Teenagers' use of sexual health services: perceived need, knowledge and ability to access

INTRODUCTION: An individual teenager's use of services may depend on perceived need, on knowledge of sexual health and local services, and on ability to access. This paper presents the first UK large-scale quantitative analysis of these factors, comparing those who use services with those who do not. METHODS: 15/16-year-olds (n = 5747) were questioned about their use of sexual health services in the SHARE trial of a school sex education programme in 25 schools in Lothian and Tayside, Scotland, UK. Multilevel statistical models examined the role of different factors on service use. RESULTS: One-third of teenagers had used a service, and use was strongly related to sexual experience. In addition, some family influences and being a school leaver were associated with service use, although we found no evidence for class, ethnic or religious barriers to use. Proximity to specialist clinics was linked with greater use, while low spending money and high parental monitoring were associated with less use. Teenagers with better knowledge, who rated their school sex education as effective, who were comfortable talking about sex and who had discussed contraception with peers were more likely to have used services. Differences in use relating to sexual experience, knowledge, feeling comfortable talking about sex and talking with peers helped to explain gender differences in service uptake. CONCLUSION: There is potential to influence service use through better knowledge and confidence imparted through school sex education, and by improving the links between services and schools

Uncovering the genetic architecture of broad antisocial behavior through a genome-wide association study meta-analysis.

Despite the substantial heritability of antisocial behavior (ASB), specific genetic variants robustly associated with the trait have not been identified. The present study by the Broad Antisocial Behavior Consortium (BroadABC) meta-analyzed data from 28 discovery samples (N = 85,359) and five independent replication samples (N = 8058) with genotypic data and broad measures of ASB. We identified the first significant genetic associations with broad ASB, involving common intronic variants in the forkhead box protein P2 (FOXP2) gene (lead SNP rs12536335, p = 6.32 × 10 <sup>-10</sup> ). Furthermore, we observed intronic variation in Foxp2 and one of its targets (Cntnap2) distinguishing a mouse model of pathological aggression (BALB/cJ strain) from controls (BALB/cByJ strain). Polygenic risk score (PRS) analyses in independent samples revealed that the genetic risk for ASB was associated with several antisocial outcomes across the lifespan, including diagnosis of conduct disorder, official criminal convictions, and trajectories of antisocial development. We found substantial genetic correlations of ASB with mental health (depression r <sub>g</sub> = 0.63, insomnia r <sub>g</sub> = 0.47), physical health (overweight r <sub>g</sub> = 0.19, waist-to-hip ratio r <sub>g</sub> = 0.32), smoking (r <sub>g</sub> = 0.54), cognitive ability (intelligence r <sub>g</sub> = -0.40), educational attainment (years of schooling r <sub>g</sub> = -0.46) and reproductive traits (age at first birth r <sub>g</sub> = -0.58, father's age at death r <sub>g</sub> = -0.54). Our findings provide a starting point toward identifying critical biosocial risk mechanisms for the development of ASB