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Andresen JB, Graugaard C, Andersson M, Bahnsen MK, Frisch M. Adverse childhood experiences, sexual risk-taking and non-consensual sexual experiences in a nationally representative study of 15-29-year-old Danes. Child Abuse & Neglect 2024; 151:106720. [PMID: 38471426 DOI: 10.1016/j.chiabu.2024.106720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 01/30/2024] [Accepted: 02/27/2024] [Indexed: 03/14/2024]
Abstract
BACKGROUND Adverse childhood experiences (ACEs) have been linked with risky health-related behaviors and poor health. OBJECTIVE This study aimed to investigate associations of ACEs with a broad panel of sexual risk-taking behaviors and non-consensual sexual experiences among young people in Denmark. PARTICIPANTS AND SETTING Baseline questionnaire data from 15 to 29-year-old participants in the nationally representative cohort study Project SEXUS were used in combination with data from Danish national registers to include a total of 13,132 individuals. METHODS In logistic regression analyses, confounder-adjusted odds ratios (aORs) with 95 % confidence intervals (CIs) were obtained for associations of five ACE categories (Household challenges, Loss or threat of loss, Material deprivation, Abuse, and Neglect) and a cumulative ACE score with measures of sexual risk-taking and non-consensual sexual experiences. RESULTS Statistically significant associations were observed between ACEs and multiple sexual risk-taking behaviors and non-consensual sexual experiences with particularly increased odds among individuals with a history of Abuse, Neglect, or an ACE score of 3 or more. Specifically, Abuse was associated with having received payment for sex (women: aOR 5.38; 95 % CI 2.73-10.61; men: aOR 2.11; 95 % CI 1.22-3.64), with having paid for sex (men: aOR 1.88; 95 % CI 1.41-2.51), and with having been the victim of a sexual assault after age 18 years (women: aOR 3.33; 95 % CI 2.36-4.68). CONCLUSIONS In this Danish study, multiple measures of sexual risk-taking and non-consensual sexual experiences were markedly more common among young people with ACEs than in those without ACEs. This knowledge should be considered in future initiatives to promote sexual health among young people.
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Affiliation(s)
- Josefine Bernhard Andresen
- Project SEXUS Group, Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark; Center for Sexology Research, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Christian Graugaard
- Center for Sexology Research, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Mikael Andersson
- Project SEXUS Group, Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark
| | - Mikkel Kjær Bahnsen
- Project SEXUS Group, Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark; Center for Sexology Research, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Morten Frisch
- Project SEXUS Group, Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark; Center for Sexology Research, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.
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Tuitt NR, Wexler LM, Kaufman CE, Whitesell NR, Rink E, Anastario M, Ivanich JD, Belone L, Moore RS, Huh D, Campbell TE, Allen J. Unsettling Settler Colonialism in Research: Strategies Centering Native American Experience and Expertise in Responding to Substance Misuse and Co-occurring Sexual Risk-Taking, Alcohol-Exposed Pregnancy, and Suicide Prevention Among Young People. Advers Resil Sci 2023; 4:389-400. [PMID: 38045956 PMCID: PMC10688593 DOI: 10.1007/s42844-023-00100-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/07/2023] [Indexed: 12/05/2023]
Abstract
Native American (NA) populations in the USA (i.e., those native to the USA which include Alaska Natives, American Indians, and Native Hawaiians) have confronted unique historical, sociopolitical, and environmental stressors born of settler colonialism. Contexts with persistent social and economic disadvantage are critical determinants of substance misuse and co-occurring sexual risk-taking and suicide outcomes, as well as alcohol exposed pregnancy among NA young people (i.e., adolescents and young adults). Despite intergenerational transmission of resistance and resiliencies, NA young people face continued disparities in substance misuse and co-occurring outcomes when compared to other racial and ethnic groups in the USA. The failure in progress to address these inequities is the result of a complex set of factors; many of which are structural and rooted in settler colonialism. One of these structural factors includes barriers evident in health equity research intended to guide solutions to address these disparities yet involving maintenance of a research status quo that has proven ineffective to developing these solutions. Explicitly or implicitly biased values, perspectives, and practices are deeply rooted in current research design, methodology, analysis, and dissemination and implementation efforts. This status quo has been supported, intentionally and unintentionally, by researchers and research institutions with limited experience or knowledge in the historical, social, and cultural contexts of NA communities. We present a conceptual framework illustrating the impact of settler colonialism on current research methods and opportunities to unsettle its influence. Moreover, our framework illustrates opportunities to resist settler colonialism in research. We then focus on case examples of studies from the Intervention Research to Improve Native American Health program, funded by the NIH, that impact substance use and co-occurring health conditions among NA young people.
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Affiliation(s)
- Nicole R. Tuitt
- Centers for American Indian and Alaska Native Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Lisa M. Wexler
- School of Social Work, University of Michigan, Ann Arbor, MI, USA
| | - Carol E. Kaufman
- Centers for American Indian and Alaska Native Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Nancy Rumbaugh Whitesell
- Centers for American Indian and Alaska Native Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Elizabeth Rink
- Center for American Indian and Rural Health Equity, College of Education, Health, and Human Resources, Montana State University, Bozeman, MT, USA
| | - Michael Anastario
- Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, USA
| | - Jerreed D. Ivanich
- Centers for American Indian and Alaska Native Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Lorenda Belone
- Center for Participatory Research, Department of Health, Exercise, and Sports Science, University of New Mexico Health Sciences Center, Albuquerque, NM, USA
| | - Roland S. Moore
- Pacific Institute for Research and Evaluation, Albuquerque, NM, USA
| | - David Huh
- School of Social Work, University of Washington, Seattle, WA, USA
| | | | - James Allen
- Department of Family Medicine and Biobehavioral Health, University of Minnesota, Minneapolis, MN, USA
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Kizito S, Namuwonge F, Nabayinda J, Nabunya P, Nattabi J, Sensoy Bahar O, Kiyingi J, Magorokosho N, Ssewamala FM. Using Hierarchical Regression to Examine the Predictors of Sexual Risk-Taking Attitudes among Adolescents Living with Human Immunodeficiency Virus in Uganda. J Adolesc Health 2023; 73:244-251. [PMID: 37074235 PMCID: PMC10523903 DOI: 10.1016/j.jadohealth.2023.02.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2022] [Revised: 02/22/2023] [Accepted: 02/24/2023] [Indexed: 04/20/2023]
Abstract
PURPOSE We explored the factors influencing sexual risk-taking attitudes-defined as beliefs and values regarding sexual activity-among adolescents living with human immunodeficiency virus (ALHIV) in Uganda. METHODS The study used baseline data from a five-year cluster-randomized control trial (2012-2018) among 702 ALHIV in Uganda. Participants were aged 10-16 years, HIV-positive, taking antiretroviral therapy, and living within a family. We fitted hierarchical regression models to assess the demographic, economic, psychological, and social predictors of sexual risk-taking attitudes. Using R2, the final model explained 11.4% of the total variance. RESULTS Under economic factors, caregiver being formally employed (β = -0.08, 95% confidence interval [CI]: -0.10-0.06, p < .001), and the ALHIV working for pay (β = 1.78, 95% CI: 0.28-3.29, p = .022), were associated with sexual risk-taking attitudes. Among the psychological factors, more depressive symptoms (β = 0.22, 95% CI: 0.11-0.32, p < .001) were associated with more approving attitudes toward sexual risk-taking. Family and social factors including communicating with the caregiver about HIV (β = 1.32, 95% CI: 0.56-2.08, p = .001), sex (β = 1.09, 95% CI: 0.20-1.97, p = .017), and experiencing peer pressure (β = 3.37, 95% CI: 1.85-4.89, p < .001) were also associated with more approving attitudes toward sexual risk-taking. The final model explained 11.54% of the total variance. DISCUSSION Economic, psychological, and social factors influence sexual risk-taking attitudes among ALHIV. There is a need for more research to understand why discussing sex with caregivers improves adolescents' positive attitudes toward sexual risk-taking. These findings have significant ramifications in preventing sexual transmission of HIV among adolescents in low-income settings.
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Affiliation(s)
- Samuel Kizito
- International Center for Child Health and Development, Brown School, Washington University in St. Louis, Missouri
| | - Flavia Namuwonge
- International Center for Child Health and Development, Masaka, Uganda
| | - Josephine Nabayinda
- International Center for Child Health and Development, Brown School, Washington University in St. Louis, Missouri
| | - Proscovia Nabunya
- International Center for Child Health and Development, Brown School, Washington University in St. Louis, Missouri
| | - Jennifer Nattabi
- International Center for Child Health and Development, Brown School, Washington University in St. Louis, Missouri
| | - Ozge Sensoy Bahar
- International Center for Child Health and Development, Brown School, Washington University in St. Louis, Missouri
| | - Joshua Kiyingi
- International Center for Child Health and Development, Brown School, Washington University in St. Louis, Missouri
| | - Natasja Magorokosho
- International Center for Child Health and Development, Brown School, Washington University in St. Louis, Missouri
| | - Fred M Ssewamala
- International Center for Child Health and Development, Brown School, Washington University in St. Louis, Missouri.
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Lee J, Gillath O. Increased Urination Urgency Exacerbates Sexual Risk-Taking Through Heightened Sexual Arousal. Arch Sex Behav 2022; 51:2955-2967. [PMID: 35849207 DOI: 10.1007/s10508-022-02326-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Revised: 03/08/2022] [Accepted: 03/09/2022] [Indexed: 06/15/2023]
Abstract
Increased urination urgency has been shown to facilitate impulse control in cognitive domains, but its effects in other areas are unknown. We examined whether inhibitory spillover effects would replicate and extend to close relationships-specifically, influencing decision making related to sexual risk-taking. Across three studies, we either measured (Studies 1 and 3) or manipulated (Study 2) participants' bladder pressure and assessed sexual self-control using a questionnaire of sexual risk-taking intentions (Study 1) or a simulated semi-behavioral sexual risk-taking (Choose Your Own Sexual Adventure) task (Studies 2 and 3). Study 1 (N = 44 men, 59 women) showed greater urination urgency was associated with greater sexual risk-taking. Study 2 (N = 65 men, 91 women) showed that increasing urination urgency led to greater sexual risk-taking, but only among men. Study 3 (N = 86 men, 183 women) showed elevated urination urgency was associated with an increase in sexual arousal, which accounted for the greater sexual risk-taking.
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Affiliation(s)
- Juwon Lee
- Department of Psychology, College of Liberal Arts & Sciences, University of Kansas, Lawrence, KS, USA.
| | - Omri Gillath
- Department of Psychology, College of Liberal Arts & Sciences, University of Kansas, Lawrence, KS, USA
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Walters KJ, Webb MK, Simons JS. The Implicit Sexual Risk Assessment: A Pilot Study of a Novel Behavioral Task. Arch Sex Behav 2022; 51:2921-2929. [PMID: 34750775 DOI: 10.1007/s10508-021-02092-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 02/11/2021] [Accepted: 06/23/2021] [Indexed: 06/13/2023]
Abstract
Risky sexual behaviors are a significant public health concern. Laboratory experiments are necessary to identify causal determinants of risky sexual behavior. However, experiments often rely on analogue sexual risk behavior, assessed by self-reported intentions in response to a sexual scenario. Using behavioral tasks to assess risk taking may be a valuable addition to self-reported intention outcome measures. The Balloon Analogue Risk Task (BART) is a commonly used measure of general risk-taking. However, BART's associations with sexual risk-taking have been mixed. In this pilot study, we developed a task akin to the BART, the Implicit Sexual Risk Assessment (ISRA), which incorporates sexual stimuli. We hypothesized sexual arousal would increase risk taking on ISRA relative to BART. Using a within-persons experimental design, 79 participants (52% women, mean age = 19.5 (SD = 1.42)) were randomized to condition (i.e., arousal versus neutral) and completed the BART and ISRA tasks. As expected, sexual arousal was associated with increased risk-taking (i.e., adjusted pumps) on ISRA relative to BART. However, this was unexpectedly the result of decreased pumps on BART instead of increased pumps on ISRA. Neither BART nor ISRA were significantly associated with sexual risk behavior or intentions. Null findings are qualified by the fact that sexual arousal was not significantly associated with sexual risk intentions.
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Affiliation(s)
- Kyle J Walters
- Department of Psychology, The University of South Dakota, 414 E Clark St, Vermillion, SD, 57069, USA.
| | - Michael K Webb
- Department of Psychology, The University of South Dakota, 414 E Clark St, Vermillion, SD, 57069, USA
| | - Jeffrey S Simons
- Department of Psychology, The University of South Dakota, 414 E Clark St, Vermillion, SD, 57069, USA
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Gebru NM, Kalkat M, Strickland JC, Ansell M, Leeman RF, Berry MS. Measuring Sexual Risk-Taking: A Systematic Review of the Sexual Delay Discounting Task. Arch Sex Behav 2022; 51:2899-2920. [PMID: 35838897 PMCID: PMC9555011 DOI: 10.1007/s10508-022-02355-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 05/10/2022] [Accepted: 05/11/2022] [Indexed: 06/15/2023]
Abstract
The Sexual Delay Discounting Task (SDDT; Johnson & Bruner, 2012) is a behavioral economic task that assesses sexual risk-taking by measuring likelihood of immediate and delayed condom use. The SDDT is ecologically valid and has been used to test effects of various substances on sexual risk-taking. However, considerable variety in implementation, analysis, and reporting of the SDDT may limit rigor and reproducibility of findings. The current review synthesized studies that used the SDDT to evaluate these possible variabilities systematically. A two-step search (citation-tracking and keyword-based search) was conducted to identify studies that met inclusion criteria (i.e., used the SDDT). Eighteen peer-reviewed articles met inclusion criteria. The SDDT has been implemented primarily in three populations: individuals who use cocaine, men who have sex with men, and college students. Comparable results across diverse populations support the SDDT's validity. A few studies administered substances before the SDDT. Evidence suggests that while cocaine and alcohol increased sexual risk-taking under some conditions, buspirone decreased preference for immediate condomless sex. There was also heterogeneity in the determination of data orderliness (i.e., outliers) and inconsistent reporting of task design and analysis. Considerable differences present in methodologic approaches could influence results. Reducing variation in the administration, analysis, and reporting of the SDDT will enhance rigor and reproducibility and maximize the task's tremendous potential.
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Affiliation(s)
- Nioud Mulugeta Gebru
- Department of Health Education and Behavior, Center for Behavioral Economic Health Research;, University of Florida, P.O. Box 118210, Gainesville, FL, 32611, USA.
- Clinical and Translational Science Institute, University of Florida, Gainesville, FL, USA.
| | - Meher Kalkat
- Department of Health Education and Behavior, Center for Behavioral Economic Health Research;, University of Florida, P.O. Box 118210, Gainesville, FL, 32611, USA
| | - Justin C Strickland
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Margaret Ansell
- Department of Health Education and Behavior, Center for Behavioral Economic Health Research;, University of Florida, P.O. Box 118210, Gainesville, FL, 32611, USA
| | - Robert F Leeman
- Department of Health Education and Behavior, Center for Behavioral Economic Health Research;, University of Florida, P.O. Box 118210, Gainesville, FL, 32611, USA
- Yale School of Medicine, New Haven, CT, USA
| | - Meredith S Berry
- Department of Health Education and Behavior, Center for Behavioral Economic Health Research;, University of Florida, P.O. Box 118210, Gainesville, FL, 32611, USA
- Department of Psychology, University of Florida, Gainesville, FL, USA
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Abstract
Emerging adulthood is a developmental period with high rates of sexual risk behavior. Effective parenting practices can reduce the likelihood of this behavior, but most research on the protective effects of parenting focuses on mothers. Research is needed to assess the role of paternal parenting in regards to their children's sexual risk behavior, particularly for children of teen mothers, who show a greater likelihood of risky sexual behaviors than those with older mothers. We investigated associations between residential fathers' parenting processes-communication, disapproval of teen sexual behavior, parental presence, and closeness-during adolescence and sexual risk behaviors reported by their children in emerging adulthood. Using multiple group structural equation modeling with data from 7399 participants at Wave I and Wave III of the National Longitudinal Study of Adolescent to Adult Health (Add Health), we examined whether and how residential fathers' parenting relates to their children's sexual risk behavior independent of mothers' parenting processes, and whether these associations differ across children's sex and for children of teen and older mothers. We found that adolescents' perceptions of higher father disapproval of teen sexual behavior predicted lower levels of sexual risk behavior during emerging adulthood with no significant differences across emerging adults' sex or for children of teen relative to older mothers. Our findings suggest that teens' relationships with their fathers during adolescence are important for their future sexual health, despite a general understanding of emerging adulthood as a period characterized by independence and separation from parents. Additionally, our results suggest that even though children of teen mothers show greater likelihood of risky sexual behaviors than those of older parents, the processes through which fathers can support teens' sexual health may be similar.
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Bond JC, Morrison DM, Hawes SE. Sexual Self-Efficacy and Entitlement to Pleasure: The Association of the Female Sexual Subjectivity Inventory with Sexual Risk Taking and Experience of Orgasm. Arch Sex Behav 2020; 49:1029-1038. [PMID: 31897825 DOI: 10.1007/s10508-019-01563-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Revised: 08/29/2019] [Accepted: 10/05/2019] [Indexed: 06/10/2023]
Abstract
Young women's understanding of their own sexuality has increasingly been acknowledged as an important component of their sexual health. The Female Sexual Subjectivity Inventory (FSSI) was developed to measure five distinct factors of young women's experiences of sexual pleasure and empowerment. No studies have explicitly evaluated the association between FSSI scores and clinical sexual health outcomes. We conducted a cross-sectional survey of women to assess the association between FSSI factors and the occurrence of three clinical sexual health outcomes in the prior 12 months: acquisition of an STI, unwanted pregnancy, or taking emergency contraception (Plan B). We also assessed the association between FSSI scores and self-reported orgasm frequency during partnered sexual activity. We used multivariate logistic regression models to estimate associations. Finally, we used the FSSI scale in a novel way to identify a population of women who are discordant on their levels of entitlement to pleasure from a partner and self-efficacy in achieving sexual pleasure. We did not find any statistically significant associations between mean score on any of the FSSI factors and clinical sexual health outcomes of interest in the prior year. We found that all FSSI factors except Sexual Self-Reflection were positively associated with increased orgasm frequency. Our study underscores the validity of the FSSI as a measure to assess psychosocial constructs relevant to young women's ability to experience sexual pleasure with a partner and introduces a novel way to use the scale to assess the development of women's sexual subjectivity.
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Affiliation(s)
- Julia C Bond
- Department of Epidemiology, University of Washington, 1959 NE Pacific Street, Health Sciences Bldg, F-262, Box 357236, Seattle, WA, 98195, USA.
| | - Diane M Morrison
- School of Social Work, University of Washington, Seattle, WA, USA
| | - Stephen E Hawes
- Department of Epidemiology, University of Washington, 1959 NE Pacific Street, Health Sciences Bldg, F-262, Box 357236, Seattle, WA, 98195, USA
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Testa M, Livingston JA, Wang W, Lewis MA. Preventing College Sexual Victimization by Reducing Hookups: a Randomized Controlled Trial of a Personalized Normative Feedback Intervention. Prev Sci 2020; 21:388-397. [PMID: 32060880 PMCID: PMC7058500 DOI: 10.1007/s11121-020-01098-3] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Sexual activity, including hooking up, increases college women's vulnerability to sexual victimization. Reducing hookups may reduce rates of sexual victimization among this vulnerable population. Because college students overestimate how frequently their peers hook up, correcting their misperceptions may lead to more accurate perceived social norms, and consequently, less hookup behavior. The study was designed as a randomized controlled trial of the efficacy of a brief, computer-administered personalized normative feedback (PNF) intervention regarding hookups during the first semester of college. We tested an indirect effects model in which PNF was hypothesized to predict perceiving fewer peer hookups, which were expected to predict fewer actual hookups and consequently, less sexual victimization during the first semester of college. Entering first-year women (N = 760) were randomly assigned to receive web-delivered PNF or no information. At the end of the semester, perceived number of hookups of others, number of hookups during the semester, and sexual victimization experiences were assessed. Women who received the intervention perceived that their peers engaged in significantly fewer hookups than did control women. Consistent with the proposed indirect effects model, intervention had a significant indirect effect on the odds of first-semester victimization via lower perceived descriptive norms, which in turn predicted fewer hookups. The study provides proof of concept for the importance of hookups as a risk factor for sexual victimization and provides novel, preliminary support for intervention to change descriptive norms as a way of reducing hookups and consequently, sexual vulnerability.
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Affiliation(s)
- Maria Testa
- Department of Psychology and Clinical and Research Institute on Addictions, University at Buffalo, Buffalo, USA.
| | | | - Weijun Wang
- Department of Psychology and Clinical and Research Institute on Addictions, University at Buffalo, Buffalo, USA
| | - Melissa A Lewis
- Department of Health Behavior and Health Systems, School of Public Health, University of North Texas Health Science Center, Fort Worth, USA
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Tuitt NR, Asdigian NL, Whitesell NR, Mousseau A, Al-Tayyib A, Kaufman CE. Moving the prevention timeline: A scoping review of the literature on precursors to sexual risk in early adolescence among youth of color. J Adolesc 2020; 80:145-156. [PMID: 32126397 DOI: 10.1016/j.adolescence.2020.02.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Revised: 02/13/2020] [Accepted: 02/22/2020] [Indexed: 12/28/2022]
Abstract
INTRODUCTION Sexual health disparities are leading causes of morbidity among youth of color in the United States. We conducted a scoping review of the literature on precursors to sexual risk-taking among young adolescents of color (ages 10-14) to assess precedents of sexual experience and their utility as measurable proximal constructs and behaviors gauging sexual risk and sexual risk prevention efforts. METHODS This study was conducted using the PRISMA extension for scoping reviews (PRISMA-ScR) guidelines. We searched for quantitative studies that assessed the relationships between precursors and subsequent sexual behaviors, incorporated youth of color, and specified young adolescents as the study sample. All articles were in English, however we explored both U.S. and International databases. RESULTS The database search yielded 11 studies published between 2000 and 2017. Most literature focused on youth in urban settings, and on Black and Latinx youth, while only two addressed the special circumstances of American Indian and Alaska Native youth. Sex expectancies outcomes for youth of color were likely to predict sexual risk taking and self-efficacy about sex was related to abstinence. CONCLUSIONS Etiologic studies that seek to understand precursors to sexual risk taking among youth of color are limited and this paucity truncates the ability to develop sexual risk prevention programs for the age group in which prevention is most needed.
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Affiliation(s)
- Nicole R Tuitt
- School of Public Health, University of California Berkeley, 2150 Shattuck, Suite 601, Berkeley, CA, 94704-1365, USA; Prevention Research Center-Pacific Institute for Research and Evaluation, Berkeley, CA, USA.
| | - Nancy L Asdigian
- Centers for American Indian and Alaska Native Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, 13001 E. 17th Place, Mail Stop B119, Aurora, CO, 80045, USA.
| | - Nancy Rumbaugh Whitesell
- Centers for American Indian and Alaska Native Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, 13001 E. 17th Place, Mail Stop B119, Aurora, CO, 80045, USA.
| | - Alicia Mousseau
- National Native Youth Trauma Center, University of Montana, 32 Campus Drive, 028 McGill Hall, Missoula, MT, 59812, USA
| | - Alia Al-Tayyib
- Denver Public Health, 605 Bannock St, Denver, CO, 80204, USA
| | - Carol E Kaufman
- Centers for American Indian and Alaska Native Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, 13001 E. 17th Place, Mail Stop B119, Aurora, CO, 80045, USA.
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11
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Warner TD, Warner DF. Precocious and Problematic? The Consequences of Youth Violent Victimization for Adolescent Sexual Behavior. J Dev Life Course Criminol 2019; 5:554-586. [PMID: 35937854 PMCID: PMC9355368 DOI: 10.1007/s40865-019-00122-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Revised: 07/26/2019] [Accepted: 08/09/2019] [Indexed: 06/11/2023]
Abstract
PURPOSE Violent victimization is concentrated in adolescence and is disruptive to both the timing and sequencing of key life course transitions that occur during this developmental stage. Drawing on recent work establishing the interpersonal consequences of youth victimization, we examined the effect of violent victimization on adolescents' timing of sexual debut and involvement in additional sexual risk behaviors (multiple sexual partnering and inconsistent contraceptive use). METHODS This study relied on secondary data analysis of 10,070 youth from four waves of the National Longitudinal Study of Adolescent to Adult Health (Add Health). To predict sexual debut and subsequent sexual risk-taking, analyses were limited to youth not yet sexually active at their wave I interview. RESULTS Findings from Cox proportional hazards models, negative binomial regression, and repeated measures ordinal logistic regression showed that adolescent victims of violence initiated sex sooner than non-victims and accumulated more sexual partners, but patterns varied by age at victimization. Youth victimized in late adolescence displayed an accelerated trajectory of sexual activity while youth victimized in early adolescence were less likely to debut or engage in other sexual risk behaviors (although younger victims were more likely to engage in other deviant activities). CONCLUSION Sexual activity is a normative part of adolescent development, yet this study finds that violent victimization may disrupt the timing of this life course task, exacerbating deviant risk-taking and undermining youths' subsequent well-being. This study also highlights the importance of life course criminology's attention to timing in lives, given that the consequences of victimization varied by the age when it occurred.
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Affiliation(s)
- Tara D. Warner
- Department of Criminal Justice, University of Alabama at Birmingham, 210 University Boulevard Office Building, 1201 University Blvd., Birmingham, AL 35294-4562, USA
| | - David F. Warner
- Department of Sociology, University of Alabama at Birmingham, 460 Heritage Hall, 1401 University Blvd., Birmingham, AL 35294-1152, USA
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Goldenberg T, Stephenson R, Bauermeister J. Cognitive and Emotional Factors Associated with Sexual Risk-Taking Behaviors Among Young Men Who Have Sex with Men. Arch Sex Behav 2019; 48:1127-1136. [PMID: 30607713 PMCID: PMC6872980 DOI: 10.1007/s10508-018-1310-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/16/2017] [Revised: 08/22/2018] [Accepted: 09/15/2018] [Indexed: 06/09/2023]
Abstract
Young men who have sex with men (YMSM) between the ages of 13 and 24 account for a disproportionate number of new HIV infections in the U.S. Recognizing the unique developmental circumstances that YMSM face and building on the dual-process model, it is important to consider the role of cognitive and emotional factors as well as self-efficacy to negotiate safer sex when understanding experiences of sexual risk-taking among YMSM. This article used structural equation modeling to examine how the decisional balance to use condoms (a cognitive factor) and limerence (an emotional factor) are both directly and indirectly associated with sexual risk-taking behaviors (the number of insertive and receptive condomless anal intercourse partners), with indirect effects occurring via limited self-efficacy to negotiate safer sex. Data were from a cross-sectional online survey of YMSM (aged 18-24) in the U.S. who did not report being in a romantic relationship. Analysis included a sample of 1084 single YMSM who had never tested positive for HIV and who had engaged in anal intercourse in the previous 2 months. Results indicated that the decisional balance to use condoms was both directly and indirectly associated with reduced sexual risk-taking behaviors. Limerence was not directly associated with sexual risk-taking behaviors; however, it was indirectly associated with sexual risk-taking behavior through limited self-efficacy to negotiate safer sex. These findings highlight the importance of considering both cognitive and emotional factors, as well as self-efficacy to use condoms, in the development and implementation of HIV prevention interventions for YMSM.
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Affiliation(s)
- Tamar Goldenberg
- Department of Health Behavior and Health Education, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI, 48109, USA.
- Center for Sexuality and Health Disparities, University of Michigan, Ann Arbor, MI, USA.
| | - Rob Stephenson
- Center for Sexuality and Health Disparities, University of Michigan, Ann Arbor, MI, USA
- Department of Systems, Populations, and Leadership, University of Michigan School of Nursing, Ann Arbor, MI, USA
| | - Jose Bauermeister
- Department of Family and Community, University of Pennsylvania School of Nursing, Philadelphia, PA, USA
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13
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Marraccini ME, Brick LA, Weyandt LL, Francis A, Clarkin C, Fang Y. Effects of self-injurious thoughts and behaviors and sexual risk-taking behaviors through emotional control. J Affect Disord 2019; 249:183-191. [PMID: 30772746 DOI: 10.1016/j.jad.2019.01.041] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2018] [Revised: 01/02/2019] [Accepted: 01/22/2019] [Indexed: 10/27/2022]
Abstract
BACKGROUND College students are at increased risk for self-injurious thoughts and behaviors (SITB) and sexual risk behaviors (SRB). Although students with a history of SITB appear to be more prone to SRB, the mechanisms linking these risk behaviors remain largely unexplored. Previous research points to emotional control (EC), defined as one's awareness and adaptability of emotions, as a potential mechanism explaining the relationship between SITB and SRB.1 METHODS: Data included 722 college students attending two different universities in the northeast and southeast regions of the United States. Multiple group structural equation models were fit to estimate the direct and indirect effects of history of SITB (suicidal ideation, attempt, and nonsuicidal self-injury) and EC on SRB jointly across men and women. RESULTS Findings supported indirect relationships between SITB and SRB through dysregulated EC, with type of SITB and patterns of SRB differing between men and women. For women, history of suicidal ideation and nonsuicidal self-injury were indirectly related to increased SRB through dysregulated EC. For men, history of suicidal ideation showed an indirect relationship on SRB through EC. LIMITATIONS Although this study employed random sampling, limitations include a cross-sectional design, which does not allow for causal inference, and reliance on self-report assessment data. CONCLUSIONS College students with a history of SITB who experience dysregulated EC may be more likely to engage in risky sexual behavior. Clinicians working with college students should concomitantly consider suicide and self-injury with SRB and consider interventions to improve EC.
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Affiliation(s)
- Marisa E Marraccini
- School of Education, University of North Carolina at Chapel Hill, 105H Peabody Hall, CB# 3500, 100 E. Cameron Ave., Chapel Hill, NC 27599, USA.
| | - Leslie A Brick
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Campus Box G-BH, 700 Butler Drive, Providence, RI 02906-7724, USA.
| | - Lisa L Weyandt
- Department of Psychology, Interdisciplinary Neuroscience Program, Chafee Social Science Center, URI, 142 Flagg Rd, Kingston, RI 02881, USA.
| | - Alyssa Francis
- Department of Psychology, Chafee Social Science Center, URI, 142 Flagg Rd, Kingston, RI 02881, USA.
| | - Christine Clarkin
- Graduate School, Interdisciplinary Neuroscience Program, Quinn Hall, 55 Lower College Road, University of Rhode Island, Kingston, RI 02881, USA.
| | - Yumeng Fang
- School of Education, University of North Carolina at Chapel Hill, 105H Peabody Hall, CB# 3500, 100 E. Cameron Ave., Chapel Hill, NC 27599, USA.
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14
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Millar BM, Starks TJ, Rendina HJ, Parsons JT. Three Reasons to Consider the Role of Tiredness in Sexual Risk-Taking Among Gay and Bisexual Men. Arch Sex Behav 2019; 48:383-395. [PMID: 30128984 PMCID: PMC6349479 DOI: 10.1007/s10508-018-1258-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2017] [Revised: 06/07/2018] [Accepted: 06/08/2018] [Indexed: 06/08/2023]
Abstract
Numerous factors have been shown to increase sexual risk-taking-especially among gay and bisexual men (GBM), who remain disproportionately affected by HIV and STIs. We present three lines of evidence that highlight the need to consider a previously under-explored situational factor in sexual risk-taking: tiredness. While tiredness has been shown, in sleep science literature, to impair cognition, emotional functioning, and decision-making in a wide range of behaviors, it has yet to be considered in-depth as a risk factor in sexual behavior. Counter to the common-sense assumption that being tired should impede the performance of active, effortful behaviors such as sex, we propose that tiredness may actually increase sexual risk-taking. Analyzing data from an online survey of 1113 HIV-negative GBM, we found that sex with casual partners most commonly occurred at night, especially among younger GBM and those with an evening chronotype, and that sex without condoms more often occurred at or later than one's usual time of feeling tired (as was reported by 44.2% of men) than did sex with condoms (reported by 36.6%). We also found that tiredness can increase sexual desire in many GBM (endorsed by 29.9%), and increases the likelihood of engaging in receptive positioning in anal sex (endorsed by almost 40% of men with a versatile sexual positioning identity). These findings highlight the importance of considering tiredness as a situational risk factor in sexual health-especially among younger GBM-and of counting sex among the behaviors that can be adversely impacted by poor or overdue sleep.
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Affiliation(s)
- Brett M Millar
- Health Psychology and Clinical Science Doctoral Program, The Graduate Center of the City University of New York, New York, NY, USA
- Center for HIV/AIDS Educational Studies and Training, Hunter College of the City University of New York, New York, NY, USA
| | - Tyrel J Starks
- Health Psychology and Clinical Science Doctoral Program, The Graduate Center of the City University of New York, New York, NY, USA
- Center for HIV/AIDS Educational Studies and Training, Hunter College of the City University of New York, New York, NY, USA
- Department of Psychology, Hunter College of the City University of New York, 695 Park Ave., New York, NY, 10065, USA
| | - H Jonathon Rendina
- Health Psychology and Clinical Science Doctoral Program, The Graduate Center of the City University of New York, New York, NY, USA
- Center for HIV/AIDS Educational Studies and Training, Hunter College of the City University of New York, New York, NY, USA
- Department of Psychology, Hunter College of the City University of New York, 695 Park Ave., New York, NY, 10065, USA
| | - Jeffrey T Parsons
- Health Psychology and Clinical Science Doctoral Program, The Graduate Center of the City University of New York, New York, NY, USA.
- Center for HIV/AIDS Educational Studies and Training, Hunter College of the City University of New York, New York, NY, USA.
- Department of Psychology, Hunter College of the City University of New York, 695 Park Ave., New York, NY, 10065, USA.
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15
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Frank K. Rethinking Risk, Culture, and Intervention in Collective Sex Environments. Arch Sex Behav 2019; 48:3-30. [PMID: 29748787 DOI: 10.1007/s10508-018-1153-3] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/21/2017] [Revised: 11/28/2017] [Accepted: 01/11/2018] [Indexed: 05/16/2023]
Abstract
This article provides a narrative overview of research on HIV/STI risk and collective sexual behavior based on an inclusive analysis of research on environments where people gather for sexual activity-sex clubs, swingers' clubs, bathhouses, parks, private sex parties, etc. The aim is to analyze how collective sex has been approached across disciplines to promote conversation across paradigms and suggest new lines of inquiry. Attention to context-such as the location of sex-was a necessary redress to universalizing models of sexual risk-taking behavior, leading to insights rooted in the particularities of each environment and its users. However, the identification of ever more precise risk groups or environmental idiosyncrasies eventually becomes theoretically restrictive, leading to an overestimation of the uniqueness of sexual enclaves, and of the difference between any given enclave and the broader social milieu. Using a theoretical framework of transgression to interpret the interdisciplinary literature, similarities in the spatial and social organization of collective sex environments are identified. Insights generated from this complementary perspective are then applied to understandings of collective sex: first, the example of male-female (MF) "swingers" is used to illustrate the need to establish, rather than assume, the distinctiveness of each non-normative sexual enclave, and to broaden the conceptualization of context; second, questions are raised about the practicality of interventions in collective sex environments. Finally, new lines of intellectual inquiry are suggested to shed light not just on collective sex but on sociosexual issues more generally, such as increasing protective sexual health behavior or negotiating consent in sexual encounters.
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Affiliation(s)
- Katherine Frank
- Department of Sociology, University of Nevada, Las Vegas, Las Vegas, NV, 89557, USA.
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16
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Rivera PM, Bray BC, Guastaferro K, Kugler K, Noll JG. Linking Patterns of Substance Use With Sexual Risk-Taking Among Female Adolescents With and Without Histories of Maltreatment. J Adolesc Health 2018; 62:556-562. [PMID: 29396082 PMCID: PMC5930059 DOI: 10.1016/j.jadohealth.2017.11.293] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2017] [Revised: 10/08/2017] [Accepted: 11/14/2017] [Indexed: 01/22/2023]
Abstract
PURPOSE This study aimed to determine the associations between patterns of substance use and sexual risk-taking among female adolescents with and without histories of maltreatment. METHODS Data are from a prospective cohort study examining the impact of maltreatment on subsequent female adolescent sexual health (N = 504). Participants averaged 18.24 years in age (SD = 1.12), and approximately 63% had substantiated incidences of maltreatment filed with Child Protective Services prior to age 18. The present study used latent class analysis to examine patterns in adolescent substance use, and negative binomial regression models to examine the links between patterns of substance use and sexual risk-taking and to determine whether these associations were moderated by adolescents' maltreatment status. RESULTS Six classes emerged from latent class analysis labeled as follows: abstainers (25% of sample); polysubstance users-early initiators (13%); polysubstance users-late initiators (23%); alcohol and cannabis users-late initiators (9%); alcohol users-late initiators (18%); and tobacco users (12%). Patterns of adolescent polysubstance use were associated with the highest levels of sexual risk-taking, and patterns of late-initiated polysubstance use, late-initiated alcohol use, and tobacco use were more strongly related to sexual risk-taking for female adolescents with histories of maltreatment. CONCLUSIONS This study is the first to determine the specific patterns of substance use that are more strongly related to sexual risk-taking for maltreated female adolescents. By doing so, this study demonstrates how a person-centered approach can facilitate our understanding of how to best leverage sexual risk-taking prevention efforts.
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Affiliation(s)
- Peter M Rivera
- Department of Marriage and Family Therapy, Seattle Pacific University, Seattle, Washington.
| | - Bethany C Bray
- The Methodology Center, The Pennsylvania State University, University Park, Pennsylvania
| | - Kate Guastaferro
- The Methodology Center, The Pennsylvania State University, University Park, Pennsylvania
| | - Kari Kugler
- Department of Biobehavioral Health, The Pennsylvania State University, University Park, Pennsylvania
| | - Jennie G Noll
- Department of Human Developmental and Family Studies, The Pennsylvania State University, University Park, Pennsylvania; University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
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17
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Svensson P, Sundbeck M, Persson KI, Stafström M, Östergren PO, Mannheimer L, Agardh A. A meta-analysis and systematic literature review of factors associated with sexual risk-taking during international travel. Travel Med Infect Dis 2018; 24:65-88. [PMID: 29567294 DOI: 10.1016/j.tmaid.2018.03.002] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2017] [Revised: 02/23/2018] [Accepted: 03/12/2018] [Indexed: 11/27/2022]
Abstract
BACKGROUND International travel facilitates global spread of sexually transmitted infections (STI). Travellers could contribute to onward transmission of pathogens rarely encountered at home and export new strains to the destination. The aim was to systematically examine evidence regarding determinants of travel-related sexual risk-taking and identify knowledge gaps and areas for targeted interventions. METHOD Articles published in peer-reviewed journals from 2000 to 2017 were screened in 6 databases and assessed for relevance against criteria. Data was extracted for factors associated with travel-related STI or proxies. Meta-analyses estimated pooled prevalence of casual sex and non-condom use. Adjusted odds ratios of predictors were pooled to generate a combined estimate. RESULT Forty-nine articles qualified for inclusion. A heterogeneity test indicated variation across studies. The pooled prevalence of casual travel sex was 35% and prevalence of non-condom use 17%. Expectations of casual sex strongly predicted sex with a new partner when travelling abroad. Planning to have sex indicated condom use. CONCLUSION The studies largely represented sub-groups of risk-taking populations from a European context, indicating substantial knowledge gaps. Studies investigating migrants travelling to visit friends and relatives, older travellers, and female travelers are needed. Post-travel harm reduction activities may serve as a focus for future interventions.
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Affiliation(s)
- Pia Svensson
- Social Medicine and Global Health, Department of Clinical Sciences, Lund University, Malmö, Sweden.
| | - Mats Sundbeck
- Social Medicine and Global Health, Department of Clinical Sciences, Lund University, Malmö, Sweden
| | - Kristina Ingemarsdotter Persson
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden; Public Health Agency, Health and Sexuality, Stockholm, Sweden
| | - Martin Stafström
- Social Medicine and Global Health, Department of Clinical Sciences, Lund University, Malmö, Sweden
| | - Per-Olof Östergren
- Social Medicine and Global Health, Department of Clinical Sciences, Lund University, Malmö, Sweden
| | - Louise Mannheimer
- Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden; Public Health Agency, Health and Sexuality, Stockholm, Sweden
| | - Anette Agardh
- Social Medicine and Global Health, Department of Clinical Sciences, Lund University, Malmö, Sweden
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18
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Jung M, Kwon D, Oh JY. Associated with Differences in Sexual Risk-Taking Behaviors Among Migrants in South Korea. J Immigr Minor Health 2017; 19:24-32. [PMID: 26455719 DOI: 10.1007/s10903-015-0300-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
We investigated influential factors on differences in sexual risk-taking among homosexual migrants. The data used in this paper are based on the survey and medical examination for migrants' sexual behaviors that was carried out by the Korea Federation for HIV/AIDS Prevention in 2011-2013 on participants living in South Korea. Among 1141 migrants, homosexuals were 0.54 times less likely to use condom than heterosexuals. Homosexuals were 2.93 times more likely to be infected with sexually transmitted diseases (STDs) than heterosexuals. Among 250 homosexual migrants, those who preferred risky sexual intercourse were 0.19 times less likely to use a condom than heterosexual migrants. Those who have a fixed sexual partner were 0.35 times less likely to be infected with HIV than their counterparts. Administrative programs for STDs prevention of migrants should be focused on their sexual risk-taking, which were limited to casual partnership, unprotected sex, and previous contraction of sexual diseases.
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19
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Abstract
Men who have sex with men (MSM) are disproportionally affected by HIV. Although some theoretical models created to explain why individuals engage in risky sexual behavior contain an affective component, there has been relatively little focus on the influence of affect on sexual risk-taking. The goal of this study is to investigate the association between affect and condom use among MSM using an archival dataset from a survey of users of a popular sex-oriented website. Multilevel modeling was used to analyze daily diary data from 2871 MSM. At the within-person level, positive affect was positively related to condomless anal sex (CAS), whereas negative affect was negatively related to CAS. However, these results were qualified by interactions of trait affect and relationship to sex partner. These findings suggest that interventions focused on emotional regulation may have the potential to reduce CAS among MSM.
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Affiliation(s)
- Elissa L Sarno
- Department of Psychology, University of Maryland, Biology-Psychology Building, College Park, MD, 20742, USA.
| | - Jonathan J Mohr
- Department of Psychology, University of Maryland, Biology-Psychology Building, College Park, MD, 20742, USA
| | - Joshua G Rosenberger
- Department of Biobehavioral Health, Pennsylvania State University, University Park, PA, USA
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20
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Wekerle C, Goldstein AL, Tanaka M, Tonmyr L. Childhood sexual abuse, sexual motives, and adolescent sexual risk-taking among males and females receiving child welfare services. Child Abuse Negl 2017; 66:101-111. [PMID: 28139252 DOI: 10.1016/j.chiabu.2017.01.013] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/31/2016] [Revised: 12/19/2016] [Accepted: 01/16/2017] [Indexed: 05/14/2023]
Abstract
Childhood sexual abuse (CSA) is associated with multiple negative outcomes, including increased risky sexual behavior. To date, the majority of research on the relationship between CSA and risky sex in adolescence has been limited, with a lack of focus on males and youth receiving child welfare services. Participants in the current study were 297 youth (mean age=15.98; SD=1.01, 57.6% female) from the child welfare system who reported being sexually active at the time of the survey. CSA was associated with severity of other types of maltreatment for both genders, and exposure to intimate partner violence for females only. In general, males engaged in more sexual risk behaviors than females. Males with CSA had stronger motives to have sex for: (1) coping, (2) peer approval and (3) partner approval, as compared to non-CSA males; as well as (4) greater motives for partner and peer approval compared to females with CSA. Males with no CSA had stronger sexual motives for enhancement (e.g., feeling pleasure) compared to females with no CSA. Mediation analyses revealed a significant indirect effect for coping motives for males: CSA was associated with increased motives to use sex for coping which was associated with increased sexual risk-taking. These findings provide important information regarding the relationship between CSA and sexual risk-taking for child welfare sample and highlight coping with negative affect as a potential mechanism that underlies the CSA-risky sex relationship. It also encourages further consideration of motives for risk and resilience behaviors among youth.
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Affiliation(s)
- Christine Wekerle
- Department of Pediatrics, McMaster University, 1280 Main Street. W., Hamilton, ON L8N 3Z5 Canada.
| | - Abby L Goldstein
- Department of Applied Psychology and Human Development, University of Toronto, Canada.
| | - Masako Tanaka
- Department of Psychiatry and Behavioural Neurosciences, Offord Centre for Child Studies, McMaster University, Canada.
| | - Lil Tonmyr
- Public Health Agency of Canada, ON, Canada.
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Abstract
Adolescents involved with the juvenile justice system have higher rates of risky sexual behaviors, resulting in high rates of sexually transmitted infections and increased risk of human immunodeficiency virus, early or complicated pregnancy, and parenting issues. Comorbid substance abuse, gang association, mental health issues, and history of having been abused as children result in further elevated rates. Girls and lesbian, gay, bisexual, and transgender youths represent growing subpopulations with special risks. Increasingly diverted to community-based alternatives, juvenile justice-involved teens obtain most of their medical care from community providers, who need to understand their risks to provide appropriate, optimal care.
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Affiliation(s)
- Ann L Sattler
- Division of Adolescent Medicine, Department of Pediatrics, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA 01655, USA.
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22
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Crandall A, Magnusson BM, Novilla MLB, Novilla LKB, Dyer WJ. Family Financial Stress and Adolescent Sexual Risk-Taking: The Role of Self-Regulation. J Youth Adolesc 2016; 46:45-62. [PMID: 27460827 DOI: 10.1007/s10964-016-0543-x] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2016] [Accepted: 07/11/2016] [Indexed: 12/19/2022]
Abstract
The ability to control one's emotions, thoughts, and behaviors is known as self-regulation. Family stress and low adolescent self-regulation have been linked with increased engagement in risky sexual behaviors, which peak in late adolescence and early adulthood. The purpose of this study was to assess whether adolescent self-regulation, measured by parent and adolescent self-report and respiratory sinus arrhythmia, mediates or moderates the relationship between family financial stress and risky sexual behaviors. We assessed these relationships in a 4-year longitudinal sample of 450 adolescents (52 % female; 70 % white) and their parents using structural equation modeling. Results indicated that high family financial stress predicts engagement in risky sexual behaviors as mediated, but not moderated, by adolescent self-regulation. The results suggest that adolescent self-regulatory capacities are a mechanism through which proximal external forces influence adolescent risk-taking. Promoting adolescent self-regulation, especially in the face of external stressors, may be an important method to reduce risk-taking behaviors as adolescents transition to adulthood.
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Affiliation(s)
- AliceAnn Crandall
- Department of Health Science, Brigham Young University, 4103 LSB, Provo, UT, 84602, USA.
| | - Brianna M Magnusson
- Department of Health Science, Brigham Young University, 4103 LSB, Provo, UT, 84602, USA
| | - M Lelinneth B Novilla
- Department of Health Science, Brigham Young University, 4103 LSB, Provo, UT, 84602, USA
| | | | - W Justin Dyer
- Department of Religious Education, Brigham Young University, 270 N JSB, Provo, UT, 84602, USA
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23
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Hernandez BF, Peskin MF, Markham CM, Burr J, Roberts T, Tortolero S. Associations between parental deployment, relocation, and risky sexual behaviors among a clinic-based sample of military-dependent youth. J Prim Prev 2015; 36:351-9. [PMID: 26324389 DOI: 10.1007/s10935-015-0399-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Although sexual behaviors have been extensively studied among youth in general, they have been relatively understudied among military-dependent youth (MDY). Furthermore, the impact of unique military stressors, such as parental deployment and multiple relocations, on the sexual behaviors of MDY has not been assessed. In this pilot study, we estimated the prevalence of sexual behaviors among MDY, and examined the association between these behaviors and parental deployment and multiple relocations. Between June and September 2011, we recruited youth (N = 208; aged 15-19 years) who attended a military treatment facility in the southern United States, to complete a short, paper-based survey. We computed prevalence estimates and conducted Chi-square analyses, as well as logistic regression analyses, while adjusting for age, gender, and race/ethnicity. More than half (53.7 %) of the youth reported being sexually experienced, and many of these youth reported engaging in risky sexual behaviors. Parental deployment and multiple relocations were significantly associated only with having had sex in the past 3 months. Although with most sexual behaviors there was no significant association between parental deployment and multiple relocations, many MDY are sexually experienced and engage in risky sexual behaviors. MDY should thus be exposed to evidence-based strategies for sexually transmitted infection and pregnancy prevention, as well as provided with teen-friendly health care services and comprehensive sexual/reproductive health counseling.
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Affiliation(s)
- Belinda F Hernandez
- Center for Health Promotion and Prevention Research, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Houston, TX, USA.
| | - Melissa F Peskin
- Center for Health Promotion and Prevention Research, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Houston, TX, USA
| | - Christine M Markham
- Center for Health Promotion and Prevention Research, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Houston, TX, USA
| | - Jean Burr
- Department of Pediatrics, San Antonio Military Medical Center, San Antonio, TX, USA
| | - Timothy Roberts
- Department of Pediatrics, San Antonio Military Medical Center, San Antonio, TX, USA
| | - Susan Tortolero
- Center for Health Promotion and Prevention Research, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Houston, TX, USA
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24
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Childs GD, Knight C, White R. Never-pregnant African American adolescent girls' perceptions of adolescent pregnancy. J Pediatr Nurs 2015; 30:310-20. [PMID: 25236337 PMCID: PMC4362966 DOI: 10.1016/j.pedn.2014.08.012] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2014] [Revised: 08/20/2014] [Accepted: 08/29/2014] [Indexed: 11/17/2022]
Abstract
Despite the decrease in adolescent pregnancy rates, rates among African American girls remain higher than other racial/ethnic adolescent groups. This descriptive qualitative study explored never-pregnant African American adolescent girls' perceptions about adolescent pregnancy. Sixty-four participants participated in individual interviews and focus groups. Individual interviews examined beliefs about adolescent pregnancy and perceptions of life changes resulting from becoming pregnant during adolescence. Focus groups were held to validate findings from the interviews. Participants agreed that becoming pregnant during adolescence would negatively impact their education, family, and peers. Participants anticipated feelings of shame and embarrassment in the event that they became pregnant.
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Affiliation(s)
| | - Candace Knight
- University of Alabama at Birmingham, School of Nursing, Birmingham, AL
| | - Reashanda White
- University of Alabama at Birmingham, School of Nursing, Birmingham, AL
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25
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Fergusson DM, McLeod GFH, Horwood LJ. Childhood sexual abuse and adult developmental outcomes: findings from a 30-year longitudinal study in New Zealand. Child Abuse Negl 2013; 37:664-74. [PMID: 23623446 DOI: 10.1016/j.chiabu.2013.03.013] [Citation(s) in RCA: 349] [Impact Index Per Article: 31.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/18/2012] [Revised: 03/20/2013] [Accepted: 03/22/2013] [Indexed: 05/22/2023]
Abstract
OBJECTIVES Childhood sexual abuse (CSA) has been associated with many adverse medical, psychological, behavioral and socioeconomic outcomes in adulthood. This study aims to examine the linkages between CSA and a wide range of developmental outcomes over a protracted time period to age 30. METHODS Data from over 900 members of the New Zealand birth cohort the Christchurch Health and Development Study were examined. CSA prior to age 16 was assessed at ages 18 and 21 years, in addition to: mental health, psychological wellbeing, sexual risk-taking behaviors, physical health and socioeconomic outcomes to age 30. RESULTS After statistical adjustment for confounding by 10 covariates spanning socio-demographic, family functioning and child factors, extent of exposure to CSA was associated with increased rates of (B, SE, p): major depression (0.426, 0.094, <.001); anxiety disorder (0.364, 0.089, <.001); suicidal ideation (0.395, 0.089, <.001); suicide attempt (1.863, 0.403, <.001); alcohol dependence (0.374, 0.118, <.002); and illicit drug dependence (0.425, 0.113, <.001). In addition, at age 30 CSA was associated with higher rates of PTSD symptoms (0.120, 0.051, .017); decreased self-esteem (-0.371, 0.181, .041); and decreased life satisfaction (-0.510, 0.189, .007). Childhood sexual abuse was also associated with decreased age of onset of sexual activity (-0.381, 0.091, <.001), increased number of sexual partners (0.175, 0.035, <.001); increased medical contacts for physical health problems (0.105, 0.023, <.001); and welfare dependence (0.310, 0.099, .002). Effect sizes (Cohen's d) for the significant outcomes from all domains ranged from .14 to .53, while the attributable risks for the mental health outcomes ranged from 5.7% to 16.6%. CONCLUSIONS CSA is a traumatic childhood life event in which the negative consequences increase with increasing severity of abuse. CSA adversely influences a number of adult developmental outcomes that span: mental disorders, psychological wellbeing, sexual risk-taking, physical health and socioeconomic wellbeing. While the individual effect sizes for CSA typically range from small to moderate, it is clear that accumulative adverse effects on adult developmental outcomes are substantial.
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Affiliation(s)
- David M Fergusson
- Christchurch Health and Development Study, Department of Psychological Medicine, University of Otago, Christchurch, PO Box 4345, Christchurch 8140, New Zealand
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