Kathleen Ford

Psychometrics of a Brief Acculturation Scale for Hispanics in a Probability Sample of Urban Hispanic Adolescents and Young Adults

This article presents data in support of the reliability and validity of afour-item measure of acculturationfor Hispanics. The study has three strengths. First, this brief measure is evaluated with a probability sample of Hispanic adolescents and young adults (ages 15-24 years) living in urban, low-income households. Second, the sample contains both second-and third-generation Puerto Rican and Mexican American adolescents and young adults. Third, the acculturation measure was administeredas part ofaface-to-face interview. The four-item acculturation scale correlated highly with generation, length of time in the United States, subjective evaluation of acculturation, country of birth, and language chosen for the interview. The psychometric properties of this brief scale are comparable to those obtained for other published scales. Results support the use of this four-item measure of acculturation as a simple, inexpensive measure that involves minimal respondent burden.

American adolescents: sexual mixing patterns, bridge partners, and concurrency.

Background American adolescents have a high incidence of sexually transmitted infections. Patterns of sexual partner choice influence the transmission of infections in this population. Goal To examine patterns of sexual mixing, bridging, and concurrency in American adolescents and the association of these characteristics with condom use. Study Design This project used the AddHEALTH survey data. The survey selected a sample of schools, then conducted in-home interviews with 18,984 students in 1995. A second wave of data collection was conducted 2 years later. The data on sexual relationships collected in the study were analyzed. Results Respondents ranged in age from 13 to 17 years. Sex partnerships with persons of differing age groups were very common in this population (45% of sexual partnerships). Relationships with persons of different ethnicity were more common among Latinos (42%) than among white (14%) and black (15%) respondents. A large proportion of the sample reported more than two partners (56%). Among these persons, a large proportion reported partners in two different age groups (69%) and ethnic groups (35%) as well as concurrent partners (54%). Condom use was lower among persons with partners in different age groups and among persons with a larger number of partners. Conclusions The large number of adolescents who have sexual relationships with persons of different characteristics creates bridges for infections between different groups. Counseling of sexually active adolescents should include discussion on issues of power and communication in these relationships.

Urban Hispanic adolescents and young adults: Relationship of acculturation to sexual behavior

As Hispanic persons in the U.S. are exposed to U.S. culture, changes may occur in values, attitudes, and behavior. This process of change has been called acculturation. The objectives of this research were to describe the sexual behavior of low income, urban Hispanic youth in Detroit and to evaluate the relationship of acculturation to sexual behavior. Data were drawn from a household probability sample of 711 low income, urban youth. The relationship of acculturation to sexual activity, types of intercourse, number and ethnicity of partners, condom use, and use of other methods were estimated for never married men and women. Level of acculturation was associated with sexual behavior. Specifically, women with high acculturation were much more likely to have had at least one sexual partner in the last year, to have non‐Hispanic partners, to have oral and anal sex, and to have used condoms. For men, high acculturation was positively associated with oral sex and having non‐Hispanic partners. Use of contracep...

Duration of Residence in the United States and the Fertility of U.S. Immigrants.

This paper analyzes census data on the fertility of U.S. immigrants to study trends in fertility after migration. The results showed that immigrant fertility may rise after arrival in the new country perhaps because immigrants are making up for births or marriages that may have been postponed due to the move. After a period of time, the fertility of immigrants may fall and as immigrants become more assimilated to the new country their fertility may come to be similar to cohorts of longer duration. These relationships were examined in a multivariate context so that variations between groups in socioeconomic status, fertility in the country of origin, age and marital status could be controlled. Relationships were studied for all U.S. immigrants as well as for subgroups defined by country or region of origin. The results indicate that simple measures of immigrant fertility that do not consider duration of residence are likely to be misleading if used to draw conclusions about the fertility impacts of immigration and advisable policy interventions.

Nutrition and Fertility in Bangladesh: Breastfeeding and Post Partum Amenorrhoea

From 1975 to 1980 a prospective study a nearly 2,500 married, fertile women was conducted in Matlab, Bangladesh at the International Centre for Diarrhoeal Disease Research. Women were interviewed at monthly intervals to collect information on nutritional and reproductive status, in order to study the factors associated with natural fertility. The median duration of amenorrhoea for women with no child deaths was 15.5 months, with older women and those of higher parities recording longer durations than younger women or those of lower parities. Median duration of amenorrhoea for women with six or more years of education was 8.4 months compared to 16.4 months among women with no education. When classified by weight at pregnancy termination, average duration of amenorrhoea of women weighing less than 38 kg was 17.6 months compared to 13.6 months among women weighing more than 44 kg. Proportional hazards analyses show that mothers education, parity, month of birth, supplementation practices and nutritional sta...

AIDS mortality and the mobility of children in KwaZulu Natal, South Africa

This paper examines the effect of parental death on the mobility of 39,163 children aged 0–17 in rural KwaZulu Natal, South Africa, in 2000 and 2001. Parental mortality from all causes prior to and during follow-up increased the risk of a child moving by nearly two times after we controlled for the age and gender of the child and household characteristics. However, in the follow-up period, child mobility following maternal deaths from AIDS was lower than child mobility following maternal deaths from other causes. Younger children, boys, and children whose mothers or fathers were resident members of the children’s households were also less likely to move.

Behavioral interventions for reduction of sexually transmitted disease/HIV transmission among female commercial sex workers and clients in Bali, Indonesia.

Objective:To describe and evaluate a behavioral intervention targeted to low-price female commercial sex workers (CSW) in large brothel complexes, their pimps, and their male clients. Design and methods:Fieldwork was conducted during 1994 in Bali, Indonesia. Intervention activities included an education program for CSW, pimp training, condom sales and distribution, and client media. Theoretical perspectives guiding the intervention were the Health Belief Model and social cognitive theory. Baseline and evaluation surveys were conducted to evaluate the intervention. Results:Both AIDS and sexually transmitted disease (STD) knowledge increased significantly over the intervention period. Condom use for vaginal sex with paid partners the day before the interview increased substantially in the two intervention areas: 18–75% and 29–62%. Condom use also increased in the control area, although the difference between baseline and evaluation measures was smaller. Multivariate analyses indicated that programmatic factors such as attendance at education sessions and reading the project brochure were related to condom use. Conclusions:Increasing community knowledge and awareness among low-price CSW, pimps, and clients regarding AIDS and STD using trained outreach workers is feasible and effective. In summary, this study has documented the effectiveness of a behavioral intervention for CSW and their clients.

The Bali STD/AIDS Study: evaluation of an intervention for sex workers.

Background Prostitution has been an important factor in the spread of HIV infection in Asia. Interventions need to be developed to reduce the risk of transmission of sexually transmitted infections in this area. Goals To educate female sex workers about sexually transmitted infections and assess the impact of the educational intervention. Study Design Brothel areas in Denpasar, Bali, Indonesia, were divided into areas of high and low program (interventional) effort. The intervention included educational sessions for sex workers, treatment of sex workers for sexually transmitted disease (STD), condom distribution, and printed information for clients of the sex workers. A high-effort area was one in which a more intensive educational intervention occurred. A clinic was available for STD treatment in both areas. Behavioral surveys and STD testing were used to evaluate the programs. Six hundred female sex workers participated in behavioral surveys and STD examinations every 6 months for four rounds of data collection. Each round, about half of the women were new to the study. A total of 1586 women participated in at least one evaluation round. Changes were evaluated in AIDS knowledge, STD knowledge, and condom use, as well as in the prevalence of Neisseria gonorrhoeae, Chlamydia trachomatis, syphilis, and Trichomonas vaginalis. Testing for HIV was conducted anonymously. Results Improvements were noted in the knowledge of sex workers about AIDS and STDs and in the reduction of some bacterial STDs. Women who remained in the study area for more than one round had increased knowledge of HIV infection/STDs and condom use and had reduced levels of syphilis, gonorrhea, and trichomonas infection (P < 0.01). The additional education received by women in the high-effort program area was associated with a reduction in the prevalence of syphilis. Prevalence of HIV remained low throughout the study. The high level of turnover of female sex workers contributed to the maintenance of significant levels of STDs in this population. Conclusions Developers of HIV/STD prevention programs for sex workers need to consider the mobility of the sex worker population. Interventions combining behavioral and medical approaches can contribute to prevention of these diseases.

Characteristics of sexual partners and STD infection among American adolescents

Adolescents are a high risk group for HIV infection and the characteristics of their partners may affect their susceptibility to infection. The goal of this study was to examine the effects of partner characteristics on sexually transmitted disease (STD) infection in a national sample of adolescents. Data from 8,024 sexually active adolescents who participated in the National Longitudinal Study of Adolescent Health (Add Health) in the United States were included in this study. Logistic models were used to examine the association of partner characteristics including age, neighbourhood, ethnicity, and school attendance on the self-report history of STD infection. The partner characteristics of age and school attendance were associated with the reporting of STD infection. The odds ratio for STD infection was 1.46 (95% confidence interval (CI) (1.22-1.75), P < 0.01) if the adolescents partner was two or more years older and 1.37 (95% CI (1.16-1.62), P < 0.01) if the partner did not attend the adolescents school. The odds ratios for having an older partner were also significant and positive for eight different STDs. Partner characteristics were associated with STD infection among American adolescents. Counselling is needed in clinics that serve adolescents to raise awareness of the risk of infection in these relationships and to improve skills in condom negotiation and use.

Sexual experiences and condom use of heterosexual, low-income African American and Hispanic youth practicing relative monogamy, serial monogamy, and nonmonogamy.

BACKGROUND AND OBJECTIVES To describe (a) demographic characteristics, (b) sexual history, (c) perceived HIV susceptibility, and (d) current sexual behavior, condom use, and alcohol and marijuana use of heterosexual, low-income African American and Hispanic youth categorized as relatively monogamous (n = 577), serial monogamous (n = 171), or nonmonogamous (n = 278). STUDY DESIGN Data were drawn from personal interviews with a probability sample of low-income youth, age 15 to 24 years, conducted in Detroit in 1991. RESULTS Many group differences were found. For example, relatively monogamous youth were most likely to be female and Hispanic and to have engaged in unprotected intercourse. Serial monogamous youth were younger and most likely to have used condoms at last intercourse. Nonmonogamous youth initiated intercourse earlier and were most likely to have experienced oral and anal intercourse and to have used alcohol and marijuana. CONCLUSION Risk reduction programs may need to be tailored differently to accommodate the needs of these three distinct subgroups of youth.