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Reyes-Lacalle A, Carnicer-Pont D, Masvidal MG, Montero-Pons L, Cabedo-Ferreiro R, Falguera-Puig G. Prevalence and Characterization of Undiagnosed Youths at Risk of Chlamydia trachomatis Infection: A Cross-sectional Study. J Low Genit Tract Dis 2022; 26:223-228. [PMID: 35584026 PMCID: PMC9232277 DOI: 10.1097/lgt.0000000000000682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The aim of this study was to determine the prevalence of Chlamydia trachomatis infection in undiagnosed young people aged between 15 and 24 years. MATERIALS AND METHODS A convenience sample of 623 youths, with a mean (SD) age of 20.1 (2.2) years, was recruited from key spaces in the North Metropolitan area of Barcelona in Catalonia, Spain. Participants completed a 21-item questionnaire and provided a urine sample or vaginal swab for testing. RESULTS The most common age at the first sexual intercourse was 16 years (24.6%), followed by 15 years (21.3%). Only 32.6% reported always use of condoms, 49.2% sometimes, and 15.6% never. A positive test for chlamydia was found in 34 participants (5.5%; 95% CI, 3.8-7.5), with no difference by sex. A positive test was significantly more common among the participants who were working, who had been diagnosed with a sexually transmitted disease (STD) at some point in their life, and who used web pages/apps to find new sexual partners more than once a month. In the multivariate analysis, working status was an independent factor associated with chlamydial infection (adjusted odds ratio[OR], 8.88; 95% CI, 1.71-46.17), whereas not having been previously diagnosed with an STD (OR, 0.34; 95% CI, 0.07-1.49) and never using the Internet to find sexual partners (OR, 0.16; 95% CI, 0.03-080) were protective factors against chlamydial infection. CONCLUSIONS The prevalence of C. trachomatis infection was 5.5%. Working status, a previous diagnosis of STD, and use of the Internet to find new sexual partners were associated with chlamydial test positivity.
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Affiliation(s)
- Azahara Reyes-Lacalle
- Atenció a la Salut Sexual I Reproductiva Sabadell, Direcció d'Atenció Primària Metropolitana Nord, Institut Catalá de la Salut (ICS), Barcelona, Spain
- Research Group Atenció a la Salut Sexual i Reproductiva (GRASSIR), Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Barcelona, Spain
| | - Dolors Carnicer-Pont
- Research Group Atenció a la Salut Sexual i Reproductiva (GRASSIR), Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Barcelona, Spain
- Programa de Prevenció i Control del Cancer, Institut Catalá d'Oncologia/WHO Collaborating Center for Tobacco Control, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Miriam Gómez Masvidal
- Research Group Atenció a la Salut Sexual i Reproductiva (GRASSIR), Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Barcelona, Spain
- Atenció a la Salut Sexual I Reproductiva Mataról, Direcció d'Atenció Primària Metropolitana Nord, Institut Catalá de la Salut (ICS), Barcelona, Spain
| | - Laura Montero-Pons
- Research Group Atenció a la Salut Sexual i Reproductiva (GRASSIR), Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Barcelona, Spain
- Atenció a la Salut Sexual I Reproductiva Santa Coloma de Grameenet, Direcció d'Atenció Primària Metropolitana Nord, Institut Catalá de la Salut (ICS), Barcelona, Spain
| | - Rosa Cabedo-Ferreiro
- Research Group Atenció a la Salut Sexual i Reproductiva (GRASSIR), Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Barcelona, Spain
- Atenció a la Salut Sexual I Reproductiva Granollers, Direcció d'Atenció Primària Metropolitana Nord, Institut Catalá de la Salut (ICS), Barcelona, Spain
| | - Gemma Falguera-Puig
- Research Group Atenció a la Salut Sexual i Reproductiva (GRASSIR), Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Barcelona, Spain
- Responsable Atenció a la Salut Sexual I Reproductiva, Direcció d'Atenció Primària Metropolitana Nord, Institut Catalá de la Salut (ICS), Barcelona, Spain
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Nelson LE, Nyblade L, Torpey K, Logie CH, Qian HZ, Manu A, Gyamerah E, Boakye F, Appiah P, Turner D, Stockton M, Abubakari GM, Vlahov D. Multi-level intersectional stigma reduction intervention to increase HIV testing among men who have sex with men in Ghana: Protocol for a cluster randomized controlled trial. PLoS One 2021; 16:e0259324. [PMID: 34843529 PMCID: PMC8629287 DOI: 10.1371/journal.pone.0259324] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Accepted: 10/12/2021] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Men with have sex with men (MSM) in Africa face high levels of stigma due to elevated HIV exposure (actual or perceived), same-sex practices, and gender non-conformity. These stigmas are documented barriers to HIV prevention and treatment. Most stigma-reduction interventions have focused on single-level targets (e.g., health care facility level [HCF]) and addressed one type of stigma (e.g., HIV), without engaging the multiple intersecting stigmas that MSM encounter. Determining the feasibility and acceptability of multi-level intervention of reducing intersectional stigma and estimating its efficacy on increasing HIV testing are needed. METHODS We proposed a mixed method study among MSM in Ghana. First, we will develop the intervention protocol using the Convergence Framework, which combines three interventions that were previously implemented separately in Ghana for reducing stigma at the HCF-level, increasing HIV testing at the peer group-level, and increasing peer social support at the individual-level. Then, we will conduct a cluster randomized controlled trial with four pairs of HCFs matched on staff size. HCFs within each pair are randomized to the HCF-level stigma-reduction intervention or control arm. MSM (n = 216) will be randomized to receive the group-level and individual-level interventions or standard of care control arm. MSM will be assigned to receive HIV testing at one of the HCFs that match their study assignment (intervention or control facility). The frequency of HIV testing between MSM in the study arms at 3 and 6 months will be compared, and the predictors of HIV testing uptake at the HCF, peer group and individual-levels will be assessed using multi-level regression models. DISCUSSION These findings from this study will provide important evidence to inform a hybrid implementation-effectiveness trial of a public health intervention strategy for increasing HIV case detection among key populations in sub-Saharan African communities. Accurate information on HIV prevalence can facilitate epidemic control through more precise deployment of public health measures aimed at HIV treatment and viral load suppression, which eliminates risk of transmission. TRIAL REGISTRATION This study was prospectively registered on ClinicalTrials.gov, Identifier: NCT04108078, on September 27, 2019.
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Affiliation(s)
- LaRon E. Nelson
- School of Nursing, Yale University, New Haven, CT, United States of America
- Center for Interdisciplinary Research on AIDS, School of Public Health, Yale University, New Haven, CT, United States of America
- Yale Institute for Global Health, School of Public Health, New Haven, CT, United States of America
| | - Laura Nyblade
- RTI International, Washington, DC, United States of America
| | - Kwasi Torpey
- Department of Population, Family & Reproductive Health, School of Public Health, University of Ghana, Legon, Accra, Ghana
| | - Carmen H. Logie
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada
| | - Han-Zhu Qian
- Department of Biostatistics, School of Public Health, Yale University, New Haven, CT, United States of America
| | - Adom Manu
- Department of Population, Family & Reproductive Health, School of Public Health, University of Ghana, Legon, Accra, Ghana
| | - Emma Gyamerah
- Educational Assessment & Research Center, Accra, Ghana
| | | | | | - DeAnne Turner
- College of Nursing, University of South Florida, Tampa, FL, United States of America
| | - Melissa Stockton
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, United States of America
| | - Gamji M. Abubakari
- Center for Interdisciplinary Research on AIDS, School of Public Health, Yale University, New Haven, CT, United States of America
| | - David Vlahov
- School of Nursing, Yale University, New Haven, CT, United States of America
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3
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Abubakari GM, Nelson LE, Ogunbajo A, Boakye F, Appiah P, Odhiambo A, Sa T, Zhang N, Ngozi I, Scott A, Maina G, Manu A, Torpey K. Implementation and evaluation of a culturally grounded group-based HIV prevention programme for men who have sex with men in Ghana. Glob Public Health 2021; 16:1028-1045. [PMID: 33050773 PMCID: PMC8728790 DOI: 10.1080/17441692.2020.1832555] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Accepted: 09/22/2020] [Indexed: 10/23/2022]
Abstract
This study examined the feasibility and acceptability of an evidence-based HIV prevention programme for men who have sex with men (MSM) in Ghana through a participatory approach. The programme involved 57 self-identified adult cisgender MSM and led by a community-based organisation in collaboration with local nurses. We used an explanatory mixed-method design to evaluate the programme. We computed descriptive statistics, relative frequency, and paired proportionate analysis for the survey data and subjected the focus groups data to summative content analysis. Five key themes from the qualitative data indicated strong evidence of the acceptability and efficacy of the programme among MSM. The programme contributed to building social support networks, a sense of social justice among MSM, and facilitated the development of personalised HIV prevention menus by the participants. We observed increases in HIV testing (from 4% to 17%) and increases in the relative frequency of condom use for anal, oral, and vaginal sex. The programme served as an example of a successfully implemented culturally grounded intervention that has the potential to increase HIV and STI awareness and prevention among MSM in Ghana and other highly stigmatised environments.
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Affiliation(s)
- Gamji M’Rabiu Abubakari
- Yale AIDS Prevention Program (Y-APT), Center for Interdisciplinary Research on AIDS, School of Public Health/Medicine, Yale University, New Haven, CT
| | - LaRon E. Nelson
- School of Nursing, Yale University, New Haven CT, USA
- Centre for Interdisciplinary Research on AIDS, Yale University, New Haven CT, USA
- Yale Institute of Global Health, Yale University, New Haven CT, USA
- MAP Centre for Urban Health Solutions, Unity Health Toronto, Toronto ON, Canada
| | | | | | | | - Apondi Odhiambo
- Dalla Lana School of Public Health, University of Toronto, Toronto ON, Canada
| | - Ting Sa
- Department of Biostatistics and Epidemiology, Cincinnati Children’s Hospital Medical Centre, Cincinnati OH, USA
| | - Nanhua Zhang
- Faculty of Health Sciences, York University, Toronto ON, Canada
| | - Ironyah Ngozi
- Faculty of Nursing, University of Saskatchewan, Prince Albert SK, Canada
| | - Adjei Scott
- Faculty of Nursing, University of Saskatchewan, Prince Albert SK, Canada
| | - Geoffrey Maina
- Faculty of Nursing, University of Saskatchewan, Prince Albert SK, Canada
| | - Adom Manu
- School of Public Health, University of Ghana, Legon, Ghana
| | - Kwasi Torpey
- School of Public Health, University of Ghana, Legon, Ghana
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4
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Norris AL, Carey KB, Guthrie KM, Rich CM, Krieger NH, Kaplan C, Carey MP. Partner Type and Young Women's Sexual Behavior: A Qualitative Inquiry. ARCHIVES OF SEXUAL BEHAVIOR 2021; 50:359-372. [PMID: 32661814 PMCID: PMC7855024 DOI: 10.1007/s10508-020-01780-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/09/2018] [Revised: 05/21/2020] [Accepted: 06/20/2020] [Indexed: 06/11/2023]
Abstract
The incidence of sexually transmitted infections (STIs) has increased over recent years, particularly among young women. Partner type is believed to influence women's STI risk. However, researchers often restrict partner type to "casual" versus "committed," labels that can mask risk variability. Therefore, in this study, we identified and explored a range of sexual partner types in order to understand how young women's perceived risk and condom use intentions vary by partner type. Data were obtained during six focus groups of young women (N =25) who were recruited from a community reproductive healthcare clinic. Women described a range of monogamous and non-monogamous partner types that were distinguished based on partner regularity (i.e., whether the sexual partnership was ongoing) and personal relationship (i.e., degree of involvement outside of the sexual relationship). Women's perceived STI risk was higher and condom use intentions stronger with new partners, particularly unfamiliar partners (i.e., "one-night stand," "fuck boy"). Women identified potential harm from condom negotiation with all but the "friends with benefits" partners. However, the nature of this harm differed by partner type. Clinicians and researchers should consider how to support women in advocating for safer sexual behaviors across these partner types by understanding how partner regularity, degree of personal relationship, and emotional attachment differentially impact couples' condom use decisions.
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Affiliation(s)
- Alyssa L Norris
- Center for Behavioral and Preventive Medicine, The Miriam Hospital, 164 Summit Avenue, Coro West Suite 309, Providence, RI, 02903, USA.
- Department of Psychiatry and Human Behavior, Alpert Medical School, Brown University, Providence, RI, USA.
| | - Kate B Carey
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, USA
- Center for Alcohol and Addiction Studies, Brown University, Providence, RI, USA
| | - Kate M Guthrie
- Center for Behavioral and Preventive Medicine, The Miriam Hospital, 164 Summit Avenue, Coro West Suite 309, Providence, RI, 02903, USA
- Department of Psychiatry and Human Behavior, Alpert Medical School, Brown University, Providence, RI, USA
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, USA
| | - Carla M Rich
- Center for Behavioral and Preventive Medicine, The Miriam Hospital, 164 Summit Avenue, Coro West Suite 309, Providence, RI, 02903, USA
| | - Naomi H Krieger
- Center for Behavioral and Preventive Medicine, The Miriam Hospital, 164 Summit Avenue, Coro West Suite 309, Providence, RI, 02903, USA
| | - Clair Kaplan
- Department of Clinical Research, Planned Parenthood of Southern New England, New Haven, CT, USA
- Center for Interdisciplinary Research on AIDS, Yale University, New Haven, CT, USA
| | - Michael P Carey
- Center for Behavioral and Preventive Medicine, The Miriam Hospital, 164 Summit Avenue, Coro West Suite 309, Providence, RI, 02903, USA
- Department of Psychiatry and Human Behavior, Alpert Medical School, Brown University, Providence, RI, USA
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, USA
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5
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Banks DE, Hensel DJ, Zapolski TCB. Integrating Individual and Contextual Factors to Explain Disparities in HIV/STI Among Heterosexual African American Youth: A Contemporary Literature Review and Social Ecological Model. ARCHIVES OF SEXUAL BEHAVIOR 2020; 49:1939-1964. [PMID: 32157486 PMCID: PMC7321914 DOI: 10.1007/s10508-019-01609-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/08/2018] [Revised: 12/03/2019] [Accepted: 12/10/2019] [Indexed: 05/21/2023]
Abstract
Heterosexual African American youth face substantial disparities in sexual health consequences such as HIV and STI. Based on the social ecological framework, the current paper provides a comprehensive, narrative review of the past 14 years of literature examining HIV/STI risk, including risky sexual behavior, among heterosexual African American youth and a conceptual model of risk among this population. The review found that individual psychological and biological factors are insufficient to explain the sexual health disparities faced by this group; instead, structural disadvantage, interpersonal risk, and community dysfunction contribute to the disparity in HIV/STI outcomes directly and indirectly through individual psychological factors. The conceptual model presented suggests that for African American youth, (1) HIV/STI risk commonly begins at the structural level and trickles down to the community, social, and individual levels, (2) risk works in a positive feedback system such that downstream effects compound the influence of structural risks, and (3) contextual and individual risk factors must be considered within the advanced stage of the epidemic facing this population. Despite advanced HIV and STI epidemics among heterosexual African American youth, multisystemic interventions that target structural risk factors and their downstream effects are posited to reduce the disparity among this high-risk population.
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Affiliation(s)
- Devin E Banks
- Department of Psychology, Indiana University Purdue University-Indianapolis, 402 N. Blackford St., LD 124, Indianapolis, IN, 46202, USA.
| | - Devon J Hensel
- Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Tamika C B Zapolski
- Department of Psychology, Indiana University Purdue University-Indianapolis, 402 N. Blackford St., LD 124, Indianapolis, IN, 46202, USA
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Ngoc Do H, Ngoc Nguyen D, Quynh Thi Nguyen H, Tuan Nguyen A, Duy Nguyen H, Phuong Bui T, Bich Thi Vu T, Thanh Le K, Tuan Nguyen D, Tat Nguyen C, Gia Vu L, Thu Vu G, Xuan Tran B, A. Latkin C, C. M. Ho R, S. H. Ho C. Patterns of Risky Sexual Behaviors and Associated Factors among Youths and Adolescents in Vietnam. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E1903. [PMID: 32183402 PMCID: PMC7143552 DOI: 10.3390/ijerph17061903] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Revised: 03/07/2020] [Accepted: 03/12/2020] [Indexed: 12/18/2022]
Abstract
Youths and adolescents are vulnerable to HIV/STIs from unprotected sex. Promotion of young population's awareness about risky sexual behaviors is essential to develop contextualized interventions. A cross-sectional study was conducted in five Vietnamese provinces to document current attitudes and practices regarding sexual behaviors among youths. The information on sociodemographic characteristics, substance use, and sexual behaviors was collected via self-reported questionnaires. The factors associated with risky sexual behaviors were identified by the multivariate logistic regression. Among the 1200 participants, 73.5% reported having sex in their lifetime, and 48.1% used condoms at their latest sexual intercourse. Participants in urban areas were more likely not to intend to use condoms and had a higher unintended pregnancy rate than in rural areas. Older age was positively associated with not wanting to use and not using condoms. Substance-using participants were more likely to not use condoms. The participants taking alcohol or other stimulants before sex had a higher likelihood of unintended pregnancy. Respondents' attitudes and practices regarding sexual behaviors were associated with gender and employment. This study indicated that young population's awareness in Vietnam is high, however, risky sexual behaviors also remain common. Sex-related educational programs about the consequences of substance use, multiple sex partners, and unprotected sex should be developed.
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Affiliation(s)
- Ha Ngoc Do
- Youth Research Institute, Ho Chi Minh Communist Youth Union, Hanoi 100000, Vietnam;
| | - Diep Ngoc Nguyen
- Institute for Global Health Innovations, Duy Tan University, Da Nang 550000, Vietnam;
- Faculty of Pharmacy, Duy Tan University, Da Nang 550000, Vietnam
| | - Hoa Quynh Thi Nguyen
- Department of Research on Youth Culture and Lifestyle, Youth Research Institute, Ho Chi Minh Communist Youth Union, Hanoi 100000, Vietnam; (H.Q.T.N.); (A.T.N.)
| | - Anh Tuan Nguyen
- Department of Research on Youth Culture and Lifestyle, Youth Research Institute, Ho Chi Minh Communist Youth Union, Hanoi 100000, Vietnam; (H.Q.T.N.); (A.T.N.)
| | - Hiep Duy Nguyen
- Department of Research on Children’s issues, Youth Research Institute, Ho Chi Minh Communist Youth Union, Hanoi 100000, Vietnam; (H.D.N.); (T.P.B.)
| | - Thanh Phuong Bui
- Department of Research on Children’s issues, Youth Research Institute, Ho Chi Minh Communist Youth Union, Hanoi 100000, Vietnam; (H.D.N.); (T.P.B.)
| | - Thao Bich Thi Vu
- Department of Research on Youth’s Organisations and Youth Campaign, Youth Research Institute, Ho Chi Minh Communist Youth Union, Hanoi 100000, Vietnam; (T.B.T.V.); (K.T.L.)
| | - Khiet Thanh Le
- Department of Research on Youth’s Organisations and Youth Campaign, Youth Research Institute, Ho Chi Minh Communist Youth Union, Hanoi 100000, Vietnam; (T.B.T.V.); (K.T.L.)
| | - Dung Tuan Nguyen
- Department of Research on Youth and Legal issues, Youth Research Institute, Ho Chi Minh Communist Youth Union, Hanoi 100000, Vietnam;
| | - Cuong Tat Nguyen
- Institute for Global Health Innovations, Duy Tan University, Da Nang 550000, Vietnam;
- Faculty of Medicine, Duy Tan University, Da Nang 550000, Vietnam
| | - Linh Gia Vu
- Center of Excellence in Evidence-based Medicine, Nguyen Tat Thanh University, Ho Chi Minh City 700000, Vietnam; (L.G.V.); (G.T.V.)
| | - Giang Thu Vu
- Center of Excellence in Evidence-based Medicine, Nguyen Tat Thanh University, Ho Chi Minh City 700000, Vietnam; (L.G.V.); (G.T.V.)
| | - Bach Xuan Tran
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi 100000, Vietnam;
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA;
| | - Carl A. Latkin
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA;
| | - Roger C. M. Ho
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore;
- Institute for Health Innovation and Technology (iHealthtech), National University of Singapore, Singapore 119077, Singapore
- Center of Excellence in Behavioral Medicine, Nguyen Tat Thanh University, Ho Chi Minh City 700000, Vietnam
| | - Cyrus S. H. Ho
- Department of Psychological Medicine, National University Hospital, Singapore 119074, Singapore;
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Qiao J, Guo Y, Zhu Y, Hong YA, Xu Z, Zeng C, Zhang H, Cai W, Li L, Liu C, Kellstedt DK. Gender differences in the relationship of sexual partnership characteristics and inconsistent condom use among people living with HIV in China. AIDS Care 2019; 32:128-135. [PMID: 31181956 DOI: 10.1080/09540121.2019.1622632] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Few studies have examined the relationship between inconsistent condom use and sexual partnership characteristics among people living with HIV (PLWH). The current study focused on such association and its gender differences. The study was conducted in a large hospital in South China in 2013. A total of 320 dyads (PLWH indexes and their sexual partners) were recruited from an outpatient clinic using convenience sampling. The proportion of inconsistent condom use in the last six months among female indexes was higher than that among male indexes (52.4% vs. 43.6%). Of sexual partnership characteristics, HIV seropositive status was a risk factor for inconsistent condom use for both male and female indexes (aOR = 2.32, 95%CI = 1.15∼4.66, aOR = 3.09, 95%CI = 1.10∼8.67, respectively). For male indexes, lower educational level was also a risk factor (aOR = 2.39, 95%CI = 1.23∼4.67); while having had emotionally intimate relationships was a protective factor (aOR = 0.40, 95%CI = 0.21∼0.77). For female indexes, receiving material support was a risk factor (aOR = 10.17, 95%CI = 2.13∼48.61) and receiving health-related advice was a protective factor (aOR = 0.11, 95%CI = 0.02∼0.55). Future HIV interventions for PLWH need to be gender-sensitive and include their sexual partners.
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Affiliation(s)
- Jiaying Qiao
- School of Public Health, Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Yan Guo
- School of Public Health, Sun Yat-sen University, Guangzhou, People's Republic of China.,Center for Migrant Health Policy, Sun Yat-sen University, Guangzhou, People's Republic of China.,Sun Yat-sen Global Health Institute, Institute of State Governance, Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Yajing Zhu
- School of Public Health, Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Y Alicia Hong
- Department of Health Administration and Policy, College of Health and Human Services, George Mason University, Fairfax, VA, USA
| | - Zhimeng Xu
- School of Public Health, Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Chengbo Zeng
- School of Public Health, Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Hanxi Zhang
- School of Public Health, Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Weiping Cai
- Department of Infectious Disease, Guangzhou Number Eight People's Hospital, Guangzhou, People's Republic of China
| | - Linghua Li
- Department of Infectious Disease, Guangzhou Number Eight People's Hospital, Guangzhou, People's Republic of China
| | - Cong Liu
- Department of Infectious Disease, Guangzhou Number Eight People's Hospital, Guangzhou, People's Republic of China
| | - Debra K Kellstedt
- School of Public Health, Texas A&M University, College Station, TX, USA
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Sehnem GD, Pedro ENR, Ressel LB, Vasquez MED. Sexuality of adolescents living with HIV/AIDS: sources of information defining learning. ESCOLA ANNA NERY 2018. [DOI: 10.1590/2177-9465-ean-2017-0120] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT Objective: To know the sources of information of adolescents living with HIV/AIDS that define learning about sexuality. Methods: A qualitative study was performed in a Specialized Care Service of a city in the state of Rio Grande do Sul, Southern Brazil, with 15 adolescents living with HIV/AIDS. A semi-structured interview and thematic analysis were used. Results: Adolescents have built up their knowledge about sexuality, especially through relationships with friends and older family members, or through access to media sources. Schools and health services were spaces for sharing information about biological aspects of sexuality. Conclusion: Nurses need to address adolescent sexuality beyond the biological dimension and support it through critical and dialogical health education.
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Nehl EJ, Elifson K, DePadilla L, Sterk C. Sex Partner Type, Drug Use and Condom Use Self-Efficacy Among African Americans from Disadvantaged Neighborhoods: Are Associations with Consistent Condom Use Moderated by Gender? JOURNAL OF SEX RESEARCH 2016; 53:805-815. [PMID: 26580813 PMCID: PMC5006675 DOI: 10.1080/00224499.2015.1092018] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Gender inequalities in sexual behavior are explored from the perspective of the theory of gender and power. This study focused on the effect of sex partner type (steady versus casual), drug use, and condom use self-efficacy regarding consistent condom use (CCU) among a community-based sample of adults. The sample included 1,357 African American men and women (M age 37.0, SD 13.1 years; 44% women, 66% men) from 61 disadvantaged census block groups in Atlanta, GA as part of a study of individual and neighborhood characteristics and HIV risk-taking. Having a steady partner decreased the odds of CCU, while higher condom use self-efficacy increased the odds of CCU. Among non-drug users, having a drug-using partner was associated with decreased odds of condom use for women only. Women with drug-using partners, especially a steady partner, were least likely to report CCU. Therefore, interventions intended to empower CCU among women need to expand beyond acknowledging the reduced control that women who use drugs demonstrate to also consider those who have drug-using sexual partners.
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Affiliation(s)
- Eric J. Nehl
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University
| | - Kirk Elifson
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University
| | - Lara DePadilla
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University
| | - Claire Sterk
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University
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Stewart JM, Rogers CK, Bellinger D, Thompson K. A Contextualized Approach to Faith-Based HIV Risk Reduction for African American Women. West J Nurs Res 2016; 38:819-36. [PMID: 26879828 DOI: 10.1177/0193945916629621] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
HIV/AIDS has a devastating impact on African Americans, particularly women and young adults. We sought to characterize risks, barriers, and content and delivery needs for a faith-based intervention to reduce HIV risk among African American women ages 18 to 25. In a convergent parallel mixed methods study, we conducted four focus groups (n = 38) and surveyed 71 young adult women. Data were collected across four African American churches for a total of 109 participants. We found the majority of women in this sample were engaged in behaviors that put them at risk for contracting HIV, struggled with religiously based barriers and matters of sexuality, and had a desire to incorporate their intimate relationships, parenting, and financial burdens into faith-based HIV risk-reduction interventions. Incorporating additional social context-related factors into HIV risk-reduction interventions for young African American women is critical to adapting and developing HIV interventions to reduce risk among young adult women in faith settings.
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Affiliation(s)
| | | | - Dawn Bellinger
- Johns Hopkins University School of Nursing, Baltimore, MD, USA
| | - Keitra Thompson
- Johns Hopkins University School of Nursing, Baltimore, MD, USA
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Masemola-Yende JPF, Mataboge SM. Access to information and decision making on teenage pregnancy prevention by females in Tshwane. Curationis 2015; 38:1540. [PMID: 26842080 PMCID: PMC6092698 DOI: 10.4102/curationis.v38i2.1540] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2015] [Revised: 09/18/2015] [Accepted: 09/20/2015] [Indexed: 11/01/2022] Open
Abstract
BACKGROUND The increase in the number of teenage pregnancies and its negative consequences has encouraged various researchers to explore the possible causes of teenage pregnancy. Findings from previously-conducted research have indicated different preventable factors that predispose female teenagers to pregnancy, such as staff attitudes and the lack of information resulting from poor access to health facilities. OBJECTIVE To explore and describe access to information and decision making on teenage pregnancy prevention by females using a primary healthcare clinic in Tshwane, South Africa. METHOD In this study, the researchers used a descriptive qualitative and exploratory research design to explore and describe the verbal reports regarding prevention of teenage pregnancy by females using a primary healthcare clinic in Tshwane, South Africa. Face-to-face semistructured interviews were conducted with 15 female participants aged between 15 and 26, who had been pregnant once or more during their teens. RESULTS Two themes emerged, namely, access to information and decision making by female teenagers. Five categories that emerged were: access to information on pregnancy prevention; ignoring of provided information; the use of alternative medicine with hormonal contraception; personal reasons for use and non-use of contraception; and decisions made by teenagers to not fall pregnant. Females in this study fell pregnant in their teens, even though they had access to information. CONCLUSION Given the complexity of this problem, female teenagers should use their families as primary sources of information for reproductive health promotion and educational institutions should build on this to aid the prevention of teenage pregnancy.
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Decker MR, Chung SE, Ellen JM, Sherman SG. Do young women engage in greater sexual risk behaviour with biological fathers of their children? Sex Transm Infect 2015; 92:276-8. [PMID: 26392630 DOI: 10.1136/sextrans-2015-052157] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2015] [Accepted: 08/31/2015] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES Qualitative research suggests that young women's relationships with the biological fathers of their children (BFRs), known colloquially as 'baby daddy' relationships, enable risk for pregnancy and STI/HIV. Our study compared partner characteristics and sexual risk within dyads based on BFR, among a sample of young women in Baltimore, Maryland, USA. METHODS We conducted secondary analysis of survey data collected in 2011-2013 from heterosexually experienced youth ages 15-24 in Baltimore, Maryland, USA. Analyses are limited to women with at least one recent (past 6 months) sex partner (n=171 participants, reporting on 271 relationships). Using generalised estimating equations with logit function for correlated binary responses, we evaluate associations of BFR with partner characteristics, sexual risk behaviour and contraceptive non-use. RESULTS At least one BFR partner was reported by 25.2%. Male partners in BFRs were more likely to have been incarcerated or arrested. BFRs were more often characterised by women as 'main' versus 'casual' partners (adjusted OR (AOR) 3.92, 95% CI 1.19 to 12.9). In adjusted analyses, BFR was associated with condom non-use for vaginal (AOR 12.3, 95% CI 3.92 to 38.7) and anal (AOR 3.32, 95% CI 1.34 to 8.22) intercourse. While BFR was associated with contraceptive non-use (AOR 2.21, 95% CI 1.01 to 4.84), this association attenuated to non-significance after adjusting for partnership type (AOR 2.06, 95% CI 0.91 to 4.67). CONCLUSIONS While few differences in BFR partner characteristics emerged, significantly greater risk for unprotected intercourse was identified within BFR relationships. Findings suggest that the relationship context of a shared child heightens sexual risk for the young women most affected by STI.
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Affiliation(s)
- Michele R Decker
- Department of Population, Family & Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Shang-En Chung
- Division of General Pediatrics and Adolescent Medicine, Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, Maryland, USA Center for Child and Community Health Research, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Jonathan M Ellen
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA All Childrens Hospital, Johns Hopkins Medicine, St Petersburg, Florida, USA
| | - Susan G Sherman
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
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Nelson LE, Thach CT, Shelton MM, Boyer CB. Co-Parenting Relationship Experiences of Black Adolescent Mothers in Active Romantic Partnerships With the Fathers of Their Children. JOURNAL OF FAMILY NURSING 2015; 21:413-442. [PMID: 25486931 DOI: 10.1177/1074840714560753] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
We conducted an interpretive description of co-parenting relationship experiences of romantically involved Black adolescent mothers and fathers with shared biological children. The study was conducted in Brooklyn, New York, using data from individual in-depth interviews with adolescent mothers and fathers (n = 10). Four themes were identified: (a) putting our heads together; (b) balancing childhood and parenthood; (c) less money, more problems; and (d) if we use condoms, it is for contraception. The co-parenting couples managed very complex relationships, but their mutual interest in the welfare of their children was a relational asset. Co-parents had sparse financial resources but used a moral economy strategy to provide mutual support. Future research is needed that focuses on identifying other co-parent relationship assets and integrating and evaluating their utility for enhancing interventions for adolescent families.
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Garcia JR, Seibold-Simpson SM, Massey SG, Merriwether AM. Casual Sex: Integrating Social, Behavioral, and Sexual Health Research. ACTA ACUST UNITED AC 2015. [DOI: 10.1007/978-3-319-17341-2_12] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2023]
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Zabrocki C, Polutnik C, Jonbekov J, Shoakova F, Bahromov M, Weine S. Condom use and intimacy among Tajik male migrants and their regular female partners in Moscow. CULTURE, HEALTH & SEXUALITY 2014; 17:17-33. [PMID: 25033817 PMCID: PMC4227949 DOI: 10.1080/13691058.2014.937748] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
This study examined condom use and intimacy among Tajik male migrants and their regular female partners in Moscow, Russia. This study included a survey of 400 Tajik male labour migrants and longitudinal ethnographic interviews with 30 of the surveyed male migrants and 30 of their regular female partners. of the surveyed male migrants, 351 (88%) reported having a regular female partner in Moscow. Findings demonstrated that the migrants' and regular partners' intentions to use condoms diminished with increased intimacy, yet each party perceived intimacy differently. Migrants' intimacy with regular partners was determined by their familiarity and the perceived sexual cleanliness of their partner. Migrants believed that Muslim women were cleaner than Orthodox Christian women and reported using condoms more frequently with Orthodox Christian regular partners. Regular partners reported determining intimacy based on the perceived commitment of the male migrant. When perceived commitment faced a crisis, intimacy declined and regular partners renegotiated condom use. The association between intimacy and condom use suggests that HIV-prevention programmes should aim to help male migrants and female regular partners to dissociate their approaches to condom use from their perceptions of intimacy.
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Affiliation(s)
- Christopher Zabrocki
- Department of Psychiatry, The University of Illinois at Chicago, Chicago, Illinois, USA
| | - Chloe Polutnik
- Department of Psychiatry, The University of Illinois at Chicago, Chicago, Illinois, USA
| | | | | | | | - Stevan Weine
- Department of Psychiatry, The University of Illinois at Chicago, Chicago, Illinois, USA
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Nelson LE, Thach CT, Zhang N. Gender equity predicts condom use among adolescent and young adult parents in Toronto, Canada. THE CANADIAN JOURNAL OF HUMAN SEXUALITY 2014. [DOI: 10.3138/cjhs.2451] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Adolescents and young adults have higher rates of sexually transmitted infections (STI) than any other age cohort in Toronto, Ontario, Canada. The sub-population of young parents is at even higher risk for acquiring STIs than the general population of adolescents and young adults. The purpose of this study was to determine whether and how co-parenting relationship functioning and gender equitable attitudes were associated with condom use among adolescent and young adult parents. We conducted a cross-sectional survey with 102 non-married adolescent and young adult parents in Toronto. Study participants used iPads to self-administer the co-parenting relationship scale, gender equitable men scale, and a sexual behaviour battery regarding their condom use during the last episode of sexual intercourse (including vaginal and anal). Logistic regression was used to determine whether scale scores predicted condom use at last intercourse, adjusting for age and sex. t-tests were performed to assess group mean differences in gender equitable attitudes and co-parenting relationship functioning between condom users and nonusers and between mothers and fathers. We observed that co-parenting relationship functioning was not associated with condom use behaviours. Instead, gender equitable attitudes predicted condom use in the overall sample (AOR=1.13; 95% CI 1.03, 1.25, p<0.05). Fathers who used condoms at last intercourse had higher gender equitable attitude scores than fathers who did not use condoms (M=58 vs. 53, p=0.02). Mothers' gender equitable attitude scores were not associated with condom use behaviours. Attitudes that support gender equity attitudes predict condom use among young parents, particularly among young fathers. Sexual risk reduction programs targeting young parents may benefit from incorporating components that promote gender equity norms.
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Affiliation(s)
- LaRon E. Nelson
- University of South Florida, College of Nursing, Tampa, FL, USA
- University of Toronto, Lawrence S. Bloomberg, Faculty of Nursing, Toronto, ON, Canada
| | - Chia T. Thach
- University of South Florida, College of Nursing, Tampa, FL, USA
| | - Nanhua Zhang
- Cincinnati Children's Hospital Medical Center, Division of Biostatistics & Epidemiology, Cincinnati, OH, USA
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Nelson LE, Morrison-Beedy D, Kearney MH, Dozier A. Black adolescent mothers' perspectives on sex and parenting in nonmarital relationships with the biological fathers of their children. J Obstet Gynecol Neonatal Nurs 2013; 41:82-91. [PMID: 22834723 DOI: 10.1111/j.1552-6909.2011.01324.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVE To understand single Black adolescent mothers' perspectives on the sexual and parenting-related aspects of their relationships with the biological fathers of their children. METHODS The study was a qualitative description of perspectives from a convenience sample of Black single (nonmarried) adolescent mothers. Data were generated through focus groups and interviews. Participants were recruited using self-referral and health provider referrals. SETTING The study was conducted in a county public health department sexually transmitted diseases clinic in Rochester, New York. PARTICIPANTS Single mothers (N = 31) ages 15 to 19 participated in the study. The mean age of participants was 17.5 years (SD = 1.4). FINDINGS Four themes were identified that reflected the major characteristics of the relationships between the mothers and the biological fathers of their children: (a) You will always care about your "baby daddy" because of your child, (b) Negative behavior is tolerated to keep the family together, (c) The "baby daddy" can get sex as long as we are not on bad terms, and (d) He will always be part of our lives. CONCLUSION Black adolescent mothers have complex relationships with the biological fathers of their children that may include ongoing sexual activity. The intersection of coparenting and sexual health needs among adolescent mothers highlights the importance of integrating sexually transmitted infections prevention with perinatal health programs. It is important to consider this unique coparenting relationship when providing risk-reduction counseling to young mothers.
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Affiliation(s)
- LaRon E Nelson
- assistant professor in the Lawrence S. Bloomberg Faculty of Nursing, University of Toronto and in the Division of Adolescent Medicine, The Hospital for Sick Children, Toronto, Ontario, Canada..
| | - Dianne Morrison-Beedy
- dean and a professor in the College of Nursing, University of South Florida (USF), and senior associate vice president of USF Health, Tampa, FL
| | - Margaret H Kearney
- Independence Foundation Professor, vice provost, and dean of graduate studies, University of Rochester, Rochester, NY
| | - Ann Dozier
- associate professor in the Department of Community & Preventive Medicine, University of Rochester, Rochester, NY
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Sales JM, DiClemente RJ, Davis TP, Sullivan S. Exploring why young African American women do not change condom-use behavior following participation in an STI/HIV prevention intervention. HEALTH EDUCATION RESEARCH 2012; 27:1091-101. [PMID: 22641793 PMCID: PMC3498602 DOI: 10.1093/her/cys059] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/09/2011] [Accepted: 04/02/2012] [Indexed: 05/30/2023]
Abstract
Human immunodeficiency virus (HIV) interventions can significantly reduce risky sexual behaviors among vulnerable populations. However, not everyone exposed to an intervention will reduce their sexual risk behavior. This qualitative study sought to identify factors associated with young African American females' lack of increase in condom use post-participation in an HIV prevention intervention. Semi-structured interviews were conducted with 50 young African American women (18-23 years; approximately half were mothers) after participating in a demonstrated effective HIV prevention intervention; 24 did not increase condom use post-intervention. Interviews were thematically coded for barriers to condom-use post-intervention. Although nearly all young women reported partner-associated challenges to using condoms, there were relational differences observed among those who changed their condom use versus those who did not. Many 'non-changers' were engaged in non-stable 'on and off' relationships, with high rates of infidelity, often with the father of their child, in which they were fearful of requesting condom use. 'Non-changers' also reported more substance use, feeling incapable of change and not thinking about condom use. Thus, future HIV prevention efforts may benefit from incorporating strategies on how young mothers can maintain a non-sexual relationship with their child's father, as well as elaborating on the intersection of substance use and risky sexual decision-making.
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Affiliation(s)
- J M Sales
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health at Emory University, 1518 Clifton Road, NE Room 570, Atlanta, GA 30322, USA.
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