The effect of sexual abstinence on females' educational attainment

The Impact of Making Proud Choices! on Youth's Sexual Health Attitudes, Knowledge, and Behaviors

PURPOSE

To estimate the effect of the Making Proud Choices! (MPC) curriculum, one of the most popular evidence-based teen pregnancy prevention curricula being implemented nationwide.

METHODS

A cluster randomized trial was used to assign high schools to receive the MPC program or to serve as a standard care comparison group. The study took place in 15 schools in four cities in the United States. A total of 31 clusters and over 2,800 youth (predominantly in grades 9 and 10) were assigned to condition between 2016 and 2019. Student surveys administered at baseline and approximately 9 months after baseline were used to estimate the effects of MPC on risk and protective factors (knowledge, attitudes, self-efficacy) as well as sexual behavior outcomes.

RESULTS

The evaluation showed several large, statistically significant, and favorable impacts on nearly all of the risk and protective factors for risky sexual behavior. In addition, the study found a favorable effect of MPC on reducing the number of episodes of sex in the past 3 months.

DISCUSSION

The evaluation showed that MPC, as it is commonly implemented today, has evidence of effectiveness on improving both risk and protective factors, and sexual behavior outcomes. Based on these findings, MPC will continue to be seen as an evidence-based teen pregnancy prevention program for implementation through federal grant programs.

Sexual abstinence as a reproductive health-promoting behavior for women: A perspective

This article is intended to provide an appropriate context for adopting sexual abstinence from a health-promoting behavioral perspective that can be applied to women of reproductive age worldwide to improve reproductive health, maintain well-being, and prevent health problems in women. The topics related to women's health status, sexual abstinence definitions, benefits, and application, as well as sexual autonomy and efficacy, including family collaboration, are discussed. This article will provide health care providers, especially nurses and midwives, with new ideas for integrating sexual abstinence into nursing and midwifery practice.

Development of a child-rearing promotion of sexual abstinence scale (CPSAS) in Thai female adolescents at two Thai universities

Purpose

Child-rearing promoting sexual abstinence has strongly predicted sexual abstinence in Thai female adolescents, and it requires a valid and reliable measurement. However, no such instrument exists. This study aimed to develop a child-rearing promotion of sexual abstinence scale (CPSAS) and assess its validity and reliability.

Design/methodology/approach

The scale development consisted of two phases; scale construction and psychometric testing. Phase I included item generation extracted from a literature review and existing measurements. Items were reviewed by five-panel experts and were then selected by considering an inter-item correlation, corrected item-total correlation, factor loading and communality value from the exploratory factor analysis (n = 299). Phase II involved confirmatory factor analysis (CFA) for construct validity and scale reliability (n = 300).

Findings

The CPSAS, first, contained 25 items with four dimensions; assuring daughter to recognize parental love, teaching daughter sexual abstinence, convincing daughter to recognize parent's expectations of sexual abstinence and encouraging daughter sexual abstinence. Two items were then deleted after the experts reviewed, and six items were removed after item analysis. The CPSAS finally contained 17 items with a 4-point Likert scale. Psychometric testing provided acceptable results. CFA reported the fit indices; χ2 = 98.06 p = 0.083, df = 80, χ2/df ratio = 1.220, CFI = 0.996, TLI = 0.992, RMSEA = 0.027 and SRMR = 0.030. The standardized factor loadings were 0.499 to 0.908 (p < 0.05). The S-CVI was 0.96, and Cronbach's alpha coefficient was 0.93.

Originality/value

The CPSAS is a reliable and valid instrument for evaluating child-rearing promoting sexual abstinence in Thai female adolescents.

Adolescent sexual behaviour and academic performance of Italian students

This article estimates the effect of sexual activity during adolescence on academic performance of high school students in Italy. We exploit a sample of university students drawn from the two waves (2000 and 2017) of the SELFY survey. The survey collects information on sexual behaviours during adolescence and on the grade obtained at the high school final examination, as well as on a number of family-related variables. Overall, results suggest a negative relationship between sexual activity and the grade obtained in the high school final examination supporting the idea that health and education consequences of sexual activities among adolescents merit public policy efforts. To deal with the potential influence of unobserved characteristics at individual and family level, we also pursue an instrumental variables approach. As instruments, we use three questions as proxy of erotophobia-erotophilia personality trait. This extension of the analysis confirms the results of the baseline models.

Marriage Age, Social Status, and Intergenerational Effects in Uganda

This study examines whether Ugandan women who marry at younger ages fare differently on a wide range of later-life outcomes than women who marry at later ages. Using a nationally representative data set, I identify the plausibly causal impacts of women's marriage age by using age at menarche as an instrumental variable. Results indicate that a one-year delay in marriage for Ugandan women leads to higher educational attainment (0.5-0.75 years), literacy (10 percentage points), and labor force participation (8 percentage points). I also explore intergenerational effects of later marriage and find that the children of mothers who marry later have higher BMI (0.11 kg/m²) and hemoglobin levels (0.18 g/dl), and they are also less likely to be anemic (4 percentage points). Finally, I present evidence suggesting that the observed effects might be mediated through an enhancement of women's agency within their household and positive assortative matching in the marriage market. By pointing to the beneficial consequences of delaying marriage, this research calls for concerted policy action to prevent child marriage.

Socio-demographic factors of early sexual debut and depression among adolescents

Background

Adolescent early sexual debut as it relates with socio-demographic factors and depression of secondary school adolescents. During the adolescent stage, attitudes, values and behaviours that shape a young person's behavior in the future develop. Age of sexual debut is generally low, yet there is dearth of knowledge on sexuality in the area of this study-Nsukka Education zone of Enugu State, Nigeria.

Objective

To determine the socio-demographic factors of early sexual debut and depression among adolescents in secondary schools in Nsukka Education zone of Enugu state, Nigeria.

Materials and methods

A cross-sectional longitudinal study of 408 secondary school adolescents in Nsukka Education zone of Enugu state, Nigeria during the 2016/2017 school year. Data was collected using pre-tested, observation schedule, structured interview and well-structured questionnaire. Tests of statistical significance were carried out using chi-square and t-tests. A p value of < 0.005 was found to be significant.”

Results

The age group at which respondents had their first sexual intercourse ranged between 13 to 19 years, the mean ages are 12.1±1.2 and 14.5±1.5 for males and females, while the modal and median ages at first sexual intercourse for male and female are 14 and 13 years respectively with a cumulative frequency percent of 56.5. The girls-initiated sex earlier than the boys (p= 0.001). Those brought up by one parent-initiated sex at an earlier age (p= 0.000), while age of sex initiation increased with maternal (p=0.000) and paternal education (p= 0.001). Depressed adolescent boys and girls were more likely than their non-depressed peers to have experienced sexual intercourse. The youngest adolescents who were depressed were more likely to have experienced intercourse than the older ones who were not depressed. Respondents sharing room with parents or adult relations of opposite sex were found to have initiated sex earlier than those staying alone or sharing room with same sex peers.

Conclusion

Age at sexual debut was found to be associated with younger age, gender, living with a one parent and parents' educational status.

Are Men's Reproductive Health Problems and Sexual Behavior Predictors of Welfare?

The study examined men's reproductive health problems and sexual behavior and their implications for men's welfare in Nigeria. It used the Nigeria Demographic and Health Survey data set of 2013. The analysis used only male recode files, representing 17,359 males. The dependent variable is the computed wealth index, which was selected as proxy for welfare condition. Analysis involved univariate and multivariate levels. The findings indicated that 49.3% of the respondents currently have more than one sexual partner. The total lifetime sexual partner index identifies 70.2% of the men interviewed have had at least two sexual partners in their lifetime. It revealed that men who experience reproductive health challenges, such as sexually transmitted infections and genital ulcer, are 44% and 93%, respectively, less likely to enjoy good welfare condition. It also indicated that men in urban area are 7.256 times more likely to enjoy good welfare condition compared with their rural counterparts. There is a negative association between total lifetime sexual partnerships and exposure to good welfare. The study concludes that social workers, marriage counselors, other health personnel, and policy makers need to focus on the practice of multiple sexual partnership and reproductive health diseases as major determinants of men's welfare. The authors suggest that the index of welfare should include reproductive health issues and indicators of sexual behavior. Also, there is need for the establishment of specialized reproductive health care services and centers that are accessible to all men for effective servicing of reproductive health needs of men in the country.

High School Dropouts and Sexually Transmitted Infections

People who drop out of high school fare worse in many aspects of life. We analyze the relationship between dropping out of high school and the probability of contracting a sexually transmitted infection (STI). Previous studies on the relationship between dropout status and sexual outcomes have not empirically addressed unobserved heterogeneity at the individual level. Using fixed effects estimators, we find evidence supporting a positive relationship between dropping out of high school and the risk of contracting an STI for females. Furthermore, we present evidence that illustrates differences between the romantic partners of dropouts versus enrolled students. These differences suggest that female dropouts may be more susceptible to contracting STIs because they partner with significantly different types of people than non-dropouts. Our results point to a previously undocumented benefit of encouraging those at risk of dropping out to stay in school longer.

Do health and education agencies in the United States share responsibility for academic achievement and health? A review of 25 years of evidence about the relationship of adolescents' academic achievement and health behaviors

PURPOSE

The United States Centers for Disease Control and Prevention monitors health-risk behaviors of adolescents in United States, which include (1) violence; (2) tobacco use; (3) alcohol and other drug use; (4) sexual behaviors contributing to unintended pregnancy and sexually transmitted diseases; (5) inadequate physical activity; and (6) unhealthy dietary behaviors. We reviewed original research published in peer-reviewed journals between 1985 and 2010 to synthesize evidence about the association of adolescent health-risk behaviors and academic achievement.

METHODS

Using predetermined selection criteria, 122 articles were included that used at least one variable for health-risk behaviors and also for academic achievement.

RESULTS

For all six health-risk behaviors, 96.6% of the studies reported statistically significant inverse relationships between health-risk behaviors and academic achievement.

CONCLUSIONS

With this persuasive evidence about the interrelationship of health-risk behaviors and academic achievement, it is imperative that leaders in education and health act together to make wise investments in our nation's school-age youth that will benefit the entire population. A unified system that addresses both health behavior and academic achievement would have reciprocal and synergistic effects on the health and academic achievement not only of children and adolescents, but also of adults in the United States.

Willingness to provide behavioral health recommendations: a cross-sectional study of entering medical students

BACKGROUND

Behavioral factors contribute importantly to morbidity and mortality, and physicians are trusted sources for information on reducing associated risks. Unfortunately, many clinical encounters do not include prevention counseling, and medical school curriculum plays an important role in training and promoting such counseling among medical students.

METHODS

We surveyed all 93 freshman medical students at entry to the University of California, Davis School of Medicine in 2009 to evaluate baseline knowledge of population health principles and examine their approach to clinical situations involving four common behavioral risk factors illustrated in brief clinical vignettes: smoking, alcohol use in a patient with indications of alcoholism, diet and exercise in an overweight sedentary patient, and a 16-year-old contemplating initiation of sexual intercourse. Based on vignette responses, we assessed willingness to (1) provide information on risks, (2) recommend elimination of the behavior as the most efficacious means for reducing risk, (3) include strategies apart from elimination of the behavior for lowering risk (i.e., harm reduction), and (4) assure of their intention to continue care whether or not recommendations are accepted.

RESULTS

Students answered correctly 71.4 % (median; interquartile range 66.7 % - 85.7 %) of clinical prevention and population health knowledge questions; men scored higher than women (median 83.3 % vs. 66.7 %, p<0.02). Students showed high willingness to provide information and strategies for harm reduction apart from risk elimination, while respecting patient autonomy. Willingness to recommend elimination of high-risk behaviors "always or nearly always" was high for smoking (78.5 %), alcohol consumption in a patient with indications of alcoholism (64.5 %), and diet and exercise in a sedentary and overweight individual (87.1 %), and low for the 16-year-old considering initiating sexual intercourse (28.0 %; Friedman test, p<0.001). Willingness was not associated with the respondent's background knowledge of population health principles or gender.

CONCLUSION

Students showed high willingness to educate and respect patient autonomy. There was high willingness to recommend elimination of risk behaviors for smoking, alcohol, and poor diet/exercise, but not for sexual intercourse in an adolescent considering sexual debut. Further research should address promoting appropriate science-based preventive health messages, and curriculum should include explicit discussion of content of recommendations.

Gender and the influence of peer alcohol consumption on adolescent sexual activity

I consider the alcohol consumption of opposite-gender peers as explanatory to adolescent sexual intercourse and demonstrate that female sexual activity is higher where there is higher alcohol consumption among male peers. This relationship is robust to school fixed effects, cannot be explained by broader cohort effects or general antisocial behaviors in male peer groups, and is distinctly different from any influence of the alcohol consumption of female peers which is shown to have no influence on female sexual activity. There is no evidence that male sexual activity responds to female peer alcohol consumption.

The effect of body weight on adolescent sexual activity

Recent research suggests that overweight females suffer penalties in the labor and marriage markets, while overweight males do not. This study explores whether similar gender differences in the effect of body weight exist in what Cawley et al. (2006) labeled 'the adolescent sex market'. Drawing on data from the National Longitudinal Study of Adolescent Health, we use fixed effects and instrumental variables identification strategies to estimate the relationship between body weight and sexual activity. We find evidence that increased body weight lowers the probability that female adolescents become sexually active. In contrast, there is little evidence of a causal relationship between body weight and sexual activity for male adolescents.

Boys will be boys: are there gender differences in the effect of sexual abstinence on schooling?

A recent study by Sabia and Rees (2009) found that delaying first intercourse leads to a substantial increase in the probability that female students graduate high school. However, it is unclear whether the effect of abstinence extends to male students. Here we identify exogenous variation in the timing of first intercourse using a physical development index available for both females and males. Two-stage least squares estimates suggest that abstaining from sexual intercourse increases the probability that females graduate from high school, but has little effect on the educational attainment of males. This pattern of results is consistent with evidence from previous studies that males are less likely than females to suffer adverse psychological consequences from engaging in sexual intercourse at an early age.