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Sexual risk taking among female delinquents represents a significant public health problem. Research is needed to understand the pathways leading to sexual risk taking among this population. This study sought to address this issue by identifying and testing two pathways from child maltreatment to non-condom use among 329 White and 484 African American female adolescent detainees: a relational pathway and a substance use coping pathway. The relational pathway indicated that child maltreatment would be related to non-condom use via depressive self-concept and condom use self-efficacy. The substance use coping pathway suggested that depressive self-concept and alcohol-based expectancies for sexual enhancement would mediate the relationship between child maltreatment and non-condom use. As hypothesized, the relational pathway variables were associated with one another in the expected directions; however, evidence of mediation was not found. Support for mediation was found for the substance use coping pathway. Exploratory across group comparison analysis indicated that the relational pathway was significant for White girls whereas the substance use coping pathway was significant for African American girls. Limitations and implications for future research are discussed.

Objective: Retrospective reports of the association between drinking and high-risk sexual behavior can be biased by implicit theories of the effects of drinking or may represent post hoc justifications instead of accurate reports of behavior. Using data from a daily diary study, we compared daily reports of condom use when drinking and not drinking with the same participants' reports of these behaviors from a retrospective questionnaire administered after diary collection was complete., Method: Participants included adolescents (n=145), adult sexually transmitted disease clinic clients (n=167), college students (n=145), and men who have sex with men (n=147). All participants reported their alcohol consumption and sexual activity daily for 8 weeks and then completed a retrospective questionnaire about their behavior over the diary period., Results: Participants' retrospective judgments about whether they used condoms more or less when drinking were not significantly related to their behavior as reported in the diary. Fewer than two thirds of the participants were accurate in their recollection of the association of condom use and drinking. Teenagers and men who have sex with men were more likely to retrospectively overestimate the negative effect of alcohol on condom use., Conclusions: Retrospective questions about the association between drinking and condom use were consistent with actual behavior only among people who consistently either never or always used condoms. These individuals correctly reported that drinking had no effect on their condom use. For people whose condom use varies, questions about associations between drinking and sex may be difficult to answer, owing to their conditional nature, and may lead to error.

Although it is often assumed that drinking alcohol interferes with condom use, most studies on this topic do not meet the conditions required for causal interpretation. We examined the association of drinking to condom use using data from diaries of alcohol use and sexual encounters, collected over 8 weeks from college students and clients of a sexually transmitted disease clinic. This method establishes the temporal relationships between drinking and condom use and controls for individual differences by using a within-subjects analysis. Multilevel models that predicted condom use from alcohol use before the sexual encounter, partner type, and the use of other contraception showed that drinking before sex was unrelated to condom use. These results do not support the persistent notion that alcohol causes people to engage in sexual risk that they would avoid when sober; instead, people tend to follow their usual pattern of condom use, regardless of alcohol use.

Although there are now several adolescent HIV and STD preventive interventions of demonstrated efficacy in the literature, little is understood about the portability of these interventions. This study replicated Stanton's Focus on Kids intervention, developed for inner city African American adolescents, in a different population, transferring it to a multicultural city. Despite careful replication of the original study's procedures, youth in the preventive intervention condition of the replication study did not improve in attitudes, perceived norms, self-efficacy, or intentions toward sexual initiation, condom use, or abstinence compared with a carefully matched control condition. We discuss several possible reasons for this failure to replicate, concluding that the most likely reason is the lower rates of sexual activity among youth in the replication city.

Sexual health research often relies on single risk indicators. However multi-variable composites may better capture the underlying construct of risk-taking. Latent Profile Analysis identified subgroups based on condom use consistency, partner numbers, and sex frequency among 605 adolescents. Three profiles were identified for each of grades 8 to 10 (Condom Users, Few Partners, and Risk-Takers) and 4 in grades 11 and 12 (Condom Users, One Partner Two Partners, and Risk-Takers). Inconsistent condom use groups reported more non-condom (and often less effective) birth control use and STD and pregnancy histories. Females had greater representation in the Few Partners, One Partners, and Two Partners groups, which also contained increasing proportions of participants in each subsequent year. Males had greater representation in the Risk-Takers group. A profile approach to measurement has methodological advantages, can add to substantive knowledge, and can inform content, timing, and targets of sexual health interventions.

Health promotion should be evidence-based, needs driven, subject to evaluation, and ecological in perspective. How can this be achieved in the context of school-based sex education? Adopting new behaviors and giving up old habits involves common decision-making, planning, motivational control, and goal prioritization processes. Consequently, despite the particular nature of sexual behavior, models of cognitive change applied to other health-related behaviors also apply to the promotion of safer sex practice. Young people are less likely to have unprotected sexual intercourse if they have acquired a variety of social skills relevant to dealing with romantic and sexual relationships. Many of these social skills and the methods employed to facilitate their development are also important to the promotion of other health behaviors. However, teaching social skills relevant to sexual behavior in classroom settings requires specialist expertise both in program design and in delivery by teachers or facilitators. Theory- and evidence-based programs designed to promote such skills and modified on the basis of effectiveness evaluations are most likely to have an impact on the rate of pregnancies and sexually transmitted infections among young people. Yet, such programs may not be used in schools because of policy and cultural constraints. When this is the case, optimally effective health promotion cannot be delivered. Health promoters should acknowledge these challenges and facilitate the adoption and implementation of effective sexual health promotion programs by targeting communities and legislators.

Context: Alcohol consumption often has been cited as increasing adolescents' risk of HIV, and several studies have shown positive relationships between drinking and risky sexual behavior among adolescents. Because most of these studies used global measures of drinking and risky sex, and conducted comparisons across persons, they could not determine whether alcohol use was a cause of risky sex or simply a correlate., Methods: A sample of 112 U.S. adolescents completed daily diaries about their health behaviors, including drinking and intercourse, for eight weeks. In analyses using t-tests and hierarchical linear modeling, each respondent's rate of condom use after drinking was compared with his or her rate of use when not drinking, and predictors of condom use were examined, Results: Rates of condom use did not differ significantly between sexual events preceded by drinking (use in 54% of events) and those not preceded by drinking (use in 52% of events). Condoms were more likely to be used during sexual events with casual partners than in those with steady partners, less likely to be used on occasions when other birth control was used and more likely to be used when the sexual encounter was expected. In the multivariate analyses, the odds of condom use were not associated either with whether a teenager had been drinking before sex or with the quantity of alcohol consumed., Conclusions: These findings challenge the widely accepted hypothesis that drinking is a cause of sexual risk-taking. Rather, they underscore the need for interventions to increase teenagers'access to and ability to use condoms.

Researchers examined individual characteristics and peer influences related to adolescents' sexual behavior, taking gender and sexual experience into account. As part of a larger, longitudinal study investigating youth health awareness, 8th, 9th, and 10th graders reported their intentions to engage in sexual activity and use condoms in the next year, the amount of pressure they felt to engage in sexual activity, and their perceptions about the number of their peers engaging in sexual activity. Findings suggest intentions to engage in sexual behavior and use condoms, feelings of pressure to have sex, and perceptions about the number of friends engaging in sexual intercourse differ by gender and sexual experience status. Implications of these findings for health and sexuality education, as well as HIV prevention programs targeted at adolescents, are discussed. (J Sch Health. 2001;71(4):153-158), The prevalence of sexual activity, pregnancy, and STDs among US adolescents has caused some alarm. Researchers have described outcomes associated with adolescent sexual behavior in terms varying from 'a public [...]