The Role of Religiosity and Personal Faith in Young People's Sexual Debut and Sexual Risk Taking: A Bayesian Approach

Using a Bayesian statistical approach, this study aimed to provide a robust assessment of associations between religiosity and personal faith, timing of sexual initiation and sexual risk taking in young people. To produce posterior probability distribution of the estimation of associations, this study combined two population-based surveys of emerging Croatian adults and meta-analytical estimates pertaining to international studies published between 2000 and 2020. Regardless of the prior used, age at sexual debut was delayed by both religiosity (correlations ranged from 0.10 to 0.13) and personal faith (r = 0.09-0.13). Apart from delaying sexual debut, the findings suggest a very limited role of religiosity and personal faith in the protection of sexual and reproductive health among young people.

A meta-analytic exploration of associations between religious service attendance and sexual risk taking in adolescence and emerging adulthood

Findings since 2000 about the association between the frequency of religious service attendance (formal religiosity) and sexual risk taking in adolescents and emerging adults were explored. A systematic literature search (April 2020) focused on articles with data on religiosity and age at sexual debut, number of sexual partners, condom use at most recent sexual intercourse, and consistent condom use. A total of 27 studies with 37,430 participants (Mage = 18.4, range: 12-25, 43.5% male) were included. In random-effects meta-analysis, the link between formal religiosity and sexual risk taking was significant only for age at sexual debut (r = 0.09, 95% CI = 0.05, 0.13) and the number of sexual partners (r = -0.14, 95% CI = -0.19, -0.09). Weak associations between the constructs of interest indicate that formal religiosity is not sufficient to protect young people's sexual health.

Factors affecting risk-taking behaviors among sexually active adolescents tested for HIV/STD

OBJECTIVE

The purpose of this secondary data analysis was to identify potential contributors to high-risk sexual behaviors among sexually active adolescents who were tested for HIV and STDs compared to those who did not test for HIV and STDs.

METHOD

Data from the 2019 Youth Risk Behavior Survey (YRBS) was used to explore potential predictors of risky behaviors among those tested for HIV/STD. A sample size of 3226 from the YRBS data base was used to explore predictors using Chi-square and logistic regressions analyses.

RESULTS

Most adolescents reported not being tested for HIV (77.4%) and STD (83.9%). There were statistical differences between those tested for HIV and condom use, sexual intercourse before the age of 13 years, sexual intercourse with multiple people, and use of marijuana. Similar findings were found with adolescents tested for STDs.

CONCLUSION

Findings of this study support the recommendations for a better understanding of the associations between drug use, early initiation of sexual activity, and condom use. Development of appropriate public health educational interventions can help decrease risky behaviors among these adolescents.

Risky Sexual Behavior of Young Adults in Hong Kong: An Exploratory Study of Psychosocial Risk Factors

There is limited knowledge of the prevalence and nature of risky sexual behavior (RSB) among young adults in Hong Kong. This cross-sectional study explored the psychosocial risk factors of RSB with a sample of 1,171 Hong Kong university students (aged 18-40 years). Grounded in the theoretical propositions of several criminological theories (i.e., the theories of self-control, general strain, social learning, social control, and routine activity), engagement in three types of RSB (i.e., general, penetrative, and non-penetrative) was studied alongside a range of psychosocial risk factors. Relative to female participants, male participants reported significantly higher mean levels of general, penetrative, and non-penetrative RSB. Male participants also reported significantly higher mean levels of negative temperament, use of alcohol and other drugs, and paraphilic interests than female participants, who reported significantly higher mean levels of self-control and social bonds than their male counterparts. The results of multivariate analyses (i.e., OLS regressions) revealed that, to a large extent, the male and female participants shared a similar set of psychosocial risk factors (i.e., use of alcohol and other drugs, and paraphilic interest) for their involvement in general, penetrative, and non-penetrative RSB. Furthermore, a high level of negative temperament was significantly associated with penetrative RSB for both genders, while a high level of perceived neighborhood disorganization was found to be an important factor in the participation of females in general, penetrative, and non-penetrative RSB. The findings of this study may have important implications for practice in regard to reducing, if not entirely preventing, the tendency to engage in RSB.

Peer Victimization and Sexual Risk Taking Among Adolescents

BACKGROUND

Research indicates that victimization exposures are associated with sexual risk-taking behaviors, but there is a relative lack of research on the relation between peer victimization and sexual risk taking among adolescents. This study fills this gap through examining how bullying, cyberbullying, and dating violence victimization at baseline are related to sexual risk-taking behaviors 1 year later.

METHODS

Participants were a convenience sample of 220 sexually active high school students who were drawn from a larger sample of 2205 adolescents attending 6 high schools in Illinois. Adolescents completed Wave 1 surveys in Spring 2015 and Wave 2 surveys in Spring 2016.

RESULTS

Latent difference score models indicated that bullying victimization was not related to sexual risk-taking behaviors. Baseline levels of cyberbullying and verbal teen dating violence, however, were both associated with more sex under the influence of alcohol at Wave 2. Further, findings revealed that changes over time in verbal teen dating violence victimization were associated with changes over time in sex under the influence of alcohol.

CONCLUSIONS

Given links between peer victimization exposures and sexual risk-taking behaviors, school-based prevention and intervention efforts should address these in concert with one another.

The Mediating Effect of Adelante brand equity on Latino Immigrant Positive Youth Development Outcomes

This paper reports on mediation analysis of effects of the Adelante brand, an innovative program for Latino immigrant adolescents and their families, and positive youth development (PYD) outcomes. Specific objectives were to increase adolescent engagement and participation in a community-based program called Adelante, based on PYD theory, which sought to reduce substance use, sexual risk taking, and interpersonal violence among Latino immigrant youth. A total of 238 parent-child dyads were recruited from a predominantly low-income Latino immigrant community and followed for an average of 22 months. Measures included demographics; acculturation; stress and coping; social support; violence, substance use, and sexual risk attitudes; future expectations; the Adelante brand equity scale; and PYD asset measures. Multiple regression modeling shows that the leadership brand equity construct is associated with decreased proviolence and increased antiviolence attitudes. Additionally, having any program exposure (vs. none) is associated with improved substance abuse attitudes in models adjusting for the loyalty brand equity construct. In mediation analysis, we observed a mediating effect of the leadership brand equity construct on improved antiviolence attitudes among those exposed to the Adelante program. As found in previous research, Adelante brand equity operated as a mediator of program effects on Latino youth PYD outcomes.

Dimensions of ethnic identity as protective factors for substance use and sexual risk behaviors in African American college students

OBJECTIVE

To examine ethnic identity and ethnic socialization as potential protective factors for risk behaviors among US college students.

PARTICIPANTS

Participants were 398 African American and Afro-Caribbean students recruited from 30 colleges and universities during September 2008-October 2009.

METHODS

Data on hazardous alcohol use, substance use, sexual behaviors, ethnic identity, and ethnic/racial socialization were collected. Hierarchical linear and negative binomial regression analyses were conducted to determine the degree to which ethnic identity and ethnic/racial socialization predicted the risk behaviors.

RESULTS

Ethnic Identity affirmation, belonging, and commitment (EI-ABC) significantly predicted lower substance use and hazardous alcohol use. Ethnic/racial socialization was not a significant predictor of substance use or sexual risk behaviors.

CONCLUSIONS

Components of ethnic identity are potentially protective against alcohol and substance use behaviors. Additional research is recommended to determine effective intervention strategies.

The association between adolescent condom use and individual and environmental resilience protective factors

OBJECTIVE

Individual and environmental resilience protective factors are suggested to be associated with adolescent condom use; however, previous studies have not comprehensively examined such associations. This study aimed to determine the associations between condom use, and numerous individual and environmental resilience protective factors in sexually active Australian adolescents.

METHODS

Participants were Grade 10 students attending 28 Australian government high schools (n=1,688). An online survey (2011) collected data regarding: sexual intercourse (past year), condom use and 14 individual and environmental resilience protective factors. Multivariable backward stepwise logistic regression models examined associations between student condom use and protective factors (total, subscale).

RESULTS

Only total environmental protective factors remained in the final total score model; students with higher total environmental protective factors scores were 2.59 times more likely to always use a condom(95%CI:1.80-3.74). Only three of 14 protective factor subscales were associated with a higher likelihood of always using a condom in the final subscale model (individual: goals/aspirations; environmental: community participation, pro-social peers).

CONCLUSIONS

Total environmental and three protective factor subscales demonstrated prominent associations with consistent use of condoms in sexually active adolescents. Implications for public health: Consideration of particular resilience protective factors in adolescent sexual risk behaviour prevention, such as condom use, is warranted.

Blackouts among male and female youth seeking emergency department care

BACKGROUND

Alcohol-related blackouts are a common consequence of heavy drinking, and these blackouts pose risk for injury and other adverse health outcomes.

OBJECTIVE

To examine the prevalence and correlates of blackouts among underage drinkers.

METHODS

Youth (ages 14-20) presenting to a suburban Emergency Department (ED) completed screening surveys. Among those reporting past-year alcohol consumption, we examined past 3-month blackouts in relation to: background characteristics (e.g., demographics, fraternity/sorority involvement), substance use, sexual risk behaviors and incapacitated sexual assault (unaware/unable to consent due to alcohol/drugs), forced sexual assault, positive depression screening, and reason for ED visit (injury vs. medical).

RESULTS

In total, 2,300 past-year drinkers participated: 58% female, 75% Caucasian, and mean age = 18.4. Regarding past 3-month blackouts, 72.7% reported none, 19.3% reported monthly or less, and 8% reported monthly or more. Multivariate cumulative logit regression indicated that blackout frequency was positively associated with: college involvement in Greek life, alcohol use severity, prescription drug misuse, marijuana, screening positive for depression, incapacitated sexual assault, and a gender by alcohol use severity interaction.

CONCLUSION

With one-quarter of this clinical sample reporting recent blackouts, as well as the association between blackout frequency and health risk behaviors and other outcomes, findings underscore the need for programs focusing on substance use, depression, and preventing sexual assault. Interventions should also address poly-substance use and drinking motives. Although findings highlight how college students in Greek life may be at high risk for blackouts, many participants not in college also reported blackouts, suggesting that interventions in other settings are also needed.

Sexual Risk Behaviors of African American Adolescent Females: The Role of Cognitive and Religious Factors

INTRODUCTION

African American (AA) high school-age girls are more likely to have had sex before age 13 years and have higher rates of all sexually transmitted infections. Cognition and religion/spirituality are associated with adolescent sexuality, therefore, the purpose of this study was to identify cognitive and religious substrates of AA girls' risky sexual behaviors.

METHOD

A descriptive study was conducted with 65 AA girls aged 15 to 20 years using computerized questionnaires and cognitive function tasks.

RESULTS

Average age was 17.8 ± 1.9 years and average sexual initiation age was 15.5 ± 2.6 years. Overall, 57.6% reported a history of vaginal sex. Girls who reported low/moderate religious importance were significantly younger at vaginal sex initiation than girls for whom religion was very/extremely important. Girls who attended church infrequently reported significantly more sexual partners.

IMPLICATIONS

Health care providers can use these findings to deliver culturally congruent health care by assessing and addressing these psychosocial factors in this population.

Acculturative Stress and Risky Sexual Behavior: The Roles of Sexual Compulsivity and Negative Affect

Recent syndemic models of sexual health disparities affecting racial/ethnic minorities have highlighted the role of discrimination. Yet no previous work has examined how acculturative stress (distress at the transition from one's original culture toward a new culture) associates with sexual HIV-risk behavior (SHRB). Work among other minority populations suggests sexual compulsivity (SC) may contribute to syndemic sexual health disparities as a means of coping with distress. With this in mind, the present study examined whether SC explained the relation between acculturative stress and SHRB. Separate analyses were conducted for males and females within a sample of 758 sexually initiated racial/ethnic minority college students. Among males and females, acculturative stress had an indirect effect on SHRB via SC. As the first study to examine SHRB in relation to acculturative stress, findings provide preliminary evidence that targeting SC among racial/ethnic minorities may help reduce sexual health disparities.

Sensation seeking predicting growth in adolescent problem behaviors

There is limited literature on the relationship between sensation seeking and adolescent risk behaviors, particularly among African Americans. We tested the association between psychometrically-derived subscales of the Zuckerman Sensation Seeking Scale and the intercepts and slopes of individual growth curves of conduct problems, sexual risk taking, and substance use from ages 13 to 18 years by sex. Boys and girls had different associations between sensation seeking and baseline levels and growth of risk behaviors. The Pleasure Seeking scale was associated with baseline levels of conduct problems in boys and girls, baseline substance use in boys, and growth in sexual risk taking and substance use by girls. Girls had the same pattern of associations with the Danger/Novelty scale as the Pleasure Seeking scale. Knowledge about the relationships between adolescent risk taking and sensation seeking can help in the targeted design of prevention and intervention programs for the understudied population of very low-income, African American adolescents.

Influences of acute alcohol consumption, sexual precedence, and relationship motivation on women's relationship and sex appraisals and unprotected sex intentions

Guided by the cognitive mediation model of sexual decision making (Norris, Masters, & Zawacki, 2004. Cognitive mediation of women's sexual decision making: The influence of alcohol, contextual factors, and background variables. Annual Review of Sex Research, 15, 258-296), we examined female social drinkers' (N = 162) in-the-moment risky sexual decision making by testing how individual differences (relationship motivation) and situational factors (alcohol consumption and sexual precedence conditions) influenced cognitive appraisals and sexual outcomes in a hypothetical sexual scenario. In a path model, acute intoxication, sexual precedence, and relationship motivation interactively predicted primary relationship appraisals and independently predicted primary sex appraisals. Primary appraisals predicted secondary appraisals related to relationship and unprotected sex, which predicted unprotected sex intentions. Sexual precedence directly increased unprotected sex intentions. Findings support the cognitive mediation model and suggest that sexual risk reduction interventions should address alcohol, relationship, sexual, and cognitive factors.

Psychological symptoms are associated with both abstinence and risky sex among men with HIV

Sexual abstinence is often deemed the "safest behavior" in HIV prevention, but is sometimes associated with psychological symptoms (e.g., depression) just as sexually risky behavior is. This study explored whether sexual abstinence and risky sexual behavior among men with HIV were associated with similar constellations of psychological symptoms. Prior research has not addressed this issue because abstinent people often are not included in the sample or, when data are analyzed, researchers combine abstinent people with sexually active people who practice safer sex. Past research also neglects the co-morbidity of psychological symptoms. A latent class analysis of the psychological symptoms (assessed with the Symptom Check List 90-R; Derogatis, 1994) of 140 men with HIV, mostly from rural New England, revealed three latent classes: men who were asymptomatic on all symptom domains (28.8 %), men who were symptomatic on all domains (34.1 %), and men who were symptomatic on internalizing domains (37.1 %), but were asymptomatic on the externalizing symptoms of hostility and paranoid ideation. Logistic regression showed that sexual behavior during the past 90 days of men in the all symptom class and the internalizing symptoms class was similar, with abstinence and risky sex predominating, and safer sex being relatively uncommon for both classes. The sexual behavior of men in the asymptomatic class differed, with safer sex being relatively more likely to occur compared to the symptomatic classes. These findings suggest that the psychological symptom profile of sexually abstinent people places them at risk for inconsistent condom use should they engage in sexual behavior.

Black men who have sex with men, sexual risk-taking, and willingness to use rapid home HIV tests

The availability of rapid home-based HIV testing (RHT) in the USA has provided us with a valuable, new option in our efforts to identify more people living with HIV and to do so sooner. Furthermore, it is possible that RHT will be or is currently being used as a means of learning one's own and one's partner's HIV status prior to engaging in condomless intercourse. Data regarding knowledge and willingness to use RHT, however, is very limited. In particular, no studies have investigated RHT use among Black men who have sex with men (BMSM). Understanding RHT use among BMSM is critical as we have observed alarming rates of HIV prevalence among this group, and RHT may provide an opportunity to slow HIV transmission among BMSM. In order to better understand RHT, we assessed knowledge, willingness to use and actual use of RHT, HIV testing history, substance use, and sexual risk-taking among 387 HIV-negative BMSM and 157 HIV-positive BMSM attending a community event in the southeastern USA. We used generalized linear modeling to assess factors associated with their willingness to use RHT. Although familiarity with the availability of RHT was somewhat limited among these men, a substantial portion of BMSM did report an interest in using RHT, including with their sex partners. Among HIV-negative BMSM, however, we found a negative relationship between willingness to use RHT and sexual risk-taking, i.e., higher numbers of condomless anal sex acts were associated with a reduction in willingness to use RHT. It appears that men who report the greatest risk-taking for HIV are least interested in RHT. Future research should focus on better understanding concerns regarding RHT among at-risk HIV-negative men and should investigate the usefulness of using RHT as a HIV prevention method.

Use of drinking protective behavioral strategies and sexual perceptions and behaviors in U.S. college students

Alcohol use among college students is linked to an increased likelihood of engaging in risky sexual behaviors, including casual sex and unprotected sex. These behaviors increase college students' risks for negative social and health-related consequences. This study examined the relationship between drinking behaviors and protective behavioral strategies (PBS), expectancies and perceptions of sexual risk, and actual alcohol-related sexual behaviors and consequences. Sexually active college students completed Web-based self-report measures of drinking behaviors and use of PBS, alcohol expectancies and perceptions of risk, and sexual behaviors and related consequences (n = 524; 57.1% women). Findings indicated that PBS were related to lower expectancies of sexual risk and sexual disinhibition, and among lighter drinkers, lower expectancies of sexual enhancement from alcohol. PBS were also related to decreased perceptions of sexual-related risks, some alcohol-related sexual behaviors, including number of drinks before/during sex, and number of sexual consequences, but were not related to abstaining during sex, frequency of alcohol-related sexual behaviors, or general condom use. These findings demonstrate a disconnect between perceived and actual risks among college students, such that decreased perceptions of risk may not be associated with protective behaviors. Prevention and intervention implications are discussed.

Contextualizing condom use: intimacy interference, stigma, and unprotected sex

Intimate relationships have received increasing attention as a context for HIV transmission. We examined the relationships among perceptions that condoms interfere with intimacy, gay-related stigma, and unprotected/protected anal intercourse. Participants included 245 single-identified men who have sex with men. Intimacy Interference was positively associated with number of unprotected anal intercourse acts, and this effect was stronger among participants who reported high levels of gay-related stigma. In contrast, Intimacy Interference was negatively associated with number of protected anal intercourse acts, and gay-related stigma was positively associated with this outcome with no evidence of interaction effects. The findings are explained in the context of rejection sensitivity theory, and implications for public health and clinical intervention are discussed.

Sexual victimization, alcohol intoxication, sexual-emotional responding, and sexual risk in heavy episodic drinking women

This study used an experimental paradigm to investigate the roles of sexual victimization history and alcohol intoxication in young women's sexual-emotional responding and sexual risk taking. A nonclinical community sample of 436 young women, with both an instance of heavy episodic drinking and some HIV/STI risk exposure in the past year, completed childhood sexual abuse (CSA) and adolescent/adult sexual assault (ASA) measures. A majority of them reported CSA and/or ASA, including rape and attempted rape. After random assignment to a high alcohol dose (.10 %) or control condition, participants read and projected themselves into an eroticized scenario of a sexual encounter involving a new partner. As the story protagonist, each participant rated her positive mood and her sexual arousal, sensation, and desire, and then indicated her likelihood of engaging in unprotected sex. Structural equation modeling analyses revealed that ASA and alcohol were directly associated with heightened risk taking, and alcohol's effects were partially mediated by positive mood and sexual desire. ASA was associated with attenuated sexual-emotional responding and resulted in diminished risk taking via this suppression. These are the first findings indicating that, compared to non-victimized counterparts, sexually victimized women respond differently in alcohol-involved sexual encounters in terms of sexual-emotional responding and risk-taking intentions. Implications include assessing victimization history and drinking among women seeking treatment for either concern, particularly women at risk for HIV, and alerting them to ways their histories and behavior may combine to exacerbate their sexual risks.

Cortisol reactivity to psychosocial stress is greater in sexual risk takers

Several studies have reported an association between deviant behaviour and cortisol reactivity to stress. However, relatively few studies have investigated the relationship between psychobiological stress reactivity and sexual risk-taking behaviours. In this study, cortisol reactivity to the Trier Social Stress Test (TSST) was measured in 26 healthy young adults prior to the administration of a sexual health and behaviour questionnaire. The cortisol response to the TSST was greater in those individuals who reported that at least one of their previous two sexual partners was someone whom they had just met. Results are discussed in the context of a model which suggests that early life stress dysregulates the hypothalamic–pituitary–adrenal axis and increases the likelihood of later life risk-taking behaviour. The findings have implications in terms of improving our understanding of psychobiological factors which predispose individuals to engage in adverse sexual health behaviours.

Sexual Decision Making in the Absence of Choice: The African American Female Dating Experience

Although links between low mate availability and increased HIV and STI risk for African American women have been documented in the literature, we know little about the impact of limited mate choices on the quality of relationships between Black men and women and how these relationship dynamics impact risk for young Black women. We conducted a qualitative study with African American female young adults (N=12) to explore the perceived impact of structural forces on African American female young adults' dating and sexual behavior. Participants reported (1) perceptions of Black men as untrustworthy and manipulative, (2) the limited and often negative roles for Black men in the larger Black community, and (3) heterosexual relationships in the Black community as increasingly influenced by economics and commerce. Recommendations for HIV prevention interventions that include micro and macro level approaches are discussed.

The potential of alcohol "heat-of-the-moment" scenarios in HIV prevention: A qualitative study exploring intervention implications

Scenarios simulating real-world risk situations have proven effective for substance use intervention methods and could potentially prove useful as an HIV-prevention method. This study explored qualitatively the development and use of such "in-the-moment" methods. We interviewed 97 moderate-drinking women (50 % Caucasian) after participation in an experiment requiring that they project themselves into a risky-sex scenario. Most participants (58 %) reported experiencing the scenario as a reflective tool characterized by two primary themes: (1) increased awareness of risk and (2) contemplation of behavior change. Findings suggest that "in-the-moment" methods depicting real-world risk situations and providing opportunities to reflect about behavioral choices and subsequent outcomes could prove a useful adjunct to HIV/AIDS-prevention interventions. Such methods could potentially augment existing prevention protocols.

How Do Alcohol and Relationship Type Affect Women's Risk Judgment of Partners with Differing Risk Histories?

Understanding how women judge male partners' sexual risk is important to developing risk reduction programs. Applying a cognitive mediation model of sexual decision making, our study investigated effects of alcohol consumption (control, low dose, high dose) and relationship type (disrupted vs. new) on women's risk judgments of a male sexual partner in three sexual risk conditions (low, unknown, high). After random assignment to an experimental condition, 328 participants projected themselves into a story depicting a sexual interaction. The story was paused to assess primary appraisals of sexual and relationship potential and secondary appraisals of pleasure, health, and relationship concerns, followed by sexual risk judgments. In all risk conditions, alcohol and disrupted relationship increased sexual potential whereas disrupted relationship increased relationship potential in the low- and high-risk conditions. In the unknown-risk condition, women in the no-alcohol, new relationship condition had the lowest primary sexual appraisals. In all conditions, sexual appraisals predicted all secondary appraisals, but primary relationship appraisals predicted only secondary relationship appraisals. Secondary health appraisals led to increased risk judgments whereas relationship appraisals predicted lower risk judgments. Possible intervention points include helping women to re-evaluate their safety beliefs about past partners, as well as to develop behavioral strategies for decreasing hazardous drinking.

Health Risk Behavior and Sexual Assault Among Ethnically Diverse Women

Sexual assault is associated with a number of health risk behaviors in women. It has been hypothesized that these risk behaviors, such as hazardous drinking, may represent women's attempts to cope with psychological distress, such as symptoms of depression and anxiety. However, extant research has failed to evaluate these relationships among ethnic minority samples or identify the mechanisms responsible for this association. The current study examined sexual assault history and two health risk behaviors (hazardous drinking and engaging in sexual behavior to regulate negative affect) in a diverse sample of 1,620 college women. Depression and anxiety were examined as mediators of the relationship between sexual assault and health risk behaviors. There was evidence of moderated mediation, such that for European American women, but not for ethnic minority women, both forms of psychological distress were significant mediators of the sexual assault/hazardous drinking relationship. In contrast, among all ethnic groups, the relationship between sexual assault and both forms of psychological distress was mediated by the use of sexual behavior as an affect regulation strategy. Results support a need to evaluate the assault experiences of ethnically diverse women, as well as the impact of the assault on their postassault experiences including health risk behaviors and psychological adjustment. Additionally, results suggest that practitioners should carefully assess health risk behaviors among victims of sexual assault and be aware that there may be differences in the risk factors and motives for these behaviors among women of various ethnic backgrounds.

A Qualitative Descriptive Study of Perceived Sexual Effects of Club Drug Use in Gay and Bisexual Men

Club drug use is often associated with unsafe sexual practices and use remains prevalent among gay and bisexual men. Although epidemiological studies commonly report the risk of engaging in unsafe sex due to the effects of particular club drugs, there remain gaps in the literature regarding the specific sexual effects of such substances and the context for their use in this population. We examined secondary data derived from interviews with 198 club drug using gay and bisexual males in New York City and qualitatively describe subjective sexual effects of five drugs: ecstasy, GHB, ketamine, powder cocaine and methamphetamine. Differences and commonalities across the five drugs were examined. Results suggest that each drug tends to provide: 1) unique sexual effects, 2) its own form of disinhibition, and 3) atypical sexual choices, often described as "lower sexual standards." Differences across drugs emerged with regard to social, sensual and sexual enhancement, sexual interest, and impotence. Although some common perceived sexual effects exist across drugs, the wide variation in these effects suggests different levels of risk and may further suggest varying motivations for using each substance. This study seeks to educate public health officials regarding the sexual effects of club drug use in this population.

Intervention induced changes on parenting practices, youth self-pride and sexual norms to reduce HIV-related behaviors among rural African American youths

AIDS is the leading killer of African Americans between the ages of 25 and 44, many of whom became infected when they were teenagers or young adults. The disparity in HIV infection rate among African Americans youth residing in rural Southern regions of the United States suggests that there is an urgent need to identify ways to promote early preventive intervention to reduce HIV-related risk behavior. The Strong African American Families (SAAF) program, a preventive intervention for rural African American parents and their 11-year-olds, was specially designed to deter early sexual onset and the initiation and escalation of alcohol and drug use among rural African American preadolescents. A clustered-randomized prevention trial was conducted, contrasting families who took part in SAAF with control families. The trial, which included 332 families, indicated that intervention-induced changes occurred in intervention-targeted parenting, which in turn facilitated changes in youths' internal protective processes and positive sexual norms. Long-term follow up assessments when youth were 17 years old revealed that intervention-induced changes in parenting practices mediated the effect of intervention-group influences on changes in the onset and escalation of risky sexual behaviors over 65 months through its positive influence on adolescents' self-pride and their sexual norms. The findings underscore the powerful effects of parenting practices among rural African American families that over time serve a protective role in reducing youth's risk behavior, including HIV vulnerable behaviors.

Pathways to sexual risk taking among female adolescent detainees

Sexual risk taking among female delinquents represents a significant public health problem. Research is needed to understand the pathways leading to sexual risk taking among this population. This study sought to address this issue by identifying and testing two pathways from child maltreatment to non-condom use among 329 White and 484 African American female adolescent detainees: a relational pathway and a substance use coping pathway. The relational pathway indicated that child maltreatment would be related to non-condom use via depressive self-concept and condom use self-efficacy. The substance use coping pathway suggested that depressive self-concept and alcohol-based expectancies for sexual enhancement would mediate the relationship between child maltreatment and non-condom use. As hypothesized, the relational pathway variables were associated with one another in the expected directions; however, evidence of mediation was not found. Support for mediation was found for the substance use coping pathway. Exploratory across group comparison analysis indicated that the relational pathway was significant for White girls whereas the substance use coping pathway was significant for African American girls. Limitations and implications for future research are discussed.

Dimensions of acculturation: associations with health risk behaviors among college students from immigrant families

In the present study, we examined a bidimensional model of acculturation (which includes both heritage and U.S. practices, values, and identifications) in relation to hazardous alcohol use, illicit drug use, unsafe sexual behavior, and impaired driving. A sample of 3,251 first- and second-generation immigrant students from 30 U.S. colleges and universities completed measures of behavioral acculturation; cultural values (individualism, collectivism, and self-construal); ethnic and U.S. identity; and patterns of alcohol and drug use, engagement in potentially unsafe sexual activities, and driving while (or riding with a driver who was) intoxicated. Results indicate that heritage practices and collectivist values were generally protective against health risk behaviors, with collectivist values most strongly and consistently protective. Nonetheless, heritage identifications were positively associated with sexual risk taking for Hispanics. U.S. practices, values, and identifications were not consistently related to risk behavior participation. Results are discussed in terms of bidimensional approaches to acculturation, the immigrant paradox, and implications for counseling practice.

Using the primary socialization theory to predict substance use and sexual risk behaviors between black and white adolescents

Using the Primary Socialization Theory (PST), we examined substance use and sexual risk-taking behaviors between Black (N = 1,464) and White (N = 3,946) adolescents in the National Longitudinal Study of Adolescent Health, Wave 1, public use (Add Health). Self-reported substance use and sexual risk-taking behaviors, PST constructs, and covariates were assessed using regression modeling techniques. Black youth were more likely to initiate sex, while White youth were more likely to report lifetime alcohol use. The PST predicted risk for White but not Black youth. The study's limitations are noted, and implications for future research are discussed.

Gender and the effects of an economic empowerment program on attitudes toward sexual risk-taking among AIDS-orphaned adolescent youth in Uganda

PURPOSE

This article examines gender differences in attitudes toward sexual risk-taking behaviors of acquired immune deficiency syndrome (AIDS)-orphaned youth participating in a randomized control trial testing an economic empowerment intervention in rural Uganda.

METHODS

Adolescents (average age 13.7 years) who had lost one or both parents to AIDS from 15 comparable schools were randomly assigned to either an experimental (n=135) or a control condition (n=142). Adolescents in the experimental condition, in addition to usual care, also received support and incentives to save money toward secondary education.

RESULTS

Findings indicate that although adolescent boys and girls within the experimental condition saved comparable amounts, the intervention appears to have benefited girls, in regard to the attitudes toward sexual risk-taking behavior, in a different way and to a lesser extent than boys.

CONCLUSIONS

Future research should investigate the possibility that adolescent girls might be able to develop equally large improvements in protective attitudes toward sexual risk taking through additional components that address gendered social norms.

Sexual marathons and methamphetamine use among HIV-positive men who have sex with men

A sexual marathon is defined as prolonged sexual activity over hours and even days. This exploratory study examined the phenomenon of sexual marathons in a sample of 341 HIV-positive methamphetamine-using men who have sex with men (MSM). Eighty-four percent of the men reported engaging in marathon sex while high on methamphetamine. MSM who engaged in sexual marathons and those who did not were compared in terms of background characteristics, methamphetamine use variables, alcohol and illicit drug use, sexual risk behaviors, and psychosocial factors. Men who engaged in marathon sex used significantly more illicit drugs, were more likely to use sildenafil (Viagra) and amyl nitrates, and scored higher on a sexual compulsivity scale compared to men who did not engage in marathon sex. In multivariate analyses, use of sildenafil in the past two months was significantly correlated with participation in sexual marathons. Findings are discussed in terms of their implications for HIV/STI prevention and intervention.

Effects of relationship motivation, partner familiarity, and alcohol on women's risky sexual decision making

This experiment examined the effects of women's relationship motivation, partner familiarity, and alcohol consumption on sexual decision making. Women completed an individual difference measure of relationship motivation and then were randomly assigned to partner familiarity condition (low, high) and to alcohol consumption condition (high dose, low dose, no alcohol, placebo). Then women read and projected themselves into a scenario of a sexual encounter. Relationship motivation and partner familiarity interacted with intoxication to influence primary appraisals of relationship potential. Participants' primary and secondary relationship appraisals mediated the effects of women's relationship motivation, partner familiarity, and intoxication on condom negotiation, sexual decision abdication, and unprotected sex intentions. These findings support a cognitive mediation model of women's sexual decision making and identify how individual and situational factors interact to shape alcohol's influences on cognitive appraisals that lead to risky sexual decisions. This knowledge can inform empirically based risky sex interventions.

Relationships of Social Context and Identity to Problem Behavior among High-Risk Hispanic Adolescents

The present study was designed to examine the extent to which (a) family and school functioning and (b) personal and ethnic identity is associated with conduct problems, drug use, and sexual risk taking in a sample of 227 high-risk Hispanic adolescents. Adolescents participated in the study with their primary parents, who were mostly mothers. Adolescents completed measures of family and school functioning, personal and ethnic identity, conduct problems, and drug use. Parents completed measures of family functioning and adolescent conduct problems. Results indicated that school functioning and personal identity confusion were related to alcohol use, illicit drug use, and sexual risk taking indirectly through adolescent reports of conduct problems. Adolescent reports of family functioning were related to alcohol use, illicit drug use, and sexual risk taking through school functioning and conduct problems. Results are discussed in terms of the problem behavior syndrome and in terms of the finding of relative independence of contextual and identity variables vis-à-vis conduct problems, substance use, and sexual risk taking.

Sexual anxiety and eroticism predict the development of sexual problems in youth with a history of sexual abuse

Youth with confirmed histories of sexual abuse (N = 118) were followed longitudinally to examine associations between their initial sexual reactions to abuse and subsequent sexual functioning. Participants were interviewed at abuse discovery (ages 8 through 15) and again 1 and 6 years later. Eroticism and sexual anxiety emerged as distinct indices of abuse-specific sexual reactions and predicted subsequent sexual functioning. Eroticism was associated with indicators of heightened sexuality, including more sexual risk behavior and views of sexual intimacy focused on partners' needs. Sexual anxiety was associated with indicators of diminished sexuality, including few sexual partners and avoidant views of sexual intimacy. Age at abuse discovery moderated some associations, suggesting that the timing of abuse-specific reactions affects trajectories of sexual development. Findings point to the need for a developmental approach to understanding how abuse-specific sexual reactions disrupt sexual development and the need for early interventions promoting healthy sexual development.