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This study used a Social network analysis (SNA) approach to describe HIV transmission and venue affiliations among social and sexual networks of young men who have sex with men (YMSM) in Houston, TX.A total of 34 YMSM indices aged 18-23 years and 23 of their network members were interviewed about their social and sexual networks and venues at which they met and spent time.Participants reported information on 220 friends (mean age = 25.3 years) and 112 sexual partners (mean age = 26.3 years). Participants spent time with friends and sexual partners at similar venues but relied more heavily on social media and dating applications to meet sexual partners. Participants lived in zip codes consistent with high concentrations of HIV positivity. Popularly frequented clubs/gay bars were often 10-20 miles away, also in zip codes with high densities of seropositivity.Both friendship and sexual networks are large, diffuse, and not limited by geography. Participants came from areas with high rates of HIV/AIDS. The venues at which participants recruited sexual partners may present increased opportunities for HIV transmission. HIV prevention interventions should focus on the heightened risk of unknown HIV serostatus.

This quasi-experimental study compared family formation and perceived partner support among pregnant adolescents in a prenatal care program. Participants were assigned to either an intervention group utilizing centering pregnancy (CP) prenatal care and case management, or to a comparison group receiving case management only. Partners were invited to participate in CP group sessions. This study included 173 predominantly minority pregnant adolescents ages 15–18 years who were enrolled in a prenatal program and followed one month postpartum. Family formation included living and relationship arrangements. Perceived partner support included six domains of perceived social provisions. Data were collected through participants’ self-reports using computer-assisted self-interviews. Changes in family formation and perceptions of partner support from baseline to postpartum did not differ between intervention and comparison groups. Male partners who attended at least one CP session were perceived as more supportive at both the beginning and end of the program than partners who did not attend any sessions. After combining groups, pregnant adolescents reported a significant shift in family formation and increased monetary support from partners from baseline to postpartum. Partner support is important for ensuring positive pregnancy outcomes. Additional strategies are needed to engage young fathers who do not readily provide support during pregnancy.

The study identified factors associated with human immunodeficiency virus (HIV) risk perception among 283 African American young adult females attending family planning clinics. This included partner communication, a forced sex experience, social support, self-efficacy, and risk behaviors. Relative to adolescents who perceived themselves to be at low/high risk for HIV, adolescents with medium HIV risk had the highest number of lifetime and recent sexual partners, were significantly less comfortable in communicating with partners about sexual issues, and reported low sex and condom self-efficacy. Additionally, the medium group had the highest proportion of participants who reported a forced sex experience. The findings suggest that a forced sex experience may affect females’ ability to accurately assess sexual risk. Screening for trauma and helping adolescents accurately appraise their HIV risk is essential for risk reduction.

The purpose of this study was to assess reproductive health professionals’ familiarity with and use of various electronic technologies to support health promotion. The study also examined the relationship between demographic characteristics and attitudes and beliefs of the effectiveness of new technologies and perceived barriers for usage. A total of 165 reproductive health professionals at two conferences related to reproductive health in the United States completed the study survey. Personal and organizational factors affected the adoption of electronic technologies for health promotion. This included lack of knowledge, skills, and confidence as well as privacy concerns. The results of the study also suggested that being from an older generation was associated with having lower levels of knowledge, skills, and confidence in using new media. These findings highlight the importance of creating learning opportunities on the use of new technology for health promotion as well as addressing specific perceived barriers among reproductive health professionals in order to promote the adoption of these technologies.

Because of its availability, anonymity, and low cost of access, the Internet is an increasingly common way for adolescents to find information about sensitive issues. Sexual health website question portals are an important way for adolescents to seek personalized information tailored to their individualized needs. Few studies have examined the content within anonymous e-mails sent to these question portals. The purpose of this qualitative evaluation was to analyze thematic content of anonymous e-mails sent through a question portal on a comprehensive sexual health clinic website for an adolescent family planning clinic in a large city in the southwest United States. Between August 2009 and June 2012, the e-mail server received questions from 484 individuals who were seeking sexual health-related information. The authors used a content analysis to identify recurrent themes in the questions submitted. The most common questions regarded the cost of the clinic's services and testing for sexually transmitted diseases. The questions revealed that adolescents lack basic sexual health knowledge and hold many misconceptions. The findings support the usefulness of online question portals as effective venues for teenagers to quickly and anonymously obtain accurate information on sensitive issues.

This study aimed to identify health issues that affect young men and the barriers they experience in accessing care. Participants were 48 minority men 18-28 years old, distributed among 9 focus groups. Four main themes emerged in the study. First, the authors identified sexually transmitted infections, mental health problems, and drug use as major health issues. Second, participants identified attitudinal and institutional barriers to accessing care. This included denial; fear; embarrassment; perception that it is not considered manly to seek help; cost; and accessibility. Third, focus group participants felt that services have to be augmented in order to address the specific needs of men. Last, participants suggested strategies to attract men to family planning clinics that are consistent with a youth culture. Focus groups are effective in obtaining input in order to augment services for men.

Objective. Adolescents and young adults remain at high risk for new HIV infections and for unknowingly transmitting the virus to others. Yet, they have demonstrated low rates of testing due to barriers such as stigma and difficulty accessing testing services. Few existing programs have successfully integrated family planning and HIV care services to improve testing and diagnosis rates among young adults and adolescents, particularly those of minority groups. This study describes the process of implementing HIV services into family planning clinics and how to train staff in routine, opt-out testing. Methods. This study used HIV screening data from 10 family planning clinics serving adolescents and young adults in Houston, Texas. A total of 34,299 patients were tested for HIV during a 48-month study period, from January 2010 through December 2014. Results. Patients tested included minors Conclusion. Routine, opt-out HIV testing integrated into family planning clinics increased rates of testing acceptance, receipt of test results, and HIV-positive diagnoses among adolescents and young adults.

The objective of this study was to assess the overall health, including sexual and reproductive health (SRH) knowledge and needs, sexual behaviors, and testicular health practices among young minority males. Anonymous questionnaires were administered to 18- to 25-year-old males receiving services at health clinics in a large southwestern U.S. city. The survey was completed by 258 males with a mean age of 20.8 years. Most young males (67.1%) identified as African American, and 32.9% as Hispanic. Results suggest study participants lack SRH knowledge related to pregnancy and condom effectiveness, and engage in risky sexual behavior including not using birth control at their last sexual encounter. Although 21.6% of participants had a sexually transmitted infection (STI) in the past year, approximately 80% perceived their STI/HIV risk as very low or low. Respondents had low engagement and lack of knowledge of testicular health practices. The majority of respondents (71.1%) reported having been in a physical fight one or more times and 18.1% reported being victims of intimate partner violence. These data support a need for comprehensive health services for minority young males.

The current study assessed the impact of individual, interpersonal, and contextual factors on HIV risk perception. A total of 426 female adolescents attending family planning clinics took part in this study. The majority, 60.1% were African-American and 39.9% were Hispanic. The results indicated that the majority of participants perceived themselves to be at no or low risk for contracting HIV. Individual, interpersonal as well as contextual factors correlated with HIV risk perception in the study. Adolescents who perceived themselves to be at no or low risk were more likely to be Hispanic, be married and had children. They also felt that they can control situations where they have to refuse sex or insist on condom use, had more frequent communication with sexual partners about condom use and held perceptions that peer norms support condom use. The findings in this study have important implications for risk reduction education for female adolescents. Risk reduction education should strengthen adolescents' personal skills to help them avoid HIV risk despite the various pressures they experience in their life.

Health care utilization of reproductive health care services among males is an emerging issue. This study examined ethnicity as a factor in reproductive health care utilization among 1,606 African American and Hispanic young males attending family planning clinics. Seventy percent were African American and 30% were Hispanic. Across groups, the most received service was treatment for a sexually transmitted infection (STI). African American males were more likely than Hispanic males to have health insurance, report a prior visit to a family planning/STI clinic, and have a history of an STI. Hispanic males had higher rates of employment. The most common source of referral for family planning services for both groups was either a current girlfriend or female friend. Hispanic males were more likely to use family as a referral source than African American males. Differences were also noted in regard to interest in health topics with African American males most interested in STI prevention and getting a job and Hispanic males in services related to working-out/eating well, controlling anger, feeling depressed, and getting along with family. Young males’ perceptions of what they consider to be important health care needs should be assessed carefully in order to maintain their interest in returning to the clinics.

This study examined differences in socio-demographics, risk factors and interest in health care topics between males who reported depression compared to those who did not. The sample consisted of 1294 African-American and Hispanic males attending family planning clinics. The results indicated major differences between depressed and non-depressed males. Depressed males were more likely than nondepressed males to be Hispanic and to engage in risk behaviors such as cigarette smoking and drug and alcohol use. Differences were also found in regard to interest in health topics, with depressed males requiring more services related to relationships and feelings than non-depressed males. The findings indicate that young males who attend family planning clinics exhibit signs of depression and profile differently from those who do not exhibit these symptoms and may need additional assessments and referral services.

The purpose of this study was to examine risk factors, knowledge, and attitudes as predictors of intent to use condoms among 290 minority female adolescents who attended family planning clinics. Data on demographic characteristics and risk behaviors such as drug use, school attendance, and contraceptive use were gathered. The results indicated that slightly over half of the teens intended to use condoms at the next intercourse. Overall knowledge about HIV/AIDS and STDs was poor and was not a predictor of intent to use condoms. Teens who intended to use condoms had more favorable attitudes about condom use and a better sense of self-protection regardless of partner feelings or beliefs. These findings suggest that program planners need to be aware that inconsistencies between knowledge and the behaviors of teens exist and this must be viewed within the teens' cultural milieu. Condom use and sex education should become a collaborative endeavor among teens, parents, and partners of female adolescents.

This study examined the impact of risk factors, self and peers’ beliefs, and parental communication on condom use among 290 female adolescents who attended family planning clinics. The major findings showed that in addition to risk factors, self and peer beliefs about condom use and parental communication about birth control predicted actual condom use. Implications for social workers about the importance of encouraging communication between adolescents and their parents are discussed.

To examine individual, interpersonal, family, and community correlates associated with moderate-to-severe depressive symptoms among pregnant adolescents. A total of 249 primarily African American and Hispanic pregnant adolescents ages 15–18 years were recruited into either an intervention group utilizing Centering Pregnancy prenatal care and case management, or to a comparison group receiving case management only. Moderate-to-severe depressive symptoms were defined as a score ≥16 on the Center for Epidemiologic Studies Depression Scale (CES-D). Intervention and comparison groups did not significantly differ on demographic characteristics or depression scores at baseline. A total of 115 (46.1 %) participants met criteria for moderate-to-severe depressive symptoms at entry into the program. Pregnant adolescents who were moderately-to-severely depressed were more likely to be African American, to have reported limited contact with the father of the baby, and to have experienced prior verbal, physical or sexual abuse. Depressed adolescents also experienced high levels of family criticism, low levels of general support, and exposure to community violence. A significant number of pregnant adolescents were affected by depression and other challenges that could affect their health. Comprehensive interventions addressing these challenges and incorporating partners and families are needed.

This study examined whether an assessment tool combining HIV-related risk behaviors and symptoms would increase HIV testing and return for post-test counseling among 466 adolescents attending family planning clinics. The results indicted that high-risk behaviors were common among these adolescents. The majority (78.3%) identified themselves as not using condoms consistently, almost a quarter (24.7%) reported a history of STDs and 129 (27.7%) reported they had pierced their bodies. A total of 214 (45.9%) received HIV testing. Two (0.4%) adolescents, one male and one female, tested positive for HIV. Of the 214 adolescents who underwent testing, 183 (85.5%) returned to the clinic for post-test counseling. The results of this study indicated that adolescents who reported risk behaviors and symptoms were not more likely than those who reported no risk behaviors and symptoms to request testing and return for post-test counseling. In light of these results, the authors review the protocols associated with testing and post-test counseling and propose solutions that can potentially improve these processes. The authors recommend integrating a risk assessment tool with HIV testing in family planning clinics as testing and return for post-test counseling rates were high.

Introduction: Harris County, Texas is the 3rd largest county in the United States, and home to a large ratio of racial/ethnic minorities and immigrants. It has one of the highest rates of cervical cancer, where nearly all cases are caused by human papillomavirus (HPV), with the incidence rate highest among African Americans and Hispanics/Latinos. A wealth of medical resources exist, yet HPV-related cancers have failed to improve over the past 10 years. Youth are particularly at risk for HPV infection and are more likely to not receive the HPV vaccine. The aim of this research was to better understand the factors influencing HPV vaccination among youth in Harris County and to develop an evidence-based approach to improve vaccine uptake. Methods: A socio-ecological framework was used to identify key stakeholders. Data was collected using a mixed methods approach between October 2014 and October 2015 in Harris County, Texas. One focus group and 31 focused interviews were conducted with parents of 5-18 year old children. Seven key informant interviews were conducted with school nurses; a political leader; and health professionals from adolescent health clinics, pediatric hospitals, health centers, community-based organizations (CBOs), and medical institutions. Three community advisory board (CAB) meetings were held with school nurses and board members; physicians; and health professionals from health departments, CBOs, and educational and advocacy organizations. Results: Parents Most parents lacked knowledge of HPV and the vaccine. Many felt the best way to receive education was from their providers. Others expressed interest in receiving education from schools, the media, seminars, and community involvement. Spanish-speaking parents emphasized the need for more linguistically appropriate literature. Some parents voiced discomfort with vaccinating 9-12 year olds, mainly due to safety concerns and vaccine efficacy. Physicians' recommendations were an influential factor in some parents' decision making regarding vaccination. Other key stakeholders Lack of education about HPV infection and the vaccine was cited as a major barrier to vaccination. CAB participants often felt misinformed by their providers, and stated some physicians lack time to hold discussions and fail to provide confident recommendations. Perceived negative side effects; cultural and religious beliefs; lack of reminders for the 2nd and 3rd doses; and labeling the vaccine as a cervical cancer and sexual vaccine were noted as other barriers. Health clinics felt some providers' recommendation approaches were a barrier. Mistrust of the healthcare system was reported as common in Hispanic/Latino communities, and lack of engagement in preventable activities was described as common in African American and immigrant communities. It was stressed that education targeting parents, use of the opt-out approach for provider recommendations, and promoting the vaccine as a cancer-prevention vaccine are essential to increasing HPV vaccine uptake. Conclusions: Comprehensive educational interventions at the provider-, school-, and community-level are needed to ensure that physicians, parents, patients, and educators receive accurate information. Provider trainings can equip physicians with the accurate knowledge needed to make confident recommendations; emphasize use of the opt-out approach for recommendations; and provide them with multilingual educational materials to share with parents and patients. Collaborative efforts with school board members and parent organizations/associations can encourage inclusion of HPV in the curriculum, and foster discussions among parents and educators. Community-based interventions should focus on innovative, culturally-appropriate ways to disseminate education messages in medically, underserved communities. Citation Format: Aba Coleman, Marva Mallory, Jane Montealegre, Peggy Smith, Ruth Buzi, Michael Scheurer, Maria Daheri, Maria Jibaja-Weiss, Matthew Anderson. Understanding the influential factors to human papillomavirus vaccination among youth in Harris County, Texas: A qualitative study. [abstract]. In: Proceedings of the Ninth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2016 Sep 25-28; Fort Lauderdale, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2017;26(2 Suppl):Abstract nr A46.

This study examines the effectiveness of Big Decisions, a sexuality curriculum developed to promote abstinence, as well as condom and contraceptive use, while overcoming school districts' concern about controversy surrounding sex education. The authors used a pre- and post-test survey design to measure changes in attitudes, self-efficacy, and behavioral intentions regarding sex, pregnancy, sexually transmitted diseases, and condom use. The sample for this analysis included 788 inner-city 9th-grade students, the majority of which (78.4%) were Hispanic. Pre- to posttest data comparisons demonstrated improvement in mean scores for each item, with statistically significant changes for 11 of the 12 items measured. The male participants' pretest responses reflected higher risk status than did those of female participants. A large majority (87.8%) of students rated the program as "great" or "good". The results suggest that Big Decisions provides a promising approach to reaching minority students with both abstinence and risk-reduction messages.

This study examined the association between depression, risk behaviors, parental communication, and perceived barriers related to condom use among adolescents attending family-planning clinics. A total of 751 minority women participated in the study. The authors collected data on demographic characteristics, depression, risk behaviors, parental communication about sex-related topics, and perceptions about partner attitudes. Results indicated that 15.2% of adolescents reported depressive symptoms. Depressive symptoms were associated with risk behaviors such as low condom use, substance use, reduced parental communication, and negative perceptions about condom use. These findings suggest that to provide a comprehensive healthcare service to adolescents, the focus of treatment must be expanded beyond the scope of the traditional family planning model. Issues such as depression, risk behaviors, and family communication have to be incorporated in prevention programs to increase the effectiveness of services aimed at risk reduction among adolescents.

The purpose of this study was to examine ethnic differences in risk behaviors among adolescents who attended family planning clinics and to evaluate the impact of parental communication regarding sexual topics on adolescent condom use. The sample for this study included 697 black and Hispanic female adolescents ranging in age from 13-22 years. Ethnic differences were found in sexually transmitted infection rates, number of sexual partners, and condom use. Although black adolescents were more likely than Hispanic adolescents to report recent condom use, Black adolescents reported higher rates of sexually transmitted infections and more sexual partners. Black adolescents reported more parental communication about sexual topics than Hispanic adolescents. Parental communication was associated with increased condom use. The results of this study emphasize the importance of parental communication in risk reduction among adolescents. As ethnicity emerged in the study as a significant factor, interventions aimed at increasing parent-adolescent communication will have to be tailored to address the needs of specific ethnic groups.

A study examining the health and behavioral consequences of child abuse was conducted among 263 parenting and 257 never-pregnant teens attending a reproductive health clinic. Both groups of teens identified the following major consequences: suicide, prostitution, school drop-out, crime and substance abuse. However, only parenting teens expressed interest in prevention programs that would address these consequences. Traditional child abuse prevention programs are focused on parenting issues and rarely address health and behavioral consequences of abuse. These health and behavioral consequences of abuse may make adolescents vulnerable to abuse their own children as well as interfere with their psychosocial development. Therefore, the authors recommend integrating health and behavioral issues into child abuse prevention programs.