1
|
Ujah OI, Adaji OC, Ujah IAO, Kirby RS. Food insecurity and early childhood development among children 24-59 months in Nigeria: A multilevel mixed effects modelling of the social determinants of health inequities. PLoS One 2025; 20:e0316381. [PMID: 39804857 PMCID: PMC11729974 DOI: 10.1371/journal.pone.0316381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2024] [Accepted: 12/10/2024] [Indexed: 01/16/2025] Open
Abstract
Food insecurity (FI) has been identified as a determinant of child development, yet evidence quantifying this association using the newly developed Early Childhood Development Index 2030 (ECDI2030) remains limited. Herein, we provide national estimates of early childhood development (ECD) risks using the ECDI2030 and examined to what extent FI was associated with ECD among children aged 24-59 months in Nigeria. This population based cross-sectional analyses used data from the UNICEF-supported 2021 Multiple Indicator Cluster Survey in Nigeria. The analytic sample comprised children aged 24-59 months (weighted N = 12,112). We measured early childhood development for each child using the ECDI2030, measured across three domains: learning, psychosocial well-being and health. Food insecurity was assessed using the Food Insecurity Experience Scale (FIES), categorized as none/mild, moderate and severe. We fitted mixed-effects multilevel logistic regression models, with random intercepts, to estimate the odds of association between FI status and ECD. A total of 11,494 children aged 24-59 months (mean ± SD age, 43.4 ± 9.9 months), including 5,797 boys (50.2%) and 5,697 girls (49.8%), were included in the study. Approximately 46.4% of children were developmentally off track and about 76% of children lived in food-insecure households. The intercept-only model indicated significant variation in ECD prevalence across communities (τ00 = 0.94, intraclass correlation = 0.22, p < 0.0001), suggesting nonignorable variability in ECD across communities. Adjusting for confounders, we observed no significant association between FI and ECD. However, increasing child's age and disability status appeared as significant risk factors for higher odds of children being developmentally off track. These findings highlight that while FI alone may not explain ECD, a combination of individual and contextual factors plays a crucial role. Future interventions addressing ECD in Nigeria should consider these multidimensional influences to promote optimal child development.
Collapse
Affiliation(s)
- Otobo I. Ujah
- College of Public Health, University of South Florida, Tampa, Florida, United States of America
- Department of Obstetrics and Gynaecology, Federal University of Health Sciences, Otukpo, Nigeria
| | | | - Innocent A. O. Ujah
- Department of Obstetrics and Gynaecology, Federal University of Health Sciences, Otukpo, Nigeria
| | - Russell S. Kirby
- College of Public Health, University of South Florida, Tampa, Florida, United States of America
| |
Collapse
|
2
|
Kalata M, Richards M, Sheeder J. Negative Perceptions and Long-Acting Reversible Contraceptive Choice in Adolescents and Young Adults: A Cross-Sectional Study. J Pediatr Adolesc Gynecol 2023; 36:465-471. [PMID: 36934799 DOI: 10.1016/j.jpag.2023.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 02/23/2023] [Accepted: 03/10/2023] [Indexed: 03/21/2023]
Abstract
OBJECTIVE Long-acting reversible contraceptives (LARCs) have high rates of safety, satisfaction, and continuation in adolescents and young adults (AYAs). Despite this, utilization of these methods by AYAs is low. The purpose of this study was to evaluate the negative personal perceptions or beliefs about birth control and LARCs and their association with contraceptive use in AYAs. METHODS We surveyed young people (14-24 years old) seeking care at a Title X-supported adolescent reproductive and sexual health clinic to assess negative perceptions of birth control methods, with an emphasis on LARCs. We used appropriate bivariate statistics to compare those endorsing 3 or fewer negative perceptions with those who had more than 3 and logistic regression to identify predictors of contraceptive choice. RESULTS We recruited 345 participants; 337 (97.7%) completed the survey. Among respondents, the median age was 20 (range 14-24) years, and 7.04% of participants had ever been pregnant. The most commonly held negative perceptions were fear of device migration or breakage causing adverse health effects and concern about effect on future fertility. The number of negative perceptions endorsed did not differ significantly by age. However, a greater number of negative perceptions and younger age were clinical predictors of LARC nonuse. CONCLUSION AYAs have negative perceptions about LARCs that are often inaccurate and may limit contraceptive acceptability and perceived options. Engaged and respectful dialogue with AYAs about their concerns and fears is essential to provide accurate and patient-centered contraceptive counseling and to ensure that young people can make informed contraceptive choices.
Collapse
Affiliation(s)
- Megan Kalata
- University of Colorado School of Medicine, Aurora, Colorado.
| | - Molly Richards
- Department of Pediatrics, Children's Hospital Colorado, Aurora, Colorado
| | - Jeanelle Sheeder
- Department of Pediatrics, Children's Hospital Colorado, Aurora, Colorado; Department of Obstetrics and Gynecology, University of Colorado School of Medicine, Aurora, Colorado
| |
Collapse
|
3
|
Lozano M, Obiol MA, Peiró J, Iftimi A, Ramada JM. Professional counseling in women with serious mental illness: achieving a shift toward a more effective contraceptive method. J Psychosom Obstet Gynaecol 2021; 42:221-227. [PMID: 32050830 DOI: 10.1080/0167482x.2020.1725463] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
OBJECTIVES Mental disorders in reproductive-aged women have significant implications for the risk of unintended pregnancies. The objective of this study is to assess the professional counseling in clinical practice based on motivational interview in women with serious mental illness (SMI) in order to achieve a change to a more effective contraceptive method. STUDY DESIGN A prospective observational cohort study (2012-2017) was conducted in a convenience sample of women with severe-moderate psychiatric disorders (n = 91). Information related to psychiatric health, contraceptive use, sexual and reproductive health and socio-demographics was collected. To assess the variation in the contraceptive method, follow-up visits were planned before and after medical counseling. All participants underwent an evidence-based individual motivational interview for contraception counseling. A multivariate logistic model was carried out to identify the factors involved in changing to a more effective contraceptive method. RESULTS After evidence-based counseling, 51.6% of participants changed their contraceptive method to a more effective one. This change was associated with gender violence (β coefficient = 1.58, p value = .006). The relation between changing to a more effective contraceptive method and both previous abortions and having children was also positive, although the coefficients did not reach statistical significance. CONCLUSIONS Evidence-based contraception counseling in clinical practice, based on an adapted protocol to patients with SMI, has shown, in this study, to be adequate to promote the shift to more effective contraceptive methods, avoiding the need of daily compliance in this population. Gender violence has been significantly associated with the shift to very high effectiveness methods as well as previous abortions and having children, not significantly.
Collapse
Affiliation(s)
- Manuel Lozano
- Departament de Medicina Preventiva i Salut Pública, Ciències de l'Alimentació, Toxicologia i Medicina Legal, Universitat de València, València, Spain
| | - María Antonia Obiol
- Centre de Salut Sexual i Reproductiva Font de Sant Lluís, Hospital Universitari Dr. Peset, València, Spain
| | - Juanjo Peiró
- Departament d'Estadística i Investigació Operativa, Universitat de València, València, Spain
| | - Adina Iftimi
- Departament d'Estadística i Investigació Operativa, Universitat de València, València, Spain
| | - José María Ramada
- Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Barcelona, Spain.,CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| |
Collapse
|
4
|
Mollborn S, Lawrence EM, Hummer RA. A gender framework for understanding health lifestyles. Soc Sci Med 2020; 265:113182. [PMID: 32942201 PMCID: PMC7738408 DOI: 10.1016/j.socscimed.2020.113182] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 06/03/2020] [Accepted: 06/28/2020] [Indexed: 11/28/2022]
Abstract
PURPOSE A health lifestyles approach holds promise for understanding change in women's and men's health behaviors and reducing gendered health disparities. The emerging theoretical and empirical literature on health lifestyles (individuals' bundled health behaviors that are shaped by group-based identities and norms) helps elucidate complex disparities in health behaviors, but research is needed on how gender shapes the development of health lifestyles. This study proposed and assessed a dynamic multilevel framework for understanding health lifestyles that draws on insights from contemporary gender and life course scholarship. DATA Using the transition from adolescence into adulthood as an empirical case, we analyzed US data from the National Longitudinal Study of Adolescent to Adult Health (Add Health; N = 6605), which followed adolescents through young adulthood, collecting information on their health behaviors and social contexts. FINDINGS Latent class analyses showed that health lifestyles differed significantly by gender. Results supported the dynamic multilevel framework, finding more variation in health lifestyle behaviors within genders than between, high levels of change across ages, intersections of gender with age, and socioeconomic status as a structural pathway for gender's influence. CONCLUSION Taken together, these findings suggest that conceptualizing gender as a dynamic multilevel system intersecting with other social statuses is fruitful for understanding how health lifestyles form and change. These findings can inform more effective policies to change health behaviors.
Collapse
Affiliation(s)
- Stefanie Mollborn
- Institute of Behavioral Science and Department of Sociology, University of Colorado Boulder, UCB 483, 1440 15th St, Boulder, CO, 80309-0483, USA.
| | - Elizabeth M Lawrence
- Department of Sociology, University of Nevada-Las Vegas, 4505 S. Maryland Pkwy, Las Vegas, NV, 89154, USA
| | - Robert A Hummer
- Carolina Population Center and Department of Sociology, University of North Carolina, Chapel Hill, 123 W. Franklin St, Chapel Hill, NC, 27516, USA
| |
Collapse
|
5
|
Ruiz Y, Riciputi S, Alexander SC, DeMaria AL, Guilamo-Ramos V. Examining dual method contraceptive use among midwestern parenting Latinx teens: Perspectives from adolescent parents, caretakers, and nurses. Public Health Nurs 2020; 37:647-654. [PMID: 32656790 DOI: 10.1111/phn.12762] [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: 05/02/2020] [Revised: 06/07/2020] [Accepted: 06/08/2020] [Indexed: 11/27/2022]
Abstract
BACKGROUND Despite dual method (DM) contraception being effective in reducing repeat-births and sexually transmitted infections (STIs), Latinx adolescent parents who live in non-traditional migration areas remain vulnerable for both outcomes. OBJECTIVE This study applied the Unified Theory of Behavior (UTB) and drew upon Bronfenbrenner's social ecological model to explore multiple stakeholders' (adolescent parents, caregivers, and nurses) perceptions of factors that influence DM intentions and use among Latinx adolescent parents. METHODS Semi-structured interviews with Latinx adolescent parent-caregiver dyads and nurses were analyzed using thematic analysis. RESULTS Study findings revealed that while all participant groups considered medical providers as DM influencers, contradicting views related to caregivers' as DM influencers emerged among adolescent parents and caregivers. Findings suggest that DM is deemed both acceptable and effective; and adolescent parents' reported DM self-efficacy. DM obstacles included negative emotions, environmental constraints, and poor knowledge and skills. CONCLUSIONS Study results suggest that constructs from the UTB framework are useful in identifying individual and social factors that can potentially influence DM intentions and use among Latinx adolescent parents. IMPLICATIONS FOR PUBLIC HEALTH NURSING This study's findings have potential implications for public health nurses interested in designing community-based interventions to reduce repeat-births and STIs among Latinx adolescent parents.
Collapse
Affiliation(s)
- Yumary Ruiz
- Department of Public Health, College of Health and Human Sciences, Purdue University, West Lafayette, IN, USA
| | - Shaina Riciputi
- Colorado Department of Human Services, Office of Behavioral Health, Denver, CO, USA
| | - Stewart C Alexander
- Department of Public Health, College of Health and Human Sciences, Purdue University, West Lafayette, IN, USA
| | - Andrea L DeMaria
- Department of Public Health, College of Health and Human Sciences, Purdue University, West Lafayette, IN, USA
| | | |
Collapse
|
6
|
Barragán V, Berenzon S, Tiburcio M, Bustos M, Villatoro J. Factors Associated with Sexual Debut in Mexican Adolescents: Results of the National Survey on Drug Use among Students in 2014. J Sex Med 2020; 16:418-426. [PMID: 30846115 DOI: 10.1016/j.jsxm.2019.01.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Revised: 01/08/2019] [Accepted: 01/10/2019] [Indexed: 10/27/2022]
Abstract
INTRODUCTION Although first sexual experience (understood as first sexual intercourse) is one of the most commonly assessed characteristics of adolescents, recent research emphasizes the importance of understanding other related social factors. This study highlights factors associated with first sexual experience in a nationally representative sample of adolescent students in Mexico. AIMS The goals of this study were (i) to determine the proportion of adolescents aged 12-17 who had had their first sexual experience; (ii) to identify the factors associated with first sexual experience; and (iii) to analyze the conditions (condom use, substance use) in which first sexual experience takes place. METHOD The data presented in this study are drawn from the 2014 National Survey on Drug Use in Students (Spanish acronym ENCODE), undertaken with the purpose of identifying the prevalence of drug use and associated variables, including sexual activity, in Mexican students. Kaplan-Meier analysis was used to estimate the probability of first sexual experience at a given age, taking sex as an outcome variable and age as a follow-up period. Logistic regression was used to assess possible factors for sexual initiation. MAIN OUTCOME MEASURES Validated standard questionnaires were used to assess sociodemographic characteristics, first sexual experience (framed as first sexual intercourse), frequency of sexual relations, sexual partners, sexual preference (framed as preferred sex of partners), substance use, having a physical illness or a behavioral problem, condom or other contraceptive use, as well as the absence or presence of parents, parents' educational attainment, and parents' substance use. RESULTS A total of 26,187 students aged 12-17 participated. Of this total, 14.8% had already had their first sexual experience, at a median age of 15; 64.5% used some type of contraceptive, and 53.2% used condoms. Proportional probabilities for having first sexual experience using age as a follow-up period showed that the probability of having sex earlier was higher among boys than girls: the probability of having sex at age of 15 was 26.5% for boys and 13.9% for girls. Predictors of first sexual experience included substance use (alcohol OR = 2.5, tobacco OR = 2.6, and other drugs OR = 2.3), having a mother who used drugs (OR= 2.2), sexual preference (female homosexual, OR = 2.2), and sex (male, OR = 2.1). CONCLUSIONS Boys are more likely to have had a first sexual experience than girls. Future strategies should incorporate specifically targeted elements with different messages that consider adolescents' sex and age. Barragán V, Berenzon S, Tiburcio M, et al. Factors Associated with Sexual Debut in Mexican Adolescents: Results of the National Survey on Drug Use among Students in 2014. J Sex Med 2019;16:418-426.
Collapse
Affiliation(s)
- Virginia Barragán
- Department of Psychiatry and Mental Health. School of Medicine, National Autonomous University of Mexico, Mexico City, Mexico
| | - Shoshana Berenzon
- Ramón de la Fuente Muñiz National Psychiatry Institute, Mexico City, Mexico
| | - Marcela Tiburcio
- Ramón de la Fuente Muñiz National Psychiatry Institute, Mexico City, Mexico
| | - Marycarmen Bustos
- Ramón de la Fuente Muñiz National Psychiatry Institute, Mexico City, Mexico
| | - Jorge Villatoro
- Ramón de la Fuente Muñiz National Psychiatry Institute, Mexico City, Mexico.
| |
Collapse
|
7
|
Deutsch AR. Dynamic Change Between Intimate Partner Violence and Contraceptive Use Over Time in Young Adult Men's and Women's Relationships. JOURNAL OF SEX RESEARCH 2019; 56:985-998. [PMID: 30156880 PMCID: PMC6395544 DOI: 10.1080/00224499.2018.1509291] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
The negative association between intimate partner violence (IPV) and contraceptive use is well established, but much of this research treats the association as static (e.g., similar across all relationships over development or time). Such studies do not account for individual development of sexual and romantic relationship mental, social, and behavioral well-being, which relate to contraceptive use. These studies are also predominantly woman-focused; such work could be complemented by examining men's associations. The current study examined how associations between sexual and physical IPV and consistent condom and birth control (BC) use changed across up to seven sequential relationships in young adulthood over a five-year period within a nationally representative sample. Results indicated that physical IPV-contraception associations were significant only across earliest or latest relationships. Sexual IPV-contraception associations were significant over more relationships but often changed in valence (negative to positive). There were few significant differences in these associations between men and women. Developmental context (e.g., prior relationship/IPV experience) may be important when considering IPV-contraception associations. In addition, although the IPV-contraception association does not appear to be a unique problem for women, research needs to explore how underlying mechanisms explaining this association may be a result of gendered and nongendered contexts.
Collapse
|
8
|
Stokes LR, Brody LR. Self-Silencing, but Not Sexual Relationship Power Associated with Condom Use for Black College-Aged Women. Behav Sci (Basel) 2019; 9:E13. [PMID: 30696006 PMCID: PMC6406997 DOI: 10.3390/bs9020013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Revised: 01/23/2019] [Accepted: 01/26/2019] [Indexed: 11/23/2022] Open
Abstract
Black adolescent and young adult women in the United States experience a disproportionately higher rate of HIV infections than White and Hispanic adolescent and young adult women. Heterosexual sexual activity is the main route of infection for women, regardless of race or ethnicity. We examined two potential barriers to reducing Black adolescent and young adult women's HIV risk: high levels of self-silencing and low levels of sexual relationship power. Data were collected on a small convenience sample of sexually active Black college-aged women (N = 57, Mage = 19.6, SD = 1.4) who answered questions about their current or most recent dating relationship. We found that higher levels of self-silencing were significantly related to lower condom use frequency and to a lower likelihood of reporting condom use at last sex. No significant associations were found between sexual relationship power and condom use (frequency or at last sex). Data from this study suggest that self-silencing, which involves putting the needs of others ahead of one's own in order to avoid conflict in relationships, is an important variable to consider when examining potential risk factors for sexually transmitted HIV among Black college-aged women. Implications for future studies on HIV risk are reviewed.
Collapse
Affiliation(s)
| | - Leslie R Brody
- Department of Psychological & Brain Sciences, Boston University, Boston, MA 02215, USA.
| |
Collapse
|
9
|
Maxwell L, Brahmbhatt H, Ndyanabo A, Wagman J, Nakigozi G, Kaufman JS, Nalugoda F, Serwadda D, Nandi A. The impact of intimate partner violence on women's contraceptive use: Evidence from the Rakai Community Cohort Study in Rakai, Uganda. Soc Sci Med 2018; 209:25-32. [DOI: 10.1016/j.socscimed.2018.04.050] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Revised: 04/23/2018] [Accepted: 04/27/2018] [Indexed: 10/17/2022]
|
10
|
Reese BM, Halpern CT. Attachment to Conventional Institutions and Adolescent Rapid Repeat Pregnancy: A Longitudinal National Study Among Adolescents in the United States. Matern Child Health J 2017; 21:58-67. [PMID: 27475827 PMCID: PMC5233596 DOI: 10.1007/s10995-016-2093-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Introduction There is limited research on rapid repeat pregnancies (RRP) among adolescents, especially using nationally representative samples. We examine distal factors-school, family, peers, and public/private religious ties-and their associations with RRP among adolescent mothers. Methods Guided by social development theory, we conducted multivariate logistic regression analyses, adjusted for sociodemographic characteristics, to examine associations between RRP and attachment to school, family, peers, and religion among 1158 female respondents from the National Longitudinal Study of Adolescent to Adult Health (Add Health) who reported at least one live birth before age 20. Results Attachments to conventional institutions were associated with lower likelihood of RRP. Adolescent mothers who had a stronger relationship with their parents had reduced odds of RRP (adjusted odds ratio [aOR] 0.83, 95 % CI 0.71-0.99). Increased odds of RRP were associated with anticipating fewer negative social consequences of sex (aOR 1.18, 95 % CI 1.02-1.35), never praying (versus praying daily; aOR 1.47, 95 % CI 1.10-1.96), and never participating in church-related youth activities (versus participating once a week; 1.04, 95 % CI 1.01-1.07). Discussion After an adolescent birth, social support from family, peers, and the community can benefit young mothers. Private aspects of religiosity may be especially important. Understanding the processes by which these distal factors are linked to the likelihood of RRP is needed to create multifaceted intervention programs that provide diverse methods of support customized to specific circumstances of adolescent mothers.
Collapse
Affiliation(s)
- Bianka M Reese
- Department of Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
- Carolina Population Center, 206 West Franklin St., Rm 208, Chapel Hill, NC, 27516, USA.
| | - Carolyn T Halpern
- Department of Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Carolina Population Center, 206 West Franklin St., Rm 208, Chapel Hill, NC, 27516, USA
| |
Collapse
|
11
|
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: 2.2] [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.
Collapse
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
| |
Collapse
|
12
|
Wang YC. Individual, interpersonal, and community predictors of consistent condom use among Taiwanese university students. AIDS Care 2015; 28:354-8. [PMID: 26477524 DOI: 10.1080/09540121.2015.1096892] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
This study examines the predictive value of individual, interpersonal, and community factors for consistent condom use among university students in Taiwan. The analytic sample for this cross-sectional study comprised 105 sexually active students, a subgroup of the respondents in a survey on university students in mid-Taiwan, with a mean age of 21, and 51.4% being female. The outcome variable was assessed as the proportion of times a condom was used in sex with steady sex partners. Risky sex appeared less related to having multiple sex partners (8.57%) than with inconsistent condom use (71.4%). Hierarchical regression analysis showed that 47.4% of variance in the outcome variable could be explained by AIDS knowledge, class adjustment, perception of good friends' condom use, and discussion of condom use with good friends. This study found that predictors across different levels may work in combination to influence students' condom use. Enhancing HIV/AIDS knowledge, improving class adjustment, facilitating peer norm of condom use may work in combination to increase students' condom use.
Collapse
Affiliation(s)
- Ya-Chien Wang
- a Department of Medical Sociology and Social Work , Chung Shan Medical University , Taichung City , Taiwan, R.O.C
| |
Collapse
|
13
|
Decker MR, Chung SE, Ellen JM, Sherman SG. Do young women engage in greater sexual risk behaviour with biological fathers of their children? Sex Transm Infect 2015; 92:276-8. [PMID: 26392630 DOI: 10.1136/sextrans-2015-052157] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2015] [Accepted: 08/31/2015] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES Qualitative research suggests that young women's relationships with the biological fathers of their children (BFRs), known colloquially as 'baby daddy' relationships, enable risk for pregnancy and STI/HIV. Our study compared partner characteristics and sexual risk within dyads based on BFR, among a sample of young women in Baltimore, Maryland, USA. METHODS We conducted secondary analysis of survey data collected in 2011-2013 from heterosexually experienced youth ages 15-24 in Baltimore, Maryland, USA. Analyses are limited to women with at least one recent (past 6 months) sex partner (n=171 participants, reporting on 271 relationships). Using generalised estimating equations with logit function for correlated binary responses, we evaluate associations of BFR with partner characteristics, sexual risk behaviour and contraceptive non-use. RESULTS At least one BFR partner was reported by 25.2%. Male partners in BFRs were more likely to have been incarcerated or arrested. BFRs were more often characterised by women as 'main' versus 'casual' partners (adjusted OR (AOR) 3.92, 95% CI 1.19 to 12.9). In adjusted analyses, BFR was associated with condom non-use for vaginal (AOR 12.3, 95% CI 3.92 to 38.7) and anal (AOR 3.32, 95% CI 1.34 to 8.22) intercourse. While BFR was associated with contraceptive non-use (AOR 2.21, 95% CI 1.01 to 4.84), this association attenuated to non-significance after adjusting for partnership type (AOR 2.06, 95% CI 0.91 to 4.67). CONCLUSIONS While few differences in BFR partner characteristics emerged, significantly greater risk for unprotected intercourse was identified within BFR relationships. Findings suggest that the relationship context of a shared child heightens sexual risk for the young women most affected by STI.
Collapse
Affiliation(s)
- Michele R Decker
- Department of Population, Family & Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Shang-En Chung
- Division of General Pediatrics and Adolescent Medicine, Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, Maryland, USA Center for Child and Community Health Research, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Jonathan M Ellen
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA All Childrens Hospital, Johns Hopkins Medicine, St Petersburg, Florida, USA
| | - Susan G Sherman
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| |
Collapse
|
14
|
Maxwell L, Devries K, Zionts D, Alhusen JL, Campbell J. Estimating the effect of intimate partner violence on women's use of contraception: a systematic review and meta-analysis. PLoS One 2015; 10:e0118234. [PMID: 25693056 PMCID: PMC4334227 DOI: 10.1371/journal.pone.0118234] [Citation(s) in RCA: 111] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2014] [Accepted: 01/09/2015] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Intimate partner violence (IPV) is an important global public health problem. While there is a growing literature on the association between IPV and women's reproductive health (RH) outcomes, most studies are cross-sectional-which weakens inference about the causal effect of IPV on women's RH. This systematic review synthesizes existing evidence from the strongest study designs to estimate the impact of IPV on women's use of contraception. METHODS We searched 11 electronic databases from January of 1980 to 3 December 2013 and reviewed reference lists from systematic reviews for studies examining IPV and contraceptive use. To be able to infer causality, we limited our review to studies that had longitudinal measures of either IPV or women's use of contraception. RESULTS Of the 1,574 articles identified by the search, we included 179 articles in the full text review and extracted data from 12 studies that met our inclusion criteria. We limited the meta-analysis to seven studies that could be classified as subject to low or moderate levels of bias. Women's experience of IPV was associated with a significant reduction in the odds of using contraception (n = 14,866; OR: 0.47; 95% CI: 0.25, 0.85; I2 = 92%; 95% CII2: 87%, 96%). Restricting to studies that measured the effect of IPV on women's use of partner dependent contraceptive methods was associated with a reduction in the heterogeneity of the overall estimate. In the three studies that examined women's likelihood of using male condoms with their partners, experience of IPV was associated with a significant decrease in condom use (OR: 0.48; 95% CIOR: 0.32, 0.72; I2 = 51%; 95% CII2: 0%, 86%). CONCLUSIONS IPV is associated with a reduction in women's use of contraception; women who experience IPV are less likely to report using condoms with their male partners. Family planning and HIV prevention programs should consider women's experiences of IPV.
Collapse
Affiliation(s)
- Lauren Maxwell
- Department of Epidemiology, Biostatistics, & Occupational Health, McGill University, Montréal, Québec, Canada
| | - Karen Devries
- Social and Mathematical Epidemiology Group and Gender Violence and Health Centre, Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Danielle Zionts
- Department of Epidemiology, Biostatistics, & Occupational Health, McGill University, Montréal, Québec, Canada
| | - Jeanne L. Alhusen
- Department of Community-Public Health, Johns Hopkins University School of Nursing, Baltimore, Maryland, United States of America
| | - Jacquelyn Campbell
- Department of Community-Public Health, Johns Hopkins University School of Nursing, Baltimore, Maryland, United States of America
| |
Collapse
|
15
|
|
16
|
Leerlooijer JN, Bos AER, Ruiter RAC, van Reeuwijk MAJ, Rijsdijk LE, Nshakira N, Kok G. Qualitative evaluation of the Teenage Mothers Project in Uganda: a community-based empowerment intervention for unmarried teenage mothers. BMC Public Health 2013; 13:816. [PMID: 24011141 PMCID: PMC3846560 DOI: 10.1186/1471-2458-13-816] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2013] [Accepted: 09/04/2013] [Indexed: 11/30/2022] Open
Abstract
Background A large proportion of unmarried teenage mothers in Uganda face physical, psychological, and social problems after pregnancy and childbirth, such as obstetric complications, lack of education, and stigmatisation in their communities. The Teenage Mothers Project (TMP) in Eastern Uganda empowers unmarried teenage mothers to cope with the consequences of early pregnancy and motherhood. Since 2000, 1036 unmarried teenage mothers, their parents, and community leaders participated in economic and social empowerment interventions. The present study explored the changes resulting from the TMP as well as factors that either enabled or inhibited these changes. Methods Semi-structured interviews (N = 23) were conducted with former teenage mothers , community leaders, and project implementers, and lifeline histories were obtained from former teenage mothers (N = 9). Quantitative monitoring data regarding demographic and social characteristics of teenage mother participants (N = 1036) were analysed. Results The findings suggest that, overall, the TMP seems to have contributed to the well-being of unmarried teenage mothers and to a supportive social environment. It appears that the project contributed to supportive community norms towards teenage mothers’ position and future opportunities, increased agency, improved coping with early motherhood and stigma, continued education, and increased income generation by teenage mothers. The study findings also suggest limited change in disapproving community norms regarding out-of-wedlock sex and pregnancy, late active enrolment of teenage mothers in the project (i.e., ten months after delivery of the child), and differences in the extent to which parents provided support. Conclusions It is concluded that strengths of the community-based TMP seem to be its socio-ecological approach, the participatory planning with community leaders and other stakeholders, counselling of parents and unmarried teenage mothers, and the emphasis on education and income generation. The project can improve by earlier active participation of unmarried pregnant adolescents and increased support for parents.
Collapse
Affiliation(s)
- Joanne N Leerlooijer
- Division of Human Nutrition, Wageningen University, Wageningen, The Netherlands.
| | | | | | | | | | | | | |
Collapse
|
17
|
Lewis DA, Martins SL, Gilliam ML. Partner roles in contraceptive use: what do adolescent mothers say? J Pediatr Adolesc Gynecol 2012; 25:396-400. [PMID: 23089574 PMCID: PMC3501542 DOI: 10.1016/j.jpag.2012.08.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2012] [Revised: 08/03/2012] [Accepted: 08/07/2012] [Indexed: 10/27/2022]
Abstract
STUDY OBJECTIVE To examine the role of sexual partners in adolescent mothers' use of non-coital dependent contraceptive methods in the postpartum period. DESIGN/SETTING/PARTICIPANTS 40 African American adolescent mothers completed surveys and qualitative interviews during the first postpartum year as part of a larger longitudinal study in Chicago, Illinois. Themes related to contraception and sexual partners were analyzed. MAIN OUTCOME MEASURES Adolescent mothers' reports of partners' roles in the use of non-coital dependent contraceptive methods (i.e., oral contraceptives, intrauterine contraception, and depot medroxyprogesterone acetate). RESULTS Partners largely supported the use of non-coital dependent contraceptive methods, yet mechanisms of support varied greatly, from advocating for specific methods to facilitating participants' continuation of their chosen method. Unsupportive partners either expressed concerns about the safety and side effects of specific methods or desired another child in the near future. Participants valued these preferences to different degrees when making their contraceptive decisions. CONCLUSIONS Partners of adolescent mothers play varying roles in postpartum contraceptive decisions. They thus have the potential both to inhibit and to facilitate the use of non-coital dependent contraception. Quantitative research is needed to further evaluate how partner attitudes and support behaviors, among other factors, affect contraceptive initiation and continuation among adolescent mothers.
Collapse
Affiliation(s)
- Dinah A Lewis
- Section of Family Planning and Contraceptive Research, Department of Obstetrics and Gynecology, The University of Chicago, IL 60637, USA
| | | | | |
Collapse
|
18
|
Sales JM, DiClemente RJ, Davis TP, Sullivan S. Exploring why young African American women do not change condom-use behavior following participation in an STI/HIV prevention intervention. HEALTH EDUCATION RESEARCH 2012; 27:1091-101. [PMID: 22641793 PMCID: PMC3498602 DOI: 10.1093/her/cys059] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/09/2011] [Accepted: 04/02/2012] [Indexed: 05/30/2023]
Abstract
Human immunodeficiency virus (HIV) interventions can significantly reduce risky sexual behaviors among vulnerable populations. However, not everyone exposed to an intervention will reduce their sexual risk behavior. This qualitative study sought to identify factors associated with young African American females' lack of increase in condom use post-participation in an HIV prevention intervention. Semi-structured interviews were conducted with 50 young African American women (18-23 years; approximately half were mothers) after participating in a demonstrated effective HIV prevention intervention; 24 did not increase condom use post-intervention. Interviews were thematically coded for barriers to condom-use post-intervention. Although nearly all young women reported partner-associated challenges to using condoms, there were relational differences observed among those who changed their condom use versus those who did not. Many 'non-changers' were engaged in non-stable 'on and off' relationships, with high rates of infidelity, often with the father of their child, in which they were fearful of requesting condom use. 'Non-changers' also reported more substance use, feeling incapable of change and not thinking about condom use. Thus, future HIV prevention efforts may benefit from incorporating strategies on how young mothers can maintain a non-sexual relationship with their child's father, as well as elaborating on the intersection of substance use and risky sexual decision-making.
Collapse
Affiliation(s)
- J M Sales
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health at Emory University, 1518 Clifton Road, NE Room 570, Atlanta, GA 30322, USA.
| | | | | | | |
Collapse
|
19
|
Bouris A, Guilamo-Ramos V, Cherry K, Dittus P, Michael S, Gloppen K. Preventing rapid repeat births among latina adolescents: the role of parents. Am J Public Health 2012; 102:1842-7. [PMID: 22897524 PMCID: PMC3490667 DOI: 10.2105/ajph.2011.300578] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/14/2011] [Indexed: 11/04/2022]
Abstract
Latina adolescent parents are at increased risk for rapid repeat births (second birth ≤ 24 months after the first), sexually transmitted infections, and negative educational and social outcomes. Although several effective parent-based interventions have been developed to prevent Latino youths' sexual risk taking, little research has explored the development of interventions to prevent repeat births that involve the parents of these adolescents. Existing preventative interventions involving parents suffer from important methodological limitations. Additional research is needed to advance theories of behavior, identify the causal pathways of parental influence, and specify appropriate behavioral targets. Future parent-based interventions to prevent repeat births should target pregnancy intentions, age of partners, contraceptive use, integrated prevention of pregnancies and sexually transmitted infections, educational attainment, and future orientations.
Collapse
Affiliation(s)
- Alida Bouris
- School of Social Service Administration, University of Chicago, IL 60637, USA.
| | | | | | | | | | | |
Collapse
|
20
|
Abstract
OBJECTIVE To determine whether the proximate context of gender-unequal norms about violence against women undermines women's ability to negotiate condom use in sexual relationships. DESIGN Secondary analysis of cross-sectional data pooled from 22 Demographic and Health Surveys conducted in sub-Saharan Africa. METHODS Each of the 22 surveys employed a multistage stratified design with probabilistic sampling and was designed to be nationally representative of reproductive-age women. The outcome was self-reported condom use at last sexual intercourse. The primary explanatory variable of interest was a scale consisting of five questions about whether the respondent agreed with the appropriateness of wife beating under five different scenarios. To measure the proximate context of norms about violence against women, this scale was aggregated to the level of the primary sampling unit. We fit logistic regression models with cluster-correlated robust standard errors and adjustment for country-level fixed effects and sociodemographic characteristics. RESULTS Our analysis sample included data from 198,806 sexually active women living in 22 sub-Saharan African countries. The wife-beating scale was internally consistent (Cronbach's α = 0.84), and factor analysis confirmed the presence of a single factor. Condom use was associated with gender-unequal contextual norms about violence against women (adjusted odds ratio = 0.88; 95% confidence interval, 0.85-0.92; P < 0.001). The estimated association was robust to adjustment for sociodemographic characteristics and several sensitivity analyses. CONCLUSIONS The proximate context of gender-unequal norms about violence against women is associated with lack of condom use among women in sub-Saharan Africa.
Collapse
Affiliation(s)
- Alexander C Tsai
- Robert Wood Johnson Health and Society Scholars Program, Harvard University, Cambridge, Massachusetts, USA.
| | | |
Collapse
|
21
|
Hahm HC, Lee J, Rough K, Strathdee SA. Gender power control, sexual experiences, safer sex practices, and potential HIV risk behaviors among young Asian-American women. AIDS Behav 2012; 16:179-88. [PMID: 21259042 PMCID: PMC3389795 DOI: 10.1007/s10461-011-9885-2] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
We examined the prevalence of three domains of sexual behaviors among young Asian-American women: sexual experiences, safer sex practices, and potential HIV risk behaviors. We also investigated the impact of gender power control on these domains. Among sexually experienced women, 51% reported using condoms during their most recent sex act, 63% reported inconsistent condom use, and 18% reported ever having forced sex. Multiple logistic regression analyses revealed that women's perceived lower relationship power control was not associated with vaginal sex or safer sex practices, but it was powerfully associated with forced sex and all three potential HIV risk behaviors. This study demonstrates that control within young Asian-American women's intimate relationships exerts different associations depending on the type of sexual behavior. The application of the Theory of Gender and Power should be employed with prudence when designing HIV interventions for this population.
Collapse
Affiliation(s)
- Hyeouk Chris Hahm
- School of Social Work, Boston University, 264 Bay State Road, Boston, MA 02215, USA,
| | - Jieha Lee
- Department of Social Welfare, Soongsil University, 511 Sangdo-dong, Donjak-Gu, Seoul, South Korea,
| | - Kathryn Rough
- Department of Health Sciences, Boston University, 635 Commonwealth Avenue, Boston, MA 02215, USA,
| | - Steffanie A. Strathdee
- Division of Global Public Health, Department of Medicine, University of California, San Diego, Institute of the Americas 10111 N. Torrey Pines Rd., La Jolla, CA 92093-0507, USA,
| |
Collapse
|
22
|
Hensel DJ, Fortenberry JD. Adolescent mothers' sexual, contraceptive, and emotional relationship content with the fathers of their children following a first diagnosis of sexually transmitted infection. J Adolesc Health 2011; 49:327-9. [PMID: 21856528 PMCID: PMC3752998 DOI: 10.1016/j.jadohealth.2010.12.020] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2010] [Revised: 12/18/2010] [Accepted: 12/21/2010] [Indexed: 10/18/2022]
Abstract
PURPOSE A sexually transmitted infection (STI) diagnosis may profoundly change the meaning of adolescent women's relationships, particularly when the relationship involves a shared child. This study explored the sexual, contraceptive, and emotional characteristics of sexual partners with whom adolescent women had and did not have children in the 3 months after the first STI diagnosis. METHODS Adolescent women (n = 387; age: 14-17 years at enrollment) were tested quarterly for STI and completed partner-specific items on emotional and sexual relationship content. We used nonparametric statistics (SPSS/18.0) to compare these characteristics between partners with whom these adolescent women did (n = 20) or did not (n = 118) share a child. RESULTS Rates of condom use at last sex, overall condom use, and condom insistence were lower with sexual partners involving shared children as compared with childless sexual partners. Relationship status, commitment to partner, and using no method of contraception were more common in parous sexual relationships as compared with nulliparous sexual relationships after an STI. CONCLUSIONS After an STI, adolescent women have different sexual risk behaviors with the fathers of their children, even after a signal event such as a recent STI diagnosis. Tailored counseling may specifically address the challenges of STI prevention with partners who have the unique status of being the "father of the baby."
Collapse
Affiliation(s)
- Devon J. Hensel
- Address correspondence to: Devon J. Hensel, Ph.D., 410 W. 10th Street, Room 1001, Indianapolis, IN 46202.
| | | |
Collapse
|
23
|
Araújo Pedrosa A, Pires R, Carvalho P, Canavarro MC, Dattilio F. Ecological Contexts in Adolescent Pregnancy: The Role of Individual, Sociodemographic, Familial and Relational Variables in Understanding Risk of Occurrence and Adjustment Patterns. CONTEMPORARY FAMILY THERAPY 2011. [DOI: 10.1007/s10591-011-9148-4] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|