Female adolescents at high, moderate, and low risk of exposure to HIV: differences in knowledge, beliefs, and behavior

Risky Sexual Behavior in American White College Women: The Role of Sex Guilt and Sexual Abuse

Ninety-five sexually active White American female college students participated in a questionnaire study about their sexual behavior in the past 12 months. A path model was tested in order to assess specific hypothesized predictors of risky sexual behavior. As predicted, participants with greater sex guilt reported using condoms more and having had fewer sexual partners. The findings of this study suggest that White American female college students are at some degree of risk due to risky sexual behavior. Taking into account attitudes about sexuality and past sexual abuse along with the requisite training in condom use self-efficacy may enhance the success of interventions designed to reduce risky sexual behavior among White American female college students.

Risk Perceptions, Condom Use, and Sexually Transmitted Diseases Among Adolescent Females According to Social Network Position

BACKGROUND AND OBJECTIVES

Adolescent females are frequently treated as a homogenous group but could differ on their sexually transmitted disease (STD) risk because of individual attitudes and exposure through sexual networks.

GOAL

The goal of this study was to determine if risk perceptions, condom use, and STD prevalence differs within sexual networks.

STUDY DESIGN

Three hundred three adolescent females participating in a longitudinal study of adolescent STD risk perceptions and condom use were categorized as "core," "bridge," and "periphery" in a sexual network according to their and their main sex partner's risk information. Regression analysis determined differences in risk perceptions by network location.

RESULTS

We demonstrated an inverse relationship between STD risk perceptions and network location. Adolescents with higher risk perceptions were more likely to use condoms, irrespective of network location.

CONCLUSION

Female adolescents are a heterogeneous group exhibiting different risk perceptions. Different intervention strategies for adolescents at higher risk could be necessary. Interventions designed to raise risk perceptions could be associated with condom use, even for those adolescents at greatest risk.

Acculturation, familism, parental monitoring, and knowledge as predictors of marijuana and inhalant use in adolescents

The authors investigated relationships between marijuana and inhalant use and several cultural and demographic factors in Anglo American and Hispanic American adolescents (N=1,094). Outcome measures assessed lifetime and 30-day marijuana and inhalant use. Predictors and covariates used in logistic regression analyses were region, grade, gender, knowledge, acculturation, familism, and parental monitoring. Hispanic Americans exhibited higher usage across all measures. In this group, high acculturation was associated with low marijuana, but high inhalant, use. Across all participants, positive family relations and parental monitoring were strongly associated with attenuated marijuana use hut only among those most knowledgeable about drugs. Familism and monitoring were not associated with diminished usage among the less knowledgeable. For inhalants, monitoring combined with high knowledge or high familism was associated with diminished usage.

The development of decision-making

PURPOSE

To describe what is currently known and not known about the development of decision-making skills during adolescence.

METHODS

The author provides a definition of competent decision-making, gives a brief overview of the literature on the development of this competence, and describes the kinds of studies that should be conducted in the near future.

RESULTS AND CONCLUSIONS

Although the literature is still too sparse to be conclusive at present, the literature as a whole suggests that adolescents may have less decision-making competence than adults in certain areas (i.e., advice-seeking, evaluation processes, adaptive goal-setting, and learning) but may have similar levels of competence in other areas (i.e., knowledge of options in familiar areas, response to certain moderating factors, and making choices in a number of areas). Moreover, age differences in deliberative aspects of competence have not yet been linked to age differences in the tendency to pursue good options, although one recent study did find a possible link between a post-decisional process (i.e., learning from decisions) and age differences in the selection of good options. Additional studies are needed to firm up the tentative conclusions that can be drawn from the extant research and determine which kinds of interventions improve decision-making in adolescents and which do not.

Substance-abusing adolescents at varying levels of HIV risk: psychosocial characteristics, drug use, and sexual behavior

PURPOSE

To evaluate the relationship of various psychosocial factors on HIV sexual risk behavior in a sample of 169 "inner city" male and female adolescents mandated into in court-ordered substance abuse treatment.

METHOD

The Millon Adolescent Clinical Inventory (MACI) and measures of sexual behavior, condom attitudes and skills, HIV knowledge, and substance abuse were administered. Data were evaluated according to five HIV risk groups: abstinent (n = 37); monogamous and practicing only protected sex (n = 19); monogamous and practicing unprotected sex (n = 45); multiple partners and practicing only protected sex (n = 11); and multiple partners and having only unprotected sex (n = 57).

RESULTS

Significant main effects were found for impulsive propensity, submissiveness, marijuana and alcohol use, condom attitudes, and intentions to engage in safer sex. Protective behavior was directly associated with submissiveness and inversely associated with impulsive personality profiles, with increased marijuana use emerging as a significant predictive factor in the choice for sexual activity vs. abstinence. More alcohol use was predictive of choosing multiple partners vs. monogamy.

IMPLICATIONS

Factoring risk variation into the design of HIV psychosocial research may enhance the tailoring of effective prevention strategies.

Hispanic adults' beliefs, attitudes, and intentions regarding the female condom

The present study used the theory of planned behavior (TPB) (Ajzen, 1985) augmented by AIDS knowledge to investigate factors influencing intentions of Hispanic adults to use the female condom. A total of 146 persons (75 women and 71 men; mean age, 27 years) recruited from community-based organizations completed an anonymous survey regarding intentions to use the female condom with their main sex partner. The TPB model had greater predictive utility for women's, than for men's, female condom use intentions. For men, attitudes and norms did not predict female condom use intentions, but greater AIDS knowledge was related to lower intentions to use the female condom, above and beyond the TPB constructs. Perceived behavioral control, operationalized as self-efficacy, significantly increased the predictive utility of the TPB model for women's female condom use intentions but not for men's. Behavior change strategies to increase female condom use are discussed in light of these findings.

Family connectedness and women's sexual risk behaviors: implications for the prevention/intervention of STD/HIV infection

The present study explores the relationship between connectedness with the intergenerational family and women's sexual risk-taking as a guide to the development of family-focused prevention and intervention. Cross-sectional interview data from a pilot study were analyzed for correlations between a number of self-reported, risky sexual practices, the range of extended family members with whom the respondent was in contact, and awareness of stories pertaining to intergenerational family history. Structured interviews were administered by female interviewers to 56 women from two contexts: a STD (sexually transmitted disease) Clinic (N = 26), and an inner-city, Hispanic Community Organization (N = 30). Knowledge of stories about grandparents or great-grandparents was a robust predictor of lower sexual risk-taking in the STD Clinic sample. This relationship persisted, but only at the trend level in the Community Organization sample. In both the total sample and the STD subsample, the number of categories of extended family members with whom a respondent was in at least monthly contact was correlated with less sexual risk-taking. Given the fundamental importance of the family system as the primary social unit, these findings argue for further family theory-based research and for its potential application in the development of health prevention and intervention. Implications for practice and future research are discussed.

AIDS knowledge and attitudes of pupils attending urban high schools in Israel

The present study compared AIDS knowledge, attitude and sources of information of 1724 students in three different high schools (academic, vocational and religious) in Holon. Forty-two percent of the students are anxious concerning the possibility of AIDS contamination; they expressed a willingness to be tested for HIV and AIDS. Pupils attending the academic school proved to have the highest knowledge concerning AIDS topics; those in the vocational school placed second; and those in the religious school came last. The knowledge increased with age (p < 0.001). Results indicated that misconceptions were still found in a second decade of that epidemic concerning the following areas: etiology, ways of exposure; symptomatology; and prognosis. Their intolerant attitudes reflect social anxiety and vulnerability to AIDS. The most liberal and comprehensive attitudes toward AIDS patients were presented by pupils attending the academic school and after that came pupils from the vocational school, while pupils in the religious school presented the most conservative and intolerant attitudes. The sources of pupils' information primarily included: the media--TV (92.3%): newspapers (87.6%); and school (66.1%) occupied the third place. It is remarkable that physicians and nurses at school and outside clinics were placed in the seventh (and last) place, as only 25.3% mentioned them at all. Only one third of the pupils agreed to participate as volunteers in medical and rehabilitation centers which help AIDS patients.

Genital human papillomavirus infections: knowledge, perception of risk, and actual risk in a nonclinic population of young women

The purpose of this study was to assess knowledge, beliefs, and attitudes about genital human papillomavirus (HPV) infections in a group of young women in a nonclinic setting and to examine the association between perception of risk and actual risk. One hundred ten women attending a state university participated in the study and were asked to complete a self-administered questionnaire about knowledge and perceptions of risk. They were then offered testing for the virus using a self-administered vaginal method. The mean age was 20 +/- 1.2 years. Ninety (82%) were sexually experienced (SE), with a mean number of lifetime partners of 5.1 +/- 4.3. The mean knowledge score was less than the 68th percentile, reflecting low levels of knowledge about genital HPV infections. The SE group had a higher knowledge score than the sexually inexperienced (p < .02), but there were no differences in knowledge between those who chose to be tested and those who refused testing. The majority of women attributed negative emotion to being hypothetically tested positive for HPV. Emotions selected by > 50% of the group included feeling scared, angry, guilty, anxious, confused, dirty, regretful, and panicky. A greater negative emotion score was associated with refusing HPV testing (p < .002). Of the SE women, 58% (51) perceived themselves at risk, and, of this group, 71% (36) agreed to be tested. Of the women who agreed to HPV testing, 36% who perceived themselves at risk and 35% who did not perceive themselves at risk were, in fact, positive for HPV (p = ns). The majority of women have little knowledge of HPV infections and have attributed many negative emotions associated with infectivity. These negative attributes appear to influence women's decision making concerning HPV testing. The risk of HPV infection in this nonclinic group was substantial, suggesting that even in a nonclinic group, the prevalence of HPV is quite high. Perception of risk was unrelated to actual risk (HPV positive test), reflecting the lack of self-identified risk.

Relationship of optimism, knowledge, attitudes, and beliefs to use of HIV antibody testing by at-risk female adolescents

This study's purpose was to examine the extent to which optimism, knowledge, attitudes, and beliefs predict use of HIV testing services in a group of at-risk female adolescents. We prospectively interviewed 124 consecutive girls engaging in risky behaviors before regularly scheduled pediatric clinic appointments at a large urban HMO. Subjects completed a self-report questionnaire assessing optimism (Scheier's Life Optimism Test, or LOT), HIV-related knowledge, beliefs, and behaviors before their regular visit. At the visit, they were counseled about risky behaviors and the availability of confidential HIV testing at the clinic. All subjects were next given an opportunity to view an educational video about HIV testing and then decided whether or not to obtain testing. LOT scores were not associated with HIV-related knowledge, perceived risk, self-efficacy, condom expectations, or most risky behaviors, including higher levels of recent unprotected intercourse. LOT scores were higher among those who did not view the video and were also higher among those who did not obtain an HIV test. We conclude that higher optimism is not necessarily associated with HIV protective behaviors among adolescent girls and, depending on the context, may serve as a barrier to HIV prevention in this population.