A Meta-Analysis of the Relations Between Three Types of Peer Norms and Adolescent Sexual Behavior

Social scripts of violence among adolescent girls and young women in Zambia: Exploring how gender norms and social expectations are activated in the aftermath of violence

Adolescent girls and young women ages 15-24 experience high rates of gender-based violence (GBV), underpinned by gender and social norms that shape their transitions to adulthood. For interventions that seek to leverage and build on existing infrastructure for health service provision, it is important to understand how gender norms operate in the background and how they shape service engagement or non-engagement. In formative work for our project, Screen & Support, outside of Lusaka, Zambia, we engaged in community conversations with adolescent girls and young women to understand common types and experiences of violence, perceptions of what causes violence, and pathways to post-violence service access. This manuscript explores emerging findings surrounding social and gender norms. We engaged n = 12 adolescent girls and young women ages 15-24, including survivors of GBV, young women living with HIV, and young married women in separate conversations conducted in a mix of Nyanja, Bemba, and English. Arts-based activities accompanied guided focus group discussions. Translated transcripts were coded and thematically analysed by two authors using Dedoose software. Key themes emerged around two major themes-understanding the norms underpinning violence, and observing how these norms were activated in the aftermath of violence. Sub-themes focused on power differentials supporting violence, social expectations and community-enacted sanctions, and understanding dominant norms and assumptions. Considering what unfolded in the aftermath of violence, young women participants considered key reference groups upholding norms, explored the contexts where norms may be contested or become more complicated, and described how accepting silence was a common means of closure. We discuss the implications of these findings for programme design, delivery, and evaluation, as well as the potential, and roadmap, for shifting norms that negative affect adolescent girls and young women.

Effect of multi-level social risk factors on developmental trajectories of sexual risk behaviors among Bahamian middle-to-late adolescents

Background

Few studies have examined how multi-level social factors interact and affect developmental patterns of sexual risk among middle-to-late adolescents who are at risk of experiencing sexual risk behaviors. We examined developmental trajectories of sexual risk behaviors of boys and girls in middle-to-late adolescence and the effects of exposure to three social risk factors (poor parental monitoring, peer risk, and neighborhood risk).

Methods

We followed 2,332 Bahamian adolescents every six months from Grades 10-12. We used group-based trajectory modeling to identify distinct trajectories of sexual risk behaviors for boys and girls.

Results

We identified three trajectories each for boys and girls. Peer risk and neighborhood risk predicted a high sexual-risk trajectory for boys, and peer risk (alone or combined with other risk factors) had the greatest impact on the membership of moderate-to-high-risk trajectory for girls. Parental monitoring had a relatively small effect on adolescents' sexual risk behavior.

Conclusion

Our results underscore the importance of early identification of adolescents with sexual risk behavior and development of targeted prevention interventions to improve adolescent health outcomes.

Learning About Sex from Different Sources: Implications for Sexual Attitudes, Sexual Knowledge, and Risky Sexual Behavior Among U.S. College Students

This exploratory cross-sectional study, guided by primary socialization theory, examined relations between four primary socialization agents of sexual learning (i.e., mothers, fathers, friends/peers, and online media) and sexual attitudes, sexual knowledge, and risky sexual behavior. Latent-variable structural equation models were tested using self-report data obtained from 515 emerging adults who had spent at least 6 months attending in-person college classes. Results showed that learning about sex from mothers was associated with more conservative sexual attitudes and lower risky sexual behavior. Sexual learning from friends/peers was linked to liberal sexual attitudes and greater sexual knowledge. Learning from online media was associated with increased sexual knowledge. To account for a shift in sexual learning patterns from before to after entry to college, we created algebraic difference scores for each source of sexual information. Greater reliance on sexual learning from friends/peers in the past 6 months of college relative to before college was associated with liberal sexual attitudes and greater sexual knowledge. Additional analyses revealed different effects of learning about sex from mothers more during college than before college between those living on campus vs. commuters living at home. The discussion emphasizes the different role that each of the primary socialization agents plays for emerging adults' sexual development, including the protective role of mothers against risky sexual behavior, the impact of friends and peers on sexual attitudes and knowledge, and the shifting dynamics of socialization processes during college.

Social media use, knowledge, attitudes, and risky sexual behavior of HIV transmission: A survey among boarding school adolescent students in Indonesia

Background

Social media has many positive and negative influences on individuals, especially for adolescents related to HIV. However, little is known about how social media impacts HIV-related outcomes among adolescents in boarding schools.

Objective

This study aims to investigate the social media use, knowledge, attitudes, and sexual behavior at risk of HIV transmission and their relationship with the demographic characteristics of adolescent students at boarding schools.

Methods

This study was school-based and used a cross-sectional design. The questionnaires were used to assess social network site usage, knowledge, attitudes, and risky behavior. Cluster random sampling involved students (n = 214) from three boarding schools in Cirebon City, West Java, Indonesia, in 2022. Chi-square tests and Cramer's V were used to explore correlations between social and demographic factors.

Results

A considerable number of adolescent students exhibited high social media addiction (58.4%), with the majority possessing limited knowledge of HIV transmission (54.7%). Additionally, nearly half displayed a negative attitude towards preventing HIV transmission (47.2%), while only a small fraction engaged in risky behavior (2.8%). Bivariate analysis revealed that social media use was moderately associated with the type of social media application (φc = 0.246, p <0.05). Knowledge of HIV transmission exhibited a moderate correlation with age (φc = 0.331, p <0.05), education level (φc = 0.240, p <0.001), and exposure to information (φc = 0.269, p <0.001). Similarly, attitudes toward HIV prevention demonstrated moderate associations with age (φc = 0.341, p = 0.001), education level (φc = 0.317, p <0.001), and exposure to information (φc = 0.266, p <0.001). Furthermore, risky sexual behavior exhibited a strong association with exposure to pornographic content (φc = 0.730, p <0.001).

Conclusion

The study found a high prevalence of social media usage among adolescents, coupled with low knowledge about HIV, negative attitudes, and risky behavior. Significant relationships were observed between social media use, knowledge, attitudes, and risky sexual behavior related to HIV transmission and demographic characteristics. This study emphasizes the vital role of nurses and healthcare professionals in implementing targeted educational interventions in boarding schools to address gaps in HIV risk knowledge influenced by social media, ultimately improving strategies for adolescents' sexual health.

Today's Adolescents Are More Satisfied With Being Single: Findings From a German Cohort-Sequential Study Among 14- to 40-Year-Olds

In Western societies, singlehood has become increasingly normative over historical time. But whether singles are more satisfied nowadays remains unclear. In this preregistered cohort-sequential study, we analyzed data from 2,936 German participants (M = 21.01 years, SD = 7.60 years) from different birth cohorts. Singlehood satisfaction and life satisfaction were reported annually at two different time periods (2008-2011 and 2018-2021). This design allowed us to compare earlier-born and later-born singles during adolescence (14-20 years), emerging adulthood (24-30 years), and established adulthood (34-40 years). Results from multilevel growth-curve models indicated that adolescent singles born in 2001 to 2003 (vs. 1991-1993) were more often single and more satisfied with singlehood. No cohort-related differences emerged among emerging and established adults. Younger age and lower neuroticism predicted higher satisfaction, regardless of birth cohort. The results highlight the importance of considering both societal and individual factors to understand singles' satisfaction.

"An escape from the isolation": Youth thoughts about the impact of COVID-19 on adolescent sexual behavior and alcohol use

INTRODUCTION

The COVID-19 pandemic likely affected adolescent sexual behaviors and alcohol use, although how is not well understood.

METHOD

Youth were sampled from the national, online longitudinal Growing up with Media study. They responded via text messaging to open-ended questions about how the COVID-19 pandemic may have impacted the sexual behavior and alcohol use of adolescents. Conventional content analysis summarized open-ended responses.

RESULTS

416 responses were analyzed from 335 participants (aged 15-30, US residents), 81 of whom provided data for both topics. Participants suggested that the pandemic affected some youths' sexual health precautions (increased and varying) and attitudes about sex (positive and negative). They discussed how adolescents met partners during the pandemic, including increased use of online platforms. Participants also suggested researchers investigate sexual risk in the realm of COVID-19 transmission and the practice of "safe sex." Many participants believed adolescents were drinking alcohol more as a result of the pandemic, both alone and with friends; however, others perceived adolescents were drinking less. Participants proposed researchers investigate adolescent drinking habits during the pandemic, as well as how this compares to before the pandemic and the type and quantity of alcohol consumed.

CONCLUSIONS

Young people believe adolescent sexual relationships and drinking behaviors changed due to the pandemic, though how varied. Future research could examine the contexts and individual differences that shape these varying behaviors. Overall, this study highlights the importance of directly asking youth about their pandemic experiences and the diversity of views on how the pandemic has influenced adolescent behavior.

Digital social multitasking (DSMT) and digital stress among adolescents: A peer norm perspective

Background

Digital stress refers to the stress resulting from persistent use of digital media. Given its major implications for well-being, it is crucial to explore how the use of digital media would contribute to the stress. Drawing on the frameworks of DSMT (i.e., using a digital device during social interactions) and perceived peer norms, we explored whether and how perceived peer norms of DSMT and adolescents' own DSMT were associated with digital stress.

Method

Adolescents between the ages of 12 and 18 were recruited through the Qualtrics survey panels. A total of 2105 adolescents completed a one-time online survey (Mage = 15.39, S.D. = 1.82).

Results

Path analysis revealed that all three self-DSMT variables (level, positive self-perception, negative self-perception) were associated with higher digital stress, with level and negative self-perception having stronger associations than did positive self-perception. Furthermore, peer DSMT level was related to higher digital stress both directly and indirectly through all three self-DSMT variables. Positive peer perception of DSMT was indirectly related to higher digital stress through higher self-DSMT level and more positive self-perception of DSMT, but was related to lower digital stress through reduced negative self-perception of DSMT. Negative peer perception of DSMT contributed to higher digital stress both directly and indirectly by intensifying teens' own negative perception of DSMT. Judging from the total-paths coefficients, all three peer norm variables were related to higher digital stress, with level having the largest coefficient, followed by negative peer perception and finally positive peer perception of DSMT.

Discussion and conclusion

All three perceived peer norms of DSMT (level, positive perception, negative perception) had the potential to increase digital stress directly and/or via impacting teens' own engagement in and perceptions of DSMT, with perceived peer engagement and negative peer perception being the greater risk factors. At the individual level, a similar pattern emerged-self-DSMT level and negative self-perception had noticeably stronger associations with digital stress than did positive self-perception.

Community-Level Factors As Positive and Negative Correlates of Sexual Aggression Perpetration Among Adolescent Boys

Often, perpetrators of sexual violence first aggress in their teens. Presently, very little is known about environmental factors that may influence adolescents' engagement in sexual aggression. Drawing upon data collected at 27 high schools in the Northeast United States, this study is the first to test the association between community-level factors and male adolescents' sexual aggression. A series of backward linear regressions determined that 10 of 19 community variables were associated with males' sexual aggression, which were then used to generate a ratio of positive to negative correlates of sexual aggression for each high school. In multilevel analyzes, as hypothesized, the ratio of positive to negative correlates was positively associated with schools' sexual aggression perpetration rates. We discuss the study's implications for future sexual assault research and prevention interventions.

Sexual Attraction Disparities in Adolescent Mental Health: The Role of School Norms

Purpose: Few studies examine whether and how heterosexist norms in schools might influence disparities in mental health between sexual minority and heterosexual adolescents. Addressing this gap, we study disparities in life satisfaction, psychosomatic complaints, and emotional problems between same/both-sex attracted and other-sex attracted adolescents and examine the moderating role of heterosexist norms on the classroom- and school-level. Methods: We used data from the 2013 and 2017 Dutch Health and Behavior in School-Aged Children study (N = 12,756; mean age = 14.02; standard deviation = 1.54). Separate multi-level analyses for life satisfaction, psychosomatic complaints, and emotional problems were conducted in which cross-level interaction effects between sexual attraction and school and classroom-level heterosexist norms were estimated. Results: Same-sex attracted, both-sex attracted, and adolescents unsure about their sexual attraction reported lower life satisfaction, more psychosomatic complaints, and more emotional problems than their other-sex attracted peers. On average, stronger school-level heterosexist norms were associated with higher life satisfaction, fewer psychosomatic complaints, and fewer emotional problems. Stronger classroom-level heterosexist norms were associated with fewer emotional problems. One moderating effect of sexual attraction and school-level heterosexist norms was found. Contrary to expectations, disparities in life satisfaction between same-sex attracted and other-sex attracted adolescents were smaller when classroom-level heterosexist norms were stronger. Standardized regression coefficients showed that the associations were small. Conclusion: Although our findings suggest pressing health disparities between heterosexual and sexual minority adolescents, heterosexist norms at the school and classroom level were weakly associated with these health disparities.

'Like fumbling around in the dark': Young people's perceptions and realities of healthy relationships

Learning to negotiate relationships is a key feature of adolescence, yet insight into young people's perspectives on what constitutes healthy relationships is lacking. In this study, therefore, insights were sought on healthy relationship qualities, common issues encountered, and relevant educational experiences. Semi-structured interviews were undertaken with 18 young people (11 self-identified as female, 5 male, and 2 trans/gender-diverse) aged 14-20 years, residing in Adelaide, South Australia. Relationships with parents, siblings, peers and intimate partners were topics for discussion. Reflexive thematic analysis was utilised to generate codes and themes. The Five Cs of Positive Youth Development were used to aid understanding of findings. Young people's accounts suggested a disjuncture between desired relationship qualities, realities and education on relationships and sexual health. Young people articulated tensions navigating peer norms and societal expectations in relation to dating and sex, including unrealistic representations, gender stereotyping and strong 'sexpectations'. Participants in this study relied more heavily on personal experience and observation than formal education to develop an understanding of healthy relationships. Achieving healthy relationships was generally perceived to be complex and requiring skills or understanding informants were unsure about. Positive Youth Development could provide a framework for meeting the needs expressed by young people, notably by building communication skills, confidence and agency.

Sexual and Dating Violence Prevention Programs for Male Youth: A Systematic Review of Program Characteristics, Intended Psychosexual Outcomes, and Effectiveness

Sexual and dating violence (SDV) by male youth (≤ 25 years)-including sexual harassment, emotional partner violence, and rape-is a worldwide problem. The goal of this preregistered (PROSPERO, ID: CRD42022281220) systematic review was to map existing SDV prevention programs aimed at male youth, including their characteristics (e.g., content, intensity), intended psychosexual outcomes, and empirically demonstrated effectiveness, guided by the principles of the theory of planned behavior (TPB). We conducted searches in six online databases for published, peer-reviewed quantitative effectiveness studies on multi-session, group focused, and interaction based SDV prevention programs for male youth ending March 2022. After screening of 21,156 hits using PRISMA guidelines, 15 studies on 13 different programs, from four continents were included. Narrative analysis showed, first, broad ranges in program intensity (2-48 h total), and few program curricula included explicit discussion of relevant aspects of the TPB. Second, programs' main intended psychosexual outcomes were to change SDV experiences, or related attitudes, or norms. Third, significant effects were found mostly on longer term behaviors and short-term attitudes. Other theoretical proxies of SDV experiences, such as social norms and perceived behavioral control, were sparsely investigated; thus, program effectiveness on these outcomes remains largely unknown. Assessed with the Cochrane Risk of Bias Tool, moderate to serious risk of bias arose in all studies. We present concrete suggestions for program content, such as explicit attention to victimization and masculinity and discuss best practices for evaluation research, including assessments of program integrity, and examining relevant theoretical proxies of SDV.

Religiosity, sexual behaviors, sexual motivations, and gender: A three-year longitudinal study

Longitudinal data are critical for examining associations of religiosity with sexual behaviors and motivations during college. We use hierarchical linear modeling on five semesters of data from a diverse sample of college students (N = 735) to examine within- and between-person associations between religious service attendance and importance of religion and sexual behaviors and motivations for and against sex and consider gender as a moderator. Between-person religiosity was associated with sexual behaviors and motivations whereas within-person religiosity was not. Students' sexual motivations co-varied across semesters with their religious service attendance and importance of religion. Our results indicated more restrictive associations between religiosity and sexual motivations for women than for men.

Pornography Use, Perceived Peer Norms, and Attitudes Toward Women: A Study of College Men

Men's negative attitudes toward women is a known risk factor for sexual aggression perpetration. Sexual aggression is a widespread public health concern, especially among emerging adults, and is associated with a multitude of negative consequences. The current study evaluated whether pornography-related perceived peer norms, own approval, and self-reported use are associated with negative attitudes towards women in a sample of college men. Types of pornography examined included: pornography (in general), pornography that included portrayals of bondage, whipping, and spanking but without explicit dissent (i.e., pornography that depicted bondage/physical aggression), as well as pornography consisting of sexually explicit rape depictions in which force is used. Self-report measures assessing the frequency of pornography exposure, self-acceptance of pornography use, and perceived peer norms were collected from 283 college men. A multiple linear regression model revealed that only perceived peer norms for acceptance of pornography that depicted rape was positively associated with negative attitudes toward women. Findings highlight the importance of better understanding and addressing perceived peer norms in sexual assault prevention programs for college men.

A longitudinal assessment of adolescents' sexual communication with parents, best friends, and dating partners

Sexual health communication in adolescence is important for sexual well-being. With limited empirical work utilizing longitudinal methodologies, this study aimed to investigate how the frequency of sexual communication with parents, peers, and dating partners changes across adolescence and varies based on sex, race/ethnicity, and sexual orientation. Participants included 886 U.S. adolescents (54.4% females; 45.9% White, 22.6% Hispanic/Latinx, 21.6% Black/African American) surveyed yearly from middle school through 12th grade. Growth curve models were used to estimate trajectories of the frequency in communication. Results showed curvilinear trajectories for adolescents' sexual communication with their parents, best friends, and dating partners over time. Although all three trajectories showed curvilinear patterns, sexual communication with parents and best friends increased earlier in adolescence and leveled off, while sexual communication with dating partners was lower in early adolescence and showed a steep increase across adolescence. Communication trajectories significantly diverged depending on adolescents' sex and race/ethnicity but not their sexual orientation. This study provides the first evidence of developmental changes over time in adolescent sexual communication with parents, best friends, and dating partners. Developmental implications for adolescents' sexual decision making are discussed. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Victim Blaming and Non-Consensual Forwarding of Sexts Among Late Adolescents and Young Adults

This study explored late adolescents' and young adults' willingness to engage in non-consensual forwarding of sexts (NCFS) and its relation to victim blaming beliefs toward female and male victims. The study further examined important determinants in the development of victim blaming beliefs (e.g., perceived victim blaming of peers). An online survey was conducted among 1343 Belgian respondents of which 78.4% were female (M_age = 21.62 years, SD = 3.57 years). Structural equation modeling showed that victim blaming beliefs (i.e., responsibility-based and characteristic-based) were related to willingness to engage in NCFS, which was related to NCFS, regardless of the victim's sex. Further, victim blaming beliefs in the context of NCFS were shaped by parents' and peers' perceived victim blaming, and respondents' high levels of narcissism and low levels of empathy. Surprisingly, pornography use was negatively correlated with characteristic-based victim blaming beliefs. Additionally, males and late adolescents appeared to hold more victim blaming beliefs toward female and male victims in comparison with females and young adults. Lastly, the willingness to engage in NCFS was more strongly related to responsibility-based victim blaming (not characteristic-based victim blaming) if the victim was male. The findings demonstrate how victim blaming encourages NCFS and emphasize that educational programs should avoid victim-focused strategies.

What Matters in a Relationship-Age, Sexual Satisfaction, Relationship Length, and Interpersonal Closeness as Predictors of Relationship Satisfaction in Young Adults

Relationship satisfaction is one of the key elements affecting overall life satisfaction. This study aimed to identify significant predictors of relationship satisfaction in young adults in a romantic relationship. The study was questionnaire-based, involving 237 young adults who were currently in a relationship. Three self-rating scales were used: CSI-32 Relationship Satisfaction Scale, Sexual Satisfaction Questionnaire, and Unidimensional Relationship Closeness Scale. Sexual satisfaction proved to be a main predictor of relationship satisfaction in both sexes. For women, interpersonal closeness was additionally important, with a sense of closeness found to be even more important than sexual satisfaction for women cohabiting with their partners. Cohabiting people are generally more satisfied with their relationship, and a higher level of closeness and applied caresses can additionally be observed in them. In contrast, the relationship length appeared to matter only for men living with their partner: they were more satisfied with the relationship at the beginning of the relationship, and then their level of satisfaction declined. Relationship satisfaction in young adults appears to be determined by other factors depending on gender and cohabitation status. Nevertheless, at this age, sexual satisfaction proves to be one of the most critical factors for a sense of relationship satisfaction.

The role of social norms on adolescent family planning in rural Kilifi county, Kenya

PURPOSE

Despite Kenya's encouraging progress in increasing access to modern contraception among youth, several barriers remain preventing large-scale efforts to reduce demand-side unmet need for family planning. Shifting social norms around the use and acceptability of modern contraception may represent a potent target for future interventions. However, the structure of normative influence on individual modern contraceptive use among youth needs to be determined. Therefore, our aim was to estimate the influence of individual and group-level normative influence on modern contraceptive use among adolescents from two villages in rural Kenya.

METHODS

Trained enumerators collected data from individuals aged 15-24 who provided oral informed consent, or parental informed consent, in two villages in rural Kilifi county. Participants completed a questionnaire related to modern contraceptive use and were asked to nominate one to five people (referents) with whom they spend free time. The enumerators photographed each individual who nominated at least one referent using Android phones and matched them with their nominated referents. Using this social network data, we estimated group-level normative influence by taking an average of referents' modern contraception use. We then explored associations between descriptive norms, injunctive norms, and network modern contraceptive use on individual modern contraceptive use, controlling for known confounders using logistic regression models. We also conducted sensitivity analyses to test a pattern of differential referent influence on individual modern contraceptive use.

RESULTS

There was a positive association between pro-modern contraception descriptive and injunctive norms and individual modern contraception use (adjusted Odds Ratio (aOR) = 1.29, 95% confidence interval (CI) = 1.05-1.6, and aOR = 1.31, CI = 1.06-1.62, respectively). Network modern contraceptive use was associated with individual use in the bivariate model (aOR = 2.57, CI = 1.6-4.12), but not in the multivariable model (aOR = 1.67, CI = 0.98-2.87). When stratified by sex and marital status, network modern contraceptive use was associated with individual modern contraceptive use among female participants (aOR = 2.9, CI = 1.31-6.42), and unmarried female participants (aOR = 5.26, CI = 1.34-20.69), but not among males. No interactive effects between norms variables were detected. Sensitivity analyses with a different estimate of network modern contraceptive use showed similar results.

CONCLUSIONS

Social norms are multilevel phenomena that influence youth modern contraceptive use, especially among young women in rural Kenya. Unmarried women with modern contraceptive users in their social network may feel less stigma to use contraception themselves. This may reflect gendered differences in norms and social influence effects for modern contraceptive use. Future research should investigate group-level normative influence in relation to family planning behaviors.

Longitudinal Associations Among Adolescents' Sexual Attitudes, Beliefs, and Behaviors

Youth sex and relationship education programs aim to improve adolescent well-being by changing their knowledge, beliefs, and attitudes regarding sex and their health. However, there is a gap in existing research linking these cognitive targets to relevant behaviors, and a particular dearth of data on links with sexual behaviors. The current study tested longitudinal links between cognitive factors related to sex (attitudes about sex, normative beliefs, risk-avoidant intentions, and confidence in refusal skills) and outcomes of sexual behaviors (recent sexual encounters, number of sexual partners, and frequency of condom use). Data were drawn from three waves of data from a panel study of US high-school students and were analyzed using cross-lagged structural equation modeling. We hypothesized direct, reciprocal links between intentions and behaviors, but this hypothesis was not supported. Instead, more conservative attitudes about sex emerged as the most consistent prospective predictor of fewer sexual encounters and sexual partners, though with small effect sizes (βs = - .08 to - .131, ps < .05). Further, bidirectional interrelationships were observed among several of the cognitive and behavioral variables over time. These results highlight attitudes about sex as a potentially useful intervention target, but also suggest that sex and relationship education curricula and evaluations should consider multiple pathways of links between cognition and behavior. Continued research is needed on causal links between adolescents' sexual attitudes, knowledge, intentions, and behavior.

Descriptive, Injunctive, and Collective Norms: An Expansion of the Theory of Normative Social Behavior (TNSB)

We propose and test several hypotheses derived from the expanded theory of normative social behavior (TNSB) that also includes collective norms (with descriptive and injunctive norms). Data come from a quasi-experiment intervention to promote safer driving among adolescents in Serbia. The intervention was administered among high school students, most of whom were on the verge of receiving their driver's licenses. Longitudinal data were collected from treatment and control schools at baseline (N = 1,449) and four months later at end line (N = 1,072). Descriptive norms at baseline predicted six-month changes in safer-driving intentions among women (β = .010 p < .05) but not among men. Main-effects of injunctive and collective norms were not significant. However, a significant interaction between descriptive norms and collective norms emerged among men (though not among women) and injunctive norms interacted with both collective norms and descriptive norms among women (but not among men). Initial evidence adds credence to the idea of enhancing the TNSB by adding both injunctive and collective (together with descriptive) norms as drivers of behaviors.

Social identity support, descriptive norms, and economic instability in PrEP engagement for emerging adult MSM in the United States

Rates of pre-exposure prophylaxis (PrEP) uptake for HIV prevention continue to increase rapidly among men who have sex with men (MSM) in the United States (U.S.); however, these increases have been slower among young MSM. Emerging adulthood (ages 18-25) is a time of transitions and social development, resulting in increased vulnerability to HIV. Analyzing data from a cross-sectional survey of emerging adult MSM (ages 18-25 years; n = 281) in the Mid-Atlantic urban metropolitan region of the U.S., we examined how social identity support, descriptive PrEP norms, and economic instability were related to PrEP engagement. In structural equation models, PrEP norms were directly associated with PrEP engagement (β = 0.29, 95% CI = [0.12,0.46]) and social identity support was indirectly associated with PrEP engagement through its association with descriptive PrEP norms (β = 0.18, 95% CI = [0.09,0.28]). Economic instability was not significantly associated with PrEP engagement, although a negative trend was present (β = -0.19, 95% CI = [-0.39,0.02]). Our results suggest that an integrative socioecological model is appropriate for the study of PrEP engagement among emerging adult MSM. Efforts to increase PrEP engagement should support community capacity building, amplify positive descriptive PrEP norms, and address unmet economic needs.

Gender Equitable Attitudes, Rape Myth Acceptance, and Perceived Peer Approval of Violence as Correlates of High School Boys' Intention to Garner Sexual Consent

The current study examines correlates of high school boys' intentions to garner consent in a future sexual encounter (N = 816). Bivariate correlation analyses demonstrated that increased intention to garner sexual consent was negatively correlated with rape myth acceptance and perceived peer acceptance of violence, and positively correlated with gender equitable attitudes. In multivariate linear regression analyses, perceived peer acceptance of violence and gender equitable attitudes remained significant in relation to intentions to garner sexual consent. Specifically, boys who reported a greater likelihood of perceiving their peers as accepting of violence and a lower likelihood of holding gender equitable attitudes also reported a lower likelihood to garner sexual consent. These findings highlight the importance of developing sexual assault prevention programs for high school boys that address the complex relationships between perceived peer norms, harmful gender role expectancies, and risk for sexual aggression. Results from this study also add to the existing literature on sexual consent communication in adolescents.

Playing by the Rules? An Investigation of the Relationship Between Social Norms and Adolescents' Hate Speech Perpetration in Schools

Hate speech is often discussed and investigated as an online phenomenon, while hate speech among adolescents in the real world (e.g., in schools) has rarely been researched. Consequently, not much is known about potential interpersonal correlates and theoretical frameworks that might help us better understand why adolescents engage in hate speech in offline environments. To add to the literature, this study investigates hate speech perpetration among young people by utilizing the Social Cognitive Theory; more specifically, the association between witnessing and perpetrating hate speech in schools, and whether this relation is weakened or strengthened by anti-hate speech injunctive norms and deviant peer pressure. The sample consists of 1719 young people (45.1% boys, 53.6% girls, 1.3% gender diverse) between 11 and 18 years old (M_age = 13.96; SD = .98) from 22 schools in Switzerland. Self-report questionnaires were administered to measure hate speech involvement and adolescents' perception of social norms (i.e., anti-hate speech injunctive norms and deviant peer pressure). Multilevel regression analyses revealed that witnessing and perpetrating hate speech were positively associated. Moreover, injunctive anti-hate speech norms were negatively related and deviant peer pressure positively related to hate speech perpetration. Finally, increasing levels of injunctive anti-hate speech norms weakened the relation between witnessing and perpetrating hate speech, whereas higher levels of deviant peer pressure strengthened this association. The findings demonstrate that the Social Cognitive Theory is a useful framework for understanding hate speech perpetration in schools. The results also highlight the importance of taking into account social norms and interpersonal relationships (e.g., within the class) when designing anti-hate speech prevention programs and not focusing solely on intrapersonal factors.

Gender norms and ideologies about adolescent sexuality: A mixed-method study of adolescents in communities, south-eastern, Nigeria

BACKGROUND

Sexual and reproductive health choices and behaviors of adolescents are shaped by gender norms and ideologies which are grounded in cultural beliefs. This study examined the perspectives of adolescents about the influence of gender norms and ideologies on sexuality.

METHODS

A cross-sectional study was undertaken in three urban and three rural communities in south-eastern Nigeria using quantitative and qualitative research methods. A modified cluster sampling procedure was used to select respondents. Data were collected from 1,057 adolescents and twelve focus group discussions with unmarried adolescents aged 13 to 18 years. For the quantitative data, univariate, bivariate and probit regression analyses were performed using Stata while the thematic framework approach was used to analyze qualitative data.

RESULTS

The dominant beliefs among adolescents are that: it is wrong for unmarried adolescents to have sex (86.4%); unmarried adolescents should abstain from sex (89.3%); consent should be obtained before sexual intercourse (89.1%); it is a girl's responsibility to ensure she does not get pregnant (66.5%), and sex should be initiated by boys (69.6%). Gender (boy or girl) was a predictor of belief in premarital abstinence (t-value = -3.88), belief that premarital sexual intercourse is acceptable provided contraceptive is used (t-value = 3.49, CI 1.14-0.49), belief that premarital sexual intercourse is wrong (t-value = -2.24) and, belief that sex should be initiated by boys only (t-value = -4.37). Adolescent boys were less likely to believe in pre-marital abstinence and less likely to believe that pre-marital sex among adolescents is wrong compared to girls. They were also more likely to believe adolescents can have sex provided contraceptive is used compared to girls. Qualitative findings revealed adolescents' beliefs that girls feel shy initiating sex and that boys experience more urge for sex hence, boys were perceived to be responsible for initiating sex. Both boys and girls experience pressure to have sex however, boys were described to experience more pressure from peers to have sex. Peer-to-peer communication, quest for material possessions and low socioeconomic conditions contribute to peer pressure to engage in sex.

CONCLUSION

Adolescents' beliefs about sexuality underline the need to contextualize interventions to address these norms and ideologies.

Not all flowers bloom in April: Self-esteem development surrounding the first romantic relationship during adolescence and emerging adulthood

Most people experience their first romantic relationship during adolescence. However, there is also a substantial proportion of youth who remain single during this time. Delaying the transition into the first romantic relationship may be associated with a decrease in self-esteem which might recover or even increase after youth engage in their first romantic relationship. The current study examined self-esteem development surrounding the transition into the first romantic relationship over a period of 10 years in a sample of N = 1395 adolescents ( Mage = 16.22 at T1; Mage = 26.22 at T11) from pairfam, a German representative panel study starting in 2008. Results from multilevel piecewise growth curve models showed that self-esteem did not change before beginning the first relationship, but slightly decreased thereafter. There were no moderating effects of age at first relationship, single satisfaction, or relationship satisfaction. However, both single and partnered youth who were more satisfied with their current relationship status reported higher self-esteem on average. Overall, the findings extend the current understanding of self-esteem development surrounding the transition into the first romantic relationship. Being single during late adolescence and emerging adulthood does not seem to pose a risk for youth’s self-esteem development.

Descriptive norms about condom use predict odds of using a condom during last sexual experience in a large, national survey of adolescents from Australia

BACKGROUND

Reducing sexually transmitted infections among adolescents is an important public health goal in Australia and worldwide. This study estimated the association between condom use during last heterosexual sexual experience with two descriptive norms among a large, national sample of secondary school students from Australia.

METHODS

A large, national online survey of 14- to 18-year-olds in Australia was conducted in 2018; a sub-analysis of sexually active participants (n=2989) used multivariable logistic regression to estimate the relationships between condom use during last sexual experience and condom use norms. The analysis controlled for the effects of age, sex, sexual orientation, religious affiliation, remoteness and knowledge of sexually transmitted diseases.

RESULTS

Overall, 1673 (56.0% [95% confidence interval: 54.2%, 57.8%]) sexually active respondents reported using condoms during their last sexual experience. Perceiving that all same-age peers used condoms conferred higher odds of using condoms during their last heterosexual sexual experience (adjusted odds ratio: 3.06 [95% CI: 1.6, 6.0]). Perceptions about whether the suggestion to initiate condom use came from boys, girls, or both boys and girls was not associated with condom use. Differences in condom use related to socio-demographic characteristics are reported.

CONCLUSIONS

As part of a holistic approach to sexuality education, health educators and service providers may emphasise that young people frequently choose to use condoms.

Meta-Analysis in Sociological Research: Power and Heterogeneity

Meta-analysis is a statistical method that combines quantitative findings from previous studies. It has been increasingly used to obtain more credible results in a wide range of scientific fields. Combining the results of relevant studies allows researchers to leverage study similarities while modeling potential sources of between-study heterogeneity. This paper provides a review of the core methodologies of meta-analysis that we consider most relevant to sociological research. After developing the foundation of the fixed-effects and random-effects models of meta-analysis, this paper illustrates the utility of the method with regression coefficients reported from two sets of social science studies. We explain the various steps of the process including constructing the meta-sample from primary studies; estimating the fixed- and random-effects models; analyzing the source of heterogeneity across studies; assessing publication bias. We conclude with a discussion of steps that could be taken to strengthen the development of meta-analysis in sociological research, which will eventually increase the credibility of sociological inquiry via a knowledge-cumulative process.

An explorative study of beliefs in two groups of community health promoters of adolescent reproductive health in Indonesia: informed by theory of planned behavior

OBJECTIVE

To explore beliefs in specific social context and potential individual-level behavioral strategies used by two groups of community health promoters to foster their participation of promoting ARH.

DESIGN

Two phases of formative studies based on the Theory of Planned Behavior (TPB) was conducted with community health promoters in the integrated service center (pos pelayanan terpadu/posyandu), posyandu cadres and peer educators of three villages in Tengger, East Java, Indonesia.

RESULT

The phase one, conducted with posyandu cadres (n = 20) and peer educators (n = 21). A survey using open-ended questions and focus group discussion was carry out to elicit accessible behavioral (advantages and disadvantages), normative (references of who have significant roles for promoters) and control (personal or situational factors) beliefs related to ARH promotion. The content analysis, elicited 15 salient beliefs for posyandu cadre and 21 for the peer educators. In phase two, the participants who previously participated in phase 1 (posyandu cadres (n = 14 and peer educators (n = 21))), completed two questionnaires to measure the belief strength and evaluation of the beliefs.

CONCLUSIONS

The result showed that each group has different characteristic in the strength of their beliefs in promoting reproductive health. The findings highlight the social context underlying beliefs associated with ARH promotion and opportunities to enhance engagement with the different groups of community health promoters.

Sexual Double Standards: Contributions of Sexual Socialization by Parents, Peers, and the Media

(Hetero)sexual double standards (SDS) entail that different sexual behaviors are appropriate for men and women. There is large variation in whether people endorse SDS in their expectations about the sexual behavior of women and men (i.e., SDS-norms). To explain these individual differences, we examined associations between SDS-norms of Dutch adolescents (aged 16-20 years, N = 566) and what parents, peers, and the media teach adolescents about appropriate sexual behavior of boys and girls (i.e., SDS-socialization). Adolescents completed an online survey at school. Regarding SDS-socialization, more traditional SDS-norms conveyed by the media and peers, but not of parents, and less perceived sexual activity of female peers, were associated with more traditional SDS-norms. Only for boys, exposure to sexy girls/women on social media and sexual music videos of female artists were associated with more traditional SDS-norms. Thus, SDS-socialization by peers and the media and opposite gender models (for boys) are important in light of adolescents' SDS-norms.

COVID-19 Among Youth in Israel: Correlates of Decisions to Vaccinate and Reasons for Refusal

PURPOSE

The primary aim of the present study is to examine the reasons for adolescents' refusal to get vaccinated with the COVID-19 vaccine, and examine correlates of vaccination among adolescents aged 12-18 years in Israel.

METHODS

A total of 150 youth aged 12-18 years participated in the study. Following parental consent (30% response rate) from an online internet Israeli participants' pool, 150 youth completed the survey (50.5% response rate). Data were collected from May to June 2021.

RESULTS

Over half (64.0%) of youth in this study had received the COVID-19 vaccine (25.5% received one dose and 38.9% two doses). Of the youth who were not vaccinated the most common reasons cited for refusing the vaccine was not knowing enough about the harms that a vaccine has in the long run, not trusting the drug companies that the vaccine will be safe, believing the virus is not dangerous, and doubting the safety of the vaccine in the short term. Bivariate odds ratios indicate that age (older) and having both parents vaccinated was related to increase the odds of the youth getting vaccinated. Higher distress over the effects of the vaccine was significantly related to lower odds of receiving the vaccine. Social media use was also related to a higher likelihood of being vaccinated at the bivariate level.

DISCUSSION

Study findings provide specific ways in which peer-designed and peer-led public health programs may encourage youth to receive the COVID-19 vaccine in a manner that recognizes concerns of Israeli youth.

Measurement of gender and sexuality in the Adolescent Brain Cognitive Development (ABCD) study

The Adolescent Brain Cognitive DevelopmentSM (ABCD) study is a longitudinal study of adolescent brain development and health that includes over 11,800 youth in the United States. The ABCD study includes broad developmental domains, and gender and sexuality are two of these with noted changes across late childhood and early adolescence. The Gender Identity and Sexual Health (GISH) workgroup recommends measures of gender and sexuality for the ABCD study, prioritizing those that are developmentally sensitive, capture individual differences in the experience of gender and sexuality, and minimize participant burden. This manuscript describes the gender and sexuality measures used in ABCD and provides guidance for researchers using these data. Data showing the utility of these measures and longitudinal trends are presented. Including assessment of gender and sexuality in ABCD allows for characterization of developmental trajectories of gender and sexuality, and the broad scope of ABCD data collection allows examination of identity development in an intersectional manner.

Relationship between Perceived Peer and Adolescents' Sexual Behaviors: The Moderating Role of Gender

In Malaysia, sexual health risks such as unprotected sex, teenage pregnancies, abandoned babies, abortion, and sexually transmitted diseases are on the rise because adolescents are increasingly engaging in such sexual behaviors. The present study aimed to investigate the relationship between perceived peer sexual behaviors and sexual behaviors among adolescents as well as to examine the interacting role of gender in such a relationship. This cross-sectional study recruited a sample of 338 school-going adolescents (M_age = 16.7; SD_age = 1.53) using the purposive sampling method. Participants were required to complete questionnaires consisting of the modified Human Sexuality Questionnaire-Orgasmic Experience Scale and the Peer Norms Scale. Results indicated that adolescents who perceived their peers to be actively engaging in sexual behaviors were more prone to being sexually active themselves. The results also showed gender as a significant moderator in the relationship between adolescents' perceived peers' sexual behaviors and sexual behaviors. Besides, the impact of perceived peer sexual behaviors on sexual behaviors was found to be stronger in male than female adolescents. Overall, the findings from this study hinted at the importance of peers and gender differences during the planning and implementation of sexual and health education.

Assessing sexual practices and beliefs among university students in Khartoum, Sudan; a qualitative study

University students in Sudan are more at risk of contracting HIV than the general population, due to a high rate of sexual activity and low uptake of preventive measures such as condoms. Hence, they are considered an important target for HIV prevention programmes. This study explored students` beliefs about abstinence and pre-marital sex. Thirty semi-structured individual interviews were conducted, based on constructs from the Integrated Change (I-Change) Model. The study sample included 16 (53%) male and 14 (47%) female university students. Their average age was 21.2 years (Range 18–27 and SD 2.5). Both sexual abstainers (N = 19) and sexually active students (N = 11) perceived HIV severity and susceptibility. Most of the participants had a positive attitude towards abstinence. However, sexually active students also perceived some advantages of engaging in sexual practices, such as sexual pleasure and proving adulthood. Sexually active students more often mentioned being influenced in their sexual practices by their peers than by their families. Sexually active students reported lower self-efficacy to refrain from sex than abstainers. Interventions that seek to promote abstinence among those willing to achieve this should stress the advantages of abstinence from sex until marriage, offer tools to resist peer pressure and enhance self-efficacy to abstain. These findings can be used to develop comprehensive HIV prevention programmes that primarily promote abstinence among university students who are not yet sexually active but also consider promoting condom use and other safer-sex practices among those who are sexually active. These interventions should also be gender-sensitive to address the needs of both male and female students.

What Does He Think? Male Knowledge and Attitudes Regarding Long-Acting Reversible Contraception

STUDY OBJECTIVE

Contraceptive counseling, especially regarding long-acting reversible contraception (LARC), has generally been directed at women. However, male partners and peers may influence contraceptive decision making. As there were no published studies examining male perceptions of LARC in the United States, this study investigated male knowledge and attitudes regarding LARC.

DESIGN

An anonymous electronic cross-sectional survey collecting qualitative and quantitative data was administered from May to September 2018.

SETTING

Participants were recruited via university e-mail listservs and in-person at a campus student organization fair at the University of Illinois at Chicago in Chicago (UIC), Illinois.

PARTICIPANTS

University students identifying as male and 18-24 years of age.

INTERVENTIONS

None.

MAIN OUTCOMES MEASURED

Knowledge of LARC, perceptions of LARC, interest in learning about LARC.

RESULTS

Participants (n = 97) were predominantly heterosexual (83.5%) men. Of those who were sexually active (63.9%), 98.4% reported female partners trying to avoid pregnancy. The most commonly used methods of contraception were oral contraceptive pills (48.4%) and/or condoms (80.6%). The majority (76.3%) of participants had not heard of LARC. Absence of prior LARC use by a partner was associated with knowledge deficits about LARC (odds ratio = 0.26, 95% confidence interval = 0.70-1.00); however, this association was not seen with other contraceptive methods. Participants familiar with LARC were generally neutral to very supportive of LARC (87.0%). Additionally, 80.4% of participants were interested in learning more about LARC.

CONCLUSION

Males 18-24 years of age had limited knowledge of LARC, with an interest in learning more about LARC. This information could shape interventions to bridge knowledge gaps, ultimately helping women to make supported contraceptive choices.

Iron and folic acid consumption and changing social norms: cluster randomized field trial, Odisha, India

Objective

To assess whether improvements in social norms related to iron and folic acid consumption are associated with increased iron and folic acid consumption.

Methods

In a cluster randomized trial in Odisha, India, we implemented an intervention to improve descriptive norms (people’s perceptions about how many other people take iron and folic acid), injunctive norms (social pressures people feel to take iron and folic acid) and collective norms (actual levels of iron and folic acid consumption). We assessed changes in these norms and self-reported iron and folic acid consumption in control and intervention arms after 6 months (September 2019–February 2020). We collected data from control (n = 2048) and intervention (n = 2060) arms at baseline and follow-up (n = 1966 and n = 1987, respectively).

Findings

At follow-up, mean scores in self-reported iron and folic acid consumption in the control arm had decreased from 0.39 to 0.31 (21% decrease; not significant). In the intervention arm, mean scores increased from 0.39 to 1.62 (315% increase; P < 0.001). The difference between the two arms was statistically significant (P < 0.001). Each of the three norms also improved at significantly higher rates in the intervention than in the control arm (P < 0.001 for each norm). Changes in descriptive and collective norms (but not injunctive norms) were associated with changes in self-reported iron and folic acid consumption (P < 0.001 for both norms).

Conclusion

Our results show that social norms can be improved and that these improvements are associated with positive behavioural changes. A social norms-based approach may help promote iron and folic acid consumption in India.

Examining Sexual Behavior Among U.S. Transgender Adolescents

The health of transgender adolescents (i.e., those identifying with a gender other than their sex assigned at birth) is gaining attention from researchers, yet little work has examined normative sexual behaviors among this population. Self-identified gender minority adolescents, including those identifying as trans boys, trans girls, nonbinary, and questioning their gender identity (age range 14-18, M_age = 16, n = 1,223) from all 50 U.S. states responded to anonymous online surveys. Participants reported on their age of initiation and number of sexual partners for four sexual behaviors ranging in intimacy (i.e., sexual touching, oral sex, vaginal sex, and anal sex). Participants also indicated the gender of their sexual partners and experiences with sexually transmitted infections (STIs), STI tests, and pregnancy. Overall, transgender adolescents' age of initiating sexual behaviors and number of sexual partners are similar to those observed in prior studies of cisgender adolescents. No differences were found between gender identity subgroups on ever engaging, age of initiation, number of partners, and gender of partners across the four sexual behaviors, with some exceptions for anal sex. Participants reported low rates of STIs and pregnancy, but also low rates of STI testing. Implications for sex education and health care are discussed.

Viewing Development Through the Lens of Culture: Integrating Developmental and Cultural Psychology to Better Understand Cognition and Behavior

Although many definitions of culture exist, studies in psychology typically conceptualize different cultures as different countries. In this article, we argue that cultural psychology also provides a useful lens through which to view developmental milestones. Like other forms of culture, different developmental milestones are demarcated by shared values and language as well as transmission of particular social norms. Viewing development through the lens of cultural psychology sheds light on questions of particular interest to cultural psychologists, such as those concerning the emergence of new cultures and the role of culture in shaping psychological processes. This novel framework also clarifies topics of particular interest to developmental psychology, such as conflict between individuals at different milestones (e.g., arguments between older and younger siblings) and age-related changes in cognition and behavior.

Norms and sexual relations among adolescents in the context of an intervention trial in rural Zambia

High levels of adolescent pregnancy and child marriage rates in low- and middle-income countries is an issue of concern to many stakeholders, including in Zambia where almost one-third of women give birth before age 18. The aim of this paper is to explore and analyse social norms concerning adolescents' sexual behaviour within the context of an intervention trial in rural communities in southern Zambia. It is based on a qualitative study applying individual interviews, focus group discussions and participatory research methods. We apply the distinction between injunctive and descriptive norms to demonstrate that adolescent girls are caught between conflicting norms. Injunctive norms express that premarital sex, contraceptive use, and discussions about sex between adults and youths are socially condemned. At the same time poor girls are reported to feel pressure towards having sexual relations for the economic benefits such relations can bring, and this practice is considered so common that it amounts to a descriptive norm. Norms and structural conditions combine to create a disabling and disempowering environment for adolescent sexual and reproductive health, which limits girls' agency and exposes them to unwanted pregnancies.

What Do Peers Think About Sexting? Adolescents’ Views of the Norms Guiding Sexting Behavior

This study examined the content of injunctive peer norms (i.e., perceived peer approval) of sexting among Swedish adolescents. Written answers from 808 adolescents ( Mage = 14.22) to an open-ended question about peers’ views of sexting were analyzed qualitatively using content analysis. Eight categories were distinguished for when and why sexting is acceptable or not in the peer group. A substantial share of adolescents believed their peers approve of sexting, especially if sexting occurs within trusted relationships and when all parties have consented. A large share of adolescents described that peers were non-accepting of sexting, emphasizing that it can be spread to others. The participants also suggested that sexting is seen as a gendered phenomenon surrounded by sexual double standards, with girls at more risk of negative consequences. Some participants emphasized the peer view that adolescents sext to seek attention, and some emphasized that sexting is viewed as an enjoyable activity. Several of these categories’ likelihood to be mentioned was related to the adolescents’ age, gender, and prior experience of sexting. We concluded that adolescents might have a hard time navigating the social context of sexting, given the conflicting and gendered messages from peers.

Communication, social norms, and contraceptive use among adolescent girls and young women in Lilongwe, Malawi

In Malawi, 50% of adolescent girls and young women (AGYW) have had a first child by age 19 and 45% report their pregnancies as unintended or mistimed. Yet, uptake of contraception remains low. Understanding how interactions with social ties impact AGYW contraceptive use might explain low uptake beyond individual and environmental factors. Data are from Girl-Power, a study among sexually active AGYW, aged 15-24, in Malawi. We used logistic regression models to examine whether contraceptive communication and social norms (descriptive and injunctive) were associated with contraceptive use (non-barrier methods and condoms) and how associations differed across social ties (older women in the family, peers, and partners). The sample included 942 participants: 28% reported using non-barrier methods and 66% reported using condoms. Contraceptive communication with older women in the family (aOR: 1.48, 95% CI: 0.99, 2.20), peers (aOR: 3.12, 95% CI: 1.96, 4.96), and partners (aOR 5.15, 95% CI: 3.13, 8.48) was associated with non-barrier method use. Descriptive norms were associated with non-barrier methods among peers (aOR 2.57, 95% CI: 1.63, 4.96) but not among older women in the family (aOR: 1.22, 95% CI 0.80, 1.88). There were no associations among contraceptive communication, social norms, and condom use across older women in the family, peers, and partners. The findings highlight the need to consider the influence of social ties in the design of future family planning interventions and suggest that interventions that encourage interpersonal communication about contraception and target peer-based descriptive norms have the potential to impact uptake of non-barrier methods.

Promoting Sexual Health in High School: A Feasibility Study of A Web-based Media Literacy Education Program

Comprehensive sexual health education (SHE) is an effective strategy for improving adolescent sexual health. However, few of these programs address media influence on sexual cognitions and behaviors. Also, more research is needed on using web-based instruction for SHE. Seventeen classes (N = 331 students) in one high school in the United States were enrolled in a pre-post randomized controlled trial to assess the feasibility of Media Aware, a web-based SHE program that uses a media literacy education (MLE) approach. Compared to a delayed-intervention group, students who received Media Aware had significant reductions in their perceived realism of and similarity to media messaging, improved cognitive elaboration of media messages, more realistic perceptions of teen sex norms and risky sex norms, increased efficacy and intention to act as a bystander to potential sexual assault, increased intent to communicate before sex, and increased efficacy to use contraception/protection. These students reported being less willing to hook up, being less willing to have unprotected sex (for males), and positive feedback on their experiences using a web-based program. This study provides evidence that web-based MLE sexual health programming is a feasible and acceptable strategy for improving media-related and sexual health outcomes among adolescents.

Adolescent Chlamydia Rates by Region, Race, and Sex: Trends From 2013 to 2017

INTRODUCTION

Chlamydia is the most common bacterial sexually transmitted infection in the United States. Adolescents (ages 15-19 years) have the highest infection rate, second only to young adults (ages 20-24 years). The purpose of this secondary data analysis is to examine trends from 2013 to 2017 in adolescent chlamydia rates by region, race, and sex.

METHOD

Adolescent chlamydia rate data were obtained from the Center for Disease Control's National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention database. Descriptive statistics were used to analyze the trends.

RESULTS

The overall trend in male and female adolescent chlamydia rates increased from 2013 to 2017. Specifically, the trend increased faster in males, White adolescents, and those in the Northeast and Midwest regions of the country.

DISCUSSION

Health care providers are uniquely positioned to positively affect adolescent chlamydia rates through targeted sexual health discussions and increased screening for sexually transmitted infections.

Social norms in adolescent risk engagement and recommendation

Social influence is an important determinant of adolescent risk-taking, but little is known about how social norms contribute to adolescents' tendency to recommend and engage in risky behaviours. Using the Adolescent Risk-taking Questionnaire, we assessed subjects' (n = 198, age = 10-26) propensity to engage in and recommend risk-taking as well as their perception of risk norms. Adolescents recommended risk-taking more often compared to children and young adults. Perceived social norms were the most important factor predicting engagement in risky behaviours, and adolescents perceived risk-taking to be more normative than children or adults. Our findings highlight two mechanisms that contribute to adolescent risk-taking, active recommendation and perceived social norms. On this basis, we discuss potential means to attenuate excessive adolescent risk-taking.

Early sexual initiation and risky sexual practices among alcohol- and tobacco-using young adults in Taiwan: mediation analysis of preceding-sex use of illicit drugs

BACKGROUND

As early sexual initiation is increasingly common in East Asia, we examined its relations to risky sexual practices in alcohol- and tobacco-using individuals in Taiwan and evaluated whether the associations were mediated through preceding-sex use of illicit drugs.

METHODS

Participants, recruited from alcohol- and tobacco-using adults aged 18 to 50 in Taipei through respondent-driven sampling (N = 1115), completed a computer-assisted self-interview covering questions on substance use and sexual experiences. In a subsample of 916 participants who had had sexual experience (median age 27), we examined the relations of early sexual initiation (< 16 years) to multiple sexual partners, casual sex, group sex, and rare condom use. Causal mediation analyses were conducted to examine whether illicit drug use preceding sex mediated these associations.

RESULTS

Around 9.3% reported early sexual initiation and the prevalence of risky sexual practices ranged from 7% (group sex) to 47% (rare condom use). Early initiators had a higher prevalence of regular binge drinking, illicit drug use, and risky sexual practices. In the multivariable analyses, higher odds of multiple sexual partners, casual sex, and group sex were consistently associated with early sexual initiation, gender, and their interaction. Mediation through preceding-sex use of illicit drugs was found between early sexual initiation and the three risky sexual practices, with the proportions mediated ranging from 17 to 19%.

CONCLUSIONS

Early sexual initiators were more likely to engage in risky sexual practices and preceding-sex use of illicit drugs partially explained this relationship, calling for more attention to this population's sexual health.

Longitudinal Associations Between Sexual Communication With Friends and Sexual Behaviors Through Perceived Sexual Peer Norms

The role of peers in adolescents' sexual behaviors is not yet fully understood. We investigated the association between sexual communication with friends (at T1) and subsequent changes in adolescents' experience with sexual behaviors (between T1-T3), and examined whether this association was explained by adolescents' perceptions of three sexual peer norms (at T2): (1) peers' sexual behaviors (descriptive norms), (2) peers' approval of sexual behaviors (injunctive norms), and (3) peer pressure to have sex. The data source was Project STARS, a longitudinal study on adolescent sexual development in the Netherlands, collected via online self-report questionnaires from 1,116 adolescents (11.5-17.9 years). Adolescents who communicated more frequently with their friends about sexuality-related topics at T1 reported significantly larger increases in their experience with different sexual behaviors between T1-T3. More sexual communication with friends also predicted adolescents subsequently perceiving more 1) peer sexual behaviors, 2) peer approval of sex, and 3) peer pressure to have sex. These stronger perceptions, in turn, predicted larger increases in their sexual behaviors between T1-T3. After adjusting for the three norms simultaneously, the main association between sexual communication with friends and sexual behavior change weakened but remained significant. Inspection of specific indirect effects showed this link was explained by injunctive norms only. No gender differences were found.

Associations Among Behavioral Risk, Sociodemographic Identifiers, and Sexually Transmitted Infections in Male and Female Army Enlisted Personnel

INTRODUCTION

Rates of sexually transmitted infections (STIs) are higher among U.S. military personnel than their civilian counterparts. Yet there is a paucity of military-specific research that has utilized theoretical frameworks to describe the relative influence of the multiple and interrelated risk factors associated with STIs in this population of young, healthy men and women. The aim of this study was to examine the relative influence of Information, Motivation, and Behavioral Skills Model (IMB) factors known to be associated with condom use and STI diagnosis, as well as examine gender differences among a cohort of young, active duty enlistees who are in the very early stages of their military careers.

MATERIALS AND METHODS

Data were collected in 2011 to 2013 through self-administered questionnaires and laboratory-confirmed tests of STIs. Logistic regression analyses were used to assess IMB constructs, behavioral risk variables, and sociodemographic factors associated with STI diagnosis and condom use separately among female and male military personnel.

RESULTS

STIs among males were significantly associated with nonwhite race, lower STI behavioral intentions and STI behavioral skills, and engaging in sex after drinking alcohol. Further, males who reported more positive attitudes toward using condoms, higher confidence in preventing drinking, higher alcohol prevention norms among peers, a lower frequency of drinking alcohol before engaging in sexual intercourse, more sexual partners, and higher STI behavioral intentions were significantly more likely to report using condoms consistently during sexual encounters. Among female participants, a history of STIs was significantly associated with higher numbers of reported sexual partners and greater alcohol prevention efficacy while lifetime consistent condom use was significantly associated only with stronger intentions to avoid behaviors that might result in STI acquisition.

CONCLUSION

Our findings support the need for development of STI prevention strategies that include education and skills-building approaches to reduce alcohol misuse among enlisted military personnel, and especially male personnel. Such programs should include factors that uniquely influence the experiences of males and females in the military context.

A Short-Term Longitudinal Investigation of the Perceived Hookup Attitude of Gender-Specific Close Friends and Hookup Behavior

Research suggests that peer injunctive norms (i.e., perceived attitudes) have an indirect effect on youth’s behavior. Few studies have explored the underlying mechanism of the relationship between the perceived attitude of gender-specific close friends and hookup behavior. Following the social norm approach and the social learning theory, a person’s own hookup attitude and their emotional reaction after a hookup would influence this relationship as mediators. We therefore examined the association between perceived hookup attitudes of students’ same-sex/opposite-sex close friends and the number of hookup partners via mediated variables (i.e., own hookup attitude and affect following a recent hookup) in Chinese college students (N = 314) who completed self-report measures at 6-month intervals. The results of a path analysis showed that students’ own attitudes toward hookups and negative affect following a hookup significantly mediated the association between perceived hookup attitudes of same-sex close friends and the number of hookup partners over 6 months. These findings indicate that same-sex close friends’ injunctive norms were more strongly associated with future hookup behavior, as compared to opposite-sex friends’ injunctive norms. To better understand the relationship between peer norms and hookup behavior, both students’ hookup attitudes and negative emotional responses should be considered.

Autistic traits, adolescence, and anti-social peer pressure

Background

The potential role of autism as a moderator of conformity has recently been investigated by a small number of studies. However, as yet, no consensus has emerged as to whether autism or autistic traits can moderate the degree to which people attend to and are influenced by social pressure, nor whether there are specific circum-stances under which this might occur. The current study adds to this ambiguous literature by looking at whether autism and autistic traits are associated with conformity in the context of adolescent peer pressure.

Participants and procedure

A sample of 12-16 year old students completed questionnaire measures of peer conformity (e.g., in relation to smoking, skipping school, etc.), resistance to peer influence, and autistic traits. Approximately half had an au-tism-related diagnosis, and none had an intellectual impairment.

Results

Controlling for age, gender, and academic ability, we found that degree of autistic traits was associated with reduced peer conformity, while a diagnosis of autism was not. In contrast, neither autism nor autistic traits were related to resistance to peer influence.

Conclusions

These results are contextualised in terms of past research and positioned within a broader model of individual differences and conformity in which autistic traits moderate the degree to which a person perceives peer influ-ence, while resistance to peer influence moderates the degree to which one conforms to peer influence. Possi-ble future avenues of inquiry are suggested.

Association of Sexual Health Interventions With Sexual Health Outcomes in Black Adolescents: A Systematic Review and Meta-analysis

IMPORTANCE

Black adolescents are at increased risk of contracting HIV and other sexually transmitted infections (STIs) and experiencing unplanned pregnancy. Although sexual health interventions aimed at decreasing these risks exist, evidence of the association between sexual health interventions and the sexual behavior of black adolescents has not been synthesized to our knowledge.

OBJECTIVE

To examine the associations between sexual health interventions and behavioral, biological, and psychological outcomes.

DATA SOURCES

For this systematic review and meta-analysis, a systematic search was conducted of studies published through January 31, 2019, using the PubMed, PsycINFO, and CINAHL databases and relevant review articles. The following key words were used: youth, adolesc* or teen*; sexual health or safe* sex or sexually transmitted disease or sexually transmitted infection or STD or STI or HIV or AIDS or pregnancy or reproductive health or condom* or contracept* or unprotected sex or abstinence; intervention or program or education or prevention or promotion or trial; latino* or latina* or latinx* or minorit* or ethnic* or hispanic or african american* or black* or race or racial or biracial.

STUDY SELECTION

Studies were included if they included a US-based sample of black adolescents, evaluated a sexual health intervention using experimental or quasi-experimental designs, included a behavioral outcome, and were published in English.

DATA EXTRACTION AND SYNTHESIS

Standardized mean differences and 95% CIs were extracted and meta-analyzed using random-effects models.

MAIN OUTCOMES AND MEASURES

Behavioral outcomes were abstinence, condom use, and number of sex partners. Biological outcomes were pregnancy and STI contraction. Psychological outcomes were sexual health intentions, knowledge, and self-efficacy.

RESULTS

Across 29 studies including 11 918 black adolescents (weighted mean age, 12.43 years), there was a significant weighted mean association of sexual health interventions with improvements in abstinence (Cohen d = 0.14; 95% CI, 0.05-0.24) and condom use (Cohen d = 0.25; 95% CI, 0.11-0.39). No significant mean association of these interventions with number of sex partners, pregnancy, or STI contraction was found. Sexual health interventions were significantly associated with improvements in psychological outcomes: sexual health intentions (Cohen d = 0.17; 95% CI, 0.05-0.30), knowledge (Cohen d = 0.46; 95% CI, 0.30-0.63), and self-efficacy (Cohen d = 0.19; 95% CI, 0.09-0.28). Intervention effect sizes were consistent across factors, such as participant sex and age and intervention dose.

CONCLUSIONS AND RELEVANCE

The findings suggest that sexual health interventions are associated with improvements in sexual well-being among black adolescents. There appears to be a need for wide-scale dissemination of these programs to address racial disparities in sexual health across the US.

Innovation and Integration of Sexuality in Family Life Education

As a fundamental aspect of the human experience, sexuality is experienced at every stage in the lifespan. Sexual values, behaviors, and health are important components of individual and family well-being. Educating about such a fundamental aspect of life is both obvious and crucial. In this article, we consider the potential of sexuality education in the field and profession of family life education (FLE). We critique sexuality education in the United States, and we critique the marginal place of human sexuality in the FLE field. We then offer recommendations for incorporating lifespan, socio-ecological, family systems and intersectionality into sexuality education, and recommendations for FLE and sexuality education research and practice. We argue that educating about sexuality in the context of FLE-and activating the profession of FLE for sexuality education-will strategically advance sexuality education, sexual health, and the field of FLE.