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Sifaki M, Flouri E, Midouhas E. Paternal and maternal psychological distress and adolescent health risk behaviors: The role of sensitive periods. J Adolesc 2024. [PMID: 39072763 DOI: 10.1002/jad.12385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Revised: 04/09/2024] [Accepted: 07/17/2024] [Indexed: 07/30/2024]
Abstract
INTRODUCTION Adolescent health risk behaviors are linked to poor physical and mental health outcomes. While past research shows that maternal psychological distress predicts those behaviors, we know less about the role of paternal psychological distress and the role of sensitive periods. METHODS Using 11,128 data from families (50.5% female children) from the UK's Millennium Cohort Study, we examined the role of timing of exposure to paternal and maternal psychological distress in engagement in health risk behaviors (smoking, alcohol use, binge drinking, and sexual activity) at age 14. Paternal and maternal psychological distress, measured with the Kessler-6 scale, were assessed at child ages 3, 7, and 11. We performed path analysis, adjusting for key covariates, modeling maternal distress parallel to paternal, and allowing for autoregressive paths. RESULTS Paternal distress experienced at age 11 predicted a higher likelihood of smoking at age 14. Maternal distress at age 7 also predicted a higher likelihood of smoking, alcohol use, and binge drinking, but only for boys. Moreover, maternal distress at age 3 was associated with a lower risk for alcohol use. Effects were not replicated in the sensitivity analysis we performed, including only families with resident biological fathers across the study period. Instead, maternal and paternal distress at age 11 raised girls' risk for binge drinking and sexual activity, respectively. CONCLUSIONS Parental distress in early childhood does not predict adolescent health risk behaviors. In late childhood, however, both paternal and maternal distress seem to influence the likelihood of engagement in such behaviors.
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Affiliation(s)
- Maria Sifaki
- Research Department of Epidemiology and Public Health, UCL Institute of Epidemiology and Health Care, London, UK
| | - Eirini Flouri
- Department on Psychology and Human Development, UCL Institute of Education, London, UK
| | - Emily Midouhas
- Department on Psychology and Human Development, UCL Institute of Education, London, UK
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Ekwueme CN, Okeke C, Eze II, Mbachu CO, Onwujekwe O. To what extent did implementing a community-embedded intervention align with the goals and roles of stakeholders in adolescent sexual and reproductive health? Reprod Health 2024; 21:27. [PMID: 38373951 PMCID: PMC10877846 DOI: 10.1186/s12978-024-01753-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 02/07/2024] [Indexed: 02/21/2024] Open
Abstract
BACKGROUND Adolescents' sexual and reproductive health (SRH) needs are largely unmet due to poor access to SRH information and services. A multicomponent community-embedded intervention, comprising advocacy to policymakers and community leaders, training of health workers on the provision of youth-friendly SRH services, and establishment of school health clubs, was implemented in Ebonyi State, Nigeria, to improve access to SRH information and services for adolescents aged 13-18 years in selected communities and secondary schools. This study explored the extent to which the intervention aligned with goals and roles of stakeholders in the State. METHODS Qualitative in-depth interviews (30) were conducted with key stakeholders in adolescent health programming in the State, and community gatekeepers (traditional and religious leaders) in the intervention communities. Sex-disaggregated focus group discussions (10) were conducted with health service providers, parents/guardians of adolescents. Data was analyzed deductively based on fit of strategy and two constructs of the Theoretical Framework for Acceptability - burden, and opportunity cost. The transcripts were coded in NVivo 12, and the subthemes that emerged from each construct were identified. RESULTS Stakeholders perceived the ASRH intervention activities to align with their individual goals of sense of purpose from serving the community and organizational goals of improving the visibility of adolescent reproductive health programs and aligned with their routine work. Hence, implementing or participating in the interventions was not considered a burden by many. Although the delivery of the interventions constituted additional workload and time commitment for the implementers, the benefits of partaking in the intervention were perceived to outweigh the inputs that they were required to make. Some of the community health workers in the intervention felt that provision of financial incentive will help with making the intervention less burdensome. To participate in the intervention, opportunity cost included forgoing work and business activities as well as family commitments. CONCLUSION Findings from the study show that the intervention aligned with individual/organizational goals of stakeholders. To improve acceptability of the ASRH interventions, interventions should leverage on existing programs and routine work of people who will deliver the interventions.
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Affiliation(s)
- Chinazom N Ekwueme
- Health Policy Research Group, University of Nigeria, Enugu, Nigeria.
- Department of Community Medicine, University of Nigeria Teaching Hospital, Enugu, Nigeria.
| | - Chinyere Okeke
- Health Policy Research Group, University of Nigeria, Enugu, Nigeria
- Department of Community Medicine, University of Nigeria Enugu Campus, Enugu, Nigeria
| | - Irene Ifeyinwa Eze
- Health Policy Research Group, University of Nigeria, Enugu, Nigeria
- Department of Community Medicine, College of Health Sciences, Alex Ekwueme Federal University Teaching Hospital, Abakaliki, Nigeria
| | - Chinyere Ojiugo Mbachu
- Health Policy Research Group, University of Nigeria, Enugu, Nigeria
- Department of Community Medicine, University of Nigeria Enugu Campus, Enugu, Nigeria
| | - Obinna Onwujekwe
- Health Policy Research Group, University of Nigeria, Enugu, Nigeria
- Department of Health Administration and Management, University of Nigeria Enugu Campus, Enugu, Nigeria
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Rahman T, Rogers CJ, Albers LD, Forster M, Unger JB. Adverse Childhood Experiences, Acculturation, and Risky Sexual Behaviors in Hispanic Young Adults: Findings from Project RED. JOURNAL OF SEX RESEARCH 2024; 61:105-118. [PMID: 36877805 PMCID: PMC10480355 DOI: 10.1080/00224499.2023.2184762] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
While adverse childhood experiences (ACE) are well-documented predictors of maladaptive behaviors in adulthood, including risky sexual behaviors (RSB), the influence of acculturation in this association remains unknown. Although Hispanics are a rapidly growing population in the United States and are disproportionately affected by adverse sexual health outcomes, there is a paucity of research examining the interplay of ACE, acculturation, and RSB in this population. We observed the ACE-RSB association and how this relationship varies across U.S. and Hispanic acculturation levels, in a sample of Hispanic young adults (n = 715). Data for this study were from Project RED, a longitudinal study of Hispanic health. We ran regression models to test associations between ACE (0, 1-3, 4+) and several RSB (e.g., early sexual initiation (≤14 years), condomless sex, lifetime sexual partners, and alcohol/drug use before intercourse), and assessed moderation by U.S./Hispanic acculturation. Compared with those without ACE, individuals with 4 + ACE had higher odds of early sexual initiation (AOR: 2.23), alcohol/drug use before last intercourse (AOR: 2.31), and condomless sex (AOR: 1.66), as well as a higher number of lifetime sexual partners (β: 0.60). For those reporting 4 + ACE, high U.S. acculturation was protective in the association between ACE and using alcohol/drugs before intercourse. Future research implications are discussed.
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Affiliation(s)
- Tahsin Rahman
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, United States
| | - Christopher J. Rogers
- Department of Health Sciences, California State University, Northridge, Los Angeles, United States
| | - Larisa D. Albers
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, United States
| | - Myriam Forster
- Department of Health Sciences, California State University, Northridge, Los Angeles, United States
| | - Jennifer B. Unger
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, United States
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Perez-Fernandez J, Arroyo-Velasco DO, Huaman MR, Chavez-Bustamante SG, Llamo-Vilcherrez AP, Delgado-Flores CJ, Toro-Huamanchumo CJ. Association between early sexual initiation and sexually transmitted infections among Peruvian reproductive-age women. Front Public Health 2023; 11:1191722. [PMID: 37790721 PMCID: PMC10544918 DOI: 10.3389/fpubh.2023.1191722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Accepted: 09/04/2023] [Indexed: 10/05/2023] Open
Abstract
Background Sexually transmitted infections (STIs) are a serious public health problem worldwide, especially among reproductive-age women. The early sexual onset of sexual intercourse (EOSI) has been suggested as a risk factor, although there is no data at the national level. Objective To evaluate the association between EOSI and STIs in Peruvian women of childbearing age. Methods Analytical cross-sectional study with secondary data analyzes of the Peruvian Demographic and Family Health Survey 2018. The outcome was the presence of STIs in the last 12 months and the exposure variable was EOSI (age < 15 years at the time of their first sexual experience). To evaluate the association of interest, crude and adjusted prevalence ratios (aPRs) were calculated using generalized linear models with Poisson family and logarithmic link function. Results We analyzed data from 31,028 women of childbearing age. The 11.3% reported having STIs in the last 12 months and 20.2% of the participants had an EOSI. After adjusting for potential confounders, we found that EOSI was associated with STIs (aPR: 1.27; 95% CI: 1.08-1.50; p = 0.005). When conducting stratified analysis by area of residence and number of sexual partners, this association was maintained in women living in urban areas (aPR: 1.36; 95% CI: 1.11-1.66; p = 0.003) those who did not report having a history of multiple sexual partners (aPR: 1.27; 95% CI: 1.08-1.51; p = 0.005), and those in the middle (aPR: 1.42; 95% CI: 1.03-1.97; p = 0.034) and highest (aPR: 2.12; 95% CI: 1.33-3.39; p = 0.002) wealth quintiles. Conclusion Among reproductive-age women from Peru, EOSI was associated with STIs, especially in women living in urban areas, with no history of multiple sexual partners, and belonging to the middle to higher wealth index. The implementation of measures to prevent EOSI and fostering appropriate sexual health counseling for women with EOSI is advised.
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Affiliation(s)
| | | | - Mariella R. Huaman
- Sociedad Científica San Fernando, Universidad Nacional Mayor de San Marcos, Lima, Peru
| | | | - Anita P. Llamo-Vilcherrez
- Grupo Peruano de Investigación Epidemiológica, Unidad de Investigación para la Generación y Síntesis de Evidencias en Salud, Universidad San Ignacio de Loyola, Lima, Peru
| | - Carolina J. Delgado-Flores
- Carrera de Farmacia y Bioquímica, Facultad de Ciencias de la Salud, Universidad Científica del Sur, Lima, Peru
| | - Carlos J. Toro-Huamanchumo
- Unidad de Investigación para la Generación y Síntesis de Evidencias en Salud, Universidad San Ignacio de Loyola, Lima, Peru
- OBEMET Centro de Obesidad y Salud Metabólica, Lima, Peru
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Birri Makota RB, Musenge E. Predicting HIV infection in the decade (2005-2015) pre-COVID-19 in Zimbabwe: A supervised classification-based machine learning approach. PLOS DIGITAL HEALTH 2023; 2:e0000260. [PMID: 37285368 DOI: 10.1371/journal.pdig.0000260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Accepted: 04/24/2023] [Indexed: 06/09/2023]
Abstract
The burden of HIV and related diseases have been areas of great concern pre and post the emergence of COVID-19 in Zimbabwe. Machine learning models have been used to predict the risk of diseases, including HIV accurately. Therefore, this paper aimed to determine common risk factors of HIV positivity in Zimbabwe between the decade 2005 to 2015. The data were from three two staged population five-yearly surveys conducted between 2005 and 2015. The outcome variable was HIV status. The prediction model was fit by adopting 80% of the data for learning/training and 20% for testing/prediction. Resampling was done using the stratified 5-fold cross-validation procedure repeatedly. Feature selection was done using Lasso regression, and the best combination of selected features was determined using Sequential Forward Floating Selection. We compared six algorithms in both sexes based on the F1 score, which is the harmonic mean of precision and recall. The overall HIV prevalence for the combined dataset was 22.5% and 15.3% for females and males, respectively. The best-performing algorithm to identify individuals with a higher likelihood of HIV infection was XGBoost, with a high F1 score of 91.4% for males and 90.1% for females based on the combined surveys. The results from the prediction model identified six common features associated with HIV, with total number of lifetime sexual partners and cohabitation duration being the most influential variables for females and males, respectively. In addition to other risk reduction techniques, machine learning may aid in identifying those who might require Pre-exposure prophylaxis, particularly women who experience intimate partner violence. Furthermore, compared to traditional statistical approaches, machine learning uncovered patterns in predicting HIV infection with comparatively reduced uncertainty and, therefore, crucial for effective decision-making.
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Affiliation(s)
- Rutendo Beauty Birri Makota
- Division of Epidemiology and Biostatistics, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Eustasius Musenge
- Division of Epidemiology and Biostatistics, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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Iwelunmor J, Ezechi O, Obiezu-Umeh C, Gbaja-Biamila T, Musa AZ, Nwaozuru U, Obasi N, Ojo V, Xian H, Oladele D, Airhihenbuwa CO, Muessig K, Rosenberg N, Conserve DF, Ong JJ, Nkengasong S, Tahlil KM, BeLue R, Engelhart A, Mason S, Tang W, Ogedegbe G, Tucker JD. Tracking adaptation strategies of an HIV prevention intervention among youth in Nigeria: a theoretically informed case study analysis of the 4 Youth by Youth Project. Implement Sci Commun 2023; 4:44. [PMID: 37101190 PMCID: PMC10131455 DOI: 10.1186/s43058-023-00404-8] [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: 09/14/2022] [Accepted: 02/27/2023] [Indexed: 04/28/2023] Open
Abstract
BACKGROUND Although many behavioral interventions are adapted, little is known about the reasons for adaptations and the process and outcomes influencing adaptations. To address this gap, we explored the adaptations made to promote HIV prevention services, including HIV self-testing (HIVST), among Nigerian youth. METHODS The main objective of this qualitative case study design was to document the adaptations made over time using the Framework for Reporting Adaptations and Modifications - Expanded (FRAME). Between 2018 and 2020, we organized four participatory activities as part of the 4 Youth by Youth project to increase the uptake of HIVST services in Nigeria-an open call, a designathon, a capacity-building bootcamp and a pilot feasibility trial. We also began the process of implementing a final intervention using a pragmatic randomized control trial (RCT). The open call solicited creative strategies to promote HIVST among Nigerian youth and then had experts evaluate them. The designathon brought together youth teams to further develop their HIVST service strategies into implementation protocols. Teams determined to be exceptional were invited to a four-week capacity-building bootcamp. The five teams that emerged from the bootcamp were supported to pilot their HIVST service strategies over a 6-month period. The adapted intervention is currently being evaluated in a pragmatic RCT. We transcribed meeting reports and conducted document reviews of study protocols and training manuals. RESULTS Sixteen adaptations were identified and categorized into three domains: (1) modifications to the content of the intervention (i.e. photo verification system and/or Unstructured Supplementary Service Data (USSD) system to verify HIVST); (2) modifications to the delivery the intervention (i.e. implement participatory learning community sessions to provide supportive supervision and technical support); (3) modifications to the evaluation processes (i.e. economic evaluation to estimate the cost of implementing intervention on a larger scale). Frequent reasons for adaptation included increasing intervention reach, modifying interventions to enhance their appropriateness and fit with the recipient, and increasing the intervention's feasibility and acceptability. Most adaptations were planned and reactive, and the need for modifications was determined by the youths, 4YBY program staff, and advisory group. CONCLUSIONS Findings suggest that the nature of adaptations made throughout the implementation process reflects the necessity of evaluating services in context while adjusting to specific challenges as they are identified. Further research is needed to understand the effect of these adaptations on the overall intervention effect as well as the quality of youth engagement.
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Affiliation(s)
- Juliet Iwelunmor
- College for Public Health & Social Justice, Saint Louis University, 3545 Lafayette Avenue, Saint Louis, MO, 63104, USA.
| | - Oliver Ezechi
- Clinical Sciences Department, Nigerian Institute of Medical Research, Lagos, Nigeria
| | - Chisom Obiezu-Umeh
- College for Public Health & Social Justice, Saint Louis University, 3545 Lafayette Avenue, Saint Louis, MO, 63104, USA
| | - Titilola Gbaja-Biamila
- College for Public Health & Social Justice, Saint Louis University, 3545 Lafayette Avenue, Saint Louis, MO, 63104, USA
- Clinical Sciences Department, Nigerian Institute of Medical Research, Lagos, Nigeria
| | - Adesola Z Musa
- Clinical Sciences Department, Nigerian Institute of Medical Research, Lagos, Nigeria
| | - Ucheoma Nwaozuru
- Department of Implementation Science, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Nnamdi Obasi
- Clinical Sciences Department, Nigerian Institute of Medical Research, Lagos, Nigeria
- College of Medicine, University of Nigeria, Nsukka, Nigeria
| | - Victor Ojo
- Clinical Sciences Department, Nigerian Institute of Medical Research, Lagos, Nigeria
- Federal University of Technology Akure, Akure, Ondo State, Nigeria
| | - Hong Xian
- College for Public Health & Social Justice, Saint Louis University, 3545 Lafayette Avenue, Saint Louis, MO, 63104, USA
| | - David Oladele
- College for Public Health & Social Justice, Saint Louis University, 3545 Lafayette Avenue, Saint Louis, MO, 63104, USA
- Clinical Sciences Department, Nigerian Institute of Medical Research, Lagos, Nigeria
| | - Collins O Airhihenbuwa
- Heath Policy and Behavioral Sciences, School of Public Health, Georgia State University, Atlanta, GA, USA
| | - Kathryn Muessig
- Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Nora Rosenberg
- Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Donaldson F Conserve
- Department of Prevention and Community Health, Milken Institute School of Public Health, The George Washington University, Washington, DC, USA
| | - Jason J Ong
- Central Clinical School, Monash University, Melbourne, Australia
- Melbourne Sexual Health Centre, Alfred Health, Melbourne, Australia
- Clinical Research Department, London, School of Hygiene and Tropical Medicine, London, UK
| | - Susan Nkengasong
- Clinical Research Department, London, School of Hygiene and Tropical Medicine, London, UK
| | - Kadija M Tahlil
- Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Rhonda BeLue
- Community and Policy, College for Health, University of Texas at San Antonio, San Antonio, TX, USA
| | - Alexis Engelhart
- College for Public Health & Social Justice, Saint Louis University, 3545 Lafayette Avenue, Saint Louis, MO, 63104, USA
| | - Stacey Mason
- College for Public Health & Social Justice, Saint Louis University, 3545 Lafayette Avenue, Saint Louis, MO, 63104, USA
| | - Weiming Tang
- Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Gbenga Ogedegbe
- Center for Healthful Behavior Change, Division of Health and Behavior, Department of Population Health, New York University School of Medicine, NY, New York, NY, USA
| | - Joseph D Tucker
- Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK
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Zhu B, Serrano M, Buck G. The influence of maternal factors on the neonatal microbiome and health. RESEARCH SQUARE 2023:rs.3.rs-2485214. [PMID: 36778490 PMCID: PMC9915805 DOI: 10.21203/rs.3.rs-2485214/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
The human microbiome plays an essential role in human health. However, the influence of maternal factors on the neonatal microbiome remains obscure. Herein, our observations suggest that the neonatal buccal microbiome is similar to the maternal buccal microbiome, but the neonatal gastrointestinal microbiome develops a unique composition at an early stage. The low complexity of the neonatal buccal microbiome is a hallmark of maternal and neonatal health, but that of the neonatal gastrointestinal microbiome is associated with maternal inflammation-related metabolites. Microbial infections in the maternal reproductive tract universally impact the complexity of the neonatal microbiomes, and the body site is most important in modulating the composition of the neonatal microbiomes. Additionally, maternal lipids attenuated the adverse influence of several maternal factors on the neonatal microbiomes. Finally, admission of neonates to the newborn intensive care unit is associated with sub-optimal states of the maternal buccal and rectal microbiomes and maternal health.
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Affiliation(s)
- Bin Zhu
- Virginia Commonwealth University
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Ramos-Olazagasti MA, Elkington KS, Wainberg ML, Feng T, Corbeil T, Canino GJ, Bird HR, Scorza P, Wildsmith E, Alegria M, Duarte CS. Does Context and Adversity Shape Sexual Behavior in Youth? Findings from Two Representative Samples of Puerto Rican Youth. ARCHIVES OF SEXUAL BEHAVIOR 2023; 52:217-231. [PMID: 36169776 PMCID: PMC9868044 DOI: 10.1007/s10508-022-02328-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/19/2020] [Revised: 02/23/2022] [Accepted: 03/12/2022] [Indexed: 06/16/2023]
Abstract
Sexual risk behaviors often co-occur. Understanding the heterogeneity in patterns of sexual behavior among youth and how context of majority and minoritized status may be related to these behaviors can inform targeted STIs/HIV interventions. Data are from the Boricua Youth Study, a longitudinal study of two probability samples of Puerto Rican youth recruited in the South Bronx (SBx) and the metropolitan area in Puerto Rico (PR). We identified patterns of sexual behaviors among young adults (ages 15-24) with sexual experience (N = 1,203) using latent class analysis. Analyses examined context differences and the prospective relationship between adverse childhood experiences (ACEs) (childhood maltreatment/violence, family/parental dysfunction) and patterns of sexual behaviors (age at first sex, number of sex partners, sex with a high-risk partner, condom use, sex while intoxicated, oral sex, anal sex). We identified five classes of sexual behaviors: (1) currently inactive (16.51%); (2) single partner, low activity (13.49%); (3) single partner, inconsistent condom use (32.19%); (4) single partner, sex without a condom (27.65%); and (5) multirisk (10.16%). Young adults from the SBx (minoritized context), those who identified as male, and those with higher child maltreatment/violence ACEs were more likely to be in the multi-risk class relative to the single partner, inconsistent condom use class. Those from the SBx were also more likely to be in the single partner, sex without condom class, relative to the single partner, inconsistent condom use class. Differences in young adults' patterns of sexual behaviors between the two contexts, one representing the minoritized context (SBx) contrasted to the majority context (PR), were not explained by ACEs. Findings highlight the heterogeneity in the patterns of sexual behaviors among Puerto Rican young adults as well as how such patterns vary based on sociocultural contexts. Exposure to child maltreatment/violence ACEs was related to the riskier patterns; however, they did not explain why riskier patterns of sexual behaviors were found in the SBx compared to PR. Results underscore the need for tailored interventions and more in-depth examination of differences across contexts.
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Affiliation(s)
- Maria A Ramos-Olazagasti
- Reproductive Health and Family Formation, Child Trends, 7315 Wisconsin Ave, Ste 1200W, Bethesda, MD, 20814, USA.
- Child and Adolescent Psychiatry, Columbia University, New York, NY, USA.
| | - Katherine S Elkington
- Child and Adolescent Psychiatry, Columbia University, New York, NY, USA
- New York State Psychiatric Institute, New York, NY, USA
| | - Milton L Wainberg
- Child and Adolescent Psychiatry, Columbia University, New York, NY, USA
- New York State Psychiatric Institute, New York, NY, USA
| | - Tianshu Feng
- New York State Psychiatric Institute, New York, NY, USA
| | | | - Glorisa J Canino
- Medical Sciences Campus, University of Puerto Rico, Rio Piedras, Puerto Rico, USA
| | - Hector R Bird
- Child and Adolescent Psychiatry, Columbia University, New York, NY, USA
| | - Pamela Scorza
- Child and Adolescent Psychiatry, Columbia University, New York, NY, USA
- New York State Psychiatric Institute, New York, NY, USA
| | - Elizabeth Wildsmith
- Reproductive Health and Family Formation, Child Trends, 7315 Wisconsin Ave, Ste 1200W, Bethesda, MD, 20814, USA
| | - Margarita Alegria
- Disparities Research Unit, Massachusetts General Hospital, Boston, MA, USA
| | - Cristiane S Duarte
- Child and Adolescent Psychiatry, Columbia University, New York, NY, USA
- New York State Psychiatric Institute, New York, NY, USA
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Ruiz-Tagle Maturana JA, Cáceres DD, Castillo-Carniglia Á. Association between substance use and number of sexual partners: evidence from Chile. JOURNAL OF SUBSTANCE USE 2022. [DOI: 10.1080/14659891.2022.2153755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- José Antonio Ruiz-Tagle Maturana
- Programa de Doctorado en Políticas Públicas, Universidad Mayor, Santiago, Chile
- Programa de Bioestadística, Escuela de Salud Pública, Universidad de Chile, Santiago, Chile
- Millennium Nucleus for the Evaluation and Analysis of Drug Policies (nDP), Chile
| | - Dante D. Cáceres
- Environmental Health Program, Public Health School, Faculty of Medicine, Universidad de Chile, Santiago, Chile
- Health Sciences School, Universidad de Tarapacá, Arica, Chile
| | - Álvaro Castillo-Carniglia
- Millennium Nucleus for the Evaluation and Analysis of Drug Policies (nDP), Chile
- Society and Health Research Center, Facultad de Ciencias Sociales y Artes, Universidad Mayor, Santiago, Chile
- Millennium Nucleus on Sociomedicine (SocioMed), Chile
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Walsh S, Jenner E, Qaragholi N, Henley C, Demby H, Leger R, Burgess K. The Impact of a High School-Based Positive Youth Development Program on Sexual Health Outcomes: Results from a Randomized Controlled Trial. THE JOURNAL OF SCHOOL HEALTH 2022; 92:1155-1164. [PMID: 35932196 PMCID: PMC9804765 DOI: 10.1111/josh.13216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Revised: 06/28/2022] [Accepted: 07/08/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Although positive youth development (PYD) programs have demonstrated effectiveness in improving adolescent reproductive health outcomes, there is a lack of evidence on effective school-based interventions designed especially for high school settings. This study examined the efficacy of Peer Group Connection (PGC-HS), a school-based PYD program, in improving sexual health outcomes for high school participants. METHODS A total of 1523 ninth-grade students at 18 schools were randomly assigned to be offered PGC-HS or a classes-as-usual control condition during 2016 to 2017 and 2017 to 2018 school years. Impacts were assessed on three confirmatory and 6 exploratory outcomes via self-reported participant questionnaire data collected at the beginning of 10th grade. RESULTS Although the offer of PGC-HS had no statistically detectable effect on confirmatory behavioral outcomes (sexual initiation, frequency of sex, and number of sexual partners) at 10th grade follow-up, causal impact estimates indicate that PGC-HS participants were less likely than control participants to ever have had vaginal sex. PGC-HS participants also scored higher on decision-making skills and perceived connection to peer connectedness. CONCLUSIONS Results suggest that by building social and emotional skills and helping students form supportive peer relationships, PGC-HS may encourage students to make healthier choices and avoid risky behaviors during a critical period in high school, thus, reducing the risk of pregnancy.
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Affiliation(s)
- Sarah Walsh
- The Policy & Research Group8434 Oak StreetNew OrleansLA70118
| | - Eric Jenner
- The Policy & Research Group8434 Oak StreetNew OrleansLA70118
| | - Noor Qaragholi
- The Policy & Research Group, 8434 Oak Street, New Orleans, LA 70118; Johns Hopkins Bloomberg School of Public HealthBaltimore
| | - Catherine Henley
- The Policy & Research Group, 8434 Oak Street, New Orleans, LA 70118; Department of Epidemiology, University of WashingtonSeattleWA
| | - Hilary Demby
- The Policy & Research Group8434 Oak StreetNew OrleansLA70118
| | - Rebekah Leger
- The Policy & Research Group8434 Oak StreetNew OrleansLA70118
| | - Kelly Burgess
- The Policy & Research Group8434 Oak StreetNew OrleansLA70118
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Adebajo SB, Nowak RG, Adebiyi R, Shoyemi E, Ekeh C, Ramadhani HO, Gaydos CA, Ake JA, Baral SD, Charurat ME, Crowell TA. Prevalence and factors associated with anogenital warts among sexual and gender minorities attending a trusted community health center in Lagos, Nigeria. PLOS GLOBAL PUBLIC HEALTH 2022; 2:e0001215. [PMID: 36962635 PMCID: PMC10021808 DOI: 10.1371/journal.pgph.0001215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Accepted: 10/03/2022] [Indexed: 11/11/2022]
Abstract
Anogenital warts caused by human papillomavirus are common in sexual and gender minorities (SGM). The prevalence of, and factors associated with warts were described for SGM with a high burden of HIV in Nigeria. Individuals who reported anal sex with men were enrolled in the TRUST/RV368 cohort. Participants completed an interviewer-led survey, provided biological samples, and had a physical examination. Specific to the Lagos site, clinic staff offered standardized warts treatment services. RDS-weighted multivariable logistic regression was used to estimate the adjusted odds ratios (AORs) and 95% confidence intervals (CIs) for factors potentially associated with anogenital warts. Of 672 enrolled SGM, 478 (71%) engaged in warts services and had complete data. The median age (interquartile range) was 22 (20-26) years, 272 (52%) initiated sex before age 18, and 347 (79%) were cisgender men. Multiple male sexual partners in the previous year were reported by 448 (90%) of the participants, and 342 (66%) were living with HIV. Warts were diagnosed in 252 (54%), including anal warts in 234 (43%) and penile warts in 44 (8%); 26 (5%) had both anal and penile warts. Factors independently associated with warts included HIV (AOR:2.97; CI:1.44-6.14), engaging in receptive anal sex (AOR:3.49; CI:1.25-9.75), having multiple male sexual partners (AOR:7.26; CI:2.11-24.87), age at sexual debut (AOR:0.53; CI:0.28-0.98), and non-binary gender identity (AOR:0.20; CI:0.05-0.71). Warts were common among SGM in Nigeria, particularly those living with HIV. Administration of HPV vaccination before sexual debut or as a catch-up vaccination may prevent HPV-associated complications.
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Affiliation(s)
- Sylvia B. Adebajo
- Center for International Health Education Biosecurity, University of Maryland, Baltimore, Abuja, Nigeria
| | - Rebecca G. Nowak
- Institute of Human Virology, University of Maryland, Baltimore, Maryland, United States of America
| | - Ruxton Adebiyi
- Center for International Health Education Biosecurity, University of Maryland, Baltimore, Abuja, Nigeria
| | | | | | - Habib O. Ramadhani
- Institute of Human Virology, University of Maryland, Baltimore, Maryland, United States of America
| | - Charlotte A. Gaydos
- Department of Medicine, Johns Hopkins University, Baltimore, Maryland, United States of America
| | - Julie A. Ake
- United States. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, Maryland, United States of America
| | - Stefan D. Baral
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
| | - Manhattan E. Charurat
- Institute of Human Virology, University of Maryland, Baltimore, Maryland, United States of America
| | - Trevor A. Crowell
- United States. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, Maryland, United States of America
- Henry Martin Jackson Foundation for the Advancement of Military Medicine, Bethesda, Maryland, United States of America
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12
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Hunt JA, Randell KA, Mermelstein S, Miller MK, Masonbrink AR. Understanding the Sexual and Reproductive Health Needs of Hospitalized Adolescent Males. Hosp Pediatr 2022; 12:e387-e392. [PMID: 36300339 PMCID: PMC9647630 DOI: 10.1542/hpeds.2021-006489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
OBJECTIVES To describe sexual behaviors and acceptability of receiving sexual and reproductive health (SRH) services among hospitalized adolescent males. METHODS We performed a cross-sectional survey of hospitalized adolescents. Eligible participants were males aged 14 to 20 years admitted at 2 academic medical centers. Outcome measures included reported healthcare utilization, sexual health behaviors (eg, sexual activity), contraception use, and acceptability of SRH discussions during a hospitalization. RESULTS Among 145 participants, 42% reported a history of vaginal sex, 27% current sexual activity, 12% early sexual debut, and 22% 4 or more prior sexual partners. At last sex, condom use was reported by 63% and use of reversible contraception by 36%. Nearly half (45%) agreed that hospital-based SRH discussions were acceptable, particularly among those with history of sexual activity (P < .01). Some (12%) reported they had not accessed care in the past year when they felt they should. CONCLUSIONS Hospitalized males in our study had similar rates of sexual activity as compared with the general population but had higher rates of early sexual debut and number of prior partners, which are independently linked with negative sexual health outcomes (eg, sexually transmitted infections). Our participants found SRH discussions to be generally acceptable. These findings reveal opportunities to screen for unmet SRH needs and provide SRH education and services for adolescent males in the hospital.
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Affiliation(s)
- Jane Alyce Hunt
- Department of Pediatrics, Washington University School of Medicine, St Louis, Missouri
| | - Kimberly A Randell
- Department of Pediatrics, Children’s Mercy Kansas City, Kansas City, Missouri
- University of Missouri-Kansas City School of Medicine, Kansas City, Missouri
- University of Kansas School of Medicine, Kansas City, Kansas
| | - Sarah Mermelstein
- Department of Pediatrics, Washington University School of Medicine, St Louis, Missouri
| | - Melissa K Miller
- Department of Pediatrics, Children’s Mercy Kansas City, Kansas City, Missouri
- University of Missouri-Kansas City School of Medicine, Kansas City, Missouri
- University of Kansas School of Medicine, Kansas City, Kansas
| | - Abbey R Masonbrink
- Department of Pediatrics, Children’s Mercy Kansas City, Kansas City, Missouri
- University of Missouri-Kansas City School of Medicine, Kansas City, Missouri
- University of Kansas School of Medicine, Kansas City, Kansas
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13
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de Waal A, Racey CS, Donken R, Plotnikoff K, Dobson S, Smith L, Grennan T, Sadarangani M, Ogilvie G. Factors associated with intention to receive vaccines for bacterial sexually transmitted infections among young HPV-vaccinated Canadian women. CANADIAN JOURNAL OF PUBLIC HEALTH 2022; 113:776-785. [PMID: 35616872 PMCID: PMC9134722 DOI: 10.17269/s41997-022-00648-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Accepted: 04/20/2022] [Indexed: 11/21/2022]
Abstract
Objective The aim of this study was to explore the acceptability of bacterial STI vaccines among young HPV-vaccinated Canadian women to inform future vaccine program implementation. Methods A 20-item cross-sectional questionnaire was administered from June 2019 to June 2020 to HPV-vaccinated participants of the pan-Canadian QUEST cohort. Multivariable logistic regression models assessed interest in chlamydia, syphilis, and gonorrhea vaccines using a priori variables and factors significant in bivariate analysis. Results Of the 1092 respondents analyzed, 82% indicated interest in receiving one or more future STI vaccines. Respondents had a median age of 19.6 years (range 16.9–23.4), and 75% of respondents identified as white/European descent. In adjusted analyses, intent to engage in positive health behaviours was associated with vaccine interest for syphilis (OR = 5.76, 95% CI 4.03–8.27), chlamydia (OR = 5.27, 95% CI 3.66–7.63), and gonorrhea (OR = 5.96, 95% CI 4.15–8.60). Willingness to pay for an STI vaccine was also associated with vaccine interest for syphilis (OR = 2.02, 95% CI 1.29–3.19), chlamydia (OR = 2.41, 95% CI 1.50–3.90), and gonorrhea (OR = 2.29, 95% CI 1.44–3.63). Ever having sexual intercourse and identifying as LGBTQ were significantly associated with vaccine interest for all infections, while age and ever being immunosuppressed were not significant in any adjusted models. Conclusion Findings indicate over 80% of participants in a cohort of young HPV-vaccinated Canadian women are interested in receiving future bacterial STI vaccines. Further exploration of STI vaccine acceptability among diverse populations is required to inform future bacterial STI vaccine program implementation. Supplementary Information The online version contains supplementary material available at 10.17269/s41997-022-00648-2.
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Affiliation(s)
- Anna de Waal
- Faculty of Medicine, McGill University, Montreal, Quebec, Canada
- BC Women's Hospital and Health Service, Women's Health Research Institute, Box 42, Room H203G - 4500 Oak Street, Vancouver, BC, V6H 3N1, Canada
- Vaccine Evaluation Center, BC Children's Hospital Research Institute, Vancouver, British Columbia, Canada
| | - C Sarai Racey
- BC Women's Hospital and Health Service, Women's Health Research Institute, Box 42, Room H203G - 4500 Oak Street, Vancouver, BC, V6H 3N1, Canada
- Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Robine Donken
- BC Women's Hospital and Health Service, Women's Health Research Institute, Box 42, Room H203G - 4500 Oak Street, Vancouver, BC, V6H 3N1, Canada
- Vaccine Evaluation Center, BC Children's Hospital Research Institute, Vancouver, British Columbia, Canada
- Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Kara Plotnikoff
- BC Women's Hospital and Health Service, Women's Health Research Institute, Box 42, Room H203G - 4500 Oak Street, Vancouver, BC, V6H 3N1, Canada
| | | | - Laurie Smith
- BC Women's Hospital and Health Service, Women's Health Research Institute, Box 42, Room H203G - 4500 Oak Street, Vancouver, BC, V6H 3N1, Canada
- BC Cancer, Vancouver, British Columbia, Canada
| | - Troy Grennan
- Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
- BC Centre for Disease Control, Vancouver, British Columbia, Canada
| | - Manish Sadarangani
- Vaccine Evaluation Center, BC Children's Hospital Research Institute, Vancouver, British Columbia, Canada
- Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Gina Ogilvie
- BC Women's Hospital and Health Service, Women's Health Research Institute, Box 42, Room H203G - 4500 Oak Street, Vancouver, BC, V6H 3N1, Canada.
- Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.
- BC Centre for Disease Control, Vancouver, British Columbia, Canada.
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Primary Contraceptive Method use and Sexually Transmitted Infections in a Nationally Representative Sample of Young Women. J Pediatr Adolesc Gynecol 2022; 35:585-592. [PMID: 35429635 DOI: 10.1016/j.jpag.2022.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 03/23/2022] [Accepted: 04/04/2022] [Indexed: 11/22/2022]
Abstract
STUDY OBJECTIVE Rates of sexually transmitted infections (STIs) in the United States have increased for the sixth consecutive year. Young people ages 15-24 account for over half of all new infections despite comprising only a quarter of the sexually active population. A potential explanation for this is the increased use of long-acting reversible contraceptives, (LARCs) which could result in lower condom use and/or increased sexual risk-taking due to higher pregnancy prevention efficacy. DESIGN This paper uses the National Survey of Family Growth to examine the relationship between primary contraceptive method use among young women ages 15-24 and STI treatment in the past year, as well as the extent to which this association is mediated by relationship status and frequency of condom use. RESULTS Findings did not show differences in STI treatment in the past year by primary contraceptive method, indicating that LARC use among young women does not equate to increased STI risk. Findings did show that young women who had been in casual-only relationships or a mix of relationship types in the past year were more likely to have been treated for an STI than young women in serious or dating-only relationships, regardless of the primary method used. Additionally, young women who used condoms "some" of the time were more likely to have been treated for an STI compared with women who used condoms "all" or "most" of the time. This association was mediated by relationship status (P = .05). CONCLUSION Findings suggest that efforts to address the growing STI burden should be directed at providing comprehensive, gender-equitable sexual health education that enables young people to engage in healthy relationships and consistent condom use.
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Liu H, Ke W, Chen H, Liang C, Yang L. The perceptions of sexuality and sexually transmitted diseases (STDs) among adolescent STD patients: A qualitative study. J Pediatr Nurs 2022; 66:e54-e60. [PMID: 35667919 DOI: 10.1016/j.pedn.2022.05.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 05/14/2022] [Accepted: 05/24/2022] [Indexed: 11/28/2022]
Abstract
PURPOSE To explore the causes and outcomes of sexually transmitted diseases (STDs) in the adolescent STD patients (ASPs) in relation to their access to and interpretation of sexual and STD knowledge, their attitudes towards premarital sex, and their feelings and thoughts after getting STDs. METHODS A qualitative study was conducted to interview 16 ASPs (12 males, 4 females) using convenience sampling. One-on-one, semi-structured, and confidential interviews were conducted in an outpatient clinic room at a dermatology hospital in Guangzhou, China. Data were analysed via thematic analysis with NVivo 12 software. RESULTS Four main themes were derived from the data: sex education before getting STDs, cognition of the definition of STDs and their transmission, attitude towards premarital sex, and impact of infection with STDs. Most of the participants had very limited information about sexuality from their families or schools, lacked STD knowledge, and considered premarital sex as normal or common. Infection with STDs had a negative influence on all the participants, especially on female participants, as they felt ashamed and some even did not want to get married in the future. CONCLUSION Limited sex education, lack of sexual knowledge, and an open attitude towards premarital sex led to STDs among adolescents. This study highlights the importance of providing effective sex education. In addition, specific and targeted health guidance and suggestions should be provided to ASPs to help them deal with STDs and the life experience with STDs objectively and correctly.
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Affiliation(s)
- Han Liu
- Department of STD Clinic, Dermatology Hospital of Southern Medical University, Guangzhou 510091, China.
| | - Wujian Ke
- Department of STD Clinic, Dermatology Hospital of Southern Medical University, Guangzhou 510091, China
| | - Huiru Chen
- Department of STD Clinic, Dermatology Hospital of Southern Medical University, Guangzhou 510091, China
| | - Chunmei Liang
- Department of STD Clinic, Dermatology Hospital of Southern Medical University, Guangzhou 510091, China
| | - Ligang Yang
- Department of STD Clinic, Dermatology Hospital of Southern Medical University, Guangzhou 510091, China
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16
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Somefun OD, Olamijuwon E. Community structure and timing of sexual activity among adolescent girls in Nigeria. PLoS One 2022; 17:e0269168. [PMID: 35895697 PMCID: PMC9328553 DOI: 10.1371/journal.pone.0269168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Accepted: 05/16/2022] [Indexed: 11/18/2022] Open
Abstract
Studies have linked the timing of sexual debut to unplanned pregnancies and sexually transmissible infections, including HIV. Current understandings of sexual debut among Nigerian adolescents focused on the roles of individual and familial characteristics. We leveraged the 2018 Nigeria Demographic and Health Survey data to examine how community features like affluence, ethnic diversity, and women empowerment may be associated with the timing of sexual debut among adolescent girls. The sample comprised 7449 adolescent girls who were usual residents in 6,505 households and 1,352 clusters or communities. Statistical associations between community characteristics and the onset of sexual debut were assessed using a two-level mixed-effects parametric survival model with Weibull distribution. We found that community affluence [aHR:0.43, 95%CI: 0.30–0.62] and community ethnic diversity [aHR: 0.63, 95%CI: 0.42–0.94] are associated with a lower hazard of sexual debut among adolescent girls. We also observed that women that married within the observation period had an earlier sexual initiation than those who were unmarried. The results disaggregated by marital status further shows that higher community level of women’s employment [aHR: 2.45, 95%CI: 1.38–4.38] and women’s education [aHR:1.85, 95%CI: 1.03–3.33] were associated with a higher hazard of sexual debut among unmarried adolescent girls but not married adolescent girls. Higher community affluence [aHR:0.40, 95%CI: 0.27–0.60] was also associated with a lower hazard of sexual debut among unmarried adolescent girls but not married adolescent girls. Our results illuminate the associated factors of the timing of sexual debut among adolescent girls that moves beyond individual characteristics to community characteristics.
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Affiliation(s)
- Oluwaseyi Dolapo Somefun
- UKRI GCRF Accelerating Achievement for Africa’s Adolescents, School of Public Health, University of the Western Cape, Cape Town, South Africa
| | - Emmanuel Olamijuwon
- School of Primary Care, Population Sciences and Medical Education, Faculty of Medicine, University of Southampton, England, United Kingdom
- School of Geography and Sustainable Development, University of St Andrews, Scotland, United Kingdom
- Demography and Population Studies Programme, Schools of Public Health and Social Sciences, Faculties of Health Sciences and Humanities, University of the Witwatersrand, Witwatersrand, South Africa
- * E-mail:
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17
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Schroeder E, Tallarico R, Bakaroudis M. The impact of adolescent initiation rites in East and Southern Africa: Implications for policies and practices. INTERNATIONAL JOURNAL OF ADOLESCENCE AND YOUTH 2022. [DOI: 10.1080/02673843.2022.2052123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Affiliation(s)
| | - Renata Tallarico
- Regional Coordinator, UNFPA East and Southern Africa Regional Office, Johannesburg, South Africa
| | - Maria Bakaroudis
- Comprehensive Sexuality Education Specialist & Disability Focal Point, UNFPA East and Southern Africa Regional Office, Johannesburg, South Africa
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18
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Carlson DL, Bellair PE, McNulty TL. Duration-Weighted Exposure to Neighborhood Disadvantage and Racial-Ethnic Differences in Adolescent Sexual Behavior. JOURNAL OF HEALTH AND SOCIAL BEHAVIOR 2022; 63:71-89. [PMID: 34605702 DOI: 10.1177/00221465211046361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Racial-ethnic disparities in adolescent sexual risk behavior are associated with health disparities during adulthood and are therefore important to understand. Some scholars argue that neighborhood disadvantage induces disparities, yet prior research is mixed. We extend neighborhood-effects research by addressing long-term exposure to neighborhood disadvantage and estimation bias resulting from inclusion of time-varying covariates. Drawing from the Fragile Families and Child Well-Being Study, we compare a point-in-time proximal measure of neighborhood disadvantage with a duration-weighted measure using marginal structural models with inverse probability of treatment weights. Findings indicate that multiracial, non-Hispanic black, and Hispanic youth exhibit significantly higher sexual risk and duration-weighted exposure to neighborhood disadvantage than non-Hispanic white adolescents. Duration-weighted exposure is a better predictor of sexual initiation and number of partners by age 15 than a point-in-time proximal measure of neighborhood disadvantage and accounts for a substantial portion of the race-ethnic differences in sexual risk.
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19
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Minnis AM, Browne EN, Chavez M, McGlone L, Raymond-Flesch M, Auerswald C. Early Sexual Debut and Neighborhood Social Environment in Latinx Youth. Pediatrics 2022; 149:184753. [PMID: 35137189 PMCID: PMC9150543 DOI: 10.1542/peds.2021-050861] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/10/2021] [Indexed: 01/22/2023] Open
Abstract
OBJECTIVES To examine whether social aspects of the neighborhood environment are associated with early sexual initiation in a California agricultural community of predominantly Latinx adolescents. METHODS In a prospective cohort study of 599 eighth graders recruited from middle schools in Salinas, California (2015-2019), participants completed five interviews over 2 years. Social environment measures included neighborhood social dynamics (neighborhood disorder, social cohesion, and social network gang exposure); experiences of discrimination; and school connectedness. We estimated associations between baseline social environment and early sexual initiation (<15 years) using Poisson regression with robust standard errors. We compared contraceptive self-efficacy and attitudes by sexual initiation status using ANOVA. RESULTS Most youth were Latinx (94%) and age 13 (70%) at enrollment; 53% were female and 49% had a parent employed in agriculture. Additionally, 14% reported first vaginal sex before age 15. Neighborhood disorder (relative risk [RR], 1.13; 95% confidence interval [CI], 1.05-1.21), social network gang exposure (RR, 2.23; 95% CI, 1.49-3.33), and experiences of discrimination (RR, 1.67 [1-2 events versus none], 95% CI, 1.09-2.55; RR, 2.33 [3+ events versus none], 95% CI, 1.07-4.64) were associated with early sexual initiation. School connectedness was protective (RR, 0.44, 95% CI, 0.29-0.69). Youth who initiated sex before age 15 had more negative birth control attitudes and expressed lower motivation to use contraceptives. CONCLUSIONS Findings underscore opportunities to promote early adolescent sexual health through strengthening supportive and safe neighborhood environments with the promise of addressing disparities in unintended pregnancy and sexually transmitted infection rates in later adolescence.
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Affiliation(s)
- Alexandra M. Minnis
- Women’s Global Health Imperative, RTI International, Berkeley, California,School of Public Health, University of California, Berkeley, California,Address correspondence to Alexandra M. Minnis, PhD, MPH, Director and Senior Research Epidemiologist, Women’s Global Health Imperative, RTI International, 2150 Shattuck Ave, Ste 800; Berkeley, CA 94704. E-mail:
| | - Erica N. Browne
- Women’s Global Health Imperative, RTI International, Berkeley, California
| | - Marisol Chavez
- Women’s Global Health Imperative, RTI International, Berkeley, California,Children’s Hospital Los Angeles (CHLA), Los Angeles, California
| | - Linda McGlone
- Monterey County Health Department, Salinas, California
| | | | - Colette Auerswald
- School of Public Health, University of California, Berkeley, California
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20
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Costa ECV, Barbosa T, Soares M, McIntyre T, Pereira MG. Factors Associated with Sexually Transmitted Infections among Users of Voluntary HIV Counseling and Testing Centers in Portugal. INTERNATIONAL JOURNAL OF SEXUAL HEALTH : OFFICIAL JOURNAL OF THE WORLD ASSOCIATION FOR SEXUAL HEALTH 2022; 34:432-449. [PMID: 38596277 PMCID: PMC10903659 DOI: 10.1080/19317611.2022.2032527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 01/12/2022] [Accepted: 01/13/2022] [Indexed: 04/11/2024]
Abstract
Objective: Users of publicly funded voluntary HIV Counseling and Testing Centers (VCT C) in the Portuguese National Service have been found to have higher rates of HIV risk behavior than the general population, but data concerning the relationship between socio-demographic, behavioral, and cognitive variables, and Sexually Transmitted Infections (ST Is) in this specific population are limited. This study tests the impact of socio-demographic, behavioral and cognitive variables on ST Is in a sample of 168 users of VCT C. Methods: A cross-sectional study using structured questionnaires was conducted. Results: Being older, being gay or bisexual, and having more barriers towards safer sex (e.g., negative attitudes toward safer sex behavior) were associated with increased odds of having had a ST I diagnosis. We found significant differences between heterosexual and gay men for number of sexual partners, frequency of anal sex, exchanging sex for money or drugs, history of ST Is, AIDS knowledge, and risk beliefs about the partner, with gay men showing higher rates. Conclusions: ST Is education should target older, gay or bisexual individuals, and focus on information as well as on changing barriers towards safer sex and associated health beliefs.
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Affiliation(s)
- Eleonora C. V. Costa
- Faculty of Philosophy and Social Sciences, Centre for Philosophical and Humanistic Studies, Universidade Católica Portuguesa, Braga, Portugal
- North Regional Health Administration, Ministry of Health, Braga, Portugal
| | - Tânia Barbosa
- Faculty of Philosophy and Social Sciences, Centre for Philosophical and Humanistic Studies, Universidade Católica Portuguesa, Braga, Portugal
| | - M. Soares
- North Regional Health Administration, Ministry of Health, Braga, Portugal
| | - Teresa McIntyre
- College of Nursing and Institute for Measurement, Evaluation and Statistics, University of Houston, Houston, TX, USA
| | - M. Graça Pereira
- Applied Psychology Department, School of Psychology, University of Minho, Braga, Portugal
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21
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Roman Lay AA, Fujimori E, Simões Duarte L, Vilela Borges AL. Prevalence and correlates of early sexual initiation among Brazilian adolescents. PLoS One 2021; 16:e0260815. [PMID: 34905552 PMCID: PMC8670678 DOI: 10.1371/journal.pone.0260815] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Accepted: 11/17/2021] [Indexed: 11/18/2022] Open
Abstract
Background Early adolescence is a critical stage in adolescents. This is the phase at which many young people start their sexual life early, increasing the risk of sexually transmitted infections and unintended pregnancy. Few studies have analyzed the factors associated with early sexual initiation in very young adolescents in low- and middle-income countries. Therefore, this study assessed the early sexual initiation stratified by sex and its correlates in a sample of Brazilian adolescents. Methods The study sample included Brazilian adolescents aged 12–14 who participated in The Study of Cardiovascular Risk in Adolescents (ERICA), a multicenter, school-based, country-wide, cross-sectional study. Early sexual initiation was defined as the first sexual intercourse at or before 14 years old. Multivariate logistic regression was used to identify independent factors associated with early sexual initiation. Results The prevalence of early sexual initiation was 7% among girls and 18% in boys. In a multivariate analysis, the adolescent’s age, mother’s schooling, smoking, alcohol consumption, and Tanner Stages were associated with early sexual initiation for both boys and girls. For girls, living with both parents, common mental disorders, and age at menarche were predictors of early sexual initiation, while race and type of school were correlated to early sexual initiation only for boys. Conclusions The early sexual initiation was associated with sociodemographic, lifestyle risk factors and secondary sexual characteristics in both sexes, while there were differences between the predictors of early sexual initiation among girls and boys. It emphasizes the importance of sex education and promotes healthy lifestyles in environments through families and schools in early adolescence.
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Affiliation(s)
| | - Elizabeth Fujimori
- Public Health Nursing Department, School of Nursing, University of São Paulo, São Paulo, Brazil
| | - Luciane Simões Duarte
- Public Health Nursing Department, School of Nursing, University of São Paulo, São Paulo, Brazil
| | - Ana Luiza Vilela Borges
- Public Health Nursing Department, School of Nursing, University of São Paulo, São Paulo, Brazil
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22
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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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Fasciana T, Capra G, Di Carlo P, Calà C, Vella M, Pistone G, Colomba C, Giammanco A. Socio-Demographic Characteristics and Sexual Behavioral Factors of Patients with Sexually Transmitted Infections Attending a Hospital in Southern Italy. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18094722. [PMID: 33925258 PMCID: PMC8125464 DOI: 10.3390/ijerph18094722] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Revised: 04/20/2021] [Accepted: 04/26/2021] [Indexed: 12/25/2022]
Abstract
Sexually transmitted infections (STIs) are a serious global health problem. In Italy, data describing the vulnerability to STIs of specific sexual minorities and the influence of sociodemographic and behavioral determinants are limited, as most infections are not subject to mandatory notification. This retrospective study describes the sociodemographic profile and main sexual behaviors of patients attending a hospital in Palermo (Sicily, Italy) from January 2018 to March 2019 as predictors of STI risk. Patients were divided in subgroups: men-who-have-sex-with-men (MSM), men-who-have-sex-with-women (MSW), bisexual men and females. Data were obtained through an anonymous questionnaire. Patients were tested for chlamydia, syphilis, Mycoplasma genitalium infection, genital herpes and HPV infection. A total of 294 subjects with STIs (male/female ratio about 2:1) were screened. Of the total sample, 79.6% of patients were Italian. MSM accounted for 34.3%, MSW for 29.6%, bisexual men for 5.8% and females for 30.3%. A total of 44.5% of patients had a high education level, 42.5% reported irregular use of condoms, 20.7% reported having had 5-10 partners in the six months prior to the visit and 32.9% were HIV-positive. HPV infection and syphilis were the most prevalent STIs. Conclusions: The most common profile of patients attending our clinic was that of an adult, Italian man with a high level of education, poor use of condoms and a high number of partners. MSM had the highest sex-behavior-related risk for STIs. In addition, our results suggest that all STD teams need to implement counselling topics and recommendations to share with patients, as well as tips on how to approach sexual health education/counselling, thereby promoting patient-centered approaches and educational programs.
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Affiliation(s)
- Teresa Fasciana
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, 90127 Palermo, Italy; (G.C.); (P.D.C.); (C.C.); (G.P.); (C.C.); (A.G.)
- Correspondence: ; Tel.: +39-3882422122
| | - Giuseppina Capra
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, 90127 Palermo, Italy; (G.C.); (P.D.C.); (C.C.); (G.P.); (C.C.); (A.G.)
| | - Paola Di Carlo
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, 90127 Palermo, Italy; (G.C.); (P.D.C.); (C.C.); (G.P.); (C.C.); (A.G.)
| | - Cinzia Calà
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, 90127 Palermo, Italy; (G.C.); (P.D.C.); (C.C.); (G.P.); (C.C.); (A.G.)
| | - Marco Vella
- Department of Surgical, Oncological and Stomatological Sciences, Section of Urology, University of Palermo, 90127 Palermo, Italy;
| | - Giuseppe Pistone
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, 90127 Palermo, Italy; (G.C.); (P.D.C.); (C.C.); (G.P.); (C.C.); (A.G.)
| | - Claudia Colomba
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, 90127 Palermo, Italy; (G.C.); (P.D.C.); (C.C.); (G.P.); (C.C.); (A.G.)
| | - Anna Giammanco
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, 90127 Palermo, Italy; (G.C.); (P.D.C.); (C.C.); (G.P.); (C.C.); (A.G.)
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Huibregtse BM, Hatoum AS, Corley RP, Rhea SA, Hewitt JK, Stallings MC. Etiological Overlap Between Sex Under the Influence and Number of Lifetime Sexual Partners. Behav Genet 2021; 51:12-29. [PMID: 33118127 PMCID: PMC8092413 DOI: 10.1007/s10519-020-10019-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Accepted: 09/17/2020] [Indexed: 10/23/2022]
Abstract
Drug and alcohol use is associated with risky sexual behavior (RSB). It is unclear whether this association is due to correlated liabilities (e.g., third variables influencing both traits), or whether use of drugs and alcohol during sexual decision making increases RSB. This study addresses this question by fitting a series of biometrical models using over 800 twin pairs assessed in early adulthood (m = 25.21 years). Measures included an index of sex under the influence (e.g., frequency that drugs or alcohol affect sexual decision making), number of lifetime sexual partners, and a general measure of substance use. Analyses suggest the covariance among these measures is explained by both genetic and environmental correlated liabilities. The overlap was not specific to sex under the influence, but was shared with a measure of general substance use. Models testing necessary but not sufficient parameters for direction of causation suggest that sex under the influence is unlikely to cause an increase in RSB; more evidence for reverse causation was found.
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Affiliation(s)
- Brooke M Huibregtse
- Institute for Behavioral Genetics, University of Colorado Boulder, Boulder, CO, USA.
- Department of Psychology and Neuroscience, University of Colorado Boulder, Boulder, CO, USA.
| | - Alexander S Hatoum
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | - Robin P Corley
- Institute for Behavioral Genetics, University of Colorado Boulder, Boulder, CO, USA
| | - Sally Ann Rhea
- Institute for Behavioral Genetics, University of Colorado Boulder, Boulder, CO, USA
| | - John K Hewitt
- Institute for Behavioral Genetics, University of Colorado Boulder, Boulder, CO, USA
- Department of Psychology and Neuroscience, University of Colorado Boulder, Boulder, CO, USA
| | - Michael C Stallings
- Institute for Behavioral Genetics, University of Colorado Boulder, Boulder, CO, USA
- Department of Psychology and Neuroscience, University of Colorado Boulder, Boulder, CO, USA
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Costa MIFD, Viana TRF, Pinheiro PNDC, Cardoso MVLML, Barbosa LP, Luna IT. Social determinants of health and vulnerabilities to sexually transmitted infections in adolescents. Rev Bras Enferm 2019; 72:1595-1601. [PMID: 31644749 DOI: 10.1590/0034-7167-2018-0726] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2018] [Accepted: 03/04/2019] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVE To verify the association between social determinants of health and the vulnerability of adolescents to Sexually Transmitted Infections (STIs). METHOD Cross-sectional study, performed with 287 students aged 11 to 17 years, in the outskirts of Fortaleza, Ceará, Brazil, from August do September 2016. Two instruments were used, one destined to social determinants of health and another to investigating the vulnerability to STIs. The magnitude of associations was expressed through odds ratio and interval of confidence, considering a 5% significance level. This research was approved by the Research Ethics Committee of the Federal University of Ceará. RESULTS 212 (73.9%) adolescents were considered more vulnerable, with a score ≥ 4. The intermediate social determinant "housing (home ownership)" obtained significant association with with the vulnerability to STIs (p of 0.022; CI 1.1 to 3.3; OR 1.9). CONCLUSION The intermediate social determinant "type of housing" influences the vulnerability to STAs.
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Lima AS, Pitangui ACR, Gomes MRDA, Mola R, Araújo RCD. Risky sexual behaviors and their association with overweight and obesity among adolescent students: a cross-sectional study. EINSTEIN-SAO PAULO 2019; 17:eAO4782. [PMID: 31271610 PMCID: PMC6611177 DOI: 10.31744/einstein_journal/2019ao4782] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2018] [Accepted: 02/27/2019] [Indexed: 01/26/2023] Open
Abstract
OBJECTIVE To determine the prevalence of risky sexual behavior and its association with overweight and obesity among adolescent students. METHODS This is a cross-sectional study, conducted in public schools with adolescents aged 12 to 17 years. We used the questionnaire Youth Risk Behavior Survey. The body mass index percentiles were calculated by means of table from the Center for Control and Prevention of Diseases. Possible associations were assessed using the χ2 test and binary logistic regression model. The odds ratio and 95%CI were calculated. RESULTS We evaluated 1,169 students, and 33.9% reported having had sexual intercourse. Of those, 33% did not use a condom during their last intercourse, and 32.7% had had four or more sexual partners thus far. Regarding nutritional status, 15.3% were overweight or obese. In relation to the non-use of condoms, we observed only an association with the number of lifetime sexual partners (OR: 0.50; 95%CI: 0.28-0.88). The number of lifetime sexual partners was associated with males (OR: 9.17; 95%CI: 4.16-20.22), sexual debut age at 13 years or less (OR: 2.51; 95%CI: 1.23-5.13) and drinking alcohol or using drugs before the last intercourse (OR: 6.16; 95%CI: 2.14-17.73). CONCLUSION Risky sexual behavior rates were high and no association was found between risky sexual behaviors and overweight and obesity.
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Affiliation(s)
| | | | | | - Rachel Mola
- Universidade de Pernambuco, Petrolina, PE, Brazil
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Men Who Have Sex With Men-Identification Criteria and Characteristics From the National Health and Nutrition Examination Survey, 1999 to 2014. Sex Transm Dis 2019; 45:337-342. [PMID: 29465678 DOI: 10.1097/olq.0000000000000762] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
OBJECTIVES This study aimed to provide identification criteria for men who have sex with men (MSM), estimate the prevalence of MSM behavior, and compare sociodemographics and sexually transmitted disease risk behaviors between non-MSM and MSM groups using data from a nationally representative, population-based survey. METHODS Using data from men aged 18 to 59 years who took part in the National Health and Nutrition Examination Survey (NHANES), 1999 to 2014, detailed criteria were developed to estimate MSM behavior-at least one lifetime same-sex partner (MSM-ever), at least one same-sex partner in the past 12 months (MSM-current), and at least one lifetime and zero same-sex partners in the past 12 months (MSM-past). RESULTS The estimated prevalence of MSM-ever was 5.5%-of these, 52.4% were MSM-current and 47.1% were MSM-past. Furthermore, MSM-ever are a nonhomogenous subpopulation, for example, 70.4% of MSM-current identified as homosexual and 71.2% of MSM-past identified as heterosexual (P < 0.001). CONCLUSIONS The prevalence of MSM behavior identified here is similar to other published estimates. This is also the first article, to our knowledge, to use National Health and Nutrition Examination Survey data to compare MSM by 2 recall periods (recent vs. lifetime) of last same-sex sexual behavior.
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Cheshire E, Kaestle CE, Miyazaki Y. The Influence of Parent and Parent-Adolescent Relationship Characteristics on Sexual Trajectories into Adulthood. ARCHIVES OF SEXUAL BEHAVIOR 2019; 48:893-910. [PMID: 30790205 DOI: 10.1007/s10508-018-1380-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/15/2014] [Revised: 12/13/2018] [Accepted: 12/14/2018] [Indexed: 06/09/2023]
Abstract
To examine sexual partner acquisition into young adulthood and to explore what characteristics of the adolescent family context might predict this change, we used growth curve modeling to examine data from a nationally representative sample of adolescents followed longitudinally over 13 years through young adulthood (N = 5385). Growth curve modeling allowed us to treat the outcome as a dynamic variable and to examine 10 potential predictors of change while accounting for the nested nature of the data. Six family characteristics emerged as predictors of mean number of partners and rate of partner acquisition, while accounting for three significant adolescent predictors. Living in a single-parent or blended family and general communication about sex predicted higher lifetime number of sexual partners in young adulthood. Parent religiosity, parent disapproval of adolescent engagement in sex, and parent-adolescent connectedness were predictive of lower lifetime number of sexual partners. By following participants into their late twenties and early thirties, we were able to detect changes in the impact of early family factors that are not apparent in studies restricted to adolescents and emerging adults. For example, parent education, parent disapproval, and parent-adolescent connectedness were associated with higher rates of partner acquisition at age 23, but faster deceleration in partner acquisition as time progressed. Communication about negative consequences of sex was not predictive, regardless of whether it was "on time" (before sexual intercourse) or not. These results reveal that parents have significant, and sometimes unexpected, influence on their children's sexual behavior that persists well into adulthood.
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Affiliation(s)
- Emily Cheshire
- Department of Human Development and Family Science (0416), College of Liberal Arts and Human Sciences, Virginia Tech, Blacksburg, VA, 24061, USA
| | - Christine E Kaestle
- Department of Human Development and Family Science (0416), College of Liberal Arts and Human Sciences, Virginia Tech, Blacksburg, VA, 24061, USA.
| | - Yasuo Miyazaki
- Faculty of Leadership, Counseling and Research, School of Education, Virginia Tech, Blacksburg, VA, USA
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Quinn K, Dickson-Gomez J, Broaddus M, Pacella M. "Running Trains" and "Sexing-In": The Functions of Sex Within Adolescent Gangs. YOUTH & SOCIETY 2019; 51:151-169. [PMID: 30853727 PMCID: PMC6402563 DOI: 10.1177/0044118x16667375] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Gang members are exposed to unique sexual risks, yet little work has explored the influence of gang social norms. This study examines the functions and meanings of sex within gangs, with a specific focus on the ways in which sex is used to reinforce gang membership and norms, gender roles, and group cohesion. We conducted 58 semi-structured interviews with adolescent members of six gangs. Data were analyzed using thematic content analysis and constant comparative method in MAXQDA. Sexual risk behaviors within gangs are upheld and reinforced through unspoken norms and expectations. These high-risk sexual practices increase group cohesion and reinforce gender norms and power differences. Despite the prevalence of such practices, many gang members felt regret and remorse over their participation but noted it was just part of "the life." Our findings highlight the need for interventions to address the norms of the gang that reinforce sexual risk behavior.
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Le GT, Deardorff J, Lahiff M, Harley KG. Intergenerational Associations Between Parental Incarceration and Children's Sexual Risk Taking in Young Adulthood. J Adolesc Health 2019; 64:398-404. [PMID: 30514651 DOI: 10.1016/j.jadohealth.2018.09.028] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Revised: 09/09/2018] [Accepted: 09/17/2018] [Indexed: 10/27/2022]
Abstract
PURPOSE Research on parental incarceration and the health of offspring is relatively scarce despite studies linking childhood adverse experiences to a range of physical and mental health conditions. This study aimed to estimate the associations between parental incarceration and sexual risk outcomes (early sexual onset, inconsistent condom use, and sexually transmitted infections [STIs]) in young adulthood. METHODS We used logistic regression to estimate associations of sexual risk taking behaviors with parental incarceration during childhood in a sample of 3,972 participants in The National Longitudinal Study of Adolescent to Adult Health (Add Health) between 2001 and 2009. RESULTS Parental incarceration was associated with early sexual onset (adjusted odds ratio [AOR] = 1.4, 95% confidence interval [CI] = 1.03-2.03) and STIs (AOR =2.0, 95% CI = 1.3-3.2). Maternal incarceration was associated with increased odds of early sexual onset (AOR = 3.6, 95% CI = 1.9-6.7), inconsistent condom use (AOR = 3.4, 95% CI = 1.3-8.9), and STIs (AOR = 5.5, 95% CI = 1.7-17.6). Additionally, paternal incarceration and parental incarceration occurring before age 10 were associated with STIs (AOR = 1.7, 95% CI = 1.1-2.8; AOR = 2.0, 95% CI = 1.1-3.7). CONCLUSIONS Parental incarceration, especially maternal imprisonment, is associated with risky sexual behavior and sexually transmitted infections in young adults in the United States. Intervening during or prior to the adolescent developmental period may ameliorate risky sexual behaviors and related health outcomes among children of incarceration parents.
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Affiliation(s)
- Gianna T Le
- University of California, Berkeley, School of Public Health, Berkeley, California.
| | - Julianna Deardorff
- University of California, Berkeley, School of Public Health, Berkeley, California
| | - Maureen Lahiff
- University of California, Berkeley, School of Public Health, Berkeley, California
| | - Kim G Harley
- University of California, Berkeley, School of Public Health, Berkeley, California
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Tsai JY, Sussman S, Pickering TA, Rohrbach LA. Is Online Partner-Seeking Associated with Increased Risk of Condomless Sex and Sexually Transmitted Infections Among Individuals Who Engage in Heterosexual Sex? A Systematic Narrative Review. ARCHIVES OF SEXUAL BEHAVIOR 2019; 48:533-555. [PMID: 30155796 DOI: 10.1007/s10508-018-1235-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2016] [Revised: 05/11/2018] [Accepted: 05/14/2018] [Indexed: 06/08/2023]
Abstract
Use of Internet websites and mobile applications to meet potential romantic and sexual partners is becoming increasingly popular. While the Internet might foster better communication and sexual negotiation between partners, it can also be a deceptive environment that instigates and accelerates sexual risk-taking. Given the complexities of the Internet, it is critical to examine the association between risky sexual behaviors (RSBs) and online partner-seeking. Five databases (i.e., Google Scholar, PubMed, PsycINFO, Web of Science, and Ovid Medline) were searched for articles published before September 10, 2017, that examined the association between online partner solicitation (either for romantic and/or sexual reasons) and RSBs. Studies were eligible for inclusion if they were empirical papers published in English-language peer-reviewed journals looking at samples of online partner seekers who practice heterosexual sex (with a comparison group) and reporting either condom use or sexually transmitted infections (STIs) status, which were the two primary outcomes. A total of 25 studies met the criteria to be included in our review. Results from this literature search do not indicate a clear association between online partner-seeking and condom use or STI status. Potential moderators (i.e., age, gender, reasons for online partner solicitation, duration of Internet correspondence, and Internet modalities) that should be included in future research were identified. Sexual health prevention efforts should address methods to negotiate safe practices between sexual partners and to encourage healthy non-virtual relationships, particularly among vulnerable populations.
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Affiliation(s)
- Jennifer Y Tsai
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Soto Street Building, 2001 N. Soto Street, 3rd Floor, Los Angeles, CA, 90089, USA.
| | - Steve Sussman
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Soto Street Building, 2001 N. Soto Street, 3rd Floor, Los Angeles, CA, 90089, USA
| | - Trevor A Pickering
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Soto Street Building, 2001 N. Soto Street, 3rd Floor, Los Angeles, CA, 90089, USA
| | - Louise Ann Rohrbach
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Soto Street Building, 2001 N. Soto Street, 3rd Floor, Los Angeles, CA, 90089, USA
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Espinoza L, Richardson JL, Ferguson K, Chou CP, Baezconde-Garbanati L, Stacy AW. Adolescent Substance Use and Sensation-Seeking on Sexual Behaviors Among Young Adults from Continuation High Schools. Subst Use Misuse 2019; 54:373-383. [PMID: 30654684 PMCID: PMC6438727 DOI: 10.1080/10826084.2018.1496453] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
BACKGROUND Youth from continuation high schools report greater substance use and sensation-seeking than youth from regular high schools, yet their long-term consequences on age at sexual onset and the number of sexual partners are unknown. OBJECTIVE To examine substance use, sensation-seeking and sexual behaviors by gender and race/ethnicity and the effects of substance use and sensation-seeking in adolescence on age at sexual initiation and numbers of sexual partners by young adulthood. METHODS Baseline and 4-year follow-up data on youth from 14 continuation high schools in Southern California who participated in a drug abuse prevention intervention were analyzed. Structural equation modeling assessed whether or not substance use or sensation-seeking in adolescence predicted age at sexual onset and numbers of sexual partners by young adulthood. RESULTS Latinos had lower sensation-seeking and frequency of substance use and a later age at sexual onset than non-Latinos. Males were more likely than females to have multiple lifetime and recent sexual partners. The effects of adolescent substance use on the number of sexual partners by young adulthood were mediated fully by their age at sexual initiation. Sensation-seeking had no direct or indirect effects on sexual behaviors. Conclusions/Importance: Factors leading to and actual sexual risk behaviors among youth from continuation high schools vary by race/ethnicity and gender. Targeting these antecedent factors by race/ethnicity and gender may improve prevention efforts.
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Affiliation(s)
- Lilia Espinoza
- a Department of Public Health , California State University Fullerton , Fullerton , California , USA
| | - Jean L Richardson
- b Department of Preventive Medicine , Institute for Prevention Research University of Southern California , Los Angeles , California , USA
| | - Kristin Ferguson
- c School of Social Work , Arizona State University , Phoenix , Arizona , USA
| | - Chih-Ping Chou
- b Department of Preventive Medicine , Institute for Prevention Research University of Southern California , Los Angeles , California , USA
| | - Lourdes Baezconde-Garbanati
- b Department of Preventive Medicine , Institute for Prevention Research University of Southern California , Los Angeles , California , USA
| | - Alan W Stacy
- d School of Community & Global Health , Claremont Graduate University , Claremont , California , USA
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Turney K, Goldberg RE. Paternal Incarceration and Early Sexual Onset among Adolescents. POPULATION RESEARCH AND POLICY REVIEW 2018; 38:95-123. [PMID: 38264735 PMCID: PMC10805465 DOI: 10.1007/s11113-018-9502-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2018] [Accepted: 11/29/2018] [Indexed: 10/27/2022]
Abstract
Despite a growing literature documenting deleterious intergenerational consequences of incarceration, relatively little is known about how exposure to paternal incarceration is associated with risk behaviors in adolescence. In this article, we use data from the Fragile Families and Child Wellbeing Study (N = 3,405)-a cohort of urban children born around the turn of the 21st century and followed for 15 years-to examine the relationship between paternal incarceration and one indicator of adolescent risk behavior, early sexual onset. Results from adjusted logistic regression models show that paternal incarceration is associated with a greater likelihood of initiating sexual activity before age 15, in part resulting from externalizing problems that follow paternal incarceration. We also find that these associations are concentrated among boys living with their fathers prior to his incarceration. Given that paternal incarceration is a stressor concentrated among already vulnerable children, paternal incarceration may exacerbate inequalities in adolescent sexual risk behavior.
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Taggart T, Gottfredson N, Powell W, Ennett S, Chatters LM, Carter-Edwards L, Eng E. The Role of Religious Socialization and Religiosity in African American and Caribbean Black Adolescents' Sexual Initiation. JOURNAL OF RELIGION AND HEALTH 2018; 57:1889-1904. [PMID: 29564617 PMCID: PMC6473800 DOI: 10.1007/s10943-018-0605-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
This study determined the nature of the associations between religious socialization, religiosity, and adolescent sexual initiation. Data originated from the National Survey of American Life-Adolescent (n = 1170), a nationally representative study of black adolescents. Factor analysis, structural equation modeling, and logistic regression were used to evaluate hypotheses. Results indicated that as black adolescents received more messages about religious beliefs and practices, their religiosity was greater and, in turn, they were less likely to report sexual initiation; findings varied by ethnicity, gender, and age. Findings contribute to understanding religious socialization and its association with sexual initiation.
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Affiliation(s)
- Tamara Taggart
- Center for Interdisciplinary Research on AIDS, Yale University, 135 College St, Suite #200, New Haven, CT, 06510, USA.
| | - Nisha Gottfredson
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Wizdom Powell
- Department of Psychiatry, University of Connecticut, Storrs, CT, USA
| | - Susan Ennett
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Linda M Chatters
- Department of Health Behavior and Health Education, School of Public Health, School of Social Work, University of Michigan, Ann Arbor, MI, USA
| | - Lori Carter-Edwards
- Public Health Leadership Program, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Eugenia Eng
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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Epstein M, Madeline Furlong, Kosterman R, Bailey JA, King KM, Vasilenko SA, Steeger CM, Hill KG. Adolescent Age of Sexual Initiation and Subsequent Adult Health Outcomes. Am J Public Health 2018; 108:822-828. [PMID: 29672143 DOI: 10.2105/ajph.2018.304372] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES To examine the mechanisms of the association between age of sexual initiation and adult health. METHODS Data from the Seattle Social Development Project (n = 808), in Seattle, Washington, included outcomes when participants were in their 30s (2005-2014): substance use disorders, depression, poor health, and obesity. Sexual consequence mediators included sexually transmitted infection, adolescent pregnancy, and a high number of sexual partners. We used linear logistic regression to model main effect and mediated associations. RESULTS Age of sexual initiation was related to nicotine and marijuana disorders, physical health, and obesity, but not alcohol disorder or depression. Mediated association with nicotine disorder was not significant; association with marijuana disorder was reduced; significant relationships with poor health and obesity remained. CONCLUSIONS The relationship between age of sexual initiation and substance use was largely explained by consequences of sexual behavior. Earlier sexual initiation was linked to poorer physical health outcomes, though the nature of the association remains unclear. Public Health Implications. Prevention approaches need to address multiple risk factors and emphasize contraceptive methods to avoid sexual consequences. For physical health outcomes, broad prevention approaches, including addressing early sexual initiation, may be effective.
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Affiliation(s)
- Marina Epstein
- Marina Epstein, Madeline Furlong, Rick Kosterman, and Jennifer A. Bailey are with the Social Development Research Group, School of Social Work, University of Washington, Seattle. Kevin M. King is at the Department of Psychology, University of Washington. Sara A. Vasilenko is with The Methodology Center, The Pennsylvania State University, State College. Christine M. Steeger and Karl G. Hill are with the Institute of Behavioral Science, University of Colorado Boulder
| | - Madeline Furlong
- Marina Epstein, Madeline Furlong, Rick Kosterman, and Jennifer A. Bailey are with the Social Development Research Group, School of Social Work, University of Washington, Seattle. Kevin M. King is at the Department of Psychology, University of Washington. Sara A. Vasilenko is with The Methodology Center, The Pennsylvania State University, State College. Christine M. Steeger and Karl G. Hill are with the Institute of Behavioral Science, University of Colorado Boulder
| | - Rick Kosterman
- Marina Epstein, Madeline Furlong, Rick Kosterman, and Jennifer A. Bailey are with the Social Development Research Group, School of Social Work, University of Washington, Seattle. Kevin M. King is at the Department of Psychology, University of Washington. Sara A. Vasilenko is with The Methodology Center, The Pennsylvania State University, State College. Christine M. Steeger and Karl G. Hill are with the Institute of Behavioral Science, University of Colorado Boulder
| | - Jennifer A Bailey
- Marina Epstein, Madeline Furlong, Rick Kosterman, and Jennifer A. Bailey are with the Social Development Research Group, School of Social Work, University of Washington, Seattle. Kevin M. King is at the Department of Psychology, University of Washington. Sara A. Vasilenko is with The Methodology Center, The Pennsylvania State University, State College. Christine M. Steeger and Karl G. Hill are with the Institute of Behavioral Science, University of Colorado Boulder
| | - Kevin M King
- Marina Epstein, Madeline Furlong, Rick Kosterman, and Jennifer A. Bailey are with the Social Development Research Group, School of Social Work, University of Washington, Seattle. Kevin M. King is at the Department of Psychology, University of Washington. Sara A. Vasilenko is with The Methodology Center, The Pennsylvania State University, State College. Christine M. Steeger and Karl G. Hill are with the Institute of Behavioral Science, University of Colorado Boulder
| | - Sara A Vasilenko
- Marina Epstein, Madeline Furlong, Rick Kosterman, and Jennifer A. Bailey are with the Social Development Research Group, School of Social Work, University of Washington, Seattle. Kevin M. King is at the Department of Psychology, University of Washington. Sara A. Vasilenko is with The Methodology Center, The Pennsylvania State University, State College. Christine M. Steeger and Karl G. Hill are with the Institute of Behavioral Science, University of Colorado Boulder
| | - Christine M Steeger
- Marina Epstein, Madeline Furlong, Rick Kosterman, and Jennifer A. Bailey are with the Social Development Research Group, School of Social Work, University of Washington, Seattle. Kevin M. King is at the Department of Psychology, University of Washington. Sara A. Vasilenko is with The Methodology Center, The Pennsylvania State University, State College. Christine M. Steeger and Karl G. Hill are with the Institute of Behavioral Science, University of Colorado Boulder
| | - Karl G Hill
- Marina Epstein, Madeline Furlong, Rick Kosterman, and Jennifer A. Bailey are with the Social Development Research Group, School of Social Work, University of Washington, Seattle. Kevin M. King is at the Department of Psychology, University of Washington. Sara A. Vasilenko is with The Methodology Center, The Pennsylvania State University, State College. Christine M. Steeger and Karl G. Hill are with the Institute of Behavioral Science, University of Colorado Boulder
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Gambadauro P, Carli V, Hadlaczky G, Sarchiapone M, Apter A, Balazs J, Banzer R, Bobes J, Brunner R, Cosman D, Farkas L, Haring C, Hoven CW, Kaess M, Kahn JP, McMahon E, Postuvan V, Sisask M, Värnik A, Zadravec Sedivy N, Wasserman D. Correlates of sexual initiation among European adolescents. PLoS One 2018; 13:e0191451. [PMID: 29420612 PMCID: PMC5805230 DOI: 10.1371/journal.pone.0191451] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2017] [Accepted: 01/04/2018] [Indexed: 11/18/2022] Open
Abstract
Background Sexuality is a physiological component of adolescent development, though early initiation is associated with reproductive health risk. This study aimed at identifying correlates and predictors of sexual initiation in a large multinational cohort of European adolescents. Methods A questionnaire addressing socio-demographics, behaviours, mental health and sexual activity, was delivered to 11,110 adolescents recruited from 168 randomly selected schools in 10 European countries between 2009 and 2011. A follow-up questionnaire was delivered after 12 months. The longitudinal association of baseline risk behaviors, psychological attributes and contextual vulnerabilities, with sexual initiation during follow-up was evaluated through simple and multivariable age/sex stratified logistic regression. Multinomial logistic regression measured the association between predictors and sexual initiation with or without coexisting reproductive risk factors, such as multiple partners or infrequent condom use. Results Baseline sexual experience was reported by 19.2% of 10,757 respondents (median age 15; IQR 14–15; females 59.6%). This was significantly more frequent among pupils older than 15 (41%) and males (20.8%). Of 7,111 pupils without previous experience who were available at follow-up (response rate 81.8%), 17% reported sexual initiation, without differences between females and males. Baseline smoking (age/sex adjusted odds ratio [aOR] 3.63), alcohol use (aOR 2.95), illegal drugs use (aOR 2.72), and poor sleep (aOR 1.71) predicted sexual initiation. Stratified analyses showed a particularly strong association in case of younger and female pupils, and, among girls, when initiation was reported together with multiple partners and/or infrequent condom use. Externalizing (i.e. conduct and hyperactivity) symptoms independently predicted sexual initiation. Internalizing difficulties (i.e. emotional and peer problems) were negatively associated with early and risky sexual initiation among boys. Significant predictors included also being bullied, fighting, truancy, and low parental involvement. Conclusions Adolescent sexual behaviours are related to non-sexual risk behaviours, psychological difficulties and contextual vulnerabilities. While gateway effects explain some associations, a comprehensive model is needed to understand adolescent sexual behaviours, their physical, mental, and social health outcomes, and their potential positive effects on wellbeing. Tailored interventions may need to consider younger girls as a particularly vulnerable group in view of a strong association between non-sexual and sexual behaviors.
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Affiliation(s)
- Pietro Gambadauro
- National Centre for Suicide Research and Prevention of Mental Ill-Health (NASP), Department of Learning, Informatics, Management and Ethics (LIME), Karolinska Institutet, Stockholm, Sweden
- Res Medica Sweden, Gynaecology and Reproductive Medicine, Uppsala, Sweden
- * E-mail:
| | - Vladimir Carli
- National Centre for Suicide Research and Prevention of Mental Ill-Health (NASP), Department of Learning, Informatics, Management and Ethics (LIME), Karolinska Institutet, Stockholm, Sweden
| | - Gergö Hadlaczky
- National Centre for Suicide Research and Prevention of Mental Ill-Health (NASP), Department of Learning, Informatics, Management and Ethics (LIME), Karolinska Institutet, Stockholm, Sweden
| | - Marco Sarchiapone
- Department of Medicine and Health Science, University of Molise, Campobasso, Italy
- National Institute of Health for Migration and Poverty, Rome, Italy
| | - Alan Apter
- Schneider’s Children Medical Center of Israel, Tel Aviv University, Tel Aviv, Israel
| | - Judit Balazs
- Vadaskert Child Psychiatric Hospital and Outpatient Clinic, Budapest, Hungary
- Institute of Psychology, Eötvös Loránd University, Budapest, Hungary
| | - Raphaela Banzer
- Addiction Help Services BIN, Innsbruck, Austria
- Institute of Psychology, University of Innsbruck, Innsbruck, Austria
| | - Julio Bobes
- Department of Psychiatry, University of Oviedo, CIBERSAM School of Medicine, Oviedo, Spain
| | - Romuald Brunner
- Department of Child & Adolescent Psychiatry, Center for Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany
| | - Doina Cosman
- Clinical Psychology Department, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Luca Farkas
- Vadaskert Child Psychiatric Hospital and Outpatient Clinic, Budapest, Hungary
| | - Christian Haring
- Psychiatry and Psychotherapy B, State Hospital Hall in Tyrol, Hall, Austria
| | - Christina W. Hoven
- Department of Child and Adolescent Psychiatry, Columbia University-New York State Psychiatric Institute, New York, United States of America
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, United States of America
| | - Michael Kaess
- Department of Child & Adolescent Psychiatry, Center for Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Jean Pierre Kahn
- Department of Psychiatry and Clinical Psychology, CHRU de NANCY and Pôle 6, Centre Psychothérapique de Nancy-Laxou, Université de Lorraine, Nancy, France
| | - Elaine McMahon
- National Suicide Research Foundation, University College Cork, Cork, Ireland
| | - Vita Postuvan
- Slovene Center for Suicide Research, Andrej Marusic Institute, University of Primorska, Koper, Slovenia
| | - Merike Sisask
- Estonian-Swedish Mental Health & Suicidology Institute, Tallinn, Estonia
- School of Governance, Law and Society (SOGOLAS), Tallinn University, Tallinn, Estonia
| | - Airi Värnik
- Estonian-Swedish Mental Health & Suicidology Institute, Tallinn, Estonia
- School of Natural Sciences and Health, Tallinn University, Tallinn, Estonia
| | - Nusa Zadravec Sedivy
- Slovene Center for Suicide Research, Andrej Marusic Institute, University of Primorska, Koper, Slovenia
| | - Danuta Wasserman
- National Centre for Suicide Research and Prevention of Mental Ill-Health (NASP), Department of Learning, Informatics, Management and Ethics (LIME), Karolinska Institutet, Stockholm, Sweden
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Donenberg G, Emerson E, Kendall AD. HIV-risk reduction intervention for juvenile offenders on probation: The PHAT Life group randomized controlled trial. Health Psychol 2018; 37:364-374. [PMID: 29389155 DOI: 10.1037/hea0000582] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Juvenile offenders report high rates of sexual risk taking, increasing the possibility of HIV. This 2-arm group randomized controlled trial tested the efficacy of PHAT Life, a sexual risk reduction program, compared with a time-matched health promotion program for youth on probation. METHOD Male and female 13- to 17-year-olds (M = 16.08; SD = 1.09) recently arrested and placed on probation at an Evening Reporting Center were eligible for the study. Youth were 66% male, and 90% African American. Teens self-reported their sexual behavior (condom use, number of sexual partners) at baseline and 6 months. Retention was 85%. RESULTS Youth were randomized to PHAT Life (n = 163) or a health promotion program (n = 147). Among youth reporting the highest risk at baseline (a composite measure of multiple partners and inconsistent condom use), those who received PHAT Life were over 4 times more likely than the control group to report a lower level of risk (i.e., no sex or one partner plus consistent condom use) by 6 months, OR = 4.28 with 95% CI [1.37, 13.38], SE = 0.58, p = .01. Among sexually active teens who reported sexual debut before 12-years-old, those who received PHAT Life reported significantly fewer sexual partners at 6-months than controls, partial eta squared = .32, p = .002. CONCLUSIONS Findings support PHAT Life's efficacy to reduce sexual risk for juvenile offenders on probation. Future research should examine how best to disseminate PHAT Life to ensure that it is self-sustaining within the juvenile justice system. (PsycINFO Database Record
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Affiliation(s)
- Geri Donenberg
- Department of Medicine, College of Medicine, University of Illinois at Chicago
| | - Erin Emerson
- Center for Dissemination and Implementation Science, Healthy Youths Program, Community Outreach Intervention Projects, University of Illinois at Chicago
| | - Ashley D Kendall
- Center for Dissemination and Implementation Science, Healthy Youths Program, Community Outreach Intervention Projects, University of Illinois at Chicago
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Boisvert I, Boislard MA, Poulin F. Early Sexual Onset and Alcohol Use and Misuse From Adolescence Into Young Adulthood. J Adolesc Health 2017; 61:514-520. [PMID: 28732719 DOI: 10.1016/j.jadohealth.2017.04.013] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2016] [Revised: 04/14/2017] [Accepted: 04/20/2017] [Indexed: 10/19/2022]
Abstract
PURPOSE Little is known about the longitudinal association between early first heterosexual intercourse (e.g., intercourse before the age of 15 years) and alcohol use during adolescence and young adulthood. This study sought to determine whether early first heterosexual intercourse is associated with (1) frequency of alcohol use at age 16 years, (2) changes in alcohol use from ages 16 to 22 years, and (3) alcohol misuse at age 22 years, while controlling for alcohol use, antisocial behavior, pubertal timing, and parental monitoring in early adolescence. METHODS A sample of 289 participants (63% female) was surveyed annually from ages 12 to 22 years. RESULTS Latent growth curve modeling indicated that youth who experienced an early first heterosexual intercourse report a higher frequency of alcohol use at age 16 years compared with those who have experienced their first heterosexual intercourse at an "on-time" age. However, timing of first heterosexual intercourse was not related to growth in frequency of alcohol use over time. Hierarchical multiple regression analysis showed that experiencing an early first heterosexual intercourse predicted problematic alcohol use at age 22 years (β = .153, p = .027). These results were found while controlling for confounding individual- and family factor-level variables. CONCLUSIONS The effect of early first heterosexual intercourse on adolescent alcohol use appears to be long lasting and is associated with a more problematic use of this substance in young adulthood. Further research should be conducted to uncover the developmental processes involved.
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Affiliation(s)
- Isabelle Boisvert
- Department of Sexology, Université du Québec à Montréal, Montréal, Québec, Canada.
| | - Marie-Aude Boislard
- Department of Sexology, Université du Québec à Montréal, Montréal, Québec, Canada
| | - François Poulin
- Department of Psychology, Université du Québec à Montréal, Montréal, Québec, Canada
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Peskin MF, Hernandez BF, Gabay EK, Cuccaro P, Li DH, Ratliff E, Reed-Hirsch K, Rivera Y, Johnson-Baker K, Emery ST, Shegog R. Using Intervention Mapping for Program Design and Production of iCHAMPSS: An Online Decision Support System to Increase Adoption, Implementation, and Maintenance of Evidence-Based Sexual Health Programs. Front Public Health 2017; 5:203. [PMID: 28848729 PMCID: PMC5554483 DOI: 10.3389/fpubh.2017.00203] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2017] [Accepted: 07/25/2017] [Indexed: 12/02/2022] Open
Abstract
In Texas and across the United States, unintended pregnancy, HIV, and sexually transmitted infections (STIs) among adolescents remain serious public health issues. Sexual risk-taking behaviors, including early sexual initiation, contribute to these public health problems. Over 35 sexual health evidence-based programs (EBPs) have been shown to reduce sexual risk behaviors and/or prevent teen pregnancies or STIs. Because more than half of these EBPs are designed for schools, they could reach and impact a considerable number of adolescents if implemented in these settings. Most schools across the U.S. and in Texas, however, do not implement these programs. U.S. school districts face many barriers to the successful dissemination (i.e., adoption, implementation, and maintenance) of sexual health EBPs, including lack of knowledge about EBPs and where to find them, perceived lack of support from school administrators and parents, lack of guidance regarding the adoption process, competing priorities, and lack of specialized training on sexual health. Therefore, this paper describes how we used intervention mapping (Steps 3 and 4, in particular), a systematic design framework that uses theory, empirical evidence, and input from the community to develop CHoosing And Maintaining Effective Programs for Sex Education in Schools (iCHAMPSS), an online decision support system to help school districts adopt, implement, and maintain sexual health EBPs. Guided by this systematic intervention design approach, iCHAMPSS has the potential to increase dissemination of sexual health EBPs in school settings.
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Affiliation(s)
- Melissa F Peskin
- University of Texas Health Science at Houston School of Public Health, Houston, TX, United States
| | - Belinda F Hernandez
- University of Texas Health Science at Houston School of Public Health, Houston, TX, United States
| | - Efrat K Gabay
- University of Texas Health Science at Houston School of Public Health, Houston, TX, United States
| | - Paula Cuccaro
- University of Texas Health Science at Houston School of Public Health, Houston, TX, United States
| | - Dennis H Li
- Northwestern University, Chicago, IL, United States
| | - Eric Ratliff
- University of Texas Health Science at Houston School of Public Health, Houston, TX, United States
| | | | - Yanneth Rivera
- University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Kimberly Johnson-Baker
- University of Texas Health Science at Houston School of Public Health, Houston, TX, United States
| | - Susan Tortolero Emery
- University of Texas Health Science at Houston School of Public Health, Houston, TX, United States
| | - Ross Shegog
- University of Texas Health Science at Houston School of Public Health, Houston, TX, United States
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40
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Lowry R, Robin L, Kann L. Effect of Forced Sexual Intercourse on Associations Between Early Sexual Debut and Other Health Risk Behaviors Among US High School Students. THE JOURNAL OF SCHOOL HEALTH 2017; 87:435-447. [PMID: 28463448 DOI: 10.1111/josh.12512] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/19/2016] [Revised: 09/20/2016] [Accepted: 11/01/2016] [Indexed: 06/07/2023]
Abstract
BACKGROUND Previous research on associations between early sexual debut and other health risk behaviors has not examined the effect of forced sexual intercourse on those associations. METHODS We analyzed data from a nationally representative sample of 19,240 high school students in the United States, age ≥16 years, to describe the effect of forced sexual intercourse on associations between early sexual debut and other health risk behaviors using adjusted prevalence ratios (APR). RESULTS Early sexual debut and forced sexual intercourse were simultaneously and independently associated with sexual risk-taking, violence-related behaviors, and substance use. For example, even after controlling for forced sexual intercourse and race/ethnicity, students who experienced their first sexual intercourse before age 13 years were more likely than students who initiated sexual intercourse at age ≥16 years to have had ≥4 sexual partners during their lifetime (girls, APR = 4.55; boys, APR = 5.82) and to have not used a condom at last sexual intercourse (girls, APR = 1.74; boys, APR = 1.47). CONCLUSIONS Associations between early sexual debut and other health risk behaviors occur independently of forced sexual intercourse. School-based sexual health education programs might appropriately include strategies that encourage delay of initiation of sexual intercourse, and coordinate with violence and substance use prevention programs.
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Affiliation(s)
- Richard Lowry
- Division of Adolescent and School Health, US Centers for Disease Control and Prevention, 1600 Clifton Road, N.E., Mailstop E-75, Atlanta, GA 30329
| | - Leah Robin
- Research Application and Evaluation Branch, Division of Adolescent and School Health, US Centers for Disease Control and Prevention, 1600 Clifton Road, N.E. Mailstop E-75, Atlanta, GA 30329
| | - Laura Kann
- School-Based Surveillance Branch, Division of Adolescent and School Health, US Centers for Disease Control and Prevention, 1600 Clifton Road, N.E. Mailstop E-75, Atlanta, GA 30329
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41
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Nelson KM, Carey KB, Scott-Sheldon LAJ, Eckert TL, Park A, Vanable PA, Ewart CK, Carey MP. Gender Differences in Relations among Perceived Family Characteristics and Risky Health Behaviors in Urban Adolescents. Ann Behav Med 2017; 51:416-422. [PMID: 27995548 PMCID: PMC5441949 DOI: 10.1007/s12160-016-9865-x] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
BACKGROUND Research regarding the role of gender in relations between family characteristics and health risk behaviors has been limited. PURPOSE This study aims to investigate gender differences in associations between family processes and risk-taking in adolescents. METHODS Adolescents (N = 249; mean age = 14.5 years) starting their first year at an urban high school in the northeastern USA completed self-report measures that assessed family characteristics (i.e., parental monitoring, family social support, family conflict) and health behaviors (i.e., tobacco use, alcohol use, marijuana use, sex initiation) as part of a prospective, community-based study. Multivariate logistic regression models were used to investigate gender differences in associations between the family characteristics and health behaviors. RESULTS Among males, higher levels of perceived parental monitoring were associated with lower odds of using tobacco and having ever engaged in sex. Among females, higher levels of perceived parental monitoring were associated with lower odds of marijuana use, alcohol use, and having ever engaged in sex. However, in contrast to males, among females (a) higher levels of perceived family social support were associated with lower odds of alcohol use and having ever engaged in sex and (b) higher levels of perceived family conflict were associated with higher odds of marijuana use and having ever engaged in sex. CONCLUSION Family processes were more strongly related to health behaviors among adolescent females than adolescent males. Interventions that increase parental monitoring and family social support as well as decrease family conflict may help to protect against adolescent risk taking, especially for females.
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Affiliation(s)
- Kimberly M Nelson
- Centers for Behavioral and Preventative Medicine, The Miriam Hospital, Coro West, Suite 309 164 Summit Ave, Providence, RI, 02906, USA.
- Department of Psychiatry and Human Behavior, Brown University, Providence, RI, USA.
| | - Kate B Carey
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, USA
| | - Lori A J Scott-Sheldon
- Centers for Behavioral and Preventative Medicine, The Miriam Hospital, Coro West, Suite 309 164 Summit Ave, Providence, RI, 02906, USA
- Department of Psychiatry and Human Behavior, Brown University, Providence, RI, USA
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, USA
| | - Tanya L Eckert
- Department of Psychology, Syracuse University, Syracuse, NY, USA
| | - Aesoon Park
- Department of Psychology, Syracuse University, Syracuse, NY, USA
| | - Peter A Vanable
- Department of Psychology, Syracuse University, Syracuse, NY, USA
| | - Craig K Ewart
- Department of Psychology, Syracuse University, Syracuse, NY, USA
| | - Michael P Carey
- Centers for Behavioral and Preventative Medicine, The Miriam Hospital, Coro West, Suite 309 164 Summit Ave, Providence, RI, 02906, USA
- Department of Psychiatry and Human Behavior, Brown University, Providence, RI, USA
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, USA
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Richardson GB, Chen CC, Dai CL, Swoboda CM, Nedelec JL, Chen WW. Substance use and mating success. EVOL HUM BEHAV 2017. [DOI: 10.1016/j.evolhumbehav.2016.06.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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HIV/Sexually Transmitted Infection Prevention Messaging: Targeting Root Causes of Sexual Risk Behavior. Sex Transm Dis 2016; 43:71-77. [PMID: 26760178 DOI: 10.1097/olq.0000000000000402] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Sexual risk behaviors (SRBs) often lead to sexually transmitted infections (STI), yet little is known about what drives SRB and whether this differs by sex. METHOD Participants (n = 920; 75% white) were drawn from the Raising Healthy Children study, enrolled in 1993 and 1994 in grades 1 to 2, and followed up through age 24/25 years. Lifetime STI diagnosis was defined by self-report or seropositivity for Chlamydia trachomatis or herpes simplex virus 2. Multivariable models assessed individual (social skills, behavioral disinhibition) and environmental factors (family involvement, school bonding, antisocial friends) predictive of STI diagnosis as mediated by 3 proximal SRB (sex under the influence of drugs or alcohol, condom use, lifetime number of sex partners). RESULTS Twenty-five percent of participants had ever had an STI. All SRBs differed by sex (P < 0.001), and female participants were more likely to have had an STI (P < 0.001). Behavioral disinhibition and antisocial friends in adolescence were associated with more SRB for both sexes, whereas social skills were associated with less SRB in female but more in male participants. Considering SRB and individual and environmental factors together, lifetime number of sex partners (adjusted relative risk [ARR], 1.04per partner; 95% confidence interval [CI], 1.03-1.05) and inconsistent condom use (ARR, 1.10per year; 95% CI, 1.04-1.16) were associated with increased risk of STI, whereas social skills were associated with decreased risk of STI (ARR, 0.84; 95% CI, 0.75-0.93). Behavioral disinhibition seemed to drive SRB, but family involvement mitigated this in several cases. CONCLUSIONS Adolescent environmental influences and individual characteristics drive some SRB and may be more effective targets for STI/HIV prevention interventions than proximal risk behaviors.
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Mullins TLK, Zimet GD, Rosenthal SL, Morrow C, Ding L, Huang B, Kahn JA. Human papillomavirus vaccine-related risk perceptions and subsequent sexual behaviors and sexually transmitted infections among vaccinated adolescent women. Vaccine 2016; 34:4040-5. [PMID: 27291086 DOI: 10.1016/j.vaccine.2016.06.026] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2016] [Revised: 05/27/2016] [Accepted: 06/03/2016] [Indexed: 01/26/2023]
Abstract
OBJECTIVE To examine the association between risk perceptions after human papillomavirus (HPV) vaccination and sexual behaviors and sexually transmitted infection (STI) diagnosis over 30months following vaccination. METHODS Participants included 112 sexually experienced girls aged 13-21years who were enrolled at the time of first HPV vaccination and completed ⩾2 of 4 follow-up visits at 2, 6, 18, 30months and including 30months. At each visit, participants completed surveys assessing risk perceptions (perceived need for safer sexual behaviors, perceived risk of STIs other than HPV) and sexual behaviors. STI testing was done at 6, 18, and 30months. Outcomes were condom use at last intercourse with main male partner, number of sexual partners since last study visit, and STI diagnosis. Associations between risk perceptions and sexual behaviors/STIs were examined using generalized linear mixed models. RESULTS Mean age was 17.9years; 88% were Black; 49% had a history of STI at baseline. Scale scores for perceived need for safer sexual behaviors did not change significantly over time. Scale scores for perceived risk of STIs other than HPV significantly changed (p=0.027), indicating that girls perceived themselves to be more at risk of STIs other than HPV over 30months following vaccination. Multivariable models demonstrated that greater perceived need for safer sexual behaviors following vaccination was associated with condom use (p=0.002) but not with number of partners or STI diagnosis. Perceived risk of STIs other than HPV was not associated with the three outcomes. CONCLUSIONS The finding that perceived risk for STIs other than HPV was not associated with subsequent sexual behaviors or STI diagnosis is reassuring. The association between perceived need for safer sexual behaviors and subsequent condom use suggests that the HPV vaccination visit is an important opportunity to reiterate the importance of safer sexual behaviors to sexually experienced girls.
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Affiliation(s)
- Tanya L Kowalczyk Mullins
- Division of Adolescent and Transition Medicine, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave MLC 4000, Cincinnati, OH 45229, USA; University of Cincinnati College of Medicine, 231 Albert Sabin Way, Cincinnati, OH 45267, USA.
| | - Gregory D Zimet
- Division of Adolescent Medicine, Indiana University, 410 West 10th Street, HS 1001, Indianapolis, IN 46202, USA
| | - Susan L Rosenthal
- Departments of Pediatrics and Psychiatry, Columbia University and New York Presbyterian Morgan Stanley Children's Hospital, 622 West 168 Street, Vanderbilt Clinic 4th Floor - Room 402, New York, NY 10032, USA
| | - Charlene Morrow
- Division of Adolescent and Transition Medicine, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave MLC 4000, Cincinnati, OH 45229, USA
| | - Lili Ding
- Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave MLC 5041, Cincinnati, OH 45229, USA
| | - Bin Huang
- Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave MLC 5041, Cincinnati, OH 45229, USA
| | - Jessica A Kahn
- Division of Adolescent and Transition Medicine, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave MLC 4000, Cincinnati, OH 45229, USA; University of Cincinnati College of Medicine, 231 Albert Sabin Way, Cincinnati, OH 45267, USA
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Gordon LP, Diaz A, Soghomonian C, Nucci-Sack AT, Weiss JM, Strickler HD, Burk RD, Schlecht NF, Ochner CN. Increased Body Mass Index Associated with Increased Risky Sexual Behaviors. J Pediatr Adolesc Gynecol 2016; 29:42-7. [PMID: 26358938 PMCID: PMC4670801 DOI: 10.1016/j.jpag.2015.06.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2015] [Revised: 05/27/2015] [Accepted: 06/01/2015] [Indexed: 11/30/2022]
Abstract
STUDY OBJECTIVE The increasing prevalence of adolescent obesity has led to consideration of the potential effect of obesity on risky sexual behaviors. In the current study we examined whether body mass index (BMI) was related to age at sexual debut, type of sexual behavior, partner number, and condom use in a population of adolescent women at high risk for obesity and risky sexual behaviors. DESIGN, SETTING, AND PARTICIPANTS Cross-sectional examination of 860 sexually active, predominantly minority, adolescent women who received medical care at an urban health center from 2007 through 2013. INTERVENTION AND MAIN OUTCOME MEASURES Self-reported age at sexual debut, types of sexual intercourse, number of partners and condom use was compared with clinically assessed BMI. RESULTS BMI was positively associated with number of sexual partners (P = .001) and history of attempted anal intercourse (P = .002). An inverse association was observed with age at first anal intercourse (P = .040). CONCLUSION In this sample of adolescent women, increased BMI was associated with riskier sexual practices at a younger age. Results of this study suggest that overweight and obese adolescents are a vulnerable population who might need targeted sexual health counseling.
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Affiliation(s)
- Lonna P Gordon
- The Mount Sinai Adolescent Health Center, Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, New York.
| | - Angela Diaz
- The Mount Sinai Adolescent Health Center, Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Christine Soghomonian
- The Mount Sinai Adolescent Health Center, Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Anne T Nucci-Sack
- The Mount Sinai Adolescent Health Center, Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Jocelyn M Weiss
- The Mount Sinai Adolescent Health Center, Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Howard D Strickler
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York
| | - Robert D Burk
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York; Departments of Pediatrics, Microbiology and Immunology, and Obstetrics and Gynecology and Women's Health, Albert Einstein College of Medicine, Bronx, New York
| | - Nicolas F Schlecht
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York
| | - Christopher N Ochner
- The Mount Sinai Adolescent Health Center, Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, New York; Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York
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46
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Dembo R, Wareham J, Krupa J, Winters KC. Sexual Risk Behavior among Male and Female Truant Youths: Exploratory, Multi-Group Latent Class Analysis. ACTA ACUST UNITED AC 2015; 3. [PMID: 27066517 DOI: 10.4172/2329-6488.1000226] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Little is known of sexual risk behaviors among truant youths across gender. This study utilized latent class analysis to examined heterogeneity of sexual risk behaviors across gender among a sample of 300 truant adolescents. Results revealed two latent subgroups within gender: low vs. high sexual risk behaviors. There were gender differences in baseline covariates of sexual risk behaviors, with male truants in higher risk group experiencing ADHD (attention deficit hyperactivity disorder) problems, and female truants in higher risk group experienced marijuana use and depression symptoms. African-American race was a significant covariate for high sexual risk behaviors for both genders. Service and practice implications of sexual risk issues of truant youth are discussed.
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Affiliation(s)
- Richard Dembo
- University of South Florida, Department of Criminology, Tampa, FL 33620, , ,
| | - Jennifer Wareham
- Department of Criminal Justice, Wayne State University, Detroit, MI 48202
| | - Julie Krupa
- Department of Criminology, University of South Florida, Tampa, FL 33620
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Huebner DM, Perry NS. Do behavioral scientists really understand HIV-related sexual risk behavior? A systematic review of longitudinal and experimental studies predicting sexual behavior. ARCHIVES OF SEXUAL BEHAVIOR 2015; 44:1915-1936. [PMID: 26123067 DOI: 10.1007/s10508-015-0482-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/16/2014] [Revised: 11/27/2014] [Accepted: 01/08/2015] [Indexed: 06/04/2023]
Abstract
Behavioral interventions to reduce sexual risk behavior depend on strong health behavior theory. By identifying the psychosocial variables that lead causally to sexual risk, theories provide interventionists with a guide for how to change behavior. However, empirical research is critical to determining whether a particular theory adequately explains sexual risk behavior. A large body of cross-sectional evidence, which has been reviewed elsewhere, supports the notion that certain theory-based constructs (e.g., self-efficacy) are correlates of sexual behavior. However, given the limitations of inferring causality from correlational research, it is essential that we review the evidence from more methodologically rigorous studies (i.e., longitudinal and experimental designs). This systematic review identified 44 longitudinal studies in which investigators attempted to predict sexual risk from psychosocial variables over time. We also found 134 experimental studies (i.e., randomized controlled trials of HIV interventions), but of these only 9 (6.7 %) report the results of mediation analyses that might provide evidence for the validity of health behavior theories in predicting sexual behavior. Results show little convergent support across both types of studies for most traditional, theoretical predictors of sexual behavior. This suggests that the field must expand the body of empirical work that utilizes the most rigorous study designs to test our theoretical assumptions. The inconsistent results of existing research would indicate that current theoretical models of sexual risk behavior are inadequate, and may require expansion or adaptation.
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Affiliation(s)
- David M Huebner
- Department of Psychology, University of Utah, 380 South 1530 East, Room 502, Salt Lake City, UT, 84102, USA,
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48
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Reaching the hard to reach: longitudinal investigation of adolescents' attendance at an after-school sexual and reproductive health programme in Western Cape, South Africa. BMC Public Health 2015; 15:608. [PMID: 26141155 PMCID: PMC4490658 DOI: 10.1186/s12889-015-1963-3] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2014] [Accepted: 06/23/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Adolescents need access to effective sexual and reproductive health (SRH) interventions, but face barriers accessing them through traditional health systems. School-based approaches might provide accessible, complementary strategies. We investigated whether a 21-session after-school SRH education programme and school health service attracted adolescents most at risk for adverse SRH outcomes and explored motivators for and barriers to attendance. METHODS Grade 8 adolescents (average age 13 years) from 20 schools in the intervention arm of an HIV prevention cluster randomised controlled trial in the Western Cape Province of South Africa, were invited to participate in an after-school SRH program and to attend school health services. Using a longitudinal design, we surveyed participants at baseline, measured their attendance at weekly after-school sessions for 6 months and surveyed them post-intervention. We examined factors associated with attendance using bivariate and multiple logistic and Poisson regression analyses, and through thematic analysis of qualitative data. RESULTS The intervention was fully implemented in 18 schools with 1576 trial participants. The mean attendance of the 21-session SRH programme was 8.8 sessions (S.D. 7.5) among girls and 6.9 (S.D. 7.2) among boys. School health services were visited by 17.3 % (14.9 % of boys and 18.7 % of girls). Adolescents who had their sexual debut before baseline had a lower rate of session attendance compared with those who had not (6.3 vs 8.5, p < .001). Those who had been victims of sexual violence or intimate partner violence (IPV), and who had perpetrated IPV also had lower rates of attendance. Participants were motivated by a wish to receive new knowledge, life coaching and positive attitudes towards the intervention. The unavailability of safe transport and domestic responsibilities were the most common barriers to attendance. Only two participants cited negative attitudes about the intervention as the reason they did not attend. CONCLUSIONS Reducing structural barriers to attendance, after-school interventions are likely to reach adolescents with proven-effective SRH interventions. However, special attention is required to reach vulnerable adolescents, through offering different delivery modalities, improving the school climate, and providing support for adolescents with mental health problems and neurodevelopmental academic problems. TRIAL REGISTRATION Current Controlled Trials ISRCTN56270821 ; Registered 13 February 2013.
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49
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De Genna N, Goldschmidt L, Richardson GA. Prenatal cocaine exposure and age of sexual initiation: direct and indirect effects. Drug Alcohol Depend 2014; 145:194-200. [PMID: 25456330 PMCID: PMC4254808 DOI: 10.1016/j.drugalcdep.2014.10.011] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2014] [Revised: 10/06/2014] [Accepted: 10/16/2014] [Indexed: 12/16/2022]
Abstract
BACKGROUND Prenatal cocaine exposure (PCE) has been linked to child behavior problems and risky behavior during adolescence such as early substance use. Behavior problems and early substance use are associated with earlier initiation of sexual behavior. The goal of this study was to examine the direct and indirect effects of PCE on sexual initiation in a longitudinal birth cohort, about half of whom were exposed to cocaine in utero. METHODS Women were interviewed twice prenatally, at delivery, and 1, 3, 7, 10, 15, and 21 years postpartum. Offspring (52% female, 54% African American) were assessed at delivery and at each follow-up phase with age-appropriate assessments. At age 21, 225 offspring reported on their substance use and sexual behavior. RESULTS First trimester cocaine exposure was a significant predictor of earlier age of first intercourse in a survival analysis, after controlling for race, sociodemographic characteristics, caregiver pre- and postnatal substance use, parental supervision, and child's pubertal timing. However, the association between PCE and age of first sexual intercourse was mediated by adolescent marijuana and alcohol use prior to age 15. CONCLUSIONS Most of the effect of PCE on age of sexual initiation occurred between the ages of 13-18, when rates of initiation were approximately 10% higher among exposed offspring. This effect was mediated by early adolescent substance use. These results have implications for identification of the exposed offspring at greatest risk of HIV risk behaviors and early, unplanned pregnancy.
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Affiliation(s)
- Natacha De Genna
- University of Pittsburgh School of Medicine, Western Psychiatric Institute and Clinic, 3811 O'Hara Street, Pittsburgh, PA 15213
| | - Lidush Goldschmidt
- University of Pittsburgh Medical Center, Program in Epidemiology, 3811 O'Hara Street, Pittsburgh, PA 15213
| | - Gale A. Richardson
- University of Pittsburgh School of Medicine, Western Psychiatric Institute and Clinic, 3811 O'Hara Street, Pittsburgh, PA 15213
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50
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Homma Y, Wong ST, Zumbo BD, Saewyc EM. Ethnic Identity and Sexual Initiation Among East Asian Youth in Canada. J Immigr Minor Health 2014; 17:1580-4. [PMID: 25204622 DOI: 10.1007/s10903-014-0101-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Despite the large number of East Asian youth in Canada, little is known about their health and risk behaviors. We examined the relationship between ethnic identity and sexual initiation among East Asians. This secondary analysis of a population-based survey selected 4,311 students in 7-12th grades who described themselves as East Asian (e.g., Chinese, Japanese, Korean). Gender-stratified logistic regression analyses examined whether ethnic identity was associated with sexual initiation, controlling for age, living situation, and cultural exposure. Boys with stronger commitment to their ethnic groups were less likely to have ever had sexual intercourse (aOR 0.80). Girls with higher levels of ethnic identity exploration were less likely to report sexual initiation (aOR 0.71). Stronger ethnic identity was associated with not having sexual intercourse among East Asian adolescents. The findings suggest the need to consider ethnocultural factors in future research and practice.
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Affiliation(s)
- Yuko Homma
- School of Nursing, University of British Columbia, T201-2211 Wesbrook Mall, Vancouver, BC, V6T 2B5, Canada,
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