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Hebert LE, Lilleston PS, Jennings JM, Sherman SG. Individual, partner, and partnership level correlates of anal sex among youth in Baltimore City. ARCHIVES OF SEXUAL BEHAVIOR 2015; 44:619-629. [PMID: 25583375 DOI: 10.1007/s10508-014-0431-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2014] [Revised: 10/27/2014] [Accepted: 10/28/2014] [Indexed: 06/04/2023]
Abstract
Anal sex is an efficient mode of STI transmission and studies indicate that anal sex is common among heterosexuals, including adolescents. We examined the association between individual, partner, and sexual partnership-level characteristics with anal sex among a household survey of 263 individuals aged 15-24 years in Baltimore City, Maryland. We used weighted multiple logistic regression to examine correlates of anal sex in a heterosexual partnership by gender. Twenty-nine percent of males and 15% of females reported anal sex in a partnership in the past 6 months. For males, anal sex was associated with having two or more partners in the past 3 months (AOR = 13.93, 95% CI 3.87-50.12), having been tested for HIV (AOR = 0.30, 95% CI 0.12-0.72), and oral sex with a partner (AOR = 8.79, 95% CI 1.94-39.78). For females, anal sex was associated with reporting having a main partner (AOR = 6.74, 95% CI 1.74-23.65), partner meeting place (AOR = 3.03, 95% CI 1.04-8.82), partner history of STI (AOR = 0.20, 95% CI 0.05-0.85), and oral sex with a partner (AOR = 8.47, 95% CI 1.08-66.25). Anal sex was associated with inconsistent condom use for both males (OR = 5.77, 95% CI 1.68-19.79) and females (OR = 5.16, 95% CI 1.46-18.30). We conclude that anal sex is a prevalent risk behavior among heterosexual youth and is associated with a range of factors at the individual and partnership levels. These findings provide support for comprehensive sex education that includes information about anal sex; findings from this study can inform public health campaigns targeting youth at risk for STIs.
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Affiliation(s)
- Luciana E Hebert
- Department of Obstetrics and Gynecology, Center for Interdisciplinary Inquiry and Innovation in Sexual and Reproductive Health, University of Chicago, 1225 E. 60th Street, Rm 122, Chicago, IL, 60637, USA,
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A partner-related risk behavior index to identify people at elevated risk for sexually transmitted infections. J Prim Prev 2014; 34:81-7. [PMID: 23355254 DOI: 10.1007/s10935-013-0290-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
The purpose of this study was to develop and test a sexual-partner-related risk behavior index to identify high-risk individuals most likely to have a sexually transmitted infection (STI). Patients from five STI and adolescent medical clinics in three US cities were recruited (N = 928; M age = 29.2 years). Data were collected using audio-computer-assisted self-interviewing. Of seven sexual-partner-related variables, those that were significantly associated with the outcomes were combined into a partner-related risk behavior index. The dependent variables were laboratory-confirmed infection with Chlamydia trachomatis, Neisseria gonorrhoeae, and/or Trichomonas vaginalis. Nearly one-fifth of the sample (169/928; 18.4%) tested positive for an STI. Three of the seven items were significantly associated with having one or more STIs: sex with a newly released prisoner, sex with a person known or suspected of having an STI, and sexual concurrency. In combined form, this three-item index was significantly associated with STI prevalence (p < .001). In the presence of three covariates (gender, race, and age), those classified as being at-risk by the index were 1.8 times more likely than those not classified as such to test positive for an STI (p < .001). Among individuals at risk for STIs, a three-item index predicted testing positive for one or more of three STIs. This index could be used to prioritize and guide intensified clinic-based counseling for high-risk patients of STI and other clinics.
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Pflieger JC, Cook EC, Niccolai LM, Connell CM. Racial/ethnic differences in patterns of sexual risk behavior and rates of sexually transmitted infections among female young adults. Am J Public Health 2013; 103:903-9. [PMID: 23488501 DOI: 10.2105/ajph.2012.301005] [Citation(s) in RCA: 89] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We examined patterns of sexual behavior and risk for sexually transmitted infections (STIs) in young adulthood for Black, Hispanic, and White females. METHODS We used a nationally representative sample of 7015 female young adults from wave III of the National Longitudinal Study of Adolescent Health. Sexual risk items assessed behaviors occurring in the previous 6 years and past year to determine classes of sexual risk and links to STIs in young adulthood. RESULTS Latent class analysis revealed 3 sexual risk classes for Black and Hispanic youths and 4 sexual risk classes for White youths. The moderate and high risk classes had the highest probabilities of risky sexual partners, inconsistent condom use, and early age of sexual initiation, which significantly increased odds for STIs compared with recent abstainers. CONCLUSIONS We found different classes of sexual behavior by race/ethnicity, with Black and Hispanic young women most at risk for STIs in young adulthood. Preventive efforts should target younger adolescents and focus on sexual partner behavior.
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Affiliation(s)
- Jacqueline C Pflieger
- Consultation Center, Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA.
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Haydon AA, Herring AH, Halpern CT. Associations between patterns of emerging sexual behavior and young adult reproductive health. PERSPECTIVES ON SEXUAL AND REPRODUCTIVE HEALTH 2012; 44:218-27. [PMID: 23231329 PMCID: PMC3531866 DOI: 10.1363/4421812] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
CONTEXT Identifying young adult outcomes associated with adolescent sexual behavior, including patterns of first oral, vaginal and anal sex, is critical to promoting healthy sexual development. METHODS Associations between patterns of emerging sexual behavior, defined using latent class analysis, and young adult sexual and reproductive health were examined among 9,441 respondents to Waves 1 (1994-1995), 3 (2001-2002) and 4 (2008) of the National Longitudinal Study of Adolescent Health. Logistic regression analyses examined associations between class membership and young adult outcomes, and tested for interactions by race and ethnicity. RESULTS Compared with respondents who initiated vaginal sex first and reported other sexual behaviors within two years, those who initiated oral and vaginal sex during the same year had similar odds of having had an STD diagnosis ever or in the last year, of having had concurrent sexual partnerships in the last year and of having exchanged sex for money. However, respondents who postponed sexual activity had reduced odds of each outcome (odds ratios, 0.2-0.4); those who initiated vaginal sex and reported only one type of sexual behavior had reduced odds of reporting STD diagnoses and concurrent partnerships (0.4-0.6). Respondents who reported early initiation of sexual activity combined with anal sex experience during adolescence had elevated odds of having had concurrent partnerships (1.6). The data suggest racial and ethnic disparities even when patterns of emerging sexual behavior were the same. CONCLUSIONS Patterns of early sexual behavior considered high-risk may not predict poor sexual and reproductive health in young adulthood.
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Affiliation(s)
- Abigail A Haydon
- American Association for the Advancement of Science/ American Psychological Association, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA.
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Silva J, Ribeiro J, Sousa H, Cerqueira F, Teixeira AL, Baldaque I, Osório T, Medeiros R. Oncogenic HPV Types Infection in Adolescents and University Women from North Portugal: From Self-Sampling to Cancer Prevention. JOURNAL OF ONCOLOGY 2011; 2011:953469. [PMID: 22174713 PMCID: PMC3228361 DOI: 10.1155/2011/953469] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/05/2011] [Accepted: 10/13/2011] [Indexed: 01/07/2023]
Abstract
This study aimed to characterize the HPV infection status in adolescents and young university women in Portugal. The distribution of HPV genotypes was evaluated by PCR DNA genotyping after self-sampling collection from 435 women of exfoliated cervical cells using a commercial kit. We observed an overall frequency of HPV infection of 11.5%. Furthermore, HPV DNA prevalence was 16.6% in those young women that self-declared as sexually active. The more frequently detected HPV types were 31, 16, 53, and 61. Statistical analysis identified median age (OR = 3.56; P = 0.001), the number of lifetime sexual partners (OR = 4.50; P < 0.001), and years of sexual activity (OR = 2.36; P = 0.008) as risk factors for HPV acquisition. Hence, our study revealed that oncogenic HPV infection is common in young asymptomatic women Portuguese women, with a history of 2-5 sexual partners and over 2 year of sexual activity. Moreover, these results demonstrate that HPV detection performed in self-collected samples may be important to appraise better preventive strategies and to monitorize the influence of vaccination programmes within different populations.
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Affiliation(s)
- Jani Silva
- Molecular Oncology Group, Portuguese Institute of Oncology of Porto, Road Dr. António Bernardino Almeida, 4200-072 Porto, Portugal
- CEBIMED, Faculty of Health Sciences, Fernando Pessoa University, 4200-150 Porto, Portugal
| | - Joana Ribeiro
- Molecular Oncology Group, Portuguese Institute of Oncology of Porto, Road Dr. António Bernardino Almeida, 4200-072 Porto, Portugal
| | - Hugo Sousa
- Molecular Oncology Group, Portuguese Institute of Oncology of Porto, Road Dr. António Bernardino Almeida, 4200-072 Porto, Portugal
- Molecular Virology Laboratory of Virology Service, Portuguese Institute of Oncology of Porto, Road Dr. António Bernardino Almeida, 4200-072 Porto, Portugal
- ICBAS, Abel Salazar Institute for the Biomedical Sciences, University of Porto, 4099-003 Porto, Portugal
| | - Fátima Cerqueira
- CEBIMED, Faculty of Health Sciences, Fernando Pessoa University, 4200-150 Porto, Portugal
- CEQUIMED, Faculty of Pharmacy, University of Porto, 4050-047 Porto, Portugal
| | - Ana Luisa Teixeira
- Molecular Oncology Group, Portuguese Institute of Oncology of Porto, Road Dr. António Bernardino Almeida, 4200-072 Porto, Portugal
- Molecular Virology Laboratory of Virology Service, Portuguese Institute of Oncology of Porto, Road Dr. António Bernardino Almeida, 4200-072 Porto, Portugal
- ICBAS, Abel Salazar Institute for the Biomedical Sciences, University of Porto, 4099-003 Porto, Portugal
| | - Ines Baldaque
- Molecular Virology Laboratory of Virology Service, Portuguese Institute of Oncology of Porto, Road Dr. António Bernardino Almeida, 4200-072 Porto, Portugal
| | - Teresa Osório
- LPCC, Liga Portuguesa Contra O Cancro, Nucleo Regional do Norte, 4200-177 Porto, Portugal
| | - Rui Medeiros
- Molecular Oncology Group, Portuguese Institute of Oncology of Porto, Road Dr. António Bernardino Almeida, 4200-072 Porto, Portugal
- CEBIMED, Faculty of Health Sciences, Fernando Pessoa University, 4200-150 Porto, Portugal
- Molecular Virology Laboratory of Virology Service, Portuguese Institute of Oncology of Porto, Road Dr. António Bernardino Almeida, 4200-072 Porto, Portugal
- ICBAS, Abel Salazar Institute for the Biomedical Sciences, University of Porto, 4099-003 Porto, Portugal
- LPCC, Liga Portuguesa Contra O Cancro, Nucleo Regional do Norte, 4200-177 Porto, Portugal
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Unwanted unprotected sex: condom coercion by male partners and self-silencing of condom negotiation among adolescent girls. ANS Adv Nurs Sci 2011; 34:243-59. [PMID: 21822072 DOI: 10.1097/ans.0b013e31822723a3] [Citation(s) in RCA: 73] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
This exploratory study used the theory of reasoned action and the theory of gender and power to guide elicitation of partner-related impediments to condom use among 64 adolescent girls living in poor urban areas with high rates of HIV and partner abuse. About 53% indicated that they had experienced unwanted, unprotected vaginal sex and 25% indicated that they were unable to discuss condom use with a partner. Novel qualitative findings related to condom coercion, condom sabotage, and self-silencing of condom negotiation are discussed in the context of connecting partner abuse to interpersonal control over condom use. Implications for intervention design are discussed.
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Carter M, Henry-Moss D, Hock-Long L, Bergdall A, Andes K. Heterosexual anal sex experiences among Puerto Rican and black young adults. PERSPECTIVES ON SEXUAL AND REPRODUCTIVE HEALTH 2010; 42:267-274. [PMID: 21126303 DOI: 10.1363/4226710] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
CONTEXT Heterosexual anal sex is not uncommon in the United States, and it poses risk for STDs. However, who engages in it and why are not well understood, particularly among young adults. METHODS In 2006-2008, data on sexual health-related topics were collected in surveys (483 respondents) and qualitative interviews (70 participants) with black and Puerto Rican 18-25-year-olds in Hartford and Philadelphia. Bivariate and multivariate analyses of survey data assessed predictors of anal sex with the most recent serious heterosexual partner. Interview transcripts were analyzed for anal sex experiences and reasons for and against engaging in this behavior. RESULTS Some 34% of survey respondents had had anal sex; this behavior was more common with serious partners than with casual partners (22% vs. 8%). Black respondents were less likely than Puerto Ricans to report anal sex (odds ratio, 0.3); women were more likely to do so than were men (2.9). In the qualitative cohort, perceptions of anal sex as painful and unappealing were the predominant reasons for not having anal sex, whereas sexual pleasure and, in serious relationships, intimacy were the main reasons for engaging in it. Condom use during anal sex was rare and was motivated by STD or hygiene concerns. CONCLUSIONS Heterosexual anal sex is not an infrequent behavior and should be considered in a broad sexual health context, not simply as an indicator of STD risk. Health providers should address it openly and, when appropriate, as a positive sexual and emotional experience.
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Affiliation(s)
- Marion Carter
- Division of Reproductive Health, Centers for Disease Control and Prevention, Atlanta, USA.
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Reynolds GL, Fisher DG, Napper LE, Fremming BW, Jansen MA. Heterosexual anal sex reported by women receiving HIV prevention services in Los Angeles County. Womens Health Issues 2010; 20:414-9. [PMID: 21051000 DOI: 10.1016/j.whi.2010.07.006] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2009] [Revised: 07/20/2010] [Accepted: 07/20/2010] [Indexed: 10/18/2022]
Abstract
BACKGROUND This study examined reported heterosexual receptive anal intercourse (HRAI) in a sample of women recruited from HIV prevention providers in Los Angeles County. METHODS The majority of women surveyed were Latina and the modal age was 19 years. Women reporting HRAI were more likely to use both injected and non injected drugs and to have sexual partners who injected drugs. RESULTS Factors associated with HRAI in a multivariate regression model included use of methamphetamine; use of alcohol before, during, or after sex; and use of dental services at the interview agency. Factors inversely associated with heterosexual anal sex were being African American (compared with Latina) and endorsing the use of condoms for episodes of vaginal sex from start to finish. CONCLUSION HIV prevention providers in Los Angeles County should be aware of the need for basic prevention messages concerning condom use and injection behavior in young Latina women.
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Affiliation(s)
- Grace L Reynolds
- California State University, Long Beach, Center for Behavioral Research and Services, Long Beach, California 90813, USA.
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Buhi ER, Marhefka SL, Hoban MT. The State of the union: sexual health disparities in a national sample of US college students. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2010; 58:337-46. [PMID: 20159757 DOI: 10.1080/07448480903501780] [Citation(s) in RCA: 74] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
OBJECTIVE To examine sexual health disparities between blacks and whites in a national sample of US college students. PARTICIPANTS AND METHOD SUMMARY: Analyses utilized secondary data from 44,165 nonmarried undergraduates (aged 18-24; M = 20.1) responding to the Spring 2007 American College Health Association-National College Health Assessment; 64% were female and 94.7% were white. RESULTS Whites reported more experience in oral and anal sex, were less likely to use condoms for oral, anal, and vaginal sex, and less likely to have been tested for HIV (human immunodeficiency virus) compared with blacks. However, blacks reported more sex partners, lower use of hormonal contraceptives, and higher rates of adverse sexual health outcomes, such as sexually transmitted infections (STIs) and unintended pregnancy. Sexual behaviors and outcomes also varied across gender. CONCLUSIONS This study highlights a need to increase access to hormonal contraceptives and early STI screening/treatment among blacks, improve HIV testing among whites, and increase condom use promotion for all students.
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Affiliation(s)
- Eric R Buhi
- Department of Community and Family Health, College of Public Health, University of South Florida, Tampa, Florida 33612, USA.
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