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Zapata JP, Rojas E, Durán P, Martínez AJ, Del Pino HE. The Impact of Sibling Relationships on Behavioral and Sexual Health among Latino Sexual Minority Men. ARCHIVES OF SEXUAL BEHAVIOR 2024; 53:2751-2763. [PMID: 38553660 PMCID: PMC11219362 DOI: 10.1007/s10508-024-02832-6] [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: 09/29/2023] [Revised: 02/08/2024] [Accepted: 02/12/2024] [Indexed: 07/03/2024]
Abstract
Pre-exposure prophylaxis (PrEP) is a highly effective method for preventing HIV acquisition and plays a crucial role in the Ending the HIV Epidemic in the US initiative. However, there are various barriers that hinder the access and uptake of PrEP among Latino sexual minority men (SMM) at individual, interpersonal, and cultural levels. While the significance of cultural factors in designing and implementing HIV prevention programs for Latino populations has been consistently emphasized in the literature and prioritized by the Centers for Disease Control and Prevention, few studies have directly integrated these cultural factors into their programs. Our study aimed to investigate the potential influence of siblings in promoting the utilization of PrEP for HIV prevention, an area that has received limited attention. We conducted interviews with 31 pairs of siblings between December 2020 and January 2021, which were held in either English or Spanish and lasted approximately 45-60 min. The data were analyzed using a deductive thematic content analysis approach. The interviews revealed several key themes and categories, including: (1) Sibling support for coming out; (2) Types of support that siblings provide to each other for behavior change; (3) Sibling support for PrEP; and (4) The impact of the study interview on the quality of the sibling relationships. Our findings indicated that siblings were willing to provide support for PrEP in various ways, ranging from emotional support for brothers who may be concerned about potential rejection to practical support such as transportation or financial assistance. These results have significant implications for the design of HIV prevention interventions for Latinos. Incorporating siblings or other extended family members into these interventions can facilitate communication between siblings and their brothers, ultimately encouraging the use of PrEP or similar prevention methods. By considering the unique dynamics and support systems within Latino communities, researchers can develop more effective strategies to promote HIV prevention and support the well-being of Latino SMM.
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Affiliation(s)
- Juan Pablo Zapata
- Institute for Sexual and Gender Minority Health and Wellbeing, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Edwin Rojas
- St. John's Community Health, Los Angeles, CA, USA
| | - Petra Durán
- Psychiatry and Human Behaviors, Charles R. Drew University of Medicine and Science, Los Angeles, CA, 90059, USA
| | - Angel J Martínez
- Charles R. Drew University of Medicine and Science, Los Angeles, CA, USA
| | - Homero E Del Pino
- Psychiatry and Human Behaviors, Charles R. Drew University of Medicine and Science, Los Angeles, CA, 90059, USA.
- Psychiatry and Behavioral Sciences, General Internal Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.
- Geriatric Research, Education, and Clinic Center, VA Greater Los Angeles Healthcare System (Geriatric Research, Education, and Clinical Center), Los Angeles, CA, USA.
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Fernandez AR, Ramírez-Ortiz D, García-Torres MM, Lor M, Luebke J, Cano MÁ, Cordova D. Ethnic discrimination, acculturative stress, and sexual risk among Latinx emerging adults: Examining moderation effects of familism support and ethnic identity. CULTURAL DIVERSITY & ETHNIC MINORITY PSYCHOLOGY 2024; 30:349-362. [PMID: 36757988 PMCID: PMC10409880 DOI: 10.1037/cdp0000570] [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: 06/18/2023]
Abstract
OBJECTIVES Ethnic discrimination and acculturative stress play an important role in sexual risk behaviors for Latinx emerging adults, who are at disproportionate risk for sexually transmitted infections. Factors such as familism support and ethnic identity may be protective, yet research is limited. This study is guided by a culturally adapted stress and coping framework to examine associations of ethnic discrimination and acculturative stress with sexual risk behaviors (i.e., multiple sex partners, alcohol or drug use before sex, and condomless sex with a primary or casual partner), and examine the moderating roles of familism support and ethnic identity among Latinx emerging adults. METHOD Participants were recruited from Arizona and Florida and were primarily female (51.3%) with a mean age of 21.48 years (SD = 2.06). Using cross-sectional data from 158 sexually active Latinx emerging adults, this study employed multiple logistic regression and moderation analyses. RESULTS Higher levels of ethnic discrimination and pressure to acculturate were associated with fewer sex partners, and higher levels of pressure against acculturation were associated with increased condomless sex with a casual partner. The moderation effect of higher levels of familism support on pressure to acculturate was associated with fewer sex partners, and the moderation effect of higher levels of ethnic identity on pressure against acculturation was associated with decreased condomless sex with casual partners. CONCLUSIONS Examining the results within a culturally informed theoretical framework supports that protective factors may help mitigate sexual risk factors among Latinx emerging adults experiencing acculturative stress. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
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Affiliation(s)
| | | | | | - Maichou Lor
- School of Nursing, University of Wisconsin-Madison
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Hamilton FL, Pleasant V. Obstetrics and Gynecology Care in Latinx Communities. Obstet Gynecol Clin North Am 2024; 51:105-124. [PMID: 38267122 DOI: 10.1016/j.ogc.2023.11.007] [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] [Indexed: 01/26/2024]
Abstract
The Latinx community represents the largest racial minority population in the nation. There are significant barriers to care and treatment as it relates to obstetrics and gynecology. Understanding cultural considerations is essential to improving care in this community. Public health strategies as well as policies to address racial health disparities facing the Latinx community are explored in this article.
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Affiliation(s)
- Felicia L Hamilton
- Department of Obstetrics & Gynecology, OB/Gyn Practice Committee, MedStar Washington Hospital Center, Georgetown University Medical Center, 110 Irving Street, Northwest Room 5B-45A, Washington, DC 20010, USA.
| | - Versha Pleasant
- Department of Obstetrics and Gynecology, Cancer Genetics & Breast Health Clinic, University of Michigan, 1500 East Medical Center Drive, Ann Arbor, MI 48109, USA
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Rosen AO, Bergam L, Holmes AL, Krebs E, Moreno M, Muñiz GS, Huedo-Medina TB. Efficacy of behavioral interventions to increase engagement in sexual health services among LatinX youth in the United States: A meta-analysis for post-pandemic implications. Int J Adolesc Med Health 2024; 36:1-15. [PMID: 38373148 PMCID: PMC10904879 DOI: 10.1515/ijamh-2022-0113] [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: 12/09/2022] [Accepted: 01/30/2024] [Indexed: 02/21/2024]
Abstract
INTRODUCTION LatinX youth in the U.S. are disproportionately affected by HIV and STIs, commonly attributed to a lack of diagnostic testing and regular physician consultations to address sexual health. These disparities have been exacerbated by the COVID-19 pandemic. This meta-analysis seeks to assess the efficacy of behavioral interventions among LatinX youth in the U.S. that aim to increase engagement in sexual health services (i.e., STI/HIV testing, physician consultations). CONTENT Following PRISMA guidelines, seven electronic databases were searched. We systematically extracted data with a coding form, and effect sizes were obtained from each study on HIV/STI testing outcomes and physician consultation. Moderator analyses were run for demographic and intervention characteristics. SUMMARY AND OUTLOOK Of nine included studies, the interventions created a small-to-moderate effect on increased engagement of sexual health services (d +=0.204, 95 % CI=0.079, 0.329). Moderator analyses showed that interventions including the following characteristics were most efficacious at facilitating care services: community-based or online setting, access to diagnostic testing, social media/remote components, parental involvement, and longer session duration. This meta-analysis provides informative results regarding behavioral interventions that have proven efficacious in facilitating engagement in sexual health services among LatinX youth. Most prominently, interventions that are remote or through social media, community-based, and incorporated parents had large positive effects. These findings prove useful for the ongoing COVID-19 pandemic situation and provide guidance for targeting LatinX youth to engage them in sexual health services as primary and secondary STI and HIV prevention.
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Affiliation(s)
- Aviana O. Rosen
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT, USA
| | | | - Ashley L. Holmes
- Department of Health Policy, Milken Institute School of Public Health, George Washington University, Washington, DC, USA
| | - Emma Krebs
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT, USA
| | - Melanie Moreno
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT, USA
| | - Geycel S. Muñiz
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT, USA
| | - Tania B. Huedo-Medina
- Department of Clinical, Health Psychology and Research Methodology, University of the Basque Country, San Sebastian - Donastia, Spain
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Zapata JP, Queiroz A, Rodriguez-Diaz CE, Mustanski B. Factors Associated with HIV Testing Among Spanish and English-Speaking Latino Adolescents Aged 13-18. AIDS Behav 2024; 28:343-356. [PMID: 37848599 DOI: 10.1007/s10461-023-04206-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/28/2023] [Indexed: 10/19/2023]
Abstract
Adolescent Latino men who have sex with men (LMSM) in the U.S. are disproportionately impacted by HIV. However, there has been limited focus on their HIV prevention and risk behaviors. In this study, we examine the rates of HIV testing and explore the significant demographic and healthcare factors that influence HIV prevention among adolescent LMSM. The analysis for this study utilized data collected during the baseline assessment of SMART, a pragmatic trial aimed at evaluating the effectiveness of an online HIV prevention intervention for adolescent LMSM (N = 524). Only 35.5% of participants had ever had an HIV test in their lifetime. Rates of testing increased among adolescent LMSM who had a doctor with whom they spoke about their sexual health (odds ratio: 4.0; 95% confidence interval: 2.1-8.4; P < 0.001) or HIV testing (odds ratio: 5.8; 95% confidence interval: 3.1-10.7; P < 0.001). Out of the 61 participants who took part in the survey conducted in Spanish, only 26% reported ever having an HIV test. Additionally, 24.5% stated that they had discussed their sexual orientation with a doctor, and only 8.2% had undergone HIV testing. Spanish-speaking adolescents who completed the SMART survey were less likely to openly discuss their sexual orientation or sexual health with most people or have a doctor with whom they discussed these topics, compared to those who completed the survey in English. These findings suggest that Spanish-speaking adolescent LMSM may face obstacles in accessing HIV prevention services in the U.S.
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Affiliation(s)
- Juan Pablo Zapata
- Department of Medical Social Science and the Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, 625 N Michigan Ave, Chicago, IL, USA
| | - Artur Queiroz
- Department of Medical Social Science and the Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, 625 N Michigan Ave, Chicago, IL, USA
| | - Carlos E Rodriguez-Diaz
- School of Public Health, Boston University, 801 Massachusetts Ave. Suite 431, Boston, MA, USA
| | - Brian Mustanski
- Department of Medical Social Science and the Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, 625 N Michigan Ave, Chicago, IL, USA.
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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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Delaney DJ, Stein LAR, Bassett SS, Clarke JG. Motivational interviewing for family planning and reducing risky sexual behavior among incarcerated men nearing release: A randomized controlled pilot study. Psychol Serv 2023; 20:538-552. [PMID: 34735198 PMCID: PMC10354667 DOI: 10.1037/ser0000552] [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] [Indexed: 11/08/2022]
Abstract
Incarcerated men are at high risk for sexually transmitted infections (STIs) and unintended partner pregnancy postrelease. Limited research has been invested in developing and testing treatments targeting risky sexual behavior and unwanted pregnancy for this at-risk population. Motivational interviewing (MI) is a promising behavioral intervention for decreasing risky sexual behaviors. This study assessed the feasibility and acceptability of MI for family planning and risky sexual behaviors with incarcerated men nearing release. Preliminary efficacy of the MI intervention was also compared to an educational control group. Thirty-two men were assessed at baseline and randomized to one 90-min session. Assessment occurred 2 months after release. MI was feasibly administered, and participants were highly satisfied with both treatments. In addition, those who received MI reported higher rates of condom use with casual partners, higher rates of partner use of hormonal contraceptives, and slightly higher rates of sex that was protected against pregnancy. Increases are readiness to discuss family planning with sexual partners, as well as reported frequency of these discussions, and increases in family planning knowledge were also found in those randomized to MI. The findings from this study indicate the need to further assess MI with this population with a full-scale clinical trial. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
- Daniel J Delaney
- Department of Psychology, Chafee Social Science Center, University of Rhode Island
| | - L A R Stein
- Department of Psychology, Chafee Social Science Center, University of Rhode Island
| | - Shayna S Bassett
- Department of Psychology, Chafee Social Science Center, University of Rhode Island
| | - Jennifer G Clarke
- Center for Primary Care and Prevention, Memorial Hospital, Brown University
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Fair C, Fraser L, Zendt M, Santana-Garces M, Homans J, Stek A, Operskalski E. "We Are Not Different than Others": A Qualitative Study of the Lived Experience of Hispanic Adolescents and Young Adults Living with Perinatally Acquired HIV. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2996. [PMID: 36833690 PMCID: PMC9957359 DOI: 10.3390/ijerph20042996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 01/05/2023] [Accepted: 02/07/2023] [Indexed: 06/18/2023]
Abstract
Though Hispanic youth with perinatally acquired HIV (PHIV) comprise 14% of those living with PHIV, little research has documented their lived experiences. Eighteen Hispanic adolescents and young adults (AYA) with PHIV were recruited from two pediatric infectious disease clinics in California (mean age = 20.8 years, 12 females and 6 males). Interview transcripts were analyzed for emergent themes regarding relationships, childbearing intentions, and future career aspirations. Participants acknowledged HIV as cause for rejection and fear of transmission from partners. Most desired children in the future. Those with children (n = 7) expressed a strong desire to continue their education for the benefit of their children. Many did not view HIV as a barrier to their career aspirations. HIV influenced their daily lives. However, the challenges of poverty, loss, and trauma also significantly shaped their well-being. Health care providers offered emotional and instrumental support which helped AYA make progress towards their goals.
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Affiliation(s)
- Cynthia Fair
- Department of Public Health Studies, Elon University, Elon, NC 27244, USA
| | - Leandra Fraser
- Department of Infectious Disease, University of Southern California Medical Center, Los Angeles, CA 90033, USA
| | - Mackenzie Zendt
- Department of Public Health Studies, Elon University, Elon, NC 27244, USA
| | | | - James Homans
- Department of Infectious Disease, University of Southern California Medical Center, Los Angeles, CA 90033, USA
| | - Alice Stek
- Department of Infectious Disease, University of Southern California Medical Center, Los Angeles, CA 90033, USA
| | - Eva Operskalski
- Department of Infectious Disease, University of Southern California Medical Center, Los Angeles, CA 90033, USA
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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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Edberg MC, Cleary SD, Andrade EL, Evans WD, Quinteros-Grady L, Alvayero RD, Gonzalez A. The Adelante project: Realities, challenges and successes in addressing health disparities among central American immigrant youth. CULTURAL DIVERSITY & ETHNIC MINORITY PSYCHOLOGY 2022; 28:402-412. [PMID: 34941282 PMCID: PMC9218001 DOI: 10.1037/cdp0000368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
OBJECTIVE The Adelante intervention, implemented between 2013 and 2018, addressed an important syndemic health disparity for Central American immigrant youth approaching or in high school-the co-occurrence of substance abuse, sex risk (pregnancy, sexually transmitted infections, HIV), and interpersonal violence. Adelante was implemented and evaluated by the Avance Center for the Advancement of Immigrant/Refugee Health, which built on a university-community partnership that has been in place since 2005. Using a tailored, ecological positive youth development (PYD) approach, Adelante employed intervention strategies across ecological levels, including individual, family, peer, and community levels, with the use of social marketing and digital media strategies to link activities under one aspirational identity and support community engagement. METHOD Using a Community Based Participatory Research approach with multiple community partners involved in the effort, the research assessed changes in co-occurring behavioral outcomes and tested hypotheses concerning relationships between PYD mediators and these outcomes. Multiple methods were used in collaboration with partners to assess intervention inputs and outcomes-detailed implementation process records; prepost surveys to assess changes in PYD assets, risk behavior knowledge, and prevention skills; a community survey in the intervention and comparison communities (total N = 3,600) at baseline and two follow-up waves; surveys of a high risk cohort (n = 238) at baseline and follow-up; and social marketing campaign surveys (n = 1,549) at baseline with 2 follow-up waves. RESULTS Analysis showed multiple improvements in PYD mediators and risk behavior outcomes, including an overall 70% increase in knowledge and a 15% increase in prevention skills. Preliminary analysis of risk behavior outcomes demonstrated, for example, a significant, inverse effect on reported sexual activity (past 3 months) for both Adelante intervention community and cohort samples. In addition, self-reported exposure to the social marketing campaign was associated with positive effects on multiple outcomes, including drug use risk and violence attitudes, and improvement in violence/sexual risk behavior outcomes in the intervention versus comparison community. CONCLUSION There are few models in the literature that provide a roadmap for how to address multiple, related health conditions in marginalized, immigrant communities, even as most health disparities are associated with complex social ecologies. The Adelante intervention adds a useful model of this nature to the evidence base, and provides support for the ecological approach to PYD with respect to such communities. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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Affiliation(s)
- Mark C Edberg
- Department of Prevention and Community Health, George Washington University, Milken Institute, School of Public Health
| | - Sean D Cleary
- Department of Epidemiology, George Washington University, Milken Institute, School of Public Health
| | - Elizabeth L Andrade
- Department of Prevention and Community Health, George Washington University, Milken Institute, School of Public Health
| | - W Douglas Evans
- Department of Prevention and Community Health, George Washington University, Milken Institute, School of Public Health
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11
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Bassett SS, Delaney DJ, Moore AM, Clair-Michaud M, Clarke JG, Stein L. Motivational interviewing to reduce risky sexual behaviors among at-risk male youth: A randomized controlled pilot study. Psychol Serv 2022; 19:167-175. [PMID: 33411550 PMCID: PMC9069535 DOI: 10.1037/ser0000498] [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] [Indexed: 02/03/2023]
Abstract
BACKGROUND Despite male youth taking more sexual risks that lead to unwanted partner pregnancy and/or sexually transmitted infections (STIs), research evaluating interventions for risky sex has focused almost exclusively on adolescent and adult females. With STIs among male youth on the rise, behavioral interventions that target risky sex among male youth are needed. PURPOSE A randomized controlled pilot study was conducted to examine the feasibility and acceptability of two manualized behavioral interventions for sexually active male youth. METHODS Sexually active at-risk male youth (N = 27) were recruited and randomized to receive one session of motivational interviewing (MI) or didactic educational counseling (DEC). Assessment interviews were conducted prior to and 3 months following the intervention session. RESULTS Support for the feasibility and acceptability of delivering behavioral interventions to reduce risky sexual behaviors among at-risk male youth was found. Compared to participants in DEC at follow-up, participants in MI reported having significantly fewer sexual encounters with casual partners, used substances at the time of sex significantly less often with all partners and casual partners, and reported fewer incidents of using substances at the time of sex without a condom with all partners. Conversely, participants who received MI used substances at the time of sex with main partners and used substances at the time of sex without a condom more often with main partners at follow-up compared to participants who received DEC. CONCLUSIONS Results of the pilot study support conducting a larger randomized controlled trial to examine treatment effects. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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Affiliation(s)
| | - Daniel J. Delaney
- Department of Psychology, Social Sciences Research Center,
University of Rhode Island, Kingston, RI
| | - Amy M. Moore
- Department of Nutrition and Food Sciences, University of
Rhode Island, Kingston, RI
| | | | - Jennifer G. Clarke
- Center for Alcohol and Addiction Studies, Brown University
School of Public Health, Providence, RI
| | - L.A.R. Stein
- Department of Psychology, Social Sciences Research Center,
University of Rhode Island, Kingston, RI
- The Rhode Island Training School, Cranston, RI
- Center for Alcohol and Addiction Studies, Brown University
School of Public Health, Providence, RI
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12
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Calatrava M, Beltramo C, Osorio A, Rodríguez-González M, De Irala J, Lopez-del Burgo C. Religiosity and Sexual Initiation Among Hispanic Adolescents: The Role of Sexual Attitudes. Front Psychol 2021; 12:715032. [PMID: 34858256 PMCID: PMC8631753 DOI: 10.3389/fpsyg.2021.715032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Accepted: 10/15/2021] [Indexed: 11/13/2022] Open
Abstract
Introduction: Religiosity and sexuality present numerous interconnections. Little is known regarding the specific causal pathways between each religiosity dimension and sexual behavior. The objectives of this study were (1) to explore the relationship between religiosity (measured through attendance at religious services, salience, and prayer) and sexual initiation in adolescents and (2) to establish the role of sexual permissiveness as mediator of the impact produced by religiosity in sexual initiation. Methods: This study analyzes data from an ongoing school-based international study examining what young people feel and think about relationships, love, and sexuality. An anonymous, self-administered online questionnaire was developed in Spanish. A total of 4,366 students, aged 14-18, completed the questionnaire. A final sample of 2,919 questionnaires was analyzed. Two unconditional logistic regression models were fit with religiosity variables and possible confounders as independent variables (with and without permissiveness, respectively). The dependent variable was sexual initiation. A final path analysis was performed to further understand the results. Results: Our study highlights that, in predominantly Catholic and Spanish-speaking countries, the fact of attending church and praying may greatly contribute to postponing sexual relations during adolescence, even independently of their attitudes on sexual permissiveness. Conversely, the effect of salience on sexual initiation seems to be fostered only through the mediation of sexual permissiveness. Our findings point to an indirect effect of the three religiosity dimensions (and in particular, religious salience) through permissive attitudes. Conclusion: Religiosity could be a relevant factor to explain sexual initiation during adolescence.
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Affiliation(s)
- Maria Calatrava
- Institute for Culture and Society, University of Navarra, Pamplona, Spain
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
- School of Education and Psychology, University of Navarra, Pamplona, Spain
| | - Carlos Beltramo
- Institute for Culture and Society, University of Navarra, Pamplona, Spain
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
- School of Education and Psychology, University of Navarra, Pamplona, Spain
| | - Alfonso Osorio
- Institute for Culture and Society, University of Navarra, Pamplona, Spain
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
- School of Education and Psychology, University of Navarra, Pamplona, Spain
| | - Martiño Rodríguez-González
- Institute for Culture and Society, University of Navarra, Pamplona, Spain
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
- School of Education and Psychology, University of Navarra, Pamplona, Spain
| | - Jokin De Irala
- Institute for Culture and Society, University of Navarra, Pamplona, Spain
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
- Department of Preventive Medicine and Public Health, School of Medicine, University of Navarra, Pamplona, Spain
| | - Cristina Lopez-del Burgo
- Institute for Culture and Society, University of Navarra, Pamplona, Spain
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
- Department of Preventive Medicine and Public Health, School of Medicine, University of Navarra, Pamplona, Spain
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13
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Beelmann A, Arnold LS, Schulz S. Buffering negative effects of immigration on cognitive, social, and educational development: A multinational meta-analysis of child and adolescent prevention programmes. INTERNATIONAL JOURNAL OF PSYCHOLOGY 2021; 56:478-490. [PMID: 33186487 DOI: 10.1002/ijop.12725] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2018] [Accepted: 10/23/2020] [Indexed: 11/09/2022]
Abstract
Growing up in migrant families is a well-known distal risk factor related to poorer outcomes in child and adolescent health, academic, socioemotional and behavioural development. This article reviews the effects of various prevention measures such as early education programmes, cognitive and language training or parent and teacher training on child and adolescent developmental outcomes in immigration samples. Using several comprehensive literature searches, we found 138 research reports with 141 studies and 175 comparisons on preventing negative effects of immigration. Overall, programmes yielded an effect size of d = 0.26 at post-test using the random effect model. These effects decreased over time while still differing significantly from zero. A cross-tabulation of prevention approach/programme type by different outcome domains revealed several important results such as high effects of child cognitive and language training programmes on child academic and language outcomes and relatively low effects of all programmes on child socioemotional outcomes. In addition, individualised and culturally tailored programmes seems to be more effective. However, generalised effects on more distal educational outcomes (e.g., school degrees) were generally weak. Hence, it remains questionable whether individual psychosocial and educational programmes are able to counterbalance the multifaceted risks of immigration.
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Affiliation(s)
- Andreas Beelmann
- Department of Research Synthesis, Intervention, Evaluation, Institute of Psychology, Friedrich Schiller University of Jena, Jena, Germany
| | - Louisa S Arnold
- Department of Research Synthesis, Intervention, Evaluation, Institute of Psychology, Friedrich Schiller University of Jena, Jena, Germany
| | - Sebastian Schulz
- Department of Educational Psychology, Institute of Psychology, Friedrich Schiller University of Jena, Jena, Germany
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14
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Lescano CM, Castillo HL, Calcano E, Mayor M, Porter M, Rivera-Torgerson Y, Dion C, Marhefka SL, Barker D, Brown LK. Latino STYLE: Preliminary Findings From an HIV Prevention RCT Among Latino Youth. J Pediatr Psychol 2021; 45:411-422. [PMID: 32330945 DOI: 10.1093/jpepsy/jsaa019] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Revised: 03/02/2020] [Accepted: 03/15/2020] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE Latino STYLE is a family-centered, HIV-focused intervention (HIV) emphasizing cultural factors and parent-adolescent communication. We hypothesized that, compared with a general health promotion (HP) intervention, the HIV arm would improve caregiver and adolescent HIV knowledge, attitudes, parental monitoring, sexual communication, and family relationships after a 3-month postintervention period. This article reports on the short-term findings of the longer trial. METHODS A single-site, two-arm, parallel, family-based, randomized, controlled trial was conducted; eligible participants were Latino adolescents aged 14-17 and their primary caregiver. The study was conducted at the University of South Florida with 227 adolescent-caregiver dyads allocated to the HIV (n = 117) or HP (n = 110) intervention after completing a baseline assessment. Interim measures at 3-month follow-up included demographics, HIV knowledge, self-efficacy, parental monitoring, sexual communication, family relationships, and adolescent sexual behavior. RESULTS Adolescents in the HIV group reported small effects in parental permissiveness and the HP group reported small effects for family support. Caregivers in both groups reported decreases in all outcomes. Incidence of past 90-day sexual intercourse decreased in both treatment arms. Among those who were sexually active over the past 90 days, the number of sex acts decreased from baseline, particularly in the HIV group. The percentage of condom-protected sex acts increased in the HIV group and decreased in the HP group, but did not reach statistical significance. CONCLUSIONS The HIV Latino STYLE intervention was not efficacious in improving hypothesized outcomes over a 3-month period. However, exploratory analyses revealed moderate effects for decreases in adolescent sexual risk behavior, particularly in the HIV group.
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Affiliation(s)
- Celia M Lescano
- Department of Mental Health Law and Policy, College of Behavioral and Community Sciences, University of South Florida
| | - Humberto López Castillo
- Department of Mental Health Law and Policy, College of Behavioral and Community Sciences, University of South Florida.,Department of Health Sciences, College of Health Professions and Sciences, University of Central Florida
| | - Ercilia Calcano
- Department of Mental Health Law and Policy, College of Behavioral and Community Sciences, University of South Florida
| | - Manuel Mayor
- Department of Mental Health Law and Policy, College of Behavioral and Community Sciences, University of South Florida
| | - Milagro Porter
- Department of Mental Health Law and Policy, College of Behavioral and Community Sciences, University of South Florida
| | - Yairí Rivera-Torgerson
- Department of Mental Health Law and Policy, College of Behavioral and Community Sciences, University of South Florida
| | - Charles Dion
- Department of Mental Health Law and Policy, College of Behavioral and Community Sciences, University of South Florida
| | - Stephanie L Marhefka
- Department of Community and Family Health, College of Public Health, University of South Florida
| | - David Barker
- Department of Psychiatry and Human Behavior, Rhode Island Hospital, Brown University
| | - Larry K Brown
- Department of Psychiatry and Human Behavior, Rhode Island Hospital, Brown University
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Piña-Watson B, Cox K, Neduvelil A. Mexican descent college student risky sexual behaviors and alcohol use: The role of general and cultural based coping with discrimination. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2021; 69:82-89. [PMID: 31513462 DOI: 10.1080/07448481.2019.1656214] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/28/2018] [Revised: 05/30/2019] [Accepted: 08/12/2019] [Indexed: 06/10/2023]
Abstract
This study investigates cultural and general coping strategies as potential protective or risk factors to risky sexual behaviors (RSBs) and alcohol use in the face of discrimination for Mexican descent college students. Participants: Data collection was conducted from September 2016 to May 2017 and included 796 Mexican descent emerging adults. Methods: Linear regressions were conducted to test main and interaction effects of discrimination, and general and cultural coping strategies on RSBs and alcohol use issues. Results: Higher discrimination experiences were not associated with RSBs or alcohol use issues. Only ethnicity-based coping was found to be a significant moderator to the relationships between discrimination and the outcome variables of RSBs and alcohol use issues. Conclusions: This study has implications for the way mental health clinicians explore the intersection of ethnic identity and coping as a means of understanding the relationship among discrimination, RSBs, and alcohol use issues.
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Affiliation(s)
- Brandy Piña-Watson
- Department of Psychological Sciences, Texas Tech University, Lubbock, Texas, USA
| | - Kassidy Cox
- Department of Psychological Sciences, Texas Tech University, Lubbock, Texas, USA
| | - Ashley Neduvelil
- Department of Psychological Sciences, Texas Tech University, Lubbock, Texas, USA
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16
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Gabrielli G, Paterno A, Strozza S. Sexual behavioural differences and risk-taking differences among born-abroad and native university students in Italy. GENUS 2020. [DOI: 10.1186/s41118-020-00088-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
AbstractThere is a substantial lack of information in the literature on affective and sexual behaviours in youths with migratory backgrounds, despite immigrants’ immediate descendants growing in recent years in many destination countries. In order to fill this gap, we use original information, collected by the “Sexual and Emotional Life of Youths (SELFY)” survey carried out in Italy in 2017. We aim to provide a deeper understanding of sexual behaviours by comparing, for the very first time, university students with a migratory background and their native counterparts, stratifying them by gender. Our results show that born-abroad male students have a greater exposure to more liberal attitudes than their native counterparts, while there are no notable differences between born-abroad and native women. Moreover, we analyse, among a number of factors, the association between three sexual behaviours (extra-couple sexual intercourse, occasional sexual intercourse, and numerous sexual partners) and multiple “risk” behaviours. Behaviours defined as “risky” include voluntary attitudes which can be responsible for negative outcomes. Our results show that reckless driving and drug use are directly associated with sexual behaviours, with no differences by gender or migratory status. The association of binge drinking and early sexual debut with the three considered sexual behaviours is largely present only among natives, while having problems with family and school rules have a gender-related role on sex.
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17
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Evans R, Widman L, Stokes M, Javidi H, Hope E, Brasileiro J. Sexual Health Programs for Latinx Adolescents: A Meta-analysis. Pediatrics 2020; 146:peds.2019-3572. [PMID: 32522785 DOI: 10.1542/peds.2019-3572] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/17/2020] [Indexed: 11/24/2022] Open
Abstract
CONTEXT Latinx adolescents are at risk for negative sexual health outcomes, and many interventions have been developed to reduce this risk. OBJECTIVE In this meta-analysis, we synthesized the literature on sexual health interventions for Latinx adolescents and examined intervention effects on 3 behavioral outcomes (abstinence, condom use, number of sex partners) and 3 psychological outcomes (safer sex knowledge, intentions, self-efficacy). Moderators of intervention success were explored. DATA SOURCES A systematic search of studies published through January 2019 was conducted by using PubMed, PsycINFO, and Cumulative Index to Nursing and Allied Health Literature databases. STUDY SELECTION All studies included a US-based sample of Latinx adolescents, evaluated sexual health intervention by using an experimental or quasiexperimental design, included a behavioral outcome, and were in English. DATA EXTRACTION Standardized mean difference (d) and 95% confidence intervals (CIs) were meta-analyzed by using random-effects models. RESULTS Effect sizes from 12 studies, sampling 4673 adolescents, were synthesized. Sexual health interventions improved abstinence (d = 0.15, 95% CI: 0.02 to 0.28), condom use (d = 0.44, 95% CI: 0.18 to 0.70), number of sex partners (d = -0.19, 95% CI: -0.37 to -0.001), and sexual health knowledge (d = 0.40, 95% CI: 0.10 to 0.70), compared with control conditions. Effects were consistent across a number of demographic and clinical characteristics, although culturally tailored interventions produced greater change in condom use than nontailored interventions. LIMITATIONS There was variation across studies in measures of sexual behavior, and some elements of individual study quality were unclear. CONCLUSIONS Sexual health interventions have a small but significant impact on improving safer sexual behavior among Latinx adolescents. Health educators should consider the importance of cultural tailoring to program success.
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Affiliation(s)
- Reina Evans
- Department of Psychology, North Carolina State University, Raleigh, North Carolina
| | - Laura Widman
- Department of Psychology, North Carolina State University, Raleigh, North Carolina
| | - McKenzie Stokes
- Department of Psychology, North Carolina State University, Raleigh, North Carolina
| | - Hannah Javidi
- Department of Psychology, North Carolina State University, Raleigh, North Carolina
| | - Elan Hope
- Department of Psychology, North Carolina State University, Raleigh, North Carolina
| | - Julia Brasileiro
- Department of Psychology, North Carolina State University, Raleigh, North Carolina
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18
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Evans R, Widman L, Stokes MN, Javidi H, Hope EC, Brasileiro J. Association of Sexual Health Interventions With Sexual Health Outcomes in Black Adolescents: A Systematic Review and Meta-analysis. JAMA Pediatr 2020; 174:676-689. [PMID: 32310261 PMCID: PMC7171582 DOI: 10.1001/jamapediatrics.2020.0382] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
IMPORTANCE Black adolescents are at increased risk of contracting HIV and other sexually transmitted infections (STIs) and experiencing unplanned pregnancy. Although sexual health interventions aimed at decreasing these risks exist, evidence of the association between sexual health interventions and the sexual behavior of black adolescents has not been synthesized to our knowledge. OBJECTIVE To examine the associations between sexual health interventions and behavioral, biological, and psychological outcomes. DATA SOURCES For this systematic review and meta-analysis, a systematic search was conducted of studies published through January 31, 2019, using the PubMed, PsycINFO, and CINAHL databases and relevant review articles. The following key words were used: youth, adolesc* or teen*; sexual health or safe* sex or sexually transmitted disease or sexually transmitted infection or STD or STI or HIV or AIDS or pregnancy or reproductive health or condom* or contracept* or unprotected sex or abstinence; intervention or program or education or prevention or promotion or trial; latino* or latina* or latinx* or minorit* or ethnic* or hispanic or african american* or black* or race or racial or biracial. STUDY SELECTION Studies were included if they included a US-based sample of black adolescents, evaluated a sexual health intervention using experimental or quasi-experimental designs, included a behavioral outcome, and were published in English. DATA EXTRACTION AND SYNTHESIS Standardized mean differences and 95% CIs were extracted and meta-analyzed using random-effects models. MAIN OUTCOMES AND MEASURES Behavioral outcomes were abstinence, condom use, and number of sex partners. Biological outcomes were pregnancy and STI contraction. Psychological outcomes were sexual health intentions, knowledge, and self-efficacy. RESULTS Across 29 studies including 11 918 black adolescents (weighted mean age, 12.43 years), there was a significant weighted mean association of sexual health interventions with improvements in abstinence (Cohen d = 0.14; 95% CI, 0.05-0.24) and condom use (Cohen d = 0.25; 95% CI, 0.11-0.39). No significant mean association of these interventions with number of sex partners, pregnancy, or STI contraction was found. Sexual health interventions were significantly associated with improvements in psychological outcomes: sexual health intentions (Cohen d = 0.17; 95% CI, 0.05-0.30), knowledge (Cohen d = 0.46; 95% CI, 0.30-0.63), and self-efficacy (Cohen d = 0.19; 95% CI, 0.09-0.28). Intervention effect sizes were consistent across factors, such as participant sex and age and intervention dose. CONCLUSIONS AND RELEVANCE The findings suggest that sexual health interventions are associated with improvements in sexual well-being among black adolescents. There appears to be a need for wide-scale dissemination of these programs to address racial disparities in sexual health across the US.
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Affiliation(s)
- Reina Evans
- Department of Psychology, North Carolina State University, Raleigh
| | - Laura Widman
- Department of Psychology, North Carolina State University, Raleigh
| | | | - Hannah Javidi
- Department of Psychology, North Carolina State University, Raleigh
| | - Elan C. Hope
- Department of Psychology, North Carolina State University, Raleigh
| | - Julia Brasileiro
- Department of Psychology, North Carolina State University, Raleigh
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19
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Sanchez D, Whittaker TA, Crosnoe R. Preliminary Findings of the Links Between Gender Role Attitudes and Sexual Behaviors in Mexican American Early Adolescent Boys. PSYCHOLOGY OF MEN & MASCULINITY 2020; 21:1-12. [PMID: 33312072 PMCID: PMC7731931 DOI: 10.1037/men0000205] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
This study explored the relations between Latino gender role attitudes (traditional machismo attitudes and caballerismo attitudes) and sexual behaviors among 242 Mexican American early adolescent boys in the southwest United States. Specifically, a multiple mediator model estimated the association between gender role attitudes and sexual activity through a mediational pathway connecting substance use, sexual motives, and peer influence. Results from analyzing this structural equation model indicated that traditional machismo attitudes were not associated with sexual behaviors. Caballerismo gender role attitudes, however, were indirectly linked with reduced sexual motives and substance via peer influence. This study underscores the importance of social context, behavior, and psychological motivations in explaining differences in sexual motives and substance use among young Mexican American adolescent boys who hold different kinds of beliefs about their gender.
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Affiliation(s)
- Delida Sanchez
- Department of Educational Psychology, The University of Texas at Austin
| | | | - Robert Crosnoe
- Department of Sociology, The University of Texas at Austin
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20
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Smith ML, Wilson KL, Bergeron CD. Condom Use for Sexually Transmitted Infection Prevention Among Hispanic Teenage Mothers: A Community-Based Randomized Trial. J Womens Health (Larchmt) 2019; 29:534-540. [PMID: 31509072 DOI: 10.1089/jwh.2018.7455] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Background: Hispanics experience a higher prevalence of sexually transmitted infections (STIs) than non-Hispanics. Specifically, Hispanic teenagers are more at risk for HIV, have close to four times the rate of primary and secondary syphilis, and close to two times the rate of chlamydia and gonorrhea compared with non-Hispanic white teenagers. Hispanic youth engage in sexual activity at a younger age than non-Hispanic white youth and are less likely to use condoms in these encounters, thereby contributing to increased rates of teenage pregnancy and STIs. Prevention of STIs is needed for unmarried Hispanic teenage mothers. The purpose of this study was to examine whether Project Mothers and Schools (Project MAS), a support program for parenting teenagers, changed condom use to prevent STIs among Hispanic participants. Methods: A longitudinal study was conducted among 84 Hispanic teenage mothers. Generalized estimating equations were used to identify factors associated with participants' reported condom use to prevent STIs. Results: Overall, participants were 3.21 times more likely to report condom use to prevent STIs from baseline to 12-month follow-up (p = 0.030). Those using condoms to prevent pregnancy at 12-month follow-up were significantly more likely to report using a condom to prevent STIs (OR = 3.23, p = 0.017). Conclusions: Participation in Program MAS improved condom use patterns for STI prevention. These services and supports have potential to change unmarried Hispanic teenage mothers' condom use behaviors and decrease STI infection disparities among the teenage Hispanic population.
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Affiliation(s)
- Matthew Lee Smith
- Center for Population Health and Aging, Texas A&M University, College Station, Texas.,Department of Environmental and Occupational Health, School of Public Health, Texas A&M University, College Station, Texas.,Department of Health Promotion and Behavior, College of Public Health, The University of Georgia, Athens, Georgia
| | - Kelly L Wilson
- Department of Health and Kinesiology, Texas A&M University, College Station, Texas
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21
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Sanjuan-Meza XS, Padrón-Salas A, Valle-Luna P, Martínez-Granada S, Ortega-Velázquez A, Cossío-Torres P. Reproductive health education program for Mexican women. EUR J CONTRACEP REPR 2019; 24:373-379. [PMID: 31502892 DOI: 10.1080/13625187.2019.1656187] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Objective: Improve knowledge, attitudes and reproductive behaviours through an educational intervention aimed at reproductive health in two groups of Mexican women. Materials and methods: We carried out an education program targeting two segments, indigenous women and marginalised adolescents, with a pre-test, immediate post-test and post-test six months after it was carried out. Instruments used: a reproductive health history was established (pre-test and post-test six months) and a questionnaire of knowledge, attitude and conduct related to reproductive health and condom use (pre-test, immediate post-test and post-test six months). Results: Improved test scores in reproductive health and condom use - knowledge, attitude and conduct, were notable in the group of indigenous women (p < .05). However, in the group of adolescents there was a significant increase (p < .05) only in reproductive health - knowledge and attitude; in condom usage, increase was only noted in knowledge and conduct, not in attitude (pre-test vs immediate post-test). Six months after post-test results there was a decrease in test scores in comparison with the immediate post-test results. They were however, higher than the pre-test scores. Conclusions: Both groups significantly increased short-term knowledge, attitude and conduct related to reproductive health and condom use through the implementation of an education program. Results show that this education program can contribute to the development of an effective education program.
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Affiliation(s)
| | - Aldanely Padrón-Salas
- Public Health Department, Medicine School, Autonomous University of San Luis Potosi , San Luis Potosí , México
| | - Paulina Valle-Luna
- Public Health Department, Medicine School, Autonomous University of San Luis Potosi , San Luis Potosí , México
| | - Sara Martínez-Granada
- Public Health Department, Medicine School, Autonomous University of San Luis Potosi , San Luis Potosí , México
| | - Aida Ortega-Velázquez
- School of Accounting and Administration, Autonomous University of San Luis Potosi , San Luis Potosí , México
| | - Patricia Cossío-Torres
- Public Health Department, Medicine School, Autonomous University of San Luis Potosi , San Luis Potosí , México
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Effectiveness of School-Based Teen Pregnancy Prevention Programs in the USA: a Systematic Review and Meta-Analysis. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2019; 19:468-489. [PMID: 29374797 DOI: 10.1007/s11121-017-0861-6] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
School-based programs have been a mainstay of youth pregnancy prevention efforts in the USA. We conducted a systematic review and meta-analysis to assess their effectiveness. Eligible studies evaluated the effect on pregnancy rates of programs delivered in elementary, middle, or high schools in the USA and Canada, published between January 1985 and September 2016. The primary outcome was pregnancy; secondary outcomes were delay in sexual initiation, condom use, and oral contraception use. Randomized controlled trials (RCTs) and non-RCTs with comparator groups were eligible. We developed a comprehensive search strategy, applied to major bibliographic databases, article bibliographies, gray literature, and contact with authors. We calculated risk ratios (RR) with 95% confidence intervals (CI) for each outcome and pooled data in random effects meta-analysis. We used Grading of Recommendations Assessment, Development and Evaluation (GRADE) to assess evidence quality. Ten RCTs and 11 non-RCTs conducted from 1984 to 2016 yielded 30 unique pooled comparisons for pregnancy, of which 24 were not statistically significant. Six showed statistically significant changes in pregnancy rates: two with increased risk (RR 1.30, 95% CI 1.02-1.65; and RR 1.39, 95% CI 1.10-1.75) and four with decreased risk ranging from RR 0.56, 95% CI 0.41-0.77, to RR 0.75, 95% CI 0.58-0.96. All studies were at high risk of bias, and the quality of evidence was low or very low. Identified evidence indicated no consistent difference in rates of pregnancies between intervention recipients and controls.
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Rubens M, Batra A, Sebekos E, Tanaka H, Gabbidon K, Darrow W. Exploring the Determinants of Risky Sexual Behavior Among Ethnically Diverse University Students: the Student Behavioral Health Survey-Web. J Racial Ethn Health Disparities 2019; 6:953-961. [PMID: 31087285 DOI: 10.1007/s40615-019-00596-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2019] [Revised: 04/27/2019] [Accepted: 05/01/2019] [Indexed: 11/24/2022]
Abstract
Universities create policies and develop programs to prevent HIV and other sexually transmitted infections. Unfortunately, most historically Black colleges and Hispanic-serving institutions have limited information about student practices and program effectiveness. This study examined the prevalence and determinants of risky sex among students attending a Hispanic-serving university. A cross-sectional online survey was conducted to obtain sensitive data from a random sample of students. Nearly two-thirds (65.2%) of 632 respondents reported engaging in risky sex. Sexual risk was significantly associated with older age (AOR = 2.16, 95% CI 1.09-4.30), lower self-control (AOR = 0.58, 95% CI 0.34-0.97), and higher alcohol (AOR = 2.10, 95% CI 1.20-3.67) and drug use (AOR = 2.59, 95% CI 1.48-4.50). Most respondents were unaware of university policies and programs. Programs to improve sexual health must influence risk-taking students. Perceptions of self-control and use of alcohol and drugs affected sexual decision-making. These factors should be ascertained and addressed by behavioral interventions aimed at minimizing risky behaviors and limiting the transmission of sexually transmitted infections.
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Affiliation(s)
- Muni Rubens
- Telehealth Center of Excellence, Baptist Health South Florida, Coral Gables, FL, USA
| | | | - Elena Sebekos
- Department of Health Promotion and Disease Prevention, Robert Stempel College of Public Health and Social Work, Florida International University, 11200 SW 8th Street, AHC 5 419, Miami, FL, 33199, USA
| | - Hideaki Tanaka
- Department of Health Promotion and Disease Prevention, Robert Stempel College of Public Health and Social Work, Florida International University, 11200 SW 8th Street, AHC 5 419, Miami, FL, 33199, USA
| | - Kemesha Gabbidon
- Department of Psychology, University of South Florida, St. Petersburg, FL, USA
| | - William Darrow
- Department of Health Promotion and Disease Prevention, Robert Stempel College of Public Health and Social Work, Florida International University, 11200 SW 8th Street, AHC 5 419, Miami, FL, 33199, USA.
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King C, Llewellyn C, Shahmanesh M, Abraham C, Bailey J, Burns F, Clark L, Copas A, Howarth A, Hughes G, Mercer C, Miners A, Pollard A, Richardson D, Rodger A, Roy A, Gilson R. Sexual risk reduction interventions for patients attending sexual health clinics: a mixed-methods feasibility study. Health Technol Assess 2019; 23:1-122. [PMID: 30916641 PMCID: PMC6452239 DOI: 10.3310/hta23120] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Sexually transmitted infections (STIs) continue to represent a major public health challenge. There is evidence that behavioural interventions to reduce risky sexual behaviours can reduce STI rates in patients attending sexual health (SH) services. However, it is not known if these interventions are effective when implemented at scale in SH settings in England. OBJECTIVES The study (Santé) had two main objectives - (1) to develop and pilot a package of evidence-based sexual risk reduction interventions that can be delivered through SH services and (2) to assess the feasibility of conducting a randomised controlled trial (RCT) to determine effectiveness against usual care. DESIGN The project was a multistage, mixed-methods study, with developmental and pilot RCT phases. Preparatory work included a systematic review, an analysis of national surveillance data, the development of a triage algorithm, and interviews and surveys with SH staff and patients to identify, select and adapt interventions. A pilot cluster RCT was planned for eight SH clinics; the intervention would be offered in four clinics, with qualitative and process evaluation to assess feasibility and acceptability. Four clinics acted as controls; in all clinics, participants would be consented to a 6-week follow-up STI screen. SETTING SH clinics in England. PARTICIPANTS Young people (aged 16-25 years), and men who have sex with men. INTERVENTION A three-part intervention package - (1) a triage tool to score patients as being at high or low risk of STI using routine data, (2) a study-designed web page with tailored SH information for all patients, regardless of risk and (3) a brief one-to-one session based on motivational interviewing for high-risk patients. MAIN OUTCOME MEASURES The three outcomes were (1) the acceptability of the intervention to patients and SH providers, (2) the feasibility of delivering the interventions within existing resources and (3) the feasibility of obtaining follow-up data on STI diagnoses (primary outcome in a full trial). RESULTS We identified 33 relevant trials from the systematic review, including videos, peer support, digital and brief one-to-one sessions. Patients and SH providers showed preferences for one-to-one and digital interventions, and providers indicated that these intervention types could feasibly be implemented in their settings. There were no appropriate digital interventions that could be adapted in time for the pilot; therefore, we created a placeholder for the purposes of the pilot. The intervention package was piloted in two SH settings, rather than the planned four. Several barriers were found to intervention implementation, including a lack of trained staff time and clinic space. The intervention package was theoretically acceptable, but we observed poor engagement. We recruited patients from six clinics for the follow-up, rather than eight. The completion rate for follow-up was lower than anticipated (16% vs. 46%). LIMITATIONS Fewer clinics were included in the pilot than planned, limiting the ability to make strong conclusions on the feasibility of the RCT. CONCLUSION We were unable to conclude whether or not a definitive RCT would be feasible because of challenges in implementation of a pilot, but have laid the groundwork for future research in the area. TRIAL REGISTRATION Current Controlled Trials ISRCTN16738765. FUNDING This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 23, No. 12. See the NIHR Journals Library website for further project information.
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Affiliation(s)
- Carina King
- Institute for Global Health, University College London, London, UK
| | - Carrie Llewellyn
- Department of Primary Care and Public Health, Brighton and Sussex Medical School, Brighton, UK
| | | | | | - Julia Bailey
- Research Department of Primary Care and Population Health, University College London, London, UK
| | - Fiona Burns
- Institute for Global Health, University College London, London, UK
| | - Laura Clark
- Brighton and Sussex University Hospitals NHS Trust, Brighton, UK
| | - Andrew Copas
- Institute for Global Health, University College London, London, UK
- London Hub for Trials Methodology Research, Medical Research Council Clinical Trials Unit, London, UK
| | - Alison Howarth
- Institute for Global Health, University College London, London, UK
| | - Gwenda Hughes
- Sexually Transmitted Infection Surveillance, Public Health England, London, UK
| | - Cath Mercer
- Institute for Global Health, University College London, London, UK
| | - Alec Miners
- Department of Health Services Research and Policy, London School of Hygiene & Tropical Medicine, London, UK
| | - Alex Pollard
- Department of Primary Care and Public Health, Brighton and Sussex Medical School, Brighton, UK
| | | | - Alison Rodger
- Institute for Global Health, University College London, London, UK
| | - Anupama Roy
- Department of Primary Care and Public Health, Brighton and Sussex Medical School, Brighton, UK
| | - Richard Gilson
- Institute for Global Health, University College London, London, UK
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Guerra-Reyes L, Rush B, Herbenick D, Dodge B, Reece M, Schick V, Sanders SA, Fortenberry JD. Sexual Health and Language Dominance Among Hispanic/Latino Women and Men: Analysis of a Nationally Representative Sample. J Immigr Minor Health 2018; 19:1059-1072. [PMID: 27351894 DOI: 10.1007/s10903-016-0446-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
This study assessed the prevalence of sexual behaviors among a nationally representative sample of Latino men and women in the United States (US) (N = 432) including Spanish language data collection. Prior studies of sexual health among US Latinos have consisted of convenience samples, and focused mainly on assessing risk behaviors. We consider a broader range of sexual behaviors, subjective sexual experiences (e.g. pleasure and arousal), and STI testing behaviors. Analyses by language dominance and gender indicate a higher variability in sexual behaviors for English-dominant participants and a link between overall STI testing to regular medical examinations, especially women. Higher rates of pleasure, orgasms and arousal was reported by Spanish-dominant men and women, relative to the English-dominant group. Results represent a nuanced examination of internal differentiation among US Latinos and provides applicable data for reducing sexual health disparities in this population.
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Affiliation(s)
- Lucia Guerra-Reyes
- Department of Applied Health Science, Indiana University Bloomington, 1025 East 7th Street, Suite 116, Bloomington, IN, 47405, USA.
| | - Benjamin Rush
- Department of Epidemiology and Biostatistics, Indiana University Bloomington, 1025 East 7th Street, Suite 116, Bloomington, IN, 47405, USA
| | - Debby Herbenick
- Center for Sexual Health Promotion, Indiana University, Bloomington, IN, USA
| | - Brian Dodge
- Center for Sexual Health Promotion, Indiana University, Bloomington, IN, USA
| | - Michael Reece
- Center for Sexual Health Promotion, Indiana University, Bloomington, IN, USA
| | | | | | - J Dennis Fortenberry
- Division of Adolescent Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
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Tebb KP, Rodriguez F, Pollack LM, Trieu SL, Hwang L, Puffer M, Adams S, Ozer EM, Brindis CD. Assessing the effectiveness of a patient-centred computer-based clinic intervention, Health-E You/Salud iTu, to reduce health disparities in unintended pregnancies among Hispanic adolescents: study protocol for a cluster randomised control trial. BMJ Open 2018; 8:e018201. [PMID: 29326184 PMCID: PMC5780691 DOI: 10.1136/bmjopen-2017-018201] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2017] [Revised: 10/02/2017] [Accepted: 10/05/2017] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION Teen pregnancy rates in the USA remain higher than any other industrialised nation, and pregnancies among Hispanic adolescents are disproportionately high. Computer-based interventions represent a promising approach to address sexual health and contraceptive use disparities. Preliminary findings have demonstrated that the Health-E You/Salud iTu, computer application (app) is feasible to implement, acceptable to Latina adolescents and improves sexual health knowledge and interest in selecting an effective contraceptive method when used in conjunction with a healthcare visit. The app is now ready for efficacy testing. The purpose of this manuscript is to describe patient-centred approaches used both in developing and testing the Health-E You app and to present the research methods used to evaluate its effectiveness in improving intentions to use an effective method of contraception as well as actual contraceptive use. METHODS AND ANALYSIS This study is designed to assess the effectiveness of a patient-centred computer-based clinic intervention, Health-E You/Salud iTu, on its ability to reduce health disparities in unintended pregnancies among Latina adolescent girls. This study uses a cluster randomised control trial design in which 18 school-based health centers from the Los Angeles Unified School District were randomly assigned, at equal chance, to either the intervention (Health-E You app) or control group. Analyses will examine differences between the control and intervention group's knowledge of and attitudes towards contraceptive use, receipt of contraception at the clinic visit and self-reported use of contraception at 3-month and 6-month follow-ups. The study began enrolling participants in August 2016, and a total of 1400 participants (700 per treatment group) are expected to be enrolled by March 2018. ETHICS AND DISSEMINATION Ethics approval was obtained through the University of California, San Francisco Institutional Review Board. Results of this trial will be submitted for publication in peer-reviewed journals. This study is registered with the US National Institutes of Health. TRIAL REGISTRATION NUMBER NCT02847858.
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Affiliation(s)
- Kathleen P Tebb
- Department of Pediatrics, University of California, San Francisco, California, USA
| | - Felicia Rodriguez
- Department of Pediatrics, University of California, San Francisco, California, USA
| | - Lance M Pollack
- Center for AIDS Prevention Studies, University of California, San Francisco, California, USA
| | - Sang Leng Trieu
- The Los Angeles Trust for Children's Health, Los Angeles, California, USA
| | - Loris Hwang
- Department of Pediatrics, University of California, Los Angeles, California, USA
| | - Maryjane Puffer
- The Los Angeles Trust for Children's Health, Los Angeles, California, USA
| | - Sally Adams
- Department of Pediatrics, University of California, San Francisco, California, USA
| | - Elizabeth M Ozer
- Department of Pediatrics, University of California, San Francisco, California, USA
| | - Claire D Brindis
- Institute for Health Policy Studies, University of California, San Francisco, California, USA
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Bartlett R, McCoy TP, Kelley A, Beamon ER, Holmes T, Shelton T, Wallace D. Feasibility Testing a Family-Level Intervention to Prevent Risky Sex Behaviors Among Middle School-Age Latinas. J Transcult Nurs 2017; 29:131-138. [PMID: 28826343 DOI: 10.1177/1043659616689289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
PURPOSE In this article, we report a pilot study that tested the feasibility and initial efficacy of a culturally, linguistically, and developmentally tailored risky sex prevention intervention for middle school-age Latinas and their mothers. DESIGN We used a one-group pre-test, post-test, and 3-month post-intervention follow-up design. Data were collected at three points on aspects of the girls' communication, beliefs, and behaviors. RESULTS Promising results included improvements in girl's self-efficacy regarding condom communication and condom consistent use, and in mother-teen sexual risk communication. There were also trends in demonstration of fewer risky sex behaviors. DISCUSSION These findings suggest that the "Latina-Girls Empowered through Mind and Mission" (L-GEMM) intervention for young Latinas and their mothers is feasible and warrants further testing. IMPLICATIONS Nurses are uniquely positioned to deliver risky sex preventive interventions to young Latinas. Including mothers and tailoring interventions to build on cultural strengths are important for success.
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Affiliation(s)
- Robin Bartlett
- 1 University of North Carolina-Greensboro, Greensboro, NC, USA
| | - Thomas P McCoy
- 1 University of North Carolina-Greensboro, Greensboro, NC, USA
| | - Allyson Kelley
- 1 University of North Carolina-Greensboro, Greensboro, NC, USA
| | - Emily R Beamon
- 1 University of North Carolina-Greensboro, Greensboro, NC, USA
| | - Tara Holmes
- 1 University of North Carolina-Greensboro, Greensboro, NC, USA
| | - Terri Shelton
- 1 University of North Carolina-Greensboro, Greensboro, NC, USA
| | - Debra Wallace
- 1 University of North Carolina-Greensboro, Greensboro, NC, USA
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Heslop CW, Burns S, Lobo R, McConigley R. Developing a framework for community-based sexual health interventions for youth in the rural setting: protocol for a participatory action research study. BMJ Open 2017; 7:e013368. [PMID: 28559453 PMCID: PMC5777453 DOI: 10.1136/bmjopen-2016-013368] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION There is limited research examining community-based or multilevel interventions that address the sexual health of young people in the rural Australian context. This paper describes the Participatory Action Research (PAR) project that will develop and validate a framework that is effective for planning, implementing and evaluating multilevel community-based sexual health interventions for young people aged 16-24 years in the Australian rural setting. METHODS AND ANALYSIS To develop a framework for sexual health interventions with stakeholders, PAR will be used. Three PAR cycles will be conducted, using semistructured one-on-one interviews, focus groups, community mapping and photovoice to inform the development of a draft framework. Cycle 2 and Cycle 3 will use targeted Delphi studies to gather evaluation and feedback on the developed draft framework. All data collected will be reviewed and analysed in detail and coded as concepts become apparent at each stage of the process. ETHICS AND DISSEMINATION This protocol describes a supervised doctoral research project. This project seeks to contribute to the literature regarding PAR in the rural setting and the use of the Delphi technique within PAR projects. The developed framework as a result of the project will provide a foundation for further research testing the application of the framework in other settings and health areas. This research has received ethics approval from the Curtin University Human Research and Ethics Committee (HR96/2015).
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Affiliation(s)
- Carl William Heslop
- Collaboration for Evidence, Research and Impact, School of Public Health, Curtin University, Perth, Western Australia, Australia
| | - Sharyn Burns
- Collaboration for Evidence, Research and Impact, School of Public Health, Curtin University, Perth, Western Australia, Australia
| | - Roanna Lobo
- Collaboration for Evidence, Research and Impact, School of Public Health, Curtin University, Perth, Western Australia, Australia
| | - Ruth McConigley
- Collaboration for Evidence, Research and Impact, School of Public Health, Curtin University, Perth, Western Australia, Australia
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Calise TV, Chow W, Doré KF, O'Brien MJ, Heitz ER, Millock RR. Healthy Futures Program and Adolescent Sexual Behaviors in 3 Massachusetts Cities: A Randomized Controlled Trial. Am J Public Health 2016; 106:S103-S109. [PMID: 27689476 DOI: 10.2105/ajph.2016.303389] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We evaluated the impact of the 3-year Healthy Futures program on reducing sexual behaviors among middle school students. METHODS Fifteen public middle schools in Haverhill, Lowell, and Lynn, Massachusetts, participated in this longitudinal school-cluster randomized controlled trial (2011-2015), which included 1344 boys and girls. We collected student survey data at baseline, immediately after each Nu-CULTURE curriculum (classroom component of Healthy Futures) in the sixth, seventh, and eighth grades, and at a 1-year follow-up in the ninth grade (cohort 1 students only). RESULTS Healthy Futures did not reduce the overall prevalence of eighth-grade students who reported ever having vaginal sex. In the eighth-grade follow-up, fewer girls in the treatment group than in the control group reported ever having vaginal sex (P = .04), and fewer Hispanic treatment students than Hispanic control students reported ever having vaginal sex (P = .002). CONCLUSIONS There was some evidence of delaying sexual initiation by the end of Nu-CULTURE, for girls and Hispanics, but not for boys. Future research should focus on improving implementation of the supplemental components intended to foster interpersonal and environmental protective factors associated with sustained delays in sexual activity.
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Affiliation(s)
| | - Wendy Chow
- The authors are with the JSI Research & Training Institute, Inc., Boston, MA
| | - Katelyn F Doré
- The authors are with the JSI Research & Training Institute, Inc., Boston, MA
| | - Michael J O'Brien
- The authors are with the JSI Research & Training Institute, Inc., Boston, MA
| | - Elizabeth R Heitz
- The authors are with the JSI Research & Training Institute, Inc., Boston, MA
| | - Rebecca R Millock
- The authors are with the JSI Research & Training Institute, Inc., Boston, MA
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Tosin OH, Tshitangano TG. Assessment of learners' exposure to health education and promotion at school in the Limpopo Province of South Africa. Afr J Prim Health Care Fam Med 2016; 8:e1-5. [PMID: 27380860 PMCID: PMC4948084 DOI: 10.4102/phcfm.v8i2.932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2015] [Revised: 02/08/2016] [Accepted: 02/29/2016] [Indexed: 11/01/2022] Open
Abstract
BACKGROUND School participation and educational attainment among adolescents have been rising rapidly in the developing world. Thus, to attain Millennium Development Goal 6 (Combat HIV and/or AIDs, malaria and other diseases), it is crucial to seize the opportunity to educate and encourage teenagers about healthy choices and proper social behaviours that will continue into adulthood. AIM This study aimed to assess the exposure of rural secondary school learners to health education and promotion at schools in the Limpopo Province of South Africa. SETTING This study was carried out at 10 secondary schools in Vhumbedzi educational circuit. METHODOLOGY The study adopted a cross-sectional quantitative approach. Data were collected from 338 randomly selected learners from 10 secondary schools that make up a rural Vhumbedzi circuit in the Limpopo province. A self-administered questionnaire was used to collect data. RESULTS The findings showed that, 102 (66.07%) male and 121 (67.60%) female learners reported that they were taught about physical changes that occur during adolescence. In the same vein, most of the participants (n = 128, 84.39%) and (n = 152, 85.39%) males and females respectively claimed to have been taught about sexually transmitted diseases. CONCLUSION In this study the secondary schools in the Limpopo Province of South Africa are making efforts to uphold and expose their learners to health education and promotion at school.Keyword: Health education and promotion, adolescents, school, learners.
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Morales-Alemán MM, Scarinci IC. Correlates and predictors of sexual health among adolescent Latinas in the United States: A systematic review of the literature, 2004-2015. Prev Med 2016; 87:183-193. [PMID: 26972472 PMCID: PMC4884463 DOI: 10.1016/j.ypmed.2016.03.005] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2015] [Revised: 01/28/2016] [Accepted: 03/06/2016] [Indexed: 11/28/2022]
Abstract
Adolescent Latinas in the United States (US) are disproportionately affected by early pregnancy, sexually transmitted infections (STIs) and human immunodeficiency virus (HIV) in comparison to their non-Hispanic white counterparts. However, only a few studies have sought to understand the multi-level factors associated with sexual health in adolescent Latinas. Adhering to the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines, we conducted a systematic literature review to better understand the correlates and predictors of sexual health among adolescent Latinas in the US, identify gaps in the research, and suggest future directions for empirical studies and intervention efforts. Eleven studies were identified: five examined onset of sexual intercourse, nine examined determinants of sexual health/risk behaviors (e.g., number of sexual partners and condom use), and three examined determinants of a biological sexual health outcome (i.e., STIs or pregnancy). Two types of variables/factors emerged as important influences on sexual health outcomes: proximal context-level variables (i.e., variables pertaining to the individual's family, sexual/romantic partner or peer group) and individual-level variables (i.e., characteristics of the individual). A majority of the studies reviewed (n=9) examined some aspect of acculturation or Latino/a cultural values in relation to sexual health. Results varied widely between studies suggesting that the relationship between individual and proximal contextual variables (including acculturation) and sexual health may be more complex than previously conceived. This review integrates the findings on correlates and predictors of sexual health among adolescent Latinas, and supports the need for strengths-based theoretically guided research on the mechanisms driving these associations.
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Affiliation(s)
| | - Isabel C Scarinci
- Division of Preventive Medicine, University of Alabama at Birmingham, United States
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32
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Wang H, Singhal A. East Los High: Transmedia Edutainment to Promote the Sexual and Reproductive Health of Young Latina/o Americans. Am J Public Health 2016; 106:1002-10. [PMID: 27077336 DOI: 10.2105/ajph.2016.303072] [Citation(s) in RCA: 56] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Latina/o Americans are at high risk for sexually transmitted infections and adolescent pregnancies. Needed urgently are innovative health promotion approaches that are engaging and culturally sensitive. East Los High is a transmedia edutainment program aimed at young Latina/o Americans. It embeds educational messages in entertainment narratives across digital platforms to promote sexual and reproductive health. We employed online analytics tracking (2013-2014), an online viewer survey (2013), and a laboratory experiment (El Paso, TX, 2014) for season 1 program evaluation. We found that East Los High had a wide audience reach, strong viewer engagement, and a positive cognitive, emotional, and social impact on sexual and reproductive health communication and education. Culturally sensitive transmedia edutainment programs are a promising health promotion strategy for minority populations and warrant further investigation.
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Affiliation(s)
- Hua Wang
- Hua Wang is with the Department of Communication and the Department of Community Health and Health Behavior, University at Buffalo, The State University of New York. Arvind Singhal is with the Department of Communication, The University of Texas at El Paso, and the Faculty of Business Administration, Hedmark University College, Rena, Norway
| | - Arvind Singhal
- Hua Wang is with the Department of Communication and the Department of Community Health and Health Behavior, University at Buffalo, The State University of New York. Arvind Singhal is with the Department of Communication, The University of Texas at El Paso, and the Faculty of Business Administration, Hedmark University College, Rena, Norway
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Ewan LA, McLinden D, Biro F, DeJonckheere M, Vaughn LM. Mapping the Views of Adolescent Health Stakeholders. J Adolesc Health 2016; 58:24-32. [PMID: 26707227 DOI: 10.1016/j.jadohealth.2015.09.020] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2015] [Revised: 09/18/2015] [Accepted: 09/18/2015] [Indexed: 02/02/2023]
Abstract
PURPOSE Health research that includes youth and family stakeholders increases the contextual relevance of findings, which can benefit both the researchers and stakeholders involved. The goal of this study was to identify youth and family adolescent health priorities and to explore strategies to address these concerns. METHODS Stakeholders identified important adolescent health concerns, perceptions of which were then explored using concept mapping. Concept mapping is a mixed-method participatory research approach that invites input from various stakeholders. In response to prompts, stakeholders suggested ways to address the identified health conditions. Adolescent participants then sorted the statements into groups based on content similarity and rated the statements for importance and feasibility. Multidimensional scaling and cluster analysis were then applied to create the concept maps. RESULTS Stakeholders identified sexually transmitted infections (STIs) and obesity as the health conditions they considered most important. The concept map for STIs identified 7 clusters: General sex education, support and empowerment, testing and treatment, community involvement and awareness, prevention and protection, parental involvement in sex education, and media. The obesity concept map portrayed 8 clusters: Healthy food choices, obesity education, support systems, clinical and community involvement, community support for exercise, physical activity, nutrition support, and nutrition education. Ratings were generally higher for importance than for feasibility. CONCLUSIONS The concept maps demonstrate stakeholder-driven ideas about approaches to target STIs and obesity in this context. Strategies at multiple social ecological levels were emphasized. The concept maps can be used to generate discussion regarding these topics and to identify interventions.
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Affiliation(s)
- Lindsay A Ewan
- Department of Pediatrics, Section of Adolescent Medicine, The Children's Hospital at OU Medical Center, OU College of Medicine, Oklahoma City, Oklahoma.
| | - Daniel McLinden
- Department of Pediatrics, Division of General and Community Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Frank Biro
- Department of Pediatrics, Division of Adolescent and Transition Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Melissa DeJonckheere
- College of Education, Criminal Justice, & Human Services, School of Education, University of Cincinnati, Cincinnati, Ohio
| | - Lisa M Vaughn
- Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; College of Education, Criminal Justice, & Human Services, School of Education, University of Cincinnati, Cincinnati, Ohio
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Fernandez-Santos DM, Miranda-Diaz C, Figueroa-Cosme WI, Ramon RO, Mayor AM, Rios-Olivares E, Hunter-Mellado RF. Impact of ASUMA Intervention on HIV Risk Behaviors among Puerto Rican Adolescents. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2015; 13:ijerph13010060. [PMID: 26703684 PMCID: PMC4730451 DOI: 10.3390/ijerph13010060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/15/2015] [Revised: 12/03/2015] [Accepted: 12/18/2015] [Indexed: 11/16/2022]
Abstract
The purpose of this manuscript is to assess and compare HIV risk behaviors among early adolescents after a three-year pilot study. A total of 135 public and private junior high schools students completed the intervention protocol. A self-administered questionnaire was given at baseline and at the end of the third year (fourth measure). Descriptive and inferential analyses were performed using SPSS 20.0. About 60% of the students were 14 years old at the fourth measure. The proportion of students that did not report at least one HIV risk behavior at baseline and those that reported any risk behavior at the fourth measure was lower in the intervention group (45.0%) than in the control group (54.5%). The proportion of students that reported at least one HIV risk behavior at baseline and those that did not report any HIV risk behavior at the fourth measure was higher in the intervention group than in the control group (33.3% vs. 8.3%). The proportion of students engaging in HIV risk behaviors was higher in the control group than in the intervention group at the fourth measure, suggesting that A Supportive Model for HIV Risk Reduction in Early Adolescence (ASUMA) intervention might be a promising initiative to reduce adolescents' engagement in HIV risk behaviors.
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Affiliation(s)
- Diana M Fernandez-Santos
- Internal Medicine Department, Universidad Central del Caribe, School of Medicine, PO BOX 60327, Bayamon 00960-6032, Puerto Rico.
| | - Christine Miranda-Diaz
- Internal Medicine Department, Universidad Central del Caribe, School of Medicine, PO BOX 60327, Bayamon 00960-6032, Puerto Rico.
| | - Wanda I Figueroa-Cosme
- Internal Medicine Department, Universidad Central del Caribe, School of Medicine, PO BOX 60327, Bayamon 00960-6032, Puerto Rico.
| | - Raul O Ramon
- Internal Medicine Department, Universidad Central del Caribe, School of Medicine, PO BOX 60327, Bayamon 00960-6032, Puerto Rico.
| | - Angel M Mayor
- Internal Medicine Department, Universidad Central del Caribe, School of Medicine, PO BOX 60327, Bayamon 00960-6032, Puerto Rico.
| | - Eddy Rios-Olivares
- Internal Medicine Department, Universidad Central del Caribe, School of Medicine, PO BOX 60327, Bayamon 00960-6032, Puerto Rico.
| | - Robert F Hunter-Mellado
- Internal Medicine Department, Universidad Central del Caribe, School of Medicine, PO BOX 60327, Bayamon 00960-6032, Puerto Rico.
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Social network recruitment for Yo Puedo: an innovative sexual health intervention in an underserved urban neighborhood—sample and design implications. J Prim Prev 2015; 36:51-64. [PMID: 25358834 DOI: 10.1007/s10935-014-0375-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Most existing evidence-based sexual health interventions focus on individual-level behavior, even though there is substantial evidence that highlights the influential role of social environments in shaping adolescents' behaviors and reproductive health outcomes. We developed Yo Puedo, a combined conditional cash transfer and life skills intervention for youth to promote educational attainment, job training, and reproductive health wellness that we then evaluated for feasibility among 162 youth aged 16-21 years in a predominantly Latino community in San Francisco, CA. The intervention targeted youth's social networks and involved recruitment and randomization of small social network clusters. In this paper we describe the design of the feasibility study and report participants' baseline characteristics. Furthermore, we examined the sample and design implications of recruiting social network clusters as the unit of randomization. Baseline data provide evidence that we successfully enrolled high risk youth using a social network recruitment approach in community and school-based settings. Nearly all participants (95%) were high risk for adverse educational and reproductive health outcomes based on multiple measures of low socioeconomic status (81%) and/or reported high risk behaviors (e.g., gang affiliation, past pregnancy, recent unprotected sex, frequent substance use; 62%). We achieved variability in the study sample through heterogeneity in recruitment of the index participants, whereas the individuals within the small social networks of close friends demonstrated substantial homogeneity across sociodemographic and risk profile characteristics. Social networks recruitment was feasible and yielded a sample of high risk youth willing to enroll in a randomized study to evaluate a novel sexual health intervention.
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Becker D, Thing JP, Baezconde-Garbanati L, Schwartz SJ, Soto DW, Unger JB. Cultural measures associated with sexual risk behaviors among Latino youth in Southern California: a longitudinal study. PERSPECTIVES ON SEXUAL AND REPRODUCTIVE HEALTH 2014; 46:193-201. [PMID: 24786352 PMCID: PMC4216635 DOI: 10.1363/46e1514] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/02/2013] [Revised: 02/14/2014] [Accepted: 02/20/2014] [Indexed: 05/12/2023]
Abstract
CONTEXT Cultural variables have been associated with sexual risk behaviors among Latino youth, but findings across studies are inconsistent. METHODS A longitudinal study of acculturation patterns followed Latino youth in Southern California from 2005 to 2012. Data from 995 participants were used in logistic and ordered regression analyses to test whether cultural variables measured in high school were associated with sexual risk behaviors in emerging adulthood, and whether gender moderated these associations. RESULTS The cultural value of respect for parents was negatively associated with participants' odds of reporting an earlier age at sexual debut (odds ratio, 0.8) and condom nonuse at most recent sexual intercourse (0.8). A measure of acculturation reflecting U.S. cultural practices was positively associated with the likelihood of being sexually experienced (1.2), having concurrent sexual partners (1.5) and, among males only, having a greater number of sexual partners (1.3). Second- and later-generation immigrant youth had lower odds of not using a condom at most recent sexual intercourse than first-generation youth (0.6 and 0.5, respectively). Strength of endorsement of Latino cultural practices was negatively associated with females' lifetime number of partners (0.8), but positively associated with males' (1.4). CONCLUSIONS The cultural measures associated with Latino youths' sexual behaviors differed across outcomes and by gender. Further understanding of these associations and their underlying mechanisms may help inform the development of culturally sensitive sexual health interventions.
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Affiliation(s)
- Davida Becker
- Postdoctoral Fellow, Institute for Health Promotion and Disease Prevention Research, Department of Preventive Medicine, Keck School of Medicine, University of Southern California, 2001 N. Soto Street, Los Angeles, CA, 90032-3628, USA. Tel: (323) 442-7259; Fax: (323) 442-8201
| | - James P. Thing
- Postdoctoral Fellow, Institute for Health Promotion and Disease Prevention Research, Department of Preventive Medicine, Keck School of Medicine, University of Southern California, 2001 N. Soto Street, Los Angeles, CA, 90032-3628, USA. Associate Professor, Institute for Health Promotion and Disease Prevention Research, Department of Preventive Medicine, Keck School of Medicine, University of Southern California, 2001 N. Soto Street, Los Angeles, CA, 90032-3628, USA
| | - Lourdes Baezconde-Garbanati
- Associate Professor, Institute for Health Promotion and Disease Prevention Research, Department of Preventive Medicine, Keck School of Medicine, University of Southern California, 2001 N. Soto Street, Los Angeles, CA, 90032-3628, USA
| | - Seth J. Schwartz
- Associate Professor, Department of Public Health Sciences, Leonard M. Miller School of Medicine, University of Miami, 1425 N. W. 10 Avenue, Suite 321, Miami, FL 33136
| | - Daniel W. Soto
- Project Manager, Institute for Health Promotion and Disease Prevention Research, Department of Preventive Medicine, Keck School of Medicine, University of Southern California, 2001 N. Soto Street, Los Angeles, CA, 90032-3628, USA
| | - Jennifer B. Unger
- Professor, Institute for Health Promotion and Disease Prevention Research, Department of Preventive Medicine, Keck School of Medicine, University of Southern California, 2001 N. Soto Street, Los Angeles, CA, 90032-3628, USA
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Haderxhanaj LT, Dittus PJ, Loosier PS, Rhodes SD, Bloom FR, Leichliter JS. Acculturation, sexual behaviors, and health care access among Hispanic and non-Hispanic white adolescents and young adults in the United States, 2006-2010. J Adolesc Health 2014; 55:716-9. [PMID: 25156896 PMCID: PMC5774013 DOI: 10.1016/j.jadohealth.2014.06.018] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2014] [Revised: 06/18/2014] [Accepted: 06/18/2014] [Indexed: 11/20/2022]
Abstract
PURPOSE To examine national estimates of sexual behaviors and health care access by acculturation among adolescents. METHODS Using the 2006-2010 National Survey of Family Growth, four acculturation groups of Hispanic and non-Hispanic whites aged 15-24 years were analyzed by sexual behaviors and health care access. RESULTS In analyses adjusted for demographics, English-speaking immigrants, Hispanic natives, and non-Hispanic white youth were less likely to have a partner age difference of ≥6 years (adjusted odds ratio [AOR], .28; 95% confidence interval [CI], .13-.60; AOR, .13; 95% CI, .07-.26; AOR, .16; 95% CI, .08-.32, respectively) and more likely to use a condom at the first vaginal sex (AOR, 1.99; 95% CI, 1.10-3.61; AOR, 2.10; 95% CI, 1.33-3.31; AOR, 2.39; 95% CI, 1.53-3.74, respectively) than Spanish-speaking immigrants. Non-Hispanic white youth and Hispanic natives were more likely to have a regular place for medical care (AOR, 2.07; 95% CI, 1.36-3.16; AOR, 3.66; 95% CI, 2.36-5.68, respectively) and a chlamydia test in the past 12 months (AOR, 3.62; 95% CI, 1.52-8.60; AOR, 2.94; 95% CI, 1.32-6.54) than Spanish-speaking immigrants. CONCLUSIONS Interventions to reduce risk and increase health care access are needed for immigrant Hispanic youth, particularly Spanish-speaking immigrants.
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Affiliation(s)
- Laura T Haderxhanaj
- Division of STD Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia.
| | - Patricia J Dittus
- Division of STD Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Penny S Loosier
- Division of STD Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Scott D Rhodes
- Division of Public Health Services, School of Medicine, Wake Forest University, Winston-Salem, North Carolina
| | - Fred R Bloom
- Division of STD Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Jami S Leichliter
- Division of STD Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia
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Volpe EM, Morales-Alemán MM, Teitelman AM. Urban adolescent girls' perspectives on romantic relationships: initiation, involvement, negotiation, and conflict. Issues Ment Health Nurs 2014; 35:776-90. [PMID: 25259641 PMCID: PMC4670570 DOI: 10.3109/01612840.2014.910582] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The purpose of this paper was to describe romantic relationships from the perspective of urban, adolescent girls, to address gaps in our understanding of their relationship dimensions. Minority adolescent girls (n = 17) participated in private semi-structured interviews aimed to elicit the understanding of the adolescents' perspectives on their own relationship experiences and dynamics. The research team conducted conventional content analysis of the interview transcripts. Four major themes emerged about romantic relationships: (1) influence of male pursuit and social norms on relationship initiation factors; (2) a romantic partner is a confidant, friend, and companion; (3) negotiating intimacy respectfully; and (4) relationship conflict through control and abuse. Adolescents described sub-themes of social norms of male pursuit and relationship pressures that dictated relationship initiation. Relationships were depicted by emotional support, caring, and companionship. Adolescents described positive negotiation skills. However, relationship conflict, including controlling behaviors and violence, was illustrated in these same relationships. This study provides a rich description of romantic relationships from the perspectives of urban, adolescent girls. Most salient findings included social pressures and a combination of both positive and negative attributes. Implications include the need for intervention development at the community level to address social pressures, recognition of positive adolescent relationship attributes, and facilitation of skills to identify and address low-quality relationship characteristics.
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Affiliation(s)
- Ellen M Volpe
- University at Buffalo, School of Nursing, Buffalo, New York, USA
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Larson KL, Ballard SM, Nuncio BJ, Swanson M. Testing the feasibility of ¡Cuídate! With Mexican and Central American youth in a rural region of a southern state. Res Nurs Health 2014; 37:409-22. [PMID: 25185453 DOI: 10.1002/nur.21621] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/11/2014] [Indexed: 11/07/2022]
Abstract
Regions of the US with growing Latino populations are in need of culturally sensitive sexual risk reduction programs. A Latino community, a public school district, and a university in eastern North Carolina collaborated to test the feasibility of ¡Cuídate!, a culturally tailored, evidence-based sexual risk reduction program, with Mexican and Central American youth. Ten male and 10 female adolescents, ages 13-17 years, participated in the ¡Cuídate! program and post-program focus groups. Early adolescent boys and girls (ages 13-15) gained the most from this program. A safe environment facilitated healthy sexual communication, and condom skills-building provided a context for shared partner responsibility. Grade-level and gender differences were significant. Analysis of the focus group data identified three important messages: Everybody needs sex education, We like this program better because it is hands-on, and I'm going to make better decisions about sex. The findings of this study support the need for community-based interventions that ensure cultural respect, trust, and a safe environment in which to discuss sexual issues.
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Affiliation(s)
- Kim L Larson
- Associate Professor, East Carolina University, College of Nursing, 3135 Health Science Building, Greenville, NC, 27858-4353
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Yavorsky RL, Hollman D, Steever J, Soghomonian C, Diaz A, Strickler H, Schlecht N, Burk RD, Ochner CN. Prevalence of sexually transmitted infections in at-risk adolescent females at a comprehensive, stand-alone adolescent health center in New York City. Clin Pediatr (Phila) 2014; 53:890-5. [PMID: 24807980 PMCID: PMC4239196 DOI: 10.1177/0009922814533816] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Sexually transmitted infections (STIs) are common among adolescents, and multiple STIs over one's lifetime can increase health risks. Few studies have assessed lifetime STI prevalence. This study evaluates minority, underserved adolescents' self-reported lifetime STI history and objective STI rates. METHODS Lifetime STI rates of female patients at an urban adolescent health center were obtained from self-administered questionnaires. Additionally, STI test results were retrieved from electronic medical records. RESULTS Patients reported a high lifetime prevalence of STIs. By comparing self-report and objective data, underreporting was identified for chlamydia, gonorrhea, and herpes. CONCLUSIONS STI rates in at-risk adolescent females are higher than in the general population and remain elevated over time. Lifetime STI reports could expand our understanding of sexual health and should be further studied. Underreporting, which may increase health risks and hinder health care delivery, requires further investigation. Improvements in STI screening and prevention targeting at-risk populations are warranted.
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Affiliation(s)
| | | | - John Steever
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | | | - Angela Diaz
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
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Althoff MD, Grayson CT, Witt L, Holden J, Reid D, Kissinger P. A Meta-Analysis of the Efficacy of Behavioral Interventions to Reduce Risky Sexual Behavior and Decrease Sexually Transmitted Infections in Latinas Living in the United States. HEALTH EDUCATION & BEHAVIOR 2014; 42:709-18. [DOI: 10.1177/1090198114540461] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The objective of this meta-analysis was to determine the effect of behavioral interventions in reducing risky sexual behavior and incident sexually transmitted infections (STI) among Latina women living in the United States. Studies were found by systematically searching the MEDLINE, EMBASE, and PsychInfo databases without language restriction. Two independent reviewers screened abstracts and full texts of articles to find randomized control trials testing the effects of behavioral interventions aimed at changing risky sexual behavior among Latinas. Articles were selected using prespecified inclusion criteria. Two independent reviewers extracted data from the included trials in duplicate using a standardized data extraction form. Six randomized control trials met the inclusion criteria for a total of 2,909 participants. Using random effects models with inverse variance weighting, we found a protective effect of the behavioral intervention on reported risky sexual behavior (odds ratio = 0.52; 95% confidence interval = 0.42, 0.64) and on incident nonviral STI (odds ratio = 0.65; 95% confidence interval = 0.46, 0.93). Behavioral interventions targeted toward Latina populations are effective in reducing risky sexual behaviors and incident STI and should be considered by policymakers as a potential tool for HIV/STI prevention in this population.
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Affiliation(s)
| | | | - Lucy Witt
- Tulane University, New Orleans, LA, USA
| | - Julie Holden
- Tulane University, New Orleans, LA, USA
- Otsuka Pharmaceutical Development & Commercialization, Inc., Princeton, NJ, USA
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Davidson TM, Lopez CM, Saulson R, Borkman AL, Soltis K, Ruggiero KJ, de Arellano M, Wingood GM, DiClemente RJ, Danielson CK. Development and preliminary evaluation of a behavioural HIV-prevention programme for teenage girls of Latino descent in the USA. CULTURE, HEALTH & SEXUALITY 2014; 16:533-46. [PMID: 24697607 PMCID: PMC4020958 DOI: 10.1080/13691058.2014.891049] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
National data suggests that teenage girls of Latino descent in the USA are disproportionately affected by HIV, with the US Centers for Disease Control and Prevention reporting the rate of new infections being approximately four times higher compared to White women of comparable age . This paper highlights the need for an effective single-sex HIV-prevention programme for teenage girls of Latino descent and describes the development and preliminary evaluation of Chicas Healing, Informing, Living and Empowering (CHILE), a culturally-tailored, HIV-prevention programme exclusively for teenage girls of Latino descent that was adapted from Sisters Informing, Healing, Living and Empowering (SiHLE), an evidence-based HIV- prevention program that is culturally tailored for African American young women. Theatre testing, a pre-testing methodology to assess consumer response to a demonstration of a product, was utilised to evaluate the relevance and utility of the HIV programme as well as opportunities for the integration of cultural constructs. Future directions for the evaluation of CHILE are discussed.
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Affiliation(s)
- Tatiana M. Davidson
- Institute of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, USA
| | - Cristina M. Lopez
- Institute of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, USA
| | - Raelle Saulson
- Institute of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, USA
| | - April L. Borkman
- Institute of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, USA
| | - Kathryn Soltis
- Institute of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, USA
| | - Kenneth J. Ruggiero
- Institute of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, USA
- National Crime Victims Research and Treatment Center, Raph H. Johnson VA Medical Center, Charleston, USA
| | - Michael de Arellano
- Institute of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, USA
| | - Gina M. Wingood
- Rollings School of Public Health, Emory University, Atlanta, USA
| | | | - Carla Kmett Danielson
- Institute of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, USA
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Leeds C, Gallagher K, Wass T, Leytem A, Shlay JC. Improving Parent-Child Communication around Reproductive Health for Latino Teen Pregnancy Prevention. ACTA ACUST UNITED AC 2014. [DOI: 10.4236/ce.2014.515158] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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