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Walden J, Stanek JR, Ebersole AM, Nahata L, Creary SE. Sexually transmitted infection testing and diagnosis in adolescents and young adults with sickle cell disease. Pediatr Blood Cancer 2024; 71:e31240. [PMID: 39099153 DOI: 10.1002/pbc.31240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2024] [Revised: 06/29/2024] [Accepted: 07/19/2024] [Indexed: 08/06/2024]
Abstract
BACKGROUND Sexually transmitted infections (STIs) are common and disproportionately affect Black adolescents and young adults (AYAs). Less is known about STIs among Black AYAs with chronic conditions, such as sickle cell disease (AYAs-SCD). This study compared STI testing and diagnosis between AYAs-SCD and their peers, overall and among STI-related encounters. PROCEDURE This retrospective, cross-sectional study used diagnosis and billing codes in the Pediatric Health Information System (PHIS) to identify inpatient and emergency department encounters from January 1, 2022 to May 31, 2023 among all AYAs 15-24 years and those with STI-related diagnoses (e.g., "cystitis"). STI testing and diagnosis rates were compared between AYAs-SCD, non-Black AYAs, and Black AYAs, controlling for age, sex, and encounter setting. RESULTS We identified 3602 AYAs-SCD, 177,783 Black AYAs, and 534,495 non-Black AYAs. AYAs-SCD were less likely to be tested for STIs than non-Black AYAs (odds ratio [OR] = 0.26; adj. p < .001) and Black AYAs (OR = 0.53; adj. p < .001). When tested, AYAs-SCD were more likely to be diagnosed with an STI than non-Black AYAs (OR = 2.39; adj. p = .006) and as likely as Black AYAs (OR = 0.67; adj. p = .15). Among STI-related encounters, AYAs-SCD were less likely to be tested than non-Black AYAs (OR = 0.18; adj. p < .001) and Black AYAs (OR = 0.44; adj. p < .001). No significant differences in STI diagnoses were found in this subset between AYAs-SCD and non-Black AYAs (OR = 0.32; adj. p = .28) or Black AYAs (OR = 1.07; adj. p = .99). CONCLUSIONS STI care gaps may disproportionately affect AYAs-SCD. STIs should be considered when evaluating symptomatic AYAs-SCD in acute settings. More research is needed to further contextualize STI care for AYAs-SCD.
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Affiliation(s)
- Joseph Walden
- Abigail Wexner Research Institute, Center for Child Health Equity and Outcomes Research, Columbus, Ohio, USA
| | - Joseph R Stanek
- Division of Hematology/Oncology/BMT, Department of Pediatrics, Nationwide Children's Hospital, Columbus, Ohio, USA
| | - Ashley M Ebersole
- Division of Adolescent Medicine, Department of Pediatrics, Nationwide Children's Hospital, Columbus, Ohio, USA
| | - Leena Nahata
- Abigail Wexner Research Institute, Center for Biobehavioral Health, Columbus, Ohio, USA
- Division of Endocrinology, Department of Pediatrics, Nationwide Children's Hospital, Columbus, Ohio, USA
| | - Susan E Creary
- Abigail Wexner Research Institute, Center for Child Health Equity and Outcomes Research, Columbus, Ohio, USA
- Division of Hematology/Oncology/BMT, Department of Pediatrics, Nationwide Children's Hospital, Columbus, Ohio, USA
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Currenti S, O'Grady T, Bomma S, Gurram N, Miranda W, Hart-Malloy R. Epidemiology of Chlamydia trachomatis and Repeat Positivity Following Detection in New York State. JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2024; 30:E215-E223. [PMID: 39041774 DOI: 10.1097/phh.0000000000002022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/24/2024]
Abstract
BACKGROUND In New York State, excluding New York City, chlamydia remains a persistent health concern. Our aim was to characterize chlamydia epidemiology and identify groups at higher risk of repeat positivity to inform targeted public health interventions. METHODS We analyzed demographic and clinical data of laboratory-confirmed chlamydia cases in New York State from 2015 to 2019. Repeat positivity was defined as a second positive chlamydia test within 31 to 365 days of the initial positive test. We compared characteristics of individuals with single and repeat positivity and evaluated associations with repeat positivity using multivariable logistic regression models. RESULTS During the study period, 176 273 individuals were diagnosed with chlamydia, with 17 253 experiencing repeat positivity. Repeat positivity was more common among individuals assigned female at birth. Key predictors of repeat positivity among females included non-Hispanic Black (adjusted odds ratio [aOR]: 1.33; 95% confidence interval [CI], 1.27-1.40) race/ethnicity, ages 13 to 19 (aOR: 1.62; 95% CI, 1.55-1.69), prior sexually transmitted infection (STI) diagnosis (aOR: 1.24; 95% CI, 1.18-1.31), symptomatic examination (aOR: 1.07; 95% CI, 1.02-1.13), and county/community (aOR: 1.10; 95% CI, 1.05-1.15) or private/public (aOR: 1.18; 95% CI, 1.11-1.25) provider. Among males, predictors included non-Hispanic Black (aOR: 1.57; 95% CI, 1.45-1.70) race/ethnicity, ages 13 to 19 (aOR: 1.27; 95% CI, 1.17-1.38), HIV coinfection (aOR: 1.30; 95% CI, 1.10-1.54), prior STI diagnosis (aOR: 1.31; 95% CI, 1.20-1.43), extragenital infection site (aOR: 2.59; 95% CI, 2.27-2.95), symptomatic examination (aOR: 1.21; 95% CI, 1.12-1.31), and county/community health (aOR: 1.09; 95% CI, 1.02-1.17) provider. CONCLUSIONS Our findings provide valuable insights for sexual health interventions to prevent chlamydia transmission and recurrence. Prioritizing resources for prevention interventions and tailored sexual health promotion among non-Hispanic Black individuals is crucial. Additionally, targeted STI prevention efforts are needed for males who have sex with men and those initially diagnosed with extragenital infection. Research is warranted on STI prevention among people living with HIV or at high risk of HIV infection. Strengthening prevention strategies through Expedited Partner Therapy and sexual health education for individuals at risk of repeat positivity could enhance prevention efforts.
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Affiliation(s)
- Salvatore Currenti
- AIDS Institute, New York State Department of Health, Albany, New York (Mrs Currenti, Bomma, and Miranda, and Drs O'Grady, Gurram, and Hart-Malloy); Department of Epidemiology and Biostatistics, School of Public Health, University at Albany, Albany, New York (Drs O'Grady and Hart-Malloy); Center for Collaborative HIV Research in Practice and Policy, School of Public Health, University at Albany, Albany, New York (Dr Hart-Malloy); and Bureau of Surveillance and Data Systems, New York State Department of Health, Albany, New York (Dr Gurram)
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Cipres DT, Whitley MY, Ward VL. Racial and Ethnic Equity, Diversity, and Inclusion in Pediatric and Adolescent Gynecology: A Call to Action from a North American Perspective. J Pediatr Adolesc Gynecol 2024:S1083-3188(24)00262-6. [PMID: 39103117 DOI: 10.1016/j.jpag.2024.07.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2024] [Revised: 07/30/2024] [Accepted: 07/31/2024] [Indexed: 08/07/2024]
Affiliation(s)
- Danielle T Cipres
- Division of Gynecology, Department of Surgery, Boston Children's Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts.
| | - Melicia Y Whitley
- Sandra L. Fenwick Institute for Pediatric Health Equity and Inclusion, Boston Children's Hospital, Boston, Massachusetts
| | - Valerie L Ward
- Harvard Medical School, Boston, Massachusetts; Sandra L. Fenwick Institute for Pediatric Health Equity and Inclusion, Boston Children's Hospital, Boston, Massachusetts; Department of Radiology, Boston Children's Hospital, Boston, Massachusetts; Office of Health Equity and Inclusion, Boston Children's Hospital, Boston, Massachusetts
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Mancilla V, Jimenez NR, Bishop NS, Flores M, Herbst-Kralovetz MM. The Vaginal Microbiota, Human Papillomavirus Infection, and Cervical Carcinogenesis: A Systematic Review in the Latina Population. J Epidemiol Glob Health 2024; 14:480-497. [PMID: 38407720 PMCID: PMC11176136 DOI: 10.1007/s44197-024-00201-z] [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: 08/18/2023] [Accepted: 01/24/2024] [Indexed: 02/27/2024] Open
Abstract
BACKGROUND Latina women experience disproportionately higher rates of HPV infection, persistence, and progression to cervical dysplasia and cancer compared to other racial-ethnic groups. This systematic review explores the relationship between the cervicovaginal microbiome and human papillomavirus infection, cervical dysplasia, and cervical cancer in Latinas. METHODS The review abides by the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. PubMed, EMBASE, and Scopus databases were searched from January 2000 through November 11, 2022. The review included observational studies reporting on the cervicovaginal microbiota in premenopausal Latina women with human papillomavirus infection, cervical dysplasia, and cervical cancer. RESULTS Twenty-five articles were eligible for final inclusion (N = 131,183). Forty-two unique bacteria were reported in the cervicovaginal microbiome of Latinas. Seven bacteria: Lactobacillus crispatus, Lactobacillus iners, Chlamydia trachomatis, Prevotella spp., Prevotella amnii, Fusobacterium spp. and Sneathia spp. were enriched across multiple stages of cervical carcinogenesis in Latinas. Therefore, the total number of reported bacteria includes four bacteria associated with the healthy state, 16 bacteria enriched in human papillomavirus outcomes, 24 unique bacteria associated with abnormal cytology/dysplasia, and five bacteria associated with cervical cancer. Furthermore, three studies reported significantly higher alpha and beta diversity in Latinas with cervical dysplasia and cancer compared to controls. Lactobacillus depletion and an increased abundance of L. iners in Latinas compared to non-Latinas, regardless of human papillomavirus status or lesions, were observed. CONCLUSIONS The identification of 42 unique bacteria and their enrichment in cervical carcinogenesis can guide future cervicovaginal microbiome research to better inform cervical cancer prevention strategies in Latinas.
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Affiliation(s)
- Vianney Mancilla
- Department of Basic Medical Sciences, University of Arizona College of Medicine-Phoenix, 425 N. 5th Street, Phoenix, AZ, 85004-2157, USA
| | - Nicole R Jimenez
- Department of Obstetrics and Gynecology, University of Arizona College of Medicine-Phoenix, 425 N. 5th Street, Phoenix, AZ, 85004-2157, USA
| | - Naomi S Bishop
- Associate Librarian, University of Arizona Health Sciences, University of Arizona College of Medicine-Phoenix, 475 N. 5th Street, Phoenix, AZ, 85004, USA
| | - Melissa Flores
- Department of Psychology, University of Arizona, 1200 E University Boulevard, Tucson, AZ, 85721, USA
| | - Melissa M Herbst-Kralovetz
- Department of Basic Medical Sciences, University of Arizona College of Medicine-Phoenix, 425 N. 5th Street, Phoenix, AZ, 85004-2157, USA.
- Department of Obstetrics and Gynecology, University of Arizona College of Medicine-Phoenix, 425 N. 5th Street, Phoenix, AZ, 85004-2157, USA.
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Ross C, Smith JG, Gawel M, Walters TL, Song Y, Cong X, Shook NJ. "They're scared that somebody's gonna judge them": Female African American youth in foster care's perspectives on sexual and reproductive health communication with caregivers. J Pediatr Nurs 2024; 75:8-15. [PMID: 38091927 DOI: 10.1016/j.pedn.2023.11.024] [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: 01/15/2023] [Revised: 11/20/2023] [Accepted: 11/23/2023] [Indexed: 03/08/2024]
Abstract
BACKGROUND Obtaining accurate information is critical for youth's sexual and reproductive health (SRH). Youth not in foster care often learn about SRH from their biological parents. Separated from their biological parents, youth in care depend on healthcare providers and caregivers for SRH information. However, they often receive insufficient information and feel unsupported in meeting their needs for SRH information. PURPOSE This study explored female African American adolescents in foster care's perspectives on effective SRH communication with caregivers to help them avoid sexual risks. METHODS A qualitative study was conducted using semi-structured interviews. We used purposive sampling to recruit 16 adolescents aged 18 to 20 years old with a history of foster care placement. The transcribed interviews underwent inductive thematic analysis. The Positive Youth Development theory underpinned this research. RESULTS Two prominent themes emerged: establishing a relationship and preferred communication approach. Youth reported that for caregivers to engage in effective SRH communication, they must first establish a relationship by being aware of the youth's childhood trauma, building trust, having patience, and being vulnerable. Youth also appreciated caregivers who ensured comfortability and were honest and straightforward. DISCUSSION Caregivers should be trained on adverse childhood experiences, trauma-informed approaches, SRH knowledge, and communication. IMPLICATIONS TO PRACTICE Healthcare providers should make use of the time spent with youth and discuss SRH topics during clinical encounters. This time spent with youth may be their only chance to obtain accurate SRH information. Youth's perspectives regarding communication about SRH should be implemented in future SRH communication interventions.
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Affiliation(s)
- Christina Ross
- University of Connecticut, School of Nursing, 231 Glenbrook Rd., Storrs, CT 06269, USA.
| | - Jessica G Smith
- University of Virginia, Department of Psychology, 485 McCormick Road, Gilmer Hall, Room 102, Charlottesville, VA 22903, USA.
| | - Marcie Gawel
- University of Connecticut, School of Nursing, 231 Glenbrook Rd., Storrs, CT 06269, USA.
| | - Tracy L Walters
- University of Connecticut, Department of Human Development and Family Sciences, 348 Mansfield Road, U-1058, Storrs, CT 06269, USA.
| | - Yutong Song
- University of Connecticut, School of Nursing, 231 Glenbrook Rd., Storrs, CT 06269, USA.
| | - Xiaomei Cong
- University of Connecticut, School of Nursing, 231 Glenbrook Rd., Storrs, CT 06269, USA.
| | - Natalie J Shook
- University of Connecticut, School of Nursing, 231 Glenbrook Rd., Storrs, CT 06269, USA.
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Baxter SLK, Hopper LN, Spinner C. Correlates of Sexual Behavior Across Fatherhood Status: Finding From the National Longitudinal Study of Adolescent to Adult Health (Add Health), 2016-2018. Am J Mens Health 2024; 18:15579883241239770. [PMID: 38545885 PMCID: PMC10981246 DOI: 10.1177/15579883241239770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Revised: 05/16/2023] [Accepted: 02/27/2024] [Indexed: 04/01/2024] Open
Abstract
Amid national trends in postponed parenthood and more diverse family structures, the fatherhood identity may be important to men's sexual behaviors. This study examined factors associated with reports of consistent contraceptive use and multiple sexual partners across fatherhood status. Using public data from the National Longitudinal Study of Adolescent to Adult Health (Add Health), Wave V (2016-2018), two sexual behaviors were examined among 1,163 men aged 32 to 42 years. Outcomes were two binary indicators: consistent contraceptive use with partner and having multiple (≥2) sexual partners in the past year. Fatherhood status was categorized as nonfather, resident father, and nonresident father. Demographic (e.g., race/ethnicity, education, income, and relationship type) and health-related (e.g., drinking, perceived stress, depressive symptoms, and insurance status) factors were considered. Logistic regression analysis produced odds ratios and 95% confidence intervals and were stratified by fatherhood categories. In the sample, 72% of men were resident fathers, 10% were nonresident fathers, and 18% were nonfathers; 28% reported consistent contraceptive use and 16% reported multiple sexual partners. For nonfathers, relationship type and race were associated with reporting multiple sexual partners. For resident fathers, relationship type was the crucial factor associated with consistent contraceptive use and reporting multiple sexual partners. In nonresident fathers, relationship type, education, and income were important factors to consistent contraceptive use and reporting multiple sexual partners. Key findings suggest that relationship type, income, and education are crucial factors to men's sexual behavior. Heterogeneous effects were observed across fatherhood status. This study adds to limited research on fatherhood and sexual behavior among men transitioning from young adulthood to middle age.
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Affiliation(s)
- Samuel L. K. Baxter
- Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Lorenzo N. Hopper
- Department of Public Health Sciences, College of Health and Human Sciences, University of North Carolina at Charlotte, Charlotte, NC, USA
| | - Chelse Spinner
- Department of Public Health Sciences, College of Health and Human Sciences, University of North Carolina at Charlotte, Charlotte, NC, USA
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Muschialli L, Samartsidis P, Presanis AM, Mercer CH. Examining changes in sexual lifestyles in Britain between 1990-2010: a latent class analysis approach. BMC Public Health 2024; 24:366. [PMID: 38310277 PMCID: PMC10837868 DOI: 10.1186/s12889-024-17850-1] [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: 07/17/2023] [Accepted: 01/23/2024] [Indexed: 02/05/2024] Open
Abstract
BACKGROUND Understanding sexual lifestyles and how they change over time is important for determining the likelihood of sexual health outcomes. Standard descriptive and regression methods are limited in their ability to capture multidimensional concepts such as sexual lifestyles. Latent Class Analysis (LCA) is a mixture modelling method that generates a categorical latent variable to derive homogenous groups from a heterogeneous population. Our study investigates (1) the potential of LCA to assess change over time in sexual lifestyles and (2) how quantifying this change using LCA compares to previous findings using standard approaches. METHODS Probability-sampled data from three rounds of the National Survey of Sexual Attitudes and Lifestyle (Natsal) were used, restricted to sexually active participants (i.e., those reporting sexual partners in the past year) aged 16-44 years (N1990 = 11,738; N2000 = 9,690; N2010 = 8,397). An LCA model was built from four variables: number of sexual partners (past year), number of partners without a condom (past year), age at first sex and self-perceived HIV risk. Covariates included age, ethnicity, educational attainment, same-sex attraction, and marital status. Multinomial regression analyses and Chi-Squared tests were used to investigate change over time in the size of each class. RESULTS We successfully used a LCA approach to examine change in sexual lifestyle over time. We observed a statistically significant increase between 1990 and 2010 in the proportion of men (χ2 = 739.49, p < 0.01) and women (χ2 = 1270.43, p < 0.01) in a latent class associated with reporting 2 or more partners in the last year, relatively high probabilities of reporting condomless sex partners, greater self-perceived HIV risk, and a high probability of first sex before age 16 years, increasing from 19.5% to 31.1% (men) and 9.9% to 22.1% (women). CONCLUSION Our results indicate the viability of LCA models to assess change over time for complex behavioural phenomena. They align with previous findings, namely changing sexual lifestyles in Britain in recent decades, partnership number driving class assignment, and significant sex differences in sexual lifestyles. This approach can be used to extend previous LCA models (e.g., to investigate the impact of COVID-19 on sexual lifestyles) and to support empirical evidence of change over time, facilitating more nuanced public health policy.
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Affiliation(s)
- Luke Muschialli
- UCL Medical School, Faculty of Medical Sciences, University College London, London, UK.
| | - Pantelis Samartsidis
- Medical Research Council Biostatistics Unit, School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - Anne M Presanis
- Medical Research Council Biostatistics Unit, School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - Catherine H Mercer
- Centre for Population Research in Sexual Health and HIV, Institute for Global Health, University College London, London, UK
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Williams C, Skrip LA, Adams AS, Vermund SH. Examining County-Level Associations between Federally Qualified Health Centers and Sexually Transmitted Infections: A Political Ecology of Health Framework. Healthcare (Basel) 2024; 12:295. [PMID: 38338180 PMCID: PMC10855137 DOI: 10.3390/healthcare12030295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 01/06/2024] [Accepted: 01/12/2024] [Indexed: 02/12/2024] Open
Abstract
Federally Qualified Health Centers (FQHCs) are the largest providers of healthcare for sexually transmitted infections (STIs) in medically underserved communities in the United States (US). Through the Affordable Care Act (ACA), FQHCs have grown in number, but the impact of this growth on STIs is poorly understood. This ecological study seeks to quantify the association between FQHCs and STI prevalence in all US counties. Variables were described utilizing medians and interquartile ranges, and distributions were compared using Kruskal-Wallis tests. Median rates of chlamydia in counties with high, low, and no FQHCs were 370.3, 422.6, and 242.1 cases per 100,000 population, respectively. Gonorrhea rates were 101.9, 119.7, and 49.9 cases per 100,000 population, respectively. Multivariable linear regression models, adjusted for structural and place-based characteristics (i.e., Medicaid expansion, social vulnerability, metropolitan status, and region), were used to examine county-level associations between FQHCs and STIs. Compared to counties with no FQHCs, counties with a high number of FQHCs had chlamydia rates that were an average of 68.6 per 100,000 population higher (β = 68.6, 95% CI: 45.0, 92.3) and gonorrhea rates that were an average of 25.2 per 100,000 population higher (β = 25.2, 95% CI: 13.2, 37.2). When controlled for salient factors associated with STI risks, greater FQHC availability was associated with greater diagnosis and treatment of STIs. These findings provide empirical support for the utility of a political ecology of health framework and the critical role of FQHCs in confronting the STI epidemic in the US.
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Affiliation(s)
- Christopher Williams
- School of Natural and Social Sciences, State University of New York at Purchase College, Purchase, NY 10577, USA
| | - Laura A. Skrip
- School of Public Health, College of Health Sciences, University of Liberia, Monrovia 1000-10, Liberia;
- Quantitative-Data for Decision-Making Lab, Monrovia 1000-10, Liberia
| | | | - Sten H. Vermund
- School of Public Health, Yale University, New Haven, CT 06510, USA;
- School of Medicine, Yale University, New Haven, CT 06510, USA
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Rahman T, Rogers CJ, Albers LD, Forster M, Unger JB. Adverse Childhood Experiences, Acculturation, and Risky Sexual Behaviors in Hispanic Young Adults: Findings from Project RED. JOURNAL OF SEX RESEARCH 2024; 61:105-118. [PMID: 36877805 PMCID: PMC10480355 DOI: 10.1080/00224499.2023.2184762] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
While adverse childhood experiences (ACE) are well-documented predictors of maladaptive behaviors in adulthood, including risky sexual behaviors (RSB), the influence of acculturation in this association remains unknown. Although Hispanics are a rapidly growing population in the United States and are disproportionately affected by adverse sexual health outcomes, there is a paucity of research examining the interplay of ACE, acculturation, and RSB in this population. We observed the ACE-RSB association and how this relationship varies across U.S. and Hispanic acculturation levels, in a sample of Hispanic young adults (n = 715). Data for this study were from Project RED, a longitudinal study of Hispanic health. We ran regression models to test associations between ACE (0, 1-3, 4+) and several RSB (e.g., early sexual initiation (≤14 years), condomless sex, lifetime sexual partners, and alcohol/drug use before intercourse), and assessed moderation by U.S./Hispanic acculturation. Compared with those without ACE, individuals with 4 + ACE had higher odds of early sexual initiation (AOR: 2.23), alcohol/drug use before last intercourse (AOR: 2.31), and condomless sex (AOR: 1.66), as well as a higher number of lifetime sexual partners (β: 0.60). For those reporting 4 + ACE, high U.S. acculturation was protective in the association between ACE and using alcohol/drugs before intercourse. Future research implications are discussed.
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Affiliation(s)
- Tahsin Rahman
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, United States
| | - Christopher J. Rogers
- Department of Health Sciences, California State University, Northridge, Los Angeles, United States
| | - Larisa D. Albers
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, United States
| | - Myriam Forster
- Department of Health Sciences, California State University, Northridge, Los Angeles, United States
| | - Jennifer B. Unger
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, United States
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Schwarz SB, Nydegger L, Hill MJ. Hard-to-Reach or Hardly Reached? The "Difficulty" of Engaging Cisgender Black Females in Sexual Health Research. J Racial Ethn Health Disparities 2023; 10:2615-2619. [PMID: 37831365 DOI: 10.1007/s40615-023-01825-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Revised: 08/10/2023] [Accepted: 09/29/2023] [Indexed: 10/14/2023]
Abstract
Rather than placing the onus on stigmatized and disenfranchised communities as hard-to-reach in sexual health research, we challenge researchers to recognize and provide outreach to populations who are hardly reached, such as cisgender Black women. We posit that the disparate human immunodeficiency virus (HIV) and sexually transmitted infection (STI) rates experienced by Black women in the USA are due in part to social and structural inequities and lack of researcher outreach within these communities. Social inequities give rise to racial and gender discrimination, which often results in structural barriers that researchers may not acknowledge. Structural barriers include medical mistrust and lack of access to preventative sexual health services, health care, education, and other resources. To achieve health equity, researchers must engage with Black women to understand the unique struggles they face and intervene with non-stigmatizing, culturally appropriate interventions. Interventions must utilize gatekeepers, influencers, community organizations, community advisory boards, and peer support. It is critical that sexual health researchers reach out to those who do not fall under the traditional hard-to-reach category but are hardly reached to counteract the current projection that 1 in 32 Black women will be diagnosed with HIV in their lifetime.
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Affiliation(s)
- Sarah B Schwarz
- Department of Kinesiology & Health Education, College of Education, University of Texas at Austin, 1717 W 6th St Ste 335, Austin, TX, 78703, USA.
| | - Liesl Nydegger
- Department of Health, Behavior & Society, Johns Hopkins Bloomberg School of Public Health, Hampton House, 624 N Broadway, Baltimore, MD, 21205, USA
| | - Mandy J Hill
- Department of Emergency Medicine, Texas Emergency Medicine Research Center, Population Health in Emergency Medicine Section, McGovern Medical School, University of Texas Health Science Center at Houston (UTHealth Houston), 6431 Fannin JJL 475G, Houston, TX, 77030, USA
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Ellis RA, Orcutt HK. The Indirect Effect of Avoidant Motives for Sex on the Pathways From Childhood Maltreatment to Risky Sex Behaviors. JOURNAL OF INTERPERSONAL VIOLENCE 2023; 38:11337-11355. [PMID: 37381819 DOI: 10.1177/08862605231179726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/30/2023]
Abstract
Literature supports a strong link between engagement in risky sex and childhood maltreatment, with engagement in risky sexual behavior proposed as a manifestation of avoidant coping. Sex motives refer to underlying motivations for engaging in sex such as increased intimacy, or peer pressure. Limited research has examined the role of sex motives on the relationship between childhood maltreatment and risky sex. This study sought to examine this path between childhood maltreatment types and later engagement in risky sex through sex motivations that seek to avoid or reduce negative affect (i.e., sex to cope and sex to affirm self-esteem). A sample of sexually active undergraduate women (n = 551) completed a series of questionnaires on childhood maltreatment, risky sexual behavior, and motivations for sexual intercourse as part of a larger parent study on revictimization. Path analysis was conducted to examine differential indirect effects of childhood maltreatment on risky sex (i.e., sex with a stranger and hookup behaviors). Results suggested sex to cope with negative affect mediated the relationship between emotional abuse, sexual abuse, physical neglect, and hookup behavior. Only an indirect path between childhood emotional abuse and sex with a stranger was identified through sex to cope. Emotional abuse was the only maltreatment to predict sex to affirm, but sex to affirm did not predict risky sex outcomes. Findings provide support for differential pathways from various forms of childhood maltreatment, specifically sexual abuse, emotional abuse, and physical neglect, to increased risky sex as a manifestation of avoidant coping. Furthermore, results support the call for more inclusion of nonsexual forms of childhood maltreatment in studies of risky sex and avoidant coping as a potential intervention target for risky sexual behavior regardless of childhood maltreatment type.
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Affiliation(s)
- Robyn A Ellis
- McLean Hospital, Belmont, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
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12
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Gupta K, Wiener HW, Tiwari HK, Geisler WM. HLA-DQB1*06 and Select Neighboring HLA Variants Predict Chlamydia Reinfection Risk. Int J Mol Sci 2023; 24:15803. [PMID: 37958786 PMCID: PMC10647357 DOI: 10.3390/ijms242115803] [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: 09/21/2023] [Revised: 10/25/2023] [Accepted: 10/27/2023] [Indexed: 11/15/2023] Open
Abstract
Associations of HLA class II alleles with genital chlamydial infection outcomes have been reported, especially HLA DQB1*06. However, the potential role of DQB1*06 in influencing reinfection risk has still not been established. The purpose of this study was to determine whether the association of DQB1*06 with chlamydia reinfection was impacted by any other nearby HLA class II variants that were also associated with reinfection. We used next-generation sequencing to map HLA class II variants spanning the HLA-DQ and -DR loci. DQB1*06 as well as DQB1*04 were confirmed as significant predictors of chlamydia reinfection, when controlling for age and percent African ancestry. SKAT analysis revealed one region each in DRB1, DRB5, DQA2, and three intergenic regions that had variants associated with reinfection. Further analyses of these variants revealed that rs112651494 within DRB5 and an intergenic SNP rs617058 in DRB1:DQA1 were significantly associated with reinfection, but this did not impact the significance of the association of DQB1*06 or DQB1*04 with reinfection.
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Affiliation(s)
- Kanupriya Gupta
- Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL 35294, USA;
| | - Howard W. Wiener
- Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL 35294, USA;
| | - Hemant K. Tiwari
- Department of Biostatistics, University of Alabama at Birmingham, Birmingham, AL 35294, USA;
| | - William M. Geisler
- Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL 35294, USA;
- Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL 35294, USA;
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13
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Trub LR, Stewart JL, Lomidze A, Lopez E, Starks TJ. Young Adult Women and Sexual Awareness in the Digital Age: Examining Pathways Linking Online Dating Debut and Mindfulness with Sexual and Mental Health. ARCHIVES OF SEXUAL BEHAVIOR 2023; 52:2859-2877. [PMID: 37726556 DOI: 10.1007/s10508-023-02692-6] [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: 08/31/2022] [Revised: 07/28/2023] [Accepted: 08/22/2023] [Indexed: 09/21/2023]
Abstract
Sexual awareness is an understudied phenomenon, despite its known effects on mental health. Little is known about the predictors of sexual awareness, including how early sexual debut and early engagement with online dating and hookup apps might impact the development of sexual mindfulness. Given the conceptual overlap between mindfulness and sexual awareness, this study tested a model that hypothesized that general mindfulness and early sexual and online dating debuts may be associated with mental health outcomes and sexual behavior through pathways involving sexual awareness (assertiveness, consciousness, appeal, and monitoring). A sample of 2,379 heterosexually active young adult women completed an online survey. Path models indicated that both early sexual debut (prior to age 15) and early online dating debut (prior to age 18) had significant, positive direct associations with anxiety and depression scores. Early online dating was also associated with condomless sex with casual male partners. However, both early sexual debut and early online dating debut were indirectly linked to greater sexual risk through greater appeal, and to lower sexual risk through sexual assertiveness. Additionally, greater monitoring contributed to more depression for those with an earlier sexual debut. These findings point to potential risks associated with early online dating. They also highlight benefits of studying sexual awareness as a multi-dimensional construct, especially as it helps to clarify divergent findings in the existing literature on the long-term consequences associated with early sexual debut. While some domains were associated with risk (monitoring and appeal), others were indicative of resilience (assertiveness).
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Affiliation(s)
- Leora R Trub
- Psychology Department, Pace University, New York, NY, 10038, USA.
| | - J L Stewart
- Psychology Department, Hunter College of the City University of New York, New York, NY, USA
- Division of General Internal Medicine, Weill Cornell Medicine, New York, NY, USA
| | - Ana Lomidze
- Psychology Department, Pace University, New York, NY, 10038, USA
| | - Eliana Lopez
- Psychology Department, Pace University, New York, NY, 10038, USA
| | - Tyrel J Starks
- Psychology Department, Hunter College of the City University of New York, New York, NY, USA
- Health Psychology and Clinical Science Doctoral Program, Graduate Center of the City University of New York, New York, NY, USA
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Opara I, Gabriel C, Duran-Becerra B, Bond K, Hill AV, Hussett-Richardson S, Alves C, Kershaw T. Sexual Health and Drug Use Prevention for Black Girls (The Dreamer Girls Project): Protocol for an Intervention Development. JMIR Res Protoc 2023; 12:e45007. [PMID: 37556188 PMCID: PMC10448282 DOI: 10.2196/45007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 05/02/2023] [Accepted: 05/05/2023] [Indexed: 08/10/2023] Open
Abstract
BACKGROUND Substance use among adolescent girls is associated with numerous risk characteristics, including engaging in sexual risk behaviors, which can lead to HIV and sexually transmitted infection (STI) diagnoses. This is an important phenomenon to target as there is a significant race-gendered paradox that occurs when Black girls use and misuse drugs. When misuse occurs among this group, they are more likely to face harsher consequences and worse health outcomes than boys and other ethnic-minority girls. Therefore, there is a need to understand the risk and protective factors of drug use and sexual risk behaviors among Black girls and develop a robust intervention that can cater for this group. OBJECTIVE We propose the development of a strengths-based prevention education intervention for Black girls between the ages of 13 and 18 years to promote protective factors. METHODS A sequential, mixed methods study will be conducted, and we will use the first 3 steps of the ADAPT-ITT (assessment, decision, adaptation, production, topical experts, integration, training, testing) framework to begin the development of the intervention. Three aims will be described in this protocol. First, aim 1 is to explore sociocultural risk and protective factors among Black girls between the ages 13 and 18 years in drug use and HIV/STI prevention using focus group methodology and surveys. We will conduct at least 10 focus groups to include up to 75 Black girls or until we reach saturation. Our target sample size for the quantitative portion of the study will be 200 participants. Aim 2 will focus on deciding upon an intervention based on findings from aim 1 and forming a youth advisory board to guide intervention development. Aim 3 will be to conduct a pretest of the intervention with the youth advisory board to determine if the intervention is feasible and will be accepted by Black girls. RESULTS The study is part of a 2-year research pilot study award from the National Institutes of Mental Health. Data collection for this study began in October 2021. For aim 1, data collection is 95% complete. We expect to complete all data collection for aim 1 on or before May 30, 2023. Study activities for aim 2 are occurring simultaneously as data are being collected and analyzed and will be completed in the summer of 2023. Study activities for aim 3 will begin in the fall of 2023. CONCLUSIONS This study will be one of the few interventions that address both sexual health and drug use together and cater to Black girls. We anticipate that the intervention will be beneficial for Black girls across the nation to work on building culturally appropriate prevention education and building peer social supports, resulting in reduction or delayed substance use and improved sexual health. TRIAL REGISTRATION ClinicalTrials.gov NCT05014074; https://clinicaltrials.gov/ct2/show/NCT05014074. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/45007.
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Affiliation(s)
- Ijeoma Opara
- Yale School of Public Health, New Haven, CT, United States
| | - Cora Gabriel
- Yale School of Public Health, New Haven, CT, United States
| | | | - Keosha Bond
- City University of New York School of Medicine, New York, NY, United States
| | - Ashley V Hill
- University of Pittsburgh, Pittsburgh, PA, United States
| | | | - Courtnae Alves
- Columbia University School of Public Health, New York, NY, United States
| | - Trace Kershaw
- Yale School of Public Health, New Haven, CT, United States
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15
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Crooks N, Barrie R, Singer R, Donenberg G. The Role of the Strong Black Woman in Black Female Sexual Development. ARCHIVES OF SEXUAL BEHAVIOR 2023; 52:1389-1402. [PMID: 36652135 DOI: 10.1007/s10508-023-02529-2] [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: 07/14/2021] [Revised: 12/20/2022] [Accepted: 01/02/2023] [Indexed: 06/17/2023]
Abstract
Black girls and women are disproportionately impacted by sexual health disparities, including an increased risk of HIV and sexually transmitted infections (STI). Early sexual development among Black females heightens their risk of HIV/STI. Utilizing the Becoming a Sexual Black Woman (SBW) framework, this study sought to understand how early sexual development and stereotype messages may underpin HIV/STI risk, building on and furthering the discussion of the consequences of the SBW schema. To better understand this phenomenon, we conducted a secondary thematic data analysis from two previously completed grounded theory studies with Black girls and women ranging in age from 11 to 62 (N = 40). Findings revealed that Black women have been socialized to be strong and independent and yet are highly vulnerable to HIV/STI. This clash between Black girl's and women's ideals of strength and heightened vulnerability to HIV/STI presents a paradox that may help explain disparities in HIV/STI risk. Four themes emerged among both Black girls and women: complex construction of the SBW schema, burden and consequences of strength, pressure to be strong, and being strong and sexual. Findings also highlight how becoming both a strong and sexual Black woman occurs over the life course and is inherent to Black female sexual development. We discuss the implications of these findings for parents, healthcare providers, educators, and researchers with the aim to improve sexual health outcomes for Black females across the life course.
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Affiliation(s)
- Natasha Crooks
- Department of Human Development Nursing Science, College of Nursing, University of Illinois Chicago, 845 S. Damen Avenue, Room 816, Chicago, IL, 60612, USA.
| | - Rabiatu Barrie
- School of Public Health, Department of Family Science, University of Maryland, College Park, MD, USA
| | - Randi Singer
- Department of Human Development Nursing Science, College of Nursing, University of Illinois Chicago, 845 S. Damen Avenue, Room 816, Chicago, IL, 60612, USA
| | - Geri Donenberg
- Department of Medicine, Center for Dissemination and Implementation Science, University of Illinois Chicago, Chicago, IL, USA
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16
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Appiah CK, Dowou RK, Balame SK, Adzigbli LA, Yeboah PA, Aboagye RG, Cadri A. Self-reported sexually transmitted infections among adolescent girls and young women in Mali: analysis of prevalence and predictors. BMJ Open 2023; 13:e069226. [PMID: 37094889 PMCID: PMC10151941 DOI: 10.1136/bmjopen-2022-069226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/26/2023] Open
Abstract
OBJECTIVE To examine the prevalence and predictors of self-reported sexually transmitted infections (SR-STIs) among adolescent girls and young women in Mali. DESIGN We performed a cross-sectional analysis of data from the Demographic and Health Survey of Mali, which was conducted in 2018. A weighted sample of 2105 adolescent girls and young women aged 15-24 was included. Percentages were used to summarise the results of the prevalence of SR-STIs. We used a multilevel binary logistic regression analysis to examine the predictors of SR-STIs. The results were presented using an adjusted odds ratio (aOR) with 95% confidence interval (CI). Statistical significance was set at p<0.05. SETTING Mali. PARTICIPANTS Adolescent girls (15-19 years) and young women (20-24 years). OUTCOME MEASURE SR-STIs. RESULTS The prevalence of SR-STIs among the adolescent girls and young women was 14.1% (95% CI=12.3 to 16.2). Adolescent girls and young women who had ever tested for HIV, those with one parity, those with multiparity, those with two or more sexual partners, those residing in urban areas, and those exposed to mass media were more likely to self-report STIs. However, those residing in Sikasso and Kidal regions were less likely to report STIs. CONCLUSION Our study has shown that SR-STIs are prevalent among adolescent girls and young women in Mali. Health authorities in Mali and other stakeholders should formulate and implement policies and programmes that increase health education among adolescent girls and young women and encourage free and easy access to STI prevention and treatment services.
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Affiliation(s)
- Collins Kwame Appiah
- Department of Epidemiology and Biostatistics, Fred N. Binka School of Public Health, University of Health and Allied Sciences, Ho, Ghana
| | - Robert Kokou Dowou
- Department of Epidemiology and Biostatistics, Fred N. Binka School of Public Health, University of Health and Allied Sciences, Ho, Ghana
| | | | - Leticia Akua Adzigbli
- Department of Epidemiology and Biostatistics, Fred N. Binka School of Public Health, University of Health and Allied Sciences, Ho, Ghana
| | - Paa Akonor Yeboah
- Fred N. Binka School of Public Health, University of Health and Allied Sciences, Ho, Ghana
| | - Richard Gyan Aboagye
- Department of Family and Community Health, Fred N. Binka School of Public Health, University of Health and Allied Sciences, Ho, Ghana
| | - Abdul Cadri
- Department of Family Medicine, McGill University Montreal, Montreal, Quebec, Canada
- Department of Social and Behavioural Science, University of Ghana, Legon, Ghana
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17
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Parekh T, Gimm G, Kitsantas P. Sexually Transmitted Infections in Women of Reproductive Age by Disability Type. Am J Prev Med 2023; 64:393-404. [PMID: 36528453 DOI: 10.1016/j.amepre.2022.10.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 10/17/2022] [Accepted: 10/20/2022] [Indexed: 12/23/2022]
Abstract
INTRODUCTION The objectives of this study were to estimate the prevalence of sexually transmitted infections in women of reproductive age by disability type and examine the association between disability types, participant characteristics, and the prevalence of sexually transmitted infections (STIs). METHODS Pooled data from 2015 to 2019 National Survey on Drug Use and Health were analyzed in 2022. The analytic sample included 90,233 women of reproductive age (18-49 years). Disability was defined as having any sensory, cognitive, physical, or ≥2 disabilities.. A total of 15% of women reported having a disability. Descriptive analyses were used to estimate the prevalence of STI, and logistic regression analyses were conducted to examine the association of disability type and other participant characteristics with the odds of having STIs. RESULTS The prevalence of STIs was more than twice as high for women of reproductive age with cognitive disabilities (6.8%) or ≥2 disabilities (6.7%) as for those without disabilities (2.7%). Women with sensory disabilities (AOR=1.47; 95% CI=1.17, 1.85), cognitive disabilities (AOR=1.89; 95% CI=1.65, 2.17), or ≥2 disabilities (AOR=1.78; 95% CI=1.49, 2.14) had greater odds of STIs than those without disabilities. Bisexual women had higher odds (AOR=1.31; 95% CI=1.14, 1.50) of STIs than straight women, whereas lesbian/gay women had lower odds (AOR=0.41; 95% CI=0.27, 0.63). The odds of STIs were higher among non-Hispanic Blacks (AOR=1.42; 95% CI=1.24, 1.63) and lower among Asian women (AOR=0.62; 95% CI=0.43, 0.90) than among non-Hispanic Whites. The odds of STIs were also greater among participants having any alcohol, cannabis, or illicit drug use. CONCLUSIONS Women of reproductive age with disabilities have a higher prevalence of sexually transmitted infections. In addition to disability type, the odds of sexually transmitted infections varied by race/ethnicity, sexual orientation, and substance use.
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Affiliation(s)
- Tarang Parekh
- Department of Health Administration and Policy, George Mason University, Fairfax, Virginia.
| | - Gilbert Gimm
- Department of Health Administration and Policy, George Mason University, Fairfax, Virginia
| | - Panagiota Kitsantas
- Department of Health Administration and Policy, George Mason University, Fairfax, Virginia
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18
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Sexual Behavior Patterns of Black Young Adults in Georgia: Results from a Latent Class Analysis. J Racial Ethn Health Disparities 2023; 10:271-281. [PMID: 35018580 DOI: 10.1007/s40615-021-01217-y] [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: 06/17/2021] [Revised: 12/21/2021] [Accepted: 12/21/2021] [Indexed: 02/03/2023]
Abstract
The state of Georgia ranks first in the rate of new diagnosis of HIV/AIDS, yet studies focused on understanding the drivers of this epidemic in the most at-risk groups outside the Atlanta Metropolitan Statistical Area (MSA) remain sparse. Among the many consequences of this is the inability to effectively design tailored intervention programs that appropriately address the reduction of HIV/AIDS and other STDS in the state. Reducing disparities in HIV/AIDS remains an important goal in the National HIV/AIDS Strategy. Given the disproportionate burden of the HIV/AIDS epidemic among Blacks in the state of Georgia, there is a significant need to focus research attention on the sexual behavior of young people that predisposes them to increased risk of HIV/AIDS infection. The current study used latent class analysis (LCA) to examine the sexual behavior patterns of Black young adults living in Georgia. LCA results revealed a two-class fit with distinct sexual behavior patterns. Gender and educational attainment emerged as significant predictors of class membership. Our findings contribute to the vast literature showing that sexual behavior patterns of Black young adults are not homogenous, and underscore the significance of socio-demographic and contextual factors in shaping sexual risk behavior.
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Ramos-Olazagasti MA, Elkington KS, Wainberg ML, Feng T, Corbeil T, Canino GJ, Bird HR, Scorza P, Wildsmith E, Alegria M, Duarte CS. Does Context and Adversity Shape Sexual Behavior in Youth? Findings from Two Representative Samples of Puerto Rican Youth. ARCHIVES OF SEXUAL BEHAVIOR 2023; 52:217-231. [PMID: 36169776 PMCID: PMC9868044 DOI: 10.1007/s10508-022-02328-1] [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: 01/19/2020] [Revised: 02/23/2022] [Accepted: 03/12/2022] [Indexed: 06/16/2023]
Abstract
Sexual risk behaviors often co-occur. Understanding the heterogeneity in patterns of sexual behavior among youth and how context of majority and minoritized status may be related to these behaviors can inform targeted STIs/HIV interventions. Data are from the Boricua Youth Study, a longitudinal study of two probability samples of Puerto Rican youth recruited in the South Bronx (SBx) and the metropolitan area in Puerto Rico (PR). We identified patterns of sexual behaviors among young adults (ages 15-24) with sexual experience (N = 1,203) using latent class analysis. Analyses examined context differences and the prospective relationship between adverse childhood experiences (ACEs) (childhood maltreatment/violence, family/parental dysfunction) and patterns of sexual behaviors (age at first sex, number of sex partners, sex with a high-risk partner, condom use, sex while intoxicated, oral sex, anal sex). We identified five classes of sexual behaviors: (1) currently inactive (16.51%); (2) single partner, low activity (13.49%); (3) single partner, inconsistent condom use (32.19%); (4) single partner, sex without a condom (27.65%); and (5) multirisk (10.16%). Young adults from the SBx (minoritized context), those who identified as male, and those with higher child maltreatment/violence ACEs were more likely to be in the multi-risk class relative to the single partner, inconsistent condom use class. Those from the SBx were also more likely to be in the single partner, sex without condom class, relative to the single partner, inconsistent condom use class. Differences in young adults' patterns of sexual behaviors between the two contexts, one representing the minoritized context (SBx) contrasted to the majority context (PR), were not explained by ACEs. Findings highlight the heterogeneity in the patterns of sexual behaviors among Puerto Rican young adults as well as how such patterns vary based on sociocultural contexts. Exposure to child maltreatment/violence ACEs was related to the riskier patterns; however, they did not explain why riskier patterns of sexual behaviors were found in the SBx compared to PR. Results underscore the need for tailored interventions and more in-depth examination of differences across contexts.
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Affiliation(s)
- Maria A Ramos-Olazagasti
- Reproductive Health and Family Formation, Child Trends, 7315 Wisconsin Ave, Ste 1200W, Bethesda, MD, 20814, USA.
- Child and Adolescent Psychiatry, Columbia University, New York, NY, USA.
| | - Katherine S Elkington
- Child and Adolescent Psychiatry, Columbia University, New York, NY, USA
- New York State Psychiatric Institute, New York, NY, USA
| | - Milton L Wainberg
- Child and Adolescent Psychiatry, Columbia University, New York, NY, USA
- New York State Psychiatric Institute, New York, NY, USA
| | - Tianshu Feng
- New York State Psychiatric Institute, New York, NY, USA
| | | | - Glorisa J Canino
- Medical Sciences Campus, University of Puerto Rico, Rio Piedras, Puerto Rico, USA
| | - Hector R Bird
- Child and Adolescent Psychiatry, Columbia University, New York, NY, USA
| | - Pamela Scorza
- Child and Adolescent Psychiatry, Columbia University, New York, NY, USA
- New York State Psychiatric Institute, New York, NY, USA
| | - Elizabeth Wildsmith
- Reproductive Health and Family Formation, Child Trends, 7315 Wisconsin Ave, Ste 1200W, Bethesda, MD, 20814, USA
| | - Margarita Alegria
- Disparities Research Unit, Massachusetts General Hospital, Boston, MA, USA
| | - Cristiane S Duarte
- Child and Adolescent Psychiatry, Columbia University, New York, NY, USA
- New York State Psychiatric Institute, New York, NY, USA
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20
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Vasilenko SA. Sexual Behavior and Health From Adolescence to Adulthood: Illustrative Examples of 25 Years of Research From Add Health. J Adolesc Health 2022; 71:S24-S31. [PMID: 36404016 PMCID: PMC9890380 DOI: 10.1016/j.jadohealth.2022.08.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 08/22/2022] [Accepted: 08/23/2022] [Indexed: 11/18/2022]
Abstract
Due to its long-term longitudinal design, the National Longitudinal Study of Adolescent to Adult Health (Add Health) has provided numerous valuable insights into adolescent and young adult sexual behavior. Framed by a conceptual model of sexual behavior and health, I review research using Add Health data to study sexual behavior and health. In this paper, I review research examining both predictors (e.g., neighborhood, family, genetic, individual) and health outcomes (e.g., sexually transmitted infections, mental health) of sexual behavior in adolescents and young adults. Where possible, I focus on long-term longitudinal studies that make use of the unique strengths of the Add Health data. Existing Add Health research has provided considerable information about both the predictors and health consequences of adolescent and young adult sexual behavior. Factors ranging from neighborhoods to genetics predict whether adolescent and young adults engage in sexual behaviors. Findings on long-term outcomes of adolescent sexual behavior suggest that early sexual behavior predicts higher rates of sexually transmitted infections and pregnancy in young adulthood, but not long-term changes to mental health. Unique contributions of Add Health include the ability to examine multidimensional bio-ecological predictors of sexual behavior and to examine long-term effects of sexual behavior and how sexual behaviors and their correlates change across adolescence into adulthood. Future work can leverage these strengths, and in particular the long-term longitudinal nature of the data, to uncover new insights about the developmental course of sexual behavior and health.
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Affiliation(s)
- Sara A Vasilenko
- Department of Human Development and Family Science, Syracuse University, Syracuse, New York.
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21
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Gause NK, Sales JM, Brown JL, Pelham WE, Liu Y, West SG. The protective role of secure attachment in the relationship between experiences of childhood abuse, emotion dysregulation and coping, and behavioral and mental health problems among emerging adult Black women: A moderated mediation analysis. JOURNAL OF PSYCHOPATHOLOGY AND CLINICAL SCIENCE 2022; 131:716-726. [PMID: 35901415 PMCID: PMC9560963 DOI: 10.1037/abn0000772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
To determine the extent to which secure attachment moderates the effects of previous child abuse history on the intermediate variables (putative mediators) of emotion dysregulation and coping, which, in turn, influence adult behavioral health and mental health problems. Black women (N = 440, M age = 20.33, SD = 1.88) were selected from the baseline data collection of a large, randomized trial. Study participants had consumed alcohol, had had unprotected sex in the last 90 days, and either reported abuse prior to age 18 or no lifetime history of abuse. Women completed measures of sociodemographics, abuse history, attachment security, coping, emotion dysregulation, psychological functioning, risky sexual behavior, and substance use problems. At low attachment security, the conditional indirect effects of childhood abuse through the intermediate variable, coping, were statistically significant for all dependent variables except proportion condom use and perceived stress. At high attachment security, none of the conditional indirect effects through coping achieved statistical significance. High attachment security also mitigated the conditional indirect effects of childhood abuse through the intermediate variable, emotion dysregulation, reducing the magnitude of the relationship with trait anger, depression, marijuana problems, and perceived stress by about 50%. These results demonstrate the potential mitigating effects of secure attachment on the relationship between childhood abuse history and select behavioral and mental health problems through the intermediate variables of coping and emotional dysregulation. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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Affiliation(s)
- Nicole K. Gause
- Department of Psychology, University of Cincinnati, Cincinnati, Ohio, USA
- Department of Student Health and Wellness, University of Virginia, Charlottesville, Virgina, USA
| | - Jessica M. Sales
- Department of Behavioral Sciences & Health Education, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
- Centers for AIDS Research, Emory University, Atlanta, Georgia, USA
| | - Jennifer L. Brown
- Department of Psychology, University of Cincinnati, Cincinnati, Ohio, USA
- Department of Psychiatry & Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
- Center for Addiction Research, University of Cincinnati, Cincinnati, Ohio, USA
| | | | - Yu Liu
- Senior Biostatistician, Hologic, Inc., San Diego, CA
| | - Stephen G. West
- Department of Psychology, Arizona State University, Tempe, Arizona, USA
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22
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Bibriescas N, Wainwright K, Thomas R, Lopez V, Romanowich P. Differential relationships between discount rates and health behaviors in an ethnically diverse college sample. Front Public Health 2022; 10:943499. [PMID: 36016889 PMCID: PMC9396243 DOI: 10.3389/fpubh.2022.943499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Accepted: 07/22/2022] [Indexed: 01/21/2023] Open
Abstract
Previous research has demonstrated associations between delay discount rate and engagement in several health behaviors. The delay discount rate is also inversely associated with social discount rates, a putative measure for sharing. However, there is little research that examines whether delay and social discount rates are differentially associated with health behavior engagement, and even less research examining the impact of ethnicity on these relationships. This study investigated whether delay and/or social discount rates predict three health behaviors varying in sociality: sexually transmitted infection (STI) testing, alcohol consumption and exercise frequency in an ethnically diverse university sample. The results showed that neither delay nor social discount rate significantly predicted alcohol consumption and exercise frequency. However, increasing social discount rates (i.e., decreased sharing) was associated with a decreased likelihood to be tested for STIs. Ethnicity significantly contributed to two models, indicating differences in STI testing and alcohol consumption across ethnicities. Ethnic differences in these health behaviors were consistent with many previous health behavior studies, suggesting a profitable way to research cultural contingencies and test the reliability of the ethnically diverse data. These findings indicate that the social discount rate is differentially associated with health behaviors with more social aspects (i.e., health behaviors related to sex) in college students.
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Affiliation(s)
- Natashia Bibriescas
- Department of Educational Psychology, The University of Texas at Austin, Austin, TX, United States
| | - Katherine Wainwright
- Department of Psychology, The University of Texas at San Antonio, San Antonio, TX, United States
| | - Rebecca Thomas
- Ecampus Research Unit, Oregon State University, Corvallis, OR, United States
| | - Victoria Lopez
- Department of Psychology, The University of Texas at San Antonio, San Antonio, TX, United States
| | - Paul Romanowich
- Department of Psychology, Gonzaga University, Spokane, WA, United States,*Correspondence: Paul Romanowich
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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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24
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Yamasaki V, Le TP. Family Matters: The Impact of Traditional and Egalitarian Gender Role Messages on Sexual and Gender Minority Latinx Adults' Alcohol Use and Sexual Risk. JOURNAL OF SEX RESEARCH 2022; 59:652-661. [PMID: 34431722 DOI: 10.1080/00224499.2021.1965948] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Latinx sexual and gender minority individuals are at increased risk for engaging in risky sexual behavior given the intersection of their sexual orientation and ethnic identities. Many studies have found that sexual and gender minority Latinx folks experience nonacceptance and discrimination from within their families due to their identity. However, none have explored how underlying familial beliefs, such as traditional and egalitarian gender roles, influence sexual and gender minority Latinx adults' risky sexual behavior. Within a sample of 168 Latinx sexual and gender minority individuals, the present study examined the indirect effect of receiving traditional and egalitarian parental gender role messages on risky sexual behavior through alcohol use and internalized stigma related to their sexual and gender minority identity. Results showed that traditional gender role messages were indirectly associated with increased risky sexual behavior through increased alcohol use, whereas no such indirect effect was found through internalized stigma. Receiving egalitarian gender role messages was not associated with risky sexual behaviors. Findings from this paper can be used to tailor community outreach programs that aim to reduce sexual risk behaviors and alcohol use in the Latinx sexual and gender minority community as a result of traditional parental gender role messages.
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Affiliation(s)
- Vic Yamasaki
- Department of Psychology, The University of Maryland, College Park, MD, USA
| | - Thomas P Le
- Department of Psychology, The University of Maryland, College Park, MD, USA
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25
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Crooks N, Sosina W, Debra A, Donenberg G. The Impact of COVID-19 Among Black Girls: A Social-Ecological Perspective. J Pediatr Psychol 2022; 47:270-278. [PMID: 35182154 PMCID: PMC8903447 DOI: 10.1093/jpepsy/jsab139] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 12/29/2021] [Accepted: 12/31/2021] [Indexed: 11/16/2022] Open
Abstract
Objective To explore the impact of the COVID-19 pandemic on Black adolescent girls’ physical, psychological, and sexual development. Methods Semistructured interviews were conducted with 25 girls (9–18 years old) primarily across the Midwestern United States. Interviews were conducted until theoretical saturation was reached. We conducted a conventional content analysis by reviewing transcripts, coding data, and developing themes. Results Utilizing the social-ecological model findings revealed themes related to the individual-, interpersonal-, institutional-, and community-level changes that Black girls experienced during the COVID-19 pandemic. Conclusions Black adolescent girls need opportunities to discuss the changes, receive relevant resources, and have spaces to support their physical, psychological, and sexual development. Systems such as families, schools, and clinics should implement programming to facilitate discussions around the impact of COVID-19 on Black girls.
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Affiliation(s)
- Natasha Crooks
- Department of Human Development Nursing Science, College of Nursing, University of Illinois Chicago, USA
- All correspondence concerning this article should be addressed to Natasha Crooks, PhD, Department of Human Development Nursing Science, College of Nursing, University of Illinois Chicago, 845 S Damen Ave, Chicago, IL 60612, USA. E-mail:
| | | | - Alyssa Debra
- College of Medicine, University of Illinois Chicago, USA
| | - Geri Donenberg
- Department of Medicine, Center for Dissemination and Implementation Science, University of Illinois Chicago, USA
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26
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Opara I, Rivera Rodas EI, Garcia-Reid P, Reid RJ. Ethnic Identity, Empowerment, Social Support and Sexual Risk Behaviors Among Black Adolescent Girls: Examining Drug Use as a Mediator. CHILD & ADOLESCENT SOCIAL WORK JOURNAL : C & A 2022; 39:71-86. [PMID: 35462639 PMCID: PMC9031836 DOI: 10.1007/s10560-020-00706-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
Substance abuse and sexual health research tends to overlook the resiliency skills that Black adolescent girls possess. Using a strengths-based lens, this study examines the role of protective factors: (e.g. ethnic identity, social support, and psychological empowerment) on sexual risk behaviors testing drug use as a mediator among a sample of Black adolescent girls. The study uses a sample (N = 340) female adolescents (13-17 years old) who identified as being Black only and reside in a northeastern urban community in New Jersey. Structural equation modeling was employed to test the hypothesized model of the mediating role of drug use on sexual risk behaviors among this sample. Findings revealed that drug use significantly mediated the relationship between social support, ethnic identity, and psychological empowerment on sexual risk behaviors, with high ethnic identity scores having the strongest relationship on low sexual risk behaviors and low levels of drug use. Given the rise of sexually transmitted infections (STIs) in the United States among Black adolescent girls, findings from this study can contribute to development of culturally appropriate and innovative strategies to reduce risky behaviors by promoting social and cultural strengths among Black girls living in urban communities.
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Affiliation(s)
- Ijeoma Opara
- School of Social Welfare, Stony Brook University, Stony Brook, USA
- Center for Interdisciplinary Research on AIDS, School of Public Health, Yale University, New Haven, USA
| | | | - Pauline Garcia-Reid
- Department of Family Science and Human Development, Montclair State University, Montclair, USA
| | - Robert J. Reid
- Department of Family Science and Human Development, Montclair State University, Montclair, USA
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27
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Min J, Faerber J, Skolnik A, Akers AY. Racial/Ethnic Disparities in Female Sexual Health from Adolescence to Young Adulthood: How Adolescent Characteristics Matter? J Pediatr Adolesc Gynecol 2021; 34:404-411. [PMID: 33227423 PMCID: PMC8547142 DOI: 10.1016/j.jpag.2020.11.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 10/20/2020] [Accepted: 11/06/2020] [Indexed: 11/17/2022]
Abstract
STUDY OBJECTIVE To describe sexual initiation patterns in female adolescents and examine their association with adolescent characteristics and racial disparities in adverse sexual health across adolescence into early adulthood. DESIGN A prospective, longitudinal, observational study from adolescence to adulthood. SETTING Nationally representative, the National Longitudinal Study of Adolescent to Adult Health data, in the range of 24-32 years old at final assessment. PARTICIPANTS Data from 43,577 US women from 1994 to 2008. INTERVENTIONS AND MAIN OUTCOME MEASURES Adolescent sex-related characteristics at the individual-, family-, and school peer-level were assessed, and multiple sex partners, sexually transmitted infections (STIs)/HIV, and intimate partner violence (IPV) were longitudinally tracked. The sexual initiation pattern and its longitudinal association with sexual health were analyzed using latent class analysis and mixed effects Poisson regression models. RESULTS Of the 43,577 subjects, the sexual initiation patterns were determined as normative (n = 28,712, 65.9%), late (n = 10,799, 24.8%), and early but unempowered (n = 4,066, 9.3%). The highest rate of the early-unempowered group was shown in Hispanic individuals (1,054/7,307 = 14.4%); they were more likely to be depressed, unsatisfied with their bodies, receiving welfare, and have less educated/permissive parents to their sexual initiation than others. The late group had a higher body mass index and greater satisfaction with their bodies. The highest number of STIs/HIV and IPV victimization was shown in non-Hispanic Black (NHB) and Hispanic individuals, respectively. However, NHB females' higher number of STIs/HIV was shown in the late/normative groups, not in the early-unempowered group. Among Hispanic females, adolescent sexual initiation patterns were not directly associated with their frequent IPV victimization. CONCLUSION NHB females' higher STI/HIV in late/normative groups and Hispanic females' frequent IPV victimization regardless of their sexual initiation patterns might indicate that racial/ethnic disparities in female sexual health was not directly determined by adolescent risk behaviors.
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Affiliation(s)
- Jungwon Min
- Department of Biomedical and Health Informatics, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Jennifer Faerber
- Department of Biomedical and Health Informatics, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Ava Skolnik
- Department of Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Aletha Y Akers
- Department of Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.
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28
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Zeidan AR, Strey K, Vargas MN, Reveles KR. Sexually transmitted infection laboratory testing and education trends in US outpatient physician offices, 2009-2016. Fam Med Community Health 2021; 9:e000914. [PMID: 34144971 PMCID: PMC8215241 DOI: 10.1136/fmch-2021-000914] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE To describe national rates of sexually transmitted infection (STI) testing and education overall and among patient subgroups in US outpatient physician offices from 2009 to 2016. DESIGN This was a cross-sectional study of the Centers for Disease Control and Prevention's National Ambulatory Medical Care Survey from 2009 to 2016. Data weights were applied to extrapolate to national estimates. SETTING Data were collected from a systematic random sample of outpatient physician office visits throughout USA. Physician office types include free standing clinics, private or group setting practices, centres offering community and mental health services, family planning clinics and health maintenance organisations/other prepaid clinics. PARTICIPANTS All sampled patient visits were eligible for inclusion and were assessed for the provision of STI prevention education and STI testing for chlamydia, gonorrhoea, hepatitis, human papillomavirus (HPV) and HIV. RESULTS Of 7.6 billion total visits, 123 million included an STI test. Hepatitis was the most commonly tested STI (9.12 per 1000), followed by chlamydia (6.67 per 1000), gonorrhoea (6.00 per 1000), HIV (5.40 per 1000) and HPV (5.03 per 1000). Testing rates for the three STIs measured for the entire 8-year period increased over time and peaked in 2015 compared with 2009: chlamydia (R2=0.36), HPV (R2=0.28) and HIV (R2=0.51). Testing was highest among women (21.93 per 1000), 15-24-year olds (46.04 per 1000), non-Hispanic blacks (37.33 per 1000) and those seen by obstetrics/gynaecology specialists (103.75 per 1000). STI prevention education was provided to 4.89 per 1000 patients and remained relatively unchanged from 2013 to 2016. CONCLUSION STI testing in outpatient physician offices increased over the study period but varied by patient characteristics and site of care. Few patients received STI prevention education, highlighting a potential gap in resource utilisation in these settings.
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Affiliation(s)
- Amina R Zeidan
- College of Pharmacy, The University of Texas at Austin, San Antonio, Texas, USA
- Pharmacotherapy Education & Research Center, The University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA
| | - Kelsey Strey
- College of Pharmacy, The University of Texas at Austin, San Antonio, Texas, USA
- Pharmacotherapy Education & Research Center, The University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA
| | - Michelle N Vargas
- College of Pharmacy, The University of Texas at Austin, San Antonio, Texas, USA
- Pharmacotherapy Education & Research Center, The University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA
| | - Kelly R Reveles
- College of Pharmacy, The University of Texas at Austin, San Antonio, Texas, USA
- Pharmacotherapy Education & Research Center, The University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA
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29
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Logan-Greene P, Bascug EW, DiClemente RJ, Voisin DR. Heterogeneity of Sexual Risk Profiles Among Juvenile Justice-Involved African American Girls. CHILD & YOUTH CARE FORUM 2021. [DOI: 10.1007/s10566-020-09594-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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30
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Niu L, Brown J, Till Hoyt L, Salandy A, Nucci-Sack A, Shankar V, Burk RD, Schlecht NF, Diaz A. Profiles of Childhood Maltreatment: Associations with Sexual Risk Behavior during Adolescence in a Sample of Racial/Ethnic Minority Girls. Child Dev 2021; 92:1421-1438. [PMID: 33442867 DOI: 10.1111/cdev.13498] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
This study examines associations between childhood maltreatment and developmental trajectories of sexual risk behaviors (SRBs) in a sample of 882 sexually active adolescent girls, predominantly Hispanic or Black, assessed every 6 months between 13 and 23 years. Latent profile analyses revealed four distinct maltreatment profiles: Low Maltreatment (76%), Moderate Emotional Neglect Only (15%), Severe Physical/Emotional Abuse (3%), and Severe Sexual Abuse (6%). Multilevel growth analyses showed the Moderate Emotional Neglect Only and Severe Sexual Abuse profiles exhibited more SRBs starting in late adolescence, and the Severe Sexual Abuse profile also exhibited a faster increase than the Low Maltreatment profile. Understanding heterogeneity within maltreated populations may have important implications for healthy sexual development.
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Affiliation(s)
- Li Niu
- Fordham University.,Mount Sinai Adolescent Health Center.,Icahn School of Medicine at Mount Sinai
| | | | | | | | | | | | | | - Nicolas F Schlecht
- Albert Einstein College of Medicine.,Roswell Park Comprehensive Cancer Center
| | - Angela Diaz
- Mount Sinai Adolescent Health Center.,Icahn School of Medicine at Mount Sinai
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31
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Haider MR, Kingori C, Brown MJ, Battle-Fisher M, Chertok IA. Illicit drug use and sexually transmitted infections among young adults in the US: evidence from a nationally representative survey. Int J STD AIDS 2020; 31:1238-1246. [PMID: 32996867 DOI: 10.1177/0956462420950603] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Young people aged 15-24 years account for half of all new sexually transmitted infections (STIs) in the United States. The aim of this study was to examine the cross-sectional associations of factors linked to STIs among US young adults (18-25 years). This study used the 2015-2018 pooled National Survey on Drug Use and Health data on 55,690 young adults. Almost 3.4% of the respondents reported having an STI in the past year. Among the participants, 38.4% used illicit drugs and 3.7% reported a history of delinquency in the past year. In the survey-weighted logistic regression model, odds for contracting STIs in the preceding year was higher among adults aged 22-25 versus 18-21 years (OR:1.26, 95%CI:1.12-1.42); male versus female (OR:2.44, 95%CI:2.11-2.82); non-Hispanic African American versus non-Hispanic White (OR:1.77, 95%CI:1.55-2.02); widowed/separated/divorced (OR:1.93, 95%CI:1.36-2.75) and never married (OR:1.29, 95%CI:1.07-1.55) versus married; full-time/part-time employed (aOR:1.17, 95% CI:1.04-1.31) compared to unemployed/other; history of delinquency (OR:2.31, 95%CI:1.89-2.83); and use of illicit drugs in the last year (OR:3.10, 95%CI:2.77-3.47). High incidence of illicit drug use by the young adults and its strong association with STI incidence in recent years warrant special attention. Tailored preventive measures should be focused on key predictors.
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Affiliation(s)
- Mohammad Rifat Haider
- Department of Social and Public Health, College of Health Sciences and Professions, Ohio University, Athens, OH, USA
| | - Caroline Kingori
- Department of Social and Public Health, College of Health Sciences and Professions, Ohio University, Athens, OH, USA
| | - Monique J Brown
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA.,South Carolina SmartState Center for Healthcare Quality, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | | | - Ilana Azulay Chertok
- School of Nursing, College of Health Sciences and Professions, Ohio University, Athens, OH, USA
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32
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Pahl K, Capasso A, Lekas HM, Lee JY, Winters J, Pérez-Figueroa RE. Longitudinal predictors of male sexual partner risk among Black and Latina women in their late thirties: ethnic/racial identity commitment as a protective factor. J Behav Med 2020; 44:202-211. [PMID: 32965619 DOI: 10.1007/s10865-020-00184-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Accepted: 09/10/2020] [Indexed: 10/23/2022]
Abstract
This study aimed to investigate predictors of male sexual partner risk among Latinas and Black women in their late thirties. We used multiple regression analysis to examine factors associated with male sexual partner risk among 296 women who participated in two waves of the Harlem Longitudinal Development Study (New York, 2011-2013 and 2014-2016). Women who experienced childhood sexual abuse had higher risk partners than those who did not [b = 0.16, 95% confidence interval (CI) = 0.06, 0.28]. Earlier marijuana use was a risk factor for partner risk in the late thirties (b = 0.12, 95% CI = 0.04, 0.27). Higher levels of ethnic/racial identity commitment mitigated this risk (b = - 0.15, 95% CI = - 0.26, - 0.04). Ethnic/racial identity commitment can be protective against male sexual partner risk among Latina and Black women who use marijuana. Further research should explore the protective role of different dimensions of ethnic/racial identity against sexually transmitted infections, including HIV.
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Affiliation(s)
- Kerstin Pahl
- Division of Social Solutions and Services Research, The Nathan S. Kline Institute for Psychiatric Research, 140 Old Orangeburg Road, Orangeburg, NY, 10962, USA.,Department of Psychiatry, New York University School of Medicine, 1 Park Avenue, 8th Floor, New York, NY, 10016, USA
| | - Ariadna Capasso
- NYU School of Global Public Health, New York University, 715/719 Broadway, 12th Floor, New York, NY, 10003, USA.
| | - Helen-Maria Lekas
- Division of Social Solutions and Services Research, The Nathan S. Kline Institute for Psychiatric Research, 140 Old Orangeburg Road, Orangeburg, NY, 10962, USA
| | - Jung Yeon Lee
- Department of Psychiatry, New York University School of Medicine, 1 Park Avenue, 8th Floor, New York, NY, 10016, USA.,Division of Biostatistics, Department of Population Health, New York University School of Medicine, 180 Madison Avenue, 3th Floor, New York, NY, 10016, USA
| | - Jewel Winters
- NYU Langone Orthopedic Hospital, 301 E. 17th Street, Room 213, New York, NY, 10003, USA
| | - Rafael E Pérez-Figueroa
- Department of Health, Behavior, and Society, College of Public Health, University of Kentucky, Bowman Hall Room 356, 151 Washington Avenue, Lexington, KY, 40536, USA
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33
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Hood KB, Pollack LM, Jackson DD, Boyer CB. Associations Among Behavioral Risk, Sociodemographic Identifiers, and Sexually Transmitted Infections in Male and Female Army Enlisted Personnel. Mil Med 2020; 186:e75-e84. [PMID: 32909601 DOI: 10.1093/milmed/usaa247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Revised: 04/29/2020] [Accepted: 07/30/2020] [Indexed: 11/12/2022] Open
Abstract
INTRODUCTION Rates of sexually transmitted infections (STIs) are higher among U.S. military personnel than their civilian counterparts. Yet there is a paucity of military-specific research that has utilized theoretical frameworks to describe the relative influence of the multiple and interrelated risk factors associated with STIs in this population of young, healthy men and women. The aim of this study was to examine the relative influence of Information, Motivation, and Behavioral Skills Model (IMB) factors known to be associated with condom use and STI diagnosis, as well as examine gender differences among a cohort of young, active duty enlistees who are in the very early stages of their military careers. MATERIALS AND METHODS Data were collected in 2011 to 2013 through self-administered questionnaires and laboratory-confirmed tests of STIs. Logistic regression analyses were used to assess IMB constructs, behavioral risk variables, and sociodemographic factors associated with STI diagnosis and condom use separately among female and male military personnel. RESULTS STIs among males were significantly associated with nonwhite race, lower STI behavioral intentions and STI behavioral skills, and engaging in sex after drinking alcohol. Further, males who reported more positive attitudes toward using condoms, higher confidence in preventing drinking, higher alcohol prevention norms among peers, a lower frequency of drinking alcohol before engaging in sexual intercourse, more sexual partners, and higher STI behavioral intentions were significantly more likely to report using condoms consistently during sexual encounters. Among female participants, a history of STIs was significantly associated with higher numbers of reported sexual partners and greater alcohol prevention efficacy while lifetime consistent condom use was significantly associated only with stronger intentions to avoid behaviors that might result in STI acquisition. CONCLUSION Our findings support the need for development of STI prevention strategies that include education and skills-building approaches to reduce alcohol misuse among enlisted military personnel, and especially male personnel. Such programs should include factors that uniquely influence the experiences of males and females in the military context.
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Affiliation(s)
- Kristina B Hood
- Department of Psychology, Virginia Commonwealth University, Richmond, VA 23284, USA
| | - Lance M Pollack
- Division of Prevention Science, Department of Medicine, University of California, San Francisco, CA 94143, USA
| | | | - Cherrie B Boyer
- Division of Adolescent Medicine, Department of Pediatrics, University of California, San Francisco, CA 94118, USA
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Addressing sexually transmitted infections in the sociocultural context of black heterosexual relationships in the United States. Soc Sci Med 2020; 263:113303. [PMID: 32862082 DOI: 10.1016/j.socscimed.2020.113303] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 07/29/2020] [Accepted: 08/14/2020] [Indexed: 12/28/2022]
Abstract
RATIONALE Black girls and women are disproportionately affected by sexually transmitted infections (STIs) and human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS). Research shows sexual networks, sexual concurrency, and assortative mixing impacting racial disparities in STI/HIV. However, the underlying sociocultural conditions of these phenomenon have yet to be fully explored within a framework of Black girls' and women's sexual development. OBJECTIVE This grounded theory study investigated the sociocultural conditions and processes of becoming a sexual Black woman in order to understand the sociocultural drivers of STI/HIV rates among this group. METHOD We used theoretical sampling to select and interview 20 Black women aged 19-62 years old from a Midwestern community. RESULTS This study revealed sociocultural conditions related to Black heterosexual relationships and STI/HIV risk. Protecting Black men, silencing Black girls and women, cultural norms and messaging about sexuality, and gendered societal expectations and sexual stereotypes contribute to STI/HIV risk in Black girls and women. CONCLUSIONS Our findings demonstrate how the intersection of social and systemic structures (i.e.,history, incarceration, unemployment) shape the context of Black heterosexual relationships. We suggest STI/HIV prevention efforts address these systemic, cultural, and societal factors in order to effectively reduce racial disparities in STI/HIV risk.
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35
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Banks DE, Hensel DJ, Zapolski TCB. Integrating Individual and Contextual Factors to Explain Disparities in HIV/STI Among Heterosexual African American Youth: A Contemporary Literature Review and Social Ecological Model. ARCHIVES OF SEXUAL BEHAVIOR 2020; 49:1939-1964. [PMID: 32157486 PMCID: PMC7321914 DOI: 10.1007/s10508-019-01609-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/08/2018] [Revised: 12/03/2019] [Accepted: 12/10/2019] [Indexed: 05/21/2023]
Abstract
Heterosexual African American youth face substantial disparities in sexual health consequences such as HIV and STI. Based on the social ecological framework, the current paper provides a comprehensive, narrative review of the past 14 years of literature examining HIV/STI risk, including risky sexual behavior, among heterosexual African American youth and a conceptual model of risk among this population. The review found that individual psychological and biological factors are insufficient to explain the sexual health disparities faced by this group; instead, structural disadvantage, interpersonal risk, and community dysfunction contribute to the disparity in HIV/STI outcomes directly and indirectly through individual psychological factors. The conceptual model presented suggests that for African American youth, (1) HIV/STI risk commonly begins at the structural level and trickles down to the community, social, and individual levels, (2) risk works in a positive feedback system such that downstream effects compound the influence of structural risks, and (3) contextual and individual risk factors must be considered within the advanced stage of the epidemic facing this population. Despite advanced HIV and STI epidemics among heterosexual African American youth, multisystemic interventions that target structural risk factors and their downstream effects are posited to reduce the disparity among this high-risk population.
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Affiliation(s)
- Devin E Banks
- Department of Psychology, Indiana University Purdue University-Indianapolis, 402 N. Blackford St., LD 124, Indianapolis, IN, 46202, USA.
| | - Devon J Hensel
- Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Tamika C B Zapolski
- Department of Psychology, Indiana University Purdue University-Indianapolis, 402 N. Blackford St., LD 124, Indianapolis, IN, 46202, USA
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36
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Houle B, Yu ST, Angotti N, Schatz E, Kabudula CW, Gómez-Olivé FX, Clark SJ, Menken J, Mojola SA. Clusters of HIV Risk and Protective Sexual Behaviors in Agincourt, Rural South Africa: Findings from the Ha Nakekela Population-Based Study of Ages 15 and Older. ARCHIVES OF SEXUAL BEHAVIOR 2020; 49:2057-2068. [PMID: 32232623 PMCID: PMC7321875 DOI: 10.1007/s10508-020-01663-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/14/2019] [Revised: 02/12/2020] [Accepted: 02/14/2020] [Indexed: 06/10/2023]
Abstract
Understanding how sexual behaviors cluster in distinct population subgroups along the life course is critical for effective targeting and tailoring of HIV prevention messaging and intervention activities. We examined interrelatedness of sexual behaviors and variation between men and women across a wide age range in a rural South African setting with a high HIV burden. Data come from the Ha Nakekela population-based survey of people aged 15-85-plus drawn from the Agincourt Health and Socio-Demographic Surveillance System. We used latent class analysis of six sexual behavior indicators to identify distinct subgroup sexual behavior clusters. We then examined associations between class membership and sociodemographic and other behavioral risk factors and assessed the accuracy of a reduced set of sexual behavior indicators to classify individuals into latent classes. We identified three sexual behavior classes: (1) single with consistent protective behaviors; (2) risky behaviors; and (3) in union with lack of protective behaviors. Patterns of sexual behaviors varied by gender. Class membership was also associated with age, HIV status, nationality, and alcohol use. With only two sexual behavior indicators (union status and multiple sexual partners), individuals were accurately assigned to their most likely predicted class. There were distinct multidimensional sexual behavior clusters in population subgroups that varied by sex, age, and HIV status. In this population, only two brief questions were needed to classify individuals into risk classes. Replication in other situations is needed to confirm these findings.
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Affiliation(s)
- Brian Houle
- School of Demography, The Australian National University, #9 Fellows Road, Acton, Canberra, ACT, 2601, Australia.
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
- Institute of Behavioral Science, University of Colorado Boulder, Boulder, CO, USA.
| | - Shao-Tzu Yu
- School of Demography, The Australian National University, #9 Fellows Road, Acton, Canberra, ACT, 2601, Australia
| | - Nicole Angotti
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Institute of Behavioral Science, University of Colorado Boulder, Boulder, CO, USA
- Department of Sociology and Center on Health, Risk and Society, American University, Washington, DC, USA
| | - Enid Schatz
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Institute of Behavioral Science, University of Colorado Boulder, Boulder, CO, USA
- Department of Public Health, University of Missouri, Columbia, MO, USA
| | - Chodziwadziwa W Kabudula
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- INDEPTH Network, Accra, Ghana
| | - Francesc Xavier Gómez-Olivé
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- INDEPTH Network, Accra, Ghana
| | - Samuel J Clark
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Department of Sociology, The Ohio State University, Columbus, OH, USA
| | - Jane Menken
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Institute of Behavioral Science, University of Colorado Boulder, Boulder, CO, USA
| | - Sanyu A Mojola
- Department of Sociology and Woodrow Wilson School of Public and International Affairs, and Office of Population Research, Princeton University, Princeton, NJ, USA
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Kraft JM, Snead MC, Brown JL, Sales JM, Kottke MJ, Hatfield-Timajchy K, Goedken P. Reproductive Coercion Among African American Female Adolescents: Associations with Contraception and Sexually Transmitted Diseases. J Womens Health (Larchmt) 2020; 30:429-437. [PMID: 32667837 DOI: 10.1089/jwh.2019.8236] [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: 10/23/2022] Open
Abstract
Background: Among adolescents, racial disparities in reproductive health outcomes persist. The question of whether reproductive coercion (RC) influences these outcomes has received increased attention. Little is known about whether RC is independently associated with contraceptive use and having a sexually transmitted disease (STD) among African American female adolescents. Materials and Methods: Survey data for self-identified African American young women 14-19 years of age (n = 735) who accessed services at a publicly funded clinic were used to assess the extent of RC, the association between RC and other forms of intimate partner violence (IPV), and whether RC was independently associated with contraceptive use and an STD diagnosis. Results: Approximately 20% of participants had experienced RC; there was a statistically significant bivariate association between RC and other forms of IPV. In multivariate analyses, experiencing two or more forms of RC (vs. not experiencing any RC) was associated with reduced odds of contraceptive use in the past 3 months (adjusted odds ratio [aOR] = 0.46; 95% confidence interval [CI] = 0.24-0.76) and with increased odds of having an STD (aOR = 2.43; 95% CI = 2.35-4.37). Experiencing only one type of RC and experiencing other forms of IPV were not associated with the outcomes. Although ease of partner communication (aOR = 0.94; 95% CI = 0.80-0.98) was associated with having an STD, few other psychosocial variables were associated with the outcomes. Conclusions: RC is associated with reduced contraceptive use and increased STDs among African American adolescent women. Interventions to prevent and respond to RC that engage adolescent women and men are needed.
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Affiliation(s)
- Joan Marie Kraft
- National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Margaret Christine Snead
- National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Jennifer L Brown
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - Jessica M Sales
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Melissa J Kottke
- Department of Gynecology and Obstetrics, Jane Fonda Center, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Kendra Hatfield-Timajchy
- National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Peggy Goedken
- Department of Gynecology and Obstetrics, Jane Fonda Center, Emory University School of Medicine, Atlanta, Georgia, USA
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Pregnancy Coercion as a Risk Factor for HIV and Other Sexually Transmitted Infections Among Young African American Women. J Acquir Immune Defic Syndr 2020; 82 Suppl 2:S155-S161. [PMID: 31658204 PMCID: PMC6820702 DOI: 10.1097/qai.0000000000002174] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Pregnancy coercion (PC), defined as a restriction of women's reproductive autonomy, may be associated with increased HIV and sexually transmitted infection (STI) risk. However, there are few empirical studies defining the association between PC and HIV risk, particularly among vulnerable African American women. SETTING AND METHODS African American women (N = 560), ages 17-24, completed an audio computer-assisted self-interview assessing PC prevalence and its association with HIV/STI risk. Women were screened for prevalent STIs using polymerase chain reaction assays. Multivariate logistic and linear regressions evaluated the association of PC and multiple HIV/STI risk-associated outcomes. RESULTS Women who had experienced PC in the last 3 months, relative to those not experiencing PC, were 78% more likely to test positive for an STI [adjusted odds ratio = 1.78, 95% confidence interval (CI) = 1.10 to 2.90]. Among women who experienced PC, odds of noncondom use in their last sexual encounter were 3.45-fold greater relative to women not experiencing PC (95% CI = 1.55 to 7.85). Women who experienced PC had lower condom use intentions (coefficient, -1.31, P = 0.002), greater fear of condom negotiation, and perceived more barriers to condom use (coefficients, 3.89 and 5.74, respectively, both P < 0.001). Women who experienced PC had 1.98 (95% CI = 1.22 to 3.21) and 1.82 (95% CI = 1.09 to 3.04) odds of depression and HIV worry relative to women not experiencing PC. CONCLUSION Among African American women, PC was associated with a range of adverse sexual health outcomes and HIV/STI-related behaviors and attitudes. The findings underscore the need for promoting gender-equitable social norms in HIV prevention interventions.
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Gottert A, Pulerwitz J, Heck CJ, Cawood C, Mathur S. Creating HIV risk profiles for men in South Africa: a latent class approach using cross-sectional survey data. J Int AIDS Soc 2020; 23 Suppl 2:e25518. [PMID: 32589340 PMCID: PMC7319107 DOI: 10.1002/jia2.25518] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2019] [Revised: 04/10/2020] [Accepted: 04/22/2020] [Indexed: 12/17/2022] Open
Abstract
INTRODUCTION Engaging at-risk men in HIV prevention programs and services is a current priority, yet there are few effective ways to identify which men are at highest risk or how to best reach them. In this study we generated multi-factor profiles of HIV acquisition/transmission risk for men in Durban, South Africa, to help inform targeted programming and service delivery. METHODS Data come from surveys with 947 men ages 20 to 40 conducted in two informal settlements from May to September 2017. Using latent class analysis (LCA), which detects a small set of underlying groups based on multiple dimensions, we identified classes based on nine HIV risk factors and socio-demographic characteristics. We then compared HIV service use between the classes. RESULTS We identified four latent classes, with good model fit statistics. The older high-risk class (20% of the sample; mean age 36) were more likely married/cohabiting and employed, with multiple sexual partners, substantial age-disparity with partners (eight years younger on-average), transactional relationships (including more resource-intensive forms like paying for partner's rent), and hazardous drinking. The younger high-risk class (24%; mean age 27) were likely unmarried and employed, with the highest probability of multiple partners in the last year (including 42% with 5+ partners), transactional relationships (less resource-intensive, e.g., clothes/transportation), hazardous drinking, and inequitable gender views. The younger moderate-risk class (36%; mean age 23) were most likely unmarried, unemployed technical college/university students/graduates. They had a relatively high probability of multiple partners and transactional relationships (less resource-intensive), and moderate hazardous drinking. Finally, the older low-risk class (20%; mean age 29) were more likely married/cohabiting, employed, and highly gender-equitable, with few partners and limited transactional relationships. Circumcision (status) was higher among the younger moderate-risk class than either high-risk class (p < 0.001). HIV testing and treatment literacy score were suboptimal and did not differ across classes. CONCLUSIONS Distinct HIV risk profiles among men were identified. Interventions should focus on reaching the highest-risk profiles who, despite their elevated risk, were less or no more likely than the lower-risk to use HIV services. By enabling a more synergistic understanding of subgroups, LCA has potential to enable more strategic, data-driven programming and evaluation.
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Affiliation(s)
| | | | | | - Cherie Cawood
- Epicentre Health ResearchPietermaritzburgSouth Africa
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Rudolph K, Littleton H, Schoemann A. Patterns of Sexual Risk Behaviors among College Women: A Latent Profile Analysis. JOURNAL OF SEX & MARITAL THERAPY 2020; 46:403-418. [PMID: 32290792 DOI: 10.1080/0092623x.2020.1748777] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Sexual risk behavior is common among college women, but little work has identified risk patterns or correlates. The current study utilized latent profile analysis to identify sexual risk patterns among 1,534 college women. Results supported four classes: low sexual risk (68.2%), moderate sexual risk: party hookups (11.0%), moderate sexual risk: risky partners (17.6%), and high sexual risk (3.1%). Membership in the moderate and high-risk classes were associated with coping motives, drinking, and risky peer norms, while membership in the low risk class was associated with sexual satisfaction and low peer approval of risky sex. Implications of the findings are discussed.
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Affiliation(s)
- Kelly Rudolph
- Department of Psychology, East Carolina University, Greenville, NC, USA
| | - Heather Littleton
- Department of Psychology, East Carolina University, Greenville, NC, USA
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Shorey RC, Cohen JR, Kolp H, Fite PJ, Stuart GL, Temple JR. Predicting sexual behaviors from mid-adolescence to emerging adulthood: The roles of dating violence victimization and substance use. Prev Med 2019; 129:105844. [PMID: 31525388 PMCID: PMC6892170 DOI: 10.1016/j.ypmed.2019.105844] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Revised: 07/19/2019] [Accepted: 09/09/2019] [Indexed: 11/30/2022]
Abstract
The purpose of the present study was to determine whether dating violence victimization (psychological, physical, and sexual) and substance use (alcohol and marijuana) predicted sexual behaviors that increase risk for poor outcomes from ages 15-19. Adolescents (N = 1042; 56% female) were recruited from high schools in Southeast Texas in 2010 and followed annually for six years. The mean age of the sample at baseline was 15.09 (SD = 0.79). Participants primarily identified as Hispanic (31.4%), White (29.4%), and Black/African American (27.9%). Participants completed measures of dating violence victimization, substance use, and sexual behaviors annually. We examined unique and interactive associations between substance use and dating violence victimization with sexual behaviors that increase risk for poor outcomes. Multilevel modeling demonstrated that, when examining predictors simultaneously, marijuana use and psychological victimization predicted sexual behaviors over time for males. For females, marijuana use, and physical and psychological victimization all predicted sexual behaviors over time, with marijuana exerting the strongest effect, particularly among females who also used alcohol. Prevention efforts for adolescent sexual behaviors that increase risk for poor outcomes should include a focus on reducing substance use, particularly marijuana, and the effects of dating violence victimization.
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Affiliation(s)
- Ryan C Shorey
- University of Wisconsin - Milwaukee, United States of America.
| | | | - Haley Kolp
- University of Wisconsin - Milwaukee, United States of America
| | | | | | - Jeff R Temple
- University of Texas Medical Branch - Galveston, United States of America
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Fergus KB, Copp HL, Tabler JL, Nagata JM. Eating disorders and disordered eating behaviors among women: Associations with sexual risk. Int J Eat Disord 2019; 52:1310-1315. [PMID: 31267548 PMCID: PMC9714254 DOI: 10.1002/eat.23132] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Revised: 06/19/2019] [Accepted: 06/20/2019] [Indexed: 01/27/2023]
Abstract
OBJECTIVE To evaluate the association between eating disorders or disordered eating behaviors and sexual risk in young women. METHOD We used prospective cohort data of young women ages 18-26 years from the National Longitudinal Study of Adolescent to Adult Health (N = 5,899). Exposures of interest (at 18-26 years) included a self-reported eating disorder diagnosis or disordered eating behaviors including fasting/skipping meals, vomiting, diet pills, or laxative/diuretic use to lose weight and binge eating. Sexual risk outcomes at 7-year follow-up included the number of new sexual partners, condom use, and sexually transmitted infections. RESULTS Having either an eating disorder or reporting any disordered eating behavior was associated with a greater number of new sexual partners (B = 1.09, 95% CI [0.18, 2.00]) and lower odds of condom use (odds ratio 0.70, 95% CI [0.53, 0.94] among a subsample of sexually active, unmarried women). DISCUSSION Young women with eating disorders or who engage in disordered eating behaviors are at higher risk for multiple new sexual partners and unprotected sex. Clinicians caring for young adults with eating disorders may consider screening for sexual risk behaviors.
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Affiliation(s)
- Kirkpatrick B. Fergus
- Department of Urology, University of California-San Francisco, San Francisco, California
| | - Hillary L. Copp
- Department of Urology, University of California-San Francisco, San Francisco, California
| | - Jennifer L. Tabler
- Department of Criminal Justice and Sociology, University of Wyoming, Laramie, Wyoming
| | - Jason M. Nagata
- Department of Pediatrics, University of California-San Francisco, San Francisco, CA
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Vasilenko SA, Espinosa-Hernández G, Rice CE, Biello KB, Novak DS, Mayer KH, Mimiaga MJ, Rosenberger JG. Patterns of Sexual Behaviors in Young Men Who Have Sex With Men in Mexico. JOURNAL OF SEX RESEARCH 2019; 56:1168-1178. [PMID: 30638395 PMCID: PMC6626694 DOI: 10.1080/00224499.2018.1563667] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Recent research has documented the importance of understanding the multidimensional nature of sexual risk behavior. However, little is known about patterns of sexual behavior among men who have sex with men (MSM) in Mexico, men who are at greatest risk for HIV and sexually transmitted infections compared to other subpopulations in the country. This study applied latent class analysis to data from a large, HIV-negative sample of 18- to 25-year-old Mexican MSM recruited from a social and sexual networking website (N = 3,722) to uncover multidimensional patterns of sexual behaviors, partner factors, and protective behaviors, and examine how these were associated with health and well-being correlates. We selected a model with seven classes. The most common class included those who reported both insertive and receptive behaviors with more than one partner, but smaller groups of individuals were in classes marked by only insertive or receptive anal sex, romantic relationships, or sexual inactivity. Class membership differed by sexual orientation, age, depressive symptoms, alcohol problems, and self-acceptance, with individuals in a class marked by same-sex relationships generally reporting more positive outcomes. Findings suggest heterogeneity of behaviors among Mexican MSM and the possible efficacy of prevention messages tailored to individuals' specific patterns of sexual behavior.
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Affiliation(s)
- Sara A Vasilenko
- Department of Human Development and Family Science, Syracuse University
| | | | - Cara E Rice
- The Methodology Center, Pennsylvania State University
| | - Katie B Biello
- Departments of Behavioral and Social Sciences and Epidemiology, Brown University, and The Fenway Institute
| | | | - Kenneth H Mayer
- The Fenway Institute and Department of Global Health and Population, Harvard University
| | - Matthew J Mimiaga
- Departments of Behavioral & Social Health Sciences and Epidemiology, Brown University and The Fenway Institute
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Factors Associated with Intention of Human Papillomavirus (HPV) Vaccine Initiation Among Females With and Without a History of Childhood Cancer. J Clin Psychol Med Settings 2019; 27:716-726. [PMID: 31587132 DOI: 10.1007/s10880-019-09664-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Vaccination is available to prevent human papillomavirus (HPV) types that cause cervical and other cancers. This study aimed to describe and compare vaccine intention among young females with and without a cancer history, in addition to identifying factors associated with a HPV vaccination intention. Vaccine-naïve females (aged 18-26 years, n = 120) and maternal caregivers with vaccine-naïve daughters (aged 9-17 years, n = 197) completed surveys querying HPV vaccination intention, HPV knowledge, and communication, along with sociodemographic, medical, and health belief factors. Multivariable logistic regression was utilized to calculate odds ratio (OR) and 95% confidence intervals for HPV vaccination intention. No differences in vaccine intention were identified across cancer and comparison groups. Vaccine intention and predictors of intention among vaccine-naïve females differ by age, and there is variation in the factors which influence vaccine intention by age group. These results suggest interventions should be tailored based on developmental level.
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Latent Classes of Sexual Risk Behavior and Engagement in Outreach, Intervention and Prevention Services Among Women Who Inject Drugs Across 20 US Cities. J Acquir Immune Defic Syndr 2019; 79:305-314. [PMID: 30044301 DOI: 10.1097/qai.0000000000001816] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND Monitoring the effects of HIV prevention efforts among persons who inject drugs is key to informing prevention programs and policy. METHODS Data for this study came from the 2012 National HIV Behavioral Surveillance interviews with persons who inject drugs across 20 US cities. The present analyses include those who identified as female, ever had sex with a man, and were at risk of HIV infection (did not report a previous positive HIV test result) (n = 2624). We conducted latent class analysis to identify sexual risk classes, and modeled associations with engagement in HIV prevention services and HIV test results. RESULTS We identified 6 classes of sexual risk behavior: (1) low risk, (2) monogamous, (3) casual partner, (4) multiple partners, (5) exchange sex, and (6) exchange plus main partner. The class distribution was similar across the mainland regions. Bisexual orientation and homelessness were significant predictors of higher-risk class. HIV prevalence and participation in behavioral interventions did not vary significantly by risk class, while obtaining and using free condoms did. Independent of risk class, women in cities in the South were significantly less likely to use free condoms, and HIV prevalence was higher among non-Hispanic black women and women aged 40-49 years. CONCLUSIONS Bisexual orientation and homelessness were predictors of higher risk. Condom distribution programs reached fewer women in cities in the South. Race and age disparities in HIV-positive rates persisted after adjusting for sexual risk class.
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Nguyen N, Powers KA, Miller WC, Howard AG, Halpern CT, Hughes JP, Wang J, Twine R, Gomez-Olive X, MacPhail C, Kahn K, Pettifor AE. Sexual Partner Types and Incident HIV Infection Among Rural South African Adolescent Girls and Young Women Enrolled in HPTN 068: A Latent Class Analysis. J Acquir Immune Defic Syndr 2019; 82:24-33. [PMID: 31169772 PMCID: PMC6692200 DOI: 10.1097/qai.0000000000002096] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND Sexual partners are the primary source of incident HIV infection among adolescent girls and young women (AGYW) in sub-Saharan Africa. Identifying partner types at greatest risk of HIV transmission could guide the design of tailored HIV prevention interventions. METHODS We conducted a secondary analysis of data from AGYW (aged 13-23 years) enrolled in a randomized controlled trial of cash transfers for HIV prevention in South Africa. Annually, AGYW reported behavioral and demographic characteristics of their 3 most recent sexual partners, categorized each partner using prespecified labels, and received HIV testing. We used latent class analysis (LCA) to identify partner types from reported characteristics, and generalized estimating equations to estimate the relationship between both LCA-identified and prespecified partner types and incident HIV infection. RESULTS Across 2140 AGYW visits, 1034 AGYW made 2968 partner reports and 63 AGYW acquired HIV infection. We identified 5 LCA partner types, which we named monogamous HIV-negative peer partner; one-time protected in-school peer partner; out-of-school older partner; anonymous out-of-school peer partner; and cohabiting with children in-school peer partner. Compared to AGYW with only monogamous HIV-negative peer partners, AGYW with out-of-school older partners had 2.56 times the annual risk of HIV infection (95% confidence interval: 1.23 to 5.33), whereas AGYW with anonymous out-of-school peer partners had 1.72 times the risk (95% confidence interval: 0.82 to 3.59). Prespecified partner types were not associated with incident HIV. CONCLUSION By identifying meaningful combinations of partner characteristics and predicting the corresponding risk of HIV acquisition among AGYW, LCA-identified partner types may provide new insights for the design of tailored HIV prevention interventions.
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Affiliation(s)
- Nadia Nguyen
- Department of Epidemiology, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, NC
- HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute and Columbia University, New York, NY
| | - Kimberly A. Powers
- Department of Epidemiology, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, NC
| | | | - Annie Green Howard
- Department of Biostatistics, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, NC
- Carolina Population Center, The University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Carolyn T. Halpern
- Carolina Population Center, The University of North Carolina at Chapel Hill, Chapel Hill, NC
- Department of Maternal and Child Health, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - James P. Hughes
- Department of Biostatistics, University of Washington, Seattle, WA
- Fred Hutchinson Cancer Research Center, Seattle, WA
| | - Jing Wang
- Fred Hutchinson Cancer Research Center, Seattle, WA
| | - Rhian Twine
- Medical Research Council/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of the Health Sciences, University of the Witwatersrand, South Africa
| | - Xavier Gomez-Olive
- Medical Research Council/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of the Health Sciences, University of the Witwatersrand, South Africa
- INDEPTH Network, Accra, Ghana
| | - Catherine MacPhail
- Medical Research Council/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of the Health Sciences, University of the Witwatersrand, South Africa
- Wits Reproductive Health and HIV Research Institute, University of the Witwatersrand, South Africa
- School of Health and Society, University of Wollongong, NSW, Australia
| | - Kathleen Kahn
- Medical Research Council/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of the Health Sciences, University of the Witwatersrand, South Africa
- INDEPTH Network, Accra, Ghana
- Epidemiology and Global Health Unit, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Audrey E. Pettifor
- Department of Epidemiology, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, NC
- Carolina Population Center, The University of North Carolina at Chapel Hill, Chapel Hill, NC
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Aicken CR, Wayal S, Blomquist P, Fabiane S, Gerressu M, Hughes G, Mercer CH. Ethnic variations in sexual partnerships and mixing, and their association with STI diagnosis: findings from a cross-sectional biobehavioural survey of attendees of sexual health clinics across England. Sex Transm Infect 2019; 96:283-292. [PMID: 31422350 PMCID: PMC7279208 DOI: 10.1136/sextrans-2018-053739] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2018] [Revised: 05/14/2019] [Accepted: 07/13/2019] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVES Ethnic differences in partnership types and sexual mixing patterns may contribute to elevated STI diagnosis rates among England's Black Caribbean (BC) population. We examined the differences between BC and White British/Irish (WBI) sexual health clinic (SHC) attendees' reported partnerships and sexual mixing, and whether these differences could explain ethnic inequalities in STI, focusing on attendees reporting only opposite-sex partners (past year). METHODS We surveyed attendees at 16 SHCs across England (May to September 2016), and linked their survey responses to routinely collected data on diagnoses of bacterial STI or trichomoniasis ±6 weeks of clinic attendance ('acute STI'). Behaviourally-heterosexual BC and WBI attendees (n=1790) reported details about their ≤3 most recent opposite-sex partners (past 3 months, n=2503). We compared BC and WBI attendees' reported partnerships and mixing, in gender-stratified analyses, and used multivariable logistic regression to examine whether they independently explained differences in acute STI. RESULTS We observed differences by ethnic group. BC women's partnerships were more likely than WBI women's partnerships to involve age-mixing (≥5 years age difference; 31.6% vs 25.5% partnerships, p=0.013); BC men's partnerships were more often 'uncommitted regular' (35.4% vs 20.7%) and less often casual (38.5% vs 53.1%) than WBI men's partnerships (p<0.001). Acute STI was higher among BC women than WBI women (OR: 2.29, 95% CI 1.24 to 4.21), with no difference among men. This difference was unaffected by partnerships and mixing: BC women compared with WBI women adjusted OR: 2.31 (95% CI 1.30 to 4.09) after adjusting for age and partner numbers; 2.15 (95% CI 1.07 to 4.31) after additionally adjusting for age-mixing, ethnic-mixing and recent partnership type(s). CONCLUSION We found that differences in sexual partnerships and mixing do not appear to explain elevated risk of acute STI diagnosis among behaviourally-heterosexual BC women SHC attendees, but this may reflect the measures used. Better characterisation of 'high transmission networks' is needed, to improve our understanding of influences beyond the individual level, as part of endeavours to reduce population-level STI transmission.
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Affiliation(s)
- Catherine Rh Aicken
- Institute for Global Health, University College London, London, UK .,School of Health Sciences, University of Brighton, Brighton, UK
| | - Sonali Wayal
- Institute for Global Health, University College London, London, UK
| | - Paula Blomquist
- Centre for Infectious Disease Surveillance and Control, Public Health England, London, UK
| | - Stella Fabiane
- Institute for Global Health, University College London, London, UK.,MRC Clinical Trials Unit, University College London, London, UK
| | - Makeda Gerressu
- Institute for Global Health, University College London, London, UK
| | - Gwenda Hughes
- Institute for Global Health, University College London, London, UK.,Centre for Infectious Disease Surveillance and Control, Public Health England, London, UK
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Murry VM, Kettrey HH, Berkel C, Inniss-Thompson MN. The Pathways for African American Success: Does Delivery Platform Matter in the Prevention of HIV Risk Vulnerability Among Youth? J Adolesc Health 2019; 65:255-261. [PMID: 31043346 DOI: 10.1016/j.jadohealth.2019.02.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2018] [Revised: 02/15/2019] [Accepted: 02/15/2019] [Indexed: 12/12/2022]
Abstract
PURPOSE Technology provides new possibilities for disseminating effective prevention programming to underserved families, such as those residing in rural communities. The present study is an evaluation of a technology-delivered HIV risk prevention program designed for rural African-American families, Pathways for African American Success (PAAS), to determine its promise for increasing access to evidence-based youth risk prevention programs among those in the greatest need. METHODS Four hundred and twelve parent/youth dyads were randomly assigned to one of three conditions: (1) in-person facilitator-led PAAS small group, (2) self-directed PAAS technology, or (3) a literature control with home-mailed educational materials. RESULTS Compared with families in the literature control condition, families assigned to the PAAS technology or small group conditions demonstrated significantly stronger intervention induced parent-child protective processes (e.g., enhanced discussion quality, clearly articulated norms, and parental expectations about risk engagement) and lower youth intentions to engage in risky behaviors 6 months postintervention. Although some important nuances were noted, this study suggests that the PAAS technology-delivered modality is just as efficacious as the in-person facilitator-led, small group modality in dissuading HIV-related risk behaviors among rural African-American youths. CONCLUSIONS Implications for having a menu of service delivery models that address the diverse needs and contexts of families are discussed, including the promise of technology as an alternative modality for reaching populations often characterized as difficult to reach and to engage in family-based preventive interventions.
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Affiliation(s)
- Velma McBride Murry
- Department of Human and Organizational Development, Peabody College, Vanderbilt University, Nashville, Tennessee.
| | - Heather Hensman Kettrey
- Department of Sociology, Anthropology & Criminal Justice, Clemson University, Clemson, South Carolina
| | - Cady Berkel
- REACH Institute (formerly the Prevention Research Center), Arizona State University, Tempe, Arizona
| | - Misha N Inniss-Thompson
- Department of Human and Organizational Development, Peabody College, Vanderbilt University, Nashville, Tennessee
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Sunil TS, Xu X. Substance abuse and HIV/STD prevention at a Hispanic-serving institution in South Texas: A study of racial/ethnic and gender heterogeneity and intersectionality. J Ethn Subst Abuse 2019; 20:257-274. [PMID: 31328656 DOI: 10.1080/15332640.2019.1641173] [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] [Indexed: 01/08/2023]
Abstract
The purpose of this study is to examine racial/ethnic and gender variations and intersectionality in the knowledge, attitudes, intentions, and behaviors pertaining to substance abuse (SA) and human immunodeficiency virus (HIV)/sexually transmitted disease (STD) prevention among racial/ethnic minority college students (ages 18-24) in South Texas. A total of 535 minority students completed a baseline survey between 2014 and 2016 (N = 535). Results revealed statistically significant (ranging from p < .05 to p < .001) racial/ethnic and gender variations in SA and HIV/STD prevention-related knowledge, attitudes, intentions, and behaviors. However, the significant interaction effects (i.e., intersectionality) were observed only for two of the nine composite variables. That is, although male minority students exhibited lower levels of awareness of sexual risks and safe sex negotiation skills than female minority students, Hispanic male students appeared to fare better in both awareness of sexual risks (p < .01) and safe sex negotiation skills (p < .05) compared to students of other racial/ethnic origin. Implications for prevention and intervention work involving minority college students are discussed.
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Affiliation(s)
- Thankam S Sunil
- The University of Texas at San Antonio, San Antonio, TX.,West China School of Public Health, Sichuan University, China
| | - Xiaohe Xu
- The University of Texas at San Antonio, San Antonio, TX.,School of Public Administration, Sichuan University, China
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Patterns of Sexual Behavior and Sexually Transmitted Infections in Young Men Who Have Sex With Men. Sex Transm Dis 2019; 45:387-393. [PMID: 29465677 DOI: 10.1097/olq.0000000000000767] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
PURPOSE Young men who have sex with men (MSM) are at an increased risk for sexually transmitted infections (STIs). Recent research has documented the importance of understanding the multidimensional nature of sexual risk behavior; however, little is known about how multidimensional patterns of sexual behavior among MSM may be associated with STIs. METHOD This study applies latent class analysis to data from a large, HIV- sample of 18- to 25-year-old MSM recruited from social and sexual networking Web sites (N = 5965; 76% white, 11% Latino, 5% black, 4% Asian, 4% other; 74% homosexual, 21% bisexual, 1% heterosexual, 3%, unsure/questioning 1% other) to uncover multidimensional patterns of past-year sexual behaviors, partner factors, and protective behavior and their associations with self-reported STI diagnosis. RESULTS We selected a model with 8 classes, with nearly half of participants belonging to a class marked by multiple behaviors with more than 1 partner, and smaller numbers of individuals in classes with a smaller number of behaviors, romantic relationships, and sexual inactivity. Class membership was associated with recent STI diagnosis, with classes marked by no penetrative sex or receptive anal sex with consistent condom use having lower prevalence than those with inconsistent condom use, including those engaging in only insertive anal sex. CONCLUSIONS Findings suggest heterogeneity of behaviors within MSM and that prevention messages may be more effective if they are tailored to individuals' patterns of sexual behavior, as well as demographic and sociocontextual factors.
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