Predictors of Heterosexual Casual Sex Among Young Adults

Casual sex is often associated with the young adult stage in the life course. Most recent research on the prevalence, motives, and consequences of heterosexual casual sex has relied on samples of college students, yet students are only a small and advantaged subset of the young adult population. The current study drew on the Toledo Adolescent Relationships Study, which was collected in 2006–2007 and included young adults (ages 18–24 years) whose trajectories reflected a wider spectrum of educational experiences (N = 1,023). We moved beyond prior work by examining both frequency and type of heterosexual casual sex: lifetime vaginal, lifetime oral, and recent vaginal sex. We found that young adults enrolled or who graduated from 4-year educational institutions reported fewer casual sex partners on all three measures compared to participants without a high school degree and those with some college experience. Sexual attitudes were key factors mediating the association between educational status and casual sex behavior. These results indicate that programs aimed at encouraging healthy sexual behavior should target individuals who are at risk of not graduating high school because they are at greatest risk of frequent casual sex partners.     

Momentary Affective States Surrounding Sexual Intercourse in Depressed Adolescents and Young Adults

Depressed young people may have sexual intercourse (sex) to regulate their disordered affective states. This study sought to determine how momentary positive and negative affect relate to subsequent sex events in depressed adolescents and young adults. Fifty-four outpatients (87% female) 15–22 years who reported clinically significant depressive symptoms and having sex at least once a week completed a baseline survey, then reported momentary affective states and the occurrence of sex events on a handheld computer in response to 4–6 random signals per day for 2 weeks. Participants identified 387 unique sex events (median, 3.5/participant/week) on 3,159 reports (median, signal response rate 80%). Most (86–96%) reported low burden of participation on questions asked at study completion. Similar to what has been reported in non-depressed young people, momentary positive and negative affect were both improved beginning approximately 6 h before until approximately 6 h after a sex event. Positive affect was lower in the 24 h before this pericoital period, compared to other times. Negative affect did not significantly differ between before the pericoital period and other times. The findings suggest that depressed youth may have sex to regulate their positive affect and have implications for provision of their mental and physical health care.     

Heterosexual Anal Intercourse: An Understudied, High-Risk Sexual Behavior

Differences between heterosexuals who have or have not engaged in anal intercourse were analyzed. Though anal intercourse is widely recognized as an activity that greatly increases the risks for HIV transmission, it has received little attention in heterosexual populations. A questionnaire was mailed to a random sample of university students, a population in which many people engage in vaginal intercourse with several partners each year. The three largest minorities were randomly oversampled in order that all four major ethnic/racial groups could be statistically evaluated for possible differences. Almost 23% of nonvirgin students had engaged in anal intercourse. Regression analysis indicated that people who had participated in anal intercourse were more likely than people without anal experience to have been younger at first vaginal intercourse, to be older when the data were collected, to have engaged in vaginal intercourse in the last three months before data collection, to be more erotophilic, to use less effective contraceptive methods, and to have used no condom at last coitus. Overall, people who engage in anal intercourse take more sexual risks when engaging in vaginal intercourse than do people without anal experience. No major ethnic/racial differences were detected. Sexologists have not explored anal sex in much detail, hence we have been weak in educating those 20 to 25% of young adults who are not reluctant or (inhibited about) exploring anal intercourse. As young adults use condoms less for anal than vaginal intercourse, they have not learned enough about the risk of anal sex.     

Unprotected Anal Intercourse and Sexually Transmitted Diseases in High-Risk Heterosexual Women

Objectives. We examined the association between unprotected anal intercourse and sexually transmitted diseases (STDs) among heterosexual women.Methods. In 2006 through 2007, women were recruited from high-risk areas in New York City through respondent-driven sampling as part of the National HIV Behavioral Surveillance study. We used multiple logistic regression to determine the relationship between unprotected anal intercourse and HIV infection and past-year STD diagnosis.Results. Of the 436 women studied, 38% had unprotected anal intercourse in the past year. Unprotected anal intercourse was more likely among those who were aged 30 to 39 years, were homeless, were frequent drug or binge alcohol users, had an incarcerated sexual partner, had sexual partners with whom they exchanged sex for money or drugs, or had more than 5 sexual partners in the past year. In the logistic regression, women who had unprotected anal intercourse were 2.6 times as likely as women who had only unprotected vaginal intercourse and 4.2 times as likely as women who had neither unprotected anal nor unprotected vaginal intercourse to report an STD diagnosis. We found no significant association between unprotected anal intercourse and HIV infection.Conclusions. Increased screening for history of unprotected anal intercourse and, for those who report recent unprotected anal intercourse, counseling and testing for HIV and STDs would likely reduce STD infections.Unprotected anal intercourse is a well-described risk factor for HIV and sexually transmitted diseases (STDs) among men who have sex with men,¹ but fewer studies have investigated its importance as a risk factor in heterosexuals. According to a recent US population estimate, one third of adults and adolescents have ever engaged in anal intercourse and few (25% of men and 16% of women) reported condom use at last anal intercourse.² Anal intercourse and unprotected anal intercourse are more common in at-risk heterosexual groups: a 1999 review found that 30% to 74% of several risk groups (sexually active injection drug users, female sex workers, and urban adolescents) had recently engaged in anal intercourse.³ Tian et al.⁴ observed that 40% of heterosexual STD clinic attendees had any anal intercourse in the past year, and 73% of those had unprotected anal intercourse. Among at-risk heterosexuals, unprotected anal intercourse often clusters with other risk behaviors, such as illicit drug and binge alcohol use,^5,6 trading sex for money,⁷ and having multiple sex partners.⁸Most heterosexuals engage in unprotected anal intercourse less frequently than they engage in unprotected vaginal intercourse, but unprotected anal intercourse presents a higher probability of HIV and STD infection than does unprotected vaginal intercourse, particularly for women.⁴ Biologically, the increased likelihood of mucosal disruption and trauma in the more fragile columnar epithelium that lines the rectum versus the vaginal lining''s squamous epithelium, along with increased risk of trauma because of the muscular anal sphincter, are postulated reasons for this increased risk.⁹ One seroconversion study estimated the probability of HIV infection per act of receptive anal intercourse at 3.4% versus less than 0.01% per act of vaginal intercourse¹⁰ and also found a 5.1 increased odds of HIV infection from anal compared with vaginal intercourse.¹¹ Whereas no mention was made about the consistency of condom use during anal versus vaginal intercourse, the study served as the basis of several modeling estimates of the per-act HIV transmission risk of unprotected anal intercourse.^12–14Two other often-cited studies also reported increased risk of HIV infection from anal intercourse,^15,16 but again did not report whether they measured protected or unprotected anal intercourse and used a broad timeframe (lifetime history) for these risk behaviors. Some research has found an increased risk for HIV or other STD infection for heterosexual men but not women,^8,17 which may contradict the estimated increased infection probability for women in the modeling studies. Residual confounding could influence these findings, given the clustering of unprotected anal intercourse with other measured and unmeasured risk behaviors. Further research is needed to explore the prevalence and correlates of heterosexual unprotected anal intercourse and its impact on HIV and STD infection in this population.Our study investigated unprotected anal intercourse among a sample of high-risk heterosexual women in New York City by using a social-network–based sampling and recruitment method. Others have found that coerced sex and sex work influence unprotected anal intercourse and other behavioral risks.^18,19 We therefore focused on women because of their predicted increased infection risk and because of a broader goal to explore female HIV/STD risks. In this analysis, we examined factors associated with having past-year unprotected anal intercourse and the relationship of unprotected anal intercourse to HIV infection or a past-year STD diagnosis. We sought to understand how the relationship between unprotected anal intercourse and other HIV or STD risk factors as well as the collinearity of unprotected anal intercourse with unprotected vaginal intercourse could affect the association of unprotected anal intercourse with these disease outcomes.     

Correlates of HIV Risk Behaviors Among Homeless and Unstably Housed Young Adults

Objectives

Homeless young adults are exposed to multiple risk factors for HIV infection. We identified HIV risk behaviors and their correlates among homeless young adults in Portland, Oregon.

Methods

We conducted a community-based, cross-sectional survey of HIV risk behaviors among homeless young adults aged 18–25 years in 2010. Participants completed three study components: (1) an interviewer-administered survey of HIV risk behaviors; (2) a brief, client-centered HIV risk-based counseling session; and (3) rapid HIV testing.

Results

Among 208 participants, 45.8% identified as racial/ethnic minority groups, 63.8% were male, and 35.7% self-identified as nonheterosexual. Six participants, all from sexual minority groups, had positive HIV screening results (two newly identified, four previously known) for a seropositivity rate of 2.9%. Female sex, belonging to a sexual minority group, frequent traveling between cities, depression, and alcohol use to intoxication were significantly associated with unprotected sex in univariate analysis. Female sex and high perceived risk of HIV were significantly associated with unprotected sex in multivariate analysis.

Conclusions

Our findings support the need for enhanced HIV prevention interventions for homeless young adults.In the Portland, Oregon, metropolitan area, an estimated 1,500–2,000 homeless young people are living on the street (Personal communication, Caitlin Campbell, Homeless Youth Continuum Coordinator, Multnomah County, Oregon, July 2009). Young adults and adolescents are at particularly high risk of human immunodeficiency virus (HIV) infection. In 2008, the Centers for Disease Control and Prevention (CDC) reported that 13% of all new HIV infections in the U.S. occur among people aged 13–24 years.¹ Statistical modeling estimates that approximately half of HIV infections in the U.S. occur before 25 years of age.² The young adult years are accompanied by escalating risk due to sexual contact and initiation of drug use in certain populations.Homeless young people live at the intersection of multiple risk factors and are especially at risk for HIV infection. Up to 35% of homeless young people identify as gay, lesbian, bisexual, or transgender.^3–6 Homeless populations frequently exchange sex for money, drugs, or a place to stay;⁷ have high rates of substance use;⁸ and experience substantial unmet needs for multiple types of health care,⁹ further increasing their risk for HIV infection. Mental illness, such as depression, has been shown to be associated with infrequent condom usage among homeless adolescents in the U.S. Pacific Northwest.¹⁰ In 1994, Allen et al. reported findings from a 16-city CDC-sponsored seroprevalence study that showed an HIV prevalence of 2.3% among runaway young people aged 15–24 years and 3.4% among homeless adults.¹¹ More recent studies demonstrate HIV prevalence proportions of 5%–16% among homeless adolescents and young adults.^12,13An updated account of HIV prevalence among homeless young adults is essential to inform HIV prevention programs, reduce HIV transmission by educating about behaviors that put people at risk for infection, and connect affected people with resources. Additionally, little is known about current risk-taking behaviors among homeless young adults. The purpose of this study was to identify HIV risk behaviors and their correlates among homeless young adults in the Portland, Oregon, metropolitan area.     

Whole-Grain Intake Correlates among Adolescents and Young Adults: Findings from Project EAT

Background

National survey data indicate few adolescents or young adults consume whole grains in the amount recommended to prevent chronic disease and maintain a healthful weight. Interventions are needed to address this gap; however, little is known about what modifiable factors influence whole-grain intake among youth.

Objective

This study aimed to identify socioenvironmental, personal, and behavioral correlates of whole-grain intake among adolescents and young adults.

Design

Data for this cross-sectional analysis were drawn from Project EAT (Eating Among Teens)-II, the second wave of a population-based study in Minnesota. Mailed surveys and food frequency questionnaires were completed by male (44.8%) and female (55.2%) participants in 2003-2004, including 792 adolescents (mean age=17.2 years) and 1,686 young adults (mean age=20.5 years). Linear regression models adjusted for demographic characteristics were used to identify factors associated with energy-adjusted daily intake of whole grains.

Results

Mean daily intake of whole grains was lower than recommended among adolescents (males: 0.59±0.04 servings, females: 0.61±0.04 servings) and young adults (males: 0.68±0.03 servings, females: 0.58±0.03 servings). Home availability of whole-grain bread, self-efficacy to consume ≥3 daily servings of whole grains, and preference for the taste of whole-grain bread were positively associated with whole-grain intake during adolescence and young adulthood across sex. Conversely, fast-food intake was associated with lower intake of whole grains among adolescents and young adults of both sexes. The factors examined in this study explained 28% to 34% of variance in whole-grain intake across sex and the two age groups.

Conclusions

The findings suggest nutrition interventions should address the availability of whole-grain foods in homes and restaurants. In addition, young people should be provided with opportunities to taste a variety of whole-grain foods to enhance taste preferences and self-efficacy to consume whole-grain products.     

Correlates of First Intercourse Among Women in Jamaica

This study examines retrospective reports offactors anticipated to impact first intercourse in arandom sample of 897 Jamaican women, and contributes toour understanding of the relationship between sexual risk, knowledge, and economic and demographiccorrelates of first intercourse. A relationship betweeninitiation of intercourse prior to the age of consent(16 Years) and factors occurring at or around the time of first intercourse was found. Earlyinitiators were more likely to have had less earlyfamily stability and to have experienced menarche at ayounger age than late initiators. Although early initiators of intercourse were more likely toreport lower socioeconomic status, less STD knowledge,and greater numbers of pregnancies, they were no morelikely to report more sexual partners than women who engaged in first intercourse after the ageof consent, and had a greater number of long-termrelationships. Regardless of age of first intercourse,women need to be made aware of the risks of sexual contact so that they can make informeddecisions about the consequences of sexual activity.Overall, results are consistent with work conducted inother parts of the Caribbean and America regarding the age at which young women engage in firstintercourse. Findings suggest the need for further workexploring expectations at first intercourse such asmarriage, economic support, or relationship stability. Implications of these findings are discussedwithin the context of economic and structural factorsthat both increase and decrease risks.     

Cultural Protection from Polysubstance Use Among Native American Adolescents and Young Adults

Prevention Science - Reservation-based Native American youth are at disproportionate risk for high-risk substance use. The culture-as-treatment hypothesis suggests aspects of tribal culture can...     

Correlates of STI Testing Among US Young Adults: Opportunities for Prevention

Prevention Science - The purpose of this study was to examine sex cognitions and behavioral strategy correlates for chlamydia, gonorrhea, and HIV testing among a national sample of young adults...     

Sexting Among Young Adults

PurposeSexting has stirred debate over its legality and safety, but few researchers have documented the relationship between sexting and health. We describe the sexting behavior of young adults in the United States, and examine its association with sexual behavior and psychological well-being.MethodsUsing an adapted Web version of respondent-driven sampling, we recruited a sample of U.S. young adults (aged 18–24 years, N = 3,447). We examined participant sexting behavior using four categories of sexting: (1) nonsexters, (2) receivers, (3) senders, and (4) two-way sexters. We then assessed the relationships between sexting categories and sociodemographic characteristics, sexual behavior, and psychological well-being.ResultsMore than half (57%) of the respondents were nonsexters, 28.2% were two-way sexters, 12.6% were receivers, and 2% were senders. Male respondents were more likely to be receivers than their female counterparts. Sexually active respondents were more likely to be two-way sexters than non–sexually active ones. Among participants who were sexually active in the past 30 days, we found no differences across sexting groups in the number of sexual partners or the number of unprotected sex partners in the past 30 days. We also found no relationship between sexting and psychological well-being.ConclusionsOur results suggest that sexting is not related to sexual risk behavior or psychological well-being. We discuss the findings of this study and propose directions for further research on sexting.     

Universal Family-Focused Intervention with Young Adolescents: Effects on Health-Risking Sexual Behaviors and STDs Among Young Adults

Considering the prevalence and consequences of health-risking sexual behaviors (HRSBs) and STDs among young adults, their prevention is a public health priority. Emerging etiological and prevention outcome literatures suggested study of the long-term effects of universal family-focused interventions on young adult HRSBs and STDs. Although earlier studies have demonstrated intervention impact on adolescent substance misuse, no study has examined universal family-focused intervention effects on young adult HRSBs and STDs via reductions in adolescent misuse. Sixth grade students and their families enrolled in 33 rural Midwestern schools were randomly assigned to experimental conditions. Self-report questionnaires provided data at pretest (Ns?=?238, 221, and 208 for the Iowa Strengthening Families Program [ISFP], Preparing for the Drug Free Years [PDFY], and control groups, respectively), with seven data points through young adulthood (age 21). In latent growth modeling, three young adult HRSB measures (number of sexual partners, condom use, substance use with sex) and lifetime STDs were specified as distal outcomes mediated by adolescent substance initiation growth factors (average level and rate of change). Results showed that the models fit the data and, except for condom use, there were significant indirect effects, with a higher frequency of significant findings for ISFP. The model additions of direct intervention effects on young adult outcomes generally were not supported, consistent with a model positing that long-term intervention effects on young adult HRSBs and STDs outcomes are indirect. As an indication of the practical significance of long-term effects, analyses revealed relative reduction rates ranging from 6 % to 46 % for significant outcomes.     

Waterpipe or Hookah-Related Poisoning Events Among U.S. Adolescents and Young Adults

PurposeWaterpipe or hookah use is associated with carbon monoxide poisoning and effects such as nausea and vomiting. We examined the public health burden of poisoning events involving hookah tobacco in the U.S., especially among adolescents and young adults.MethodsWe analyzed events involving hookah tobacco that were reported to U.S. poison control centers between 2001 and 2017 by age and over time as well as by medical outcome, health care level, and clinical effects.ResultsA total of 276 relevant poisoning events involving hookah were reported. Among the 248 individuals with a specific age reported, 35 (14.1%) were aged between 10 and 17 years and 136 (54.8%) were aged between 18 and 24 years. Common clinical effects included dizziness/vertigo, nausea, headache, and vomiting.ConclusionsHookah tobacco use is associated with poisoning events consistent with exposure to high levels of carbon monoxide.