Search

Sexual risk reduction interventions are often ineffective for women who drink alcohol. The present study examines whether an alcohol-related sexual risk reduction intervention successfully trains women to increase assertive communication behaviors and decrease aggressive communication behaviors. Women demonstrated their communication skills during interactive role-plays with male role-play partners. Young, unmarried, and nonpregnant African American women (N = 228, ages 18-24) reporting unprotected vaginal or anal sex and greater than three alcoholic drinks in the past 90 days were randomly assigned to a control, a sexual risk reduction, or a sexual and alcohol risk reduction (NLITEN) condition. Women in the NLITEN condition significantly increased assertive communication behavior compared to women in the control condition, yet use of aggressive communicative behaviors was unchanged. These data suggest assertive communication training is an efficacious component of a sexual and alcohol risk reduction intervention. Public health practitioners and health educators may benefit from group motivational enhancement therapy (GMET) training and adding a GMET module to existing sexual health risk reduction interventions. Future research should examine GMET's efficacy in combination with other evidence-based interventions within other populations and examine talking over and interrupting one's sexual partner as an assertive communication behavior within sexual health contexts.

Unlabelled: Background The aim of this study was to describe acceptance of and experiences utilising expedited partner therapy (EPT) among African-American girls recruited from short-term juvenile detention centres.Methods: Ninety-five detained African-American girls (aged 13-17 years) completed audio computer-assisted self-interviews (ACASI) and self-collected vaginal swab specimens assayed for chlamydia and gonorrhoea. EPT was offered to sexually transmissible infection (STI)-positive participants (n=51); follow-up phone interviews assessed medication delivery to partners. Summary statistics described EPT acceptance frequency. Generalised estimating equations assessed correlates of acceptance. Nine semi-structured interviews elicited EPT experiences.Results: EPT was offered 69 times, accepted by 70% (n=37) girls and provided to 68% (n=36) of girls. Acceptance was significantly associated with sexual risk behaviours such as infrequent partner STI prevention discussion (OR=3.2, 95% CI: 1.0,-10.1, P=0.048) and≥4 lifetime sex partners (OR=3.3, 95% CI: 1.0-11.0, P=0.048). Discontinued relationships were the most common barrier to EPT acceptance. Emergent interview themes included sense of responsibility, which appeared to motivate acceptance and help overcome identified discomfort with partner disclosure conversations.Conclusions: Future research is needed to determine EPT efficacy among African-American juvenile populations and feasibility of its use outside of research settings. [ABSTRACT FROM AUTHOR]

Background: The identification of antecedents to sexual risk among youth is critical to the development and dissemination of multilevel interventions. Therefore, the aim of the present study was to examine the effect of sexual sensation-seeking on partner age, partner communication, and the sexual attitudes and behaviours of African-American female youth. Methods: This study examined survey data collected by audio computer-assisted self-interviews from 701 young African-American females between 14 and 20 years of age. The survey consisted of items designed to measure adolescents' sexual risk and preventive behaviours. Results: The results of this study suggest that sexual sensation-seeking is associated with condom use among adolescent African-American females. For adolescents who reported greater sexual sensation-seeking, lower levels of sexual happiness were associated with a decreased likelihood of condom use at last intercourse (β = 1.01, P≤0.05). For those reporting lower levels of sexual sensation-seeking, greater sexual enjoyment was associated with a greater likelihood of condom use at last intercourse (β = 0.93, P≤0.01). Adolescents with younger sexual partners and lower levels of sexual sensation-seeking reported a higher proportion of condom use in the past 6 months (β = 0.70, P = 0.01). Higher partner communication self-efficacy and decreasing levels of sexual sensation-seeking were associated with fewer lifetime sexual partners (β = -0.54, P≤0.05). Conclusions: Future research should address the impact of these variables on adolescent relationship dynamics and sexual decision-making. [ABSTRACT FROM AUTHOR]

Not everyone exposed to an efficacious human immunodeficiency virus (HIV) intervention will reduce sexual risk behaviors, yet little is known about factors associated with 'failure to change' high-risk sexual behaviors post-intervention. History of abuse and polymorphisms in the serotonin transporter gene ( 5- HTT) may be associated with non-change. The current study sought to identify genetic, life history, and psychosocial factors associated with adolescents' failure to change condom use behaviors post-participation in an HIV prevention intervention. A sub-set of participants from a clinic-based sample of adolescent African-American females ( N = 254) enrolled in a randomized trial of an HIV-prevention was utilized for the current study. Forty-four percent did not increase their condom use from baseline levels 6 months after participating in the sexually transmitted infection (STI)/HIV prevention intervention. In multivariable logistic regression analysis, an interaction between abuse and 5-HTTLPR group was significantly associated with non-change status, along with partner communication frequency scores at follow-up. Follow-up tests found that having a history of abuse was significantly associated with greater odds of non-change in condom use post-intervention for only those with the s allele. For those with ll allele, participants with higher partner communication frequency scores were at decreased odds of non-change in condom use post-intervention. Thus, STI/HIV interventions for adolescent females may consider providing a more in-depth discussion and instruction on how to manage and overcome fear or anxiety related to being assertive in sexual decisions or sexual situations. Doing so may improve the efficacy of STI/HIV prevention programs for adolescent women who have experienced abuse in their lifetime. [ABSTRACT FROM AUTHOR]

Previous research has demonstrated that a history of gender-based victimization is associated with higher rates of sexual risk-taking behaviors among adolescents. Victimization can occur in various forms. To date, no published studies have examined the relationship between the different forms of victimization and sexual risk-taking behaviors among African American adolescent women. This study explored the association between different forms of victimization and sexual risk behaviors using baseline data from participants (N = 715) with a mean age of 17.9 (SD = 1.7), who were enrolled in a larger intervention study. The results revealed that a history of any form of victimization was associated with some form of sexual risk behaviors. [ABSTRACT FROM AUTHOR]

Previous research has established the association between psychosocial factors and risky sexual behaviour. However, few studies have examined the relationship between psychological distress and sexually transmitted infection (STI)/HIV-associated behaviours in African-American youth. The present study examined the association of psychological distress with STI/HIV-risk behaviour and psycho-social mediators of HIV-preventive behaviours. A sample of 715 African-American female adolescents, 15-21 years old, completed an audio computer assisted self-interviewing (ACASI) assessing sociodemographics, psychological distress, self-efficacy, communication and STI/HIV-associated sexual behaviours. Participants also provided self-collected vaginal swab specimens, which were assayed for STIs. High levels of psychological distress were defined as having a score of ≥7 on the eight-item Centre for Epidemiological Studies-Depression Scale. The overall prevalence of high levels of psychological distress was 44.5%. Logistic regression analyses revealed that adolescents with high psychological distress, relative to those with low psychological distress, were more likely to have a biologically confirmed STI (adjusted odd ratio (AOR) = 1.40), use condoms inconsistently (AOR = 1.50), not use condoms during their last casual sexual encounter (AOR = 1.89), have sex while high on alcohol or drugs (AOR = 1.47), have male sexual partners with concurrent female sexual partners (AOR = 1.98), have low condom use self-efficacy (AOR = 1.54), partner sexual communication self-efficacy (AOR = 1.77), refusal self-efficacy (AOR = 2.05) and be more fearful of communicating with their partners (AOR = 1.98). These findings, although preliminary, could be used to inform HIV intervention programs and physicians/clinicians providing regular health care maintenance to African-American female adolescents engaging in risky sexual behaviour. [ABSTRACT FROM AUTHOR]

African-American female adolescents who engaged in vaginal sex only ( N = 272) were compared to adolescents who engaged in two types (vaginal plus oral or anal; N = 295) and three types (vaginal, oral and anal; N = 144) on a constellation of other sexual risk behaviors (SRBs) and on sexually transmitted infections (STIs). Adjusted contrasts among groups revealed that adolescents who engaged in two and in three types of sex as compared to those who engaged in vaginal sex only were more likely to engage in six of the seven SRBs, but were just as likely to have a STI. One SRB, having ≥ 4 lifetime sex partners, was in turn associated with STI. Two-way interactions indicated that having a casual sex partner and having multiple sex partners in the last 60 days increased the likelihood of STI, but only for adolescents who engaged in all three types. [ABSTRACT FROM AUTHOR]

Objectives: To identify relational correlates of unprotected oral sex (UOS) and vaginal intercourse (UVI) among African-American females. Methods: Participants (n = 715) provided data on demographics, sexual communication self efficacy (SCSE), sexual communication frequency, condom self-efficacy, power in sexual relationships, fear of negotiating condom use, UOS and UVI. Results: Participants reporting low SCSE were 2.5 and 1.6 times more likely to report UOS and UVI respectively. Additionally, participants who reported fear of condom negotiation were 3.1 times more likely to report UVI. Conclusions: Interventions promoting stronger SCSE may be a protective factor against having UOS and UVI among African-American females. [ABSTRACT FROM AUTHOR]

The article presents a study which aims to determine whether it is possible to identify high-risk populations that need to be prioritized for human papillomavirus (HPV) immunization among African-American adolescent females. The study collected data through an audio computer-assisted survey interview plus testing for trichomonas vaginalis, chlamydia trachomatis, gonorrhoea and HPV. It was found that HPV prevalence was not associated with other sexually-transmissible infections but was prevalent among the younger respondents who reported the use of birth control pills. It concluded that it was not possible to identify high-risk HPV populations and therefore recommends HPV vaccination as the most effective public health strategy regardless of risk indicators.

Objective: To determine the association between oral contraceptive and condom use, and laboratory- confirmed sexually transmitted infection (STI) among African-American adolescent females at a high risk of STI acquisition. Methods: A cross-sectional study of 715 African-American adolescent females (15-21 years old) was conducted. Data collection included (a) an audio-computer-assisted self-interview and a self-collected vaginal swab for nucleic acid amplification testing of Trichomonas vaginalis, Chlamydia trachomatis and Neisseria gonorrhoeae. Results: The age-adjusted odds ratio (AOR) indicated a modest protective effect of oral contraceptive use against unprotected vaginal sex (UVS) using a 60-day recall period (AOR=0.66; 95% CI 0.43 to 0.99). The age-adjusted difference in mean frequency of UVS in the past 60 days was non-significant (p=0.23) as was condom use at last sex (p=0.34). The age-AOR relative to STI prevalence also showed a protective effect (AOR=0.60; 95% CI 0.36 to 0.98) for those using oral contraceptives. Conclusion: The findings suggest that the use of oral contraceptives may not preclude safer sex practices for the prevention of STIs among high-risk African-American adolescent females. [ABSTRACT FROM AUTHOR]

Although group-delivered HIV/sexually transmitted disease (STD) risk-reduction interventions for African American adolescent females have proven efficacious, they require significant financial and staffing resources to implement and may not be feasible in personnel- and resource-constrained public health clinics. We conducted a study assessing adoption and implementation of an evidence-based HIV/STD risk-reduction intervention that was translated from a group-delivered modality to a computer-delivered modality to facilitate use in county public health departments. Usage of the computer-delivered intervention was low across 8 participating public health clinics. Further investigation is needed to optimize implementation by identifying, understanding, and surmounting barriers that hamper timely and efficient implementation of technology-delivered HIV/STD risk-reduction interventions in county public health clinics. [ABSTRACT FROM AUTHOR]

The article presents a study, which examines the high quantity of alcohol as a longitudinal indicator of risky sexual behavior and sexually transmitted diseases (STDs) among adult female African-American. The results showed that high quantity of alcohol used predicted positive test results in HIV, in contrast with the use of condom. Furthermore, these outcomes propose that HIV/STD-related behavioral treatments should discuss the connection between alcohol and risk behavior in HIV/STD.

Condom use at last sex is a widely used indicator in sexual behavior research; however, there is little empirical research validating this indicator. This study examined whether a single-event recall period (the last time coitus occurred) was consistent with longer recall periods (14 days and 60 days) for a sample of African American adolescent females (N = 566). The findings from this study demonstrate that condom use at last coitus is a valid proxy for condom use behaviors spanning longer time periods. [ABSTRACT FROM AUTHOR]

Objectives: To pilot test the feasibility of screening pregnant teens for HSV-2 infection during their first prenatal visit.Study Design: A cross-sectional study of 127 African-American adolescent females recruited during their first attendance to a prenatal clinic in a large urban hospital. A rapid serologic test (POCkit, manufactured by Diagnology Inc.) was used to assess HSV-2. The test uses a membrane-based immunoassay to detect circulating IgG antibodies to a specific antigen obtained from HSV-2 (semi-purified glycoprotein G2).Results: More than one-fifth (21.3%) of the adolescents tested positive for HSV-2; only 1 adolescent was previously aware of her infection. Older adolescents and those reporting a history of other STDs were significantly more likely to test positive for HSV-2.Conclusions: Testing for HSV-2 in early pregnancy may be an efficient strategy for (1) initiating patient education designed to promote adoption of protective behaviors among adolescents at risk of HSV-2 acquisition during the remainder of their pregnancy and (2) teaching those who test positive how to recognize symptoms of HSV-2 outbreaks; patients reporting recurrent outbreaks during pregnancy may benefit from predelivery assessment. [Copyright &y& Elsevier]