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Diaz JE, Preciado E, Chiasson MA, Hirshfield S. Association Between Age of Anal Sex Debut and Adult Health Behaviors Among Sexual Minoritized Men Living with HIV. ARCHIVES OF SEXUAL BEHAVIOR 2023; 52:3565-3575. [PMID: 37378702 PMCID: PMC11034742 DOI: 10.1007/s10508-023-02642-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 06/01/2023] [Accepted: 06/02/2023] [Indexed: 06/29/2023]
Abstract
Earlier age of anal sex debut (ASD) has been linked with contemporary and long-term health outcomes, including vulnerability to HIV acquisition. The goal of this study was to utilize a life course approach to examine associations between earlier ASD and recent health behaviors among sexual minoritized men (SMM) living with HIV. A total of 1156 U.S. SMM living with HIV recruited from social and sexual networking apps and websites completed online surveys as part of a longitudinal eHealth intervention. Data from baseline surveys were analyzed to determine associations between age of ASD and adult health outcomes, including mental health, HIV viral load, and substance use. The median age of ASD among these participants was 17 years old, consistent with other work. Earlier ASD was significantly associated with a greater likelihood of past 2-week anxiety (AOR = 1.45, 95% CI 1.07-1.97) and past 3-month opioid use (AOR = 1.60, 95% CI 1.13-2.26); no significant associations were found for recent depression, HIV viral load, or stimulant use. Earlier ASD may function as an important proxy measure for deleterious health outcomes in adulthood, particularly recent anxiety and opioid use. Expansion of comprehensive and affirming sexual health education is critical to early engagement of individuals with a higher risk of HIV acquisition, with plausible downstream health benefits lasting into adulthood among SMM living with HIV.
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Affiliation(s)
- José E Diaz
- Department of Medicine, STAR Program, SUNY Downstate Health Sciences University, 450 Clarkson Avenue, Brooklyn, NY, 11203, USA
| | | | - Mary Ann Chiasson
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA
- Division of Infectious Diseases, Department of Medicine, Columbia University Irving Medical Center, New York, NY, USA
| | - Sabina Hirshfield
- Department of Medicine, STAR Program, SUNY Downstate Health Sciences University, 450 Clarkson Avenue, Brooklyn, NY, 11203, USA.
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Laughney CI, Lee YG, Mergenova G, Vinogradov V, Zhakupova G, Paine EA, Primbetova S, Terlikbayeva A, Wu E. Earlier Sexual Debut and Anti-Gay Victimization Among Men Who Have Sex With Men (MSM) in Kazakhstan. JOURNAL OF INTERPERSONAL VIOLENCE 2023; 38:10795-10813. [PMID: 37272025 DOI: 10.1177/08862605231176800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Limited research has examined predictors of anti-gay victimization among men who have sex with men (MSM), despite anti-gay violence continuing to be a global problem. We conducted a secondary analysis of data from structured interviews with 600 MSM adults to examine anti-gay victimization and earlier sexual debut among MSM in Kazakhstan. Multiple linear regression was used to test for associations between earlier sexual debut-categorized as age of sexual onset between 13 and 15 years of age and prior to 13 years old, with ages 16 and older as the reference group-and recent and lifetime anti-gay victimization. Adjusted logistic regression models were used to assess earlier sexual debut and specific types of victimization. The majority of MSM reported lifetime (89%) or recent (68%) experiences of anti-gay victimization. Earlier sexual debut prior to 13 years of age was significantly associated with greater number of types of lifetime and recent reports of anti-gay victimization. Among specific types of anti-gay victimization, earlier sexual debut was associated with higher odds of experiencing verbal, physical, and sexual violence. Anti-gay violence in Kazakhstan is a significant and prevalent public health issue. Future research and clinical interventions addressing anti-gay victimization among MSM populations should consider the lifetime and current implications of consensual and non-consensual childhood and adolescent sexual experiences.
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Affiliation(s)
| | - Yong Gun Lee
- Columbia School of Social Work, New York, NY, USA
| | | | | | | | - Emily Allen Paine
- HIV Center for Clinical and Behavioral Studies, Columbia University and New York State Psychiatric Institute, New York, NY, USA
| | | | | | - Elwin Wu
- Columbia School of Social Work, New York, NY, USA
- Global Health Research Center of Central Asia, Almaty, Kazakhstan
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Whitworth HS, Baisley KJ, Nnko S, Irani J, Aguirre-Beltran A, Changalucha J, Crucitti T, Francis S, Hashim R, Hansen CH, Hayes RJ, Buvé A, Watson-Jones D. Associations between age of menarche, early sexual debut and high-risk sexual behaviour among urban Tanzanian schoolgirls: A cross-sectional study. Trop Med Int Health 2023; 28:237-246. [PMID: 36717965 DOI: 10.1111/tmi.13858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
OBJECTIVES This cross-sectional survey aimed to explore associations between age of menarche, early sexual debut and high-risk sexual behaviour among urban Tanzanian schoolgirls. METHODS Secondary schoolgirls aged 17-18 years from Mwanza, Tanzania, participated in structured face-to-face questionnaire-based interviews, conducted by nurses and clinicians. Age of menarche was evaluated in categories of 11-12, 13-14, 15-16 or ≥17 years. Primary outcome measures were self-reported early sexual debut (first vaginal sex at <16 years) and high-risk sexual behaviour, including non-use of condoms, having sex for gifts/money, having older sexual partners and/or other risky behaviours. RESULTS Of 401 girls enrolled, 174 (43.4%) reported prior vaginal sex. Prevalence of early sexual debut was 14.2% but pressured/forced sex and risky sexual behaviours were common. Adjusted for potential confounding, younger age at menarche was associated with early sexual debut (adjusted odds ratio for linear trend: 1.88 per category, 95% confidence interval: 1.21-2.92, p = 0.005). This association remained after excluding girls with first sex at <8 years or experiencing pressure or force at first sex. Further, adjusted for potential confounding (including ever experiencing forced sex), early sexual debut was associated with high-risk sexual behaviour (adjusted odds ratio: 2.85, 95% confidence interval: 1.38-5.88, p = 0.004). CONCLUSIONS Among urban Tanzanian school girls, younger age of menarche was associated with early sexual debut, and early sexual debut was associated with high-risk sexual behaviour. Researchers and public health professionals developing and delivering interventions aimed at preventing adverse sexual health outcomes should consider the impact of these early biological and sexual exposures.
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Affiliation(s)
- Hilary S Whitworth
- Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, UK
- Mwanza Intervention Trials Unit, National Institute for Medical Research, Mwanza, Tanzania
| | - Kathy J Baisley
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
| | - Soori Nnko
- National Institute for Medical Research, Mwanza, Tanzania
| | - Julia Irani
- Mwanza Intervention Trials Unit, National Institute for Medical Research, Mwanza, Tanzania
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
| | - Aura Aguirre-Beltran
- Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, UK
- Mwanza Intervention Trials Unit, National Institute for Medical Research, Mwanza, Tanzania
| | - John Changalucha
- Mwanza Intervention Trials Unit, National Institute for Medical Research, Mwanza, Tanzania
- National Institute for Medical Research, Mwanza, Tanzania
| | - Tania Crucitti
- Experimental Bacteriology Unit, Institut Pasteur de Madagascar, Antananarivo, Madagascar
| | - Suzanna Francis
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
| | - Ramadhan Hashim
- Mwanza Intervention Trials Unit, National Institute for Medical Research, Mwanza, Tanzania
| | - Christian Holm Hansen
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
| | - Richard J Hayes
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
| | - Anne Buvé
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
| | - Deborah Watson-Jones
- Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, UK
- Mwanza Intervention Trials Unit, National Institute for Medical Research, Mwanza, Tanzania
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Integrative Review of Methods From Youth Risk Behavior Survey Secondary Data Analyses Examining HIV Syndemic Factors Among Adolescent Gay and Bisexual Men. Nurs Res 2023; 72:141-149. [PMID: 36729784 DOI: 10.1097/nnr.0000000000000632] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND Adolescent gay/bisexual men exhibit the highest prevalence of undiagnosed HIV infections. Ascertaining antecedents of behaviorally acquired HIV infections among adolescent gay/bisexual men can be challenging; however, these challenges can be overcome through the utilization of secondary data, such as the Youth Risk Behavior Survey. OBJECTIVE Syndemics theory suggests that HIV infections are not a singular phenomenon; instead, many infections occur at the intersection of syndemic factors, such as substance use, violence, and mental health. Our objective is to describe and synthesize research methods of secondary data analyses that examine syndemic factors in relation to HIV risk behavior outcomes among subsamples of adolescent gay/bisexual men. METHODS Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, PubMed, Cumulative Index to Nursing and Allied Health Literature, and PsycInfo were systematically searched. Inclusion criteria were (a) peer-reviewed Youth Risk Behavior Survey secondary data analyses conducted in the United States after 1991, (b) subsamples with adolescent gay/bisexual men, (c) one or more syndemic factor(s), and (d) one or more HIV risk behavior outcome(s). We used the National Institutes of Health Quality Assessment Tools for quality appraisal. RESULTS Of 1,036 citations retrieved, nine studies met inclusion criteria. Results included using logistic regression analysis and data from 2015 to 2017 in six studies and underpinnings with minority stress theory in four studies. Eight studies omitted race/ethnicity in subsamples and six grouped lesbians with adolescent gay/bisexual men. Seven studies examined substance use, six examined violence, and five examined mental health. Condom use and number of partners were the most studied HIV risk behavior outcomes in four studies, whereas intercourse in the last 3 months was an outcome in only one study. Protective factors were not present. CONCLUSION Limitations found the need to highlight better inclusion of race/ethnicity and sexual orientation. Adding contemporary survey items is also necessary, such as nonbinary sex and gender identity, access to HIV prevention (condoms, HIV testing, and preexposure prophylaxis), and experiences with stigma, to elucidate risk behaviors among populations disproportionately affected by HIV infections, including Blacks/African Americans and Hispanics/Latinos.
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Reeves JM, Zigah EY, Shamrock OW, Aidoo-Frimpong G, Dada D, Batten J, Abu-Ba'are GR, Nelson LE, Djiadeu P. Investigating the impact of stigma, accessibility and confidentiality on STI/STD/HIV self-testing among college students in the USA: protocol for a scoping review. BMJ Open 2023; 13:e069574. [PMID: 36792328 PMCID: PMC9933744 DOI: 10.1136/bmjopen-2022-069574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/17/2023] Open
Abstract
INTRODUCTION In 2019, there were 2.5 million reported cases of chlamydia, gonorrhoea and syphilis. The Centers for Disease Control and Prevention reported in the USA, young people aged 15-24 made up 61% and 42% of chlamydia and gonorrhoea cases, respectively. Moreover, the highest rates of sexually transmitted infections (STIs) were reported among college-aged students. In this paper, we outline our protocol to systematically review the published literature on, the use of STI/HIV self-test kits, increasing STI/HIV testing uptake, and stigma, access and confidentiality issues, among young adult college students in the USA. METHODS AND ANALYSIS This scoping review will be conducted and reported according to the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews. We will search electronic databases, OVID Medline, OVID Embase, Web of Science, Cochrane Library, PubMed and CINAHL, for articles published in English from inception to the present. We will search other alternative sources such as ProQuest, Google Scholar and Google to identify grey literature. A two-step process will be used to identify eligible studies based on the defined inclusion criteria. First, the title and abstract of identified articles will be screened for possible inclusion. Second, full-text articles of relevant studies will be retrieved and screened for inclusion. Both screening steps will be done by two people independently. Finally, data will be extracted by two researchers working independently. Any arising disagreements will be resolved by consensus or by a third author. ETHICS AND DISSEMINATION This study is a scoping review of the literature. Therefore, ethics approval is not required. Our plan for the dissemination of findings includes peer-reviewed manuscripts, conferences and webinars.
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Affiliation(s)
- Jaquetta M Reeves
- College of Nursing and Health Innovation, The University of Texas Arlington, Arlington, Texas, USA
| | - Edem Yaw Zigah
- School of Nursing, University of Rochester, Rochester, New York, USA
| | - Osman W Shamrock
- School of Nursing, University of Rochester, Rochester, New York, USA
| | - Gloria Aidoo-Frimpong
- Center Interdisciplinary Research on AIDS, Yale University School of PublicHealth, New Haven, Connecticut, USA, New Haven, Connecticut, USA
| | - Debbie Dada
- School of Nursing, Yale University, New Haven, Connecticut, USA
- MAP Centre for Urban Health Solutions, St. Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada
| | - Janene Batten
- Medical Library, Yale University, Harvey Cushing/John Hay Whitney Medical Library, New Haven, Connecticut, USA
| | - Gamji R Abu-Ba'are
- Center for Interdisciplinary Research on AIDS, Yale University School of Public Health, New Haven, Connecticut, USA
- School of Nursing, Behavioral, Sexual, and Global Health Lab, University of Rochester, Rochester, New York, USA
| | - LaRon E Nelson
- School of Nursing, Yale University, New Haven, Connecticut, USA
- MAP Centre for Urban Health Solutions, St. Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada
| | - Pascal Djiadeu
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Health Research Methods Evidence and Impact, McMaster University, Faculty of Health Sciences, Hamilton, Ontario, Canada
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Haupt KR, Stout CD, Simmons J, Nelson KM. Differences in the sexual health information parents/guardians give their adolescent sexual minority sons by outness. JOURNAL OF LGBT YOUTH 2023; 21:132-149. [PMID: 38434757 PMCID: PMC10906741 DOI: 10.1080/19361653.2023.2176399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Accepted: 01/30/2023] [Indexed: 03/05/2024]
Abstract
Introduction Parents and guardians are a potentially valuable source of sexual health information for adolescent sexual minority males (ASMM). The current study examines what sexual health topics ASMM report discussing with a parent/guardian and whether topics differ by outness about sexual attraction to other males. Methods ASMM (N=154; ages 14-17) in the United States completed the baseline of an online sexual health intervention pilot in 2020. They reported which of twelve sexual health topics they discussed with a parent/guardian and if they had disclosed their sexual attraction to other males. Associations between topics discussed and outness to a parent/guardian were examined with Firth logistic regression. Results Eighty-eight (57%) participants reported being out to a parent/guardian. Six sexual health topics were significantly more likely to be discussed if participants were out. The three categories with the largest differences by outness were how to: discuss with a partner what they would not like to do sexually (aOR = 7.0, 95% CI: 2.0-24.6), use condoms (aOR = 5.9, 95% CI: 2.3-15.1), and prevent HIV/AIDS (aOR = 3.5, 95% CI = 1.4-8.7). Conclusions Interventions on parental/guardian provision of sexual health information are needed to ensure ASMM receive relevant sexual health knowledge.
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Affiliation(s)
- Kaitlin R Haupt
- Department of Community Health Sciences, Boston University School of Public Health, Boston, MA, USA
| | - Claire D Stout
- Department of Community Health Sciences, Boston University School of Public Health, Boston, MA, USA
| | - Journey Simmons
- Department of Community Health Sciences, Boston University School of Public Health, Boston, MA, USA
| | - Kimberly M Nelson
- Department of Community Health Sciences, Boston University School of Public Health, Boston, MA, USA
- Department of Psychiatry, Boston University School of Medicine, Boston, MA, USA
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Li Y, Zhou D, Dai Y, Zhang J. Gender Differences in the Association Between Sexual Orientation and Risky Sexual Behavior Among College Students With Sexual Experience in Sichuan Province, Chinese. Sex Med 2022; 10:100547. [PMID: 35952614 PMCID: PMC9537270 DOI: 10.1016/j.esxm.2022.100547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 05/26/2022] [Accepted: 06/27/2022] [Indexed: 11/23/2022] Open
Abstract
Background Limited information is available regarding risky sexual behavior among college students with different sexual orientations. Aim The aim of this study was to examine the gender differences in the association between sexual orientation and risky sexual behavior among Chinese college students with sexual experience. Methods With a self-assessment questionnaire, we conducted a cross-sectional survey among 73,800 students from 25 vocational colleges (3-year colleges) in the Sichuan province of China. Multivariate logistic regression models were used to examine the association between sexual orientation and risky sexual behavior among students with sexual experience. Outcomes The main outcome measures used regarding risky sexual behavior are the following: condom use in the last sexual intercourse, early sexual debut, and having multiple sexual partners. Results 12,711 students with sexual experience were included. Sexual minority students were more likely to have an early sexual debut (For male students, homosexual: OR = 1.88, P < .001; bisexual: OR = 1.96, P < .001; unsure: OR = 1.68, P < .001. For female students, homosexual: OR = 1.87, P < .01; bisexual: OR = 2.07, P < .01; unsure: OR = 1.53, P < .05), and less likely to use condoms in their last sexual intercourse (except for homosexual male students) (For male students, bisexual: OR = 0.65, P < .01; unsure: OR = 0.60, P < .001. For female students, homosexual: OR = 0.21, P < .001; bisexual: OR = 0.54, P < .001; unsure: OR = 0.68, tP < .05). There are gender differences in the association between sexual orientation and having multiple sexual partners. Male sexual minorities were more likely to have multiple sexual partners than heterosexual students (homosexual: OR = 2.06, P < .001; bisexual: OR = 1.66, P < .001; unsure: OR = 1.31, P < .05), while the same result was only observed in bisexual female students (OR = 1.46, P < .01). Clinical Implications Sexual health education professionals should consider the sexual orientation of students when providing counseling services or educational intervention, especially for male students and LGBT ones. Strengths & Limitations We examined gender differences in the association between sexual orientation and risky sexual behavior among college students with sexual experience. However, the ability for the cross-sectional survey to address causality is limited, and will be further tested in cohort studies. Conclusion Gender and sexual orientation affect the likelihood of risky sexual behavior among China's college students, and gender differences in the association between sexual orientation and risky sexual behavior should be noticed. Li Y, Zhou D, Dai Y, et al. Gender Differences of the Association Between Sexual Orientation and Risky Sexual Behavior Among College Students With Sexual Experience in Sichuan Province, Chinese. Sex Med 2022;10:100547.
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Affiliation(s)
- Yajie Li
- Tibet Center for Disease Control and Prevention, Lhasa, China
| | - Dinglun Zhou
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Yingxue Dai
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Jianxin Zhang
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China.
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Ren J, Qi X, Cao W, Wang Z, Guo Y, Gaoshan J, Liang X, Tang K. Early Sexual Initiation Is Associated with Suicide Attempts among Chinese Young People. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19073966. [PMID: 35409650 PMCID: PMC8997714 DOI: 10.3390/ijerph19073966] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Revised: 03/15/2022] [Accepted: 03/17/2022] [Indexed: 02/06/2023]
Abstract
This study aimed to investigate the association between early sexual initiation and suicide attempts (SAs) among Chinese young people. Our analysis included 9131 college students who had sexual experience from a national sample of 31 provincial administrative regions. Self-reported age at first intercourse was categorized as ≤15, 15–18, and ≥18 years, and the experience of SAs was recorded and analyzed. Compared with females whose sexual debut age was ≥18 years, those ≤15 years (defined as early sexual initiation) had higher odds of SAs in both the forced debut group (odds ratio (OR) 17.04, 95% confidence interval (CI) 4.87–59.66) and the voluntary debut group (OR 37.63, 95% CI 14.96–94.66). Early sexual initiators who lived in rural areas were more inclined to have SAs (female: OR 65.76, 95% CI 19.80–218.42; male: OR 15.39, 95% CI 1.64–144.19). Early sexual initiators who never had parent–child communication about sex were more likely to report having SAs (female: OR 37.81, 95% CI 12.28–116.46). Sexual debut during adolescence, particularly early sexual initiation, was a crucial risk factor for SAs among both sexes. Comprehensive sexuality education and smooth parental communication about sex will provide a supportive environment for young people and hence reduce the potential risks of SAs.
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Affiliation(s)
- Jianing Ren
- Vanke School of Public Health, Tsinghua University, Beijing 100084, China; (J.R.); (X.Q.); (Z.W.)
- School of Public Health, Peking University, Beijing 100191, China
| | - Xinran Qi
- Vanke School of Public Health, Tsinghua University, Beijing 100084, China; (J.R.); (X.Q.); (Z.W.)
- School of Nursing, Capital Medical University, Beijing 100069, China
| | - Wenzhen Cao
- School of Public Health and Management, Wenzhou Medical University, Wenzhou 325035, China;
| | - Zhicheng Wang
- Vanke School of Public Health, Tsinghua University, Beijing 100084, China; (J.R.); (X.Q.); (Z.W.)
- Research Center for Public Health, School of Medicine, Tsinghua University, Beijing 100084, China
| | - Yueping Guo
- School of Journalism and Communication, Graduate School of Chinese Academy of Social Sciences, Beijing 102488, China;
| | - Junjian Gaoshan
- Department for Health, University of Bath, Bath BA2 7AY, UK;
| | - Xiao Liang
- China Family Planning Association, Beijing 100035, China;
| | - Kun Tang
- Vanke School of Public Health, Tsinghua University, Beijing 100084, China; (J.R.); (X.Q.); (Z.W.)
- Correspondence:
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Saewyc EM, Lin C, Parrilla JS, Nath R, Ybarra ML. First time sexual experiences of sexual minority adolescent girls in the United States. PSYCHOLOGY & SEXUALITY 2022. [DOI: 10.1080/19419899.2022.2049631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Elizabeth M. Saewyc
- Stigma and Resilience among Vulnerable Youth Centre, University of British Columbia School of Nursing, Vancouver, BC, Canada
| | - Chichun Lin
- Stigma and Resilience among Vulnerable Youth Centre, University of British Columbia School of Nursing, Vancouver, BC, Canada
| | - Julia Santana Parrilla
- Stigma and Resilience among Vulnerable Youth Centre, University of British Columbia School of Nursing, Vancouver, BC, Canada
| | - Ronita Nath
- Stigma and Resilience among Vulnerable Youth Centre, University of British Columbia School of Nursing, Vancouver, BC, Canada
| | - Michele L. Ybarra
- Center for Innovative Public Health Research, Santa Ana, California, USA
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Scoggins D, Khan AS, Dai H. Hierarchical Analysis of Disparities in Suicidal Outcomes With Intersection of Sexual Minority and Gender Among U.S. Youth, 2017. HEALTH EDUCATION & BEHAVIOR 2021; 49:569-583. [PMID: 34628973 DOI: 10.1177/10901981211045933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Sexual minority youth have a higher risk of suicidal behaviors than their straight peers. Despite this alarming trend, there is limited information on how health-risk factors are systematically associated with suicidal outcomes in relation to the intersection of sex and sexual orientation identity. Data from the 2017 Youth Risk Behavior Survey (Grades 9-12, N = 14,108) were analyzed to examine three distinct suicidal outcomes (i.e., suicidal ideation, suicide planning, and suicide attempt). Separate hierarchical logistic regression models were performed to gradually adjust for influencing factors in examining the association between suicidal outcomes and sexual orientation identity (i.e., heterosexual, gay/lesbian, bisexual, and unsure), stratified by self-reported sex. There exist significant differences in youth suicidal behaviors based on sexual orientation identity and sex: lesbians (adjusted odds ratio [AOR] = 2.7, 95% CI [1.5, 5.0]), bisexual girls (AOR = 1.9, 95% CI [1.3, 2.6]) and bisexual boys (AOR = 2.6, 95% CI [1.3, 5.2]) had higher odds of suicide attempts than their straight peers. Unsure boys and girls also reported higher risks of suicidal ideation and suicide plan as compared with their straight peers. Having a very short sleep duration, reporting ever use of illicit drugs, being bullied, and feeling sad/hopeless were associated with elevated risks of suicidality across males and females. This study identified potential disparities in suicidal outcomes by sexual orientation identity as well as factors that attenuate or strengthen this relationship in a representative sample of adolescents across the United States. An improved understanding of the differences in suicidal outcomes will serve as an opportunity to ameliorate any potential inequalities and improve sexual minority youth' health outcomes.
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Affiliation(s)
| | - Ali S Khan
- University of Nebraska Medical Center, Omaha, NE, USA
| | - Hongying Dai
- University of Nebraska Medical Center, Omaha, NE, USA
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11
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Baiden P, Jahan N, Mets VE, Adeku Y. An examination of the association between risky sexual behaviors and suicidal behaviors among adolescents: Findings from the 2017 Youth Risk Behavior Survey. CURRENT PSYCHOLOGY 2021. [DOI: 10.1007/s12144-021-02328-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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12
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Hunt JA, Randell KA, Mermelstein S, Miller MK, Sherman AK, Philipose S, Masonbrink AR. Sexual Health Behaviors and Pregnancy Risk Among Hospitalized Female Adolescents. Hosp Pediatr 2021; 11:1129-1136. [PMID: 34518336 DOI: 10.1542/hpeds.2021-005810] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
OBJECTIVES To describe sexual health behaviors, contraceptive use, and pregnancy risk among hospitalized female adolescents. METHODS We conducted a cross-sectional survey of hospitalized female patients aged 14 to 21 years at 2 academic medical centers to assess sexual health behaviors, contraceptive use, contraceptive counseling receipt, and factors associated with pregnancy complications (eg, diabetes, teratogenic exposure). We calculated the validated Pregnancy Risk Index (PRI) (number per 100 who will become pregnant in the next year). RESULTS Among 177 participants (mean age 16 years, SD 1.5), 75 (43%) were sexually active. At last vaginal sex, 65% reported condom use; 49%, reversible contraception; and 12%, long-acting reversible contraception (LARC). Past-year contraceptive counseling was reported by 73% of sexually active female participants and was associated with increased use of reversible (P = .001) and dual contraception (P = .03) but not LARC (P = .24). The mean PRI among all participants was 4.75. Nearly three-quarters (73%) had a medical comorbidity or teratogenic exposure. Those with teratogenic medication use had the lowest PRI of 0.32 (P < .05), with 88% using reversible contraception and 31% using LARC. CONCLUSIONS Hospitalized female adolescents had a PRI similar to that of adolescents in the general population. However, nearly three-quarters had a medical comorbidity and/or teratogenic exposure, which increased risk for pregnancy complications. Contraceptive counseling was associated with increased reversible and dual contraception use but not LARC use. Efforts to improve comprehensive contraceptive counseling, highlighting LARC, are critically needed in this population.
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Affiliation(s)
- Jane Alyce Hunt
- Department of Pediatrics, Washington University in St Louis, St Louis, Missouri
| | - Kimberly A Randell
- School of Medicine, University of Missouri-Kansas City, Kansas City, Missouri.,Departments of Pediatrics
| | - Sarah Mermelstein
- Department of Pediatrics, Washington University in St Louis, St Louis, Missouri
| | - Melissa K Miller
- School of Medicine, University of Missouri-Kansas City, Kansas City, Missouri.,Departments of Pediatrics
| | - Ashley K Sherman
- Health Services and Outcomes Research, Children's Mercy Kansas City, Kansas City, Missouri
| | - Shirene Philipose
- Department of Internal Medicine, School of Medicine, University of Kansas, Kansas City, Kansas
| | - Abbey R Masonbrink
- School of Medicine, University of Missouri-Kansas City, Kansas City, Missouri.,Departments of Pediatrics
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13
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Baiden P, Panisch LS, Kim YJ, LaBrenz CA, Kim Y, Onyeaka HK. Association between First Sexual Intercourse and Sexual Violence Victimization, Symptoms of Depression, and Suicidal Behaviors among Adolescents in the United States: Findings from 2017 and 2019 National Youth Risk Behavior Survey. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18157922. [PMID: 34360215 PMCID: PMC8345499 DOI: 10.3390/ijerph18157922] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/19/2021] [Revised: 07/22/2021] [Accepted: 07/22/2021] [Indexed: 11/16/2022]
Abstract
The objective of this study was to investigate the association between first sexual intercourse and sexual violence victimization, symptoms of depression, and suicidal ideation among sexually active adolescents in the United States. Data for this study came from the U.S. 2017 and 2019 iterations of the National Youth Risk Behavior Survey. An analytic sample of 6252 adolescents aged 14–18 years old (49.5% female) who reported ever having sexual intercourse was analyzed using Poisson regression. The outcome variables investigated in this study were sexual violence victimization, symptoms of depression, suicidal ideation, a suicide plan, and suicide attempts, and the main explanatory variables were age at first sexual intercourse and forced sexual intercourse. We also analyzed differences by gender and race. Of the 6252 adolescents who reported ever having sexual intercourse, 7.1% had their first sexual intercourse before age 13, and 14.8% experienced forced sexual intercourse. About 16% of adolescents experienced sexual violence during the past year, 42.6% reported symptoms of depression, 23.9% experienced suicidal ideation, 19.3% made a suicide plan, and 11.1% attempted suicide during the past year. In the regression analysis, early sexual intercourse was significantly and positively associated with suicidal ideation (relative risk (RR) = 1.15, 95% Confidence Interval (CI) = 1.02–1.30), suicide plan (RR = 1.18, 95% CI = 1.00–1.38), and suicide attempts (RR = 1.36, 95% CI = 1.15–1.61). Controlling for the effects of covariates, history of forced sexual intercourse was positively associated with the five outcomes examined with the relative risk ranging between 1.59 and 6.01. Findings of this study suggest that history of early or forced sexual intercourse is associated with poor mental health outcomes among adolescents and underscores the importance of developing interventions that offer psychological support in reducing the adverse impact of early sexual intercourse and forced sexual intercourse on adolescent health.
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Affiliation(s)
- Philip Baiden
- School of Social Work, University of Texas at Arlington, Arlington, TX 76019, USA;
- Correspondence:
| | - Lisa S. Panisch
- Department of Psychiatry, University of Rochester Medical Center, Rochester, NY 14642, USA;
| | - Yi Jin Kim
- Department of Social Work, University of Mississippi, University, MS 38677, USA;
| | - Catherine A. LaBrenz
- School of Social Work, University of Texas at Arlington, Arlington, TX 76019, USA;
| | - Yeonwoo Kim
- Department of Kinesiology, University of Texas at Arlington, Arlington, TX 76019, USA;
| | - Henry K. Onyeaka
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA 02114, USA;
- Department of Psychiatry, Harvard Medical School, Boston, MA 02114, USA
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14
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Philbin MM, Wang X, Feaster DJ, LaBossier NJ, Phillips G. LGB-Affirming School Climates and Sexual Health Outcomes Among U.S. High School Students 2015-2017: Differences by Sex and Sexual Identity. J Adolesc Health 2021; 68:1121-1128. [PMID: 33419621 PMCID: PMC8686698 DOI: 10.1016/j.jadohealth.2020.11.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 11/05/2020] [Accepted: 11/05/2020] [Indexed: 12/28/2022]
Abstract
PURPOSE Lesbian, gay, and bisexual (LGB) adolescents face disparities in sexual health outcomes compared to their heterosexual peers, which has implications for health outcomes and developmental trajectories. We examined whether adolescents living in jurisdictions with school climates that were more exclusionary toward LGB individuals engaged in higher risk sexual behaviors than those in jurisdictions with more inclusive school climates. METHODS Data on sexual identity, age at first sex, condom use at last sex and the number of lifetime partners came from the 2015 (20 jurisdictions) and 2017 (19 jurisdictions) Youth Risk Behavior Surveillance Surveys. Data on LGB climates in schools, aggregated to the state level, came from the School Health Profile Survey of the Centers for Disease Control and Prevention. Multilevel multivariable regressions examined the association between LGB school climate and sexual behaviors, including effect modification. RESULTS Overall, living in jurisdictions with more exclusionary LGB school climates was significantly associated with a lower age at first sex (β = -.04[-.07, -.02]) and a lower likelihood of condom use (OR = .94[.90, .98]), but not the number of lifetime partners. Associations differed by subgroup: sexual identity modified the relationship between school climate and age at first sex (β = -.09[-.15, -.03]) for bisexual adolescents, and school climate and condom use for bisexual (OR = .86[.76, .98]) and gay adolescents (OR = .66[.64, .68]). CONCLUSIONS Exclusionary LGB school climates are associated with a lower age at first sex and a lower likelihood of condom use for all adolescents, and particularly bisexual individuals. Additional research and practice should address school-level climates to support adolescents' healthy sexual development.
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Affiliation(s)
- Morgan M. Philbin
- Department of Sociomedical Sciences, Columbia University Mailman School of Public Health. 722 West 168 Street, New York, NY, 10032 USA
| | - Xinzi Wang
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, 625 N Michigan Ave., #14-043, Chicago, IL, 60611, USA; Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL, USA
| | - Daniel J. Feaster
- Department of Public Health Sciences, University of Miami Miller School of Medicine, 1120 NW 14 Street, Miami FL 33136 USA
| | | | - Gregory Phillips
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, 625 N Michigan Ave., #14-043, Chicago, IL, 60611, USA; Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL, USA
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15
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Halkitis PN, LoSchiavo C, Martino RJ, De La Cruz BM, Stults CB, Krause KD. Age of Sexual Debut among Young Gay-identified Sexual Minority Men: The P18 Cohort Study. JOURNAL OF SEX RESEARCH 2021; 58:573-580. [PMID: 32609010 PMCID: PMC7775328 DOI: 10.1080/00224499.2020.1783505] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Age of sexual debut is a critical health indicator for young sexual minority men (YSMM), associated with an increased likelihood of HIV acquisition, use of alcohol, tobacco, and other substances, and psychological distress. This study examined the age of same-sex sexual debut for five sexual behaviors in a sample of racially/ethnically and socioeconomically diverse gay-identified YSMM in New York City. The mean age of sexual debut of any behavior was 14.5 years old and 19% of the sample reported sexual debut prior to age 13. Overall, mutual masturbation occurred at the youngest mean age, followed by performed oral, received oral, receptive anal, and insertive anal intercourse. There were significant differences by race/ethnicity and perceived familial socioeconomic status (SES), such that Black and Hispanic/Latino men had earlier ages of debut for performed oral and receptive and insertive anal sex, while upper SES men had later ages of debut for receptive and insertive anal intercourse. These findings are relevant to trends in HIV incidence in the U.S., which are highest among Black and Hispanic/Latino YSMM and may be associated with earlier age of sexual debut. These findings also underscore a need for comprehensive and inclusive sex education at younger ages.
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Affiliation(s)
- Perry N. Halkitis
- School of Public Health, Rutgers University, 683 Hoes Ln. West, Piscataway, NJ 08854
- Center for Health, Identity, Behavior & Prevention Studies, Rutgers School of Public Health, 1 Riverfront Plaza, Suite 1020, Newark, NJ 07102
| | - Caleb LoSchiavo
- School of Public Health, Rutgers University, 683 Hoes Ln. West, Piscataway, NJ 08854
- Center for Health, Identity, Behavior & Prevention Studies, Rutgers School of Public Health, 1 Riverfront Plaza, Suite 1020, Newark, NJ 07102
| | - Richard J. Martino
- Center for Health, Identity, Behavior & Prevention Studies, Rutgers School of Public Health, 1 Riverfront Plaza, Suite 1020, Newark, NJ 07102
| | - Blas Martin De La Cruz
- Center for Health, Identity, Behavior & Prevention Studies, Rutgers School of Public Health, 1 Riverfront Plaza, Suite 1020, Newark, NJ 07102
- School of Social Work, Rutgers University, 120 Albany St., Tower One - Suite 200, New Brunswick, NJ 08901
| | - Christopher B. Stults
- Center for Health, Identity, Behavior & Prevention Studies, Rutgers School of Public Health, 1 Riverfront Plaza, Suite 1020, Newark, NJ 07102
- Baruch College, City University of New York, 55 Lexington Ave., New York, NY 10010
| | - Kristen D. Krause
- School of Public Health, Rutgers University, 683 Hoes Ln. West, Piscataway, NJ 08854
- Center for Health, Identity, Behavior & Prevention Studies, Rutgers School of Public Health, 1 Riverfront Plaza, Suite 1020, Newark, NJ 07102
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16
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Emery CR, Xie QW, Chan JSM, Leng LL, Chan CHY, So KF, Li A, Po KKT, Chouliara Z, Chan CLW, Choi AWM, Yuen LP, Ku KS, Kung W, Ng SM. The Counterintuitive Relationship between Telomerase Activity and Childhood Emotional Abuse: Culture and Complexity. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18041619. [PMID: 33567728 PMCID: PMC7914855 DOI: 10.3390/ijerph18041619] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 01/29/2021] [Accepted: 01/30/2021] [Indexed: 01/21/2023]
Abstract
BACKGROUND: A burgeoning literature has found relationships between telomere length, telomerase activity, and human health and longevity. Although some research links a history of childhood adversity with shortened telomere length, our review found no prior research on the relationship between child maltreatment history and telomerase activity in adulthood. We hypothesized a negative relationship between child maltreatment and telomerase activity and hypothesized that the association would be moderated by sex. METHODS: These relationships were tested on a sample of 262 Hong Kong Chinese adults (200 females versus 62 males) with mild to moderate depression. RESULTS: Counterintuitively, emotional abuse was positively associated with telomerase activity, while other maltreatment types were non-significant. The positive relationship between emotional abuse and telomerase activity was significantly moderated by the sex of the participant. CONCLUSIONS: We advance two possible explanations for this finding (1) a culturally informed resilience explanation and (2) a homeostatic complexity explanation. The two explanations are not mutually exclusive. This trial is registered under Hong Kong Clinical Trial Register number HKCTR-1929. SIGNIFICANCE STATEMENT: Emotional abuse was significantly positively associated with telomerase activity. There are at least two non-mutually exclusive explanations for the findings. Simply put, either (1) in the cultural context of Hong Kong emotional abuse was not a risk factor, and/or (2) the conceptualization of telomerase activity as a straightforward indicator of longevity is overly simplistic. The first story we might term a “resilience explanation” while the second we might call a “homeostatic complexity” story.
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Affiliation(s)
- Clifton R. Emery
- SWSA, University of Hong Kong, Pok Fu Lam, Hong Kong; (L.-L.L.); (C.H.Y.C.); (C.L.W.C.)
- Correspondence: (C.R.E.); (S.-M.N.)
| | - Qian-Wen Xie
- School of Public Affairs, Zhejiang University, Hangzhou 310027, China;
| | - Jessie S. M. Chan
- Department of Psychology, University of Hong Kong, Pok Fu Lam, Hong Kong;
| | - Ling-Li Leng
- SWSA, University of Hong Kong, Pok Fu Lam, Hong Kong; (L.-L.L.); (C.H.Y.C.); (C.L.W.C.)
| | - Celia H. Y. Chan
- SWSA, University of Hong Kong, Pok Fu Lam, Hong Kong; (L.-L.L.); (C.H.Y.C.); (C.L.W.C.)
| | - Kwok-Fai So
- State Key Laboratory of Brain and Cognitive Sciences, University of Hong Kong, Pok Fu Lam, Hong Kong; (K.-F.S.); (K.K.T.P.)
- Joint International Research Laboratory of CNS Regeneration Ministry of Education, Guangdong-Hong Kong-Macau Institute of CNS Regeneration, Jinan University, Guangzhou 510632, China;
| | - Ang Li
- Joint International Research Laboratory of CNS Regeneration Ministry of Education, Guangdong-Hong Kong-Macau Institute of CNS Regeneration, Jinan University, Guangzhou 510632, China;
| | - Kevin K. T. Po
- State Key Laboratory of Brain and Cognitive Sciences, University of Hong Kong, Pok Fu Lam, Hong Kong; (K.-F.S.); (K.K.T.P.)
| | - Zoe Chouliara
- Independent Practice, Edinburgh, Midlothian EH7, UK;
| | - Cecilia Lai Wan Chan
- SWSA, University of Hong Kong, Pok Fu Lam, Hong Kong; (L.-L.L.); (C.H.Y.C.); (C.L.W.C.)
| | - Anna W. M. Choi
- Department of Social and Behavioral Sciences, City University of Hong Kong, Kowloon, Hong Kong;
| | - L. P. Yuen
- International Association for Health and Yangsheng, 20 Venturi Rd., Happy Valley, Hong Kong;
| | - Kam Shing Ku
- Haven of Hope Haven of Hope Christian Service, 7 Haven of Hope Rd, Hong Kong;
| | - Winnie Kung
- Graduate School of Social Service, Fordham University, New York, NY 10023, USA;
| | - Siu-Man Ng
- SWSA, University of Hong Kong, Pok Fu Lam, Hong Kong; (L.-L.L.); (C.H.Y.C.); (C.L.W.C.)
- Correspondence: (C.R.E.); (S.-M.N.)
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17
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D'Agati D, Kahn GD, Swartz KL. Preteen Behaviors and Sexual Orientation of High School Students Who Report Depressive Symptoms, United States, 2015-2017. Public Health Rep 2021; 136:132-135. [PMID: 33494657 DOI: 10.1177/0033354920971718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Unhealthy preteen behaviors are associated with adolescent depression. However, little is known about preteen factors among sexual minority young people, a group at increased risk for teen depression and suicide. We completed weighted multivariate logistic regression analyses on data from the national 2015 and 2017 Youth Risk Behavior Survey of 30 389 high school students in the United States. Preteen sex, cigarette smoking, and alcohol and marijuana use were significantly more prevalent among lesbian, gay, or bisexual (LGB) and questioning students who reported depressive symptoms than among their heterosexual peers (adjusted prevalence ratio [APR] range, 1.33-2.34; all significant at P < .05). The only exception was that marijuana use among questioning students was not significantly different from use among heterosexual peers (APR = 1.34; P = .11). Assessment of preteen sex and substance use-especially among LGB and questioning young people, who are more prone to depressive symptoms and more likely to initiate risky preteen behaviors than their heterosexual counterparts-will facilitate a life course approach to sexual minority mental health that should begin by early adolescence.
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Affiliation(s)
- Douglas D'Agati
- 8784 Department of Psychiatry, University of California San Diego Health System, La Jolla, CA, USA
| | - Geoffrey D Kahn
- 25802 Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Karen L Swartz
- 1500 Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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18
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Brief Report: Sexual Debut Among 14- to 17-year-old Sexual Minority Males: A Preliminary Investigation of Early HIV Risk and Sexual Health Needs. J Acquir Immune Defic Syndr 2021; 84:280-284. [PMID: 32149857 DOI: 10.1097/qai.0000000000002342] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Adolescent sexual minority males (ASMM) are disproportionately at risk of HIV. PURPOSE This study documents the sexual debut behaviors of ASMM, tests whether sexual debut and sexual behavior differed by race/ethnicity, and explores the association between early anal sex debut and engaging in condomless anal sex. METHODS Sexually active ASMM (N = 118; ages 14-17) in the United States completed an online sexual health survey. We used Fisher exact tests to explore differences by race/ethnicity in sexual debut characteristics and hypothesized relationships between sexual debut and risk behavior. RESULTS The average age of sexual debut with a male partner was 14 years (SD = 2.4). Approximately one-third (31%) reported anal sex at their sexual debut, with non-Latino black/African American ASMM more likely to report anal sex at debut (63%) compared with non-Latino white (28%), Latino (21%), or mixed race/other identified youth (19%; χ = 12.1, P = 0.01). All participants (100%) who reported an anal sex debut before the age of 14 years reported engaging in condomless anal sex in their lifetime, compared to 60% of those who reported an anal sex debut when they were 14 years old or older (χ = 5.6, P = 0.03). Participants wanted information about how to safely and comfortably have anal sex (59%) and skills around partner communication (>50%) before debut. CONCLUSION Sexually active ASMM begin engaging in sexual behavior with other males early and with incomplete knowledge and skills regarding sexual health and safety.
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19
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Social-Ecological Examination of Non-Consensual Sexting Perpetration among U.S. Adolescents. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17249477. [PMID: 33348870 PMCID: PMC7766393 DOI: 10.3390/ijerph17249477] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Revised: 12/11/2020] [Accepted: 12/13/2020] [Indexed: 11/29/2022]
Abstract
Adolescent sexting is a serious public health concern and is associated with adverse psychosocial outcomes, including depression, anxiety, low self-esteem, declining academic performance, and health problems. Effective prevention of sexting requires a comprehensive and deep understanding of the multiple contexts whereby sexting is likely to occur. The present study explores individual and contextual risk and protective factors that are associated with sexting behavior among a large sample of adolescents. Participants were high school students in midwestern U.S. (N = 2501; LGB n = 309, 76.4% female; non-LGB n = 2192, 47.4% female) who completed self-report measures of sexting and risk (e.g., pornography exposure, impulsivity) and protective (e.g., social support) factors. Path analysis models were conducted with the sexting outcome for groups of LGB and non-LGB students. Among LGB students, results indicated a significant association between sexting and parental monitoring (b = −0.08, p < 0.01); pornography exposure (b = 0.13, p < 0.05); dating partners (b = 0.01, p < 0.01); bullying perpetration (b = 0.17, p < 0.001); and delinquency (b = 0.13; p < 0.001). Among non-LGB students, significant associations were found between sexting and alcohol/substance use (b = 0.05, p < 0.001); bullying (b = 0.08, p < 0.001); and delinquency (b = 0.06, p < 0.001). Moderation analyses suggest that parental monitoring may have a buffering effect between sexting and several risk factors. Recommendations for practitioners include considering the protective factors of sexting perpetration and encouraging appropriate levels of parental monitoring and the continued importance of bullying and alcohol and drug prevention programming to decrease risk factors of sexting perpetration.
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20
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Self-Injurious Thoughts and Behaviors Among Sexual and Gender Minority Youth: a Systematic Review of Recent Research. CURRENT SEXUAL HEALTH REPORTS 2020. [DOI: 10.1007/s11930-020-00295-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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21
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Heiden-Rootes K, Salas J, Moore R, Hasan S, Wilson L. Peer Victimization and Mental Health Outcomes for Lesbian, Gay, Bisexual, and Heterosexual Youth: A Latent Class Analysis. THE JOURNAL OF SCHOOL HEALTH 2020; 90:771-778. [PMID: 32812237 DOI: 10.1111/josh.12940] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Revised: 02/01/2020] [Accepted: 02/02/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Lesbian, gay, bisexual, and questioning (LGBQ) adolescents are at increased risk of poor mental health due to minority stress, a chronic stress associated discrimination, social rejection, and victimization brought on by prejudicial attitudes towards LGBQ individuals. To improve understanding of the differential impact of various kinds of victimization on mental health outcomes for LGBQ adolescents, we analyzed data from the 2015 Youth Risk Behavior Survey (YRBS) for victimization and mental health symptom clusters and associations high school youth and compared by sexual orientation and gender. METHODS Separate Latent Class Analysis (LCA) was conducted to identify profiles of both victimization and mental health symptoms for participants (N = 15,624). Subsequently, stratified weighted logistic regression models were used on an eligible analytic sample of 11,458 to assess differences in the association of victimization and mental health between LGBQ and heterosexual high school students. RESULTS In each LCA, participants were assigned to one of 3 classes for victimization (minimal, 81.3%; bullying, 12.5%; or physical/sexual violence, 6.2%) and 1 of 2 classes for mental health symptoms (minimal, 81.2%; severe, 18.8%). LGBQ participants were overrepresented in physical/sexual violence and bullying victimization profiles. Both bullying and physical/sexual violence profiles were associated with almost 5 times the odds of endorsing severe mental health symptoms. CONCLUSIONS This study expands our understanding of the relationship between types and effect of peer victimization for LGBQ and heterosexual youth with implications for school health and prevention efforts through increased positive school climate for LGBQ students.
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Affiliation(s)
| | - Joanne Salas
- Saint Louis University, 1402 S Grand Blvd, St. Louis, MO, 63104
| | - Rachel Moore
- Saint Louis University, 3700 Lindell Blvd, Suite 1101, St. Louis, MO, 63108
| | - Shah Hasan
- Saint Louis University, 3700 Lindell Blvd, Suite 1101, St. Louis, MO, 63108
| | - Lauren Wilson
- Saint Louis University, 3700 Lindell Blvd, Suite 1101, St. Louis, MO, 63108
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22
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Ortensi LE, Farina P. Sexual violence victimisation among university students in Italy: a gendered intersectional quantitative approach. GENUS 2020. [DOI: 10.1186/s41118-020-00101-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
AbstractThere is rising attention in Italy and Europe to the occurrence, consequences, and factors related to sexual violence. The focus on women as the primary victims of sexual violence has, however, left data collection and research on young men and sexual minorities in the background. Moreover, young people’s experiences of sexual abuse in the context of their relationships with peers are hardly recognised as a policy concern. The ultimate aim of this paper is to disentangle intersectionalities between gender, migration background, sexual orientation, and sexual experience in shaping the risk of experiencing sexual violence among university students in Italy.We use data from the Sexual and Emotional LiFe of Youths (SELFY) survey carried out in Italy in 2017. Our data confirm that women and foreign-born students are at higher risk of sexual violence. Our data also support previous evidence that bisexual women are at a higher risk of sexual violence victimisation compared with peer students with other sexual orientations. Previous same-sex sexual experience is more relevant than sexual orientation in shaping the risk. The effect is gendered: the risk of sexual violence is lower for women with previous same-sex sexual experience compared with their male peers. The intersection between gender, sexual orientation, and same-sex sexual experience generate specific high-risk profiles whose needs should be targeted by support services.
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23
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Dai H, Ingram DG, Taylor JB. Hierarchical and Mediation Analysis of Disparities in Very Short Sleep among Sexual Minority Youth in the U.S., 2015. Behav Sleep Med 2020; 18:433-446. [PMID: 31068017 DOI: 10.1080/15402002.2019.1607738] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
BACKGROUND Insufficient sleep is associated with increased risk of chronic diseases, substance use, and unintentional injuries. Little is known about the disparities in short sleep among sexual minority youth. METHODS A nationally representative sample of U.S. students in grades 9-12 (n = 14,703) from the 2015 Youth Risk Behavior Survey was analyzed to examine the prevalence and risk factors of short sleep. Self-reported sleep duration (very short: ≤5 h, short: 6-7 h, normal: ≥8 h per day) were compared by sex group (male vs. female) and sexual orientation (heterosexual, gay, lesbian, bisexual, and unsure). RESULTS Of all respondents, 88.8% were heterosexual/straight, 2.0% were lesbian or gay, 6.0% were bisexual, and 3.2% were unsure about their sexual identity. Bisexual and unsure girls (36.2%, 95% CI [31.3-41.0] and 33.7%, CI [25.6-41.8], respectively) had a higher prevalence of very short sleep duration than straight girls (19.8%, CI [18.3-21.4]). Gay and unsure boys (38.5%, CI [25.6-51.5] and 33.3%, CI [23.5-32.1], respectively) had a higher prevalence of very short sleep duration than straight boys (16.5%, CI [15.1-17.9]). The effects of sexual minority status on very short sleep duration attenuated when incrementally adjusting for influencing factors, and further analysis identified that feeling sad/hopeless had the largest standardized mediation effect. CONCLUSIONS AND RELEVANCE Sexual minority adolescents had a higher prevalence of reporting very short sleep duration as compared to their straight peers, and the effects were mediated by influencing variables including demographic factors, substance use, excessive media use, and experiences of victimization/mental health problems.
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Affiliation(s)
- Hongying Dai
- College of Public Health, University of Nebraska Medical Center , Omaha, Nebraska
| | - David G Ingram
- Department of Pediatrics, University of Missouri-Kansas City , Kansas City.,Sleep Center, Children's Mercy Hospital , Kansas City, Missouri
| | - Jane B Taylor
- Department of Pediatrics, University of Missouri-Kansas City , Kansas City.,Pulmonology, Children's Mercy Hospital , Kansas City, Missouri
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24
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Barragán V, Berenzon S, Tiburcio M, Bustos M, Villatoro J. Factors Associated with Sexual Debut in Mexican Adolescents: Results of the National Survey on Drug Use among Students in 2014. J Sex Med 2020; 16:418-426. [PMID: 30846115 DOI: 10.1016/j.jsxm.2019.01.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Revised: 01/08/2019] [Accepted: 01/10/2019] [Indexed: 10/27/2022]
Abstract
INTRODUCTION Although first sexual experience (understood as first sexual intercourse) is one of the most commonly assessed characteristics of adolescents, recent research emphasizes the importance of understanding other related social factors. This study highlights factors associated with first sexual experience in a nationally representative sample of adolescent students in Mexico. AIMS The goals of this study were (i) to determine the proportion of adolescents aged 12-17 who had had their first sexual experience; (ii) to identify the factors associated with first sexual experience; and (iii) to analyze the conditions (condom use, substance use) in which first sexual experience takes place. METHOD The data presented in this study are drawn from the 2014 National Survey on Drug Use in Students (Spanish acronym ENCODE), undertaken with the purpose of identifying the prevalence of drug use and associated variables, including sexual activity, in Mexican students. Kaplan-Meier analysis was used to estimate the probability of first sexual experience at a given age, taking sex as an outcome variable and age as a follow-up period. Logistic regression was used to assess possible factors for sexual initiation. MAIN OUTCOME MEASURES Validated standard questionnaires were used to assess sociodemographic characteristics, first sexual experience (framed as first sexual intercourse), frequency of sexual relations, sexual partners, sexual preference (framed as preferred sex of partners), substance use, having a physical illness or a behavioral problem, condom or other contraceptive use, as well as the absence or presence of parents, parents' educational attainment, and parents' substance use. RESULTS A total of 26,187 students aged 12-17 participated. Of this total, 14.8% had already had their first sexual experience, at a median age of 15; 64.5% used some type of contraceptive, and 53.2% used condoms. Proportional probabilities for having first sexual experience using age as a follow-up period showed that the probability of having sex earlier was higher among boys than girls: the probability of having sex at age of 15 was 26.5% for boys and 13.9% for girls. Predictors of first sexual experience included substance use (alcohol OR = 2.5, tobacco OR = 2.6, and other drugs OR = 2.3), having a mother who used drugs (OR= 2.2), sexual preference (female homosexual, OR = 2.2), and sex (male, OR = 2.1). CONCLUSIONS Boys are more likely to have had a first sexual experience than girls. Future strategies should incorporate specifically targeted elements with different messages that consider adolescents' sex and age. Barragán V, Berenzon S, Tiburcio M, et al. Factors Associated with Sexual Debut in Mexican Adolescents: Results of the National Survey on Drug Use among Students in 2014. J Sex Med 2019;16:418-426.
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Affiliation(s)
- Virginia Barragán
- Department of Psychiatry and Mental Health. School of Medicine, National Autonomous University of Mexico, Mexico City, Mexico
| | - Shoshana Berenzon
- Ramón de la Fuente Muñiz National Psychiatry Institute, Mexico City, Mexico
| | - Marcela Tiburcio
- Ramón de la Fuente Muñiz National Psychiatry Institute, Mexico City, Mexico
| | - Marycarmen Bustos
- Ramón de la Fuente Muñiz National Psychiatry Institute, Mexico City, Mexico
| | - Jorge Villatoro
- Ramón de la Fuente Muñiz National Psychiatry Institute, Mexico City, Mexico.
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Hogben M, Leichliter J, Aral SO. An Overview of Social and Behavioral Determinants of STI. Sex Transm Infect 2020. [DOI: 10.1007/978-3-030-02200-6_3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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Valencia R, Wang LY, Dunville R, Sharma A, Sanchez T, Rosenberg E. Sexual Risk Behaviors in Adolescent Sexual Minority Males: A Systematic Review and Meta-Analysis. J Prim Prev 2019; 39:619-645. [PMID: 30446869 PMCID: PMC6267112 DOI: 10.1007/s10935-018-0525-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Although adolescent sexual minority males (ASMM) are at increased risk for human immunodeficiency virus (HIV) in the United States (US), studies that estimate sexual risk behaviors that contribute to HIV risk in ASMM are limited. We completed a systematic review and meta-analysis to compile available data and estimate the prevalence of risk behaviors in this population. We searched four databases for key terms related to ASMM, defined as males aged 14 through 19 who identified as gay or bisexual, reported sex with a male in their lifetime, and/or were considered sexual minority by the study. Articles eligible for inclusion were in English, from US studies, and reported quantitative data on sexual risk behaviors among ASMM. We extracted data from eligible articles and meta-analyzed outcomes reported in three or more articles using random effects. Of 3864 articles identified, 21 were eligible for data extraction. We meta-analyzed nine outcomes. Sixty-two percent of adolescent males self-identifying as gay or bisexual ever had sex with a male, and 67% of participants from ASMM studies recently had sex. Among ASMM who had sex in the last 6 months or were described as sexually active, 44% had condomless anal intercourse in the past 6 months, 50% did not use a condom at last sex, and 32% used alcohol or drugs at their last sexual experience. Available data indicate that sexual risk behaviors are prevalent among ASMM. We need more data to obtain estimates with better precision and generalizability. Understanding HIV risk in ASMM will assist in intervention development and evaluation, and inform behavioral mathematical models.
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Affiliation(s)
- Rachel Valencia
- Department of Epidemiology, Emory University Rollins School of Public Health, 1518 Clifton Road NE, Atlanta, GA, 30322, USA.
| | - Li Yan Wang
- Division of Adolescent and School Health, Centers for Disease Control and Prevention, Atlanta, GA, 30329, USA
| | - Richard Dunville
- Division of Adolescent and School Health, Centers for Disease Control and Prevention, Atlanta, GA, 30329, USA
| | - Akshay Sharma
- Department of Health Behavior and Biological Sciences, University of Michigan School of Nursing, Ann Arbor, MI, 48109, USA
| | - Travis Sanchez
- Department of Epidemiology, Emory University Rollins School of Public Health, 1518 Clifton Road NE, Atlanta, GA, 30322, USA
| | - Eli Rosenberg
- Department of Epidemiology and Biostatistics, University at Albany School of Public Health, SUNY, Albany, NY, 12144, USA
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Patchin JW, Hinduja S. The Nature and Extent of Sexting Among a National Sample of Middle and High School Students in the U.S. ARCHIVES OF SEXUAL BEHAVIOR 2019; 48:2333-2343. [PMID: 31309428 DOI: 10.1007/s10508-019-1449-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Revised: 04/01/2019] [Accepted: 04/02/2019] [Indexed: 05/10/2023]
Abstract
Sexting is the sending or receiving of sexually explicit or sexually suggestive images or video, usually via mobile devices. Despite widespread public concern about these behaviors as they occur among adolescents, including potentially serious legal consequences, relatively little research has been done to estimate the frequency of sexting among middle and high school students. The current study contributes to this scant body of knowledge by reporting prevalence rates for sending and receiving sexually explicit images or video among a nationally representative sample of 5593 American middle and high school students. Overall, approximately 13% of students reported that they had sent a sext, while 18.5% had received a sext. About one-third of those who sext had done it just one time. Rates of asking for, being asked for, and sharing of sexts are also presented, and are broken down further by gender, sexual orientation, race, and age. Implications for preventing sexting behaviors with these results in mind are also discussed.
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Affiliation(s)
- Justin W Patchin
- Department of Political Science, University of Wisconsin-Eau Claire, Eau Claire, WI, 54701, USA.
| | - Sameer Hinduja
- School of Criminology and Criminal Justice, Florida Atlantic University, Jupiter, FL, USA
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Thitasan A, Aytar O, Annerbäck EM, Velandia M. Young people's health and risk behaviours in relation to their sexual orientation: A cross-sectional study of Thailand and Sweden. SEXUAL & REPRODUCTIVE HEALTHCARE 2019; 21:67-74. [PMID: 31395236 DOI: 10.1016/j.srhc.2019.05.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2018] [Revised: 04/13/2019] [Accepted: 05/24/2019] [Indexed: 10/26/2022]
Abstract
OBJECTIVES This study examined the associations between sexual orientation of young people and their health and risk behaviours in Thailand and Sweden, and to explore similarities and differences between the countries. STUDY DESIGN A cross-sectional study using data from the Life and Health - Young surveys in Thailand and Sweden. Three different statistical analyses were used to examine the associations of the variables. RESULTS In total, 3869 students aged 16-18 years old were included: 1488 Thai students and 2381 Swedish students. Significantly more Thai (20%) than Swedish (9%) students identified themselves as bisexual, homosexual or unsure (p < .001). Bivariate analysis showed that, in Thailand, self-harm was more often reported by the homosexual, unsure, and bisexual groups than by the heterosexual group (p = .005). In Sweden, early sexual debut was more often reported by the unsure, bisexual, and homosexual groups than by the heterosexual group (p = .033). Multiple logistic regression analysis showed that homosexual and unsure sexual orientations were significantly associated with self-harm (p < .05) among Thai students. Unsure sexual orientation was significantly associated with early sexual debut (p = .04) among Swedish students. Multiple correspondence analysis indicated that sexual orientation was associated with health and risk behaviours, and varied by different subcategories of students' backgrounds such as country, sexual orientation, family structure and adult support. CONCLUSIONS Sexual minority young people reported more risk behaviours and poorer health than their heterosexual counterparts. The findings are useful for policy programmes on sexual and reproductive health and rights of young people.
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Affiliation(s)
- Anchalee Thitasan
- School of Health, Care and Social Welfare, Mälardalen University, Sweden; Boromarajonani, College of Nursing, Sunpasithiprasong, Thailand.
| | - Osman Aytar
- School of Health, Care and Social Welfare, Mälardalen University, P.O. Box 325, SE-631 05 Eskilstuna, Sweden.
| | - Eva-Maria Annerbäck
- Centre for Clinical Research, Uppsala University, Kungsgatan 41, S-63188 Eskilstuna, Sweden.
| | - Marianne Velandia
- School of Health, Care and Social Welfare, Mälardalen University, Box 883, S-721 23 Västerås, Sweden.
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Rendina HJ, Carter JA, Wahl L, Millar BM, Parsons JT. Trajectories of sexual identity development and psychological well-being for highly sexually active gay and bisexual men: A latent growth curve analysis. PSYCHOLOGY OF SEXUAL ORIENTATION AND GENDER DIVERSITY 2019; 6:64-74. [PMID: 30984797 DOI: 10.1037/sgd0000308] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Objective Examining sexual identity development-the process through which sexual minorities discover and disclose their sexual orientations-within a minority stress framework may help to contextualize sexual and mental health disparities among gay and bisexual men. Research on sexual identity development has typically focused on ages of achieving specific milestones (i.e., awareness, identification, sexual experience, and disclosure), though differences in onset and speed of the process and impact of these trajectories on healthy functioning in adulthood are understudied. Method We analyzed cross-sectional data from 374 highly sexually active gay and bisexual men in NYC. Using latent growth curve modelling, we examined trajectories of sexual identity development through the four primary milestones. We next examined their associations with childhood and background characteristics, adult experiences of sexual minority stress, and adult mental health. Results Gay sexual identity and greater childhood gender nonconformity were associated with earlier reported onset of sexual identity development and younger age was significantly associated with faster progression through the developmental process. The model showed that faster progression through sexual identity development was associated with higher levels of sexual orientation-based discrimination, emotion dysregulation, sexual compulsivity, and anxiety and depression in adulthood. Conclusions These findings support the need for a comprehensive and developmentally-informed model of adulthood functioning among gay and bisexual men that considers trajectories of sexual identity development-including onset and duration-as potential precursors to mental health difficulties in adulthood. Given the early onset of sexual identity development and potential lifelong sequelae, early prevention programs promoting positive sexual identity development are warranted.
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Affiliation(s)
- H Jonathon Rendina
- The Center for HIV/AIDS Educational Studies & Training (CHEST), Hunter College of the City University of New York (CUNY), New York, NY, USA.,Department of Psychology, Hunter College of the City University of New York (CUNY), New York, NY, USA.,Health Psychology and Clinical Science Doctoral Program, The Graduate Center of the City University of New York (CUNY), New York, NY, USA
| | - Joseph A Carter
- The Center for HIV/AIDS Educational Studies & Training (CHEST), Hunter College of the City University of New York (CUNY), New York, NY, USA
| | - Logan Wahl
- The Center for HIV/AIDS Educational Studies & Training (CHEST), Hunter College of the City University of New York (CUNY), New York, NY, USA
| | - Brett M Millar
- The Center for HIV/AIDS Educational Studies & Training (CHEST), Hunter College of the City University of New York (CUNY), New York, NY, USA
| | - Jeffrey T Parsons
- The Center for HIV/AIDS Educational Studies & Training (CHEST), Hunter College of the City University of New York (CUNY), New York, NY, USA.,Department of Psychology, Hunter College of the City University of New York (CUNY), New York, NY, USA.,Health Psychology and Clinical Science Doctoral Program, The Graduate Center of the City University of New York (CUNY), New York, NY, USA
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Espinoza L, Richardson JL, Ferguson K, Chou CP, Baezconde-Garbanati L, Stacy AW. Adolescent Substance Use and Sensation-Seeking on Sexual Behaviors Among Young Adults from Continuation High Schools. Subst Use Misuse 2019; 54:373-383. [PMID: 30654684 PMCID: PMC6438727 DOI: 10.1080/10826084.2018.1496453] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
BACKGROUND Youth from continuation high schools report greater substance use and sensation-seeking than youth from regular high schools, yet their long-term consequences on age at sexual onset and the number of sexual partners are unknown. OBJECTIVE To examine substance use, sensation-seeking and sexual behaviors by gender and race/ethnicity and the effects of substance use and sensation-seeking in adolescence on age at sexual initiation and numbers of sexual partners by young adulthood. METHODS Baseline and 4-year follow-up data on youth from 14 continuation high schools in Southern California who participated in a drug abuse prevention intervention were analyzed. Structural equation modeling assessed whether or not substance use or sensation-seeking in adolescence predicted age at sexual onset and numbers of sexual partners by young adulthood. RESULTS Latinos had lower sensation-seeking and frequency of substance use and a later age at sexual onset than non-Latinos. Males were more likely than females to have multiple lifetime and recent sexual partners. The effects of adolescent substance use on the number of sexual partners by young adulthood were mediated fully by their age at sexual initiation. Sensation-seeking had no direct or indirect effects on sexual behaviors. Conclusions/Importance: Factors leading to and actual sexual risk behaviors among youth from continuation high schools vary by race/ethnicity and gender. Targeting these antecedent factors by race/ethnicity and gender may improve prevention efforts.
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Affiliation(s)
- Lilia Espinoza
- a Department of Public Health , California State University Fullerton , Fullerton , California , USA
| | - Jean L Richardson
- b Department of Preventive Medicine , Institute for Prevention Research University of Southern California , Los Angeles , California , USA
| | - Kristin Ferguson
- c School of Social Work , Arizona State University , Phoenix , Arizona , USA
| | - Chih-Ping Chou
- b Department of Preventive Medicine , Institute for Prevention Research University of Southern California , Los Angeles , California , USA
| | - Lourdes Baezconde-Garbanati
- b Department of Preventive Medicine , Institute for Prevention Research University of Southern California , Los Angeles , California , USA
| | - Alan W Stacy
- d School of Community & Global Health , Claremont Graduate University , Claremont , California , USA
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Thienkrua W, van Griensven F, Mock PA, Dunne EF, Raengsakulrach B, Wimonsate W, Howteerakul N, Ungsedhapand C, Chiwarakorn A, Holtz TH. Young Men Who Have Sex with Men at High Risk for HIV, Bangkok MSM Cohort Study, Thailand 2006-2014. AIDS Behav 2018; 22:2137-2146. [PMID: 29138981 DOI: 10.1007/s10461-017-1963-7] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
High HIV incidence has been reported in young men who have sex with men (YMSM) in North America and Western Europe, but there are limited data from Southeast Asia suggesting MSM may be the driver of the HIV epidemic in this region. We described HIV incidence and risk factors among 494 YMSM enrolled in a cohort study in Bangkok, Thailand. The HIV incidence was 7.4 per 100 person-years. In multivariable analysis, reporting use of an erectile dysfunction drug in combination with club drugs, having receptive or both insertive and receptive anal intercourse with men, having hepatitis A infection, having rectal Chlamydia trachomatis, having hepatitis B infection prior to HIV seroconversion, and reporting not always using condoms with male steady partners were significantly associated with HIV incidence in YMSM. Reduction in new HIV infections in YMSM are critical to reach targets set by Thailand and the region.
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Personality stability and change between age 12 and 14 predicts relationships, sexual activity and same-sex sexual attraction at age 14. JOURNAL OF RESEARCH IN PERSONALITY 2018. [DOI: 10.1016/j.jrp.2018.02.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Krantz M, Goldstein T, Rooks B, Merranko J, Liao F, Gill MK, Diler R, Hafeman D, Ryan N, Goldstein B, Yen S, Hower H, Hunt J, Keller M, Strober M, Axelson D, Birmaher B. Sexual Risk Behavior Among Youth With Bipolar Disorder: Identifying Demographic and Clinical Risk Factors. J Am Acad Child Adolesc Psychiatry 2018; 57:118-124. [PMID: 29413144 PMCID: PMC5806213 DOI: 10.1016/j.jaac.2017.11.015] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2017] [Revised: 11/07/2017] [Accepted: 11/21/2017] [Indexed: 11/16/2022]
Abstract
OBJECTIVE This study aims to document rates of sexual activity among youth with bipolar spectrum disorder (BD) and to examine demographic and clinical factors associated with first sexual activity and sexual risk behavior during follow-up. METHOD The sample was drawn from the Course and Outcome of Bipolar Youth (COBY) study of 413 youth 7 to 17 years at baseline who met criteria for bipolar spectrum disorder according to the Schedule for Affective Disorders and Schizophrenia for School-Aged Children. Psychiatric symptoms during follow-up were assessed using the Adolescent Longitudinal Interview Follow-Up Evaluation (ALIFE). Sexual behavior and level of sexual risk (e.g., unprotected sex, multiple partners, and/or partners with known sexually transmitted infections) were assessed by trained evaluators using the ALIFE Psychosocial Functioning Scale. Analyses were conducted in relation to first sexual behavior during follow-up and then to subsequent sexual behaviors (mean 9.7 years, standard deviation 3.2). RESULTS Sexually active COBY youth (n = 292 of 413; 71%) were more likely females, using substances, and not living with both parents. Consistent with findings among healthy youth, earlier first sexual activity in the sample was significantly associated with low socioeconomic status, female sex, comorbid disruptive behavior disorder, and substance use. As with healthy youth, sexual risk behavior during follow-up was significantly associated with non-Caucasian race, low socioeconomic status, substance use, and history of sexual abuse. Of those COBY youth who were sexually active, 11% reported sexual assault or abuse, 36% reported becoming pregnant (or the significant other becoming pregnant), and 15% reported having at least 1 abortion (or the significant other having an abortion) during follow-up. Hypomanic symptoms during follow-up were temporally associated with the greatest risk for sexual risk behavior. CONCLUSION Demographic and clinical factors could help identify youth with bipolar spectrum disorder at significantly greatest risk for sexual activity and sexual risk behavior. Attending to sexual risk behaviors in this population is warranted.
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Affiliation(s)
- Megan Krantz
- Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - Tina Goldstein
- Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, PA.
| | - Brian Rooks
- Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - John Merranko
- Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - Fangzi Liao
- Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - Mary Kay Gill
- Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - Rasim Diler
- Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - Danella Hafeman
- Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - Neal Ryan
- Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - Benjamin Goldstein
- Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada
| | - Shirley Yen
- Alpert Medical School and Butler Hospital, Providence
| | - Heather Hower
- Alpert Medical School of Brown University, Providence, RI
| | - Jeffrey Hunt
- Alpert Medical School and Bradley Hospital, Providence
| | | | - Michael Strober
- David Geffen School of Medicine, University of California, Los Angeles
| | - David Axelson
- Nationwide Children's Hospital and The Ohio State College of Medicine, Columbus
| | - Boris Birmaher
- Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, PA
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