Adolescent sexual risk behavior: a multi-system perspective

A Systematic Review and Meta-analysis of Interventions for Sexual Health Promotion Involving Serious Digital Games

OBJECTIVE

Serious games may be effective in promoting sexual health behavior. Their confidential nature may encourage users to discuss sensitive sexuality topics. Furthermore, they can tailor messages to the individual's needs and may be intrinsically motivating. This meta-analysis investigates the effectiveness of interventions for sexual health promotion that use serious games.

MATERIALS AND METHODS

A database search was conducted in PubMed, Web of Science, CINAHL, and PsycINFO for publications before the end of July 2013. Serious digital games studies measuring effects on behavior or its determinants, using a control condition, allowing the calculation of an effect size (Hedges' g, random-effects model) were included.

RESULTS

Seven game studies for sexual health promotion were included. These showed positive effects on determinants (g=0.242; 95 percent confidence interval, 0.129, 0.356), albeit of small effect size. The effects on behavior, measured in only two studies, were not significant (g=0.456; 95 percent confidence interval, -0.649, 1.561). Most games did not use many game features that are considered to be immersive or enhancing flow. Instead, there was a strong reliance on pure gamification features, such as rewards and feedback.

CONCLUSIONS

The effectiveness of the next generation of games may be enhanced by building on the behavioral change and educational gaming literatures (e.g., using role-play and simulation game formats, individual tailoring, offering adaptation in the difficulty of the challenge, and amount and timing of the feedback). There is a need for studies with rigorous evaluations of game effectiveness, longer-term follow-up, and using measures of behavior rather than merely their determinants.

The contribution of parents' driving behavior, family climate for road safety, and parent-targeted intervention to young male driving behavior

One of the prominent issues in contemporary research on young drivers deals with the mechanisms underlying parents' influences on their offspring's driving behavior. The present study combines two sets of data: the first gathered from in-vehicle data recorders tracking the driving of parents and their teenage sons, and the second derived from self-report questionnaires completed by the young drivers. The aim was to evaluate the contribution of parents' driving behavior, participation in a parent-targeted intervention, and the teen drivers' perception of the family climate for road safety, to the driving behavior of young drivers during solo driving. The data was collected over the course of 12 months, beginning with the licensure of the teen driver, and examined a sample of 166 families who were randomly assigned to one of three intervention groups (receiving different forms of feedback) or a control group (with no feedback). Findings indicate that young male drivers' risky driving events rate was positively associated with that of their parents. In addition, any type of intervention led to a lower rate of risky driving events among young drivers compared to the control group. Finally, a higher perception of parents as not committed to safety and lower perceived parental monitoring were related to a higher risky driving events rate among young drivers. The results highlight the need to consider a complex set of antecedents in parents' attitudes and behavior, as well as the family's safety atmosphere, in order to better understand young drivers' risky driving. The practical implications refer to the effective use of the family as a lever in the attempt to promote safety awareness among young drivers.

Change in Age-Specific, Psychosocial Correlates of Risky Sexual Behaviors Among Youth: Longitudinal Findings From a Deep South, High-Risk Sample

The current study examined psychosocial predictors of change in intercourse frequency and number of sexual partners among youth within a socio-ecological framework and assessed whether these determinants vary by stage of adolescent development. Longitudinal data were derived from a large, community study of adolescent risky behavior among predominantly high-risk, African American youth. Significant predictors of intercourse frequency for early adolescents included age, gender, self-worth, and familial factors; for older youth, age, gender, self-worth, curfews, and sense of community exerted significant effects. Among early adolescents, age, gender, self-worth, familial factors, and sense of community predicted change in the number of sexual partners in the previous year, while age, gender, self-worth, parental knowledge, curfews, and sense of community were predictive of change in the number of sexual partners in the previous year among older youth. Study implications and future directions are discussed.

Peer rejection, affiliation with deviant peers, delinquency, and risky sexual behavior

Risky sexual behavior poses significant health risks by increasing sexually transmitted infections and unintended pregnancies. Previous research has documented many factors related to risky sexual behavior. This study adds to the literature by proposing a prospective, developmental model of peer factors related to risky sexual behavior. Developmental pathways to risky sexual behavior were examined in a sample of 517 individuals (51% female; 82% European American, 16% African American, 2% other) followed from age 5-27. Structural equation models examined direct and indirect effects of peer rejection (assessed via peer nominations at ages 5, 6, 7, and 8), affiliation with deviant peers (assessed via self-report at ages 11 and 12), and delinquency (assessed via maternal report at ages 10 and 16) on risky sexual behavior (assessed via self-report at age 27). More peer rejection during childhood, affiliation with deviant peers during pre- adolescence, and delinquency in childhood and adolescence predicted more risky sexual behavior through age 27, although delinquency at age 16 was the only risk factor that had a significant direct effect on risky sexual behavior through age 27 above and beyond the other risk factors. Peer rejection was related to subsequent risk factors for girls but not boys. Peer risk factors as early as age 5 shape developmental pathways through childhood and adolescence and have implications for risky sexual behavior into adulthood.

A meta-analytic review of the relationship between adolescent risky sexual behavior and impulsivity across gender, age, and race

BACKGROUND

Impulsivity is frequently included as a risk factor in models of adolescent sexual risk-taking; however, findings on the magnitude of association between impulsivity and risky sexual behavior are variable across studies. The aims of the current meta-analysis were to examine (1) how specific impulsivity traits relate to specific risky sexual behaviors in adolescents, and (2) how the impulsivity-risky sex relationship might differ across gender, age, and race.

METHOD

Eighty-one studies were meta-analyzed using a random effects model to examine the overall impulsivity-risky sex relationship and relationships among specific impulsivity traits and risky sexual behaviors.

RESULTS

Overall, results revealed a significant, yet small, association between impulsivity and adolescent risky sexual behavior (r=0.19, p<0.001) that did not differ across impulsivity trait. A pattern of stronger effects was associated with risky sexual behaviors as compared to negative outcomes related to these behaviors. Gender moderated the overall relationship (β=0.22, p=0.04), such that effect sizes were significantly larger in samples with more females. Age, race, study design, and sample type did not moderate the relationship, although there was a pattern suggesting smaller effects for adolescents in juvenile detention settings.

CONCLUSIONS

Adolescent samples with more females showed a larger impulsivity-risky sex relationship, suggesting that impulsivity may be a more important risk factor for risky sex among adolescent females. Research and treatment should consider gender differences when investigating the role of impulsivity in adolescent sexual risk-taking.

A Meta-Analysis of the Relations Between Three Types of Peer Norms and Adolescent Sexual Behavior

The aim of the present meta-analysis was to investigate the associations between three types of peer norms-descriptive norms (peer sexual behaviors), injunctive norms (peer sexual attitudes), and peer pressure to have sex-and two adolescent sexual behavior outcomes (sexual activity and sexual risk behavior). Adolescent sexual activity was more strongly associated with descriptive norms (ESrfixed=.40) than with injunctive norms (ESrfixed=.22) or peer pressure (ESrfixed=.10). Compared with the sexual activity outcome, the effect size for descriptive norms (peer sexual risk behavior) for sexual risk behavior was smaller (ESrfixed=.11). Age, gender, peer type, and socio-cultural context significantly moderated these associations. Additional analyses of longitudinal studies suggested that selection effects were stronger than socialization effects. These findings offer empirical support for the conceptual distinction between three types of peer norms and hold important implications for theory, research, and intervention strategies.

SOCIO-ECOLOGICAL PREDICTORS OF INTERCOURSE FREQUENCY AND NUMBER OF SEXUAL PARTNERS AMONG MALE AND FEMALE AFRICAN AMERICAN ADOLESCENTS

The current study examined 14 waves of data derived from a large, community-based study of the sexual behavior of impoverished youth between 12 and 17 years of age residing in the Deep South. We used multilevel linear modeling to identify ecological predictors of intercourse frequency and number of sexual partners among gender-specific subsamples. Results indicated that predictors of adolescent sexual behavior differed by both type of sexual behavior and gender. For males, age, maternal warmth, parental knowledge, curfew, self-worth, and sense of community predicted intercourse frequency, while age, parental knowledge, curfew, self-worth, friend support, and sense of community were significantly associated with having multiple sexual partners. Among females, age, curfew, and self-worth exerted significant effects on intercourse frequency, while age, parental knowledge, curfew, and self-worth exerted significant effects on having multiple sexual partners. Implications and future directions are discussed.

Parents as moderators of longitudinal associations between sexual peer norms and Dutch adolescents' sexual initiation and intention

PURPOSE

The present study investigated how parents and peers interact in promoting or delaying Dutch adolescents' sexual initiation and intention and focused specifically on parents as moderators of peer influence.

METHODS

Using a longitudinal design, two waves of online questionnaire data were collected among 900 Dutch adolescents (M = 13.8 years at T1), who were sexually inexperienced at baseline. At T1, participants reported on three types of perceived sexual peer norms: friends' sexual behaviors (descriptive norms), friends' sexual attitudes (injunctive norms), and experienced peer pressure to have sex. They also rated two parenting aspects at T1: the general quality of their relationship with parents and the frequency of sexuality-specific communication with their parents. Six months later, the participants reported on their experience with different sexual behaviors ranging from naked touching or caressing to intercourse and their intention to have sex in the next school year.

RESULTS

Relationship quality with parents was significantly associated with both outcomes, with a higher relationship quality predicting smaller odds of sexual initiation and less intention to have sex. Two significant interaction effects showed that frequent sexual communication with parents significantly reduced the effects of sexually active friends and experienced peer pressure on adolescents' intention to have sex.

CONCLUSIONS

Our findings show that different types of sexual peer norms and both general and sexuality-specific parenting play an important role in the early stages of Dutch adolescents' sexual trajectories. Moreover, parent-adolescent communication about sexuality can function as a buffer for the sex-stimulating effects of sexual peer norms.

Adolescent sexual health communication and condom use: a meta-analysis

OBJECTIVE

Condom use is critical for the health of sexually active adolescents, and yet many adolescents fail to use condoms consistently. One interpersonal factor that may be key to condom use is sexual communication between sexual partners; however, the association between communication and condom use has varied considerably in prior studies of youth. The purpose of this meta-analysis was to synthesize the growing body of research linking adolescents' sexual communication to condom use, and to examine several moderators of this association.

METHOD

A total of 41 independent effect sizes from 34 studies with 15,046 adolescent participants (M(age) = 16.8, age range = 12-23) were meta-analyzed.

RESULTS

Results revealed a weighted mean effect size of the sexual communication-condom use relationship of r = .24, which was statistically heterogeneous (Q = 618.86, p < .001, I² = 93.54). Effect sizes did not differ significantly by gender, age, recruitment setting, country of study, or condom measurement timeframe; however, communication topic and communication format were statistically significant moderators (p < .001). Larger effect sizes were found for communication about condom use (r = .34) than communication about sexual history (r = .15) or general safer sex topics (r = .14). Effect sizes were also larger for communication behavior formats (r = .27) and self-efficacy formats (r = .28), than for fear/concern (r = .18), future intention (r = .15), or communication comfort (r = -.15) formats.

CONCLUSIONS

Results highlight the urgency of emphasizing communication skills, particularly about condom use, in HIV/STI prevention work for youth. Implications for the future study of sexual communication are discussed.

Intervening on conflict, parental bonds, and sexual risk acts among adolescent children of mothers living with HIV

Objective

In 1993–1994, a psychosocial intervention conducted in New York City significantly improved outcomes for parents living with HIV and their adolescent children over six years. We examine if the intervention benefits are similar for adolescents of mothers living with HIV (MLH) in 2004–2005 in Los Angeles when MLH’s survival had increased substantially.

Methods

Adolescents of MLH in Los Angeles (N = 256) aged 12–20 years old were randomized with their MLH to either: 1) a standard care condition (n = 120 adolescent-MLH dyads); or 2) an intervention condition consisting of small group activities to build coping skills (n = 136 adolescent-MLH dyads, 78% attended the intervention). At 18 months, 94.7% of adolescents were reassessed. Longitudinal structural equation modeling examined if intervention participation impacted adolescents’ relationships with parents and their sexual risk behaviors.

Results

Compared to the standard care, adolescents in the intervention condition reported significantly more positive family bonds 18 months later. Greater participation by MLH predicted fewer family conflicts, and was indirectly associated with less adolescent sexual risk behavior at the 18 month follow-up assessment. Anticipated developmental patterns were observed - sexual risk acts increased with age. Reports were also consistent with anticipated gender roles; girls reported better bonds with their mothers at 18 months, compared to boys.

Conclusions

Adolescents of MLH have better bonds with their mothers as a function of participating in a coping skills intervention and reduced sexual risk-taking as a function of MLH intervention involvement.

Dual method use among a sample of first-year college women

CONTEXT

Dual method use-using one protective method to reduce the risk of STDs and another to prevent pregnancy-is effective but understudied. No prior studies have employed an event-level approach to examining characteristics associated with dual method use among college women.

METHODS

In 12 consecutive monthly surveys conducted in 2009-2010, data on 1,843 vaginal intercourse events were collected from 296 first-year college women. Women reported on their use of condoms and hormonal contraceptives during all events. Multilevel regression analysis was used to assess associations between event-, month- and person-level characteristics and hormonal use and dual method use.

RESULTS

Women used hormonal contraceptives during 53% of events and condoms during 63%. Dual method use was reported 28% of the time, and only 14% of participants were consistent users of dual methods. The likelihood of dual method use was elevated when sex partners were friends as opposed to romantic partners or ex-boyfriends (odds ratios, 2.5-2.8), and among women who had received an STD diagnosis prior to college (coefficient, 2.9); it also increased with level of religiosity (0.8). Dual use was less likely when less reliable methods were used (odds ratio, 0.2) and when women reported more months of hormonal use (0.8), were older than 18 (coefficient, -4.7) and had had a greater number of partners before college (-0.3).

CONCLUSIONS

A better understanding of the characteristics associated with dual method use may help in the design of potential intervention efforts.

Adolescent substance use and unplanned pregnancy: strategies for risk reduction

Substance use among adolescents increases the risk of unplanned pregnancies, which then increases the risk of fetal exposure to addictive, teratogenic substances. Specific interventions are necessary to target pregnancy planning and contraception among reproductive-age substance users. Screening for substance use using the CRAFFT is recommended in all health care settings treating adolescent patients. Screening for tobacco and nicotine use is also recommended along with the provision of smoking cessation interventions. Using motivational interviewing style and strategies is recommended to engage adolescents in discussions related to reducing substance use, risky sexual behavior, and probability of unplanned pregnancy or late-detection pregnancy.

Gambling and sexual behaviors in African-American adolescents

OBJECTIVES

Late adolescence represents a developmental risk period when many youth become involved in multiple forms of high-risk behaviors with adverse consequences. This study assessed the degree to which two such behaviors, adolescent sexual behaviors and gambling, were associated in a community-based sample with a large African-American presence.

STUDY DESIGN

Data are derived from a cohort study. This study focuses on 427 African-American participants with complete information on gambling and sexual behaviors by age 18 (72% of original cohort). Gambling involvement and related problems were based on responses to the South Oaks Gambling Screen - Revised for Adolescents. Several questions assessed sexual behaviors, including age of initiation. Multivariable logistic regression models adjusted for demographics, intervention status, impulsivity, depressive and anxiety symptoms, and alcohol and illegal drug use.

RESULTS

Almost half of the sample (49%, n=211) had gambled at least once before age 18. More gamblers than non-gamblers had initiated sexual intercourse by age 18 (aOR: 2.29 [1.16, 4.52]). Among those who had initiated sexual activity, more gamblers than non-gamblers with high impulsivity levels at age 13 (vs. low impulsivity levels) had become pregnant or had impregnated someone. Among those who had initiated sexual activity by age 18, more male gamblers had impregnated someone by age 18 as compared to female gamblers becoming pregnant.

CONCLUSIONS

Gambling and sexual behaviors often co-occur among adolescents. Such findings prompt the need for the inclusion of gambling, an often overlooked risky behavior, in behavioral prevention/intervention programs targeting adolescents.

Maternal and Paternal Psychological Control as Moderators of the Link between Peer Attitudes and Adolescents' Risky Sexual Behavior

Maternal and paternal psychological control, peer attitudes, and the interaction of psychological control and peer attitudes at age 13 were examined as predictors of risky sexual behavior before age 16 in a community sample of 181 youth followed from age 13 to 16. Maternal psychological control moderated the link between peer attitudes and sexual behavior. Peer acceptance of early sex predicted greater risky sexual behaviors, but only for teens whose mothers engaged in high levels of psychological control. Paternal psychological control demonstrated the same moderating effect for girls; for boys, however, high levels of paternal control predicted risky sex regardless of peer attitudes. Results are consistent with the theory that peer influences do not replace parental influences with regard to adolescent sexual behavior; rather, parental practices continue to serve an important role either directly forecasting sexual behavior or moderating the link between peer attitudes and sexual behavior.

Sexarca, informação e uso de métodos contraceptivos: comparação entre adolescentes

Este trabalho teve por objetivo comparar a idade da primeira relação sexual, a informação sobre métodos contraceptivos, além de seu uso com a ocorrência da gestação na adolescência em dois grupos (50 grávidas e 50 não grávidas). Foi utilizado um questionário desenvolvido para o estudo que investigou essas variáveis. Verificou-se que não há diferença significativa nos grupos entre idade da sexarca, uso de contracepção na sexarca e tipo de contraceptivo utilizado. Contudo, os grupos diferem em relação ao uso de métodos contraceptivos nas relações sexuais subsequentes. Os dados revelam a multiplicidade de fatores envolvidos no comportamento contraceptivo demonstrando a necessidade de absorção desses fatores por parte das políticas públicas voltadas para o público adolescentes.

Prescription drug misuse and sexual risk behaviors among adolescents and emerging adults

OBJECTIVE

The purpose of this study was to evaluate associations between prescription drug misuse (PDM) and sexual risk behaviors (SRBs) among adolescents and emerging adults.

METHOD

In a hospital emergency department, 2,127 sexually active 14- to 20-year-olds (61% female) reported on past-year alcohol use severity (using the Alcohol Use Disorders Identification Test-consumption [AUDIT-C]), cannabis use, PDM (n = 422), and SRBs (inconsistent condom use, multiple partners, intercourse following alcohol/other drug use).

RESULTS

Bivariately, AUDIT-C score, cannabis use, and PDM of stimulants, opioids, and sedatives were positively associated with each SRB. Because many participants reported PDM for multiple drug classes (i.e., sedatives, stimulants, opioids), participants were categorized as (a) no PDM (n = 1,705), (b) PDM of one class (n = 251), (c) PDM of two classes (n = 90), or (d) PDM of three classes (n = 81). Three hierarchical logistic regression models evaluated the associations of number of classes of PDM with SRBs separately, after accounting for demographics (age, gender, race), AUDIT-C score, and cannabis use. Adding PDM statistically improved each model beyond what was accounted for by demographics, alcohol, and cannabis use. For inconsistent condom use and substance use before sex, PDM of one, two, or three classes was significantly associated with increased odds of these SRBs. PDM of two or three classes was associated with increased odds of reporting multiple partners.

CONCLUSIONS

Findings suggest that PDM, especially poly-PDM, may be a pertinent risk factor for SRBs among youth. Event-based research could further evaluate how PDM, as well as other substance use, is related to SRBs at the event level in order to inform interventions.

Factors associated with sexual arousal, sexual sensation seeking and sexual satisfaction among female African American adolescents

BACKGROUND

Sexuality-related constructs, such as sexual arousal, sexual sensation seeking (SSS) and sexual satisfaction, have been related to sexual behaviours that place one at risk of adverse consequences, such as sexually transmissible infections, HIV and unintended pregnancy. The biopsychosocial model posits an array of factors, ranging from social environmental factors to biological and psychological predispositions, that may be associated with these sexuality constructs in adolescents.

METHODS

Female African Americans aged 14-20 years were recruited from reproductive health clinics for an HIV intervention. Baseline survey and follow-up DNA data (n=304) were used to assess biological, psychological and social environmental associations with the sexuality constructs of arousal, SSS and sexual satisfaction.

RESULTS

Multivariate linear regression analysis revealed that a higher depressive symptom rating was associated with higher arousability, whereas short serotonin transporter gene allele(s) status was associated with lower arousability. Impulsivity and perceived peer norms supportive of unsafe sexual behaviours were associated with increased SSS, whereas short serotonin transporter gene allele(s) status was associated with lower SSS. Higher social support was associated with higher levels of sexual satisfaction, whereas short serotonin transporter gene allele(s) status was associated with lower satisfaction. The sexuality constructs were also significantly related to the number of sex partners, the frequency of vaginal sex and the number of unprotected vaginal sex acts in the past 6 months.

CONCLUSIONS

The findings emphasise the importance of understanding biopsychosocial factors, including the role of serotonin as an indicator of natural variations in sexual inclination and behaviours, that influence sexuality constructs, which, in turn, are associated with sexual behaviours, to allow further refinement of sexual health clinical services and programs and promote the development of healthy sexuality.

Trajectories of risk for early sexual activity and early substance use in the Fast Track prevention program

Children who exhibit early-starting conduct problems are more likely than their peers to initiate sexual activity and substance use at an early age, experience pregnancy, and contract a sexually-transmitted disease [STD], placing them at risk for HIV/AIDS. Hence, understanding the development of multi-problem profiles among youth with early-starting conduct problems may benefit the design of prevention programs. In this study, 1,199 kindergarten children (51% African American; 47% European American; 69% boys) over-sampled for high rates of aggressive-disruptive behavior problems were followed through age 18. Latent class analyses (LCA) were used to define developmental profiles associated with the timing of initiation of sexual activity, tobacco and alcohol/drug use and indicators of risky adolescent sex (e.g. pregnancy and STD). Half of the high-risk children were randomized to a multi-component preventive intervention (Fast Track). The intervention did not significantly reduce membership in the classes characterized by risky sex practices. However, additional analyses examined predictors of poor outcomes, which may inform future prevention efforts.

Ecological factors influencing HIV sexual risk and resilience among young people in rural Kenya: implications for prevention

Most new HIV infections in Kenya occur among young people. The purpose of this study was to understand ecological factors that influence HIV-related sexual risk and resilience among young people in rural Kenya and to elicit their ideas for HIV prevention interventions. Nine focus groups (N = 199) were conducted with both female (55%) and male (45%) participants (ages 14-24 years) living in rural communities in Kenya. Findings were organized into thematic areas related to the following systems of influence: (i) intrapersonal (substance use, HIV knowledge), (ii) interpersonal (peer pressure, lack of parent-child communication, interpersonal sexual violence), (iii) institutional/community (pornography, transactional sex, 'idleness', lack of role models) and (iv) socio-cultural/policy (Kikuyu culture, Western influence, religious beliefs, HIV-related stigma and gendered sexual scripts). Results regarding the types of HIV prevention programs that participants believed should be developed for young people in rural Kenya revealed seven primary themes, including (i) HIV prevention community/group workshops, (ii) condom distribution, (iii) job skills trainings, (iv) athletic and social clubs, (v) HIV-related stigma reduction campaigns, (vi) community-wide demonstrations and (vii) other HIV/AIDS activities led by young people. Implications for the development of culturally and developmentally appropriate HIV prevention interventions for young people in rural Kenya are discussed.

Caregiver Involvement in Sexual Risk Reduction with Substance Using Juvenile Delinquents: Overview and Preliminary Outcomes of a Randomized Trial

BACKGROUND

Substance using juvenile offenders have some of the highest rates for engaging in risky sexual behaviors compared to other adolescent subgroups.

METHODS

An overview of the literature on sexual risk behaviors among these youth is provided, including the empirical support for including caregivers/parents as critical partners in sexual risk reduction efforts with this population. In particular, there is (a) evidence that family factors contribute to adolescent sexual risk, (b) emerging support for caregiver focused interventions that target adolescent sexual risk, and (c) established support for caregiver focused interventions that target other complex adolescent behavior problems. In addition, this paper presents preliminary results from a randomized controlled trial evaluating a family-based intervention for substance using juvenile delinquents that combines contingency management (CM) for adolescent substance use with a novel sexual risk reduction (SRR) protocol. Results through six months post-baseline (corresponding with the end of treatment) are presented for intervention fidelity and outcomes including number of intercourse acts (Sex Acts), use of condoms or abstinence (Safe Sex), and obtaining HIV testing (Testing).

CONCLUSIONS

In comparison to youth focused group substance abuse treatment, the CM-SRR intervention was associated with significantly greater therapist use of SRR techniques and greater caregiver involvement in treatment sessions (supporting treatment fidelity) and significantly lower increases in Sex Acts (supporting treatment efficacy). There were also higher odds for Safe Sex and for Testing, although these results failed to reach statistical significance. Findings add to the growing literature supporting the feasibility and efficacy of caregiver focused interventions targeting sexual risk behaviors among high-risk adolescent populations.

College men's and women's respective perceptions of risk to perpetrate or experience sexual assault: the role of alcohol use and expectancies

The present study examines alcohol use, expectancies (i.e., beliefs about the outcomes of alcohol consumption), and college men's (n = 127) and women's (n = 191) respective perceptions of risk to perpetrate/experience sexual violence. Interactions between alcohol consumption and expectancies were examined. Alcohol expectancies regarding assertiveness increased women's perceived risk for sexual intercourse via alcohol/drugs. Among women reporting high alcohol use, global expectancies were positively associated with perceived risk for sexual intercourse via alcohol/drugs. Furthermore, among women reporting low alcohol use, expectancies regarding assertiveness were positively associated with perceived risk for coerced sexual contact. Implications are discussed.

Family Efficacy as a Protective Factor Against Immigrant Adolescent Risky Behavior

Research suggests that family efficacy—defined as a family’s beliefs in its capability to manage different situations in order to achieve a desired outcome—is linked to a decreased likelihood of adolescents to engage in risky health behaviors. It is not clear, however, if this is true for immigrant families when they are encountering with increased challenges in their host countries. To provide holistic nursing care to immigrant families, it is important to know the sources of family efficacy particularly for immigrant adolescents when they are developing health behavior. This integrative review examined existing literature to learn about the sources of family efficacy among immigrant adolescents and how different domain of family efficacy is related to risky behaviors. We examined 22 studies on the topics of immigration, adaptation, risky adolescent behavior, and family function. Findings showed that multidimensional sources of family efficacies (specifically those in the relational, pragmatic, and value-laden domains) exert significant positive effects on immigrant adolescents’ health behaviors.

Associations among text messaging, academic performance, and sexual behaviors of adolescents

BACKGROUND

Text messaging is an increasingly common mode of communication, especially among adolescents, and frequency of texting may be a measure of one's sociability. This study examined how text messaging ("texting") frequency and academic performance are associated with adolescent sexual behaviors.

METHODS

A cross-sectional survey was administered to students at a public charter high school in Los Angeles County, CA. Two hundred fifty-six high school students aged 14-20 years participated. Outcome measures were history of vaginal sex, condom use, and worries about pregnancy. The main predictors were text messaging frequency and self-reported academic performance.

RESULTS

In general, students with lower grades were more likely to have had vaginal sex. Greater texting frequency, however, was associated with vaginal sex only among students with higher grades. In addition, despite similar rates of condom use, sexually active students who both had good grades and texted frequently were more likely than others to have thought they or their partner might be pregnant.

CONCLUSIONS

The association between texting and sexual behaviors may vary based on adolescent's academic performance. Adolescent sexual health interventions may benefit from using a combination of sociability measures (such as texting frequency) and academic performance as risk predictors.

Outcomes of childhood conduct problem trajectories in early adulthood: findings from the ALSPAC study

Although conduct problems in childhood are stably associated with problem outcomes, not every child who presents with conduct problems is at risk. This study extends previous studies by testing whether childhood conduct problem trajectories are predictive of a wide range of other health and behavior problems in early adulthood using a general population sample. Based on 7,218 individuals from the Avon longitudinal study of parents and children, a three-step approach was used to model childhood conduct problem development and identify differences in early adult health and behavior problems. Childhood conduct problems were assessed on six occasions between age 4 and 13 and health and behavior outcomes were measured at age 18. Individuals who displayed early-onset persistent conduct problems throughout childhood were at greater risk for almost all forms of later problems. Individuals on the adolescent-onset conduct problem path consumed more tobacco and illegal drugs and engaged more often in risky sexual behavior than individuals without childhood conduct problems. Levels of health and behavior problems for individuals on the childhood-limited path were in between those for stable low and stable high trajectories. Childhood conduct problems are pervasive and substantially affect adjustment in early adulthood both in at-risk samples as shown in previous studies, but also in a general population sample. Knowing a child's developmental course can help to evaluate the risk for later maladjustment and be indicative of the need for early intervention.

Having "The Talk": Individual, Family, and Partner Factors on Unprotected Sex among Female Adolescent Offenders

This study assessed the influence of individual age and substance use, family support and communication, and partner support and communication on the frequency of unprotected sex among incarcerated adolescent females. Subjects (n = 273) completed a survey on psychosocial correlates and risk behaviors for sexually transmitted infections (STI). Communication with male partners and sex while under the influence have a significant impact on condom use. Findings highlight the necessity of providing assertive communication skills training and increasing self-efficacy as STI/HIV prevention components for adolescent females thus empowering their decision-making processes.

A longitudinal examination of parenting processes and Latino youth's risky sexual behaviors

Latino adolescents engage in riskier sexual behaviors compared to their peers, shown by their higher rates of sexually transmitted infections and lower rates of condom usage; therefore, examining the precursors and correlates of these risky sexual behaviors is important for prevention-intervention program development. Based on cultural-ecological, symbolic interaction, and gender socialization perspectives, we examined associations among mothers' and fathers' parenting and Latino youth's sexual risk over a 5 year period. Further, we investigated the direct and moderating roles of acculturation (e.g., language spoken in the home), nativity (e.g., citizenship status), and adolescents' gender. Using data from the National Longitudinal Study of Youth (N = 1,899 Latino youth; 49 % female), we conducted a multi-level path model controlling for adolescents' age and prior sexual experience. Our findings revealed that more strictness by mothers and less strictness by fathers at Time 1 were related to lower sexual risk for adolescents at Time 2. Additionally, more monitoring by fathers at Time 2 was associated with lower sexual risk for adolescents at Time 3. Significant gender differences were found such that there were stronger associations among parenting processes and sexual risk for girls than for boys. Finally, we found support for the immigrant paradox (foreign-born youth reported lower sexual risk than US-born youth) and greater gender differences (boys had riskier sexual behaviors than girls) for immigrant compared to US-born youth. The findings reveal the complex associations among parenting processes, nativity status, gender, and sexual risk for Latino adolescents.

Are sexual media exposure, parental restrictions on media use and co-viewing TV and DVDs with parents and friends associated with teenagers' early sexual behaviour?

Sexual content in teenagers' media diets is known to predict early sexual behaviour. Research on sexual content has not allowed for the social context of media use, which may affect selection and processing of content. This study investigated whether sexual media content and/or contextual factors (co-viewing, parental media restrictions) were associated with early sexual behaviour using 2251 14-15 year-olds from Scotland, UK. A third (n = 733) reported sexual intercourse. In multivariable analysis the likelihood of intercourse was lower with parental restriction of sexual media and same-sex peer co-viewing; but higher with mixed-sex peer co-viewing. Parental co-viewing, other parental restrictions on media and sexual film content exposure were not associated with intercourse. Findings suggest the context of media use may influence early sexual behaviour. Specific parental restrictions on sexual media may offer more protection against early sex than other restrictions or parental co-viewing. Further research is required to establish causal mechanisms.

Genetic influences on adolescent sexual behavior: Why genes matter for environmentally oriented researchers

There are dramatic individual differences among adolescents in how and when they become sexually active adults, and early sexual activity is frequently cited as a cause of concern for scientists, policymakers, and the general public. Understanding the causes and developmental impact of adolescent sexual activity can be furthered by considering genes as a source of individual differences. Quantitative behavioral genetics (i.e., twin and family studies) and candidate gene association studies now provide clear evidence for the genetic underpinnings of individual differences in adolescent sexual behavior and related phenotypes. Genetic influences on sexual behavior may operate through a variety of direct and indirect mechanisms, including pubertal development, testosterone levels, and dopaminergic systems. Genetic differences may be systematically associated with exposure to environments that are commonly treated as causes of sexual behavior (gene-environment correlation). Possible gene-environment correlations pose a serious challenge for interpreting the results of much behavioral research. Multivariate, genetically informed research on adolescent sexual behavior compares twins and family members as a form of quasi experiment: How do twins who differ in their sexual experiences differ in their later development? The small but growing body of genetically informed research has already challenged dominant assumptions regarding the etiology and sequelae of adolescent sexual behavior, with some studies indicating possible positive effects of teenage sexuality. Studies of Gene × Environment interaction may further elucidate the mechanisms by which genes and environments combine to shape the development of sexual behavior and its psychosocial consequences. Overall, the existence of heritable variation in adolescent sexual behavior has profound implications for environmentally oriented theory and research.

Ambivalent messages: adolescents' perspectives on pregnancy and birth

PURPOSE

To examine, from a youth's perspective, adolescent pregnancy and parenting in Baltimore, Maryland, a city with high rates of adolescent pregnancy.

METHODS

Six gender-stratified focus groups with 13- to 19-year-olds (4 female and 2 male groups; n = 47). We recorded focus groups, transcribed them verbatim, and analyzed them using the constant comparison method. Participants completed questionnaires to collect demographic and behavioral information.

RESULTS

Results fit into a social-ecological framework. Individual (e.g., contraceptive use behaviors, religion), interpersonal (e.g., peer norms, maintaining male partners), and community (e.g., clinic factors, perceptions of community) level influences on adolescent pregnancy emerged. Participants discussed contradictory messages that were often gendered in their expectations; for instance, women were responsible for not getting pregnant and raising children. Adolescents expressed beliefs both against (e.g., challenging to complete school) and supporting early childrearing (e.g., religion). Recommendations for addressing the different influences included mentors, education, and community resources.

CONCLUSIONS

Adolescents' perspectives and values regarding pregnancy and parenting may not mirror traditional and expected norms for pregnancy and requirements for raising a child. These findings challenge the framing of existing interventions as they may not accurately reflect adolescents' values regarding pregnancy and parenting, and thus may need to be modified to highlight positive attitudes toward contraception and postponing pregnancy.

The development of conventional sexual partner trajectories among african american male adolescents

African American male youth disproportionately report involvement with multiple sexual partners, which increases their risk for sexually transmitted infections and initiation of unplanned pregnancies. Little is known about the developmental precursors of sexual partner trajectories among African American male youth. Moreover, few studies focus on the many African American youth who evince highly conventional sexual partner trajectories, i.e., youth who have only one partner or abstain from sexual activity across time. Using four waves of data from a longitudinal study, we hypothesized that an accumulation of social and economic disadvantages in early adolescence would negatively influence youths' conventional sexual partner trajectories in late adolescence. We expected these disadvantages to affect youths' receipt of protective family processes and their reports of a set of intrapersonal processes (self-regulation, hope, and low levels of anger) linked to generally conventional behavior. Hypotheses were tested with data from 315 African American male youth from 11 to 18.5 years of age and their primary caregivers. Our results supported the hypotheses. Socioeconomic disadvantages during preadolescence predicted less involvement in conventional sexual partner trajectories from ages 16 to 18.5 years. This association was mediated by protective family processes and a set of interrelated intrapersonal protective processes. Preventive interventions designed to promote protective parenting and intrapersonal processes can be expected to promote sexual behavior trajectories characterized by abstinence or relations with very few partners.

Childhood behavior problems and adolescent sexual risk behavior: familial confounding in the child and adolescent twin study in Sweden (CATSS)

OBJECTIVE

Previous studies have found associations between childhood behavior problems and adolescent sexual risk behavior. Using a quasi-experimental approach, we examined the extent to which this association may be due to between-family differences (i.e., unmeasured familial confounds) not adequately explored in prior research.

METHODS

We used data from a longitudinal, population-based cohort of young twins in Sweden (first assessment: age 9 or 12 years; second assessment: age 15; n = 2,388). We explored the nature of the association between symptom scores for attention deficit hyperactivity disorder (ADHD), oppositional defiant disorder (ODD), and conduct disorder (CD) at age 9 or 12 and the likelihood of having had sexual intercourse and number of sexual partners by age 15. Two-level mixed-effects models were used to estimate the effect of symptom score on each outcome after controlling for potential unmeasured familial confounds.

RESULTS

Higher ADHD, ODD, and CD scores were associated with significantly increased likelihood of sexual intercourse by age 15. Higher ADHD and ODD scores were also associated with increased number of sexual partners. After controlling for unmeasured familial confounds, however, behavior problems were no longer significantly associated with either outcome.

CONCLUSION

The association between childhood behavior problems and sexual risk behaviors may be due to characteristics shared within families. Hence, prevention strategies aimed at reducing these behaviors might need to address broader risk factors that contribute to both behavior problems and a greater likelihood of sexual risk behavior.

Family climate for road safety: a new concept and measure

This research adapted the workplace concept of safety climate to the domain of safe driving, defining a new construct of "family climate for road safety". Four studies were conducted in Israel with the aim of developing and validating a multidimensional instrument to assess this construct among young drivers. Study 1 (n=632) focused on developing the Family Climate for Road Safety Scale (FCRSS), a self-report scale assessing the family climate by means of seven aspects of the parent-child relationship: Modeling, Feedback, Communication, Monitoring, Noncommitment, Messages, and Limits. Significant differences were found between young men and women on all factors. In addition, significant associations were found between the FCRSS factors on the one hand, and the reported frequency of risky driving and personal commitment to safety on the other. Studies 2-4 confirmed the factorial structure of the FCRSS and the reliability of its factors, adding to its criterion and convergent validity. Study 2 (n=178) yielded significant associations between the scale and young drivers' perception of their parents as involved, encouraging autonomy, and providing warmth; Study 3 (n=117) revealed significant associations between the scale and youngsters' reported proneness to take risks while driving, as well as significant associations between the factors and various dimensions of family functioning; and Study 4 (n=156) found associations between the FCRSS factors and both driving styles (risky, angry, anxious, careful) and family cohesion and adaptability. The discussion deals with the validity and utility of the concept of family climate for road safety and its measurement, addressing the practical implications for road safety.

Risky sexual behaviors in emerging adults: longitudinal changes and within-person variations

This study examined longitudinal changes in condom use inconsistency and sexual encounters involving alcohol use and the within-person associations of these two risky sexual behaviors with other personal and contextual factors. Data were drawn from a sample of college students who completed surveys on four occasions across 3 years and included 317 participants (48 % male; 32 % African American, 28 % Latino American, and 40 % European American) who reported recent penetrative sexual activities on at least one of the occasions. Multilevel models revealed that, although condom use inconsistency increased and then leveled off over time, sexual encounters involving alcohol use showed a linear increase. Moreover, at times when students held more negative attitudes toward condoms than usual, they used condoms less consistently than usual; at times when students felt more anxious about HIV/AIDS than usual, they had more sexual encounters involving alcohol use than usual; and at times when students were involved in a serious relationship, they used condoms less consistently and had fewer sexual encounters involving alcohol use than usual. Findings demonstrate the utility of a developmental perspective in understanding sexual behaviors, the importance of examining the unique correlates of different risky sexual behaviors, and the distinctiveness between within-person versus between-person associations.

It's Your Game…Keep It Real: can innovative public health prevention research thrive within a comparative effectiveness research framework?

The federal comparative effectiveness research (CER) initiative is designed to evaluate best practices in health care settings where they can be disseminated for immediate benefit to patients. The CER strategic framework comprises four categories (research, human and scientific capital, data infrastructure, and dissemination) with three crosscutting themes (conditions, patient populations, and types of intervention). The challenge for the field of public health has been accommodating the CER framework within prevention research. Applying a medicine-based, research-to-practice CER approach to public health prevention research has raised concerns regarding definitions of acceptable evidence (an evidence challenge), effective intervention dissemination within heterogeneous communities (a dissemination and implementation challenge), and rewards for best practice at the cost of other promising but high-risk approaches (an innovation challenge). Herein, a dynamic operationalization of the CER framework is described that is compatible with the development, evaluation, and dissemination of innovative public health prevention interventions. An effective HIV, STI, and pregnancy prevention program, It's Your Game…Keep It Real, provides a case study of this application, providing support that the CER framework can compatibly coexist with innovative, community-based public health prevention research.

HIV prevention interventions for adolescents and young adults: what about the needs of gay and bisexual males?

While rates of HIV infection among gay/bisexual male adolescents have been increasing in the U.S., there has not been a commensurate increase in the development of HIV prevention interventions targeted specifically for this population. This editorial review examines primary HIV prevention interventions published in peer-reviewed journals between 1991 and 2010 in order to explore the differential focus on heterosexual versus gay/bisexual male adolescents/young adults. Of the 92 articles reviewed, only 5 (5.44 %) included interventions that addressed gay/bisexual sexual orientation or same-gender sexual activity. HIV prevention interventions developed for adolescents/young adults in the U.S. are not targeting those at highest risk of infection. Recommendations for addressing this gap are discussed.

HIV/AIDS risk behaviors and substance use by young adults in the United States

The current research assessed the extent to which substance use behaviors (i.e., heavy episodic drinking, marijuana use, and use of illicit drugs other than marijuana) were associated with behaviors that confer risk for HIV infection (i.e., sex with multiple partners, inconsistent condom use, and injection drug use) in a nationally representative sample of young adults. Generalized estimating equations (GEEs) examined patterns in the data from U.S. young adults (N = 7,595), ages 21 to 30, who participated in the Monitoring the Future (MTF) panel study between 2004 and 2009. Fifty-two percent of the participants were female and 70% were White. Time-varying effects indicated that more frequent heavy episodic drinking, marijuana use, and other illicit drug use were associated with a greater number of sex partners. Frequency of marijuana and other illicit drug use was associated with less frequent condom use, and marijuana use was associated with use of injection drugs. Younger individuals (i.e., 21-24 years old versus 25-30 years old) had fewer sexual partners, more frequent condom use, and a stronger association between heavy episodic drinking and number of sexual partners than did older individuals. These effects did not vary across gender. Findings highlight the covariation of substance use with HIV-related risk factors among recent cohorts of young adults in the U. S. and the particularly strong link between heavy episodic drinking and number of sexual partners among individuals aged 21 to 24. Prevention programs should acknowledge the co-occurring risks of substance use and HIV risk behaviors, especially among young adults in their early twenties.

Life-course origins of the ages at menarche and menopause

A woman's age at menarche (first menstrual period) and her age at menopause are the alpha and omega of her reproductive years. The timing of these milestones is critical for a woman's health trajectory over her lifespan, as they are indicators of ovarian function and aging. Both early and late timing of either event are associated with risk for adverse health and psychosocial outcomes. Thus, the search for a relationship between age at menarche and menopause has consequences for chronic disease prevention and implications for public health. This article is a review of evidence from the fields of developmental biology, epidemiology, nutrition, demography, sociology, and psychology that examine the menarche-menopause connection. Trends in ages at menarche and menopause worldwide and in subpopulations are presented; however, challenges exist in constructing trends. Among 36 studies that examine the association between the two sentinel events, ten reported a significant direct association, two an inverse association, and the remainder had null findings. Multiple factors, including hormonal and environmental exposures, socioeconomic status, and stress throughout the life course are hypothesized to influence the tempo of growth, including body size and height, development, menarche, menopause, and the aging process in women. The complexity of these factors and the pathways related to their effects on each sentinel event complicate evaluation of the relationship between menarche and menopause. Limitations of past investigations are discussed, including lack of comparability of socioeconomic status indicators and biomarker use across studies, while minority group differences have received scant attention. Suggestions for future directions are proposed. As research across endocrinology, epidemiology, and the social sciences becomes more integrated, the confluence of perspectives will yield a richer understanding of the influences on the tempo of a woman's reproductive life cycle as well as accelerate progress toward more sophisticated preventive strategies for chronic disease.

Gender Differences in HIV-Related Sexual Behavior among College Students from Spain and Portugal

Under the perspective of the Theory of Planned Behavior, the objective of this study was to know the gender differences in the variables involved in the use of effective preventive measures in sexual relations against HIV in a sample of university students from Spain and Portugal. Furthermore, it is examined whether these factors produce different predictions concerning the adoption of safe sexual behaviour for young man and women in each country. The sample consisted of 683 university students, 319 Portuguese (64% female and 36% male) from the University of Algarve and 364 Spanish students (51% female and 49% male) from the University of Huelva. Data were obtained by means of a questionnaire. The data revealed that there are gender differences which apply in both countries, highlighting that the young women have more positive attitudes, greater perceived behavioural control and intention of condom use than young men. However, they protect themselves less that their male counterparts: the percentage of females who say using condoms as a contraceptive method is less than the percentage of males, and especially with their steady partners. The results are discussed in relation to gender role norms, to have a steady partner or not, gender relations, the associated meaning to sexual relations for men and women and their implications for the design of sexual educational programmes for them.

Mother's and father's monitoring is more important than parental social support regarding sexual risk behaviour among 15-year-old adolescents

BACKGROUND AND OBJECTIVES

There is strong evidence that parental processes such as monitoring and social support play an important role with regard to sexual risk behaviour among adolescents. We wished to explore the influence of both parents' monitoring and support on sexual risk behaviour among adolescent boys and girls.

METHODS

Questionnaires concerning sexual risk behaviour, parental support and parental monitoring were administered to 15-year-old students (n = 1343; 628 boys). Crude and adjusted logistic regression models were used to explore the effect of parents' monitoring and support on sexual risk behaviour among adolescent boys and girls.

RESULTS

Parental monitoring was more strongly associated with sexual risk behaviour than parental social support. In particular, less monitoring by the father was significantly linked to early first sexual intercourse among girls and to not using a condom during last intercourse among boys. Less monitoring by the mother was associated only with not using a condom at last intercourse among boys.

CONCLUSION

Parental monitoring, even more than parental support, may delay the onset of sexual activity and increase the frequency of condom use among adolescents. The effects of mothers' and fathers' parenting processes on sexual risk behaviour of adolescents differ. Paternal monitoring affects condom use among boys, and initiation of sexual activity in girls.

Sexual behaviours and associated risks in Chinese young people: a meta-analysis

Background The earlier and unprotected sexual behaviour of young Chinese, and the consequences of these actions, have become a health concern, posing a challenge to traditional Chinese concepts. The aim of the present study was to investigate changes in sexual behaviour and associated risks among adolescents and young people in mainland China over the past three decades. Methods: A meta-analysis was undertaken to comprehensively review the sexual behaviour of Chinese young people (aged from 10 to 24 years) over the past 30 years. Relevant data published from 1979 to 2009 in the Chinese literature database were identified and retrieved. Analysis was performed based on set criteria. Results: Seventy-five studies were identified that were published after 1990. Overall, the estimated prevalence of sexual intercourse among young people was 12.6%, with an average age at sexual debut of 19.4 years. The rate of condom use at sexual debut was 37.2%; 53.6% of young people reported not using a condom during the most recent act of sexual intercourse. The rates of unintentional pregnancy and abortion among the sexually active were 15.1% and 10.8%, respectively. Reviewing the data according to decades revealed that the number of young people engaging in sexual intercourse decreased from 14.3% in 1990–1999 to 11.8% in 2000–2009. However, these rates are higher than the prevalence of sexual activity reported before 1990, which, according to sporadic studies, did not exceeded 1%. Conclusions: There have been increases in sexual activity and high-risk sexual behaviour in Chinese young people in the decades since the adoption of the open door policy in China, particularly since the mid-1990s. High-risk sexual behaviours have contributed to certain adverse consequences in adolescents and young people, such as unwanted pregnancy and sexually transmissible infection. Thus, efficacious intervention strategies need to be developed and implemented.

Qualitative inquiry into premarital sexual behaviours and contraceptive use among multiethnic young women: implications for education and future research

Background

This study was a qualitative investigation into sexual attitudes and behaviours, and contraceptive use among Malaysian youth, based on constructs from the health belief model, theory of reasoned action, and problem behaviour theory.

Methods

A total of 34 focus group discussions with 185 participants were conducted among the Malay (35%), Chinese (34%), and Indian (31%) young females between November, 2010 and April, 2011. The participants were secondary school students and university undergraduates from Selangor and the Federal Territory of Kuala Lumpur.

Results

The study found a lack of knowledge about sexual issues and contraception among the participants. Many engaged in unprotected sexual intercourse and relied on periodic abstinence, natural methods, and traditional folk pregnancy preventive practices. The findings also revealed numerous categories of factors influencing sexual attitudes and behaviours: ethnic group and religion, level of religiosity, peer pressure and norms, and parental monitoring. With regard to condom use, factors such as embarrassment about condom acquisition, low perceived susceptibility to sexually transmitted infections (STIs), and perceived efficacy of traditional and folk methods of contraception, were uncovered from the discussions.

Conclusion

This study underscores the importance of development of culturally specific interventions that address the identified promoting factors of premarital sex. Behavioral interventions to promote condom use should increase awareness about condom effectiveness against not only unwanted pregnancies but also STIs.

Identifying teens at risk: developmental pathways of online and offline sexual risk behavior

OBJECTIVES

The aims of this study were (1) to investigate the prevalence and development of both online (OnSRB) and offline sexual risk behavior (OffSRB) in adolescence, (2) to establish whether OnSRBs and OffSRBs are related, and (3) to identify risk factors that determine problematic pathways of OnSRB and OffSRB.

METHODS

A 4-wave longitudinal study with 1762 Dutch adolescents aged 12 to 18 was conducted (mean age, T1 = 14.52, 49% girls). By using group-based modeling, developmental pathways for OnSRB and OffSRB were identified and the relationship between both behaviors over time was examined.

RESULTS

Substantial intraindividual differences in the development of OnSRB and OffSRB were found. The analysis revealed 3 developmental pathways of OnSRB: no risk (70.2%), moderate risk (23.7%), and high risk (6.1%). For OffSRB, we identified a no risk (90.6%) and an increasing pathway (9.4%). OnSRBs and OffSRBs were related and had common predictors (ie, sensation seeking, low educational level, gender).

CONCLUSIONS

Only a minority of adolescents shows sustained high OnSRB. This group is likely to consist of low-educated, high-sensation-seeking adolescents who spend more time communicating on the Internet and come from less cohesive families. These same adolescents are also more likely to engage in OffSRB. Preventions should focus on these adolescents.

Paternal influences on adolescent sexual risk behaviors: a structured literature review

BACKGROUND AND OBJECTIVE

To date, most parent-based research has neglected the role of fathers in shaping adolescent sexual behavior and has focused on mothers. The objective of this study was to conduct a structured review to assess the role of paternal influence on adolescent sexual behavior and to assess the methodological quality of the paternal influence literature related to adolescent sexual behavior.

METHODS

We searched electronic databases: PubMed, PsychINFO, Social Services Abstracts, Family Studies Abstracts, Sociological Abstracts, and the Cumulative Index to Nursing and Allied Health Literature. Studies published between 1980 and 2011 that targeted adolescents 11 to 18 years and focused on paternal parenting processes were included. Methodological quality was assessed by using an 11-item scoring system.

RESULTS

Thirteen articles were identified and reviewed. Findings suggest paternal factors are independently associated with adolescent sexual behavior relative to maternal factors. The most commonly studied paternal influence was emotional qualities of the father-adolescent relationship. Paternal communication about sex was most consistently associated with adolescent sexual behavior, whereas paternal attitudes about sex was least associated. Methodological limitations include a tendency to rely on cross-sectional design, nonprobability sampling methods, and focus on sexual debut versus broader sexual behavior.

CONCLUSIONS

Existing research preliminarily suggests fathers influence the sexual behavior of their adolescent children; however, more rigorous research examining diverse facets of paternal influence on adolescent sexual behavior is needed. We provide recommendations for primary care providers and public health practitioners to better incorporate fathers into interventions designed to reduce adolescent sexual risk behavior.

The Role of Implicit Measurement in the Assessment of Risky Behavior: A Pilot Study with African American Girls

With the aim of developing a novel strategy for identifying vulnerability for early sexual activity and adjustment problems, African American girls (n = 39) completed partially structured scenarios in which female characters of similar age faced circumstances characterized by varying levels of risk. Most girls indicated that they believed the characters would have sex, regardless of their own sexual history or the level of risk in the scenario. However, the combination of girls' sexual history and girls' predictions of characters' behavior in the scenario provided more information regarding the girls at greatest risk for adjustment problems. Implicit techniques offer an additional strategy for identifying girls most vulnerable to adjustment difficulties in the context of early sexual activity.

Teacher-student interactions and attachment states of mind as predictors of early romantic involvement and risky sexual behaviors

Adolescents' capacities to negotiate sexual behavior in romantic relationships have important implications for their reproductive and health outcomes. This study examined adolescents' interactions with teachers and attachment states of mind as predictors of their romantic involvement and risky sexual behavior in an economically disadvantaged sample. Negative interactions with teachers predicted increased sexual risk-taking behaviors and females' early romantic involvement. Preoccupied states of mind increased risk for early romantic involvement and the likelihood that females would engage in risky sexual behavior. The findings demonstrate how adolescents' school experiences contribute to adaptation in romantic relationships in mid to late adolescence above and beyond representations of parent-child attachment.

Future expectations among adolescents: a latent class analysis

Future expectations have been important predictors of adolescent development and behavior. Its measurement, however, has largely focused on single dimensions and misses potentially important components. This analysis investigates whether an empirically-driven, multidimensional approach to conceptualizing future expectations can substantively contribute to our understanding of adolescent risk behavior. We use data from the National Longitudinal Survey of Youth 1997 to derive subpopulations of adolescents based on their future expectations with latent class analysis. Multinomial regression then determines which covariates from Bronfenbrenner's ecological systems theory are associated with class membership. After modeling these covariates, we examine whether future expectations is associated with delinquency, substance use, and sexual experience. Our analysis suggests the emergence of four distinct classes labeled the Student Expectations, Student/Drinking Expectations, Victim Expectations, and Drinking/Arrest Expectations classes according to their indicator profiles. These classes differ with respect to covariates associated with membership; furthermore, they are all statistically and differentially associated with at least one adolescent risk behavior. This analysis demonstrates the additional benefit derived from using this multidimensional approach for studying future expectations. Further research is needed to investigate its stability and role in predicting adolescent risk behavior over time.