Socio-Demographic, Health and Lifestyle Factors Influencing Age of Sexual Initiation among Adolescents

School Connectedness and Risk for Sexual Intercourse and Nonconsensual Sex in Adolescence

The CDC reports that 30% of high school students have engaged in sexual intercourse. Evidence suggests biological, personal, peer, societal, and family variables affect when a child will initiate sex. The school environment plays an important role in a child's development. Evidence suggests that greater attachment to the school community can modify sexual risk-taking activity in adolescents. Future of Families and Child Wellbeing Study (FFCWS) comprises a cohort of approximately 4,700 families of children born in the U.S. between 1998-2000, over-sampled for non-marital births in large U.S. cities. Adolescents (N = 3,444 of 4,663 eligible) completed the wave six teen survey at approximately age 15. School connectedness was self-reported with four items measuring inclusiveness, closeness, happiness, and safety felt by the adolescent in their school environment. Sexual intercourse and nonconsensual sex were self-reported by the adolescent. Hierarchical regression analyses were conducted examining sexual intercourse, nonconsensual sex, risk factors, and school connectedness. In this sample of adolescents (48% female, 49% Black, 25% Hispanic, ages 14-19), school connectedness appears to reduce boys' risk of nonconsensual sex (OR = 0.29, p < 0.01), and reduce girls' risk of engaging in sexual intercourse (OR = 0.55, p < 0.01). Findings suggest gender differences in the association between school connectedness and sexual practices in adolescents. School connectedness may confer protection for boys' risk of nonconsensual sex, and for girls' risk of engaging in sexual intercourse. Further exploration of the relationship between school connectedness may allow for recommendations into preventative measures for teenage sexual behaviors.

A systematic review of social processes and mechanisms in the community that influence risky sexual behaviour among adolescents and young adults

AIMS

To examine the associations between social processes and mechanisms within the community and risky sexual behaviour (RSB) among adolescents and young adults.

DESIGN

Systematic review.

METHODS

We used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and conducted a literature search in August 2020. From 11,216 identified articles, 605 were for full-text screen. We used 24 articles, 22 after applying inclusion criteria and 2 manually searched relevant articles.

RESULTS

Social processes and mechanisms within the community included collective efficiency and social support, community safety and community norm. Collective efficacy and social support and community safety were examined using 10 and 16 studies, respectively. We found that collective efficiency and social support, and community norms partially supported the occurrences of RSB among adolescents and young adults. Community safety displayed inconclusive relationships with RSB.

CONCLUSIONS

The findings highlight the importance of social processes and mechanisms within the community in preventing RSB among adolescents and young adults. Community-based programs to improve community efficacy and social support would be effective strategies to reduce such RSB and to promote better reproductive health among adolescents and young adults.

Trends in Early Sexual Initiation and Its Association with Socio-Environmental Factors among Korean Adolescents

There has been no research on the trends in early sexual initiation associated with socio-environmental factors in Korea. This study aimed to examine the trends of early sexual initiation with various socio-environmental factors among adolescents. The Korea Youth Risk Behavior Web-based Survey data were used, and two pooled datasets extracted from the 2006-2008 and 2014-2016 waves were conducted and compared. In this study, early sexual initiation was defined as sexual intercourse at the age of 13 years or younger. The weighted percentage and 95% confidence interval reporting early sexual initiation were estimated, and multiple logistic regression was performed for each subgroup of socio-environmental variables with the 2006-2008 pooled data as a reference. Regardless of sex, the weighted percentage of adolescents with sexual experience who reported early sexual initiation increased in 2014-2016 with statistical significance in most cases. Moreover, the possibility of experiencing early sexual intercourse overtime was more prominent among girls than boys. While indifference to adolescent sexual behavior continues, more adolescents become involved in early sexual initiation. Socio-environmental considerations, such as the establishment of safe environments for adolescents' sexual activity, along with systematized monitoring mechanisms, should be administered.

Sexual Behavior Patterns of Black Young Adults in Georgia: Results from a Latent Class Analysis

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.

Associations between sexual and reproductive health knowledge, attitude and practice of partners and the occurrence of unintended pregnancy

Background

Although global contraceptive coverage has increased significantly, high rates of unintended pregnancy remain the current global status quo. A comparative analysis of the differences and correlations of knowledge, attitude and practice (KAP) of sexual and reproductive health (SRH) of both partners will help guide public health work according to gender characteristics and needs, and reduce the occurrence of unintended pregnancy.

Methods

A questionnaire survey of people with unintended pregnancies including women and their male partners (n = 1,275 pairs) who sought help from the Shanghai General Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from October 2017 to October 2021. Data were collected on sexual and reproductive health knowledge, attitudes, and practices in both partners who had unintended pregnancies. Chi-square test and Logistic regression were used to analyze the relationship between the occurrence of unintended pregnancy and KAP and its influencing factors. Paired odds ratio and McNemar's test were used to estimate the difference and concordance of KAP between partners.

Results

This study included 1,275 partners with a mean age of 30.0 years. The partner's overall level of KAP is good. Compared with women, men had better knowledge (χ2 = 3.93, p = 0.047) and more active contraceptive practices (χ2 = 19.44, p < 0.001). In the analysis of partner concordance, male contraceptive intention was found to be better than female [matched pairs odds ratio (ORMP) = 2.56, p < 0.001], and the concordance of positive contraceptive practice between partners increased with male education [adjusted odds ratio (aOR) = 1.556, 95% confidence interval (CI) = 1.185-2.044, p = 0.001]. In partner-paired regression analysis, compared with good contraceptive knowledge in both men and women in the partner, the risk of negative contraceptive practice was 1.7 times (aOR = 1.721, 95% CI = 1.234-2.400, p = 0.001) higher with good contraceptive knowledge in women but negative in men, while women with poor contraceptive knowledge but men with good knowledge are 1.3 times (aOR = 1.349, 95% CI = 1.000-1.819, p = 0.05) more likely to have negative contraceptive practices. In addition, compared with partners with positive contraceptive attitudes, women with positive attitudes but negative men and women with negative attitudes but positive men had 1.7 and 1.4 times the risk of negative contraceptive practices, respectively.

Conclusion

The study found that unintended pregnancy occurs mainly in young people, and the younger age of first sexual intercourse, the low education background and the lack of discussion of contraception between partners are risk factors for not taking contraceptive measures. Men's better knowledge and contraceptive practices compared with female partners, and poor male contraceptive knowledge and attitudes may lead to a higher risk of negative contraceptive practices, the results suggest that male KAP plays an important role in promoting contraceptive use and reducing unintended pregnancy.

Harnessing machine learning models for non-invasive pre-diabetes screening in children and adolescents

BACKGROUND AND OBJECTIVES

Pre-diabetes has been identified as an intermediate diagnosis and a sign of a relatively high chance of developing diabetes in the future. Diabetes has become one of the most frequent chronic disorders in children and adolescents around the world; therefore, predicting the onset of pre-diabetes allows a person at risk to make efforts to avoid or restrict disease progression. This research aims to create and implement a cross-validated machine learning model that can predict pre-diabetes using non-invasive methods.

METHODS

We have analysed the national representative dataset of children and adolescents (5-19 years) to develop a machine learning model for non-invasive pre-diabetes screening. Based on HbA1c levels the data (n = 26,567) was segregated into normal (n = 23,777) and pre-diabetes (n = 2790). We have considered eight features, six hyper-tuned machine learning models and different metrics for model evaluation. The final model was selected based on the area under the receiver operator curve (AUC), Cohen's kappa and cross-validation score. The selected model was integrated into the screening tool for automated pre-diabetes prediction.

RESULTS

The XG boost classifier was the best model, including all eight features. The 10-fold cross-validation score was highest for the XG boost model (90.13%) and least for the support vector machine (61.17%). The AUC was highest for RF (0.970), followed by GB (0.968), XGB (0.959), ETC (0.918), DT (0.908), and SVM (0.574) models. The XGB model was used to develop the screening tool.

CONCLUSION

We have developed and deployed a machine learning model for automated real-time pre-diabetes screening. The screening tool can be used over computers and can be transformed into software for easy usage. The detection of pre-diabetes in the pediatric age may help avoid its enhancement. Machine learning can also show great competence in determining important features in pre-diabetes.

The associations of dietary habits with health, well-being, and behavior in adolescents: A cluster analysis

INTRODUCTION

Dietary habits may be associated with adolescents' health and behavior. However, previous findings are inconsistent and often unadjusted for sociodemographic confounders. The aim of this study was to investigate (1) whether dietary habits (consumption of fruits, vegetables, sweets, soft drinks, breakfast, and family meals) cluster among adolescents and (2) how these clusters associate with a range of health, well-being, and behavior outcomes in a large population-based sample of adolescents.

METHODS

The study included adolescents (n = 7529; n = 3891 [51.7%] girls; mean [standard deviation] age = 14.9[2.1] years) from the 2018 Luxembourg Health Behaviour in School-aged Children study. We used cluster analysis to define clusters of dietary habits (consumption of fruits, vegetables, sweets, soft drinks, breakfast, and family meals) and logistic regression analyses to assess the cross-sectional associations of the clusters with health, well-being and behavior, adjusted for age, gender, family affluence, and migration background.

RESULTS

Cluster analysis yielded five clusters of dietary habits: (1) healthy, (2) family meal and breakfast skippers, (3) sugar consumption, (4) unbalanced diet, and (5) unhealthy. The healthy cluster was associated with better health and positive mental health and behavior, whereas the less healthy clusters were associated with worse health, mental health problems, and risk behavior.

CONCLUSION

Findings suggest that healthy dietary habits associate with positive health and behavior, whereas unhealthy dietary habits associate with health problems and risk behavior during adolescence. More research is needed to investigate the underlying mechanisms. Interventions should include dietary habits as a component of lifestyle modification to improve adolescents' health, well-being, and behavior.

Changes in sexual behavior among high-school students over a 40-year period

The aim of this study was to investigate sexual behavior, contraceptive use, risk factors as well as sources of sex information among first-year high-school students in Sweden. Secondly, to assess differences between genders and study programs as well as changes over a 40-year period. A repeated cross-sectional survey was conducted in two cities. A questionnaire comprising 77 items was used. The study population consisted of 415 students (63.4% females). The median age of sexual intercourse was 15 years. In total, 37% had had sexual intercourse, compared to 56.3% in 2009 and 45% in 1999 (p < 0.001), and the proportion of students who had their first sexual intercourse was not influenced by gender. More students in vocational programs (46.3%), compared to theoretical (33.3%), had experience of at least one sexual intercourse (p = 0.019). The same extend of contraception use at first and latest intercourse was reported, compared to previous studies. Forty-nine percent were mostly informed about sex from the internet, while in previous years, magazines, family and youth clinics were the main information sources. Comparing over time, students were in general less sexually experienced and less engaged in non-penetrative sex and physical intimacy. These findings call for a new approach, when designing sex and relationship education and health-care counseling in adolescents.

Individual and social determinants of early sexual activity: A study of gender-based differences using the 2018 Canadian Health Behaviour in School-aged Children Study (HBSC)

Introduction

Early sexual activity, often defined as initiation before the age of 16, is a risk behaviour associated with negative health outcomes in adulthood. The objective of this study was to explore links between early sexual activity and individual and contextual characteristics in Canadian youth, and whether these differ for girls and boys.

Methods

Data were from the 2018 Canadian Health Behaviour in School-aged Children (HBSC) survey administered in classrooms across Canada to students in grades 6 to 10 (ages 11 to 16). The sample includes the 7882 students in grades 9 and 10 who were asked about sexual activity. Individual and contextual measures used included emotional well-being, socioeconomic status, participation in team sports, body image, social media use, family structure, and family support. Descriptive data overall and separately for girls and boys are presented, followed by Poisson regression models to estimate relative risks and associated 95% confidence intervals for strength of associations between characteristics and early sexual activity. Models were adjusted for clustering by school using generalised estimating equations.

Results

Overall, contextual factors i.e. disrupted family structure or low family support were the characteristics most strongly associated with early sexual activity. Among boys there was an incremental and strong relationship between hours spent in organised sport and early sexual activity. Among girls, poorer body image, lower socioeconomic status, and higher social media use aligned most strongly with early sexual activity.

Conclusion

Persistent gender stereotypes appear to underlie differences in individual and contextual factors associated with adolescents’ sexual behaviour. Findings from this exploratory analysis may be of benefit to subsequent researchers, policy makers and those who care for youth.