Patterns of Sexual Experience among Urban Latino & African American 9th Grade Students

This analysis assessed patterns of sexual experience, the order in which behaviors were initiated, and associated factors, among Latino and African American ninth grade students (average age 15.2) who self-administered audio-computer-assisted surveys on netbooks in classes at 10 Los Angeles–area public high schools. 

Lifetime experiences with vaginal and oral sex were most common (19% and 16%, respectively); fewer reported anal sex (6%). Of the 23% reporting any sex, 91% fell into four categories: 36% reporting both oral and vaginal sex; 23% vaginal only; 18% all three; and 13% oral only. Most sexually experienced students (88%) initiated with vaginal or oral sex (46% vaginal, 33% oral, 9% both same day). 

No dominant pathway of sexual onset emerged for those reporting all three types of sex. We found no evidence that oral or anal sex substituted for or delayed vaginal sex. Males, those with a current partner, and those reporting multiple partners were more likely than others to report all three sexual behaviors versus vaginal only (odds ratios [ORs] 2.0, 1.5, 3.0; p = .02, .06, < .01, respectively). 

Although vaginal intercourse dominated their early sexual behavior, one-fifth of sexually experienced students reported anal intercourse, highlighting the need for specific prevention messages surrounding this higher-risk behavior.

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By:  Robin A. Donatello^a*, Christine J. De Rosa^b, Bret D. Moulton^c,Emily Q. Chung^d, Rachel Viola^c, Louise Ann Rohrbach^c &Abdelmonem A. Afifi^e

^a Department of Mathematics and Statistics, California State University, Chico

^b Los Angeles County Department of Public Health, Division of HIV and STD Programs; Institute for Health Promotion and Disease Prevention, University of Southern California

^c Institute for Health Promotion and Disease Prevention, University of Southern California

^d Los Angeles County Department of Public Health, Division of HIV and STD Programs

^e Department of Biostatistics, Fielding School of Public Health, University of California at Los Angeles 

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Age of Sexual Debut and Cannabis Use in the United States

BACKGROUND:

Understanding the interrelationships between risky health behaviors is critical for health promotion efforts. Conceptual frameworks for understanding substance misuse (e.g. stepping-stone models) have not yet widely incorporated other risky behaviors, including those related to sexual health.

OBJECTIVES:

The goals of this study were to assess the relationship between early sexual debut and cannabis use, examine the role of licit substance use in this association, and evaluate differences by gender and race/ethnicity.

METHODS:

Data came from the National Comorbidity Survey-Replication (NCS-R). Primary analysis was restricted to respondents who reported sexual debut at ≥12 years (n = 5,036). Age at sexual debut was categorized as early (<18 years), average (18 years) and late (>18 years). Logistic regression was used to assess the relationship between age at sexual debut and cannabis use. Interaction terms were used to evaluate effect modification by gender and race/ethnicity.

RESULTS:

Later age of sexual debut was associated with lower odds of cannabis use relative to the average age of debut (AOR = 0.50, 95% CI = 0.37-0.66). For every year that respondents delayed their sexual debut, the relative odds of lifetime cannabis use declined by 17%. After accounting for alcohol and tobacco use the association between early sexual debut and cannabis was attenuated (AOR = 0.90, 95% CI = 0.68-1.20), while later age of debut remained protective (AOR = 0.57, 95% CI = 0.42-0.78). Results were generally consistent across race/ethnicity and gender.

CONCLUSIONS:

Multifactorial intervention strategies targeting both sexual health and substance use may be warranted.

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By:  Cha S1, Masho SW1,2,3, Mezuk B1,4.

• 1 Department of Family Medicine and Population Health , School of Medicine, Virginia Commonwealth University , Richmond , Virginia , USA.
• 2 Department of Obstetrics and Gynecology, School of Medicine , Virginia Commonwealth University , Richmond , Virginia , USA.
• 3 Institute for Women's Health , Virginia Commonwealth University , Richmond , Virginia , USA.
• 4 Virginia Institute for Psychiatric and Behavioral Genetics , Virginia Commonwealth University , Richmond , Virginia , USA.
• Subst Use Misuse. 2016 Mar 20;51(4):439-48. doi: 10.3109/10826084.2015.1110177. Epub 2016 Feb 16. 

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Level of Young People Sexual and Reproductive Health Service Utilization and Its Associated Factors among Young People in Awabel District, Northwest Ethiopia

Background

Currently in Ethiopia, young people’s sexual and reproductive health services are limited and there is a growing issue of confidentiality and affordability of these health services. Moreover, the available services provided are not sensitive to the special needs of young people. Therefore, this study was aimed to assess young people’s sexual and reproductive health service utilization and its associated factors in Awabel district, Northwest Ethiopia.

Methods

A community based cross-sectional study was conducted among 781 randomly selected young people using a pre-tested structured questionnaires in Awabel district, Northwest Ethiopia. Data were entered into Epi data version 3.1 and analyzed using SPSS version 16.0 software.

Results

The mean age of respondents were 17.80 (+ 2.65) years. About 41% of young people had utilized sexual and reproductive health services. Young people from families of higher family expenditure, lived with mothers, participated in peer education and lived near to a Health Center were more likely to utilize sexual and reproductive health services. Furthermore, those who had a parental discussion on sexual and reproductive health (AOR (95% C.I): 2.23 (1.43, 3.46)) and ever had sexual intercourse (AOR (95% C.I): 1.88 (1.30, 2.71)) were more likely to utilize the service than their counterparts. On the other hand, those young people lived with their father and had a primary level of educational attainment was less likely to utilize the service.

Conclusion

Utilization of sexual and reproductive health services is low which needs a great attention where; if not intervened, young people might engage in risky sexual activities. Therefore, it needs a concerted effort from all the concerned bodies to improve their service utilization and thereby reduce the burden of young people’s disease and disabilities associated with sexual and reproductive health.

Below:  Situations how first sexual intercourse was started among young people in Northwest Ethiopia, 2015 (n = 474).

Below:  Reasons of young people for not utilizing SRH services in Northwest Ethiopia, 2015 (n = 439)

Full article at:   http://goo.gl/KrHnht

By:  Atitegeb Ayehu,1 Teketo Kassaw,2,* and Getachew Hailu2

¹Students Clinic, Debre Markos University, Debre Markos, Ethiopia

²Department of Public Health, College of Medicine and Health Sciences, Debre Markos University, Debre Markos, Ethiopia

National Institute of Health, ITALY

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Pathways to Adolescent Sexual Risk Behaviors: Effects of Prenatal Cocaine Exposure

Highlights

• Prenatal cocaine exposure (PCE) was related to adolescent sexual risk.
• PCE is related to externalizing behavior, which increased early sexual intercourse.
• Substance use was related to early sexual intercourse and sexual risk behaviors.
• Reducing maternal drug use may mitigate offspring sexual risk behavior.

BACKGROUND:

To assess the impact of prenatal cocaine exposure (PCE) on adolescent sexual risk behaviors. Externalizing behavior, teen substance use, and early sexual intercourse were examined as pathways mediating the effects of PCE on sexual risk behaviors.

METHODS:

Adolescents (N=364; 185 PCE, 179 non-cocaine exposure (NCE); 205 girls, 159 boys), primarily African-American and of low socioeconomic status, were prospectively enrolled in a longitudinal study at birth. Risky sexual behaviors were assessed at ages 15 and 17. Externalizing behavior at 12 years was assessed with the Youth Self-Report. Substance use, via self-report and biologic assays, and early (before age 15) sexual intercourse were assessed at age 15. Path analyses with the weighted least squares estimator with mean and variance adjustments were performed.

RESULTS:

The final structural equation model-based path model, χ(2)=31.97 (df=27), p=.23, CFI=.99, TLI=.99, RMSEA=.021, WRMR=.695, indicated a direct effect of PCE on sexual risk behavior (β=.16, p=.02). Although PCE was related to greater externalizing behavior (β=.14, p=.009), which in turn, predicted early sexual intercourse (β=.16, p=.03), leading to sexual risk behavior (β=.44, p<.001), bootstrapping indicated a non-significant indirect effect (β=.01, p>.10). Substance use was correlated with early sexual intercourse (r=.60, p<.001) and predicted sexual risk behavior by age 17 (β=.31, p=.01).

CONCLUSIONS:

Prenatal cocaine exposure was related to more engagement in sexual risk behaviors, suggesting the importance of reducing substance use among pregnant women as a means of prevention of offspring substance use and sexual risk behavior.

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By:  Min MO1, Minnes S2, Lang A2, Albert JM3, Kim JY2, Singer LT4.

• 1Case Western Reserve University, Jack, Joseph and Morton Mandel School of Applied Social Sciences, Cleveland, OH, United States. Electronic address: meeyoung.min@case.edu.
• 2Case Western Reserve University, Jack, Joseph and Morton Mandel School of Applied Social Sciences, Cleveland, OH, United States.
• 3School of Medicine, Department of Epidemiology and Biostatistics, Cleveland, OH, United States.
• 4Departments of Environmental Health Sciences, Psychiatry & Pediatrics, Cleveland, OH, United States. 
• Drug Alcohol Depend. 2016 Apr 1;161:284-91. doi: 10.1016/j.drugalcdep.2016.02.013. Epub 2016 Feb 16.

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Cultural Scripts Surrounding Young People's Sexual & Romantic Relationships in the Western Highlands of Guatemala

Guatemala has one of the world's highest teenage pregnancy rates and 92% of young people report not using contraception for first sex. 

We conducted narrative-based thematic analysis of a sample of narratives (n = 40; 15 male-authored, 25 female-authored) on HIV and sexuality, submitted to a 2013 scriptwriting competition by young people aged 15-19 years from Guatemala's Western Highlands. Our objective was to identify dominant cultural scripts and narratives that deviated positively from that norm with a view to informing the development of educational curricula and communication materials promoting youth sexual and reproductive health. 

The narratives are characterised by romantic themes and melodramatic plotlines: three in four had tragic endings. Rigid gender norms and ideologies of enduring love make female characters blind to the potential consequences of unprotected sex and vulnerable to betrayal and abandonment. 

Unprotected sex is the norm, with contraception and sexually transmitted infection protection mentioned rarely. In the four positively deviant narratives, female and male characters' interaction is based on mutual respect, dialogue and genuine affection. 

The narratives reveal opportunities for action to increase sexual health knowledge and access to services and to challenge harmful cultural scripts, potentially by leveraging the positive value attached to romantic love by authors of both sexes.

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By:  Singleton R1, Schroffel H1, Findlay T1, Winskell K1.

• 1 Hubert Department of Global Health , Rollins School of Public Health, Emory University , Atlanta, GA , USA. 
• Cult Health Sex. 2016 Mar 17:1-15. 

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Sexual Violence Against Men Who Have Sex with Men in Brazil: A Respondent-Driven Sampling Survey

We estimated the prevalence of sexual violence (SV) experience among men who have sex with men (MSM) in Brazil and identified its associated risk factors. 

We recruited 3859 MSM through respondent driven sampling. A multivariable hierarchical analysis was performed using an ecological model. The prevalence of having ever experienced SV was 15.9 %. SV experience was independently associated with discrimination due to sexual orientation, prior HIV testing, ≤14 years at first sex, first sex with a man, presenting STI symptoms (last year), and having suicidal ideas (last 6 months). 

The high levels of SV against MSM in Brazil place them at a markedly higher risk of SV than the general population. Homophobic prejudice is the strongest determinant of SV and urgently needs to be included at the forefront of the national response to SV.

********************

Se estimó la prevalencia de haber experimentado violencia sexual (VS) entre hombres que tienen sexo con hombres (HSH) en Brasil y se identificó sus factores de riesgo. Se reclutó 3859 HSH mediante respondent driven sampling. Se realizó un análisis multivariado hierárquico usando un modelo ecológico. La prevalencia de experiencia de VS alguna vez fue 15.9 % (Intervalo de confianza [IC] 95 % 14.7–17.1). Los factores asociados independientemente con haber sufrido VS alguna vez fueron discriminación debida a orientación sexual (odds ratio [OR] 3.05; 95 % CI 2.10–4.42), haber realizado la prueba del VIH (OR 1.81; 95 % CI 1.25–2.63), ≤14 años de edad en la primera relación sexual (OR 1.86; 95 % CI 1.28–2.71), primera relación sexual con un hombre (OR 1.89; 95 % CI 1.28–2.79), presentar síntomas de ITS durante el último año (OR 1.66; 95 % CI 1.12–2.47), y tener ideas suicidas durante los últimos 6 meses (OR 2.08; 95 % CI 1.30–3.35). Los altos niveles de VS contra los HSH en Brasil sitúan este grupo ante un riesgo de VS superior que la población general. La homofobia es el determinante más importante y debe de encabezar urgentemente la respuesta nacional ante la VS.

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By:  Sabidó M1, Kerr LR, Mota RS, Benzaken AS, de A Pinho A, Guimaraes MD, Dourado I, Merchan-Hamman E, Kendall C.

• 1Fundação de Medicina Tropical Doutor Heitor Vieira Dourado (FMT-HVD), Avenida Pedro Teixeira 25, Manaus, AM, CEP: 69040-000, Brazil, xellsabido@gmail.com. 

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Characteristics of Youth Who Report Early Sexual Experiences in Sweden

Abstract
Early timing of first sex is a common risk factor for adverse sexual and reproductive health (SRH) outcomes. This study explored characteristics and circumstances associated with early sexual experience (at or below age 14) among Swedish youth. Data were drawn from UngKAB09, a national study of youth SRH in Sweden. 24,000 youth 16-28 years were randomly selected for a web-based survey with a response rate of 24 %. Post-stratification weights were used to correct for over- and under representation in response. Adjusted logistic regression was used to model associations with early sexual experience, by gender. In the final sample (N = 5,321, 49 % girls), 9 in 10 were sexually experienced, of whom 21 % reported early first sex. In multivariate analysis, early sex was significantly associated with 7 of the 9 predictor variables selected for the model among boys and 14 of 15 selected factors among girls. Early sex was positively associated with low educational attainment, early pubertal onset, bisexual identity and (girls only) rural residence. For girls, first generation immigrant status, greater religiosity, conservative sexual attitudes and low Chlamydia knowledge decreased the odds of early sex. Early experience was more common if youth had older partners and, among girls, felt that sex was expected. Being in love, feelings of intimacy, alcohol use at first sex, and (girls only) causal sexual partner and wantedness of first sex were inversely associated with early first sex. The findings and implications are discussed in relation to the European and global literature on early sexual experiences.

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