Perceptions of the benefits and costs associated with condom use and unprotected sex among late adolescent college students

To assess the differential effects of the perceived benefits and costs associated with both condom use and unprotected sex on sexual risk behaviors, data were collected from 704 ethnically diverse male and female sexually experienced late adolescent college students (aged 17-25). Perceived benefits and costs for condom use and perceived benefits and costs for unprotected sex were measured separately through an anonymous self-report survey. In addition, participants completed measures of self-efficacy for practicing safer sex and temptation for unsafe sex in various situations, and three measures of sexual risk-taking (stage of change for condom use, consistency of condom use during the past month, and whether or not a condom was used for the last act of intercourse). Univariate analyses indicated that benefits and costs of condom use, benefits of unprotected sex, self-efficacy and situational temptation were all related to sexual risk-taking. Gender differences were identified, with females reporting more benefits of condom use and costs of unprotected sex, fewer benefits of unprotected sex and costs of condom use, greater self-efficacy for practicing safer sex, and less situational temptation for unsafe sex. Multivariate analyses indicated that sexual risk behaviors were most related to situational temptation, self-efficacy for safer sex, and perceived benefits of unprotected sex. The results suggest that, among late adolescents, perceived benefits of the unhealthy behavior (unprotected sex) were better determinants of sexual risk-taking than were perceived benefits (or costs) associated with the healthy behavior (condom use). Perceived costs associated with unprotected sex were unrelated to sexual behaviors. These findings support previous work identifying adolescents as more driven by their perceptions of the positive benefits associated with risky behaviors, rather than knowledge of the costs or dangers involved in risk-taking.     

Correlates of inconsistent condom use among youth aged 18–24 years in South Africa

This paper examines the correlates of inconsistent condom use with most recent sexual partner among sexually experienced youth (N = 2 138) in South Africa. A cross-sectional population based survey with youth aged 18 to 24 years was conducted in 4 provinces (Eastern Cape, Gauteng, KwaZulu-Natal and Mpumalanga). More women than men (57.7% vs. 25.8%) reported inconsistent condom use with their most recent partner. Multivariate analysis indicated that for males, not having talked with a partner about condoms in the past 12 months, having 2 or more sexual partners in the past 12 months, having ever had a transactional sex partner and alcohol use before sex in the past 3 months were associated with inconsistent condom use with their most recent sexual partner. In females multivariate analysis showed that lack of self-efficacy, not having talked with a partner about condoms in the past 12 months, having ever had or been subjected to forced sex and hazardous or harmful alcohol use were found to be associated with inconsistent condom use with their most recent sexual partner in multivariate analysis.     

Self-cutting and sexual risk among adolescents in intensive psychiatric treatment

The purpose of this study was to identify the relationships between self-cutting, sexual abuse, and psychological variables in predicting infrequent condom use among 293 adolescents in intensive psychiatric treatment. Logistic regression analyses indicated that being female, being Caucasian, having been sexually abused, and reporting less impulse control were predictive of self-cutting. Further analysis found that those who self-cut were three and a half times more likely to report infrequent condom use than those who did not self-cut, even after the analysis controlled for sexual abuse history and HIV prevention self-efficacy. Self-cutting is strongly associated with sexual risk behaviors, and adolescents who engage in self-cutting should be assessed carefully for sexual risk behaviors.     

Impact of sexual abuse on the HIV-risk-related behavior of adolescents in intensive psychiatric treatment

OBJECTIVE: This study compared the HIV-risk-related behaviors and attitudes of adolescents with and without a history of sexual abuse who were in intensive psychiatric treatment. METHOD: Adolescent patients (N=208) completed measures of psychological functioning and HIV-related knowledge, attitudes, and behaviors. RESULTS: Among sexually active adolescents in psychiatric treatment (N=116), those with a history of abuse reported significantly less condom self-efficacy (emotional ability to use condoms), less knowledge of HIV, less impulse control, less frequent use and purchase of condoms, and significantly higher rates of sexually transmitted diseases than their peers. Multiple logistic regression indicated that a history of sexual abuse was strongly associated with inconsistent condom use. CONCLUSIONS: Sexual abuse was associated with HIV-risk-related attitudes and behaviors among adolescents in psychiatric treatment. Clinicians should thus view a history of sexual abuse as a marker for sexual behavior that puts adolescents at risk for HIV.     

Do parents and peers matter? A prospective socio-ecological examination of substance use and sexual risk among African American youth

We examined the direct contribution of parent and peer risk and promotive factors on youth condom use trajectories, in addition to the indirect influence of these factors via youth’s substance use over four years in a sample of urban, African American youth (N = 679; 51% female; M = 14.86 years; SD = 0.65). Growth curve modeling was used to estimate changes in substance use and sexual risk across adolescence and test their association with parent and peer factors. Parent and peer risk factors were strongly associated with increasing substance use as youth aged. Substance use and condom use were interrelated. Parent and peer risk factors were indirectly associated with youth condom use; parent and peer promotive factors were directly associated with condom use, after accounting for substance use. Findings suggest the value of considering multiple influences on youth risk behavior.     

Religiosity and sexual risk-taking behavior during the transition to college

The degree to which religious identity acts as a protective buffer against sexual risk-taking in late adolescence was investigated in 230 first-year college students. Allport and Ross' Religious Orientation Scale was used to examine the relationship between religiosity, and sexual activity and condom use. Results indicate that greater intrinsic and extrinsic religiosity were associated with less sexual activity and condom use. Therefore religious identification may protect against initiating sexual activity among late adolescents, but may fail to protect against practicing unsafe sex among students who are already sexually active.     

Gender differences in the perceived self-efficacy of safer HIV practices among polydrug abusers in Taiwan

Studies have documented that the perceived self-efficacy of attempts to engage in safer behavior is critical for the prevention of blood-borne diseases, including hepatitis C and HIV. The aim of this study was to examine gender differences in the perceived self-efficacy of safer HIV-related behavior among heroin and amphetamine abusers. Of the eligible participants from Taiwan prisons, 1622 polydrug users voluntarily agreed to complete a questionnaire regarding HIV risks. Participants had to be polydrug abusers (amphetamines and heroin), 18 years or older, sexually experienced, and literate. The questionnaire addressed background information, drug abuse, sexual behavior, and perceived self-efficacy in drug- and sex-related HIV risk situations. Twenty-four percent of respondents were HIV positive. Compared to men, women started illicit drug use at a younger age and were less likely to share syringes. Women also tended to have their first sexual coitus at an older age and were less likely to use a condom in their last sexual encounter. Men were more likely to have multiple sexual partners in the past 6 months. Results from a multinomial logistic regression indicate that gender, age, their interaction, age of first sexual encounter, HIV knowledge, condom use at last sexual encounter, and multiple sexual partners were associated with perceived self-efficacy of condom use. Results also show that gender, HIV serostatus, HIV knowledge, condom use at last sexual encounter, and sharing needles at last injection were associated with perceived self-efficacy in not sharing needles. The findings provide evidence for gender differences among polydrug abusers in Taiwan regarding perceived self-efficacy in adopting HIV prevention practices. Findings also provide evidence that knowledge about HIV transmission is related to perceived self-efficacy in promoting safe behavior. To raise polydrug abusers' perceived self-efficacy, gender and HIV/AIDS education must be taken into consideration in counseling and/or public health education related to HIV prevention for drug abusers.     

Effects of gender,media influences,and traditional gender role orientation on disordered eating and appearance concerns among Latino adolescents

This study examined the main and interaction effects of gender, traditional gender role orientation, and media-influenced sociocultural values and ideals about appearance in a sample of 96 Latino adolescents controlling for age, country of origin, and BMI. Girls and less traditionally oriented youth reported significantly more disordered eating and appearance concerns than did boys and more traditionally oriented youth. Gender moderated the relationship between traditional gender role orientation and disordered eating and appearance concerns. Contrary to our hypothesis, media-influenced sociocultural values and ideals about appearance did not significantly predict disordered eating and appearance concerns. However, the interaction between gender and sociocultural values and ideals about appearance was significant. Our findings highlight the importance of continued research on gender, media, and cultural influences as they relate to disordered eating and appearance concerns among Latino youth.     

Working to Promote Resilience with Latino Youth in Schools: Perspectives from the United States and Mexico

Throughout the Americas large numbers of children and adolescents would benefit from some type of mental health intervention. For many, however, traditional mental health approaches are culturally dystonic and fail to incorporate the child's cultural worldview, the result being that Latino young people use mental health facilities less than they might. Intervention with Latino young people requires consideration of contextual factors and accounts for the significant stigma associated with seeking mental health treatment. School-based mental health services attempt to decrease the gap between need and underutilization by providing support for Latino young people in a key area of access – the schools. This paper focuses on the provision of mental health services to Latino youth in the United States (US) and Mexico. Factors associated with risk and resilience are discussed as are ways to provide culturally syntonic school-based mental health to US Latino and Mexican youth.     

HIV Risk Reduction for Substance Using Seriously Mentally Ill Adults: Test of the Information-Motivation-Behavior Skills (IMB) Model

The information-motivation-behavioral skills (IMB) model (Fisher & Fisher, 1992) was used as the theoretical framework for predicting unprotected sexual behavior among substance abusing men and women diagnosed with serious mental illnesses (n = 320; 150 men and 170 women, primarily of minority ethnicity). In a structural equation model, gender, HIV transmission knowledge, and motivational variables of pro-condom norms and attitudes, and perceived susceptibility predicted behavioral skills markers: condom use skills and condom use self-efficacy. Along with the other variables in the model, condom skills and condom self-efficacy were hypothesized to predict condom use over a six-month period. Results showed that greater condom skills were predicted by female gender, positive condom attitudes, and transmission knowledge. Engaging in lower rates of unprotected sex was predicted by pro-condom norms, less perceived susceptibility, and greater condom self-efficacy. Positive attitudes toward condoms had a significant indirect effect on rates of unprotected sex, exerting its influence through condom use self-efficacy. Results suggest that changing personal attitudes about condoms and reinforcing pro-condom attitudes among significant others will encourage condom use among seriously mentally ill (SMI) adults who are at high risk for HIV and other sexually transmitted diseases (STDs).     

Family orientation, language, and anxiety among low-income Latino youth

There is emerging evidence that Latino youth report higher levels of anxiety symptoms than children from other ethnic groups. Although often implicated, cultural variables have not been systematically evaluated to determine their relationship to anxiety symptoms in Latino youth. The present study examined family orientation values, as measured by family obligation and affiliative obedience, and their relationship to youth anxiety symptoms. The sample consisted of 133 Latino students (grades 5th through 7th) of low-income backgrounds in an urban public school setting. Structural equation models revealed that higher family orientation was associated with separation anxiety/panic (β=.32) and harm avoidance (β=.51). Models employing language proficiency and use mirrored those employing family orientation, suggesting that language fluency captures, in part, family socialization values. The results provide support for the impact of culture in the assessment and specific needs of Latino youth with anxiety problems.     

Brief report: sexual sensation seeking and its relationship to risky sexual behaviour among African-American adolescent females

The relationship between sexual sensation seeking and sexual risk taking has been investigated among adult populations. There are limited data, however, regarding this relationship for adolescents. Since African-American adolescent females continue to be disproportionately diagnosed with STDs, including HIV, we examined this association among a clinic-based sample of African-American adolescent females (N=715) enrolled in an STD/HIV prevention intervention. Participants (ages 15-21) endorsing higher levels of sexual sensation seeking reported higher levels of sexual risk-taking behaviours (e.g. frequency of vaginal intercourse, number of sexual partners, and poorer condom use). Results remained significant after controlling for known covariates associated with sexual risk-taking behaviours. Results are consistent with the adult literature and highlight the need for future investigations examining sexual sensation seeking among adolescents. These results, though preliminary, could be used to better inform prevention interventions and clinicians/health educators who provide direct services to adolescents.     

Structural Stigma and Cigarette Smoking in a Prospective Cohort Study of Sexual Minority and Heterosexual Youth

Background

Sexual minority youth are more likely to smoke cigarettes than heterosexuals, but research into the determinants of these disparities is lacking.

Purpose

This study aimed to examine whether exposure to structural stigma predicts cigarette smoking in sexual minority youth.

Methods

Prospective data from adolescents participating in the Growing Up Today Study (2000–2005) were utilized.

Results

Among sexual minority youth, living in low structural stigma states (e.g., states with non-discrimination policies inclusive of sexual orientation) was associated with a lower risk of cigarette smoking after adjustment for individual-level risk factors (relative risk [RR]?=?0.97; 95 % confidence interval [CI], 0.96, 0.99; p?=?0.02). This association was marginally significant after additional controls for potential state-level confounders (RR?=?0.97; 95 % CI, 0.93, 1.00; p?=?0.06). In contrast, among heterosexual youth, structural stigma was not associated with past-year smoking rates, documenting specificity of these effects to sexual minority youth.

Conclusions

Structural stigma represents a potential risk factor for cigarette smoking among sexual minority adolescents.     

Online or off-line victimisation and psychological well-being: a comparison of sexual-minority and heterosexual youth

The purpose of this study was to compare sexual-minority and heterosexual youths' exposure to sexual abuse off-line, problematic sexual meetings off-line with person/s met online and online harassment with regard to prevalence, psychological well-being and support seeking. A nationally representative sample of 3,432 Swedish high school seniors completed an anonymous school-based survey about sexuality, health, sexual abuse and online-related sexual victimisation or harassment. Sexual-minority adolescents reported a greater rate of sexual abuse, problematic sexual meetings off-line with person/s met online and online harassment, compared to heterosexual youth. When compared to non-victimised heterosexual adolescents, victimised heterosexual adolescents and non-victimised and victimised sexual-minority adolescents reported more psychiatric symptoms, lower self-esteem and a weaker sense of coherence. Same-sex sexual orientation was related to more psychiatric symptoms, lower self-esteem and a weaker sense of coherence even when controlled for victimisation and gender. Compared to victimised heterosexual adolescents, victimised sexual-minority adolescents were more likely to seek support because of sexual abuse (females) or Internet-related problems (males and females). Results for sexual-minority youth were basically the same whether sexual orientation was assessed as sexual identity or as sexual or emotional attraction. Health care providers are challenged to not only provide the same care to sexual-minority youth who seek counselling or psychiatric treatment for mental health problems or problems related to victimisation that all adolescents should receive but also to find ways to address topics like prevention of sexual abuse and risk-taking behaviour online or off-line.     

Factors associated with substance use among orphaned and non-orphaned youth in South Africa

Substance use is increasing among youth in South Africa, and may be contributing to transmission of HIV. As parental death often leaves youth with altered emotional and physical resources, substance use may be greater among orphaned adolescents. Utilizing data from a household survey of 15-24 year old South Africans (n?=?11,904), multivariable models were fitted to examine the association of factors from five domains with alcohol and drug use, and to compare substance use among orphaned versus non-orphaned youth. Results showed that factors from individual, family, and community domains were most associated with substance use. Compared with non-orphans, paternal and double orphaned males were more likely to have consumed alcohol, and paternally orphaned females had significantly greater odds of having used drugs. Findings confirm that some sub-groups of orphaned youth are at increased risk of substance use and families and communities may be influential in moderating this risky behavior.     

Moving the prevention timeline: A scoping review of the literature on precursors to sexual risk in early adolescence among youth of color

IntroductionSexual 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.MethodsThis 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.ResultsThe 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.ConclusionsEtiologic 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.     

Sexual attraction and experiences in the primary care setting: Examining disparities in satisfaction with provider and health self-efficacy

IntroductionTo test whether sexual minority males and females report lower satisfaction with primary care providers and lower health self-efficacy relative to heterosexual males and females.MethodsData from 535 adolescents who participated in one of two randomized clinical trials conducted in a primary care setting were analyzed. Multiple linear regressions controlling for demographic characteristics and treatment condition were used to examine sexual attraction differences in indicators of satisfaction with provider and health self-efficacy.ResultsSexual minority and heterosexual youth both endorsed high satisfaction with providers. Relative to heterosexual males, sexual minority males reported lower self-efficacy in reaching their health goals. Relative to heterosexual females, sexual minority females reported lower confidence in positively impacting their own health, and lower self-efficacy in setting goals and working actively to improve their health.ConclusionsSexual minority youth may benefit from additional support from health care providers to enhance their health self-efficacy and reach their health goals.     

Mechanisms linking violence exposure to health risk behavior in adolescence: motivation to cope and sensation seeking

OBJECTIVE: This study examined two potential mechanisms linking violence exposure and health risk behavior among adolescents in psychiatric care: sensation seeking and coping with stress through escape behavior. METHOD: Male (59%) and female adolescents (N = 251), ages 12 to 19 years, from diverse ethnic backgrounds (61% African American, 19% white, 12% Latino, 8% biracial or other ethnicity) completed a computer-administered survey assessing study variables from 1999-2004. Overall clinic consent rate was 41%. Age and gender were included in all analyses. RESULTS: Consistent with the literature on nonpsychiatric samples, violence exposure was associated with both increased substance use and sexual risk taking. Violence exposure was not associated with motivation to engage in risk behavior as a means of escape, although motivation to cope through escape was associated with a greater likelihood of substance use. Sensation seeking was related to substance use and sexual risk taking among all adolescents and with violence exposure primarily within male adolescents. CONCLUSIONS: Clinical interventions should promote adaptive coping strategies that emphasize maintaining healthy behavior, effective problem solving skills, and stress management techniques.     

Risk factors for alcohol use among male adolescents and emerging adults in Haiti

This study examined risk factors associated with alcohol use in the past 3 months among young men aged 15-24 in Haiti using data from the 2000 Enquête Mortalité, Morbidité et Utilization des Services. Findings indicate that life-time smoking, multiple sexual partnerships, witnessing inter-parental conflict in childhood, disruption of parental monitoring, and residing in communities with high levels of youth drinking differentiated experimenters from abstainers. Youth out-of-school employment and co-residence with adults who had a history of drunkenness were among risk factors associated with regular alcohol use. The greater was the number of risk factors to which a young man was exposed, the higher were the probabilities of alcohol experimentation and regular use. The findings call for prevention strategies at the family and community levels and for initiatives that focus on sexual and non-sexual individual behaviour change.     

Comparison of comprehensive and abstinence-only sexuality education in young African American adolescents

The purpose of this study was to identify predictors of sexual behavior and condom use in African American adolescents, as well as to evaluate the effectiveness of comprehensive sexuality and abstinence-only education to reduce adolescent sexual behavior and increase condom use. Participants included 450 adolescents aged 12–14 years in the southern United States. Regression analyses showed favorable attitudes toward sexual behavior and social norms significantly predicted recent sexual behavior, and favorable attitudes toward condoms significantly predicted condom usage. Self-efficacy was not found to be predictive of adolescents' sexual behavior or condom use. There were no significant differences in recent sexual behavior based on type of sexuality education. Adolescents who received abstinence-only education had reduced favorable attitudes toward condom use, and were more likely to have unprotected sex than the comparison group. Findings suggest that adolescents who receive abstinence-only education are at greater risk of engaging in unprotected sex.