Adolescent adjustment in a nationally collected sample: identifying group differences by adoption status, adoption subtype, developmental stage and gender

Transactional sex among adolescent girls and young women enrolled in a cash plus intervention in rural Tanzania: a mixed-methods study

INTRODUCTION

Transactional sex or material exchange for sex is associated with HIV infection among adolescent girls and young women in sub-Saharan Africa. The motivations for engaging in transactional sex vary from the fulfilment of basic needs, to enhancing social status or for romantic reasons with the expectation that men should provide. Transactional sex is also associated with HIV risk behaviours, such as multiple sexual partners and other determinants of HIV risk, including partner violence and abuse, alcohol consumption and inconsistent condom use.

METHODS

We use data from a mixed-method, cluster randomised controlled trial of the Ujana Salama cash "plus" intervention in rural Tanzania. The data are from the first and third rounds of data collection (2017-2019). The impact evaluation consisted of a parallel mixed-methods design where the quantitative and qualitative data collection occurred simultaneously, and integration of the findings was done during the discussion. We first examine contextual factors associated with transactional sex using multivariable logistic regression models and then estimate whether the "plus" intervention reduced transactional sex among adolescent girls and young women using analysis of covariance. We used thematic content analysis for analysing qualitative transcripts.

RESULTS

The prevalence of transactional sex among unmarried adolescent girls and young women at round 3 was 26%. Findings show that increasing age is a risk factor for transactional sex (OR = 1.80; 95% CI: [1.50, 2.17]), staying in school was negatively associated with engagement in transactional sex (OR = 0.24; 95% CI: [0.14, 0.40]). The cash plus intervention showed no impacts on reducing transactional sex (β = 0.003, p = 0.905).

CONCLUSIONS

The mechanisms of impact for a cash plus intervention on transactional sex are complex; economic insecurity is an important driver of transactional sex and HIV infection, but psychosocial factors and gendered social norms need consideration in intervention development. Our findings suggest that combination prevention interventions to address the structural drivers of HIV infection should focus on efforts to increase school enrolment and completion.

Relational uncertainty: Does parental perception of adopted children's academic success change over time?

While initial findings suggested that children who are adopted (adoptees) perform less well academically, this result is not consistent across the literature. To explain these, often conflicting, results, researchers acquired a lagging view, in which adoptees need to "catch up" to their non-adopted peers. According to the lagging view, those adopted at a younger age have less catching up to do than those adopted when they are older. However, the lagging view does not account for the period in which adoptees and their new families adjust to one another. A period that we refer to as relational uncertainty. This is particularly relevant as data on adoptees' academic performance is largely based on parent reports. The overarching goal of this study was to determine if parental perception of adoptees' academic achievement changed over time, after accounting for the impact of age of adoption. Using a nationally representative dataset, we found that after accounting for age of adoption the length of time that children resided in their adoptive homes predicted parental perception of academic performance. Specifically, after accounting for age of adoption, parental perception of adoptees' academic performance demonstrated early consistency followed by a significant decline. We also investigated if the relation, of those factors previously associated with parental perception of adoptees' academic performance, remained after variance was accounted for by both age of adoption and children's length of stay in their adoptive homes. Several previous factors (where the child lived pre-adoption and the socioeconomic status of their adoptive household) and child characteristics (sex and the first language the child learned to speak) demonstrated a continued association. Results indicate the need for a paradigm shift in how we view parent reports of adoptees' academic achievement, as well as the frequently reported factors surrounding adoptees' academic performance. The implications for how to support adoptees' academic achievement are discussed.

Adoptive and Nonadoptive Mother-Child Behavioral Interaction: A Comparative Study at 4 Years of Age

Comparable samples of low-risk adopted and nonadopted children and mothers were observed during 3 tasks at age 4 years. Quality of mother-child interactions, child level of functioning in 4 domains, and maternal parenting satisfaction and social support were assessed. Adopted children were as competent as nonadopted children on measures of developmental functioning. Both groups of mothers expressed high satisfaction and support as parents. However, ratings of child, maternal, and dyadic behavior when interacting were all lower for adoptive dyads than for nonadoptive dyads, and adoptive dyads with boys accounted for the maternal and dyadic group differences.

Adoption status and family relationships during the transition to young adulthood

Although adoptive family research has increased, most has focused on childhood and adolescence. Despite the known importance of parent-adolescent relationships drawn from the general population, we know little about how adoptive family relationships change or remain the same as adopted adolescents enter young adulthood. Using the Sibling Interaction and Behavior Study, the purpose of this study was to build on previous research to explore differences in conflict, closeness, and relationship quality between adoptive and nonadoptive families during the transition from late adolescence into young adulthood. Self-report and independent observations were collected from children, mothers, and fathers at late adolescence (range: 14.50-18.49 years) and young adulthood (range:18.50-22.49 years), and analyzed using within-subjects repeated measures. Although adoptive family dyads had lower relationship indicators than nonadoptive family dyads, similar trends over time occurred for both family types. Using individuation theory, we suggest individuation occurs for both types of families, with adoptees facing unique additional challenges during this process, including integration of adoption status, adoption communicativeness, adoption information seeking, and relationship with birth parents as possible influences in this process.

Conduct Problems in Adopted and Non-adopted Adolescents and Adoption Satisfaction as a Protective Factor

The present study compared the level of conduct problems at age 17 in a large, non-clinical sample of adopted participants placed in infancy and children in non-adoptive families matched to the adoptive families on demographic characteristics. Higher levels of adolescent and parent adoption satisfaction were associated with lower levels of conduct problems. Gender by adoption status interactions were not significant. However, female adopted participants had higher levels of conduct problems than female non-adopted participants, whereas male adopted and non-adopted participants had similar levels of conduct problems. In the overall sample, differences between adopted and matched control participants on all conduct problem measures were nonsignificant.