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Mlandu C, Machisa M, Christofides N. Consistent condom use among Botswana's female population and associated factors. WOMEN'S HEALTH (LONDON, ENGLAND) 2024; 20:17455057241266453. [PMID: 39135506 PMCID: PMC11320669 DOI: 10.1177/17455057241266453] [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: 08/18/2023] [Revised: 05/20/2024] [Accepted: 06/18/2024] [Indexed: 08/15/2024]
Abstract
BACKGROUND Botswana is one of the countries severely impacted by the HIV/AIDS pandemic. Despite an extensive HIV prevention campaign, the incidence of HIV, particularly among women, remains high. Condoms play a significant role in preventing new HIV infections, although men and women do not consistently use them. OBJECTIVE The study assessed the individual, relationship and community factors associated with consistent condom use among women in Botswana. DESIGN A cross-sectional study using secondary data drawn from a national survey on Gender-Based Violence Indicators in 2012. METHODS The primary survey sampled 639 women, aged 18 years and older, using a multistage procedure. The final sample size for the secondary analysis included a total of 480 women who were sexually experienced and had reported using condoms with their male partners. Multivariate logistic regression analysis was employed to assess the association between consistent condom use and the explanatory variables. The multivariate logistic regression adjusted for cluster/community random effects. RESULTS About 43% of the women used condoms consistently in the past year. Consistent condom use was more likely among women who were employed in the past year (adjusted odds ratio = 1.77; 95% confidence interval = 1.25-2.50). While, women who lived with their partners (adjusted odds ratio = 0.46; 95% confidence interval = 0.28-0.74), had non-Christian beliefs (adjusted odds ratio = 0.52; 95% confidence interval = 0.29-0.92), perceived that their partners would be angry if they ask to use a condom (adjusted odds ratio = 0.19; 95% confidence interval = 0.06-0.58) and perceived that their community says women need their husband's permission to do paid work (adjusted odds ratio = 0.56; 95% confidence interval = 0.38-0.83) were less likely to use condoms consistently. CONCLUSION Consistent condom use among Botswana's female population is suboptimal. Consistent condom use was higher among women with employment, and lower among women who lived with their partners, had non-Christian beliefs, feared their partners' reaction upon asking for condom use and held inequitable community gender beliefs. To enhance women's consistent use of condoms, friendly condom use information, female economic empowerment strategies and programmes that involve religious leaders and promote progressive and healthy masculine practices in Sexual Reproductive Health/HIV interventions should be considered.
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Affiliation(s)
- Chenai Mlandu
- School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
| | - Mercilene Machisa
- School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
| | - Nicola Christofides
- School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
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2
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Wiese AL, Sease TB, Joseph ED, Becan JE, Knight K, Knight DK. Avoidance Self-Efficacy: Personal Indicators of Risky Sex and Substance Use among At-Risk Youth. CHILDREN AND YOUTH SERVICES REVIEW 2023; 147:106846. [PMID: 36844888 PMCID: PMC9957012 DOI: 10.1016/j.childyouth.2023.106846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
Adolescent substance use (SU) is associated with risky sex behavior and sexually transmitted infections and is a risk factor for subsequent risky sex decisions. Based on a sample of 1,580 youth in residential SU treatment, this study investigated how a static factor (race) and two dynamic personal factors (risk-taking, assertiveness) contributed to adolescents' perceived ability to avoid high-risk SU and sex behavior (avoidance self-efficacy). Results showed that race correlated with risk-taking and assertiveness, with White youth reporting higher ratings of assertiveness and risk-taking. Self-reported assertiveness and risk-taking also predicted SU and risky sex avoidance. This study underscores the importance of race and personal factors in relation to adolescents' confidence in avoiding high-risk situations.
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Affiliation(s)
- Amanda L Wiese
- Institute of Behavioral Research, Texas Christian University, 3034 Sandage Ave., Fort Worth, TX 76109
| | - Thomas B Sease
- Institute of Behavioral Research, Texas Christian University, 3034 Sandage Ave., Fort Worth, TX 76109
| | - Elizabeth D Joseph
- Institute of Behavioral Research, Texas Christian University, 3034 Sandage Ave., Fort Worth, TX 76109
| | - Jennifer E Becan
- Institute of Behavioral Research, Texas Christian University, 3034 Sandage Ave., Fort Worth, TX 76109
| | - Kevin Knight
- Institute of Behavioral Research, Texas Christian University, 3034 Sandage Ave., Fort Worth, TX 76109
| | - Danica K Knight
- Institute of Behavioral Research, Texas Christian University, 3034 Sandage Ave., Fort Worth, TX 76109
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Perkins TR, Aleibar D, Leath S, Pittman JC. Black Women’s Sexual Assertiveness and Satisfaction: The Role of the Superwoman Schema. JOURNAL OF BLACK PSYCHOLOGY 2022. [DOI: 10.1177/00957984221147796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Although extant research highlights the detrimental effects of the Superwoman Schema (SWS) on Black women’s physical and psychological well-being, researchers have yet to examine the implications of SWS endorsement on Black women’s sexual attitudes and behaviors. As a culturally salient racialized gender schema that reifies Black women’s supposed superhuman emotional and physical strength, to what extent does endorsement of the SWS contribute to Black women’s reported sexual assertiveness and satisfaction? In the present work, 406 Black women completed an online survey measuring their endorsement of the SWS, as well as their sexual assertiveness and sexual satisfaction. SWS dimensions moderated the association between sexual assertiveness and sexual satisfaction. Findings from the present study highlight the importance of considering culturally salient racialized gender schemas when examining Black women’s sexual attitudes and behaviors.
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Affiliation(s)
| | | | - Seanna Leath
- Washington University in St. Louis, St. Louis, MO, USA
| | - Jami C. Pittman
- University of Maryland School of Medicine, Baltimore, MD, USA
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4
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The Associations of Mental Health Disturbances, Self-Esteem, and Partner Violence Victimization with Condom Use in Spanish Adolescents. J Clin Med 2022; 11:jcm11092467. [PMID: 35566593 PMCID: PMC9104900 DOI: 10.3390/jcm11092467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2022] [Revised: 04/25/2022] [Accepted: 04/26/2022] [Indexed: 11/16/2022] Open
Abstract
Risky sexual behaviors, such as not using a condom for preventing sexually transmittable diseases and unwanted pregnancies, are associated with emotional and psychological problems in adolescence, including higher levels of depression, anxiety, stress, and low self-esteem. Adolescents with a history of violence victimization are also at increased risk of engaging in sexual risk behaviors. In this study, we examined the associations between mental health disturbances and partner violence victimization and the non-use of condoms among young people in Spain. We also examined self-esteem as a mediator of mental health problems and unprotected sexual relationships. A cross-sectional study was conducted on a sample of 831 adolescents randomly selected from 25 high schools in Spain. From the initial sample, 285 students (144 men and 141 women) from high schools in Alicante (Spain) who reported having experienced sexual activity with at least one partner were approached. The results showed that one in three adolescents between 14 and 19 years old did not use condoms during sexual intercourse. The factors associated with the non-use of condoms in the estimated models of Poisson robust variance were having a history of physical, psychological, or sexual violence; having been expelled from school because of behavioral problems; and having higher levels of depression, anxiety, and stress and lower levels of self-esteem. Self-esteem was independently associated with the non-use of condoms. Having lower levels of self-esteem increased the risk of not using a condom during participants’ last sexual intercourse. These findings suggest the importance of developing public health strategies for mental health promotion to increase condom use among adolescents.
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5
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van Lankveld J, van den Eijnden R, Emmerink P, Ter Bogt T, Pat-El R, Vanwesenbeeck I. An Indirect Measure of Implicit Sexual Assertiveness: Reliability and Validity of the Sexual Assertiveness IAT in Young Adults in The Netherlands. JOURNAL OF SEX & MARITAL THERAPY 2022; 48:628-640. [PMID: 35188080 DOI: 10.1080/0092623x.2022.2035868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
In the present study we investigated the reliability and validity of an Implicit Association Test of sexual assertiveness (the SA-IAT) in a sample of young adults (n = 159). The D600 algorithm was used to calculate implicit sexual assertiveness scores. Explicit sexual assertiveness was measured using a selection of items from the Hurlbert Index of Sexual Assertiveness. Personality traits were assessed using the revised, short version of the Eysenck Personality Questionnaire. The internal consistency of the SA-IAT was evaluated based on split-half reliability, and found acceptable with α = 0.61 for the practice trials, and α = 0.70 for the test trials, after correction for attenuation. Convergent and divergent validity were evaluated using correlation analysis. Correlation with explicit sexual assertiveness was found to be low, as expected. Divergent validity of the SA-IAT was evaluated against the personality traits of extraversion, neuroticism, and social desirability. Except for a significant correlation of implicit sexual assertiveness with extraversion in the full sample and the female subsample, implicit sexual assertiveness and personality traits were not found to share variance, as expected.
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Affiliation(s)
- Jacques van Lankveld
- Open University of the Netherlands, PO Box 2960, 6401 DLHeerlen, The Netherlands
| | - Regina van den Eijnden
- Utrecht University, Department of Interdisciplinary Social Sciences, Padualaan 14, 3584CH Utrecht, The Netherlands
| | - Peggy Emmerink
- Utrecht University, Department of Interdisciplinary Social Sciences, Padualaan 14, 3584CH Utrecht, The Netherlands
| | - Tom Ter Bogt
- Utrecht University, Department of Interdisciplinary Social Sciences, Padualaan 14, 3584CH Utrecht, The Netherlands
| | - Ron Pat-El
- Open University of the Netherlands, PO Box 2960, 6401 DLHeerlen, The Netherlands
| | - Ine Vanwesenbeeck
- Utrecht University, Department of Interdisciplinary Social Sciences, Padualaan 14, 3584CH Utrecht, The Netherlands
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Kirwan M, Lanni DJ, Nagy S, Pickett SM. Building a Model to Predict Sexual Assault Victimization Frequency Among Undergraduate Women. Violence Against Women 2021; 28:1925-1946. [PMID: 34229524 DOI: 10.1177/10778012211022777] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Previous research has identified several factors, including sexual risk behaviors, alcohol consumption, sexual refusal assertiveness, impulse control difficulties, drinking to cope, and sex to cope, as being associated with sexual assault victimization. Data were collected from 465 adult, undergraduate women, and analyzed using structural equation modeling to determine how these variables related to one another. Results showed that together, these factors predicted 17.1% of the variance in victimization frequency. These findings may help future researchers better understand the etiology of sexual assault victimization on college campuses and prove crucial to the development of future intervention programs which reduce victimization.
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Ménard AD, MacIntosh HB. Childhood Sexual Abuse and Adult Sexual Risk Behavior: A Review and Critique. JOURNAL OF CHILD SEXUAL ABUSE 2021; 30:298-331. [PMID: 33403939 DOI: 10.1080/10538712.2020.1869878] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Revised: 09/14/2020] [Accepted: 12/11/2020] [Indexed: 06/12/2023]
Abstract
Childhood sexual abuse (CSA) is a global problem with serious repercussions for survivors in various domains of adult interpersonal functioning, including sexual risk behavior. This review aimed to summarize findings from the recent literature on the connections between CSA and later adult sexual risk behaviors (e.g., unprotected intercourse, sexually transmitted infection [STSI] diagnosis). The sexual risk behaviors consistently associated with CSA were having sex under the influence of alcohol/substances and reports of concurrent sexual partners/infidelity. Notably, studies investigating the links between CSA and history of STI diagnosis and CSA and reports of unprotected sex (with the exception of samples comprised men who have sex with men) produced inconsistent findings. The methodological limitations of existing studies are considered and suggestions for future research are offered.
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Stockman JK, Syvertsen JL, Hayashi HD, Ludwig-Barron N, Tsuyuki K, Morris MD, Palinkas LA. "Violence and love and drugs…it all goes hand in hand": A mixed methods analysis of the substance abuse, violence, and HIV/AIDS syndemic among women who use methamphetamine. Subst Abus 2021; 42:821-831. [PMID: 33492198 PMCID: PMC8442613 DOI: 10.1080/08897077.2020.1865242] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Background: The synergistic epidemics of substance use, violence, and HIV/AIDS, also known as the SAVA syndemic, disproportionately affects vulnerable women in the United States. Methamphetamine use is closely linked with physical and sexual violence, including intimate partner violence (IPV), which heightens women's vulnerability to HIV. This mixed methods study examined the prevalence and correlates of violence among women who use methamphetamine, (n = 209) enrolled in an HIV intervention study in San Diego, California. Methods: At baseline, 209 women completed an interviewer-administered computer-assisted survey. A sub set of women who reported lifetime IPV (n = 18) also participated in qualitative interviews to contextualize our understanding of patterns of violence over time. Results: In the overall cohort, reports of lifetime (66.0%) and past 2-month (19.6%) IPV were prevalent. Moreover, women reported lifetime physical only (27.3%), sexual only (6.2%), or both forms of violence (50.7%) by multiple perpetrators. Factors independently associated with lifetime IPV were having unprotected sex with a steady partner (odds ratio [OR]: 2.50, 95% confidence interval [CI]: 1.04, 6.00) and being high on methamphetamine during unprotected sex with a steady partner (OR: 2.56, 95% CI: 1.30, 5.09) within the past 2 months. Our qualitative narratives illuminated how IPV in women's steady relationships often reflects a culmination of violent victimization throughout their lifetime which is further exacerbated by methamphetamine use and sexual risk through gendered power dynamics. Conclusions: HIV prevention interventions should address the SAVA syndemic in a holistic manner, including the role of methamphetamine use in the context of women's abusive steady relationships.
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Affiliation(s)
- Jamila K. Stockman
- Division of Infectious Diseases and Global Public Health, Department of Medicine, University of California, San Diego, La Jolla, CA, USA
| | | | - Hitomi D. Hayashi
- Department of Health Promotion and Behavioral Sciences, University of Texas School of Public Health, Houston, TX, USA
| | - Natasha Ludwig-Barron
- Division of Infectious Diseases and Global Public Health, Department of Medicine, University of California, San Diego, La Jolla, CA, USA
| | - Kiyomi Tsuyuki
- Division of Infectious Diseases and Global Public Health, Department of Medicine, University of California, San Diego, La Jolla, CA, USA
| | - Meghan D. Morris
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, USA
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9
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Kelley EL, Gidycz CA. Mediators of the Relationship Between Sexual Assault and Sexual Behaviors in College Women. JOURNAL OF INTERPERSONAL VIOLENCE 2020; 35:4863-4886. [PMID: 29294822 DOI: 10.1177/0886260517718188] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Some research shows that sexual assault victimization is associated with increased engagement in risky sexual behavior (e.g., intercourse without use of a condom or contraceptives), whereas other research indicates sexual assault victimization is related to sexual aversion. The purpose of the current study was to examine whether posttraumatic stress symptoms, alcohol use, and sexual assertiveness mediated the relationship between adolescent/emerging adulthood sexual assault (ASA) and risky sexual behavior, and whether posttraumatic stress symptoms mediated the relationship between ASA and sexual aversion, among college women. A sample of 462 women from a Midwestern university completed online questionnaires assessing ASA, child sexual abuse (CSA), posttraumatic stress symptoms (i.e., intrusion, avoidance, hyperarousal, and dissociation), alcohol use, sexual assertiveness, risky sexual behavior, and sexual aversion. CSA was considered as a covariate in the mediation models. Results of mediation analyses showed that the relationship between ASA and risky sexual behavior with a new partner was partially mediated by greater alcohol use and lower sexual assertiveness and that the relationship between ASA and risky sexual behavior with a regular partner was partially mediated by greater alcohol use. Results of a model examining mediators of ASA and sexual aversion detected no significant mediators. Results suggest that college women with a history of ASA would benefit from psychoeducation on the effect of alcohol on sexual decision-making, as well as from sexual assertiveness skills training, to reduce potential risks associated with risky sexual behaviors, particularly with lesser known partners, including sexually transmitted infections and sexual revictimization.
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Affiliation(s)
- Erika L Kelley
- VA Palo Alto Health Care System, Palo Alto, CA, USA
- Stanford University School of Medicine, Stanford, CA, USA
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10
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Granados R, Moyano N, Sierra JC. Behavioral intention to have risky sex in young men and women: The role of sexual excitation and assertiveness. PLoS One 2020; 15:e0232889. [PMID: 32437352 PMCID: PMC7241822 DOI: 10.1371/journal.pone.0232889] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Accepted: 04/23/2020] [Indexed: 12/11/2022] Open
Abstract
Due to the complex role of sexual excitation in risky sexual behaviors, this study aimed to disentangle this phenomenon by jointly analyzing the combined role of three forms of sexual excitation: genital and subjective, and individual´s propensity. Therefore, we examined the relationship between the components of the Dual Control Model, that is, propensity for sexual excitation/inhibition, in addition to genital and subjective arousal, and sexual assertiveness and intention to engage in casual sexual encounters in which sexual risk was implicitly or explicitly present. The sample consisted of 99 heterosexual young adults (55 men and 45 women) with ages ranging from 18 to 32 years. Participants performed an experiment in the laboratory, which involved them watching a sexual clip and then being presented with two erotic excerpts (stories) depicting casual sexual encounters in which there was an existence of implicit and explicit sexual risks. In men, the propensity for sexual inhibition was the most determining variable in preventing them from sexual risk-taking. In women, intention to engage in risky sexual behaviors was better determined by their propensity for sexual excitation and sexual assertiveness in negotiating the use of contraceptive methods. This research highlights the relevance of excitation and inhibition as a trait, in addition to subjective arousal and sexual assertiveness in intention to engage in risky sexual behaviors.
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Affiliation(s)
- Reina Granados
- Nursing Department, Faculty of Health Sciences, University of Granada, Granada, Spain
| | - Nieves Moyano
- Department of Evolutionary Psychology and Education, Faculty of Humanities and Sciences Education, University of Jaén, Jaén, Spain
- * E-mail:
| | - Juan Carlos Sierra
- Mind, Brain and Behavior Research Center (CIMCYC), University of Granada, Granada, Spain
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NasrollahiMola N, Bahrami N, Ranjbaran M, Alimoradi Z. Predictors of sexual assertiveness in a sample of Iranian married women of reproductive age. SEXUAL AND RELATIONSHIP THERAPY 2020. [DOI: 10.1080/14681994.2020.1740672] [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: 10/24/2022]
Affiliation(s)
- Nastaran NasrollahiMola
- Students Research Committee, School of Nursing & Midwifery, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Nasim Bahrami
- Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Mehdi Ranjbaran
- School of Public Health, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Zainab Alimoradi
- Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran
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12
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López-Alvarado S, Van Parys H, Cevallos-Neira A, Enzlin P. Latin American Women´s Beliefs, Views and Ideas About Sexual Assertiveness: A Focus Group Study in Cuenca (Ecuador). JOURNAL OF SEX RESEARCH 2020; 57:307-321. [PMID: 31140883 DOI: 10.1080/00224499.2019.1615031] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
In an attempt to extend our understanding of how social contexts co-create female sexuality in Latin America, the aim of the current study was to explore the beliefs, views, and ideas about sexual assertiveness in Latino emerging adult women. Seventeen women between 22 and 30 years old living in Cuenca, Ecuador, participated in focus groups. A constructivist grounded theory approach was used to analyze the data. Findings suggest that the overall views about sexual assertiveness in emerging adult women can be grouped into five categories: (1) gender role schemata; (2) concerns about the partner's thoughts and reactions; (3) gendered attitudes towards the use of specific methods of contraception; (4) talking about sexual histories as a challenging task; and (5) replication of family patterns. The findings of this study are discussed within existing literature that highlights the influence of gender role schemata on sexual assertiveness. Finally, a plea for more culturally sensitive research is formulated as well as some educational - the need to reinforce sex education programs - and clinical - highlighting the ability to be sexually assertive from the start of a relationship - implications are mentioned.
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Affiliation(s)
- Silvia López-Alvarado
- Humsex Project, University of Cuenca, Faculty of Psychology, University of Cuenca
- Institute for Family and Sexuality Studies, Department of Neurosciences, KU Leuven
| | | | | | - Paul Enzlin
- Institute for Family and Sexuality Studies, Department of Neurosciences, KU Leuven
- CeKSS - Center for Clinical Sexology and Sex Therapy, UPC KU Leuven
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Baggio M, Chong A, Simon D. Sex, marijuana and baby booms. JOURNAL OF HEALTH ECONOMICS 2020; 70:102283. [PMID: 31931268 DOI: 10.1016/j.jhealeco.2019.102283] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Revised: 12/19/2019] [Accepted: 12/23/2019] [Indexed: 06/10/2023]
Abstract
We study the behavioral changes caused by marijuana use on sexual activity, contraception, and birth counts by applying a differences-in-differences approach that exploits the variation in timing of the introduction of medical marijuana laws (MMLs) among states. We find that MMLs cause an increase in sexual activity, a reduction in contraceptive use conditional on having sex, and an increase in number of births. There is also suggestive evidence on temporary increases in the state-year gonorrhea rate. These changes may be attributed to behavioral responses including increased attention to the immediate hedonic effects of sexual contact, increased sexual frequency, as well as delayed discounting and ignoring the future costs associated with sex. Our findings on births suggest that behavioral factors can counteract the physiological changes from marijuana use that tend to decrease fertility. Our findings are robust to a broad set of tests.
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Affiliation(s)
| | - Alberto Chong
- Georgia State University, United States and Universidad del Pacifico, Peru.
| | - David Simon
- University of Connecticut and NBER, United States.
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Kim DH, Um MY, Cho H, Lee EB, Chun JS, Chang H. Factors Associated With Types of Sexual Assault Victimization and Bystander Behavior Among South Korean University Students. VIOLENCE AND VICTIMS 2019; 34:952-971. [PMID: 31836645 DOI: 10.1891/0886-6708.vv-d-18-00068] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
The aim of the current study was to gain understanding about incidences of sexual misconduct and bystander behaviors in South Korean universities. Specifically, risk factors were examined associated with three different types of sexual assault victimization (verbal or visual sexual harassment, physically forced sexual assault, and incapacitated sexual assault) and investigated the factors related to bystander behaviors. Data were collected via an online survey tool called SurveyMonkey in 2016. The total sample of participants comprised 1,944 enrolled undergraduate and graduate students from six universities in Seoul, South Korea. One logistic regression was conducted with a sample who reported sexual assault victimization (n = 1,079) to examine the risk factors associated with the three types of sexual misconduct. The other logistic regression was conducted with the subsample of bystanders (n = 540) to examine the relationships between bystander behavior and risk factors. In the main results, each type of sexual misconduct was associated differentially with age, alcohol blackouts, depression, child abuse and neglect, being an international student, and childhood sexual victimization. Also, persons who were older, self-identified LGBT, and victimized by verbal or visual sexual harassment at university were more likely to intervene when sexual misconduct occurred. These findings have implications for policies and interventions to reduce and prevent sexual misconduct in Korean universities.
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Affiliation(s)
- Dong Ha Kim
- Department of Social Welfare, Chungwoon University, Chungnam, Republic of Korea
| | - Myung-Yong Um
- Department of Social Welfare, Sungkyunkwan University, Seoul, Republic of Korea
| | - Hyunkag Cho
- School of Social Work, Michigan State University, Michigan
| | - Eui Bhin Lee
- Department of Social Welfare, Sungkyunkwan University, Seoul, Republic of Korea
| | - Jong Serl Chun
- Department of Social Welfare, Ewha Womans University, Seoul, Republic of Korea
| | - Heesuk Chang
- Department of Social Welfare, Sungkonghoe University, Seoul, Republic of Korea
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Vaillancourt-Morel MP, Bergeron S, Blais M, Hébert M. Longitudinal Associations Between Childhood Sexual Abuse, Silencing the Self, and Sexual Self-Efficacy in Adolescents. ARCHIVES OF SEXUAL BEHAVIOR 2019; 48:2125-2135. [PMID: 31300978 DOI: 10.1007/s10508-019-01494-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Revised: 06/07/2019] [Accepted: 06/10/2019] [Indexed: 06/10/2023]
Abstract
Sexual self-efficacy-the belief in one's ability to engage in desired and to refuse unwanted, sexual activities and behaviors-is an important feature in promoting adolescent sexual health and well-being. One factor that may affect the development of sexual self-efficacy is child sexual abuse. However, little is known about the processes underlying the relation between child sexual abuse and sexual self-efficacy. Using longitudinal data from a sample of 739 adolescent girls and boys aged between 14 and 18 years, we examined the mediational role of two "silencing the self" attitudes and behaviors in romantic relationships-self-silencing, i.e., inhibiting fulfilling one's own needs, and divided self, i.e., presenting an outer compliant self-in the associations between child sexual abuse severity and two dimensions of sexual self-efficacy: the ability to set clear sexual limits and the ability to use sexual protection. Results of path analysis showed that child sexual abuse severity was associated with more self-silencing and more divided self. In turn, self-silencing was associated with lower protection use self-efficacy, whereas divided self was associated with lower limit-setting and protection use self-efficacy. Thus, self-silencing strategies in romantic relationships mediated the associations between child sexual abuse severity and lower sexual self-efficacy. The overall findings may inform the development of prevention/intervention programs that target the enhancement of an integrated sense of self in intimate relationships to promote assertive strategies in sexual situations.
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Affiliation(s)
- Marie-Pier Vaillancourt-Morel
- Department of Psychology, Université de Montréal, C.P. 6128, Succursale Centre-Ville, Montréal, QC, H3C 3J7, Canada.
| | - Sophie Bergeron
- Department of Psychology, Université de Montréal, C.P. 6128, Succursale Centre-Ville, Montréal, QC, H3C 3J7, Canada
| | - Martin Blais
- Department of Sexology, Université du Québec à Montréal, Montréal, QC, Canada
| | - Martine Hébert
- Department of Sexology, Université du Québec à Montréal, Montréal, QC, Canada
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Maas MK, Bray BC, Noll JG. Online Sexual Experiences Predict Subsequent Sexual Health and Victimization Outcomes Among Female Adolescents: A Latent Class Analysis. J Youth Adolesc 2019; 48:837-849. [PMID: 30778831 DOI: 10.1007/s10964-019-00995-3] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2018] [Accepted: 02/06/2019] [Indexed: 12/26/2022]
Abstract
Adolescents' online sexual experiences (e.g., pornography use, sexual chatting, sexualized social media use, and nude image exchange) provide a new context for sexual socialization. Traditionally, online sexual experiences are often aggregated averages, which neglect their complexity and fail to identify individual differences in the experience. Moreover, the lack of longitudinal research in this area has failed to determine if these experiences predict later offline sexual health and violence outcomes. An analysis of two waves of surveys completed by ethnically and socioeconomically diverse female adolescents (N = 296; 49% maltreated; aged 14-16 years) participating in a larger cross-sequential study was conducted to address these gaps. Established latent classes from the prerequisite study of online sexual experiences at Time 1 were Online Abstinent (low probability of any online sexual experiences), Online Inclusive (high probability of all online sexual experiences), Attractors (high probability of attracting attention from others), and Seekers (high probability of seeking out sexual content and interaction). Class membership uniquely predicted HIV risk, number of physically violent romantic partners, and the occurrence of sexual assault at Time 2. Although membership in risker online sexual experience classes predicted later offline risk and victimization, this was especially true for maltreated participants. These findings demonstrate the advantages of examining online sexual experiences in a way that emphasizes their complexity and individual differences in influential susceptibility.
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Affiliation(s)
- Megan K Maas
- Department of Human Development and Family Studies, Michigan State University, 552W. Circle Drive 13D Human Ecology, East Lansing, MI, 48824, USA.
| | - Bethany C Bray
- The Methodology Center, The Pennsylvania State University, 404 Health and Human Development Building, University Park, PA, 16802, USA
| | - Jennie G Noll
- Department of Human Development and Family Studies, The Pennsylvania State University, 119 Health and Human Development Building, University Park, PA, 16802, USA
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Maas MK, Bray BC, Noll JG. A Latent Class Analysis of Online Sexual Experiences and Offline Sexual Behaviors Among Female Adolescents. JOURNAL OF RESEARCH ON ADOLESCENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR RESEARCH ON ADOLESCENCE 2018; 28:731-747. [PMID: 29152811 PMCID: PMC5960611 DOI: 10.1111/jora.12364] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
This study used latent class analysis to identify patterns (i.e., classes) across a broad range of online sexual experiences among female adolescents (n = 312) and to explore offline sexual behavior and substance use correlates of as well as maltreatment differences in class membership. The following four classes were identified: Online Abstinent, Online Inclusive, Attractors, and Seekers. Maltreated female adolescents were more likely to be members of the Online Inclusive class and less likely to be members of the Online Abstinent class than nonmaltreated female adolescents. Offline sexual behaviors and substance use differentially predicted class membership. These results suggest online sexual experiences vary greatly and should not be aggregated together as a global risk factor for all female adolescents.
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Babowitch JD, Vanable PA, Carey MP. Gender Moderates the Association of Depressive Symptoms to Sexual Risk Behavior Among HIV-Positive African-American Outpatients. AIDS Behav 2018; 22:1430-1434. [PMID: 29185079 DOI: 10.1007/s10461-017-1981-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Previous research has reported an association between depressive symptoms and sexual risk behavior. The purpose of this study was to explore whether gender moderates this association in a sample of HIV-positive African-Americans. Participants (N = 93) self-reported depressive symptoms (Center for Epidemiological Studies-Depression Scale; CES-D), and sexual risk behavior for the past 4 months. Analyses revealed that the depressive symptoms-by-gender interaction was associated with condomless sex and substance use proximal to sex. When analyses were stratified by gender, depressive symptoms were associated with condomless sex and frequency of substance use only for women. We conclude that depressive symptoms may be a more powerful sexual risk factor among women relative to men.
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Affiliation(s)
- Jacklyn D Babowitch
- Department of Psychology, Syracuse University, 430 Huntington Hall, Syracuse, NY, 13224, USA.
| | - Peter A Vanable
- Department of Psychology, Syracuse University, 430 Huntington Hall, Syracuse, NY, 13224, USA
| | - Michael P Carey
- Centers for Behavioral and Preventive Medicine, The Miriam Hospital and Brown University, Providence, RI, USA
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19
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Sexual Perfectionism and Women’s Sexual Assertiveness: Understanding the Unique Effects of Perfectionistic Expectations about Sex Originating from and Directed toward the Sexual Partner. SEX ROLES 2018. [DOI: 10.1007/s11199-018-0901-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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20
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Latimer J, Fleckman J, Wallace M, Rountree M, Theall K. The Influence of Violence Victimization on Sexual Health Behaviors and Outcomes. AIDS Patient Care STDS 2017; 31:237-244. [PMID: 28429958 PMCID: PMC5446596 DOI: 10.1089/apc.2016.0265] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
This study examines the implications of a history of personal violence on health and health behaviors. A secondary analysis of cross-sectional data involving adults (n = 214) from a semirural area in southern Louisiana between October 2008 and December 2010 was conducted to ascertain the association between a personal history of violence victimization and indicators of sexual health behaviors and outcomes: communication with sexual partners about HIV status, consistent condom use, and sexually transmitted infection (STI). While violence victimization is widely accepted as a risk factor for high-risk sex behavior, the mechanisms underlying violence victimization's influence on sexual health outcomes remain unclear. Bivariate analyses demonstrated a significant positive association between experience of physical abuse and lifetime history of STI. Surprisingly, respondents reporting lifetime physical violence were more than two times more likely to ask sexual partners about HIV status [odds ratio (OR) for physical attack = 2.23, 95% confidence intervals (CI) = 1.00-4.97; OR for physical injury = 4.60, 95% CI = 1.79-11.85]. Consistent condom use was not significantly associated with violence exposure in adjusted models. There was no evidence that communication with sexual partners mediated the relationship between experiences of violence and condom use. The link between personal history of violence and condom use may be mediated through alternative pathways beyond communication.
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Affiliation(s)
- Jennifer Latimer
- Department of Global Community Health and Behavioral Sciences, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana
| | - Julia Fleckman
- Department of Global Community Health and Behavioral Sciences, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana
| | - Maeve Wallace
- Department of Global Community Health and Behavioral Sciences, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana
- Comprehensive Alcohol Research Center, Louisiana State University Health Sciences Center School of Medicine, New Orleans, Louisiana
| | | | - Katherine Theall
- Department of Global Community Health and Behavioral Sciences, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana
- Comprehensive Alcohol Research Center, Louisiana State University Health Sciences Center School of Medicine, New Orleans, Louisiana
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21
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Blanc A, Rojas AJ, Sayans-Jiménez P. Erotofobia-erotofilia, asertividad sexual y deseo sexual de las mujeres inmigrantes que ejercen la prostitución. Rev Int Androl 2017. [DOI: 10.1016/j.androl.2016.07.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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22
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Carrotte ER, Vella AM, Hellard ME, Lim MSC. Mental Health and Associated Sexual Health Behaviours in a Sample of Young People Attending a Music Festival in Melbourne, Victoria. Community Ment Health J 2016; 52:1082-1088. [PMID: 26738496 DOI: 10.1007/s10597-015-9981-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2015] [Accepted: 12/15/2015] [Indexed: 10/22/2022]
Abstract
Poor mental health has previously been associated with risky sexual health behaviours among young people internationally and in clinical samples, but little is known about this relationship in non-clinical settings. We conducted a cross-sectional survey with a convenience sample of 1345 Australians aged 15-29. Multivariable logistic regression was used to identify sexual health behaviours independently associated with recent poor mental health including contraception use, STI testing, sexting and age at first sexual intercourse. Recent poor mental health was reported by 29.7 % of participants and independently associated with female gender (OR 1.8; 95 % CI 1.4-2.4), not identifying as heterosexual (OR 3.0; 95 % CI 2.1-4.4) and young age at first sexual intercourse among female participants (OR 1.4; 95 % CI 1.0-2.0). Results suggest mental health is largely driven by variables other than sexual health behaviours, although youth mental health services should consider inclusion of sexual health promotion within the scope of their services.
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Affiliation(s)
- Elise R Carrotte
- Burnet Institute, 85 Commercial Road, Melbourne, VIC, 3004, Australia.
| | - Alyce M Vella
- Burnet Institute, 85 Commercial Road, Melbourne, VIC, 3004, Australia
| | - Margaret E Hellard
- Burnet Institute, 85 Commercial Road, Melbourne, VIC, 3004, Australia.,School of Public Health and Preventive Medicine, Alfred Hospital, Monash University, Commercial Road, Melbourne, VIC, 3004, Australia
| | - Megan S C Lim
- Burnet Institute, 85 Commercial Road, Melbourne, VIC, 3004, Australia.,School of Public Health and Preventive Medicine, Alfred Hospital, Monash University, Commercial Road, Melbourne, VIC, 3004, Australia.,Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, 3010, Australia
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23
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Klein H, Elifson KW, Sterk CE. How the Interaction of Childhood Sexual Abuse and Gender Relates to HIV Risk Practices among Urban-Dwelling African Americans. ACTA ACUST UNITED AC 2016; 2. [PMID: 30197963 DOI: 10.15744/2454-499x.2.105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Purpose Previous research has demonstrated that HIV risk practices often differ based on gender and on whether or not people experienced sexual abuse during their formative (i.e., childhood and adolescence) years. The interaction of these two factors, which is the focus of this paper, has received limited attention. Methods Based on a model derived from Social Disorganization Theory and Syndemics Theory, interviews were conducted between 2009 and 2012 with 1,864 African American adults residing in Atlanta, Georgia in 80 strategically-chosen consensus block groups. Results Based on multiple regression and structural equation analyses, the interaction of sexual abuse and gender was found to be a significant predictor of involvement in (un)protected sex. The interaction of sexual abuse and gender also was related to condom use self-efficacy, which was one of the strongest factors underlying (un)protected sex. Conclusion The relationship of sexual abuse history and gender is relevant in the understanding of HIV risk practices. The interaction of these factors with one another and with other relevant influences that shape people's HIV risk profiles is complex. The Syndemics Theory approach used to conceptualize the relationships among relevant variables in this study is an effective way of trying to understand and address HIV risk practices.
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Affiliation(s)
- H Klein
- Kensington Research Institute, Kensington MD and Rollins School of Public Health, Emory University, Atlanta GA, United States
| | - K W Elifson
- Rollins School of Public Health, Emory University, Atlanta GA, United States
| | - C E Sterk
- Rollins School of Public Health, Emory University, Atlanta GA, United States
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24
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Brawner BM, Alexander KA, Fannin EF, Baker JL, Davis ZM. The Role of Sexual Health Professionals in Developing a Shared Concept of Risky Sexual Behavior as it Relates to HIV Transmission. Public Health Nurs 2015; 33:139-50. [PMID: 26184496 DOI: 10.1111/phn.12216] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
"Risky sexual behavior" accounts for the majority of new HIV infections regardless of gender, age, geographic location, or ethnicity. The phrase, however, refers to a relatively nebulous concept that hampers development of effective sexual health communication strategies. The purpose of this paper was to propose development of a shared conceptual understanding of "risky sexual behavior." We reviewed multidisciplinary HIV/AIDS literature to identify definitions of risky sexual behavior. Both the linguistic components and the social mechanisms that contribute to the concept of risky sexual behaviors were noted. Risky sexual behavior was often defined in a subjective manner in the literature, even in the scientific research. We urge a paradigm shift to focus on explicit behaviors and the social context of those behaviors in determining HIV risk. We also propose a new definition that reduces individual biases and promotes a broader discussion of the degree of sexual risk across a diversity of behavioral contexts. Sexual health professionals can strengthen practice and research initiatives by operating from a concise working definition of risky sexual behavior that is broadly transferable and expands beyond a traditional focus on identity-based groups.
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Affiliation(s)
- Bridgette M Brawner
- Department of Nursing, Center for Health Equity Research and Center for Global Women's Health, University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania
| | - Kamila A Alexander
- Johns Hopkins School of Nursing, Department of Community Public Health, Baltimore, Maryland
| | - Ehriel F Fannin
- Center for Health Equity Research and Center for Global Women's Health, University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania
| | - Jillian L Baker
- Department of Urban Public Health & Nutrition, School of Nursing & Health Sciences, La Salle University, Philadelphia, Pennsylvania
| | - Zupenda M Davis
- Department of Urban Public Health & Nutrition, School of Nursing & Health Sciences, La Salle University, Philadelphia, Pennsylvania
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25
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Adaptation and Validation of the Sexual Assertiveness Scale (SAS) in a Sample of Male Drug Users. SPANISH JOURNAL OF PSYCHOLOGY 2015; 18:E21. [PMID: 25896498 DOI: 10.1017/sjp.2015.25] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
The aim of the present study was to adapt and validate the Sexual Assertiveness Scale (SAS) in a sample of male drug users. A sample of 326 male drug users and 322 non-clinical males was selected by cluster sampling and convenience sampling, respectively. Results showed that the scale had good psychometric properties and adequate internal consistency reliability (Initiation = .66, Refusal = .74 and STD-P = .79). An evaluation of the invariance showed strong factor equivalence between both samples. A high and moderate effect of Differential Item Functioning was only found in items 1 and 14 (∆R 2 Nagelkerke = .076 and .037, respectively). We strongly recommend not using item 1 if the goal is to compare the scores of both groups, otherwise the comparison will be biased. Correlations obtained between the CSFQ-14 and the safe sex ratio and the SAS subscales were significant (CI = 95%) and indicated good concurrent validity. Scores of male drug users were similar to those of non-clinical males. Therefore, the adaptation of the SAS to drug users provides enough guarantees for reliable and valid use in both clinical practice and research, although care should be taken with item 1.
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26
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Redding CA, Prochaska JO, Armstrong K, Rossi JS, Hoeppner BB, Sun X, Kobayashi H, Yin HQ, Coviello D, Evers K, Velicer WF. Randomized trial outcomes of a TTM-tailored condom use and smoking intervention in urban adolescent females. HEALTH EDUCATION RESEARCH 2015; 30:162-78. [PMID: 24794584 PMCID: PMC4296884 DOI: 10.1093/her/cyu015] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2013] [Accepted: 03/18/2014] [Indexed: 06/03/2023]
Abstract
Smoking and sexual risk behaviors in urban adolescent females are prevalent and problematic. Family planning clinics reach those who are at most risk. This randomized effectiveness trial evaluated a transtheoretical model (TTM)-tailored intervention to increase condom use and decrease smoking. At baseline, a total of 828 14- to 17-year-old females were recruited and randomized within four urban family planning clinics. Participants received TTM or standard care (SC) computerized feedback and stage-targeted or SC counseling at baseline, 3, 6 and 9 months. Blinded follow-up telephone surveys were conducted at 12 and 18 months. Analyses revealed significantly more consistent condom use in the TTM compared with the SC group at 6 and 12, but not at 18 months. In baseline consistent condom users (40%), significantly less relapse was found in the TTM compared with the SC group at 6 and 12, but not at 18 months. No significant effects for smoking prevention or cessation were found, although cessation rates matched those found previously. This TTM-tailored intervention demonstrated effectiveness for increasing consistent condom use at 6 and 12 months, but not at 18 months, in urban adolescent females. This intervention, if replicated, could be disseminated to promote consistent condom use and additional health behaviors in youth at risk.
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Affiliation(s)
- Colleen A Redding
- Cancer Prevention Research Center, University of Rhode Island, 130 Flagg Road, Kingston, RI 02881 and Family Planning Council of Pennsylvania, Philadelphia, PA 19103, USA
| | - James O Prochaska
- Cancer Prevention Research Center, University of Rhode Island, 130 Flagg Road, Kingston, RI 02881 and Family Planning Council of Pennsylvania, Philadelphia, PA 19103, USA
| | - Kay Armstrong
- Cancer Prevention Research Center, University of Rhode Island, 130 Flagg Road, Kingston, RI 02881 and Family Planning Council of Pennsylvania, Philadelphia, PA 19103, USA
| | - Joseph S Rossi
- Cancer Prevention Research Center, University of Rhode Island, 130 Flagg Road, Kingston, RI 02881 and Family Planning Council of Pennsylvania, Philadelphia, PA 19103, USA
| | - Bettina B Hoeppner
- Cancer Prevention Research Center, University of Rhode Island, 130 Flagg Road, Kingston, RI 02881 and Family Planning Council of Pennsylvania, Philadelphia, PA 19103, USA
| | - Xiaowu Sun
- Cancer Prevention Research Center, University of Rhode Island, 130 Flagg Road, Kingston, RI 02881 and Family Planning Council of Pennsylvania, Philadelphia, PA 19103, USA
| | - Hisanori Kobayashi
- Cancer Prevention Research Center, University of Rhode Island, 130 Flagg Road, Kingston, RI 02881 and Family Planning Council of Pennsylvania, Philadelphia, PA 19103, USA
| | - Hui-Qing Yin
- Cancer Prevention Research Center, University of Rhode Island, 130 Flagg Road, Kingston, RI 02881 and Family Planning Council of Pennsylvania, Philadelphia, PA 19103, USA
| | - Donna Coviello
- Cancer Prevention Research Center, University of Rhode Island, 130 Flagg Road, Kingston, RI 02881 and Family Planning Council of Pennsylvania, Philadelphia, PA 19103, USA
| | - Kerry Evers
- Cancer Prevention Research Center, University of Rhode Island, 130 Flagg Road, Kingston, RI 02881 and Family Planning Council of Pennsylvania, Philadelphia, PA 19103, USA
| | - Wayne F Velicer
- Cancer Prevention Research Center, University of Rhode Island, 130 Flagg Road, Kingston, RI 02881 and Family Planning Council of Pennsylvania, Philadelphia, PA 19103, USA
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27
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Wilson HW, Donenberg GR, Emerson E. Childhood violence exposure and the development of sexual risk in low-income African American girls. J Behav Med 2014; 37:1091-101. [PMID: 24557448 PMCID: PMC4177032 DOI: 10.1007/s10865-014-9560-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2013] [Accepted: 02/11/2014] [Indexed: 10/25/2022]
Abstract
Low-income, urban African American (AA) girls are at heightened risk for sexually transmitted infections (STIs), and violence exposure may be an important risk factor. AA girls (N = 177) from low-income communities in Chicago completed a 2-year longitudinal study of HIV-risk behavior involving five waves of data collection (ages 12-16 at baseline) and a sixth wave (ages 14-22) assessing lifetime trauma and victimization history. Childhood exposure to violence (CEV) represented reports of physical, sexual, or witnessed violence before age 12. Latent growth curve analysis examined CEV as a covariate of sexual experience, number of sexual partners, and inconsistent condom use trajectories. CEV was associated with greater sexual risk, although the pattern differed across the three outcomes. Overall, findings emphasize the need for early interventions to reduce sexual risk among low-income urban girls who have experienced violence. Efforts to address or prevent violence exposure may also reduce rates of STIs in this population.
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Affiliation(s)
- Helen W Wilson
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, 401 Quarry Road, Stanford, CA, 94304-5718, USA,
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28
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George WH, Davis KC, Masters NT, Jacques-Tiura AJ, Heiman JR, Norris J, Gilmore AK, Nguyen HV, Kajumulo KF, Otto JM, Andrasik MP. Sexual victimization, alcohol intoxication, sexual-emotional responding, and sexual risk in heavy episodic drinking women. ARCHIVES OF SEXUAL BEHAVIOR 2014; 43:645-58. [PMID: 23857517 PMCID: PMC3858485 DOI: 10.1007/s10508-013-0143-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/14/2012] [Revised: 03/07/2013] [Accepted: 05/06/2013] [Indexed: 05/08/2023]
Abstract
This study used an experimental paradigm to investigate the roles of sexual victimization history and alcohol intoxication in young women's sexual-emotional responding and sexual risk taking. A nonclinical community sample of 436 young women, with both an instance of heavy episodic drinking and some HIV/STI risk exposure in the past year, completed childhood sexual abuse (CSA) and adolescent/adult sexual assault (ASA) measures. A majority of them reported CSA and/or ASA, including rape and attempted rape. After random assignment to a high alcohol dose (.10 %) or control condition, participants read and projected themselves into an eroticized scenario of a sexual encounter involving a new partner. As the story protagonist, each participant rated her positive mood and her sexual arousal, sensation, and desire, and then indicated her likelihood of engaging in unprotected sex. Structural equation modeling analyses revealed that ASA and alcohol were directly associated with heightened risk taking, and alcohol's effects were partially mediated by positive mood and sexual desire. ASA was associated with attenuated sexual-emotional responding and resulted in diminished risk taking via this suppression. These are the first findings indicating that, compared to non-victimized counterparts, sexually victimized women respond differently in alcohol-involved sexual encounters in terms of sexual-emotional responding and risk-taking intentions. Implications include assessing victimization history and drinking among women seeking treatment for either concern, particularly women at risk for HIV, and alerting them to ways their histories and behavior may combine to exacerbate their sexual risks.
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Affiliation(s)
- William H George
- Department of Psychology, University of Washington, Box 351525, Seattle, WA, 98195, USA,
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29
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Xiao Z, Li X, Lin D, Jiang S, Liu Y, Li S. Sexual communication, safer sex self-efficacy, and condom use among young Chinese migrants in Beijing, China. AIDS EDUCATION AND PREVENTION : OFFICIAL PUBLICATION OF THE INTERNATIONAL SOCIETY FOR AIDS EDUCATION 2013; 25:480-494. [PMID: 24245595 DOI: 10.1521/aeap.2013.25.6.480] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Mediation effect of sexual communication on the relationship between safer sex self-efficacy and condom use was tested among 307 homosexually active migrant men, 376 heterosexually active migrant men, and 265 heterosexually active migrant women. The study found certain aspects of sexual communication mediated the effect of self-efficacy on condom use among the three samples. The findings underscored the importance of including components that promote safer sex self-efficacy and sexual communication in HIV prevention interventions for Chinese migrants.
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30
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Steinberg JR, Tschann JM, Henderson JT, Drey EA, Steinauer JE, Harper CC. Psychological distress and post-abortion contraceptive method effectiveness level chosen at an urban clinic. Contraception 2013; 88:717-24. [PMID: 24094755 DOI: 10.1016/j.contraception.2013.08.009] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2013] [Revised: 08/22/2013] [Accepted: 08/29/2013] [Indexed: 11/25/2022]
Abstract
OBJECTIVE We investigated whether more psychological distress before an abortion is associated with the effectiveness of contraception selected (low, moderate, or high effectiveness) at an abortion clinic visit. METHOD Using data from 253 women attending an urban abortion clinic that primarily serves low-income women, we tested the association between pre-abortion psychological distress and the effectiveness level of post-abortion contraceptive choice. Based on typical use failure rates, we classified effectiveness of contraceptive choice into three levels-low, moderate, and high effectiveness. We measured psychological distress with four validated measures of depressive, anxious, and stress symptoms, and negative affect, as well as with a global measure comprising these four measures. We used multivariable ordinal logistic regression to measure the association of each psychological distress measure with post-abortion contraceptive method effectiveness level, adjusting for sociodemographic factors, pregnancy history, trimester of abortion, and importance of avoiding pregnancy in the next year. RESULTS We found that compared to women experiencing less stress symptoms, negative affect and global psychological distress, women experiencing more stress symptoms [AOR=1.028, 95% CI: 1.001-1.050], negative affect [AOR=1.05, 95% CI: 1.01-1.09] and global psychological distress [AOR=1.46, 95% CI: 1.09-1.95] were more likely to choose more effective versus less effective methods, p<.05, in adjusted models. Using dichotomous psychological measures we found similar results. CONCLUSIONS Women experiencing more psychological distress before an abortion selected more effective contraceptive methods after their abortion. Future research should examine whether this distress is associated with subsequent contraceptive use or continuation. IMPLICATIONS The current study suggests that contraceptive providers should not assume that women experiencing more psychological distress prefer to use less effective contraceptive methods.
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Affiliation(s)
- Julia R Steinberg
- Department of Psychiatry, University of California, 3333 California St., Ste. 465, Box 0848, San Francisco, CA 94143-0848, USA.
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31
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32
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Wilson HW, Emerson E, Donenberg GR, Pettineo L. History of sexual abuse and development of sexual risk behavior in low-income, urban African American girls seeking mental health treatment. Women Health 2013; 53:384-404. [PMID: 23751092 DOI: 10.1080/03630242.2013.790337] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
OBJECTIVE This study examined relationships between sexual abuse and patterns of sexual risk-taking among low-income, urban African American adolescent girls seeking mental health treatment. METHOD Participants (N = 158) were 12- to 16-year-old African American girls recruited from outpatient mental health clinics serving urban, mostly low-socioeconomic status communities in Chicago, Illinois and followed for two years between 2003 and 2010. This study included self-reports of sexual abuse and four waves (T2-T5) of self-reported data on sexual experience and sexual risk-taking (number of partners, inconsistent condom use, and sex with a risky partner). Latent curve modeling was used to examine patterns of sexual behavior over the four time points with sexual abuse and mental health symptoms as covariates. RESULTS Sexual abuse was significantly associated with T2 sexual experience, T2-T4 number of partners, T3 inconsistent condom use, and T2-T3 having a risky partner. These relationships decreased when mental health symptoms were controlled. CONCLUSIONS This longitudinal study revealed a complex relationship between sexual abuse and sexual risk that would be missed if sexual risk were assessed at a single time point. Findings supported early intervention to delay onset of sexual risk behavior among low-income African American girls with mental health concerns and histories of sexual abuse.
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Affiliation(s)
- Helen W Wilson
- Department of Psychiatry andBehavioral Sciences, Stanford University School of Medicine, 401 Quarry Road, Stanford, CA94305-5718, USA.
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33
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Forced sexual initiation, sexual intimate partner violence and HIV risk in women: a global review of the literature. AIDS Behav 2013; 17:832-47. [PMID: 23143750 DOI: 10.1007/s10461-012-0361-4] [Citation(s) in RCA: 146] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Coerced or forced sexual initiation and sexual intimate partner violence (sexual IPV) contribute significantly to a woman's risk for HIV infection. This review systematically examines global research (n = 21 studies) published since 2000 on the role of coerced/forced sexual initiation and sexual IPV on HIV risk in women. In predominantly low- and middle-income countries, coerced/forced sexual initiation was associated with HIV/STIs, multiple and high-risk sex partners, and no condom use. Most studies using behaviorally specific terms for sexual IPV found strong associations between sexual IPV and HIV risk behaviors. In contrast, studies using less specific definitions often failed to find these significant associations. To develop more comprehensive HIV prevention programs, future efforts should integrate behaviorally specific terms into assessing prevalence of sexual IPV and its association with HIV risk, consider cultural differences, and identify causal pathways between coerced or forced sexual initiation, HIV risk behaviors and HIV/STI infection.
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Byers ES, Nichols S, Voyer SD, Reilly G. Sexual well-being of a community sample of high-functioning adults on the autism spectrum who have been in a romantic relationship. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2012; 17:418-33. [PMID: 23045223 DOI: 10.1177/1362361311431950] [Citation(s) in RCA: 76] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This study explored factors (gender, age, relationship status, symptomatology) associated with the sexual well-being of 141 (56 men and 85 women) adults with high-functioning autism and Asperger syndrome (HFA/AS) living in the community. Participants completed an online survey consisting of a measure of autistic symptoms as well as measures of dyadic and solitary sexual well-being. Canonical correlation analyses showed that participants who were currently in a romantic relationship reported more frequent dyadic affectionate and genital activity and greater sexual assertiveness and sexual satisfaction, pointing to the importance of context in an active sex life. After controlling for the first variate, men and individuals with less autism symptomatology, particularly in the social and communication domains, generally reported significantly greater dyadic sexual well-being, including greater sexual satisfaction, assertiveness, arousability, and desire and lower sexual anxiety and fewer sexual problems. Men also reported better solitary sexual well-being, including more sexual thoughts, more sexual desire, and more frequent solitary sexual activity; however, they had lower sexual knowledge. These results highlight the importance for research and sexuality education with individuals with HFA/AS to conceptualize sexual well-being as a multidimensional construct consisting of both dyadic and solitary aspects.
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Affiliation(s)
- E Sandra Byers
- Department of psychology, University of New Brunswick, Canada.
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Parks KA, Collins RL, Derrick JL. The influence of marijuana and alcohol use on condom use behavior: findings from a sample of young adult female bar drinkers. PSYCHOLOGY OF ADDICTIVE BEHAVIORS 2012; 26:888-94. [PMID: 22612253 DOI: 10.1037/a0028166] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Prevalence data indicate that alcohol and marijuana are frequently used intoxicants among young adults in the United States. In a number of studies, both alcohol use and marijuana use have been associated with failure to use condoms, a high-risk sexual behavior. The purpose of the current study was to assess the individual and additive effects of alcohol and marijuana use on this risky sexual behavior among 251 young adult, female bar drinkers. Multilevel modeling was used to assess the likelihood of condom use during sexual events that occurred as a function of substance use (none, only alcohol, only marijuana, or both) prior to and partner type (known or casual) during the event, as well as individual differences in sexual assertiveness. Initial model testing (Levels 1 and 2) revealed that there were significant main effects for partner type (known), substance use (alcohol and marijuana) and sexual assertiveness (refusal, pregnancy/STI prevention) on risky sex. Final model testing indicated that sexual assertiveness interacted with substance use to influence risky sex. Women who were low in sexual assertiveness refusal were more likely to engage in risky sex on days when they had consumed both alcohol and marijuana prior to the sexual activity. These findings highlight the complex nature of the relationship between substance use and risky sex.
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Affiliation(s)
- Kathleen A Parks
- Research Institute on Addictions, University at Buffalo, The State University of New York, Buffalo, NY 14203, USA.
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Paterno MT, Jordan ET. A review of factors associated with unprotected sex among adult women in the United States. J Obstet Gynecol Neonatal Nurs 2012; 41:258-274. [PMID: 22376055 DOI: 10.1111/j.1552-6909.2011.01334.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVE To provide an updated review of research since 2005 on factors associated with unprotected sex among women in the United States. DATA SOURCES PubMed, CINAHL, and PsychINFO were searched from January 2006 through April 2011 using the terms unsafe sex, sexual risk taking, contraception, contraception behavior, birth control, condoms, and condom utilization. STUDY SELECTION Inclusion criteria included studies written in English on adult women in the United States age ≥ 18. Forty-five publications met inclusion criteria. DATA EXTRACTION All factors associated with engagement in unprotected sex are presented. DATA SYNTHESIS Unprotected sex has been associated with increasing age, being married, establishment of trust, recent experience of intimate partner violence, contraceptive side effects, infrequent sexual intercourse, and decreased arousal and pleasure due to contraceptive use. Religion, depression, history of abortion, number of children, having children, and number of pregnancies have not been associated with unprotected sex in recent studies. Several other variables have been studied with mixed results, possibly due to differences in research methods and sample characteristics. CONCLUSIONS More research is needed to elucidate the impact of cultural factors, relationship factors, attitude to pregnancy and motherhood, and reproductive coercion on prevention of pregnancy and sexually transmitted infections. Nurses can lead research on these topics and implement evidence-based practice based on study findings.
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Affiliation(s)
- Mary T Paterno
- School of Nursing, Johns Hopkins University, Baltimore, MD..
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Wilson HW, Widom CS. Pathways from childhood abuse and neglect to HIV-risk sexual behavior in middle adulthood. J Consult Clin Psychol 2011; 79:236-46. [PMID: 21355638 PMCID: PMC3066267 DOI: 10.1037/a0022915] [Citation(s) in RCA: 60] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE This study examines the relationship between childhood abuse and neglect and sexual risk behavior in middle adulthood and whether psychosocial factors (risky romantic relationships, affective symptoms, drug and alcohol use, and delinquent and criminal behavior) mediate this relationship. METHOD Children with documented cases of physical abuse, sexual abuse, and neglect (ages 0-11) processed during 1967-1971 were matched with nonmaltreated children and followed into middle adulthood (approximate age 41). Mediators were assessed in young adulthood (approximate age 29) through in-person interviews between 1989 and 1995 and official arrest records through 1994 (N = 1,196). Past year HIV-risk sexual behavior was assessed via self-reports during 2003-2004 (N = 800). Logistic regression was used to examine differences in sexual risk behavior between the abuse and neglect and control groups, and latent variable structural equation modeling was used to test mediator models. RESULTS Child abuse and neglect was associated with increased likelihood of risky sexual behavior in middle adulthood, odds ratio = 2.84, 95% CI [1.74, 4.64], p ≤ .001, and this relationship was mediated by risky romantic relationships in young adulthood. CONCLUSIONS Results of this study draw attention to the potential long-term consequences of child abuse and neglect for physical health, in particular sexual risk, and point to romantic relationships as an important focus of intervention and prevention efforts.
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Affiliation(s)
- Helen W Wilson
- Department of Psychology, Rosalind Franklin University of Medicine and Science, 3333 Green Bay Road, North Chicago, IL 60064, USA.
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