Browsing by Subject "adolescent women"

Now showing 1 - 6 of 6
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    Feasibility of Functional Neuroimaging to Understand Adolescent Women’s Sexual Decision Making
    (Elsevier, 2015-04) Hensel, Devon J.; Hummer, Tom A.; Acrurio, Lindsay R.; James, Thomas W.; Fortenberry, J. Dennis; Department of Pediatrics, Indiana University School of Medicine
    Purpose For young women, new sexual experiences normatively increase after puberty and coincide with extensive changes to brain regions governing self-regulation of risk behavior. These neurodevelopmental changes could leave some young women vulnerable for negative sexual outcomes, including sexually transmitted infection and unintended pregnancy. We evaluated the feasibility of using functional neuroimaging to understand the sexual decision making of adolescent women. Methods Adolescent women (N = 14; 14–15 years) completed enrollment interviews, a neuroimaging task gauging neural activation to appetitive stimuli, and 30 days of prospective diaries following the scan characterizing daily affect and sexual behaviors. Descriptive and inferential statistics assessed the association between imaging and behavioral data. Results Young women were highly compliant with neuroimaging and diary protocol. Neural activity in a cognitive-affective network, including prefrontal and anterior cingulate regions, was significantly greater during low-risk decisions. Compared with other decisions, high-risk sexual decisions elicited greater activity in the anterior cingulate, and low-risk sexual decision elicited greater activity in regions of the visual cortex. Young women's sexual decision ratings were linked to their sexual history characteristics and daily self-reports of sexual emotions and behaviors. Conclusions It is feasible to recruit and retain a cohort of female participants to perform a functional magnetic resonance imaging task focused on making decisions about sex, on the basis of varying levels of hypothetical sexual risk, and to complete longitudinal prospective diaries following this task. Preliminary evidence suggests that risk level differentially impacts brain activity related to sexual decision making in these women, which may be related to past and future sexual behaviors.
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    Relationship length and repeated experiences of sexual coercion within adolescent women's romantic relationships
    (2017-06) Muzzey, Allison Kaye; Hensel, Devon J.
    Sexual coercion is a prevalent and problematic aspect of adolescent women’s sexual experiences, with nationally representative data reporting that 15% of adolescent women were forced by a romantic partner to do sexual things they did not want to do in the past year. However, little is known about how the length of a given adolescent relationship may impact ongoing instances of sexual coercion, and what impact these repeated instances have on the emotional and behavioral characteristics of a given relationship. Accordingly, the current study examines the impact of relationship length on relationship attributes and behaviors within adolescent women’s romantic relationships with repeated experiences of sexual coercion and compares these associations between age groups. Data for the current study were drawn from a larger, longitudinal cohort study (N = 385); utilizing quarterly interviews (N = 5151) that were administered from 1999-2009. Relationship timing of initial and repeat experiences of sexual coercion are discussed. Specifically, our findings suggest that within relationships with repeat experiences of sexual coercion, longer relationship length decreases sexual satisfaction and condom use, while simultaneously increasing vaginal intercourse and the odds of acquiring a sexually transmitted infection.
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    Study of sexual partner accrual patterns among adolescent women via Generalized Additive Mixed Models
    (Office of the Vice Chancellor for Research, 2014-04-11) Harezlak, Jaroslaw; He, Fei; Fortenberry, J. Dennis
    The number of lifetime partners is a consistently identified epidemiological risk factor for sexually transmitted infections (STIs). Higher rate of partner accrual during adolescence has been associated with increased STI rates among adolescent women. To study sexual partner accrual pattern among adolescent females, we applied generalized additive mixed models (GAMM) to the data obtained from a longitudinal STI study. GAMM regression components included a bivariate function enabling separation of cohort (“age at study entry”) and longitudinal (“follow-up years”) effects on partner accrual while the correlation was accounted for by the subject-specific random components. Longitudinal effect partial derivative was used to estimate within-subject rates of partner accrual and their standard errors. The results show that slowing of partner accrual depends more on the prior sexual experience and less on the females’ chronological age. Our modeling approach combining the GAMM flexibility and the time covariates’ of interest definition enabled clear differentiation between the cohort (chronological age) and longitudinal (follow-up time) effects, thus providing the estimates of both between-subject differences and within-subject trajectories of partner accrual.
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    Time From First Intercourse to First Sexually Transmitted Infection Diagnosis Among Adolescent Women
    (2009-12) Tu, Wanzhu; Batteiger, Byron E.; Wiehe, Sarah E.; Ofner, Susan; Van Der Pol, Barbara; Katz, Barry P.; Orr, Donald P.; Fortenberry, J. Dennis
    Objective To determine the time between first intercourse and first sexually transmitted infection (STI) with Chlamydia trachomatis, Neisseria gonorrhoeae, or Trichomonas vaginalis and time between repeated infections. Design Observational study. Setting Three adolescent medicine clinics. Participants A cohort of 386 urban young women aged 14 to 17 years at enrollment. Main Outcome Measures Age at first intercourse; organism-specific interval between first intercourse and first STI diagnosis; interval between repeated infections; and age at first STI test prior to study participation. Results Participants had first intercourse at a young age (first, second, and third quartiles were 13, 14, and 15 years of age, respectively). By age 15 years, 25% of the women acquired their first STI, most often C trachomatis. Median interval between first intercourse and first STI diagnosis was 2 years. Within 1 year of first intercourse, 25% had their first C trachomatis infection. Repeated infections were common; within 3.6, 6, and 4.8 months, 25% of the women with prior C trachomatis, N gonorrhoeae, and T vaginalis infection were reinfected with the respective organisms. Considerable delay in STI testing was found for those who began sex at a younger age. The median interval between first sex and first test were 4.9, 3.5, 2.1, 1.8, and 1.2 years for those who had first sex at ages 10, 11, 12, 13, and 14 years, respectively. Conclusions Timely screening and treatment are important for prevention of STI sequelae. For urban adolescent women, STI screening (especially for C trachomatis) should begin within a year after first intercourse and infected individuals should be retested every 3 to 4 months.
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    Vaginal Microbicide Preferences Among Midwestern Urban Adolescent Women
    (2008-10) Tanner, Amanda E.; Katzenstein, Jennifer M.; Zimet, Gregory D.; Cox, Dena S.; Cox, Anthony D.; Fortenberry, J. Dennis
    Purpose The purpose of this study was to assess adolescent women's preferences for specific microbicide characteristics including pregnancy prevention, timing of application, potential for side effects, and whether it targeted human immunodeficiency virus (HIV) or other sexually transmitted infections (STI). Potential differences in microbicide preferences by adolescent age group and behavioral patterns including engaging in sexual intercourse and use of hormonal contraception were examined, as it was hypothesized that as adolescents progress into adulthood and gain sexual experience their preferences in microbicide characteristics may shift. Method Adolescent and young women (N = 405, 56.0% African American; 24.0% Euro-American) between the ages of 14 and 20 (mean = 17.0, SD = 1.8) were recruited from urban community-based clinics. Video-Audio Computer-Assisted Self-Interviews were conducted with the young women, during which they were asked about their preferences regarding the characteristics of hypothetical vaginal microbicides. Conjoint analysis was utilized to determine adolescent women's relative preferences for each microbicide characteristic and intent-to-purchase microbicides based upon a combination of the selected properties. Results Overall, the results suggest adolescent and young women had an ordered preference for a microbicide with (1) no side effects, (2) pregnancy prevention, (3) postcoital application, and (4) protection against HIV. Age and behavioral group conjoint analyses resulted in the same pattern of preferences as those reported for the entire group. However, women having sex and not using hormonal contraception had a stronger preference for postcoital application. Conclusion The findings suggest that young women's ratings of microbicides were sensitive to characteristics such as side effects, pregnancy prevention, and timing of application and should be considered in microbicide development. The conjoint analysis approach is useful in understanding microbicide preferences, and should be utilized with other populations to assess preferences for specific microbicide characteristics.
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    Weekly variations in feelings of trust predict incident STI within a prospective cohort of adolescent women from a US city FREE
    (BMJ, 2018) Matson, Pamela A.; Fortenberry, J. Dennis; Chung, Shang-en; Gaydos, Charlotte A.; Ellen, Jonathan M.; Pediatrics, School of Medicine
    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.