122 results on '"Ellen, Jonathan"'
Search Results
2. The Impact of Relationship Stressors on Trust and Prorelationship Behavior Within Adolescent Romantic Relationships: A Systems Approach.
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Matson PA, Chung SE, Fortenberry JD, Lich KH, and Ellen JM
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- Adolescent, Female, Humans, Prospective Studies, Sexual Behavior, Sexual Partners, Systems Analysis, Trust, Adolescent Behavior, Sexually Transmitted Diseases
- Abstract
Purpose: Trust is an essential component of romantic relationships. It is not understood how youth respond to a relationship stressor, which may impact trust, such as perceiving to be at risk for a sexually transmitted infection or their partner has other sex partners. We used a system science approach to examine feedback between trust and prorelationship behaviors within adolescent relationships., Methods: A prospective cohort of clinic-recruited young women (N = 122), aged 16-19 years, completed daily questionnaires on partner-specific feelings and risk perceptions for 18 months. Relationship stressor defined as either perceiving the risk of sexually transmitted infection from a partner or partner had other sex partners. Prorelationship behaviors were more time spent with partner, sex with partner, and/or gift from partner. Time-lagged generalized estimating equation models were used to examine whether a relationship stressor is associated with a decrease in trust and whether prorelationship behaviors changed following the stressor., Results: Experiencing a stressor was associated with threefold increased odds of having a decrease in trust in the same week (odds ratio [OR] = 3.30, 95% confidence interval [CI]: 2.30-4.72). Trust increased significantly the week following the stressor (OR = 2.09, 95% CI: 1.54-2.85). An increase in trust relative to the week of the stressor was associated with a 65% increase in prorelationship behavior in the week following the stressor (OR = 1.65, 95% CI: 1.20-2.26)., Conclusions: Data uniquely show that trust is impacted following a relationship stressor and that youth increase prorelationship behaviors following a drop in trust. The findings suggest that adolescents prioritize maintaining trust, which may impact engagement in protective health behaviors., (Copyright © 2020 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.)
- Published
- 2021
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3. Childbearing Motivations and Desires, Fertility Beliefs, and Contraceptive Use among Urban African-American Adolescents and Young Adults with STI Histories.
- Author
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Alexander KA, Perrin N, Jennings JM, Ellen J, and Trent M
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- Adolescent, Adult, Black or African American statistics & numerical data, Contraception Behavior statistics & numerical data, Female, Humans, Male, Pregnancy, Reproductive Behavior statistics & numerical data, Sex Factors, United States, Young Adult, Black or African American psychology, Contraception Behavior psychology, Fertility, Motivation, Reproductive Behavior psychology, Sexually Transmitted Diseases psychology
- Abstract
This study explored the influence of STI history on childbearing motivations, fertility beliefs, current childbearing desires, and contraception use among urban African-American adolescents and young adults (AYA). Secondary data were from the Neighborhood Influences on Adolescent and Young Adult Health (NIAAH) study, conducted from 2004 to 2007. Sample included 517 AYA ages 15-24 years (male: n = 199, female: n = 318). Linear and logistic regression models examined gender differences in childbearing motivations (CBM) and desires, fertility beliefs, condom, and contraception use. Logistic regression models were constructed to examine age, pregnancy history, and STI fertility knowledge as potential confounders. AYA men (3.29) and AYA women (3.23) had similar CBM mean scores. AYA women had more positive CBM and used condoms less. Condom use was not associated with CBM among AYA men (OR = 0.71, p = 0.069). Low beliefs about fertility (OR = 0.52, p = 0.003) and prior pregnancy (OR = 5.27, p = 0.002) were associated with current childbearing desires among AYA women. AYA men's low fertility beliefs were only associated with current childbearing desires (OR = 0.56, p = 0.044). AYA men reported more contraception use (67.46 vs. 55.04%), especially with no partner pregnancy history (OR = 0.26, p = 0.017). Younger men (15 to 18 years old) reported more contraception or condom use compared to older AYA men (19-25 years old) (OR = 0.40, p = 0.016). Young men reporting a partner's prior pregnancy used fewer condoms or contraception (OR = 0.23, p = 0.028). STI history did not influence CBM in this sample of urban youth. Prior pregnancy experiences and chronological age, however, were important milestones shaping proximal motivations and desires to bear children, beliefs about fertility, and contraception behaviors.
- Published
- 2019
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4. Weekly variations in feelings of trust predict incident STI within a prospective cohort of adolescent women from a US city.
- Author
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Matson PA, Fortenberry JD, Chung SE, Gaydos CA, and Ellen JM
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- Adolescent, Baltimore epidemiology, Chlamydia Infections epidemiology, Chlamydia Infections urine, Emotions, Female, Gonorrhea epidemiology, Gonorrhea urine, Humans, Incidence, Longitudinal Studies, Prospective Studies, Risk Factors, Sexual Partners, Sexually Transmitted Diseases transmission, Surveys and Questionnaires, Young Adult, Sexual Behavior physiology, Sexually Transmitted Diseases epidemiology, Trust psychology
- Abstract
Objectives: Feelings of intimacy, perceptions of partner concurrency (PPC) and perceptions of risk for an STD (PRSTD) are meaningful and dynamic attributes of adolescent sexual relationships. Our objective was to examine whether variations in these STI-associated feelings and perceptions predicted incident Chlamydia trachomatis and/or Neisseriagonorrhoeae infection within a prospective cohort of urban adolescent women., Methods: A cohort of clinic-recruited women aged 16-19 completed daily surveys on feelings and risk perceptions about each current sex partner on a smartphone continuously for up to 18 months. Urine was tested for C. trachomatis and N. gonorrhoeae every 3 months. Daily responses were averaged across the week. As overall means for trust, closeness and commitment were high, data were coded to indicate any decrease in feelings from the previous week. PRSTD and PPC were reverse coded to indicate any increase from the previous week. An index was created to examine the cumulative effect of variation in these feelings and perceptions. Generalised linear models were used to account for correlation among repeated measures within relationships., Results: For each week that there was a decrease in trust, there was a 45% increase in the risk of being infected with an STI at follow-up (relative risk (RR) 1.45, 95% CI 1.18 to 1.78, P=0.004). Neither a decrease in closeness or commitment, nor an increase in PRSTD or PPC was associated with an STI outcome. Cumulatively, the index measure indicated that a change in an additional feeling or perception over the week increased the odds of an STI by 14% (RR 1.14, 95% CI 1.02 to 1.29, P=0.026)., Conclusions: A decrease in feelings of trust towards a main partner may be a more sensitive indicator of STI risk than PRSTD, PPC or commitment. The next generation of behavioural interventions for youth will need strategies to address feelings of intimacy within adolescent romantic relationships., Competing Interests: Competing interests: None declared., (© Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.)
- Published
- 2018
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5. Examination of Behavioral, Social, and Environmental Contextual Influences on Sexually Transmitted Infections in At Risk, Urban, Adolescents, and Young Adults.
- Author
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Boyer CB, Santiago Rivera OJ, Chiaramonte DM, and Ellen JM
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- Adolescent, Black or African American, Child, Female, Homosexuality, Male, Humans, Logistic Models, Male, Prevalence, Self Report, Sex Factors, Sexual Partners, Sexual and Gender Minorities, Social Class, Transgender Persons, Young Adult, HIV Infections epidemiology, Sexual Behavior, Sexually Transmitted Diseases epidemiology
- Abstract
Background: Despite the large body of extant literature on sexually transmitted infections (STIs) in adolescents and young adults (AYAs), more research on social and environmental contextual factors is needed. Also, further examination of STI indicators by gender remains a critical area of research focus., Methods: Anonymous survey data were collected using audio computer-assisted self-interviews in community venues in urban, low-income, STI prevalent, US neighborhoods to reach AYAs, aged 12 to 24 years. Conventional descriptive statistics, bivariate analysis, and multiple logistical regression models were used to assess indicators of a self-reported lifetime prevalence of STIs., Results: Participants (N = 1540) were on average 20.6 years; 57.2% were women, the majority were racial and ethnic minorities (92%), and almost half (49.2%) identified as sexual minorities. Nearly one third (32.%) had 1 or more STIs. As expected, gender differences were identified. For AYA men, being African American/Black, moving residences more than 4 times since kindergarten, and having a history of human immunodeficiency virus testing were each positively associated with STIs. Also, those who strongly disagreed that many young people in their community exchanged sex for money had a significantly lower likelihood of having an STI. For AYA women, exchanging sex for drugs or money, lacking money, which prevented activities, and using marijuana were each associated with STIs., Conclusions: This research extends our understanding of social and environmental contextual influences on AYAs' risk for STIs. It highlights differences in risk exposures that are distinctly different for AYA women and men, suggesting the need for tailored interventions to address their unique economic needs and social challenges.
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- 2018
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6. The Interaction of Sexual Validation, Criminal Justice Involvement, and Sexually Transmitted Infection Risk Among Adolescent and Young Adult Males.
- Author
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Matson PA, Towe V, Ellen JM, Chung SE, and Sherman SG
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- Adolescent, Humans, Logistic Models, Male, Prisons, Risk Factors, Self Report, Sexual Behavior statistics & numerical data, Sexually Transmitted Diseases psychology, United States epidemiology, Young Adult, Criminal Law statistics & numerical data, Sexual Behavior psychology, Sexual Partners psychology, Sexually Transmitted Diseases epidemiology
- Abstract
Background: Young men who have been involved with the criminal justice system are more likely to have concurrent sexual partners, a key driver of sexually transmitted infections. The value men place on having sexual relationships to validate themselves may play an important role in understanding this association., Methods: Data were from a household survey. Young men (N = 132), aged 16 to 24 years, self-reported whether they ever spent time in jail or juvenile detention and if they had sexual partnerships that overlapped in time. A novel scale, "Validation through Sex and Sexual Relationships" (VTSSR) assessed the importance young men place on sex and sexual relationships (α = 0.91). Weighted logistic regression accounted for the sampling design., Results: The mean (SD) VTSSR score was 23.7 (8.8) with no differences by race. Both criminal justice involvement (CJI) (odds ratio [OR], 3.69; 95% confidence interval [CI], 1.12-12.1) and sexual validation (OR, 1.10; 95% CI, 1.04-1.16) were associated with an increased odds of concurrency; however, CJI did not remain associated with concurrency in the fully adjusted model. There was effect modification, CJI was associated with concurrency among those who scored high on sexual validation (OR, 9.18; 95% CI, 1.73-48.6]; however, there was no association among those who scored low on sexual validation. Racial differences were observed between CJI and concurrency, but not between sexual validation and concurrency., Conclusions: Sexual validation may be an important driver of concurrency for men who have been involved with the criminal justice system. Study findings have important implications on how sexual validation may explain racial differences in rates of concurrency.
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- 2018
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7. Do young women engage in greater sexual risk behaviour with biological fathers of their children?
- Author
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Decker MR, Chung SE, Ellen JM, and Sherman SG
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- Adolescent, Baltimore epidemiology, Coitus psychology, Condoms statistics & numerical data, Cross-Sectional Studies, Female, Humans, Male, Pregnancy, Qualitative Research, Risk-Taking, Sexually Transmitted Diseases epidemiology, Unsafe Sex psychology, Unsafe Sex statistics & numerical data, Young Adult, Fathers psychology, Mothers psychology, Sexual Behavior psychology, Sexual Behavior statistics & numerical data, Sexual Partners psychology, Sexually Transmitted Diseases transmission
- Abstract
Objectives: Qualitative research suggests that young women's relationships with the biological fathers of their children (BFRs), known colloquially as 'baby daddy' relationships, enable risk for pregnancy and STI/HIV. Our study compared partner characteristics and sexual risk within dyads based on BFR, among a sample of young women in Baltimore, Maryland, USA., Methods: We conducted secondary analysis of survey data collected in 2011-2013 from heterosexually experienced youth ages 15-24 in Baltimore, Maryland, USA. Analyses are limited to women with at least one recent (past 6 months) sex partner (n=171 participants, reporting on 271 relationships). Using generalised estimating equations with logit function for correlated binary responses, we evaluate associations of BFR with partner characteristics, sexual risk behaviour and contraceptive non-use., Results: At least one BFR partner was reported by 25.2%. Male partners in BFRs were more likely to have been incarcerated or arrested. BFRs were more often characterised by women as 'main' versus 'casual' partners (adjusted OR (AOR) 3.92, 95% CI 1.19 to 12.9). In adjusted analyses, BFR was associated with condom non-use for vaginal (AOR 12.3, 95% CI 3.92 to 38.7) and anal (AOR 3.32, 95% CI 1.34 to 8.22) intercourse. While BFR was associated with contraceptive non-use (AOR 2.21, 95% CI 1.01 to 4.84), this association attenuated to non-significance after adjusting for partnership type (AOR 2.06, 95% CI 0.91 to 4.67)., Conclusions: While few differences in BFR partner characteristics emerged, significantly greater risk for unprotected intercourse was identified within BFR relationships. Findings suggest that the relationship context of a shared child heightens sexual risk for the young women most affected by STI., (Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/)
- Published
- 2016
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8. Attitudes Towards Power in Relationships and Sexual Concurrency Within Heterosexual Youth Partnerships in Baltimore, MD.
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Lilleston PS, Hebert LE, Jennings JM, Holtgrave DR, Ellen JM, and Sherman SG
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- Adolescent, Adult, Baltimore epidemiology, Female, Heterosexuality, Humans, Male, Risk Factors, Young Adult, Attitude, HIV Infections epidemiology, Sexual Behavior, Sexual Partners, Sexually Transmitted Diseases epidemiology
- Abstract
Sexual concurrency may increase risk for HIV/STIs among youth. Attitudes about gender roles, including power balances within sexual partnerships, could be a driver. We examined this association among Baltimore youth (N = 352), aged 15-24. Data were collected from February, 2011 to May, 2013. We examined whether index concurrency in male-reported partnerships (N = 221) and sex partner's concurrency in female-reported partnerships (N = 241) were associated with youth's attitudes towards relationship power. Males with more equitable beliefs about power were less likely to report index concurrency. Females with more equitable beliefs were more likely to report sex partner's concurrency. The relationship was significant in main and casual partnerships among females and main partnerships among males. The strongest associations were detected among middle-socioeconomic status (SES) males and low-SES and African American females. Implementing interventions that recognize the complex relationship between socioeconomic context, partner dynamics, gender, and sexual behavior is an important step towards reducing HIV/STI risk among youth.
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- 2015
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9. Social place as a location of potential core transmitters-implications for the targeted control of sexually transmitted disease transmission in urban areas.
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Jennings JM, Polk S, Fichtenberg C, Chung SE, and Ellen JM
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- Adolescent, Adult, Baltimore, Cross-Sectional Studies, Female, Heterosexuality, Humans, Male, Risk-Taking, Sexually Transmitted Diseases psychology, Social Environment, Urban Population, Young Adult, Sexual Behavior, Sexual Partners psychology, Sexually Transmitted Diseases prevention & control, Sexually Transmitted Diseases transmission, Unsafe Sex statistics & numerical data, Urban Health statistics & numerical data
- Abstract
Purpose: Places are an important determinant of risk for sexually transmitted infection (STI) acquisition and transmission. We sought to identify social places that are critical for targeted STI control activities. The objective of this study was to determine whether sex partner meeting places characterized by drug markets, sex markets, and separately, drug and/or sex markets were more likely to have potential core transmitters as compared with other sex partner meeting places in one urban setting., Methods: In 2008-2009, heterosexual sex partner places or venues were identified in Baltimore, MD using a venue-based study approach., Results: A total of 1334 participants aged 18 to 35 years were enrolled at 85 venues. In those participants, 39 potential core transmitters were identified and 31% of venues had at least one potential core transmitter. In final age-adjusted and gender-adjusted models, core transmitters were significantly more likely to be identified at drug markets (OR = 1.37; 95% CI = 1.23-1.53), sex markets (OR = 1.27; 95% CI = 1.14-1.41), and drug and/or sex markets (OR = 1.49; 95% CI = 1.32-1.68)., Conclusions: This study identified key characteristics of venues, such as drug and sex market activity, that may be important in identifying places for the targeted control of STI transmission., (Copyright © 2015 Elsevier Inc. All rights reserved.)
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- 2015
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10. Understanding variability in adolescent women's sexually transmitted infection-related perceptions and behaviors associated with main sex partners.
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Matson PA, Chung SE, Huettner S, and Ellen JM
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- Adolescent, Analysis of Variance, Emotions, Female, Health Knowledge, Attitudes, Practice, Humans, Perception, Prospective Studies, Sexually Transmitted Diseases prevention & control, Trust, Young Adult, Adolescent Behavior psychology, Condoms statistics & numerical data, Risk-Taking, Safe Sex psychology, Sexual Partners psychology, Sexually Transmitted Diseases psychology
- Abstract
Background: It is not well understood whether characteristics of adolescent main partnerships differ categorically from one relationship to the next or whether observed differences in sexually transmitted infection (STI)-related perceptions and sexual behaviors between main partnerships results from a failure to capture variability within adolescent main partnerships. The objective of this study was to examine the extent to which female adolescents' STI-related feelings, perceptions, and sexual behavior associated with main sex partners varied over the course of their relationship., Methods: A cohort of adolescent women aged 16 to 19 years at baseline, recruited from health clinics or community venues, completed daily diaries on a Smartphone continuously for 18 months. Participants reported daily on their partner-specific feelings of closeness, trust, commitment, perceived risk for acquiring a sexually transmitted disease (PRSTD), perception of partner concurrency (PPC), and condom use for their main sexual partners., Results: Relationships from 49 participants were used to examine variability over time in STI-related feelings, perceptions, and behavior. Overall, relationships were characterized by high levels of trust, closeness, and commitment and low levels of PPC, PRSTD, and condom use. However, for all but PRSTD, there was more variation (>50%) within than between relationships for each of these measures, although variability of PRSTD was high (47.1%). Residual variability for all perceptions and behaviors remained significant after controlling for trends over time., Conclusions: Diary data illustrate wide day-to-day fluctuations in feelings of intimacy, PPCs, PRSTDs, and condom use indicating that these are dynamic attributes of adolescent romantic relationships.
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- 2014
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11. Perceived neighborhood partner availability, partner selection, and risk for sexually transmitted infections within a cohort of adolescent females.
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Matson PA, Chung SE, and Ellen JM
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- Adolescent, Black or African American psychology, Age Distribution, Baltimore epidemiology, Female, Humans, Interviews as Topic, Perception, Prospective Studies, Risk Assessment, Sexual Behavior statistics & numerical data, Sexually Transmitted Diseases etiology, Sexually Transmitted Diseases psychology, Urban Health statistics & numerical data, Young Adult, Black or African American statistics & numerical data, Residence Characteristics statistics & numerical data, Sexual Behavior psychology, Sexual Partners psychology, Sexually Transmitted Diseases ethnology
- Abstract
Purpose: This research examined the association between a novel measure of perceived partner availability and discordance between ideal and actual partner characteristics as well as trajectories of ideal partner preferences and perceptions of partner availability over time., Methods: A clinic-recruited cohort of adolescent females (N = 92), aged 1619 years, were interviewed quarterly for 12 months using audio computer-assisted self-interview. Participants ranked the importance of characteristics for their ideal main sex partner and then reported on these characteristics for their current main partner. Participants reported on perceptions of availability of ideal sex partners in their neighborhood. Paired t-tests examined discordance between ideal and actual partner characteristics. Random-intercept regression models examined repeated measures., Results: Actual partner ratings were lower than ideal partner preferences for fidelity, equaled ideal preferences for emotional support and exceeded ideal preferences for social/economic status and physical attractiveness. Discordance on emotional support and social/economic status was associated with sex partner concurrency. Participants perceived low availability of ideal sex partners. Those who perceived more availability were less likely to be ideal/actual discordant on fidelity [OR = .88, 95% CI: .78, 1.0]. Neither ideal partner preferences nor perceptions of partner availability changed over 12 months., Conclusions: Current main sex partners met or exceeded ideal partner preferences in all domains except fidelity. If emotional needs are met, adolescents may tolerate partner concurrency in areas of limited partner pools. Urban adolescent females who perceive low availability may be at increased risk for sexually transmitted infection (STI) because they may be more likely to have nonmonogamous partners., (Copyright © 2014 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.)
- Published
- 2014
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12. Screening juvenile justice-involved females for sexually transmitted infection: a pilot intervention for urban females in community supervision.
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Donaldson AA, Burns J, Bradshaw CP, Ellen JM, and Maehr J
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- Adolescent, Adult, Child, Chlamydia Infections diagnosis, Chlamydia Infections epidemiology, Chlamydia Infections prevention & control, Female, Gonorrhea diagnosis, Gonorrhea epidemiology, Gonorrhea prevention & control, Humans, Mass Screening methods, Patient Education as Topic organization & administration, Pilot Projects, Racial Groups, Reproductive Health Services organization & administration, Risk-Taking, Sexual Behavior, Sexually Transmitted Diseases epidemiology, Sexually Transmitted Diseases prevention & control, Mass Screening statistics & numerical data, Prisoners statistics & numerical data, Sexually Transmitted Diseases diagnosis, Urban Population statistics & numerical data
- Abstract
Little is known about Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (GC) rates in community-supervised juvenile justice-involved (CSJJI) females, or how to best provide screening for sexually transmitted infections in this population. A pilot intervention allowed case managers to offer optional CT/GC screening to CSJJI females during mandated visits. Anonymous satisfaction surveys and discussion groups assessed intervention acceptability. Case managers met with 514 CSJJI females; 102 (20%) agreed to screening and 117 tests were completed. Among those screened, 21 (18%) had CT and 3 (3%) had GC. Intervention feedback from case managers and clients was positive, but there were barriers to recruitment. Lessons learned from this case manager-facilitated intervention may increase the acceptability and effectiveness of future screening methods in this setting.
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- 2013
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13. Sexually transmitted infection risk behaviors in rural Thai adolescents and young adults: support for sex- and age-specific interventions.
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Latimore AD, Aramrattana A, Sherman SG, Galai N, Srirojn B, Thompson N, Ellen JM, Willard N, and Celentano DD
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- Adolescent, Adult, Age Distribution, Female, Health Knowledge, Attitudes, Practice, Humans, Male, Prevalence, Risk Factors, Risk-Taking, Sex Distribution, Sexual Behavior psychology, Sexual Partners psychology, Sexually Transmitted Diseases prevention & control, Sexually Transmitted Diseases psychology, Social Support, Surveys and Questionnaires, Thailand epidemiology, Rural Population statistics & numerical data, Sexual Behavior statistics & numerical data, Sexually Transmitted Diseases epidemiology, Substance-Related Disorders epidemiology, Substance-Related Disorders etiology
- Abstract
Sexually transmitted infection (STI) prevalence and risks in a sample of rural Thai adolescents and young adults (14-29 years) were examined. Unprotected sex with a casual partner conferred the greatest risk for prevalent STIs, particularly for younger adolescents, and alcohol use increased the STI risk for women but not for men.
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- 2013
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14. The role of feelings of intimacy on perceptions of risk for a sexually transmitted disease and condom use in the sexual relationships of adolescent African-American females.
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Matson PA, Chung SE, Sander P, Millstein SG, and Ellen JM
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- Adolescent, Female, Humans, Longitudinal Studies, Prospective Studies, Young Adult, Black or African American, Condoms statistics & numerical data, Risk-Taking, Safe Sex psychology, Sexually Transmitted Diseases prevention & control
- Abstract
Objectives: A core construct targeted by behavioural interventions is the perception that one is at risk for acquiring a sexually transmitted disease (STD). The objective of this analysis was to examine the role of intimacy on perceptions of risk for an STD (PRSTD) and condom use within late adolescent females' main relationships., Methods: A clinical sample of African-American women aged 14-19 years at enrolment were followed prospectively for 3 years. At each semiannual interview, participants reported their partner-specific PRSTD, feelings of intimacy, perceptions of partner's concurrency and condom use at last sex for each of their main sex partners., Results: A total of 285 individuals reported 724 main relationships. Using generalised estimating equations, intimacy was negatively associated with risk perception, after adjusting for perceptions of partner concurrency (OR: 0.68; 95% CI 0.60 to 0.76). PRSTD was no longer associated with condom use after adjusting for intimacy (OR: 1.30; 95% CI 0.83 to 2.02., Conclusions: Intimacy was found to be associated with risk perception and condom use within adolescent main relationships. Adolescents may not view their intimate partners as sources of infection. The success of individual-level STD prevention efforts, such as condom promotion, might be limited as condoms may be in conflict with adolescents' expectations about intimate relationships.
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- 2012
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15. Context, networks, and sexually transmitted infections: a study of sex ratios and male incarceration.
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Ellen JM and Fichtenberg CM
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- Female, Humans, Male, HIV Seropositivity epidemiology, Prisoners statistics & numerical data, Sexual Partners, Sexually Transmitted Diseases epidemiology, Substance-Related Disorders epidemiology
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- 2012
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16. When they break up and get back together: length of adolescent romantic relationships and partner concurrency.
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Matson PA, Chung SE, and Ellen JM
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- Adolescent, Black or African American statistics & numerical data, Baltimore epidemiology, Cohort Studies, Emotions, Female, Humans, Logistic Models, Male, Prospective Studies, Sexually Transmitted Diseases epidemiology, Sexually Transmitted Diseases etiology, White People statistics & numerical data, Young Adult, Adolescent Behavior psychology, Interpersonal Relations, Sexual Behavior psychology, Sexual Behavior statistics & numerical data, Sexual Partners, Sexually Transmitted Diseases prevention & control
- Abstract
Background: Sex partner concurrency is an important risk factor for sexually transmitted infection transmission. Understanding how adolescents conceptualize the length of their relationships when they break up and get back together is essential to the assessment of concurrency., Methods: A prospective cohort of 392 late adolescents and emerging adults, aged 14 to 19 years at baseline, were recruited from 2 clinics in Baltimore, MD and interviewed semiannually for 3 years. At each interview, participants were asked to report on all of their sexual partners in the previous 6 months, the length of relationship, and whether they thought their partner had other sex partners. For relationships that had broken up and gotten back together, reports of length of the relationship were compared before and after the breakup. Random effects logistic regression was used to examine the association between length of relationship and both breakup and partner concurrency., Results: For relationships that ended and subsequently got back together, participants considered the length of relationship to include the period when they were broken up. Longer relationships were at increased odds of both having broken up and gotten back together (odds ratio [OR] = 1.04, 95% confidence interval [CI]: 1.02, 1.05) and of partner concurrency (OR = 1.03, 95% CI: 1.02, 1.04). The magnitude of the odds of concurrency was greater for relationships that had broken up and gotten back together (OR = 1.07, 95% CI: 1.02, 1.11)., Conclusions: Findings from this study emphasize the need for an improved understanding of the association between the temporal dynamics of late adolescent and emerging adult romantic relationships and concurrency.
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- 2012
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17. Discordance between adolescent real and ideal sex partners and association with sexually transmitted infection risk behaviors.
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Polk S, Ellen JM, Chung SE, Huettner S, and Jennings JM
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- Adolescent, Baltimore epidemiology, Choice Behavior, Cross-Sectional Studies, Female, Humans, Male, Risk Factors, Risk-Taking, Sex Distribution, Sexually Transmitted Diseases epidemiology, Sexually Transmitted Diseases psychology, Socioeconomic Factors, Urban Population, Young Adult, Adolescent Behavior, Sexual Behavior, Sexual Partners, Sexually Transmitted Diseases prevention & control
- Abstract
Purpose: Epidemic levels of sexually transmitted infections (STIs) among urban youth have drawn attention to the potential role of sex partner selection in creating risk for STIs. The objectives of this study were to describe the ideal preferences and real selection of sex partners, to evaluate sex partner ideal versus real discordance using quantitative methods, and to determine the association between discordance and STI risk behaviors., Methods: Data are obtained from an urban, household sample of 429 individuals aged 15-24 years. Trait clusters were developed for participants' ratings of their real and ideal sex partners and tested for reliability. Discordance between the ratings of real and ideal partners was measured. Logistic regression was used to assess associations between sex partner discordance and STI risk behaviors., Results: Ratings of the real sex partners were often lower than participants' ideal sex partner ratings. A total of 33% of male adolescents and young men and 66% of female adolescents and young women were discordant on at least one trait cluster. Male adolescents and young men who were discordant on the emotional support they expected of their partner were more likely to report more than two sex partners in the past 90 days (odds ratio = 2.13, 95% confidence interval: 1.06-4.26) and perceived partner concurrency (odds ratio = 3.85, 95% confidence interval: 1.53-9.72). For female adolescents and young women, discordance on fidelity or emotional support significantly increased the odds of all risk behaviors., Conclusion: Male and female adolescents with discordant real and ideal sex partner ratings were more likely to report STI-related risk behaviors. Further steps should involve identification of factors associated with ideal versus real sex partner discordance, such as features of the social context., (Copyright © 2011 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.)
- Published
- 2011
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18. Neighborhood socioeconomic environment and sexual network position.
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Fichtenberg CM, Jennings JM, Glass TA, and Ellen JM
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- Adolescent, Black or African American, Female, Humans, Longitudinal Studies, Male, Risk Assessment, San Francisco epidemiology, Sexually Transmitted Diseases transmission, Social Environment, Unsafe Sex, Young Adult, Residence Characteristics, Sexual Behavior, Sexually Transmitted Diseases epidemiology, Social Class
- Abstract
Rates of sexually transmitted infections (STIs) are strongly associated with neighborhood poverty; however, the mechanisms responsible for this association remain unclear. Using a population-based study of sexual networks among urban African American adolescents, we tested the hypothesis that poverty, unemployment, and the sex ratio drive STI rates by affecting sexual network structure. Participants were categorized as being in one of three network positions that had previously been found to be strongly linked to infection with chlamydia and gonorrhea: being in a confirmed dyad (i.e., a monogamous pair), being connected to a larger network through one partner, and being in the center of a larger network. We found that only poverty was statistically significantly associated with sexual network position. Residing in the poorest third of neighborhoods was associated with 85% decreased odds of being in confirmed dyads. There was no association of sexual network position with neighborhood employment. Living in a neighborhood with an unequal number of young men and women appeared to be associated with a higher likelihood of being in a confirmed dyad; however, the differences were not statistically significant. These results suggest that poverty may impact STI rates by shaping sexual network structure, but we did not find any evidence that this association operates through unemployment or the sex ratio.
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- 2010
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19. Mobilizing communities around HIV prevention for youth: how three coalitions applied key strategies to bring about structural changes.
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Chutuape KS, Willard N, Sanchez K, Straub DM, Ochoa TN, Howell K, Rivera C, Ramos I, and Ellen JM
- Subjects
- Adolescent, Black or African American, Child, Community-Based Participatory Research, Community-Institutional Relations, Female, Florida, Hispanic or Latino, Humans, Male, Organizational Case Studies, Prisons, Puerto Rico, Sex Education, Urban Population, Young Adult, Community Networks organization & administration, HIV Infections prevention & control, Sex Offenses prevention & control, Sexually Transmitted Diseases prevention & control
- Abstract
Increasingly, HIV prevention efforts must focus on altering features of the social and physical environment to reduce risks associated with HIV acquisition and transmission. Community coalitions provide a vehicle for bringing about sustainable structural changes. This article shares lessons and key strategies regarding how three community coalitions located in Miami and Tampa, Florida, and San Juan, Puerto Rico engaged their respective communities in bringing about structural changes affecting policies, practices and programs related to HIV prevention for 12-24-year-olds. Outcomes of this work include increased access to HIV testing and counseling in the juvenile correctional system (Miami), increased monitoring of sexual abuse between young women and older men within public housing, and support services to deter age discordant relationships (Tampa) and increased access to community-based HIV testing (San Juan).
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- 2010
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20. Relationships between perceived STD-related stigma, STD-related shame and STD screening among a household sample of adolescents.
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Cunningham SD, Kerrigan DL, Jennings JM, and Ellen JM
- Subjects
- Adolescent, Baltimore, Female, Humans, Interviews as Topic, Logistic Models, Male, Mass Screening, Young Adult, Sexually Transmitted Diseases diagnosis, Sexually Transmitted Diseases psychology, Shame, Stereotyping
- Abstract
Context: Important barriers to STD testing may include individuals' perceptions of STD-related stigma (negative societal attitudes toward STD infection) and expectations of STD-related shame (negative personal feelings) that would result from a positive STD test. Obtaining a clear understanding of the relationship between STD-related stigma, STD-related shame and STD testing may help inform programs and policies aimed at reducing STD transmission., Methods: Measures derived from previously published scales were used to assess perceived STD-related stigma, anticipated STD-related shame and receipt of an STD test in the past year in an urban, household sample of 594 sexually active 15-24-year-olds interviewed in 2004-2007. Logistic regression was used to examine associations between recent STD testing and perceived stigma, shame and other participant characteristics., Results: Thirty-seven percent of males and 70% of females reporting having had an STD test in the past year; the largest proportions of tests (42% among males and 59% among females) had occurred in the context of a routine health care visit, not because adolescents had had disease symptoms or were concerned about exposure to infection. For both males and females, the level of STD-related stigma was negatively associated with the odds of having been tested (odds ratio, 0.5 for each). STD-related shame was not related to STD testing., Conclusions: Adolescents who view STDs as stigmatizing have a reduced likelihood of being screened, but it is unclear whether this relationship reflects their care seeking or providers' practice of offering STD screening at a routine health visit.
- Published
- 2009
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21. Subsequent sexually transmitted infection after outpatient treatment of pelvic inflammatory disease.
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Trent M, Chung SE, Forrest L, and Ellen JM
- Subjects
- Adolescent, Chlamydia Infections drug therapy, Chlamydia Infections microbiology, Chlamydia trachomatis isolation & purification, Demography, Female, Follow-Up Studies, Gonorrhea drug therapy, Gonorrhea microbiology, Humans, Neisseria gonorrhoeae isolation & purification, Prospective Studies, Recurrence, Ambulatory Care, Chlamydia Infections epidemiology, Gonorrhea epidemiology, Pelvic Inflammatory Disease drug therapy, Pelvic Inflammatory Disease epidemiology, Sexually Transmitted Diseases epidemiology
- Abstract
Objective: To determine the frequency of recurrent sexually transmitted infections (STIs) and/or pelvic inflammatory disease (PID), the average time until subsequent infection following a baseline PID diagnosis, and age- and insurance-related associations with subsequent diagnoses., Design: This study used prospective longitudinal follow-up of STI and/or PID outcome data from electronic medical records., Setting: An urban academic hospital system., Participants: A total of 110 adolescent girls treated for PID as outpatients in pediatric ambulatory sites. Main Exposure Electronic medical records used to assess subsequent PID diagnoses and/or infections with Neisseria gonorrhoeae or Chlamydia trachomatis during the study window., Main Outcome Measures: Demographic, health care use, and STI and/or PID outcome data were examined. Incidence of an STI and/or PID was calculated as incident cases per person-months of exposure. Cox proportional hazard modeling was performed to evaluate the incidence of STI by age or insurance status., Results: The mean (SD) age was 16.8 (1.9) years, 89% of patients were black, and 39% had laboratory results that were positive for N gonorrhoeae or C trachomatis at baseline. Thirty-four percent of patients had an additional diagnosis of an STI during the 48-month follow-up window (incidence, 3.1 per 100 person-months) and the mean (SD) time to a subsequent STI and/or PID was 377 (297) days. Of those patients, 67% (n = 18) had chlamydia, 11% had gonorrhoeae, and 44% had PID. There were no differences based on age or insurance status., Conclusions: Adolescents treated for PID are at risk for subsequent STI and/or PID for a 48-month period. Given the need to prevent future infections in these vulnerable youths, efforts to explore the value of ongoing strategies for risk reduction after diagnosis are warranted.
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- 2008
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22. Rate and predictors of repeat Chlamydia trachomatis infection among men.
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Dunne EF, Chapin JB, Rietmeijer CA, Kent CK, Ellen JM, Gaydos CA, Willard NJ, Kohn R, Lloyd L, Thomas S, Birkjukow N, Chung S, Klausner J, Schillinger JA, and Markowitz LE
- Subjects
- Adolescent, Adult, Chlamydia Infections microbiology, Chlamydia Infections prevention & control, Contact Tracing, Female, Humans, Incidence, Male, Nucleic Acid Amplification Techniques, Predictive Value of Tests, Sexually Transmitted Diseases microbiology, Sexually Transmitted Diseases prevention & control, United States, Urban Health, Urine microbiology, Young Adult, Chlamydia Infections diagnosis, Chlamydia Infections epidemiology, Chlamydia trachomatis isolation & purification, Mass Screening methods, Sexually Transmitted Diseases diagnosis, Sexually Transmitted Diseases epidemiology
- Abstract
Background: Chlamydia trachomatis (Ct) infection, especially repeat infection, is associated with serious sequelae among women, including pelvic inflammatory disease, ectopic pregnancy, and infertility. There are few reports evaluating repeat infection and predictors among men treated for Ct infection., Objective: To measure the predictors and incidence of repeat Ct infection among men., Methods: Men 15 to 35 years of age were screened for Ct infection in different venues in Baltimore, Denver, and San Francisco using urine-based nucleic acid amplification tests. Men with Ct infection were evaluated for repeat Ct infection from February 2001 until September 2003. Enrolled men had a baseline, 1-month, and 4-month follow-up visit and were tested for Ct infection at each visit. Project staff sought to locate and notify all female sex partners of infected men during the study to provide testing and treatment. We evaluated predictors of repeat Ct infection, time to infection, and incidence of infection., Results: Three hundred fifty-nine men were recruited into the study and 272 (76%) had at least 1 follow-up visit with Ct results. Repeat infection occurred in 13% of men with Ct infection; there was no significant difference in repeat infection by site (Denver 13%, Baltimore 13%, San Francisco 12%). Independent predictors of repeat infection were history of an STD and venue. Incidence of repeat infection was 45.4 infections per 100 person years., Conclusion: Repeat Ct infection is common among men and similar in geographically distinct cities. Incidence of repeat Ct infection support routine rescreening of men within the first 3 months after Ct infection.
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- 2008
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23. Poverty and sexual concurrency: a case study of STI risk.
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Tsui EK, Leonard L, Lenoir C, and Ellen JM
- Subjects
- Adolescent, Anthropology, Cultural, Baltimore, Family ethnology, Female, Humans, Interviews as Topic, Male, Residence Characteristics, Risk-Taking, Adolescent Behavior ethnology, Black or African American psychology, Interpersonal Relations, Poverty, Risk Assessment, Sexual Behavior ethnology, Sexual Partners psychology, Sexually Transmitted Diseases ethnology, Social Environment
- Abstract
This paper is about sexual concurrency, or maintaining multiple sexual partnerships that overlap in time. Sexual concurrency is a concept that is used in the field of public health to explain the spread of sexually transmitted diseases. Sexual concurrency has also been proposed as a site of intervention to reduce sexually transmitted infection (STI) rates, particularly among those populations who carry the heaviest STI burden: adolescents and African Americans. In this paper, we use ethnographic data collected from a group of African American adolescents living in Baltimore to examine the socially produced configurations of risks and relationships that are obscured by the term sexual concurrency. The data we present show the limits of this concept, and suggest that structural reforms, including improvements to education, drug treatment, and work opportunities, are necessary to reduce racial disparities in STI rates.
- Published
- 2008
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24. New sexually transmitted infections among adolescent girls infected with HIV.
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Trent M, Chung SE, Ellen JM, and Clum G
- Subjects
- Adolescent, Adolescent Health Services, Cohort Studies, Disease-Free Survival, Female, Humans, Incidence, Longitudinal Studies, Prevalence, Proportional Hazards Models, Prospective Studies, Sexually Transmitted Diseases blood, Sexually Transmitted Diseases etiology, Sexually Transmitted Diseases mortality, United States epidemiology, Viral Load, Adolescent Behavior, HIV Infections, Sexually Transmitted Diseases epidemiology, Sexually Transmitted Diseases prevention & control
- Abstract
Objectives: Although the prevalence of sexually transmitted infections (STIs) among girls infected with HIV has been reported, the incidence of STI diagnoses has not been well documented. The objectives of this study were to examine (1) incident STI diagnoses and (2) the association between viral load (VL) and incident STI diagnosis among HIV-infected adolescent girls in care., Methods: This was a prospective longitudinal 18-month study of girls enrolled in the Adolescent HIV trials network. Cox proportional hazard modelling was performed to evaluate the incidence of STI by baseline viral load., Results: The mean (SD) age of participants was 20.6 (2.0) years, viral load of participants was 66,917 (165,942) copies/ml and median viral load was 7,096 copies/ml. The incidence of STIs for the entire cohort was 1.4 per 100 person-months. During the 18-month follow-up period, there were no significant differences in the STI incidence between the high and low viral load groups (hazard ratio (HR) = 0.86, 95% CI 0.37 to 1.95) There was also no significant association between STI incidence and log-transformed viral load (HR = 1.10, 95% CI 0.92 to 1.3)., Conclusions: Adolescent girls with HIV infection continue to acquire sexually transmitted infections after diagnosis. This analysis does not suggest that VL is a critical factor in STI acquisition over time. Additional work exploring the role of other contextual factors on STI acquisition among HIV-infected adolescent girls is warranted.
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- 2007
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25. Venue-based sampling in STD research: generalizeable to and independent of whom?
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Ellen JM and Fichtenberg CM
- Subjects
- Adolescent, Female, Georgia epidemiology, Humans, Male, Prevalence, Sexually Transmitted Diseases etiology, Urban Population, Adolescent Behavior, Contact Tracing, Sexually Transmitted Diseases epidemiology, Sexually Transmitted Diseases prevention & control, Social Support
- Published
- 2007
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26. Perceived neighborhood social cohesion and condom use among adolescents vulnerable to HIV/STI.
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Kerrigan D, Witt S, Glass B, Chung SE, and Ellen J
- Subjects
- Adolescent, Cross-Sectional Studies, Female, HIV Infections psychology, Health Behavior, Humans, Male, Multivariate Analysis, Psychology, Adolescent, Risk Factors, Sexually Transmitted Diseases psychology, Socioeconomic Factors, Adolescent Behavior psychology, Condoms statistics & numerical data, HIV Infections prevention & control, Residence Characteristics, Sexually Transmitted Diseases prevention & control, Social Environment
- Abstract
The relationship between neighborhood social dynamics and adolescent sexual behavior has not been well explored. We conducted a cross-sectional survey with 343 adolescents recruited from two health clinics in Baltimore. Multivariate logistic regression was utilized to assess the influence of perceived neighborhood social cohesion and collective monitoring of youth on condom use at last sex, controlling for family and individual factors. Condom use was significantly higher among participants who perceived their neighborhoods as high, 54.7%, versus low, 40.4%, in social cohesion. Neighborhood cohesion was significantly associated with condom use in multivariate analyses, as was parental communication, family structure, and gender. No association between perceived neighborhood collective monitoring of youth and condom use was found. We conclude that perceived neighborhood social cohesion is positively associated with condom use among adolescents vulnerable to HIV/STI and should be encouraged in the context of community-based prevention efforts.
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- 2006
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27. Does partner selection contribute to sex differences in sexually transmitted infection rates among African American adolescents in San Francisco?
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Auerswald CL, Muth SQ, Brown B, Padian N, and Ellen J
- Subjects
- Adolescent, Adolescent Behavior, Adult, Cohort Studies, Female, Humans, Male, San Francisco epidemiology, Sexually Transmitted Diseases ethnology, Sexually Transmitted Diseases etiology, Surveys and Questionnaires, Black or African American, Black People statistics & numerical data, Sex Characteristics, Sexual Behavior, Sexual Partners, Sexually Transmitted Diseases epidemiology, Sexually Transmitted Diseases prevention & control
- Abstract
Introduction: Little is known regarding whether partner characteristics explain sex differences in sexually transmitted infection (STI) rates in nonclinic-based, school-aged African American youth., Materials and Methods: A random digit dial household sample of 14- to 19-year-old youth in San Francisco reported the total number, age, race, and perceived history of incarceration, gang membership, and level of sexual activity of their partners. Youth were tested for gonorrhea and chlamydia., Results: Female participants were more likely than male participants to have a partner who was older or had been incarcerated and less likely to have a non-African American partner. Controlling for partner number, female's odds ratio (OR) for having an STI was 1.39 (95% confidence interval [CI] = 0.98-1.98; P = 0.07). Controlling for partner incarceration and number of partners, the borderline sex difference was eliminated (OR = 1.07; 95% CI = 0.70-1.63)., Conclusion: Sex differences in STI rates among African American adolescents may be determined more by the risk of the partner than the risk of the individual.
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- 2006
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28. Sex partner selection, social networks, and repeat sexually transmitted infections in young men: a preliminary report.
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Ellen JM, Gaydos C, Chung SE, Willard N, Lloyd LV, and Rietmeijer CA
- Subjects
- Adolescent, Adult, Baltimore epidemiology, Colorado epidemiology, Contact Tracing, Humans, Male, Recurrence, Risk Factors, Sexual Partners, Sexually Transmitted Diseases epidemiology, Social Support
- Abstract
Goal: The goal of this study was to examine the risk for repeat sexually transmitted infections (STIs) associated with reducing the number of sex partners who come from within the social networks of males 13 to 25 years old in Baltimore, Maryland, and Denver, Colorado., Study: Asymptomatic males diagnosed with chlamydia and/or gonorrhea as part of an asymptomatic chlamydia and gonorrhea male screening project were recruited and interviewed about their sexual behaviors and their perceptions of social characteristics and sexual behaviors of their sex partners. We characterized the sex partners of each participant as belonging to or not belonging to his social network. We examined whether a decrease in percentage of sex partners who were in the participant's social network was associated with repeat infection., Results: There were 47 participants in Baltimore and 92 in Denver. In both cities, there was a trend toward a finding that decreasing the percentage of sex partners belonging to a participant's social network was protective for repeat STI., Conclusion: These data suggest that interventions may need to be designed to reduce the prevalence of infection in the social networks of infected men.
- Published
- 2006
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29. Factors associated with self-risk perception for sexually transmitted diseases among adolescents.
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Gurvey JE, Adler N, and Ellen JM
- Subjects
- Adolescent, Condoms statistics & numerical data, Female, Humans, Male, Sexual Partners, Surveys and Questionnaires, Adolescent Behavior psychology, Health Knowledge, Attitudes, Practice, Risk-Taking, Sexual Behavior, Sexually Transmitted Diseases prevention & control
- Published
- 2005
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30. Adolescent partner-type experience: psychosocial and behavioral differences.
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Rosengard C, Adler NE, Gurvey JE, and Ellen JM
- Subjects
- Adolescent, Chi-Square Distribution, Female, Humans, Male, Psychology, Adolescent, Retrospective Studies, Risk Factors, San Francisco epidemiology, Sex Factors, Surveys and Questionnaires, Adolescent Behavior psychology, Coitus psychology, Contraception Behavior psychology, Contraception Behavior statistics & numerical data, Sexual Partners psychology, Sexually Transmitted Diseases epidemiology, Sexually Transmitted Diseases psychology
- Abstract
Context: Adolescents behave differently with main and casual sexual partners. These differences in behavior may be due to how adolescents perceive main and casual partners, but may also be informed by which types of partners adolescents have had experience with., Methods: Data were collected in interviews with 276 sexually experienced STD clinic attendees in 1996-1998. Chi square tests and one-way analyses of variance were conducted to compare risk and protective variables among groups with different types of partner experience (main only, casual only, main and casual). Post hoc analyses determined differences between pairs of groups., Results: Adolescents with different partner-type experiences evidenced different risk and protective factors. For example, adolescents who had had only main partners perceived a greater risk of contracting STDs from both main and casual partners than those who had had both partner types. Women in the casual-only group were the least likely to have been pregnant. Adolescents who had had main and casual partners intended a significantly shorter delay in initiating sex with a new main partner than did those in the main-only group; they also more strongly intended to have a side partner than did those who had had only main partners., Conclusions: The design of risk reduction and prevention interventions for at-risk sexually experienced adolescents ought to consider adolescents' sexual partner-type experiences and tailor messages to capitalize on associated protective factors and address or minimize associated risk factors.
- Published
- 2005
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31. Understanding the role of perceived severity in STD-related care-seeking delays.
- Author
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Cunningham SD, Kerrigan D, Pillay KB, and Ellen JM
- Subjects
- Adolescent, Adult, Baltimore, Educational Status, Female, Humans, Longitudinal Studies, Male, Severity of Illness Index, Sexually Transmitted Diseases psychology, Sexually Transmitted Diseases therapy, Time Factors, Adolescent Behavior psychology, Attitude to Health, Sexually Transmitted Diseases classification
- Abstract
Purpose: To gain a more in-depth understanding of the relationship between perceived severity of symptoms and STD-related care-seeking behavior among adolescent African-American females in Baltimore City., Methods: Twenty-one female adolescents were interviewed in depth to elicit their experiences with an STD in the previous 3 months. Comparisons were made between those who sought care on account of their symptoms and those who did not., Results: High perceived seriousness about symptoms has both cognitive and emotional components that may function independently to either promote or delay STD-related care seeking., Conclusions: Both cognitive and emotional responses to STD symptoms must be considered when examining the effect of perceived severity on adolescents' STD-related care-seeking behaviors.
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- 2005
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32. Sex partner concurrency, geographic context, and adolescent sexually transmitted infections.
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Jennings J, Glass B, Parham P, Adler N, and Ellen JM
- Subjects
- Adolescent, Adult, Baltimore epidemiology, Chlamydia Infections epidemiology, Chlamydia Infections etiology, Chlamydia Infections prevention & control, Chlamydia trachomatis isolation & purification, Demography, Female, Gonorrhea epidemiology, Gonorrhea etiology, Gonorrhea prevention & control, Humans, Male, Neisseria gonorrhoeae isolation & purification, Prevalence, Sexual Partners, Sexually Transmitted Diseases etiology, Surveys and Questionnaires, Urban Health, Adolescent Behavior, Sexual Behavior, Sexually Transmitted Diseases epidemiology, Sexually Transmitted Diseases prevention & control
- Abstract
Background: Geographic areas characterized by a high prevalence of sexually transmitted infections (STIs) are critical to the maintenance and persistence of STIs within populations. Sex partner concurrency has been shown to be associated with increased risk for individual-level STIs., Objectives: The objectives of this study were to determine whether gonorrhea rate per census block group and sex partner concurrency independently and interactively are associated with a current bacterial STI among adolescents., Study: Face-to-face interviews and urine testing for Chlamydia trachomatis and Neisseria gonorrhoeae were conducted among female, sexually active, 14- to 19-year-olds presenting for reproductive clinic care between August 2000 and June 2002., Results: Gonorrhea rate per census block group and sex partner concurrency were not independently but were interactively associated with a current bacterial STI. Among participants with a main sex partner who practiced concurrency, living in high-prevalence geographic areas was significantly associated with a current bacterial STI., Conclusions: The results suggest that geographic context may moderate an adolescent sex partner's behaviors. The research adds to the basic understanding of sexually transmitted disease transmission and acquisition in a high-prevalence inner-city setting.
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- 2004
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33. Post-HIV test counselling of clients of a mobile STD/HIV clinic.
- Author
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Ellen JM, Liang TS, Jacob CA, Erbelding E, and Christmyer C
- Subjects
- AIDS Serodiagnosis, Adult, Community Health Services, Female, HIV Infections drug therapy, HIV Infections transmission, Health Knowledge, Attitudes, Practice, Humans, Male, Sexually Transmitted Diseases drug therapy, Counseling, HIV Infections prevention & control, Mobile Health Units, Sexually Transmitted Diseases prevention & control
- Abstract
The objective of the study was to determine the post-test counselling (PTC) rates for HIV-infected and uninfected individuals receiving HIV counselling and testing on a mobile STD/HIV screening clinic and to determine whether individuals at highest risk for transmitting their infection were less likely to receive PTC than those at lower risk for transmitting. Clients presenting for HIV counselling and testing were asked about their demographic characteristics, clinical history, personal risk behaviours, and partner risk factors and told to return after 14 days for results. Disease intervention specialists (DIS) attempted to locate and counsel positive clients. The PTC rate among infected and uninfected clients was 66% and 46%, respectively. There were significant differences in demographics and risk factors for those who were post-test counselled versus those who were not. Among HIV-uninfected clients, there was a positive association between PTC and drug treatment in the past three months and having engaged in sex work within the last three months. Being female was negatively associated with PTC. Among HIV-infected clients, there was a positive association between PTC and current enrollment in drug treatment. These data suggest that mobile STD/HIV screening clinics may be limited in their effectiveness by low rates of PTC.
- Published
- 2004
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34. Risk perceptions, condom use, and sexually transmitted diseases among adolescent females according to social network position.
- Author
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Bettinger JA, Adler NE, Curriero FC, and Ellen JM
- Subjects
- Adolescent, Adult, Female, Humans, Longitudinal Studies, Prevalence, Risk Factors, Risk-Taking, San Francisco epidemiology, Sexually Transmitted Diseases etiology, Sexually Transmitted Diseases prevention & control, Adolescent Behavior, Condoms statistics & numerical data, Health Knowledge, Attitudes, Practice, Sexual Partners, Sexually Transmitted Diseases epidemiology
- Abstract
Background and Objectives: Adolescent females are frequently treated as a homogenous group but could differ on their sexually transmitted disease (STD) risk because of individual attitudes and exposure through sexual networks., Goal: The goal of this study was to determine if risk perceptions, condom use, and STD prevalence differs within sexual networks., Study Design: Three hundred three adolescent females participating in a longitudinal study of adolescent STD risk perceptions and condom use were categorized as "core," "bridge," and "periphery" in a sexual network according to their and their main sex partner's risk information. Regression analysis determined differences in risk perceptions by network location., Results: We demonstrated an inverse relationship between STD risk perceptions and network location. Adolescents with higher risk perceptions were more likely to use condoms, irrespective of network location., Conclusion: Female adolescents are a heterogeneous group exhibiting different risk perceptions. Different intervention strategies for adolescents at higher risk could be necessary. Interventions designed to raise risk perceptions could be associated with condom use, even for those adolescents at greatest risk.
- Published
- 2004
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35. Does parental involvement predict new sexually transmitted diseases in female adolescents?
- Author
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Bettinger JA, Celentano DD, Curriero FC, Adler NE, Millstein SG, and Ellen JM
- Subjects
- Adolescent, Adult, Chlamydia Infections epidemiology, Chlamydia Infections prevention & control, Cohort Studies, Confidence Intervals, Female, Gonorrhea epidemiology, Gonorrhea prevention & control, Humans, Incidence, Logistic Models, Odds Ratio, Poverty statistics & numerical data, Prospective Studies, Time Factors, United States epidemiology, Women's Health, Adolescent Behavior psychology, Black or African American statistics & numerical data, Parent-Child Relations, Parenting psychology, Safe Sex statistics & numerical data, Sexually Transmitted Diseases epidemiology, Sexually Transmitted Diseases prevention & control
- Abstract
Background: African American female adolescents living in low-income urban areas are at increased risk for sexually transmitted diseases., Objective: To determine if high levels of perceived parental supervision and communication were associated with reduced gonorrhea (GC) and chlamydia (CT) incidence in low-income, African American, sexually experienced female adolescents, aged 14 to 19 years, attending urban health clinics., Design: A prospective cohort study was used to determine the predictive value for high levels of parental supervision and communication on GC and CT infection in 158 adolescent females. Multiple logistic regression analysis explored the association between incident infection and perceived parental supervision and perceived parental communication while controlling for relevant demographic and behavioral factors (age, religious involvement, school enrollment, a 2-parent household, having a main sex partner, and having concurrent sex partners)., Results: When adjusted for age and baseline GC and CT infection, high levels of perceived parental supervision were associated with reduced GC and CT incidence (adjusted odds ratio, 0.06; 95% confidence interval, 0.01-0.31). High levels of perceived parental communication were not associated with reduced GC and CT incidence (adjusted odds ratio, 0.55; 95% confidence interval, 0.21-1.42)., Conclusions: The link between parental supervision and disease acquisition is particularly valuable because it provides evidence that parental supervision can result in lower sexually transmitted disease rates in urban high-prevalence populations. This is important for interventions designed to increase parental involvement as a strategy for promoting protective sexual behaviors in female adolescents because it indicates that increased parental involvement can also influence subsequent disease acquisition.
- Published
- 2004
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36. Qualitative assessment of venues for purposive sampling of hard-to-reach youth: an illustration in a Latino community.
- Author
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Auerswald CL, Greene K, Minnis A, Doherty I, Ellen J, and Padian N
- Subjects
- Adolescent, Female, Focus Groups, Humans, Interviews as Topic, Male, Pregnancy, Pregnancy in Adolescence statistics & numerical data, Residence Characteristics, Risk Factors, Sampling Studies, San Francisco epidemiology, Sexually Transmitted Diseases epidemiology, Social Support, Adolescent Behavior ethnology, Hispanic or Latino psychology, Pregnancy in Adolescence ethnology, Sexual Partners, Sexually Transmitted Diseases ethnology, Sexually Transmitted Diseases transmission
- Abstract
Background: Latino youth suffer disproportionately from unintended pregnancy and sexually transmitted infections (STIs), but studies of the social context of their sexual behaviors are lacking., Goal: Our qualitative assessment of recruitment venues in a Latino neighborhood had 3 objectives: to identify venues where youth at risk of unintended pregnancy and STIs could be found; to describe different youth "crowds"; and to investigate how and where youth meet their sex partners., Study Design: We conducted ethnographic interviews with 62 youth recruited primarily from street sites. Mapping of venues was conducted with Map-Info., Results: Youth crowds included the Regulars, gang-related crowds, street-economy affiliated crowds, and female crowds. Maps demonstrated the dominance of the venues in the Mission by gang members. Street sites are important venues for meeting sexual partners., Conclusion: The qualitative assessment produced insights and hypotheses that can contribute to the planning of research, outreach, testing, and interventions with Latino youth.
- Published
- 2004
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37. Editorial response: moving from core groups to risk spaces.
- Author
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Fichtenberg CM and Ellen JM
- Subjects
- Adolescent, Adult, Female, Humans, Male, Sexual Behavior, Sexually Transmitted Diseases etiology, Cohort Studies, Epidemiologic Studies, Sexually Transmitted Diseases epidemiology, Sexually Transmitted Diseases prevention & control
- Published
- 2003
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38. Comparison of clients of a mobile health van and a traditional STD clinic.
- Author
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Ellen JM, Bonu S, Arruda JS, Ward MA, and Vogel R
- Subjects
- Adult, Female, HIV Infections drug therapy, Humans, Male, Sexually Transmitted Diseases drug therapy, Community Health Services, HIV Infections prevention & control, Mobile Health Units, Sexually Transmitted Diseases prevention & control
- Abstract
The objective of this study was to determine if there were any demographic, behavioral, and clinical differences between clients seen aboard a mobile sexually transmitted disease (STD)/HIV clinic compared with those seen in a traditional municipal STD/HIV health clinic for receipt of STD/HIV services. Clients seen in the two different settings were interviewed about demographic characteristics, reasons for their visit, STD history, their HIV/STD risk factors, and the risk factors of their sex partners. Clients in both settings were also offered testing for syphilis, gonorrhea, chlamydia, and HIV. Results suggested that clients seen at the mobile clinic were older, more likely to be injecting drug users themselves and/or to have sex partners who were, or had engaged in prostitution for money or drugs. Over half (54.4%) of the mobile clinic clients sought testing for HIV, and they were far less likely to be seeking care for symptoms of an STD. In contrast, only 7.1% of municipal clinic clients indicated HIV testing as the reason for their visit, whereas nearly two thirds (64.5%) reported symptoms of disease. Two percent of municipal clinic clients and 5.4% of mobile clinic clients had a positive HIV test ( p<.001), and 17.8% of STD clinic clients and 5.6% of mobile van clients had a positive gonorrhea and/or test ( p<.001). These data suggest that a mobile STD/HIV clinic may be an effective strategy to reach individuals at high risk for HIV who are not being served by traditional municipal STD/HIV health clinics.
- Published
- 2003
- Full Text
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39. Discordant sexual partnering: a study of high-risk adolescents in San Francisco.
- Author
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Lee JK, Jennings JM, and Ellen JM
- Subjects
- Adolescent, Adolescent Behavior, Female, Humans, Interpersonal Relations, Logistic Models, Longitudinal Studies, Male, Risk-Taking, San Francisco epidemiology, Sexually Transmitted Diseases etiology, Surveys and Questionnaires, Disease Transmission, Infectious, Sexual Partners, Sexually Transmitted Diseases epidemiology, Sexually Transmitted Diseases transmission
- Abstract
Background: In sexual networks, bridge members engaging in discordant partnering play key roles in maintaining and transmitting sexually transmitted infections (STIs) within a population., Goal: The goal was to characterize adolescents likely to engage in discordant sexual relationships with main and casual sex partners., Study Design: Egocentric data about adolescents and their most recent sex partner(s) collected over 6 months were analyzed with use of logistic regression., Results: History of STI, drug use, and meeting venue were significantly associated with discordant sexual partnering among high-risk adolescents. Participants with histories of high-risk behavior, e.g., hard drug use or STI, were more likely to have had a recent, dissimilar partner than those with lower-risk profiles. Particular meeting venues, such as clubs and street locations, were more likely to be associated with age-discordant, race-discordant, and drug use-discordant partnerships for females., Conclusion: Bridge members of adolescent sexual networks were more likely to have a history of STI, hard drug use, or meeting their sex partner through particular venues.
- Published
- 2003
- Full Text
- View/download PDF
40. Adolescent condom use and perceptions of risk for sexually transmitted diseases: a prospective study.
- Author
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Ellen JM, Adler N, Gurvey JE, Millstein SG, and Tschann J
- Subjects
- Adolescent, Adult, Female, Humans, Interviews as Topic, Male, Prospective Studies, Risk-Taking, San Francisco, Sexual Partners, Adolescent Behavior psychology, Condoms statistics & numerical data, Sexual Behavior, Sexually Transmitted Diseases prevention & control, Sexually Transmitted Diseases psychology, Social Perception
- Abstract
Background: The authors' previous research has shown that in cross-sectional analysis, partner-specific perceptions of risk for gonorrhea and chlamydial and HIV infection correlated with partner-specific intentions to use condoms., Goal: The goal was to determine whether partner-specific measures of perception of risk for STDs (PRSTD) predict partner-specific condom use 6 months later among high-risk and low-risk youth., Study Design: Youths aged 14 to 19 years were recruited from an STD clinic (n = 236) and an HMO teen clinic (n = 306) and were interviewed at baseline and at 6 months about PRSTD, attitudes about condoms, self-efficacy, normative expectations, and condom use., Results: PRSTD with a main sex partner was an independent predictor of condom use with a main sex partner in the STD clinic cohort (odds ratio = 2.5; 95% CI = 1.1-6.2). There was no association between PRSTD with a casual sex partner and condom use in this cohort or between PRSTD for main or casual sex partners and condom use in the HMO teen clinic cohort., Conclusion: Interventions that target high-risk adolescents should focus on PRSTD with a main sex partner.
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- 2002
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41. A randomized comparison of A-CASI and phone interviews to assess STD/HIV-related risk behaviors in teens.
- Author
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Ellen JM, Gurvey JE, Pasch L, Tschann J, Nanda JP, and Catania J
- Subjects
- Adolescent, Black or African American psychology, Bias, Child, Female, Humans, Male, Microcomputers statistics & numerical data, Reproducibility of Results, Risk-Taking, San Francisco epidemiology, Self Disclosure, Telephone statistics & numerical data, Urban Population, Adolescent Behavior ethnology, HIV Infections ethnology, Interviews as Topic methods, Sexual Behavior ethnology, Sexually Transmitted Diseases ethnology
- Abstract
Purpose: To compare response bias associated with a telephone survey of sexually transmitted disease/human immunodeficiency virus (STD/HIV)-related risk behaviors and an in-home self-administered audio computer assisted self interview (A-CASI)., Methods: We randomly assigned an urban household sample of 223 African-American adolescents to a telephone interview or an A-CASI in their home. The sample was previously recruited by telephone for an earlier study regarding STDs and sexual behavior. We queried participants about their STD/HIV-related risk behaviors. We also assessed their perceived comfort, honesty, and accuracy in answering questions in the different modes through a telephone computer-assisted self-interview (T-CASI)., Results: There were no significant differences by mode in percentages of participants reporting STD/HIV-related risk behaviors, except more A-CASI participants reported having engaged in sexual intercourse in past 3 months (43.8% vs. 33.3%). There were no differences in perceived comfort, honesty, and accuracy in answering questions in the different modes. These results also did not change after we adjusted for age, household structure, and current school enrollment., Conclusions: Telephone interviews, a more economical mode, can be employed without much risk of increasing the response bias in the data assessing crude measures of risk.
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- 2002
- Full Text
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42. Relative power between sexual partners and condom use among adolescents.
- Author
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Tschann JM, Adler NE, Millstein SG, Gurvey JE, and Ellen JM
- Subjects
- Adolescent, Adolescent Behavior ethnology, Adult, Age Factors, Decision Making, Female, HIV Infections prevention & control, Humans, Male, San Francisco, Sexual Behavior ethnology, Adolescent Behavior psychology, Condoms statistics & numerical data, Power, Psychological, Sexual Behavior psychology, Sexual Partners psychology, Sexually Transmitted Diseases prevention & control
- Abstract
Purpose: To examine how the relative power of adolescent sexual partners in the domain of emotional intimacy is related to condom use., Methods: Interviewed 228 adolescents who visited an STD clinic in San Francisco. Adolescents were aged 14-19 years, 69% were female, and they were ethnically diverse. We developed a measure of relative power in the domain of emotional intimacy, by adapting five items from existing measures and developing three items ourselves. The partner who had less desire for emotional intimacy was considered to have more power in that domain. We also measured relative decision-making power. Data were analyzed using logistic regression and Student's t-tests., Results: Adolescents who had more power than their partners in the domain of emotional intimacy were more likely to get their way about condom use than adolescents who had less power in this domain. Decision-making power was not related to whether adolescents got their way about condom use. Young men reported greater emotional intimacy power and greater decision-making power than young women. However, gender was not related to getting one's way about condom use., Conclusions: The results suggest the importance of assessing relative power in the sexual relationships of adolescents when predicting condom use.
- Published
- 2002
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43. Sexual Partner Characteristics, Relationship Type, and HIV Risk among a Community Venue-Based Sample of Urban Adolescent and Young Adult Men Who Have Sex with Men
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Boyer, Cherrie B., Greenberg, Lauren, Korelitz, James, Harper, Gary W., Stewart-Campbell, Rachel, Straub, Diane, Sanders, Renata, Reid, Lisa-Henry, Futterman, Donna, Lee, Sonia, and Ellen, Jonathan M.
- Abstract
Few studies have examined sexual partnerships and HIV risk in diverse samples of African American/Black and Hispanic/Latino adolescent and young adult men who have sex with men (YMSM), a group that have a high burden of HIV in the United States. A community-venue recruitment approach was used, which identified significant differences in HIV risk by sexual partner type among 1,215 YMSM. Those with casual partners had a higher number of sexual partners, had more sexually transmitted infections (STIs), were more likely to engage in transactional sex, and to use alcohol, marijuana, or other substances compared with those with main partners only. Among those with female sexual partners, many used condoms "every time" when engaging in vaginal sex with casual partners, but a sizable proportion "never/rarely" used condoms with their main partners. Our findings demonstrate a need for tailored HIV prevention education and counseling with necessary skills regarding consistent and correct condom use with all sexual partnerships. [The Adolescent Medicine Trials Network for HIV/AIDS Interventions contributed to the writing of this report.]
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- 2019
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44. Young African American Male-Male Relationships: Experiences, Expectations, and Condom Use
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Taggart, Tamara, Ellen, Jonathan, and Arrington-Sanders, Renata
- Abstract
HIV disproportionately impacts young African American men who have sex with men (MSM). In this study, we sought to understand how previous relationship experiences and expectations for romantic relationships influence condom use among young African American MSM. Twenty African American MSM aged 16 to 24 years completed a semi-structured interview and questionnaire on sexual experiences, romantic relationships, and sexual behavior. We identified three major themes characterizing romantic male-male relationships: (1) partner selection, (2) relationship ideals and expectations, and (3) relationship rules for condom use. Our findings indicate that young African American MSM rely on previous relationship experiences and desires for romantic relationships to determine condom use in subsequent relationships. Participants revealed that their previous relationship experiences and desires are often in conflict with their descriptions of their ideal romantic relationships and subsequently influence their condom use. Our findings fill a gap in the literature describing male-male romantic relationships and condom use among young African American MSM.
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- 2017
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45. Mobilizing Communities around HIV Prevention for Youth: How Three Coalitions Applied Key Strategies to Bring about Structural Changes
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Chutuape, Kate S., Willard, Nancy, Sanchez, Kenia, Straub, Diane M., Ochoa, Tara N., Howell, Kourtney, Rivera, Carmen, Ramos, Ibrahim, and Ellen, Jonathan M.
- Abstract
Increasingly, HIV prevention efforts must focus on altering features of the social and physical environment to reduce risks associated with HIV acquisition and transmission. Community coalitions provide a vehicle for bringing about sustainable structural changes. This article shares lessons and key strategies regarding how three community coalitions located in Miami and Tampa, Florida, and San Juan, Puerto Rico engaged their respective communities in bringing about structural changes affecting policies, practices and programs related to HIV prevention for 12-24-year-olds. Outcomes of this work include increased access to HIV testing and counseling in the juvenile correctional system (Miami), increased monitoring of sexual abuse between young women and older men within public housing, and support services to deter age discordant relationships (Tampa) and increased access to community-based HIV testing (San Juan).
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- 2010
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46. Evaluation of the Effect of Human Immunodeficiency Virus–Related Structural Interventions: The Connect to Protect Project
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Ellen, Jonathan M, Greenberg, Lauren, Willard, Nancy, Korelitz, James, Kapogiannis, Bill G, Monte, Dina, Boyer, Cherrie B, Harper, Gary W, Henry-Reid, Lisa M, Friedman, Lawrence B, and Gonin, René
- Subjects
Paediatrics ,Biomedical and Clinical Sciences ,Clinical Research ,Infectious Diseases ,Prevention ,HIV/AIDS ,Sexually Transmitted Infections ,Behavioral and Social Science ,3.1 Primary prevention interventions to modify behaviours or promote wellbeing ,Prevention of disease and conditions ,and promotion of well-being ,Infection ,Good Health and Well Being ,Adolescent ,Child ,Condoms ,Cross-Sectional Studies ,Female ,HIV Infections ,Health Promotion ,Health Surveys ,Humans ,Male ,Risk Assessment ,Risk Factors ,Risk Reduction Behavior ,Sexual Behavior ,Sexually Transmitted Diseases ,Viral ,United States ,Young Adult - Abstract
ImportanceWith the emphasis on structural-level interventions that target social determinants of human immunodeficiency virus (HIV) transmission to curb the HIV epidemic, there is a need to develop evaluation models that can detect changes in individual factors associated with HIV-related structural changes.ObjectiveTo describe whether structural changes developed and achieved by community coalitions are associated with an effect on individual factors associated with the risk of contracting HIV.Design, setting, and participantsIn this serial cross-sectional survey design, data were collected from 8 cities during 4 rounds of annual surveys from March 13, 2007, through July 29, 2010. Study recruitment took place at venues where the population of focus was known to congregate, such as clubs, bars, community centers, and low-income housing. The convenience sample of at-risk youth (persons aged 12-24 years) included 5337 individuals approached about the survey and 3142 (58.9%) who were screened for eligibility. Of the 2607 eligible participants, 2559 (98.2%) ultimately agreed to participate.InterventionsAchievement of locally identified structural changes that targeted public and private entities (eg, federal agencies, homeless shelters, and school systems) with the goal of fostering changes in policy and practice to ultimately facilitate positive behavioral changes aimed at preventing HIV.Main outcomes and measuresNumber of sexual partners, partner characteristics, condom use, and history of sexually transmitted infections and HIV testing.ResultsExposure to structural changes was not statistically significantly associated with any of the outcome measures, although some results were in the direction of a positive structural change effect (eg, a 10-unit increase in a structural change score had an odds ratio of 0.88 [95% CI, 0.76-1.03; P = .11] for having an older sexual partner and an odds ratio of 0.91 [95% CI, 0.60-1.39; P = .39] for using a condom half the time or less with a casual partner).Conclusions and relevanceThis study evaluated a broad representation of at-risk individuals and assessed the effect of numerous structural changes related to various HIV risk factors. No structural changes as measured in this study were associated with a statistically significant reduction in risk behaviors. These null findings underscore the need for a long-term approach in evaluating structural interventions and the development of more nuanced methods of quantifying and comparing structural-change initiatives and determining the appropriate strategies for evaluating effect.
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- 2015
47. Understanding Sex Partner Selection from the Perspective of Inner-City Black Adolescents
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Ellen, Jonathan M.
- Published
- 2006
48. The Trade-Off between Hormonal Contraceptives and Condoms among Adolescents
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Ott, Mary A., Adler, Nancy E., Millstein, Susan G., Tschann, Jeanne M., and Ellen, Jonathan M.
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- 2002
- Full Text
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49. Individuals' Perceptions about Their Sex Partners' Risk Behaviors
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Ellen, Jonathan M., Vittinghoff, Eric, Bolan, Gail, Boyer, Cherrie B., and Padian, Nancy S.
- Published
- 1998
50. An Investigation of Geographic Clustering of Repeat Cases of Gonorrhea and Chlamydial Infection in San Francisco, 1989-1993: Evidence for Core Groups
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Ellen, Jonathan M., Hessol, Nancy A., Kohn, Robert P., and Bolan, Gail A.
- Published
- 1997
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