Proximal and Distal Indirect Influences on Adolescent Sexual Activity and Post Risky Sexual Behaviors

Proximal and Distal Indirect Influences on Adolescent Sexual Activity and Post Risky Sexual Behaviors INTRODUCTION: Prior literature has revealed a correlation between adolescent sexual debut and parenting behaviors. However, most existing studies has only focused on parental monitoring and control. This limitation, in addition to small, cross-sectional studies, has resulted in inconsistent and limited findings. These gaps are addressed in this present paper by investigating how family connectedness contributes to the age of sexual debut. It is hypothesized that adolescents who are 13 years of age and have a lack of family connectedness engage in high-risk behaviors sooner than their 13-year-old peers with greater family connectedness. METHODS: Data were drawn from the 1997 National Longitudinal Survey of Youth. This paper focused on adolescents born in the year 1983 who had no sexual debut at baseline. Those selected were initially interviewed for baseline family connectedness and prospectively followed up to adulthood. Family connectedness was measured using five aspects: shared activities, parent-adolescent communication, parent admiration, parental support and the presence of family dinners. SAS 9.4 was used to perform survival analyses to examine the rate of teenage sexual debut by family connectedness. RESULTS: Findings suggest that family connectedness, specifically weekly family dinners and parent-child communication were significant familial factors that delayed adolescent sexual behavior. The hazards ratio of having an adolescent sexual debut at any time for an individual who had family activity at least once a week was 0.91 (95CI: 0.74, 1.14), having weekly family dinner (HR 0.70; 95CI: 0.53, 0.93), communication with parents (HR 0.78; 95CI: 0.68, 0.91), perceived parental support (HR 1.04; 95CI:0.91, 1.02), think highly of parents (HR 1.08; 95CI 0.93, 1.25). CONCLUSION: This study attempted to observe other factors outside of the parental monitor and control that could contribute to adolescent sexual activity. However, family connectedness was found to be a protective factor only among family weekly dinner and parent-child communitcation. Public health policy and interventions aimed at family connectedness alone will unlikely influence adolescent sexual behaviors. Therefore, other factors along with family connectedness should be further assessed to discover its true correlation on sexual debut

Forced Sexual Intercourse in Relation to Female Adolescents\u27 Risky Sexual Behavior, Psychopathology, and Behavior Problems

During 1995, over 20,000 adolescents completed the in-home interview for The National Longitudinal Study of Adolescent Health (Add Health). One question asked females if they had ever been forced to have sexual intercourse (FSI). In addition, they were asked about other sexual behavior, their psychological well-being, and behavior problems. The present study examines the associations between FSI and 26 outcome variables, comparing adolescent females who reported FSI with females who reported voluntary intercourse, and with females who reported no intercourse. In addition, the large Add Health sample allowed comparisons between five race/ethnicity groups and four adolescent groups broken down by age. Psychological and emotional correlates of sexual abuse have been widely documented, but until now, studies of sexual abuse had largely consisted of small samples of mostly White females with limited generalizability. The Add Health sample was large enough to go beyond psychopathology to include risky sexual behavior, and behavior problems. The Add Health sample is representative of the overall population of adolescents in the United States during the mid 1990s. Results showed that females forced to have intercourse have earlier and more frequent risky sexual behavior, more severe symptoms of psychopathology, and were much more likely to report behavior problems such as smoking, drinking, and drug use (a finding that has been largely unreported) than were females who reported no intercourse. Drug use was the variable on which females who reported forced intercourse and those who reported no intercourse differed most. Females who reported FSI were five times more likely to have reported illicit drug use than were females who reported no intercourse. Asian and White females who reported forced intercourse had the greatest vulnerability for negative outcomes, while African American females who reported forced intercourse had the greatest resilience against negative outcomes. Among female adolescents who reported forced intercourse, the youngest (ages 12, 13, and 14 years) were the most vulnerable to experience severe psychopathology and to report cigarette smoking and drinking alcohol

The Influence of Race and Gender on HIV Risk Behaviors in High School Students in the Southern States of the United States

The incidence of the Human Immunodeficiency Virus (HIV) is highest in the southern states of the United States (US), with adolescents in this region being one of the most affected populations in the country. A limited amount of information is available on adolescent HIV risk behaviors in the southern states, specifically focusing on race and gender. The purpose of this study was to use the Centers for Disease Control and Prevention’s National Youth Risk Behaviors Survey (YRBS) for high school students in the southern states for 2011 and 2013 to examine the influence of race and gender on 1) early sexual initiation, 2) number of sexual partners, and 3) condom use. Descriptive statistics and multiple logistic regression was used for the analysis. A total of 6,244 (6.7%) students reported early sexual initiation, 13,121 (14.1%) reported having multiple sex partners, and 11,820 (41.1%) reported condom use in southern states for 2011 and 2013. Minority males were greater than 10 times more likely to engage in early sexual initiation compared to white females (OR-10.40; 95% Confidence Interval (CI)-9.03-11.98). Minorities and males were more likely to have multiple sex partners compared to whites and females (OR- 1.84; CI-1.73-1.95, OR-2.20; CI-2.07-2.34, respectively). Minority males were over 2 times more likely to use condoms compared to white females (OR-2.04; CI-1.87-2.23). There was a statistically significant association between the three sexual health behaviors and psychosocial factors, such as dating violence, forced sex, body weight perception, and substance use before sex. Gender and race along with psychosocial factors were associated with HIV risk behaviors for high school students in the southern states. These preliminary findings could potentially be used to target HIV/AIDS awareness and preventative actions to populations affected by the HIV burden in the southern states

Changes in Sexual Risk Perception and Risk Taking Among Urban African American Adolescents

Background: Adolescents and young adults aged 15 to 24 acquire nearly half of all new STDs in the United States, yet they represent only 25% of the sexually active population. Young men and women in this age group have the highest rates of chlamydia, gonorrhea, and syphilis, especially in the African American population. Adolescent risk factors include having a history of pregnancy or STDs, being arrested or incarcerated, substance abuse, early sexual debut and having 4 or more lifetime sexual partners. Protective behaviors such as parental involvement, school enrollment, and consistent condom use have been associated with decreased incidence of STDs. The purpose of this study is to observe changes in adolescent behaviors and experiences that are known risk factors for acquiring sexually transmitted diseases. The aim is to identify the time at which STD prevention interventions may be administered most effectively. In addition, the study aims to identify relevant themes and content that may be useful in creating interventions targeted to different age groups and genders. Methods: This study utilizes primary data collected between 1999 and 2003 by Dr. Rothenberg and colleagues for a community-based network study of low-income African American adolescents living in a working class neighborhood in Southwest Atlanta. Two descriptive analyses were conducted: a period analysis in which all participants ages 15 to 18 who completed any or all of three interviews were included; and a cohort analysis, which included only participants who completed three interviews and who were 15, 16, 17 or 18 years of age at the time of the first interview. Univariate analysis was used to describe each variable and the resulting frequencies and percentages were reported. Results: In both period and cohort analyses, higher proportions of older adolescents (ages 17 and 18) reported engaging in risky behaviors including drinking alcohol, using marijuana, having sex and having multiple sexual partners, compared to younger adolescents (ages 15 and 16). Males reported higher proportions of engaging in risky behaviors than females, but also higher proportions of condom use. The proportion of participants diagnosed with one or more STDs decreased at each interview. In the cohort analysis, the proportion of participants who perceived their STD risk as “medium” or “high” increased over time. Conclusions: The findings suggest that as adolescents mature they engage in a greater variety of risky behaviors known to have a positive association to STD diagnosis. Period analyses, which have usually been done to study the sexual behaviors of adolescents, may give aberrant results that are clearer when the population is studied as a cohort. Future studies are needed to more precisely identify the period during which adolescents experience rapid changes in their risk behaviors

The Context of Sexual Risk among African-American Female College Students

Objective: To assess the sexually transmitted infection (STI) awareness, sexual risk behaviors, and related contextual factors of African-American female college students. Participants: Eighty-nine African-American first year female students attending a majority public four-year college in the southern U.S. participated in the study in Spring, 2006. Methods: Participants completed an anonymous self-administered paper-and-pencil survey and received a $15 cash incentive. Results: Participants were highly knowledgeable and aware about STIs and their consequences. While this awareness translated into low levels of risk for many, still others engaged in behaviors and maintained beliefs that could potentially put them at high risk for contracting STIs. Conclusions: Given the disproportionate rates of STIs among young African-American females, researchers must not ignore the non-behavioral factors (i.e. beliefs and perceptions) that may influence sexual risk behaviors to help in determining optimal methods for intervention and prevention among young African-American females

Predicting condom use from adolescence to emergent adulthood: A comprehensive health behavior model

The study utilized a comprehensive health behavior model to predict condom use longitudinally from adolescence into emergent adulthood. The comprehensive model was created by combining and extending widely used models of health behavior. Participant data for this secondary analysis were drawn from The National Longitudinal Study of Adolescent Health. The aims of the study were to document the prevalence of condom use, to investigate the relationship between the factors of the model and condom use, and to predict condom use from adolescence into emergent adulthood. Results revealed that condom use decreased with time. Gender and racial differences emerged. The correlational data produced mixed results with regard to anticipated strength and direction of effect. Finally, the predictive ability of the model was inconsistent and minimal across groups and time. The model is discussed in terms of its developmental limitations when used with adolescents, and implications for future prevention programs are explored

An Assessment of Sexually Transmitted Disease Knowledge Among 7th Grade Students

Sexually transmitted diseases (STDs) continue to remain a public health concern in the United States, especially among young people. Levels of knowledge with regard to STDs have been investigated in prior research; however, these investigations have been limited primarily to older adolescents and young adults. Grounded in the social cognitive and subjective culture theories, this quantitative, cross-sectional study assessed STD knowledge (other than HIV/AIDS) among 7th grade students attending a public middle school in the United States. Demographic differences (age, gender, and ethnicity) in STD knowledge were examined to determine if these demographic variables predict STD knowledge scores and if the Sexually Transmitted Disease Knowledge Questionnaire (STD-KQ) is a valid and reliable instrument among this study population. Chi-square analysis demonstrated that STD knowledge scores significantly differed by age only: Twelve-year-olds had higher STD scores than did 13-year-olds, contrary to research in older adolescents, which may be the result of confounding factors that warrant further investigation. Multiple regression analysis showed that age, gender, and ethnicity were not associated with STD knowledge scores. The STD-KQ was found to have face validity as well as high consistency and reliability among all questions related to STDs other than HIV/AIDS using Crohnbach\u27s alpha. Content validity for individual STD-KQ items was shown using Lawshe\u27s content validity ratio and subject matter experts. Results of the study support positive social change and highlight the need for earlier STD education, other than HIV/AIDS, with middle school children and the need to examine other factors that may impact STD knowledge within this age group

Innovative Sexually Transmitted Infection Prevention-Intervention for African-American Adolescent Girls

The purpose of this study is to determine whether implementation of an innovative STI prevention intervention design affects participants’ knowledge of sexually transmitted infections and sexual self-efficacy. The population this research focuses on is African-American adolescent girls. The participants included in this study are aged 13-19. This particular population is disproportionately infected by sexually transmitted diseases, so it is vital that intervention programs be tailored to fit their culture and gender-specific needs in order to achieve maximum results. However, current interventions for African-American girls could be improved. The researcher has designed an innovative STI prevention intervention that draws from current, best evidence interventions. The researcher has hypothesized that: (1) participants that complete the intervention will have increased STI knowledge; and, (2) upon completion of the intervention, participants will have greater sexual self-efficacy

Perceived Risk for HIV among High Risk Individuals: A Comparison of Adolescents and Adults

The United States continues to be affected by the HIV/AIDS epidemic, and now public health is faced with new challenges in mitigating the spread of the disease. African-Americans are disproportionately affected by HIV and a further understanding about the factors that influence high risk sexual behaviors needs to be continuously examined. The aim of this study was to understand and compare the the perception of HIV risk and factors associated with risk perception in high risk adult and adolescent groups. After multivariate analysis, having multiple partners was the only predictor of an increased risk perception among adults. Among adolescents, no significant relationship was found between HIV risk indicators and having an increased HIV risk perception. Both adults and adolescents appeared to underestimate their HIV risk based on their reported risk sexual behaviors. More work is necessary to help adolescents accurately assess their risk of infection

Demographic Factors Associated with Condom Use in 18-24 Year Olds For Two States, 1998 and 2000/2001

Despite knowledge about the transmission of HIV and other sexually transmitted diseases (STDs), young adults continue to participate in sexual risk behaviors such as unprotected sexual intercourse. This study examines factors that influence condom use in adults aged 18-24 years in the United States. Using secondary data from the 1998, 2000, and 2001 Behavioral Risk Factor Surveillance System (BRFSS), univariate and multivariate analyses were conducted to assess the factors influencing condom use stratified by gender and study year. A p-value of \u3c0.05 and 95% confidence intervals were used to determine statistical significance throughout all analysis performed. Univariate analysis found that increased age and being male were associated with increased odds of condom use. Multivariate analysis stratified by study year found that in 1998 increased age and unemployment was associated with increased odds of condom use. In 2000/2001, increased age was the only factor associated with increased odds of condom use. Being female was associated with decreased odds of condom use in that study year. When stratified by gender, only increased age was associated with increased condom use. The study results suggest that the factors influencing condom use vary between gender and year. Since different factors impact condom use for each gender, the interventions designed to increase condom use must be centered on those factors. Since age was one of the consistent factors positively associated with condom use, interventions must begin earlier to affect the decision-making processes of young adults