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Diaz A, Nucci-Sack A, Colon R, Guillot M, Hollman D, Brunelli M, Burk RD, Schlecht NF. Impact of COVID-19 Mitigation Measures on Inner-City Female Youth in New York City. J Adolesc Health 2022; 70:220-227. [PMID: 34836802 PMCID: PMC8547169 DOI: 10.1016/j.jadohealth.2021.10.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 10/06/2021] [Accepted: 10/07/2021] [Indexed: 12/24/2022]
Abstract
PURPOSE New York City (NYC) was the global epicenter of the COVID-19 pandemic in spring 2020. A "shelter in place" mandate was issued in March 2020. The effect on vulnerable populations of adolescent and young adult females has not been well documented. METHODS We administered a monthly online survey between May and November 2020 to adolescent and young adult females participating in a longitudinal study at Mount Sinai Adolescent Health Center. Surveys asked about death of loved ones, financial impacts, social interactions, exposure to dangerous situations, and mental health impacts. Differences in responses by age, race/ethnicity, and living situation were assessed, and compared to data obtained on the same cohort prior to the pandemic. RESULTS Four hundred seventeen females aged 15-28 years completed at least one survey, 94% of whom were youth of color. A third of responders (33%) had lost relatives or other people they were close to (loved ones). Most (68%) reported one or more financial losses, and 21% reported food insecurity, with those not living with parents or a guardian experiencing significantly higher rates. One in 10 reported experiencing sexual abuse or interpersonal partner violence during the "shelter in place" period. Over a third (37%) reported symptoms of clinical depression, which represented a significant increase compared to before the pandemic (p = .01). The negative financial impacts and higher proportion of patients with depressive symptomatology remained elevated for adolescents without support at home. CONCLUSIONS The COVID-19 pandemic had unprecedented negative short-term financial and psychosocial health impacts on inner-city female youth with potential long-term negative impacts.
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Affiliation(s)
- Angela Diaz
- Department of Pediatrics, Mount Sinai Adolescent Health Center, Icahn School of Medicine at Mount Sinai, Manhattan, New York; Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, Manhattan, New York.
| | - Anne Nucci-Sack
- Department of Pediatrics, Mount Sinai Adolescent Health Center, Icahn School of Medicine at Mount Sinai, Manhattan, New York
| | - Rachel Colon
- Department of Pediatrics, Mount Sinai Adolescent Health Center, Icahn School of Medicine at Mount Sinai, Manhattan, New York
| | - Mary Guillot
- Department of Pediatrics, Mount Sinai Adolescent Health Center, Icahn School of Medicine at Mount Sinai, Manhattan, New York
| | - Dominic Hollman
- Department of Pediatrics, Mount Sinai Adolescent Health Center, Icahn School of Medicine at Mount Sinai, Manhattan, New York
| | - Marie Brunelli
- Department of Pediatrics, Mount Sinai Adolescent Health Center, Icahn School of Medicine at Mount Sinai, Manhattan, New York
| | - Robert D Burk
- Departments of Pediatrics, Microbiology & Immunology, and Obstetrics, Gynecology & Women's Health, Albert Einstein College of Medicine, Bronx, New York; Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, New York
| | - Nicolas F Schlecht
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, New York; Department of Cancer Prevention & Control, Roswell Park Comprehensive Cancer Center, Buffalo, New York
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Niu L, Hoyt LT, Pickering S, Nucci-Sack A, Salandy A, Shankar V, Rodriguez EM, Burk RD, Schlecht NF, Diaz A. Neighborhood Profiles and Body Mass Index Trajectory in Female Adolescents and Young Adults. J Adolesc Health 2021; 69:1024-1031. [PMID: 34312066 PMCID: PMC8612950 DOI: 10.1016/j.jadohealth.2021.06.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Revised: 05/24/2021] [Accepted: 06/07/2021] [Indexed: 11/28/2022]
Abstract
PURPOSE The purpose of this study is to identify distinct neighborhood profiles patterned by key structural, physical, and social characteristics and test whether living in different profiles are associated with body mass index trajectories during adolescence in racial/ethnic minority female youth. METHODS Participants were 1,328 sexually active female adolescents and young adults aged 14-23 years, predominately Hispanic and black, enrolled in an human papillomavirus type 4 vaccine (Gardasil) surveillance study at a large adolescent health clinic in New York City between 2007 and 2018. Body mass index was calculated from weight and height every 6 months. A comprehensive set of neighborhood structural, social, and physical characteristics from multiple national and state datasets was linked to each participant based on home address. RESULTS Latent profile analysis revealed five distinct neighborhood profiles in New York City: High Structural/High Social Advantage, Moderate Advantage/Low Crime, Low SES (Socioeconomic Status)/High Activity, Low SES/High Social Advantage, and High Disadvantage. Results from multilevel growth curve analysis revealed that living in Low SES/High Activity neighborhoods was associated with a lower BMI at age 22 (b = -1.32, 95% confidence interval -2.49, -.16), as well as a slower increase in BMI from age 14 to 22 years (b = -.22, 95% confidence interval -.46, .02), compared to the High Disadvantage profile. CONCLUSIONS Our findings suggest that improving neighborhood structural, social, and physical environments may help promote healthy weight and reduce health disparities during adolescence and young adulthood.
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Affiliation(s)
- Li Niu
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, Manhattan, New York; Department of Pediatrics, Mount Sinai Adolescent Health Center, Mount Sinai Hospital, New York, New York.
| | - Lindsay T. Hoyt
- Applied Developmental Psychology, Fordham University, Bronx, NY
| | - Sarah Pickering
- Department of Pediatrics, Mount Sinai Adolescent Health Center, Mount Sinai Hospital, New York, NY, USA
| | - Anne Nucci-Sack
- Department of Pediatrics, Mount Sinai Adolescent Health Center, Mount Sinai Hospital, New York, NY, USA
| | - Anthony Salandy
- Department of Pediatrics, Mount Sinai Adolescent Health Center, Mount Sinai Hospital, New York, NY, USA
| | - Viswanathan Shankar
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Elisa M. Rodriguez
- Department of Cancer Prevention & Control, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Robert D. Burk
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, NY, USA, Departments of Pediatrics, Microbiology & Immunology, and Obstetrics, Gynecology & Women’s Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Nicolas F. Schlecht
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, NY, USA, Department of Cancer Prevention & Control, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Angela Diaz
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, Manhattan, NY, USA, Department of Pediatrics, Mount Sinai Adolescent Health Center, Mount Sinai Hospital, New York, NY, USA
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3
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Shyhalla K, Smith DM, Diaz A, Nucci-Sack A, Guillot M, Hollman D, Goniewicz ML, O'Connor RJ, Shankar V, Burk RD, Schlecht NF. Changes in cannabis, tobacco, and alcohol use among sexually active female adolescents and young adults over a twelve-year period ending in 2019. Addict Behav 2021; 121:106994. [PMID: 34087767 PMCID: PMC8223231 DOI: 10.1016/j.addbeh.2021.106994] [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] [Received: 11/07/2020] [Revised: 03/26/2021] [Accepted: 05/21/2021] [Indexed: 11/21/2022]
Abstract
BACKGROUND The United States has experienced an increasing divergence in cannabis, tobacco, and alcohol use among adolescents and young adults (AYA). We assessed the changes in cannabis, tobacco and alcohol use in an inner-city population of predominantly minority AYA females attending a large adolescent-specific health center in New York City. METHODS This was a longitudinal study of AYA women recruited and followed over a twelve-year period between 2007 and 2019. Lifetime and past 30-day use were assessed by self-administered questionnaire every six months. In addition, we assessed associations with race, ethnicity, sexual behaviors, receipt of social services, living situation at home (e.g., with or without parents), and use of other drugs. RESULTS Participants included 1549 AYA females aged 13-21 at baseline, 95% of whom were youth of color. Use of cannabis increased significantly over the twelve-year period, with frequent cannabis use (≥20 times in 30-days) increasing almost 18% per year (OR = 1.18; 95%CI:1.13-1.23). In contrast, past 30-day tobacco use declined over the same period (OR = 0.86; 95%CI:0.83-0.89). Past 30-day cannabis use was more likely among African Americans (OR = 1.33; 95%CI:1.08-1.63), women who had sex with both men and women compared to with men only (OR = 1.44; 95%CI:1.18-1.75), recent users of tobacco (OR = 2.20; 95%CI:1.92-2.52) and alcohol (OR = 2.84; 95%CI:2.52-3.20), and ever users of other drugs (OR = 1.69; 95%CI:1.44-1.99), independent of age, time and living situation. CONCLUSIONS Increasing rates of cannabis use and the association with concurrent tobacco and alcohol use in AYA females underscore the need to screen for unhealthy cannabis use, in addition to tobacco and alcohol, especially among inner-city AYA.
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Affiliation(s)
- Kathleen Shyhalla
- Department of Cancer Prevention & Control, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Danielle M Smith
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Angela Diaz
- Department of Pediatrics, Mount Sinai Adolescent Health Center, Icahn School of Medicine at Mount Sinai, Manhattan, NY, USA; Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, Manhattan, NY, USA
| | - Anne Nucci-Sack
- Department of Pediatrics, Mount Sinai Adolescent Health Center, Icahn School of Medicine at Mount Sinai, Manhattan, NY, USA
| | - Mary Guillot
- Department of Pediatrics, Mount Sinai Adolescent Health Center, Icahn School of Medicine at Mount Sinai, Manhattan, NY, USA
| | - Dominic Hollman
- Department of Pediatrics, Mount Sinai Adolescent Health Center, Icahn School of Medicine at Mount Sinai, Manhattan, NY, USA
| | - Maciej L Goniewicz
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Richard J O'Connor
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Viswanathan Shankar
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Robert D Burk
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, NY, USA; Departments of Pediatrics, Microbiology & Immunology, and Obstetrics, Gynecology & Women's Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Nicolas F Schlecht
- Department of Cancer Prevention & Control, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA; Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, NY, USA.
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Gradissimo A, Shankar V, Wiek F, St. Peter L, Studentsov Y, Nucci-Sack A, Diaz A, Pickering S, Schlecht NF, Burk RD. Anti-HPV16 Antibody Titers Prior to an Incident Cervical HPV16/31 Infection. Viruses 2021; 13:v13081548. [PMID: 34452413 PMCID: PMC8402915 DOI: 10.3390/v13081548] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 07/30/2021] [Accepted: 08/02/2021] [Indexed: 12/16/2022] Open
Abstract
The goal of this study was to investigate the serological titers of circulating antibodies against human papillomavirus (HPV) type 16 (anti-HPV16) prior to the detection of an incident HPV16 or HPV31 infection amongst vaccinated participants. Patients were selected from a prospective post-HPV vaccine longitudinal cohort at Mount Sinai Adolescent Health Center in Manhattan, NY. We performed a nested case-control study of 43 cases with incident detection of cervical HPV16 (n = 26) or HPV31 (n = 17) DNA who had completed the full set of immunizations of the quadrivalent HPV vaccine (4vHPV). Two control individuals whom had received three doses of the vaccine (HPV16/31-negative) were selected per case, matched on age at the first dose of vaccination and follow-up time in the study: a random control, and a high-risk control that was in the upper quartile of a sexual risk behavior score. We conducted an enzyme-linked immunosorbent assay (ELISA) for the detection of immunoglobulin G (IgG) antibodies specific to anti-HPV16 virus-like particles (VLPs). The results suggest that the average log antibody titers were higher among high-risk controls than the HPV16/31 incident cases and the randomly selected controls. We show a prospective association between anti-HPV16 VLP titers and the acquisition of an HPV16/31 incident infection post-receiving three doses of 4vHPV vaccine.
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Affiliation(s)
- Ana Gradissimo
- Department of Pediatrics, Albert Einstein College of Medicine, Bronx, NY 10461, USA; (A.G.); (F.W.); (L.S.P.); (Y.S.)
| | - Viswanathan Shankar
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, NY 10461, USA; (V.S.); (N.F.S.)
| | - Fanua Wiek
- Department of Pediatrics, Albert Einstein College of Medicine, Bronx, NY 10461, USA; (A.G.); (F.W.); (L.S.P.); (Y.S.)
| | - Lauren St. Peter
- Department of Pediatrics, Albert Einstein College of Medicine, Bronx, NY 10461, USA; (A.G.); (F.W.); (L.S.P.); (Y.S.)
| | - Yevgeniy Studentsov
- Department of Pediatrics, Albert Einstein College of Medicine, Bronx, NY 10461, USA; (A.G.); (F.W.); (L.S.P.); (Y.S.)
| | - Anne Nucci-Sack
- Department of Pediatrics, Icahn School of Medicine, Mount Sinai Adolescent Health Center, Manhattan, NY 10128, USA; (A.N.-S.); (A.D.); (S.P.)
| | - Angela Diaz
- Department of Pediatrics, Icahn School of Medicine, Mount Sinai Adolescent Health Center, Manhattan, NY 10128, USA; (A.N.-S.); (A.D.); (S.P.)
| | - Sarah Pickering
- Department of Pediatrics, Icahn School of Medicine, Mount Sinai Adolescent Health Center, Manhattan, NY 10128, USA; (A.N.-S.); (A.D.); (S.P.)
| | - Nicolas F. Schlecht
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, NY 10461, USA; (V.S.); (N.F.S.)
- Department of Pediatrics, Icahn School of Medicine, Mount Sinai Adolescent Health Center, Manhattan, NY 10128, USA; (A.N.-S.); (A.D.); (S.P.)
- Department of Cancer Prevention and Control, Roswell Park Comprehensive Cancer Center, Buffalo, NY 14203, USA
| | - Robert D. Burk
- Department of Pediatrics, Albert Einstein College of Medicine, Bronx, NY 10461, USA; (A.G.); (F.W.); (L.S.P.); (Y.S.)
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, NY 10461, USA; (V.S.); (N.F.S.)
- Departments of Microbiology & Immunology, and Obstetrics, Gynecology & Women’s Health, Albert Einstein College of Medicine, Bronx, NY 10461, USA
- Correspondence: ; Tel.: +1-718-430-3720
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5
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Lanier Y, Goldstein A, Lavarin C, Choi E, Bond K, Riascos K. A Qualitative Investigation of Facilitators to Black and Latino Adolescent and Young Adults' Participation in a Couple-Based HIV Prevention Study. Am J Health Promot 2021; 35:809-817. [PMID: 33641448 PMCID: PMC10878312 DOI: 10.1177/0890117121997040] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
PURPOSE Recruitment and retention of adolescents and young adults (AYAs) in couple-based HIV prevention research can be difficult. This study's primary objective is to identify factors that influenced Black and Latino AYAs to participate in couple-based HIV/STI prevention research. DESIGN In-depth, semi-structured qualitative interviews. SETTING Face-to-face interviews with couples recruited from the South Bronx, New York. PARTICIPANTS Twenty-three heterosexual couples (46 individuals) aged 16-28 (M = 20.1, SD = 3.01). METHODS Participants completed 60 to 90-minute individual and dyadic interviews. All interviews were audio-recorded and transcribed. Thematic analysis was conducted to identify key themes. RESULTS Two levels of influence emerged from participants' interviews regarding their reasons for study participation: 1) individual factors (interest in the study topic, study incentives, opportunity to help their community, and opportunity to learn something new), 2) interpersonal factors (positive interactions with the research team, partner's desire to participate and relationship strengthening). There were key differences by gender and recruitment order. CONCLUSION Black and Latino AYAs report multiple reasons for participating in couple-based research. Highlighting the benefits of study participation to themselves, their relationships, and their communities may be an important strategy for engaging AYAs in couple-based research.
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Affiliation(s)
- Yzette Lanier
- New York University, Rory Meyers College of Nursing, New York, NY, USA
| | | | | | - Elizabeth Choi
- New York University, Steinhardt School of Culture, Education, and Human Development, New York, NY, USA
| | - Keosha Bond
- New York Medical College, School of Health Sciences & Practice, Hawthorne, New York, NY, USA
| | - Katerin Riascos
- New York University, Steinhardt School of Culture, Education, and Human Development, New York, NY, USA
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Zimet GD, Silverman RD, Fortenberry JD. Coronavirus Disease 2019 and Vaccination of Children and Adolescents: Prospects and Challenges. J Pediatr 2021; 231:254-258. [PMID: 33161025 PMCID: PMC7644179 DOI: 10.1016/j.jpeds.2020.11.002] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Revised: 10/30/2020] [Accepted: 11/02/2020] [Indexed: 12/15/2022]
Affiliation(s)
- Gregory D. Zimet
- Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN,Reprint requests: Gregory D. Zimet, PhD, Division of Adolescent Medicine, Department of Pediatrics, Indiana University School of Medicine, 410 W. 10 St, HS 1001, Indianapolis, IN 46202
| | - Ross D. Silverman
- Department of Health Policy and Management, Indiana University Richard M. Fairbanks School of Public Health, Indianapolis, IN,Indiana University Robert H. McKinney School of Law, Indianapolis, IN
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Niu L, Brown J, Till Hoyt L, Salandy A, Nucci-Sack A, Shankar V, Burk RD, Schlecht NF, Diaz A. Profiles of Childhood Maltreatment: Associations with Sexual Risk Behavior during Adolescence in a Sample of Racial/Ethnic Minority Girls. Child Dev 2021; 92:1421-1438. [PMID: 33442867 DOI: 10.1111/cdev.13498] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
This study examines associations between childhood maltreatment and developmental trajectories of sexual risk behaviors (SRBs) in a sample of 882 sexually active adolescent girls, predominantly Hispanic or Black, assessed every 6 months between 13 and 23 years. Latent profile analyses revealed four distinct maltreatment profiles: Low Maltreatment (76%), Moderate Emotional Neglect Only (15%), Severe Physical/Emotional Abuse (3%), and Severe Sexual Abuse (6%). Multilevel growth analyses showed the Moderate Emotional Neglect Only and Severe Sexual Abuse profiles exhibited more SRBs starting in late adolescence, and the Severe Sexual Abuse profile also exhibited a faster increase than the Low Maltreatment profile. Understanding heterogeneity within maltreated populations may have important implications for healthy sexual development.
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Affiliation(s)
- Li Niu
- Fordham University.,Mount Sinai Adolescent Health Center.,Icahn School of Medicine at Mount Sinai
| | | | | | | | | | | | | | - Nicolas F Schlecht
- Albert Einstein College of Medicine.,Roswell Park Comprehensive Cancer Center
| | - Angela Diaz
- Mount Sinai Adolescent Health Center.,Icahn School of Medicine at Mount Sinai
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Diaz A, Shankar V, Nucci-Sack A, Linares LO, Salandy A, Strickler HD, Burk RD, Schlecht NF. Effect of child abuse and neglect on risk behaviors in inner-city minority female adolescents and young adults. CHILD ABUSE & NEGLECT 2020; 101:104347. [PMID: 31884248 PMCID: PMC7059863 DOI: 10.1016/j.chiabu.2019.104347] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Revised: 12/16/2019] [Accepted: 12/20/2019] [Indexed: 05/03/2023]
Abstract
BACKGROUND Over six million children each year are referred to child protective services for child abuse (sexual, physical and emotional) and neglect (physical and emotional). OBJECTIVE While the relationship between child sexual abuse and sexually transmitted infections has been documented, there has been little research regarding the effects of other forms of maltreatment. PARTICIPANTS AND SETTING 882 inner-city females aged 12-20 years of age seen at a large adolescent and young adult (AYA) health center in New York City between 2012-2017. METHODS History of maltreatment was assessed using the Childhood Trauma Questionnaire. Associations with depressive symptoms, antisocial behavior, peer deviancy, drug/alcohol use, and risky sexual behaviors were assessed. RESULTS History of maltreatment was common in our cohort of inner-city AYA females, with 59.6 % reporting any type of maltreatment, including sexual abuse (17.5 %), physical abuse (19.5 %) or neglect (26.2 %), and emotional abuse (30.7 %) or neglect (40.4 %). We observed significant associations between all forms of maltreatment and risk of depression, drug/alcohol use, antisocial behaviors, peer deviancy, and risky sexual risk behaviors (including having a higher number of sexual partners, having a sexual partner 5+ years older, and anal sex). Physical and emotional abuse were associated with having unprotected sex while under the influence of drugs/alcohol. CONCLUSIONS AND RELEVANCE Reporting a history of maltreatment was associated with an increased likelihood of engaging in risky sexual and antisocial behaviors, as well as depression in inner-city female youth. These data highlight the broad, lingering repercussions of all types of child maltreatment.
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Affiliation(s)
- Angela Diaz
- Department of Pediatrics, Mount Sinai Adolescent Health Center, Icahn School of Medicine at Mount Sinai, Manhattan, NY, USA; Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, Manhattan, NY, USA.
| | - Viswanathan Shankar
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Anne Nucci-Sack
- Department of Pediatrics, Mount Sinai Adolescent Health Center, Icahn School of Medicine at Mount Sinai, Manhattan, NY, USA
| | - Lourdes Oriana Linares
- Department of Pediatrics, Mount Sinai Adolescent Health Center, Icahn School of Medicine at Mount Sinai, Manhattan, NY, USA
| | - Anthony Salandy
- Department of Pediatrics, Mount Sinai Adolescent Health Center, Icahn School of Medicine at Mount Sinai, Manhattan, NY, USA
| | - Howard D Strickler
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Robert D Burk
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, NY, USA; Departments of Pediatrics, Microbiology & Immunology, and Obstetrics, Gynecology & Women's Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Nicolas F Schlecht
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, NY, USA; Department of Cancer Prevention & Control, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
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Schlecht NF, Masika M, Diaz A, Nucci-Sack A, Salandy A, Pickering S, Strickler HD, Shankar V, Burk RD. Risk of Oral Human Papillomavirus Infection Among Sexually Active Female Adolescents Receiving the Quadrivalent Vaccine. JAMA Netw Open 2019; 2:e1914031. [PMID: 31651968 PMCID: PMC6822084 DOI: 10.1001/jamanetworkopen.2019.14031] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
IMPORTANCE Human papillomavirus (HPV) is the most common sexually transmitted infection in the United States, and oral HPV infection is associated with increased risk of oropharyngeal cancer. OBJECTIVE To describe the risk factors for oral HPV in sexually active female adolescents receiving the quadrivalent vaccine. DESIGN, SETTING, AND PARTICIPANTS Longitudinal cohort study involving repeated collection of oral rinse specimens from sexually active female adolescents conducted between October 19, 2007, and March 9, 2017, at a large adolescent health center in New York, New York, that provides free health care, including HPV vaccination. EXPOSURES Human papillomavirus vaccination and self-reported history of sexual behavior. MAIN OUTCOMES AND MEASURES Prevalence of HPV in the oral cavity. RESULTS Among the 1259 participants who were included in this study, median age at entry into the study was 18 (range, 13-21) years; 638 (50.7%) were of African American descent, 569 (45.2%) were of Hispanic descent, 43 (3.4%) reported another race/ethnicity, and race/ethnicity was unspecified for 9 (0.7%). The median (mode) age at first sexual activity was 14.8 (14) years, and 1161 (92.2%) reported having had oral sex. Human papillomavirus DNA was detected in baseline oral rinse samples of 78 of the 1259 participants (6.2%; 95% CI, 4.9%-7.6%). There was a significant decrease in oral HPV detection with time (in years) since first engaging in sexual activities, independent of age and concurrent detection of cervical HPV; comparing 4 or more years with 1 year or less, the odds ratio was 0.45 (95% CI, 0.21-0.96). Detection of vaccine types (HPV-6, HPV-11, HPV-16, and HPV-18) was significantly lower among participants who had received at least 1 dose of the quadrivalent HPV vaccine at the time of enrollment compared with those who were unvaccinated (odds ratio, 0.20; 95% CI, 0.04-0.998). CONCLUSIONS AND RELEVANCE This study's findings suggest that detection of HPV in the oral cavity is not uncommon in sexually active female adolescents. In addition, HPV vaccination is associated with a significant decrease in detection of HPV vaccine types in the oral cavity.
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Affiliation(s)
- Nicolas F. Schlecht
- Department of Cancer Prevention and Control, Roswell Park Comprehensive Cancer Center, Buffalo, New York
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, New York
| | - Martin Masika
- Department of Cancer Prevention and Control, Roswell Park Comprehensive Cancer Center, Buffalo, New York
| | - Angela Diaz
- Mount Sinai Adolescent Health Center, Department of Pediatrics, Icahn School of Medicine at Mount Sinai, Manhattan, New York
| | - Anne Nucci-Sack
- Mount Sinai Adolescent Health Center, Department of Pediatrics, Icahn School of Medicine at Mount Sinai, Manhattan, New York
| | - Anthony Salandy
- Mount Sinai Adolescent Health Center, Department of Pediatrics, Icahn School of Medicine at Mount Sinai, Manhattan, New York
| | - Sarah Pickering
- Mount Sinai Adolescent Health Center, Department of Pediatrics, Icahn School of Medicine at Mount Sinai, Manhattan, New York
| | - Howard D. Strickler
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, New York
| | - Viswanathan Shankar
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, New York
| | - Robert D. Burk
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, New York
- Department of Pediatrics, Division of Genetics, Albert Einstein College of Medicine, Bronx, New York
- Department of Microbiology & Immunology, Albert Einstein College of Medicine, Bronx, New York
- Department of Obstetrics & Gynecology and Women’s Health, Albert Einstein College of Medicine, Bronx, New York
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Francis JKR, de Roche AM, Mauro C, Landers SE, Chang J, Catallozzi M, Breitkopf CR, Rosenthal SL. Adolescent-Parent Dyadic Retention in an Interview Study and Changes in Willingness to Participate in a Hypothetical Microbicide Safety Study. J Pediatr Adolesc Gynecol 2018; 31:592-596. [PMID: 29906513 PMCID: PMC6218291 DOI: 10.1016/j.jpag.2018.06.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Revised: 05/17/2018] [Accepted: 06/04/2018] [Indexed: 11/19/2022]
Abstract
STUDY OBJECTIVE In this study we describe adolescent and parent retention and changes in willingness to participate (WTP) in research among adolescents, parents, and adolescent-parent dyads. DESIGN AND SETTING Adolescent-parent dyads were recruited to participate in a longitudinal study to assess research participation attitudes using simultaneous individual interviews of the adolescent and parent with a return visit 1 year later using the same interview. PARTICIPANTS Adolescents (14-17 years old) and their parents. INTERVENTIONS None. MAIN OUTCOME MEASURES The relationship between participant characteristics and dyad retention was assessed. WTP was measured on a Likert scale and dichotomized (willing/unwilling) to assess changes in WTP attitudes over time for adolescents, parents, and dyads. RESULTS Eighty-three percent of the 300 dyads were retained. Dyads in which there was successful contact with the parent before follow-up were more likely to be retained (odds ratio, 4.88; 95% confidence interval, 2.57-9.26). For adolescents at baseline, 59% were willing to participate and 55% were willing to participate at follow-up (McNemar S = 0.91; P = .34). For parents at baseline, 51% were willing to participate and 57% were willing to participate at follow-up (McNemar S = 5.12; P = .02). For dyads at baseline, 57% were concordant (in either direction) and 70% of dyads were concordant at follow-up (McNemar S = 10.56; P = .001). CONCLUSION Over 1 year, parent contact might positively influence successful adolescent retention. Parents become more willing to let their adolescents participate over time, with dyads becoming more concordant about research participation.
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Affiliation(s)
- Jenny K R Francis
- Department of Pediatrics, Columbia University Medical Center, Vagelos College of Physicians and Surgeons, New York, New York; NewYork-Presbyterian Hospital, New York, New York.
| | - Ariel M de Roche
- Department of Pediatrics, Columbia University Medical Center, Vagelos College of Physicians and Surgeons, New York, New York
| | - Christine Mauro
- Department of Biostatistics, Columbia University Medical Center, Mailman School of Public Health, New York, New York
| | - Sara E Landers
- Department of Pediatrics, Columbia University Medical Center, Vagelos College of Physicians and Surgeons, New York, New York
| | - Jane Chang
- Department of Pediatrics, Weill Cornell Medical College, New York, New York
| | - Marina Catallozzi
- Department of Pediatrics, Columbia University Medical Center, Vagelos College of Physicians and Surgeons, New York, New York; NewYork-Presbyterian Hospital, New York, New York; Heilbrunn Department of Population & Family Health, Columbia University Medical Center, Mailman School of Public Health, New York, New York
| | | | - Susan L Rosenthal
- Department of Pediatrics, Columbia University Medical Center, Vagelos College of Physicians and Surgeons, New York, New York; NewYork-Presbyterian Hospital, New York, New York; Department of Psychiatry, Columbia University Medical Center, Vagelos College of Physicians and Surgeons, New York, New York
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11
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Mohanty S, Leader AE, Gibeau E, Johnson C. Using Facebook to reach adolescents for human papillomavirus (HPV) vaccination. Vaccine 2018; 36:5955-5961. [PMID: 30172634 DOI: 10.1016/j.vaccine.2018.08.060] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2018] [Revised: 08/20/2018] [Accepted: 08/24/2018] [Indexed: 11/28/2022]
Abstract
BACKGROUND Despite numerous public health campaigns to promote the human papillomavirus (HPV) vaccine, uptake among adolescents in the US has remained below the Healthy People 80% goal for 3-dose completion. The Philadelphia Department of Public Health (PDPH) used an innovative social media strategy to raise awareness and increase rates of HPV immunization initiation and series completion among adolescents. METHODS Between June 2012 and July 2013, PDPH launched a Facebook campaign to target Philadelphia adolescents (13-18 years) with specific messages about HPV immunization benefits and announce opportunities for vaccination. Six distinct advertising campaigns ran for two-week intervals. Facebook metrics and vaccine clinic data were used to track success. Reminder-recall letters were also sent to adolescents as part of the campaign. RESULTS On average, each advertising campaign reached 155,110 adolescents and engaged 2106 adolescents. The advertising campaigns that focused on HPV disease risk and local resources were the most successful in engaging adolescents. During advertising campaigns, there were sizeable increases in both reach and engagement compared to non-campaign periods. Overall, 3400 adolescents became fans of the campaign and 176 doses of HPV vaccine were administered to 152 adolescents. Only 2 adolescents were vaccinated as a result of the Facebook campaign while the rest were prompted by reminder-recall letters or through community events. CONCLUSION The campaign was well-received, far-reaching and generated awareness and conversations among adolescents. However, the campaign did not appear to be a sufficient driver for HPV uptake even when common barriers to HPV immunization were minimized.
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Affiliation(s)
- Salini Mohanty
- University of Pennsylvania, Philadelphia, PA, United States; Philadelphia Department of Public Health, Philadelphia, PA, United States.
| | - Amy E Leader
- Thomas Jefferson University, Philadelphia, PA, United States
| | - Emily Gibeau
- Philadelphia Department of Public Health, Philadelphia, PA, United States
| | - Caroline Johnson
- Philadelphia Department of Public Health, Philadelphia, PA, United States
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12
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Flores D, McKinney R, Arscott J, Barroso J. Obtaining waivers of parental consent: A strategy endorsed by gay, bisexual, and queer adolescent males for health prevention research. Nurs Outlook 2018; 66:138-148. [PMID: 28993074 PMCID: PMC5857413 DOI: 10.1016/j.outlook.2017.09.001] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Accepted: 09/05/2017] [Indexed: 11/24/2022]
Abstract
BACKGROUND Requiring parental consent in studies with sexual minority youth (SMY) can sometimes be problematic as participants may have yet to disclose their sexual orientation, may not feel comfortable asking parents' permission, and may promote a self-selection bias. PURPOSE We discuss rationale for waiving parental consent, strategies to secure waivers from review boards, and present participants' feedback on research without parents' permission. METHODS We share our institutional review board proposal in which we made a case that excluding SMY from research violates ethical research principles, does not recognize their autonomy, and limits collection of sexuality data. DISCUSSION Standard consent policies may inadvertently exclude youth who are at high risk for negative health outcomes or may potentially put them at risk because of forced disclosure of sexual orientation. Securing a waiver addresses these concerns and allows for rich data, which is critical for providers to have a deeper understanding of their unique sexual health needs. CONCLUSION To properly safeguard and encourage research informed by SMY, parental consent waivers may be necessary.
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Affiliation(s)
| | - Ross McKinney
- Association of American Medical Colleges, Washington, DC
| | | | - Julie Barroso
- Medical University of South Carolina School of Nursing, Charleston, SC
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13
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Schlecht NF, Diaz A, Shankar V, Szporn AH, Wu M, Nucci-Sack A, Peake K, Strickler HD, Burk RD. Risk of Delayed Human Papillomavirus Vaccination in Inner-City Adolescent Women. J Infect Dis 2016; 214:1952-1960. [PMID: 27738056 DOI: 10.1093/infdis/jiw486] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2016] [Accepted: 10/06/2016] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Uptake of human papillomavirus (HPV) vaccine in the United States is slow, and the effectiveness of the vaccine has not been assessed in high-risk adolescent populations. METHODS We conducted a longitudinal study of 1139 sexually active, inner-city adolescent women receiving the 3-dose quadrivalent (4vHPV) vaccine. Cervical and anal specimens collected semiannually were tested using an L1-specific polymerase chain reaction assay. Postvaccination incidence of 4vHPV vaccine and nonvaccine HPV types, and risk of cervical cytological abnormalities, were assessed in relation to time to completion of all 3 vaccine doses. RESULTS Compared to vaccine naive women at enrollment, vaccinated women had significantly lower incidence rate ratios of cervical infection with HPV6/11/16/18 (0.2; 95% confidence interval [CI], .1-.4) and the related types HPV31 and HPV45 (0.4 [95% CI, .2-1.0] and 0.3 [95% CI, .1-.6], respectively), as well as significantly lower incidence rate ratios of anal infection with HPV6/11/16/18 (0.4; 95% CI, .2-.7). Notably, we observed higher risks of cervical HPV6/11/16/18 infection (hazards ratio [HR], 2.9; 95% CI, 1.0-8.0) and associated cytological abnormalities (HR, 4.5; 95% CI, .7-26.0) among women immunized at ≥15 years of age who took ≥12 months (vs <12 months) to complete the 3-dose regimen. CONCLUSIONS Among adolescents immunized at ≥15 years of age, a longer time to complete the 3-dose schedule was associated with an increased risk of anogenital HPV6/11/16/18 infection and an increased incidence of associated cervical cytological abnormalities.
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Affiliation(s)
| | - Angela Diaz
- Mount Sinai Adolescent Health Center.,Icahn School of Medicine at Mount Sinai, Manhattan, New York
| | | | - Arnold H Szporn
- Icahn School of Medicine at Mount Sinai, Manhattan, New York
| | - Maoxin Wu
- Icahn School of Medicine at Mount Sinai, Manhattan, New York
| | - Anne Nucci-Sack
- Mount Sinai Adolescent Health Center.,Icahn School of Medicine at Mount Sinai, Manhattan, New York
| | - Ken Peake
- Mount Sinai Adolescent Health Center.,Icahn School of Medicine at Mount Sinai, Manhattan, New York
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14
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Parents' and Adolescents' Attitudes about Parental Involvement in Clinical Research. J Pediatr Adolesc Gynecol 2016; 29:372-7. [PMID: 26820441 PMCID: PMC4916057 DOI: 10.1016/j.jpag.2016.01.119] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2015] [Revised: 01/05/2016] [Accepted: 01/08/2016] [Indexed: 11/23/2022]
Abstract
STUDY OBJECTIVE To understand parent and adolescent attitudes toward parental involvement during clinical trials and factors related to those attitudes. DESIGN As part of a study on willingness to participate in a hypothetical microbicide study, adolescents and their parents were interviewed separately. SETTING Adolescent medicine clinics in New York City. PARTICIPANTS There were 301 dyads of adolescents (ages 14-17 years; 62% female; 72% Hispanic) and their parents. INTERVENTIONS None. MAIN OUTCOME MEASURES The interview included questions on demographic characteristics, sexual history, and family environment (subscales of the Family Environment Scale) that were associated with attitudes about parental involvement. RESULTS Factor analysis of the parental involvement scale yielded 2 factors: LEARN, reflecting gaining knowledge about study test results and behaviors (4 items) and PROCEDURE, reflecting enrollment and permissions (4 items). Adolescents endorsed significantly fewer items on the LEARN scale and the PROCEDURE scale indicating that adolescents believed in less parental involvement. There was no significant concordance between adolescents and their own parents on the LEARN scale and the PROCEDURE scale. In final multivariate models predicting attitudes, adolescents who were female and had sexual contact beyond kissing, and non-Hispanic parents had lower LEARN scores. Adolescents who were older, had previous research experience, and reported less moral or religious emphasis in their family had lower PROCEDURE scores; there were no significant predictors for parents in the multivariate analyses. CONCLUSION Parents wanted greater involvement in the research process than adolescents. Recruitment and retention might be enhanced by managing these differing expectations.
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15
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Nagpal J, Linares LO, Weiss J, Schlecht NF, Shankar V, Braun-Courville D, Nucci-Sack A, Strickler HD, Burk RD, Diaz A. Knowledge about Human Papillomavirus and Time to Complete Vaccination among Vulnerable Female Youth. J Pediatr 2016; 171:122-7. [PMID: 26846571 PMCID: PMC4808615 DOI: 10.1016/j.jpeds.2015.12.070] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2015] [Revised: 10/23/2015] [Accepted: 12/28/2015] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To examine the association of knowledge about human papillomavirus (HPV) on the time to completion of the 3-dose quadrivalent vaccine series in an inner-city population of adolescent female subjects at high risk for infection. STUDY DESIGN We prospectively followed 139 female subjects aged 14-20 years enrolled in a vaccine surveillance study in New York City during a period of at least 24 months. Participants were given a 30-item true or false survey on HPV at enrollment and ranked according to the number of correct responses. Multivariate Cox regression was used to examine the association between level of knowledge about HPV and time to completion (in days) of vaccine dose 1-3, dose 1-2, and dose 2-3. RESULTS Overall time to completion of the 3-dose vaccine ranged from 158 days to 1114 days. Participants in the high knowledge group (top quartile) were significantly more likely to complete the 3-dose series earlier (hazard ratio 1.69, 95% CI 1.03-2.77; P = .04), in particular doses 2-3 (hazard ratio 1.71, 95% CI 1.02-2.89; P = .04), than those with low-to-moderate knowledge (bottom 3 quartiles). CONCLUSIONS These findings suggest that knowledge of HPV is associated with shorter time to complete the 3-dose HPV vaccine series. Educational campaigns at time of vaccination may be important to improve vaccine adherence.
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Affiliation(s)
- Julie Nagpal
- Department of Pediatrics, The Mount Sinai Medical Center, New York, NY.
| | | | - Jocelyn Weiss
- Department of Pediatrics, The Mount Sinai Medical Center, New York, NY
| | - Nicolas F Schlecht
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY; Departments of Pediatrics, Microbiology & Immunology, and Obstetrics & Gynecology and Women's Health, Albert Einstein College of Medicine, Bronx, NY
| | - Viswanathan Shankar
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY
| | | | - Anne Nucci-Sack
- Department of Pediatrics, The Mount Sinai Medical Center, New York, NY
| | - Howard D Strickler
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY
| | - Robert D Burk
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY
| | - Angela Diaz
- Department of Pediatrics, The Mount Sinai Medical Center, New York, NY
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16
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Gordon LP, Diaz A, Soghomonian C, Nucci-Sack AT, Weiss JM, Strickler HD, Burk RD, Schlecht NF, Ochner CN. Increased Body Mass Index Associated with Increased Risky Sexual Behaviors. J Pediatr Adolesc Gynecol 2016; 29:42-7. [PMID: 26358938 PMCID: PMC4670801 DOI: 10.1016/j.jpag.2015.06.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2015] [Revised: 05/27/2015] [Accepted: 06/01/2015] [Indexed: 11/30/2022]
Abstract
STUDY OBJECTIVE The increasing prevalence of adolescent obesity has led to consideration of the potential effect of obesity on risky sexual behaviors. In the current study we examined whether body mass index (BMI) was related to age at sexual debut, type of sexual behavior, partner number, and condom use in a population of adolescent women at high risk for obesity and risky sexual behaviors. DESIGN, SETTING, AND PARTICIPANTS Cross-sectional examination of 860 sexually active, predominantly minority, adolescent women who received medical care at an urban health center from 2007 through 2013. INTERVENTION AND MAIN OUTCOME MEASURES Self-reported age at sexual debut, types of sexual intercourse, number of partners and condom use was compared with clinically assessed BMI. RESULTS BMI was positively associated with number of sexual partners (P = .001) and history of attempted anal intercourse (P = .002). An inverse association was observed with age at first anal intercourse (P = .040). CONCLUSION In this sample of adolescent women, increased BMI was associated with riskier sexual practices at a younger age. Results of this study suggest that overweight and obese adolescents are a vulnerable population who might need targeted sexual health counseling.
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Affiliation(s)
- Lonna P Gordon
- The Mount Sinai Adolescent Health Center, Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, New York.
| | - Angela Diaz
- The Mount Sinai Adolescent Health Center, Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Christine Soghomonian
- The Mount Sinai Adolescent Health Center, Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Anne T Nucci-Sack
- The Mount Sinai Adolescent Health Center, Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Jocelyn M Weiss
- The Mount Sinai Adolescent Health Center, Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Howard D Strickler
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York
| | - Robert D Burk
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York; Departments of Pediatrics, Microbiology and Immunology, and Obstetrics and Gynecology and Women's Health, Albert Einstein College of Medicine, Bronx, New York
| | - Nicolas F Schlecht
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York
| | - Christopher N Ochner
- The Mount Sinai Adolescent Health Center, Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, New York; Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York
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17
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Guss CE, Wunsch CA, McCulloh R, Donaldson A, Alverson BK. Using the hospital as a venue for reproductive health interventions: a survey of hospitalized adolescents. Hosp Pediatr 2015; 5:67-73. [PMID: 25646198 DOI: 10.1542/hpeds.2014-0043] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
BACKGROUND AND OBJECTIVES Less than one-half of sexually active adolescents have received counseling regarding contraception and sexually transmitted disease (STD) from their health care provider. We hypothesized that hospitalized adolescents would be interested in receiving reproductive health education and/or STD testing. In addition, we assessed the opinion of female adolescents on initiation of contraception during hospitalization. METHODS A convenience sample of 13- to 18-year-old male and female adolescent patients hospitalized at a tertiary pediatric hospital were approached for inclusion. Consenting patients completed a self-administered anonymous questionnaire. RESULTS Questionnaires from 49 female adolescents and from 51 male adolescents were collected. Based on their answers, 37% of female adolescents and 44% of male adolescents want to learn more about contraception and/or abstinence in the hospital independent of sexual activity. Thirty percent of respondents reported a desire for STD testing in the hospital. Fifty-seven percent of female subjects answered that adolescents should be offered contraception while in the hospital. CONCLUSIONS Among hospitalized adolescents in this study, there was an interest in reproductive health education and contraception even among those with a primary care provider and without sexual experience. Thus, hospital-based pediatricians can play a pivotal role in expanding critical sexual health services by discussing and offering sexual health care to hospitalized adolescents. We recommend that hospitals make a brochure available to all admitted adolescents, with opportunity for follow-up discussions with their hospitalist.
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Affiliation(s)
- Carly E Guss
- Boston Children's Hospital, Boston, Massachusetts
| | - Caroline A Wunsch
- Department of Pediatrics, Rhode Island Hospital, Providence, Rhode Island; and
| | | | - Abigail Donaldson
- Department of Pediatrics, Rhode Island Hospital, Providence, Rhode Island; and
| | - Brian K Alverson
- Department of Pediatrics, Rhode Island Hospital, Providence, Rhode Island; and
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