Shang-en Chung

Ambivalent Childbearing Motivations: Predicting Condom Use by Urban, African-American, Female Youth

STUDY OBJECTIVE To describe a model of how interactions between positive and negative childbearing motivations affect the use of condoms for contraceptive purposes and test hypotheses based on that model. DESIGN Psychological and behavioral data were collected during a study that sampled randomly selected census block groups. SETTING Respondents were household residents of Baltimore City, Maryland, between 2004 and 2007. PARTICIPANTS English-speaking, sexually active African-American women between the ages of 15 and 24 who had completed a reliable and valid measure of both positive and negative childbearing motivations. MAIN OUTCOME MEASURES Regularity of condom use during the past 90 days and contraceptive method at last sex. RESULTS The results of regression analyses with the total sample confirm that antinatal childbearing motivations predicted more regular condom use and that ambivalent, pronatal, and indifferent childbearing motivations acting together each predicted less regular condom use. The results with a subgroup using condom and not hormonal contraception confirmed that ambivalent childbearing motivation alone predicted less regular condom use. CONCLUSIONS Our findings demonstrate how positive and negative childbearing motivations interact to create a dynamic effect on contraceptive behavior that transcends the effect of either positive or negative motivation acting alone. We conclude that the dynamics of these motivational interactions have important implications for further research on contraceptive decision-making, for augmenting the understanding of caretakers and providers, and for the formation of new policies that focus on the prevention of unplanned pregnancy among youth.

Perceived Social Support, Parental Notification, and Parental Engagement after Pelvic Inflammatory Disease among Urban Adolescent and Young Adults

BACKGROUND Urban adolescent and young adult women often require adult support throughout their transition to adulthood particularly regarding seeking healthcare. While confidentiality is crucial feature of care delivery, successful adherence to treatment can be multi-factorial. The purpose of this study is to determine factors associated with parental notification and engagement in self-care of young women diagnosed with Pelvic Inflammatory Disease (PID). METHODS This study utilizes data from 187 participants in the Technology Enhanced Community Health Nursing (TECH-N) study, a randomized controlled trial of an intervention to prevent recurrent STIs after a diagnosis of mild-moderate PID. Participants were recruited from pediatric ambulatory settings provided baseline demographic, reproductive history, and perceived social support using an audio computerized self-interview at baseline and parental notification collected during a two-week follow-up interview, served as the primary outcome. RESULTS Sixty-five percent of participants informed a parent of their PID diagnosis, 74% of whom reported receiving supportive care. Participants who reported a higher sense of responsibility to others were 17% less likely to inform a parent of their diagnosis. CONCLUSION Most urban young women with PID notify parents of their diagnosis and obtain support for self-management in the outpatient setting. While autonomy is a critical milestone for transition to young adulthood, these data suggest that proactive youth-managed parental engagement may be an underutilized resource for young women diagnosed with PID.

The Interaction of Sexual Validation, Criminal Justice Involvement and STI Risk among Adolescent and Young Adult Males

Background Young men who have been involved with the criminal justice system are more likely to have concurrent sexual partners, a key driver of sexually transmitted infections. The value men place on having sexual relationships to validate themselves may play an important role in understanding this association. Methods Data were from a household survey. Young men (N = 132), aged 16 to 24 years, self-reported whether they ever spent time in jail or juvenile detention and if they had sexual partnerships that overlapped in time. A novel scale, “Validation through Sex and Sexual Relationships” (VTSSR) assessed the importance young men place on sex and sexual relationships (&agr; = 0.91). Weighted logistic regression accounted for the sampling design. Results The mean (SD) VTSSR score was 23.7 (8.8) with no differences by race. Both criminal justice involvement (CJI) (odds ratio [OR], 3.69; 95% confidence interval [CI], 1.12–12.1) and sexual validation (OR, 1.10; 95% CI, 1.04–1.16) were associated with an increased odds of concurrency; however, CJI did not remain associated with concurrency in the fully adjusted model. There was effect modification, CJI was associated with concurrency among those who scored high on sexual validation (OR, 9.18; 95% CI, 1.73–48.6]; however, there was no association among those who scored low on sexual validation. Racial differences were observed between CJI and concurrency, but not between sexual validation and concurrency. Conclusions Sexual validation may be an important driver of concurrency for men who have been involved with the criminal justice system. Study findings have important implications on how sexual validation may explain racial differences in rates of concurrency.

Perceived social support and sexually transmitted disease related health care utilization in sexually experienced African American adolescents

Conclusions: Perceived social support has been shown to be important in health care seeking and well-being. We found perceived social support to be related to STD related health care among sexually experienced adolescents. However perceived parental support and participation in outside of school activities were not significant. These findings may suggest that friends more so than parents have an impact on the seeking of confidential health care services such as care for STDs. (excerpt)