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Item 88. The Impact of Sexual Identity Development On The Sexual Health of Former Foster Youth(Elsevier, 2019-02) Brandon-Friedman, Richard A.; School of Social WorkItem The Association between Sexual Health and Physical, Mental and Social Health in Adolescent Women(Elsevier, 2016-10) Hensel, Devon J.; Nance, Jennifer; Fortenberry, J. Dennis; Department of Pediatrics, IU School of MedicinePurpose Developmental models link sexual well-being to physical, mental/emotional, and social well-being, yet little empirical literature evaluates these relationships in adolescents. Better understanding of how and when sexuality complements other aspects of health may yield important points to enhance existing health education and prevention efforts. Methods Data were drawn from a 10-year longitudinal cohort study of sexual relationships and sexual behavior among adolescent women (N = 387; 14–17 years at enrollment). Sexual health data were drawn from quarterly partner-specific interviews and were linked to physical, mental/emotional, and social health information in annual questionnaires. Random intercept, mixed effects linear, ordinal logistic, or binary logistic regression were used to estimate the influence of sexual health on health and well-being outcomes (Stata, v.23, StataCorp, College Station, TX). All models controlled for participant age and race/ethnicity. Results Higher sexual health was significantly associated with less frequent nicotine and substance use, lower self-reported depression, lower thrill seeking, higher self-esteem, having fewer friends who use substances, higher religiosity, better social integration, lower frequency of delinquent behavior and crime, and more frequent community group membership. Sexual health was not associated with the number of friends who used cigarettes. Conclusions Positive sexually related experiences in romantic relationships during adolescence may complement physical, mental/emotional, and social health. Addressing specific aspects of healthy sexual development during clinical encounters could dually help primary prevention and health education address other common adolescent health issues.Item Associations of health behaviors with human papillomavirus vaccine uptake, completion, and intentions among female undergraduate students(SAGE Journals, 2016-09) Winger, Joseph G.; Christy, Shannon M.; Mosher, Catherine E.; Psychology, School of ScienceThis study explored associations between health behaviors and human papillomavirus vaccine receipt/intentions among female undergraduates. Participants (N = 286) completed a survey assessing human papillomavirus vaccine uptake (receiving 1–3 shots vs no shots), completion (receiving 3 shots vs 1–2 shots), and intentions as well as various health behaviors. Human papillomavirus vaccine uptake and completion were associated with receipt of other preventive medical care; completion was associated with having a regular healthcare provider. Among unvaccinated students (n = 115), increased human papillomavirus vaccine intentions were associated with flu shot and human immunodeficiency virus test receipt. Findings suggest promoting human papillomavirus vaccination with other preventive medical care might improve vaccine receipt.Item Gender Differences in Sexual Well-Being and Sexual Identity Development among Youth Formerly in the Foster Care System in the United States(MDPI, 2023-02) Brandon-Friedman, Richard A.; Swafford, Tayon R.; School of Social WorkLittle research has heretofore examined differences in the sexual well-being and sexual health outcomes between female and male youth in the foster care system. This cross-sectional study examined these differences and as well as how sexual identity development impacts sexual well-being using a sample of 217 youth formerly in the foster care system. It found that females have lower levels of overall sexual well-being, lower scores on several components of sexual well-being, and more negative sexual health outcomes than males. The four domains of sexual identity development explored all predicted overall sexual well-being for both females and males, with a pronounced negative impact of being a gay male. These results support the importance of sexual identity development and indicate that the sexual health needs of females within the foster care system are not being addressed as well as those of their male counterparts. To address these discrepancies professionals and caregivers working with youth in the foster care system need to be attuned to the specific needs of female youth and work to address these needs in a manner that considers their gender.Item Knowledge of Zika and perception of risk among sexually-active adults in the United States of America: results from a nationally representative sample(World Health Organization, 2018-06-07) Guerra-Reyes, Lucia; Fu, Tsung-chieh Jane; Williams, Deana; Herbenick, Debby; Dodge, Brian; Reece, Michael; Fortenberry, J. Dennis; Medicine, School of MedicineObjective To examine knowledge of Zika transmission and risk perception and to assess variability by condom use in a probability sample of sexually-active adults in the United States. Methods Data for this study came from the 2016 wave of the National Survey of Sexual Health and Behavior, a nationally representative probability sample of adults in the United States. Data were collected in November 2016 via a cross-sectional Internet-based survey administered to members of a Knowledge Panel, an address-based random sample service managed by GfK. A weighted subsample (n = 1 713) of sexually active adults, 18 – 50 years of age, was included in analyses. Results More than 90% of men and women reported low or no perceived risk of Zika. Most participants identified mosquito bite as a route of transmission, while significantly fewer identified sexual intercourse (≈ 40%) and vertical (29% men, 41% women) transmission routes. Conclusion Sexually-active adults in the United States, especially young men, lack awareness of sexual and vertical transmission of Zika Virus. Given the likely endemic nature of Zika, this low-risk perception is an important prevention challenge. Zika prevention messaging should address lesser known transmission routes, emphasize male education, and promote correct and consistent condom use.Item Quality of life concerns and depression among hematopoietic stem cell transplant survivors(Springer, 2011) Mosher, Catherine E.; DuHamel, Katherine N.; Rini, Christine; Corner, Geoffrey; Lam, Joanne; Redd, William H.Purpose This study examined quality of life, transplant-related concerns, and depressive symptoms and their demographic and medical correlates at 1 to 3 years following hematopoietic stem cell transplantation (HSCT). Methods HSCT survivors (N = 406) completed telephone-administered questionnaires that assessed demographic variables, functional status, quality of life, transplant-related concerns, and depressive symptoms. Results The most prevalent concerns among HSCT survivors included physical symptoms (e.g., fatigue and pain), maintaining current health status and employment, changes in appearance, and lack of sexual interest and satisfaction. In addition, almost one-third (32%) of survivors age 40 years and younger reported concern about their ability to have children. Unemployed survivors and those with lower incomes and worse functional status were more likely to experience poorer quality of life in multiple domains. Fifteen percent of the sample reported moderate to severe depressive symptoms, and these symptoms were higher among allogeneic transplant recipients and those with lower functional status. Conclusions Results suggest that interventions are needed to address physical symptoms, coping with an uncertain future, infertility, and sexual issues during the early phase of HSCT survivorship.Item The Relationship Between Sexually Coercive Experience Frequency, Coping, Social Support and Sexual and Mental Health in Adult Women(Office of the Vice Chancellor for Research, 2015-04-17) Muzzey, Allison K.; Hensel, Devon J.Introduction: Existing literature separately identifies social support and coping methods as mediating influences between sexual coercion and adverse health outcomes, yet few empirical studies actually evaluate their influence in the same model. The objective of this study was to analyze how adult women’s coping methods and social support jointly mediate the impact of sexually coercive experience on sexual and mental health. Methods: Data are drawn from a larger internet-based, cross-sectional survey examining adult men’s and women’s health and life experiences. For the current study, we retained all female participants (N=113). Structural equation modelling (SEM) (Stata, v. 22; all p<.05) analyzed the hypothesized structural relationships between coping (adaptive and maladaptive), social support (subjective and emotional), sexual coercion, sexual health (sexual openness, sexual anxiety, sexual esteem, and sexual entitlement) and mental health (depression, self-esteem, and anxiety). Results: More frequent sexual coercion predicted higher maladaptive coping (β = .364). Higher levels of maladaptive coping were associated with higher levels of depression (β = .199), anxiety (β = .393), sexual anxiety (β = .346), and sexual openness (β = .251). Additionally, higher levels of maladaptive coping were associated with lower self-esteem (β = -.226). Adaptive coping and social support were not associated with sexual coercion. Conclusion: Adult women’s sexually coercive experiences impact sexual and mental health indirectly through maladaptive coping, but not through adaptive coping or any social support. Our data raise the possibility that maladaptive coping could be an important catalyst for poor mental and sexual health outcomes following a sexually coercive experience. From an education and policy perspective, this means that a focus on reducing maladaptive coping methods may increase mental and sexual health and reduce the likelihood of accruing more sexually coercive experiences.Item 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.Item Sexual health behaviors and outcomes among current and former foster youth: A review of the literature(Elsevier, 2016-05) Ramseyer Winter, Virginia; Brandon-Friedman, Richard A.; Ely, Gretchen E.; School of Social WorkThis review examines literature related to pregnancy, sexual health outcomes, and sexual risk behaviors for foster youth and youth who are aging/have aged out of foster care. Using the search terms foster youth, aging out, pregnancy, sexually transmitted diseases, sexually transmitted infections, sexual risk, sexual behavior, and sexual health, 26,376 sources were initially identified. After removing duplicate sources and those that did not meet inclusion criteria and adding others identified through the references of identified sources, 53 sources were included in the review. Outcome measures were grouped into broad categories of pregnancy, sexually transmitted infections, and risky sexual behaviors, with each having several subparts. Implications for social work practice and policy are presented and directions for future research are highlighted.Item Social Support and Well-being: A Quantitative Study of the Effects of Friendship on the Sexual Well-being of Older Adults(Office of the Vice Chancellor for Research, 2015-04-17) Williams, Monica M.Background: Social support has been shown to positively impact various aspects of health across the lifespan, including sexual health and well-being. While past research on sexual well-being has tended to focus on the earlier stages of the life course, notably adolescence and young adulthood, this is a largely ignored area of research past the reproductive stage of life. Current research finds that while social support, from partners, family, and friends alike, has generally positive influences on health in mid to late adulthood, these outcomes are varied in regards to sexual well-being. Objectives: This study aims to (1) assess the role of friend support in the sexual wellbeing of older adults and (2) to explore if physical and mental health are significant mediators of this relationship. Methods: This study uses data from Wave II of the National Social Life, Health, and Aging Project (NSHAP), a longitudinal, population-based study of health and social factors, aiming to understand the well-being of older, community-dwelling adults. Using binary logistic regression, a series of models were created to evaluate whether social support of friends is a significant predictor of sexual well-being in older adults and whether that relationship is reduced with the introduction of each mediator individually. Covariates included age, race, gender, education, partner status, presence of close family members, and sexual functioning. Results: Sixty two percent of older adults are not having sex as much as they would like and 61% feel that their sex life is lacking in quality. Significant correlates of satisfaction of sex frequency include having a romantic partner (OR .209; p<.000), reliable friends (OR 1.366; p=.010) and sexual dysfunction (OR 1.257; p<.000). Significant correlates of quality of sex life included gender (OR .636; p=.001), education (OR 1.136, p=.037), and sexual dysfunction (OR 1.355; p=.000). Neither mental health nor physical health status were significant mediators of the dependent variables. Conclusion: Similar to findings related to sexual well-being and familial support and reliance (Wait and Das 2010), this study showed that having reliable friends actually decreased the likelihood of satisfaction with sex frequency, one important aspect of sexual well-being. While this relationship may be due to friendship being a proxy for romantic relationships, more research is needed to ascertain the cause of this relationship.