Browsing by Subject "Sexual Behavior"
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Item Adolescent women's daily academic behaviors, sexual behaviors, and sexually related emotions(Elsevier, 2014-12) Hensel, Devon J.; Sorge, Brandon H.; Department of Pediatrics, IU School of MedicinePURPOSE: Emerging literature suggests that the emotional and behavioral experience in young women's romantic/sexual relationships may link to their academic success. However, existing studies' reliance on retrospective and/or global measures prevents detailed understanding of how and when specific academic experiences link to specific relationship experiences and whether these associations could vary over different school days. METHODS: Adolescent women (N = 387; 14-17 years at enrollment) were recruited from primary care adolescent clinics for a longitudinal cohort study of sexual relationships and sexual behavior. Participants provided daily diary information on academic behaviors, sexual emotions, and sexual behaviors. Chi-square and generalized estimating equation ordinal logistic or linear regression, respectively, assessed prevalence of sexual behaviors or differences in sexual emotions when academic behaviors did and did not occur. RESULTS: Young women's weekday reports of skipping school or failing a test were significantly linked to more frequent vaginal sex, less frequent condom use, and different levels of sexual emotions, on that same day. CONCLUSIONS: Our findings provide evidence that the emotional and behavioral experiences in young women's romantic/sexual relationships may impact young women's reaction to academic events.Item Are social organizational factors independently associated with a current bacterial sexually transmitted infection among urban adolescents and young adults?(Elsevier, 2014-10) Jennings, Jacky M.; Hensel, Devon J.; Tanner, Amanda E.; Reilly, Meredith L.; Ellen, Jonathan M.; Department of Pediatrics, IU School of MedicineThis study explored the relationship between the social organization of neighborhoods including informal social control and social cohesion and a current bacterial sexually transmitted infection (STI) among adolescents and young adults in one U.S. urban setting. Data for the current study were collected from April 2004 to April 2007 in a cross-sectional household study. The target population included English-speaking, sexually-active persons between the ages of 15 and 24 years who resided in 486 neighborhoods. The study sample included 599 participants from 63 neighborhoods. A current bacterial STI was defined as diagnosis of a chlamydia and/or gonorrhea infection at the time of study participation. Participants reported on informal social control (i.e. scale comprised of 9 items) and social cohesion (i.e. scale comprised of 5 items) in their neighborhood. In a series of weighted multilevel logistic regression models stratified by gender, greater informal social control was significantly associated with a decreased odds of a current bacterial STI among females (AOR 0.53, 95% CI 0.34, 0.84) after controlling for individual social support and other factors. The association, while in a similar direction, was not significant for males (AOR 0.73, 95% CI 0.48, 1.12). Social cohesion was not significantly associated with a current bacterial STI among females (OR 0.85, 95% CI 0.61, 1.19) and separately, males (OR 0.98, 95% CI 0.67, 1.44). Greater individual social support was associated with an almost seven-fold increase in the odds of a bacterial STI among males (AOR 6.85, 95% CI 1.99, 23.53), a finding which is in contrast to our hypotheses. The findings suggest that neighborhood social organizational factors such as informal social control have an independent relationship with sexual health among U.S. urban youth. The causality of the relationship remains to be determined.Item Case 27-2021: A 16-Year-Old Boy Seeking Human Immunodeficiency Virus Prophylaxis(NEJM Group, 2021-09) Neilan, Anne M.; Salvant Valentine, Sheila; Knopf, Amelia S.; School of NursingItem Changes in Solo and Partnered Sexual Behaviors during the COVID-19 Pandemic: Findings from a U.S. Probability Surve(medRxiv, 2020) Hensel, Devon; Rosenberg, Molly; Luetke, Maya; Fu, Tsung-chieh; Herbenick, DebbyBackground Research demonstrates that pandemics adversely impact sexual and reproductive health (SRH), but few have examined their impact on people’s participation in sex. We examined self-reported changes in solo and sexual behaviors in U.S. adults during early stages of the public health response to COVID-19. Methods We conducted an online, nationally representative, cross-sectional survey of U.S. adults (N=1010; aged 18-94 years; 62% response rate) from April 10-20, 2020. We used weighted multinomial logistic regression to examine past month self-reported changes (decreased, stable or increased) in ten solo and partnered sexual behaviors. Predictor variables included: having children at home, past month depressive symptoms, (ACHA 3-item scale), past month loneliness (UCLA 3-Item Loneliness scale), COVID-19 protection behaviors (adapted 12-item scale), perceived COVID-19 consequences (adapted 10-item scale) and COVID-19 knowledge (adapted 10-item scale). Results Nearly half of all adults reported some kind of change – most commonly, a decrease – in their sexual behavior in the past month. Having elementary aged children at home, past month depressive symptoms and loneliness and enacting more COVID-19 protective behaviors were associated with both reduced partnered bonding behaviors, such as hugging, cuddling, holding hands and kissing, as well as reduced partnered sexual behaviors, such as oral sex, partnered genital touching and vaginal sex. Greater COVID-19 risk perception and greater COVID-19 knowledge were associated with mixed effects in behavior outcomes. Conclusions Our data illustrate the very personal ways in which different pandemic-associated factors may create or inhibit opportunities for solo and partnered sex. The centrality of sexuality to health and well-being – even during pandemics – means that a critical piece of public health prevention and management responses should is ensuring that services and resource that support positive sexual decision making remain open and available.Item Condoms and developmental contexts in younger adolescent boys(BMJ Publishing Group, 2010-10) Rosenberger, Joshua G.; Bell, David L.; McBride, Kimberly R.; Fortenberry, J. Dennis; Ott, Mary A.; Pediatrics, School of MedicineBACKGROUND: Condom use is a key part of sexually transmitted infection (STI) prevention for young men. Yet little is known about how younger adolescent boys initially learn about and use condoms. We examined sources of information, attitudes towards, acquisition, practice and early use of condoms among 14-16-year-old boys. METHODS: Thirty 14-16-year-old boys were recruited from a teen clinic serving a community with high STI rates and were asked open-ended questions about condoms, such as, "Where did you learn about condoms?" and "In what situations would you/would you not, use condoms." Interviews were audio recorded, transcribed and coded. Qualitative analysis focused upon key concepts and shared social cognitions related to condom use. RESULTS: Both sexually inexperienced and experienced participants perceived that sex feels or would feel less pleasurable with condoms. For almost all participants, families were the primary source of both information about condoms and of condoms themselves. This information focused on pregnancy prevention, with STIs secondary. Participants' views of condoms fell into three developmental groups: not interested in condoms and equating their use with interest in sex; exploring condoms out of either curiosity or in preparation for sex; and experienced with condom use. Exploring included behaviours such as checking condoms out and trying them on. CONCLUSIONS: Our findings of existing negative perceptions of condoms, the importance of families in learning about condoms and the developmental need to test and try on condoms before use have implications for adolescent STI prevention programmes.Item Longitudinal associations among relationship factors, partner change, and sexually transmitted infection acquisition in adolescent women(Lippincott, Williams & Wilkins, 2011-03) Ott, Mary A.; Katschke, Adrian; Tu, Wanzhu; Fortenberry, J. Dennis; Pediatrics, School of MedicineOBJECTIVES: New sex partners put adolescents at increased risk for sexually transmitted infections (STIs), even when these sex partners are nonoverlapping. Although the risk of partner change is well described, little is known about its antecedents. We prospectively examined associations between relationship characteristics, partner change, and subsequent STI during intervals of "serial monogamy." METHODS: As part of a longitudinal study, 332 adolescent women were interviewed and tested for gonorrhea, chlamydia, and trichomonas every 3 months for up to just over 6 years. Interviews covered partner-specific relationship characteristics and sexual behaviors. The quarterly interval, a 3-month period bracketed by interviews and STI testing, was the unit of analysis. We examined associations among relationship factors, partner change, and subsequent STI using a series of mixed regression models, controlling for age, STI at Time 1, and condom nonuse. RESULTS: Age, lower relationship quality, and lower levels of partner closeness to friends and family predicted partner change from Time 1 to Time 2. In turn, partner change was associated with acquisition of a new STI at Time 2. Although relationship factors did not exert a direct effect on STI at Time 2, they improved partner change-STI model fit. Similar patterns were seen with each organism. CONCLUSION: Relationship factors drive partner change, which in turn contributes to STI acquisition. STI prevention research may need to focus on the relationship antecedents to partner change, in addition to the partner change itself.Item Proceed With Caution in Generating Evidence in the “Oropharyngeal-Anorectal Chlamydia Hypothesis” in Humans(Wolters Kluwer, 2019-09-01) Leenen, Jeanine; van Liere, Geneviève A. F. S.; Hoebe, Christian J. P. A.; Dukers-Muijrers, Nicole H. T. M.; Microbiology and Immunology, School of MedicineItem Risk perceptions, sexual attitudes, and sexual behavior after HPV vaccination in 11-12 year-old girls(Elsevier, 2015-07-31) Mullins, Tanya L. Kowalczyk; Widdice, Lea E.; Rosenthal, Susan L.; Zimet, Gregory D.; Kahn, Jessica A.; Department of Pediatrics, IU School of MedicineOBJECTIVES: Among 11-12 year-old girls who received the human papillomavirus (HPV) vaccine, we explored, over the subsequent 30 months: (1) trajectories of knowledge about HPV/HPV vaccines and vaccine-related risk perceptions; (2) whether knowledge and risk perceptions impacted sexual attitudes and sexual experience; (3) whether mothers, clinicians, and media influenced girls' risk perceptions, attitudes, and behavior. METHODS: Girls and mothers (n=25dyads) completed separate, semi-structured interviews within 2 days of, and 6, 18, and 30 months after, their first HPV vaccine dose. Knowledge, risk perceptions related to HPV and other sexually transmitted infections (STIs), and attitudes about sexual behaviors were assessed. Sexual experience was assessed at girls' 30 month interviews. Clinicians completed interviews at baseline. Transcribed interviews were analyzed using framework analysis. RESULTS: Girls' baseline knowledge was poor but often improved with time. Most girls (n=18) developed accurate risk perceptions about HPV but only half (n=12) developed accurate risk perceptions about other STIs by 30 months. The vast majority of girls thought that safer sex was still important, regardless of knowledge, risk perceptions, or sexual experience. Girls whose HPV knowledge was high at baseline or increased over time tended to articulate accurate risk perceptions; those who were able to articulate accurate risk perceptions tended to report not having initiated sexual activity. Girls whose mothers demonstrated higher knowledge and/or communication about HPV vaccination tended to articulate accurate risk perceptions, whereas clinicians and media exposure did not appear to influence risk perceptions. CONCLUSIONS: Higher knowledge about HPV vaccines among mothers and girls was linked with more accurate risk perceptions among girls. Clinicians may play an important role in providing education about HPV vaccines to mothers and girls.Item The Sexual Health Needs of Adolescent Boys Involved in a Pregnancy(Elsevier, 2019-01-14) Ott, Mary A.; Wells, Matthew; Imburgia, Teresa M.; Yang, Ziyi; Tu, Wanzhu; Auerswald, Colette L.; Pediatrics, School of MedicineObjectives: Little is known about fatherhood in middle adolescence. In order to better understand their sexual health needs, we describe relationship characteristics, perception of masculinity and associated STI risk behaviors in a community-based sample of urban middle adolescent boys who have fathered a child or been involved with a pregnancy. Methods: We employed venue-based sampling to recruit 339 boys (14-17 years old) in neighborhoods with high STI prevalence. We administered a brief survey on sexual, relationship and pregnancy history, STI risk, juvenile justice involvement, and masculinity. Results: Fifteen percent had either fathered a child or been involved with a pregnancy. In multivariate analysis, controlling for age and ethnicity, adolescent fathers were more likely to be involved with juvenile justice and engage in STI risk behaviors. These included condom non-use and partner checking a cell phone. Although of borderline significance, older partners, past STI testing, and drug or alcohol use at last sex improved model fit. Conclusion: Adolescent fathers have distinct relational and sexual health needs. Their specific needs should be targeted by prevention programs. Implications and Contribution: Most research on young men involved in pregnancy is with older adolescents/young adults, and in clinical or institutional settings. Using community engagement and venue-based sampling, this study describes sexual behaviors, masculinity, and relationship characteristics among 14-17 year old boys who have caused a pregnancy. Findings identify their distinct sexual health needs.Item Temporal Trends and Disparities in Suicidal Behaviors by Sex and Sexual Identity Among Asian American Adolescents(JAMA, 2021-04-01) Xiao, Yunyu; Lu, Wenhua; School of Social WorkImportance: Although suicide is the second leading cause of death among Asian American adolescents, there is a dearth of studies examining overall and possible sex and sexual orientation disparities in the trends in suicidal behaviors among Asian American adolescents. Such information is crucial to inform targeted efforts of suicide prevention among Asian American adolescents. Objective: To examine temporal trends and sex and sexual orientation disparities in trends of nonfatal suicidal behaviors in Asian American adolescents from 1991 through 2019. Design, setting, and participants: This cross-sectional study used data from the national Youth Risk Behavior Survey from 1991 through 2019, analyzing a representative sample of US adolescents in grades 9 through 12 using a 3-stage cluster-sampling design. Data were analyzed from October through November 2020. Exposures: Calendar year, sex, sexual identity, sex of sexual contact, and interaction terms of these factors. Main outcomes and measures: Crude prevalence and annual percentage changes (APCs) in self-reported suicidal ideation, suicide plan, suicide attempts, and injury by suicide attempt for the overall sample and by sex, sexual identity, and sex of sexual contacts were calculated. Sexual minorities were defined as individuals whose sexual identity was gay or lesbian, bisexual, or not sure. Results: Among 7619 Asian Americans who participated in the Youth Risk Behavior Survey from 1991 to 2019 (mean [SD] age, 16.09 [1.29] years; 3760 [47.1%] female adolescents), 1576 individuals completed the sexual identity and behaviors questions after 2015 (mean [SD] age, 15.97 [1.28] years; 810 [49.2%] female adolescents). From 2009 through 2019, there was a 1.3-fold (95% CI, -0.8 to 3.3; P = .22) increase in suicide attempts and a 1.7-fold (95% CI, -2.6 to 5.9; P = .45) increase in injury by suicide attempt among Asian American female adolescents, although these increases were not statistically significant. Among 39 Asian American adolescents who identified as gay, lesbian, or bisexual or who were attracted to and had sexual contact with partners of the same sex or both sexes, compared with 1556 Asian American adolescents who were heterosexual, prevalence was greater for suicidal ideation (24 individuals [68.2%] vs 223 individuals [15.0%]; P < .001), suicide plan (15 individuals [57.7%] vs 179 individuals [11.9%]; P < .001), suicide attempts (14 individuals [41.0%] vs 74 individuals [5.5%]; P < .001), and injury by suicide attempt (5 individuals [17.6%] vs 23 individuals [1.7%]; P < .001) between 2015 and 2019. These sexual minorities identified by sexual identity and sexual contact also had an increasing rate over this period in suicide plan (APC, 10.5%; 95% CI, 4.4% to 16.9%; P < .001). Conclusions and relevance: This study found significant increases in rates of suicide plan among Asian American adolescents who were sexual minorities identified by sexual identity and sexual contact together. These findings suggest that suicide screening needs to inquire about sexual minority status in terms of sexual identity and sex of sexual contact when identifying Asian American adolescents who are at risk for suicidal behaviors. Culturally relevant suicide-prevention programs addressing unique risk and protective factors, racial discrimination, and sexual orientation-related stigma may be needed for Asian American adolescents.