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Bhochhibhoya S, Edison B, Baumler ER, Markham CM, Emery ST, Peskin MF, Shegog R, Addy RC, Temple JR, Reidy DE. Abstinence beliefs in early adolescence and sexual risk behavior two years later. J Adolesc 2024. [PMID: 38922710 DOI: 10.1002/jad.12365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 05/29/2024] [Accepted: 06/06/2024] [Indexed: 06/28/2024]
Abstract
INTRODUCTION The United States has the highest teen pregnancy rate and sexually transmitted infection rates among developed countries. One common approach that has been implemented to reduce these rates is abstinence-only-until-marriage programs that advocate for delaying sexual intercourse until marriage. These programs focus on changing adolescents' beliefs toward abstinence until marriage; however, it is unclear whether adolescents' beliefs about abstinence predict their sexual behavior, including sexual risk behavior (SRB). An alternative approach may be encouraging youth to delay their sexual debut until they reach the age of maturity, but not necessarily until marriage. METHODS To address this question, we compare the longitudinal association between abstinence beliefs (i.e., abstaining completely until marriage) and beliefs about delayed sexual debut with subsequent SRB 24 months later. The harmonized data set included 4620 (58.2% female, Mage = 13.0, SDage = 0.93) participants from three randomized controlled trials attending 44 schools in the southern United States. Negative binomial regressions were employed to examine the association of abstinence until marriage beliefs and beliefs regarding delaying sex with SRB. RESULTS We identified that beliefs supporting delaying sex until an age of maturity were associated with lower odds of engaging in SRB, such as having multiple sex partners and frequency of condomless sex, for both sexes. However, stronger abstinence beliefs had no significant associations with all SRB outcomes. CONCLUSIONS Findings suggest prevention programming that focuses on encouraging youth to delay sex until an appropriate age of maturity may be more effective at preventing SRB and consequent negative sexual health outcomes.
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Affiliation(s)
- Shristi Bhochhibhoya
- Department of Health, Human Performance & Recreation, University of Arkansas, Fayetteville, North Carolina, USA
| | - Briana Edison
- School of Public Health & Center for Research on Interpersonal Violence Georgia State University, Atlanta, Georgia, USA
| | - Elizabeth R Baumler
- School of Behavioral Health Sciences, University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Christine M Markham
- School of Public Health, University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Susan T Emery
- School of Public Health, University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Melissa F Peskin
- School of Public Health, University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Ross Shegog
- School of Public Health, University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Robert C Addy
- School of Public Health, University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Jeff R Temple
- School of Behavioral Health Sciences, University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Dennis E Reidy
- School of Public Health & Center for Research on Interpersonal Violence Georgia State University, Atlanta, Georgia, USA
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Gaines TL, Werb D, Harris O. Young, Black/African American, and Latino communities are left behind despite legislative efforts in California to reduce HIV/STI disparities. FRONTIERS IN REPRODUCTIVE HEALTH 2023; 5:1179334. [PMID: 37779638 PMCID: PMC10538965 DOI: 10.3389/frph.2023.1179334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Accepted: 08/24/2023] [Indexed: 10/03/2023] Open
Abstract
Objectives Sexually transmitted infections (STI) have been on the rise in the United States with racial/ethnic minority groups, gay and bisexual men, and youth experiencing the highest STI and HIV infection rates. In 2022, California became the first state in the nation to pass legislation, Senate Bill 306 (SB 306), requiring health care plans to cover the costs of home test kits for STIs, including HIV. This study examines provisions within SB 306 and its potential to reduce STI and HIV disparities among key demographic groups and geographic regions within California. Study design Ecological cross-sectional study involving 58 California counties. Methods Descriptive statistics and choropleth maps compared HIV/STI prevalence rates, uninsured rates, demographic composition, and healthcare provider coverage across California counties. Three geographically weighted Poisson regression analyses were conducted to separately examine the association between proportion of uninsured and HIV, gonorrhea, and chlamydia prevalence rates. Results HIV/STI rates were significantly and positively associated with the proportion of uninsured residents in Central and Southern California counties. These counties had a higher proportion of demographic groups vulnerable to HIV/STI including a large Latino, Black/African American, and younger (age 15-24) population but had a lower rate of healthcare providers with prescription authority for home testing kits, which is a requirement under SB 306. Conclusions Cutting-edge solutions are needed to stem the rising tide of new STI and HIV infections. While SB 306 is novel and innovative in intent, its coverage gaps will increase disparities and inequities among historically underserved populations.
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Affiliation(s)
- Tommi L. Gaines
- Department of Medicine, University of California San Diego, La Jolla, CA, United States
| | - Dan Werb
- Department of Medicine, University of California San Diego, La Jolla, CA, United States
- Centre on Drug Policy Evaluation, MAP Centre on Urban Health Solutions, St. Michael’s Hospital, Toronto, ON, Canada
| | - Orlando Harris
- Department of Community Health Systems, School of Nursing, University of California, San Francisco, San Francisco, CA, United States
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Manzer JL, Berndt VK, Bell AV. Intersections between culture, contraception, knowledge and the body in the USA. CULTURE, HEALTH & SEXUALITY 2023; 25:1164-1179. [PMID: 36327491 DOI: 10.1080/13691058.2022.2141330] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Accepted: 10/25/2022] [Indexed: 06/16/2023]
Abstract
Women's contraceptive use is a central feature of US culture around reproduction as evinced by high usage rates and nationwide public health efforts to further increase its use. Paradoxically, women know little about contraception within its biomedical framing, and successive public health-related educational campaigns have produced only moderate knowledge gains. Drawing on 86 in-depth interviews with a diverse sample of reproductive-age women, we set out to understand this persistent learning lag. In doing so, we found that women's limited contraceptive knowledge extended beyond simply being uneducated about various methods. Rather, these learning lags can be attributed to many women's lack of knowledge or misunderstandings about their anatomical bodies and reproductive processes. Employing feminist perspectives, we argue that these misunderstandings derive from factors beyond individual women's control. Indeed, they are rooted in cultural norms that stifle and stigmatise women's reproductive learning. Traditional public health efforts may inevitably fail to overcome these cultural barriers, perpetuating women's gaps in knowledge. Recognising the cultural dimensions of contraceptive knowledge and education reveals how critical action is needed around sexuality education in the USA as well as the limitations of on-going educational efforts.
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Lieberman LD, Goldfarb ES. Sex Ed in the Post- Roe World: Implications for Public Health Education. HEALTH EDUCATION & BEHAVIOR 2022; 49:919-923. [PMID: 36172998 DOI: 10.1177/10901981221125429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The overturning of Roe v. Wade and the increasing assaults on lesbian, gay, bisexual, transgender, queer (LGBTQ+) rights in legislatures across the country have put our sexual and reproductive health in peril. They are likely also bellwethers of more to come. While a full reckoning of the repercussions from these attacks will not be known for a long time, the field of public health must act now with a strong and cohesive plan to mitigate the harms, fight these threats to our well-being, and lead the way forward.
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Bergam S, Kuo C, Atujuna M, Pellowski JA, Mtukushe B, Ndevu-Qwabe N, Matiwane M, Rencken CA, Belsky M, Hoare J, Bekker LG, Harrison AD. “We Should Be Taught Self-Respect, Self-Confidence and Self-Love”: Youth Perspectives of Adult Influences on Their Sexuality and Relationships Among South African Adolescents Living With HIV. FRONTIERS IN REPRODUCTIVE HEALTH 2022; 4:913170. [PMID: 36303635 PMCID: PMC9580667 DOI: 10.3389/frph.2022.913170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 06/23/2022] [Indexed: 11/29/2022] Open
Abstract
Introduction Of the 1.75 million adolescents aged 10–19 years living with HIV globally, 84% reside in sub-Saharan Africa. This problem is most acute in South Africa, where there are 720,000 adolescents living with HIV (ALHIV). ALHIV navigate the same challenges as other adolescents—such as puberty and first relationships—as well as challenges specific to their HIV-status—including stigma, disclosure, and concerns about HIV transmission. This dual burden calls for tailored sexual and reproductive health (SRH) programs. Here, we qualitatively explore the reflections of South African ALHIV on SRH education, communication, and discussion provided by adults in schools, clinics, and the home related to their unique SRH needs. Methods This paper reports on qualitative data from a mixed-methods study to inform interventions that meet the SRH needs of ALHIV. In-depth interviews (N = 20) were conducted with ALHIV recruited from two clinics in Cape Town, South Africa. Nine males and 11 females aged 16–19 participated in semi-structured in-depth interviews to discuss their sexual health as ALHIV. The interview guide explored 1) perceived SRH needs; 2) healthy living with HIV; 3) future goals; 4) intimate relationships; 5) psychosocial challenges; and 6) preferred interventions. Data were thematically applied to an iteratively-developed codebook and analyzed by the cross-cultural research team using NVivo 12. Results These qualitative data reveal the pressing needs among ALHIV for open communication and accurate information about sexuality and HIV, given the risk to themselves and their partners as they enter intimate relationships. Three themes emerged from the data: 1) Intergenerational pressures coming from caregivers, clinicians, and teachers often stigmatize the sexual heath behaviors of ALHIV; 2) When present, open intergenerational communication can provide ALHIV with crucial information, resources, and social support that supports healthy decisions, and 3) ALHIV offer specific ideas about how adults can support their decision-making in the transition to adulthood. Conclusions Findings highlight adolescents' recommendations for programs involving open communication, stigma-reduction around sexuality, and support from both peer and adult mentors. This study lays the foundation for strategies to improve intergenerational communication about sexual health to promote positive approaches to sexuality for ALHIV.
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Affiliation(s)
- Scarlett Bergam
- Brown University School of Public Health, Providence, RI, United States
| | - Caroline Kuo
- Brown University School of Public Health, Providence, RI, United States
| | | | | | - Bulelwa Mtukushe
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | | | - Mluleki Matiwane
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | | | - Mikaela Belsky
- Department of Health and Human Biology, Brown University, Providence, RI, United States
| | - Jacqueline Hoare
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Linda-Gail Bekker
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Abigail D. Harrison
- Brown University School of Public Health, Providence, RI, United States
- *Correspondence: Abigail D. Harrison
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Fahs B. ‘I just tell myself it’s okay’: U.S. women’s narratives about sexual safety and how they assess risk for sexually-transmitted infections. PSYCHOLOGY & SEXUALITY 2022. [DOI: 10.1080/19419899.2021.1871775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Breanne Fahs
- Women and Gender Studies Program, Arizona State University, Glendale, AZ, USA
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Diamond LM, Alley J. Rethinking minority stress: A social safety perspective on the health effects of stigma in sexually-diverse and gender-diverse populations. Neurosci Biobehav Rev 2022; 138:104720. [PMID: 35662651 DOI: 10.1016/j.neubiorev.2022.104720] [Citation(s) in RCA: 70] [Impact Index Per Article: 35.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 04/25/2022] [Accepted: 05/30/2022] [Indexed: 12/13/2022]
Abstract
For over two decades, the minority stress model has guided research on the health of sexually-diverse individuals (those who are not exclusively heterosexual) and gender-diverse individuals (those whose gender identity/expression differs from their birth-assigned sex/gender). According to this model, the cumulative stress caused by stigma and social marginalization fosters stress-related health problems. Yet studies linking minority stress to physical health outcomes have yielded mixed results, suggesting that something is missing from our understanding of stigma and health. Social safety may be the missing piece. Social safety refers to reliable social connection, inclusion, and protection, which are core human needs that are imperiled by stigma. The absence of social safety is just as health-consequential for stigmatized individuals as the presence of minority stress, because the chronic threat-vigilance fostered by insufficient safety has negative long-term effects on cognitive, emotional, and immunological functioning, even when exposure to minority stress is low. We argue that insufficient social safety is a primary cause of stigma-related health disparities and a key target for intervention.
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Affiliation(s)
- Lisa M Diamond
- Department of Psychology, University of Utah, Salt Lake City, UT, USA.
| | - Jenna Alley
- Department of Psychology, University of Utah, Salt Lake City, UT, USA
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Tabaac AR, Johns MM, Zubizarreta D, Haneuse S, Tan AS, Austin SB, Potter J, Lindberg L, Charlton BM. Associations between sexual orientation, sex education curriculum, and exposure to affirming/disaffirming LGB content in two US-based cohorts of adolescents. SEX EDUCATION 2022; 23:506-523. [PMID: 37771517 PMCID: PMC10530727 DOI: 10.1080/14681811.2022.2072286] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/11/2021] [Accepted: 04/27/2022] [Indexed: 09/30/2023]
Abstract
Sexual health education experienced by lesbian, gay, and bisexual (LGB) youth varies widely in relevancy and representation. However, associations among sexual orientation, type of sex education, and exposure to affirming or disaffirming content have yet to be examined. Understanding these patterns can help to address gaps in LGB-sensitive sex education. Our goal in this study was to examine the prevalence and associations among abstinence-only until marriage (AOUM) and comprehensive sex education with LGB-affirming and -disaffirming content sought/received before age 18 (from 1999-2014) by sexual orientation (completely heterosexual with same-sex contact, completely heterosexual with no same-sex contact, mostly heterosexual, bisexual, gay/lesbian) in a sample of 12,876 US young adults from the Growing Up Today Study. Compared to completely heterosexual referents, LGB participants who received AOUM sex education were more likely to encounter LGB-disaffirming content, and this effect was largest among sexual minority participants. Conversely, exposure to comprehensive sex education was associated with receipt of LGB-affirming information. Overall, participants commonly reported receiving AOUM sex education, which may lead to deficits and potential harm to sexual minorities.
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Affiliation(s)
- Ariella R. Tabaac
- Division of Adolescent/Young Adult Medicine, Boston Children’s Hospital, Boston, MA, USA
- Department of Pediatrics, Harvard Medical School, Boston, MA, USA
| | - Michelle M. Johns
- Division of Adolescent and School Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Dougie Zubizarreta
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Sebastien Haneuse
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Andy S.L. Tan
- Annenberg School for Communication, University of Pennsylvania, Philadelphia, PA, USA
| | - S. Bryn Austin
- Division of Adolescent/Young Adult Medicine, Boston Children’s Hospital, Boston, MA, USA
- Department of Pediatrics, Harvard Medical School, Boston, MA, USA
- Department of Social and Behavioral Sciences, Harvard TH Chan School of Public Health, Boston, MA, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital, Boston, MA, USA
| | - Jennifer Potter
- Beth Israel Deaconess Medical Center, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
- Fenway Institute, Boston, MA, USA
| | | | - Brittany M. Charlton
- Division of Adolescent/Young Adult Medicine, Boston Children’s Hospital, Boston, MA, USA
- Department of Pediatrics, Harvard Medical School, Boston, MA, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital, Boston, MA, USA
- Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Healthcare Institute, Boston, MA, USA
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Mata D, Korpak AK, Sorensen B, Dodge B, Mustanski B, Feinstein BA. A mixed methods study of sexuality education experiences and preferences among bisexual, pansexual, and queer (bi+) male youth. SEXUALITY RESEARCH & SOCIAL POLICY : JOURNAL OF NSRC : SR & SP 2022; 19:806-821. [PMID: 35756362 PMCID: PMC9230504 DOI: 10.1007/s13178-021-00593-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/16/2021] [Indexed: 06/03/2023]
Abstract
Introduction Bisexual male youth are more likely to engage in certain behaviors that contribute to HIV/STI transmission (e.g., substance use) than are heterosexual and gay male youth. However, sexuality education rarely addresses the unique needs of sexual minority youth, especially bisexual, pansexual, and queer (bi+) youth, and little is known about their sexuality education experiences and preferences. As such, the goal of this study was to examine bi+ male youth's experiences learning about sex and their preferences for sexuality education. Methods In 2019, 56 bi+ male youth ages 14-17 were surveyed and interviewed about their sexuality education experiences and preferences. Participants identified as bisexual (64%), pansexual (27%), and queer (9%), were racially/ethnically diverse (39% white, 32% Latinx, 20% Black, 9% other races), and included cisgender (79%) and transgender (21%) male youth. Results Participants described varied experiences with school-based sexuality education (e.g., none, abstinence only, covered sexual health in some way), but it rarely addressed their unique needs. They typically learned about sex by searching for information online and from sexually explicit media. Participants identified several topics they wanted to learn more about (e.g., sex with same-gender partners, anal sex, consent), but they typically believed they were prepared to have sex. Finally, some participants described benefits of tailoring sexuality education to their unique needs, while others described benefits of more inclusive programs. Conclusions and Policy Implications Findings suggest that bi+ male youth do not receive adequate sexuality education to make informed decisions about safer sex, highlighting the critical need for reform.
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Affiliation(s)
- David Mata
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University
| | - Aaron K. Korpak
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University
- Feinberg School of Medicine, Northwestern University
| | | | - Brian Dodge
- Center for Sexual Health Promotion, Indiana University Bloomington
| | - Brian Mustanski
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University
- Feinberg School of Medicine, Northwestern University
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Burns PA, Teng F, Omondi AA, Burton ET, Ward L. Sex Education and Sexual Risk Behavior among Adolescents and Youth in the Deep South: Implications for Youth HIV Prevention. South Med J 2022; 115:310-314. [PMID: 35504611 DOI: 10.14423/smj.0000000000001391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVES Adolescents and young adults represent the largest group of new human immunodeficiency virus (HIV) infections in the United States, especially in the South. We wanted to determine whether abstinence only until marriage (AOUM) sex education programs were effective in reducing HIV vulnerability among youth in Mississippi. METHODS Using the 2015 Mississippi Youth Risk Behavior Surveillance System, we examined the effect of AOUM sex education among a sample of youth ages 12 to 18 years on 4 HIV-related sexual risk behaviors. RESULTS Compared with youth not enrolled in AOUM sex education, we found no statistically significant differences on sexual risk behaviors. Race, age, and gender were significant risk factors in predicting sexual risk behavior. CONCLUSIONS AOUM sex education programs are ineffective in reducing HIV vulnerability among youth in Mississippi. There is an urgent need to implement comprehensive sex education if we are to reduce the numbers of new HIV infections among youth and achieve our goals of ending the HIV epidemic by 2030.
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Affiliation(s)
- Paul A Burns
- From the John D. Bower School of Population Health, University of Mississippi Medical Center, Jackson, and the University of Tennessee Medical Center, Le Bonheur Children's Hospital, Memphis
| | - Fei Teng
- From the John D. Bower School of Population Health, University of Mississippi Medical Center, Jackson, and the University of Tennessee Medical Center, Le Bonheur Children's Hospital, Memphis
| | - Angela A Omondi
- From the John D. Bower School of Population Health, University of Mississippi Medical Center, Jackson, and the University of Tennessee Medical Center, Le Bonheur Children's Hospital, Memphis
| | - E Thomaseo Burton
- From the John D. Bower School of Population Health, University of Mississippi Medical Center, Jackson, and the University of Tennessee Medical Center, Le Bonheur Children's Hospital, Memphis
| | - Lori Ward
- From the John D. Bower School of Population Health, University of Mississippi Medical Center, Jackson, and the University of Tennessee Medical Center, Le Bonheur Children's Hospital, Memphis
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Kirubarajan A, Li X, Yau M, Yu C, Got T, Li Q, Huszti E, Leung S, Thangavelu N, Sobel M. Awareness, knowledge, and misconceptions of adolescents and young people regarding long-acting reversible contraceptives: a systematic review and meta-analysis. Fertil Steril 2022; 118:168-179. [DOI: 10.1016/j.fertnstert.2022.03.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Revised: 03/21/2022] [Accepted: 03/22/2022] [Indexed: 11/04/2022]
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Conley TD, Klein V. Women Get Worse Sex: A Confound in the Explanation of Gender Differences in Sexuality. PERSPECTIVES ON PSYCHOLOGICAL SCIENCE 2022; 17:960-978. [PMID: 35171743 DOI: 10.1177/17456916211041598] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Gender differences in sexuality have gained considerable attention both within and outside of the scientific community. We argue that one of the main unacknowledged reasons for these differences is simply that women experience substantially worse sex than men do. Thus, in examinations of the etiology of gender differences in sexuality, a confound has largely been unacknowledged: Women and men are treated to different experiences of what is called "sexuality" and "having sex." We discuss four arenas in which women's experience of sexuality may often be worse than men's: (a) anatomical differences, (b) sexual violence, (c) stigma, and (d) masculine cultures of sexuality. Then we consider how each disparity might explain well-known gender differences in sexuality.
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Affiliation(s)
| | - Verena Klein
- Department of Psychology, University of Michigan
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Asante KO, Nketiah-Amponsah E, Andoh-Arthur J, Ampaw S. The interactive effect of gender, residence, and socioeconomic status on early sexual debut among sexually active young adults in Ghana. J Public Health (Oxf) 2022. [DOI: 10.1007/s10389-020-01285-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
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Williams A, Reid R, Bayer CR. Whose Line Is It Anyway?: Dismantling the Foundations of Rape Culture. ARCHIVES OF SEXUAL BEHAVIOR 2022; 51:707-708. [PMID: 35132486 DOI: 10.1007/s10508-022-02294-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/08/2021] [Revised: 01/11/2022] [Accepted: 01/12/2022] [Indexed: 06/14/2023]
Affiliation(s)
- Alexandria Williams
- Department of Medical Education, Morehouse School of Medicine, 720 Westview Dr SW, Atlanta, GA, 30310, USA.
| | - Rachel Reid
- Department of Medical Education, Morehouse School of Medicine, 720 Westview Dr SW, Atlanta, GA, 30310, USA
| | - Carey Roth Bayer
- Departments of Community Health and Preventive Medicine/Medical Education, Morehouse School of Medicine, Atlanta, GA, USA
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Usonwu I, Ahmad R, Curtis-Tyler K. Parent-adolescent communication on adolescent sexual and reproductive health in sub-Saharan Africa: a qualitative review and thematic synthesis. Reprod Health 2021; 18:202. [PMID: 34629082 PMCID: PMC8504018 DOI: 10.1186/s12978-021-01246-0] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Accepted: 09/22/2021] [Indexed: 11/10/2022] Open
Abstract
Background Improving adolescent sexual and reproductive health continues to be a global public health need. Effective parent–adolescent communication on sexual health issues has been cited as a factor that could influence adolescents towards adopting safer sexual behaviour. The current review synthesises qualitative literature to understand the nature and relevance of parent–adolescent sexual and reproductive health communication and the barriers to effective communication in sub-Saharan Africa. Methods We systematically searched and synthesised qualitative literature published between 1st January 1990 to December 2019 and searched from CINAHL, PsycINFO, MEDLINE, Global Health, EMBASE, PubMed, and Google Scholar. We assessed the methodological quality of included studies using the Critical Appraisal Skills Programme (CASP) checklist. We thematically analysed qualitative data from the included primary studies. Results Fifteen studies were included. Social and physiological events act as triggers for initiating discussions. Fear of personal, social, and economic consequences of high-risk sexual behaviours act as drivers for communication but also carry a negative framing which hinders open discussion. Lack of parental self-efficacy and cultural and religious norms create an uncomfortable environment leaving peers, media, teachers, and siblings as important and sometimes preferred sources of sexual health information. Conclusions While mothers recognise their own role in adolescent sexual and reproductive health and school-based interventions can act as useful prompts for initiating discussion, fathers are mainly absent from home-based dialogue. Fear dominates the narrative, and the needs of adolescents remain unarticulated. Supplementary Information The online version contains supplementary material available at 10.1186/s12978-021-01246-0. Improving adolescent sexual and reproductive health remains an important public health need globally. Effective communication on sexual health issues between adolescents and their parents has been recognised to influence safer sexual behaviour among adolescents. This review combined qualitative evidence to understand the nature of, and barriers to communication about sex between parents and adolescents in sub-Saharan Africa. We searched academic databases for relevant articles published between January 1990 and December 2019 and found 15 studies of appropriate quality. Data on parents and adolescents’ experiences of sex communication in these studies was synthesised. Drivers for sex communication including fear of personal and economic consequences were highlighted. Results also identified barriers to communication such as cultural and religious norms and lack of parental knowledge and skills. Findings showed that adolescents sometimes prefer other sources of sexual health information like peers, media, and siblings. Mothers are recognised to be more involved with home-based interactions on sexual health with adolescents compared to fathers. The results of this review point to the necessity for adolescents’ needs to be understood and articulated towards influencing policy and programmes. Adolescents in sub-Saharan Africa remain at high risk for sexually transmitted infections, female genital mutilation, and early pregnancy. Adolescents mostly view sex-related discussions with parents as uncomfortable, and interactions are driven by fear of personal, social, and economic consequences of sexual risk-taking behaviour. Parents recognise their lack of capacity to engage with adolescents and are influenced by cultural norms and religious beliefs. Future research needs to address the current imbalance of adult versus adolescent voices in published work and also ensure a creation of space for conversations about sexuality with sexual and gender minority youth in the Lesbian, Gay, Bi-sexual, Transgender, Queer, Intersex, and Asexual communities.
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Affiliation(s)
- Ijeoma Usonwu
- Nursing, City University of London School of Health Sciences, London, UK.
| | - Raheelah Ahmad
- Division of Health Services Research and Management, City University of London School of Health Sciences, London, UK
| | - Katherine Curtis-Tyler
- Division of Health Services Research and Management, City University of London School of Health Sciences, London, UK
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Franco Vega I, Eleftheriou A, Graham C. Using video games to improve the sexual health of young people aged 15-25 years: A rapid review (Preprint). JMIR Serious Games 2021; 10:e33207. [PMID: 35587873 PMCID: PMC9164099 DOI: 10.2196/33207] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Revised: 03/19/2022] [Accepted: 04/07/2022] [Indexed: 11/24/2022] Open
Abstract
Background Sexually transmitted infections and unintended pregnancies among young people remain public health concerns in many countries. To date, interventions that address these concerns have had limited success. Serious games are increasingly being used as educational tools in health and professional public education. Although acknowledged as having great potential, few studies have evaluated the use of serious games in sexual health education among young people, and to date, there have been no published reviews of these studies. Objective This study aims to assess the effects of video game–based sexual health interventions for risky sexual behavior in young people aged between 15 and 25 years. Methods A rapid review of randomized controlled trials and quasi–randomized controlled trials was performed. The search included the following bibliographic databases: Cochrane Central Register of Controlled Trials, Embase, MEDLINE, PsycINFO, and Scopus. A total of 2 reviewers independently screened 50% (35/70) of the retrieved articles during the full-text screening phase. Results From a total of 459 identified citations, after removing duplicates, 327 (71.2%) articles were deemed eligible for title and abstract screening. Of the 327 articles, 70 (21.4%) full texts were screened, from which 10 (3.1%) articles (evaluating 11 different games) were included in the review. The findings highlighted the considerable diversity in video game–based interventions and assessed sexual health outcomes. Although there were some promising findings in outcome studies using game-based interventions, the results across studies were mixed. Conclusions Although game interventions for sexual health have been in existence for almost three decades, relatively few studies have evaluated them, and the results of previous outcome studies have been mixed. Moreover, there is little clarity regarding which specific elements of a game facilitate positive outcomes. We provide recommendations for future researchers developing video game–based interventions to improve sexual health in young people.
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Affiliation(s)
- Ignacio Franco Vega
- Department of Social & Policy Sciences, University of Bath, Bath, United Kingdom
| | | | - Cynthia Graham
- Department of Psychology, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, United Kingdom
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17
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Atkins DN, Bradford WD. The Effect of State-Level Sex Education Policies on Youth Sexual Behaviors. ARCHIVES OF SEXUAL BEHAVIOR 2021; 50:2321-2333. [PMID: 33537882 DOI: 10.1007/s10508-020-01867-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/20/2018] [Revised: 10/12/2020] [Accepted: 10/13/2020] [Indexed: 06/12/2023]
Abstract
Two types of sex education are generally offered in the U.S. abstinence-only and comprehensive sex education. There is no clear scientific consensus over which approach minimizes the risk of unintended pregnancy and sexually transmitted diseases for youth. While there have been many studies of specific programs in clinical or quasi-experimental settings, there are very few evaluations of how state-level sex education policies affect the youth population. We estimate the impact of various state-level sex education policies on youth sexual activity and contraceptive use using data from four waves of the Youth Risk Behavior Surveillance System from 39 states. We found that states that require sexuality (sex and/or HIV/STD) education and contraceptive content or states that mandate education but leave the actual content up to local districts have lower rates of sexually active youth and higher rates of contraception use when youth are sexually active. States that require sexuality education and require abstinence content increase the rate at which youth are sexually active, and youth in those states are less likely to use hormonal birth control if they are sexually active. In conclusion, we found that state policies regarding sex and HIV/STD education had statistically significant effects that are meaningful in magnitude from a public health perspective.
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Affiliation(s)
- Danielle N Atkins
- Department of Health Management and Informatics, University of Central Florida, Orlando, FL, 32816, USA.
| | - W David Bradford
- Department of Public Administration and Policy, University of Georgia, Athens, GA, USA
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18
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Pasqualini M, Sacker A, McMunn A. Birth Order and First Sexual Experience: Do Siblings Influence Sexual Debut in Adolescents? ARCHIVES OF SEXUAL BEHAVIOR 2021; 50:2395-2409. [PMID: 34417640 PMCID: PMC8416888 DOI: 10.1007/s10508-021-01979-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 02/01/2021] [Accepted: 02/08/2021] [Indexed: 06/13/2023]
Abstract
Birth order may foster specific roles for individuals within the family and set in train a dynamic that influences the development of specific behaviors. In this paper, we explored the relationship between birth order, sex, timing of sexual initiation, and its consequences for risky sexual behavior and sexual health. We conducted a path analysis to simultaneously estimate direct and indirect effects using data from the National Survey of Sexual Attitudes and Lifestyles (NATSAL-3). Whereas women born as only-children were more likely to sexually debut at later ages, middle-child boys were significantly more prone to initiate sexual intercourse earlier compared with first-borns. As expected, early sexual initiation was associated with riskier behaviors and sexual health outcomes. These associations were partially moderated by siblings role as confidants about sexuality. Our findings have implications for preventive programs aimed at promoting healthy sexual debuts and behaviors over the life span.
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Affiliation(s)
- Marta Pasqualini
- Observatoire Sociologique du Changement, Sciences Po, 75007, Paris, France
| | - Amanda Sacker
- Department of Epidemiology and Public Health, University College of London, London, UK
| | - Anne McMunn
- Department of Epidemiology and Public Health, University College of London, London, UK.
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19
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Philbin MM, Wang X, Feaster DJ, LaBossier NJ, Phillips G. LGB-Affirming School Climates and Sexual Health Outcomes Among U.S. High School Students 2015-2017: Differences by Sex and Sexual Identity. J Adolesc Health 2021; 68:1121-1128. [PMID: 33419621 PMCID: PMC8686698 DOI: 10.1016/j.jadohealth.2020.11.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 11/05/2020] [Accepted: 11/05/2020] [Indexed: 12/28/2022]
Abstract
PURPOSE Lesbian, gay, and bisexual (LGB) adolescents face disparities in sexual health outcomes compared to their heterosexual peers, which has implications for health outcomes and developmental trajectories. We examined whether adolescents living in jurisdictions with school climates that were more exclusionary toward LGB individuals engaged in higher risk sexual behaviors than those in jurisdictions with more inclusive school climates. METHODS Data on sexual identity, age at first sex, condom use at last sex and the number of lifetime partners came from the 2015 (20 jurisdictions) and 2017 (19 jurisdictions) Youth Risk Behavior Surveillance Surveys. Data on LGB climates in schools, aggregated to the state level, came from the School Health Profile Survey of the Centers for Disease Control and Prevention. Multilevel multivariable regressions examined the association between LGB school climate and sexual behaviors, including effect modification. RESULTS Overall, living in jurisdictions with more exclusionary LGB school climates was significantly associated with a lower age at first sex (β = -.04[-.07, -.02]) and a lower likelihood of condom use (OR = .94[.90, .98]), but not the number of lifetime partners. Associations differed by subgroup: sexual identity modified the relationship between school climate and age at first sex (β = -.09[-.15, -.03]) for bisexual adolescents, and school climate and condom use for bisexual (OR = .86[.76, .98]) and gay adolescents (OR = .66[.64, .68]). CONCLUSIONS Exclusionary LGB school climates are associated with a lower age at first sex and a lower likelihood of condom use for all adolescents, and particularly bisexual individuals. Additional research and practice should address school-level climates to support adolescents' healthy sexual development.
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Affiliation(s)
- Morgan M Philbin
- Department of Sociomedical Sciences, Columbia University Mailman School of Public Health, New York, New York.
| | - Xinzi Wang
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Illinois; Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, Illinois
| | - Daniel J Feaster
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, Florida
| | | | - Gregory Phillips
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Illinois; Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, Illinois
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20
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Changes in psychological distress after first vaginal intercourse in late adolescence. J Adolesc 2021; 89:213-216. [PMID: 34030022 DOI: 10.1016/j.adolescence.2021.05.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 05/04/2021] [Accepted: 05/05/2021] [Indexed: 11/20/2022]
Abstract
INTRODUCTION Although early sexual intercourse may be associated with increased depressive symptoms, little research has examined whether first intercourse in late adolescence is associated with changes in mental health. METHODS This paper uses 3 years of longitudinal data from previously sexually abstinent late adolescent students at a large state university in the northeastern United States (N = 144, 53.5% male, M age = 18.5 years old, 47.2% White, 26.4% Asian/Hawaiian/Pacific Islander, 20.1% Hispanic/Latino, 18.1% Black/African American) to examine whether levels of psychological distress changed after first intercourse. RESULTS Students' distress decreased after first intercourse, although this effect was only significant two or more semesters after first intercourse. There were no gender differences in these associations. CONCLUSIONS Findings suggest first intercourse was, on average, associated with decreased psychological distress for both male and female late adolescents.
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21
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Fekih-Romdhane F, Nefzi H, Cheour M. Relationship between religiosity and sexuality among unmarried male medical students. SEXOLOGIES 2021. [DOI: 10.1016/j.sexol.2021.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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22
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Bishop MD, Mallory AB, Gessner M, Frost DM, Russell ST. School-based Sexuality Education Experiences across Three Generations of Sexual Minority People. JOURNAL OF SEX RESEARCH 2021; 58:648-658. [PMID: 32486928 PMCID: PMC7708407 DOI: 10.1080/00224499.2020.1767024] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Sexual minority people face greater risk for compromised sexual health than their heterosexual peers, yet school-based sexuality education often excludes them. Little is known about whether or how sexual minority people's sexuality education experiences have varied across sociohistorical contexts of rapid social change in both sexuality education and sexual minority visibility. Semi-structured qualitative interviews were conducted among 191 sexual minority people from three distinct sociohistorical generations (ages 18-25, 34-41, and 52-59, respectively) and four geographic regions of the United States. Data were analyzed using thematic content analysis following a consensual qualitative protocol. Fifty-one participants (i.e., 27%) discussed school-based sexuality education experiences despite the lack of an explicit question in the interview protocol prompting them to do so. Four distinct yet overlapping themes emerged in participants' experiences of sexuality education: 1) Silence; 2) The profound influence of HIV/AIDS; 3) Stigma manifest through fear, shame, and prejudice; and, 4) Comparing school-based experiences to sexuality education outside of school. The presence of themes varied across groups defined by sociohistorical generation. The implications of sexuality education experiences for the wellbeing of sexual minority people are discussed.
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Affiliation(s)
- Meg D. Bishop
- Department of Human Development and Family Sciences, University of Texas at Austin, 108 E. Dean Keaton Street, Austin, Texas 78712, U.S.A
| | - Allen B. Mallory
- Department of Human Development and Family Sciences, University of Texas at Austin, 108 E. Dean Keaton Street, Austin, Texas 78712, U.S.A
| | - McKenna Gessner
- Department of Human Development and Family Sciences, University of Texas at Austin, 108 E. Dean Keaton Street, Austin, Texas 78712, U.S.A
| | - David M. Frost
- Department of Social Science, University College London, 27-28 Woburn Square, London, WC1H 0AA
| | - Stephen T. Russell
- Department of Human Development and Family Sciences, University of Texas at Austin, 108 E. Dean Keaton Street, Austin, Texas 78712, U.S.A
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23
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Bowling J, Montanaro E, Gattuso J, Gioia D, Guerrero Ordonez S. "Everything feels risky now": Perceived "risky" sexual behavior during COVID-19 pandemic. J Health Psychol 2021; 27:1498-1506. [PMID: 33855871 PMCID: PMC8685755 DOI: 10.1177/13591053211004684] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Social distancing through the COVID-19 pandemic has impacted sexuality and relationships, which may also change risk perceptions beyond traditional definitions (e.g. sexually transmitted infections). This study examines risk perceptions related to sexuality during the pandemic. We present qualitative analyses of a survey of adults in the United States (N = 333) to identify impacts of COVID-19 on individuals’ risk perceptions. Risky sexual behavior definitions included: (1) COVID-19-related, (2) STI/pregnancy, (3) relationship-related, (4) physical boundaries, (5) drug or alcohol, and (6) multiple risks. Conventional public health messaging may need to incorporate changing risk definitions to address sexual health during the pandemic.
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Affiliation(s)
| | | | | | - Diana Gioia
- University of North Carolina at Charlotte, USA
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24
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Garg N, Volerman A. A National Analysis of State Policies on Lesbian, Gay, Bisexual, Transgender, and Questioning/Queer Inclusive Sex Education. THE JOURNAL OF SCHOOL HEALTH 2021; 91:164-175. [PMID: 33314223 DOI: 10.1111/josh.12987] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/05/2020] [Revised: 06/16/2020] [Accepted: 10/23/2020] [Indexed: 05/28/2023]
Abstract
BACKGROUND Many youth engage in risky sexual behaviors that are associated with adverse sexual health outcomes. Lesbian, gay, bisexual, transgender, and questioning/queer (LGBTQ) youth are disproportionately affected. Comprehensive sex education is instrumental to minimize these outcomes; however, each state varies in the topics taught. METHODS This paper is a comprehensive review of all 50 states and the District of Columbia's policies, including laws and education standards, for LGBTQ inclusive material in school-based sex education for youth in K-12. RESULTS Overall, 48 states have policies that mandate sex education in the public schools. This review describes policy differences relevant to students who identify as LGBTQ, by comparing required topics, parental/guardian permission, LGBTQ inclusion, and normative language requirements. CONCUSIONS There is a lack of uniformity and presence of discrimination in school-based sex education policies in the United States, particularly related to LGBTQ topics. Therefore, young people, especially LGBTQ students, face geographical barriers to accessing sexual health information and schools are limited in implementing curriculum essential for students to optimize sexual health outcomes. State policymakers, school administrators, child health advocates, and parents should work to eliminate barriers for comprehensive sex education.
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Affiliation(s)
- Namrata Garg
- Doctorate of Medicine Candidate, , University of Chicago Pritzker School of Medicine, 924 E 57th St, Suite 104, Chicago, IL, 60637., USA
| | - Anna Volerman
- Assistant Professor of Medicine and Pediatrics, , University of Chicago, 5841 S Maryland Ave, MC 2007, Chicago, IL, 60637., USA
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25
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Currin JM, Hubach RD, Croff JM. Sex-Ed without the Stigma: What Gay and Bisexual Men Would like Offered in School Based Sex Education. JOURNAL OF HOMOSEXUALITY 2020; 67:1779-1797. [PMID: 31135290 DOI: 10.1080/00918369.2019.1616429] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
This study highlights the experiences of gay and bisexual men who live in Oklahoma with formalized sex education. Open-ended prompts were provided to individuals (N= 112) who completed an online questionnaire assessing their experience with sex education and what they would like to see offered. The majority of participants did not receive a formalized sex education and they want to see a comprehensive sex education program provided in public schools. A need exists for a more comprehensive and inclusive formalized sex education program to be provided in socio-politically conservative areas like Oklahoma.
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Affiliation(s)
- Joseph M Currin
- Department of Psychological Sciences, Texas Tech University , Lubbock, Texas, USA
| | - Randolph D Hubach
- Rural Health, Oklahoma State University Center for Health Sciences , Tulsa, Oklahoma, USA
| | - Julie M Croff
- Rural Health, Oklahoma State University Center for Health Sciences , Tulsa, Oklahoma, USA
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26
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Hill BJ, Motley DN, Rosentel K, VandeVusse A, Garofalo R, Schneider JA, Kuhns LM, Kipke MD, Reisner S, Rupp BM, Sanchez M, McCumber M, Renshaw L, Loop MS. An Employment Intervention Program (Work2Prevent) for Young Men Who Have Sex With Men and Transgender Youth of Color (Phase 1): Protocol for Determining Essential Intervention Components Using Qualitative Interviews and Focus Groups. JMIR Res Protoc 2020; 9:e16384. [PMID: 32773383 PMCID: PMC7445600 DOI: 10.2196/16384] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Revised: 12/13/2019] [Accepted: 02/24/2020] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND HIV continues to have a disparate impact on young cisgender men who have sex with men (YMSM), young trans women (YTW), and gender-nonconforming (GNC) youth who are assigned male at birth. Outcomes are generally worse among youth of color. Experiences of discrimination and marginalization often limit educational attainment and may even more directly limit access to gainful employment. Though seemingly distal, these experiences influence young people's proximity to HIV risk by limiting their access to health care and potentially moving them toward sex work as a means of income as well as increased substance use. Work2Prevent (W2P) aims to achieve economic stability through employment as a structural-level intervention for preventing adolescent and young adult HIV infection. The study will pilot-test an effective, theoretically driven employment program (increased individual income and independence [iFOUR]), for HIV-positive adults, and adapt it to the needs of black and Latinx YMSM, YTW, and GNC youth aged 16 to 24 years who are vulnerable to HIV exposure. OBJECTIVE This paper aimed to describe the protocol for the exploratory phase of W2P. The purpose of this phase was to determine the essential components needed for a structural-level employment intervention aimed at increasing job-seeking self-efficacy and career readiness among black and Latinx YMSM, YTW, and GNC youth aged 16 to 24 years. METHODS The exploratory phase of the W2P study consisted of in-depth interviews and focus groups with members of the target community as well as brief interviews with lesbian, gay, bisexual, transgender, and queer (LGBTQ)-inclusive employers. The study team will conduct in-depth interviews with up to 12 YMSM and 12 YTW and GNC youth, up to 10 focus groups with a maximum of 40 YMSM and 40 YTW and GNC youth, and up to 40 brief interviews with LGBTQ-inclusive employers. Participants will be recruited through a community-based recruiter, passive recruitment in community spaces and on social media, and active recruitment by research staff in community spaces serving LGBTQ youth. RESULTS In-depth interviews were conducted with 21 participants, and 7 focus groups were conducted with 46 participants in total. In addition, 19 brief interviews with LGBTQ-inclusive employers were conducted. The analysis of the data is underway. CONCLUSIONS Preliminary findings from the formative phase of the study will be used to inform the tailoring and refinement of the iFOUR adult-based intervention into the youth-focused W2P intervention curriculum. Perspectives from YMSM, YTW, GNC youth, and LGBTQ-inclusive employers offer a multidimensional view of the barriers and facilitators to adolescent and young adult LGBTQ employment. This information is critical to the development of a culturally appropriate and relevant youth-focused intervention. TRIAL REGISTRATION ClinicalTrials.gov NCT03313310; https://clinicaltrials.gov/ct2/show/NCT03313310. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/16384.
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Affiliation(s)
- Brandon J Hill
- Planned Parenthood Great Plains, Overland Park, KS, United States
| | - Darnell N Motley
- Center for Interdisciplinary Inquiry and Innovation in Sexual and Reproductive Health, Department of Obstetrics and Gynecology, University of Chicago, Chicago, IL, United States
| | - Kris Rosentel
- Center for Interdisciplinary Inquiry and Innovation in Sexual and Reproductive Health, Department of Obstetrics and Gynecology, University of Chicago, Chicago, IL, United States
| | | | - Robert Garofalo
- Division of Adolescent Medicine, Ann & Robert H Lurie Children's Hospital, Department of Pediatrics, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - John A Schneider
- Department of Medicine, University of Chicago, Chicago, IL, United States
| | - Lisa M Kuhns
- Division of Adolescent Medicine, Ann & Robert H Lurie Children's Hospital, Department of Pediatrics, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Michele D Kipke
- Division of Research on Children, Youth, and Families, Children's Hospital Los Angeles, Los Angeles, CA, United States
| | - Sari Reisner
- Fenway Health, The Fenway Institute, Boston, MA, United States
| | - Betty M Rupp
- Collaborative Studies Coordinating Center, Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Maria Sanchez
- Collaborative Studies Coordinating Center, Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Micah McCumber
- Collaborative Studies Coordinating Center, Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Laura Renshaw
- Collaborative Studies Coordinating Center, Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Matthew Shane Loop
- Collaborative Studies Coordinating Center, Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
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27
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Joodaki K, Nedjat S, Vahid Dastjerdi M, Larijani B. Ethical considerations and challenges of sex education for adolescents in Iran: a qualitative study. J Med Ethics Hist Med 2020; 13:2. [PMID: 33088429 PMCID: PMC7569533 DOI: 10.18502/jmehm.v13i2.2664] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2018] [Accepted: 01/26/2020] [Indexed: 11/24/2022] Open
Abstract
Adolescence is a period in one’s lifetime during which sexual maturation occurs. Major changes and increased sexual instinct raise many questions in the minds of adolescents. Receiving wrong education or inappropriate information can affect adolescents’ life and future deeply. Obviously, ethical considerations cannot be ignored in nationwide macro policies and educational programs on such a sensitive issue. In this qualitative study, we attempted to explore the ethical considerations and challenges of sex education for adolescents. The study was conducted between May 2015 and March 2017. Data were collected through semi-structured in-depth interviews with 25 participants, and MAXQDA 11 was used for coding. Six hundred sixty-two codes (662) were extracted and classified into four categories: 1) the potential risks of sex education for adolescents; 2) the advantages of sex education for adolescents, and the approaches; 3) the challenges in the interval between sexual maturation and marriage, and the role of religion; and 4) the measures implemented in Iran. Shame, embarrassment, and some cultural beliefs surrounding the subject of sex education are obstacles to providing adolescents with the necessary information. According to the principles of medical ethics, the main principle in sex education is beneficence, and sometimes infringement of confidentiality has its advantages.
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Affiliation(s)
- Kobra Joodaki
- PhD Candidate in Medical Ethics, Department of Medical Ethics, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Saharnaz Nedjat
- Professor, Department of Epidemiology and Biostatistics, Knowledge Utilization Research Center, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Marziyeh Vahid Dastjerdi
- Associated Professor, Department of Obstetrics and Gynecology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Bagher Larijani
- Professor, Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
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28
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Restar AJ, Adia A, Nazareno J, Hernandez L, Sandfort T, Lurie M, Cu-Uvin S, Operario D. Barriers and facilitators to uptake of condoms among Filipinx transgender women and cisgender men who have sex with men: A situated socio-ecological perspective. Glob Public Health 2020; 15:520-531. [PMID: 31630622 PMCID: PMC7093239 DOI: 10.1080/17441692.2019.1679218] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Accepted: 09/12/2019] [Indexed: 10/25/2022]
Abstract
Transgender women (TW) and cisgender men who have sex with men (cis-MSM) are disproportionately impacted by the national HIV crisis in the Philippines, where the HIV incidence has, in large part, been attributed to condomless sex. This study sought to qualitatively examine the socio-ecological factors that contribute to low condom uptake among Filipinx TW and cis-MSM communities in Manila. Between July and August 2017, we conducted semi-structured qualitative interviews with 30 TW and cis-MSM participants (n = 23 and 7, respectively). We identified structural factors described by TW and cis-MSM, and noted that they varied per situation and context of: (a) friends (e.g. as condom promoters and educators), (b) schools (e.g. lack of sex education and HIV curriculum), (c) health care facilities (e.g. availability, educational programmes, and HIV testing requirement), (d) stores (e.g. placement of condoms, distance to store, and cost), and (e) church (e.g. prohibition of condom distribution programmes, and unsupportiveness). Condom-related stigma as a social factor was pervasively present across all situation or context. Our findings support the need for multilevel condom promotion interventions that are tailored per situation or context. Future research is needed to identify factors that can be leveraged for condom promotion strategies within diverse situations.
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Affiliation(s)
- Arjee J. Restar
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, Rhode Island, USA
- The Philippine Health Initiative for Research, Service, and Training, Brown University Global Health Initiative, Providence, Rhode Island, USA
- amfAR, The Foundation of AIDS Research, Washington, DC, USA
| | - Alexander Adia
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, Rhode Island, USA
- The Philippine Health Initiative for Research, Service, and Training, Brown University Global Health Initiative, Providence, Rhode Island, USA
| | - Jennifer Nazareno
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, Rhode Island, USA
- The Philippine Health Initiative for Research, Service, and Training, Brown University Global Health Initiative, Providence, Rhode Island, USA
| | - Laufred Hernandez
- Department of Behavioral Sciences, University of Philippines in Manila, Philippines
| | - Theo Sandfort
- HIV Center for Clinical and Behavioral Studies, Department of Psychiatry, Division on Gender, Sexuality, and Health, New York State Psychiatric Institute and Columbia University, New York, NY, USA
| | - Mark Lurie
- Department of Epidemiology, Brown University School of Public Health, Providence, Rhode Island, USA
| | - Susan Cu-Uvin
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, Rhode Island, USA
- The Philippine Health Initiative for Research, Service, and Training, Brown University Global Health Initiative, Providence, Rhode Island, USA
- Providence-Boston Center for AIDS Research, Providence, Rhode Island, USA
- Miriam Hospital, Department of Medicine, Providence, RI, USA
| | - Don Operario
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, Rhode Island, USA
- The Philippine Health Initiative for Research, Service, and Training, Brown University Global Health Initiative, Providence, Rhode Island, USA
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29
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Mustanski B, Moskowitz DA, Moran KO, Rendina HJ, Newcomb ME, Macapagal K. Factors Associated With HIV Testing in Teenage Men Who Have Sex With Men. Pediatrics 2020; 145:peds.2019-2322. [PMID: 32047100 PMCID: PMC7049943 DOI: 10.1542/peds.2019-2322] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/15/2019] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Adolescent men who have sex with men (AMSM) have a high rate of HIV diagnoses. An estimated 14.5% of HIV infections in the United States are undiagnosed; but among 13- to 24-year-olds, the rate is 51.4%. We describe HIV testing rates and identifies salient individual, family, school, and health care influences among AMSM. METHODS Data were collected as part of SMART, an ongoing pragmatic trial of an online HIV prevention intervention for AMSM (N = 699). Measures included lifetime HIV testing, demographics, sexual behaviors, condom use, HIV education from school and family, sexual health communication with doctors, HIV knowledge, and risk attitudes. RESULTS Only 23.2% of participants had ever had an HIV test. Rates of testing increased with age (5.6% in 13- to 14-year-olds; 15.8% in 15- to 16-year-olds; 37.8% in 17- to 18-year-olds), and sexual experience was a strong predictor of testing (odds ratio: 6.54; 95% confidence interval: 3.95-11.49; P < .001). Most participants had a regular doctor (67.5%), but few had conversations about same-sex sexual behaviors (21.3%), HIV testing (19.2%), or sexual orientation (29.2%). Speaking to a doctor about HIV testing had a large effect (odds ratio: 25.29; confidence interval: 15.91-41.16; P < .001), with 75.4% who had such conversations having been tested, compared to only 10.8% of those who had not had such conversations. CONCLUSIONS Despite higher risk, few participants reported ever having received an HIV test. Data indicate pediatricians are an important, but largely untapped, source of testing and could be integral to achieving testing rates needed to end the epidemic.
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Affiliation(s)
- Brian Mustanski
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, Illinois; and .,Departments of Medical Social Sciences and
| | - David A. Moskowitz
- Departments of Medical Social Sciences and,Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, Illinois; and
| | - Kevin O. Moran
- Departments of Medical Social Sciences and,Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, Illinois; and
| | - H. Jonathon Rendina
- Department of Psychology, Hunter College of the City University of New York, New York, New York
| | - Michael E. Newcomb
- Departments of Medical Social Sciences and,Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, Illinois; and
| | - Kathryn Macapagal
- Departments of Medical Social Sciences and,Psychiatry and Behavioral Sciences, Feinberg School of Medicine and,Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, Illinois; and
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30
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Patchin JW, Hinduja S. It is Time to Teach Safe Sexting. J Adolesc Health 2020; 66:140-143. [PMID: 31831321 DOI: 10.1016/j.jadohealth.2019.10.010] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Accepted: 10/21/2019] [Indexed: 10/25/2022]
Affiliation(s)
- Justin W Patchin
- Department of Political Science, University of Wisconsin-Eau Claire, Eau Claire, Wisconsin.
| | - Sameer Hinduja
- School of Criminology and Criminal Justice, Florida Atlantic University, Jupiter, Florida
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Effects of Church-Based Parent-Child Abstinence-Only Interventions on Adolescents' Sexual Behaviors. J Adolesc Health 2020; 66:107-114. [PMID: 31630923 DOI: 10.1016/j.jadohealth.2019.07.021] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Revised: 07/26/2019] [Accepted: 07/27/2019] [Indexed: 11/23/2022]
Abstract
PURPOSE The aim of the study was to evaluate the efficacy of faith-based and nonfaith-based parent-child abstinence-only interventions in reducing sexual risk behavior among young African American adolescents. METHODS Randomized controlled trial recruiting 613 African American parent-adolescent dyads from urban African American Baptist churches and randomizing them to one of three parent-child interventions: faith-based abstinence-only intervention emphasizing delaying or reducing sexual intercourse drawing on Biblical scriptures; nonfaith-based abstinence-only emphasizing intervention delaying or reducing sexual intercourse without referencing scriptures; or attention-matched control intervention targeting health issues unrelated to sexual behavior. Primary outcome was the self-reported frequency of condomless sexual intercourse in the past 3 months assessed periodically through 18 months postintervention. Secondary outcomes were frequency of sexual intercourse, number of sexual partners, consistent condom use and, among sexually inexperienced adolescents, sexual debut. RESULTS Generalized estimating equations analyses revealed that nonfaith-based abstinence-only intervention reduced the frequency of condomless sexual intercourse, frequency of sexual intercourse, and number of sexual partners compared with the attention-matched control intervention, whereas faith-based abstinence-only intervention did not. Neither intervention affected consistent condom use or sexual debut. CONCLUSIONS Parent-child abstinence-only interventions can reduce condomless sexual intercourse among young African American adolescents in church settings. Linking the abstinence message to Biblical scriptures may not be efficacious.
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George C, Roberts R, Brennen D, Deveaux L, Read SE. Knowledge and awareness of Human Papillomavirus (HPV) and HPV vaccines among Caribbean youth: the case of the Bahamas. Hum Vaccin Immunother 2019; 16:573-580. [PMID: 31464555 PMCID: PMC7227632 DOI: 10.1080/21645515.2019.1661205] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
There is a high burden of cervical cancer in the Caribbean region, particularly in the Bahamas, yet there are few studies of Human Papillomavirus (HPV) and HPV vaccine in the region. The objective of this study was to assess the knowledge and awareness of HPV and the HPV vaccine among school-aged youth (15–18 years) living in the Bahamas. Cross-sectional data were obtained from the “Getting to Zero” HIV study in the Bahamas conducted in 2014/2015 (n = 1553). The questionnaire elicited information on knowledge of HPV and HPV vaccines, using previously validated scales. Data analysis included Chi-square tests and Mann Whitney U test. In this sample of school-aged youth, only 10.7% (146/1364) had ever heard of HPV. With respect to those who were sexually active (n = 685), only 10.7% had ever heard of HPV. For those who had heard of HPV, knowledge of HPV and HPV vaccines was assessed on an HPV Knowledge and HPV Vaccine Knowledge scale, respectively. There was no statistically significant difference in mean HPV knowledge score between males and females, or HPV vaccine knowledge scores, between males and females. There was a general lack of awareness of HPV and HPV vaccines among school-aged youth in the Bahamas. This is an important gap in the HPV vaccine strategy and cancer prevention, as this is the age at which most people acquire HPV. It emphasizes the importance of developing a careful implementation plan, with an evaluation of knowledge and attitudes, in order to have an effective HPV vaccine uptake.
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Affiliation(s)
- Clemon George
- University of Ontario Institute of Technology and Faculty of Medical Sciences, Oshawa, Ontario and the University of the West Indies, Cave Hill, Barbados
| | - Robin Roberts
- UWI School of Clinical Medicine and Research, Nassau, The Bahamas
| | | | | | - Stanley E Read
- Division of Infectious Diseases, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
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33
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Prendergast LE, Toumbourou JW, McMorris BJ, Catalano RF. Outcomes of Early Adolescent Sexual Behavior in Australia: Longitudinal Findings in Young Adulthood. J Adolesc Health 2019; 64:516-522. [PMID: 30578117 PMCID: PMC6431557 DOI: 10.1016/j.jadohealth.2018.10.006] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Revised: 09/25/2018] [Accepted: 10/07/2018] [Indexed: 11/30/2022]
Abstract
PURPOSE Limited longitudinal research has examined the adult health and behavioral outcomes associated with early adolescent sexual behavior. This paper examined whether adolescent sexual behavior predicted young adult health and social outcomes within longitudinal cohorts in Victoria, Australia. METHODS Adolescents were recruited in 2002 to be state-representative of school students in Victoria, Australia, and resurveyed in 2003 and 2004. The sample responded to a web-based survey as young adults in 2010/2011. Multivariate negative binomial regression models examined the predictive effect of sex by age 15 on young adult outcomes (average age 21) of sexual risk taking, substance use, antisocial behavior, and psychological distress (N = 2,147). RESULTS After adjustment for other factors, sex at age 15 or younger (early sex) predicted higher rates of young adult sexual risk taking such as pregnancy, lifetime partners, and sex without using a condom. Early sex also predicted higher rates of young adult substance use (alcohol, tobacco, and/or illicit substance use) and antisocial behavior, but rates of adult psychological distress were not affected. CONCLUSIONS This study found that early adolescent sex had unique predictive effects on a range of adverse young adulthood outcomes. Public health policies should synthesize longitudinal data on the risks of early sexual behavior, while advocating evidence-based adolescent sexual health promotion interventions.
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Affiliation(s)
- Laura E. Prendergast
- School of Psychology and Centre for Social and Early Emotional Development (SEED), Deakin University, Victoria, Australia
| | - John W. Toumbourou
- School of Psychology and Centre for Social and Early Emotional Development (SEED), Deakin University, Victoria, Australia,Centre for Adolescent Health, Murdoch Children’s Research Institute, Victoria, Australia
| | - Barbara J. McMorris
- Center for Adolescent Nursing, School of Nursing, University of Minnesota, Minnesota, United States
| | - Richard F Catalano
- Social Development Research Group, School of Social Work, University of Washington, Washington, United States
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34
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Lee M. I wish I had known sooner: stratified reproduction as a consequence of disparities in infertility awareness, diagnosis, and management. Women Health 2019; 59:1185-1198. [PMID: 30931839 DOI: 10.1080/03630242.2019.1593283] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Infertility affects one in eight couples in the US, yet many couples report feeling blindsided by the diagnosis. Lack of awareness about infertility can lead to missed opportunities for prevention, delays in diagnosis, and greater emotional distress when a diagnosis is made. This paper reports on the results of interviews with 54 American women experiencing infertility, conducted via phone between 2013 and 2015 with participants from across the country. The interviews explored whether differences in infertility awareness were related to patient trajectories for time to diagnosis and initiation of treatment. Interview data indicated a significant lack of informational resources for these women concerned about fertility. Older participants expressed regret that they were not educated about age-related fertility decline, while patients with infertility secondary to medical conditions often reported delays in diagnosis and lack of counseling about fertility implications. Participants' data also revealed that infertility was consistently absent from sex education curricula and that minorities may be more likely to experience delayed diagnosis of infertility and lack of appropriate fertility counseling. These findings suggest that the inequitable distribution of health information and education about reproduction is one mechanism by which experiences of infertility can become racially stratified.
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Affiliation(s)
- Mihan Lee
- Department of Health Policy, Harvard Graduate School of Arts & Sciences, Cambridge, MA, USA
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35
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Fox AM, Himmelstein G, Khalid H, Howell EA. Funding for Abstinence-Only Education and Adolescent Pregnancy Prevention: Does State Ideology Affect Outcomes? Am J Public Health 2019; 109:497-504. [PMID: 30676806 PMCID: PMC6366514 DOI: 10.2105/ajph.2018.304896] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/17/2018] [Indexed: 11/04/2022]
Abstract
OBJECTIVES To examine the relationship between adolescent pregnancy-prevention and sexuality and abstinence-only education funding and adolescent birthrates over time. Also, to determine whether state ideology plays a moderating role on adolescent reproductive health, that is, whether the funding has its intended effect at reducing the number of adolescent births in conservative but not in liberal states. METHODS We modeled time-series data on federal abstinence-only and adolescent pregnancy-prevention and sexuality education block grants to US states and rates of adolescent births (1998-2016) and adjusted for state-level confounders using 2-way fixed-effects models. RESULTS Federal abstinence-only funding had no effect on adolescent birthrates overall but displayed a perverse effect, increasing adolescent birthrates in conservative states. Adolescent pregnancy-prevention and sexuality education funding eclipsed this effect, reducing adolescent birthrates in those states. CONCLUSIONS The millions of dollars spent on abstinence-only education has had no effect on adolescent birthrates, although conservative states, which experience the greatest burden of adolescent births, are the most responsive to changes in sexuality education-funding streams.
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Affiliation(s)
- Ashley M Fox
- Ashley M. Fox is with the Department of Public Administration and Policy, Rockefeller College of Public Affairs and Policy, Albany, NY. Georgia Himmelstein is a PhD candidate in the Program in Demography and Social Policy at Princeton University, Princeton, NJ. Hina Khalid is with the Department of Economics, Information Technology University, Lahore, Pakistan. Elizabeth A. Howell is with the Departments of Population Health Science and Policy and Obstetrics, Gynecology, and Reproductive Science and the Blavatnik Family Women's Health Research Institute, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Georgia Himmelstein
- Ashley M. Fox is with the Department of Public Administration and Policy, Rockefeller College of Public Affairs and Policy, Albany, NY. Georgia Himmelstein is a PhD candidate in the Program in Demography and Social Policy at Princeton University, Princeton, NJ. Hina Khalid is with the Department of Economics, Information Technology University, Lahore, Pakistan. Elizabeth A. Howell is with the Departments of Population Health Science and Policy and Obstetrics, Gynecology, and Reproductive Science and the Blavatnik Family Women's Health Research Institute, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Hina Khalid
- Ashley M. Fox is with the Department of Public Administration and Policy, Rockefeller College of Public Affairs and Policy, Albany, NY. Georgia Himmelstein is a PhD candidate in the Program in Demography and Social Policy at Princeton University, Princeton, NJ. Hina Khalid is with the Department of Economics, Information Technology University, Lahore, Pakistan. Elizabeth A. Howell is with the Departments of Population Health Science and Policy and Obstetrics, Gynecology, and Reproductive Science and the Blavatnik Family Women's Health Research Institute, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Elizabeth A Howell
- Ashley M. Fox is with the Department of Public Administration and Policy, Rockefeller College of Public Affairs and Policy, Albany, NY. Georgia Himmelstein is a PhD candidate in the Program in Demography and Social Policy at Princeton University, Princeton, NJ. Hina Khalid is with the Department of Economics, Information Technology University, Lahore, Pakistan. Elizabeth A. Howell is with the Departments of Population Health Science and Policy and Obstetrics, Gynecology, and Reproductive Science and the Blavatnik Family Women's Health Research Institute, Icahn School of Medicine at Mount Sinai, New York, NY
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36
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Franco M, Mazzucca S, Padek M, Brownson RC. Going beyond the individual: how state-level characteristics relate to HPV vaccine rates in the United States. BMC Public Health 2019; 19:246. [PMID: 30819149 PMCID: PMC6393974 DOI: 10.1186/s12889-019-6566-y] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Accepted: 02/20/2019] [Indexed: 01/25/2023] Open
Abstract
Background The human papillomavirus (HPV) vaccine is an underutilized cancer control practice in the United States. Although individual contextual factors are known to impact HPV vaccine coverage rates, the impact of macro-level elements are still unclear. The aim of this analysis was to use HPV vaccination rates to explore the underuse of an evidence-based cancer control intervention and explore broader-level correlates influencing completion rates. Methods A comprehensive database was developed using individual-level date from the National Immunization Survey (NIS)-Teen (2016) and state-level data collected from publically available sources to analyze HPV vaccine completion. Multi-level logistic models were fit to identify significant correlates. Level-1 (individual) and level-2 (state) correlates were fitted to a random intercept model. Deviance and AIC assessed model fit and sampling weights were applied. Results The analysis included 20,495 adolescents from 50 U.S. states and the District of Columbia. Teen age, gender, race/ethnicity, and maternal education were significant individual predictors of HPV completion rates. Significant state-level predictors included sex education policy, religiosity, and HPV vaccine mandate. States with the lowest HPV coverage rates were found to be conservative and highly religious. Little variation in vaccine exemptions and enacted sex and abstinence education polices were observed between states with high and low HPV vaccine coverage suggesting various contextual and situational factors impact HPV vaccine completion rates. Conclusions Given that gender, religiosity, political ideology, and education policies are predictors of HPV vaccine completion, the interaction and underlying mechanism of these factors can be used to address the underutilization of the HPV vaccine.
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Affiliation(s)
- Melissa Franco
- Prevention Research Center in St. Louis, Brown School, Washington University in St. Louis, One Brookings Drive, Campus Box 1196, St. Louis, MO, 63130, USA
| | - Stephanie Mazzucca
- Prevention Research Center in St. Louis, Brown School, Washington University in St. Louis, One Brookings Drive, Campus Box 1196, St. Louis, MO, 63130, USA
| | - Margaret Padek
- Prevention Research Center in St. Louis, Brown School, Washington University in St. Louis, One Brookings Drive, Campus Box 1196, St. Louis, MO, 63130, USA.
| | - Ross C Brownson
- Prevention Research Center in St. Louis, Brown School, Washington University in St. Louis, One Brookings Drive, Campus Box 1196, St. Louis, MO, 63130, USA.,Department of Surgery (Division of Public Health Sciences), Washington University School of Medicine, Washington University in St. Louis, St. Louis, MO, 63103, USA
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37
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Diamand M, Regev D, Snir S. Growing Up Together: Teenage Pregnancy and Motherhood in the Israeli New Orthodox Sector as Reflected in Drawings and Interviews. JOURNAL OF LOSS & TRAUMA 2019. [DOI: 10.1080/15325024.2018.1548998] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Moria Diamand
- The School of Creative Arts Therapies, University of Haifa, Haifa, Israel
| | - Dafna Regev
- The School of Creative Arts Therapies and the Emili Sagol Creative Arts Therapies Research Center, University of Haifa, Haifa, Israel
| | - Sharon Snir
- Department of Art Therapy, Tel Hai College, Qiryat Shemona, Israel
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38
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Speno AG, Aubrey JS. Adolescent Sexting: The Roles of Self-Objectification and Internalization of Media Ideals. PSYCHOLOGY OF WOMEN QUARTERLY 2018. [DOI: 10.1177/0361684318809383] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
We examined adolescent sexting using objectification theory as a framework. We hypothesized that sexting is a manifestation of trait self-objectification and the internalization of gender-specific media ideals about attractiveness. We conducted a cross-sectional survey of 201 Midwestern adolescents, 14–17 years old. We tested a three-stage path model, which differed for female and male adolescents. For female adolescents, self-objectification was positively associated with favorable attitudes about sexting, which further predicted two types of intentions to engage in sexting: sexting when there is trust in the sexting partner (security-based intentions) and sexting that is spurred by situational cues. Although there was a serial mediation effect of self-objectification on sexting behaviors through sexting attitudes and total sexting intentions, only the indirect effect of sexting attitudes on behaviors through security-based intentions was individually significant. For male adolescents, internalization of media ideals was positively associated with sexting attitudes, which further predicted the two types of sexting intentions. Similar to female adolescents, there was a serial mediation effect of internalization of media ideals on sexting behaviors through sexting attitudes and total sexting intentions; however, only security-based sexting intentions predicted sexting behaviors. Our results have implications regarding how to conceptualize adolescent sexting and how researchers, parents, and educators may help teenage youth to establish healthy sexting attitudes and behaviors. Additional online materials for this article are available to PWQ subscribers on PWQ’s website at http://journals.sagepub.com/doi/suppl/10.1177/0361684318809383
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Affiliation(s)
- Ashton Gerding Speno
- Department of Mass Communications, Southern Illinois University Edwardsville, Edwardsville, IL, USA
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Brisson J, Ravitsky V, Williams-Jones B. Towards an Integration of PrEP into a Safe Sex Ethics Framework for Men Who Have Sex with Men. Public Health Ethics 2018; 12:54-63. [PMID: 30936942 DOI: 10.1093/phe/phy018] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
The ethics of safe sex in the gay community has, for many years, been focused on debates surrounding the responsibility (or lack thereof) regarding the use of condoms to prevent HIV transmission, once the only tool available. With the development of Truvada as a pre-exposure prophylaxis (PrEP) for HIV, for the first time in the history of the HIV/AIDS epidemic there is the potential to significantly reduce the risk of HIV transmission during sex without the use of condoms (without taking into consideration 'treatment as prevention' with HIV-positive people). The introduction of PrEP necessitates a renewed discussion about the politics and ethics of safe sex for men who have sex with men (MSM). We present the arguments of authors who hold radically opposite positions with regard to the ethics of condom use by gay men, but who currently both criticize the use of PrEP. We offer a critique of their arguments and advance the position that the use of PrEP, even without condoms, can be acceptable and part of a safe sex ethics framework for MSM.
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Nelson KM, Golden MR, Glick SN. Measuring exposure to sexually explicit media among young men who have sex with men: a pilot study. Sex Health 2018; 13:93-5. [PMID: 26535592 DOI: 10.1071/sh15163] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2015] [Accepted: 09/14/2015] [Indexed: 11/23/2022]
Abstract
UNLABELLED Background Sexually explicit media (SEM) consumption may contribute to sexual risk-taking among young men who have sex with men (YMSM). METHODS The prevalence and frequency of SEM consumption as well as associations with contextual and sexual risk characteristics among 61 YMSM were estimated. RESULTS All participants (n=61, 100%) reported viewing SEM; 45 (74%) in the past week. There were no significant associations between viewing SEM in the past week and measured characteristics. CONCLUSION SEM use among YMSM is extremely common. Future research should clarify potential relations between SEM and sexual risk-taking with larger samples of YMSM and specific measures, including SEM content and amount.
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Affiliation(s)
- Kimberly M Nelson
- Centers for Behavioral and Preventative Medicine, The Miriam Hospital, Coro West, Suite 309, 164 Summit Avenue, Providence, RI 02906, USA
| | - Matthew R Golden
- Division of Allergy and Infectious Diseases, School of Medicine, University of Washington, Box 359777, Seattle, WA 98104, USA
| | - Sara Nelson Glick
- Division of Allergy and Infectious Diseases, School of Medicine, University of Washington, Box 359777, Seattle, WA 98104, USA
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Feinstein BA, Thomann M, Coventry R, Macapagal K, Mustanski B, Newcomb ME. Gay and Bisexual Adolescent Boys' Perspectives on Parent-Adolescent Relationships and Parenting Practices Related to Teen Sex and Dating. ARCHIVES OF SEXUAL BEHAVIOR 2018; 47:1825-1837. [PMID: 29280027 PMCID: PMC6019640 DOI: 10.1007/s10508-017-1057-7] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/15/2016] [Revised: 07/19/2017] [Accepted: 08/09/2017] [Indexed: 05/25/2023]
Abstract
Close parent-adolescent relationships and specific parenting practices (e.g., communication about sex, monitoring) are associated with reduced sexual risk behavior among heterosexual youth. Despite gay/bisexual male youth being at increased risk of HIV, little is known about parental influences on their sexual behavior. As such, the goal of the current study was to examine parent-adolescent relationships and parenting practices related to teen sex and dating from the perspective of gay/bisexual adolescent boys. Online focus groups were conducted with 52 gay/bisexual male youth ages 14-17 years. Most gay/bisexual adolescent boys felt that their sexual orientation had an influence on their relationships with their parents and discussions about sex/dating. Although some felt that their relationships improved after coming out, a larger percentage reported that it put strain on their relationships. Discussions about sex/dating generally decreased after coming out, but some youth described positive conversations with their parents. Many reported that their parents struggled with whether or not to adapt parenting practices (e.g., rules about dating) after they came out. Youth consistently noted that parent-adolescent relationships and parenting practices depended on the adolescent's level of outness. Findings have important implications for refining HIV prevention programs for gay/bisexual adolescent boys, especially interventions that include parents.
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Affiliation(s)
- Brian A Feinstein
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, 625 N. Michigan Ave., Suite 1400, Chicago, IL, 60611, USA.
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL, USA.
| | - Matthew Thomann
- Department of Anthropology and Sociology, Kalamazoo College, Kalamazoo, MI, USA
| | - Ryan Coventry
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, 625 N. Michigan Ave., Suite 1400, Chicago, IL, 60611, USA
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL, USA
| | - Kathryn Macapagal
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, 625 N. Michigan Ave., Suite 1400, Chicago, IL, 60611, USA
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL, USA
| | - Brian Mustanski
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, 625 N. Michigan Ave., Suite 1400, Chicago, IL, 60611, USA
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL, USA
| | - Michael E Newcomb
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, 625 N. Michigan Ave., Suite 1400, Chicago, IL, 60611, USA
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL, USA
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42
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Feinstein BA, Dellucci TV, Graham S, Parsons JT, Mustanski B. Sexually transmitted infections among young men who have sex with men: Experiences with diagnosis, treatment, and reinfection. SEXUALITY RESEARCH & SOCIAL POLICY : JOURNAL OF NSRC : SR & SP 2018; 15:172-182. [PMID: 30505356 PMCID: PMC6261487 DOI: 10.1007/s13178-017-0312-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Despite high rates of sexually transmitted infections (STIs) among young men who have sex with men (YMSM), little is known about their experiences with diagnosis, treatment, and reinfection. To fill this gap, we interviewed 17 YMSM ages 18-29 who participated in an online HIV prevention trial and tested positive for STIs at both the baseline and three-month follow-up assessments. Participants were asked about their reactions to testing positive, experiences with treatment, disclosure to partners, and changes in thinking and behavior. Reactions were diverse, the most common being surprise and concern. Most participants sought treatment, although type of provider varied (e.g., primary care physician, clinic that specialized in gay/bisexual men's health). Providers tended to re-test participants, but some did so at the incorrect anatomical site. Participants who felt comfortable talking to providers about STIs tended to use their regular provider or one who specialized in gay/bisexual men's health. Most participants described changes in their thinking and behavior (e.g., increased condom use, decreased sex partners, questioning their partners' trust). Most participants disclosed to at least one partner, but some did not remember or were not in contact with partners. Experiences were similar the first and second time participants tested positive for STIs during the study with a few exceptions (e.g., more self-blame and comfort talking to providers the second time). In sum, YMSM have diverse experiences with STI diagnosis and treatment. Implications for public policy and STI prevention are discussed.
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Affiliation(s)
- Brian A. Feinstein
- Northwestern University, Feinberg School of Medicine, Department of Medical Social Sciences, Chicago, IL
- Northwestern University Institute for Sexual and Gender Minority Health and Wellbeing, Chicago, IL
| | - Trey V. Dellucci
- Northwestern University, Feinberg School of Medicine, Department of Medical Social Sciences, Chicago, IL
- Northwestern University Institute for Sexual and Gender Minority Health and Wellbeing, Chicago, IL
- Center for HIV Educational Studies & Training (CHEST), Hunter College of the City University of New York, New York, NY
- Health Psychology and Clinical Science Doctoral Training Program, Graduate Center of the City University of New York, New York, NY
| | - Simon Graham
- Center for HIV Educational Studies & Training (CHEST), Hunter College of the City University of New York, New York, NY
- Centre for Epidemiology and Biostatistics, School of Population and Global Health, University of Melbourne, Melbourne, 3052, Australia
| | - Jeffrey T. Parsons
- Center for HIV Educational Studies & Training (CHEST), Hunter College of the City University of New York, New York, NY
- Hunter College of the City University of New York, Department of Psychology, New York, NY
- Health Psychology and Clinical Science Doctoral Training Program, Graduate Center of the City University of New York, New York, NY
| | - Brian Mustanski
- Northwestern University, Feinberg School of Medicine, Department of Medical Social Sciences, Chicago, IL
- Northwestern University Institute for Sexual and Gender Minority Health and Wellbeing, Chicago, IL
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Lo NC, Lowe A, Bendavid E. Abstinence Funding Was Not Associated With Reductions In HIV Risk Behavior In Sub-Saharan Africa. Health Aff (Millwood) 2018; 35:856-63. [PMID: 27140992 DOI: 10.1377/hlthaff.2015.0828] [Citation(s) in RCA: 71] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
The President's Emergency Plan for AIDS Relief (PEPFAR) has been the largest funder of abstinence and faithfulness programming in sub-Saharan Africa, with a cumulative investment of over US $1.4 billion in the period 2004-13. We examined whether PEPFAR funding for abstinence and faithfulness programs, which aimed to reduce the risk of HIV transmission, was associated with a relative change in five outcomes indicative of high-risk sexual behavior: number of sexual partners in the past twelve months for men and for women, age at first sexual intercourse for men and for women, and teenage pregnancies. Using nationally representative surveys from twenty-two sub-Saharan African countries, we compared trends between people living in countries that received PEPFAR abstinence and faithfulness funding and those living in countries that did not in the period 1998-2013. We found no evidence to suggest that PEPFAR funding was associated with population-level reductions in any of the five outcomes. These results suggest that alternative funding priorities for HIV prevention may yield greater health benefits.
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Affiliation(s)
- Nathan C Lo
- Nathan C. Lo is an MD-PhD candidate at Stanford University School of Medicine, in California
| | - Anita Lowe
- Anita Lowe is a medical student at Stanford University School of Medicine
| | - Eran Bendavid
- Eran Bendavid is an assistant professor in the Department of Medicine at Stanford University School of Medicine
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Hill BJ, Crosby R, Bouris A, Brown R, Bak T, Rosentel K, VandeVusse A, Silverman M, Salazar L. Exploring transgender legal name change as a potential structural intervention for mitigating social determinants of health among transgender women of color. SEXUALITY RESEARCH & SOCIAL POLICY : JOURNAL OF NSRC : SR & SP 2018; 15:25-33. [PMID: 29520314 PMCID: PMC5837073 DOI: 10.1007/s13178-017-0289-6] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
The purpose of this exploratory study was to examine the effects of legal name change on socioeconomic factors, general and transgender-related healthcare access and utilization, and transgender-related victimization in a sample of young transgender women (transwomen) of color. A cross-sectional group comparison approach was used to assess the potential effects of legal name change. A convenience sample of young transwomen enrolled in a no-cost legal name change clinic were recruited to complete a 30-minute interviewer-guided telephone survey including sociodemographic and socioeconomic factors, health and well-being, health care utilization, transgender transition-related health care, and transgender-related victimization. Sixty-five transgender women of color (37 = pre-name change group; 28 = post-name change group) completed the survey. Results indicated that the transwomen in the post-name change group were significantly older than the pre-name change group. In age-adjusted analyses, the post-name change group was significantly more likely to have a higher monthly income and stable housing than the pre-name change group. No significant differences were observed for general healthcare utilization; however, a significantly greater percentage of transwomen in the pre-name change group reported postponing medical care due to their gender identity. In addition, a significantly larger proportion of transwomen in the pre-name change group reported using non-prescribed hormones injected by friends and experiencing verbal harassment by family and friends compared to transwomen in the post-name change group. Findings suggest that legal name change may be an important structural intervention for low-income transwomen of color, providing increased socioeconomic stability and improved access to primary and transition-related health care.
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Affiliation(s)
- Brandon J Hill
- Center for Interdisciplinary Inquiry and Innovation in Sexual and Reproductive Health (Ci3), Department of Obstetrics and Gynecology, University of Chicago, 6030 S. Ellis Ave, Edelstone 266, Chicago, IL 60637, USA
- Section of Family Planning and Contraceptive Research, Department of Obstetrics and Gynecology, University of Chicago, 5841 S Maryland Ave., Chicago, IL 60637, USA
- The Kinsey Institute for Research in Sex, Gender, and Reproduction, Indiana University, 1165 E. Third St., Morrison Hall 313, Bloomington, IN 47405, USA
| | - Richard Crosby
- The Kinsey Institute for Research in Sex, Gender, and Reproduction, Indiana University, 1165 E. Third St., Morrison Hall 313, Bloomington, IN 47405, USA
- College of Public Health, University of Kentucky, 111 Washington Ave., Lexington, KY 40536, USA
| | - Alida Bouris
- Center for Interdisciplinary Inquiry and Innovation in Sexual and Reproductive Health (Ci3), Department of Obstetrics and Gynecology, University of Chicago, 6030 S. Ellis Ave, Edelstone 266, Chicago, IL 60637, USA
- School of Social Service Administration, University of Chicago, 969 E. 60 St., Chicago, IL 60637, USA
- Chicago Center for HIV Elimination, University of Chicago, 5837 S. Maryland Ave., Chicago, IL 60637, USA
| | - Rayna Brown
- Center for Interdisciplinary Inquiry and Innovation in Sexual and Reproductive Health (Ci3), Department of Obstetrics and Gynecology, University of Chicago, 6030 S. Ellis Ave, Edelstone 266, Chicago, IL 60637, USA
| | - Trevor Bak
- Center for Interdisciplinary Inquiry and Innovation in Sexual and Reproductive Health (Ci3), Department of Obstetrics and Gynecology, University of Chicago, 6030 S. Ellis Ave, Edelstone 266, Chicago, IL 60637, USA
| | - Kris Rosentel
- Center for Interdisciplinary Inquiry and Innovation in Sexual and Reproductive Health (Ci3), Department of Obstetrics and Gynecology, University of Chicago, 6030 S. Ellis Ave, Edelstone 266, Chicago, IL 60637, USA
- School of Social Service Administration, University of Chicago, 969 E. 60 St., Chicago, IL 60637, USA
| | - Alicia VandeVusse
- Center for Interdisciplinary Inquiry and Innovation in Sexual and Reproductive Health (Ci3), Department of Obstetrics and Gynecology, University of Chicago, 6030 S. Ellis Ave, Edelstone 266, Chicago, IL 60637, USA
| | - Michael Silverman
- Transgender Legal Defense & Education Fund, Inc., 20 West 20 St., Suite 705, New York, NY 10011, USA
| | - Laura Salazar
- School of Public Health, Georgia State University, 33 Gilmer St. SE, Atlanta, GA 30303, USA
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45
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Clark M, Buchanan R, Leve LD. Young Women's Perspectives of Their Adolescent Treatment Programs: A Qualitative Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:E373. [PMID: 29470424 PMCID: PMC5858442 DOI: 10.3390/ijerph15020373] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Revised: 02/17/2018] [Accepted: 02/19/2018] [Indexed: 11/17/2022]
Abstract
The perspectives of at-risk adolescent clients can play an important role in informing treatment services. The current study examines qualitative interview data from 15 young women with histories of maltreatment. Using a semi-structured qualitative interview approach, we asked the women to think retrospectively about their treatment experiences as adolescent girls. Results highlight the need for providing adolescent girls with reliable and practical information about risky sexual behavior and drug use from relatable and trustworthy helping professionals. We discuss strategies for developing and maintaining trust and delivering specific content.
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Affiliation(s)
- Miriam Clark
- Oregon Social Learning Center, Eugene, OR 97401, USA.
| | | | - Leslie D Leve
- College of Education, University of Oregon, Eugene, OR 97403, USA.
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46
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Guzzo KB, Hayford SR. Adolescent Reproductive and Contraceptive Knowledge and Attitudes and Adult Contraceptive Behavior. Matern Child Health J 2018; 22:32-40. [PMID: 28755044 PMCID: PMC5764783 DOI: 10.1007/s10995-017-2351-7] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Objectives Ineffective and inconsistent contraceptive use is common among adults, perhaps due to limited knowledge about reproduction and unfavorable attitudes toward contraception. Knowledge and attitudes are first developed in adolescence. We test whether adolescent knowledge and attitudes have long-term implications for adult contraceptive behavior. Methods Using the National Longitudinal Survey of Adolescent to Adult Health, our analytical sample (n = 6662) consists of those asked sex and contraception questions at Wave I (1995; students aged 15 and older) and who were sexually active and not pregnant at the time of the Wave IV (2007-2008) survey. We examined whether adolescent attitudes toward contraception, knowledge of condoms and reproduction, and confidence in contraceptive knowledge were predictive of adult contraceptive efficacy and consistency using logistic regression. Results In models adjusted for a range of socioeconomic, demographic, and life course factors, favorable attitudes toward contraception in adolescence increased the odds (aOR 1.21, CI 1.08-1.36) of using more effective methods rather than a less effective or no method of contraception in adulthood, as did more accurate condom knowledge (aOR 1.07, CI 1.00-1.14) and more accurate reproductive knowledge (aOR 1.07, CI 1.00-1.13). Adolescents with more favorable attitudes toward contraception also used contraception more consistently as adults (aOR 1.27, CI 1.14-1.43), as did those with more accurate condom knowledge (aOR 1.10, CI 1.03-1.18). Conclusions Attitudes towards contraception and knowledge about condoms and reproduction acquired during adolescence are predictive of adult contraceptive behavior. Results suggest that comprehensive sex education during adolescence could improve effective contraceptive behavior throughout the life course.
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Affiliation(s)
- Karen Benjamin Guzzo
- Department of Sociology, Bowling Green State University, 212 Williams Hall, Bowling Green, OH, 43403, USA.
| | - Sarah R Hayford
- Department of Sociology, The Ohio State University, 205 Townshend Hall, 1885 Neil Avenue Mall, Columbus, OH, 43210, USA
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47
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Spears H, Jemmott JB, Heeren GA. Predictors of sexual abstinence: A prospective study of college women in the United States. COGENT PSYCHOLOGY 2017. [DOI: 10.1080/23311908.2017.1304605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Affiliation(s)
- Hazel Spears
- Center for Health Behavior and Communication Research, Annenberg School for Communication, University of Pennsylvania, 3901 Walnut Street Suite 503, Philadelphia, PA 19104, USA
- Department of Social and Behavioral Sciences, Cheyney University of Pennsylvania, Cheyney, PA, USA
| | - John B. Jemmott
- Center for Health Behavior and Communication Research, Annenberg School for Communication, University of Pennsylvania, 3901 Walnut Street Suite 503, Philadelphia, PA 19104, USA
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, 3901 Walnut Street, Philadelphia, PA 19104, USA
| | - G. Anita Heeren
- Health Services, St. Joseph’s University, Philadelphia, PA, USA
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Mokwena K, Morabe M. Sexual abstinence: What is the understanding and views of secondary school learners in a semi-rural area of North West Province, South Africa? SAHARA J 2017; 13:81-7. [PMID: 27315574 PMCID: PMC5642428 DOI: 10.1080/17290376.2016.1195281] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Among strategies to prevent HIV, other sexually transmitted infections (STIs) and unwanted pregnancies, are programs that promote sexual abstinence among adolescents. However, literature suggests that there may be differences in the understanding of abstinence across adolescents, and this study sought to explore the understanding of sexual abstinence among both male and female learners in a secondary school in a semi-rural area of North West Province, South Africa. Focus group discussions were used to collect data from learners who were in grades 8–10 at the time of the study. The findings are that the learners in this area understand sexual abstinence as the decision not to have sex, and this was associated with prevention of HIV, STIs and unwanted pregnancies, which ensures a better future. Barriers to sexual abstinence include peer pressure, myths and wrong perceptions about sex, influence of drugs and alcohol and the influence of television. Based on how it is delivered, school-based sex education was viewed as both an enabler and barrier to sexual abstinence. It is recommended that programs to promote sexual abstinence be strengthened and such programs be community-based.
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Affiliation(s)
- Kebogile Mokwena
- a EdD, Department of Public Health , Sefako Makgatho Health Sciences University , Pretoria , South Africa
| | - Mamaponesa Morabe
- b MPH, Department of Public Health , Sefako Makgatho Health Sciences University , Pretoria , South Africa
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49
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Rodríguez-Díaz CE, Garriga-López A, Malavé-Rivera SM, Vargas-Molina RL. Zika virus epidemic in Puerto Rico: Health justice too long delayed. Int J Infect Dis 2017; 65:144-147. [PMID: 29153921 PMCID: PMC5725246 DOI: 10.1016/j.ijid.2017.07.017] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2017] [Revised: 07/10/2017] [Accepted: 07/18/2017] [Indexed: 11/29/2022] Open
Abstract
Over the course of 16 months, more than 35400 cases of Zika virus infection have been confirmed in Puerto Rico. This represents 85% of all cases reported in the USA and its territories. The Zika epidemic is exposing the profound failure of socioeconomic policies, as well as the failure to protect sexual and reproductive health rights in Puerto Rico. Considering the high poverty rates, high levels of sexuality-related stigma, poor quality sex education, limited access to contraception, and limited participation in the allocation of resources for prevention, it is unreasonable to focus public health efforts to prevent Zika virus infection on vector control. The allocation and equitable management of resources for research and intervention are required in order to understand and address the barriers to and facilitators of prevention at the individual, social, and structural levels. Further, the impact of efforts to tackle the social determinants of the Zika virus epidemic on the island should be assessed.
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Affiliation(s)
- Carlos E Rodríguez-Díaz
- Center for Sociomedical Research and Evaluation, School of Public Health, University of Puerto Rico-Medical Sciences Campus, San Juan, Puerto Rico; Doctoral Program in Public Health with Specialty in Social Determinants of Health, Social Sciences Department, School of Public Health, University of Puerto Rico-Medical Sciences Campus, San Juan, Puerto Rico.
| | - Adriana Garriga-López
- Department of Anthropology, Columbia University. New York, New York, USA; Department of Anthropology and Sociology, Kalamazoo College. Kalamazoo, Michigan, USA
| | - Souhail M Malavé-Rivera
- Center for Sociomedical Research and Evaluation, School of Public Health, University of Puerto Rico-Medical Sciences Campus, San Juan, Puerto Rico; Doctoral Program in Public Health with Specialty in Social Determinants of Health, Social Sciences Department, School of Public Health, University of Puerto Rico-Medical Sciences Campus, San Juan, Puerto Rico
| | - Ricardo L Vargas-Molina
- Center for Sociomedical Research and Evaluation, School of Public Health, University of Puerto Rico-Medical Sciences Campus, San Juan, Puerto Rico
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50
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Mane P, Aggleton P. Enabling positive change: Progress and setbacks in HIV and sexual and reproductive health and rights. Glob Public Health 2017; 13:1341-1356. [PMID: 29143571 DOI: 10.1080/17441692.2017.1401652] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
At a point in history when the future of sexual and reproductive health including HIV looks particularly uncertain, it is helpful to recognise that many of the challenges currently faced are neither new nor insurmountable. Reflecting on past achievements and lessons learned helps us to have confidence that positive change is feasible. This paper reflects on some of the changes observed in countries like India and Mozambique and identifies a range of factors which need to coalesce to enable these developments, along with specific contextual factors. It is the combination of these influences rather than any one of them alone that brought about the change in the three instances described - fostering a positive political response to HIV in its early years in India; bringing about policy reform on abortion in Mozambique; and increasing contraceptive prevalence and age at marriage in some districts in Bihar, India. Change is always fragile and susceptible to setbacks, but change-seekers can learn in the process and gain renewed hope that progress can and often does take place if they persevere.
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Affiliation(s)
- Purnima Mane
- a Centre for Social Research in Health , UNSW Australia , Kensington , NSW , Australia
| | - Peter Aggleton
- a Centre for Social Research in Health , UNSW Australia , Kensington , NSW , Australia
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