Individual, Family, and Relationship Predictors of Young Women's Sexual Risk Perceptions

Objective: To identify the individual, dyad, and family variables that influence young women's perceptions of risk for sexually transmitted diseases (STDs), including human immunodeficiency virus (HIV).
Design: Cross-sectional telephone survey using forced-choice questioning. Data were analyzed using first-order correlations and logistic regression.
Setting: Participants were recruited from a mid-Atlantic study of young adults and from volunteers at a mid-Atlantic university and surrounding community.
Participants: A convenience sample of 93 sexually active, unmarried, heterosexual women, ages 17–26 years. The majority of the study sample was white.
Main Outcome Measure: Respondents were asked to estimate their own level of risk for STDs, including HIV, using the responses no, low, moderate, and high risk. Responses were later recoded into no risk versus some risk.
Results: Communication with parents about sexual risk decreased the odds that women would see themselves as being at no risk. Consistent condom use, relationship satisfaction, and perceiving the partner as no risk increased the odds that women would believe they were at no risk.
Conclusions: Nurses can incorporate these and other study findings into the design of sexual risk reduction programs. Programs that enhance parent-teen communication about sexual risks and assist young women to examine their perceptions of their partners may be more effective than programs that provide information only.     

Sexual abuse during childhood and adolescence as predictors of HIV-related sexual risk during adulthood among female sexual partners of injection drug users

This study explores the relationship of sexual abuse during childhood and adolescence with HIV-related sexual risk behaviors during adulthood among female sexual partners of injection drug users. It analyzed data that was gathered between 1990 and 1993, which included a sample of 2794 women from the US, Mexico, and Puerto Rico. 6 HIV-related sexual risk behaviors that occurred during the month prior to interview were examined; namely, number of sexual partners, number of drug-injecting sexual partners, number of sexual intercourse while high on alcohol and/or other drugs, number of times trading sex for drugs and/or money, proportion of all sexual acts involving protection, and overall HIV-related sexual risk. The results showed that more than one-third of the women (36.3%) experienced some form of sexual abuse during childhood, whereas 34.4% reported that they had been abused sexually during adolescence; 1 in 5 women (18.4%) stated being abused during both periods. The results further indicate that there is a strong link between sexual abuse victimization early in life and involvement later in life in HIV-related sexual risk behaviors. It was found out that certain forms of sexual abuse, such as forced exposure and touching of one's sexual parts were more strongly related than other forms of sexual abuse to subsequent involvement in HIV-related sexual behaviors.     

Safety Behaviors of Abused Women After an Intervention During Pregnancy

Objective: To evaluate an intervention protocol, administered during pregnancy, for increasing safety-seeking behaviors of abused women.
Design: Prospective, ethnically stratified cohort analysis.
Setting: Public prenatal clinics.
Participants: Pregnant women reporting physical or sexual abuse in the year before or during the present pregnancy. One hundred thirty-two women met study criteria, received the intervention, and were followed for 1 year after the completion of the pregnancy.
Intervention: Three education, advocacy, and community referral sessions that included information on safety behaviors.
Main outcome Measure: Adoption of safety behaviors by abused women. Safety behaviors were measured before the intervention, twice during pregnancy, and at 2, 6, and 12 months after completion of the pregnancy.
Results: Repeated measures analysis of variance showed a significant increase in adoption of each safety behavior (p < .0001), with most behaviors showing a significant increase after the first intervention session.
Conclusions: Pregnant women who were abused and were offered an intervention protocol report a significant increase in safety behavior adoption during and after pregnancy. Abuse during pregnancy is common. Identification of abuse and immediate clinical intervention that includes information about safety behaviors can result in safety behavior adoption that may prevent future abuse and increase the safety and well-being of women and infants.     

Recent and past intimate partner abuse and HIV risk among young women

OBJECTIVE: To examine the associations between past intimate partner abuse experienced during adolescence (verbal and physical), recent intimate partner abuse (verbal, physical, and sexual), and HIV risk (as indicated by lack of condom use) for sexually active young adult women in relationships with male partners. DESIGN: Secondary data analysis of waves II and III of the National Longitudinal Study of Adolescent Health (Add Health). SETTING: The Add Health Study is a longitudinal, in-home survey of a nationally representative sample of adolescents. SAMPLE: Analyses involved 2,058 sexually active young adult women. MAIN OUTCOME MEASURES: HIV risk was measured by consistent condom use over the past 12 months. RESULTS: Physical and verbal abuse experienced in adolescence were associated with physical/verbal abuse experienced in young adulthood. Young, sexually active women experiencing no abuse in their relationships were more likely to consistently use condoms in the past 12 months than were their abused counterparts. CONCLUSION: A causal pathway may exist between prior abuse, current abuse, and HIV risk.     

Human Papillomavirus Vaccination and Sexual Behavior in Young Women

Study ObjectiveTo compare sexual attitudes and behaviors of young women who have received or declined the HPV vaccine.DesignCross-sectional survey.SettingObstetrics and gynecology and pediatrics clinics at a large, Midwestern, academic health center.Participants223 young women (ages 13-24): 153 who had received HPV vaccination and 70 with no prior HPV vaccination.Main Outcome MeasuresSexual behaviors; attitudes toward sexual activity.ResultsVaccinated young women were slightly but significantly younger than unvaccinated (mean age 19.2 vs 20.0). Both groups showed a large percentage of participants engaging in high-risk sexual behavior (75% vs 77%). The mean age at sexual debut was not significantly different between the groups (16.8 vs 17.0) nor was the average number of sexual partners (6.6 for both). Unvaccinated participants were more likely to have been pregnant (20% vs 8.6%, P = .016), although this difference was not significant in multivariate analysis CI [0.902-5.177]. Specific questions regarding high-risk sexual behaviors and attitudes revealed no significant differences between the groups.ConclusionWe found that sexual behaviors, including high-risk behaviors, were similar between young women who had and had not received HPV vaccination. Our findings provide no support for suggestions that the vaccine is associated with increased sexual activity. Importantly, we found that young women in our population are sexually active at a young age and are engaged in high-risk behaviors, affirming the importance of early vaccination.     

未婚流动人口中性相关行为

目的:了解流动人口中未婚青年性相关行为的发生状况。方法:采用结构式匿名问卷对上海市长宁区新泾镇1 092名15-24周岁未婚流动人口的性与生殖健康知识、态度、行为和需求状况进行调查。结果:34.8％的男性和12.7％的女性报告有性经历,其中45.3％、33.9％的男性和34.2％、32.9％的女性已订婚和同居;22.7％的对象报告有过商业性行为(男:22.8％,女:22.4％);13.0％的对象在过去的一年内有2个及以上的性伴(男:13.5％,女:11.8％);分别有10.9％的对象曾强迫别人发生性交行为和被迫发生性交行为;仅7.3％的对象每次性生活时都使用避孕措施,21.1％的对象从未采取过避孕;41.7％的对象曾经怀孕或使其性伴怀孕(男:39.2％,女:47.4％);过去一年内有过生殖道感染/性病的人数比例为32.8％(男:30.4％,女:38.2％)。结论:未婚流动人口中婚前性行为较为普遍,他们中存在的商业性行为、强迫性行为和多性伴现象使他们面临着未婚妊娠、人工流产、性病和HIV感染等生殖健康问题的危险。     

Intimate partner sexual assault against women: frequency, health consequences, and treatment outcomes

OBJECTIVE: To describe the characteristics and consequences of sexual assault within intimate relationships specific to racial or ethnic group, compare the findings to a similar group of physically assaulted-only women, and measure the risk of reassault after victim contact with justice and health services. METHODS: A personal interview survey of 148 African-American, Hispanic, and white English- and Spanish-speaking abused women seeking a protection order. Extent of sexual assault, prevalence of rape-related sexually transmitted diseases and pregnancy, symptoms of posttraumatic stress disorder (PTSD) and depression, and risk of reassault after treatment were measured. RESULTS: Sixty-eight percent of the physically abused women reported sexual assault. Fifteen percent of the women attributed 1 or more sexually-transmitted diseases to sexual assault, and 20% of the women experienced a rape-related pregnancy. Sexually assaulted women reported significantly (P = .02) more PTSD symptoms compared with nonsexually assaulted women. One significant (P = .003) difference occurred between ethnic groups and PTSD scores. Regardless of sexual assault or no assault, Hispanic women reported significantly higher mean PTSD scores compared with African-American women (P = .005) and White women (P = .012). The risk of sexual reassault was decreased by 59% and 70% for women who contacted the police, or applied for a protection order, after the first sexual assault. Receiving medical care decreased the woman's risk of further sexual assault by 32%. CONCLUSION: Sexual assault is experienced by most physically abused women and associated with significantly higher levels of PTSD compared with women physically abused only. The risk of reassault is decreased if contact is made with health or justice agencies.     

Experiences of physical and sexual abuse and their implications for current health

OBJECTIVE: To estimate the prevalence of a history of physical and sexual abuse in adulthood among gynecological patients and the association with general and reproductive health. METHODS: A cross-sectional questionnaire study on abusive experiences of gynecologic outpatients in a tertiary hospital. The total sample size was 691. RESULTS: Of all women, 42.4% had experienced moderate or severe physical or sexual abuse as an adult. One hundred forty-seven (21.6%) women reported physical abuse, 84 (12.3%) sexual abuse, and 58 (8.5%) both. The abused and nonabused women did not differ in mean age, education, or parity. Sexually abused women and those who were both sexually and physically abused reported poor general health significantly more often (P=.005 and P=.001, respectively) than the nonabused. They also rated their sex life as significantly worse than the nonabused women (P=.002 and P=.012, respectively). Over half of abused women had experienced common physical complaints during the previous 12 months compared with one third of the nonabused (P<.001). Two thirds of both the abused and the nonabused women preferred that their gynecologist not ask directly about abuse. CONCLUSION: Abusive experiences were common in gynecologic outpatients. Women with abusive experiences had ill health and poor sexual life more often than the controls. In contrast to the results of previous studies, most of the women did not want to be asked about abuse by their gynecologist.     

Sexual Protective Strategies of Late Adolescent Females: More Than Just Condoms

OBJECTIVE: To identify the sexual protective strategies of late adolescent heterosexual women. DESIGN: Open-ended questioning regarding sexual protective strategies was included in a larger cross-sectional survey on sexual risk. Participants' responses were recorded verbatim and analyzed using content analysis. PARTICIPANTS: 234 African American, Hispanic/ Latina, and non-Hispanic white 19- to 21-year-old females were recruited from the driver's license records of a mid-Atlantic state. MAIN OUTCOME MEASURES: Participants responded to the open-ended question, "How or what do you do to reduce your risk for sexually transmitted diseases and HIV?" RESULTS: Seven primary sexual protective strategies were identified from participants' responses: using condoms, abstaining or postponing sexual intercourse, getting tested for human immunodeficiency virus (HIV) and sexually transmitted diseases (STDs), selecting safe partners, negotiating condom use, talking about sexual risk histories, and limiting the number of sexual partners. CONCLUSIONS: Some of the sexual protective strategies identified by study participants were less than effective and left young women vulnerable to infection with HIV and STDs. In addition, the use of these alternative strategies may leave young women feeling less at risk and thus less likely to use other more effective strategies such as condoms. The implications for nursing practice and the assessment of the sexual protective strategies of young heterosexual women are discussed.     

不同特征未婚流动人口性相关行为的发生状况

目的:了解流动人口中不同性别、年龄和职业的未婚青年性相关行为及其不良后果的发 生比例及其影响因素。方法:采用结构式匿名问卷对上海市某区1 092名15-24周岁未婚流动人 口的性与生殖健康知识、态度、行为和需求状况进行调查。结果:有22．6％的对象自我报告有性 经历(男:34．8％,女:12．7％)。分别有18．4％(男:26．3％,女:12．0％)和7．6％(男:11．8％,女:4．2％) 的对象已订婚和同居。有5．1％的对象报告有过商业性行为经历(男:7．9％,女:2．8％)。有2．8％ 的对象在过去的一年内有2个及以上的性伴(男:4．5％,女:1．5％)。9．4％的对象曾经怀孕或使其性 伴怀孕(男:13．7％,女:6．0％)。过去一年内有过生殖道感染／性病的人数比例为11．5％(男:14．9％, 女:8．7％)。分性别的多因素分析结果表明,年龄大、看过色情录像及受同伴的影响和压力较大的 男女对象发生婚前性行为的可能性较大。此外,问过父母性相关问题的男性及从事服务行业工作、 外出打工时间较长和对婚前性行为持开放态度的女性发生婚前性行为的可能性较大。结论:未婚 流动人口中婚前性行为较为普遍,尤其男性和服务行业女性的性相关行为的发生比例较高,他们 面临着未婚妊娠、人工流产、生殖道感染／性病等生殖健康问题的危险。     

Sexual behaviour, HIV-related knowledge and condom use by intra-city commercial bus drivers and motor park attendants in Lagos, Nigeria

A study was undertaken among 395 intra-city commercial bus drivers, conductors and motor park attendants in a sub-urban community in Lagos, Nigeria. It was aimed at ascertaining the level of knowledge of the participants on sexually transmitted diseases including AIDS, their sexual practices and perceived vulnerability to these diseases and, in particular, their attitude to and use of condoms. A semi-structured interview schedule was used for data collection. The men were found to have a strongly woven network of sexual relationships. Their sexual network included, apart from their wives and regular partners, commercial sex workers, young female hawkers, schoolgirls, and market women within and outside the motor parks. More than two thirds (74.3%) of the men had multiple sex partners and many of them had had sexually transmitted diseases at one time or another. Condom ever-use rate was 65.6% but consistent and regular use rate with casual partners was 11.6%. Almost all the respondents (96.4%) knew themselves to be at high risk of contracting STDs, while 87.6% felt that it was impossible for them to "catch" AIDS. Poor knowledge of risk factors for STDs was exhibited, as many of them attributed their previous STDs to excessive exposure to the sun, having sex in the sun, and their partners remaining in the bath for too long. Intra-city commercial bus operators and men at motor parks are a high risk group for acquiring HIV infection. Their sexual networking with a variety of women within and outside the parks also seems to suggest that they play a major role in transmitting HIV infection in urban communities in Nigeria. There is a need for intervention programmes with a focus on men at motor parks and similar high risk groups.     

The consequences of young people's sexuality

Women who engage in unsafe sexual intercourse may be at risk of unwanted pregnancy and/or infection with sexually transmitted diseases (STDs). In a study of male industrial workers and students in the Republic of Korea, 21% of the sexually experienced workers and 11% of the sexually experienced students reported having caused pregnancy in a female sex partner. Most of the pregnancies were aborted, but 13% of the workers and 11% of the students became fathers. 22% of the sexually experienced workers and 8% of the sexually experienced students reported having had a STD, and some reported having sexual intercourse while infected. In a survey of students in Ilorin, Nigeria, 13% of the males reported having caused pregnancy, of which 70% were aborted. 9% of the females surveyed reported being pregnant at least once, with 77% ending in abortion. 10% of the young women reported experiencing abnormal vaginal discharge during the year before the study. A study of young men and women in rural Thailand found that only slightly more than half of the male respondents with STDs sought medical care from a physician; others either bought medicines from pharmacies or received no treatment at all.     

Sexuell ��bertragene Erkrankungen

Sexually transmitted diseases (STDs) are all infectious diseases which can be transmitted by sexual contact. They can be subdivided empirically into the following categories: classical STDs, other STDs and sexually transmitted infections with diseases of other organs. The classical STDs syphilis, gonorrhea, chancroid ulcer and venereal lymphogranuloma now play a subordinate but still very important role due to the low incidence at central European latitudes. Some risk factors for sexually transmitted infections in women have now been identified and these are probably a reflection of the sexual life style as well as sex education. The spread of STDs can be significantly limited by the constant use of condoms and in this respect the education of children and adolescents on sexuality, genital diseases and sexual hygiene is a decisive factor.     

Prenatal Depressive Symptoms and Postpartum Sexual Risk Among Young Urban Women of Color

Study ObjectiveTo determine whether prenatal depressive symptoms are associated with postpartum sexual risk among young, urban women of color.DesignParticipants completed surveys during their second trimester of pregnancy and at 1 year postpartum. Depressive symptoms were measured using the Center for Epidemiologic Studies-Depression Scale, excluding somatic items because women were pregnant. Logistic and linear regression models adjusted for known predictors of sexual risk and baseline outcome variables were used to assess whether prenatal depressive symptoms make an independent contribution to sexual risk over time.SettingFourteen community health centers and hospitals in New York City.ParticipantsThe participants included 757 predominantly black and Latina (91%, n = 692) pregnant teens and young women aged 14-21 years.Interventions and Main Outcome MeasuresThe main outcome measures were number of sex partners, condom use, exposure to high-risk sex partners, diagnosis of a sexually transmitted disease, and repeat pregnancy.ResultsHigh levels of prenatal depressive symptoms were significantly associated with increased number of sex partners (β = 0.17; standard error, 0.08), decreased condom use (β = −7.16; standard error, 3.08), and greater likelihood of having had sex with a high-risk partner (odds ratio = 1.84; 95% confidence interval, 1.26-2.70), and repeat pregnancy (odds ratio = 1.72; 95% confidence interval, 1.09-2.72), among participants who were sexually active (all P < .05). Prenatal depressive symptoms were not associated with whether participants engaged in postpartum sexual activity or sexually transmitted disease incidence.ConclusionScreening and treatment for depression should be available routinely to women at risk for antenatal depression.     

Physical Abuse, Smoking, and Substance Use During Pregnancy: Prevalence, Interrelationships, and Effects on Birth Weight

Objective: To establish the singular and combined occurrence of physical abuse, smoking, and substance use (i.e., alcohol and illicit drugs) during pregnancy and its effect on birth weight.
Design: Prospective cohort analysis.
Setting: Urban public prenatal clinics.
Participants: 414 African American, 412 Hispanic, and 377 white pregnant women.
Main outcome Measure(s): Occurrence of physical abuse was 16%; smoking, 29-5%; and alcohol/illicit drug use, 11.9%. Significant relationships existed between physical abuse and smoking for African American and white women. For African American women, 33.7% of women who were not abused smoked, versus 49.5% of women who were abused (χ²= 8.21; df= 1; p < 0.005). Alcohol/illicit drug use was 20.8% for nonabused women compared with 42.1% for abused women (χ²= 18.18; df= 1 ;p < 0.001). For white women, 46.6% of women who were not abused smoked, versus 59.6% of those who were abused (χ²= 5.22; df= 1 ; p < 0.005). As a triad, physical abuse, smoking, and alcohol/ illicit drug use were significantly related to birth weight ( F [3,1040] = 30.19, p < 0.001).
Conclusions: Physical abuse during pregnancy is common, readily detected with a five-question screen, and associated with significantly higher use of tobacco, alcohol, and illicit drugs. Clinical protocols that integrate assessment and intervention for physical abuse, smoking, and substance use are essential for preventing further abuse and improving smoking and substance cessation rates.     

Sexual risk behaviour in women carriers of Mycoplasma hominis

Objective To study the sexual behaviour of women harbouring Mycoplasma hominis in the vagina. Setting Two family planning clinics and a youth clinic for contraceptive advice.
Methods The vaginal flora of 996 women were investigated microbiologically, including culturing for M. hominis from the posterior vaginal fornix. Cultures and tests were also made to diagnose genital Chlamydia trachomatis infections, gonorrhoea, genital herpes, cervical human papillomavirus infection, trichomoniasis, genital warts and human immunodeficiency virus. The sexual behaviour of these women was investigated by structured in-depth personal interviews.
Results Of the 996 women, 123 (12.3%) harboured M. hominis in the vagina. The remainder (87.7%), who had a negative M. hominis culture, served as a reference group. Those with M. hominis were significantly more likely to have had more than 10 partners during their lifetime, had a greater frequency of more than one sexual partner during the preceding month and the last six months, and reported more frequent experience of 'casual sex', including casual 'travel sex'. More of them also had experience of group sex and were more likely to have been sexually abused than the women in the reference group. Fewer women with M. hominis had a current steady partner and were less often cohabitors, but more had had sexual intercourse during the previous week than those in the reference group. There was an association between the occurrence of M. hominis and bacterial vaginosis and genital chlamydia1 infection. Adjustment in multifactorial regression analyses therefore changed the results only marginally.
Conclusions Women with M. hominis have almost the same sexual risk behaviour as women with classic sexually transmitted diseases.     

The Interrelationships Between Abuse, Substance Use, and Psychosocial Stress During Pregnancy

Objective: To describe the association between abuse during pregnancy and substance use and psychosocial stress.
Design: Prospective study of pregnant women.
Setting: Urban prenatal clinics.
Participants: 1,937 predominately low-income, ethnically diverse women.
Main Outcome Measures(s): Three questions from the Abuse Assessment Screen were used to measure abuse. For the total sample, 25.7% reported physical abuse in the past year, 10.5% physical abuse since pregnancy, and 4.5% sexual abuse in the past year. Adolescents were significantly more likely to report any abuse (37.6%) than were adults (22.6%) (chi-square = 44.94; df = 1; p < 0.001). White abused women were significantly more likely to report use of tobacco (chi-square = 17.34; df = 1; p < 0.001) and alcohol (chi-square = 5.65; df = 1, p < 0.01). Abused Asian women were more likely to smoke (chi-square = 12.13; df = 1, p < 0.001), as were women ethnically described as "other" (chi-square = 8.39; df = 1, p < 0.001). There was a higher, but not statistically significant, rate of substance use between abused and nonabused African-American, Native-American, and Hispanic women. Abused women of all races reported higher stress, less support from partners, less support from others, and lower self-esteem.
Conclusions: Abuse during pregnancy is associated with an increased incidence of substance use and psychosocial stress. These relationships must be incorporated into the clinical care of abused pregnant women.     

Alcohol and drug abuse and risky sexual behaviours in young adult women

Objective: To assess alcohol abuse as a predictor of risky sexual behavior among adolescents and young adult women, a high-risk population for unintended pregnancies.

Subjects: Totally 3163 adolescent and young adult women, 18–29 years, were assessed on sociodemographics, alcohol and drug use and risky sexual behaviors.

Interventions: Participants answered a structured questionnaire on their leisure habits, drug and alcohol consumption, contraception and sexual behaviors.

Results: Most of the young adult women perceive that sexuality is an important part of their life but not a main concern (77.6%) and that alcohol removes the barriers to have sex (62.3%). Additionally, 77.0% claimed that contraception had “a lot” (53.4%) and “quite” (23.6%) influence on the quality of their sexuality. However, up to a 38.4% of the interviewed women had had sex without using any contraception and 29.6% of them acknowledged that had taken alcohol and of these, 40.7% said that alcohol was responsible for not using contraception. Alcohol abuse predicted an increase in risky sexual behaviours (4.45 CI: 2.01–9.75, p?Conclusions: These findings suggest that contraception-related behavioural interventions for young adult women should discuss the link between alcohol and sexual risk behavior.     

Sexual function,sexual abuse and sexually transmitted diseases in adolescence

As adolescents progress through puberty, many biological changes occur and, for young women, this includes the onset of menses and the capability for reproduction. During this time, sexual identity is developed and expressions of sexuality become more frequent. Adolescent women engage in a variety of sexual behaviours, both non-coital and coital. As teens begin dating relationships, they are at risk for dating violence and sexual abuse. Some may even be raped after sedation with a 'date rape' drug. As adolescents attempt to develop intimate sexual relationships, they may be at high risk for health consequences associated with sexual activity, such as pregnancy and sexually transmitted diseases (STDs). Providers, such as physicians, nurse practitioners, physician assistants and nurses, must know current STD diagnosis and treatment recommendations to decrease morbidity caused by these infections. By knowing how to interview, understanding legal issues and anticipating concerns pertinent to teens, providers have the opportunity to decrease barriers to health care for adolescents.