Ninive Sanchez

Sexual intercourse among adolescents in Santiago, Chile: a study of individual and parenting factors

OBJECTIVE to examine a range of individual, parenting, and family factors associated with sexual intercourse among a community sample of youth and their families in Santiago, Chile. METHODS Data were taken from the Santiago Longitudinal Study conducted in January 2008-November 2009. Participants were 766 youth (mean age = 14.03 years, 51% male) from municipalities of low- to mid-socioeconomic status. Variables included emotional and behavioral subscales from the Child Behavior Checklists Youth Self Report, parental monitoring, family involvement, parental control and autonomy, relationship with each parent, and sexual activity. Bivariate and multivariate logistic regression models were used to examine the odds of sexual intercourse initiation. RESULTS seventy (9.14%) youth reported having had sex in their lifetime; the average age of first sexual intercourse among this group was 13.5 years (Standard Deviation [SD] = 1.74) for males and 14.08 (SD = 1.40) for females. Having sex was inversely associated with withdrawn-depressed symptoms (Odds Ratio [OR] = 0.84, Confidence Interval [CI] = 0.72-0.97), but positively associated with somatic complaints (OR = 1.20, CI = 1.04-1.38) and rule breaking behavior (OR = 1.21, CI = 1.08-1.36), after adjusting for demographic and other individual and parenting variables. The majority (80%) of the youth who had had sex reported using protection at the time of last intercourse. CONCLUSIONS findings highlight the role that mental health problems-some of them not commonly associated with onset of sexual activity-may play in a youths decision to have sex. The potential protective effects of several parenting and family characteristics disappeared with youth age and youth behavioral problems.

A life course perspective on polycystic ovary syndrome

Polycystic ovary syndrome (PCOS) is a major public health problem in the US. Worldwide, the public is largely unaware of the condition and health care providers do not seem to fully understand it. Research on PCOS has primarily focused on its etiology and clinical characteristics and less on the psychosocial aspects of human development associated with PCOS. This paper posits that a life course perspective provides a framework for further understanding the psychosocial experiences of women with PCOS and the contexts in which they live. The paper discusses how life course principles of human development, constraints on agency, interdependence of lives, time and place, and timing of events and experiences are relevant to the management of PCOS and prevention of its complications.

Parental Perceptions of Neighborhood Effects in Latino Comunas: The Script of "the Delinquent" in Understanding Drug Use, Violence, and Social Disorganization

Objectives: To obtain rich information about how adult Latinos living in high-poverty/high-drug use neighborhoods perceive and negotiate their environment. Methods: In 2008, 13 adult caregivers in Santiago, Chile, were interviewed with open-ended questions to ascertain beliefs about neighborhood effects and drug use. Analysis: Inductive analysis was used to develop the codebook/identify trends. Discussion: Residents externalized their understanding of drug use and misuse by invoking the concept of delinquent youth. A typology of their perceptions is offered. Learning more about residents’ circumstances may help focus on needs-based interventions. More research with Latino neighborhoods is needed for culturally competent models of interventions.

Ecological Factors and Adolescent Marijuana Use: Results of a Prospective Study in Santiago, Chile

Purpose: Despite the growing evidence that ecological factors contribute to substance use, the relationship of ecological factors and illicit drugs such as marijuana use is not well understood, particularly among adolescents in Latin America. Guided by social disorganization and social stress theories, we prospectively examined the association of disaggregated neighborhood characteristics with marijuana use among adolescents in Santiago, Chile, and tested if these relationships varied by sex. Methods: Data for this study are from 725 community-dwelling adolescents participating in the Santiago Longitudinal Study, a study of substance using behaviors among urban adolescents in Santiago, Chile. Adolescents completed a two-hour interviewer administered questionnaire with questions about drug use and factors related to drug using behaviors. Results: As the neighborhood levels of drug availability at baseline increased, but not crime or noxious environment, adolescents had higher odds of occasions of marijuana use at follow up, approximately 2 years later (odds ratio [OR] = 1.39; 95% CI = 1.16–1.66), even after controlling for the study’s covariates. No interactions by sex were significant. Discussion: The findings suggest that “poverty”, “crime”, and “drug problems” may not be synonyms and thus can be understood discretely. As Latin American countries re-examine their drug policies, especially those concerning decriminalizing marijuana use, the findings suggest that attempts to reduce adolescent marijuana use in disadvantaged neighborhoods may do best if efforts are concentrated on specific features of the “substance abuse environment”.

Adult Awareness of a Youth-Focused Anti-Tobacco Campaign: Does Having Children Matter?

Data from a survey of tobacco use conducted in 2001 was used to examine if Floridas youth-focused anti-tobacco media campaign, which focused on cigarette smoking, reached adults. The majority of the sample was white (87%), high school or college educated (85%), and over half with children (56%). Differences in awareness and intentions to quit among adult smokers with and without children were examined. About 50% of adults were aware of the campaign and the awareness of the tobacco industry manipulation theme was associated with intentions to quit, independent of having children. These findings provide evidence that youth-targeted anti-tobacco media campaigns can reach adults; however, to change the behavior of adults who smoke, it may not be appropriate to have a “one-size-fits-all” program. The studys limitations are noted.

I Know God’s Got a Day 4 Me: Violence, Trauma, and Coping Among Gang-Involved Twitter Users

Trauma-based interventions are common in mental health practice, and yet there is a gap in services because social media has created new ways of managing trauma. Practitioners identify treatments for traumatic experiences and are trained to implement evidence-based practices, but there is limited research that uses social media as a data source. We use a case study to explore over 400 Twitter communications of a gang member in Chicago’s Southside, Gakirah Barnes, who mourned the death of her friend on Twitter. We further explore how, following her own death, members of her Twitter network mourn her. We describe expressions of trauma that are difficult to uncover in traditional trauma-based services. We discuss practice and research implications regarding using Twitter to address trauma among gang-involved youth.

Suitability of the National Health Care Surveys to Examine Behavioral Health Services Associated with Polycystic Ovary Syndrome

The National Institutes of Health, Office of Disease Prevention, has described polycystic ovary syndrome (PCOS) as a major public health problem for women in the USA. This study examines the suitability of the National Health Care Surveys, collected by the Centers for Disease Control and Prevention, to understand patient demographics and behavioral health services associated with PCOS-related medical visits. Data were from the 2005–2010 National Ambulatory Medical Care Survey and National Hospital Ambulatory Medical Care Survey. PCOS-related medical visits were identified using the International Classification of Diseases, 9th Revision, Clinical Modification code 256.4. Items on mental health and health education ordered or provided did not meet the National Center for Health Statistics criteria necessary to produce reliable national estimates (i.e., at least 30 unweighted records and a relative standard error <30%). Findings underscore the need to strengthen national surveillance to further understand behavioral health care for patients with PCOS.

An Agenda for Longitudinal Research on Substance Use and Abuse with Hispanics in the U.S. And with Latin American Populations

As a result of the fast growing Hispanic population and the overrepresentation of substance use, including the social, political, and economic risk factors they experience, there is an urgent need for more research to be conducted to better understand the etiology of substance use across developmental stages among the large diversity that exist among Hispanic populations. The main goal of this chapter is to provide a convincing argument to encourage more longitudinal research with Hispanic youth and their families to develop a more comprehensive body of knowledge about substance use among these populations, knowledge that, we argue, can better inform the field of prevention and treatment with these populations.

Adolescent Pregnancy in Chile: A Social, Cultural, and Political Analysis

The purpose of this chapter is to provide a comprehensive overview and discussion of pregnancy and sexuality among youth in Chile from a social, cultural, and political perspective. Trends and patterns of a number of behaviors (i.e., pregnancy rates, infant mortality rates, use of contraceptives, attitudes toward sex) are presented, and the historical influences on contemporary youth are discussed. We argue that youth live under competing epistemological stances that converge and play out within the social space as both promoting sexualized behavior and admonishing it. These confusing and seeming arbitrary messages (both explicit and implicit through the denial of sexual health education) are likely to have a confusing and negative effect on the lives and development of Chilean adolescents. Today, Chile maintains a democratically lead government and claims to be the most economically and socially stable country in Latin America. These changes have dramatically changed the social and political climate for all Chileans and especially for adolescent females. Young Chilean girls and boys must not only manage the changing hormonal and social pressures of their adolescent lives, but they must also navigate a current reality marked by historical, religious, cultural, economic, and political processes. This chapter posits that the complex social realities of Chilean history and present social and political realities contribute to the country’s failure to properly address issues concerning adolescent sexuality, sexual and reproductive rights, health, and education, and teenage motherhood. We conclude that Chilean policies and practices need to align with the changing social realities, however, for this to occur a new radical approach needs to be considered especially for those young women who are the most vulnerable in society.

Adolescent Cigarette Use in the Americas: The Link with Depression

While society’s understanding of the burden of disease associated with substance use and mental health disorders continues to grow, serious gaps remain in our ability to help all individuals with these disorders. It has been estimated that the use of tobacco and alcohol each represent 8.7% and 3.8% of all deaths worldwide. In addition, the Disability-Adjusted Life Years (DALYs) caused by alcohol, tobacco and illicit drug use are estimated to be 4.4%, 3.7% and 0.9%, respectively (WHO, 2009). Unfortunately, these gaps are likely to be substantially larger among racial and ethnic minorities and culturally diverse populations.