Alcohol Use Problems and Sexual Risk Among Young Adult African American Mothers

Ten years later: Satisfaction with intimate relationships and parenthood of young people aging out of residential care

BACKGROUND

Care leavers, young people who have aged out of residential or foster care, experience many challenges during their transition to adulthood. However, there is relatively little research on care leavers' intimate relationships. Their parenthood has been explored to a greater extent, but mostly qualitatively.

OBJECTIVE

This study focused on Israeli care leavers a decade after leaving care and explored various factors associated with satisfaction with both intimate relationships and parenthood.

METHODS

One-hundred-and-fifty-two young people participated in the study ten years after leaving care. Toward the end of their 20s, 74.3% were either married or had stable intimate relationships, and 40.1% were parents. To assess satisfaction with intimate relationships and parenthood, two hierarchical regressions were conducted that examined the cumulative contribution of background factors (care variables and traumatic life events), personal characteristics (self-esteem, mental distress, and alcohol use) and social support.

RESULTS

Satisfaction with intimate relationships was associated with higher income, fewer traumatic life events, and higher self-esteem. Gender moderated the association of traumatic life events with satisfaction with intimate relationships. Satisfaction with parenthood was associated with fewer traumatic events throughout care leavers' lives; it was also associated with lower levels of mental distress and alcohol use and with higher levels of satisfaction with intimate relationships. Gender moderated the association of mental distress with satisfaction with parenthood.

CONCLUSIONS

Ten years after leaving care, care leavers' backgrounds (i.e., their traumatic life events) were strongly associated with their situation as adults. Other risk factors such as alcohol use and mental distress were especially relevant to care leavers' satisfaction as parents, demanding longitudinal interventions. Further exploration of the role of gender in satisfaction with intimate relationships and parenthood is needed.

Developmental Changes in Sexual Risk and Substance Use Among African American Females: an Integrated Data Analysis Approach Using Time-varying Effect Models

The aim of this study was to describe age-related changes in sexual risk and substance use using existing data from three HIV/sexually transmitted infection (STI) prevention trials conducted in Atlanta, Georgia, that enrolled young African American women. We used two novel analysis methods: integrative data analysis (IDA) and time-varying effect models (TVEM). Each trial collected self-reported behavioral data and vaginal swab specimens assayed for chlamydia, gonorrhea, and trichomonas. Baseline data from all participants and follow-up data from participants not randomized to an active intervention arm were integrated in a pooled dataset using an IDA approach. The pooled dataset included observations for 1974 individuals, aged 14-25 years for behavioral outcomes and 16-25 years for STI outcomes. We used TVEM to model age-related changes in sexual risk and substance use behaviors and STI acquisition, adjusting for trial as a fixed effect. Coital frequency and condomless sex increased through the early 20s while multiple partnerships remained fairly steady. Alcohol use and cigarette smoking increased through about age 24 years before declining. Marijuana use peaked at age 16-17 years and thereafter generally declined. STI acquisition was highest at age 16 years. This study demonstrates the feasibility and utility of innovative methodological techniques to address novel questions related to adolescent development using existing data from multiple trials. The results suggest that mid-adolescence and the early 20s may be periods of particular risk. The findings may be useful for timing culturally and developmentally relevant prevention interventions for young African American women.

Dating Violence in Adolescence: Implications for Girls' Sexual Health

Adolescents in the United States are too often involved in relationships characterized by coercion and violence. An emerging body of research suggests that dating violence is linked with other health risks in adolescent relationships, particularly sexual risk behavior. The confluence of risks conferred by dating violence and sexual risk behavior are particularly acute for adolescent girls. Adolescent gynecology providers need to understand the nature of dating violence in adolescence and the ways in which dating violence and sexual risk behavior are mutually influential. This article reviews the literature on the links between dating violence and sexual risk in adolescent girls' relationships. The prevalence, risk factors, and consequences of dating violence in adolescence are discussed, followed by a review of the research linking dating violence and sexual risk, with a focus on common mechanisms underlying these relationship risk behaviors. The review concludes with implications for screening, prevention, intervention, and future directions for research.

Age-related associations between substance use and sexual risk behavior among high-risk young African American women in the South

BACKGROUND

We assessed age-related associations between substance use and sexual risk behavior using data from three HIV prevention trials that enrolled young African American women.

METHODS

We used integrative data analysis to pool data from 1862 individuals aged 16-25 years. We used time-varying effect models to examine associations between substance use (alcoholic drinks per month, recent marijuana use, cigarettes smoked per day) and sexual risk behaviors (monthly frequency of vaginal sex, multiple sex partners, condomless sex), adjusting for the fixed effect of trial.

RESULTS

In models that included all three substances, cigarette smoking was not associated with any outcome. Alcohol quantity was associated with greater frequency of sex at all ages, an increased likelihood of having multiple sex partners from about age 17-24 years, and an increased likelihood of condomless sex after about age 18.5 years. Associations between alcohol quantity and sex frequency were relatively stable; associations with having multiple sex partners and condomless sex increased beginning at about age 22 years. Marijuana use was associated with greater sex frequency at approximate ages 16.5-24 years and an increased likelihood of having multiple sex partners at ages 18-24 years. Associations with sex frequency were relatively stable; associations with having multiple sex partners increased from about age 18 and peaked at about age 23 years.

CONCLUSIONS

We observed developmentally-dependent relationships between both alcohol and marijuana and sexual risk behavior. The findings underscore the need to address substance-related sexual risk among young African American women and may inform optimal timing of intervention.

Contributing factors of teenage pregnancy among African-American females living in economically disadvantaged communities

AIM

To identify contributing factors that increased the risk of pregnancy among African-American adolescent females living in economically disadvantaged communities and to evaluate the current pregnancy prevention programs addressing these factors in order to provide suggestions for the development of tailored pregnancy prevention programs for this target population.

BACKGROUND

Pregnancy rates among adolescents in the United States have declined over the past several years. Despite this trend, the pregnancy rate for African-American adolescent females is disproportionately higher than the adolescent pregnancy rates for other ethnicities. Limited attempts have been made to compile and synthesize the factors that increase risk of pregnancy in this population or to evaluate the effectiveness of intervention programs for African-American females that incorporate these risk factors.

METHOD

An integrative literature review was conducted to identify the major contributing factors of pregnancy among African American adolescents living in economically disadvantaged areas.

RESULTS

Of the identified contributing risk factors for early pregnancy among African-American adolescent females, the five most supported risk factors were: parental influence, peer influence, social messages, substance use including alcohol, and pregnancy desire. Twelve pregnancy prevention programs were identified that addressed one or more of the five contributing factors to pregnancy. Parental influence and social messages were the most addressed factors among these programs.

CONCLUSIONS

This review found five contributing factors related to teenage pregnancy; however, current intervention programs are not well addressed substance use as a component of alcohol use. Thus, development of a tailored pregnancy prevention program incorporating those factors will help decrease the high pregnancy rate among this target population.