Post-Loss Adjustment and Funeral Perceptions of Parentally Bereaved Adolescents and Adults

To explore the differential impact that a parent's death would have on persons who vary in age, 84 parentally bereaved adolescents and 79 parentally bereaved adults completed the Texas Revised Inventory of Grief and the Hopkins Symptom Checklist, in addition to answering questions regarding their perceptions of the parent's funeral. Results suggested more intense grief reactions and more negative interpersonal perceptions among bereaved adolescents. Moreover, this younger group reported less positive perceptions of their parents' funerals. These findings point to greater sensitivity of adolescents to the death of a parent, and underscore the importance of investigating the availability, timeliness, and efficacy of social support and interventions designed to lessen loneliness and isolation from others when a parent dies during this life phase.

Adjustment to Loss among Adolescents

The purpose of the present investigation was to explore the adjustment of adolescents who had experienced the death of a parent relative to those who had experienced parental divorce. A 3 (type of loss: parental death, parental divorce, and control) × 3 (age: early, middle, late) × 2 (gender) Multivariate analysis of covariance with socioeconomic status and social desirability as covariates was performed on the subscales of the Hopkins Symptom Checklist (HSCL). Main effects for type of loss indicated that the parental death and divorce groups, although not differing from each other, scored significantly higher than the control group on the HSCL subscales of Somatization, Obsessive-Compulsive, and Depression. In contrast, only the parental death group scored significantly higher on the HSCL Interpersonal Sensitivity subscale which measures uneasiness and negative expectations regarding personal communications as well as interpersonal inadequacy and inferiority. These results indicate that parental death and divorce losses impair the intrapersonal adjustment of adolescents. In addition, findings suggest that parental death is unique in that it disturbs perceptions of interpersonal relationships, a fact which may result in isolation and rob adolescents of needed support at a time when relationships with others (e.g., peers, parents, teachers) are critical to adjustment, well-being, and identity development.

A qualitative analysis of emerging adult black men's sexual decision-making behavior and substance use

Emerging adult Black men and substance users may have an increased risk for compromised sexual health. This study qualitatively investigated how substance use affects the sexual decision-making of emerging adult Black men. Nineteen Black men in college (18-24 years) completed a semi-structured interview about their sexual attitudes, behaviors, and perceptions and their substance use. Results show that substance use may not independently affect sexual risk behavior among emerging adult Black men. Findings highlight the importance of using approaches that incorporate structural and sociocultural factors when framing research and interventions related to substance use, sexual decision making, and Black men.

An evaluation of immediate outcomes and fidelity of a drug abuse prevention program in continuation high schools: project towards no drug abuse (TND)

The present study provides an implementation fidelity, process, and immediate outcomes evaluation of Project Towards No Drug Abuse (TND), a drug prevention program targeting continuation high school youth (n=1426) at risk for drug abuse. A total of 24 schools participated in three randomized conditions: TND Only, TND and motivational interviewing follow-up, and no treatment control. Fidelity was high: across program schools the curriculum was implemented as intended and was received favorably by students. Relative to controls, intervention conditions produced effects on hypothesized mediators, including greater gains in program related knowledge, greater reductions in drug use intentions, and positive changes in motivation. However, few generalizations to attitudes and intentions regarding risky sexual behavior were found. The pattern of results suggests that the experimental manipulations worked as intended.

Communication About Sexually-Related Topics Among Hispanic Substance-Abusing Adolescents and Their Parents

Hispanic adolescents have been shown to have high prevalence of sexually transmitted infections and HIV, and substance abuse has been linked to risky sexual behaviors. The literature indicates that good parent-adolescent communication about sexual risk and safe sexual behaviors may help protect youth, yet little is known about this type of communication in Hispanic families. This article reports data on adolescent and parent factors associated with communication about moral and birth control talk between 108 Hispanic substance abusing adolescents and their parents. Results indicate that Hispanic parents who had older adolescents, reported more involvement, were less concerned of possible negative reactions from their child, and felt more knowledgeable and confident regarding sex and birth control also reported greater frequency of birth control talk. Hispanic parents with a daughter, who reported more involvement, or whose child reported more communication were more likely to report greater frequency of talking about moral issues.

A qualitative study of the relationship between alcohol consumption and risky sex in adolescents

This study examined how alcohol consumption over a single session can affect the likelihood of risky sex in adolescents. Risky sexual behavior, as defined in this study, included sexual intercourse without the use of contraception or aNY sexual behavior that was subsequently regretted. In-depth interviews were conducted with 64 adolescents (aged 14-17 years). Data were analyzed following the principles of Interpretative Phenomenological Analysis. The impact of alcohol consumption upon risky sexual behavior was found to operate through a "continuum of influence." The 5 effects or explanations within this continuum, possibly determined through the level of inebriation, are summarized as follows: (1) alcohol affecting young people's assessment of a person's sexual attractiveness; (2) alcohol used as an "excuse" for socially unacceptable behavior; (3) increased confidence and lowering of inhibitions; (4) impaired judgment in accurately recognizing and controlling a potentially risky situation; and (5) complete loss of control, memory loss, and "black-out." These explanations were ordered with increasing significance. That is, impaired judgment (Explanation 4) and complete loss of control (Explanation 5) arguably represented the most significant effects of drinking alcohol upon risky sexual behavior. For those participants who reported both risky and non-risky sexual behavior, risky events were more likely to occur when alcohol consumption had increased and when the impaired judgment and complete loss of control explanations were applicable. The implications of understanding this complex relationship are outlined, and they will be of interest to academics, practitioners, and policy-makers in the alcohol and sex fields.

Early alcohol initiation and subsequent sexual and alcohol risk behaviors among urban youths

OBJECTIVES

We examined relations between early alcohol use and subsequent alcohol and sexual risk behaviors among urban adolescents.

METHODS

A total of 1034 African American and Hispanic youths completed surveys assessing alcohol and sexual behaviors at 7th and 10th grade. After we controlled for early sexual initiation, we examined relations between early drinking and subsequent alcohol and sexual behaviors.

RESULTS

Early drinking was associated with alcohol and sexual risks through mid-adolescence. Early drinkers were more likely to report subsequent alcohol problems, unprotected sexual intercourse, multiple partners, being drunk or high during sexual intercourse, and pregnancy. Among females, early drinking was also related to sexual initiation and recent sexual intercourse.

CONCLUSIONS

Prevention programs should address combined risks of early alcohol use and sexual intercourse, especially where levels of HIV and other sexually transmitted infections are elevated.

Communities, opportunities, and adolescents' sexual behavior in KwaZulu-Natal, South Africa

In 2002, the prevalence of HIV among South African clinic attendees under the age of 20 was 15 percent, suggesting a correspondingly high level of unprotected sex and risky sexual behavior. Past research focused on the dynamics of individuals' and partners' sexual decisionmaking without accounting for the larger context in which such decisions are made. Do adolescents' opportunities for schooling, work, and other community activities make a difference? This study uses data collected from a representative sample of young people living in KwaZulu-Natal, South Africa, to explore these questions. Logit analyses show that for girls, higher levels of education reduced the probability of having had sex in the 12 months prior to the survey, and average wages were positively associated with condom use. Greater participation in community sports increased risk-taking behaviors among boys but decreased them among girls. Within the household, education of adults had a positive effect on condom use for both boys and girls.

Understanding high school students' risk behaviors to help reduce the HIV/AIDS epidemic in KwaZulu-Natal, South Africa

Of 901 rural learners (X age 16.1, SD = 2.4) at 10 randomly selected high schools in KwaZulu-Natal, South Africa, those living with a parent were less likely to drink alcohol (P < 0.0001) or use drugs (P = 0.006). Thirty percent (95% CI 26.9, 33.1) were sexually active, and 53.1% used a condom in the past 30 days. The odds of males being sexually active was 7.27 the likelihood of females (95% CI 5.2, 10.1). Only one-third of male respondents always used condoms. Of sexually active respondents, 46.5% had experienced coercive sex. More males (14.1%) than females (3.6%) smoked cigarettes (P < 0.0001). The odds of males drinking alcohol was 4.5 times that of females (P < 0.0001). Smoking, (OR 2.42, 95% CI 1.32, 4.44) and drinking, (OR 2.67, 95% CI 1.71, 4.19) among learners increased the likelihood of sexual activity. With youth at increasing risk of HIV/AIDS in KwaZulu-Natal, South Africa, interventions to reduce learners' risk behaviors are required.

Women, sex, and HIV: social and contextual factors, meta-analysis of published interventions, and implications for practice and research

This article is focused on examining social and contextual factors related to HIV-risk behavior for women. Specifically, this article has three main purposes: to review the literature on selected social and contextual factors that contribute to the risk for the heterosexual transmission of HIV and AIDS, to review and conduct a meta-analysis of HIV-prevention interventions targeting adult heterosexual populations, and to suggest future directions for HIV-prevention intervention research and practice. Results suggest that the HIV-prevention interventions reviewed for this article had little impact on sexual risk behavior, that social and contextual factors are often minimally addressed, and that there was a large gap between research and the practice of HIV-prevention intervention.

Adolescent sexual risk behavior: a multi-system perspective

Adolescents are at high risk for a number of negative health consequences associated with early and unsafe sexual activity, including infection with human immunodeficiency virus, other sexually transmitted diseases, and unintended pregnancy. As a result, researchers have attempted to identify those factors that influence adolescent sexual risk behavior so that meaningful prevention and intervention programs may be developed. We propose that research efforts so far have been hampered by the adoption of models and perspectives that are narrow and do not adequately capture the complexity associated with the adolescent sexual experience. In this article, we review the recent literature (i.e., 1990-1999) pertaining to the correlates of adolescent sexual risk-taking, and organize the findings into a multisystemic perspective. Factors from the self, family, and extrafamilial systems of influence are discussed. We also consider several methodological problems that limit the literature's current scope, and consider implications of the adoption of a multisystemic framework for future research endeavors. We conclude with a discussion of the implications of the available research for practitioners working to reduce sexual risk behavior among adolescents.

An early intervention program for adolescent mothers: a nursing demonstration project

OBJECTIVE

To improve health outcomes in a vulnerable population of adolescent mothers and their infants.

DESIGN

Effects of an intensive early intervention program (EIP) are compared with those of traditional public health nursing (TPHN) care.

SETTING

A large California county with urban and rural communities, an ethnically diverse population, and a high teen birth rate.

PARTICIPANTS

One hundred twenty-one young mothers and their children from impoverished and predominantly minority backgrounds.

INTERVENTIONS

During pregnancy and through 1 year postpartum, participants (n=63) in the EIP were provided with 4 prenatal classes and approximately 17 home visits by specially trained public health nurses. Interventions addressed health issues, sexuality and family planning, life skills, the maternal role, and social support systems. Participants in TPHN (n=58) received three home visits (for intake, prenatal care, and postpartum/well-baby care information).

MAIN OUTCOME MEASURES

Antepartum, intrapartum, and newborn medical records; maternal responses to written questionnaires; and nurse interviews.

RESULTS

Early program outcomes indicate reduced premature birth rates for both groups compared with national data on adolescent mothers, and fewer days of infant hospitalization during the first 6 weeks postpartum for the EIP participants.

CONCLUSION

Public health nurse care (both traditional and intensive) significantly improved perinatal outcomes; the intensive intervention significantly reduced the number of infant hospitalization days.

Practice what we preach? HIV knowledge, beliefs, and behaviors of adolescents and adolescent peer educators

The purpose of this article is to (a) describe the knowledge, beliefs, and sexual behaviors of urban adolescents and adolescent peer educators, and (b) identify elements needed to design effective HIV/AIDS prevention programs for out-of-school youth. Thirty-three predominantly African American adolescents (female = 14; male = 19) between the ages of 14 and 24 in a large urban city including adolescent (n = 18) and adolescent peer educators (n = 15) participated. Paper-and-pencil questionnaire and focus-group interviewing methods were used. Adolescents and adolescent peer educators had a moderately high level of HIV knowledge, confidence in their ability to use condoms, and beliefs that condom use would not decrease sexual pleasure or imply infidelity. Both groups reported low perceptions of susceptibility of HIV infection. Engagement in sexual risk behavior was low, but was significantly higher among males. Although adolescent male peer educators engaged in a higher frequency of risk behaviors over time, they had a lower frequency of sexual risk behaviors in the past 2 months compared with male adolescents. Study findings showed that HIV prevention interventions need to include information about specific risk behaviors, such as using condoms for oral sex, and cleaning drug paraphernalia. Community-based and church programs, visible HIV prevention messages, specifically those aimed at increasing perceptions of HIV risk, and the development of condom-use skills were identified by adolescents and adolescent peer educators as relevant approaches to reduce HIV infection among this population.

Building community partnerships to improve HIV prevention efforts: implications for nurses

Acquired immune deficiency syndrome (AIDS), caused by the human immunodeficiency virus (HIV), is a major and complex public health crisis. The Centers for Disease Control and Prevention (CDC) issued effective community-based HIV prevention planning in its 1993 "Supplemental Guidance on HIV Prevention Community Planning" through the formation of community planning groups (CPGs). These guidelines are reviewed along with behavioral and social science theories that are the crux of HIV prevention theory-based research and program development. Nurses' roles in community-based HIV prevention as community advocates, HIV prevention program planners, practitioners, and researchers are discussed. The article concludes with nursing implications for HIV prevention.

The context of condom nonuse among older adolescents and young adults

This exploratory-descriptive study examined the context of condom nonuse among older adolescents and young adults. The convenience sample consisted of 23 freshman university students (18 to 20 years of age) in a rural state. Participants were asked to describe situations when condoms were not used. The responses were content-analyzed using an inductive process. Descriptions (n = 86) were identified and analyzed for common themes. The seven themes were assessment of risks, location and timing of sexual experience, extraneous events, communication about condoms, feelings of the moment, contraceptive responsibility, and relationships between sexual partners. The findings suggest strategies to promote condom use when working with older adolescents and young adults.