Predicting Condom Use Among Sexually Experienced Latino Adolescents

Subjective culture and HIV preventive behaviour among young Latin Americans: a systematic review

Given high levels of new HIV infection globally, calls have been made for greater attention to the cultural variables that hinder prevention and testing. However, no reviews exist to systematise the findings. This study aimed to identify the cultural variables associated with three HIV preventive behaviours (condom use, HIV testing behaviour, and injection drug use with non-shared or sterilised syringes) among young Latin Americans. A systematic review was conducted guided by PRISMA-P criteria, on five databases (Web of Science, Scopus, PubMed, Medline and Scielo), which identified 2474 articles. Scientific articles and empirical studies that addressed cultural variables and HIV preventive behaviours among young people aged 15-24 years of age using Latin American samples were selected, with 37 articles being included in the final review. Six key cultural variables: the importance of female virginity; the role of trust in the couple's relationship; the disorienting effects of romantic love; the role of subjective norms; the importance of decision-making norms; and impulse control beliefs. Gender norms provide a framework for understanding sexual decision-making among young Latin Americans. Although young people have begun to adopt more egalitarian views of gender norms, deep-rooted beliefs about gender, sexuality and relationships continue to impact on HIV prevention behaviour.

A Review of Recent HIV Prevention Interventions and Future Considerations for Nursing Science

ABSTRACT

As our knowledge of HIV evolved over the decades, so have the approaches taken to prevent its transmission. Public health scholars and practitioners have engaged in four key strategies for HIV prevention: behavioral-, technological-, biomedical-, and structural/community-level interventions. We reviewed recent literature in these areas to provide an overview of current advances in HIV prevention science in the United States. Building on classical approaches, current HIV prevention models leverage intimate partners, families, social media, emerging technologies, medication therapy, and policy modifications to effect change. Although much progress has been made, additional work is needed to achieve the national goal of ending the HIV epidemic by 2030. Nurses are in a prime position to advance HIV prevention science in partnership with transdisciplinary experts from other fields (e.g., psychology, informatics, and social work). Future considerations for nursing science include leveraging transdisciplinary collaborations and consider social and structural challenges for individual-level interventions.

Core Processes: How to Use Evidence, Theories, and Research in Planning Behavior Change Interventions

Psychology is not only a basic behavioral science but also an applied discipline that is used to solve societal problems. In a problem-driven context, the search for existing literature, the correct application of appropriate theories, and the collection of additional research data are basic tools essential for the systematic development of any theory- and evidence-based behavior change intervention. The processes of brainstorming, literature review, theory selection and application, and data collection are “Core Processes” that can be used in different phases/steps of intervention planning—from needs assessment to intervention design to program implementation and evaluation—and within different planning frameworks. In this paper, we illustrate how the use of these “Core Processes” provides expert, empirical and theoretical guidance to planners from problem definition to problem solution. Specific emphasis is put on finding theories that are potentially useful in providing answers to planning questions using a combination of approaches to access and select theories (i.e., the topic, concept, and general theories approaches). Furthermore, emphasis is put on the logic of answering planning questions in a specific order by first brainstorming before consulting the literature, then applying theories, and finally collecting additional data.

'Love and trust, you can be blinded': HIV risk within relationships among Latina women in Miami, Florida

OBJECTIVES

Latina women are disproportionately affected by HIV in the US, and account for 30% of all HIV infections in Miami-Dade County, Florida. The main risk for Latina women is heterosexual contact. Little is known about the relational and cultural factors that may impact women's HIV risk perception. This study aims to describe Latina women's perception of their HIV risk within a relational, cultural, and linguistic context.

DESIGN

Eight focus groups of Latina women (n = 28), four English speaking groups and four Spanish speaking groups, were conducted between December 2013 and May 2014. Women were recruited from a diversion program for criminal justice clients and by word of mouth. Eligibility criteria included the following: self-identify as Hispanic/Latino, 18-49 years of age, and self-identify as heterosexual. A two-level open coding analytic approach was conducted to identify themes across groups.

RESULTS

Most participants were foreign-born (61%) and represented the following countries: Cuba (47%), Honduras (17.5%), Mexico (12%), as well as Nicaragua, Puerto Rico, Colombia, and Venezuela (15%). Participant ages ranged between 18 and 49, with a mean age of 32 years. Relationship factors were important in perceiving HIV risk including male infidelity, women's trust in their male partners, relationship type, and getting caught up in the heat of the moment. For women in the English speaking groups, drug use and trading sex for drugs were also reasons cited for putting them at risk for HIV. English speaking women also reported that women should take more responsibility regarding condom use.

CONCLUSION

Findings emphasize the importance of taking relational and cultural context into account when developing HIV prevention programs for Latina women. Interventions targeting English speaking Latina women should focus on women being more proactive in their sexual health; interventions focused on Spanish speaking women might target their prevention messages to either men or couples.

Condoms, Culture, and Conviction: The Effect of Acculturation and Religiosity on Latina Condom Use during First Sex with New Partners

Latinas in the United States are less likely than their non-Hispanic peers to use condoms. Previous research has identified acculturation and religiosity as two key determinants of Latina condom use, but results are inconsistent, impairing the translation of findings to practice. The current study examines these constructs together and addresses methodological concerns noted in the literature. Structural equation modeling performed on a nationally representative sample of Latinas indicated that intrinsic religiosity increased condom use whereas acculturation decreased condom use. Extrinsic religiosity indirectly increased condom use via intrinsic religiosity. Implications for practice and policy are discussed.

Source of Sex Information and Condom Use Intention Among Latino Adolescents

Adolescence is a common time for sexual initiation and information seeking about sexual health, yet little is known about how adolescents’ sources of information about sex influence their sexual beliefs and behaviors. This is particularly true for Latino adolescents, whose sources of sex information and sexual behaviors are vastly understudied. A survey of ninth-grade Latino adolescents ( N = 1,186) was employed to examine the relationship between adolescents’ primary source of sex information and their intention to use condoms. The study also examined the potential influences of demographics (age, gender), sociodemographics (socioeconomic status, parent education, and linguistic acculturation), and sexual experience on condom use intention. Among Latino youth, the most commonly reported source of sex information was parents (37.8%), followed by another relative (17.1%), school (13.4%), and friends (11.4%). Hierarchical regression analyses showed that after controlling for other factors, primary source of sex information was significantly associated with condom use intention ( p = .042). Hierarchical regression results stratified by gender showed that this relationship remained significant for males ( p = .004) but not for females ( p = .242). Males who reported friends (odds ratio [ OR] = 0.44, p = .003) or the media/Internet ( OR = 0.44, p = .008) as their primary sources of sex information, as compared to parents as their primary source, reported significantly lower intention to use condoms. These findings suggest it may be important for Latino adolescents, particularly males, to have additional or other sources for sex information in order to promote healthy sexual behaviors. Alternatively, interventions targeting parents or other family members to improve sexual health communication with adolescent boys may prove essential.

Sexual Behaviors in Mexico: The Role of Values and Gender Across Adolescence

Adolescent sexuality research has expanded to include noncoital behaviors, but there is limited knowledge about individual factors such as cultural values associated with these sexual behaviors outside of industrialized nations. Thus, we examined associations between Latino values (familism, sexual guilt, and importance of female virginity) and three sexual behaviors (making out, oral sex, and vaginal sex), among adolescents ages 12-19 (53% female) in Mexico. Findings indicate that sexual guilt and importance of female virginity were consistently associated with all sexual behaviors. Some associations differed by gender and school level. For instance, sexual guilt was a better predictor of high school girls' oral and vaginal sex. This study expands our understanding of adolescent sexuality in Mexico.

Correlates and predictors of sexual health among adolescent Latinas in the United States: A systematic review of the literature, 2004-2015

Adolescent Latinas in the United States (US) are disproportionately affected by early pregnancy, sexually transmitted infections (STIs) and human immunodeficiency virus (HIV) in comparison to their non-Hispanic white counterparts. However, only a few studies have sought to understand the multi-level factors associated with sexual health in adolescent Latinas. Adhering to the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines, we conducted a systematic literature review to better understand the correlates and predictors of sexual health among adolescent Latinas in the US, identify gaps in the research, and suggest future directions for empirical studies and intervention efforts. Eleven studies were identified: five examined onset of sexual intercourse, nine examined determinants of sexual health/risk behaviors (e.g., number of sexual partners and condom use), and three examined determinants of a biological sexual health outcome (i.e., STIs or pregnancy). Two types of variables/factors emerged as important influences on sexual health outcomes: proximal context-level variables (i.e., variables pertaining to the individual's family, sexual/romantic partner or peer group) and individual-level variables (i.e., characteristics of the individual). A majority of the studies reviewed (n=9) examined some aspect of acculturation or Latino/a cultural values in relation to sexual health. Results varied widely between studies suggesting that the relationship between individual and proximal contextual variables (including acculturation) and sexual health may be more complex than previously conceived. This review integrates the findings on correlates and predictors of sexual health among adolescent Latinas, and supports the need for strengths-based theoretically guided research on the mechanisms driving these associations.

Using the Program Logic Model to Evaluate ¡Cuídate!: A Sexual Health Program for Latino Adolescents in a School-Based Health Center

BACKGROUND

Addressing the disparities in pregnancy and sexually transmitted infection (STI) rates for Latino youth in the United States requires an evidence-based approach. Although randomized controlled trials for sexual risk reduction interventions have shown promise in improving short-term outcomes, program sustainability has not been extensively examined in school settings where teens spend time. Latina teen pregnancy rates are nearly twice the national average. Adolescents comprise only 17% of the U.S. population, yet they account for 50% of STIs. ¡Cuídate! is a high-impact sexual health group program endorsed by the Centers for Disease Control and Prevention that has not been replicated in a real-world setting.

AIMS

The program logic model (PLM) was used as the systematic approach to plan, implement, and evaluate a sustainable model of sexual health group programing (¡Cuídate!) in a U.S. high school with a large Latino student population.

METHODS

The PLM provided the framework for the evaluation of outputs, outcome, and impact. A multivariate repeated measures analysis of variance was used as the means to evaluate the participant outcomes immediately postprogram and at 8-12 weeks.

RESULTS

¡Cuídate! was executed within an existing school structure and time constraints, below cost projections, and with high participant retention (95.8%). Three cohorts (N = 24) of female teens demonstrated significant increases in STI or HIV knowledge, self-efficacy, and intention to use condoms (p < .01). Condom use increased postprogram. No participants initiated sexual behavior, nor were there any reported pregnancies or STIs.

CONCLUSIONS

An evidence-based intervention previously tested in randomized controlled trials can be sustained in a school-based health center with similar results of efficacy.

LINKING EVIDENCE TO ACTION

Our success served as a platform for a sustainable program. We continue to extend the impact of the program by delivering ¡Cuídate! in the school setting using a community health worker.

Cultural measures associated with sexual risk behaviors among Latino youth in Southern California: a longitudinal study

CONTEXT

Cultural variables have been associated with sexual risk behaviors among Latino youth, but findings across studies are inconsistent.

METHODS

A longitudinal study of acculturation patterns followed Latino youth in Southern California from 2005 to 2012. Data from 995 participants were used in logistic and ordered regression analyses to test whether cultural variables measured in high school were associated with sexual risk behaviors in emerging adulthood, and whether gender moderated these associations.

RESULTS

The cultural value of respect for parents was negatively associated with participants' odds of reporting an earlier age at sexual debut (odds ratio, 0.8) and condom nonuse at most recent sexual intercourse (0.8). A measure of acculturation reflecting U.S. cultural practices was positively associated with the likelihood of being sexually experienced (1.2), having concurrent sexual partners (1.5) and, among males only, having a greater number of sexual partners (1.3). Second- and later-generation immigrant youth had lower odds of not using a condom at most recent sexual intercourse than first-generation youth (0.6 and 0.5, respectively). Strength of endorsement of Latino cultural practices was negatively associated with females' lifetime number of partners (0.8), but positively associated with males' (1.4).

CONCLUSIONS

The cultural measures associated with Latino youths' sexual behaviors differed across outcomes and by gender. Further understanding of these associations and their underlying mechanisms may help inform the development of culturally sensitive sexual health interventions.

The influence of religion on sexual HIV risk

This systematic review examines the relationship between religion and sexual HIV risk behavior. It focuses primarily on how studies have conceptualized and defined religion, methodologies, and sexual risk outcomes. We also describe regions where studies were conducted and mechanisms by which religion may be associated with sexual risk. We included 137 studies in this review, classifying them as measuring: (1) only religious affiliation (n = 57), (2) only religiosity (n = 48), and (3) both religious affiliation and religiosity (n = 32). A number of studies identified lower levels of sexual HIV risk among Muslims, although many of these examined HIV prevalence rather than specific behavioral risk outcomes. Most studies identified increased religiosity to be associated with lower levels of sexual HIV risk. This finding persists but is weaker when the outcome considered is condom use. The paper reviews ways in which religion may contribute to increase and reduction in sexual HIV risk, gaps in research, and implications for future research on religion and HIV.

Religiosity and the Transition to Nonmarital Parity

Nonmarital parity is associated with several negative outcomes, including health problems, educational problems, and poverty. Understanding the risk and protective factors associated with nonmarital parenthood can inform policy and interventions, reducing both the incidences and associated consequences. The current study focuses on how intrinsic and extrinsic religiosity (the degree to which individuals or groups employ religious ideology in forming values and making decisions) are related to the timing of nonmarital parity using discrete time hazard modeling of a nationally representative sample of adolescent females (N=7,367) from the National Longitudinal Study of Adolescent Health. The majority of the sample (86 %) claimed a religious affiliation and almost a third (32 %) had a nonmarital birth during the study. Even though the majority of the sample is White (67 %), Black and Hispanic females were more likely to experience a nonmarital birth. Results indicate that intrinsic and extrinsic religiosity and religious affiliation assert protective effects for some populations while religious affiliation increases risk in the full model. Recommendations for policy, intervention, and future research are offered.

Risky sexual behavior among young adult Latinas: are acculturation and religiosity protective?

A sexual health disparity exists among U.S. Latinas, who have rates of sexually transmitted infections (STIs) that are more than double their peers. Previous research has identified acculturation and religiosity as key social determinants of sexual health, but such findings have been inconsistent, with some researchers identifying protective benefits and other researchers noting increased risk. The purpose of this study was to explain how intrinsic and extrinsic religiosity as well as acculturation predict risky sexual behavior using Structural Equation Modeling of a nationally representative sample of self-identified Latinas (N=1,168) from the National Longitudinal Survey of Adolescent Health. Results indicated that intrinsic religiosity and acculturation assert protective effects while extrinsic religiosity increases risk. Recommendations for policy, intervention, and future research are offered.

Acculturation and HIV-related sexual behaviours among international migrants: a systematic review and meta-analysis

This review examines the global literature regarding the relationship between acculturation and HIV-related sexual behaviours among international migrants. Seventy-nine articles published in English-language journals prior to July 2012 met the criteria for inclusion. We conducted a systematic review and subset meta-analysis of correlations between acculturation and five types of sexual behaviours including condom use, multiple partnerships, early sexual initiation, sexually transmitted diseases (STDs) and other unsafe sexual practices. Immigrants high in mainstream acculturation were more likely to have multiple partnerships, early sexual initiation, STDs and unsafe sex (rs ranged from 0.10 to 0.16), but acculturation was not associated with condom use (r = 0.02). Gender moderated the relationships between acculturation and multiple partnerships, STDs and unsafe sex. The relationship between acculturation and unsafe sex also varied across ethnicity. These findings suggest that acculturation may serve as a risk factor towards immigrants' HIV-related sexual health. We offered a theoretical framework and suggested applying cross-cultural and longitudinal designs in future research on acculturation and health behaviours.

Psychosocial Correlates of Condom Use and their Relationship with Worry about STI and HIV in Native and Immigrant Adolescents in Spain

The goal of this study was to analyze how worry about sexually-transmitted infections (STI) and HIV influences attitudes and self-efficacy towards condom use, HIV-related knowledge, HIV-perceived susceptibility and HIV-misconceptions in a multicultural sample in Spain. The sample was composed of 3,051 adolescents aged between 14 and 19 years old who lived in Spain. Of these, 67.7% were native Spaniards and the remaining 32.3% were Latin American immigrants. Results showed that worry about STI and HIV has a direct influence on condom use self-efficacy and HIV-knowledge and HIV-perceived susceptibility. Native Spanish adolescents showed higher positive attitudes towards condom use, greater HIV-knowledge and HIV-perceived susceptibility, and lower negative attitudes towards condoms use and HIV-misconceptions than Latin American adolescents. In the discussion, the importance of worry about STI and HIV is highlighted as a mediator variable that can predict risky sexual behavior and is related to cultural origin.

Condom use among sexually active rural high school adolescents personal, environmental, and behavioral predictors

Adolescents who engage in unprotected intercourse are at risk of pregnancy and sexually transmitted infection (STI). Although adolescents in rural areas participate in levels of sexual risk taking similar to that of nonrural youth, few data are available identifying factors that influence condom use among rural adolescents. The purpose of this study is to determine the predictive value of selected personal, environmental, and behavioral factors for condom use among rural adolescents in grades 9-12. A cross-sectional survey was conducted among sexually active youth (N = 613), ages 14-19, in three rural school districts in the Northeast. Using logistic regression, identified predictors for condom use include personal standards (odds ratio [OR] = 2.45; confidence interval [CI]: [2.39, 6.47]), condom use goals (OR = 1.32; CI [1.21, 1.45]), condom use at first intercourse (OR = 3.93; CI [2.39, 6.47]) and male gender. School nurses are encouraged to incorporate identified predictors of condom use when considering interventions promoting safer sexual behaviors among rural youth.

The relationship between spirituality and religiosity on psychological outcomes in adolescents and emerging adults: a meta-analytic review

The present study used meta-analytic techniques to examine the association between spirituality and religiosity (S/R) and psychological outcomes in adolescents and emerging adults. The outcome measures of risk behavior, depression, well-being, self-esteem, and personality were examined with respect to the influence of S/R across 75 independent studies encompassing 66,273 adolescents and emerging adults extracted from electronic databases between 1990 and 2010. Results showed significant main effect sizes of S/R with several outcomes: risk behavior, -.17; depression, -.11; well-being, .16; self-esteem, .11; and the personality measures of Conscientiousness, .19; Agreeableness, .18; Openness, .14. Moderating effects were found for age, race, and type of S/R measure. Results show that S/R has a positive effect on psychological outcomes in adolescents and emerging adults. Possible explanations and implications of these results are discussed.

Cultural tailoring and feasibility assessment of a sexual health middle school curriculum: a pilot test in Puerto Rico

BACKGROUND

To assess the need for cultural tailoring of an effective sexual health middle school curriculum, "It's Your Game: Keep It Real" (IYG), prior to implementation in Puerto Rican (PR) middle schools.

METHODS

Seventy-three seventh-grade bilingual students participated in IYG curriculum activities (both group-based and computer-based) in two 2-hour testing sessions in spring 2008. Rating scales of acceptability, understandability, credibility, ease of use, and motivational appeal and qualitative feedback via open-ended responses and group process provided insight into needed surface and deep structure cultural tailoring.

RESULTS

Students rated IYG highly on cultural tailoring and motivational parameters and were highly engaged by the lesson content. School personnel rated IYG as a feasible strategy for use in PR middle schools. While surface cultural elements (eg, characters, attire, body language) were identified as important foci for adaptation, content related to deeper cultural elements such as core behaviors, risky situations, attitudes, and specific skills were considered as relevant to PR youth as to their US counterparts.

CONCLUSION

Effective human immunodeficiency virus, sexually transmitted disease, and pregnancy skills training prevention programs such as IYG that are developed for minority US youth may offer a feasible option for international implementation when extensive cultural adaptation is not a viable option.

The impact of familism on physical and mental health among Hispanics in the United States

The rapidly expanding number of Hispanics living in USA has increased the need for their inclusion in research on physical and mental health. Current studies that have explored health outcomes among Hispanics have often noted an 'epidemiological paradox', in which there is a discrepancy between their minority status and positive health outcomes when compared with other racial/ethnic groups. Certain socio-cultural variables, in particular the value placed on family, have been largely implicated in these findings. This review will provide a summary of the literature exploring familism within the structure of the Hispanic family and its potential impact on health. We will focus on research exploring the plausible impact that family and familism values may have on the physical health (particularly within the HIV, diabetes, and breast cancer literature) and also on health behaviours of Hispanics, as well as its effect on mental health (particularly related to acculturative stress and caregiver stress). Throughout the review, we highlight some of the potential mechanisms by which familism may impact on the health status of Hispanics. We conclude the review by noting some of the clinical and ethical implications of this research, and by offering suggestions for future work in this area.

Risk behaviors among adolescent girls in an HIV prevention trial

Adolescent girls remain vulnerable to HIV and other sexually transmitted infections. Understanding their sexual and substance use behaviors is essential to designing effective interventions to reduce their risk. In this study, baseline data were analyzed from 738 adolescent girls ages 15 to 19 years in Rochester, New York. Data on sexual behavior and substance use (lifetime, past 3 months, and most recent sexual experience) were collected. Nearly one half of recent vaginal (42%) and anal (45%) sex acts were not condom protected; 39% had a prior sexually transmitted infection (STI) and 12% were currently infected with an STI. Approximately one third (31%) of girls had more than one sex partner in the past 3 months. Girls with multiple partners reported that their recent sexual experiences were more likely to involve drug and alcohol use by themselves and partners. Adolescent girls, particularly those with multiple sexual partners, continue to report high-risk sexual behaviors and need focused risk-reduction interventions.

Sexual values and risky sexual behaviors among Latino youths

CONTEXT

Understanding Latino youths' sexual values is key to informing HIV prevention efforts. Few studies have examined associations between culturally based sexual values and behaviors among Latinos.

METHODS

A sample of 839 sexually active Latinos aged 16-22 residing in San Francisco were interviewed in 2003-2006. Multiple regression and multinomial logistic regression analyses were conducted to examine associations between sexual values and behaviors, while adjusting for language use (a proxy for acculturation) and other covariates.

RESULTS

The importance attached to female virginity was negatively associated with the number of sexual partners women had had in their lifetime (odds ratio, 0.8) and in the past year (0.9), and was positively associated with women's nonuse of condoms, rather than consistent use, during the first month of their current relationships (1.8). For men, the importance of satisfying sexual needs increased with the numbers of lifetime and recent sexual partners (1.4 and 1.1, respectively), and with inconsistent condom use in the first month of their relationships (1.9). Comfort with sexual communication was positively associated with inconsistent use or nonuse of condoms in the last month of both men's and women's current relationships (2.0-2.2). For women, considering satisfaction of sexual needs important was associated with more sexual partners only among those who attached little value to female virginity.

CONCLUSIONS

It is important to integrate themes of virginity and sexual desire into intervention curricula so youth can better understand how these sexual norms influence their developing sexual identities and behaviors.

Acculturation and sexual risk behaviors among Latina adolescents transitioning to young adulthood

Latinas in the United States are at a disproportionate risk for STDs and sexual risk behaviors. Among Latinas, acculturation has been found to be one of the most important predictors of these behaviors. Therefore, this study examined the longitudinal association between Latina adolescents' level of acculturation and multiple sexual risk outcomes, including self-report STD diagnosis, four or more life-time sex partners, regret of sexual initiation after alcohol use, and lack of condom use during young adulthood. Based on the National Longitudinal Study of Adolescent Health (Add Health), this study includes a nationally representative sample of 1,073 Latina adolescents (ages 11-20 at Wave 1) transitioning into young adulthood (ages 18-27 at Wave 3). Our findings indicate that more acculturated Latinas who spoke English at home were more likely to have STDs and to exhibit sexual risk behaviors than Latinas who were foreign-born and did not use English at home. Interventions that aim to promote sexual and reproductive health among young Latinas should take into consideration their different levels of acculturation. This approach holds greater potential for reducing health disparities among Latinas.

Trajectories of HIV risk behavior from age 15 to 25 in the national longitudinal survey of youth sample

This study utilized data from the National Longitudinal Survey of Youth to investigate youth risk trajectories for HIV and factors associated with different trajectories. The sample (N = 8,208) was 49.2% female, with a mean age of 14.31 (SD = 1.48). A group-based trajectory model was applied, which identified four distinct trajectories for both males and females: (1) consistently higher sexual risk levels, increasing to early adulthood followed by some decrease ("high"); (2) a short period of increase to late teens, followed by a longer period of decrease ("decreased"); (3) an initially slow increase, with the increase accelerating by late teens, and a slight decline beginning in early adulthood ("increased"); and (4) consistently lowest levels of sexual risk ("low"). More African Americans were found among the decreased trajectory group; among the low risk group a higher number of youth came from families with parents who spoke a language other than English. The high-risk group had a higher percentage of subjects in non-metropolitan areas and highest alcohol use. Among males, being employed and being in the military were associated with inclusion in the high-risk group. Results have implications for specializing prevention strategies for youth with different patterns of sexual risk.

Familial and cultural influences on sexual risk behaviors among Mexican, Puerto Rican, and Dominican youth

The present study examined the relationship among acculturation, familismo, and HIV-related adolescent sexual risk behavior. Data were collected from Latino mother-adolescent dyads to permit parent and adolescent analyses of familismo for predicting oral, vaginal, and anal sexual behaviors. A random sample of 702 Latino eighth-grade students and their mothers was recruited from New York City. The sample included Mexicans (n = 203), Puerto Ricans (n = 239), and Dominicans (n = 260). Acculturation was unrelated to sexual behavior, but adolescent familismo was related to girls' but not boys' sexual behavior. The most important facet of familismo was subjugation to the family, which was negatively associated with girls' sexual behavior. The implications for HIV prevention programs for Latino youth are discussed.

Mexican adolescents' alcohol use, family intimacy, and parent-adolescent communication

Despite widespread adolescent alcohol use, research on individual and contextual factors among Mexican adolescents is limited. This study describes the relationship between adolescent risk/protective factors, parent-adolescent communication, and their effects on alcohol use of 14- to 17-year-old adolescents living in Mexico (N = 829; 458 girls, 371 boys). In this study, adolescents reported that 55% ever used alcohol, 24% used alcohol in the past 30 days, and 10% reported binge drinking. Adolescents with high family intimacy were less likely to report ever using alcohol and binge drinking. Regression analysis revealed that parent-adolescent communication mediated the effect of family intimacy on overall and binge drinking. Alcohol use prevention with Mexican adolescents should focus on family intimacy and parent-adolescent communication.

Cultural factors and family-based HIV prevention intervention for Latino youth

Latino youth are the fastest growing ethnic group in the United States and are at considerable risk for HIV and other sexually transmitted infections (STIs), given that they have an earlier onset of sexual activity and use condoms less consistently than European American adolescents. Theorists and scholars have emphasized the importance of taking culture into account in sexuality interventions with Latino adolescents, yet few culturally tailored interventions have been developed for this population. Given the emphasis on familismo and collectivism among Latinos, family-based programs are likely to be well received and could contribute to long-term maintenance of adolescent safety. In this synthesis of the relevant literature, cultural factors that have been identified as relevant to Latino sexuality are reviewed and implications for family-based intervention with Latinos are addressed.

Immigration measures and reproductive health among Hispanic youth: findings from the national longitudinal survey of youth, 1997-2003

PURPOSE

To explore relationships between immigration measures and risk of reproductive and sexual events among U.S. Hispanic adolescents.

METHODS

We examined generation status, language in the home and country of origin in relation to sexual activity, contraception, and childbearing among 1614 Hispanic adolescents, using nationally representative 1997-2003 longitudinal data. Multivariable analyses controlled for potentially confounding variables. Tests for effect modification by gender and Mexican origin were conducted.

RESULTS

Fewer first generation adolescents transitioned to sexual intercourse before age 18 (odds ratio [OR]=.80, 95% confidence interval [CI]=.66-.98) and fewer first and second generation sexually active teens used contraceptives consistently at age 17 (OR=.32, 95% CI=.17-.60 and OR=.50, 95% CI=.31-.80, respectively) than third-generation teens. Language was similarly associated with the transition to sexual intercourse and contraceptive practices. Versus teens of Mexican origin, teens of Puerto Rican origin and origins other than Cuba and Central/South America had greater odds of becoming sexually active; youth of all origins except Central/South America had fewer multiple live births (OR=.14-.31). Gender modified the effects of generation on consistent use of contraceptives and condoms at age 17. Gender also modified the effect of country of origin on transitioning to sexual intercourse before age 18 years.

CONCLUSIONS

Results expand on previous observations that generation, language, and country of origin are predictors of reproductive and sexual risks for Hispanic adolescents. These immigration measures may therefore be useful in targeting community and clinical preventive services.