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Khurana B, Olson RM, Temple JR, Loder RT. Age-specific Patterns of Intimate Partner Violence Related Injuries in US Emergency Departments. J Adolesc Health 2024; 74:1249-1255. [PMID: 38506777 PMCID: PMC11102314 DOI: 10.1016/j.jadohealth.2024.01.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 01/24/2024] [Accepted: 01/25/2024] [Indexed: 03/21/2024]
Abstract
PURPOSE To identify intimate partner violence (IPV)-related injury patterns of U.S. patients of three age groups: <18 years (adolescents), 18-25 years (emerging adults), and >25 years (adults). METHODS We performed a nationally representative retrospective review of all patients presenting to U.S. Emergency Department for IPV-related injuries from 2005 through 2020. Demographics and injury patterns were calculated using statistical methods accounting for the weighted stratified data. Main outcomes were injury morphology, mechanism, severity, location, and temporal associations of IPV-related injuries among the three age groups. RESULTS There was a higher proportion of female victims, sexual assault cases, and lower trunk injuries among adolescents compared to emerging adults and adults. There was increasing injury severity, fractures, and hospital admissions with increasing age. Adolescents experienced a greater prevalence of fractures of the head, neck, hands, fingers, and distal lower extremity, while trunk fractures increased with age. The peak prevalence of violence-related Emergency Department visits among adolescents was in June and September, with the peak day as Tuesday. DISCUSSION Injurious forms of IPV are prevalent across all age groups, with sexual assault cases demonstrably higher among adolescents and increasing severity of injuries as victims age. Identification of age-specific injury patterns will aid health-care professionals and policymakers in developing targeted interventions for adolescents who experience IPV.
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Affiliation(s)
- Bharti Khurana
- Trauma Imaging Research and Innovation Center, Brigham and Women's Hospital, Boston, Massachusetts; Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts; Department of Radiology, Brigham and Women's Hospital, Boston, Massachusetts; Department of Radiology, Harvard Medical School, Boston, Massachusetts.
| | - Rose McKeon Olson
- Trauma Imaging Research and Innovation Center, Brigham and Women's Hospital, Boston, Massachusetts; Department of Medicine, Harvard Medical School, Boston, Massachusetts
| | - Jeff R Temple
- Center for Violence Prevention, School of Behavioral Health Sciences, University of Texas Houston Health Science Center, Houston, Texas
| | - Randall T Loder
- Department of Orthopedic Surgery, Indiana University Shcool of Medicine, Riley Children's Hospital, Indianapolis, Indiana
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2
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Nyakio O, Kibukila F, Mukwege D, Bwani J, Tambwe A, Bhattacharjee P, Bandyopadhyay S, Akilimali A, Kakudji P, Kakoma JB. A cross-sectional study exploring the characteristics of female survivors of sexual violence living with HIV/AIDS in the eastern region of Democratic Republic of Congo. Aust N Z J Obstet Gynaecol 2024; 64:283-290. [PMID: 38272828 DOI: 10.1111/ajo.13789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Accepted: 12/18/2023] [Indexed: 01/27/2024]
Abstract
BACKGROUND Sexual violence remains a persistent and devastating issue in eastern Democratic Republic of Congo (DRC). AIM To elucidate the sociodemographic, sexual, and obstetrical characteristics associated with the experiences of victims of sexual violence (VSV) among women in the region. MATERIALS AND METHODS A cross-sectional study was conducted involving 625 women from eastern DRC. Participants provided self-reported data, collected through interviews conducted by trained female interviewers in secure environments. Associations between VSV and various sociodemographic and reproductive health factors were examined. RESULTS Of the respondents, 26.1% reported experiences of sexual violence. VSV were predominantly younger, with 56.44% aged between 15 and 24 years. Single women comprised 57.67% of VSV, and 37.42% identified as farmers. There were 33.13% of VSV who were illiterate, and 81.60% belonged to the low socio-economic stratum. Early physiological and reproductive milestones characterised VSV: 52.15% experienced menarche at or before 13 years, 34.97% initiated sexual intercourse before age 15, and 18.70% reported their first pregnancy before age 15. Higher nulliparity was observed in VSV (29.45%) compared to non-VSV (9.31%). A lower prevalence of HIV infection was found among VSV (11.04%) relative to non-VSV (25.76%). CONCLUSION Sexual violence in the eastern DRC exhibits multifactorial associations. Younger women, those in certain occupations, and those with specific reproductive histories appear more vulnerable. The findings underscore the urgency for targeted interventions, enhanced access to education, and improved reproductive health services. Addressing these pressing issues should remain a primary focus in both societal and public health spheres.
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Affiliation(s)
- Olivier Nyakio
- Faculty of Medicine, Evangelic University in Africa, Bukavu, Democratic Republic of Congo
- Faculty of Medicine, Official University of Bukavu, Bukavu, Democratic Republic of Congo
| | - Fabrice Kibukila
- Faculty of Medicine, Official University of Bukavu, Bukavu, Democratic Republic of Congo
- Faculty of Medicine, University of Burundi, Bujumbura, Burundi
| | - Denis Mukwege
- Faculty of Medicine, Evangelic University in Africa, Bukavu, Democratic Republic of Congo
| | - Joyeux Bwani
- Faculty of Medicine, Evangelic University in Africa, Bukavu, Democratic Republic of Congo
| | - Albert Tambwe
- Faculty of Medicine, University of Lubumbashi, Lubumbashi, Democratic Republic of Congo
| | - Priyadarshini Bhattacharjee
- Department of Clinical Medicine, Cambridge University Hospitals NHS Foundation Trust, University of Cambridge, Cambridge, UK
| | - Soham Bandyopadhyay
- Clinical Neurosciences, Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, Hampshire, UK
- Oxford University Global Surgery Group, Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK
| | - Aymar Akilimali
- Department of Research, Medical Research Circle (MedReC), Goma, Democratic Republic of Congo
- Society for Maternal-Fetal Medicine (SMFM), Washington, District of Columbia, USA
- Standing committee of research and exchange, Medical Students Association of DR Congo
| | - Prosper Kakudji
- Faculty of Medicine, University of Lubumbashi, Lubumbashi, Democratic Republic of Congo
| | - Jean Baptiste Kakoma
- Faculty of Medicine, University of Lubumbashi, Lubumbashi, Democratic Republic of Congo
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Kanagasabai U, Thorsen V, Zhu L, Annor FB, Chiang L, McOwen J, Augusto A, Manuel P, Kambona C, Coomer R, Kamagate F, Ramphalla P, Denhard L, Cain M, Hegle J, de Barros RB, Saenz S, Kamami M, Patel P. Adverse childhood experiences, HIV and sexual risk behaviors - Five sub-Saharan countries, 2018-2020. CHILD ABUSE & NEGLECT 2024; 150:106541. [PMID: 38114359 DOI: 10.1016/j.chiabu.2023.106541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 10/31/2023] [Accepted: 11/07/2023] [Indexed: 12/21/2023]
Abstract
BACKGROUND Adverse childhood experiences (ACEs) have been shown to have negative, lasting effects on health including increasing the likelihood of engaging in sexual risk behaviors. OBJECTIVE This study aimed to identify associations between exposures to ACEs and sexual risk behaviors and HIV service utilization among young people. PARTICIPANTS AND SETTING A sample of 8023 sexually active young people (19-24 year olds) from five sub-Saharan African countries participated Violence Against Children and Youth Surveys (VACS). METHODS Descriptive analysis of demographic variables, individual ACEs, cumulative ACEs, sexual risk behaviors, HIV testing, antiretroviral treatment (ART) and Antenatal Care (ANC) attendance were completed. Bivariate and multivariable logistic regression analyses were conducted to assess the associations between both individual and cumulative ACEs, sexual HIV risk behaviors, and service utilization while controlling for important covariates such as demographic, having ever been pregnant, had an STI, and used contraception. RESULTS Exposure to three or more ACEs was higher among males (26.1 %) compared to females (21.3 %); p = 0.003. The most prominent sexual risk behavior for females was having sexual partners who were at least 5 years older (45.7 % compared to males 3.7 %; p < 0.0001) whereas in males it was no or infrequent condom use (45.3 % compared to females 30.1 %; p < 0.0001). Males and females exposed to childhood sexual violence had seven and four times the odds of engaging in transactional sex (aOR = 7.34, 95 % CI: [3.5-15.0]) and (aOR =3.75, 95 % CI: [2.3-6.2], respectively. Females exposed to three or more ACEs were four times more likely to engage in transactional sex (aOR = 4.85, 95 %, CI: [1.6-14.4]) compared to those who did not experience any ACEs. Males exposed to three or more ACEs were two times more likely to engage in early sexual debut (aOR = 2.2, 95 % CI: [1.3-3.4]),]) compared to those who did not experience any ACEs. Females who had witnessed IPV or violence in the community had significantly higher odds of getting tested for HIV (aOR = 2.16, 95 % CI: [1.63-2.87]) and (aOR = 1.36, 95 % CI: [1.03-1.81]), respectively. CONCLUSIONS This study demonstrated that experiencing ACEs during childhood is associated with higher HIV risk behaviors in sub-Saharan Africa (SSA) with unique differences between males and females.
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Affiliation(s)
| | - Viva Thorsen
- Division of Global HIV and Tuberculosis, Centers for Disease Control and Prevention, Atlanta, USA.
| | - Liping Zhu
- Division of Violence Prevention, Centers for Disease Control and Prevention, Atlanta, USA
| | - Francis B Annor
- Division of Violence Prevention, Centers for Disease Control and Prevention, Atlanta, USA
| | - Laura Chiang
- Division of Violence Prevention, Centers for Disease Control and Prevention, Atlanta, USA
| | - Jordan McOwen
- Division of Global HIV and Tuberculosis, Centers for Disease Control and Prevention, Mozambique
| | | | - Pedro Manuel
- Division of Global HIV and Tuberculosis, Centers for Disease Control and Prevention, Mozambique
| | - Caroline Kambona
- Division of Global HIV and Tuberculosis, Centers for Disease Control and Prevention, Kenya
| | - Rachel Coomer
- Division of Global HIV and Tuberculosis, Centers for Disease Control and Prevention, Namibia
| | - Fathim Kamagate
- Division of Global HIV and Tuberculosis, Centers for Disease Control and Prevention, Cote d'Ivoire
| | - Puleng Ramphalla
- Division of Global HIV and Tuberculosis, Centers for Disease Control and Prevention, Lesotho
| | - Langan Denhard
- Division of Global HIV and Tuberculosis, Centers for Disease Control and Prevention, Atlanta, USA
| | - Meagan Cain
- Division of Global HIV and Tuberculosis, Centers for Disease Control and Prevention, Atlanta, USA
| | - Jennifer Hegle
- Division of Global HIV and Tuberculosis, Centers for Disease Control and Prevention, Atlanta, USA
| | | | - Shantal Saenz
- Division of Global HIV and Tuberculosis, Centers for Disease Control and Prevention, Atlanta, USA
| | - Mwikali Kamami
- Division of Global HIV and Tuberculosis, Centers for Disease Control and Prevention, Atlanta, USA
| | - Pragna Patel
- Division of Global HIV and Tuberculosis, Centers for Disease Control and Prevention, Atlanta, USA
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Reidy DE, Bhochhibhoya S, Baumler ER, Markham CM, Peskin MF, Shegog R, Emery ST, Addy RC, Temple JR. The longitudinal association between sexual violence victimization and sexual risk behavior in adolescence. Prev Med Rep 2023; 35:102387. [PMID: 37680859 PMCID: PMC10480619 DOI: 10.1016/j.pmedr.2023.102387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 08/22/2023] [Accepted: 08/24/2023] [Indexed: 09/09/2023] Open
Abstract
Being a victim of sexual violence (SV) is generally believed to be associated with subsequent sexual risk behavior (SRB) during adolescence. While this assumption makes intuitive sense, it is based on methodologically limited research, including a reliance on cross-sectional data. To address this gap in research, we test whether experiencing SV victimization in early adolescence is associated with self-reported SRB approximately two years later. The sample comprised 4,618 youth (58% female; 52% Hispanic; 39% Black) attending 44 schools in the southern United States. Self-reported data were collected using an audio computer-assisted self-interview (ACASI). Baseline data were collected when students were in 7th or 8th grade and follow-up data were collected approximately 24 months later when students were in 9th or 10th grade. Indices of SRB included behaviors related to oral, vaginal, and anal sex (e.g., number of partners, number of times without a condom). Girls, but not boys, who reported SV victimization at baseline reported engaging more frequently in all oral and vaginal SRBs at 24 month follow-up compared to their non-victimized female counterparts. Additionally, girls reporting SV victimization reported more anal sex partners than non-victimized girls. Girls who are victims of SV engage in significantly more SRB by early high school placing them at greater risk to contract STIs and become pregnant. Victims of SV should be screened for SRB and provided access to the appropriate resources. Teen pregnancy and STI prevention planning should consider SV victimization in their strategy planning.
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Affiliation(s)
- Dennis E. Reidy
- School of Public Health & Center for Research on Interpersonal Violence, Georgia State University, USA
| | - Shristi Bhochhibhoya
- School of Public Health & Center for Research on Interpersonal Violence, Georgia State University, USA
| | | | | | - Melissa F. Peskin
- School of Public Health, University of Texas Health Science Center Houston, USA
| | - Ross Shegog
- School of Public Health, University of Texas Health Science Center Houston, USA
| | - Susan T. Emery
- School of Public Health, University of Texas Health Science Center Houston, USA
| | - Robert C. Addy
- School of Public Health, University of Texas Health Science Center Houston, USA
| | - Jeff R. Temple
- Center for Violence Prevention, University of Texas Medical Branch, USA
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Fedina L, Moss L, Rousson AN, Smith ME, Bright C, Herrenkohl TI, DeVylder J. Effects of Neighborhood Disconnection on Psychological Distress and Suicide Risk Associated with Interpersonal Violence Within Racial Groups. JOURNAL OF CHILD & ADOLESCENT TRAUMA 2023; 16:681-697. [PMID: 37593058 PMCID: PMC10427586 DOI: 10.1007/s40653-023-00532-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/08/2023] [Indexed: 08/19/2023]
Abstract
Negative mental health outcomes have been associated with adverse childhood experiences (ACEs) and intimate partner violence (IPV); however, few studies have identified risk and protective factors across levels of the social ecology that mitigate the onset of psychological distress and suicide risk associated with trauma. This study examines the relationship between ACEs, IPV, and mental health (i.e., psychological distress, suicidal ideation, and suicide attempts) within racial sub-populations of Black American, Latinx, and White adults. An online, cross-section survey was administered to a general population sample of adults in Baltimore and New York City. ACEs, IPV, and mental health outcomes were assessed within racial sub-populations of Black American (N = 390), Latinx (N = 178), and White (N = 339) adults, while accounting for within-group demographic differences. Moderating effects of social support and neighborhood disconnection on the relationship between ACEs, IPV, and mental health outcomes were also assessed. IPV was associated with psychological distress and suicidal ideation for Black and Latinx adults, but not for White adults. ACEs were associated with increased psychological distress for all three groups, and increased odds for suicidal ideation among Black and Latinx adults.. A significant negative interaction effect for neighborhood disconnection was found in the relationship between ACEs and psychological distress for Black adults. Findings highlight the significant mental health burdens of ACEs and IPV within racial and ethnic groups. Neighborhood disconnection may exacerbate psychological distress associated with ACEs among populations most impacted by interpersonal violence and mental health inequalities.
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Affiliation(s)
- Lisa Fedina
- School of Social Work, University of Michigan, 1080 S. University Ave, Ann Arbor, MI 48105 USA
| | - Lolita Moss
- School of Social Work, University of Michigan, 1080 S. University Ave, Ann Arbor, MI 48105 USA
| | | | | | | | - Todd I. Herrenkohl
- School of Social Work, University of Michigan, 1080 S. University Ave, Ann Arbor, MI 48105 USA
| | - Jordan DeVylder
- Graduate School of Social Service, Fordham University, New York, NY USA
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6
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Kanagasabai U, Aholou T, Chevalier MS, Tobias JL, Okuku J, Shiraishi RW, Sheneberger R, Pande YC, Chifuwe C, Mamane LE, Njika G, Obongo C, Thorsen VC. Reaching Youth Through Faith Leaders: Evaluation of the Faith Matters! Initiative. AIDS EDUCATION AND PREVENTION : OFFICIAL PUBLICATION OF THE INTERNATIONAL SOCIETY FOR AIDS EDUCATION 2023; 35:82-99. [PMID: 37406142 PMCID: PMC11075127 DOI: 10.1521/aeap.2023.35.suppa.82] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/07/2023]
Abstract
Faith leaders can be uniquely positioned to guide and support young people on health issues, particularly HIV/AIDS and sexual violence. Faith Matters!, a 2-day training workshop for faith leaders, was delivered in September 2021 in Zambia. Sixty-six faith leaders completed a questionnaire at baseline, 64 at posttraining, and 59 at 3-month follow-up. Participants' knowledge, beliefs, and comfort communicating about HIV/AIDS and sexual violence were assessed. More faith leaders accurately identified common places where sexual violence occurs at the 3-month point compared to baseline: at church (2 vs. 22, p = .000), the fields (16 vs. 29, p = .004), parties (22 vs. 36, p = .001), and clubs (24 vs. 35, p = .034). More faith leaders stated that they engaged in conversations that supported people living with HIV (48 at baseline vs. 53, p = .049 at 3-month follow-up). These findings can inform future HIV/AIDS initiatives focusing on increasing the capacity among communities of faith.
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Affiliation(s)
- Udhayashankar Kanagasabai
- Division of Global HIV and Tuberculosis (TB), Center for Global Health (CGH), Centers for Disease Control and Prevention (CDC), Atlanta, Georgia
| | - Tiffiany Aholou
- Division of Global HIV and Tuberculosis (TB), Center for Global Health (CGH), Centers for Disease Control and Prevention (CDC), Atlanta, Georgia
| | - Michelle S Chevalier
- Division of Global HIV and Tuberculosis (TB), Center for Global Health (CGH), Centers for Disease Control and Prevention (CDC), Atlanta, Georgia
| | - James L Tobias
- Division of Global HIV and Tuberculosis (TB), Center for Global Health (CGH), Centers for Disease Control and Prevention (CDC), Atlanta, Georgia
| | - Jackson Okuku
- Division of Global HIV & TB, CGH, CDC, Lusaka, Zambia
| | - Ray W Shiraishi
- Division of Global HIV and Tuberculosis (TB), Center for Global Health (CGH), Centers for Disease Control and Prevention (CDC), Atlanta, Georgia
| | | | | | - Clifton Chifuwe
- Executive Director and Global Master Trainer at the Centre for Peace Research and Advocacy, Zambia
| | - Lauren Erickson Mamane
- Division of Global HIV and Tuberculosis (TB), Center for Global Health (CGH), Centers for Disease Control and Prevention (CDC), Atlanta, Georgia
- Office of the Director, CGH, CDC, Atlanta, Georgia
| | | | - Chris Obongo
- Regional Measurement Specialist and Global Master Trainer at PATH, Kenya
| | - Viva C Thorsen
- Division of Global HIV and Tuberculosis (TB), Center for Global Health (CGH), Centers for Disease Control and Prevention (CDC), Atlanta, Georgia
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7
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Xie Y, Xiong M, Qi Z, Shen J, Xu X, Luo X, Wang C, Tang W. Client-Perpetrated Violence Experience Among Female Sex Worker in Guangdong, South China: Results from a Cross-Sectional Study. AIDS Behav 2023; 27:806-815. [PMID: 36044124 DOI: 10.1007/s10461-022-03813-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/10/2022] [Indexed: 11/28/2022]
Abstract
Client-perpetrated violence (CPV) can lead to worse health consequences. However, little attention is paid to the CPV experience among Chinese female sex workers. Our study aimed to assess the association between CPV experience and health risk behaviors among FSWs in China. Data used in this study was from the baseline interviewer-administered questionnaire of a cluster randomized controlled trial conducted in June-October 2020. The collected information included sociodemographic characteristics, HIV/STI symptoms, number of clients, quality of the workplace, and past CPV experience. The association between violence experience and potential HIV/STI risk factors was explored using multivariable regression. Among 480 FSWs who participated in this study, 13.5% experienced CPV in the past. Compared to those who had never experienced CPV, FSWs who experienced CPV were more likely to report previous STI-related symptoms (aOR 4.29, 95% CI 1.73-10.64), more than 15 clients in the past month (aOR 2.56, 95% CI 1.18-5.52), a history of HIV testing (aOR 2.99, 95% CI 1.64-5.46), and work at low-tier workplaces (aOR 2.09, 95% CI 1.18-3.70). Overall, CPV prevalence is not low among Chinese FSWs, and there are some associations with HIV/STI risk factors; a future intervention targeting CPV in HIV/STI prevention programs is needed.
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Affiliation(s)
- Yewei Xie
- Duke Global Health Institute, Duke University, Durham, NC, USA.,University of North Carolina at Chapel Hill Project-China, Guangzhou, China
| | - Mingzhou Xiong
- Dermatology Hospital of South Medical University, Guangzhou, China
| | - Zhidong Qi
- Yunfu Chronic Disease Prevention Center, Yunfu, China
| | - Jingwen Shen
- Maoming Chronic Disease Prevention Center, Maoming, China
| | - Xiaojuan Xu
- Yangjiang Public Health Hospital, Yangjiang, China
| | - Xinyi Luo
- Yingde Chronic Disease Control Hospital, Yingde, China
| | - Cheng Wang
- Dermatology Hospital of South Medical University, Guangzhou, China.
| | - Weiming Tang
- Dermatology Hospital of South Medical University, Guangzhou, China. .,Institute for Global Health and Infectious Diseases, School of Medicine, University of North Carolina at Chapel Hill, 130 Mason Farm Road 7030, Chapel Hill, NC, 27599, USA.
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Srikanth N, Weerakoon SM, Mathew MS, Xie L, Messiah SE. Relationship Between Dating Violence and Contraceptive Use Among Texas Adolescents. JOURNAL OF INTERPERSONAL VIOLENCE 2023; 38:4852-4876. [PMID: 36000420 DOI: 10.1177/08862605221119519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
The recent overturning of Roe v. Wade has the potential to adversely impact reproductive health among adolescents experiencing unplanned pregnancies from dating violence. We examined the associations between contraceptive use and dating violence among Texas high schoolers in the years leading up to this new law. Youth Risk Behavior Surveillance System data from Texas 9th to 12th graders from 2011, 2013, 2017, and 2019 were analyzed. Multinomial logistic regression analyses examined the association between contraceptive use and key descriptive predictors (physical and/or sexual dating violence, survey year, age, sex, and race/ethnic group). Eleven percent of Texas adolescents surveyed reported experiencing either physical or sexual dating violence and 2% reported experiencing both types of violence. Those who experienced any dating violence were significantly more likely to report not using contraception versus those who did not experience violence (12.5% vs. 68.3%, p = 0.01). Adolescents who experienced any type of dating violence were more likely to report using hormonal contraception, condom use, or withdrawal versus those who did not experience dating violence. Hispanic adolescents were 63% more likely than their ethnic group counterparts to use no contraception (odds ratio [OR] 1.63; 95% confidence interval [CI] [1.11-2.40]). A significant proportion of Texas adolescents reported experiencing dating violence, and this group also reported higher noncontraception use versus those not experiencing dating violence. Given new strict Texas antiabortion laws, dating violence prevention and contraceptive use promotion to prevent unwanted reproductive outcomes such as sexually transmitted infections or unplanned pregnancies are imperative in this age group.
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Affiliation(s)
- Nimisha Srikanth
- University of Texas Health Science Center at Houston, Dallas, TX USA
- University of Texas Health Science Center at Houston, Dallas, TX, USA
- Texas A&M University, College Station, TX, USA
| | - Sitara M Weerakoon
- University of Texas Health Science Center at Houston, Dallas, TX USA
- University of Texas Health Science Center at Houston, Dallas, TX, USA
- Yale School of Medicine, New Haven, CT, USA
| | - Matthew S Mathew
- University of Texas Health Science Center at Houston, Dallas, TX USA
- University of Texas Health Science Center at Houston, Dallas, TX, USA
| | - Luyu Xie
- University of Texas Health Science Center at Houston, Dallas, TX USA
- University of Texas Health Science Center at Houston, Dallas, TX, USA
| | - Sarah E Messiah
- University of Texas Health Science Center at Houston, Dallas, TX USA
- University of Texas Health Science Center at Houston, Dallas, TX, USA
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9
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Hill AV, Hill AL, Jackson Z, Gilreath TD, Fields A, Miller E. Adolescent Relationship Abuse, Gender Equitable Attitudes, Condom and Contraception Use Self-Efficacy Among Adolescent Girls. JOURNAL OF INTERPERSONAL VIOLENCE 2022; 37:NP22329-NP22351. [PMID: 35324369 PMCID: PMC9549914 DOI: 10.1177/08862605221080976] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Introduction: Experiencing adolescent relationship abuse (ARA) negatively impacts sexual health and influences risk behaviors of adolescent girls. ARA may be associated with more inequitable gender attitudes among girls, a potentially modifiable factor in violence prevention. This study examines the association among gender equitable attitudes, experiences of ARA, and sexual behaviors among girls participating in Sisterhood 2.0, a community-based violence prevention program implemented in low resource neighborhoods. Methods: Data were from baseline surveys collected for Sisterhood 2.0 implemented in Pittsburgh, PA. Participant demographics, gender equitable attitudes, self-efficacy to use condoms with partners, and self-efficacy to select appropriate contraception were assessed. A latent class analysis (LCA) estimated probability of responses to nine indicators, including sexual behavior self-efficacy and violence. Multigroup LCA by grade (9-12) was also estimated and analyses were performed with SAS V9.4. Results: Female-identified adolescents ages 13-19 (n = 246) were primarily Black (75%) and evenly distributed across grade in school. Sixty-five percent reported emotional relationship abuse and 31% reported physical abuse within the previous nine months. A three-class solution was best fitting for the LCA. Experiences of violence were related to less equitable gender attitudes, being sexually active, and lower condom and contraception self-efficacy. Younger participants who were sexual minorities with less educated heads of household had more experiences with ARA and less equitable gender attitudes. Discussion: Gender equitable attitudes were lower in adolescent girls with greater experiences of ARA and worse condom and contraception self-efficacy. Integrating discussions about healthy sexual relationships and gender equity may be salient factors in violence prevention.
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Affiliation(s)
- Ashley V. Hill
- Department of Epidemiology, University of Pittsburgh, School of Public Health, Pittsburgh, PA, USA
- Division of Adolescent and Young Adult Medicine, UPMC Children’s Hospital of Pittsburgh, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Amber L. Hill
- Division of Adolescent and Young Adult Medicine, UPMC Children’s Hospital of Pittsburgh, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
- Department of Pediatrics, C.S. Mott Children’s Hospital, University of Michigan, Ann Arbor, MI, USA
| | - Zachary Jackson
- Department of Health and Kinesiology, Whitlowe R. Green College of Education, Prairie View A&M University, Prairie View, TX, USA
| | - Tamika D. Gilreath
- Transdisciplinary Center for Health Equity Research, College of Health and Human Development, Texas A&M University, College Station, TX, USA
| | - Alana Fields
- Division of Adolescent and Young Adult Medicine, UPMC Children’s Hospital of Pittsburgh, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Elizabeth Miller
- Division of Adolescent and Young Adult Medicine, UPMC Children’s Hospital of Pittsburgh, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
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10
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Emezue C, Chase JD, Udmuangpia T, Bloom TL. Technology-based and digital interventions for intimate partner violence: A systematic review and meta-analysis. CAMPBELL SYSTEMATIC REVIEWS 2022; 18:e1271. [PMID: 36909881 PMCID: PMC9419475 DOI: 10.1002/cl2.1271] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
Background A growing body of research shows the promise and efficacy of technology-based or digital interventions in improving the health and well-being of survivors of intimate partner violence (IPV). In addition, mental health comorbidities such as anxiety, post-traumatic stress disorder (PTSD), and depression occur three to five times more frequently in survivors of IPV than non-survivors, making these comorbidities prominent targets of technology-based interventions. Still, research on the long-term effectiveness of these interventions in reducing IPV victimization and adverse mental health effects is emergent. The significant increase in the number of trials studying technology-based therapies on IPV-related outcomes has allowed us to quantify the effectiveness of such interventions for mental health and victimization outcomes in survivors. This meta-analysis and systematic review provide critical insight from several randomized controlled trials (RCTs) on the overall short and long-term impact of technology-based interventions on the health and well-being of female IPV survivors. Objectives To synthesize current evidence on the effects of technology-based or digital interventions on mental health outcomes (depression, anxiety, and PTSD) and victimization outcomes (physical, psychological, and sexual abuse) among IPV survivors. Search Methods We examined multiple traditional and grey databases for studies published from 2007 to 2021. Traditional databases (such as PubMed Central, Web of Science, CINAHL Plus, and PsychINFO) and grey databases were searched between April 2019 and February 2021. In addition, we searched clinical trial registries, government repositories, and reference lists. Authors were contacted where additional data was needed. We identified 3210 studies in traditional databases and 1257 from grey literature. Over 2198 studies were determined to be duplicates and eliminated, leaving 64 studies after screening titles and abstracts. Finally, 17 RCTs were retained for meta-analysis. A pre-registered protocol was developed and published before conducting this meta-analysis. Selection Criteria We included RCTs targeting depression, anxiety, PTSD outcomes, and victimization outcomes (physical, sexual, and psychological violence) among IPV survivors using a technology-based intervention. Eligible RCTs featured a well-defined control group. There were no study restrictions based on participant gender, study setting, or follow-up duration. Included studies additionally supplied outcome data for calculating effect sizes for our desired outcome. Studies were available in full text and published between 2007 and 2021 in English. Data Collection and Analysis We extracted relevant data and coded eligible studies. Using Cochrane's RevMan software, summary effect sizes (Outcome by Time) were assessed using an independent fixed-effects model. Standardized mean difference (SMD) effect sizes (or Cohen's d) were evaluated using a Type I error rate and an alpha of 0.05. The overall intervention effects were analyzed using the Z-statistic with a p-value of 0.05. Cochran's Q test and Higgins' I 2 statistics were utilized to evaluate and confirm the heterogeneity of each cumulative effect size. The Cochrane risk of bias assessment for randomized trials (RoB 2) was used to assess the quality of the studies. Campbell Systematic Reviews registered and published this study's protocol in January 2021. No exploratory moderator analysis was conducted; however, we report our findings with and without outlier studies in each meta-analysis. Main Results Pooled results from 17 RCTs yielded 18 individual effect size comparisons among 4590 survivors (all females). Survivors included college students, married couples, substance-using women in community prisons, pregnant women, and non-English speakers, and sample sizes ranged from 15 to 672. Survivors' ages ranged from 19 to 41.5 years. Twelve RCTs were conducted in the United States and one in Canada, New Zealand, China (People's Republic of), Kenya, and Australia. The results of this meta-analysis found that technology-based interventions significantly reduced depression among female IPV survivors at 0-3 months only (SMD = -0.08, 95% confidence interval [CI] = -0.17 to -0.00), anxiety among IPV survivors at 0-3 months (SMD = -0.27, 95% CI = -0.42 to -0.13, p = 0.00, I 2 = 25%), and physical violence victimization among IPV survivors at 0-6 months (SMD = -0.22, 95% CI = -0.38 to -0.05). We found significant reductions in psychological violence victimization at 0-6 months (SMD = -0.34, 95% CI = -0.47 to -0.20) and at >6 months (SMD = -0.29, 95% CI = -0.39 to -0.18); however, at both time points, there were outlier studies. At no time point did digital interventions significantly reduce PTSD (SMD = -0.04, 95% CI = -0.14 to 0.06, p = .46, I 2 = 0%), or sexual violence victimization (SMD = -0.02, 95% CI = -0.14 to 0.11, I 2 = 21%) among female IPV survivors for all. With outlier studies removed from our analysis, all summary effect sizes were small, and this small number of comparisons prevented moderator analyses. Authors' Conclusions The results of this meta-analysis are promising. Our findings highlight the effectiveness of IPV-mitigating digital intervention as an add-on (not a replacement) to traditional modalities using a coordinated response strategy. Our findings contribute to the current understanding of "what works" to promote survivors' mental health, safety, and well-being. Future research could advance the science by identifying active intervention ingredients, mapping out intervention principles/mechanisms of action, best modes of delivery, adequate dosage levels using the treatment intensity matching process, and guidelines to increase feasibility and acceptability.
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Affiliation(s)
- Chuka Emezue
- Department of Women, Children and Family NursingRush University College of NursingChicagoIllinoisUSA
| | - Jo‐Ana D. Chase
- Sinclair School of NursingUniversity of MissouriColumbiaMissouriUSA
| | - Tipparat Udmuangpia
- Department of Maternal‐Child Health and MidwiferyBoromarajonani College of NursingKhon KaenThailand
| | - Tina L. Bloom
- School of NursingNotre Dame of Maryland UniversityBaltimoreMarylandUSA
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Rothman EF, Campbell JK, Hoch AM, Bair-Merritt M, Cuevas CA, Taylor B, Mumford EA. Validity of a three-item dating abuse victimization screening tool in a 11-21 year old sample. BMC Pediatr 2022; 22:337. [PMID: 35689198 PMCID: PMC9185716 DOI: 10.1186/s12887-022-03397-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Accepted: 05/25/2022] [Indexed: 11/24/2022] Open
Abstract
Background Dating abuse (DA) is prevalent and consequential, but no brief DA screening tools are available for use in pediatric or other settings. This study was designed to determine the sensitivity, specificity, and predictive values of the MARSHA-C, which is a three-item DA victimization screening tool. Methods The participants were 224 U.S. youth ages 11–21 years old (20% male, 77% female, 3% non-binary gender). Youth completed an online questionnaire about adolescent relationship abuse. The survey included the Measure of Adolescent Relationship Harassment and Abuse (MARSHA), which is a comprehensive DA measurement instrument normed on a nationally representative sample. Of 34 DA victimization items from the MARSHA, the three most prevalent items were hypothesized to have good predictive validity of the full scale score as a brief, screening version (MARSHA-C). The sensitivity, specificity, positive predictive value, and negative predictive value of the MARSHA-C to identify victims of DA was calculated. Results Using the MARSHA as the reference standard, the cutpoint of 1 on the MARSHA-C screening tool was identified as optimal. The MARSHA-C had a sensitivity of 84%, a specificity of 91%, and positive predictive value of 91%. Thus, for youth who endorse ≥ 1 MARSHA-C items, there is a 91% probability that they have experienced DA in the past year. Exploratory analyses by demographic subgroups suggest that the predictive validity of the MARSHA-C is approximately equivalent for females and males, younger and older adolescents, Asian, Black, Latinx, Multiracial and White youth, and heterosexual and lesbian, gay, and bisexual youth. Conclusions The MARSHA-C can be used to detect DA among 11–21-year-old youth via online surveys for research purposes, or in clinical care settings to facilitate proactive patient counseling or parent-oriented anticipatory guidance.
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Affiliation(s)
- Emily F Rothman
- Department of Occupational Therapy, Boston University, 635 Commonwealth Ave, Boston, MA, 02215, USA.
| | - Julia K Campbell
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Ariel M Hoch
- Boston University School of Medicine, Boston, MA, USA
| | | | | | - Bruce Taylor
- NORC at the University of Chicago, Chicago, IL, USA
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Hill AV, Mistry S, Paglisotti TE, Dwarakanath N, Lavage DR, Hill AL, Iwuanyanwu R, Stokes LR, Jones KA, Miller E. Assessing feasibility of an adolescent relationship abuse prevention program for girls. J Adolesc 2022; 94:333-353. [PMID: 35390205 PMCID: PMC9009219 DOI: 10.1002/jad.12026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Accepted: 11/19/2021] [Indexed: 11/11/2022]
Abstract
INTRODUCTION Sexual violence and relationship abuse are prevalent among adolescents and programs promoting gender equity, reproductive justice, and healthy relationships are key strategies for prevention. While such "gender transformative" approaches appear promising for boys, they have not been evaluated among girls. This study assessed the feasibility of this community-based program, called Sisterhood 2.0, among girls in socially disadvantaged urban neighborhoods in Pittsburgh, Pennsylvania. METHODS This quasi-experimental trial examined feasibility of Sisterhood 2.0 (n = 246), delivered through 8 weekly sessions, assessed through attendance, retention and satisfaction. Participants completed surveys at baseline and end of program assessing other relevant measures. Generalized linear mixed models estimated changes from baseline to follow up comparing intervention to control participants. RESULTS Eleven neighborhoods were assigned to Sisterhood 2.0 (n = 5 neighborhoods) or job-readiness training (n = 6 neighborhoods). Girls were between the ages of 13 and 19, 8-10th graders (59%), and self-identified as Black (69%). Participants most often attended because they thought the program would be interesting (74%) and returned because of the women teaching the program (71%). Girls reported experiences with physical adolescent relationship abuse (ARA) (30% in both arms), emotional ARA (66% intervention; 56% control), or sexual ARA (11% intervention; 12% control). Physical ARA perpetration was high in both arms (intervention: 47%; control: 46%). Significant intervention effects were observed in recognition of abuse (β = 0.41, 95% confidence interval 0.03-0.78). No other significant intervention effects were observed. CONCLUSIONS Community-based gender-transformative programming for girls is feasible and may be a promising approach for addressing interpersonal violence and promoting sexual health.
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Affiliation(s)
- Ashley V Hill
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.,Division of Adolescent and Young Adult Medicine, UPMC Children's Hospital of Pittsburgh, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Sejal Mistry
- Division of Adolescent and Young Adult Medicine, UPMC Children's Hospital of Pittsburgh, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - T E Paglisotti
- Division of Adolescent and Young Adult Medicine, UPMC Children's Hospital of Pittsburgh, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Namita Dwarakanath
- Division of Adolescent and Young Adult Medicine, UPMC Children's Hospital of Pittsburgh, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Daniel R Lavage
- Division of Adolescent and Young Adult Medicine, UPMC Children's Hospital of Pittsburgh, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Amber L Hill
- Division of Adolescent and Young Adult Medicine, UPMC Children's Hospital of Pittsburgh, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Rosemary Iwuanyanwu
- Division of Adolescent and Young Adult Medicine, UPMC Children's Hospital of Pittsburgh, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Lynissa R Stokes
- Division of Adolescent and Young Adult Medicine, UPMC Children's Hospital of Pittsburgh, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Kelley A Jones
- Division of Adolescent and Young Adult Medicine, UPMC Children's Hospital of Pittsburgh, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.,Department of Population Health Sciences, Duke University School of Medicine, Durham, North Carolina, USA
| | - Elizabeth Miller
- Division of Adolescent and Young Adult Medicine, UPMC Children's Hospital of Pittsburgh, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
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Ponsford R, Meiksin R, Allen E, Melendez-Torres GJ, Morris S, Mercer C, Campbell R, Young H, Lohan M, Coyle K, Bonell C. The Positive Choices trial: study protocol for a Phase-III RCT trial of a whole-school social marketing intervention to promote sexual health and reduce health inequalities. Trials 2021; 22:818. [PMID: 34789322 PMCID: PMC8596352 DOI: 10.1186/s13063-021-05793-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Accepted: 11/03/2021] [Indexed: 11/13/2022] Open
Abstract
Background Positive Choices is a whole-school social marketing intervention to promote sexual health among secondary school students. Intervention comprises school health promotion council involving staff and students coordinating delivery; student survey to inform local tailoring; teacher-delivered classroom curriculum; student-run campaigns; parent information; and review of sexual/reproductive health services to inform improvements. This trial builds on an optimisation/pilot RCT study which met progression criteria, plus findings from another pilot RCT of the Project Respect school-based intervention to prevent dating and relationship violence which concluded such work should be integrated within Positive Choices. Young people carry a disproportionate burden of adverse sexual health; most do not report competence at first sex. Relationships and sex education in schools can contribute to promoting sexual health but effects are small, inconsistent and not sustained. Such work needs to be supplemented by ‘whole-school’ (e.g. student campaigns, sexual health services) and ‘social marketing’ (harnessing commercial marketing to social ends) approaches for which there is good review-level evidence but not from the UK. Methods We will conduct a cluster RCT across 50 schools (minimum 6440, maximum 8500 students) allocated 1:1 to intervention/control assessing outcomes at 33 months. Our primary outcome is non-competent first sex. Secondary outcomes are non-competent last sex, age at sexual debut, non-use of contraception at first and last sex among those reporting heterosexual intercourse, number of sexual partners, dating and relationship violence, sexually transmitted infections, and pregnancy and unintended pregnancy for girls and initiation of pregnancy for boys. We will recruit 50 school and undertake baseline surveys by March 2022; implement the intervention over the 2022–2024 school years and conduct the economic and process evaluations by July 2024; undertake follow-up surveys by December 2024; complete analyses, all patient and policy involvement and draft the study report by March 2025; and engage in knowledge exchange from December 2024. Discussion This trial is one of a growing number focused on whole-school approaches to public health in schools. The key scientific output will be evidence about the effectiveness, costs and potential scalability and transferability of Positive Choices. Trial registration ISRCTN No: ISRCTN16723909. Trial registration summary: Date:. Funded by: National Institute for Health Research Public Health Research Programme (NIHR131487). Sponsor: LSHTM. Public/scientific contact: Chris Bonell. Public title: Positive Choices trial. Scientific title: Phase-III RCT of Positive Choices: a whole-school social marketing intervention to promote sexual health and reduce health inequalities. Countries of recruitment: UK. Intervention: Positive Choices. Inclusion criteria: Students in year 8 (age 12–13 years) at baseline deemed competent by schools to participate in secondary schools excluding pupil referral units, schools for those with special educational needs and disabilities, and schools with ‘inadequate’ Ofsted inspections. Study type: interventional study with superiority phase III cluster RCT design. Enrollment: 1/9/21-31/3/22. Sample size: 50 schools and 6440–8500 students. Recruitment status: pending. Primary outcome: binary measure of non-competent first sex. Secondary outcomes: non-competent last sex; age at sexual debut; non-use of contraception at first and last sex; number of sexual partners; dating and relationship violence (DRV) victimisation; sexually transmitted infections; pregnancy and unintended pregnancy for girls and initiation of pregnancy for boys using adapted versions of the RIPPLE measures. Ethics review: LSHTM research ethics committee (reference 26411). Completion data: 1/3/25. Sharing statement: Data will be made available after the main trial analyses have been completed on reasonable request from researchers with ethics approval and a clear protocol. Amendments to the protocol will be communicated to the investigators, sponsor, funder, research ethics committee, trial registration and the journal publishing the protocol. Amendments affecting participants’ experience of the intervention or important amendments affecting the overall design and conduct of the trial will be communicated to participants.
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Affiliation(s)
- Ruth Ponsford
- London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, WC1H 9SH, London, UK
| | - Rebecca Meiksin
- London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, WC1H 9SH, London, UK
| | - Elizabeth Allen
- London School of Hygiene and Tropical Medicine, Keppel Street, WC1E 7HT, London, UK
| | - G J Melendez-Torres
- University of Exeter College of Medicine and Health, South Cloisters, St Luke's Campus, Heavitree Road, EX1 2, Exeter, LU, UK
| | - Steve Morris
- Department of Public Health & Primary Care, Cambridge University, Strangeways Research Laboratory, Worts Causeway, Cambridge, CB1 8RN, UK
| | - Catherine Mercer
- UCL Institute for Global Health, 3rd Floor Mortimer Market Centre, off Capper Street, WC1E 6JB, London, UK
| | - Rona Campbell
- University of Bristol, 1-5 Whiteladies Road, Clifton, Bristol, BS8 1NU, UK
| | - Honor Young
- DECIPHer, Cardiff School of Social Sciences, Cardiff University, 1-3 Museum Place, Cardiff, CF10 3BD, UK
| | - Maria Lohan
- School of Nursing and Midwifery, Medical Biology Centre, 97 Lisburn Road, Belfast, BT9 7BL, UK
| | - Karin Coyle
- , 5619 Scotts Valley Drive, Suite 140, Scotts Valley, CA, 95066, Scotts Valley, USA
| | - Chris Bonell
- London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, WC1H 9SH, London, UK.
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Baiden P, Mengo C, Small E. History of Physical Teen Dating Violence and Its Association With Suicidal Behaviors Among Adolescent High School Students: Results From the 2015 Youth Risk Behavior Survey. JOURNAL OF INTERPERSONAL VIOLENCE 2021; 36:NP9526-NP9547. [PMID: 31271096 DOI: 10.1177/0886260519860087] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Although studies have investigated and found physical teen dating violence (TDV) has a significant negative impact on mental health outcomes, few studies are yet to investigate the effect of physical TDV on suicidal behaviors among adolescents. The objectives of this study are to examine the prevalence of physical TDV, suicidal ideation, suicide plan, and suicide attempt among adolescents aged 14 to 18 years and the association between physical TDV and these suicidal behaviors. Data for this study were obtained from the 2015 Youth Risk Behavior Survey. A sample of 9,693 adolescents aged 14 to 18 years (50.4% males) was analyzed using logistic regression with suicidal ideation, suicide plan, and suicide attempt as outcome variables and physical TDV as the main explanatory variable. About 17% of the adolescent students experienced suicidal ideation, 13.7% made a suicide plan, and 7.6% attempted suicide during the past 12 months. Among those who were dating, 9.9% experienced physical TDV. In the multivariate logistic regression, adolescent students who experienced physical TDV were 1.92 times more likely to have experienced suicidal ideation, 1.67 times more likely to have made a suicide plan, and 2.42 times more likely to have attempted suicide during the past 12 months when compared with their counterparts who were dating but experienced no physical TDV. Other significant predictors of suicidal behaviors include being a sexual minority, experiencing forced sex, bullying, feeling sad or hopeless, and binge drinking. Having sufficient sleep lowered the odds of suicidal ideation and suicide plan. The topic of physical TDV and its association with suicidal behaviors among adolescents is such an important issue for researchers, policymakers, and practitioners in the United States and around the world. Prevention and intervention efforts should be culturally tailored to reflect the unique experiences with physical TDV and suicide among minority populations such as sexual minority adolescents.
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Wiebelhaus JN, Miller MK, Sherman AK, Pickett ML, Jackson J, Randell KA. Adolescent and Parent Perspectives on Confidentiality After Adolescent Relationship Abuse Disclosure. J Adolesc Health 2021; 69:242-247. [PMID: 33183924 DOI: 10.1016/j.jadohealth.2020.09.042] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2020] [Revised: 08/29/2020] [Accepted: 09/27/2020] [Indexed: 10/23/2022]
Abstract
PURPOSE This study aimed to assess adolescent and parent perspectives on parent notification after disclosure of adolescent relationship abuse (ARA) to a health care provider. METHODS A computerized survey was administered to a convenience sample of adolescents aged 14-18 years and their parents presenting to three Midwestern pediatric emergency departments. The survey assessed the acceptability of parent notification after hypothetical adolescent disclosure of different forms of ARA (i.e., physical, cyber, psychological and sexual ARA, reproductive coercion, controlling behavior, and feeling unsafe) to a health care provider. Chi-square and Fisher's exact tests were used to examine possible relationships between acceptability of parent notification and prior ARA victimization, adolescent dating relationship status, and demographic factors. RESULTS One-hundred fifty adolescent-parent dyads and 53 individual adolescents participated in this study. Most adolescents and parents found it acceptable to inform parents after disclosure of any type of ARA, although acceptability was higher among parents for all types of abuse assessed. Adolescent-parent dyads were more likely to both agree that parent notification was acceptable after disclosure of physical ARA, compared with other forms of ARA. Acceptability of parent notification after some types of ARA disclosure was less common among adolescents reporting previous sexual activity, prior ARA victimization, and adolescents currently in a dating relationship. CONCLUSIONS Most adolescents and parents found parent notification after ARA disclosure acceptable. However, adolescents most at risk, including those who reported previous sexual activity, prior ARA victimization, and those in a dating relationship, were less likely to find parent notification acceptable. Further study to assess barriers or concerns with parent involvement is crucial to optimizing provider response after ARA disclosure.
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Affiliation(s)
| | - Melissa K Miller
- Division of Emergency Medicine, Children's Mercy, Kansas City, Missouri
| | - Ashley K Sherman
- Health Service and Outcomes Research, Children's Mercy, Kansas City, Missouri
| | - Michelle L Pickett
- Department of Pediatrics, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Jami Jackson
- Division of Emergency Medicine, Children's Mercy, Kansas City, Missouri
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Factors Associated With HIV Testing Among High-School Girls in the U.S., 2015‒2017. Am J Prev Med 2021; 61:20-27. [PMID: 33965266 PMCID: PMC8312734 DOI: 10.1016/j.amepre.2021.01.039] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 01/20/2021] [Accepted: 01/25/2021] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Few studies have examined the factors associated with HIV testing, specifically among U.S. high-school girls. METHODS Investigators analyzed 2015 and 2017 Youth Risk Behavior Survey data to calculate the prevalence ratios and the corresponding 95% CIs for the association of HIV-related risk behaviors and other factors with HIV testing. Analyses were completed in March 2020. RESULTS Approximately 1 in 10 high-school girls reported ever having had an HIV test. Ever having had an HIV test was most common among girls who had ≥4 lifetime sexual partners and those who had ever injected illegal drugs. CONCLUSIONS High-school girls who engage in behaviors or experience other factors that put them at higher risk for HIV are more likely to have ever gotten tested. However, the prevalence of having ever had an HIV test remains relatively low, indicating that continued efforts may be warranted to reduce risk behaviors and increase testing among high-school girls.
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Emezue C, Bloom TL. PROTOCOL: Technology-based and digital interventions for intimate partner violence: A meta-analysis and systematic review. CAMPBELL SYSTEMATIC REVIEWS 2021; 17:e1132. [PMID: 37050972 PMCID: PMC8356356 DOI: 10.1002/cl2.1132] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
Introduction Studies show digital interventions such as mobile and wireless platforms (e.g., smartphone apps, text messaging) and web-based platforms (online support groups and telehealth services) can improve the mental health outcomes for victims/survivors of partner abuse. Depression, posttraumatic stress disorder (PTSD), and anxiety are three to five times higher among victims than nonvictims and are thus popular targets of digital interventions. Even then, the evidence is scant. The current review uses both narrative and quantitative (meta-analysis) techniques to present extensive evidence on the effects of intimate partner violence (IPV) digital interventions on the mental health outcomes among survivors of partner violence across all genders and ages, specifically, depression, anxiety, and PTSD. This is the first meta-analysis on IPV-related mental health outcomes targeted by digital interventions. Objectives To synthesize current evidence on the intervention and treatment effects of digital and technology-based interventions (mHealth and eHealth) addressing IPV mental health outcomes (depression, anxiety, and PTSD) among survivors of IPV. This study's research questions are as follows: (a) What are the overall average treatment effects of IPV digital interventions on IPV survivors' mental health outcomes? (b) Do these mental health outcomes vary based on methodological study designs, sample characteristics, and intervention characteristics? Methods An extensive search strategy will be utilized to find qualifying studies. Various electronic bibliographic databases will be searched for studies since 2009 (coinciding with the onset of mobile health interventions). Other databases, such as government databases, grey literature databases, trial registers, specialty journals, and citations in other studies will be searched. Also, we will search "grey databases," such as Google Scholar. Ethical and safety concerns preclude the randomization of IPV survivors to specific intervention conditions. Therefore, we will not exclude studies based on a lack of random assignment. Studies will be full-text accessible, published in any language (translatable into English). We will also contact researchers where needed data is missing in their report. Neither language, study location, nor study settings will be a limiter for searches. Keyword and MeSH headings will be used. Effect sizes (Hedges' g) will be estimated with a Type I error rate set at an alpha of .05. Results All studies will measure IPV-related mental health as an outcome and provide outcome data to calculate effect sizes for PTSD, anxiety, depression, and victimization (physical, psychological, and sexual violence). Conclusion Digital interventions may clinically reduce depression, anxiety, PTSD, and IPV victimization. Summary effect sizes ranging from small to large will signal the usefulness of digital interventions to IPV survivors contending with common mental health issues. Future studies beyond this one may identify other active intervention ingredients of digital interventions, best modes of delivery, and guidelines to increase their feasibility and acceptability.
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Affiliation(s)
- Chuka Emezue
- Sinclair School of NursingUniversity of Missouri‐ColumbiaColumbiaMOUSA
| | - Tina L. Bloom
- Sinclair School of NursingUniversity of Missouri‐ColumbiaColumbiaMOUSA
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Decker MR, Wood SN, Kennedy SR, Hameeduddin Z, Tallam C, Akumu I, Wanjiru I, Asira B, Omondi B, Case J, Clough A, Otieno R, Mwiti M, Perrin N, Glass N. Adapting the myPlan safety app to respond to intimate partner violence for women in low and middle income country settings: app tailoring and randomized controlled trial protocol. BMC Public Health 2020; 20:808. [PMID: 32471469 PMCID: PMC7260790 DOI: 10.1186/s12889-020-08901-4] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Accepted: 05/12/2020] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Intimate partner violence (IPV) is a leading threat to women's health and safety globally. Women in abusive relationships make critical decisions about safety and harm reduction while weighing multiple competing priorities, such as safety of children, housing and employment. In many low- and middle-income countries (LMIC), IPV prevention and response services are limited and women lack access to safety planning resources. In high-resource settings, an interactive safety decision aid app (myPlan) has been found valuable in reducing decisional conflict and empowering women to take action in accordance with their safety priorities. This paper describes 1) the community-participatory formative process used to adapt the myPlan app content, interface, and implementation for the Kenya context, and 2) the randomized clinical trial study protocol for efficacy evaluation of myPlan Kenya. METHODS A community-participatory formative process engaged service providers and stakeholders, as well as IPV survivors for adaptation, followed by an in-depth pilot and final refinements. A randomized clinical trial design will then be used to determine efficacy of the myPlan Kenya app compared to standard care among women reporting IPV or fear of partner and living in an urban settlement. myPlan Kenya app provides and solicits information on a) relationship health; b) safety priorities; and c) severity of relationship violence. Based on the woman's inputs, the evidence-based algorithm developed for myPlan Kenya generates a tailored safety plan. Outcome measures are assessed at baseline, immediate post-intervention, and 3-month post-baseline. Difference-in-differences analysis compares primary (e.g. safety preparedness, safety behavior, IPV), and secondary outcomes (e.g. resilience, mental health, service utilization, self-blame) across timepoints by group. DISCUSSION Formative phase revealed high feasibility and acceptability of a technology-based intervention for safety planning in this LMIC setting. This phase generated essential refinements to myPlan Kenya app readability, content and implementation, including increased visualization of messaging, and implementation via community health volunteers (CHVs). The resulting trial will be the first to evaluate efficacy of a community-partnered technology-based IPV intervention in a LMIC. Our adaptation process and trial results will inform researchers and interventionists to integrate multiple data sources to adapt IPV intervention content and interface in settings where technology-based interventions for IPV are novel and literacy is limited. TRIAL REGISTRATION Pan African Clinical Trial Registry approval received 25 April 2018 (PACTR201804003321122); retrospectively registered.
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Affiliation(s)
- Michele R Decker
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205, USA. .,Center for Public Health & Human Rights, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
| | - Shannon N Wood
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205, USA
| | | | - Zaynab Hameeduddin
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205, USA
| | | | - Irene Akumu
- Ujamaa-Africa, Mashinani Department, Nairobi, Kenya
| | | | - Ben Asira
- Ujamaa-Africa, Mashinani Department, Nairobi, Kenya
| | | | - James Case
- Johns Hopkins School of Nursing, Baltimore, USA
| | | | | | - Morris Mwiti
- Ujamaa-Africa, Mashinani Department, Nairobi, Kenya
| | | | - Nancy Glass
- Johns Hopkins School of Nursing, Baltimore, USA.,Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA.,Center for Global Health, Johns Hopkins University, Baltimore, USA
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Abstract
Intimate partner violence among adolescents (also called adolescent relationship abuse or teen dating violence) is common and is associated with poor health and social outcomes. Pediatric providers are uniquely positioned to offer universal education (anticipatory guidance) about healthy and unhealthy relationships to all their adolescent patients. Pediatric practices can ensure that youth know about available resources and supports for relationship abuse (for themselves or for their friends) and can facilitate safe connections to victim service advocates.
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Affiliation(s)
- Ellen S Rome
- Center for Adolescent Medicine, Cleveland Clinic Children's, and Department of General Pediatrics, Cleveland Clinic Lerner College of Medicine at Case, Cleveland, OH
| | - Elizabeth Miller
- Division of Adolescent and Young Adult Medicine, University of Pittsburgh Medical Center Children's Hospital of Pittsburgh, and Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, PA
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20
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Leddy AM, Weiss E, Yam E, Pulerwitz J. Gender-based violence and engagement in biomedical HIV prevention, care and treatment: a scoping review. BMC Public Health 2019; 19:897. [PMID: 31286914 PMCID: PMC6615289 DOI: 10.1186/s12889-019-7192-4] [Citation(s) in RCA: 59] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Accepted: 06/17/2019] [Indexed: 12/17/2022] Open
Abstract
Background While gender-based violence (GBV) has been shown to increase women’s risk of HIV acquisition, the role of GBV in the HIV testing to care continuum is less clear. Clarifying how GBV may act as a barrier to accessing HIV services, treatment and care - such as anti-retroviral treatment (ART) or pre-exposure prophylaxis (PrEP) - will not only provide insights into how to best meet individual women’s HIV care needs, but also inform public health oriented HIV epidemic control strategies. Methods Through a comprehensive scoping review, we synthesized and analyzed existing evidence regarding the influence of GBV on engagement in PrEP and the HIV care continuum among women living with HIV, including members of key populations (female sex workers, transgender women and women who use drugs). We explored PubMed, Scopus and Web of Science for peer-reviewed studies published in 2003–2017. Of the 279 sources identified, a subset of 51 sources met the criteria and were included in the scoping review. Results Studies were identified from 17 countries. The majority of studies utilized quantitative cross-sectional designs (n = 33), with the rest using longitudinal (n = 4), qualitative (n = 10) or mixed methods (n = 4) designs. Taken together, findings suggest that GBV impedes women’s uptake of HIV testing, care, and treatment, yet this can vary across different geographic and epidemic settings. Substantial gaps in the literature do still exist, including studies on the impact of GBV on engagement in PrEP, and research among key populations. Conclusions This scoping review contributes to our knowledge regarding the role GBV plays in women’s engagement in PrEP and the HIV care continuum. Findings reveal the need for more longitudinal research to provide insights into the causal pathways linking GBV and HIV care and treatment outcomes. Research is also needed to illuminate the impact of GBV on PrEP use and adherence as well as the impact of GBV on engagement along the HIV care continuum among key populations. It is critical that programs and research keep pace with these findings in order to reduce the global burden of GBV and HIV among women.
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Affiliation(s)
- Anna M Leddy
- Division of Prevention Science, Center for AIDS Prevention Studies, University of California, San Francisco, 550 16th St., 3rd Floor, San Francisco, CA, 94158, USA.
| | - Ellen Weiss
- Population Council, 4301 Connecticut Ave. NW, # 280, Washington, DC, 20008, USA
| | - Eileen Yam
- Population Council, 4301 Connecticut Ave. NW, # 280, Washington, DC, 20008, USA
| | - Julie Pulerwitz
- Population Council, 4301 Connecticut Ave. NW, # 280, Washington, DC, 20008, USA
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21
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Abstract
Adolescent relationship abuse and sexual violence are prevalent throughout adolescence and are associated with serious physical and mental health consequences. Trauma-informed approaches to care balance adolescent confidentiality, autonomy, and a young person's safety. The provision of trauma-informed care can include universal education and brief counseling about healthy relationships with all adolescent patients during clinical encounters to promote healthy adolescent sexual relationships, ensure youth know about resources for relationship abuse and sexual violence, and facilitate connections to advocates who serve survivors of abuse. Providers can integrate evidence-based relationship abuse and sexual violence prevention into their work with adolescents. [Pediatr Ann. 2019;48(7):e274-e279.].
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22
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Pampati S, Lowry R, Steiner RJ. Substance use, violence experiences, and mental health issues: are these health risks associated with HIV testing among sexually experienced U.S. high school students? AIDS Care 2019; 31:1106-1113. [PMID: 31129997 DOI: 10.1080/09540121.2019.1619666] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
HIV testing is a critical strategy for prevention of HIV yet testing among sexually experienced adolescents is sub-optimal. The purpose of this study is to examine associations between risk behaviors and experiences related to substance use, violence, and mental health and suicide and receipt of testing. We analyzed cross-sectional data from the 2017 national Youth Risk Behavior Survey, a nationally representative sample of U.S. high school students in grades 9-12. Analyses were limited to sexually experienced participants (n = 5192). Measures included nine indicators related to substance use, violence, and mental health and suicide. Unadjusted and adjusted prevalence ratios were calculated for each indicator to examine associations with testing. Adjusted models controlled for same-sex sexual behavior, sexual risk, and demographic characteristics. Prevalence of HIV testing was 17.2%. In adjusted models, forced sexual intercourse, injection drug use, other illicit drug use, and persistent feelings of sadness or hopelessness were associated with a higher likelihood of testing. Prevalence of HIV testing in this sexually experienced sample was low. Some behaviors and experiences that may be indicative of HIV risk, including sexual dating violence and prescription opioid misuse, were not associated with testing.
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Affiliation(s)
- Sanjana Pampati
- a Oak Ridge Institute for Science and Education (ORISE) , Oak Ridge , TN , USA
| | - Richard Lowry
- b Centers for Disease Control and Prevention, Division of Adolescent and School Health , Atlanta , GA , USA
| | - Riley J Steiner
- b Centers for Disease Control and Prevention, Division of Adolescent and School Health , Atlanta , GA , USA
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23
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Zelazny SM, Chang JC, Burke JG, Hawk M, Miller E. Adolescent and young adult women's recommendations for establishing comfort with family planning providers' communication about and assessment for intimate partner violence. JOURNAL OF COMMUNICATION IN HEALTHCARE 2019; 12:32-43. [PMID: 31983925 PMCID: PMC6980289 DOI: 10.1080/17538068.2018.1560073] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
BACKGROUND Intimate partner violence (IPV) is a serious public health problem that disproportionately affects adolescent women seeking family planning services. Current clinical guidelines recommend routine IPV assessment yet provide limited guidance on how to establish patient comfort in addressing this sensitive issue. Few studies exist describing the perspectives of adolescent female patients who have experienced IPV and their suggestions on how providers should communicate about IPV. METHODS This study is a subset of a larger IPV intervention trial in family planning clinics. For this study, we chose a qualitative approach using individual interviews to explore patient perspectives in an open, in-depth manner without limiting potential responses with predetermined answers or investigator-imposed assumptions. We audio recorded clinic encounters for participating providers and patients and interviewed patient participants, asking them to listen to and reflect on how their provider talked about IPV in their audiorecorded clinic encounters. RESULTS The mean age for the 44 participants was 22.8 years old. Participants named 'comfort' as a main component for discussing and disclosing IPV in the clinical setting. The sub-themes associated with how to create patient comfort include: Build the patient-provider relationship, Provider should communicate like a friend/be on the patient's level, Patient needs to feel cared for by provider, and Appropriate timing and space. CONCLUSION Methods for establishing patient comfort via communication should be incorporated into and examined within sensitive healthcare areas such as IPV and can be extended to HIV, palliative, and oncological care to improve patient health outcomes.
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Affiliation(s)
- Sarah My Zelazny
- University of Pittsburgh, Department of Pediatrics, 3414 Fifth Avenue, Pittsburgh, PA 15213
| | - Judy C Chang
- Magee Women's Hospital of UPMC, University of Pittsburgh, School of Medicine, 3380 Boulevard of the Allies, Suite 309, Pittsburgh, PA 15213
| | - Jessica G Burke
- University of Pittsburgh Graduate School of Public Health, 6132 Parran Hall, 130 De Soto Street, Pittsburgh, PA 15261
| | - Mary Hawk
- University of Pittsburgh Graduate School of Public Health, 207E Parran Hall, 130 De Soto Street, Pittsburgh, PA 15261
| | - Elizabeth Miller
- University of Pittsburgh, Department of Pediatrics, 3414 Fifth Avenue, Pittsburgh, PA 15213
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24
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Stark L, Asghar K, Seff I, Yu G, Tesfay Gessesse T, Ward L, Assazenew Baysa A, Neiman A, Falb KL. Preventing violence against refugee adolescent girls: findings from a cluster randomised controlled trial in Ethiopia. BMJ Glob Health 2018; 3:e000825. [PMID: 30398223 PMCID: PMC6203052 DOI: 10.1136/bmjgh-2018-000825] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Revised: 07/30/2018] [Accepted: 08/03/2018] [Indexed: 11/05/2022] Open
Abstract
Introduction Interpersonal violence is a critical public health concern in humanitarian contexts, but evidence of effective violence prevention programmes targeting adolescent girls is lacking. We investigated the efficacy of a life skills and safe spaces programme to reduce adolescent girls’ experiences of interpersonal violence in a refugee setting. Methods In this two-arm, single-blinded, cluster randomised controlled trial, we recruited 919 Sudanese and South Sudanese girls ages 13–19 years residing in refugee camps in Ethiopia. Girls were divided into 31 clusters, with 457 and 462 participants assigned to the intervention and control arms, respectively. Intervention clusters received 30 life skills sessions delivered in safe spaces and 8 complementary sessions for caregivers. The primary outcome was exposure to sexual violence in the previous 12 months. Secondary outcomes included disaggregated forms of sexual violence, physical violence, emotional violence, transactional sex, child marriage, feelings of safety, attitudes around rites of passage and perceptions of social support. Intent-to-treat analysis was used. Results At 12-month follow-up, the intervention was not significantly associated with reduction in exposure to sexual violence (adjusted OR =0.96, 95% CI 0.59 to 1.57), other forms of violence, transactional sex or feelings of safety. The intervention was associated with improvements in attitudes around rites of passage and identified social supports. Additionally, the intervention showed a decrease in reported child marriage among girls who were married at baseline. Conclusion While the intervention impacted key markers along the causal pathway to violence reduction, further research and programmatic adaptations are needed to prevent violence towards adolescents in humanitarian contexts. Trial registration NCT02506543.
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Affiliation(s)
- Lindsay Stark
- Department of Population and Family Health, Columbia University Mailman School of Public Health, New York City, New York, USA.,Brown School at Washington University in St. Louis, St. Louis, MO, United States
| | - Khudejha Asghar
- Department of Population and Family Health, Columbia University Mailman School of Public Health, New York City, New York, USA
| | - Ilana Seff
- Department of Population and Family Health, Columbia University Mailman School of Public Health, New York City, New York, USA
| | - Gary Yu
- Department of Population and Family Health, Columbia University Mailman School of Public Health, New York City, New York, USA.,New York University Rory Meyers College of Nursing, New York City, New York, USA
| | | | - Leora Ward
- International Rescue Committee, New York City, New York, USA
| | | | - Amy Neiman
- International Rescue Committee, New York City, New York, USA
| | - Kathryn L Falb
- International Rescue Committee, New York City, New York, USA
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25
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Abstract
The Mentors in Violence Prevention (MVP) model seeks to address the root causes of gender violence using a bystander approach and leadership training to challenge structures of patriarchy. Emerging research on adolescent relationship abuse and sexual violence points to key modifiable targets-transforming gender norms, addressing homophobia, integrating with comprehensive sexuality education, and acknowledging the needs of youth already exposed to violence. A social justice-based bystander approach such as the MVP model should be part of a multi-level approach to sexual violence prevention that addresses gender and power, encourages healthy sexuality conversations, and provides safety and support for survivors.
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26
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Reproductive Coercion in High School-Aged Girls: Associations with Reproductive Health Risk and Intimate Partner Violence. J Pediatr Adolesc Gynecol 2017; 30:603-608. [PMID: 28668360 DOI: 10.1016/j.jpag.2017.06.007] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2017] [Revised: 06/23/2017] [Accepted: 06/26/2017] [Indexed: 11/22/2022]
Abstract
STUDY OBJECTIVE To determine the prevalence of reproductive coercion, a form of intimate partner violence (IPV) including contraceptive sabotage and pregnancy pressure, among urban high school-aged girls and to examine its associations with reproductive health risks. DESIGN AND SETTING A self-administered survey completed by high school-aged girls living in high-poverty neighborhoods while awaiting medical care in a pediatric emergency room, inpatient service, school-based, and hospital-based clinic. PARTICIPANTS One hundred forty-nine sexually active girls aged 14-17 years. INTERVENTIONS AND MAIN OUTCOME MEASURES To determine the prevalence of reproductive coercion and to examine associations with unprotected sex, sexually transmitted infections, physical IPV, and risk factors for abusive relationships. RESULTS Twenty-nine of 149 (19%) of girls reported reproductive coercion, most frequently that a romantic or sexual partner had ever: "told them not to use any birth control" (n = 23; 79%); "took off a condom during sex so they would get pregnant" (n = 12; 43%); and "said he would leave them if they didn't get pregnant" (n = 6; 21%). Girls reporting reproductive coercion were nearly 3 times more likely than those not coerced to have had chlamydia (odds ratio [OR], 2.7; 95% confidence interval [CI], 1.01-7.19) and nearly 5 times more likely to report IPV (OR, 4.8; 95% CI, 2.0-11.8). In addition, girls reporting coercion were less likely to have high recognition of abusive behaviors (OR, 0.10; 95% CI, 0.01-0.8) and less likely to have high comfort communicating with their sexual partners (OR, 0.32; 95% CI, 0.1-0.7) than girls not reporting coercion. CONCLUSION Reproductive coercion is experienced by 1 in 5 high school-aged girls in a high-poverty community and is associated with chlamydia infection and IPV. Awareness of the high prevalence and health risks of coercion might allow for intervention.
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27
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Abstract
The main aim of this review article is to outline the factors linked to vulnerability of women to HIV infection and to understand the challenges and possible management of HIV among women. The review is a theoretical endeavour to understand women’s experiences of living with HIV. This review primarily focuses on studies in the Indian set-up, but to further substantiate the arguments and describe the relevant concepts it also takes into account literature from other cultures. On the basis of studies included in this article, it can be surmised that women are more susceptible to HIV due to cultural barriers, health vulnerabilities and social structures. They show less awareness about the treatment facilities, prevention strategies and perceived risk of infection. Women have to face numerous challenges after the infection, such as lack of social support, a higher level of stigma and discrimination, decreased quality of life, mental health issues and adverse coping. To prevent the spread of HIV among women as well as men, it is necessary to plan strategies which deal with empowerment of women, education and awareness regarding the vulnerabilities and knowledge and challenges of HIV infection. There is also a need to address the management of HIV among the infected and even those at risk. This article describes the possible interventions based on existing literature. The review also attempts to suggest certain future directions for the research.
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Affiliation(s)
- Anu Malik
- Research Scholar in Psychology, Department of Humanities and Social Sciences, Indian Institute of Technology, Kanpur, India
| | - Shikha Dixit
- Professor in Psychology, Department of Humanities and Social Sciences, Indian Institute of Technology, Kanpur, India
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28
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Raible CA, Dick R, Gilkerson F, Mattern CS, James L, Miller E. School Nurse-Delivered Adolescent Relationship Abuse Prevention. THE JOURNAL OF SCHOOL HEALTH 2017; 87:524-530. [PMID: 28580675 DOI: 10.1111/josh.12520] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/13/2016] [Revised: 10/10/2016] [Accepted: 10/13/2016] [Indexed: 06/07/2023]
Abstract
BACKGROUND Project Connect is a national program to build partnerships among public health agencies and domestic violence services to improve the health care sector response to partner and sexual violence. Pennsylvania piloted the first school nurse-delivered adolescent relationship abuse intervention in the certified school nurses' office setting. The purpose of this study was to assess the feasibility of implementing this prevention intervention. METHODS In 5 schools in Pennsylvania, school nurses completed a survey before and 1 year after receiving training on implementing the intervention as well as a phone interview. Students seeking care at the nurses' offices completed a brief anonymous feedback survey after their nurse visit. RESULTS The school nurses adopted the intervention readily, finding ways to incorporate healthy relationship discussions into interactions with students. School nurses and students found the intervention to be acceptable. Students were positive in their feedback. Barriers included difficulty with school buy-in and finding time and private spaces to deliver the intervention. CONCLUSIONS A school nurse healthy relationships intervention was feasible to implement and acceptable to the students as well as the implementing nurses. While challenges arose with the initial uptake of the program, school nurses identified strategies to achieve school and student support for this intervention.
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Affiliation(s)
- Claire A Raible
- Division of Adolescent and Young Adult Medicine, University of Pittsburgh, Children's Hospital of Pittsburgh, UPMC, 3414 Fifth Avenue, Pittsburgh, PA 15213
| | - Rebecca Dick
- Division of Adolescent and Young Adult Medicine, Children's Hospital of Pittsburgh, 3414 Fifth Avenue, Pittsburgh, PA 15213
| | - Fern Gilkerson
- Pennsylvania Coalition against Domestic Violence, PCADV Project Connect Manager, 3605 Vartan Way #101, Harrisburg, PA 17110
| | | | - Lisa James
- Futures Without Violence, 100 Montgomery Street, The Presidio San Francisco, CA 94129
| | - Elizabeth Miller
- Division of Adolescent and Young Adult Medicine, Children's Hospital of Pittsburgh of UPMC, University of Pittsburgh School of Medicine, 3420 Fifth Avenue, Pittsburgh, PA 15213
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29
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Miller E, McCauley HL, Decker MR, Levenson R, Zelazny S, Jones KA, Anderson H, Silverman JG. Implementation of a Family Planning Clinic-Based Partner Violence and Reproductive Coercion Intervention: Provider and Patient Perspectives. PERSPECTIVES ON SEXUAL AND REPRODUCTIVE HEALTH 2017; 49:85-93. [PMID: 28272840 PMCID: PMC5453817 DOI: 10.1363/psrh.12021] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/14/2016] [Revised: 12/19/2016] [Accepted: 01/11/2017] [Indexed: 05/27/2023]
Abstract
CONTEXT Despite multiple calls for clinic-based services to identify and support women victimized by partner violence, screening remains uncommon in family planning clinics. Furthermore, traditional screening, based on disclosure of violence, may miss women who fear reporting their experiences. Strategies that are sensitive to the signs, symptoms and impact of trauma require exploration. METHODS In 2011, as part of a cluster randomized controlled trial, staff at 11 Pennsylvania family planning clinics were trained to offer a trauma-informed intervention addressing intimate partner violence and reproductive coercion to all women seeking care, regardless of exposure to violence. The intervention sought to educate women about available resources and harm reduction strategies. In 2013, at the conclusion of the trial, 18 providers, five administrators and 49 patients completed semistructured interviews exploring acceptability of the intervention and barriers to implementation. Consensus and open coding strategies were used to analyze the data. RESULTS Providers reported that the intervention increased their confidence in discussing intimate partner violence and reproductive coercion. They noted that asking patients to share the educational information with other women facilitated the conversation. Barriers to implementation included lack of time and not having routine reminders to offer the intervention. Patients described how receiving the intervention gave them important information, made them feel supported and less isolated, and empowered them to help others. CONCLUSIONS A universal intervention may be acceptable to providers and patients. However, successful implementation in family planning settings may require attention to system-level factors that providers view as barriers.
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Affiliation(s)
- Elizabeth Miller
- director, Division of Adolescent and Young Adult Medicine, Children's Hospital of Pittsburgh, and professor of pediatrics, Department of Pediatrics, University of Pittsburgh School of Medicine
| | - Heather L McCauley
- assistant professor, Human Development & Family Studies, Michigan State University, East Lansing, and assistant professor, Division of Adolescent and Young Adult Medicine, Department of Pediatrics, University of Pittsburgh School of Medicine
| | - Michele R Decker
- associate professor, Department of Population, Family and Reproductive Health, and director, Women's Health & Rights Program, Center for Public Health & Human Rights, Bloomberg School of Public Health, Johns Hopkins University, Baltimore
| | | | - Sarah Zelazny
- clinical research assistant, Division of Adolescent and Young Adult Medicine, Department of Pediatrics, University of Pittsburgh School of Medicine
| | - Kelley A Jones
- postdoctoral associate, Division of Adolescent and Young Adult Medicine, Department of Pediatrics, University of Pittsburgh School of Medicine
| | - Heather Anderson
- clinical research coordinator, Division of Adolescent and Young Adult Medicine, Department of Pediatrics, University of Pittsburgh School of Medicine
| | - Jay G Silverman
- director of research, Center on Gender Equity and Health, and professor of medicine and global public health, University of California, San Diego, La Jolla
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30
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Decker MR, Flessa S, Pillai RV, Dick RN, Quam J, Cheng D, McDonald-Mosley R, Alexander KA, Holliday CN, Miller E. Implementing Trauma-Informed Partner Violence Assessment in Family Planning Clinics. J Womens Health (Larchmt) 2017; 26:957-965. [PMID: 28375750 DOI: 10.1089/jwh.2016.6093] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE Intimate partner violence (IPV) and reproductive coercion (RC) are associated with poor reproductive health. Little is known about how family planning clinics implement brief IPV/RC assessment interventions in practice. We describe the uptake and impact of a brief, trauma-informed, universal IPV/RC assessment and education intervention. METHODS Intervention implementation was evaluated via a mixed methods study among women ages 18 and up receiving care at one of two family planning clinics in greater Baltimore, MD. This mixed methods study entailed a quasi-experimental, single group pretest-posttest study with family planning clinic patients (baseline and exit survey n = 132; 3-month retention n = 68; retention rate = 52%), coupled with qualitative interviews with providers and patients (total n = 35). RESULTS Two thirds (65%) of women reported receiving at least one element of the intervention on their exit survey immediately following the clinic-visit. Patients reported that clinic-based IPV assessment is helpful, irrespective of IPV history. Relative to those who reported neither, participants who received either intervention element reported greater perceived caring from providers, confidence in provider response to abusive relationships, and knowledge of IPV-related resources at follow-up. Providers and patients alike described the educational card as a valuable tool. Participants described trade-offs of paper versus in-person, electronic medical record-facilitated screening, and patient reluctance to disclose current situations of abuse. CONCLUSION In real-world family planning clinic settings, a brief assessment and support intervention was successful in communicating provider caring and increasing knowledge of violence-related resources, endpoints previously deemed valuable by IPV survivors. Results emphasize the merit of universal education in IPV/RC clinical interventions over seeking IPV disclosure.
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Affiliation(s)
- Michele R Decker
- 1 Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health , Baltimore, Maryland.,2 Department of Women's Health & Rights Program, Center for Public Health and Human Rights, Johns Hopkins Bloomberg School of Public Health , Baltimore, Maryland
| | - Sarah Flessa
- 3 Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health , Baltimore, Maryland
| | - Ruchita V Pillai
- 4 Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health , Baltimore, Maryland
| | - Rebecca N Dick
- 5 Division of Adolescent and Young Adult Medicine and Children's Hospital of Pittsburgh of UPMC, University of Pittsburgh School of Medicine , Pittsburgh, Pennsylvania
| | - Jamie Quam
- 1 Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health , Baltimore, Maryland
| | - Diana Cheng
- 6 Maryland Department of Health and Mental Hygiene, Baltimore, Maryland
| | | | - Kamila A Alexander
- 8 Department of Community Public Health Nursing, John Hopkins School of Nursing , Baltimore, Maryland
| | - Charvonne N Holliday
- 1 Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health , Baltimore, Maryland
| | - Elizabeth Miller
- 5 Division of Adolescent and Young Adult Medicine and Children's Hospital of Pittsburgh of UPMC, University of Pittsburgh School of Medicine , Pittsburgh, Pennsylvania
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31
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Abstract
Dating violence (also known as adolescent relationship abuse) and sexual violence are prevalent from the middle school years throughout adolescence, peak in young adulthood, and are associated with multiple poor physical and mental health consequences. By offering universal education and brief anticipatory guidance with all adolescent patients about healthy and unhealthy relationships and sexual consent, health care providers can help promote healthy adolescent sexual relationships, ensure youth know about available resources and supports for relationship abuse and sexual violence (including how to help a friend), and facilitate connections to victim service advocates, both for prevention and intervention.
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Affiliation(s)
- Elizabeth Miller
- Division of Adolescent and Young Adult Medicine, Pediatrics, Children's Hospital of Pittsburgh of UPMC, University of Pittsburgh School of Medicine, 3420 Fifth Avenue, Pittsburgh, PA 15213, USA.
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32
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Weisz AN, Black BM, Hawley AC. What Would They Do? Parents' Responses to Hypothetical Adolescent Dating Violence Situations. VIOLENCE AND VICTIMS 2017; 32:311-325. [PMID: 28130900 DOI: 10.1891/0886-6708.vv-d-15-00136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Although adolescent dating violence (ADV) is recognized as a significant public health problem, little is known about how parents respond to it. This article analyzes exploratory, qualitative data from a public opinion survey of 529 Midwestern, U. S. parents' ideas about how they would respond to a daughter victimized by ADV. It examines differing responses between mothers and fathers across 3 vignettes. Most parents viewed the ADV as serious, meriting deeper discussions with the daughter, boyfriend, or his parents. Many planned to handle the incident by trying to end the adolescents' relationship, talking to the boyfriend, or informing the daughter about ADV. These findings can help prevention workers show how knowledge about parents' typical reactions can help parents modulate their responses to increase effective communication with adolescents.
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33
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East L, Peters K, Jackson D. Violated and vulnerable: women's experiences of contracting a sexually transmitted infection from a male partner. J Clin Nurs 2017; 26:2342-2352. [PMID: 28071836 DOI: 10.1111/jocn.13723] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/04/2017] [Indexed: 11/27/2022]
Abstract
AIMS AND OBJECTIVES To explore women's stories of contracting a sexually transmitted infection from a male partner and elucidate the gendered constructs and violence experienced that made the women vulnerable to these infections. BACKGROUND Violence against women can result in both physical and psychological consequences and expose women to multiple health risks including sexual health adversity. DESIGN Feminist storytelling approach. METHODS Qualitative interviews were conducted with 10 women. All data underwent thematic analysis. FINDINGS Findings from this study revealed the women were vulnerable to contracting sexually transmitted infection/s from their male sexual partners as a result of unequal gender and abusive relationship dynamics. Subsequently, contracting a sexual infection within this context potentially increased their vulnerability in both current and future relationships, through their loss of self-confidence and perceived ability to have a trusting loving heterosexual relationship as women with sexually transmitted infection/s. CONCLUSION Women in relationships in which they are subordinate to their male partner are at heightened risk of sexual health adversity, including contracting a sexually transmitted infection. Contracting a sexually transmitted infection within the context of an abusive relationship can further increase women's vulnerability to dominant male partners, thus further exposure to sexual risk and adversity. RELEVANCE TO CLINICAL PRACTICE Nurses working in clinical settings are well placed to conduct opportunistic screening of women's sexual health, including assessment of sexually transmitted infections and the nature of the encounter in which they were contracted. Thorough assessment can potentially identify relationship and personal factors that can increase a woman's risk to both sexual adversity and forms of abuse. Also, if women do divulge that they have suffered abuse, nurses are positioned to provide support and guidance in implementing strategies to minimise risk as well as referring them to specialised services.
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Affiliation(s)
- Leah East
- University of New England, School of Health, Armidale, NSW, Australia
| | - Kath Peters
- School of Nursing & Midwifery, Western Sydney University, Penrith, NSW, Australia
| | - Debra Jackson
- Oxford Institute for Nursing and Allied Health Research (OxINAHR), Oxford, UK.,Faculty of Health & Life Sciences, Oxford Brookes University, Oxford, UK.,Oxford University Hospitals NHS Foundation Trust, Oxford, UK.,University of New England (Australia), Armidale, NSW, Australia
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34
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Jones KA, Cornelius MD, Silverman JG, Tancredi DJ, Decker MR, Haggerty CL, De Genna NM, Miller E. Abusive Experiences and Young Women's Sexual Health Outcomes: Is Condom Negotiation Self-Efficacy a Mediator? PERSPECTIVES ON SEXUAL AND REPRODUCTIVE HEALTH 2016; 48:57-64. [PMID: 27077497 PMCID: PMC4909564 DOI: 10.1363/48e8616] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/18/2015] [Revised: 11/19/2015] [Accepted: 11/20/2015] [Indexed: 05/12/2023]
Abstract
CONTEXT Intimate partner violence and reproductive coercion are associated with unintended pregnancies and STDs. Greater condom negotiation self-efficacy among young women may mediate these associations. METHODS A sample of 841 female adolescents (aged 16-19) and 1,387 young adult women (aged 20-24) recruited from 24 family planning clinics in western Pennsylvania in 2011-2012 reported on intimate partner violence, reproductive coercion, condom negotiation self-efficacy and sexual health outcomes at baseline and four- and 12-month follow-ups. Mixed models were used to test associations of intimate partner violence and reproductive coercion with unintended pregnancy and STD diagnosis. The Sobel test of mediation was used to measure indirect effects of condom negotiation self-efficacy. RESULTS At baseline, 15% of adolescents and 11% of young adults reported recent intimate partner violence victimization; 7% and 6%, respectively, reported recent reproductive coercion. For both age-groups, intimate partner violence and reproductive coercion were associated with a reduced level of condom negotiation self-efficacy (coefficients, -0.27 to -0.13) and increased odds of STD diagnosis (odds ratios, 1.03-1.1). However, only reproductive coercion was associated with unintended pregnancy (odds ratios, 1.1 for each group). The only association that condom negotiation self-efficacy mediated was between reproductive coercion and unintended pregnancy among young adults (17% of total effect). CONCLUSIONS Targeting condom negotiation self-efficacy alone in abusive relationships would likely not translate into improved sexual health outcomes in this population. Other strategies are needed to prevent unintended pregnancy and STDs.
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Affiliation(s)
- Kelley A Jones
- Division of Adolescent and Young Adult Medicine, School of Medicine, University of Pittsburgh.
| | - Marie D Cornelius
- Department of Psychiatry, School of Medicine, University of Pittsburgh
| | - Jay G Silverman
- Division of Global Public Health, School of Medicine, University of California, San Diego, La Jolla, CA
| | - Daniel J Tancredi
- Department of Pediatrics, School of Medicine, University of California, Davis, Sacramento, CA
| | - Michele R Decker
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore
| | - Catherine L Haggerty
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh
| | | | - Elizabeth Miller
- Department of Pediatrics, School of Medicine, University of Pittsburgh
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Teitelman AM, Jemmott JB, Bellamy SL, Icard LD, O'Leary A, Heeren GA, Ngwane Z, Ratcliffe SJ. Partner violence, power, and gender differences in South African adolescents' HIV/sexually transmitted infections risk behaviors. Health Psychol 2016; 35:751-760. [PMID: 27111184 DOI: 10.1037/hea0000351] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVES Low relationship power and victimization by intimate partner violence (IPV) have been linked to HIV risks among adult and adolescent women. This article examines associations of IPV and relationship power with sexual-risk behaviors and whether the associations differ by gender among South African adolescents. METHOD Sexual-risk behaviors (multiple partners in past 3 months; condom use at last sex), IPV, and relationship power were collected from 786 sexually experienced adolescents (mean age = 16.9) in Eastern Cape Province, South Africa, during the 54-month follow-up of a HIV/sexually transmitted infection (STI) risk-reduction intervention trial. The data were analyzed with logistic regression models. RESULTS Adolescent boys were less likely to report condom use at last sex (p = .001) and more likely to report multiple partners (p < .001). A Gender × IPV interaction (p = .002) revealed that as IPV victimization increased, self-reported condom use at last sex decreased among girls, but increased among boys. A Gender × Relationship Power interaction (p = .004) indicated that as relationship power increased, self-reported condom use at last sex increased among girls, but decreased among boys. A Gender × IPV interaction (p = .004) indicated that as IPV victimization increased, self-reports of having multiple partners increased among boys, but not among girls. As relationship power increased, self-reports of having multiple partners decreased irrespective of gender. CONCLUSIONS HIV risk-reduction interventions and policies should address gender differences in sexual-risk consequences of IPV and relationship power among adolescents and promote gender equity. (PsycINFO Database Record
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Affiliation(s)
| | | | | | | | | | - G Anita Heeren
- University of Pennsylvania, Annenberg School for Communication
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Abstract
OBJECTIVE This guideline reviews the evidence relating to the provision of first-trimester medical induced abortion, including patient eligibility, counselling, and consent; evidence-based regimens; and special considerations for clinicians providing medical abortion care. INTENDED USERS Gynaecologists, family physicians, registered nurses, midwives, residents, and other healthcare providers who currently or intend to provide pregnancy options counselling, medical abortion care, or family planning services. TARGET POPULATION Women with an unintended first trimester pregnancy. EVIDENCE Published literature was retrieved through searches of PubMed, MEDLINE, and Cochrane Library between July 2015 and November 2015 using appropriately controlled vocabulary (MeSH search terms: Induced Abortion, Medical Abortion, Mifepristone, Misoprostol, Methotrexate). Results were restricted to systematic reviews, randomized controlled trials, clinical trials, and observational studies published from June 1986 to November 2015 in English. Additionally, existing guidelines from other countries were consulted for review. A grey literature search was not required. VALUES The quality of evidence in this document was rated using the criteria described in the Report of the Canadian Task Force for Preventive Medicine rating scale (Table 1). BENEFITS, HARMS AND/OR COSTS Medical abortion is safe and effective. Complications from medical abortion are rare. Access and costs will be dependent on provincial and territorial funding for combination mifepristone/misoprostol and provider availability. SUMMARY STATEMENTS Introduction Pre-procedure care Medical abortion regimens Providing medical abortion Post-abortion care RECOMMENDATIONS Introduction Pre-procedure care Medical abortion regimens Providing medical abortion Post-abortion care.
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Alleyne-Green B, Grinnell-Davis C, Clark TT, Quinn CR, Cryer-Coupet QR. Father Involvement, Dating Violence, and Sexual Risk Behaviors Among a National Sample of Adolescent Females. JOURNAL OF INTERPERSONAL VIOLENCE 2016; 31:810-30. [PMID: 25475102 PMCID: PMC5007216 DOI: 10.1177/0886260514556762] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
This study explored the relationship between the involvement of biological fathers and the sexual risk behaviors and dating violence/victimization and/or perpetration of adolescent girls. The data used in this cross-sectional analysis were drawn from the second wave of the public release of the National Longitudinal Study of Adolescent Health. Only adolescents who reported their biological sex as female, reported a history of being sexually active, and reported having a romantic partner in the previous 18 months were selected (N = 879). This study focused on overall positive sexual behaviors and use of contraception. Structural equation modeling (SEM) was used to best utilize capacity for dealing with latent variables and to test for possible mediation effects. The analysis demonstrated main effects of dating violence and father involvement on sexual behaviors. The more dating violence an adolescent girl experiences, the less likely she is to engage in healthy sexual behaviors. Likewise, the more involvement the biological father has in a woman's life, the more likely she is to engage in positive sexual behaviors. Perceived father involvement was associated with risky sexual behaviors among sexually experienced adolescent girls. Dating violence was directly associated with risky sexual behaviors among sexually experienced adolescent girls, particularly non-White girls. Future studies should use longitudinal models and test theoretically and empirically guided potential mediators. Future studies should also consider father figures such as step-fathers and grandfathers in addition to biological fathers, as having a father figure may be a stronger predictor of adolescent sexual behaviors than having a biological connection.
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Brady SS, Gruber SK, Wolfson JA. Positive and Negative Aspects of Relationship Quality and Unprotected Sex among Young Women. SEX EDUCATION 2016; 16:586-601. [PMID: 28989324 PMCID: PMC5628753 DOI: 10.1080/14681811.2016.1141286] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
The aim of this study was to examine both positive and negative aspects of relationship quality in relation to condom use. Sexually active young women aged 14-18 years (n=111; 34% non-white) were recruited from community clinics and schools in the Midwest USA and provided data via an online survey. The number of unprotected sex acts in the past month with the most recent male partner was regressed on relationship quality with that partner, adjusting for demographics and other characteristics. Negative relationship quality was associated with a greater number of unprotected sex acts among women reporting a low level of positive relationship quality and among women taking hormonal/IUD contraception. Positive relationship quality was associated with unprotected sex among women who reported multiple partners in the past month. Both positive and negative aspects of relationship quality may confer risk for unprotected sex. This risk appears modified by patterns of contraceptive use and other sexual behaviours. Health professionals may be more effective in promoting condom use if they ask questions about both positive and negative aspects of young people's relationship quality and tailor their conversations based on the responses received.
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Affiliation(s)
- Sonya S Brady
- Division of Epidemiology & Community Health, University of Minnesota School of Public Health, Minneapolis, USA
| | - Sandra K Gruber
- Division of Epidemiology & Community Health, University of Minnesota School of Public Health, Minneapolis, USA
| | - Julian A Wolfson
- Division of Biostatistics, University of Minnesota School of Public Health, Minneapolis, USA
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Miller E, Tancredi DJ, Decker MR, McCauley HL, Jones KA, Anderson H, James L, Silverman JG. A family planning clinic-based intervention to address reproductive coercion: a cluster randomized controlled trial. Contraception 2016; 94:58-67. [PMID: 26892333 DOI: 10.1016/j.contraception.2016.02.009] [Citation(s) in RCA: 77] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2015] [Revised: 02/01/2016] [Accepted: 02/07/2016] [Indexed: 11/19/2022]
Abstract
OBJECTIVE We assessed the effectiveness of a provider-delivered intervention targeting reproductive coercion, an important factor in unintended pregnancy. STUDY DESIGN We randomized 25 family planning clinics (17 clusters) to deliver an education/counseling intervention or usual care. Reproductive coercion and partner violence victimization at 1 year follow-up were primary outcomes. Unintended pregnancy, recognition of sexual and reproductive coercion, self-efficacy to use and use of harm reduction behaviors to reduce victimization and contraception nonuse, and knowledge and use of partner violence resources were secondary outcomes. Analyses included all available data using an intention-to-treat approach. RESULTS Among 4009 females ages 16 to 29 years seeking care, 3687 completed a baseline survey prior to clinic visit from October 2011 to November 2012; 3017 provided data at 12-20weeks post-baseline (T2) and 2926 at 12months post-baseline (T3) (79% retention). Intervention effects were not significant for reproductive coercion [adjusted risk ratio (ARR) 1.50 (95% confidence interval 0.95-2.35)] or partner violence [ARR 1.07 (0.84-1.38)]. Intervention participants reported improved knowledge of partner violence resources [ARR 4.25 (3.29-5.50)] and self-efficacy to enact harm reduction behaviors [adjusted mean difference 0.06 (0.02-0.10)]. In time point-specific models which included moderating effects of exposure to reproductive coercion at baseline, a higher reproductive coercion score at baseline was associated with a decrease in reproductive coercion 1 year later (T3). Use and sharing of the domestic violence hotline number also increased. CONCLUSION This brief clinic intervention did not reduce partner violence victimization. The intervention enhanced two outcomes that may increase safety for women, specifically awareness of partner violence resources and self-efficacy to enact harm reduction behaviors. It also appeared to reduce reproductive coercion among women experiencing multiple forms of such abuse.
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Affiliation(s)
- Elizabeth Miller
- Division of Adolescent and Young Adult Medicine, Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
| | - Daniel J Tancredi
- Department of Pediatrics and Center for Healthcare Policy and Research, University of California, Davis, Sacramento, CA, USA
| | - Michele R Decker
- Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | - Heather L McCauley
- Division of Adolescent and Young Adult Medicine, Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Kelley A Jones
- Division of Adolescent and Young Adult Medicine, Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Heather Anderson
- Division of Adolescent and Young Adult Medicine, Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Lisa James
- Futures Without Violence, San Francisco, CA, USA
| | - Jay G Silverman
- Division of Global Public Health in the Department of Medicine & Center on Gender Equity and Health, University of California, San Diego, La Jolla, CA, USA
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Park J, Nordstrom SK, Weber KM, Irwin T. Reproductive coercion: uncloaking an imbalance of social power. Am J Obstet Gynecol 2016; 214:74-8. [PMID: 26314520 DOI: 10.1016/j.ajog.2015.08.045] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2015] [Revised: 08/10/2015] [Accepted: 08/19/2015] [Indexed: 11/30/2022]
Abstract
Reproductive coercion involves behavior that interferes with contraceptive and pregnancy choices of women and occasionally men. This includes birth control sabotage (intentional destruction of a woman's chosen method of contraception), pregnancy pressure (behaviors to coerce pregnancy against one's wishes), and pregnancy coercion (threats to direct the outcome of a pregnancy). All are associated with serious reproductive consequences including unintended pregnancy, abortion, sexually transmitted infections, poor pregnancy outcomes, and psychological trauma. This article presents an overview of the recent literature surrounding reproductive coercion and how it relates to the reproductive health outcomes of women, adolescents, and the lesbian, gay, bisexual, and transgender community. Men's experience with reproductive coercion will also be discussed. Clinical implications and evidence-based strategies for assessment and intervention will be identified.
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Affiliation(s)
- Jeanna Park
- Department of Obstetrics and Gynecology, University of Illinois, Chicago, Chicago, IL.
| | - Sherry K Nordstrom
- Department of Obstetrics and Gynecology, University of Illinois, Chicago, Chicago, IL; Department of Obstetrics and Gynecology, Advocate Medical Group, Oak Lawn, IL
| | - Kathleen M Weber
- The CORE Center, Cook County Health and Hospital Systems and Hektoen Institute of Medicine, Chicago, IL
| | - Tracy Irwin
- Department of Obstetrics and Gynecology, University of Washington, Seattle, WA
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Temple JR, Choi HJ, Brem M, Wolford-Clevenger C, Stuart GL, Peskin MF, Elmquist J. The Temporal Association Between Traditional and Cyber Dating Abuse Among Adolescents. J Youth Adolesc 2015; 45:340-9. [PMID: 26525389 DOI: 10.1007/s10964-015-0380-3] [Citation(s) in RCA: 73] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2015] [Accepted: 10/25/2015] [Indexed: 11/29/2022]
Abstract
While research has explored adolescents' use of technology to perpetrate dating violence, little is known about how traditional in-person and cyber abuse are linked, and no studies have examined their relationship over time. Using our sample of 780 diverse adolescents (58 % female), we found that traditional and cyber abuse were positively associated, and cyber abuse perpetration and victimization were correlated at each time point. Cyber abuse perpetration in the previous year (spring 2013) predicted cyber abuse perpetration 1 year later (spring 2014), while controlling for traditional abuse and demographic variables. In addition, physical violence victimization and cyber abuse perpetration and victimization predicted cyber abuse victimization the following year. These findings highlight the reciprocal nature of cyber abuse and suggest that victims may experience abuse in multiple contexts.
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Affiliation(s)
- Jeff R Temple
- Department of Ob/Gyn, University of Texas Medical Branch, 301 University Blvd, Galveston, TX, 77555-0587, USA.
| | - Hye Jeong Choi
- Department of Communication, University of Missouri, 108 Switzler Hall, Columbia, MO, 65211, USA
| | - Meagan Brem
- Department of Psychology, University of Tennessee, 204 Austin Peay Bldg, Knoxville, TN, 37996, USA
| | | | - Gregory L Stuart
- Department of Psychology, University of Tennessee, 204 Austin Peay Bldg, Knoxville, TN, 37996, USA
| | - Melissa Fleschler Peskin
- Health Promotion and Behavioral Sciences, University of Texas School of Public Health, 7000 Fannin St., Suite 2658, Houston, TX, 77030, USA
| | - JoAnna Elmquist
- Department of Psychology, University of Tennessee, 204 Austin Peay Bldg, Knoxville, TN, 37996, USA
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Kazmerski T, McCauley HL, Jones K, Borrero S, Silverman JG, Decker MR, Tancredi D, Miller E. Use of reproductive and sexual health services among female family planning clinic clients exposed to partner violence and reproductive coercion. Matern Child Health J 2015; 19:1490-6. [PMID: 25416386 PMCID: PMC10641793 DOI: 10.1007/s10995-014-1653-2] [Citation(s) in RCA: 67] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
To examine the associations of recent intimate partner violence (IPV) and reproductive coercion (RC) with frequency of use of reproductive and sexual health services, a cross-sectional survey was administered to 16-29 year old women seeking care in five family planning clinics (n = 1,262). We evaluated associations of recent experiences of IPV, RC, or both IPV and RC with recent care seeking for pregnancy testing, emergency contraception, and sexually transmitted infection testing using multinomial logistic regression. Sixteen percent of respondents reported IPV and 13.5 % reported RC in the past 3 months. Four percent of all respondents reported both IPV and RC. Recent RC without IPV was associated with increased odds of seeking one (AOR = 2.0, 95 % CI 1.3-2.9) or multiple pregnancy tests (AOR = 2.3, 95 % CI 1.2-4.5), multiple STI tests (AOR = 2.5, 95 % CI 1.5-4.1), or using emergency contraception once (AOR = 2.6, 95 % CI 1.2-5.8) or multiple times (AOR = 2.2, 95 % CI 1.7-2.7). Recent IPV without RC was associated with increased odds of seeking one (AOR = 1.4, 95 % CI 1.1-1.7) or multiple pregnancy tests (AOR = 2.2, 95 % CI 1.4-3.2) and using emergency contraception once (AOR = 1.6, 95 % CI 1.3-2.0). The combined effect of recent IPV and RC increased the odds of seeking multiple pregnancy tests (AOR = 3.6, 95 % CI 3.3-3.8), using emergency contraception multiple times (AOR = 2.4, 95 % CI 1.5-4.1) and seeking STI testing once (AOR = 2.5, 95 % CI 1.6-3.9) or multiple times (AOR = 2.9, 95 % CI 1.02-8.5). Frequent requests for pregnancy and STI testing and emergency contraception among young females seeking care may be an indicator of greater risk for recent RC, alone and in combination with IPV.
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Affiliation(s)
- Traci Kazmerski
- Children's Hospital of Pittsburgh of UPMC, 4401 Penn Ave. AOB 3rd Floor, Suite 3300, Pittsburgh, PA, 15224, USA,
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McCauley HL, Silverman JG, Decker MR, Agénor M, Borrero S, Tancredi DJ, Zelazny S, Miller E. Sexual and Reproductive Health Indicators and Intimate Partner Violence Victimization Among Female Family Planning Clinic Patients Who Have Sex with Women and Men. J Womens Health (Larchmt) 2015; 24:621-8. [PMID: 25961855 DOI: 10.1089/jwh.2014.5032] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Sexual minority women are more likely than heterosexual women to have ever experienced intimate partner violence (IPV). Although IPV is associated with sexual risk and poor reproductive health outcomes among US women overall, little is known about whether IPV is related to sexual and reproductive health indicators among sexual minority women in particular. METHODS Baseline data from a prospective intervention trial were collected from women ages 16-29 years at 24 family planning clinics in western PA (n=3,455). Multivariable logistic regression for clustered survey data was used to compare women who have sex with men only (WSM) and women who have sex with women and men (WSWM) on (1) IPV prevalence and (2) sexual and reproductive health behaviors, outcomes, and services use, controlling for IPV. Finally, we tested the interaction of sexual minority status and IPV. RESULTS WSWM were significantly more likely than WSM to report a lifetime history of IPV (adjusted odds ratio (AOR): 3.00; 95% confidence interval (CI): 2.30, 3.09). Controlling for IPV, WSWM reported higher levels of sexual risk behaviors (e.g., unprotected vaginal and anal sex), male-perpetrated reproductive coercion, unwanted pregnancy, and sexually transmitted infection (STI) and pregnancy testing but less contraceptive care seeking. The association between IPV and lifetime STI diagnosis was greater among WSWM than among WSM. CONCLUSIONS IPV was pervasive and associated with sexual risk and reproductive health indicators among WSWM in this clinic-based setting. Healthcare providers' sexual risk assessment and provision of sexual and reproductive health services should be informed by an understanding of women's sexual histories, including sex of sexual partners and IPV history, in order to help ensure that all women receive the clinical care they need.
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Affiliation(s)
- Heather L McCauley
- 1 Department of Pediatrics, Division of Adolescent and Young Adult Medicine, University of Pittsburgh School of Medicine, Children's Hospital of Pittsburgh of UPMC , Pittsburgh, Pennsylvania
| | - Jay G Silverman
- 2 Division of Global Public Health, University of California San Diego School of Medicine , La Jolla, California
| | - Michele R Decker
- 3 Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health , Baltimore, Maryland
| | - Madina Agénor
- 4 Department of Social and Behavioral Sciences, Harvard School of Public Health , Boston, Massachusetts.,5 Center for Community-Based Research, Dana-Farber Cancer Institute , Boston, Massachusetts
| | - Sonya Borrero
- 6 Department of Medicine, University of Pittsburgh School of Medicine , Pittsburgh, Pennsylvania.,7 VA Center for Health Equity Research and Promotion , Pittsburgh, Pennsylvania
| | - Daniel J Tancredi
- 8 Department of Pediatrics, University of California Davis School of Medicine , Sacramento, California
| | - Sarah Zelazny
- 1 Department of Pediatrics, Division of Adolescent and Young Adult Medicine, University of Pittsburgh School of Medicine, Children's Hospital of Pittsburgh of UPMC , Pittsburgh, Pennsylvania
| | - Elizabeth Miller
- 1 Department of Pediatrics, Division of Adolescent and Young Adult Medicine, University of Pittsburgh School of Medicine, Children's Hospital of Pittsburgh of UPMC , Pittsburgh, Pennsylvania
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O'Leary A, Jemmott JB, Jemmott LS, Teitelman A, Heeren GA, Ngwane Z, Icard LD, Lewis DA. Associations between psychosocial factors and incidence of sexually transmitted disease among South African adolescents. Sex Transm Dis 2015; 42:135-9. [PMID: 25668645 PMCID: PMC4351752 DOI: 10.1097/olq.0000000000000247] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Adolescents living in South Africa are at high risk for HIV and other sexually transmitted diseases (STDs). The present study sought to identify correlates of curable STD incidence among a cohort of adolescents in Eastern Cape Province, South Africa. METHODS Data were collected in conjunction with an HIV/STD prevention intervention randomized controlled trial. At 54 months postintervention, curable STD incidence (gonorrhea, chlamydial infection, and trichomoniasis) was assayed and self-report measures of potential correlates of STD incidence were collected. RESULTS Participants were adolescents reporting at least 1 sexual partner in the past 3 months (n = 659). As expected, univariate analyses revealed that girls were more likely than boys to have an STD. In addition, intimate partner violence, unprotected sex, and having older partners were associated with incident STD. In Poisson multiple regression analyses, sex (risk ratio [RR], 4.00; 95% confidence interval [CI], 2.51-6.39), intimate partner violence (RR, 1.23; 95% CI, 1.12-1.35), unprotected sex (RR, 1.42; 95% CI, 1.09-2.01), and multiple partners (RR, 1.70; 95% CI, 1.11-2.61), but not partner's age (RR, 1.00; 95% CI, 0.94-1.07) were associated with incident STD, adjusting for 42-month STD prevalence. Binge drinking, forced sex, and age were unrelated to STD incidence in both analyses. Interactions between sex and the hypothesized correlates were nonsignificant, suggesting that sex did not modify these relationships. CONCLUSIONS Interventions to reduce HIV/STD incidence among adolescents in South Africa should address the risk associated with sex, unprotected sex, intimate partner violence, and multiple partnerships.
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Affiliation(s)
- Ann O'Leary
- From the *Centers for Disease Control and Prevention, Atlanta GA; †University of Pennsylvania, Philadelphia, PA; ‡Haverford College, Haverford, PA; Temple University, Philadelphia, PA; and ¶Centre for HIV and Sexually Transmitted Infections, National Institute for Communicable Diseases, Johannesburg, South Africa; and ║Centre for Infectious Diseases and Microbiology & Marie Bashir Institute for Infectious Diseases and Biosecurity, Westmead Clinical School, University of Sydney, Sydney, Australia
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Gender-based violence against adolescent and young adult women in low- and middle-income countries. J Adolesc Health 2015; 56:188-96. [PMID: 25620301 DOI: 10.1016/j.jadohealth.2014.09.003] [Citation(s) in RCA: 89] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2014] [Revised: 09/05/2014] [Accepted: 09/05/2014] [Indexed: 11/21/2022]
Abstract
PURPOSE Gender-based violence (GBV) is a global health and human rights issue with individual and social determinants. Youth are considered high risk; national influences include norms, policies and practices. By age, nation, and region, we contrast key GBV indicators, specifically intimate partner violence (IPV) and forced sexual debut among adolescent and young adult women using Demographic and Health Surveys across low- and middle-income countries. METHODS National prevalence estimates were generated among adolescents (15-19 years) and young adults (20-24 years) for lifetime and the past-year physical and sexual IPV among ever-married/cohabitating women (30 nations) and forced sexual debut among sexually experienced women (17 nations). Meta-analyses provided regional estimates and cross-national comparisons, and compared the past-year IPV prevalence among adolescent and young adult women to adult women. RESULTS An estimated 28% of adolescent and 29% of young adult women reported lifetime physical or sexual IPV, most prevalent in the East and Southern Africa region. Regional and cross-national variation emerged in patterns of violence by age; overall, young adult women demonstrated higher risk for the past-year IPV relative to adult women (meta-analysis odds ratio, 1.20; 95% confidence interval, 1.10-1.37) and adolescents had a comparable risk (meta-analysis odds ratio, 1.07; 95% confidence interval, .91-1.23). Forced sexual debut was estimated at 12% overall, highest in the East and Southern Africa region. CONCLUSIONS GBV is pervasive among adolescent and young adult women in low- and middle-income countries. The unique risk to youth varies across nations, suggesting an age-place interaction. Future research is needed to clarify contextual determinants of GBV. Findings provide direction for integrating youth within GBV prevention efforts.
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Guigno C, Yiannaki K, Hallmark C. Teen Dating Abuse: A Paradigm for Mental Health Counselors. JOURNAL OF CREATIVITY IN MENTAL HEALTH 2015. [DOI: 10.1080/15401383.2014.938794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Miller E, Goldstein S, McCauley HL, Jones KA, Dick RN, Jetton J, Silverman JG, Blackburn S, Monasterio E, James L, Tancredi DJ. A school health center intervention for abusive adolescent relationships: a cluster RCT. Pediatrics 2015; 135:76-85. [PMID: 25535265 DOI: 10.1542/peds.2014-2471] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Few evidence-based interventions address adolescent relationship abuse in clinical settings. This cluster randomized controlled trial tested the effectiveness of a brief relationship abuse education and counseling intervention in school health centers (SHCs). METHODS In 2012-2013, 11 SHCs (10 clusters) were randomized to intervention (SHC providers received training to implement) or standard-of-care control condition. Among 1062 eligible students ages 14 to 19 years at 8 SHCs who continued participation after randomization, 1011 completed computer-assisted surveys before a clinic visit; 939 completed surveys 3 months later (93% retention). RESULTS Intervention versus control adjusted mean differences (95% confidence interval) on changes in primary outcomes were not statistically significant: recognition of abuse = 0.10 (-0.02 to 0.22); intentions to intervene = 0.03 (-0.09 to 0.15); and knowledge of resources = 0.18 (-0.06 to 0.42). Intervention participants had improved recognition of sexual coercion compared with controls (adjusted mean difference = 0.10 [0.01 to 0.18]). In exploratory analyses adjusting for intensity of intervention uptake, intervention effects were significant for increased knowledge of relationship abuse resources and self-efficacy to use harm reduction behaviors. Among participants reporting relationship abuse at baseline, intervention participants were less likely to report such abuse at follow-up (mean risk difference = -0.17 [-0.21 to -0.12]). Adolescents in intervention clinics who reported ever being in an unhealthy relationship were more likely to report disclosing this during the SHC visit (adjusted odds ratio = 2.77 [1.29 to 5.95]). CONCLUSIONS This is the first evidence of the potential benefit of a SHC intervention to address abusive relationships among adolescents.
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Affiliation(s)
- Elizabeth Miller
- Division of Adolescent and Young Adult Medicine, Children's Hospital of Pittsburgh of University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania; Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania;
| | - Sandi Goldstein
- California Adolescent Health Collaborative, Public Health Institute, Oakland, California
| | - Heather L McCauley
- Division of Adolescent and Young Adult Medicine, Children's Hospital of Pittsburgh of University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania; Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Kelley A Jones
- Division of Adolescent and Young Adult Medicine, Children's Hospital of Pittsburgh of University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania; Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Rebecca N Dick
- Division of Adolescent and Young Adult Medicine, Children's Hospital of Pittsburgh of University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania; Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Johanna Jetton
- California Adolescent Health Collaborative, Public Health Institute, Oakland, California
| | - Jay G Silverman
- Division of Global Public Health, School of Medicine, University of California-San Diego, La Jolla, California
| | - Samantha Blackburn
- California School-Based Health Alliance, Oakland, California; School of Nursing, California State University-Sacramento, Sacramento, California
| | - Erica Monasterio
- Department of Family Health Care Nursing, School of Nursing, University of California-San Francisco, San Francisco, California
| | - Lisa James
- Futures Without Violence, San Francisco, California; and
| | - Daniel J Tancredi
- School of Medicine, University of California-Davis, Sacramento, California
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49
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Decker MR, Peitzmeier S, Olumide A, Acharya R, Ojengbede O, Covarrubias L, Gao E, Cheng Y, Delany-Moretlwe S, Brahmbhatt H. Prevalence and Health Impact of Intimate Partner Violence and Non-partner Sexual Violence Among Female Adolescents Aged 15-19 Years in Vulnerable Urban Environments: A Multi-Country Study. J Adolesc Health 2014; 55:S58-67. [PMID: 25454004 DOI: 10.1016/j.jadohealth.2014.08.022] [Citation(s) in RCA: 114] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2014] [Revised: 08/16/2014] [Accepted: 08/20/2014] [Indexed: 10/24/2022]
Abstract
PURPOSE Globally, adolescent women are at risk for gender-based violence (GBV) including sexual violence and intimate partner violence (IPV). Those in economically distressed settings are considered uniquely vulnerable. METHODS Female adolescents aged 15-19 from Baltimore, Maryland, USA; New Delhi, India; Ibadan, Nigeria; Johannesburg, South Africa; and Shanghai, China (n = 1,112) were recruited via respondent-driven sampling to participate in a cross-sectional survey. We describe the prevalence of past-year physical and sexual IPV, and lifetime and past-year non-partner sexual violence. Logistic regression models evaluated associations of GBV with substance use, sexual and reproductive health, mental health, and self-rated health. RESULTS Among ever-partnered women, past-year IPV prevalence ranged from 10.2% in Shanghai to 36.6% in Johannesburg. Lifetime non-partner sexual violence ranged from 1.2% in Shanghai to 12.6% in Johannesburg. Where sufficient cases allowed additional analyses (Baltimore and Johannesburg), both IPV and non-partner sexual violence were associated with poor health across domains of substance use, sexual and reproductive health, mental health, and self-rated health; associations varied across study sites. CONCLUSIONS Significant heterogeneity was observed in the prevalence of IPV and non-partner sexual violence among adolescent women in economically distressed urban settings, with upwards of 25% of ever-partnered women experiencing past-year IPV in Baltimore, Ibadan, and Johannesburg, and more than 10% of adolescent women in Baltimore and Johannesburg reporting non-partner sexual violence. Findings affirm the negative health influence of GBV even in disadvantaged urban settings that present a range of competing health threats. A multisectoral response is needed to prevent GBV against young women, mitigate its health impact, and hold perpetrators accountable.
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Affiliation(s)
- Michele R Decker
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
| | - Sarah Peitzmeier
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Adesola Olumide
- Institute of Child Health, College of Medicine, University of Ibadan/University College Hospital, Ibadan, Oyo State, Nigeria
| | | | - Oladosu Ojengbede
- Department of Obstetrics and Gynecology, College of Medicine, University of Ibadan/University College Hospital, Ibadan, Oyo State, Nigeria
| | - Laura Covarrubias
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Ersheng Gao
- Shanghai Institute of Planned Parenthood Research, Shanghai, China
| | - Yan Cheng
- Shanghai Institute of Planned Parenthood Research, Shanghai, China
| | - Sinead Delany-Moretlwe
- Wits Reproductive Health & HIV Institute, School of Clinical Medicine, University of the Witwatersrand, Johannesburg
| | - Heena Brahmbhatt
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
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50
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Acculturation, risk behaviors and physical dating violence victimization among Cuban-American adolescents. J Pediatr Nurs 2014; 29:633-40. [PMID: 24680919 DOI: 10.1016/j.pedn.2014.03.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2013] [Revised: 02/07/2014] [Accepted: 03/04/2014] [Indexed: 11/23/2022]
Abstract
The purpose of this study is to describe the relationships among acculturation, risk behaviors, and reported physical dating violence among Cuban-American ninth grade adolescents. Participants (N=82) completed a questionnaire that assessed their level of acculturation to the U.S. (Americanism), their maintenance of the Hispanic culture (Hispanicism), binge drinking, drug use, sexual intercourse, condom use and physical dating violence victimization. Multiple logistic regression was conducted. Hispanicism was associated with a decrease in odds of reporting physical dating violence victimization. Drug use and not using a condom were associated with an increase in odds of reporting physical dating violence victimization.
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