Research with Disadvantaged, Vulnerable and/or Marginalized Adolescents

Disadvantaged, vulnerable and/or marginalized adolescents (DVMAs) are individuals aged 10–19, who are excluded from social, economic and/or educational opportunities enjoyed by other adolescents in their community due to numerous factors beyond their control. These include factors at the social level (such as economic inequality, violence, stigma, racism, migration), family level (including neglect and abuse) and individual level (e.g. disability, ethnicity). DVMAs include adolescents who are immigrants or refugees; sexual minorities; orphans; incarcerated; those who have run away or been turned out of their homes following neglect and/or abuse; those who are trafficked; and those who belong to a stigmatized indigenous, ethnic, tribal or religious groups. Though gender plays an important role within each of these categories and for the group as a whole, in this brief we do not treat all girls and young women as DVMAs. As a result of their social exclusion, DVMAs suffer from health inequities, or avoidable inequalities in their health and well-being compared to the well-being of other adolescents. Research is needed to inform ways to address these inequities

The Sexual Health Needs of Adolescent Boys Involved in a Pregnancy

Objectives: Little is known about fatherhood in middle adolescence. In order to better understand their sexual health needs, we describe relationship characteristics, perception of masculinity and associated STI risk behaviors in a community-based sample of urban middle adolescent boys who have fathered a child or been involved with a pregnancy. Methods: We employed venue-based sampling to recruit 339 boys (14-17 years old) in neighborhoods with high STI prevalence. We administered a brief survey on sexual, relationship and pregnancy history, STI risk, juvenile justice involvement, and masculinity. Results: Fifteen percent had either fathered a child or been involved with a pregnancy. In multivariate analysis, controlling for age and ethnicity, adolescent fathers were more likely to be involved with juvenile justice and engage in STI risk behaviors. These included condom non-use and partner checking a cell phone. Although of borderline significance, older partners, past STI testing, and drug or alcohol use at last sex improved model fit. Conclusion: Adolescent fathers have distinct relational and sexual health needs. Their specific needs should be targeted by prevention programs. Implications and Contribution: Most research on young men involved in pregnancy is with older adolescents/young adults, and in clinical or institutional settings. Using community engagement and venue-based sampling, this study describes sexual behaviors, masculinity, and relationship characteristics among 14-17 year old boys who have caused a pregnancy. Findings identify their distinct sexual health needs

“It is all about the fear of being discriminated [against]…the person suffering from HIV will not be accepted”: a qualitative study exploring the reasons for loss to follow-up among HIV-positive youth in Kisumu, Kenya

BACKGROUND: Youth represent 40% of all new HIV infections in the world, 80% of which live in sub-Saharan Africa. Youth living with HIV (YLWH) are more likely to become lost to follow-up (LTFU) from care compared to all other age groups. This study explored the reasons for LTFU among YLWH in Kenya. METHODS: Data was collected from: (1) Focus group Discussions (n = 18) with community health workers who work with LTFU youth. (2) Semi-structured interviews (n = 27) with HIV + youth (15–21 years old) that had not received HIV care for at least four months. (3) Semi-structured interviews (n = 10) with educators selected from schools attended by LTFU interview participants. Transcripts were coded and analyzed employing grounded theory. RESULTS: HIV-related stigma was the overarching factor that led to LTFU among HIV + youth. Stigma operated on multiple levels to influence LTFU, including in the home/family, at school, and at the clinic. In all three settings, participants’ fear of stigma due to disclosure of their HIV status contributed to LTFU. Likewise, in the three settings, the dependent relationships between youth and the key adult figures in their lives were also adversely impacted by stigma and resultant lack of disclosure. Thus, at all three settings stigma influenced fear of disclosure, which in turn impacted negatively on dependent relationships with adults on whom they rely (i.e. parents, teachers and clinicians) leading to LTFU. CONCLUSIONS: Interventions focusing on reduction of stigma, increasing safe disclosure of HIV status, and improved dependent relationships may improve retention in care of YLWH

The worlds of homeless white and African American youth in San Francisco, California: A cultural epidemiological comparison

Research to date has given little attention to differences in the experience of youth homelessness by ethnicity. This article provides a comparative descriptive analysis of the effect of differences and similarities in paths to homelessness, self-perception, and survival strategies on health behaviors and consequent health outcomes of African American and white homeless youth in San Francisco, USA. We conducted participant observation and ethnographic interviews with 54 youth primarily recruited from street venues. Hypotheses generated from the ethnographic data were validated in between-group analyses using concurrent epidemiological data collected from a sample of 205 youth. Our samples of unstably housed African American and white youth, though sharing common histories of family dysfunction, differed in both the ethnographic accounts and epidemiological analyses in their experiences of family, access to housing, street survival strategies, self-presentation, health behaviors and service utilization. Our sample of white youth generally identified with the term "homeless," engaged in survival activities associated with such a label, and accessed the services intended to address the needs of homeless youth. In contrast, our sample of African American youth generally did not perceive themselves as "homeless," a stigmatized term, and were thus less likely to utilize, or be accessed by, relevant services.USA Homeless youth Race Health behavior White youth African American youth

Factors Influencing Abstinence, Anticipation, and Delay of Sex Among Adolescent Boys in High–Sexually Transmitted Infection Prevalence Communities

PurposeAbstinence is a core pregnancy and sexually transmitted infection (STI) prevention strategy. We explore the attitudinal, behavioral, and family contexts relating to abstinence and the decision to delay sex among adolescent boys.MethodsAdolescent boys ages 14-17 years were recruited from community sites using a venue-based sampling method. All eligible boys at venues were invited to participate in an electronic survey. Question items included sexual behaviors, attitudes related to sex, relationships, masculine values, and family contextual items.ResultsWe enrolled 667 participants, mean age 15.7 years, of diverse ethnicity. A total of 252 were abstinent (38%). Abstinent participants were younger and less likely to report non-coital behaviors, and reported lower conventional masculine values. Among abstinent participants, 62% planned to delay sex, whereas 38% anticipated sex in the next year. Participants with lower conventional masculine values and more religious or moral motivations for abstinence were more likely to plan to delay sex.ConclusionsAbstinence among boys is common, even in high-STI risk communities. For these boys, abstinence appears to be a complex behavioral decision influenced by demographic, behavioral, attitudinal, and contextual factors such as age, race, non-coital sexual behaviors, and masculine values. Understanding the attitudes and contexts of abstinence, including plans to delay sex, can inform the development of public health programs for early fatherhood and STI prevention

Erratum to: Coming of Age on the Margins: Mental Health and Wellbeing Among Latino Immigrant Young Adults Eligible for Deferred Action for Childhood Arrivals (DACA).

© 2016, Springer Science+Business Media New York. The second author’s family name was erroneously submitted and published as Raymond-Flesh, instead of Raymond- Flesch. This erratum is issued to fix the error