Rape Victimization and High Risk Sexual Behaviors: Longitudinal Study of African-American Adolescent Females

Objectives: African-American women are affected by disproportionately high rates of violence and sexually transmitted infections (STI)/human immunodeficiency virus (HIV) infection. It is imperative to address the intersection of these two urgent public health issues, particularly as these affect African-American adolescent girls. This study assessed the prevalence of rape victimization (RV) among a sample of African-American adolescent females and examined the extent to which participants with a history of RV engage in STI/HIV associated risk behaviors over a 12-month time period.Methods: Three hundred sixty-seven African-American adolescent females ages 15-21, seeking sexual health services at three local teenager-oriented community health agencies in an urban area of the Southeastern United States, participated in this study. Participants were asked to complete an audio computer-assisted self-interview (ACASI) at baseline, six- and 12-month follow-up. We assessed sociodemographics, history of RV and sexual practices. At baseline, participants indicating they had experienced forced sex were classified as having a history of RV.Results: Twenty-five percent of participants reported a history of RV at baseline. At six- and 12-months, victims of RV had significantly lower proportions of condom-protected sex (p=.008), higher frequency of sex while intoxicated (p=.005), more inconsistent condom use (p=.008), less condom use at last sex (p=.017), and more sex partners (p=.0001) than non-RV victims. Over the 12-month follow-up period, of those who did not report RV at baseline, 9.5% reported that they too had experienced RV at some point during the 12-month time frame.Conclusion: African-American adolescent females who experience RV are engaging in more risky sexual behaviors over time than non-RV girls, thereby placing themselves at higher risk for contracting STIs. In light of the results from this unique longitudinal study, we discuss considerations for policies and guidelines targeting healthcare, law enforcement and educational and community settings. The complexities of RV screening in healthcare settings are examined as is the need for tighter collaboration between healthcare providers and law enforcement. Finally, we consider the role of prevention and intervention programs in increasing awareness about RV as well as serving as an additional safe environment for screening and referral. [West J Emerg Med. 2011;12(3):333-342.

Confidentiality considerations for use of social-spatial data on the social determinants of health: Sexual and reproductive health case study

Understanding whether and how the places where people live, work, and play are associated with health behaviors and health is essential to understanding the social determinants of health. However, social-spatial data which link a person and their attributes to a geographic location (e.g., home address) create potential confidentiality risks. Despite the growing body of literature describing approaches to protect individual confidentiality when utilizing social-spatial data, peer-reviewed manuscripts displaying identifiable individual point data or quasi-identifiers (attributes associated with the individual or disease that narrow identification) in maps persist, suggesting that knowledge has not been effectively translated into public health research practices. Using sexual and reproductive health as a case study, we explore the extent to which maps appearing in recent peer-reviewed publications risk participant confidentiality. Our scoping review of sexual and reproductive health literature published and indexed in PubMed between January 1, 2013 and September 1, 2015 identified 45 manuscripts displaying participant data in maps as points or small-population geographic units, spanning 26 journals and representing studies conducted in 20 countries. Notably, 56% (13/23) of publications presenting point data on maps either did not describe approaches used to mask data or masked data inadequately. Furthermore, 18% (4/22) of publications displaying data using small-population geographic units included at least two quasi-identifiers. These findings highlight the need for heightened education for researchers, reviewers, and editorial teams. We aim to provide readers with a primer on key confidentiality considerations when utilizing linked social-spatial data for visualizing results. Given the widespread availability of place-based data and the ease of creating maps, it is critically important to raise awareness on when social-spatial data constitute protected health information, best practices for masking geographic identifiers, and methods of balancing disclosure risk and scientific utility. We conclude with recommendations to support the preservation of confidentiality when disseminating results

Public Housing Relocations and Relationships of Changes in Neighborhood Disadvantage and Transportation Access to Unmet Need for Medical Care

Cross-sectional research suggests that neighborhood characteristics and transportation access shape unmet need for medical care. This longitudinal analysis explores relationships of changes in neighborhood socioeconomic disadvantage and transportation access to unmet need for medical care

Public Housing Relocations and Partnership Dynamics in Areas With High Prevalences of Sexually Transmitted Infections

We investigated the implications of one structural intervention—public housing relocations—for partnership dynamics among individuals living areas with high sexually transmitted infection (STI) prevalence. High-prevalence areas fuel STI endemicity and are perpetuated by spatially assortative partnerships

Images of sexual stereotypes in rap videos and the health of African American female adolescents

ABSTRACT Objective: This study sought to determine whether perceiving portrayals of sexual stereotypes in rap music videos was associated with adverse health outcomes among African American adolescent females. Methods: African American female adolescents (n ‫؍‬ 522) were recruited from community venues. Adolescents completed a survey consisting of questions on sociodemographic characteristics, rap music video viewing habits, and a scale that assessed the primary predictor variable, portrayal of sexual stereotypes in rap music videos. Adolescents also completed an interview that assessed the health outcomes and provided urine for a marijuana screen. Results: In logistic regression analyses, adolescents who perceived more portrayals of sexual stereotypes in rap music videos were more likely to engage in binge drinking (OR 3.8, 95% CI 1.32-11.04, p ‫؍‬ 0.01), test positive for marijuana (OR 3.4, 95% CI 1.19-9.85, p ‫؍‬ 0.02), have multiple sexual partners (OR 1.9, 95% CI 1.01-3.71, p ‫؍‬ 0.04), and have a negative body image (OR 1.5, 95% CI 1.02-2.26, p ϭ 0.04). This is one of the first studies quantitatively examining the relationship between cultural images of sexual stereotypes in rap music videos and a spectrum of adverse health outcomes in African American female adolescents. Conclusions: Greater attention to this social issue may improve the health of all adolescent females. 115

Challenges of a Hidden Epidemic: HIV Prevention Among Women in the United States

HIV/AIDS trends in the United States depict a concentrated epidemic with hot spots that vary by location, poverty, race/ethnicity, and transmission mode. HIV/AIDS is a leading cause of death among US women of color; two thirds of new infections among women occur in black women, despite the fact that black women account for just 14% of the US female population. The gravity of the HIV epidemic among US women is often not appreciated by those at risk as well as by the broader scientific community. We summarize the current epidemiology of HIV/AIDS among US women and discuss clinical, research, and public health intervention components that must be brought together in a cohesive plan to reduce new HIV infections in US women. Only by accelerating research and programmatic efforts will the hidden epidemic of HIV among US women emerge into the light and come under control

Impact of Public Housing Relocations: Are Changes in Neighborhood Conditions Related to STIs Among Relocaters?

Cross-sectional and ecologic studies suggest that place characteristics influence sexual behaviors and sexually-transmitted infections (STIs). Using data from a predominately substance-misusing cohort of African-American adults relocating from US public housing complexes, this multilevel longitudinal study tested the hypothesis that participants who experienced greater post-relocation improvements in neighborhood conditions (i.e., socioeconomic disadvantage, social disorder, STI prevalence, male:female sex ratios) would have reduced odds of testing positive for an STI over time