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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AMP!: A Cross-Site Analysis of the Effects of a Theater-based Intervention on Adolescent Awareness, Attitudes, and Knowledge about HIV

AMP! (Arts-based, Multiple component, Peer-education) is an HIV intervention developed for high school adolescents. AMP! uses interactive theater-based scenarios developed by trained college undergraduates to deliver messages addressing HIV/STI prevention strategies, healthy relationships, and stigma reduction towards people living with HIV/AIDS. 

We used a pre-test/post-test, control group study design to simultaneously assess intervention effect on ninth grade students in an urban county in California (N = 159) and a suburban county in North Carolina (N = 317). In each location, the control group received standard health education curricula delivered by teachers; the intervention group received AMP! in addition to standard health education curricula. Structural equation modeling was used to determine intervention effects. The post-test sample was 46 % male, 90 % self-identified as heterosexual, 32 % reported receiving free or reduced lunch, and 49 % White. 

Structural models indicated that participation in AMP! predicted higher scores on HIV knowledge (p = 0.05), HIV awareness (p = 0.01), and HIV attitudes (p = 0.05) at the post-test. Latent means comparison analyses revealed post-test scores were significantly higher than pre-test scores on HIV knowledge (p = 0.001), HIV awareness (p = 0.001), and HIV attitudes (p = 0.001). 

Further analyses indicated that scores rose for both groups, but the post-test scores of intervention participants were significantly higher than controls (HIV knowledge (p = 0.01), HIV awareness (p = 0.01), and HIV attitudes (p = 0.05)). 

Thus, AMP!'s theater-based approach shows promise for addressing multiple adolescent risk factors and attitudes concerning HIV in school settings.

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By:  Taggart T1, Taboada A2, Stein JA2, Milburn NG3, Gere D2, Lightfoot AF4,5.

• 1Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill (UNC), 302 Rosenau Hall, CB #7440, Chapel Hill, NC, 27599-7440, USA. ttaggart@email.unc.edu.
• 2Art & Global Health Center, University of California, Los Angeles (UCLA), Los Angeles, CA, USA.
• 3Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles (UCLA), Los Angeles, CA, USA.
• 4Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill (UNC), 302 Rosenau Hall, CB #7440, Chapel Hill, NC, 27599-7440, USA.
• 5Center for Health Promotion and Disease Prevention, University of North Carolina at Chapel Hill (UNC), Chapel Hill, NC, USA. 
• Prev Sci. 2016 Apr 8.

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Relationships among Substance Use, Multiple Sexual Partners & Condomless Sex: Differences Between Male & Female U.S. High School Adolescents

Male and female students manifest different behaviors in condomless sex. This cross-sectional, exploratory, correlational study examined the differences in risk factors for condomless sex between male and female high school students, using secondary data from 4,968 sexually active males and females participating in the 2011 National Youth Risk Behavior Survey. 

Results in descriptive statistics and multivariate binary logistic regressions revealed that condomless sex was reported as 39.70% in general. A greater proportion of females engaged in condomless sex (23.26%) than did males (16.44%). 

Physical abuse by sex partners was a common reason for failure to use condoms regardless of gender. Lower condom use was found in 

• those experiencing forced sex by a partner in males, 
• female smokers, and 
• female with multiple sex partners. 

Thus, sexual health education should address the different risk factors and consider gender characteristics to reduce condomless sex.

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By:  Zhao YL1, Kim H2, Peltzer J3.

• 1School of Nursing, University of Kansas, Kansas City, KS, USA School of Nursing, Boise State University, Boise, ID, USA.
• 2College of Nursing, Yonsei University, Seoul, South Korea Mo-Im Kim Nursing Research Institute, Seoul, South Korea hkim80@yuhs.ac.
• 3School of Nursing, University of Kansas, Kansas City, KS, USA. 
• J Sch Nurs. 2016 Mar 31. pii: 1059840516635712

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Does Gender Moderate the Relationship between Polydrug Use & Sexual Risk-Taking among Australian Secondary School Students Under 16 Years of Age?

INTRODUCTION AND AIMS:

This study examines the association of alcohol and polydrug use with risky sexual behaviour in adolescents under 16 years of age and if this association differs by gender.

DESIGN AND METHODS:

The sample consisted of 5412 secondary school students under 16 years of age from Victoria, Australia. Participants completed an anonymous and confidential survey during class time. The key measures were having had sex before legal age of consent (16 years), unprotected sex before 16 (no condom) and latent-class derived alcohol and polydrug use variables based on alcohol, tobacco, cannabis, inhalants and other illegal drug use in the past month.

RESULTS:

There were 7.52% and 2.55% of adolescents who reported having sex and having unprotected sex before 16 years of age, respectively. After adjusting for antisocial behaviours, peers' drug use and family and school risk factors, girls were less likely to have unprotected sex (odds ratio = 0.31, P = 0.003). However, the interaction of being female and polydrug use (odds ratio = 4.52, P = 0.004) was significant, indicating that girls who engaged in polydrug use were at higher risk of having unprotected sex. For boys, the effect of polydrug use was non-significant (odds ratio = 1.44, P = 0.310). Discussion and Conclusions For girls, polydrug use was significantly associated with unprotected sex after adjusting for a range of risk factors, and this relationship was non-significant for boys. Future prevention programs for adolescent risky sexual behaviour and polydrug use might benefit from a tailored approach to gender differences.

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By:  Chan GC1, Kelly AB1, Hides L1,2, Quinn C1,2, Williams JW3,4,5,6.

• 1Centre for Youth Substance Abuse Research, University of Queensland, Brisbane, Australia.
• 2Queensland University of Technology, Brisbane, Australia.
• 3School of Health and Social Development, Deakin University, Melbourne, Australia.
• 4Centre for Adolescent Health, The Royal Children's Hospital, Melbourne, Australia.
• 5Population Health Studies of Adolescents and Health Services Delivery for Adolescents, Murdoch Children's Research Institute, Melbourne, Australia.
• 6Department of Paediatrics, The University of Melbourne, Melbourne, Australia.
• Drug Alcohol Rev. 2016 Mar 23. doi: 10.1111/dar.12394. 

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Risk & Protective Factors for Adolescent Substance Use: A Comparative Study of Secondary School Students in Rural & Urban Areas of Osun State, Nigeria

BACKGROUND:

Substance use is a leading adolescent health problem globally, but little is known regarding associated factors for adolescent substance use in Nigeria. This study compared the prevalence of substance use among in-school adolescents in urban and rural areas of Osun State, Nigeria, and identified risk and protective factors.

METHODS:

This cross-sectional study involved 600 randomly selected adolescents (aged 10-19 years) from rural and urban areas of Osun State, Nigeria. Data were collected using the facilitated self-completed questionnaire method. Binary logistic regression was used to examine the association of individual, peer, and parental factors with adolescent substance use. Adjusted odds ratio (OR) and 95% confidence interval (CI) were obtained.

RESULTS:

About two-thirds of respondents had used substances in both rural (65.7%) and urban areas (66.0%) (p=0.93). Logistic analysis showed private school attendance as a risk factor for substance use and adolescent disapproval of adult substance use as a protective factor  in rural areas. For urban areas, having friends who use substances and a mother having had tertiary education were risk factors while parental disapproval of substance use was a protective factor.

CONCLUSION:

Lifetime prevalence of substances is high among in-school adolescents in Osun State. The risk and protective factors for adolescent substance use somewhat differ for rural and urban areas, and these have implications for designing effective intervention strategies.

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By:  Olabanjo O. Ogunsola¹ / Adesegun O. Fatusi²

¹Department of Community Health, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria

²Faculty of Clinical Sciences, Department of Community Health, College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Nigeria

Corresponding author: Adesegun O. Fatusi, Faculty of Clinical Sciences, Department of Community Health, College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Nigeria,

Int J Adolesc Med Health. 2016 Jan 29. pii: /j/ijamh.ahead-of-print/ijamh-2015-0096/ijamh-2015-0096.xml. doi: 10.1515/ijamh-2015-0096.

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The Relationship Between Food Frequency & Menstrual Distress in High School Females - Iran

BACKGROUND:

Nutrition pattern is one of the important factors predicting menstrual distress, which varies among different cultures and countries. The purpose of this study is to determine the relationship between food frequency and menstrual distress in high school girls from Mashhad.

MATERIALS AND METHODS:

This cross-sectional study was conducted in 2012 using a two-stage sampling method on 407 high school female students from Mashhad who met the inclusion criteria. Subjects completed questionnaires of demographic characteristics, food frequency, and Menstrual Distress Questionnaire (MDQ) during three phases of the menstrual cycle (a week before bleeding, during menstrual bleeding period, and a week after menstruation). The collected data were analyzed by statistical tests such as Pearson correlation coefficient test, independent Student's t-test, and one-way analysis of variance (ANOVA).

RESULTS:

Results showed that 87.7% of the students were at moderate economic status, 82.2% were exposed to cigarette smoke, 94.8% had mothers without university education, and 9.4% had working mothers. About 71% of the students reported minor pre-menstruation distress, 81% reported minor distress during bleeding, and 39% reported minor post-menstruation distress. In addition, the mean (SD) values for sweet-fatty foods, salty-fatty foods, fast foods, and caffeine were 3.6, 3.3, 1.3, and 10.2 per week, respectively. In addition, Pearson correlation coefficient test showed no significant correlation between total menstruation distress and food frequency (P > 0.05).

CONCLUSIONS:

With regard to the inappropriate food frequency and high intensity of menstrual distress among high school students and as health care and educational efforts for prevention and health promotion in society are among the duties of health workers, the results of this study can help the officials involved in education to emphasize on nutrition and the menstrual health of students.

Below:  Frequency distribution of age, BMI, and socioeconomic status among female students

Below:  Frequency distribution of nightly and daily sleep, physical activity and length of physical activity, and exposure to smoke among female students

Below:  Frequency distribution of subjects’ nutritional pattern based on the number of weekly consumptions

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

By:  Mohamadirizi S1, Kordi M2.

• 1Department of Midwifery, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran.
• 2Department of Midwifery School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran.
• Iran J Nurs Midwifery Res. 2015 Nov-Dec;20(6):689-93. doi: 10.4103/1735-9066.170000. 

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HIV Testing among US High School Students and Young Adults

BACKGROUND:

We assessed HIV testing trends among high school students and young adults.

METHODS:

We analyzed National Youth Risk Behavior Survey (YRBS) and Behavioral Risk Factor Surveillance System (BRFSS) data to assess HIV testing prevalence among high school students and young adults aged 18 to 24, respectively. Logistic regression models for each sample stratified by gender and race/ethnicity were estimated to assess trends in the percentages ever tested, with year as a continuous linear variable. We report absolute differences in HIV testing prevalence and model results for 2005-2013 (YRBS) and 2011-2013 (BRFSS).

RESULTS:

During the study periods, an average of 22% of high school students (17% of male and 27% of female students) who ever had sexual intercourse and 33% of young adults reported ever being tested for HIV. Among high school students, no change was detected in HIV testing prevalence during 2005-2013, regardless of gender or race/ethnicity. Among young adult males, an average of 27% had ever been tested, and no significant changes were detected overall or by race/ethnicity during 2011-2013. Significant decreases in testing prevalence were detected during 2011-2013 among young adult females overall (from 42.4% to 39.5%), young adult white females (from 37.2% to 33.9%), and young adult black females (from 68.9% to 59.9%).

CONCLUSIONS:

HIV testing prevalence was low among high school students and young adults. No increase in testing among young adult males and decreased testing among young adult black females is concerning given their higher risk of HIV infection.

Full article at:  http://goo.gl/NBXnI4

Below:  Trends in HIV testing prevalence among US high school students and young adults aged 18 to 24 years

Below:  HIV test settings for young adults ever tested for HIV

By:  Van Handel M1, Kann L2, Olsen EO2, Dietz P3.

• 1Divisions of HIV/AIDS Prevention, and ioq4@cdc.gov.
• 2Adolescent and School Health, Centers for Disease Control and Prevention, Atlanta, Georgia.
• 3Divisions of HIV/AIDS Prevention, and. 

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Correlates of Rape Perpetration among Male Teens in Nigeria

This study examined male adolescents' self-report of rape of adolescent girls and the socio-demographic variables that correlated with self-report of rape. Descriptive-correlational design was used and the study was conducted in five public senior secondary schools in Ile-Ife, Nigeria. 

Three hundred and thirty-eight male adolescents participated in the study. A structured questionnaire was used to collect data. Findings from the study revealed the mean age of the adolescent males to be 16 years, with the majority (73%) of them in the middle adolescent stage. 

• Six percent of the adolescent males reported they had raped an adolescent girl in the past. 
• Among the boys who reported rape, 55% reported they had raped their sexual partners, and
• 55% reported they had perpetrated gang rape. 

Smoking (p = .0001), alcohol consumption (p = .001), and birth order (p = .006) predicted self-report of rape. The coefficient of birth order showed that odds of self-report of rape by first-born male increases by 6 times compared with other children. Study findings also provided evidence that adolescent males are moving from lone rape to gang rape in intimate partner relationships. 

Male adolescents are important group to target in rape prevention programs.

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By:  Ogunfowokan AA1, Olagunju OE2, Olajubu AO2, Faremi FA2, Oloyede AS2, Sharps PW3.

• 1Obafemi Awolowo University, Ile-Ife, Nigeria solafowokan@oauife.edu.ng.
• 2Obafemi Awolowo University, Ile-Ife, Nigeria.
• 3Johns Hopkins University School of Nursing (http://nursing.jhu.edu/), Baltimore, MD, USA.
• J Interpers Violence. 2016 Feb;31(4):555-71. doi: 10.1177/0886260514556104. Epub 2014 Nov 6. 

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Dating Violence Victimization among High School Students in Minnesota: Associations with Family Violence, Unsafe Schools, and Resources for Support

The present study examines whether being a victim of violence by an adult in the household, witnessing intra-familial physical violence, and feeling unsafe at school are associated with physical dating violence victimization. It also examines whether extracurricular activity involvement and perceived care by parents, teachers, and friends attenuate those relationships, consistent with a stress-buffering model. 

Participants were 75,590 ninth-and twelfth-grade students (51% female, 77% White, 24% receiving free/reduced price lunch) who completed the 2010 Minnesota Student Survey. 

Overall, 8.5% of students reported being victims of dating violence. Significant differences were found by gender, grade, ethnicity, and free/reduced price lunch status. Logistic regression analyses demonstrated that being a victim of violence by an adult in the household, witnessing intra-familial physical violence, feeling unsafe at school, and low perceived care by parents were strongly associated with dating violence victimization. 

Associations of moderate strength were found for low perceived care by teachers and friends. Little to no extracurricular activity involvement was weakly associated with dating violence victimization. Attenuating effects of perceived care and extracurricular activity involvement on associations between risk factors (victimization by a family adult, witnessing intra-familial violence, feeling unsafe at school) and dating violence victimization were smaller in magnitude than main effects. 

Findings are thus more consistent with an additive model of risk and protective factors in relation to dating violence victimization than a stress-buffering model. Health promotion efforts should attempt to minimize family violence exposure, create safer school environments, and encourage parental involvement and support.

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By:  Earnest AA1, Brady SS2.

• 1University of Minnesota School of Public Health (http://www.sph.umn.edu/), Minneapolis, MN, USA.
• 2University of Minnesota School of Public Health, Minneapolis, MN, USA ssbrady@umn.edu. 

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Trends in Injection Drug Use among High School Students, U.S., 1995-2013

INTRODUCTION:

Injection drug use is the most frequently reported risk behavior among new cases of hepatitis C virus infection, and recent reports of increases in infection are of great concern in many communities. This study assessed the prevalence and trends in injection drug use among U.S. high school students.

METHODS:

Data were from CDC's Youth Risk Behavior Surveillance System, which collects information on health risk behaviors at the national, state, and large urban school district levels. Analyses were conducted in 2014.

RESULTS:

In 2013, 1.7% of high school students nationwide had ever injected any illegal drug. Nationwide, ever injecting any illegal drug did not change significantly from 1995 to 2013, except among black non-Hispanic students. For this subgroup, both a significant linear increase from 1995 to 2013 and a significant quadratic trend were observed, with injection drug use increasing from 1995 to 2009 and decreasing from 2009 to 2013. 

• Significant linear increases in injection drug use occurred in five states (Arkansas, Hawaii, Maine, Maryland, and New York) and six large urban school districts (Baltimore, Memphis, Miami-Dade County, New York City, Philadelphia, and Seattle). 
• Significant linear decreases occurred in three states (Massachusetts, South Dakota, and West Virginia). Both a significant linear increase and quadratic trend were observed in Maine; quadratic trends were observed in Tennessee, Utah, and Palm Beach County, Florida. 

CONCLUSIONS:

In some geographic areas and population groups, an increasing or high frequency of injection drug use was found among high school students, who should be targeted for prevention.

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By:   Klevens RM¹, Jones SE², Ward JW³, Holtzman D³, Kann L².

¹Division of Viral Hepatitis, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, CDC, Atlanta, Georgia. Electronic address: rmk2@cdc.gov.

²Division of Adolescent and School Health, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, CDC, Atlanta, Georgia.

³Division of Viral Hepatitis, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, CDC, Atlanta, Georgia.

Am J Prev Med. 2016 Jan;50(1):40-6. doi: 10.1016/j.amepre.2015.05.026. Epub 2015 Aug 24.

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Adverse Psychosocial Outcomes Associated with Drug Use among US High School Seniors: A Comparison of Alcohol & Marijuana

Objectives

There is debate about whether marijuana (cannabis) use is more dangerous than alcohol use. Although difficult to make objective comparisons, research is needed to compare relative dangers in order to help inform preventive efforts and policy.

Methods

Data were analyzed from a nationally representative sample of high school seniors in the Monitoring the Future study (2007–2011; Weighted n = 7437; modal age: 18) who reported lifetime use of alcohol or marijuana. Students were asked to indicate whether they experienced various adverse psychosocial outcomes resulting from use of each substance. We examined which outcomes were more prevalent for each substance.

Results

Compared to alcohol use, marijuana use was more commonly reported to compromise relationships with teachers or supervisors, result in less energy or interest, and result in lower school or job performance. Compared to marijuana use, alcohol was more commonly reported to compromise relationships with friends and significant others; it was also reported to lead to more regret (particularly among females), and driving unsafely. Marijuana users were more likely to report no adverse outcomes. Females and white students were more likely to report various adverse outcomes and higher frequency use of each substance also increased occurrences of reported adverse outcomes.

Conclusions

Marijuana and alcohol are associated with unique adverse psychosocial outcomes. Outcomes differ by sex and race/ethnicity, and perception or experience of outcomes may also be related to legal status and associated stigma. Public health interventions may be more effective by focusing on harm reduction strategies for these drug-specific outcomes.

Table 6

Comparison of adverse outcomes resulting from use of alcohol and marijuana by sex.

	Alcohol			Marijuana
	Male % (n = 3348)	Female % (n = 3564)	χ2rs	Male % (n = 2209)	Female % (n = 2084)	χ2rs
Caused you to behave in ways that you later regretted	31.4	41.9	61.4***	11.0	14.4	7.9
Hurt your relationship with your parents	8.8	13.0	23.4***	12.3	13.2	0.5
Hurt your relationship with your spouse, fiancée, or girlfriend/boyfriend	9.6	15.6	42.9***	9.0	13.1	13.2**
Hurt your relationships with your friends	6.7	11.7	39.1***	6.8	10.3	12.8**
Hurt your relationships with teachers or supervisors	1.8	2.3	1.6	2.1	4.1	10.0*
Involved you with people you think are a bad influence on you	8.9	15.1	48.9***	17.6	24.4	22.0***
Hurt your performance in school and/or on the job	4.6	6.5	8.6	10.0	11.2	1.1
Caused you to be less interested in other activities than you were before	3.6	6.4	21.3***	10.3	14.0	10.5*
Caused you to be less stable emotionally	4.1	13.7	159.5***	4.6	9.9	33.5***
Caused you to have less energy	7.1	9.3	8.8	17.9	25.6	28.8***
Interfered with your ability to think clearly	18.8	26.6	45.9***	17.9	25.0	24.8***
Had other bad psychological effects	1.7	3.8	22.4***	3.1	7.1	27.7***
Caused your physical health to be bad	3.2	5.3	13.7**	3.8	6.0	8.2
Caused you to drive unsafely	9.9	8.6	2.7	5.9	7.1	2.1
Gotten you into trouble with the police	6.3	5.4	2.2	5.8	4.1	5.3
Caused you none of the above problems	11.8	11.6	0.1	15.7	12.4	7.3

Rao-Scott Chi-squares each contain 1 degree of freedom. Utilizing the Bonferroni correction,

*p < 0.003,

**p < 0.001,

***p < 0.0001.

Full article at:   http://goo.gl/22J5zy

By:   Joseph J. Palamar, PhD, MPH,^1,2,3 Michael Fenstermaker, BA,⁴ Dimitra Kamboukos, PhD,¹ Danielle C. Ompad, PhD,^2,3,5 Charles M. Cleland, PhD,^3,6 and Michael Weitzman, MD⁴

¹New York University Langone Medical Center, Department of Population Health, New York

²Center for Health, Identity, Behavior, and Prevention Studies, New York University, New York, USA

³Center for Drug Use & HIV Research, New York University, New York, USA

⁴Departments of Pediatrics and Environmental Medicine, New York University, New York, USA

⁵Department of Nutrition, Food Studies and Public Health, Steinhardt School of Culture, Education and Human Development, New York University, New York, USA

⁶College of Nursing, New York University, New York, USA

Address correspondence to Joseph J. Palamar, One Park Avenue, 7th Floor, New York, NY 10016, USA. Tel: +1 646 754 4980. Fax: +1 646 754 5209. Email: gro.cmuyn@ramalap.hpesoj

  

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