Discrimination and sexual risk among Caribbean Latinx young adults

ABSTRACT

Objectives: Discrimination, such as being treated unfairly due to race, contributes to stress. Individuals may cope with this by engaging in risky behaviors. Consistent with this premise, prior studies found that discrimination is associated with substance use. Research has also shown that sex while ‘high’ on alcohol and drugs is associated with increased risk for HIV and other STIs. The present study examines the relationship between discrimination and sexual risk. We investigate whether discrimination is associated with sex while high on alcohol and drugs.

Design: Analyses focus on a sample of 356 Caribbean Diasporic young adults, primarily Caribbean Latinx, aged 18 to 25 who participated in the Drug Use and HIV Risk among Youth Survey carried out from 1997 to 2000 in Brooklyn, New York. Logistic regression examined the association between self-reported discrimination and sex while high.

Results: More than half (52.3%) of respondents reported moderate discrimination. Sex while high was also reported: 35.7% for alcohol, 43.3% for marijuana, and 32.6% for heroin/cocaine. Discrimination was associated with increased risk of sex while high on (1) marijuana and (2) heroin/cocaine, but was not with alcohol.

Conclusions: Discrimination may be a risk factor for engaging in sex while high on drugs, which may put individuals at risk for HIV as well as other STIs. Future research should explore relationships between discrimination and sex while high on alcohol and drugs among various racial/ethnic groups and Diasporas, while also assessing how this relationship may contribute to HIV incidence.     

Predictors of STDs among Asian and Pacific Islander young adults

CONTEXT: Limited information is available on factors associated with STDs among Asian and Pacific Islander young adults. Such information is vital to developing effective interventions to reduce STDs within this group. METHODS: Data were derived from the National Longitudinal Study of Adolescent Health, Wave 3; the sample consisted of 605 female and 578 male Asian and Pacific Islander young adults. Logistic regression analysis was used to assess factors associated with ever having had an STD. RESULTS: Thirteen percent of females and 4% of males had ever had an STD. Among those who had had an STD, 75% were female, 9% had ever been paid for sex, 31% had had sex before age 15 and 55% had had multiple sex partners in the previous 12 months. Being female (odds ratio, 4.1), being Indian (compared with being Filipino; 4.8), having ever been paid money for sex (4.7) and having had more than one sex partner in the past 12 months (2.5) were associated with increased odds of having had an STD diagnosis. The more respondents believed that STDs were responsive to treatment, the greater their odds of having had an STD (2.3); the more they believed that STDs had negative consequences for a relationship, the lower their odds of having had an STD (0.7). CONCLUSIONS: Asian and Pacific Islander women and Indians are priority groups for both research and clinical attention; prevention efforts to reduce STDs should be tailored to these groups. Clinicians working with Asians and Pacific Islanders need to focus on clients' number of sexual partners and health-related beliefs.     

Reproductive and sexual health among young adults in Uzbekistan

Since 1991, contraceptive use has risen significantly in Uzbekistan while reliance on abortion has declined; yet reproductive health improvements have not translated into better conditions for sexual health. The prevalence of sexually transmitted diseases increased significantly in the 1990s, and UNAIDS currently identifies the Central Asian region as a high HIV-growth zone. Structural, institutional, and attitudinal factors have contributed to the disconnection between reproductive and sexual health in Uzbekistan, even though family planning programs have been well established during the HIV pandemic. Integrating state statistics, Demographic and Health Survey data, and focus-group-discussion results, we highlight the ways in which a heavily centralized program focusing on reproductive health did little to better sexual health, especially among young adults. The example of Uzbekistan reveals pathways by which reproductive health efforts may continue to be compartmentalized, decreasing their potential contributions to sexual health, especially among young adults.     

Racial and ethnic disparities in sexual risk behaviors and STDs during young men's transition to adulthood

CONTEXT: Racial and ethnic health disparities are an important issue in the United States. The extent to which racial and ethnic differences in STDs among youth are related to differences in socioeconomic characteristics and risky sexual behaviors requires investigation. METHODS: Data from three waves of the National Survey of Adolescent Males (1988, 1990–1991 and 1995) were used to examine 1,880 young men’s history of STDs and their patterns and trajectories of sexual risk behavior during adolescence and early adulthood. Multinomial and logistic regression analyses were conducted to test whether racial and ethnic differences in STDs are due to the lower socioeconomic status and higher levels of risky sexual behavior among minority groups. RESULTS: Young black men reported the highest rates of sexual risk and STDs at each wave and across waves. Compared with white men, black and Latino men had higher odds of maintaining high sexual risk and increasing sexual risk over time (odds ratios, 1.7–1.9). In multivariate analyses controlling for socioeconomic characteristics, black men were more likely than white men to have a history of STDs (3.2–5.0); disparities persisted in analyses controlling for level of risky sexual behavior. CONCLUSIONS: Race and ethnicity continue to differentiate young black and Latino men from their white peers in terms of STDs. Prevention programs that target different racial and ethnic subgroups of adolescent men and address both individual‐ and contextual‐level factors are needed to curb STD incidence.     

Timing of alcohol and other drug use and sexual risk behaviors among unmarried adolescents and young adults

CONTEXT: Although alcohol and drug use by young people has been associated with sexual risk behavior in some research, detailed data are lacking on the timing of substance use in relationship to sexual risk-taking. METHODOLOGY: Cross-sectional data on 7,441 unmarried young people aged 14-22 from the 1992 Youth Risk Behavior Survey (household supplement) were used in the analysis. Alcohol and other drug use at last sexual intercourse, substance use in the past 30 days (recent use), the number of different substances ever used (lifetime use) and age at initiation of alcohol use are examined here. The outcome variables assessed through multivariate regression analyses were condom use at last intercourse and more than one sexual partner in the past three months. RESULTS: Failure to use a condom was strongly associated with the lifetime substance-use scale or, alternatively, with age at initiation of alcohol. Once the number of substances ever used was controlled for, neither substance use at last sexual intercourse nor recent use was associated with the likelihood of using a condom at last coitus. Among young men and women, recent substance use and use of either alcohol or drugs at last intercourse were both strongly associated with having had more than one sexual partner in the past three months. For females only, lifetime use also increased the probability of recent multiple partners. CONCLUSIONS: The relationships between alcohol and other drug use and two sexual behaviors--condom use and multiple partners-suggest distinct mechanisms of influence and the need for different prevention strategies.     

青少年及青年HIV感染影响因素

青少年及青年正处于由儿童向完备成年人转变的阶段,性生理趋于成熟,而性心理尚不完善,具有特有的生理与心理特点,易于发生不安全性行为,从而增加了自身感染HIV的风险。青少年及青年中存在较多的易感因素,近年来HIV感染新报告病例数逐年上升,引起了多方面的关注。本文从青少年及青年HIV感染现状、感染与发现途径、易感因素3个方面...     

Sexual risk reduction behaviors among young heterosexual adults

Although young, sexually-active heterosexuals have always been at risk for contracting sexually transmitted diseases, the recent appearance of Acquired Immunodeficiency Syndrome (AIDS) has increased the possible peril of sexual experimentation. Currently, behaviors to reduce the risk of contracting AIDS are being widely advocated. The present study examines predictors of self-reported risk reduction behaviors in a sample of 188 young, sexually-active heterosexuals. Three factors (perceptions of personal vulnerability, sexual behaviour history, and homophobia) were hypothesized to predict levels of worry about contracting a sexually transmitted disease. Worry, in turn, was hypothesized to predict behavior change. Structural equation modeling provided support for these predictions, but found somewhat different patterns for women and men. For both sexes, higher levels of worry were a significant predictor of risk reduction behavior implementation. For women only, more extensive sexual behavior histories significantly predicted levels of worry. In contrast, for men only, perceptions of personal vulnerability and homophobia were significant predictors of worry. Results suggest that gender plays an important role in understanding cognitive predictors of sexual risk reduction behaviors.     

Long-term effects of self-control on alcohol use and sexual behavior among urban minority young women

High risk alcohol use and sexual behaviors peak in young adulthood and often occur in the same individuals. Alcohol use has been found to impair decision-making and contribute to high risk sexual activity. However, the association between alcohol use and risky sexual behavior may also reflect enduring individual differences in risk taking, sociability, self-control, and related variables. Both behaviors can serve similar functions related to recreation, interpersonal connection, and the pursuit of excitement or pleasure. The present study examined the extent to which high risk drinking and sexual behavior clustered together in a sample of urban minority young adult women, a demographic group at elevated risk for negative outcomes related to sexual health. We tested whether psychosocial functioning measured at the beginning of high school predicted classes of risk behaviors when girls were tracked longitudinally into young adulthood. Latent class analysis indicated three distinct profiles based on high risk drinking and sexual behavior (i.e., multiple sex partners) in young adulthood. The largest class (73% of the sample) reported low levels of risky drinking and sexual behavior. The next largest class (19%) reported high risk drinking and low risk sexual behavior, and the smallest class (8%) reported high levels of both behaviors. Compared to women from other racial/ethnic groups, black women were more likely to be categorized in the high risk drinking/low risk sex class. Multinomial logistic regression indicated that self-control in adolescence had a broad and enduring protective effect on risk behaviors eight years later and was associated with a greater probability of being in the low risk drinking/low risk sex class. Findings are discussed in terms of understanding the phenotypic expressions of risk behavior as they relate to early psychosocial development and the long-term protective function of self-control in reducing high risk drinking and sexual behaviors.     

Major dietary patterns and cardiovascular risk factors among young Brazilian adults

Purpose  

Diet is one of the most important modifiable risk factors for cardiovascular diseases. The scientific literature has consistently shown the effects of certain diets on health; however, given the variety of cultures and dietary habits across the world, it is likely that much remains to be learned about dietary patterns and health outcomes. We assessed the associations between main dietary patterns and cardiovascular risk factors among 4,202 young Brazilian adults in a cross-sectional analysis.     

Exploring gender and sexual minority status among street-involved youth

This article compares heterosexual and sexual minority street-involved youth across a number of sociodemographic, risk and current mental health, victimization and delinquency measures with a particular focus on gender differences. The sample consists of 147 homeless and street-involved young men and women aged 16–21 years in Toronto, Ontario, Canada. Bivariate analyses indicate that many of the differences between the heterosexual and sexual minority youth are driven by differences among the young women. Multivariate analyses are then used to test for interactions between gender and sexual minority status alongside controls. The results suggest that gender, sexuality and street involvement intersect to shape outcomes in more complex ways than are acknowledged by the notion of accumulating or multiplying disadvantage common in the literature. The article concludes with a discussion focused on providing a more nuanced view of the experience of youth homelessness at the intersection of gender and sexuality.     

性感觉寻求与青少年男男性行为人群危险性行为的关系

目的 研究25岁及以下青少年男男性行为人群(YMSM)性感觉寻求与其艾滋病相关危险性行为的关系。方法 于2013年5-11月通过互联网宣传、外展活动以及例行的艾滋病自愿咨询检测服务招募403名YMSM, 采用匿名问卷调查, 回收375份(93.05%)有效问卷。结果 YMSM中有37.9%首次同性性行为未使用安全套, 最近6个月有55.7%发生多性伴行为, 51.7%有“419”(一夜情)行为, 5.6%有群交行为。性感觉寻求与首次同性性行为未使用安全套、多性伴行为、“419”行为、群交行为呈正相关(偏相关系数分别为0.247、0.218、0.296、0.252)。分别以首次同性性行为未使用安全套、多性伴行为、“419”行为、群交行为作为因变量进行logistic回归分析, 结果显示性感觉寻求高者更有可能发生以上危险性行为。结论 青少年性感觉寻求水平对危险性行为有影响, 应加强基于人群性感觉寻求分析的艾滋病相关知识及行为教育, 强化艾滋病相关危险性行为的风险意识, 从而更有效开展YMSM艾滋病干预。     

Substance use, sexual intercourse, and condom nonuse among depressed adolescents and young adults

PurposeTo examine daily- and event-level associations of substance use with occurrence of sex and condom nonuse among depressed youth.MethodsDepressed, sexually active outpatients aged 15–22 years reported alcohol use, marijuana use, and sex on a personal digital assistant for 2 weeks. If they reported sex, participants indicated partner type and condom use. Data were analyzed for participants who reported both substance use and sex events (N = 39) using generalized estimating equations. Daily-level models compared the likelihood of sex and of condom nonuse between days on which participants did or did not use substances. Event-level models examined the likelihood of sex in the 2, 6, and 12 hours after substance use and the likelihood of condom nonuse if substances were used in the preceding 2, 6, and 12 hours.ResultsParticipants reported 307 sex events (180 unprotected) and 391 substance use events on 572 days. Substance use was associated with increased odds of sex on the same day, but not after adjusting for weekend. Depressed youth were less likely to have sex within 2 hours after substance use and more likely to have sex within 12 hours after marijuana use. There was no main effect of substance use on condom nonuse; however, there was a significant interaction such that on weekdays, condom nonuse was less likely when substances were used within 6 hours before sex.ConclusionsThe findings from this small, predominantly female sample suggest that contextual factors, not intoxication, influence associations of substance use with sexual behavior in depressed youth.     

Predictors of Mpox vaccine uptake among sexual and gender minority young adults living in Illinois: Unvaccinated vs. double vs. single dose vaccine recipients

IntroductionThe 2022 global outbreak of Monkeypox virus (Mpox), which has primarily spread through the sexual networks of sexual and gender minority (SGM) individuals, has introduced new public health challenges. While an efficacious Mpox vaccine is in active circulation, few Mpox vaccine studies have examined its uptake among SGM groups. The aims of this study were to investigate (a) the prevalence of Mpox vaccine uptake among SGM and (b) the contextual, Mpox-disease specific, and Mpox-vaccine specific factors associated with Mpox vaccine among SGM.MethodsWe conducted a cross-sectional survey in Illinois, USA in September 2022; 320 young SGM completed self-administered questionnaires. Multinomial logistic regression was used to assess the contextual, Mpox-disease specific, and Mpox-vaccine specific factors associated with Mpox vaccine uptake. Adjusted Odds Ratios (aORs) and 95 % Confidence Intervals (CI) are reported.ResultsApproximately 50 % of the SGM participants included in this study had received at least their first dose of the Mpox vaccine. Multinomial regression analysis showed that individuals who had recently experienced food insecurity, had higher degrees of fear of social rejection due to Mpox acquisition, and were more Mpox-vaccine hesitant were more likely to be unvaccinated. Conversely, knowing people who have contracted Mpox, having higher formal educational attainment, having higher degrees of Mpox-related internalized heterosexism, and being more concerned about one’s safety regarding Mpox morbidity were more likely to be double-dosers.ConclusionApproximately 50 % of the SGMs included in this study received at least their first dose of the Mpox vaccine; however, only one-quarter of participants completed the recommended 2-dose Mpox regimen. Our findings indicate that socioeconomic stability, fear of social rejection due to disease acquisition, and Mpox-specific vaccine hesitancy may be important structural targets to consider when developing vaccine-uptake prevention and intervention strategies tailored to the needs of sexual and gender minorities.     

少数民族流动人口婚外性行为与社会文化关系

目的了解少数民族流动人口婚外性行为现况,分析社会文化因素对婚外性行为的影响。方法2012年7—10月,采用分阶段抽样方法,在贵州省兴义市、七星关区、威宁县少数民族流动人口就业集中的工厂、建筑工地、服务场所随机抽取291名少数民族流动人口进行艾滋病高危性行为一对一面访匿名问卷调查,并采用多元logistic逐步回归方法分析影响婚外性行为的社会文化因素。结果贵州省少数民族流动人口中有婚外性行为者占31.6%;不同民族、性别、宗教信仰、文化程度、月均收入、有无串姑娘习俗、有无放寮习俗、有无不落夫家习俗的少数民族流动人口婚外性行为比较,差异均有统计学意义（P<0.05）;侗族（OR=10.77）、苗族（OR=7.70）、月均收入≥2 000元（OR=2.34~5.95）、不落夫家习俗（OR=3.56）、串姑娘习俗（OR=2.18）、男性（OR=2.57）是少数民族流动人口婚外性行为的危险因素,文化程度大专及以上（OR=0.34）是少数民族流动人口婚外性行为的保护因素。结论少数民族流动人口婚外性行为发生率较高;民族、月均收入、不落夫家习俗、串姑娘习俗、性别、文化程度等社会文化因素影响婚外性行为。     

Missed conceptions or misconceptions: perceived infertility among unmarried young adults in the United States

CONTEXT: Perceived infertility is an individual’s belief that she or he is unable to conceive or impregnate, regardless of whether this belief is medically accurate. This perception may lead to contraceptive nonuse, which may, in turn, lead to unintended pregnancy. Little research has examined perceived infertility among young adults, including potential associations with contraceptive behaviors. METHODS: The frequency of perceived infertility among young adults was assessed using 2009 data from a nationally representative telephone survey of 1,800 unmarried men and women aged 18–29. Multinomial regression analyses assessed associations between respondents’ perceived infertility and selected background, reproductive knowledge, sexual experience and contraceptive use characteristics. RESULTS: Overall, 19% of women and 13% of men believed that they were very likely to be infertile. Hispanic women and women who had received public assistance in the past year had elevated odds of perceived infertility (odds ratios, 3.4 and 3.0, respectively), as did Hispanic men and men of other racial or ethnic minorities, except blacks (2.5 and 6.1, respectively). Men who had some college education, had received sex education or were not in a current relationship had decreased odds of thinking they were very likely to be infertile (0.3–0.4). Among men, perceived infertility was associated with the belief that they were likely to have sex without using a contraceptive in the next three months (2.6). CONCLUSIONS: A substantial proportion of young adults believe they are infertile. Improved provider counseling and sex education may be useful in helping them to better understand their actual probability of infertility, and this knowledge may lead to improved contraceptive use.     

Risky sexual behavior and alcohol use among young adults: results from a national survey

PURPOSE. To examine the relationship between alcohol use and sexual activity in a sample of young adults. DESIGN. Data were collected as part of a 1990 survey of a multistage area household probability sample. SETTING. In-home interviews were conducted by experienced interviewers. SUBJECTS. In total, 1006 persons from 18 to 30 years of age living in the contiguous United States were contacted. MEASURES. Detailed information was collected on alcohol use and sexual behavior. To minimize the reluctance of respondents to answer queries on sexual behavior, those questions were contained in a self-administered questionnaire. RESULTS. At the population level, having had multiple sexual partners in the past year was more likely among men who consumed five or more drinks per sitting. Condom use was less likely among respondents who had consumed five or more drinks on at least one occasion in the past year. In multivariate analyses, the amount of alcohol consumed at the new partner event was not associated with condom use with a new partner. When the effects of other demographic and psychosocial factors were removed, the number of drinks consumed during the heaviest drinking event was a significant predictor of engaging in sex for women but not for men. CONCLUSION. In young adults, alcohol use with sex does not necessarily lead directly to lapses in judgment about safe sexual practices. Alcohol is but one of a number of factors that play an important role in determining the riskiness of a particular sexual encounter.     

Sexually transmitted infections,sexual risk behaviours and perceived barriers to safe sex among drug users

Objective : Drug users are at elevated risk of HIV and other sexually transmitted infections (STIs). This study examines prevalence of STIs and perceived barriers to safe sex among drug users accessing low‐threshold primary healthcare in inner‐city Sydney. Methods : Data were extracted manually from clients’ medical records and analysed using STATA. Results : Prevalence of HIV, syphilis, chlamydia and gonorrhoea were low (<2%), whereas hepatitis C (62%), hepatitis A (30%), and previous exposure to hepatitis B (25%) were more common. Recent unprotected vaginal and anal intercourse were reported by 85% and 26% of clients, respectively. Younger clients and those with a history of sex work or recent anal intercourse were more likely to report multiple recent unprotected sex partners. Having a regular sex partner was the most prevalent barrier to condom use (37%), and was more likely to be identified by clients who were older, of Indigenous descent, and/or heterosexual. Drug intoxication was a second important barrier (20%), and was more commonly identified by excessive alcohol users. Conclusions : Targeted programs might increase awareness regarding the benefits of condom use and potential sexual risk associated with regular partners. Periodic assessments of alcohol use, and brief interventions for drug users who report problematic use, should also be considered.     

Health among teenagers and young adults

The objective of this article is to analyse different behaviours and opinions about health and health determinants of Spanish young people by age, sex, and place of residence. They have a broad concept of their health, tending to identify health as physical activity and healthy eating behaviours. Most of them (91%) declared enjoying good or very good health. Depending upon the age, sex, and place of residence 10 to 20% could have mental health problems. Young people consider illegal drugs as their main health problem. Boys have higher prevalence of overweight and obesity than girls. However, girls reported more often than boys that they perceived themselves as obese. Practice of sporting activities is influenced by family and friends. The proportion of young people that practice sport declines after the age of 15, both in boys and girls. Young people perceive cannabis consumption as normal, but remain ambivalent towards other illegal drugs and asked for more information about drugs. We found a high proportion of young people declaring that they not would try illegal drugs. In the urban settings, smoking is more common among girls than among boys, but the contrary happens in rural areas. Most of them know that smoking is harmful for health, and among those who are smokers, 20 to 40% declared that they want to stop smoking. They consider that health care services are useless for preventing health problems. It is necessary to improve behaviours involving safety, such as use of seat belts and helmets, mainly in rural areas. Young people associated traffic accidents with driving conditions rather than with identification of risk.