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Masonbrink AR, Abella M, Hall M, Gooding HC, Burger RK, Goyal MK. Sexually Transmitted Infection Diagnoses at Children's Hospitals During COVID-19. Hosp Pediatr 2024; 14:e1-e5. [PMID: 38130205 PMCID: PMC10750167 DOI: 10.1542/hpeds.2022-006750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2023]
Abstract
OBJECTIVES COVID-19 mitigation strategies resulted in changes in health care access and utilization, which could negatively impact adolescents at risk for sexually transmitted infections (STIs). We evaluated changes in STI diagnoses during adolescent visits at children's hospitals during COVID-19. METHODS We conducted a retrospective cohort study using the Pediatric Health Information System database comparing adolescent (11-18 years) hospital visits with an STI diagnosis by International Classification of Diseases, 10th revision, code during COVID-19 (2020) to pre-COVID-19 (2017-2019). Data were divided into spring (March 15-May 31), summer (June 1-August 31), and fall (September 1-December 31). Median weekly visits and patient characteristics were compared using median regression. RESULTS Of 2 747 135 adolescent encounters, there were 10 941 encounters with an STI diagnosis from 44 children's hospitals in 2020. There was a decrease in overall median weekly visits for STIs in spring during COVID-19 (n = -18.6%, P = .001) and an increase in overall visits in summer (11%, P = .002) during COVID-19. There were significant increases in inpatient median weekly visits for STIs in summer (30%, P = .001) and fall (27%, P = .003) during COVID-19. We found increases in Neisseria gonorrhoeae (50%, P < .001) and other STI diagnoses (defined as other or unspecified STI by International Classification of Diseases, 10th revision, code; 38%, P = .040) in fall COVID-19 (2020), and a decrease in pelvic inflammatory disease (-28%, P = .032) in spring COVID-19 (2020). CONCLUSIONS We found increases in median weekly adolescent inpatient visits with an STI diagnosis in summer and fall COVID-19 (2020). These findings were likely partially driven by changes in behaviors or health care access. Further work is needed to improve STI care and thus potentially improve related health outcomes.
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Affiliation(s)
- Abbey R. Masonbrink
- Department of Pediatrics, Children’s Mercy Hospital, University of Missouri-Kansas City, Kansas City, Missouri
| | - Margarita Abella
- Department of Pediatrics, Children’s Mercy Hospital, University of Missouri-Kansas City, Kansas City, Missouri
| | - Matt Hall
- Department of Pediatrics, Children’s Mercy Hospital, University of Missouri-Kansas City, Kansas City, Missouri
- Children’s Hospital Association, Lenexa, Kansas
| | | | - Rebecca K. Burger
- Division of Emergency Medicine, Department of Pediatrics, Emory University School of Medicine and Children's Healthcare of Atlanta, Atlanta, Georgia
| | - Monika K. Goyal
- Children’s National Hospital, George Washington University, Washington, District of Columbia
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Ewing AC, Kottke MJ, Kraft JM, Sales JM, Brown JL, Goedken P, Wiener J, Kourtis AP. 2GETHER - The Dual Protection Project: Design and rationale of a randomized controlled trial to increase dual protection strategy selection and adherence among African American adolescent females. Contemp Clin Trials 2017; 54:1-7. [PMID: 28007634 PMCID: PMC5890330 DOI: 10.1016/j.cct.2016.12.014] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2016] [Revised: 12/13/2016] [Accepted: 12/18/2016] [Indexed: 11/29/2022]
Abstract
BACKGROUND African American adolescent females are at elevated risk for unintended pregnancy and sexually transmitted infections (STIs). Dual protection (DP) is defined as concurrent prevention of pregnancy and STIs. This can be achieved by abstinence, consistent condom use, or the dual methods of condoms plus an effective non-barrier contraceptive. Previous clinic-based interventions showed short-term effects on increasing dual method use, but evidence of sustained effects on dual method use and decreased incident pregnancies and STIs are lacking. METHODS/DESIGN This manuscript describes the 2GETHER Project. 2GETHER is a randomized controlled trial of a multi-component intervention to increase dual protection use among sexually active African American females aged 14-19years not desiring pregnancy at a Title X clinic in Atlanta, GA. The intervention is clinic-based and includes a culturally tailored interactive multimedia component and counseling sessions, both to assist in selection of a DP method and to reinforce use of the DP method. The participants are randomized to the study intervention or the standard of care, and followed for 12months to evaluate how the intervention influences DP method selection and adherence, pregnancy and STI incidence, and participants' DP knowledge, intentions, and self-efficacy. DISCUSSION The 2GETHER Project is a novel trial to reduce unintended pregnancies and STIs among African American adolescents. The intervention is unique in the comprehensive and complementary nature of its components and its individual tailoring of provider-patient interaction. If the trial interventions are shown to be effective, then it will be reasonable to assess their scalability and applicability in other populations.
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Affiliation(s)
- Alexander C Ewing
- National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - Melissa J Kottke
- Jane Fonda Center, Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, GA, USA
| | - Joan Marie Kraft
- National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Jessica M Sales
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Jennifer L Brown
- Addiction Sciences Division, Department of Psychiatry & Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Peggy Goedken
- Jane Fonda Center, Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, GA, USA
| | - Jeffrey Wiener
- National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Athena P Kourtis
- National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
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Abstract
This study explores the relationship between teenage pregnancy and male partner violence by examining the prevalence and effect of partner violence in a sample of new adolescent mothers. Data for this study are drawn from in-depth interviews with 35 new teenage mothers who had never been in, were currently involved in, or had recently exited from abusive partner relationships. The effect of partner violence on contraceptive use and pregnancy resolution are discussed as important variables in order to understand adolescent pregnancy. The role of social support is discussed as an important buffer for many of the adolescent mothers.
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Dunn HK, Gjelsvik A, Pearlman DN, Clark MA. Association between sexual behaviors, bullying victimization and suicidal ideation in a national sample of high school students: implications of a sexual double standard. Womens Health Issues 2015; 24:567-74. [PMID: 25213749 DOI: 10.1016/j.whi.2014.06.008] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2013] [Revised: 04/24/2014] [Accepted: 06/19/2014] [Indexed: 12/21/2022]
Abstract
PURPOSE The sexual double standard is the notion that women are more harshly judged for their sexual behaviors than men. The purpose of this study was to investigate if the sexual double standard could explain gender differences in bullying victimization among adolescents and the extent to which that relationship correlated with depression and suicidal ideation. METHODS Analyses were conducted using a sample of high school students (n = 13,065) from the 2011 Youth Risk Behavior Survey, a cross-sectional and national school-based survey conducted by the Centers for Disease Control and Prevention. Data were assessed using multiple logistic regression, gender-stratified analyses, and interaction terms. FINDINGS Students who engaged in sexual intercourse (sexually active) had higher odds of being bullied. When this association was stratified by gender, odds of being bullying increased for girls (odds ratio [OR], 1.83; 95% CI, 1.58-2.13) and decreased for boys (OR, 0.94; 95% CI, 0.77-1.16). Sexually active students who were bullied also displayed more than five times (OR, 5.65; 95% CI, 4.71-6.78) the adjusted odds of depression and three times (adjusted OR, 3.38; 95% CI, 2.65-4.32) the adjusted odds of suicidal ideation compared with students who reported neither of those behavioral characteristics. When stratified by gender, girls had slightly higher odds of depression and suicidal ideation but overall, the odds remained strong for both genders. CONCLUSIONS Results provide some evidence that a sexual double standard exists and may play a prominent role in bullying victimization among girls. Therefore, addressing the sexual double may be important to consider when tailoring school bullying intervention programs.
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Affiliation(s)
- Hailee K Dunn
- School of Public Health, Brown University, Providence, Rhode Island.
| | - Annie Gjelsvik
- Department of Epidemiology, School of Public Health, Brown University, Providence, Rhode Island
| | - Deborah N Pearlman
- Department of Epidemiology, School of Public Health, Brown University, Providence, Rhode Island
| | - Melissa A Clark
- Department of Epidemiology, School of Public Health, Brown University, Providence, Rhode Island
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Kaplanoglu M, Kaplanoglu D, Usman MG. Postpartum contraception in adolescents: data from a single tertiary clinic in southeast of Turkey. Glob J Health Sci 2014; 7:80-6. [PMID: 25716393 PMCID: PMC4796411 DOI: 10.5539/gjhs.v7n2p80] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2014] [Accepted: 09/04/2014] [Indexed: 12/03/2022] Open
Abstract
Aim: We aimed to evaluate the postpartum contraception preferences of adolescent women in this study. Material and Method: This descriptive study was prepared after a retrospective analysis of file records of primigravida women who had given birth at the Adiyaman University School of Medicine Training and Research Hospital Department of Obstetric and Gynecology between January 2010 and June 2012. More than 12 months had passed after birth. The adolescents who were included in the study and the control group women were called by phone and invited to our clinic. A total of 506 adolescents and 1,046 control group women came to the clinic and were evaluated. The control group was formed of women between the age of 20-35 years who gave given birth in our clinic during the same period and were randomly selected. Postpartum obstetric history, contraception methods and data of these patients were recorded. Results: The mean age was 18.3±0.4 years and 28.2±4.9 years in the adolescent group and control group respectively. No contraception other than lactation amenorrhea was used by 256 women of the adolescent group (50.6%) and 345 women of the control group (33%). The most commonly used contraceptive method in both groups other than lactation amenorrhea was condoms (160 women (64%) and 230 women (32.8%) respectively). The annual contraceptive failure rate was 3.95% in the adolescent group and 1.72% in the control group. The highest failure rate was with lactation amenorrhea in both groups. Discussion: Adolescent women mostly use contraceptive methods with low reliability such as lactation amenorrhea and the calendar method in the postpartum period. Providing adequate contraceptive education is therefore important. On the other hand, starting such training starting in the early postnatal period will prevent recurring adolescent pregnancies with a short pregnancy interval.
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Abstract
Rates of sexual activity, pregnancies, and births among adolescents have continued to decline during the past decade to historic lows. Despite these positive trends, many adolescents remain at risk for unintended pregnancy and sexually transmitted infections (STIs). This policy statement has been developed to assist the pediatrician in understanding and supporting the use of condoms by their patients to prevent unintended pregnancies and STIs and address barriers to their use. When used consistently and correctly, male latex condoms reduce the risk of pregnancy and many STIs, including HIV. Since the last policy statement published 12 years ago, there is an increased evidence base supporting the protection provided by condoms against STIs. Rates of acquisition of STIs/HIV among adolescents remain unacceptably high. Interventions that increase availability or accessibility to condoms are most efficacious when combined with additional individual, small-group, or community-level activities that include messages about safer sex. Continued research is needed to inform public health interventions for adolescents that increase the consistent and correct use of condoms and promote dual protection of condoms for STI prevention with other effective methods of contraception.
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Bjorn MBN, Jesus SND, Morales MIC. Estrategias de relajación durante el período de gestación. Beneficios para la salud. CLÍNICA Y SALUD 2013. [DOI: 10.1016/s1130-5274(13)70009-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Miozzo L, Dalberto ER, Silveira DXD, Terra MB. Consumo de substâncias psicoativas em uma amostra de adolescentes e sua relação com o comportamento sexual. JORNAL BRASILEIRO DE PSIQUIATRIA 2013. [DOI: 10.1590/s0047-20852013000200001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
OBJETIVO: Avaliar o consumo de substâncias psicoativas e o padrão de comportamento sexual em alunos do ensino médio, na cidade de Serafina Corrêa - RS, com uma população aproximada de 15 mil habitantes. MÉTODO: Em estudo transversal, a amostra foi composta por todos os alunos, de ambos os sexos, que estavam cursando o ensino médio nessa cidade. Foram aplicados: um questionário para verificação das variáveis sociodemográficas, um sobre comportamento sexual e outro sobre o consumo de drogas. RESULTADOS: A amostra constituiu-se de 453 alunos, sendo 261 (57,62%) do sexo feminino. A droga mais usada durante a vida foi o álcool (82,34%), seguida por tabaco (12,58%), maconha (6,62%) e cocaína (5,30%). Em relação ao comportamento sexual dos adolescentes, observou-se que 247 (54,5%) referiram já ter tido relação sexual. Foi encontrada uma associação entre o adolescente já ter utilizado drogas em geral (p < 0,001), álcool (p < 0,001) ou tabaco (p = 0,023) e já ter tido relação sexual. CONCLUSÃO: O estudo permitiu conhecer o uso de drogas e características do comportamento sexual dos adolescentes dessa cidade e poderá ser útil para a elaboração de um programa de intervenção para diminuir os fatores de risco para drogadição, incluindo a educação para a promoção da saúde.
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Affiliation(s)
- Luciane Miozzo
- Universidade Federal de Ciências da Saúde de Porto Alegre
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Blashill AJ, Gordon JR, Safren SA. Anabolic-androgenic steroids and condom use: potential mechanisms in adolescent males. JOURNAL OF SEX RESEARCH 2013; 51:690-695. [PMID: 23718635 PMCID: PMC3762910 DOI: 10.1080/00224499.2013.766823] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Previous research has revealed a significant bivariate relationship between anabolic-androgenic steroid (AAS) use and reduced condom use among adolescent boys. However, to date, no known studies have explored the psychological mechanisms that may explain this relationship. Thus, the current study sought to examine two possible mediators in the association between AAS and condom use: depressive symptoms and substance use. Data were extracted from a nationally representative sample of U.S. adolescents. Participants were 3,780 U.S. high school boys who responded to self-report items assessing a number of health behaviors, including symptoms of depression, substance use, AAS use, and use of condoms during their most recent act of intercourse. Both depression and substance use were significant mediators in the relationship between AAS and condom use. However, when these effects were contrasted, the indirect effect of substance use was significantly stronger in magnitude than the effect of depression. Although AAS use was associated with sexual risk behaviors among adolescent boys, significant variance in this relationship was accounted for by elevated levels of depression and substance use, with substance use demonstrating a particularly salient pathway.
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Jones V, Modeste N, Hopp Marshak H, Fox C. The Effect of HIV/AIDS Education on Adolescents in Trinidad and Tobago. ACTA ACUST UNITED AC 2013. [DOI: 10.5402/2013/691054] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Objective. This study was conducted to determine the effectiveness of an HIV/AIDS educational intervention on adolescents’ knowledge about and perceptions of susceptibility and severity of HIV/AIDS. We also examined whether providing information about assertiveness skills led to an intention to delay initiation of sexual activity. Methods. A quasi-experimental design was used to conduct this study among secondary school students in Trinidad and Tobago. The five constructs of the Health Belief Model were used to design and test the impact of the educational lessons for the intervention group while the comparison group watched one educational video about HIV over four sessions. A total of 196 secondary school students (from nine schools) between the ages of 11 and 18 years participated in the study, 92 in the intervention group and 104 in the comparison group. Results. Those in the comparison group had higher knowledge scores at posttest than the intervention group, controlling for pretest knowledge (), but those in the intervention group were more likely to plan to delay sexual initiation (). Conclusions. While knowledge scores increased for both groups, intention to delay sexual intercourse was only seen among the intervention group and within the younger age groups.
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Affiliation(s)
- Vanessa Jones
- School of Nursing, Loma Linda University, Loma Linda, CA 92350, USA
| | - Naomi Modeste
- School of Public Health, Loma Linda University, Loma Linda, CA 92350, USA
| | - Helen Hopp Marshak
- School of Public Health, Loma Linda University, Loma Linda, CA 92350, USA
| | - Curtis Fox
- School of Behavioral Health, Loma Linda University, Loma Linda, CA 92350, USA
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Sayegh A, Rose S, Schapiro NA. Condom availability in middle schools: evidence and recommendations. J Pediatr Health Care 2012; 26:471-5. [PMID: 22981151 DOI: 10.1016/j.pedhc.2012.07.018] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2012] [Revised: 07/31/2012] [Accepted: 07/31/2012] [Indexed: 10/27/2022]
Affiliation(s)
- Anthony Sayegh
- PrEP Demonstration Project Study Clinician, San Francisco City Clinic, San Francisco, CA, USA.
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Haley T, Puskar K, Terhorst L, Terry MA, Charron-Prochownik D. Condom use among sexually active rural high school adolescents personal, environmental, and behavioral predictors. J Sch Nurs 2012; 29:212-24. [PMID: 23008185 DOI: 10.1177/1059840512461282] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Adolescents who engage in unprotected intercourse are at risk of pregnancy and sexually transmitted infection (STI). Although adolescents in rural areas participate in levels of sexual risk taking similar to that of nonrural youth, few data are available identifying factors that influence condom use among rural adolescents. The purpose of this study is to determine the predictive value of selected personal, environmental, and behavioral factors for condom use among rural adolescents in grades 9-12. A cross-sectional survey was conducted among sexually active youth (N = 613), ages 14-19, in three rural school districts in the Northeast. Using logistic regression, identified predictors for condom use include personal standards (odds ratio [OR] = 2.45; confidence interval [CI]: [2.39, 6.47]), condom use goals (OR = 1.32; CI [1.21, 1.45]), condom use at first intercourse (OR = 3.93; CI [2.39, 6.47]) and male gender. School nurses are encouraged to incorporate identified predictors of condom use when considering interventions promoting safer sexual behaviors among rural youth.
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Affiliation(s)
- Tammy Haley
- University of Pittsburgh at Bradford, Bradford, PA 16701, USA.
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13
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Abstract
On October 25, 2011, the Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention recommended that the quadrivalent human papillomavirus vaccine (Gardasil; Merck & Co, Inc, Whitehouse Station, NJ) be used routinely in males. The American Academy of Pediatrics has reviewed updated data provided by the Advisory Committee on Immunization Practices on vaccine efficacy, safety, and cost-effectiveness as well as programmatic considerations and supports this recommendation. This revised statement updates recommendations for human papillomavirus immunization of both males and females.
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Abstract
Male adolescents' sexual and reproductive health needs often go unmet in the primary care setting. This report discusses specific issues related to male adolescents' sexual and reproductive health care in the context of primary care, including pubertal and sexual development, sexual behavior, consequences of sexual behavior, and methods of preventing sexually transmitted infections (including HIV) and pregnancy. Pediatricians are encouraged to address male adolescent sexual and reproductive health on a regular basis, including taking a sexual history, performing an appropriate examination, providing patient-centered and age-appropriate anticipatory guidance, and delivering appropriate vaccinations. Pediatricians should provide these services to male adolescent patients in a confidential and culturally appropriate manner, promote healthy sexual relationships and responsibility, and involve parents in age-appropriate discussions about sexual health with their sons.
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O'Leary A. Are dual-method messages undermining STI/HIV prevention? Infect Dis Obstet Gynecol 2011; 2011:691210. [PMID: 22144850 PMCID: PMC3227437 DOI: 10.1155/2011/691210] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2011] [Revised: 08/01/2011] [Accepted: 09/08/2011] [Indexed: 11/28/2022] Open
Abstract
Adolescent girls and young women who are at risk for unplanned pregnancy and sexually transmitted infection (STI), including HIV, are frequently counseled to use a hormonal contraceptive to protect against the former and condoms to protect against the latter, for example, American College of Obstetricians and Gynecologists, 2011. The present paper reviews the literature on multiple risk messages, compliance with this dual-use recommendation, predictors of dual use, and interventions developed to encourage dual use. Data indicate that simultaneous use of these two methods is not common, and that efforts to encourage dual use have not yielded promising results. An alternative is to recommend condom use alone, since condoms protect very well against STI and HIV, and quite well against pregnancy when used consistently and correctly. The availability of emergency contraception is relevant here. Research utilizing a randomized controlled trial is recommended.
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Affiliation(s)
- Ann O'Leary
- Division of HIV/AIDS Prevention, National Center for HIV, Hepatitis, Sexually Transmitted Diseases, and Tuberculosis Prevention, Centers for Disease Control and Prevention, 1600 Clifton Road, MS E-37, Atlanta, GA 30333, USA.
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Correlates of sexual activity and sexually transmitted infections among human immunodeficiency virus-infected youth in the LEGACY cohort, United States, 2006. Pediatr Infect Dis J 2011; 30:967-73. [PMID: 22001904 PMCID: PMC4820757 DOI: 10.1097/inf.0b013e3182326779] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND To determine the prevalence and correlates of sexual activity and sexually transmitted infections (STIs) among human immunodeficiency virus (HIV)-infected youth. METHODS The Longitudinal Epidemiologic Study to Gain Insight into HIV/AIDS in Children and Youth (LEGACY) is an observational medical record study of perinatally and behaviorally HIV-infected (PHIV and BHIV) youth followed at 22 US HIV clinics. PHIV youth were HIV infected at birth or by breast-feeding. BHIV youth were HIV infected sexually or by injection drug use. We determined the prevalence of sexual activity during 2006 and examined correlates of sexual activity among 13- to 24-year-old PHIV youth using multivariable generalized linear models. Among sexually active persons, we determined the association between mode of HIV acquisition and non-HIV STI diagnosis using multivariable generalized linear models. RESULTS In all, 34% (195/571) of PHIV and 89% (162/181) of BHIV youth were sexually active. Eighty percent (155/195) of sexually active PHIV youth reported ever using condoms. Ninety-three percent discussed sex with a health care provider. Increasing age (adjusted prevalence ratio [APR]: 1.17 per year of age, 95% confidence interval [CI] = 1.12-1.23), having a boyfriend/girlfriend (APR: 2.74, 95% CI = 1.75-4.29), and injection drug use (APR: 1.38, 95% CI = 1.06-1.79) correlated with sexual activity after adjusting for socio-demographic and HIV-related clinical variables. Among sexually active youth, after adjusting for relevant confounders, PHIV youth were less likely than BHIV youth to have been diagnosed with an STI in 2006 (APR: 0.25, 95% CI = 0.13-0.46). CONCLUSIONS Sexual activity among HIV-infected adolescents is common. Factors associated with sexual activity in this study should be taken into account in developing behavioral risk reduction interventions targeting PHIV youth.
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Determinants of multimethod contraceptive use in a sample of adolescent women diagnosed with psychological disorders. Infect Dis Obstet Gynecol 2011; 2011:510239. [PMID: 21969802 PMCID: PMC3182562 DOI: 10.1155/2011/510239] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2011] [Revised: 06/25/2011] [Accepted: 07/28/2011] [Indexed: 11/18/2022] Open
Abstract
Objective. Despite recommendations for concurrent use of contraceptives and condoms to prevent unintended pregnancy and STIs, multimethod contraceptive use among women is poor. This study examined individual-, interpersonal-, and environmental-level factors that predict multimethod use among sexually active adolescent women diagnosed with psychological disorders. Methods. This multisite study analyzed data from 288 sexually active adolescent women who provided sociodemographic, psychosocial, and behavioral data related to birth control and condom use. Results. 34.7% of the participants reported multimethod use in the past three months. Controlling for empirically and theoretically relevant covariates, a multivariable logistic regression identified self-efficacy, multiple partners, pregnancy history, parental communication, parental norms about sex, and neighborhood cohesion as significant predictors of multimethod use. Conclusions. While continued targeted messages about multi-method contraceptive use are imperative at the individual level, an uptake in messages targeting interpersonal- and environmental-level factors such as adolescents' parents and the broader community is urgently needed.
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Sales JM, Latham TP, Diclemente RJ, Rose E. Differences between dual-method and non-dual-method protection use in a sample of young African American women residing in the Southeastern United States. ARCHIVES OF PEDIATRICS & ADOLESCENT MEDICINE 2010; 164:1125-31. [PMID: 21135341 PMCID: PMC3815712 DOI: 10.1001/archpediatrics.2010.230] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
OBJECTIVES To characterize dual-method protection users and report the prevalence of dual-method use among young adult African American women residing in the Southeastern United States. DESIGN Analysis of baseline data from a randomized controlled trial. SETTING A clinic-based sample of young women enrolled in a randomized trial of a human immunodeficiency virus (HIV)-prevention program in Atlanta, Georgia, from June 2005 to June 2007. PARTICIPANTS African American women aged 14 to 20 years who reported unprotected sexual activity in the past 6 months. Of the eligible adolescents, 94% (N = 701) were enrolled in the study and completed baseline assessments. OUTCOME MEASURES Dual-method protection use as well as sociodemographic, individual-level, interpersonal-level, and community-level factors and interpersonal communication skills. Only data from the baseline assessment, before randomization, were used for the analysis. RESULTS A total of 102 participants (14.6%) were classified as dual-method protection users. After controlling for age and clinic, significant differences between dual-method users and non-dual-method users were found for impulsivity, self-esteem, social support, relationship style, partner communication self-efficacy, and fear of condom negotiation. CONCLUSIONS Dual-method protection use is low. Identification of factors that differentiate dual-method users from non-dual-method users at the individual, interpersonal, and community levels in this young African American sample suggests that HIV, sexually transmitted disease, and unintended pregnancy risk-reduction programs should address factors at each level, not simply the individual level, and that this may involve structural and/or clinical counseling practice changes in clinics that serve young women, to optimally facilitate dual-method protection use among young African American women in the Southeastern United States.
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Affiliation(s)
- Jessica M Sales
- Department of Behavioral Science and Health Education, Emory University, Rollins School of Public Health, Atlanta, GA 30322, USA.
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Rosenberger JG, Bell DL, McBride KR, Fortenberry JD, Ott MA. Condoms and developmental contexts in younger adolescent boys. Sex Transm Infect 2010; 86:400-3. [PMID: 20448100 PMCID: PMC5913749 DOI: 10.1136/sti.2009.040766] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Condom use is a key part of sexually transmitted infection (STI) prevention for young men. Yet little is known about how younger adolescent boys initially learn about and use condoms. We examined sources of information, attitudes towards, acquisition, practice and early use of condoms among 14-16-year-old boys. METHODS Thirty 14-16-year-old boys were recruited from a teen clinic serving a community with high STI rates and were asked open-ended questions about condoms, such as, "Where did you learn about condoms?" and "In what situations would you/would you not, use condoms." Interviews were audio recorded, transcribed and coded. Qualitative analysis focused upon key concepts and shared social cognitions related to condom use. RESULTS Both sexually inexperienced and experienced participants perceived that sex feels or would feel less pleasurable with condoms. For almost all participants, families were the primary source of both information about condoms and of condoms themselves. This information focused on pregnancy prevention, with STIs secondary. Participants' views of condoms fell into three developmental groups: not interested in condoms and equating their use with interest in sex; exploring condoms out of either curiosity or in preparation for sex; and experienced with condom use. Exploring included behaviours such as checking condoms out and trying them on. CONCLUSIONS Our findings of existing negative perceptions of condoms, the importance of families in learning about condoms and the developmental need to test and try on condoms before use have implications for adolescent STI prevention programmes.
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Affiliation(s)
- Joshua G. Rosenberger
- Section of Adolescent Medicine, Department of Pediatrics, Indiana University School of Medicine, Indianapolis IN
| | - David L. Bell
- Mailman School of Public Health, Columbia University, New York NY
| | - Kimberly R. McBride
- Section of Adolescent Medicine, Department of Pediatrics, Indiana University School of Medicine, Indianapolis IN
| | - J. Dennis Fortenberry
- Section of Adolescent Medicine, Department of Pediatrics, Indiana University School of Medicine, Indianapolis IN
| | - Mary A. Ott
- Section of Adolescent Medicine, Department of Pediatrics, Indiana University School of Medicine, Indianapolis IN
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Brêtas JRDS, Ohara CVDS, Jardim DP, Muroya RDL. [Knowledge of STD/AIDS among adolescent students]. Rev Esc Enferm USP 2009; 43:551-7. [PMID: 19842585 DOI: 10.1590/s0080-62342009000300008] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
This study aims to analyze the degree of knowledge adolescents have on STD/AIDS prevention, transmission, signs, and symptoms, and to contribute with the elaboration of educational actions in the University Extension Program called Corporality and Health Promotion. The research counted on 1,087 adolescents (40% females, 60% males) and was carried out in three elementary and high schools located in the municipality of Embu. A structured, multiple choice questionnaire was applied. Data indicated the achievement of the following results: as per the prevention, 92% of girls and 78% of boys referred to the use of condoms, while 42% of girls and 43% of boys affirmed to wash their genitalia after the sexual relation; 75% females and 52% males quoted television as their source of information. As per the knowledge of STD, girls and boys indicated not to have much information on the issue. Regarding STD healing programs, 57% females and 71% males affirmed not to have any knowledge on the issue; 5% of girls and 6% of boys thought AIDS to be curable. In a general perspective, we can conclude that girls were more familiar with the study's issues than boys.
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Brêtas JRDS, Ohara CVDS, Jardim DP, Muroya RDL. Conhecimentos de adolescentes sobre Doenças Sexualmente Transmissíveis: subsídios para prevenção. ACTA PAUL ENFERM 2009. [DOI: 10.1590/s0103-21002009000600010] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Objetivo: Identificar o conhecimento de adolescentes sobre as formas de transmissão e prevenção das Doenças Sexualmente Transmissíveis. Metodos: envolveu 920 adolescentes entre 10 e 19 anos de idade eos dados foram obtidos por meio de um questionário estruturado. Resultado: os resultados demonstraram que a principal fonte para obtenção de informações sobre o assunto foi o professor; as Doenças Sexualmente Transmissíveis não são totalmente desconhecidas para os adolescentes do estudo, sendo a AIDS a mais conhecida.
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Allgood KL, Silva A, Shah A, Whitman S. HIV testing practices and attitudes on prevention efforts in six diverse Chicago communities. J Community Health 2009; 34:514-22. [PMID: 19705263 DOI: 10.1007/s10900-009-9177-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Data describing local level HIV testing practices and attitudes regarding HIV prevention are rarely available, yet would be useful for HIV policy and evaluation. A comprehensive health survey was conducted in six community areas of Chicago (n = 1,699) in 2002-2003. The HIV prevention module of this survey was used for this analysis. The proportion that ever tested for HIV ranged from 40 to 75% and 11 to 38% were tested in the past 12 months. Residents favored: needle exchange programs (59-77%), HIV information in high schools (95-100%) and elementary schools (85-94%), and condom distribution in high schools (74-93%). Attitudes were less favorable regarding pharmacies selling clean needles (37-58%) and condom distribution in elementary schools (22-66%). Adults in these areas are over three times more likely to have been tested recently than adults nationally. Residents strongly favor community based HIV prevention initiatives such as needle exchange programs, condom distribution in high schools, and HIV prevention taught in schools. These evidence-based observations may be valuable in planning HIV prevention programs and in shaping policy.
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Paiva V, Calazans G, Venturi G, Dias R. [Age and condom use at first sexual intercourse of Brazilian adolescents]. Rev Saude Publica 2009; 42 Suppl 1:45-53. [PMID: 18660924 DOI: 10.1590/s0034-89102008000800007] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2007] [Accepted: 04/02/2008] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To analyze age and condom use at first sexual intercourse among Brazilian adolescents at two periods: 1998 and 2005. METHODS Representative samples of the Brazilian urban population were interviewed during a household survey for two studies, carried out in 1998 and 2005. Interviewees included 670 sexually active young people (aged 16 to 19) who were selected for the study, 312 in 1998 and 358 in 2005. Pearson's chi-square test and Fisher's exact test (+/-<5%) were used to analyze the weighted data. RESULTS In 2005, 61.6% of young interviewees had practiced sex and the average age for first intercourse was 14.9, with no significant difference to young interviewees in 1998. Condom use during first sexual intercourse increased significantly in both stable relationships (48.5% in 1998 vs. 67.7% in 2005) and casual relationships (47.2% in 1998 vs. 62.6% in 2005) across almost all segments. There were differences by gender, skin color and schooling for both age of first sexual intercourse and condom use, as per findings in 1998. Decreases in condom use for young people who were sexually active before the age of 14, across all types of partnerships, were marked in the Southeast region and for people with more schooling. CONCLUSIONS As in other countries, there was a trend towards the stabilizing of the age of first sexual intercourse for young people aged 15 to 19. The postponement of the first sexual intercourse is more frequent among youth with more years of schooling, a theme that should be discussed in the planning of sexual education and STI prevention initiatives for adolescents. In terms of reductions in vulnerability to HIV, the increase in condom use at first sexual intercourse is both relevant and significant.
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Affiliation(s)
- Vera Paiva
- Núcleo de Estudos para a Prevenção da AIDS, Instituto de Psicologia, Universidade de São Paulo, Av. Professor Mello Moraes 1721, São Paulo, SP, Brasil.
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Rugpao S. Women's reports of condom use in Thai couples under intensive and regular STI/HIV risk reduction counseling. AIDS Behav 2008; 12:419-30. [PMID: 17665303 DOI: 10.1007/s10461-007-9283-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2006] [Accepted: 07/03/2007] [Indexed: 11/25/2022]
Abstract
The objective of this study was to determine factors affecting condom use and condom use rates among Thai couples. A cohort of 1,391 reproductive aged women who attended seven family planning clinics in all regions of Thailand and met study eligibility were followed at 3-month intervals for 15-24 months. At each visit, the woman was interviewed about sexual risk behaviors and counseled for sexual risk reduction and condom use. Condoms were provided free of charge. The women were classified into 3 groups according to contraceptive use at baseline: single contraceptive method group, dual methods consisting of contraceptives with condoms, and condoms only. We found that condom use rates were generally low in all contraceptive groups. Significant factors affecting condom use in multivariate analyses included, contraceptive method at baseline, polygynous marriage, higher education, engaging in commercial sex work, multiple sex partners, sex during menses, more frequent sex, laboratory confirmed STIs, husbands spending nights away from home, husbands having sex with other women, and penile ulcers or sores.
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Affiliation(s)
- Sungwal Rugpao
- Department of Obstetrics and Gynecology, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand,
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Hlaing WM, de la Rosa M, Niyonsenga T. Human immunodeficiency virus (HIV) and substance use risk behaviors among tri-ethnic adolescents of Florida. AIDS Behav 2007; 11:239-51. [PMID: 16783534 DOI: 10.1007/s10461-006-9132-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Previous research documents the co-occurrence of substance use and HIV risk behaviors, but most studies examined these behaviors among adults and White adolescents. The diversity of Florida's adolescents presents a unique setting for examining the variations in these risk behaviors. An in-depth analysis of HIV and substance use behaviors among White, African American, and Hispanic adolescents in Florida was conducted. Results suggest that significant ethnic variations exist in lifetime alcohol and illicit drug use and HIV risk. Compared with Hispanics, African Americans were less likely and Whites were more likely to be frequent alcohol and illicit drug users. White and African American adolescents were 1.3 and 1.5 times, respectively, at higher risk of at least one HIV risk behavior compared with their Hispanic counterparts. Future research should seek to identify sources and consequences of such variations in risk behavior and design culturally appropriate prevention programs for adolescents.
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Affiliation(s)
- WayWay M Hlaing
- Department of Epidemiology and Biostatistics, Stempel School of Public Health, Florida International University, 12000 SW 8th Street (HLS II-584), Miami, FL 33199, USA.
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Cheah WH. College Students’ Perspectives in Sexually Transmitted Infections (STIs) in Malaysia, Singapore, England, and the US: Formative Evaluation Insights and Implications. ACTA ACUST UNITED AC 2006. [DOI: 10.1080/17475750601026974] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Ito KE, Gizlice Z, Owen-O'Dowd J, Foust E, Leone PA, Miller WC. Parent opinion of sexuality education in a state with mandated abstinence education: does policy match parental preference? J Adolesc Health 2006; 39:634-41. [PMID: 17046498 DOI: 10.1016/j.jadohealth.2006.04.022] [Citation(s) in RCA: 70] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2006] [Revised: 04/06/2006] [Accepted: 04/28/2006] [Indexed: 11/25/2022]
Abstract
PURPOSE Despite public debate about the content of sexuality education in schools, state and federal policy has increasingly financed and legislated abstinence-only education over the past decade. Although public schools strive to meet the needs of parents who, as taxpayers, fund the educational system, little is known about parental desires regarding sexuality education in states with mandated abstinence education. The objective of this study was to assess parental opinion about sexuality education in public schools in North Carolina, a state with mandated abstinence education. METHODS Computer-assisted, anonymous, cross-sectional telephone surveys were conducted among 1306 parents of North Carolina public school students in grades K-12. Parental support for sexuality education in public schools and 20 sexuality education topics was measured. We defined comprehensive sexuality education as education that includes a discussion of how to use and talk about contraception with partners. RESULTS Parents in North Carolina overwhelmingly support sexuality education in public schools (91%). Of these respondents, the majority (89%) support comprehensive sexuality education. Less than a quarter of parents oppose teaching any specific topic, including those typically viewed as more controversial, such as discussions about sexual orientation, oral sex, and anal sex. Parents' level of education was inversely related to support for specific sexuality education topics and comprehensive education, although these differences were small in magnitude. More than 90% of respondents felt that parents and public health professionals should determine sexuality education content and opposed the involvement of politicians. CONCLUSIONS Current state-mandated abstinence sexuality education does not match parental preference for comprehensive sexuality education in North Carolina public schools.
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Affiliation(s)
- Kristin E Ito
- University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599, USA.
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Geluda K, Bosi MLM, da Cunha AJLA, Trajman A. ["It takes two to tango": a study on inconsistent use of male condoms by adolescents in Rio de Janeiro, Brazil]. CAD SAUDE PUBLICA 2006; 22:1671-80. [PMID: 16832538 DOI: 10.1590/s0102-311x2006000800015] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
This study assessed gender-related aspects involved in the inconsistent use of male condoms by adolescents in Rio de Janeiro, Brazil. Four focus groups were conducted, two with each gender, two in a public school and two in a private school, totaling 34 participants, comparing gender and social status. The resulting material was analyzed using a critical interpretative approach. Among the emerging themes, "gender relations" were chosen, consisting of three dimensions: trust, submission, and initiative. So-called unequal gender power was not detected in the adolescents' discourse, which however revealed an apparent inequality in negotiation and initiative in condom use. Differences between public and private schools were subtle. Some changes may be occurring in the field of adolescent sexual behavior. The results indicate the importance of channels for dialogue, taking into account the singularity of groups in order to establish intervention strategies adapted to subjects and different historical and cultural contexts.
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Affiliation(s)
- Kátia Geluda
- Instituto de Puericultura e Pediatria Martagão Gesteira, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brasil.
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Berenson AB, Wu ZH, Breitkopf CR, Newman J. The relationship between source of sexual information and sexual behavior among female adolescents. Contraception 2006; 73:274-8. [PMID: 16472570 DOI: 10.1016/j.contraception.2005.08.014] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2005] [Revised: 07/29/2005] [Accepted: 08/11/2005] [Indexed: 11/30/2022]
Abstract
INTRODUCTION The relationship between the source of sexual information and adolescent sexual behavior is not well understood. MATERIALS AND METHODS As part of a larger study, 892 sexually active female adolescents between 15 and 18 years of age completed a paper-and-pencil survey which assessed discussions about sexual intercourse, contraceptive use and condom use among friends and family members and their own sexual behavior. Multivariate logistic regression analyses were performed to examine associations while controlling for key demographics. RESULTS Adolescents who had never used condoms were less likely to report having had discussions about sexual intercourse with their friends [adjusted odds ratio (AOR) = 0.2]. Discussions about condom use among friends and family members were associated with condom use in the past 3 months, with adolescents who used condoms at least half of the time being more likely to report hearing discussions relative to adolescents who never used condoms (AORs 2.0-3.8). Furthermore, the number of sexual partners was related to whether the adolescent had heard discussions among her family about condom use; the higher the number of sexual partners, the more likely the adolescent was to have heard discussions. For adolescents reporting 2-3, 4-5 and 6 or more partners (relative to one partner), the AORs were 1.7, 2.3 and 2.7, respectively. DISCUSSION Adolescents exposed to information about condom use among the primary individuals in their lives are more likely to be engaging in this behavior themselves.
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Affiliation(s)
- Abbey B Berenson
- Department of Obstetrics and Gynecology, University of Texas Medical Branch, Galveston, TX, 77555-0587, USA.
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Martins LBM, da Costa-Paiva LHS, Osis MJD, de Sousa MH, Pinto-Neto AM, Tadini V. Fatores associados ao uso de preservativo masculino e ao conhecimento sobre DST/AIDS em adolescentes de escolas públicas e privadas do Município de São Paulo, Brasil. CAD SAUDE PUBLICA 2006; 22:315-23. [PMID: 16501744 DOI: 10.1590/s0102-311x2006000200009] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Comparar o conhecimento sobre DST/AIDS e avaliar fatores associados ao conhecimento adequado e ao uso consistente do preservativo masculino, em adolescentes de escolas públicas e privadas do Município de São Paulo. Participaram 1.594 adolescentes entre 12 e 19 anos, de 13 escolas públicas e 5 privadas, que responderam um questionário sobre DST/AIDS e uso de preservativo. Calcularam-se as razões de prevalência com intervalo de confiança de 95%. O escore de conhecimento sobre DST teve o ponto de corte equivalendo a 50% de acerto. Os testes estatísticos foram qui-quadrado e Wilcoxon-Gehan. Realizou-se regressão múltipla de Poisson. O uso consistente de preservativo foi 60% nas escolas privadas e 57,1% nas públicas (p > 0,05) e esteve associado ao sexo masculino e menor nível sócio-econômico. O sexo feminino, maior escolaridade, escola privada, cor branca e estado marital solteiro associaram-se ao maior conhecimento sobre DST. Os adolescentes de escola pública e privada apresentam conhecimento adequado sobre prevenção de DST, entretanto esse conhecimento não determina adoção de atitudes efetivas de prevenção. Programas de conscientização sobre DST/AIDS devem ser ampliados visando minimizar as vulnerabilidades.
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Affiliation(s)
- Laura B Motta Martins
- Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Av. Angelica 1968, conj. 33, Campinas, São Paulo, SP 01228-200, Brazil.
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Abstract
Substance abuse, specifically the use of illicit drugs that are administered intravenously, continues to play a role in the transmission of human immunodeficiency virus type 1 (HIV-1) among adolescents and young adults (youth). Risks of HIV-1 infection may result from direct exposure to contaminated blood through sharing of injection drug equipment and from unsafe sexual practices (while under the influence of drugs and/or in exchange for drugs). Reducing the risk of HIV-1 infection that is associated with illicit drug use requires prevention education and prompt engagement in treatment. Providing patients with education, instruction on decontamination of used injection drug equipment, improved access to sterile syringes and needles, and postexposure prophylaxis may decrease their risk of acquiring HIV-1 infection. Pediatricians should assess risk behaviors as part of every health care encounter, including queries about tobacco, alcohol, and marijuana use. The risks and benefits of postexposure prophylaxis with antiretroviral drugs should be considered for youth with a single recent (within 72 hours) high-risk exposure to HIV-1 through sharing needles/syringes with an HIV-1-infected individual or having unprotected intercourse with an individual who engages in injection drug use. Such prophylaxis must be accompanied by risk-reduction counseling, appropriate referrals for treatment, and evaluation for pregnancy and associated sexually transmitted infections. There is an urgent need for more substance-abuse prevention and treatment programs, legislation that facilitates unencumbered access to sterile syringes, and expedient availability of reproductive health care services for sexually active youth, including voluntary HIV-1 counseling and testing.
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Novak DP, Karlsson RB. Gender differed factors affecting male condom use. A population-based study of 18-year-old Swedish adolescents. Int J Adolesc Med Health 2005; 17:379-90. [PMID: 16445076 DOI: 10.1515/ijamh.2005.17.4.379] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
UNLABELLED Despite preventive measures promoting the condom as a good barrier method and a good preventive measure for STIs, teenage abortions and STIs are increasing in our society. OBJECTIVE The aim of this study was to explore which male factors are associated with non-condom use and also which female factors are associated with non-condom use among their sexual partners. STUDY GROUP A population-based study, among all 18-year old girls and boys in four cities in northern Sweden. METHOD The participants answered a questionnaire regarding their social lifestyle, psychological-, and sexual health. The associations between the independent variables and the dependent variable (non-condom use) were investigated by multivariate logistic regression analysis. RESULTS Four significant (p<0.05) male variables associated with non-condom use were identified: living with partner during the weekends, feeling depressed, being a party smoker, and girl partner taking oral contraceptives. Two significant (p<0.05) female variables were associated with non-condom: using oral contraceptives and feeling forced into sex. Having TV and movie watching as favourite free time activity was identified as a significant protective female variable associated with condom use. CONCLUSION The study found several male and female factors associated with non-condom use, where the usage of oral contraception was the strongest indicator for non-condom use. The study showed a gender difference in the variables associated with condom use and the results have been suggested as useful in future preventive measures promoting condom usage.
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Affiliation(s)
- Daniel P Novak
- Department of Public Health, Clinical Medicine and Family Medicine, University of Umeå, SE 901 85 Umeå, Sweden
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Evans AE, Sanderson M, Griffin SF, Reininger B, Vincent ML, Parra-Medina D, Valois RF, Taylor D. An exploration of the relationship between youth assets and engagement in risky sexual behaviors. J Adolesc Health 2004; 35:424.e21-30. [PMID: 15488436 DOI: 10.1016/j.jadohealth.2004.02.008] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/04/2004] [Indexed: 11/26/2022]
Abstract
PURPOSE To examine the relationship between specific youth assets and adolescents' engagement in risky sexual behaviors, as measured by an Aggregate Sexual Risk score, and to specifically explore which youth assets and demographic variables were predictive of youth engagement in risky sexual intercourse. METHODS A total of 2108 sexually active high school students attending public high schools in a southern state completed a self-report questionnaire that measured youth assets. Based upon responses to items measuring risk behaviors, an Aggregate Sexual Risk score was calculated for each student. Unconditional logistic regression and multivariate logistic regression analyses were conducted to examine the relationships between the assets and the Aggregate Risk Score. Four separate analyses (white females, white males, black females, and black males) were conducted. RESULTS In general, the patterns in all four groups indicated that students who had an Aggregate Risk Score of > or = 3 (high risk) possessed less of the measured youth assets. The assets that were most significantly associated with engagement in risky sexual behaviors included self peer values regarding risky behaviors, quantity of other adult support, and youths' empathetic relationships. Thus, students who reported not having these assets were significantly more likely to engage in the risky sexual behaviors. CONCLUSIONS Results underscore the relationship of specific youth assets to sexual risk behaviors. Health researcher and practitioners who work to prevent teen pregnancy and sexually transmitted infections among teenagers need to understand and acknowledge these factors within this population so that the assets can be built or strengthened.
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Affiliation(s)
- Alexandra E Evans
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina 29208, USA.
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Abstract
The American Academy of Pediatrics issued its first statement on homosexuality and adolescents in 1983, with a revision in 1993. This report reflects the growing understanding of youth of differing sexual orientations. Young people are recognizing their sexual orientation earlier than in the past, making this a topic of importance to pediatricians. Pediatricians should be aware that some youths in their care may have concerns about their sexual orientation or that of siblings, friends, parents, relatives, or others. Health care professionals should provide factual, current, nonjudgmental information in a confidential manner. All youths, including those who know or wonder whether they are not heterosexual, may seek information from physicians about sexual orientation, sexually transmitted diseases, substance abuse, or various psychosocial difficulties. The pediatrician should be attentive to various potential psychosocial difficulties, offer counseling or refer for counseling when necessary and ensure that every sexually active youth receives a thorough medical history, physical examination, immunizations, appropriate laboratory tests, and counseling about sexually transmitted diseases (including human immunodeficiency virus infection) and appropriate treatment if necessary. Not all pediatricians may feel able to provide the type of care described in this report. Any pediatrician who is unable to care for and counsel nonheterosexual youth should refer these patients to an appropriate colleague.
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Gurman T, Borzekowski DLG. Condom use among Latino college students. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2004; 52:169-178. [PMID: 15018428 DOI: 10.3200/jach.52.4.169-178] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
Recent reports indicate that Latinos, the largest racial/ethnic minority group in the United States, are disproportionately affected by HIV and AIDS. College health professionals, therefore, should understand current sexual behaviors and risk factors among Latino youth. The authors assessed students' condom use at their most recent sexual encounter by using data from those students who reported oral, vaginal, or anal sex during the last 30 days. Fewer than half of recently sexually active Latino students had used condoms during their last oral (4.9%), vaginal (41.3%), or anal (27.8%) sexual encounter. Predictors of condom use varied according to the type of sexual activity. Findings from this exploratory study offer current information about condom use and sexual behaviors among Latino college students and suggest that prevention interventions and messages should be tailored to students' gender and types of sexual activity.
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Affiliation(s)
- Tilly Gurman
- Department of Population and Family Health Sciences at Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland 21205, USA.
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Bulk S, Visser O, Rozendaal L, Verheijen RHM, Meijer CJLM. Cervical cancer in the Netherlands 1989-1998: Decrease of squamous cell carcinoma in older women, increase of adenocarcinoma in younger women. Int J Cancer 2004; 113:1005-9. [PMID: 15515017 DOI: 10.1002/ijc.20678] [Citation(s) in RCA: 101] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Cervical cancer is a preventable disease, occurring in relatively young women. In the Netherlands, population-based cervical screening aims at women aged 30-60 years. We performed a population-based study of the incidence of invasive cervical cancer in the Netherlands to evaluate trends, with emphasis on age at time of diagnosis. Histologic diagnosis was retrieved from the Netherlands Cancer Registry for all women residing in the Netherlands with invasive cervical cancer between January 1, 1989, and December 31, 1998. In this 10-year period, the incidence rate of squamous cell carcinoma decreased significantly from 7.1/100,000 to 6.1/100,000 (p < 0.001), with the greatest decrease in women aged 60-74 (-5.5%). While the overall incidence rate of adenocarcinoma remained stable, it increased in women aged 15-29 (+15.8%) and in women aged 30-44 (+2.5%), though the number of cases was small. For squamous cell carcinoma, the incidence of stage II at diagnosis decreased most (-2.7%). There was no change in stage at diagnosis for adenocarcinoma. Most cases of cervical cancer, 60.5%, were detected between ages 30 and 60 years, i.e., the Dutch screening age interval. Cervical cancer in women below age 30 contributed 5.0% to the total incidence, with 3.0% occurring between ages 27 and 29. Thus, screening for cervical cancer in the Netherlands is associated with a decrease in the incidence of squamous cell carcinoma and adenocarcinoma incidence appears to be increasing in younger women.
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Affiliation(s)
- Saskia Bulk
- Department of Pathology, VU University Medical Center, Amsterdam, The Netherlands
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Abstract
Teenage pregnancy rates remain unacceptably high in the United States, despite the availability of numerous contraceptive options. This article examines contraceptive methods currently available to adolescents and highlights newer products that may help meet some of the unique contraceptive needs of sexually active teens. The three newest agents (OrthoEvra trade mark, NuvaRing trade mark, and Seasonale) offer advantages such as higher contraceptive efficacy, increased privacy, ease of use, and low side effect profiles. A major advantage of each of these methods is that they eliminate the need for the teen to take daily action to prevent pregnancy. Nurses can be instrumental in helping teens to avoid unwanted pregnancy by assessing teens' contraceptive needs and educating them about contraceptive options. However, it is important to remember that because none of these new methods offer protection against sexually transmitted diseases, we should continue to educate adolescents about the need for condom use and provide them with instructions on using condoms correctly.
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Affiliation(s)
- Connie R Kartoz
- Family Nurse Practioner, Hi Tops, Teen Health and Education Center, Princeton, NJ 08540, USA.
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40
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Kuzujanakis M, Kleinman K, Rifas-Shiman S, Finkelstein JA. Correlates of parental antibiotic knowledge, demand, and reported use. AMBULATORY PEDIATRICS : THE OFFICIAL JOURNAL OF THE AMBULATORY PEDIATRIC ASSOCIATION 2003; 3:203-10. [PMID: 12882598 DOI: 10.1367/1539-4409(2003)003<0203:copakd>2.0.co;2] [Citation(s) in RCA: 59] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND Clinicians cite parental misconceptions and requests for antibiotics as reasons for inappropriate prescribing. AIMS To identify misconceptions regarding antibiotics and predictors of parental demand for antibiotics and to determine if parental knowledge and attitudes are associated with use. METHODS Survey of parents in 16 Massachusetts communities. Domains included antibiotic-related knowledge, attitudes about antibiotics, antibiotic use during a 12-month period, demographics, and access to health information. Bivariate and multivariate analyses evaluated predictors of knowledge and proclivity to demand antibiotics. A multivariate model evaluated the associations of knowledge, demand, and demographic factors with parent-reported antibiotic use. RESULTS A total of 1106 surveys were returned (response rates: 54% and 32% for commercially-insured and Medicaid-insured families). Misconceptions were common regarding bronchitis (92%) and green nasal discharge (78%). Two hundred sixty-five (24%) gave responses suggesting a proclivity to demand antibiotics. Antibiotic knowledge was associated with increased parental age and education, having more than 1 child, white race, and receipt of media information on resistance. Factors associated with a proclivity to demand antibiotics included decreased knowledge, pressure from day-care settings, lack of alternatives offered by clinicians, and lack of access to media information. Among all respondents, reported antibiotic use was associated with younger child age and day-care attendance. Among Medicaid-insured children only, less antibiotic knowledge and tendency to demand antibiotics were associated with higher rates of antibiotic use. CONCLUSIONS Misconceptions regarding antibiotic use are widespread and potentially modifiable by clinicians and media sources. Particular attention should be paid to Medicaid-insured patients in whom such misconceptions may contribute to inappropriate prescribing.
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Affiliation(s)
- Marianne Kuzujanakis
- Harvard Pediatric Health Sevices Research Fellowship, the Department of Ambulatory Care and Prevention, Harvard Medical School and Harvard Pilgrim Health Care, Boston, Mass 02215, USA
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Blake SM, Ledsky R, Goodenow C, Sawyer R, Lohrmann D, Windsor R. Condom availability programs in Massachusetts high schools: relationships with condom use and sexual behavior. Am J Public Health 2003; 93:955-62. [PMID: 12773362 PMCID: PMC1447877 DOI: 10.2105/ajph.93.6.955] [Citation(s) in RCA: 81] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES This study assessed relationships between condom availability programs accompanied by community discussion and involvement and adolescent sexual practices. METHODS Sexual practice and condom use differences were assessed in a representative sample of 4166 adolescents enrolled in high schools with and without condom availability programs. RESULTS Adolescents in schools where condoms were available were more likely to receive condom use instruction and less likely to report lifetime or recent sexual intercourse. Sexually active adolescents in those schools were twice as likely to use condoms, but less likely to use other contraceptive methods, during their most recent sexual encounter. CONCLUSIONS The strategy of making condoms available, an indication of socioenvironmental support for condom use, may improve HIV prevention practices.
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Affiliation(s)
- Susan M Blake
- Department of Prevention and Community Health, George Washington University School of Public Health and Health Services, Washington, DC 20037, USA.
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Burstein GR, Lowry R, Klein JD, Santelli JS. Missed opportunities for sexually transmitted diseases, human immunodeficiency virus, and pregnancy prevention services during adolescent health supervision visits. Pediatrics 2003; 111:996-1001. [PMID: 12728079 DOI: 10.1542/peds.111.5.996] [Citation(s) in RCA: 87] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE To describe prevention counseling on pregnancy and sexually transmitted diseases (STDs), including human immunodeficiency virus (HIV), received by sexually experienced youth in the primary care setting and to test associations between recent sexual risk behaviors and preventive counseling. METHODS Using data from the 1999 Youth Risk Behavior Surveillance survey, a nationally representative survey (N = 15 349) of high school students, we analyzed responses to questions about sexual experience, time since last preventive health care visit, and discussion of STD, HIV, or pregnancy prevention with a doctor or nurse during their last preventive health care visit. Logistic regression was used to test associations; students' demographic characteristics were controlled. RESULTS More than half of the US high school students surveyed reported a preventive health care visit in the 12 months preceding the survey: 60.4% (95% confidence interval [CI]: 57.2%-63.6%) of female students and 57.5% (95% CI: 53.9%-61.1%) of male students. For female students, sexual experience was positively associated with a preventive health care visit (odds ratio [OR]: 1.3; 95% CI: 1.1-1.6), but for male students, sexual experience had a negative effect (OR: 0.8; 95% CI: 0.7-0.9). Of the students who reported a preventive health care visit in the 12 months preceding the survey, 42.8% (95% CI: 38.6%-47.1%) of female students and 26.4% (95% CI: 22.7%-30.2%) of male students reported having discussed STD, HIV, or pregnancy prevention at those visits. Sexual experience was associated with a higher likelihood of engaging in a dialogue about sexual health once a student entered the health care system: female students (OR: 3.8; 95% CI: 3.0-4.9) and male students (OR: 1.9; 95% CI: 1.3-2.7). CONCLUSION Primary care providers miss opportunities to provide STD, HIV, and pregnancy prevention counseling to high-risk youth.
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Affiliation(s)
- Gale R Burstein
- Division of HIV and AIDS Prevention, National Center for HIV, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA.
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Abstract
Oh, to travel again with the carefree attitude of the adolescent! Yet most readers will think that this enormous list of precautions would merit never letting the adolescent out of the house. The traveler and his or her provider can be reassured that with appropriate (and confidential) forethought, the journeys that lie ahead can be joyful and healthy. The bottom line? The more information obtained before travel both for the traveler and his or her family, the less morbidity will be incurred. The primary care provider is in the perfect position to provide all of these services to the adolescent traveler.
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Affiliation(s)
- Cora Collette Breuner
- Adolescent Medicine Section, Department of Pediatrics, University of Washington, Children's Hospital and Medical Center, Seattle, WA 98195, USA.
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