Heidi Collins Fantasia

College Men's Knowledge, Attitudes, and Beliefs about the Human Papillomavirus Infection and Vaccine

Men enrolled in an urban university participated in focus groups (k=6; n=45) to explore knowledge about human papillomavirus and attitudes toward prophylactic vaccine. Results suggest that regardless of whether vaccines become available to men, educational efforts should include them, as men tend to have many misconceptions and do not perceive themselves to be vulnerable.

Human papillomavirus (HPV) risk factors, vaccination patterns, and vaccine perceptions among a sample of male college students.

Abstract Objective: To examine human papillomavirus (HPV) vaccination rates, including initiation and completion of the vaccine series, and barriers to vaccination in a sample of male college students. Participants: Male students between the ages of 18 and 25 who reported being currently or previously sexually active (N = 735). Methods: A cross-sectional Web-based survey was administered during October 2012 at a large public university in the northeast United States. Student e-mail addresses were obtained from the university after institutional review board approval. Results: Although condom use was low and number of lifetime sexual partners was high, 93% reported they were not at risk for sexually transmitted infections. The college men in the sample had low HPV vaccine awareness, knowledge, perceived severity, and perceived susceptibility, and 74% of the sample had not obtained the HPV vaccine. Conclusions: There is a disconnect between actual and perceived risks of HPV and barriers to HPV vaccination exist.

Chronicity of partner violence, contraceptive patterns and pregnancy risk

BACKGROUND Partner violence may interfere with a womans ability to maintain continuous contraception and therefore contribute to increased risk of pregnancy among childbearing women. STUDY DESIGN A retrospective review of medical records (N=2000) was conducted from four family planning clinics in the northeast United States. Eligibility criteria for inclusion were as follows: (1) female, (2) reproductive age (menarche through menopause), (3) seeking reproductive services and (4) clinic visit for annual gynecologic exam between 2006 and 2011. RESULTS Partner violence was documented in 28.5% (n=569) of medical records. Chronicity of violence influenced contraceptive patterns and pregnancy risk. Women reporting past year partner violence only [odds ratio (OR)=10.2] and violence during the last 5 years (OR=10.6) had the highest odds of not using a current method of contraception. Women reporting recent exposure to violence were most likely to change birth control methods and use emergency contraception (OR=6.5). Women experiencing any history of violence reported more frequent contraceptive method changes during the previous year. CONCLUSIONS A history of partner violence was common among women utilizing family planning services. The chronicity of violence appeared to play a significant role in contraceptive method changes, types of methods used and pregnancy risk. These results may be one explanation for increased pregnancies among women who experience partner violence.

Concept Analysis: Sexual Decision‐Making in Adolescence

PURPOSE This papers aims to clarify and explore the topic of adolescent decision-making regarding sexual activity. SOURCES Published literature. CONCLUSIONS Adolescent decision-making regarding the initiation or continuation of sexual activity is influenced by desire for intimacy, perceived relationship safety, problem-solving ability, cognitive ability, family and peer relationships, and concern regarding pregnancy or sexually transmitted infection.

Screening for intimate partner and sexual violence in college women: missed opportunities

BACKGROUND Intimate partner violence (IPV) and sexual violence (SV) are significant health issues for college women. Leading organizations and experts recommend screening for IPV/SV in health care settings, including college health centers. Given the prevalence and health risks associated with IPV/SV among college women, it is important to examine screening in this population. METHODS A cross-sectional, web-based survey was administered to college women at two universities in the northeastern United States. The survey consisted of demographic questions, assessment of experiences with IPV/SV (lifetime and past 6 months), use of health care services with either a college health center or an off-campus provider, and assessment of health care setting screening practices. RESULTS The sample included 615 college women (M = 21.5 years). Lifetime experiences of IPV/SV were reported by 222 women (36.1%). Approximately 8.1% of participants (n = 51) experienced IPV/SV in the past 6 months. Almost 63% (n = 238) reported not being asked about IPV/SV at their most recent off-campus health care visit. Nearly 90% (n = 237) reported not being asked about IPV/SV at their most recent visit to the college health center. CONCLUSIONS Participants reported high rates of IPV/SV and low rates of violence screening at college health centers and off-campus settings. Routine provider screening for IPV/SV in health care settings can identify women at risk and can lead to interventions that reduce subsequent violence and improve health outcomes and referrals. Theory-based, culture-specific, multilevel interventions are needed to promote IPV/SV screening among college health providers.

The Sexual Safety of Adolescents

In this article, the authors review issues that affect the sexual safety of adolescents. First and foremost, these issues include risks for unintended pregnancy and sexually transmitted infections. Clinicians also need to understand other critical issues that affect sexual safety. These include adolescent dating patterns, decision making, communication and negotiation skills, social and environmental influences, and risks related to violence. Suggestions for clinical interventions to promote sexual safety are discussed.

Intimate Partner Violence and the CDC's Best‐Evidence HIV Risk Reduction Interventions

OBJECTIVES Intimate partner violence (IPV) is a prevalent health burden in the United States and is a risk factor for HIV (human immunodeficiency virus) transmission. Despite the association between IPV and HIV risk, IPV is often omitted from HIV prevention research and interventions. This review analyzes the Centers for Disease Control and Preventions best-evidence HIV risk reduction interventions and their incorporation of IPV assessment, education and evaluation. DESIGN AND SAMPLE The Centers for Disease Control and Preventions best-evidence HIV risk reduction interventions (n = 44) were reviewed for inclusion of IPV content. RESULTS Of the 44 best evidence interventions, 5 addressed IPV. These 5 interventions were further examined for method, measurement and uniformity. CONCLUSIONS Justification for IPV integration in HIV risk reduction programs is explored and supported by evidence-based research and practice.

The Effects of Intimate Partner Violence Duration on Individual and Partner-Related Sexual Risk Factors Among Women

INTRODUCTION Intimate partner violence (IPV) is associated with risk of sexually transmitted infections (STIs) and HIV among women, but less is known about mechanisms of this association and if length of relationship violence is a factor. The purpose of this study was to explore the relationship between the duration of IPV and both individual and partner-related sexual risk factors that may increase womens risk for STIs and HIV. METHODS This was a secondary analysis of data collected from the medical records of 2000 women. Four distinct categories defined the duration of partner violence: violence in the past year only, past year and during the past 5 years, past year plus extending for greater than 5 years, and no past year violence but a history of partner violence. Logistic regression models were used to examine the associations between the duration of partner violence and individual sexual risk behaviors (eg, number of sexual partners, drug and/or alcohol use, anal sex) and partner-related sexual risk factors (eg, nonmonogamy, STI risk, condom nonuse). RESULTS Nearly 30% of the women in the study reported a history of partner violence during their lifetime. All of the individual risk factors, as well as partner-related risk factors, were significantly associated (P < .05) with partner violence and duration of violence. DISCUSSION The study findings extend the knowledge related to partner violence as a risk factor for STIs/HIV, highlighting the effects of partner violence duration on the health of women. Assessing for lifetime experiences of partner violence may improve outcomes for women and their families.

Sexual Health and Dissociative Experiences among Abused Women

Sexually transmitted infections are a significant public health issue impacting women. Intimate partner violence (IPV) is one risk factor for STIs/HIV. Women who are the victims of IPV often experience psychological difficulties, including dissociation. Dissociative symptoms may play a role in womens ability to practice safe sex and negotiate condom use, although this has been underexplored. This mixed methods study examined the dissociative symptoms of 22 women experiencing IPV and examined the ways in which these women described their own sexual health and behaviors as well as how they protected themselves from sexually transmitted infections and HIV.

Increasing HPV vaccination and eliminating barriers: Recommendations from young men who have sex with men

BACKGROUND There is a disparity in HPV vaccination rates in particular among young men who have sex with men (YMSM) and until very recently there has been a dearth of research examining factors related to HPV vaccination for YMSM. The purpose of this study was to elicit YMSMs beliefs about HPV and the HPV vaccine as well as describe perceived barriers and facilitators of vaccine initiation and completion. METHODS A qualitative, descriptive study that utilized a focus group design was conducted among an urban and racially diverse sample of YMSM. Questionnaire data were analyzed using descriptive statistics, and focus group data were analyzed using content analysis. FINDINGS 34 YMSM with a mean age of 20.8years participated. The sample was diverse, with the largest proportion of youth identifying as Black (35.4%). Over 90% reported having an annual exam each year, 61.8% reported obtaining a flu vaccine during the past year, and 58.8% reported initiating the HPV vaccine 3-dose series. Themes identified included low HPV knowledge and awareness, positive vaccine beliefs, perceived stigmas, and HPV vaccine facilitators. Participants identified 3 ways health providers/ researchers could facilitate vaccination: creative use of mobile technology, bundling vaccination with other health services, and increasing HPV and HPV vaccine awareness. CONCLUSIONS Our findings point to some clear avenues to pursue in research and practice to improve HPV vaccination rates among YMSM, including increased use of mobile health strategies, making HPV vaccination a co-occurring part of other health-related services (e.g., HIV testing), and providing information on the relevance of HPV and HPV vaccination to YMSM.