Predicting the Onset of Sexual and Drug Risk Behaviors in HIV-Negative Youths with HIV-Positive Mothers: The Role of Contextual,Self-Regulation,and Social-Interaction Factors

HIV-negative, inner-city adolescents with HIV-infected parents are considered to be at high risk for acquiring HIV themselves. Using a modified theory of health behavior, this study examined the effects of maternal HIV infection and psychosocial variables on the onset of sexual and drug risk behavior in 144 HIV-negative adolescents with and without HIV-positive mothers. Adolescents and their mothers were interviewed when the youths were 10–14 years old and again when they were 13–19 years old. By follow-up, 42% of youths reported the onset of vaginal sex (vs 5% at baseline). Marijuana and alcohol use increased from 6 and 38%, respectively, at baseline to 25 and 60% at follow-up. Among those reporting risk behaviors, 40--50% reported onset prior to 14 years. Youth and family psychosocial variables, but not maternal HIV status, were associated with risk behaviour outcomes. Claude A. Mellins research interests include mental health, psychosocial, and public effects of maternal and pediatric HIV; interventions for HIV-affected families; and adherence. Curtis Dolezal research interests include HIV-related sexual behavior in a variety of populations with a particular emphasis on methodology/measurement issues. Elizabeth Brackis-Cott research interests include impact of HIV/AIDS on the lives of children and families directly affected by the disease. Ouzama Nicholson research interests include international public health and pediatric HIV infection and operational issues in developing effective prevention of mother-to-child transmission of HIV infection and pediatric HIV care programs. Patricia Warne research interests include program development, structural interventions for HIV, and policy. Heino F. L. Meyer-Bahlburg research interests include psychosexual assessment, the development and determinants of sexual risk behavior, and the effects of HIV disease on sexual functioning.     

Undetermined Manner of Death: An Autopsy Series

A manner of death may be ruled undetermined by the forensic pathologist when there is insufficient information about the circumstances surrounding the death to make a ruling. The aim of our study was to retrospectively analyze a series of autopsy cases that were classified as undetermined manner of death after complete investigations. In all, 48 cases were examined. In 23 cases (48%), the cause of death was determined. The most frequent cause of death was toxic death (n = 11). More than one manner of death was deemed conceivable for most cases (n = 39). The most frequent and the most probable manner of death was accident (n = 37). Homicide was not excluded in about 23% of the cases. Our study showed that the manner of death may remain undetermined despite an established cause of death, and even when two or more conceivable causes of death are considered. Our study pointed out that undetermined manner of death covers a wide range of situations and that homicide may be underestimated.