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Perez-Fernandez J, Arroyo-Velasco DO, Huaman MR, Chavez-Bustamante SG, Llamo-Vilcherrez AP, Delgado-Flores CJ, Toro-Huamanchumo CJ. Association between early sexual initiation and sexually transmitted infections among Peruvian reproductive-age women. Front Public Health 2023; 11:1191722. [PMID: 37790721 PMCID: PMC10544918 DOI: 10.3389/fpubh.2023.1191722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Accepted: 09/04/2023] [Indexed: 10/05/2023] Open
Abstract
Background Sexually transmitted infections (STIs) are a serious public health problem worldwide, especially among reproductive-age women. The early sexual onset of sexual intercourse (EOSI) has been suggested as a risk factor, although there is no data at the national level. Objective To evaluate the association between EOSI and STIs in Peruvian women of childbearing age. Methods Analytical cross-sectional study with secondary data analyzes of the Peruvian Demographic and Family Health Survey 2018. The outcome was the presence of STIs in the last 12 months and the exposure variable was EOSI (age < 15 years at the time of their first sexual experience). To evaluate the association of interest, crude and adjusted prevalence ratios (aPRs) were calculated using generalized linear models with Poisson family and logarithmic link function. Results We analyzed data from 31,028 women of childbearing age. The 11.3% reported having STIs in the last 12 months and 20.2% of the participants had an EOSI. After adjusting for potential confounders, we found that EOSI was associated with STIs (aPR: 1.27; 95% CI: 1.08-1.50; p = 0.005). When conducting stratified analysis by area of residence and number of sexual partners, this association was maintained in women living in urban areas (aPR: 1.36; 95% CI: 1.11-1.66; p = 0.003) those who did not report having a history of multiple sexual partners (aPR: 1.27; 95% CI: 1.08-1.51; p = 0.005), and those in the middle (aPR: 1.42; 95% CI: 1.03-1.97; p = 0.034) and highest (aPR: 2.12; 95% CI: 1.33-3.39; p = 0.002) wealth quintiles. Conclusion Among reproductive-age women from Peru, EOSI was associated with STIs, especially in women living in urban areas, with no history of multiple sexual partners, and belonging to the middle to higher wealth index. The implementation of measures to prevent EOSI and fostering appropriate sexual health counseling for women with EOSI is advised.
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Affiliation(s)
| | | | - Mariella R. Huaman
- Sociedad Científica San Fernando, Universidad Nacional Mayor de San Marcos, Lima, Peru
| | | | - Anita P. Llamo-Vilcherrez
- Grupo Peruano de Investigación Epidemiológica, Unidad de Investigación para la Generación y Síntesis de Evidencias en Salud, Universidad San Ignacio de Loyola, Lima, Peru
| | - Carolina J. Delgado-Flores
- Carrera de Farmacia y Bioquímica, Facultad de Ciencias de la Salud, Universidad Científica del Sur, Lima, Peru
| | - Carlos J. Toro-Huamanchumo
- Unidad de Investigación para la Generación y Síntesis de Evidencias en Salud, Universidad San Ignacio de Loyola, Lima, Peru
- OBEMET Centro de Obesidad y Salud Metabólica, Lima, Peru
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Ibrahim N, Hassler C, Jousselme C, Barry C, Lefèvre H, Falissard B, Bouyer J, Rouquette A. Chronic conditions, subjective wellbeing and risky sexual behaviour among adolescents and young adults. Eur J Pediatr 2023; 182:1163-1171. [PMID: 36602622 DOI: 10.1007/s00431-022-04784-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 12/22/2022] [Accepted: 12/23/2022] [Indexed: 01/06/2023]
Abstract
The purpose of this study is to clarify the relationship between having a chronic condition (CC) and several types of risky sexual behaviour (RSB) among adolescents and young adults. We used data from a multicentre cross-sectional study carried out on 14,431 adolescents from 137 French schools. Logistic regression was used to assess the association between several types of RSB and CCs among the 2680 participants aged 17 years or over who reported sexual intercourse. Survival analysis was conducted to assess the association between CCs and age at first sexual intercourse across the whole sample. Analyses were conducted separately by gender with and without adjustment for the parents' education level, early menarche and subjective wellbeing (relationship with mother and father, depression, perceived health status and liking school). Among boys, having a CC was associated with a higher risk of RSB in both univariate (OR: 1.58 [95% CI: 1.10-2.27]) and multivariate analyses (aOR: 1.62 [95% CI: 1.11-2.38]). Among girls, the association between chronic condition and RSB in univariate analysis was non-significant (OR: 1.30 [95% CI: 0.97-1.76]) and disappeared after adjustment on subjective wellbeing (aOR: 1.08 [95% CI: 0.78-1.49]). There was no association between CC and age at first sexual intercourse. Conclusion: There were major gender differences. Boys with a CC were more prone to engage in RSB independent of their subjective wellbeing, whereas in girls, subjective wellbeing seemed to mediate the relationship between CC and RSB. Clinicians should be aware of those gender differences in order to deliver preventive strategies regarding sexuality that target both genders. What is Known: • Young people with chronic conditions have a higher likelihood of engaging in risky sexual behaviour. • Engaging in such behaviours can be much more costly, as it can weaken their underlying state of health. What is New: • We found major gender differences. Boys were more prone to engage in risky behaviour independent of their subjective wellbeing, whereas in girls, it seemed to play an important role. • By understanding how risky sexual behaviour differs according to gender, clinicians can deliver prevention messages that target both genders.
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Affiliation(s)
- Nour Ibrahim
- Paris-Saclay University, UVSQ, CESP, Inserm U1018, Paris, France.
- French Research Group in Adolescent Health (GRMSA), Maison de Solenn, 97 Boulevard de Port Royal, Paris, France.
| | | | - Catherine Jousselme
- Paris-Saclay University, UVSQ, CESP, Inserm U1018, Paris, France
- Fondation Vallée, Paris-Saclay University, Gentilly, France
| | - Caroline Barry
- Paris-Saclay University, UVSQ, CESP, Inserm U1018, Paris, France
| | - Hervé Lefèvre
- Paris-Saclay University, UVSQ, CESP, Inserm U1018, Paris, France
- French Research Group in Adolescent Health (GRMSA), Maison de Solenn, 97 Boulevard de Port Royal, Paris, France
- AP-HP, Hôpital Cochin, Maison de Solenn, 97 Boulevard de Port-Royal, 75014, Paris, France
| | - Bruno Falissard
- Paris-Saclay University, UVSQ, CESP, Inserm U1018, Paris, France
- Public Health and Epidemiology Department, AP-HP, Hôpital du Kremlin Bicêtre, Le Kremlin Bicêtre, France
| | - Jean Bouyer
- Paris-Saclay University, UVSQ, CESP, Inserm U1018, Paris, France
- Public Health and Epidemiology Department, AP-HP, Hôpital du Kremlin Bicêtre, Le Kremlin Bicêtre, France
| | - Alexandra Rouquette
- Paris-Saclay University, UVSQ, CESP, Inserm U1018, Paris, France
- Public Health and Epidemiology Department, AP-HP, Hôpital du Kremlin Bicêtre, Le Kremlin Bicêtre, France
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3
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Fischer N, Træen B, Samuelsen SO. Sexual Debut Ages in Heterosexual Norwegians Across Six Birth Cohorts. SEXUALITY & CULTURE 2023; 27:916-929. [PMID: 36531156 PMCID: PMC9734895 DOI: 10.1007/s12119-022-10045-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/08/2022] [Indexed: 05/11/2023]
Abstract
This study aims to estimate six different sexual debut ages in heterosexual Norwegians in six birth cohorts of the general population in Norway. The results are based on a 2020 national web panel survey of 18-89-year-olds in Norway (n = 4160). There was a general decline in the median debut age from those aged 70+ to those 18-29 (born 1991-2002). Oral sex with a female partner has become increasingly common among men at an earlier age across generations. The same pattern was found in women as well with regard to oral sex with a male partner and receptive anal sex. There was a slight increase in median debut age in 18-29-year-olds for receptive vaginal sex (born 1991-2002). The median debut age for vaginal sex was fairly stable for generations of men and women born after 1950.
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Affiliation(s)
- Nantje Fischer
- Department of Psychology, University of Oslo, Oslo, Norway
| | - Bente Træen
- Department of Psychology, University of Oslo, Oslo, Norway
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4
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Torres Munguía JA, Martínez-Zarzoso I. Determinants of Emotional Intimate Partner Violence against Women and Girls with Children in Mexican Households: An Ecological Framework. JOURNAL OF INTERPERSONAL VIOLENCE 2022; 37:NP22704-NP22731. [PMID: 35135364 PMCID: PMC9679571 DOI: 10.1177/08862605211072179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
The purpose of this paper is to identify the risk factors for emotional intimate partner violence (IPV) against women and girls with children in Mexico from an ecological perspective. To that end, we generate a dataset with 35,004 observations and 42 covariates, to which we apply an additive probit model estimated with a boosting algorithm to overcome high-dimensionality and simultaneously perform variable selection and model choice. The dataset integrates 10 information sources, allowing us to properly characterize the four levels of the ecological approach, which is the first contribution of this paper. In addition, there are three key contributions. First, we identify a number of factors significantly linked to emotional IPV against women with children: age, age at sexual initiation, age at marriage (or cohabitation), autonomy regarding professional issues, social support networks, division of housework, the community's Gini index, women's economic participation in the municipality, and the prevalence of crime against males in the region. Second, we discuss some risk factors whose effects have not been examined or have been underexplored for Mexico; these include women's decision-making autonomy, social support networks, distribution of housework, the community's economic inequality, and criminality. Third, we identify specific risk subgroups that are generally overlooked: women who had their first sexual intercourse during childhood and women who got married (or moved in together with a partner) late in life. The main results suggest that strategies aiming to promote women's social and economic empowerment and reduce criminality should also incorporate a gender component regarding emotional violence against women with children in the context of intimate relationships.
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The Risks and Benefits of Being “Early to Bed": Toward a Broader Understanding of Age at Sexual Debut and Sexual Health in Adulthood. J Sex Med 2022; 19:1343-1358. [DOI: 10.1016/j.jsxm.2022.06.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 06/07/2022] [Accepted: 06/08/2022] [Indexed: 11/18/2022]
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Ongaro F, Tocchioni V. Adding up risks: Sexual debut and substance use among Italian university students. ADVANCES IN LIFE COURSE RESEARCH 2022; 53:100491. [PMID: 36652209 DOI: 10.1016/j.alcr.2022.100491] [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: 09/27/2021] [Revised: 05/31/2022] [Accepted: 06/01/2022] [Indexed: 06/17/2023]
Abstract
Adolescence and youth are periods of great changes in an individual's life, during which experiencing first events of the transition to adulthood and, sometimes, violating social norms. Literature has identified an association of risk behaviours with timing of first sexual intercourse, but scant information is available about their relationship with the use of protection or the choice of a casual partner. This study focuses on the relation between initiation of risk behaviours (get drunk and drug use) and initiation of intercourse. Using event history analysis - also in their competing risk form - on data on Italian university students collected in 2000-2001 and in 2017, we intend to verify to what extent the initiation and the timing to risk behaviours is associated with the circumstances of first intercourse (timing, use of protection, type of partner), and if and how initiation to risk behaviours interacts differently with age at sexual debut. Our results show that in a country such as Italy, where family and sexual norms are relatively traditional, young people who got drunk, used marijuana or ecstasy at least one time in their life are more likely to experience risky sexual intercourse.
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Affiliation(s)
- Fausta Ongaro
- Dipartimento di Scienze Statistiche, Università degli Studi di Padova, Via Cesare Battisti 241, 35121 Padova, Italy.
| | - Valentina Tocchioni
- Dipartimento di Statistica, Informatica, Applicazioni "G. Parenti", Università degli Studi di Firenze, Italy.
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7
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Darfour-Oduro SA, Grigsby-Toussaint DS. Impact of social environment on sexual behaviors of adolescent girls in 12 sub-Saharan African countries: a cross-sectional study. Reprod Health 2022; 19:139. [PMID: 35710414 PMCID: PMC9205096 DOI: 10.1186/s12978-022-01448-0] [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: 03/03/2022] [Accepted: 05/28/2022] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Early sexual debut among adolescent girls may result in teenage pregnancy and sexually transmitted diseases. In sub-Saharan Africa (SSA), pregnancy among adolescent girls may adversely impact the continuation of their education, general health status, and birth outcomes. However, few cross-national studies have examined the role that the social environment plays in adolescent girls' sexual behaviors in SSA. In this study, we explored adolescent girls' social environment and the impact on their sexual behaviors.. METHODS The country selection was based on availability of Global School-Based Student Health Survey (GSHS) national data (2003-2015). The total analytic sample was 22,067 adolescent girls from 12 countries in SSA. Descriptive statistics were generated to determine the characteristics of adolescent girls and independent samples t-test analysis were performed to determine whether there were differences between the social environment and age of sexual debut and sexual partners. Logistic regression models were used to determine the association between adolescent girls' social environment and sexual debut. RESULTS The study results showed variations across the 12 countries. Almost one in five (19.9%) adolescent girls reported to have ever engaged in sexual intercourse. Their mean age of sexual debut was 13.21 (13.04-13.37) years and mean number of sexual partners was 2.19 (2.08-2.29). We found that adolescent girls who reported not being connected with their parents were more likely to debut sex (aOR = 1.32, 95% CI, 1.14-1.53, p < 0.000). Parental monitoring was significantly associated with sexual debut but after controlling for the confounding variables (age, class grade and drug use), the association was no longer significantly positively associated. Adolescent girls who felt supported by their peers had a significantly higher number of sexual partners than those who did not feel supported by their peers. CONCLUSION The social environment of adolescent girls plays a very important role in sexual debut, age of sexual debut, and the number of sexual partners. Sexual health policies targeting adolescent girls are likely to achieve positive impacts if they focus on improving parental connectedness and peer support.
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Affiliation(s)
- Sandra A. Darfour-Oduro
- grid.8652.90000 0004 1937 1485Department of Epidemiology and Disease Control, School of Public Health, University of Ghana, Accra, Ghana
| | - Diana S. Grigsby-Toussaint
- grid.40263.330000 0004 1936 9094Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI USA ,grid.40263.330000 0004 1936 9094Department of Epidemiology, Brown University School of Public Health, Providence, RI USA
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8
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Barrense-Dias Y, Bélanger RE, Desbiens F, Leatherdale ST, Haddad S. Understanding Sexual Health Indicators During Adolescence: A Study to Consider Time Since Sexual Debut When Exploring Multiple Sexual Partners. ARCHIVES OF SEXUAL BEHAVIOR 2022; 51:1765-1772. [PMID: 35075599 DOI: 10.1007/s10508-021-02207-1] [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: 05/01/2020] [Revised: 02/17/2021] [Accepted: 10/26/2021] [Indexed: 06/14/2023]
Abstract
Understanding risky sexual behaviors among adolescents is key in efforts devoted to reducing the health burden related to sexually transmitted infections and unintended or unplanned pregnancies. The aims of this study were to understand the association between number of lifetime sexual partners and time since sexual debut (TSSD) among adolescents and to determine whether sex modified this association. Data were drawn from the 2018-2019 COMPASS-Quebec study, a cohort study conducted in secondary schools in the province of Quebec, Canada. Of 18,467 respondents aged 14 years and older, 6991 (37.9%; mean age 15.3) reported consensual sexual intercourse and answered questions on their age at sexual initiation and number of lifetime sexual partners. Multilevel Poisson regressions with robust standard errors were estimated to adjust for covariates and produce adjusted group mean differences. The adjusted mean number of lifetime sexual partners ranged from 1.5 for those who had recently begun sexual activity (< 12 months) to 4.0 for those who had been active for > 35 months, an average rise of about 0.6 per year. Females-to-males adjusted mean differences showed that males reported more sexual partners than females at all time points, but the differences were only significant at the shorter (< 12 months) and longer (> 35 months) time spans. This study highlights the importance of taking into account TSSD when using and interpreting the number of lifetime sexual partners as risky sexual behavior among adolescents. Sex did not have a significant modifying effect on the relationship between number of lifetime sexual partners and TSSD.
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Affiliation(s)
- Yara Barrense-Dias
- Centre de Recherche Sur Les Soins Et Les Services de Première Ligne de L, Université Laval, 2525 Chemin de la Canardière, Québec, QC, G1J 0A4, Canada.
| | - Richard E Bélanger
- Centre de Recherche Sur Les Soins Et Les Services de Première Ligne de L, Université Laval, 2525 Chemin de la Canardière, Québec, QC, G1J 0A4, Canada
- Centre Intégré Universitaire de Santé Et de Services Sociaux de La Capitale-Nationale, Québec, QC, Canada
| | - François Desbiens
- Centre de Recherche Sur Les Soins Et Les Services de Première Ligne de L, Université Laval, 2525 Chemin de la Canardière, Québec, QC, G1J 0A4, Canada
- Centre Intégré Universitaire de Santé Et de Services Sociaux de La Capitale-Nationale, Québec, QC, Canada
| | - Scott T Leatherdale
- School of Public Health and Health Systems, University of Waterloo, Waterloo, ON, Canada
| | - Slim Haddad
- Centre de Recherche Sur Les Soins Et Les Services de Première Ligne de L, Université Laval, 2525 Chemin de la Canardière, Québec, QC, G1J 0A4, Canada
- Centre Intégré Universitaire de Santé Et de Services Sociaux de La Capitale-Nationale, Québec, QC, Canada
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Schroeder E, Tallarico R, Bakaroudis M. The impact of adolescent initiation rites in East and Southern Africa: Implications for policies and practices. INTERNATIONAL JOURNAL OF ADOLESCENCE AND YOUTH 2022. [DOI: 10.1080/02673843.2022.2052123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Affiliation(s)
| | - Renata Tallarico
- Regional Coordinator, UNFPA East and Southern Africa Regional Office, Johannesburg, South Africa
| | - Maria Bakaroudis
- Comprehensive Sexuality Education Specialist & Disability Focal Point, UNFPA East and Southern Africa Regional Office, Johannesburg, South Africa
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10
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Diverse pathways in young Italians’ entrance into sexual life: The association with gender and birth cohort. DEMOGRAPHIC RESEARCH 2022. [DOI: 10.4054/demres.2022.46.13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Algren MH, Deen L, Tolstrup JS, Thygesen LC. Associations between health-risk behaviours and non-condom use among 28,620 Danish students: a cross-sectional study. EUR J CONTRACEP REPR 2021; 27:45-52. [PMID: 34907840 DOI: 10.1080/13625187.2021.2005018] [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: 10/19/2022]
Abstract
PURPOSE Investigations into the associations between health-risk behaviours and non-condom use are important for planning effective preventive interventions targeted sexually transmitted infections. To date, there are no such studies on the Danish general population. The aim of this study was to examine associations between health-risk behaviours (including daily smoking, frequent binge-drinking, cannabis use within the last month and illicit drug use) and non-condom use among Danish students. MATERIAL AND METHOD Cross-sectional data from 28,620 sexually active students aged 15-25 years from the Danish National Youth Study 2014 were analysed using multilevel logistic regression. RESULTS Health-risk behaviours (daily smoking, frequent binge-drinking, cannabis use within the last month and illicit drug use) were significantly associated with higher odds for non-condom use among Danish students, even after adjustment for age, gender, education, religion, and geographical region. The associations remained significant after adjusting for the remaining health-risk behaviours. CONCLUSION Overall, the study showed a clear association between health-risk behaviours and non-condom use among Danish students. The findings of this study have important implications for future planning of more targeted health promotion intervention programmes aimed to increase condom use among young people as a means to reduce sexually transmitted infections.
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Affiliation(s)
- Maria Holst Algren
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Laura Deen
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | | | - Lau Caspar Thygesen
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
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12
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Yoon S, An S, Noh DH, Tuan LT, Lee J. Effects of health education on adolescents' non-cognitive skills, life satisfaction and aspirations, and health-related quality of life: A cluster-randomized controlled trial in Vietnam. PLoS One 2021; 16:e0259000. [PMID: 34851980 PMCID: PMC8635366 DOI: 10.1371/journal.pone.0259000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Accepted: 10/08/2021] [Indexed: 11/18/2022] Open
Abstract
Objective The effectiveness of health education on adolescents has been questioned, along with a growing body of empirical studies documenting the absence of behavioral changes after the intervention. However, evidence on its impact on other crucial health domains, besides health practices, is lacking. We evaluated the causal effects of a school-based health education program on adolescents’ multidimensional psychological health factors. Design A cluster-randomized controlled trial. Methods We conducted a cluster-randomized controlled trial involving 140 lower secondary schools in Vietnam. After stratifying by district, schools were randomized 1:1 to either treatment or control groups. Students enrolled in the treatment schools received monthly stand-alone health education in five topics by school teachers at the class level, but control group students did not receive any intervention. The primary outcomes of the study were students’ non-cognitive skills, life satisfaction, aspirations gap, and the Health-Related Quality of Life at five-month follow-up. We estimated the intention-to-treat effects with the panel fixed effects model using student panel data. Results Of the 6,477 students enrolled at baseline, 2,958 (92%) treated and 2,967 (91%) control students completed the follow-up survey five months after baseline data collection from October to December 2018. Compared with controls, health education led to improved treatment school students’ self-efficacy (p-value = 0.013), presumed life satisfaction five years from the present (p-value = 0.001), aspirations gap for a socially and mentally healthy future (p-value = 0.036), and the Health-Related Quality of Life (p-value = 0.036). Conclusion A school-based health education program enhanced students’ non-cognitive skills, life satisfaction and aspirations gap, and the Health-Related Quality of Life significantly. This study proposes essential psychological factors that should be taken into account when evaluating the effectiveness of a health education program in resource-limited settings.
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Affiliation(s)
- Sangchul Yoon
- Department of Medical Humanities and Social Sciences, College of Medicine, Yonsei University, Seoul, Republic of Korea.,Department of Ophthalmology, College of Medicine, Yonsei University, Seoul, Republic of Korea
| | - Shinki An
- Department of Medical Education, College of Medicine, Yonsei University, Seoul, Republic of Korea
| | - Dave Haeyun Noh
- Department of Agricultural and Resource Economics, University of Maryland, College Park, United States of America
| | - Le Thanh Tuan
- Department of Quality Testing, Thanh Hoa Medical College, Thanh Hoa, Vietnam
| | - Jongwook Lee
- Department of Agricultural Economics and Rural Development, College of Agriculture and Life Sciences, Seoul National University, Seoul, Republic of Korea
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Distribution of HPV Genotypes Differs Depending on Behavioural Factors among Young Women. Microorganisms 2021; 9:microorganisms9040750. [PMID: 33918429 PMCID: PMC8066411 DOI: 10.3390/microorganisms9040750] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 03/28/2021] [Accepted: 03/30/2021] [Indexed: 11/23/2022] Open
Abstract
Risk factors for the different human papillomavirus (HPV) genotypes are not well understood, although the risk of cancer is known to vary among them. Our aim was to evaluate the association of diverse behavioral and reproductive factors with genotype-specific HPV prevalence among 879 unvaccinated women aged 18–75 years referred to the colposcopy clinic at Helsinki University Hospital in Finland. Cervical swabs for HPV genotyping were collected in the first visit and assessed for 34 high-risk (hr) and low-risk (lr) HPV genotypes. Participants completed a questionnaire on behavioral, reproductive, and lifestyle factors. Differences in genotype-specific HPV prevalence were analyzed overall and in age groups using binary logistic regression. Smoking was associated with higher prevalence in HPV16 compared with other hrHPV genotypes together with decreasing age, being highest among younger women <30 years old, odds ratio (OR) 3.74 (95% CI 1.42–9.88). The later the sexual debut, the more it seemed to protect from HPV16 infection. The best protection was achieved when the sexual debut took place at >20 years of age, with an OR of 0.43 (95% CI 0.23–0.83). This association was not seen with other hrHPV genotypes. Methods of contraception seemed not to have an effect on hrHPV positivity, regardless of the HPV genotype. The genotype specific hrHPV prevalence differs, depending on behavioral factors, especially among younger women referred to colposcopy.
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14
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Halkett A, Hinshaw SP. Initial Engagement in Oral Sex and Sexual Intercourse Among Adolescent Girls With and Without Childhood Attention-Deficit/Hyperactivity Disorder. ARCHIVES OF SEXUAL BEHAVIOR 2021; 50:181-190. [PMID: 32458300 PMCID: PMC7688561 DOI: 10.1007/s10508-020-01733-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Revised: 04/24/2020] [Accepted: 04/27/2020] [Indexed: 06/11/2023]
Abstract
We investigated initial engagement in oral sex and sexual intercourse, as well as number of sexual partners, among a prospectively followed sample of adolescent girls with and without a thorough childhood diagnosis of attention-deficit/hyperactivity disorder (ADHD). Participants were adolescent girls (ages 12-19) followed longitudinally as part of a study of ADHD in females. A diverse sample of 140 girls with clinician-diagnosed ADHD (47 inattentive, 93 combined) and 88 age- and ethnicity-matched comparison girls were initially recruited and invited to partake in research summer programs. We utilized data on initial engagement in oral sex, sexual intercourse, and number of sexual partners, collected during follow-up interviews conducted 5 and 10 years after baseline participation. Girls with a childhood diagnosis of ADHD engaged in oral sex at a significantly younger age and reported nearly twice as many oral sex partners than their typically developing peers. Post hoc tests revealed that group differences were driven largely by girls with the combined presentation of ADHD (i.e., those with childhood histories of both inattention and hyperactivity/impulsivity). No significant differences emerged with respect to age of initial sexual intercourse or number of male sexual intercourse partners. In sum, adolescent girls with ADHD, particularly those with the combined presentation, were more likely to engage in oral sexual activity at a young age and with a greater number of both male and female partners. Findings highlight the need for longitudinal research that quantifies and distinguishes between various forms of sexual behavior and later reproductive and mental health outcomes.
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Affiliation(s)
- Ashley Halkett
- Department of Psychology, 2121 Berkeley Way West, University of California, Berkeley, Berkeley, CA, 94704, USA.
| | - Stephen P Hinshaw
- Department of Psychology, 2121 Berkeley Way West, University of California, Berkeley, Berkeley, CA, 94704, USA
- Department of Psychiatry, UCSF Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
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Wu TL, Ting TT, Chen CY, Su LW, Chen WJ. Early sexual initiation and risky sexual practices among alcohol- and tobacco-using young adults in Taiwan: mediation analysis of preceding-sex use of illicit drugs. BMC Public Health 2020; 20:1647. [PMID: 33143679 PMCID: PMC7641850 DOI: 10.1186/s12889-020-09777-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Accepted: 10/26/2020] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND As early sexual initiation is increasingly common in East Asia, we examined its relations to risky sexual practices in alcohol- and tobacco-using individuals in Taiwan and evaluated whether the associations were mediated through preceding-sex use of illicit drugs. METHODS Participants, recruited from alcohol- and tobacco-using adults aged 18 to 50 in Taipei through respondent-driven sampling (N = 1115), completed a computer-assisted self-interview covering questions on substance use and sexual experiences. In a subsample of 916 participants who had had sexual experience (median age 27), we examined the relations of early sexual initiation (< 16 years) to multiple sexual partners, casual sex, group sex, and rare condom use. Causal mediation analyses were conducted to examine whether illicit drug use preceding sex mediated these associations. RESULTS Around 9.3% reported early sexual initiation and the prevalence of risky sexual practices ranged from 7% (group sex) to 47% (rare condom use). Early initiators had a higher prevalence of regular binge drinking, illicit drug use, and risky sexual practices. In the multivariable analyses, higher odds of multiple sexual partners, casual sex, and group sex were consistently associated with early sexual initiation, gender, and their interaction. Mediation through preceding-sex use of illicit drugs was found between early sexual initiation and the three risky sexual practices, with the proportions mediated ranging from 17 to 19%. CONCLUSIONS Early sexual initiators were more likely to engage in risky sexual practices and preceding-sex use of illicit drugs partially explained this relationship, calling for more attention to this population's sexual health.
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Affiliation(s)
- Tat Leong Wu
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Te-Tien Ting
- School of Big Data Management, Soochow University, Taipei, Taiwan
| | - Chuan-Yu Chen
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
- Institute of Public Health, National Yang-Ming University, Taipei, Taiwan
- Center for Neuropsychiatric Research, National Health Research Institutes, Zhunan, Miaoli County, Taiwan
| | - Lien-Wen Su
- Kunming Prevention and Control Center, Taipei City Hospital, Taipei, Taiwan
| | - Wei J Chen
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan.
- Center for Neuropsychiatric Research, National Health Research Institutes, Zhunan, Miaoli County, Taiwan.
- Department of Public Health, College of Public Health, National Taiwan University, Taipei, Taiwan.
- Department of Psychiatry, National Taiwan University Hospital and College of Medicine, National Taiwan University, Taipei, Taiwan.
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16
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Nygård M, Hansen BT, Kjaer SK, Hortlund M, Tryggvadóttir L, Munk C, Lagheden C, Sigurdardottir LG, Campbell S, Liaw KL, Dillner J. Human papillomavirus genotype-specific risks for cervical intraepithelial lesions. Hum Vaccin Immunother 2020; 17:972-981. [PMID: 32990181 PMCID: PMC8018444 DOI: 10.1080/21645515.2020.1814097] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Prevalence of different HPV genotypes is changing after HPV vaccination. The associated risks are needed for optimizing cervical cancer screening.To estimate HPV type-specific prevalence, odds ratio (OR), and positive predictive value (PPV) for cervical cytological abnormalities, we determined 41 different HPV genotypes in cervical samples from a population-based sample of 8351 women aged 18-51 years before HPV vaccination era (V501-033; NCT01077856).Prevalence of HPV16 was 4.9% (95% CI: 4.4-5.5) with the PPV for high-grade cytology 11.2%, and OR 11.9 (95% CI: 8.5-16.5). Carcinogenic HPVs included in the nonavalent vaccine (HPV16,18,31,33,45,52,58) had a population prevalence of 14.4% (95% CI: 13.5-15.4), with PPV of 8.0% (95% CI: 6.8-9.3) and OR 23.7 (95% CI: 16.0-63.5) for high-grade cytology. HPV types currently included in most screening tests, but not vaccinated against (HPV35,39,51,56,59,66,68) had a joint prevalence of 8.5% (95% CI: 7.8-9.2) with PPV of 4.4% (95% CI: 3.3-5.7) and OR of 2.9 (95% CI: 2.0-4.0) for high-grade cytology. The other 27 non-carcinogenic genotypes had a prevalence of 11.8%, PPV of 2.9% (95% CI:2.1-3.9), and OR 1.5 (95% CI: 1.1-2.2.) for high-grade cytology.These results suggest that HPV screening tests in the post-vaccination era might perform better if restricted to the HPV types in the nonavalent vaccine and screening for all 14 HPV types might result in suboptimal balance of harms and benefits.
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Affiliation(s)
- Mari Nygård
- Department of Research, Cancer Registry of Norway, Oslo, Norway
| | - Bo T Hansen
- Department of Research, Cancer Registry of Norway, Oslo, Norway
| | - Susanne K Kjaer
- Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark.,Gynecologic Clinic, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Maria Hortlund
- Formerly at WHO HPV LabNet Global Reference Laboratory, Clinical Microbiology, Skåne University Hospital, Malmö, Sweden.,International HPV Reference Center, Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Laufey Tryggvadóttir
- Icelandic Cancer Registry, Icelandic Cancer Society, Reykjavik, Iceland.,Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | - Christian Munk
- Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Camilla Lagheden
- Formerly at WHO HPV LabNet Global Reference Laboratory, Clinical Microbiology, Skåne University Hospital, Malmö, Sweden.,International HPV Reference Center, Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden
| | | | | | - Kai-Li Liaw
- Merck Research Laboratories, Merck Sharp & Dohme, Kenilworth, NJ, USA
| | - Joakim Dillner
- Formerly at WHO HPV LabNet Global Reference Laboratory, Clinical Microbiology, Skåne University Hospital, Malmö, Sweden.,International HPV Reference Center, Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden
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17
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Suris JC, Akre C, Jacot-Descombes C, Leeners B, Morselli D, Barrense-Dias Y. Does regretting first vaginal intercourse have an effect on young adults' sexual behaviour? Sex Health 2020; 17:247-254. [DOI: 10.1071/sh19174] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Accepted: 02/11/2020] [Indexed: 11/23/2022]
Abstract
Background
The aims of this research were to determine personal differences depending on the reason for regretting or not first vaginal intercourse and its effects on sexual behaviour later on among young adults, and to assess the association between reasons for engaging in first vaginal intercourse and regretting it. Methods: Data were drawn from the 2017 Swiss national survey on youth sexual behaviours among young adults (mean age 26 years) living in Switzerland. Out of the 7142 participants, 4793 (51% females) answered the question ‘Looking back now to the first time you had vaginal intercourse, do you think that…’ with five possible answers: (1) I should not have done it (6.7%); (2) I should have waited longer (7.7%); (3) I should have done it earlier (7.4%); (4) It was about the right time (67.9%); and (5) I don’t know (10.3%). The five groups were compared on sociodemographic and sex behaviour-related variables, analysed separately by gender. Results: One-third of participants regretted their first experience. In the multivariate analysis, compared with the ‘right time’ group, all other groups were more likely to find their first experience unpleasant and to have done it with a casual partner. Those in the ‘I should not have done it’ and ‘I should have waited longer’ groups were also more likely to have done it because of external pressure, especially among females. Conclusions: The study results underline the significance to choose the right time and the right partner for first vaginal intercourse and the importance of including partner respect and avoiding external pressure as part of sexual education.
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18
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Hansen BT, Kjaer SK, Arnheim-Dahlström L, Liaw KL, Juul KE, Thomsen LT, Frederiksen K, Elfström KM, Munk C, Nygård M. Age at first intercourse, number of partners and sexually transmitted infection prevalence among Danish, Norwegian and Swedish women: estimates and trends from nationally representative cross-sectional surveys of more than 100 000 women. Acta Obstet Gynecol Scand 2019; 99:175-185. [PMID: 31529491 DOI: 10.1111/aogs.13732] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Revised: 08/23/2019] [Accepted: 09/07/2019] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Sexual behavior at the population level impacts on public health. Recent representative sexual behavior data are lacking. MATERIAL AND METHODS Cross-sectional surveys in 2005 and 2012 on women age 18-45 years randomly selected from the general population in Denmark (n = 40 804), Norway (n = 30 331) and Sweden (n = 32 114). RESULTS Median (interquartile range) age at first intercourse was 16 (15-18) years in Denmark, 17 (16-18) years in Norway, and 17 (15-18) years in Sweden. Women in the most recent birth cohort had sexual debut at the lowest age, and were most likely to have sexual debut before the legal age of consent. Proportions with debut age ≤14 years among women born 1989-1994 vs 1971-1976, odds ratio (95% confidence interval) were: 18.4% vs 10.9%, 1.95 (1.74-2.18) in Denmark, 12.9% vs 6.3%, 2.38 (2.01-2.82) in Norway, 17.8% vs 11.4%, 1.75 (1.55-1.98) in Sweden. Median (interquartile range) number of lifetime sexual partners was 6 (3-10) in Denmark, 5 (2-10) in Norway, and 6 (3-11) in Sweden. The proportion of women reporting >10 sexual partners was also highest in the most recent survey. The percentage with odds ratio (95% confidence interval) in 2012 vs 2005 surveys were: 24.9% vs 22.8%, 1.13 (1.07-1.18) for Denmark; 23.8% vs 19.8%, 1.27 (1.19-1.34) for Norway; and 28.3% vs 23.8%, 1.31 (1.24-1.38) for Sweden. Similarly, the proportion of women reporting ever having had a sexually transmitted infection among women age <30 years were: 29.4% vs 26.4%, 1.21 (1.13-1.31) in Denmark, 28.9% vs 25.0%, 1.20 (1.10-1.31) in Norway, and 29.4% vs 22.2%, 1.45 (1.33-1.58) in Sweden. CONCLUSIONS Scandinavian women reported lower age at first intercourse in younger birth cohorts. Moreover, they reported more lifetime sexual partners and a higher prevalence of ever having a sexually transmitted infection in 2012 than in 2005. Our findings may inform the interpretation of trends in outcomes associated with sexual health, and public health policies.
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Affiliation(s)
- Bo T Hansen
- Department of Research, Cancer Registry of Norway, Oslo, Norway
| | - Susanne K Kjaer
- Unit of Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark.,Department of Gynecology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Lisen Arnheim-Dahlström
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Kai-Li Liaw
- Epidemiology, Merck Sharp & Dome Corporation, Whitehouse Station, NJ, USA
| | - Kirsten E Juul
- Unit of Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Louise T Thomsen
- Unit of Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Kirsten Frederiksen
- Unit of Statistics and Pharmacoepidemiology, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - K Miriam Elfström
- Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Christian Munk
- Unit of Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Mari Nygård
- Department of Research, Cancer Registry of Norway, Oslo, Norway
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19
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Gambadauro P, Carli V, Wasserman C, Hadlaczky G, Sarchiapone M, Apter A, Balazs J, Bobes J, Brunner R, Cosman D, Haring C, Hoven CW, Iosue M, Kaess M, Kahn JP, McMahon E, Postuvan V, Värnik A, Wasserman D. Psychopathology is associated with reproductive health risk in European adolescents. Reprod Health 2018; 15:186. [PMID: 30400907 PMCID: PMC6220505 DOI: 10.1186/s12978-018-0618-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Accepted: 10/01/2018] [Indexed: 01/21/2023] Open
Abstract
Background Reproductive and mental health are key domains of adolescent wellbeing but possible interrelationships are poorly understood. This cross-sectional study evaluated the association between psychopathology and reproductive health risk among European adolescents. Methods A structured self-report questionnaire was delivered to 12,395 pupils of 179 randomly selected schools in 11 European countries within the EU funded “Saving and Empowering Young Lives in Europe” (SEYLE) project. The questionnaire included items about sexual initiation and reproductive health risk factors, such as number of sexual partners, frequency of condom use, and pregnancy involvement. Psychopathology was evaluated with validated instruments and/or ad-hoc questions. Results Of 11,406 respondents (median age 15; interquartile range [IQR] 14–15; 57% females), 18.8% reported sexual initiation. Sixty percent of them also reported at least one reproductive risk factor. Sexual initiation was significantly more common among pupils older than 15 years (38% versus 13.2% younger pupils) and males (21.3% versus 16.9% females). It was also more common among pupils with depression (age/sex-adjusted odds ratio [aOR] 1.871), anxiety (aOR 2.190), severe suicidal ideation (aOR 2.259), self-injurious behaviour (aOR 2.892), and suicide attempts (aOR 3.091). These associations were particularly strong among pupils ≤15 years old and, for overt psychopathology, among pupils with low non-sexual risk behaviour profile and females. Depression (aOR 1.937), anxiety (aOR 2.282), severe suicidal ideation (aOR 2.354), self-injurious behaviour (aOR 3.022), and suicide attempts (aOR 3.284) were associated with higher reproductive health risk, defined by an increasing number of coexisting reproductive risk factors. Conclusions These findings suggest an alignment between mental and reproductive health risk and support the value of cross-domain collaboration in adolescent health. The association between psychopathology and reproductive health risk, as well as its variations with age, sex, and associated risk behaviours, should be considered when designing health-promoting or disease-preventing interventions for adolescents.
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Affiliation(s)
- Pietro Gambadauro
- National Centre for Suicide Research and Prevention of Mental Ill-Health (NASP), Department of Learning, Informatics, Management and Ethics (LIME), Karolinska Institutet, 171 77, Stockholm, Sweden. .,Department of Women's and Children's Health, Uppsala University, 75185, Uppsala, Sweden. .,Res Medica Sweden, Gynaecology and Reproductive Medicine, 75224, Uppsala, Sweden.
| | - Vladimir Carli
- National Centre for Suicide Research and Prevention of Mental Ill-Health (NASP), Department of Learning, Informatics, Management and Ethics (LIME), Karolinska Institutet, 171 77, Stockholm, Sweden
| | - Camilla Wasserman
- National Centre for Suicide Research and Prevention of Mental Ill-Health (NASP), Department of Learning, Informatics, Management and Ethics (LIME), Karolinska Institutet, 171 77, Stockholm, Sweden.,Department of Child and Adolescent Psychiatry, Columbia University-New York State Psychiatric Institute, New York, USA
| | - Gergö Hadlaczky
- National Centre for Suicide Research and Prevention of Mental Ill-Health (NASP), Department of Learning, Informatics, Management and Ethics (LIME), Karolinska Institutet, 171 77, Stockholm, Sweden
| | - Marco Sarchiapone
- Department of Medicine and Health Science, University of Molise, 86100, Campobasso, Italy.,National Institute of Health for Migration and Poverty, Via di San Gallicano 25/a, 00100, Rome, Italy
| | - Alan Apter
- Schneider Children's Medical Center of Israel, Tel Aviv University, Tel Aviv, Israel
| | - Judit Balazs
- Vadaskert Child Psychiatric Hospital and Outpatient Clinic, Budapest, 1021, Hungary.,Institute of Psychology, Eötvös Loránd University, Izabella u. 46, Budapest, 1064, Hungary
| | - Julio Bobes
- Department of Psychiatry, University of Oviedo, CIBERSAM School of Medicine, Julian Claveria 6 - 3°, 33006, Oviedo, Spain
| | - Romuald Brunner
- Department of Child & Adolescent Psychiatry, Center for Psychosocial Medicine, University of Heidelberg, Blumenstrasse 8, D-69115, Heidelberg, Germany
| | - Doina Cosman
- Clinical Psychology Department, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Christian Haring
- Department for Psychiatry and Psychotherapy B, State Hospital Hall in Tyrol, Tirol-kliniken, Milser Straße 10, A- 6060, Hall, Austria
| | - Christina W Hoven
- Department of Child and Adolescent Psychiatry, Columbia University-New York State Psychiatric Institute, New York, USA.,Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, USA
| | - Miriam Iosue
- Department of Medicine and Health Science, University of Molise, 86100, Campobasso, Italy
| | - Michael Kaess
- Department of Child & Adolescent Psychiatry, Center for Psychosocial Medicine, University of Heidelberg, Blumenstrasse 8, D-69115, Heidelberg, Germany
| | - Jean Pierre Kahn
- Department of Psychiatry and Clinical Psychology, CHRU de NANCY and Pôle 6, Centre Psychothérapique de Nancy-Laxou, Université de Lorraine, NANCY, France
| | - Elaine McMahon
- National Suicide Research Foundation, University College Cork, Cork, Ireland
| | - Vita Postuvan
- Slovene Center for Suicide Research, Andrej Marusic Institute, University of Primorska, Muzejski trg 2, 6000, Koper, Slovenia
| | - Airi Värnik
- Estonian-Swedish Mental Health & Suicidology Institute, Ctr. Behav. & Hlth. Sci, Tallinn University, Tallinn, Estonia
| | - Danuta Wasserman
- National Centre for Suicide Research and Prevention of Mental Ill-Health (NASP), Department of Learning, Informatics, Management and Ethics (LIME), Karolinska Institutet, 171 77, Stockholm, Sweden
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20
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Guleria S, Faber MT, Hansen BT, Arnheim-Dahlström L, Liaw KL, Munk C, Nygård M, Kjær SK. Self-perceived risk of STIs in a population-based study of Scandinavian women. Sex Transm Infect 2018; 94:522-527. [PMID: 29523719 DOI: 10.1136/sextrans-2017-053397] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2017] [Revised: 02/13/2018] [Accepted: 02/20/2018] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE This study examined the associations between current behaviours/characteristics and self-perceived risk for STIs, among randomly selected women aged 18-45 years from Denmark, Norway and Sweden. METHOD A population-based, cross-sectional, questionnaire study (paper based, web based and telephone based) was conducted during 2011-2012. We compared medium-high STI risk perception with no/low risk perception. The associations were explored for women who had ever had sexual intercourse and for women with a new partner in the last 6 months using multivariable logistic regression. RESULT The overall prevalence of medium-high STI risk perception was 7.4%. It was highest among women aged 18-24 years (16.2%) and among the Danish women (8.8%). Number of new sexual partners in the last 6 months (≥3vs 0 partners, OR 14.94, 95% CI 13.20 to 16.94) was strongly associated with medium-high STI risk perception. Among women with a new partner in the last 6 months, lack of condom use increased medium-high STI risk perception (OR 1.73, 95% CI 1.52 to 1.96). Genital warts in the last year, binge drinking and being single were associated with increased risk perception and remained statistically significant after additional adjustments were made for number of new partners and condom use with new partners in the last 6 months. CONCLUSION Subjective perception of risk for STI was associated with women's current risk-taking behaviours, indicating women generally are able to assess their risks for STIs. However, a considerable proportion of women with multiple new partners in the last 6 months and no condom use still considered themselves at no/low risk for STI.
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Affiliation(s)
- Sonia Guleria
- Unit of Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Mette Tuxen Faber
- Unit of Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Bo T Hansen
- Department of Research, Cancer Registry of Norway, Oslo, Norway
| | - Lisen Arnheim-Dahlström
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Kai-Li Liaw
- Epidemiology at Merck, Merck Research Laboratories, Kenilworth, NJ, USA
| | - Christian Munk
- Unit of Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Mari Nygård
- Department of Research, Cancer Registry of Norway, Oslo, Norway
| | - Susanne Krüger Kjær
- Unit of Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark
- Department of Gynecology, Rigshospitalet, University of Copehagen, Copenhagen, Denmark
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21
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Burke L, Nic Gabhainn S, Kelly C. Socio-Demographic, Health and Lifestyle Factors Influencing Age of Sexual Initiation among Adolescents. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15091851. [PMID: 30150572 PMCID: PMC6163828 DOI: 10.3390/ijerph15091851] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/11/2018] [Revised: 08/21/2018] [Accepted: 08/23/2018] [Indexed: 11/16/2022]
Abstract
Behavioural and developmental factors mean that adolescents who initiate sexual intercourse early may be at an increased risk of adverse sexual health outcomes at the time of first sex and later in life. In an Irish context, there is insufficient knowledge about the specific correlates of early sexual initiation. This research explores relationships between contextual socio-demographic, health and lifestyle factors and the timing of first sexual intercourse among 15–17-year-olds in Ireland. Multiple regression analysis was carried out in conjunction with Multiple Imputation using data collected through the 2014 Health Behaviour in School-Aged Children Ireland study on a sample of 879 sexually active adolescents. The socio-demographic and lifestyle factors measured were a stronger predictor of age of sexual initiation among girls than boys. Risk behaviour initiation was significantly related to age of sexual initiation for adolescents, while alcohol use/drunkenness and unhealthy food consumption was significant among girls only. Family support and number of male friends were significant predictors for boys only. The study highlights the need for holistic approaches to sexual health promotion and provides a foundation for the development of alternative strategies and policies aimed at reducing negative health, well-being, educational and economic outcomes.
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Affiliation(s)
- Lorraine Burke
- Health Promotion Research Centre, Discipline of Health Promotion, School of Health Sciences, National University of Ireland Galway, H91 TK33 Galway, Ireland.
| | - Saoirse Nic Gabhainn
- Health Promotion Research Centre, Discipline of Health Promotion, School of Health Sciences, National University of Ireland Galway, H91 TK33 Galway, Ireland.
| | - Colette Kelly
- Health Promotion Research Centre, Discipline of Health Promotion, School of Health Sciences, National University of Ireland Galway, H91 TK33 Galway, Ireland.
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22
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Yaya S, Bishwajit G. Age at First Sexual Intercourse and Multiple Sexual Partnerships Among Women in Nigeria: A Cross-Sectional Analysis. Front Med (Lausanne) 2018; 5:171. [PMID: 29938205 PMCID: PMC6002498 DOI: 10.3389/fmed.2018.00171] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2018] [Accepted: 05/17/2018] [Indexed: 12/28/2022] Open
Abstract
Background: Little is known about sexual behavior such as first sexual intercourse and number of sexual partnerships among women in Nigeria. Early sexual debut is a widely recognized public health issue due to its influence on higher lifetime sexual partners which in turn is associated with increased vulnerability to pregnancy complications, HIV/AIDS and other and sexually-transmitted diseases. In the present study, we attempted to explore the patterns of age of sexual debut and multiple sexual partnerships among women of reproductive age in Nigeria. Methods: Women who responded to the questions about the age at first sex and number of lifetime sex partners were selected from two latest rounds Nigeria Demographic and Health Survey (DHS). In total 60,611 women aged between 15 and 49 years were selected for this analysis. Age at sexual debut was used as the predictor of multiple sexual partnerships which was assessed by multinomial regression models with logit link function in complex sample analysis mode. Results: The median age at first sex was 16 years (Interquartile range 16–24). Age at first sexual intercourse below the age of 19 years was reported by 30.8% of the women. Respectively 45.4% (95%CI = 42.9–47.9) 49.8% (95%CI = 47.8–51.7) of the women reported experiencing first intercourse before reaching 15 and 17 years, whereas 46.9% (95%CI = 45.2–48.7) of the women reported being monogamous and 47.2% (95%CI = 45.6–48.8) and 47.6% (95%CI = 43.8–51.3) had 2–3 and >3 lifetime sexual partners. In multivariable analysis after adjusting for confounding factors, women having sexual debut below 18 years were found to be significantly more likely to have 2–3 and more than 3 lifetime sexual partner. Conclusion: The study concludes that an increasing proportion of Nigerian women are experiencing sexual debut before reaching 15 years. The findings suggest that early sexual debut is associated with multiple sexual partnerships which may increase the risk of STIs. Stakeholders in health care system need to be aware that early sexual debut can be associated with successive unsafe sexual practices which can lead to adverse health outcomes including HIV infection and STIs, early marriage, unwanted pregnancy, and abortion. Therefore, it is important to design effective interventions to encourage women delay sexual debut to help prevent unintended pregnancies and decrease the disproportionate burden of adverse health outcomes.
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Affiliation(s)
- Sanni Yaya
- School of International Development and Global Studies, University of Ottawa, Ottawa, ON, Canada
| | - Ghose Bishwajit
- School of International Development and Global Studies, University of Ottawa, Ottawa, ON, Canada
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23
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Johansen MB, Koch A, Wohlfahrt J, Kamper-Jørgensen M, Hoffmann S, Soborg B. Increased incidence of gonorrhoea and chlamydia in Greenland 1990-2012. Int J Circumpolar Health 2018; 76:1324748. [PMID: 28570206 PMCID: PMC5497551 DOI: 10.1080/22423982.2017.1324748] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Background: Since the 1970s, Greenland has presented the highest reported incidence rates of the sexually transmitted infections (STIs) gonorrhoea and chlamydia in the Arctic regions. Objective: This study aims to describe sex- and age-specific incidence rates of gonorrhoea and chlamydia from 1990 to 2012 in Greenland, and to evaluate if changes in case definitions, diagnostic procedures and implementation of STI interventions during the period coincide with rate changes. Design: Gonorrhoea and chlamydia cases were identified from the national STI surveillance. For 1990–2008, STI cases were identified from weekly notified aggregated data. For 2009–2012, cases were identified in person-identifiable national registers. We used log-linear Poisson regression to calculate incidence rates (IRs) and incidence rate ratios (IRRs) with 95% confidence intervals (95% CI). Analyses were stratified according to sex, age and calendar period. Results: Gonorrhoea and chlamydia incidence rates have increased since 1995 to reach 2,555 per 100,000 person-years (PY) for gonorrhoea and 6,403 per 100,000 PY for chlamydia in 2012. From 2006 to 2012, the incidence rates among young adults aged 15–19 years were 8,187 and 22,515 per 100,000 PY for gonorrhoea and chlamydia, respectively. Changes in surveillance reporting did not seem to influence the incidence rates for either disease, whereas a change in diagnostic test coincided with an increased incidence of chlamydia. Conclusion: Overall, the incidence of chlamydia in Greenland increased during the study period, whereas the incidence of gonorrhoea decreased until 1995 but increased thereafter. Young adults aged 15–24 years were at highest risk of infection. The increase in incidence rates was independent of changes in case definitions, whereas an observed increase in chlamydia incidence in 2005 coincided with a change in diagnostic test. None of the STI interventions launched after 1995 seemed to coincide with decreasing national incidence rates.
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Affiliation(s)
- Mila Broby Johansen
- a Department of Epidemiology Research , Statens Serum Institut , Copenhagen S , Denmark
| | - Anders Koch
- a Department of Epidemiology Research , Statens Serum Institut , Copenhagen S , Denmark
| | - Jan Wohlfahrt
- a Department of Epidemiology Research , Statens Serum Institut , Copenhagen S , Denmark
| | | | - Steen Hoffmann
- c Department of Microbiology and Infection Control , Statens Serum Institut , Copenhagen S , Denmark
| | - Bolette Soborg
- a Department of Epidemiology Research , Statens Serum Institut , Copenhagen S , Denmark
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24
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Gambadauro P, Carli V, Hadlaczky G, Sarchiapone M, Apter A, Balazs J, Banzer R, Bobes J, Brunner R, Cosman D, Farkas L, Haring C, Hoven CW, Kaess M, Kahn JP, McMahon E, Postuvan V, Sisask M, Värnik A, Zadravec Sedivy N, Wasserman D. Correlates of sexual initiation among European adolescents. PLoS One 2018; 13:e0191451. [PMID: 29420612 PMCID: PMC5805230 DOI: 10.1371/journal.pone.0191451] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2017] [Accepted: 01/04/2018] [Indexed: 11/18/2022] Open
Abstract
Background Sexuality is a physiological component of adolescent development, though early initiation is associated with reproductive health risk. This study aimed at identifying correlates and predictors of sexual initiation in a large multinational cohort of European adolescents. Methods A questionnaire addressing socio-demographics, behaviours, mental health and sexual activity, was delivered to 11,110 adolescents recruited from 168 randomly selected schools in 10 European countries between 2009 and 2011. A follow-up questionnaire was delivered after 12 months. The longitudinal association of baseline risk behaviors, psychological attributes and contextual vulnerabilities, with sexual initiation during follow-up was evaluated through simple and multivariable age/sex stratified logistic regression. Multinomial logistic regression measured the association between predictors and sexual initiation with or without coexisting reproductive risk factors, such as multiple partners or infrequent condom use. Results Baseline sexual experience was reported by 19.2% of 10,757 respondents (median age 15; IQR 14–15; females 59.6%). This was significantly more frequent among pupils older than 15 (41%) and males (20.8%). Of 7,111 pupils without previous experience who were available at follow-up (response rate 81.8%), 17% reported sexual initiation, without differences between females and males. Baseline smoking (age/sex adjusted odds ratio [aOR] 3.63), alcohol use (aOR 2.95), illegal drugs use (aOR 2.72), and poor sleep (aOR 1.71) predicted sexual initiation. Stratified analyses showed a particularly strong association in case of younger and female pupils, and, among girls, when initiation was reported together with multiple partners and/or infrequent condom use. Externalizing (i.e. conduct and hyperactivity) symptoms independently predicted sexual initiation. Internalizing difficulties (i.e. emotional and peer problems) were negatively associated with early and risky sexual initiation among boys. Significant predictors included also being bullied, fighting, truancy, and low parental involvement. Conclusions Adolescent sexual behaviours are related to non-sexual risk behaviours, psychological difficulties and contextual vulnerabilities. While gateway effects explain some associations, a comprehensive model is needed to understand adolescent sexual behaviours, their physical, mental, and social health outcomes, and their potential positive effects on wellbeing. Tailored interventions may need to consider younger girls as a particularly vulnerable group in view of a strong association between non-sexual and sexual behaviors.
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Affiliation(s)
- Pietro Gambadauro
- National Centre for Suicide Research and Prevention of Mental Ill-Health (NASP), Department of Learning, Informatics, Management and Ethics (LIME), Karolinska Institutet, Stockholm, Sweden
- Res Medica Sweden, Gynaecology and Reproductive Medicine, Uppsala, Sweden
- * E-mail:
| | - Vladimir Carli
- National Centre for Suicide Research and Prevention of Mental Ill-Health (NASP), Department of Learning, Informatics, Management and Ethics (LIME), Karolinska Institutet, Stockholm, Sweden
| | - Gergö Hadlaczky
- National Centre for Suicide Research and Prevention of Mental Ill-Health (NASP), Department of Learning, Informatics, Management and Ethics (LIME), Karolinska Institutet, Stockholm, Sweden
| | - Marco Sarchiapone
- Department of Medicine and Health Science, University of Molise, Campobasso, Italy
- National Institute of Health for Migration and Poverty, Rome, Italy
| | - Alan Apter
- Schneider’s Children Medical Center of Israel, Tel Aviv University, Tel Aviv, Israel
| | - Judit Balazs
- Vadaskert Child Psychiatric Hospital and Outpatient Clinic, Budapest, Hungary
- Institute of Psychology, Eötvös Loránd University, Budapest, Hungary
| | - Raphaela Banzer
- Addiction Help Services BIN, Innsbruck, Austria
- Institute of Psychology, University of Innsbruck, Innsbruck, Austria
| | - Julio Bobes
- Department of Psychiatry, University of Oviedo, CIBERSAM School of Medicine, Oviedo, Spain
| | - Romuald Brunner
- Department of Child & Adolescent Psychiatry, Center for Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany
| | - Doina Cosman
- Clinical Psychology Department, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Luca Farkas
- Vadaskert Child Psychiatric Hospital and Outpatient Clinic, Budapest, Hungary
| | - Christian Haring
- Psychiatry and Psychotherapy B, State Hospital Hall in Tyrol, Hall, Austria
| | - Christina W. Hoven
- Department of Child and Adolescent Psychiatry, Columbia University-New York State Psychiatric Institute, New York, United States of America
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, United States of America
| | - Michael Kaess
- Department of Child & Adolescent Psychiatry, Center for Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Jean Pierre Kahn
- Department of Psychiatry and Clinical Psychology, CHRU de NANCY and Pôle 6, Centre Psychothérapique de Nancy-Laxou, Université de Lorraine, Nancy, France
| | - Elaine McMahon
- National Suicide Research Foundation, University College Cork, Cork, Ireland
| | - Vita Postuvan
- Slovene Center for Suicide Research, Andrej Marusic Institute, University of Primorska, Koper, Slovenia
| | - Merike Sisask
- Estonian-Swedish Mental Health & Suicidology Institute, Tallinn, Estonia
- School of Governance, Law and Society (SOGOLAS), Tallinn University, Tallinn, Estonia
| | - Airi Värnik
- Estonian-Swedish Mental Health & Suicidology Institute, Tallinn, Estonia
- School of Natural Sciences and Health, Tallinn University, Tallinn, Estonia
| | - Nusa Zadravec Sedivy
- Slovene Center for Suicide Research, Andrej Marusic Institute, University of Primorska, Koper, Slovenia
| | - Danuta Wasserman
- National Centre for Suicide Research and Prevention of Mental Ill-Health (NASP), Department of Learning, Informatics, Management and Ethics (LIME), Karolinska Institutet, Stockholm, Sweden
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25
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Maranhão TA, Gomes KRO, Oliveira DCD, Moita JM. Impact of first sexual intercourse on the sexual and reproductive life of young people in a capital city of the Brazilian Northeast. CIENCIA & SAUDE COLETIVA 2017; 22:4083-4094. [PMID: 29267725 DOI: 10.1590/1413-812320172212.16232015] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2015] [Accepted: 04/17/2016] [Indexed: 11/22/2022] Open
Abstract
This study aimed to analyze the repercussion of first sexual intercourse on the number of pregnancies and partners of teenagers with obstetric history in Teresina (PI), Brazil. This is a cross-sectional study with 464 young women selected by accidental sampling who gave birth at 15-19 years of age in the first four months of 2006 in six maternity hospitals of the municipality. Primary data was collected from May to December 2008 at the participants' homes after tracking them in the hospital medical records. The univariate and bivariate analysis were performed by descriptive statistics and Pearson's Correlation Coefficient Test or T-test, respectively. Tukey's post hoc test was used as post hoc test and significant variables on the bivariate analysis (p < 0.05) were also included in the multifactor analysis of variance model. Schooling (p < 0,001) and menarche's age (p < 0,001) influenced the age of first sexual intercourse and this, in turn, showed significant negative correlation (p < 0.01) with the number of partners and pregnancies of young women. Thus, the earlier the young women start sexual activity, the higher the number of pregnancies and sexual partners until the moment of their reproductive life. Thus, early first sexual intercourse had a negative repercussion on these variables.
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Affiliation(s)
- Thatiana Araújo Maranhão
- Curso de Enfermagem, Universidade Estadual do Piauí. Av. Nossa Senhora de Fátima S/N, Bairro de Fátima. 64202-220 Parnaíba PI Brasil.
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26
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McKellar K, Little L, Smith MA, Sillence E. Seeking sexual health information? Professionals' novel experiences of the barriers that prevent female adolescents seeking sexual health information. Int J Adolesc Med Health 2017; 32:/j/ijamh.ahead-of-print/ijamh-2016-0118/ijamh-2016-0118.xml. [PMID: 28731855 DOI: 10.1515/ijamh-2016-0118] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2016] [Accepted: 02/12/2017] [Indexed: 11/15/2022]
Abstract
Objective Sexual health professionals are key stakeholders in implementing sexual health intervention programmes, yet their views are largely absent from the literature. Sexual health professionals provide a unique perspective on teen sexual health issues as they engage in confidential discussions with a wide range of teenagers. This study aimed to provide an in-depth exploration of professionals' perceptions of teenagers' sexual health information seeking practices and barriers. Furthermore, the research provided a unique re-examination of key predictors of risky sexual behaviours, which have been highlighted by previous research. Methods Nine semi-structured interviews were undertaken with sexual health professionals to explore their perceptions of teenagers' sexual health information seeking practises and barriers. Subsequently the professionals rank ordered the 57 factors identified in previous research in terms of their perceived importance in predicting risky sexual behaviours. Results Four themes emerged: "society and media"; "environment and family"; "peer influences"; and "the self". The rank order task confirmed that 33 of the 57 factors were perceived as highly important by sexual health professionals. Conclusion Society, peers, environment and family are perceived as barriers to teenagers seeking reliable sexual health information, but these are dependent on the individual person. An individual with higher self-esteem is more confident in seeking sexual health information and applying this knowledge appropriately. Self-esteem was also identified as a key perceived predictor of risky sexual behaviours. Therefore, there is scope for intervention programmes targeting self-esteem and knowledge, so teenagers have the confidence to seek out sexual health information and to make their own informed sexual health decisions.
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Affiliation(s)
- Kerry McKellar
- Psychology and Communication Technology (PaCT) Lab, Department of Psychology, Faculty of Health and Life Sciences,Northumbria University, Northumberland Building, Newcastle upon Tyne, NE1 8ST,UK, Phone: +44 (0)191 227 3716
| | - Linda Little
- Psychology and Communication Technology (PaCT) Lab, Department of Psychology, Faculty of Health and Life Sciences,Northumbria University, Northumberland Building, Newcastle upon Tyne, UK
| | - Michael A Smith
- Psychology and Communication Technology (PaCT) Lab, Department of Psychology, Faculty of Health and Life Sciences,Northumbria University, Northumberland Building, Newcastle upon Tyne, UK
| | - Elizabeth Sillence
- Psychology and Communication Technology (PaCT) Lab, Department of Psychology, Faculty of Health and Life Sciences,Northumbria University, Northumberland Building, Newcastle upon Tyne, UK
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27
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Lara LAS, Abdo CHN. Age at Time of Initial Sexual Intercourse and Health of Adolescent Girls. J Pediatr Adolesc Gynecol 2016; 29:417-423. [PMID: 26655691 DOI: 10.1016/j.jpag.2015.11.012] [Citation(s) in RCA: 58] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2015] [Revised: 11/20/2015] [Accepted: 11/24/2015] [Indexed: 10/22/2022]
Abstract
Adolescence is characterized by marked changes in the body, psychology, and sexual behavior due to increasing production of hormones. In this review we aimed to assess the effect of age at the time of first sexual intercourse (sexarche) on the health of adolescent girls, and identify factors that might protect against early initiation of sexual relations in girls. The PubMed, Lilacs, and Google Scholar databases were searched for clinical trials, comparative studies, case-control studies, cross-sectional studies, cohort studies, multicenter studies, observational studies, meta-analyses, and systematic reviews published up to December 2014 on this theme. The search terms were: "sexual debut," "coitarche," "sexarche," and "young people," "adolescent," "unplanned pregnancy," "adolescent contraception," and "STDs." Data were extracted from 28 studies and 41 references were used to introduce the theme and to support the discussion. Sexarche has been occurring in increasingly younger girls. A young age at sexarche can lead to subsequent risky sexual behavior. Girls who have sexarche when they are 14 years old or younger are less likely to use contraception on this occasion, take more time before they start using contraception in subsequent sexual relations, are more likely to have several sex partners, have a higher risk for depression, have lower self-esteem and more episodes of repentance, and have a higher risk for a sexually transmitted disease and cervical cancer. Girls with low educational, socioeconomic, and cultural status, little parental monitoring, parental separation, and absence of religiosity tend to experience sexarche at a younger age. Adolescent girls who postpone sexarche until they are 16 years old are physically and psychologically healthier than those who have sexarche at a younger age. This suggests that providing adolescent girls with appropriate education about sexual relations might reduce the negative effect of sexual relations at a young age.
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Affiliation(s)
- Lúcia A S Lara
- Sexual Medicine Service, Human Reproduction Sector, Department of Gynaecology and Obstetrics, Ribeirão Preto Medical School, São Paulo University, Ribeirão Preto, São Paulo, Brazil.
| | - Carmita H N Abdo
- Department of Psychiatry, Medical School, University of São Paulo, São Paulo, Brazil
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28
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Svahn MF, Munk C, von Buchwald C, Frederiksen K, Kjaer SK. Burden and incidence of human papillomavirus-associated cancers and precancerous lesions in Denmark. Scand J Public Health 2016; 44:551-9. [DOI: 10.1177/1403494816653669] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/12/2016] [Indexed: 11/16/2022]
Abstract
Aim: The aim of the study was to investigate the incidence of human papillomavirus (HPV)-associated cancers in Denmark between 1978 and 2011, estimate the current absolute annual number (burden) of HPV-associated cancers (HPVaCa) and their precancerous lesions, and assess whether there is socioeconomic inequality in the risk of HPV-associated cancers. Methods: From four nationwide population-based registries, information was collected on HPVaCa diagnosed during 1978–2011 and age-standardised incidence rate for each site by calendar year and birth cohort was calculated. Furthermore, the current annual burden of HPVaCa and severe precancerous lesions was estimated. Incidence rate ratios and corresponding 95% confidence intervals for HPVaCa were calculated according to socioeconomic status. Results: The age-standardised incidence rate of HPV-associated cancers for the two sexes converged during the study period, and almost identical incidence rates were seen for women and men in the youngest birth cohorts. The current burden of HPV-associated lesions amounted to more than 5000 cases, the vast majority (85%) being severe precancerous lesions. The highest risk for HPV-associated cancers was associated with lower socioeconomic status. Conclusions: The burden of HPV-associated cancers among men will likely surpass that among women in the near future if the incidence trends continue. As many of these cancers and their precancerous lesions are associated with HPV type 16, a substantial proportion of cases are, in theory, preventable by the currently available vaccines.
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Affiliation(s)
| | - Christian Munk
- Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Christian von Buchwald
- Department of ORL, H&N Surgery and Audiology, Rigshospitalet, Copenhagen University Hospital, Denmark
| | | | - Susanne K. Kjaer
- Danish Cancer Society Research Center, Copenhagen, Denmark
- Department of Gynaecology, Rigshospitalet, Copenhagen University Hospital, Denmark
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29
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Brüne M. Borderline Personality Disorder: Why 'fast and furious'? EVOLUTION MEDICINE AND PUBLIC HEALTH 2016; 2016:52-66. [PMID: 26929090 PMCID: PMC4782519 DOI: 10.1093/emph/eow002] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/13/2015] [Accepted: 01/14/2016] [Indexed: 12/15/2022]
Abstract
The term 'Borderline Personality Disorder' (BPD) refers to a psychiatric syndrome that is characterized by emotion dysregulation, impulsivity, risk-taking behavior, irritability, feelings of emptiness, self-injury and fear of abandonment, as well as unstable interpersonal relationships. BPD is not only common in psychiatric populations but also more prevalent in the general community than previously thought, and thus represents an important public health issue. In contrast to most psychiatric disorders, some symptoms associated with BPD may improve over time, even without therapy, though impaired social functioning and interpersonal disturbances in close relationships often persist. Another counterintuitive and insufficiently resolved question is why depressive symptoms and risk-taking behaviors can occur simultaneously in the same individual. Moreover, there is an ongoing debate about the nosological position of BPD, which impacts on research regarding sex differences in clinical presentation and patterns of comorbidity.In this review, it is argued that many features of BPD may be conceptualized within an evolutionary framework, namely behavioral ecology. According to Life History Theory, BPD reflects a pathological extreme or distortion of a behavioral 'strategy' which unconsciously aims at immediate exploitation of resources, both interpersonal and material, based on predictions shaped by early developmental experiences. Such a view is consistent with standard medical conceptualizations of BPD, but goes beyond classic 'deficit'-oriented models, which may have profound implications for therapeutic approaches.
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Affiliation(s)
- Martin Brüne
- LWL University Hospital, Department of Psychiatry, Psychotherapy and Psychiatric Preventive Medicine, Division of Cognitive Neuropsychiatry and Psychiatric Preventive Medicine, Ruhr-University Bochum, Germany
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30
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Lee SY, Lee HJ, Kim TK, Lee SG, Park EC. Sexually Transmitted Infections and First Sexual Intercourse Age in Adolescents: The Nationwide Retrospective Cross-Sectional Study. J Sex Med 2015; 12:2313-23. [PMID: 26685982 DOI: 10.1111/jsm.13071] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
INTRODUCTION Sexually transmitted infections (STIs) are major causes of medical and psychological problems globally, while adolescents in South Korea have recently shown rapid changes in sexual behaviors. AIMS We aimed to examine the association between the age of first sexual intercourse and the experience of STIs among adolescents. Additionally, in which specific time period would more likely to get infected from sexual intercourse. METHODS We used data from the 2007-2013 Korea Youth Risk Behavior Web-based Survey. Only adolescents with sexual intercourse experience (N = 22,381) were included, and multiple logistic regression analysis was performed. MAIN OUTCOME MEASURES One dichotomized measure and one continuous measure were assessed: (i) STIs experience (defined as having had STIs); and (ii) association between STIs experience and absolute age gap (defined as temporal differences between secondary sexual character emergence age and first sexual intercourse age). RESULTS Approximately 7.4% of boys and 7.5% of girls reported had STI. For both boys and girls, the chance of experiencing STIs increased as the age of first sexual intercourse decreased (boys: before elementary school [age 7 or under]: odds ratio [OR] = 10.81, first grade [age 7 or 8]: OR = 4.44, second grade [age 8 or 9]: OR = 8.90, fourth grade [age 10 or 11]: OR = 7.20, ninth grade [age 15 or 16]: OR = 2.31; girls: before elementary school: OR = 18.09, first grade: OR = 7.26, second grade: OR = 7.12, fourth grade: OR = 8.93, ninth grade: OR = 2.74). The association between the absolute age gap and STI experience was examined additionally (boys: OR = 0.93, girls: OR = 0.87). CONCLUSIONS This study shows that earlier initiation of sexual intercourse increases the odds of experiencing STIs. Also as the age gap gets shorter, the odds of experiencing STIs increase. Our study suggests that it is important to consider the time period of first sexual intercourse and to reinforce a monitoring system along with the development of other preventive strategies.
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Affiliation(s)
- Seo Yoon Lee
- Department of Health Policy and Management, Graduate School of Public Health, Yonsei University, Seoul, South Korea.,Institute of Health Services Research, Yonsei University, Seoul, South Korea
| | - Hyo Jung Lee
- Institute of Health Services Research, Yonsei University, Seoul, South Korea.,Department of Public Health, Graduate School, Yonsei University, Seoul, South Korea
| | - Tae Kyoung Kim
- Institute of Health Services Research, Yonsei University, Seoul, South Korea.,Department of Public Health, Graduate School, Yonsei University, Seoul, South Korea
| | - Sang Gyu Lee
- Institute of Health Services Research, Yonsei University, Seoul, South Korea.,Department of Hospital Management, Graduate School of Public Health, Yonsei University, Seoul, South Korea
| | - Eun-Cheol Park
- Institute of Health Services Research, Yonsei University, Seoul, South Korea.,Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, South Korea
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31
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Gravningen K, Braaten T, Schirmer H. Self-perceived risk and prevalent chlamydia infection among adolescents in Norway: a population-based cross-sectional study. Sex Transm Infect 2015; 92:91-6. [PMID: 26275416 DOI: 10.1136/sextrans-2014-051927] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2014] [Accepted: 07/22/2015] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES Risk judgements are key factors in adolescents' decisions related to sexual health. We examine the associations between self-perceived risk and prevalent chlamydia infection, and sexual behaviours related to risk perception in a general adolescent population in Norway. METHODS Population-based cross-sectional study among 1028 sexually experienced girls and boys, age 15-20 years (85% participation), including web questionnaires and urine samples for Chlamydia trachomatis PCR testing. Participants rated self-perceived risk as: no/low/medium/high/very high. We used binary and ordinal logistic regressions to examine associations with chlamydia prevalence and self-perceived risk, respectively, adjusting for potentially confounding variables. RESULTS Chlamydia prevalence increased with increasing risk perception. Although girls had twice the chlamydia prevalence of boys (7.3% vs 3.9%), their risk distribution was similar and 65% of both genders rated their risk as no/low with half of infections detected in this group. In multivariable analyses, reporting multiple sexual risk behaviours, non-steady relationship, previous chlamydia testing and treatment, and urogenital symptoms increased self-perceived risk. More boys overestimated their personal risk whereas more girls underestimated it (52% vs 30%, respectively, and 15% vs 31%, p<0.001). The main reasons for perceiving no/low risk were: 'I have a steady partner' and 'I trust my partner will tell me about an infection'. CONCLUSIONS These sexually experienced adolescents acknowledged their chlamydia infection risk, but wrong beliefs were incorporated in their assessments, and more than half had incorrect risk perception. We suggest that sexually transmitted infection prevention programmes should be directed at closing the gap between perceived and actual risk and focus on how context may bias personal judgement.
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Affiliation(s)
- Kirsten Gravningen
- Department of Microbiology and Infection Control, University Hospital of North Norway (UNN), Tromsø, Norway
| | - Tonje Braaten
- Department of Community Medicine, Faculty of Health Sciences, The Arctic University of Norway, Tromsø, Norway
| | - Henrik Schirmer
- Institute of Clinical Medicine, The Arctic University of Norway, Tromsø, Norway Department of Cardiology, Division of Cardiothoracic and Respiratory Medicine, Tromsø, Norway
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32
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Shrestha R, Karki P, Copenhaver M. Early Sexual Debut: A Risk Factor for STIs/HIV Acquisition Among a Nationally Representative Sample of Adults in Nepal. J Community Health 2015; 41:70-7. [PMID: 26184108 DOI: 10.1007/s10900-015-0065-6] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/11/2015] [Indexed: 10/23/2022]
Abstract
While early sexual debut is highly prevalent in Nepal, its link to sexually transmitted infections (STIs/HIV) risk factors has not been explored at a national level. The objective of this study was to assess potential association between early sexual debut and risk factors for STIs/HIV acquisition, including sexual risk behaviors, sexual violence, and teenage pregnancy among adults in Nepal. Data were taken from the nationally representative Nepal Demographic Health Survey (2011), which employed a two-stage complex design to collect data. A sample of 12,756 adults (ages 15-49 years) were included. Multivariate logistic models were conducted, adjusted for demographic characteristics, to assess the association between early sexual debut and STIs/HIV-related risk factors. The prevalence of early sexual debut in this sample was 39.2%, with a mean age of coital debut at 17.9 years. After adjusting for potential confounders, individuals with early sexual debut were significantly more likely to report a history of STIs (aOR 1.19; 95% CI 1.06-1.35) and had a significantly higher risk profile, including having multiple sex partner (aOR 2.14; 95% CI 1.86-2.47), inconsistent condom use (aOR 0.72; 95% CI 0.61-0.86), paid for sex (aOR 1.61; 95% CI 1.14-2.27), a history of sexual violence (aOR 1.99; 95% CI 1.63-2.43), and teenage pregnancy (aOR 12.87; 95% CI 11.62-14.26). Individuals who have early sexual debut are more likely to engage in risk behaviors that place them at increased risk of STIs/HIV acquisition. STIs/HIV prevention strategies should aim at delaying sexual debut to decrease the disproportionate burden of adverse health outcomes, including STIs/HIV, among individuals in Nepal.
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Affiliation(s)
- Roman Shrestha
- Department of Community Medicine and Health Care, University of Connecticut Health Center, 263 Farmington Avenue, Farmington, CT, 06030, USA. .,Center for Health, Intervention, and Prevention (CHIP), University of Connecticut, Storrs, CT, 06269, USA.
| | - Pramila Karki
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT, 06269, USA
| | - Michael Copenhaver
- Center for Health, Intervention, and Prevention (CHIP), University of Connecticut, Storrs, CT, 06269, USA.,Department of Allied Health Sciences, University of Connecticut, Storrs, CT, 06269, USA
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Heywood W, Patrick K, Smith AMA, Pitts MK. Associations between early first sexual intercourse and later sexual and reproductive outcomes: a systematic review of population-based data. ARCHIVES OF SEXUAL BEHAVIOR 2015; 44:531-69. [PMID: 25425161 DOI: 10.1007/s10508-014-0374-3] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/14/2013] [Revised: 02/13/2014] [Accepted: 03/24/2014] [Indexed: 05/12/2023]
Abstract
The assumption that early sexual debut leads to adverse outcomes has been used as justification for sexual health interventions and policies aimed at delaying sexual initiation, yet research in the area has been limited. This review identified and synthesized published literature on the association between early first sexual intercourse and later sexual/reproductive outcomes. Literature searches were conducted in Medline, Embase, PsycINFO, and Current Contents. In all, 65 citations met the selection criteria (industrialized, population-based studies). By far the most common sexual behavior to have been investigated has been sexual partners. Studies consistently reported early first intercourse to be associated with more recent, lifetime, and concurrent sexual partners. Early initiators were also more likely to participate in a wider range of sexual practices and report increased sexual satisfaction (among men). Furthermore, early first intercourse, in some studies, was shown to increase the risk of teen pregnancies, teen births, and having an abortion, while findings on STIs and contraceptive use have been mixed. These findings, however, must be interpreted with caution due to methodological problems and limitations present in the research, including a lack of consensus on what constitutes early sexual intercourse and inconsistencies and problems with analyses.
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Affiliation(s)
- Wendy Heywood
- Australian Research Centre in Sex, Health & Society, La Trobe University, 215 Franklin St., Melbourne, VIC, 3000, Australia,
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34
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Männistö T, Vääräsmäki M, Sipola-Leppänen M, Tikanmäki M, Matinolli HM, Pesonen AK, Räikkönen K, Järvelin MR, Hovi P, Kajantie E. Independent living and romantic relations among young adults born preterm. Pediatrics 2015; 135:290-7. [PMID: 25624386 DOI: 10.1542/peds.2014-1345] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Young adults born preterm at very low birth weight start families later. Whether less severe immaturity affects adult social outcomes is poorly known. METHODS The study "Preterm birth and early life programming of adult health and disease" (ESTER, 2009-2011) identified adults born early preterm (<34 weeks' gestation, N = 149), late preterm (≥ 34 to <37 weeks' gestation, N = 248), and at term (≥ 37 weeks' gestation, N = 356) from the Northern Finland Birth Cohort 1986 and the Finnish Medical Birth Register (1987-1989), with perinatal data, medical and family history, socioeconomic status, and lifestyle from routine visits or questionnaires. Cox, logistic, and ordinal regressions estimated the hazard and odds ratios (HR and OR) with 95% confidence intervals of outcomes related to preterm birth. RESULTS Compared with term-born subjects, those born early and late preterm were less likely to have cohabited with a romantic partner (HR, 0.79; [0.61-1.03] and HR, 0.80; [0.65-0.99], respectively) or experienced sexual intercourse (HR, 0.83; [0.66-1.05] and HR, 0.76; [0.63-0.92], respectively) by young adulthood. They also had higher odds of obtaining a 1-point lower score in a visual analog scale of self-perceived sexual attractiveness (OR, 1.45; [1.09-1.98] and OR, 1.44; [1.06-1.97] for early and late preterm birth, respectively). No difference was observed in the likelihood of departing from childhood home and number of individuals having their own families. CONCLUSIONS Young adults born preterm experience more social challenges, which may affect their romantic relationships and future family planning.
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Affiliation(s)
- Tuija Männistö
- Diabetes Prevention Unit, Department of Chronic Disease Prevention, National Institute for Health and Welfare, Helsinki, Finland; Department of Obstetrics and Gynecology and Medical Research Center, Oulu University Hospital and University of Oulu, Oulu, Finland;
| | - Marja Vääräsmäki
- Department of Obstetrics and Gynecology and Medical Research Center, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Marika Sipola-Leppänen
- Diabetes Prevention Unit, Department of Chronic Disease Prevention, National Institute for Health and Welfare, Helsinki, Finland; Department of Pediatrics and Adolescence, Oulu University Hospital, Oulu, Finland; Institute of Health Sciences and Biocenter Oulu, University of Oulu, Oulu, Finland
| | - Marjaana Tikanmäki
- Diabetes Prevention Unit, Department of Chronic Disease Prevention, National Institute for Health and Welfare, Helsinki, Finland; Institute of Health Sciences and Biocenter Oulu, University of Oulu, Oulu, Finland
| | - Hanna-Maria Matinolli
- Diabetes Prevention Unit, Department of Chronic Disease Prevention, National Institute for Health and Welfare, Helsinki, Finland
| | | | - Katri Räikkönen
- Institute of Behavioral Sciences, University of Helsinki, Helsinki, Finland
| | - Marjo-Riitta Järvelin
- Institute of Health Sciences and Biocenter Oulu, University of Oulu, Oulu, Finland; Department of Epidemiology and Biostatistics, MRC Health Protection Agency (HPA) Centre for Environment and Health, School of Public Health, Imperial College London, London, United Kingdom; Department of Children, Young People and Families, National Institute for Health and Welfare, Oulu, Finland; Unit of Primary Care, Oulu University Hospital, Oulu, Finland; and
| | - Petteri Hovi
- Diabetes Prevention Unit, Department of Chronic Disease Prevention, National Institute for Health and Welfare, Helsinki, Finland; Children's Hospital, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland
| | - Eero Kajantie
- Diabetes Prevention Unit, Department of Chronic Disease Prevention, National Institute for Health and Welfare, Helsinki, Finland; Department of Obstetrics and Gynecology and Medical Research Center, Oulu University Hospital and University of Oulu, Oulu, Finland; Children's Hospital, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland
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Sex in a lifetime: Sexual behaviors in the United States by lifetime number of sex partners, 2006-2010. Sex Transm Dis 2015; 41:345-52. [PMID: 24825330 DOI: 10.1097/olq.0000000000000132] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Using data from the 2006-2010 National Survey of Family Growth, we found that lifetime number of vaginal sex partners is positively associated with the number of sex partners in the past 12 months and negatively associated with age at first vaginal intercourse among 15- to 44-year-old male and female respondents.
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Young Risk Takers: Alcohol, Illicit Drugs, and Sexual Practices among a Sample of Music Festival Attendees. JOURNAL OF SEXUALLY TRANSMITTED DISEASES 2014; 2014:357239. [PMID: 26316974 PMCID: PMC4437411 DOI: 10.1155/2014/357239] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/27/2014] [Accepted: 11/20/2014] [Indexed: 11/29/2022]
Abstract
Background. Alcohol and other drug use and sexual risk behaviour are increasing among young Australians, with associated preventable health outcomes such as sexually transmissible infections (STIs) on the rise. Methods. A cross-sectional study of young people's health behaviours conducted at a music festival in Melbourne, Australia, in 2011. Results. 1365 young people aged 16–29 completed the survey; 62% were female with a mean age of 20 years. The majority (94%, n = 1287) reported drinking alcohol during the previous 12 months; among those, 32% reported “binge” drinking (6+ drinks) at least weekly. Half (52%) reported ever using illicit drugs and 25% reported past month use. One-quarter (27%) were identified as being at risk of STIs through unprotected sex with new or casual partners during the previous 12 months. Multivariable analyses found that risky sexual behaviour was associated with younger age (≤19 years), younger age of sexual debut (≤15 years), having discussed sexual health/contraception with a doctor, regular binge drinking, and recent illicit drug use. Conclusion. Substance use correlated strongly with risky sexual behaviour. Further research should explore young people's knowledge of alcohol/drug-related impairment and associated risk-taking behaviours, and campaigns should encourage appropriate STI testing among music festival attendees.
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Remschmidt C, Fesenfeld M, Kaufmann AM, Deleré Y. Sexual behavior and factors associated with young age at first intercourse and HPV vaccine uptake among young women in Germany: implications for HPV vaccination policies. BMC Public Health 2014; 14:1248. [PMID: 25476713 PMCID: PMC4289360 DOI: 10.1186/1471-2458-14-1248] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2014] [Accepted: 12/02/2014] [Indexed: 11/21/2022] Open
Abstract
Background In Germany, immunization against human papillomaviruses (HPV) is free of charge for all females aged 12 to 17 years. Since HPV infection rates rise soon after first intercourse, immunization against HPV should be completed before sexual debut. Knowledge of country-specific data on age at first intercourse and related risk factors is important to optimize prevention of HPV and other sexually transmitted infections. Therefore, the primary aim of this study was to describe sexual behavior in young women in Germany. Secondary aims were to identify factors that are (i) associated with younger age at first intercourse and (ii) with HPV vaccine uptake. Methods Between 2010 and 2012, we conducted a cross-sectional study among randomly selected women aged 20 to 25 years in Germany. We used a structured, self-administered questionnaire to collect sociodemographic data, information on sexual habits such as age at first intercourse, and information on HPV vaccine uptake. We used univariate and multivariate logistic regression analyses to identify factors associated with younger age at first intercourse and with HPV vaccine uptake. Results A total of 823 women (response rate: 14.2%) participated, 785 (95.4%) of which reported having had intercourse already. 70% of these women experienced first intercourse before the age of 18 years. However, less than 5% were younger than 14 years at sexual debut. Younger age at first intercourse was independently associated with a higher number of sexual partners, smoking, and past pregnancies. HPV vaccine uptake was associated with higher education, whereas smoking and a migrant background reduced the chance of being vaccinated. Conclusion In Germany, only a small proportion of women experienced first intercourse before the age of 14 years. Younger age at first intercourse was associated with behavior that might increase the risk of HPV infections or other sexually transmitted infections. Therefore, to optimize the HPV vaccination strategy, HPV vaccination series should be completed before the age of 14 years in Germany.
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Affiliation(s)
- Cornelius Remschmidt
- Department for Infectious Disease Epidemiology, Immunization Unit, Robert Koch Institute, Seestrasse 10, 13353 Berlin, Germany.
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Brüne M. Life History Theory as Organizing Principle of Psychiatric Disorders: Implications and Prospects Exemplified by Borderline Personality Disorder. PSYCHOLOGICAL INQUIRY 2014. [DOI: 10.1080/1047840x.2014.914120] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Nygård M, Hansen BT, Dillner J, Munk C, Oddsson K, Tryggvadottir L, Hortlund M, Liaw KL, Dasbach EJ, Kjær SK. Targeting human papillomavirus to reduce the burden of cervical, vulvar and vaginal cancer and pre-invasive neoplasia: establishing the baseline for surveillance. PLoS One 2014; 9:e88323. [PMID: 24505474 PMCID: PMC3914976 DOI: 10.1371/journal.pone.0088323] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2013] [Accepted: 01/10/2014] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Infection with high-risk human papillomavirus (HPV) is causally related to cervical, vulvar and vaginal pre-invasive neoplasias and cancers. Highly effective vaccines against HPV types 16/18 have been available since 2006, and are currently used in many countries in combination with cervical cancer screening to control the burden of cervical cancer. We estimated the overall and age-specific incidence rate (IR) of cervical, vulvar and vaginal cancer and pre-invasive neoplasia in Denmark, Iceland, Norway and Sweden in 2004-2006, prior to the availability of HPV vaccines, in order to establish a baseline for surveillance. We also estimated the population attributable fraction to determine roughly the expected effect of HPV16/18 vaccination on the incidence of these diseases. METHODS Information on incident cervical, vulvar and vaginal cancers and high-grade pre-invasive neoplasias was obtained from high-quality national population-based registries. A literature review was conducted to define the fraction of these lesions attributable to HPV16/18, i.e., those that could be prevented by HPV vaccination. RESULTS Among the four countries, the age-standardised IR/10⁵ of cervical, vaginal and vulvar cancer ranged from 8.4-13.8, 1.3-3.1 and 0.2-0.6, respectively. The risk for cervical cancer was highest in women aged 30-39, while vulvar and vaginal cancers were most common in women aged 70+. Age-standardised IR/10⁵ of cervical, vulvar and vaginal pre-invasive neoplasia ranged between 138.8-183.2, 2.5-8.8 and 0.5-1.3, respectively. Women aged 20-29 had the highest risk for cervical pre-invasive neoplasia, while vulvar and vaginal pre-invasive neoplasia peaked in women aged 40-49 and 60-69, respectively. Over 50% of the observed 47,820 incident invasive and pre-invasive cancer cases in 2004-2006 can be attributed to HPV16/18. CONCLUSION In the four countries, vaccination against HPV 16/18 could prevent approximately 8500 cases of gynecological cancer and pre-cancer annually. Population-based cancer and vaccination registries are essential to assess the predicted public health effects of HPV vaccination.
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Affiliation(s)
- Mari Nygård
- Department of Research, Cancer Registry of Norway, Oslo, Norway
| | | | - Joakim Dillner
- Departments of Laboratory Medicine, Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Christian Munk
- Unit of Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Kristján Oddsson
- The Cancer Detection Clinic, The Icelandic Cancer Society, Reykjavik, Iceland
| | - Laufey Tryggvadottir
- Icelandic Cancer Registry, Reykjavik, Iceland
- Faculty of Medicine, Laeknagardur, University of Iceland, Reykjavik, Iceland
| | - Maria Hortlund
- Office for Medical Service, Department of Clinical Microbiology, Division of Laboratory Medicine, Region Skåne, Malmö, Sweden
| | - Kai-Li Liaw
- Department of Epidemiology, Merck Research Laboratories, North Wales, Pennsylvania, United States of America
| | - Erik J. Dasbach
- Health Economic Statistics, Merck Research Laboratories, North Wales, Pennsylvania, United States of America
| | - Susanne Krüger Kjær
- Unit of Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark
- Department of Gynecology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
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Vella AM, Agius PA, Bowring AL, Hellard ME, Lim MSC. Early age at first sex: associations with sexual health and sociodemographic factors among a sample of young music festival attendees in Melbourne. Sex Health 2014; 11:359-65. [DOI: 10.1071/sh14058] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2014] [Accepted: 08/01/2014] [Indexed: 11/23/2022]
Abstract
Background
Age at first sex (AFS) is associated with adverse outcomes. We explore associated factors and correlates of ‘early’ AFS (<16 years). Methods: In 2009–11, participants (16–29 years) were recruited. Multivariate Cox regression explored correlates of AFS. Logistic regression analysis explored associations between early AFS and risk behaviours. Results: Of 3563 participants, 79% were sexually active. Median AFS was 17 years. Compared with those aged 25–29 years, younger participants reported younger AFS [16–17 years: adjusted hazard ratio (AHR) = 1.87, P < 0.01; 18–19 years: AHR = 1.47, P < 0.01, 20–24 years: AHR = 1.19, P < 0.01]. Of those sexually active, 29% reported early AFS. Early AFS was associated with being male [adjusted odds ratio (AOR) = 1.25, P < 0.05], being younger (16–17 years: AOR = 11.10, P < 0.01; 18–19 years: AOR = 3.60, P < 0.01; 20–24 years: AOR = 1.83, P < 0.01; compared with 25–29 years), having no education after high school (AOR = 1.52, P < 0.01), living alone (AOR = 1.84, P < 0.01) or with a partner (AOR = 1.57, P = 0.01), having more than five lifetime sex partners (AOR = 3.22, P = 0.01), inconsistent condom use in the past 12 months (AOR = 1.43, P < 0.01), ever using illicit drugs (AOR = 1.69, P < 0.01) and ever injecting drugs (AOR = 3.45, P < 0.01). Conclusions: The results highlight the importance of comprehensive sex education.
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The Age of Initiation of Drug Use and Sexual Behavior May Influence Subsequent HIV Risk Behavior: A Systematic Review. ISRN AIDS 2013; 2013:976035. [PMID: 24381791 PMCID: PMC3870609 DOI: 10.1155/2013/976035] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/10/2013] [Accepted: 10/08/2013] [Indexed: 11/17/2022]
Abstract
Researchers examining injection drug users (IDUs) in drug treatment have been trying for decades to determine the optimal way to intervene to prevent the transmission and spread of human immunodeficiency virus (HIV) in this population. Although efficacious HIV risk reduction interventions are widely available, questions remain about what specific factors are most related to HIV risk behavior and defined as unprotected sexual activity and/or high risk drug use. This review involved an evaluation of the research literature in order to better understand the association between drug use and sexual behavior debut on HIV risk behavior. Findings suggest that drug use debut and sexual behavior debut may be related to subsequent HIV risk behavior. Evidence to date implies that intervening at an earlier age to assist youth to avoid or delay these high risk behaviors may be an additional means of reducing subsequent HIV risk.
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Eriksson T, Torvinen S, Woodhall SC, Lehtinen M, Apter D, Harjula K, Hokkanen M, Rissanen P, Paavonen J, Lehtinen M. Impact of HPV16/18 vaccination on quality of life: a pilot study. EUR J CONTRACEP REPR 2013; 18:364-71. [PMID: 23768267 DOI: 10.3109/13625187.2013.801953] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVES Genital human papillomavirus (HPV) infections and associated precancerous lesions adversely affect health-related quality of life (HRQoL). HPV vaccines provide effective protection against these conditions. We therefore investigated the impact of HPV vaccination on HRQoL in young women five years after participation in a phase III HPV vaccination trial. METHODS A total of 4808 originally 16- to 17-year-old Finnish girls had participated in the PATRICIA trial and received either bivalent HPV 16/18 vaccine or hepatitis A-virus (HAV) vaccine in 2004 to 2005. Unvaccinated girls (n = 9602), from adjacent birth cohorts, had participated in the control cohort in 2005. From 2009 to 2011, at 22 to 23 years of age, all participants received a questionnaire consisting of two generic HRQoL instruments (RAND36 and EQ VAS) and a disease-specific questionnaire (CECA10). RESULTS We analysed responses of 1143 HPV 16/18-vaccinated, 980 HAV-vaccinated, and 3753 unvaccinated young women. The unadjusted mean outcome measures of the different HRQoL estimates were similar in the three different responder cohorts. CONCLUSIONS Five years after vaccination the health-related quality of life of HPV 16/ 18- vaccinated young women did not differ from those of HAV-vaccinated or unvaccinated controls representing the general population.
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Affiliation(s)
- Tiina Eriksson
- * School of Health Sciences, University of Tampere , Tampere , Finland
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De Genna NM, Feske U, Larkby C, Angiolieri T, Gold MA. Pregnancies, abortions, and births among women with and without borderline personality disorder. Womens Health Issues 2012; 22:e371-7. [PMID: 22749198 PMCID: PMC3397795 DOI: 10.1016/j.whi.2012.05.002] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2011] [Revised: 04/27/2012] [Accepted: 05/06/2012] [Indexed: 02/07/2023]
Abstract
BACKGROUND The purpose of this study was to examine history of pregnancies among women with and without borderline personality disorder (BPD), to determine whether BPD symptoms are associated with teenage pregnancies, unplanned pregnancies, elective and spontaneous abortions, and live births. METHODS Three hundred seventy-nine women completed the Structured Clinical Interview for DSM-IV Axis I diagnoses, Structured Interview for DSM-IV Personality for Axis II diagnoses, and a reproductive health interview. African-American (AA) women were oversampled, because little is known about BPD in AA women and they are at greater risk of teenage pregnancy, unplanned pregnancies, and spontaneous abortions. RESULTS BPD symptom severity was associated with a teenage pregnancy, even after controlling for race and socioeconomic status. Symptom severity was also associated with unplanned pregnancies and live births, but only for women without a history of a substance use disorder. BPD symptom severity was not associated with abortion. CONCLUSION Women with BPD become pregnant and have children, often during the period when BPD symptoms emerge and intensify. They are at increased risk of teenage pregnancies and unintended pregnancies compared with women with Axis I disorders. Treatment planning for this population should include attention to their reproductive health and better integration of physical and mental health services.
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Affiliation(s)
- Natacha M. De Genna
- NM De Genna is the Corresponding Author. Department of Psychiatry, University of Pittsburgh Medical School, Program in Epidemiology, Webster Hall - Suite 108, 4415 Fifth Avenue, Pittsburgh, PA, 15213. . Phone: (412) 246-6213 Fax: 412-246-6875
| | - Ulrike Feske
- School of Pharmacy, University of Pittsburgh, 3520 Forbes Avenue, Suite 203, Pittsburgh, PA, 15213. , Phone: (412) 383-2334 Fax: (412) 624-2489
| | - Cynthia Larkby
- NM De Genna is the Corresponding Author. Department of Psychiatry, University of Pittsburgh Medical School, Program in Epidemiology, Webster Hall - Suite 108, 4415 Fifth Avenue, Pittsburgh, PA, 15213. . Phone: (412) 246-6213 Fax: 412-246-6875
| | - Teresa Angiolieri
- School of Pharmacy, University of Pittsburgh, 3520 Forbes Avenue, Suite 203, Pittsburgh, PA, 15213. , Phone: (412) 383-2334 Fax: (412) 624-2489
| | - Melanie A. Gold
- Division of Adolescent Medicine, Department of Pediatrics, University of Pittsburgh School of Medicine, Medical Arts Building - Suite 500, 3708 Fifth Avenue, Pittsburgh, PA, 15213. Phone: (412) 383-1800 Fax: (412) 383-1807
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