, similar to findings in previous studies of at-risk population in the United States, were somewhat less likely than the general population to perceive themselves as at-risk of contracting TB (Ailinger et al, 2004;Nyamathi et al, 2004). Lack of knowledge about TB and a low perceived risk of infection elevate the risk of TB infection and transmission to others (Nyamathi et al, 2004).…”

“…Unlike many other studies, and a point of concern for the researchers was that the level of professional knowledge about TB among study subjects was similar to that among the general public (Ailinger et al, 2003;Ailinger, Armstrong, Nguyen, & Lasus, 2004;Carey et al, 1997;Gibson et al, 2005;Nyamathi et al, 2004;Orrett & Shurland, 2001;Westaway, 1989). In addition, answers to questions targeted to test knowledge show that study subjects may hold fundamental misunderstandings regarding TB.…”

State policies matter: The case of outpatient drug treatment program practices

“…It is clearly the case that the current analyses do not indicate whether state policy preceded services. However, inclusion of policy requirements regarding the provision of infectious disease/STD testing in state policies is a fairly low-cost policy mandate (relative to other mandates) that could have enormous public health benefits because of the documented link between substance use/abuse and infectious disease/ STD (Aktan, Calkins, & Johnson, 2001;Batki & Ferrando, 1996;Broome et al, 1999;Edlin et al, 2005;Holmberg, 1996;National Institute on Drug Abuse, 1999;Nyamathi, Sands, Pattatucci-Aragon, Berg, & Leake, 2004).…”

The Ecology of Homelessness

“…In a study of 415 homeless persons in Los Angeles, Nyamathi et al (2004) found a notable lack of knowledge regarding the risk factors associated with TB infection and modes of transmission. Injecting drug users and Latinos evidenced lower rates of TB knowledge.…”