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The Fracking Boom, Labor Structure, and Adolescent Fertility. POPULATION RESEARCH AND POLICY REVIEW 2022. [DOI: 10.1007/s11113-022-09722-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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2
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Finigan-Carr NM, Craddock JB, Johnson T. Predictors of condom use among system-involved youth: The importance of Sex Ed. CHILDREN AND YOUTH SERVICES REVIEW 2021; 127:106130. [PMID: 36090583 PMCID: PMC9457273 DOI: 10.1016/j.childyouth.2021.106130] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Sexual health education has been proven effective in improving adolescent sexual reproductive health outcomes. System-involved youth, including those in child welfare or juvenile justice systems, experience disproportionately poor outcomes as compared to youth in the general population, especially concerning STIs and early or unplanned pregnancies. Using logistic regression, this cross-sectional study examined the odds of condom use in a sample (n = 318; 61.3% males; 79.9% African American) of system-involved youth with multiple high-risk sexual behaviors. Specifically, it examined the impact of sexual health education, attitudes and beliefs about condoms, and the moderating effect of gender. The logistic regression models showed that youth were more likely to use a condom when exposed to comprehensive sexual health education (p < .05). Beliefs about condom effectiveness increased the odds of condom use in the second model (p < .01). Gender was not found to have a moderating effect. This study examined whether receiving comprehensive sexual health education and adolescent attitudes and beliefs towards condoms were associated with non-condom use using logistic regression in a sample of system-involved youth. Results suggest that comprehensive sexual health education could improve condom use in this vulnerable population.
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Affiliation(s)
| | - Jaih B. Craddock
- University of Maryland, Baltimore: School of Social Work, Baltimore, MD, USA
| | - Tonya Johnson
- Baltimore City Health Department, Baltimore, MD, USA
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Kovensky R, Khurana A, Guyer S, Leve LD. Childhood Adversity, Impulsivity, and HIV Knowledge as Predictors of Sexual Risk Outcomes in At-Risk Female Youth. ADOLESCENTS 2021; 1:56-69. [PMID: 33954297 DOI: 10.3390/adolescents1010006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Sexual risk behavior in adolescence can lead to adverse health consequences, particularly for female youth. Most interventions focus on imparting knowledge about the consequences of such behaviors, even though little research has examined whether increasing such knowledge results in desired behavioral changes. Further, individual factors such as impulsivity and childhood adversity might moderate this relationship. We examined associations between HIV knowledge and sexual risk behavior and condom use efficacy in a sample of 122 at-risk females, aged 13-18. HIV knowledge was unrelated to sexual risk behavior, but positively related to condom use efficacy. Impulsivity and childhood adversity had direct effects, with no interaction effects. Increasing HIV knowledge may play an important role in promoting proximal predictors of safer sex practices.
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Affiliation(s)
- Rachel Kovensky
- Department of Counseling Psychology and Human Services, University of Oregon, Eugene, OR 97403, USA
| | - Atika Khurana
- Department of Counseling Psychology and Human Services, University of Oregon, Eugene, OR 97403, USA
- Prevention Science Institute, University of Oregon, Eugene, OR 97403, USA
| | - Sally Guyer
- Prevention Science Institute, University of Oregon, Eugene, OR 97403, USA
| | - Leslie D Leve
- Department of Counseling Psychology and Human Services, University of Oregon, Eugene, OR 97403, USA
- Prevention Science Institute, University of Oregon, Eugene, OR 97403, USA
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McCloskey LA, Eloff I, Doran K. Determinants of intergenerational sexual relationships and HIV risk among South African women outpatients in Gauteng. AIDS Care 2020; 33:654-662. [PMID: 32964726 DOI: 10.1080/09540121.2020.1823311] [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: 10/23/2022]
Abstract
Age-discrepant sexual relationships may place women at risk for HIV infection in South Africa. Results are based on medical records and case-control interview data of 889 sexually experienced women outpatients aged 15-29 in a Gauteng township. Women with partners at least ten years older (intergenerational) show an elevated chance of having an early sexual debut, concurrent and transactional partners, and intimate partner violence. Hardship during childhood including parental loss, food insecurity and abuse are related to age asymmetric relationships. HIV is two times more likely (aOR=1.96) with an intergenerational partner. Transactional sex increases the odds of HIV independently (aOR=1.76) as does intimate partner violence (aOR=1.6). To the extent that transactional and intergenerational sex overlap the chance of contracting HIV increases more than two-fold (uOR=4.57). Girls (15-19) with intergenerational partners face the highest chance of HIV (uOR=8.55) compared to other age groups. They are also five times more likely than controls to have lived with a cross-age partner. Our findings indicate there are multiple pathways emanating from childhood leading to women's choice of intergenerational partners, and the link to HIV is strongest among the youngest women.
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Affiliation(s)
- Laura Ann McCloskey
- Department of Applied Health Science, School of Public Health, Indiana University, Bloomington, IN, USA
| | - Irma Eloff
- Department of Educational Psychology, University of Pretoria School of Education, Pretoria, South Africa
| | - Kelly Doran
- UNH Institute on Disability, College of Health and Human Services, University of New Hampshire, Durham, NH, USA
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Moreau N, Költő A, Young H, Maillochon F, Godeau E. Negative feelings about the timing of first sexual intercourse: findings from the Health Behaviour in School-aged Children study. Int J Public Health 2018; 64:219-227. [DOI: 10.1007/s00038-018-1170-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Revised: 09/24/2018] [Accepted: 11/03/2018] [Indexed: 10/27/2022] Open
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Clark M, Buchanan R, Kovensky R, Leve LD. Partner influences on young women's risky drug and sexual behavior. Reprod Health 2018; 15:156. [PMID: 30219076 PMCID: PMC6139176 DOI: 10.1186/s12978-018-0598-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2017] [Accepted: 08/31/2018] [Indexed: 11/11/2022] Open
Abstract
Background Adolescent girls with a history of maltreatment are at heightened risk for health-risking behaviors, including unsafe sexual behaviors and drug use. However, few studies have examined the views of this population in regard to sexual partner choice, sexual behaviors, and decisions to use drugs with sexual partners. Methods We conducted 15 semistructured, open-ended qualitative interviews with young women ages 18–24 with a history of maltreatment and asked them to reflect on their experiences as adolescents. We used the constant comparison method to group the qualitative coded data into themes. Results Analysis of the interviews suggested that adolescent girls with maltreatment histories often report that they chose partners who are promotive of risky drug and sexual behavior. The interviews also provided insight into why this population is likely to use drugs with their partner and why they might be hesitant to talk about or practice safe sex with their partner. Conclusion The young women’s feedback highlighted five areas where adolescent girls with maltreatment histories could benefit: (a) provision of information about partner characteristics that are promotive of both risky behavior and those that are linked to healthy relationships, (b) provision of information about how one’s partner can influence one’s own drug use, (c) practice talking about safe sex with partners, (d) provision of information about safe sex practices and the risks associated with unsafe sex, and (e) provision of information about the risks associated with drug use and unsafe sexual behavior to adolescent boys.
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Affiliation(s)
- Miriam Clark
- Oregon Social Learning Center, 10 Shelton McMurphey Blvd, Eugene, OR, 97401, USA
| | - Rohanna Buchanan
- Oregon Social Learning Center, 10 Shelton McMurphey Blvd, Eugene, OR, 97401, USA.
| | - Rachel Kovensky
- Prevention Science Institute, 6217 University of Oregon, Eugene, OR, 97403, USA
| | - Leslie D Leve
- Prevention Science Institute, 6217 University of Oregon, Eugene, OR, 97403, USA
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Beauclair R, Hens N, Delva W. The role of age-mixing patterns in HIV transmission dynamics: Novel hypotheses from a field study in Cape Town, South Africa. Epidemics 2018; 25:61-71. [PMID: 29866422 DOI: 10.1016/j.epidem.2018.05.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Revised: 02/15/2018] [Accepted: 05/17/2018] [Indexed: 10/16/2022] Open
Abstract
BACKGROUND Age-disparate relationships are thought to put young women at increased risk of HIV, though current evidence is inconclusive. Studying population-level age-mixing patterns as well as individual-level measures of age difference variation may provide insight into the persistence and magnitude of the epidemic in South Africa. METHODS We used data from a survey in Cape Town (n = 506) to describe age-mixing dynamics in the four population strata of HIV negative and HIV positive male and female participants. Mixed-effects models were used to calculate the average increase in partner age for each year increase in age of participant, the average partner age for 15 year olds, and the between-subject and the within-subject standard deviation of partner ages. We conducted 2000 bootstrap replications of the models. Using negative binomial models, we also explored whether HIV status was associated with participants having a larger range in partner ages. RESULTS HIV positive women had large variability in partner ages at the population level, and at the individual level had nearly three times the expected range of partner ages compared to HIV negative women. This pattern may increase the potential for HIV transmission across birth cohorts and may partially explain the persistence of the epidemic in South Africa. Young men, who have been previously absent from the age-disparity discourse, also choose older partners who may be putting them at increased risk of HIV infection due to the high HIV prevalence among older age categories of women.
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Affiliation(s)
- Roxanne Beauclair
- International Centre for Reproductive Health, Ghent University, Gent, Belgium; The South African Department of Science and Technology-National Research Foundation (DST-NRF) Centre of Excellence in Epidemiological Modelling and Analysis (SACEMA), Stellenbosch University, Stellenbosch, South Africa.
| | - Niel Hens
- Center for Statistics, I-BioStat, Hasselt University, Martelarenlaan 42, BE3500 Hasselt, Belgium; Centre for Health Economics Research and Modelling Infectious Diseases and Centre for the Evaluation of Vaccination, Vaccine & Infectious Disease Institute, University of Antwerp, Antwerp, Belgium
| | - Wim Delva
- International Centre for Reproductive Health, Ghent University, Gent, Belgium; The South African Department of Science and Technology-National Research Foundation (DST-NRF) Centre of Excellence in Epidemiological Modelling and Analysis (SACEMA), Stellenbosch University, Stellenbosch, South Africa; Center for Statistics, I-BioStat, Hasselt University, Martelarenlaan 42, BE3500 Hasselt, Belgium; Rega Institute for Medical Research, KU Leuven, Herestraat 49, 3000 Leuven, Belgium; Department of Global Health Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa
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Beauclair R, Dushoff J, Delva W. Partner age differences and associated sexual risk behaviours among adolescent girls and young women in a cash transfer programme for schooling in Malawi. BMC Public Health 2018; 18:403. [PMID: 29587710 PMCID: PMC5872581 DOI: 10.1186/s12889-018-5327-7] [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: 08/21/2017] [Accepted: 03/16/2018] [Indexed: 11/23/2022] Open
Abstract
Background Age disparities in sexual relationships have been proposed as a key risk factor for HIV transmission in Sub-Saharan Africa, but evidence remains inconclusive. The SIHR study, a cluster randomised trial of a cash transfer programme in Malawi, found that young women in the intervention groups were less likely to have had a sexual partner aged 25 or older, and less likely to test positive for HIV and HSV-2 at follow-up compared to control groups. We examined the hypotheses that girls in the intervention groups had smaller age differences than control groups and that large age differences were associated with relationship-level HIV transmission risk factors: inconsistent condom use, sex frequency, and relationship duration. Methods We conducted an analysis of schoolgirls in the Schooling, Income, and Health Risk (SIHR) study aged 13-22 at baseline (n = 2907). We investigated the effects of study arm, trial stage and participant age on age differences in sexual relationships using a linear mixed-effects model. Cumulative-link mixed-effects models were used to estimate the effect of relationship age difference on condom use and sex frequency, and a Cox proportional hazard model was used to estimate the effect of relationship age difference on relationship duration. We controlled for the girl’s age, number of partners, study group and study round. Results Girls receiving cash transfers, on average, had smaller age differences in relationships compared to controls, though the estimated difference was not statistically significant (− 0.43 years; 95% CI: -1.03, 0.17). The older the participant was, the smaller her age differences (− 0.67 per 4-year increase in age; 95% CI: -0.99, − 0.35). Among controls, after the cash transfers had ended the average age difference was 0.82 years larger than during the intervention (95% CI: 0.43, 1.21), suggesting a possible indirect effect of the study on behaviour in the community as a whole. Across treatment groups, larger age differences in relationships were associated with lower levels of condom use, more frequent sex, and longer relationship durations. Conclusions Cash-transfer programmes may prevent HIV transmission in part by encouraging young women to form age-similar relationships, which are characterised by increased condom use and reduced sex frequency. The benefits of these programmes may extend to those who are not directly receiving the cash. Electronic supplementary material The online version of this article (10.1186/s12889-018-5327-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Roxanne Beauclair
- International Centre for Reproductive Health, Ghent University, De Pintelaan 185, 9000, Ghent, Belgium. .,The South African Department of Science and Technology-National Research Foundation (DST-NRF) Centre of Excellence in Epidemiological Modelling and Analysis (SACEMA), Stellenbosch University, 19 Jonkershoek Road, Stellenbosch, 7600, South Africa.
| | - Jonathan Dushoff
- Department of Biology, McMaster University, 1280 Main St. West, Hamilton, ON, L8S 4K1, Canada
| | - Wim Delva
- International Centre for Reproductive Health, Ghent University, De Pintelaan 185, 9000, Ghent, Belgium.,The South African Department of Science and Technology-National Research Foundation (DST-NRF) Centre of Excellence in Epidemiological Modelling and Analysis (SACEMA), Stellenbosch University, 19 Jonkershoek Road, Stellenbosch, 7600, South Africa.,Center for Statistics, Hasselt University, Campus Diepenbeek, Agoralaan Building D, 3590, Diepenbeek, Belgium.,Rega Institute for Medical Research, KU Leuven, Herestraat 49, 3000, Leuven, Belgium
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Morrison-Beedy D, Grove L, Ji M, Baker E. Understanding the "Why" for High-Risk Behavior: Adolescent Girls' Motivations for Sex. J Assoc Nurses AIDS Care 2017; 28:877-887. [PMID: 28784584 DOI: 10.1016/j.jana.2017.06.012] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2017] [Accepted: 06/20/2017] [Indexed: 11/16/2022]
Abstract
Identifying why girls participate in safe and risky sexual behaviors is key to developing successful intervention strategies. This study identified motivations for sex in 738 girls enrolled in the Health Improvement Project for Teens (HIPTeens) randomized controlled trial and analyzed differences in sex motives among at-risk subgroups. Sexually active girls, ages 15-19 years, were recruited from urban community-based settings. Baseline data were collected via audio computer-assisted self-interview surveys including a modified Sex Motives Scale based on six domains (intimacy, enhancement, self-affirmation, coping, peer pressure, and partner approval), assessing drivers of both protective and risk-promoting motivations. Statistically significant motive differences across domains were identified among subgroups with different risk profiles, including mental health issues (depression, drug and alcohol use) as well as demographic group characteristics (race, age, and parental status). Understanding why girls have sex provides an opportunity to address motivation-focused strategies that may augment intervention efficacy.
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Masho SW, Chambers GJ, Wallenborn JT, Ferrance JL. Associations of Partner Age Gap at Sexual Debut with Teenage Parenthood and Lifetime Number of Partners. PERSPECTIVES ON SEXUAL AND REPRODUCTIVE HEALTH 2017; 49:77-83. [PMID: 28301095 DOI: 10.1363/psrh.12022] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/08/2016] [Revised: 12/22/2016] [Accepted: 01/13/2017] [Indexed: 06/06/2023]
Abstract
CONTEXT Age at sexual debut and age gap between partners at debut are modifiable characteristics that may be related to risky sexual behaviors. Understanding any such relationships is a necessary first step toward strengthening risk interventions. METHODS Age at sexual debut and partner age gap were examined for 3,154 female and 2,713 male respondents to the 2011-2013 National Survey of Family Growth who first had intercourse before age 18. Multivariable logistic regression was used to assess associations between these measures and teenage parenthood and reporting a high lifetime number of partners (i.e., a number above the sample median). RESULTS Females' odds of teenage parenthood were elevated if sexual debut occurred at ages 15-17 and involved a partner age gap of 3-4 years (odds ratio, 1.8) or more (2.0); they were reduced if debut occurred before age 15 and the gap was 3-4 years (0.8). Females' likelihood of reporting a high lifetime number of partners was negatively associated with age gap (0.4-0.7, depending on age at debut and length of age gap). Males' likelihood of reporting a large number of partners was positively associated with age gap if sexual debut was before age 15 and the gap was five or more years (1.7) or if debut was at ages 15-17 and involved a 3-4-year gap (2.0). CONCLUSION Identifying the mechanisms underlying these associations could inform program design and implementation.
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Affiliation(s)
- Saba W Masho
- Professor at the Department of Family Medicine, Population Health, Division of Epidemiology, School of Medicine, Virginia Commonwealth University, Richmond
| | - Gregory J Chambers
- Research assistant at the Department of Family Medicine, Population Health, Division of Epidemiology, School of Medicine, Virginia Commonwealth University, Richmond
| | - Jordyn T Wallenborn
- Research assistant at the Department of Family Medicine, Population Health, Division of Epidemiology, School of Medicine, Virginia Commonwealth University, Richmond
| | - Jacquelyn L Ferrance
- Project evaluator at the Department of Family Medicine, Population Health, Division of Epidemiology, School of Medicine, Virginia Commonwealth University, Richmond
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Morrison-Beedy D, Passmore D, Baker E. A "Triple Threat" to Research Protocols and Logistics: Adolescents, Sexual Health, and Poverty. Nurs Sci Q 2017; 29:14-20. [PMID: 26660768 DOI: 10.1177/0894318415614623] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The purpose of this article is to discuss lessons learned from conducting research with urban communities. A brief overview of the Health Improvement Project for Teens (HIPTeens) will be provided. It will be followed by several suggestions concerning recruitment and retention of participants, challenges related to working in impoverished environments, hiring and training of research teams, interacting with administration and community, and strategies for doing research in diverse settings.
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Age differences between sexual partners, behavioural and demographic correlates, and HIV infection on Likoma Island, Malawi. Sci Rep 2016; 6:36121. [PMID: 27805053 PMCID: PMC5090960 DOI: 10.1038/srep36121] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2016] [Accepted: 10/11/2016] [Indexed: 02/01/2023] Open
Abstract
Patterns of age differences between sexual partners – “age-mixing” – may partially explain the magnitude of HIV epidemics in Sub-Saharan Africa. However, evidence of age-disparity as a risk factor for HIV remains mixed. We used data from a socio-centric study of sexual behaviour in Malawi to quantify the age-mixing pattern and to find associations between relationship characteristics and age differences for 1,922 participants. Three age difference measures were explored as predictors of prevalent HIV infection. We found that for each year increase in male participant age, the average age difference with their partners increased by 0.26 years, while among women it remained approximately constant around 5 years. Women in the study had larger within-individual variation in partner ages compared to men. Spousal partnerships and never using a condom during sex were associated with larger age differences in relationships of both men and women. Men who were more than five years younger than their partners had 5.39 times higher odds (95% CI: 0.93–31.24) of being HIV-infected than men 0–4 years older. The relationship between HIV-infection and age-asymmetry may be more complex than previously described. The role that women play in HIV transmission should not be under-estimated, particularly in populations with large within-individual variation in partner ages.
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Recalled Explanations for Adolescent Girls' Engagement in Age-Discordant Sexual Relationships. AIDS Behav 2016; 20:1327-33. [PMID: 26662265 DOI: 10.1007/s10461-015-1259-8] [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] [Indexed: 10/22/2022]
Abstract
Age-discordant sexual relationships are associated with negative sexual health outcomes for adolescent females. We were particularly interested in females' motivations for engaging in these relationships, and in contextual factors that increase receptivity to age-discordant relationships in the United States (U.S.). However, recent research addressing this topic in the U.S. has been sparse. To address this gap in the literature, we recruited 15 women (Mdn age = 26 years; 93 % African American) from an urban, publicly funded sexually transmitted disease clinic to qualitative interviews. Reasons given by women for their involvement in age-discordant sexual relationships as adolescents included: (a) desire for an actively engaged father figure, (b) to obtain material support, (c) to escape from a troubled home life, and (d) to express independence and maturity. Thus, familial, economic, and developmental factors motivate socioeconomically disadvantaged adolescent females to enter into age-discordant sexual relationships. Efforts to reduce females' participation in these relationships will need to address socioeconomic vulnerability and family relationships.
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Zhao YL, Kim H, Peltzer J. Relationships Among Substance Use, Multiple Sexual Partners, and Condomless Sex. J Sch Nurs 2016; 33:154-166. [PMID: 27036551 DOI: 10.1177/1059840516635712] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Male and female students manifest different behaviors in condomless sex. This cross-sectional, exploratory, correlational study examined the differences in risk factors for condomless sex between male and female high school students, using secondary data from 4,968 sexually active males and females participating in the 2011 National Youth Risk Behavior Survey. Results in descriptive statistics and multivariate binary logistic regressions revealed that condomless sex was reported as 39.70% in general. A greater proportion of females engaged in condomless sex (23.26%) than did males (16.44%). Physical abuse by sex partners was a common reason for failure to use condoms regardless of gender. Lower condom use was found in (1) those experiencing forced sex by a partner in males, (2) female smokers, and (3) female with multiple sex partners. Thus, sexual health education should address the different risk factors and consider gender characteristics to reduce condomless sex.
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Affiliation(s)
- Yunchuan Lucy Zhao
- 1 School of Nursing, University of Kansas, Kansas City, KS, USA.,2 School of Nursing, Boise State University, Boise, ID, USA
| | - Heejung Kim
- 3 College of Nursing, Yonsei University, Seoul, South Korea.,4 Mo-Im Kim Nursing Research Institute, Seoul, South Korea
| | - Jill Peltzer
- 1 School of Nursing, University of Kansas, Kansas City, KS, USA
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Schmid A, Leonard NR, Ritchie AS, Gwadz MV. Assertive Communication in Condom Negotiation: Insights From Late Adolescent Couples' Subjective Ratings of Self and Partner. J Adolesc Health 2015; 57:94-9. [PMID: 25937470 PMCID: PMC4478194 DOI: 10.1016/j.jadohealth.2015.03.005] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2014] [Revised: 03/05/2015] [Accepted: 03/05/2015] [Indexed: 11/20/2022]
Abstract
PURPOSE Assertive communication has been associated with higher levels of condom use among youth using self-report survey methodology. The purpose of this study was to examine the subjective ratings of assertiveness among young, romantically involved couples in the context of a condom negotiation task. METHODS Using an innovative video-recall procedure, 32 couples (64 youth) engaged in a videotaped condom negotiation task and then rated self and partners' level of assertiveness. Both individual ratings of assertiveness and couple-level assertiveness were assessed using dyadic hierarchical linear modeling. RESULTS Individuals' assertiveness was positively associated with condom use. Unexpectedly, the overall level of assertiveness in couples showed a curvilinear association with condom use. Very high and very low assertiveness was associated with lower condom use, whereas moderate levels of assertiveness were associated with higher condom use. CONCLUSIONS Moderate levels of assertiveness during condom negotiation may facilitate condom use in young couples. Increasing condom use among romantic partners may require developing interventions that strengthen youths' ability to engage in assertive communication strategies that balance emotional intimacy with self-advocacy.
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Affiliation(s)
- Amy Schmid
- Department of Health and Behavior Studies, Teachers College, Columbia University, New York, New York
| | - Noelle R Leonard
- Department of Health and Behavior Studies, Teachers College, Columbia University, New York, New York; Center for Drug Use and HIV Research, College of Nursing, New York University, New York, New York.
| | - Amanda S Ritchie
- Center for Drug Use and HIV Research, College of Nursing, New York University, New York, New York
| | - Marya V Gwadz
- Center for Drug Use and HIV Research, College of Nursing, New York University, New York, New York
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Prevalence and Frequency of Heterosexual Anal Intercourse Among Young People: A Systematic Review and Meta-analysis. AIDS Behav 2015; 19:1338-60. [PMID: 25618257 DOI: 10.1007/s10461-015-0997-y] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
We aim to assess if heterosexual anal intercourse (AI) is commonly practiced and how frequently it is practiced by young people. We searched PubMed for articles published 1975 to July 2014 reporting data on the proportion of young people (mean age <25) practicing heterosexual AI (AI prevalence) and on number of AI acts (AI frequency). Stratified random-effects meta-analysis and meta-regression were used to produce summary estimates and assess the influence of participant and study characteristics on AI prevalence. Eighty-three and thirteen of the 136 included articles reported data on lifetime AI prevalence and monthly AI frequency, respectively. Estimates were heterogenous. Overall summary estimates of lifetime AI prevalence were 22 % (95 % confidence interval 20-24) among sexually active young people, with no statistically significant differences by gender, continent or age. Prevalence increased significantly with confidentiality of interview method and, among males and in Europe, by survey year. Prevalence did not significantly differ by recall period. An estimated 3-24 % of all reported sex acts were AI. Reported heterosexual AI is common but variable among young people worldwide. To fully understand its impact on STI spread, more and better quality data on frequency of unprotected AI, and trends over time are required.
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Schmid A, Leonard NR, Ritchie AS, Gwadz MV. Assertive Communication in Condom Negotiation: Insights From Late Adolescent Couples' Subjective Ratings of Self and Partner. J Adolesc Health 2015. [PMID: 25937470 DOI: 10.1016/jjadohealth.2015.03.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
Abstract
PURPOSE Assertive communication has been associated with higher levels of condom use among youth using self-report survey methodology. The purpose of this study was to examine the subjective ratings of assertiveness among young, romantically involved couples in the context of a condom negotiation task. METHODS Using an innovative video-recall procedure, 32 couples (64 youth) engaged in a videotaped condom negotiation task and then rated self and partners' level of assertiveness. Both individual ratings of assertiveness and couple-level assertiveness were assessed using dyadic hierarchical linear modeling. RESULTS Individuals' assertiveness was positively associated with condom use. Unexpectedly, the overall level of assertiveness in couples showed a curvilinear association with condom use. Very high and very low assertiveness was associated with lower condom use, whereas moderate levels of assertiveness were associated with higher condom use. CONCLUSIONS Moderate levels of assertiveness during condom negotiation may facilitate condom use in young couples. Increasing condom use among romantic partners may require developing interventions that strengthen youths' ability to engage in assertive communication strategies that balance emotional intimacy with self-advocacy.
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Affiliation(s)
- Amy Schmid
- Department of Health and Behavior Studies, Teachers College, Columbia University, New York, New York
| | - Noelle R Leonard
- Department of Health and Behavior Studies, Teachers College, Columbia University, New York, New York; Center for Drug Use and HIV Research, College of Nursing, New York University, New York, New York.
| | - Amanda S Ritchie
- Center for Drug Use and HIV Research, College of Nursing, New York University, New York, New York
| | - Marya V Gwadz
- Center for Drug Use and HIV Research, College of Nursing, New York University, New York, New York
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18
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Livingston JA, Testa M, Windle M, Bay-Cheng LY. Sexual risk at first coitus: Does alcohol make a difference? J Adolesc 2015; 43:148-58. [PMID: 26121927 DOI: 10.1016/j.adolescence.2015.05.018] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2014] [Revised: 04/02/2015] [Accepted: 05/29/2015] [Indexed: 11/24/2022]
Abstract
This study examines whether use of alcohol at first coitus is associated with increased sexual risk for young women. First coitus is the focus of the investigation because it is a memorable, formative experience that has implications for subsequent sexual health. A community sample of young women ages 18-19 years (N = 227) completed retrospective interviews. Characteristics and perceptions of the first coital event were examined using chi squares and one-way multivariate analysis of variance (MANOVA) to determine if there were differences based on alcohol-involvement. Alcohol-involved first coitus events occurred in social settings with risky partners, were rated less positively, and were non-consensual relative to those that did not involve alcohol. Alcohol use was not related to condom use. Alcohol-involvement was associated with subsequent pairing of alcohol with sex and incapacitated rape. Adolescent alcohol use occurs in contexts that increases young women's sexual risk through exposure to risky partners.
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Affiliation(s)
- Jennifer A Livingston
- Research Institute on Addictions, University at Buffalo, State University of New York, 1021 Main Street, Buffalo, NY 14203, United States.
| | - Maria Testa
- Research Institute on Addictions, University at Buffalo, State University of New York, 1021 Main Street, Buffalo, NY 14203, United States
| | - Michael Windle
- Rollins School of Public Health, Department of Behavioral Sciences and Health Education, Emory University, 1518 Clifton Road NE, Atlanta, GA 30322, United States
| | - Laina Y Bay-Cheng
- School of Social Work, University at Buffalo, 685 Baldy Hall, Buffalo, NY 14260, United States
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19
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Goldsamt LA, Clatts MC, Le G, Yu G. Injection and sexual risk practices among young heroin users in Hanoi, Vietnam. DRUGS (ABINGDON, ENGLAND) 2015; 22:166-172. [PMID: 25995608 PMCID: PMC4435536 DOI: 10.3109/09687637.2014.979765] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Epidemiological data in Vietnam shows high HIV prevalence rates among injection drug users, especially in urban centres. However, there are limited data on specific practices used to prepare and inject drugs or on sexual practices among Vietnamese injectors. A street-based cross-sectional interview was conducted with 862 heroin injectors in Hanoi, Vietnam, to collect such data. Variability was seen in both injection and sexual risk, with 12.9% of current injectors reporting at least one unsafe method of drug sharing and 57.1% reporting unsafe sex in the past 30 days. These risks were strongly associated with those who engaged in unsafe injection significantly more likely to engage in unsafe sex (69.4% vs. 55.3%) and those engaging in unsafe sex significantly more likely to engage in unsafe injection (15.7% vs. 9.2%). These findings highlight the overlap of injection and sexual risk practices among Vietnamese heroin users and suggest the need for strong, broadly targeted HIV prevention activities among this population.
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Affiliation(s)
| | - Michael C. Clatts
- School of Public Health, University of Puerto Rico, San Juan, Puerto Rico
| | - Giang Le
- Center for Research and Training on HIV/AIDS, Hanoi Medical University, Hanoi, Vietnam
| | - Gary Yu
- College of Nursing, New York University, New York, NY, USA
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