AIM To study the pattern of risk behavior in adolescents from rural area in Pune district, India.

1. RISK BEHAVIOR AMONG ADOLESCENTS IN RURAL AREA OF PUNE DISTRICT, INDIA SWANAND TILEKAR, MPH1, ASHWINI ERANDE 2, PRAMOD BANKHELE 3, RAJESH MALI, MPH 4. 1 LA Gay & Lesbian Center, Los Angeles, USA. 2 BJ-JHUMIT project, B.J. Medical College, Pune, India. 3 Trupti Nursing Home, Manchar, India. 4 Department of Ecotrophology &Health Sciences, Hamburg University of Applied Sciences, Hamburg, Germany. Abstract ID#: 137631 Contact Email :swanandtilekar@yahoo.com BACKGROUND Risk behaviors such as smoking, tobacco use, and alcohol consumption, unprotected sexual encounter (with multiple partners) at a very young age are proven to be associated with increased susceptibility to a specific injury, disease & affects the precious growing phase causing greater health impacts in adulthood. The World Health Organization attributes some four million deaths a year to tobacco use. By 2020, 70% of those deaths will occur in developing countries. The tobacco use begins in adolescence & recent trends indicate rising smoking prevalence rates among children and adolescents and earlier age of initiation. If these patterns continue, tobacco will result in the deaths of 250 million children and adolescents alive today, many of them in the developing world. In India tobacco use is estimated to cause 800,000 deaths annually. More adolescents, 20 % men and 5% women becoming vulnerable to unsafe sexual practices. (First community based survey in India, 2006, by Population Council.) Seventy two percent (13-15 yrs) of students first tried tobacco, at less than 10 yrs of age. (Global Youth Tobacco Survey In Uttar Pradesh, India, 2002.) Fourteen percent males and 2.3 % of female adolescents reported to have smoked any time in the past. Forty four percent had started this habit between 10 to 15 years of age. (Prevalence of tobacco use among school and college going adolescents of Haryana, Kapoor SK et.al. Indian J Pediatrics. 1995) Present study would help measure the prevalence of above mentioned reported risk behaviors & examine their association with each other and with other factors as gender, absenteeism and contraceptive use. • The sample (n=2839), were subjects in the age group 12-18 yrs. The data was collected (Twice in December 2005) by using self administered-questionnaire that required retrospective self-reporting about engaging in health- risk activities/behaviors. • Data entry & management in MS Access & Data analysis using SAS.Odds ratios were calculated to estimate the measure of association between different variables. • The objectives are based on reported responses by the subjects. • The table provides the significant association between smoking & gender showing higher odds for males to try smoking than for females. • The table also highlights the low age at which smoking is initiated. • 51 % of male subjects reported having smoked cigarette at least for 2 days in last 1 month. Of those, 30 % had smoked at least for 5 days. • Out of the 193 males, who ever smoked, 16 % smoked 5 per day in last month whenever they smoked. • Out of those who smoked, 22% of them smoked in school campus at least for 2 days. (Findings not shown in table) 2. Alarming finding: 52% of those who ever engaged in sexual intercourse, did not use condom. 3. The average number of sexual partners in past 3 months was reported as 2 & during life as 3. 4. Eighty percent of students wanted HIV/sex education to be provided in schools. (Findings not shown in table) CONCLUSION 1. Considering the low age &vulnerability of this target group, efforts must be taken to sensitize the parents of the adolescents about the physiological as wells as psychological changes, the children undergo during that period & the harmful risk behaviors which might be adopted causing serious health hazards. 2. As the data revealed that subjects <15 yrs of age are more likely, (OR=1.63* (1.03 - 2.57)) to face any of the above mentioned assaults than those >= 15 yrs of age, which may result into psychological and physical stress at the precious growing phase, more in-depth studies focusing on issues related assaults, should be conducted. 3. The finding from the data that 10% of those who smoked or consumed tobacco procured it from family member underlines the need of encouraging parents, to discuss tobacco-related issues with their children, which would also be worth exploring as an intervention strategy to prevent adolescents taking up tobacco use. 4.Fifty three percent of the subjects could procure tobacco containing products from ‘pan-stall’. Constructive action is required to limit adolescents, the exposure and access to tobacco products. However, the finding that those who used tobacco are more likely to practice smoking & alcohol consumption are consistent with those from other developed countries. 5.The finding that the 51% of subjects did not use condom during sexual contact and that the mean number of sexual partners is 2 in past 1 month makes it essential to make them aware of Sexually transmitted infections, HIV/AIDS, and importance of use of contraception. 6.Unlike the study findings from the developed countries, the chances that females practicing such behavior are lower than those of males which can be attributed to the cultural factors those prevail in maledominated societies found in conservative rural areas in India. 7.Dissemination of proper scientific information is essential as 80% of the subjects reported the need of HIV & Sex education in schools. Awareness programs should be conducted in schools & colleges making them more aware of the harmful effects of such behaviors on their physical & psychological health. 8. The results of this baseline study show enough need to conduct more in-depth studies regarding such risk behaviors, which are required to draw the attention of policy makers. • Of those who ever used tobacco, 60 % of males had used it at least once in the past 1 month as against only 6% females. (OR=2.95, P value< 0.02). • Out of the 161, who ever consumed tobacco, • 1. 16 (10%) had it at least for 10 days, 17(11%) at least for 20-29 days and 23% had it everyday. • 2. 20 % had it at least 2-5 times a day & 35% used it on school campus. (Findings not shown in table) • The graph 2. shows the comparison between males & females facing the risk behaviors. • It explains, males are more vulnerable to face assaults/ abuses (bullying/groping, threatening/ injuring, belongings being stolen) and engage in the risk behaviors such as smoking, tobacco chewing, alcohol consumption & sexual encounter than females. • This shows that 21% of those who smoked & 32 % of those who consumed tobacco, procured it from a ‘pan stall’. • Very important finding: 10% of those who used tobacco could get it from family member. • AIM • To study the pattern of risk behavior in adolescents from rural area in Pune district, India. • OBJECTIVES • To measure prevalence of smoking, tobacco & alcohol use. • To measure the prevalence of violence, abuse and unsafe sexual behavior. • To examine the relationship between risk factors & gender. • To examine the relationship between assault faced & absenteeism. • To study the association between sex encounter & alcohol influence. • METHODOLOGY • A no probable convenient sampling method was followed to collect data from 6 schools located in 3 small towns & 1 village. The schools had students coming from nearby villages and towns. • Males were more likely to consume alcohol than females. • Out of 113, who ever consumed alcohol, 14 % had it (1 peg= 30 ml) in a row at least for 2 days in last month. (not shown in table) • RESULT 1: ASSAULT: Above tables show that, males were more likely (2.9- 4.02*-5.5) to face assaults like groping/ bullying , threatening /injury with weapon (4.09-6.3*-9.8) & belongings getting stolen or damaged (2.13-2.5*-3.1) on the way to school or back home than females. • The subjects facing any kind of assaults were also more likely to be absent (1.93-2.74*-3.87) from the school than those who didn’t face any. • Analysis done using age groups, (<15 & >=15 yrs), revealed that subjects <15 yrs of age are more likely ((1.03 - 1.63* - 2.57)) to face any of the 3 assaults mentioned above than those >= 15 yrs of age. LIMITATIONS 1. A few factors responsible for missing data might be the lack of understating of the questions, no exposure to such surveys conducted in schools (unlike in the western countries) and the fear of breach of confidentiality on the part of researcher. 2. The analysis bears the limitations to some extent in the verity of the findings by involving bias as the risk behaviors had been reported by subjects but not observed by the researchers. # 1. Alcohol emerged as an important factor as of these 116, 13% (all males) reported they had sexual contact sometime in their life under alcohol influence, though no significant association was found gender wise. Contd.. Contd.. Contd..