Neighborhood-level influences on young men's sexual and reproductive health behaviors

We used data from the 2002 National Survey of Family Growth to examine the influence of neighborhood characteristics on young males' sexual and reproductive health (SRH). We linked census-tract data to construct a Neighborhood Disadvantage Scale for 1092 never-married males aged 15 to 19 years, and we examined the association of neighborhood disadvantage with 11 SRH behaviors for each male. We found significant associations between neighborhood disadvantage and measures of partnering and pregnancy. Public health research and policies must consider the role of neighborhood context when addressing health behaviors.     

Older sexual partners during adolescence: links to reproductive health outcomes in young adulthood

CONTEXT: Sex at a young age with an older partner has been linked to poor reproductive health outcomes during adolescence, but minimal research has examined the influence of teenagers' having an older sexual partner on reproductive health outcomes during the transition to young adulthood. METHODS: Logistic regression and contrast analyses of three waves of data from the National Longitudinal Study of Adolescent Health were used to examine whether individuals who had had sex before age 16 with a partner at least three years their senior were at increased risk of becoming teenage or unmarried parents or of contracting an STD by young adulthood. RESULTS: Ten percent of females and 2% of males had had early sex with an older partner. These females were more likely to acquire an STD as young adults than were those whose riskiest relationship was before age 16 with a similar-aged partner (odds ratio, 2.1) or at age 16 or later with a similar-aged or older partner (2.4 and 2.6, respectively). For males, having sex before 16, regardless of partner age, was associated with an elevated STD risk (odds ratio, 1.9), although controlling for relationship history characteristics attenuated the association. CONCLUSIONS: Adolescents, particularly young adolescents, should be made aware of the potential risks associated with having older sexual partners. In particular, program providers should be alerted that females who engage in early sexual activity with older partners are at especially high risk of experiencing adverse reproductive health consequences.     

Multiple levels of social influence on adolescent sexual and reproductive health decision-making and behaviors in Ghana

ABSTRACT

Little is known about the multilevel social determinants of adolescent sexual and reproductive health (SRH) that shape the use of family planning (FP) among young women in Africa. We conducted in-depth, semi-structured, qualitative interviews with 63 women aged 15–24 years in Accra and Kumasi, Ghana. We used purposive, stratified sampling to recruit women from community-based sites. Interviews were conducted in English or local languages, recorded, and transcribed verbatim. Grounded theory-guided thematic analysis identified salient themes. Three primary levels of influence emerged as shaping young women’s SRH experiences, decision-making, and behaviors. Interpersonal influences (peers, partners, and parents) were both supportive and unsupportive influences on sexual debut, contraceptive (non) use, and pregnancy resolution. Community influences included perceived norms about acceptability/unacceptability of adolescent sexual activity and its consequences (pregnancy, childbearing, abortion). Macro-social influences involved religion and abstinence and teachings about premarital sex, lack of comprehensive sex education, and limited access to confidential, quality SRH care. The willingness and ability of young women in our study to use FP methods and services were affected, often negatively, by factors operating within and across each level. These findings have implications for research, programs, and policies to address social determinants of adolescent SRH.     

Living arrangements and health behaviors in adolescence and young adulthood

This paper discusses the significance of living arrangementsfor the adoption of health behaviors in a national sample of1458 adolescents and young adults in the age group 16–25years in Norway. Living arrangements were operationalized interms of living with spouse or partner, living with parents/siblingsor living alone. Results from multiple logistic regression analysesshowed that the effect of living arrangements was most significantfor health compromising behaviors, i.e. smoking and alcoholconsumption. Results from discriminant analyses indicated thatadolescent men and women constituted two separate systems ofengagement in health behaviors but that living arrangementsfunctioned in the same manner within each system.     

Investing in very young adolescents' sexual and reproductive health

Very young adolescents (VYAs) between the ages of 10 and 14 represent about half of the 1.2 billion adolescents aged 10–19 in the world today. In lower- and middle-income countries, where most unwanted pregnancies, unsafe abortions, maternal deaths and sexually transmitted infections occur, investment in positive youth development to promote sexual and reproductive health (SRH) is increasing. Most interventions, though, focus on older adolescents, overlooking VYAs. Since early adolescence marks a critical transition between childhood and older adolescence and adulthood, setting the stage for future SRH and gendered attitudes and behaviours, targeted investment in VYAs is imperative to lay foundations for healthy future relationships and positive SRH. This article advocates for such investments and identifies roles that policy-makers, donors, programme designers and researchers and evaluators can play to address the disparity.     

Developmental relationships between adolescent substance use and risky sexual behavior in young adulthood.

PURPOSE: To examine the developmental relationship between adolescent substance use and risky sexual behavior in young adulthood. A gender-balanced, ethnically diverse urban sample of 808 children in Seattle was surveyed at age 10 years in 1985 and followed prospectively to age 21 years in 1996. Semiparametric group-based modeling was used to determine trajectory groups of binge-drinking, cigarette smoking, marijuana use, and the use of other illicit drugs. Negative binomial regressions and logistic regressions were used to examine whether these trajectory groups predicted the number of sex partners and condom use at age 21 years. Specific forms of adolescent substance use significantly predicted risky sexual behavior at age 21 years, after other substance use and early measures of sexual behavior were controlled. Early binge-drinkers had significantly more sex partners than nonbinge-drinkers. Late onset binge-drinkers and marijuana users had significantly more sex partners and were less likely to use condoms consistently than those who did not binge drink or use marijuana. Experimenters in cigarette smoking, who did not escalate smoking, were more likely to use condoms consistently than nonsmokers. In contrast, the use of other illicit drugs in adolescence did not predict risky sexual behavior at age 21 years. The effects of adolescent substance use on risky sexual behavior at age 21 years differed for youths with developmentally different substance use trajectories in this urban sample disproportionately drawn from high crime neighborhoods. To prevent risky sexual behavior among young adults, attention should be paid to binge-drinking and marijuana use during adolescence.     

不同性别务工青少年生殖健康状况分析

目的 了解15～24岁不同性别进城务工青少年的性与生殖健康知信行状况及影响因素。方法 采用自编结构式匿名问卷对山东省济南市1075名15～24岁进城务工青少年进行自填式问卷调查。结果 男性与女性进城务工青少年的性与生殖健康知识水平均较低,尤其流产相关知识,男性得分中位数仅25.0分;35.0%的男性认为只要双方愿意就可以发生婚前性行为,高于女性的16.1%;面对恋人性要求,男性坚持不发生性行为的比例(18.1%)远低于女性(53.1%),差异有统计学意义(χ²=141.704,P<0.001);30.7%的调查对象自我报告发生过性行为,其中男性为40.1%,女性为23.7%,差异有统计学意义(χ²=29.385,P<0.001);不同性别进城务工青少年发生婚前性行为的共同影响因素为年龄、文化程度、对避孕的态度;女性还与对婚前性行为的看法、对恋人性要求的处理方式有关。结论 为进城务工青少年提供性与生殖健康教育及服务时应考虑性别差异。     

Trends in adolescent sexual risk behaviors

Many societies worldwide are faced with an increase in adolescent pregnancy, rape, sexual abuse and sexually transmitted disease due to different sexual behaviors and sometimes lack of responsible sexual behaviors. The World Health Organization and the Surgeon General of the United States Government have called for action to this serious public health issue. In this short communication data from the United States, Canada and Israel is presented with a call for a professional response to this public health challenge.     

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.     

The association between impulsiveness and sexual risk behaviors in adolescent and young adult women.

Cross-sectional survey data from 462 female adolescents were analyzed to determine associations between impulsiveness and sexual risk behaviors and related outcomes. Higher impulsiveness was significantly associated with early age of first sexual intercourse, higher number of sexual partners, non-use of contraception and condoms, and prior Chlamydia infection.     

Risky parental behavior and adolescent sexual activity at first coitus

Data from the National Longitudinal Study of Adolescent Health (Add Health) were used to examine the impact of parents' behavior on adolescents' sexual experience and contraceptive use. All else being equal, adolescents whose parents engage in risky behaviors are especially likely to be sexually active and to have had sex before age 15. These findings are only partly attributable to the link between parents' risky behaviors (smoking, drinking, driving without seatbelts) and adolescents' risky behaviors (smoking, drinking, delinquent activity, association with substance-using peers). Although parental behaviors are effective predictors of adolescents' sexual activity, they are not effective predictors of contraceptive use or of method choice at first coitus. Overall, parents with low levels of self-efficacy seem to be especially likely to have children at risk of engaging in problem behaviors.     

Setting research priorities for adolescent sexual and reproductive health in low- and middle-income countries

Objective

To conduct an expert-led process for identifying research priorities in adolescent sexual and reproductive health in low- and middle-income countries.

Methods

The authors modified the priority-setting method of the Child Health and Nutrition Research Initiative (CHNRI) to obtain input from nearly 300 researchers, health programme managers and donors with wide-ranging backgrounds and experiences and from all geographic regions. In a three-Phase process, they asked these experts to: (i) rank outcome areas in order of importance; (ii) formulate research questions within each area, and (iii) rank the formulated questions.

Findings

Seven areas of adolescent sexual and reproductive health were identified as important: (i) maternal health; (ii) contraception; (iii) gender-based violence; (iv) treatment and care of patients with human immunodeficiency virus (HIV) infection; (v) abortion; (vi) integration of family planning and HIV-related services and (vii) sexually transmitted infections. Experts generated from 30 to 40 research questions in each area, and to prioritize these questions, they applied five criteria focused on: clarity, answerability, impact, implementation and relevance for equity. Rankings were based on overall mean scores derived by averaging the scores for individual criteria. Experts agreed strongly on the relative importance of the questions in each area.

Conclusion

Research questions on the prevalence of conditions affecting adolescents are giving way to research questions on the scale-up of existing interventions and the development of new ones. CHNRI methods can be used by donors and health programme managers to prioritize research on adolescent sexual and reproductive health.     

性健康与生殖健康的关系

随着经济和社会的不断发展以及人们对健康需求的普遍提高,作为健康重要组成部分的性健康和生殖健康已受到广泛关注.性健康是生殖健康的基石,不仅关系着当代人的健康,也影响着下一代人的健康.而随着性领域出现的如多性伴、未保护性、不洁性、性功能障碍及有关性别和性行为的暴力等相关问题的日益凸显,更导致相关的生殖健康问题愈加严重,为了让人们深入地了解性健康与生殖健康的关系,加强对性健康的重视,更好地满足人们对性及生殖方面的健康需求,该文分析了近年来有关性健康与生殖健康的文献,总结当前性健康及生殖健康问题出现的新趋势,为改善性健康与生殖健康状况提供理论基础.     

贵州兴义农村在校儿童性与生殖健康知识及行为调查

目的 了解贵州省兴义市农村在校儿童性与生殖健康知识知晓情况、发生性行为及其影响因素,为改善农村在校儿童性与生殖健康状况提供依据。方法 2015年3-4月采用整群抽样方法对兴义市小学五、六年级和初中一、二年级548名农村在校儿童进行调查,采用单因素及多因素logistic回归分析知识知晓及发生性行为的影响因素。结果 调查的548名儿童中,有297人（54.2%）知晓性与生殖健康知识;多因素logistic回归分析显示,男生（OR_调整=1.454,95% CI=1.027~2.058）、经常与父母交流沟通（OR_调整=1.460,95% CI=1.003~2.125）、经常与老师交流沟通（OR_调整=1.608,95% CI=1.129~2.289）、在校学习过性教育课程（OR_调整=2.035,95% CI=1.418~2.919）是知晓性与生殖健康知识的影响因素。5.8%（32/548）的农村在校儿童发生过性行为,多因素分析显示,经常与父母交流沟通（OR_调整=0.267,95% CI=0.128~0.558）和在校学习过性教育课程（OR_调整=0.447,95% CI=0.216~0.925）是减少儿童过早性行为的保护因素。结论 农村在校儿童性与生殖健康知识待完善,应注意加强学校及家庭教育,营造良好网络环境,促进农村儿童健康成长。     

Risky sexual behaviors among adolescents with alcohol use disorders.

Little is known about risky sexual activity among adolescents with alcohol use disorders. This study of 371 adolescent drinkers found that those with alcohol disorders were more likely than other drinkers to be sexually active, to have greater numbers of partners, and to initiate sexual activity at slightly younger ages. Independent of alcohol group, females were more likely than males to have unprotected sexual encounters.