Erum Ikramullah

Pathways from Family Religiosity to Adolescent Sexual Activity and Contraceptive Use

CONTEXT Few studies with nationally representative longitudinal data have examined whether and how family religiosity is associated with adolescent sexual and contraceptive behavior. METHODS Data from the 1997 National Longitudinal Survey of Youth were used to examine associations between a multidimensional measure of family religiosity assessed during early adolescence and reproductive health outcomes (sexual activity, number of partners and consistent contraceptive use) at age 17. Pathways through which family religiosity is associated with these outcomes were identified using structural equation models. RESULTS Family religiosity was negatively associated with adolescent sexual activity, both directly (beta, -0.14) and indirectly (-0.02). The indirect association was mediated by family cohesion (as reflected in parental monitoring among the entire sample and among males, and in parent-teenager relationship quality and family routine activities among females) and negative peer behaviors. Greater family religiosity was indirectly associated with having fewer sexual partners (-0.03) and with using contraceptives consistently (0.02); these relationships were mediated through later age at first sex, more positive peer environments and higher levels of parental monitoring and awareness. However, among sexually active males (but not females), family religiosity was directly and negatively associated with contraceptive consistency (-0.11). CONCLUSION Cohesive family environments and positive peer networks contribute to reduced levels of risky sexual behavior among adolescents from religious families. Parents who monitor their childrens activities and peer environments, engage their families in regular activities and foster strong parent-child relationships can help reduce risky sexual behavior, regardless of family religiosity. Parental involvement in prevention programs may help reduce rates of teenage pregnancy and STDs.

Trends in Sexual Experience, Contraceptive Use, and Teenage Childbearing: 1992–2002

PURPOSE To examine how cohort trends in family, individual, and relationship characteristics are linked to trends in adolescent reproductive health outcomes to provide a better understanding of factors behind recent declines in teenage birth rates. METHODS We examine a sample of three cohorts of females and males aged 15-19 in 1992, 1997, and 2002, based on retrospective information from the 2002 National Survey of Family Growth. We identify how family, individual, and relationship characteristics are associated with the transition to sexual intercourse, contraceptive use at first sex, and the transition to a teen birth. RESULTS Cohort trends and multivariate analyses indicate changes in family and relationship characteristics among American teens have been associated with positive trends in reproductive health since the early 1990s. Factors associated with improvement in adolescent reproductive health include positive changes in family environments (including increases in parental education and a reduced likelihood of being born to a teen mother) and positive trends in sexual relationships (including an increasing age at first sex and reductions in older partners). These positive trends may be offset, in part, by negative changes in family environments (including an increased likelihood of being born to unmarried parents) and the changing racial/ethnic composition of the teen population. CONCLUSIONS Recent increases in the U.S. teen birth rate highlight the continued importance of improving reproductive health outcomes. Our research suggests that it is important for programs to take into consideration how family, individual, and relationship environments influence decision-making about sex, contraception, and childbearing.

Immigration Measures and Reproductive Health Among Hispanic Youth: Findings from the National Longitudinal Survey of Youth, 1997-2003

PURPOSE To explore relationships between immigration measures and risk of reproductive and sexual events among U.S. Hispanic adolescents. METHODS We examined generation status, language in the home and country of origin in relation to sexual activity, contraception, and childbearing among 1614 Hispanic adolescents, using nationally representative 1997-2003 longitudinal data. Multivariable analyses controlled for potentially confounding variables. Tests for effect modification by gender and Mexican origin were conducted. RESULTS Fewer first generation adolescents transitioned to sexual intercourse before age 18 (odds ratio [OR]=.80, 95% confidence interval [CI]=.66-.98) and fewer first and second generation sexually active teens used contraceptives consistently at age 17 (OR=.32, 95% CI=.17-.60 and OR=.50, 95% CI=.31-.80, respectively) than third-generation teens. Language was similarly associated with the transition to sexual intercourse and contraceptive practices. Versus teens of Mexican origin, teens of Puerto Rican origin and origins other than Cuba and Central/South America had greater odds of becoming sexually active; youth of all origins except Central/South America had fewer multiple live births (OR=.14-.31). Gender modified the effects of generation on consistent use of contraceptives and condoms at age 17. Gender also modified the effect of country of origin on transitioning to sexual intercourse before age 18 years. CONCLUSIONS Results expand on previous observations that generation, language, and country of origin are predictors of reproductive and sexual risks for Hispanic adolescents. These immigration measures may therefore be useful in targeting community and clinical preventive services.

Union Transitions Following the Birth of a Child to Cohabiting Parents

Despite a growing interest in the family trajectories of unmarried women, there has been limited research on union transitions among cohabiting parents. Using data from the 2002 National Survey of Family Growth, we examined how family complexity (including relationship and fertility histories), as well as characteristics of the union and birth, were associated with transitions to marriage or to separation among 1,105 women who had a birth in a cohabiting relationship. Cohabiting parents had complex relationship and fertility histories, which were tied to union transitions. Having a previous nonmarital birth was associated with a lower relative risk of marriage and a greater risk of separation. In contrast, a prior marriage or marital birth was linked to union stability (getting married or remaining cohabiting). Characteristics of the union and birth were also important. Important racial/ethnic differences emerged in the analyses. Black parents had the most complex family histories and the lowest relative risk of transitioning to marriage. Stable cohabitations were more common among Hispanic mothers, and measures of family complexity were particularly important to their relative risk of marriage. White mothers who began cohabiting after conception were the most likely to marry, suggesting that “shot-gun cohabitations” serve as a stepping-stone to marriage.