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Jepsen D, Healy KV, Bernard M, Markert J, Brzank PJ. Patterns of Sexual Risk Behaviors and Sexuality-Related Risk Factors among Young Adults in Germany: Implications for Prevention and Therapy. ARCHIVES OF SEXUAL BEHAVIOR 2024; 53:2671-2688. [PMID: 38816590 PMCID: PMC11219385 DOI: 10.1007/s10508-024-02877-7] [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] [Received: 07/21/2023] [Revised: 04/19/2024] [Accepted: 04/20/2024] [Indexed: 06/01/2024]
Abstract
Sexual risk behavior (SRB) includes behavioral (sex without contraception, sexualized substance use, sex work, sexual partner violence, other sexual activities that harm oneself or others) and affective subtypes (sexuality-related feelings of shame/guilt, relationship impairments) and leads to psychosocial and health-related consequences. Young adults comprise a vulnerable group regarding the development of SRB. The study aimed to identify SRB patterns among young adults and their relation to sexuality-related risk factors. A cross-sectional online survey measured behavioral and affective aspects of SRB with nine items. Latent class analysis was conducted to identify patterns of SRB. Gender, sexual orientation, age of first intercourse, number of sexual partners, hypersexuality, and sexual dysfunction were captured as risk factors via multinomial logistic regression. Within this convenience sample (n = 609; nfemale = 365; nmale = 245; Mage = 23.1 years), the SRB patterns unremarkable (67%; low values in all SRB subtypes), shame-ridden (17%; high values in sexual feelings of shame/guilt) and risky sexual behavior (16%; high values in all subtypes of SRB, especially sexualized drug use) were identified. The shame-ridden and risky patterns were strongly associated with higher hypersexuality values, the risky pattern moreover with being non-heterosexual, of younger age at first sexual experience, and a higher number of sexual partners. Male and sexual minority participants demonstrated SRB more often than females and heterosexuals. Within prevention and treatment of SRB, it seems beneficial to address sexuality-related feelings of shame/guilt and addictive patterns (concerning sexual behaviors/substances) via gender- and diversity-sensitive measurements.
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Affiliation(s)
- Dennis Jepsen
- Institute of Medical Sociology, Interdisciplinary Center of Health Sciences, Martin Luther University Halle-Wittenberg, Magdeburgerstraße 8, 06112, Halle (Saale), Germany.
| | - Karl Vince Healy
- Institute of Medical Sociology, Interdisciplinary Center of Health Sciences, Martin Luther University Halle-Wittenberg, Magdeburgerstraße 8, 06112, Halle (Saale), Germany
| | - Marie Bernard
- Institute of Medical Sociology, Interdisciplinary Center of Health Sciences, Martin Luther University Halle-Wittenberg, Magdeburgerstraße 8, 06112, Halle (Saale), Germany
| | - Jenny Markert
- Institute of Medical Sociology, Interdisciplinary Center of Health Sciences, Martin Luther University Halle-Wittenberg, Magdeburgerstraße 8, 06112, Halle (Saale), Germany
| | - Petra J Brzank
- Institue of Social Medicine, Rehabilitation Sciences and Healthcare Research, University of Applied Sciences Nordhausen, Nordhausen, Germany
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2
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Ferstad JO, Aslam M, Wang LY, Henaghan K, Zhao J, Li J, Salomon JA. State-level population estimates of sexual minority adolescents in the United States: A predictive modeling study. PLoS One 2024; 19:e0304175. [PMID: 38935807 PMCID: PMC11210845 DOI: 10.1371/journal.pone.0304175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 05/08/2024] [Indexed: 06/29/2024] Open
Abstract
PURPOSE The Youth Risk Behavior Survey (YRBS) among high school students includes standard questions about sexual identity and sex of sexual contacts, but these questions are not consistently included in every state that conducts the survey. This study aimed to develop and apply a method to predict state-level proportions of high school students identifying as lesbian, gay, or bisexual (LGB) or reporting any same-sex sexual contacts in those states that did not include these questions in their 2017 YRBS. METHODS We used state-level high school YRBS data from 2013, 2015, and 2017. We defined two primary outcomes relating to self-reported LGB identity and reported same-sex sexual contacts. We developed machine learning models to predict the two outcomes based on other YRBS variables, and comparing different modeling approaches. We used a leave-one-out cross-validation approach and report results from best-performing models. RESULTS Modern ensemble models outperformed traditional linear models at predicting state-level proportions for the two outcomes, and we identified prediction methods that performed well across different years and prediction tasks. Predicted proportions of respondents reporting LGB identity in states that did not include direct measurement ranged between 9.4% and 12.9%. Predicted proportions of respondents reporting any same-sex contacts, where not directly observed, ranged between 7.0% and 10.4%. CONCLUSION Comparable population estimates of sexual minority adolescents can raise awareness among state policy makers and the public about what proportion of youth may be exposed to disparate health risks and outcomes associated with sexual minority status. This information can help decision makers in public health and education agencies design, implement and evaluate community and school interventions to improve the health of LGB youth.
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Affiliation(s)
- Johannes O. Ferstad
- Department of Management Science and Engineering, Stanford University School of Engineering, Stanford, California, United States of America
| | - Maria Aslam
- Office of the Director, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, United States of America
| | - Li Yan Wang
- Division of Adolescent and School Health, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, United States of America
| | - Katherine Henaghan
- Department of Health Policy, School of Medicine, Stanford University, Stanford, California, United States of America
| | - Jiayi Zhao
- Department of Health Policy, School of Medicine, Stanford University, Stanford, California, United States of America
| | - Jingjing Li
- Division of Adolescent and School Health, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, United States of America
| | - Joshua A. Salomon
- Department of Health Policy, School of Medicine, Stanford University, Stanford, California, United States of America
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Wright MF, Wachs S. Longitudinal Associations between Different Types of Sexting, Adolescent Mental Health, and Sexual Risk Behaviors: Moderating Effects of Gender, Ethnicity, Disability Status, and Sexual Minority Status. ARCHIVES OF SEXUAL BEHAVIOR 2024; 53:1115-1128. [PMID: 38216785 DOI: 10.1007/s10508-023-02764-7] [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: 12/02/2022] [Revised: 11/25/2023] [Accepted: 11/26/2023] [Indexed: 01/14/2024]
Abstract
The present study investigated the moderating effect of adolescent demographic variables in the longitudinal associations among different types of sexting, mental health (i.e., depression, self-harm, subjective health complaints), and sexual risk behaviors. There were 1113 adolescents (ages 14-17 years; Mage = 16.36; SDage = .81; 50% female) from six high schools located in the United States included in this study. Adolescents completed questionnaires on their sexting behaviors, mental health, and sexual risk behaviors during the ninth grade; in tenth grade, they completed questionnaires on mental health and sexual risk behaviors. Non-consensual sexting and pressured sexting were both related positively to each of the mental health variables and sexual risk behaviors. The relationship between non-consensual sexting and depressive symptoms was stronger for girls, ethnic minorities, those adolescents with disabilities, and sexual minorities. Similar patterns were found for pressured sexting, non-suicidal self-harm, and subjective health complaints. The relationships between pressured sexting and sexual risk behaviors were stronger for girls, ethnic minorities, those adolescents with disabilities, and those who identified as sexual minorities. Research focused on the relationships among different types of sexting, mental health, and sexual risk behaviors is important as such research facilitates the development of evidence-based recommendations for sexting harm prevention and sexual education programs.
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Affiliation(s)
- Michelle F Wright
- Department of Psychology, Indiana State University, Terre Haute, IN, 47809, USA.
| | - Sebastian Wachs
- Educational Sciences, University of Münster, Munster, Germany
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4
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Kesler K, Gerber A, Laris BA, Anderson P, Baumler E, Coyle K. High School FLASH Sexual Health Education Curriculum: LGBTQ Inclusivity Strategies Reduce Homophobia and Transphobia. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2023; 24:272-282. [PMID: 36930403 PMCID: PMC10764373 DOI: 10.1007/s11121-023-01517-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/26/2023] [Indexed: 03/18/2023]
Abstract
Homophobic and transphobic beliefs that lead to bias-based harassment remain a critical concern for young people in the USA. The aim of the present study was to examine the impact of an inclusive comprehensive sex education program (High School FLASH) on homophobic and transphobic beliefs. Data from this study come from a randomized controlled trial that evaluated the impact of High School FLASH on students' sexual behaviors and related outcomes with 20 schools in two U.S. regions (Midwest and South). Following the baseline survey, the 20 schools were randomly assigned to receive FLASH or a comparison curriculum. Ninth and 10th grade students completed follow-up surveys 3 and 12 months after the instructional period. We examined changes in homophobic beliefs using multilevel linear regression models in the full sample and two sub-groups: straight cisgender young people versus those who identified as not straight or cisgender. Mean scores on the homophobic and transphobic beliefs scale were statistically significantly lower among young people receiving FLASH relative to the comparison at both the 3- and 12-month timepoints (p-values for adjusted mean differences were < 0.01, n = 1357 and 1275, respectively). Specifically, FLASH's positive impact on reducing homophobic and transphobic beliefs was statistically significant for straight and cisgender youth at both survey follow-ups (p < 0.01, n = 1144 and p = 0.05, n = 1078, respectively); the effects for the LGBTQ sub-group reached statistical significance at only the final follow-up (p = 0.01, n = 197). Our results show that carefully designed, inclusive comprehensive sexual health education programs like High School FLASH can play a role in promoting better school climates for all youth by reducing beliefs that may lead to bullying, violence, and victimization.
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Affiliation(s)
- Kari Kesler
- Public Health-Seattle & King County, Seattle, WA, USA.
| | - Andrea Gerber
- Public Health-Seattle & King County, Seattle, WA, USA
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5
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Oliveira CM, Marques LM, de Medeiros DS, Salgado VDJ, Soares F, Magno L, Dourado I, da Silva ÁMB, de Brito HIL, Figueiredo TB, Campos GB. Prevalence of Neisseria gonorrhoeae and Chlamydia trachomatis infections among adolescent men who have sex with men and transgender women in Salvador, Northeast Brazil. Epidemiol Infect 2023; 151:e196. [PMID: 37869965 PMCID: PMC10728983 DOI: 10.1017/s095026882300170x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 09/29/2023] [Accepted: 10/08/2023] [Indexed: 10/24/2023] Open
Abstract
Adolescent men who have sex with men (AMSM) and transgender women (ATGW) enrolled as part of the PrEP1519 study between April 2019 and February 2021 in Salvador were tested for Neisseria gonorrhoeae (NG) and Chlamydia trachomatis (CT) infections.We performed real-time polymerase chain reaction using oropharyngeal, anal, and urethral swabs; assessed factors associated with NG and CT infections using multivariable Poisson regression analysis with robust variance; and estimated the prevalence ratios (PRs) and 95% confidence intervals (95% CIs). In total, 246 participants were included in the analyses (median age: 18.8; IQR: 18.2-19.4 years). The overall oropharyngeal, anal, and urethral prevalence rates of NG were 17.9%, 9.4%, 7.6%, and 1.9%, respectively. For CT, the overall, oropharyngeal, anal, and urethral prevalence rates were 5.9%, 1.2%, 2.4%, and 1.9%, respectively. A low level of education, clinical suspicion of STI (and coinfection with Mycoplasma hominis were associated with NG infection. The prevalence of NG and CT, especially extragenital infections, was high in AMSM and ATGW. These findings highlight the need for testing samples from multiple anatomical sites among adolescents at a higher risk of STI acquisition, implementation of school-based strategies, provision of sexual health education, and reduction in barriers to care.
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Affiliation(s)
| | - Lucas Miranda Marques
- Multidisciplinary Institute for Health, Federal University of Bahia, Salvador, Brazil
- State University of de Santa Cruz, Ilhéus, Brazil
| | | | | | - Fabiane Soares
- Collective Health Institute, Federal University of Bahia, Salvador, Brazil
| | - Laio Magno
- Collective Health Institute, Federal University of Bahia, Salvador, Brazil
- Department of Life Sciences, State University of Bahia, Salvador, Brazil
| | - Inês Dourado
- Collective Health Institute, Federal University of Bahia, Salvador, Brazil
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6
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Reidy DE, Salazar LF, Baumler E, Wood L, Daigle LE. Sexual Violence against Women in STEM: A Test of Backlash Theory Among Undergraduate Women. JOURNAL OF INTERPERSONAL VIOLENCE 2023; 38:8357-8376. [PMID: 36803036 DOI: 10.1177/08862605231155124] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
It has been argued that increasing the number of women in the science, technology, engineering, and math (STEM) fields could mitigate violence against women by advancing gender equality. However, some research points to a "backlash" effect wherein gains in gender equality are associated with heighted sexual violence (SV) against women. In this study, we compare SV against undergraduate women majoring in STEM disciplines to those majoring in non-STEM disciplines. Data were collected between July and October of 2020 from undergraduate women (N = 318) at five institutions of higher education in the United States. Sampling was stratified by STEM versus non-STEM majors and male-dominated versus gender-balanced majors. SV was measured using the revised Sexual Experiences Survey. Results indicated that women majoring in STEM disciplines that are gender balanced reported more SV victimization in the form of sexual coercion, attempted sexual coercion, attempted rape, and rape compared to their peers in both gender-balanced and male-dominated non-STEM and male-dominated STEM majors. These associations held even after controlling for age, race/ethnicity, victimization prior to college, sexual orientation, college binge drinking, and hard drug use during college. These data suggest that the risk of repeated SV victimization within STEM populations may be a threat to sustained gender parity in these fields and ultimately to gender equality and equity. Gender balance in STEM should not be furthered without addressing the potential use of SV as a potential means of social control over women.
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Affiliation(s)
| | | | | | - Leila Wood
- The University of Texas Medical Branch, Galveston, TX, USA
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7
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Hazelwood A. Looking Within: An Analysis of Intimate Partner Violence Victimization Among Sexual Minority Youth. JOURNAL OF INTERPERSONAL VIOLENCE 2023; 38:8042-8064. [PMID: 36762523 DOI: 10.1177/08862605231153887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Sexual minority youth are at increased risk of intimate partner violence (IPV) victimization compared to their heterosexual peers. However, the sexual minority population is not a homogenous group and risk of IPV victimization varies by LGB+ subgroup (e.g., gay/lesbian, bisexual, and unsure). Using two waves of data (2017, 2019) from the National Youth Risk Behavior Survey (YRBS), this study analyzes (a) differences in physical and sexual IPV victimization between heterosexual and sexual minority youth, (b) within group differences among sexual minority youth, and (c) if the relationship between IPV victimization and sexual identity is attenuated after controlling for sociodemographic characteristics and theoretically relevant risk factors. Results indicate that sexual minority youth are at elevated risk of IPV victimization compared to their heterosexual peers. Within-LGB+ analyses show that bisexual youth are more likely than gay/lesbian youth to be victims of sexual IPV. The association between physical and sexual IPV victimization and sexual identity is partially attenuated by sociodemographic variables and observed risk factors. Findings indicate that intervention and prevention programming should be tailored to identify, and treat, the risks and needs of unique, at-risk populations.
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8
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Lozano A, Ocasio MA, Boga DJ, Fernandez A, Hodge S, Estrada Y, Cano MÁ, Prado G. Measurement Invariance of Family Functioning Among Latina/o/x Sexual Minority Youth and Heterosexual Latina/o/x Youth. LGBTQ+ FAMILY : AN INTERDISCIPLINARY JOURNAL 2023; 19:367-381. [PMID: 38264060 PMCID: PMC10805466 DOI: 10.1080/27703371.2023.2217096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/25/2024]
Abstract
Positive family functioning is negatively associated with drug use, sexual risk behaviors, and depression; however, existing measures of family functioning were not specifically developed for Latina/o/x sexual minority youth (LSMY). This study examined the factor structure of family functioning and whether it is invariant across sexual orientation (i.e., LSMY and heterosexual Latina/o/x youth). Participants included 454 Latina/o/x youth (LSMY: n = 115, 25.3%). Results yielded a higher-order family functioning factor consisting of parental involvement, positive parenting, parent-adolescent communication, and parental monitoring. The model fit for the sample was acceptable (CFI/RMSEA = .91/.04) and configural invariance indicated that the model fit the data adequately in both groups (CFI/RMSEA = .87/.05). Fit of the metric invariance model (∆χ2 (42) = 54.83, p = .09, ΔCFI, ΔRMSEA, ΔTLI < .001) was not significantly worse than the configural model, however, the scalar invariance model (∆χ2 (42) = 80.18, p < .001, ΔCFI = .01, ΔRMSEA, ΔTLI < .001) was significantly worse than the less constrained models, suggesting that family functioning was noninvariant with regard to sexual orientation. Noninvariance may be related to the unique experiences of LSMY related to sexual orientation that are not captured in existing measures of family functioning.
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Affiliation(s)
- Alyssa Lozano
- Department of Public Health Sciences, Miller School of Medicine, University of Miami
| | - Manuel A. Ocasio
- Section of Adolescent Medicine, Department of Pediatrics, Tulane University School of Medicine
| | - Devina J. Boga
- Department of Public Health Sciences, Miller School of Medicine, University of Miami
| | - Alejandra Fernandez
- Department of Health Promotion and Behavioral Sciences, UTHealth School of Public Health, Center for Pediatric Population Health
| | - Shanelle Hodge
- School of Nursing and Health Studies, University of Miami
| | | | - Miguel Ángel Cano
- School of Public Health, The University of Texas Southwestern Medical Center
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9
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Sanabria G, Greene KY, Tran JT, Gilyard S, DiGiovanni L, Emmanuel PJ, Sanders LJ, Kosyluk K, Galea JT. "A Great Way to Start the Conversation": Evidence for the Use of an Adolescent Mental Health Chatbot Navigator for Youth at Risk of HIV and Other STIs. JOURNAL OF TECHNOLOGY IN BEHAVIORAL SCIENCE 2023:1-10. [PMID: 37362063 PMCID: PMC10172071 DOI: 10.1007/s41347-023-00315-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 03/14/2023] [Accepted: 03/31/2023] [Indexed: 06/28/2023]
Abstract
Chatbot use is increasing for mobile health interventions on sensitive and stigmatized topics like mental health because of their anonymity and privacy. This anonymity provides acceptability to sexual and gendered minority youth (ages 16-24) at increased risk of HIV and other STIs with poor mental health due to higher levels of stigma, discrimination, and social isolation. This study evaluates the usability of Tabatha-YYC, a pilot chatbot navigator created to link these youth to mental health resources. Tabatha-YYC was developed using a Youth Advisory Board (n = 7). The final design underwent user testing (n = 20) through a think-aloud protocol, semi-structured interview, and a brief survey post-exposure which included the Health Information Technology Usability Evaluation Scale. The chatbot was found to be an acceptable mental health navigator by participants. This study provides important design methodology considerations and key insights into chatbot design preferences of youth at risk of STIs seeking mental health resources.
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Affiliation(s)
| | - Karah Y. Greene
- College of Behavioral and Community Sciences, School of Social Work, University of South Florida, Tampa, FL USA
| | - Jennifer T. Tran
- College of Behavioral and Community Sciences, Department of Mental Health Law and Policy, University of South Florida, Tampa, FL USA
- School of Nursing, Department of Family and Community Health, University of Pennsylvania, Philadelphia, PA USA
| | - Shelton Gilyard
- College of Behavioral and Community Sciences, School of Social Work, University of South Florida, Tampa, FL USA
| | - Lauren DiGiovanni
- Department of Pediatrics, Morsani College of Medicine, University of South Florida, Tampa, FL USA
| | - Patricia J. Emmanuel
- Department of Pediatrics, Morsani College of Medicine, University of South Florida, Tampa, FL USA
| | - Lisa J. Sanders
- Department of Pediatrics, Morsani College of Medicine, University of South Florida, Tampa, FL USA
| | - Kristin Kosyluk
- College of Behavioral and Community Sciences, Department of Mental Health Law and Policy, University of South Florida, Tampa, FL USA
| | - Jerome T. Galea
- College of Behavioral and Community Sciences, School of Social Work, University of South Florida, Tampa, FL USA
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA USA
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10
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Rabbitte M, Enriquez M. Factors that impact assigned female sexual minority individuals health care experiences: A qualitative descriptive study. AMERICAN JOURNAL OF SEXUALITY EDUCATION 2023; 19:97-120. [PMID: 38576876 PMCID: PMC10989845 DOI: 10.1080/15546128.2023.2187502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/06/2024]
Abstract
This qualitative descriptive study identified factors that impact assigned female at birth (AFAB) cisgender and non-binary sexual minority individuals' decision to engage, or not engage, in health-seeking behaviors and receive preventative health care services. AFAB sexual minority individuals were asked to describe their health care experiences to determine modifiable factors that could improve their intention to seek care and improve their health care experiences. Purposive sampling was used to recruit AFAB sexual minority individuals between 18-30 years of age in the Chicago metropolitan area. Three main themes emerged from data acquired through individual interviews: (1) "ask the right questions"; main themes (2 lack of trust in health professionals; (3 the need for better sexual health education. An important finding was participants wanted to be asked about their sexual orientation, sexual behavior, and gender identity. Participants wanted to be able to share their sexual orientation and gender identity with health care professionals so they could receive appropriate care, accurate information, and feel comfortable sharing aspects about their life. Additionally, the results suggested that general and health sciences curricula should include content about diverse sexual and gender minority populations. Findings have important implications for health education and clinical practice.
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11
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Haupt KR, Stout CD, Simmons J, Nelson KM. Differences in the sexual health information parents/guardians give their adolescent sexual minority sons by outness. JOURNAL OF LGBT YOUTH 2023; 21:132-149. [PMID: 38434757 PMCID: PMC10906741 DOI: 10.1080/19361653.2023.2176399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Accepted: 01/30/2023] [Indexed: 03/05/2024]
Abstract
Introduction Parents and guardians are a potentially valuable source of sexual health information for adolescent sexual minority males (ASMM). The current study examines what sexual health topics ASMM report discussing with a parent/guardian and whether topics differ by outness about sexual attraction to other males. Methods ASMM (N=154; ages 14-17) in the United States completed the baseline of an online sexual health intervention pilot in 2020. They reported which of twelve sexual health topics they discussed with a parent/guardian and if they had disclosed their sexual attraction to other males. Associations between topics discussed and outness to a parent/guardian were examined with Firth logistic regression. Results Eighty-eight (57%) participants reported being out to a parent/guardian. Six sexual health topics were significantly more likely to be discussed if participants were out. The three categories with the largest differences by outness were how to: discuss with a partner what they would not like to do sexually (aOR = 7.0, 95% CI: 2.0-24.6), use condoms (aOR = 5.9, 95% CI: 2.3-15.1), and prevent HIV/AIDS (aOR = 3.5, 95% CI = 1.4-8.7). Conclusions Interventions on parental/guardian provision of sexual health information are needed to ensure ASMM receive relevant sexual health knowledge.
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Affiliation(s)
- Kaitlin R Haupt
- Department of Community Health Sciences, Boston University School of Public Health, Boston, MA, USA
| | - Claire D Stout
- Department of Community Health Sciences, Boston University School of Public Health, Boston, MA, USA
| | - Journey Simmons
- Department of Community Health Sciences, Boston University School of Public Health, Boston, MA, USA
| | - Kimberly M Nelson
- Department of Community Health Sciences, Boston University School of Public Health, Boston, MA, USA
- Department of Psychiatry, Boston University School of Medicine, Boston, MA, USA
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12
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Deal C, Doshi RD, Gonzales G. Gender Minority Youth Experiencing Homelessness and Corresponding Health Disparities. J Adolesc Health 2023; 72:763-769. [PMID: 36646565 DOI: 10.1016/j.jadohealth.2022.11.229] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 11/06/2022] [Accepted: 11/21/2022] [Indexed: 01/15/2023]
Abstract
PURPOSE Pediatricians and youth service providers frequently interface with vulnerable populations, including gender minority youth (e.g., transgender, nonbinary, gender questioning, and other gender diverse individuals) and youth experiencing homelessness. The purposes of this study are to estimate the prevalence of homelessness and types of homelessness experienced among gender minority youth and their corresponding health outcomes. METHODS Data for this study came from gender minority (n = 3,194) and cisgender (n = 93,337) high school students who answered questions on transgender status and homelessness status in the 2017 and 2019 Youth Risk Behavior Survey (YRBS). We compared the prevalence of homelessness between gender minority and cisgender youth and assessed where youth experiencing homelessness had slept in the prior month: shelters, nonparental homes, streets, hotel, or other locations. Finally, logistic regression models and marginal effects (ME) were used to examine health outcomes at the intersection of gender minority status and homelessness. RESULTS 22% of gender minority youth reported homelessness during the prior month. Cisgender youth were significantly less likely to report being homeless (3%). Transgender youth experiencing homelessness were significantly more likely to live on the streets than cisgender youth experiencing homelessness (ME = 0.20; 95% CI = 0.10-0.30; p < .001). Gender minority youth experiencing homelessness reported elevated health-risk behaviors in excess of nonhomeless gender minority youth and cisgender youth experiencing homelessness. DISCUSSION Public health campaigns, housing interventions, and youth service providers should consider and create tailored programs to secure housing and to promote the health of gender minority youth experiencing homelessness.
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Affiliation(s)
- Cameron Deal
- Program for Public Policy Studies, Vanderbilt University, Nashville, Tennessee
| | - Riya D Doshi
- Department of Medicine, Health & Society, Vanderbilt University, Nashville, Tennessee
| | - Gilbert Gonzales
- Department of Medicine, Health & Society, Department of Health Policy, Program for Public Policy Studies, Vanderbilt University, Nashville, Tennessee.
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13
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Berezin MN, Javdani S, Godfrey E. Predictors of Sexual and Reproductive Health Among Girls Involved in the Juvenile Legal System: the Influence of Resources, Race, and Ethnicity. CHILDREN AND YOUTH SERVICES REVIEW 2022; 136:106426. [PMID: 35370335 PMCID: PMC8975126 DOI: 10.1016/j.childyouth.2022.106426] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
Girls involved in the juvenile legal system are at among the highest risk for sexual and reproductive health (SRH) challenges. Yet, few studies focus on girls or examine multiple predictors of their SRH in tandem. In addition to individual and familial-level risk factors (e.g., trauma, substance use, parental monitoring), this study also examines the influence of structural disadvantage on girls' SRH by assessing the degree to which girls' self-identified resource needs and access challenges across multiple areas (e.g., housing, employment, healthcare) predict SRH risk. Cross-sectional data collected from 269 girls involved in the legal system and their caregivers were analyzed using hierarchical regression analyses. Findings suggest that, over and above individual and familial level predictors, resource access challenges significantly predict girls' SRH, while high resource needs and access challenges predict Black girls' SRH specifically. Implications for programming, policy, and research are delineated.
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Affiliation(s)
| | - Shabnam Javdani
- New York University, Department of Applied Psychology
- Corresponding Author: 246 Greene Street, New York, NY 10012; ; 212 992 9739
| | - Erin Godfrey
- New York University, Department of Applied Psychology
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Harper CR, Johns MM, Orenstein D, Pampati S, Jones TM, Leonard S, Taylor KR, Robin L. Association Between LGBTQ Student Nondiscrimination Laws in Selected States and School District Support for Gay-Straight Alliances. J Adolesc Health 2022; 70:584-587. [PMID: 35165028 DOI: 10.1016/j.jadohealth.2021.11.032] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 10/21/2021] [Accepted: 11/24/2021] [Indexed: 10/19/2022]
Abstract
PURPOSE To examine the association between state laws protecting lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ) students and school districts' recommendations or requirements for establishing gay-straight alliances (GSAs) in schools. Beginning in fall 2013, 19 state education agencies (SEAs) engaged in HIV/STI and pregnancy prevention activities in "priority" school districts. SEAs provided support to priority districts to require or recommend GSAs in their schools. METHODS This study used semi-annually collected program evaluation data and state law data from the Gay, Lesbian, and Straight Education Network. We assessed whether increases in the percentage of priority districts recommending or requiring schools to provide GSAs varied by the presence of nondiscrimination or enumerated antibullying laws with a difference-in-difference design. RESULTS States with nondiscrimination laws began with more priority districts recommending or requiring schools to provide GSAs (52.5%) compared to states without laws (47.5%). We found a significant interaction (p < .01) between increases in the percentage of priority districts recommending or requiring a GSA and having a state nondiscrimination law. Across the first 3 years of program implementation, there was a 30% increase (p < .01) in priority districts recommending or requiring schools to provide GSAs in states with nondiscrimination laws, compared to a 12% increase (p < .01) in states without laws. There was no significant interaction between states with enumerated antibullying laws and districts recommending or requiring a GSA. DISCUSSION State LGBTQ nondiscrimination laws for students may facilitate school district support of GSAs, which may decrease health risks among LGBTQ youth.
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Affiliation(s)
- Christopher R Harper
- Division of Adolescent and School Health, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Michelle M Johns
- Division of Adolescent and School Health, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Diane Orenstein
- Division of Adolescent and School Health, Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | | | | | | | - Leah Robin
- Division of Adolescent and School Health, Centers for Disease Control and Prevention, Atlanta, Georgia.
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Chan CT, Olivieri-Mui BL, Mayer KH. Associations between State-Level High School HIV Education Policies and Adolescent HIV Risk Behaviors. THE JOURNAL OF SCHOOL HEALTH 2022; 92:316-324. [PMID: 34951018 PMCID: PMC10069761 DOI: 10.1111/josh.13130] [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] [Received: 06/10/2021] [Revised: 07/02/2021] [Accepted: 07/08/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND School-based human immunodeficiency virus (HIV) education can reach most adolescents, but inconsistencies exist in state-level content policies. The purpose of this study was to evaluate the associations between state-level high school HIV education policies and adolescent HIV risk behaviors. METHODS This was a cross-sectional analysis of the 2019 Youth Risk Behavior Survey linked to the Guttmacher Institute Sex and HIV Education report. Logistic regression models examined the associations of state-level HIV education mandates and content policies with 3 HIV risk behaviors: (1) 4 or more lifetime sexual partners; (2) substance use before last sex; (3) condomless last sex. RESULTS Across 33 states, 128,986 high school students were included. Multivariable adjusted models demonstrated no associations between mandated HIV education and risk behaviors. Covering abstinence along with other safe sex options was associated with lower odds, whereas stressing abstinence was associated with higher odds of at least 4 lifetime sexual partners and condomless last sex. Discriminatory sexual orientation content was associated with increased condomless last sex; associations for all HIV risk behaviors were stronger among sexual minority youth. CONCLUSIONS Increased HIV risk behaviors associated with state policies stressing abstinence or requiring discriminatory sexual orientation content support the need for comprehensive and inclusive HIV education.
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Affiliation(s)
- Carrie T Chan
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA, 02115
- Stanford Children's Health, 750 Welch Road Suite 212, Palo Alto, CA, 94304
- Department of Family Health Care Nursing, University of California San Francisco, 2 Koret Way, San Francisco, CA, 94131
| | - Brianne L Olivieri-Mui
- The Hinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife, Harvard Medical School, Boston, 1200 Centre Street, Roslindale, MA, 02131
| | - Kenneth H Mayer
- The Fenway Institute, Fenway Health, 7 Haviland Street, Boston, MA, 02215
- Department of Medicine, Beth Israel Deaconess Medical Center/Harvard Medical School, 330 Brookline Avenue, Boston, MA, 02215
- Department of Global Health and Population, Harvard School of Public Health, 9 Bow Street, Cambridge, MA, 02138
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Szucs LE, Barrios LC, Young E, Robin L, Hunt P, Jayne PE. The CDC's Division of Adolescent and School Health Approach to Sexual Health Education in Schools: 3 Decades in Review. THE JOURNAL OF SCHOOL HEALTH 2022; 92:223-234. [PMID: 34964130 PMCID: PMC10924689 DOI: 10.1111/josh.13115] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Accepted: 08/22/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND School health education, including sexual health education, plays a crucial role in shaping adolescents' protective health behaviors, experiences, and outcomes. Adolescents need functional knowledge and skills to practice, adopt, and maintain healthy behaviors for preventing sexually transmitted infections (STIs), including human immunodeficiency virus (HIV), and unintended pregnancy. METHODS The US Centers for Disease Control and Prevention's Division of Adolescent and School Health (CDC/DASH) has advanced school-based approaches to STI/HIV and pregnancy prevention through surveillance, research and evaluation, and program partnership and collaboration for over 3 decades. RESULTS CDC/DASH uses systematic and innovative strategies to identify the breadth of adolescent sexual health evidence; characterize key elements of effective educational curricula; and provide practical guidance to support school-based delivery. CDC/DASH's approach to effective health and sexual health education in schools has changed dramatically over the past 30 years and must continue to progress. CONCLUSION This paper describes how and why that approach has evolved and outlines directions for the future.
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Affiliation(s)
- Leigh E. Szucs
- Research Application and Evaluation Branch, Division of Adolescent and School Health, The US Centers for Disease Control and Prevention, 1600 Clifton Rd NE, US8-1, Atlanta, GA, 30329-4027
| | - Lisa C. Barrios
- Research Application and Evaluation Branch, Division of Adolescent and School Health, The US Centers for Disease Control and Prevention, 1600 Clifton Rd NE, US8-1, Atlanta, GA, 30329-4027
| | - Emily Young
- Research Application and Evaluation Branch, Division of Adolescent and School Health, The US Centers for Disease Control and Prevention, 1600 Clifton Rd NE, US8-1, Atlanta, GA 30329-4027; Oak Ridge Institute of Science and Education, 1299 Bethel Valley Road, TN, Oak Ridge, TN, 37830
| | - Leah Robin
- Research Application and Evaluation Branch, Division of Adolescent and School Health, The US Centers for Disease Control and Prevention, 1600 Clifton Rd NE, US8-1, Atlanta, GA 30329-4027
| | - Pete Hunt
- Research Application and Evaluation Branch, Division of Adolescent and School Health (Retired), The US Centers for Disease Control and Prevention, 1600 Clifton Rd, NE, US8-1, Atlanta, GA, 30329-4027
| | - Paula E. Jayne
- Research Application and Evaluation Branch, Division of Adolescent and School Health (Retired); ICF, The US Centers for Disease Control and Prevention, 1600 Clifton Rd NE, US8-1; ICF, 2635 Corporate Blvd NE Suite 1000, Atlanta, GA, 30345
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Katz DA, Hamilton DT, Rosenthal EM, Wang LY, Dunville RL, Aslam M, Barrios LC, Zlotorzynska M, Sanchez TH, Sullivan PS, Rosenberg ES, Goodreau SM. Effects of Condom Use on Human Immunodeficiency Virus Transmission Among Adolescent Sexual Minority Males in the United States: A Mixed Epidemiology and Epidemic Modeling Study. Sex Transm Dis 2021; 48:973-980. [PMID: 34091584 PMCID: PMC8594521 DOI: 10.1097/olq.0000000000001485] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Accepted: 05/17/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND We examined condom use patterns and potential population-level effects of a hypothetical condom intervention on human immunodeficiency virus (HIV) transmission among adolescent sexual minority males (ASMM). METHODS Using 3 data sets: national Youth Risk Behavior Survey 2015 to 2017 (YRBS-National), local YRBS data from 8 jurisdictions with sex of partner questions from 2011 to 2017 (YRBS-Trends), and American Men's Internet Survey (AMIS) 2014 to 2017, we assessed associations of condom use with year, age, and race/ethnicity among sexually active ASMM. Using a stochastic agent-based network epidemic model, structured and parameterized based on the above analyses, we calculated the percent of HIV infections averted over 10 years among ASMM ages 13 to 18 years by an intervention that increased condom use by 37% for 5 years and was delivered to 62% of ASMM at age 14 years. RESULTS In YRBS, 51.8% (95% confidence interval [CI], 41.3-62.3%) and 37.9% (95% CI, 32.7-42.3%) reported condom use at last sexual intercourse in national and trend data sets, respectively. In AMIS, 47.3% (95% CI, 44.6-49.9%) reported condom use at last anal sex with a male partner. Temporal trends were not observed in any data set (P > 0.1). Condom use varied significantly by age in YRBS-National (P < 0.0001) and YRBS-Trends (P = 0.032) with 13- to 15-year-olds reporting the lowest use in both; age differences were not significant in AMIS (P = 0.919). Our hypothetical intervention averted a mean of 9.0% (95% simulation interval, -5.4% to 21.2%) of infections among ASMM. CONCLUSIONS Condom use among ASMM is low and appears to have remained stable during 2011 to 2017. Modeling suggests that condom use increases, consistent with previous interventions, have potential to avert 1 in 11 new HIV infections among ASMM.
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Affiliation(s)
| | - Deven T. Hamilton
- Center for Studies in Demography and Ecology, University of Washington, Seattle, WA
| | - Elizabeth M. Rosenthal
- Department of Epidemiology and Biostatistics, University of Albany School of Public Health, State University of New York, Rensselaer, NY
| | | | | | - Maria Aslam
- Office of the Director, Centers for Disease Control and Prevention, Atlanta, GA
| | | | | | | | - Patrick S. Sullivan
- Department of Epidemiology
- Department of Global Health, Emory University, Atlanta, GA
| | - Eli S. Rosenberg
- Department of Epidemiology and Biostatistics, University of Albany School of Public Health, State University of New York, Rensselaer, NY
| | - Steven M. Goodreau
- Center for Studies in Demography and Ecology, University of Washington, Seattle, WA
- Department of Anthropology, University of Washington, Seattle, WA
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Flynn G, Scherr T, Garofalo R, Kuhns LM, Bushover B, Nash N, Davis R, Schnall R. Usability Evaluation of the mLab App for Improving Home HIV Testing Behaviors in Youth at Risk of HIV Infection. AIDS EDUCATION AND PREVENTION : OFFICIAL PUBLICATION OF THE INTERNATIONAL SOCIETY FOR AIDS EDUCATION 2021; 33:312-324. [PMID: 34370566 PMCID: PMC8487399 DOI: 10.1521/aeap.2021.33.4.312] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Improving access to HIV testing among youth at high risk is essential for reaching those who are most at risk for HIV and least likely to access health care services. This study evaluates the usability of mLab, an app with image-processing feature that analyzes photos of OraQuick HIV self-tests and provides real-time, personalized feedback. mLab includes HIV prevention information, testing reminders, and instructions. It was developed through iterative feedback with a youth advisory board (N = 8). The final design underwent heuristic (N = 5) and end-user testing (N = 20). Experts rated mLab following Nielsen's heuristic checklist. End-users used the Health Information Technology Usability Evaluation Scale. While there were some usability problems, overall study participants found mLab useful and user-friendly. This study provides important insights into using a mobile app with imaging for interpreting HIV test results with the goal of improving HIV testing and prevention in populations at high risk.
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Affiliation(s)
- Gabriella Flynn
- University of South Florida, College of Public Health, 4202 E. Fowler Ave, Tampa, FL 33620, USA
| | - Thomas Scherr
- Department of Chemistry, Vanderbilt University, 2201 West End Ave, Nashville, Tennessee 37235, USA
| | - Robert Garofalo
- Division of Adolescent Medicine, Lurie Children’s Hospital, & Northwestern University, Feinberg School of Medicine, Department of Pediatrics, 1440 N. Dayton Street, Chicago, Illinois 60642 USA
| | - Lisa M. Kuhns
- Division of Adolescent Medicine, Lurie Children’s Hospital, & Northwestern University, Feinberg School of Medicine, Department of Pediatrics, 1440 N. Dayton Street, Chicago, Illinois 60642 USA
| | - Brady Bushover
- Division of Scholarship and Research, Columbia University School of Nursing, 560 West 168th Street, New York, New York 10032, USA
| | - Nathanael Nash
- Division of Adolescent Medicine, Lurie Children’s Hospital, & Northwestern University, Feinberg School of Medicine, Department of Pediatrics, 1440 N. Dayton Street, Chicago, Illinois 60642 USA
| | - Rindcy Davis
- H. Sergievsky Center, Columbia University Medical Center, 630 West 168 Street, New York, New York 10032, USA
| | - Rebecca Schnall
- Division of Scholarship and Research, Columbia University School of Nursing, 560 West 168th Street, New York, New York 10032, USA
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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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Abstract
Addiction disorders/substance use disorders (SUD) are on the rise. However, many mental health care providers have never experienced SUD themselves, leading to higher chances of poor patient care through stigma, judgement, and the misunderstanding of patients. An alternative approach to understanding patients with addictive behaviors using a comparison of sex is discussed in this paper. Since most health care providers will have experienced sex, this analog can help mental health workers with no lived experience of SUD better understand their patients. This can help reduce stigma, misunderstanding, countertransference feeling, and the judgment of patients, thereby leading to better patient care.
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Affiliation(s)
- Mark Mohan Kaggwa
- Department of Psychiatry, Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
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21
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Rigsby DC, Keim SA, Milanaik R, Adesman A. Electronic Vapor Product Use and Sexual Risk Behaviors in US Adolescents. Pediatrics 2021; 147:peds.2020-022533. [PMID: 34035073 DOI: 10.1542/peds.2020-022533] [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] [Accepted: 02/24/2021] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Adolescent electronic vapor product (EVP) usage continues to increase and is associated with heightened engagement in other risk behaviors. However, there is limited research on associations between youth EVP use and sexual risk behaviors (SRBs). In this study, we examined how current youth EVP and/or cigarette usage, as well as EVP usage frequency, is related to several SRBs. METHODS Respondents (N = 12 667) of the 2017 National Youth Risk Behavior Survey were categorized by previous 30-day EVP and/or cigarette usage: nonuse, EVP use only, cigarette use only, or dual use. Separately, respondents were categorized by previous 30-day EVP usage frequency: 0, 1 to 9, 10 to 29, or 30 days. Ten SRBs were identified as dependent variables. Adjusted prevalence ratios were calculated by using modified Poisson regression to determine associations between SRBs and both current EVP and/or cigarette usage and EVP usage frequency. Linear contrasts compared adjusted prevalence ratios across usage and frequency categories. RESULTS Youth EVP-only users and dual users were more likely than nonusers to engage in 9 of 10 SRBs. Prevalence proportions did not differ between EVP-only users and dual users for 7 of 10 behaviors. Occasional EVP users were more likely than nonusers to engage in 9 of 10 SRBs and were similarly as likely as frequent and daily users to engage in all 10 SRBs. CONCLUSIONS EVP usage among US high school students, with or without concurrent cigarette use, was associated with heightened engagement in several SRBs. Prevalence of engagement in most SRBs did not differ among occasional, frequent, and daily EVP users.
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Affiliation(s)
- Devyn C Rigsby
- Department of Pediatrics, Steven and Alexandra Cohen Children's Medical Center of New York, New Hyde Park, New York
| | - Sarah A Keim
- Center for Biobehavioral Health, The Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, Ohio.,Department of Pediatrics, College of Medicine and.,Division of Epidemiology, College of Public Health, The Ohio State University, Columbus, Ohio; and
| | - Ruth Milanaik
- Department of Pediatrics, Steven and Alexandra Cohen Children's Medical Center of New York, New Hyde Park, New York.,Department of Pediatrics, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York
| | - Andrew Adesman
- Department of Pediatrics, Steven and Alexandra Cohen Children's Medical Center of New York, New Hyde Park, New York; .,Department of Pediatrics, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York
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23
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Rabbitte M. Sex Education in School, are Gender and Sexual Minority Youth Included?: A Decade in Review. AMERICAN JOURNAL OF SEXUALITY EDUCATION 2020; 15:530-542. [PMID: 33762901 PMCID: PMC7986966 DOI: 10.1080/15546128.2020.1832009] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Comprehensive sexual health education increases sexual health knowledge and decreases adverse health outcomes and high-risk behaviors in heterosexual youth but lacks information relevant to gender and sexual minority youth. Universal access to comprehensive sexual health education that includes information relevant to gender and sexual minority individuals is lacking in the United States, leading to poor health outcomes for gender and sexual minority youth. The purpose of this review was to examine sexual health education programs in schools in the United States for the inclusion of information on gender identity and sexual orientation. The review provides information on current programs offered in schools and suggestions to make them more inclusive to gender and sexual minority youth.
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Affiliation(s)
- Maureen Rabbitte
- University of Missouri Sinclair School of Nursing, Columbia, Missouri, Saint Xavier University, Chicago, Illinois
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24
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Charmaraman L, Grossman JM, Richer AM. Same-Sex Attraction Disclosure and Sexual Communication Topics within Families. JOURNAL OF GLBT FAMILY STUDIES 2020; 17:118-134. [PMID: 34737682 PMCID: PMC8562695 DOI: 10.1080/1550428x.2020.1820414] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Few studies compare family communication about sex and relationships for sexual minority youth versus hetero-sexual teenagers. Further, existing studies often focus on mothers, overlooking fathers and extended family. Our survey of 952 adolescents aged 14-21 included 115 adolescents disclosing non-heterosexual attraction. Mothers offered more sexual protection methods messages to their non-SM teens, whereas fathers talked less with SM teens about risks of sex and relational sex. Most participants identified mothers, sisters, and female cousins, with male SMs having the highest number of disclosures to family members, whereas female and non-binary SMs confided in fewer family members or no one.
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Affiliation(s)
- Linda Charmaraman
- Wellesley Centers for Women, Wellesley College, Wellesley, Massachusetts, USA
| | - Jennifer M Grossman
- Wellesley Centers for Women, Wellesley College, Wellesley, Massachusetts, USA
| | - Amanda M Richer
- Wellesley Centers for Women, Wellesley College, Wellesley, Massachusetts, USA
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Salerno JP, Kachingwe ON, Fish JN, Parekh E, Geddings-Hayes M, Boekeloo BO, Aparicio EM. "Even if you think you can trust them, don't trust them": An exploratory analysis of the lived experiences of sexual health among sexual minority girls in foster care. CHILDREN AND YOUTH SERVICES REVIEW 2020; 116:105161. [PMID: 34393310 PMCID: PMC8356775 DOI: 10.1016/j.childyouth.2020.105161] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Girls in foster care are at heightened risk for poor sexual health outcomes compared to their general population counterparts. Sexual minority girls are also at greater risk for poor sexual health compared to their heterosexual counterparts. Yet, little is known about the sexual health of sexual minority girls in foster care. This study aims to provide a preliminary understanding of how sexual minority girls in foster care experience the phenomenon of sexual health. Using a single-case interpretative phenomenological analysis (IPA) design, we interviewed five sexual minority girls in foster care using a single in-depth focus group discussion and analyzed the data using a series of IPA steps. Analysis revealed three major themes about the lived experiences of sexual health among sexual minority girls in foster care: fear of being victimized and distrust within sexual relationships, self-protection from sexual relationship harm, and sexual health communication. Further research is warranted to investigate the sexual health experiences and needs of sexual minority girls in foster care, with particular sensitivity to the potential impact of past sexual victimization and abuse on their sexual health and wellbeing.
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Affiliation(s)
- John P. Salerno
- University of Maryland, School of Public Health, Department of Behavioral and Community Health, 4200 Valley Drive, College Park, MD 20742, United States
| | - Olivia N. Kachingwe
- University of Maryland, School of Public Health, Department of Behavioral and Community Health, 4200 Valley Drive, College Park, MD 20742, United States
| | - Jessica N. Fish
- University of Maryland, School of Public Health, Department of Family Science, College Park, MD, United States
| | - Eshana Parekh
- University of Maryland, College of Computer, Mathematical, and Natural Sciences, United States
| | | | - Bradley O. Boekeloo
- University of Maryland, School of Public Health, Department of Behavioral and Community Health, 4200 Valley Drive, College Park, MD 20742, United States
| | - Elizabeth M. Aparicio
- University of Maryland, School of Public Health, Department of Behavioral and Community Health, 4200 Valley Drive, College Park, MD 20742, United States
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Agwu A. Sexuality, Sexual Health, and Sexually Transmitted Infections in Adolescents and Young Adults. TOPICS IN ANTIVIRAL MEDICINE 2020; 28:459-462. [PMID: 32886466 PMCID: PMC7482983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Adolescents in the United States are at increased risk for acquiring HIV and other sexually transmitted infections (STIs). Rates of chlamydia, gonorrhea, and primary and secondary syphilis are increasing among individuals aged 15 to 24 years, among both sexes. Approximately 1 in 5 new HIV diagnoses is occurring among individuals aged 13 to 24 years. Compared with heterosexual and cisgender youth, sexual and gender minority youth may be more likely to have had sex before age 13 years, and young transgender women have the highest rates of HIV and STIs than other sexual and gender minority youth. Comprehensive, culturally sensitive, and developmentally sensitive care is needed to address sexuality-related issues in adolescents and young adults. This article summarizes a presentation by Allison Agwu, MD, ScM, at the International Antiviral Society-USA (IAS-USA) annual continuing education program held in New York, New York, in September 2019.
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Affiliation(s)
- Allison Agwu
- The Johns Hopkins University, Baltimore, MD, USA
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27
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Cygan HR, McNaughton D, Reising V, Fogg L, Marshall B, Simon J. Teen pregnancy in Chicago: Who is at risk? Public Health Nurs 2020; 37:353-362. [PMID: 32196754 DOI: 10.1111/phn.12726] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Revised: 02/27/2020] [Accepted: 02/28/2020] [Indexed: 01/12/2023]
Abstract
BACKGROUND Teenage pregnancy, with its associated health and social consequences for young people and society as a whole, is one of the nation's most important public health issues. The purpose of this study was to use Youth Risk Behavior Survey (YRBS) data describe self-reported, pregnancy experiences in 9-12th grade Chicago Public Schools (CPS) students and identify teens at highest risk based on gender, grade-level, race, ethnicity, and sexual orientation. METHODS Secondary data analysis of the 2017 CPS high school Youth Risk Behavior Survey was conducted. RESULTS The survey response rate was 73% (n = 1,883). 4.9% (n = 91) of CPS students in grades 9 - 12 reported a pregnancy experience, and 1.9% (n = 34) reported being "unsure" of a pregnancy experience. Statistically significant differences in the likelihood of self-reporting a pregnancy experience were found based on grade level (p = .000), race (p = .023), and sexual orientation (p = .000). CONCLUSION While risk for a teen pregnancy experience varies across all groups, public health nurses can use YRBS data to better understand pregnancy risk in the populations they serve and can leverage core competencies, and robust community relationships to adapt, implement and evaluate evidence-based teen pregnancy prevention programs for maximum impact on teens at greatest risk.
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Affiliation(s)
- Heide R Cygan
- Community, Systems and Mental Health Nursing, Rush University College of Nursing, Chicago, IL, USA
| | - Diane McNaughton
- Community, Systems and Mental Health Nursing, Rush University College of Nursing, Chicago, IL, USA
| | - Virginia Reising
- Department of Health Systems Science, University of Illinois at Chicago College of Nursing, Chicago, IL, USA
| | - Louis Fogg
- Community, Systems and Mental Health Nursing, Rush University College of Nursing, Chicago, IL, USA
| | - Booker Marshall
- Office of Student Health and Wellness, Chicago Public Schools, Chicago, IL, USA
| | - Jeremiah Simon
- Office of Student Health and Wellness, Chicago Public Schools, Chicago, IL, USA
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28
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Sanchez A, Del Giudice P, Peneau A, Grange P, Dupin N, Hubiche T. [A case of "early" syphilis]. Ann Dermatol Venereol 2020; 147:127-130. [PMID: 31955971 DOI: 10.1016/j.annder.2019.10.032] [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: 05/02/2019] [Revised: 08/31/2019] [Accepted: 10/15/2019] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Syphilis mainly affects men who have sex with men (MSM) between the ages of 20 and 49. Herein we report a case in a teenager illustrating extension of the epidemic to other populations. PATIENTS AND METHODS A 15-year-old boy consulted in May 2018 for an anal fissure and painful oral erosions. He reported having had unprotected anal sex with another male teenager of the same age three months earlier. Syphilis serology was positive, with a positive treponemal test (TT) and non-treponemal test (VDRL) at 1/128. A treponemal bacterial DNA PCR assay was also positive for swabs obtained from the oral erosions and anal fissure. Due to a history of allergy to penicillin the patient was treated with doxycycline 200mg daily for 14 days. One month later, the mucosal lesions had subsided, and 3 months later the VDRL titer had decreased by 2 dilutions. CONCLUSION This case of "early" syphilis illustrates a change in the French epidemiology of sexually transmitted diseases (STIs). STIs currently affect very young and previously unexposed metropolitan French populations. These infections are increasing in teenagers due to an increase in high-risk sexual behavior associated with a lack of knowledge of STIs. This case is a reminder of the current decline in the level of knowledge about STIs among teenagers as compared to young people of the same age in the 1990s.
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Affiliation(s)
- A Sanchez
- Service de dermatologie-infectiologie, CHI de Fréjus/Saint-Raphaël, 240, avenue Saint-Lambert, 83608 Fréjus, France.
| | - P Del Giudice
- Service de dermatologie-infectiologie, CHI de Fréjus/Saint-Raphaël, 240, avenue Saint-Lambert, 83608 Fréjus, France
| | - A Peneau
- Service d'hépato-gastro-entérologie, CHI de Fréjus/Saint-Raphaël, 240, avenue Saint-Lambert, 83608 Fréjus, France
| | - P Grange
- Inserm, laboratoire de dermatologie-CNR des IST bactériennes LA Syphilis, faculté de médecine, université Sorbonne Paris Descartes, institut Cochin U1016, Paris, France
| | - N Dupin
- Inserm, laboratoire de dermatologie-CNR des IST bactériennes LA Syphilis, faculté de médecine, université Sorbonne Paris Descartes, institut Cochin U1016, Paris, France; Service de dermatologie-vénéréologie, groupe hospitalier Paris Centre Cochin-Hôtel Dieu-Broca, AP-HP, Paris, France
| | - T Hubiche
- Service de dermatologie-infectiologie, CHI de Fréjus/Saint-Raphaël, 240, avenue Saint-Lambert, 83608 Fréjus, France; Service de dermatologie, hôpital Archet 2, CHU de Nice, 151, route St-Antoine-de-Ginestiere, 06202 Nice, France
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Andrzejewski J, Rasberry CN, Mustanski B, Steiner RJ. Sexual and Reproductive Health Web Sites: An Analysis of Content for Sexual and Gender Minority Youth. Am J Health Promot 2020; 34:393-401. [PMID: 31928056 DOI: 10.1177/0890117119899217] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
PURPOSE Sexual and gender minority (SGM) youth face risks for negative sexual and reproductive health (SRH) outcomes; it is critical to provide these populations with health education that is both inclusive of and specific to their needs. We sought to characterize the strengths and weaknesses of SGM-related messages from web sites that address SRH for young people. We considered who is included, what topics are discussed, and how messages are framed. METHODS A systematic Google search and screening process was used to identify health promotion web sites with SRH content for adolescents and young adults. Using MAXQDA, we thematically coded and analyzed SGM content qualitatively. RESULTS Of 32 SRH web sites identified, 23 (71.9%) contained SGM content. Collectively, the sites included 318 unique SGM codes flagging this content. Approximately two-thirds of codes included messages that discussed SGM youth in aggregate (eg, lesbian, gay, bisexual, and transgender)-specific content about the diverse subpopulations within this umbrella term (eg, transgender youth) was more limited. In addition to SRH topics, most web sites had messages that addressed a broad array of other health issues including violence, mental health, and substance use (n = 17, 73.9%) and SGM-specific topics, for example coming out (n = 21, 91.3%). The former were often risk-framed, yet affirmational messages were common. Most web sites (n = 16; 69.6%) presented information for SGM youth both in stand-alone sections and integrated into broader content. Yet, integrated information was slightly more common (56.6% of all codes) than stand-alone content. CONCLUSIONS Challenges of developing SRH content related to SGM youth include: (1) aggregate terms, which may not represent the nuances of sexual orientation and gender, (2) balancing risk versus affirmational messages, and (3) balancing stand-alone versus integrated content. However, SGM-related content also offers an opportunity to address diverse topics that can help meet the needs of these populations.
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Affiliation(s)
- Jack Andrzejewski
- Oak Ridge Associated Universities, TN, USA.,San Diego State University-University of California, San Diego Joint Doctoral Program in Public Health, San Diego, CA, USA
| | - Catherine N Rasberry
- Division of Adolescent and School Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Brian Mustanski
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.,Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL, USA
| | - Riley J Steiner
- Division of Adolescent and School Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
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Apidechkul T. Sexual behaviors and seroprevalence of HIV, HBV, and HCV among hill tribe youths of Northern Thailand. BMC Public Health 2019; 19:1101. [PMID: 31412838 PMCID: PMC6693098 DOI: 10.1186/s12889-019-7459-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Accepted: 08/08/2019] [Indexed: 12/28/2022] Open
Abstract
Background Sexual behaviors reflect the degree of exposure to human immunodeficiency virus (HIV), hepatitis B virus (HBV), and hepatitis C virus (HCV), especially in people in sexually active stages, such as youths. Hill tribe people have their own cultures, beliefs and lifestyles related to their behaviors, including sexual behaviors, which may lead to HIV, HBV, and HCV infections, especially among youths. The study aimed to examine sexual behaviors and assess the seroprevalence of HIV, HBV, and HCV among hill tribe youths. Methods A cross-sectional study was conducted. The participants were recruited from 60 randomly selected hill tribe villages in Chiang Rai Province, Thailand. A validated questionnaire and 5 mL blood specimens were used to collect data. Data were collected by a self-reporting method. Rapid immunochromatographic tests were used to detect hepatitis B surface antibody (anti-HBs), hepatitis B surface antigen (HBsAg), hepatitis C antibody (anti-HCV), and human immunodeficiency virus antibody-I and- II (anti-HIV-1 and -2). Chi-square and Fisher’s exact test were used to detect the associations between variables. Results A total of 1325 participants were recruited for the analysis. The majority were females (60.5%) and aged 15–17 years (58.9%). A total of 14.5% smoked, 22.4% drank alcohol, 14.2% were tattooed, and 61.4% had their ears pierced. Among the 30.3% who had sexual experience, 42.0% experienced one-night stands, 26.9% had sexual contact with a prostitute within 1 year prior to the study, 18.9% used alcohol prior to having sexual intercourse, and 15.7% had been tested for HIV/AIDS previously. Among males, 11.5% were males who had sex with males (MSM), and 4.6% were bisexual. Among females, 83.0% were females who had sex with males, and 5.0% were females who had sex with females. Different sexes and tribes were found to have significantly different risk behaviors and sexual behaviors, such as overall males having a greater proportion of sexual experience than females, and Lahu, Akha and Hmong had a higher proportion of sexual experience, having sexual experience with one-night stands, and having sexual experience with a prostitute 1 year prior to the study than others. Among the 836 obtained blood samples, none were positive for anti-HIV-I and -II, 6.4% were positive for anti-HBs, 1.9% were positive for HBsAg, and 0.2% were positive for anti-HCV. Conclusion Hill tribe youths in Thailand are at risk of STIs such as HBV and HCV infections according to their risk behaviors and sexual behaviors, which differ between sexes and tribes. Effective behavioral interventions should be promoted among hill tribe youths to minimize the risk for these diseases in the future.
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Affiliation(s)
- Tawatchai Apidechkul
- Center of Excellence for the Hill tribe Health Research, Mae Fah Laung University, Chiang Rai, Thailand. .,School of Health Science, Mae Fah Luang University, Chiang Rai, Thailand.
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