Sexual activity and other risk-taking behaviors among Asian-American adolescents

Acculturation and risk of traffic crashes in young Asian-born Australian drivers

The study examines changes over time in crash risk differences between young Australian drivers born in Asia and those born in Australia.Data from the 2003 baseline survey of the DRIVE cohort of 20 806 young drivers aged 17-24 years were linked to police, hospital and death data up until 2016. The association between country of birth and crash was investigated using flexible parametric survival models adjusted for confounders.Six months after baseline, the crash risk in Asian-born drivers was less than half that of their Australian-born counterparts (mean HR, MHR 0.41; 95% CI 0.29 to 0.57), only to increase steadily over time to resemble that of Australian-born drivers 13 years later (MHR 0.94; 95% CI 0.66 to 1.36).This is likely to be associated with acculturation and the adoption by young Asian-born Australian drivers of driving behaviour patterns akin to those born locally. This needs to be considered in future road safety campaigns.

The role of community and culture in abortion perceptions, decisions, and experiences among Asian Americans

Introduction

Culture and community can play a role in views, stigma, and access related to abortion. No research to date has documented the influence of culture and community attitudes on Asian American (AA) experiences accessing abortion care in the United States (US). This paper aims to fill gaps in research and understand how cultural and community views influence medication abortion access and experiences among AAs.

Methods

We used a community-based participatory research approach, which included collaboration among experts in public health, advocates, practitioners, and community partners to understand abortion knowledge, attitudes, and experiences among AAs. Using a semi-structured interview guide, we interviewed twenty-nine eligible people of reproductive age over 18 that self-identified as Asian American or mixed race including Asian American, Native Hawaiian, and/or Pacific Islander (AANHPI), and had a medication abortion in the US between January 2016 and March 2021. Interviews were analyzed and coded in NVivo 12 using a modified grounded theory approach.

Results

Participants described various influences of religion negatively impacting acceptability of abortion among their family and community. Lack of openness around sexual and reproductive health (SRH) topics contributed to stigma and influenced most participants' decision not to disclose their abortion to family members, which resulted in participants feeling isolated throughout their abortion experience. When seeking abortion care, participants preferred to seek care with providers of color, especially if they were AANHPI due to past experiences involving stigma and judgment from White providers. Based on their experiences, respondents recommended ways to improve the abortion experience for AAs in the US including, (1) more culturally aware abortion providers from one's community who better understand their needs; (2) clinics providing abortion services located in or near AA communities with signage in local languages; and (3) tailored mental health resources with culturally aware therapists.

Conclusion

This study demonstrates ways in which culture and community opinions toward SRH can influence both the acceptability of abortion and experiences seeking abortion care among AAs. It is important to consider family and community dynamics among AAs to better tailor services and meet the needs of AAs seeking abortion care in the US.

Sexual activity, contraceptive use and sexual violence among Asian high school students in the United States

OBJECTIVE

To compare the prevalence of sexual behaviors and experiences between Asian high school students in the U.S. and students of other race/ethnicities.

STUDY DESIGN

We pooled the 2013, 2015 and 2017 rounds of the Youth Risk Behavior Survey (N = 42,854). Logistic regression was used to identify differences between racial/ethnic groups and by sex.

RESULTS

Compared to their peers, a smaller proportion of Asian students reported engaging in sexual behaviors or using contraception, including prescription methods, at last sex. Asian students also reported fewer experiences of forced sexual intercourse compared to their peers.

CONCLUSIONS

These findings demonstrate distinct patterns in Asian students' sexual health behaviors compared to their peers. Future research should examine determinants of these differences.

IMPLICATIONS

Filling a gap in the literature, these data can inform education and health practices that support the sexual and reproductive health needs of Asian and all adolescents in the country.

Changes in American Adults' Sexual Behavior and Attitudes, 1972-2012

In the nationally representative General Social Survey, U.S. Adults (N = 33,380) in 2000-2012 (vs. the 1970s and 1980s) had more sexual partners, were more likely to have had sex with a casual date or pickup or an acquaintance, and were more accepting of most non-marital sex (premarital sex, teen sex, and same-sex sexual activity, but not extramarital sex). The percentage who believed premarital sex among adults was "not wrong at all" was 29 % in the early 1970s, 42 % in the 1980s and 1990s, 49 % in the 2000s, and 58 % between 2010 and 2012. Mixed effects (hierarchical linear modeling) analyses separating time period, generation/birth cohort, and age showed that the trend toward greater sexual permissiveness was primarily due to generation. Acceptance of non-marital sex rose steadily between the G.I. generation (born 1901-1924) and Boomers (born 1946-1964), dipped slightly among early Generation X'ers (born 1965-1981), and then rose so that Millennials (also known as Gen Y or Generation Me, born 1982-1999) were the most accepting of non-marital sex. Number of sexual partners increased steadily between the G.I.s and 1960s-born GenX'ers and then dipped among Millennials to return to Boomer levels. The largest changes appeared among White men, with few changes among Black Americans. The results were discussed in the context of growing cultural individualism and rejection of traditional social rules in the U.S.

Factors related to sexual behaviors and sexual education programs for Asian-American adolescents

AIM

To understand the influential factors related to sexual behaviors among Asian-American adolescents and to evaluate common factors across successful sexual education programs for this population.

BACKGROUND

Despite a rapid increase in cases of STIs/HIV among Asian-American populations, there remains a need for a comprehensive understanding of the influential factors related to risky sexual behaviors for this population.

METHODS

An integrative literature review was conducted. Peer-reviewed articles and government resources were analyzed.

RESULTS

Five influential factors were identified: family-centered cultural values, parental relationship, acculturation, gender roles, and lack of knowledge and information about sex and STIs. Only two sexual educational programs met the inclusion criteria and provided evidence towards effectiveness: Safer Choices and Seattle Social Development Project.

CONCLUSIONS

The findings of this study indicate an urgent need for culturally sensitive sexual education programs that incorporate the identified influential factors, especially cultural values in order to reduce risky sexual behaviors among Asian-American adolescents.

Acculturation and HIV-related sexual behaviours among international migrants: a systematic review and meta-analysis

This review examines the global literature regarding the relationship between acculturation and HIV-related sexual behaviours among international migrants. Seventy-nine articles published in English-language journals prior to July 2012 met the criteria for inclusion. We conducted a systematic review and subset meta-analysis of correlations between acculturation and five types of sexual behaviours including condom use, multiple partnerships, early sexual initiation, sexually transmitted diseases (STDs) and other unsafe sexual practices. Immigrants high in mainstream acculturation were more likely to have multiple partnerships, early sexual initiation, STDs and unsafe sex (rs ranged from 0.10 to 0.16), but acculturation was not associated with condom use (r = 0.02). Gender moderated the relationships between acculturation and multiple partnerships, STDs and unsafe sex. The relationship between acculturation and unsafe sex also varied across ethnicity. These findings suggest that acculturation may serve as a risk factor towards immigrants' HIV-related sexual health. We offered a theoretical framework and suggested applying cross-cultural and longitudinal designs in future research on acculturation and health behaviours.

Identification and characterization of adolescents' sexual boundaries

PURPOSE

Adolescents' decisions to have sex may be based on a priori boundaries placed on sex. This study addresses: (1) to what extent adolescents set vaginal sexual boundaries; (2) the types of sexual boundaries most and least likely to be endorsed; and (3) to what extent sexual boundaries vary by sex, race/ethnicity, and sexual experience.

METHODS

A cross-sectional study of 518 students attending 10th grade. Survey measures queried about demographics, ever having sex, and existence of sexual boundaries (e.g., being in love, having an attractive partner) that must be in place before having vaginal sex.

RESULTS

The most frequently endorsed boundaries were maturity, commitment, trust, love, and marriage. These boundaries were more frequently endorsed than having a safer-sex method. Compared with females, males were more likely to choose boundaries based on partner attractiveness (p < .001) and avoiding trouble (p < .04). Compared with Asians and Pacific Islanders, whites were more likely to endorse wanting to be a certain age to have sex (p < .01 and p < .05, respectively); Asians and Pacific Islanders were more likely to choose sexual boundaries based on marriage (p's < .05). Adolescents who were sexually experienced were more likely than inexperienced adolescents to endorse boundaries related to relationship characteristics and partner attractiveness (OR = 2.5), and less likely to endorse boundaries related to feeling mature (OR = .34) and waiting until marriage (OR = .34).

CONCLUSIONS

Identifying adolescents' sexual boundaries should help healthcare professionals better understand under what circumstances adolescents are more or less likely to have sex; and this information should ultimately inform the development of new interventions.

Religiosity and substance use among Asian American college students: moderated effects of race and acculturation

BACKGROUND

Religiosity is a well-established protective factor against substance use among Caucasians, but limited research has examined its role among Asian Americans. The purposes of this study were (1) to examine whether the associations between religiosity and substance use outcomes differed across Caucasians and Asian Americans, and (2) to test whether acculturation moderated the associations between religiosity and substance use outcomes among Asian Americans.

METHOD

We utilized a large and diverse cross-sectional sample of 839 college students to test whether race moderated the associations between religiosity and substance use outcomes (Study 1). We then replicated and extended our findings in a separate college sample of 340 Asian Americans, and examined the moderating role of acculturation on the associations between religiosity and substance use outcomes (Study 2).

RESULTS

Controlling for age, gender, and paternal education, religiosity was protective against alcohol use, alcohol problems, and marijuana use among Caucasians but was unrelated to these outcomes among Asian Americans in Study 1. In Study 2, religiosity was protective against alcohol problems only at high levels of acculturation. Moreover, religiosity was protective against marijuana use at both high and mean levels of acculturation, but not at low levels of acculturation.

CONCLUSIONS

The protective effects of religiosity on alcohol use and problems varied across Caucasian and Asian American college students, and religiosity protected against alcohol problems and marijuana use only among more acculturated Asian Americans. These findings underscore the need to examine culturally-specific correlates of substance use outcomes among Asian Americans.

Adolescents speak: why do we smoke?

OBJECTIVES

To assess the role of different factors that are associated with initiation and continuation of adolescent smoking.

MATERIALS AND METHODS

A total of 2535 students (1465 males and 1070 females) between the age groups of 14 and 19 years were selected from four schools and two colleges of the city by two-stage cluster sampling design for this cross-sectional study.

RESULTS

The prevalence of cigarette smoking was 21.58%. Smoking was found to be considerably influenced with having seen best friend, father, sibling and favorite movie star smoke and also with receiving pocket money.

CONCLUSION

Experimentation of substance use, motivated by family members, peer groups and the surrounding environment is common among adolescents and starts early in life. Therefore, it is necessary to come up with health promotion programs directed toward students which encourage attitude shaping among them toward self-confidence and healthy life style.

Prevalence of health-risk behaviors among Asian American and Pacific Islander high school students in the U.S., 2001-2007

OBJECTIVES

We provided national prevalence estimates for selected health-risk behaviors for Asian American and Pacific Islander high school students separately, and compared those prevalence estimates with those of white, black, and Hispanic students.

METHODS

We analyzed data from the Youth Risk Behavior Surveillance System. To generate a sufficient sample of Asian American and Pacific Islander students, we combined data from four nationally representative surveys of U.S. high school students conducted in 2001, 2003, 2005, and 2007 (total n = 56,773).

RESULTS

Asian American students were significantly less likely than Pacific Islander, white, black, or Hispanic students to have drunk alcohol or used marijuana. Asian American students also were the least likely to have carried a weapon, to have been in a physical fight, to have ever had sexual intercourse, or to be currently sexually active. Once sexually active, Asian American students were as likely as most other racial/ethnic groups to have used alcohol or drugs at last sexual intercourse or to have used a condom at last sexual intercourse. Pacific Islander students were significantly more likely than Asian American, white, black, or Hispanic students to have seriously considered or attempted suicide.

CONCLUSIONS

The prevalence estimates of health-risk behaviors exhibited by Asian American students and Pacific Islander students are very different and should be reported separately whenever feasible. To address the different health-risk behaviors exhibited by Asian American and Pacific Islander students, prevention programs should use culturally sensitive strategies and materials.

Risky driving behavior and road traffic crashes among young Asian Australian drivers: findings from the DRIVE study

OBJECTIVE

To examine differences in risky driving behavior and likelihood of traffic crash according to the country of birth of recently licensed young drivers. The groups examined include those born in Australia, those born in Asia, and those born in other countries.

DESIGN AND SETTING

The DRIVE study is a prospective cohort study of drivers aged 17-24 years holding their first-year provisional driver license in New South Wales, Australia. Information obtained from 20,822 participants who completed a baseline questionnaire was linked to police-reported traffic crashes.

MAIN OUTCOME MEASURES

Self-reported risky driving behaviors and police-reported traffic crashes in young drivers.

RESULTS

Young drivers who were born in Asian countries were less likely to report engaging in risky driving behaviors than their Australian-born counterparts. The proportion of participants reporting a high level of risky driving was 31.5 percent (95% confidence intervale [CI], 30.8-32.1) among Australian-born drivers compared to 25.6 percent (95% CI, 23.1-28.2) among Asian-born drivers and 30.4 percent (95% CI, 28.4-32.5) among those born in other regions. Asian-born participants had half the risk of a crash as a driver than their Australian-born counterparts (relative risk [RR] 0.55; 95% CI, 0.41-0.75) after adjusting for a number of demographic factors and driving and risk-taking behaviors. The comparative risk was even lower among those aged 17 years (RR 0.29; 95% CI, 0.29-0.75). Risk estimates for people born in other regions did not differ to those for Australian-born respondents.

CONCLUSIONS

The study highlights the lower level of risky driving and significantly reduced crash risk for Australian drivers born in Asian countries relative to those born locally. Further research is needed to examine factors underlying this reduced risk and the impact of the length of residence in the host country.

Adolescents' Sexual Initiation: The Interaction of Race/Ethnicity and Immigrant Status

This paper provides an in-depth examination of the joint effects of race/ethnicity and immigrant status on adolescents' intercourse risk. We employ a sample of 4,535 females and 3,759 males from the National Education Longitudinal Study (NELS 88/94) who were followed for 6 years beginning in the eighth grade. We use discrete-time logistic regression models to estimate the associations of race/ethnicity and immigrant generational status with first intercourse hazard, and to evaluate the statistical interactions between race/ethnicity and immigrant status. Overall, Asian and Hispanic girls had lower and non-Hispanic Black girls had higher estimated risks relative to non-Hispanic White girls. Hispanic boys and White non-Hispanic boys had similar intercourse risks, but Black boys had higher and Asian boys lower relative risks. However, these patterns are contingent on immigrant status. Among girls, the protective effects of Asian or Hispanic identity are found only among second generation youth. Risk profiles for boys are more complex: being a third-plus generation Hispanic is associated with a higher risk while an Asian identity is associated with a lower risk only among first- and second-generation youth. These findings confirm the importance of accounting for the overlap between race/ethnicity and immigrant status in models of adolescent behavior. As the demographic diversity of the US population grows, researchers must include both race/ethnicity and immigrant status in their models of adolescent behavior.

Sociocultural dimensions of HIV/AIDS among Middle Eastern immigrants in the US: bridging culture with HIV/AIDS programmes

The population of Middle Eastern immigrants in the US has been increasing dramatically over the past 30 years, growing from 200,000 in 1970 to 1.5 million in 2000. These immigrants and their descendants constitute an important new population of interest for public health and other social programmes. With this addition to the cultural diversity of American society, it is important for healthcare programmes to be responsive to the unique cultural needs of those of Middle Eastern origin and to include them in healthcare curricula. This need is particularly imperative for human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) intervention programmes, where the reduction of risky behaviours is essential to controlling the epidemic. When Middle Easterners emigrate to the US they must adjust to the American culture, which leads to preservation of some aspects of their culture and adjustment of behaviors to match American customs. This article aims to present sociocultural factors of HIV risk behaviours that are specific to Middle Eastern culture. The article also provides recommendations for HIV/AIDS-culturally appropriate intervention programmes.

Racial/ethnic disparities and culturally competent health care among youth and young men

Racial/ethnic disparities in health and health care are receiving increasing national attention from the fields of public health and medicine. Efforts to reduce disparities should adopt a life-span approach and recognize the role of gender. During adolescence, young people make increasingly independent decisions about health-related behavior and health care, while developing gender identity. Little is known about how cultural context shapes gender identity and gender identity's influence on health-related behavior and health care utilization. The authors review disparities in health status and health care among adolescents, especially young men, by reviewing health care access, clinical services, and issues related to culture, identity, and acculturation. Significant differences in health status by gender exist in adolescence, with young men faring worse on many health markers. This article discusses gaps in research and offers recommendations for improving health care quality and strengthening the research base on gender and disparities during adolescence.

Association of conventional goals and perceptions of pregnancy with female teenagers' pregnancy avoidance behavior and attitudes

CONTEXT

Fostering conventional goals is a key component of pregnancy prevention interventions for teenagers. However, research has not shown whether having goals independently influences sexual behavior, or whether the perception that pregnancy represents an impediment to achieving goals mediates any association.

METHODS

In 1999-2001, a racially mixed group of 351 sexually experienced female teenagers who were inadequate contraceptive users completed surveys about goals, the anticipated impact of childbearing on these goals, and protective behaviors and attitudes. Chi-square, regression and two-by-two table analyses assessed associations between goals and perceptions of early childbearing and pregnancy avoidance measures.

RESULTS

Three-fourths of respondents had educational or vocational goals. Eight in 10 of these teenagers perceived their goals to be achievable, but fewer than half thought pregnancy would be an impediment to achieving these goals. Teenagers who had goals were more likely than others to have used a contraceptive at last intercourse (odds ratio, 1.9), but controlling for the perception of pregnancy as an impediment eliminated this association. In contrast, considering pregnancy an impediment was associated with an increased likelihood of supporting each pregnancy avoidance measure (2.1-9.6), and of intending to avoid pregnancy and to have an abortion if pregnant, regardless of whether teenagers had goals (8.3-13.8).

CONCLUSIONS

Conventional goals appear to motivate teenagers to avoid getting pregnant only if they believe pregnancy will be an impediment. Thus, it may be less important to encourage young women to formulate goals than to ensure that they consider adolescent childbearing a threat to their plans.

Cigarette smoking among school-going adolescents in Kafue, Zambia

INTRODUCTION

Cigarette smoking is a leading cause of global morbidity and mortality. Interest in developing countries smoking prevalence has been growing since 1999.

OBJECTIVES

To estimate the prevalence of current cigarette smoking and associated factors among school-age adolescents in Kafue, Zambia.

METHODS

A cross sectional study was conducted using standard Global Youth Tobacco Survey (GYTS) methodology. Frequencies and odds ratios were obtained to assess the association between selected factors and current cigarette smoking.

RESULTS

Data on current smoking were available for 1872 adolescents, of whom 891 (47.6%) were males and 981 females. Overall 154 (8.2%) adolescents were current cigarette smokers, while 93 (10.4%) males and 61 (6.2%) females were current smokers (p <0.001). The majority of the smokers usually smoked at their own home or at a friend's house. Having some pocket money, having friends or parents who are smokers, and being exposed to pro-tobacco advertisements at social gatherings were associated with being a current cigarette smoker.

CONCLUSIONS

The traditional factors associated with smoking among adolescents elsewhere are also associated with smoking among adolescents in Kafue, Zambia. Public health interventions aimed to reduce adolescent smoking should be designed with these identified associations in mind.