A Multidimensional Approach to Assessing Infectious Disease Risk: Identifying Risk Classes Based on Psychological Characteristics

Patterns of Sexual Well-Being in Mexican Adolescents and Associations with Psychological Adjustment: A Latent Profile Analysis Approach

We examined Mexican adolescent sexual well-being tasks, defined as the positive cognitive and emotional evaluations of one's sexuality. We assessed three dimensions: acceptance of sexual desire, sexual decision-making involving mutual consent, and, when sexually active, the practice of safe sex. We utilized a person-centered approach to examine how patterns marked by different aspects of sexual well-being predict psychological adjustment. Participants were 1123 Mexican high or middle school (72%) students (54% girls; Mage = 15.1, SD = 1.52). We found a 6-profile model: 1) Average Sexual Health (40%); 2) High Protective Low Acceptance (20%); 3) Multidimensional Healthy (19%); 4) Multidimensional Risky (11%); 5) High Acceptance Low Contraception and Consent (6%); and 6) High Consent Low Contraception (4%). These profiles included some adolescents who experienced both low and high sexual scores on different sexual well-being indicators. For example, adolescents who belonged to the High Protective, Low Acceptance profile understood the importance of safe sex and mutual consent; but still felt sexual guilt. Profile membership was associated with gender, religion, age, and sexual experience. Adolescents in classes marked by high levels of well-being reported high levels of psychological adjustment. Findings may help educators develop more targeted sexual risk and violence prevention programs.

Identifying Sexually Transmitted Infection Risk Groups Based on Behavioral and Psychological Characteristics Among Heterosexuals During the COVID-19 Pandemic

BACKGROUND

Measures to reduce coronavirus disease (COVID-19) transmission may impact sexual health. We aimed to examine the impact of COVID-19 on sexual behavior and sexually transmitted infection (STI) testing and to characterize individuals who were at high STI risk.

METHODS

Dutch heterosexual males and females who participated in a cohort study in 2016 to 2018 were invited to fill out 2 questionnaires again in 2020 (age, 21-28 years). We used behavioral and psychological data from: prelockdown (September 2019 to February 2020), lockdown (March to May 2020), and postlockdown (June to August 2020). Behavior change was compared between subgroups identified with latent class analysis.

RESULTS

Four latent classes were identified (n = 238). Individuals in class 1 (48% of study population) and class 2 (36%) were at low STI risk and reported mostly steady partnerships. Individuals in class 3 (9%) and class 4 (7%) reported multiple casual partners prelockdown. Class 4 was characterized by lower condom use and health goals, negative infection prevention attitudes, and higher impulsiveness compared with class 3. Furthermore, same/increased partner numbers during lockdown (class 3, 18%; class 4, 56%) and postlockdown (class 3, 36%; class 4, 42%) compared with prelockdown was often reported. Of individuals who wanted an STI test during the pandemic, 62% in class 3 and 56% in class 4 did not get tested, mainly because they were unable to get an appointment.

CONCLUSIONS

A subgroup of individuals, characterized by low health goals, negative infection prevention attitudes, and high impulsiveness, engaged in high-risk behavior during the pandemic. Identifying these individuals may help provide appropriate health care during strict lockdowns and after relaxation of measures.

Modelling the impact of tailored behavioural interventions on chlamydia transmission

Behavioural interventions tailored to psychological characteristics of an individual can effectively achieve risk-reducing behaviour. The impact of tailored interventions on population-level chlamydia prevalence is unknown. We aimed to assess the impact on overall chlamydia prevalence five years after the introduction of an intervention aimed at increasing self-efficacy, social norms, attitudes and intentions towards condom use (i.e., condom intervention), and an intervention aimed at increasing health goals and decreasing impulsiveness (i.e., impulsiveness intervention). A pair model, informed by longitudinal psychological and behavioural data of young heterosexuals visiting sexual health centers, with susceptible-infected-susceptible structure was developed. The intervention effect was defined as an increased proportion of each subgroup moving to the desired subgroup (i.e., lower risk subgroup). Interventions tailored to subgroup-specific characteristics, assuming differential intervention effects in each subgroup, more effectively reduced overall chlamydia prevalence compared to non-tailored interventions. The most effective intervention was the tailored condom intervention, which was assumed to result in a relative reduction in chlamydia prevalence of 18% versus 12% in the non-tailored scenario. Thus, it is important to assess multiple psychological and behavioural characteristics of individuals. Tailored interventions may be more successful in achieving risk-reducing behaviour, and consequently, reduce chlamydia prevalence more effectively.