Clustering of sex and substance use behaviours in adolescence

BACKGROUND Adolescents often experiment with substance use and sexual activity, which can impact upon their health and well-being, and establish harmful patterns of behavior which continue into adulthood. While substance use and participation in sexual behaviors often co-occur, few studies have examined whether these behaviors cluster in adolescence. OBJECTIVE To investigate clustering of sexual activity and substance use among youth in Northern Ireland. METHOD Data from 875 young people (aged 16) who participated in the 2008 Northern Ireland Life and Times Survey were used to investigate clustering using the Odds/Expected ratio method. Gender differences in clustering were explored. RESULTS Alcohol consumption was the most prevalent risk behavior (75%), followed by cigarette smoking, sexual intercourse, illicit substance use, and solvent use the least prevalent. Over 40% of young people participated in multiple risk behaviors (2 or more). Several behavior combinations were statistically clustered, for most the reported prevalence was lower than expected, however, participation in all five risk behaviors occurred at a much higher rate than expected, particularly for male youth. CONCLUSIONS While experimentation with risky behaviors is often considered developmentally appropriate in adolescence it is important to understand how young people experience these behaviors, and the potential for multiple risk exposures as a result of participation in substance use and sexual behaviors. These findings highlight the clustering of substance use and sexual behaviors, and indicate variations in vulnerability to participation in multiple risk behaviors by gender

Informing theoretical development of salutogenic, asset-based health improvement to reduce syndemics among gay, bisexual and other men who have sex with men: empirical evidence from secondary analysis of multi-national, online cross-sectional surveys

Globally, gay, bisexual and other men who have sex with men (GBMSM) experience an increased burden of poor sexual, mental and physical health. Syndemics theory provides a framework to understand comorbidities and health among marginalised populations. Syndemics theory attempts to account for the social, environmental, and other structural contexts that are driving and/or sustaining simultaneous multiple negative health outcomes, but has been widely critiqued. In this paper, we conceptualise a new framework to counter syndemics by assessing the key theoretical mechanisms by which pathogenic social context variables relate to ill-health. Subsequently, we examine how salutogenic, assets-based approaches to health improvement could function among GBMSM across diverse national contexts. Comparative quantitative secondary analysis of data on syndemics and community assets are presented from two international, online, cross-sectional surveys of GBMSM (SMMASH2 in Scotland, Wales, Northern Ireland and the Republic of Ireland and Sex Now in Canada). Negative sexual, mental and physical health outcomes were clustered as hypothesised, providing evidence of the syndemic. We found that syndemic ill-health was associated with social isolation and the experience of stigma and discrimination, but this varied across national contexts. Moreover, while some of our measures of community assets appeared to have a protective effect on syndemic ill-health, others did not. These results present an important step forward in our understanding of syndemic ill-health and provide new insights into how to intervene to reduce it. They point to a theoretical mechanism through which salutogenic approaches to health improvement could function and provide new strategies for working with communities to understand the proposed processes of change that are required. To move forward, we suggest conceptualising syndemics within a complex adaptive systems model, which enables consideration of the development, sustainment and resilience to syndemics both within individuals and at the population-level

Age related factors influence HIV testing within subpopulations: a cross sectional survey of MSM within the Celtic nations

Objectives: Despite a recent fall in the incidence of HIV within the UK, men who have sex with men (MSM) continue to be disproportionately affected. As biomedical prevention technologies including pre-exposure prophylaxis are increasingly taken up to reduce transmission, the role of HIV testing has become central to the management of risk. Against a background of lower testing rates among older MSM, this study aimed to identify age-related factors influencing recent (≤12 months) HIV testing. Methods: Cross-sectional subpopulation data from an online survey of sexually active MSM in the Celtic nations—Scotland, Wales, Northern Ireland and Ireland (n=2436)—were analysed to compare demographic, behavioural and sociocultural factors influencing HIV testing between MSM aged 16–25 (n=447), 26–45 (n=1092) and ≥46 (n=897). Results: Multivariate logistic regression demonstrated that for men aged ≥46, not identifying as gay (OR 0.62, CI 0.41 to 0.95), location (Wales) (OR 0.49, CI 0.32 to 0.76) and scoring higher on the personalised Stigma Scale (OR 0.97, CI 0.94 to 1.00) significantly reduced the odds for HIV testing in the preceding year. Men aged 26–45 who did not identify as gay (OR 0.61, CI 0.41 to 0.92) were also significantly less likely to have recently tested for HIV. For men aged 16–25, not having a degree (OR 0.48, CI 0.29 to 0.79), location (Republic of Ireland) (OR 0.55, CI 0.30 to 1.00) and scoring higher on emotional competence (OR 0.57, CI 0.42 to 0.77) were also significantly associated with not having recently tested for HIV. Conclusion: Key differences in age-related factors influencing HIV testing suggest health improvement interventions should accommodate the wide diversities among MSM populations across the life course. Future research should seek to identify barriers and enablers to HIV testing among the oldest and youngest MSM, with specific focus on education and stigma

Dyadic parent-child creative activities and early childhood resilience : audio-recordings and home activities as methodological propositions

This commentary invites creativity researchers to address an area that, to date, has received little attention: the effects of dyadic creative activities on early childhood resilience. There is, indeed, a growing body of work on how creative behaviour can contribute to resilience in older children, adolescents, and adults. There is less research on this topic for populations of children aged 3 to 6 years. Yet, young children are particularly dependent upon the bonds they form with their caregivers, notably their parents. The quality of the ties they maintain with them can promote, or on the contrary hinder, their resilience. After presenting the need to foster resilience among young children through dyadic creative activities, the commentary proposes audio recording as a method of investigating this phenomenon. It presents perspectives on the analysis of momentary processes. It concludes with perspectives creative activities at home that researchers can propose to parents and children to address their effects on young children’s resilienc