Sinead N. Younge

Applying ecological perspectives to adolescent sexual health in the United States: rhetoric or reality?

This study sought to determine the perspective taken toward understanding adolescent sexual risk behaviors and related biological outcomes (i.e. pregnancy, sexually transmitted diseases) since 1990. We content analyzed 324 abstracts representing observational research published between January 1990 and December 2007 for inclusion of ecological (environmental) factors, level of analysis, sample composition and type of behavioral and biological outcomes. A majority (95%) of studies included individual characteristics; half were void of any environmental factors. Of those including environmental factors, 27% included familial, 23% community, 13% relational and 3% societal factors. Most (80%) were positioned at the individual level of analysis. Samples were diverse (43%) and of mixed gender (71%). Biomarkers of sexually transmitted diseases (7.5%) or pregnancy outcomes (2%) were rare. Ecological inclusion was not related to year of publication. Despite the rhetoric highlighting, the importance of an ecological perspective in understanding adolescent sexual risk behavior, much published research, excludes environmental influences.

Risk Revisited: The Perception of HIV Risk in a Community Sample of Low-Income African American Women

Despite the high rate of HIV infection among low-income African American women, research suggests that perceptions of HIV risk among this population are not elevated compared to other groups. It is evident that an individual’s subjective perception of risk is based on a multiplicity of both internal and external factors, including relationship context and cultural worldview. This study examines the contribution of cultural worldview to low-income African American women’s HIV risk perception. A hierarchical linear regression was conducted on a community sample of low-income African American women (N = 196). Results demonstrate that when partner infidelity was controlled, financial independence and interpersonal control were significant predictors of perceived HIV risk, with lack of power related to elevated levels of perceived risk. When relationship power and HIV knowledge were taken into account, cultural worldview was a significant negative predictor of perceived risk, with high levels of fatalism associated with low perceived risk. Findings suggest that knowledge alone is not enough to explain HIV risk perception. The role of cultural worldview must be taken into account.

The associations of multiple dimensions of discrimination and abdominal fat in African American adults: the Jackson Heart Study.

BackgroundDiscrimination may be adversely associated with abdominal obesity, but few studies have examined associations with abdominal fat.PurposeThe purpose of this study was to examine whether discrimination was independently associated with visceral (VAT) and subcutaneous (SAT) fat and whether these associations differed by sex and age.MethodsParticipants self-reported experiences of everyday and lifetime discrimination. The main reason for and the coping response to these experiences were also reported. VAT and SAT were quantified by computed tomography.ResultsIn fully adjusted models, higher reports of everyday discrimination were associated with greater SAT, but not VAT, volumes in men only: SAT increased by 3.6 (standard error = 1.8) cm3 for each unit increase in the everyday discrimination score. In women, higher reports of lifetime non-racial discrimination were associated with greater VAT (71.6 ± 32.0, P < 0.05) and SAT (212.6 ± 83.6, P < 0.05), but these relationships were attenuated after controlling for body mass index.ConclusionsThese cross-sectional findings do not fully support the independent hypothesis of discrimination and abdominal fat. Additional investigations involving longitudinal designs are warranted.

The paradox of risk: historically black college/university students and sexual health.

Abstract Objective: This literature review provides an analysis of the current state of the empirical research on sexual health among students attending historically black colleges and universities (HBCUs). Methods: Several electronic databases were used to identify 24 empirical studies that met criteria for inclusion in this review. Results: The results indicated that perceived human immunodeficiency virus (HIV) risk, religiosity, HIV testing, condom use, and substance use were as high or higher for black HBCU students in comparison with students of other racial/ethnic groups. Comment: Consistent with past findings, sexually transmitted infections continue to be of concern among HBCU students, as seen in the general black population. Limitations: This review only examined cross-sectional studies published between 2000 and 2013. Conclusions: The findings in this review suggest the importance of moving beyond individual risk models to examining structural barriers and assets related to promoting sexual health on HBCU campuses.

Development of the Sexual Sensation-Seeking Scale for African American Adolescent Women

ABSTRACT We used data derived from two independent studies to examine the psychometric properties of a new scale to measure adolescents’ willingness to engage in sexual sensation-seeking behavior. In Study 1, the Sexual Sensation-Seeking Scale for Adolescents (SSSA) was administered to a sample of 715 African American adolescents ranging in age from 15 to 21 years. The SSSA demonstrated strong internal consistency, moderate stability, and satisfactory construct validity. In Study 2, the SSSA data from a subsample of African American adolescent women detained in youth detention centers were analyzed (N = 103). Strong internal consistency was demonstrated with this sample as well. The results indicate that the SSSA is a reliable and valid measure of sexual sensation seeking for African American adolescent women.

A comprehensive examination of the health knowledge, attitudes and behaviors of students attending historically black colleges and universities.

There is limited information about African American students attending Historically Black Colleges and Universities (HBCUs) in the areas of health behavior, health knowledge, and attitudes. To fill this gap, a comprehensive examination of first-year students was undertaken at a consortium of HBCUs. A non-random sample of 1,115 freshmen were administered a survey that assessed several domains including: (1) demographics, (2) general health, (3) smoking habits, (4) disease risk, (5) weight perception, (6) physical activity, (7) perceived stress, (8) eating habits, (9) social support, (10) personal/family medical history, (11) leadership, (12) domestic violence, (13) substance use, and (14) sexual behavior. In general, most students knew about health behaviors and disease risk. Areas that warrant further exploration include physical activity, sexual behavior, and drug use. The analyses provide key information for health education and prevention.

Human papillomavirus vaccine intention among college men: what's oral sex got to do with it?

Abstract Objective: To identify associations between engaging in oral sex and perceived risk of oral cancer among college men. Also, to identify associations, and their moderating factors, between oral sex and human papillomavirus (HPV) vaccine acceptance. Methods: Young men were recruited from 2 university campuses in the South (N = 150). Men completed an audio computer-assisted self-administered interview. Results: With the exception of receiving fellatio, each measure of oral sex behavior was significantly associated with greater perceived risk of oral cancer. Four oral sex behaviors evidenced significant associations with vaccine acceptance. Men engaging in recent oral sex or reporting oral sex behaviors with more than 2 partners were more likely to indicate vaccine intent. African American/black race, communication with parents about sex-related topics, and HPV-related stigma/shame were identified as moderating factors. Conclusion: Young college men giving or receiving oral sex with multiple partners may be predisposed to HPV vaccination.

Is male intent to be vaccinated against HPV a function of the promotion message

We aimed to determine whether the type of outcome expectation, stemming from HPV vaccination, would have any effect on young mens HPV vaccine intent. We recruited young men (18–24 years of age) from two university campuses (n = 150). After answering a series of questions they were randomly assigned to one of three information conditions (all delivered by computer): (1) how women may benefit from mens HPV vaccination, (2) preventing genital warts and (3) preventing head and neck cancers. Intent to be vaccinated against HPV in the next 12 months was assessed before and after receiving the informational session corresponding to the assigned condition. A repeated-measures t-test indicated that a significant increase in young mens intent to be vaccinated after they received the assigned information (t = 9.48, [147], P = 0.0001). However, the increase in intent to be vaccinated did not vary by group assignment as there were no significant differences in mean intent scores between the three groups (F = 0.59, [2/144], (P = 0.56). Information that promotes the outcome expectations of protecting women from cervical cancer, preventing genital warts for men and preventing head and neck cancers for men may be equally effective in promoting increased intent for HPV vaccine acceptance among young university men.

Condom Use among HIV-Positive Sexually Active Adults and Partner's HIV Status in Dar es Salaam, Tanzania

Consistent and proper use of condoms has been found to be effective in preventing HIV transmission and other sexually transmitted diseases. We examined the predictors of condom use and knowledge of partner’s HIV status among 731 HIV-positive individuals who had sex in the past six months. Data are from an incoming service form administered to clients who visited the Muhimbili University College of Health Sciences’ Voluntary Counseling and Testing (VCT) site in Dar es Salaam, Tanzania between 1997–2008 (N=45,071). Sixteen percent reported always using a condom in the past six months. Multivariate logistic regression revealed that age, and knowledge of partner’s HIV status were the strongest predictors of consistent condom use. The risk of future HIV infections in this region remains high. Future efforts to prevent new HIV infections should aim to increase condom use, and prevention practices that facilitate HIV-positive individuals to communicate their HIV status with partners.

Emotional Victimization and Sexual Risk-Taking Behaviors Among Adolescent African American Women

Previous research has demonstrated that a history of gender-based victimization is associated with higher rates of sexual risk-taking behaviors among adolescents. Victimization can occur in various forms. To date, no published studies have examined the relationship between the different forms of victimization and sexual risk-taking behaviors among African American adolescent women. This study explored the association between different forms of victimization and sexual risk behaviors using baseline data from participants (N = 715) with a mean age of 17.9 (SD = 1.7), who were enrolled in a larger intervention study. The results revealed that a history of any form of victimization was associated with some form of sexual risk behaviors.