Melissa A. Sutherland

Parental Influences of Sexual Risk Among Urban African American Adolescent Males

PURPOSE This study examined the influence of parental marital status, parent-child sexual communication, parent-child closeness on the HIV-related knowledge, safer-sex intentions, and behaviors of late adolescent urban African American males. DESIGN The study employed a cross-sectional design with retrospective recall of salient parental influences and behaviors. METHODS Data were collected via paper-and-pencil questionnaire from 134 late adolescent African American males, 18 to 22 years of age, recruited from urban communities in and around Boston, Massachusetts. Data were analyzed using bivariate correlations, paired t tests, and regression modeling. FINDINGS Young men reported greater amounts of sexual communication with mothers than fathers (p < .001). Parent-child closeness was positively correlated with amount of parent-child sexual communication with both mothers and fathers (p < .001 for both). Parent-child closeness was, in turn, associated with greater condom use self-efficacy (p < .01), less permissive sexual attitudes (p < .001), fewer sexual partners (p < .01), and less unprotected sex (p < .01). Greater amounts of parent-child sexual communication were associated with fewer sexual risk behaviors, more consistent condom use, and greater intentions to use condoms in the future. There was evidence that parental influences on sexual risk behaviors and condom use intentions were mediated through young mens condom use self-efficacy, attitudes, and beliefs. CONCLUSIONS These findings highlight the importance of the parent-child relationship and the role of parent-child communication between parents and sons. Further studies are needed to better understand the nature of father-son communication and develop strategies to help parents communicate effectively with sons. CLINICAL RELEVANCE Evidence has shown that African American adolescent males are more likely to engage in high-risk sexual behaviors. Understanding the sexual risk communication between African American adolescent males and their parents is important to developing strategies in reducing sexual risk behavior.

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.

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.

Evaluation of a Bystander Education Program

Sexual and partner violence are widespread problems on college campuses. By changing attitudes, beliefs, and behavior, bystander education programs have been found to prevent sexual and partner violence and improve the responses of peers to survivors. The purpose of this study is to evaluate the effectiveness and feasibility of a bystander education program that was adapted to a specific university setting. A convenience sample of 202, full-time undergraduate students aged 18–22 years participated in the bystander education program and completed pre- and post-test measures of attitudes related to sexual and partner violence and willingness to help. Paired sample t-tests were used to examine changes in scores between pre- and post-test conditions. After the program, participants’ reported decreased rape myth acceptance and denial of interpersonal violence, and increased intention to act as a bystander and an increased sense of responsibility to intervene. Mental health nurses can use principles of bystander education in violence prevention programs and in providing support to survivors.

Gender differences in attitudes and beliefs associated with bystander behavior and sexual assault.

ABSTRACT Sexual violence is a significant problem on many college campuses. Bystander education programs have been found to train individuals to act to prevent sexual and partner violence and improve the responses of peers to survivors. Limited evidence suggests that gender differences exist between males and females regarding both attitudes toward, and use of, bystander behavior, with females reporting more supportive attitudes and greater use of bystander behavior. The purpose of this study is to compare male and female college students on attitudes toward date rape, bystander efficacy, intention to act as a bystander, and actual use of bystander behaviors. A secondary aim explored gender differences in theoretically driven bystander behaviors and barriers to acting as a bystander. A convenience sample of 157 full-time undergraduate students aged 18–24 years completed survey measures of attitudes related to sexual and partner violence and willingness to help. Analysis of variance and chi-square were used to compare gender differences in scores. Significant gender differences were found for date rape attitudes, efficacy, and intention to act as a positive bystander. Men reported more rape-supportive attitudes and greater intention to act as a bystander than women, whereas women reported greater levels of bystander efficacy than men. The findings can be used in tailoring gender-specific components of bystander education programs for sexual assault prevention and intervention.

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.

Who sends the email? Using electronic surveys in violence research.

Introduction: Students aged 16–24 years are at greatest risk for interpersonal violence and the resulting short and long-term health consequences. Electronic survey methodology is well suited for research related to interpersonal violence. Yet methodological questions remain about best practices in using electronic surveys. While researchers often indicate that potential participants receive multiple emails as reminders to complete the survey, little mention is made of the sender of the recruitment email. The purpose of this analysis is to describe the response rates from three violence-focused research studies when the recruitment emails are sent from a campus office, researcher or survey sampling firm. Methods: Three violence-focused studies were conducted about interpersonal violence among college students in the United States. Seven universities and a survey sampling firm were used to recruit potential participants to complete an electronic survey. The sender of the recruitment emails varied within and across the each of the studies depending on institutional review boards and university protocols. Results: An overall response rate of 30% was noted for the 3 studies. Universities in which researcher-initiated recruitment emails were used had higher response rates compared to universities where campus officials sent the recruitment emails. Researchers found lower response rates to electronic surveys at Historically Black Colleges or Universities and that other methods were needed to improve response rates. Conclusion: The sender of recruitment emails for electronic surveys may be an important factor in response rates for violence-focused research. For researchers identification of best practices for survey methodology is needed to promote accurate disclosure and increase response rates.