Age of sexual debut among US adolescents

Background

This study examined gender and racial/ethnic differences in sexual debut.

Study Design

We analyzed 1999-2007 data from the Youth Risk Behavior Surveillance System (YRBSS), a cross-sectional, nationally representative survey of students in Grades 9-12 established by the Centers for Disease Control and Prevention. The Kaplan-Meier method was used to compute the probability of survival (not having become sexually active) at each year (age 12 through 17), and separate estimates were produced for each level of gender and racial/ethnic group.

Results

African-American males experienced sexual debut earlier than all other groups (all tests of significance at p<.001) and Asian males and females experienced sexual debut later than all groups (all tests of significance at p<.001). By their 17th birthday, the probability for sexual debut was less than 35% for Asians (females 28%, males 33%) and less than 60% for Caucasians (58% females, 53% males) and Hispanic females (59%). The probability for sexual debut by their 17th birthday was greatest for African Americans (74% females, 82% males) and Hispanic males (69%).

Conclusions

These results demonstrate a need for sexual education programs and policy to be sensitive to the roles of race and ethnicity in sexual debut.     

中国北方两城市青少年健康危险行为多发特点分析

目的了解城市青少年健康危险行为的多发特点。方法典型抽取北京、济南两城市7230名大中学生进行无记名式问卷调查,比较不同年级、家庭结构和学习成绩学生10种主要健康危险行为多发情况。结果33.3%学生无任何健康危险行为,男生、大学生、单亲/重组家庭和成绩差的学生中健康危险行为多发现象比较突出。随年级增高,步行违规、斗殴、自杀等伤害相关行为逐渐被吸烟、饮酒等物质成瘾性行为取代。与具有一种健康危险行为学生相比,具有四种及以上健康危险行为的学生中吸烟、不健康减肥、网络成瘾发生率大幅增加,可作为青少年学生标志性的健康危险行为。结论青少年健康危险行为多发现象与年龄、家庭结构和学习成绩有关,应针对行为多发特点,在青少年中开展综合性行为干预。     

避孕节育干预项目对上海市流动人口避孕行为的影响

目的:通过对避孕节育干预项目对上海市闵行区流动人口避孕行为的影响分析,为探讨流动人口避孕节育行为干预模式提供依据。方法:多阶段随机整群抽取上海市闵行区流动人口相对集中的工厂、建筑工地、服务娱乐场所,分干预组和对照组,通过倡导、动员、管理、培训、宣传教育、咨询服务、技术服务、随访服务、转诊机制等干预措施对研究对象进行干预。应用卡方检验及有序多分类Logistic回归分析方法对其影响进行分析。结果:1 791名研究对象中,采用避孕方法的占94.26%,干预组与对照组避孕方法使用比例差异无统计学意义。研究期间,干预组婚姻状况发生变化者避孕方法的使用率为100%(共51人),高于对照组(42.05%)。评估调查时干预组避孕方法由本人和双方决定的比例略有升高(干预前28.89%,干预后33.52%),但多因素Logistic回归分析未发现干预对避孕方法的决定者有统计学意义,OR为1.226(P=0.0662),95%可信区间为0.986~1.523。多因素分析发现学历高的对象,自主选择避孕方法的能力较强。结论:干预项目取得了一定的效果,提高了避孕方法的使用率和自主选择避孕方法的能力,但今后还应加强对学历低、收入低的流动人口的干预和服务。     

Relationship between physical disabilities or long-term health problems and health risk behaviors or conditions among US high school students

BACKGROUND: This study explores the relationship between self-reported physical disabilities or long-term health problems and health risk behaviors or adverse health conditions (self-reported engagement in violent behaviors, attempted suicide, cigarette smoking, alcohol and other drug use, sexual activity, physical activity, dietary behaviors, self-reported overweight [based on height and weight], physical health, and mental health) among US high school students. METHODS: Data were from the Centers for Disease Control and Prevention's 2005 national Youth Risk Behavior Survey, a cross-sectional paper-and-pencil survey collected from a representative sample of public and private high school students (grades 9 through 12) in the United States. RESULTS: Significantly more students with physical disabilities or long-term health problems than without described their health as fair or poor and reported being in a physical fight, being forced to have sexual intercourse, feeling sad or hopeless, seriously considering and attempting suicide, cigarette smoking, using alcohol and marijuana, engaging in sexual activity, using computers 3 or more hours per day, and being overweight (for all, p < or = .05). For none of the health risk behaviors analyzed were the rates significantly lower among students with physical disabilities or long-term health problems than among other students. CONCLUSIONS: Young people who live with physical disabilities or long-term health problems may be at greater risk for poor health outcomes. Public health and school health programs, with guidance from health care providers, need to work with these adolescents and their families to develop and implement appropriate interventions, with particular emphasis on promoting mental health.     

Self-reported health risk behaviors among adolescents in Luang Namtha province of Lao PDR: Prevalence and determinants

The purpose of this study was to assess self-reported prevalence of alcohol, tobacco, and drug use, and sexual risk behaviors, as well as to identify sources of sex education and individual, family, and peer factors that might influence adolescents’ health risk behaviors (HRB). In a community-based, cross-sectional study, 1360 adolescents aged 14–19 years were interviewed from June to September 2008 in Luang Namtha province. Multistage systematic random sampling was used to select participants. Logistic regression was used to identify the determinants of single HRB. Alcohol and tobacco use, and sexual risk behaviors were common. Just under half (42.5%) used alcohol, 9.6% smoked during the past 30 days, and 1.4% had used amphetamine during their lifetime, and 19.6% had ever had sex. Of those, 58.8% were currently sexually active, 40.1% reported having two or more sexual partners, and 34.5% had used a condom during last sexual intercourse. The mean age at sexual debut was 15.3 years for boys and 15.1 years for girls. Khamu ethnicity, not attending school, and peers’ drinking, smoking, and using drugs were significant determinants of current alcohol use, whereas being male, not attending school, Khamu ethnicity, and peers’ smoking and using drugs predicted current smoking. Being male, younger age, Akha ethnicity, having low level of education, peers’ smoking, being sexually active, and being pregnant or having made someone pregnant were significantly associated with ever having sex, whereas being male, Akha and Khamu ethnicities, peers’ smoking, drinking alcohol, and being sexually active were correlated with sexual risk behaviors. Individual and socio-demographic background factors as well as peer influence are determinants of risk behaviors. Thus, efforts should be made to keep adolescents in school, particularly until secondary school, and increase school connectedness.     

Risk factors for self-report of not receiving an HIV test among adolescents in NYC with a history of sexual intercourse, 2013 YRBS

The Centers for Disease Control and Prevention has previously recommended that all adolescents undergo HIV testing in the United States (US). Despite these recommendations, national HIV testing among US adolescents has remained low. This study estimated the prevalence of and identified risk factors for not receiving an HIV test among adolescents with a history of sexual intercourse in New York City (NYC), an urban area that has been greatly impacted by the HIV epidemic. Cross-sectional data on 1199 NYC high school students who completed the 2013 NYC Youth Risk Behavior Survey were used. Modified Poisson regression models were used to assess whether demographic factors, alcohol/drug use and sexual behaviors were associated with self-report of lack of HIV testing. In the weighted study population, about 72% were ≥16 years old, approximately 35% were African-American and nearly half were male. Sixty percent reported no history of HIV testing. In adjusted analyses, younger age, male gender, White race/ethnicity, heroin use, as well as reporting one prior sexual partner, were significantly and positively associated with no prior history of HIV testing. Our findings suggest that among NYC adolescents with a history of sexual intercourse, the prevalence of HIV testing is low. HIV testing may have been low in part because of limited experience with current screening guidelines among clinicians. Furthermore, many of the adolescents identified as being more likely to not be tested may have not been screened because of inadequate knowledge about HIV, a low perceived HIV risk or an unstable lifestyle. Therefore, to increase HIV testing among NYC adolescents, interventions that enhance HIV knowledge among adolescents as well as interventions that promote review and application of current screening guidelines among clinicians should be implemented in NYC. Educational interventions should especially be targeted at the adolescents identified in this study.     

Misalignment of sexual and reproductive health priorities among older Latino adolescents and their mothers

Objective

The study describes maternal and adolescent perspectives on sexual decision making and the role of mothers in shaping use of contraception for the prevention of unplanned pregnancies and sexually transmitted infections (STIs) among older Latino adolescents.

Predicting health behaviors with an experimental measure of risk preference

We conduct a large-scale economics experiment paired with a survey to examine the association between individual risk preference and health-related behaviors among adults aged 18-87 years. Risk preference is measured by the lottery choice experiment designed by Holt and Laury [Holt, C.A., Laury, S.K., 2002. Risk aversion and incentive effects. The American Economic Review 92(5), 1644-1655]. Controlling for subject demographic and economic characteristics, we find that risk aversion is negatively and significantly associated with cigarette smoking, heavy drinking, being overweight or obese, and seat belt non-use. In additional specifications, we find that risk aversion is negatively and significantly associated with the likelihood a subject engaged in any of five risky behaviors and the number of risky behaviors reported.     

不同性别大学生健康危险行为现状及影响因素研究

目的 了解大学生健康危险行为现状及影响因素,促进大学生健康发展.方法 采用分层随机抽样的方法,对5所高校的2 510名大学生进行问卷调查,利用SPSS 25.0统计软件进行统计描述、x2检验和logistic回归分析.结果 男生健康危险行为发生率均高于女生:饮酒(81.99％/34.57％)、通宵上网(47.24％/2...     

Relationship between number of sexual intercourse partners and selected health risk behaviors among public high school adolescents.

PURPOSE: To examine the relationship between number of sexual partners and selected health risk behaviors in a statewide sample of public high school students. METHODS: The Centers for Disease Control and Prevention Youth Risk Behavior Survey was used to secure usable sexual risk-taking, substance use, and violence/aggression data from 3805 respondents. Because simple polychotomous logistic regression analysis revealed a significant Race x Gender interaction, subsequent multivariate models were constructed separately for each race-gender group. Odds ratios and 95% confidence intervals was calculated from polychotomous logistic regression models for number of sexual intercourse partners and their potential risk behavior correlates. RESULTS: An increased number of sexual intercourse partners were correlated with a cluster of risk behaviors that place adolescents at risk for unintended pregnancy, human immunodeficiency virus/acquired immunodeficiency syndrome, and other sexually transmitted infections. For Black females, alcohol, tobacco, marijuana use, and dating violence behaviors were the strongest predictors of an increased number of sexual partners; white females had similar predictors with the addition of physical fighting. For white males, alcohol, tobacco, marijuana use, physical fighting, carrying weapons, and dating violence were the strongest predictors of an increased number of sexual intercourse partners. Black males had similar predictors with the addition of binge alcohol use. CONCLUSION: Prevention of adolescent sexual and other health risk behaviors calls for creative approaches in school and community settings and will require long-term intervention strategies focused on adolescent behavior changes and environmental modifications.     

Online dating and mating: Perceptions of risk and health among online users

In this paper, we examine the behaviours and experiences of people who use online dating and how they may or may not address risk in their use of online dating. Fifteen people who used online dating took part in in-depth, online chat interviews. We found that online daters use a variety of methods for managing and understanding the risks they perceived to be associated with online dating. Online daters compared the risks of online dating with other activities in their lives to justify their use of the medium. Many felt self-confident in their personal ability to manage and limit any risks they might encounter and, for some, the ability to be able to scapegoat risk (that is to blame others) was a method by which they could contextualize their own experiences and support their own risk strategies. For many, the control offered by the online environment was central to risk management. Additionally, the social context in which an individual encountered a potential risk would shape how they perceived the risk and responded to it. People who use online dating do consider the risks involved and they demonstrate personal autonomy in their risk management. From a public health perspective, it is important to understand how risk is experienced from an individual perspective, but it is imperative that any interventions are implemented at a population level.     

Contraceptive use at last intercourse among reproductive-aged women with disabilities: an analysis of population-based data from seven states

Objective

To assess patterns of contraceptive use at last intercourse among women with physical or cognitive disabilities compared to women without disabilities.

重庆市大学生亚健康症状与健康危险行为研究

目的:研究重庆市大学生亚健康的现状及其健康危险行为因素,为大学生保健工作提供科学依据。方法:应用分层整群随机抽样的方法抽取重庆市三所大学1903名大学生进行一般情况、自编青少年亚健康危险行为因素调查问卷和《青少年亚健康多维评定问卷》调查。结果:重庆市大学生亚健康症状的检出率为42.8%。女生亚健康症状检出率高于男生(P<0.05);低年级大学生心理亚健康症状检出率高于大三年级(P<0.05);师范类学生亚健康症状检出率高于医学类和理工类学生(P<0.05);学习压力较高者亚健康症状检出率高于压力一般和较低者(P<0.05);睡眠时间小于八小时的大学生亚健康症状检出率高于睡眠时间大于等于八小时的大学生(P<0.05)。影响大学生亚健康症状的主要危险行为因素有偏食行为、无大强度运动行为、无小强度运动行为、非故意伤害行为、故意伤害行为、自杀行为、滥用药物行为和网络成瘾行为等。结论:大学生亚健康症状检出率较高,与多种健康危险行为因素有关,相关部门应该区别对待进行干预,提高大学生的健康水平。     

广州市男男性行为人群性感觉寻求与高危性行为的关联

目的  分析广州市男男性行为人群(men who have sex with men,MSM)性感觉寻求与高危性行为的关联。 方法  2017年6月-2018年4月,通过智同公益服务中心友同门诊招募年龄18岁及以上的MSM。采用自行设计的电子问卷收集一般人口学特征、性行为特征、高危性行为和性感觉寻求等信息。采用非条件Logistic回归分析多性伴、一夜情和无保护肛交与性感觉寻求的关联。 结果  500名调查对象平均年龄(27.77±5.96)岁。调整了一般人口学特征与性行为特征后,多因素Logistic回归分析结果显示高性感觉寻求得分的MSM发生多性伴(OR=2.05,95%CI：1.40~2.30,P < 0.001),一夜情(OR=2.11,95%CI：1.44~3.09,P < 0.001)和无保护肛交(OR=1.70,95%CI：1.16~2.50,P=0.007)的风险高于低性感觉寻求者。 结论  广州市MSM高性感觉寻求者更可能发生高危性行为,在制定行为干预措施时应该考虑性感觉寻求的影响,以提高艾滋病干预的效果。     

贵州省农村初中生健康危险行为共存模式及影响因素分析

目的 了解贵州省农村初中生健康危险行为共存模式及影响因素。方法 采用多阶段分层随机整群抽样方法抽取贵州省5个市（州）的4 452名农村初中生进行问卷调查。结果 贵州省农村初中生健康危险行为共存模式分为暴力与自杀意念共存模式组（15.1%）、偏食与自伤行为共存模式组（49.1%）、失眠与孤独感共存模式组（2.9%）、低风险组（32.9%）4个组别。无序多分类logistic回归分析发现,遭受家庭暴力（OR = 8.746, 95%CI:5.507～13.889）、学业压力较大（OR = 3.024, 95%CI: 2.083～4.389）等因素是暴力与自杀意念共存模式组的危险因素,学业压力较大（OR = 2.687, 95%CI: 2.032～3.553）、亲子关系较差（OR = 2.515, 95%CI:1.508～4.195）等因素是偏食与自伤行为共存模式组的危险因素,学业压力较大（OR = 5.308, 95%CI:2.514～11.208）、同伴关系较差（OR = 4.719, 95%CI:2.094～10.639）等因素是失眠与孤独感共存模式组的危险因素（P值均＜0.05）。结论 贵州省农村初中生健康危险行为共存模式特征明显并受多种因素影响。