College women’s sexual and reproductive health screening behaviors and the role of mother–daughter communication

Abstract

Objective: The study investigated the role of mother–daughter communication and race in college women’s decisions to pursue sexual health screening services. Participants: Participants were 301 college women who primarily identified as White and Asian American (M_age = 19?years). Methods: Participants completed an online survey that assessed mother–daughter communication about sex and responded to items pertaining to pursuing sexual health screening services. Results: Maternal communication predicted daughters’ screening behaviors and sexual anxiety mediated the negative association between conservative communication from mothers and screening behaviors. Asian American college women were less likely than White college women to report that they received frequent and open communication about sex from their mothers and reported higher levels of sexual anxiety. Conclusions: Mothers should be aware of the implications their communication patterns may have on their daughters’ sexual and reproductive health, and college women’s sexual anxiety should be addressed in order to increase utilization of screening services.     

Family Structure,Mother–Daughter Relationship Quality,Race and Ethnicity,and Adolescent Girls' Health Risks

Using a sample of 7,114 adolescent girls (4,269 White, 1,707 African American, and 1,138 Hispanic) and biological mothers from Wave 1 of the National Longitudinal Study of Adolescent Health, we examined how family structure, girls' perceptions of mother–daughter relationship quality, and race and ethnicity related to girls' health risks. In general, results indicate heightened risk for both precocious events and depressive symptoms for girls in mother–stepfather, single-mother, and nonresident mother families compared to mother–father families. However, significant two- and three-way interactions suggest that adolescent girls' health risks vary considerably based on the combination of family structure, mother–daughter relationship quality, and race and ethnicity.     

Uptake of HPV vaccine in traditional-age undergraduate students: Knowledge,behaviors, and barriers

Abstract

Objective: This study investigated potential factors associated with HPV vaccine uptake in a diverse population of traditional-age undergraduate students. Participants: One hundred and twenty-nine undergraduate students aged 18–24 attending a small southeastern university completed surveys in January to March of 2013. Methods: Questionnaires included demographic information, basic HPV knowledge, HPV vaccine uptake, and factors influencing uptake decision. Survey results were analyzed with chi-square and t-test analyses. Results: Vaccine uptake was significantly higher in students who reported that health care provider, public health information, parents, and access to vaccine were important factors in their decision to get vaccinated. Female students had a significantly higher vaccine uptake in comparison to males and the HPV knowledge scores differed significantly by race but not gender. Conclusions: It is especially important to consider how public health campaigns and communication with parents and health care providers help promote HPV vaccine uptake in this high-risk group.     

The Special Historical Section of the Journal of American College Health

Abstract

Objective: To identify human papillomavirus (HPV) infection and HPV vaccine–related attitudes among college-aged women and the relationship between HPV vaccine uptake and subsequent sexual behaviors. Methods: PubMed, MEDLINE, CINAHL, and Google Scholar searches were performed from 2006, the date after the first HPV vaccine became available, to present. Results: Of the 13 studies identified, most were cross-sectional. College-aged women saw HPV infection as serious and had positive attitudes toward the HPV vaccine. Barriers (ie, cost, lack of insurance coverage) existed that prevented women from obtaining the vaccine and many women did not see themselves at risk for HPV. The vaccine uptake rate, although increasing, has been slow. Conclusion: College-aged women in the United States may need unbiased information about HPV and HPV vaccine. Studies that focus on risk perception and the relationship between knowledge, attitudes, vaccine uptake, and sexual behaviors are needed to inform interventions and public health programs.     

Disparities in Human Papillomavirus Vaccine Literacy and Vaccine Completion Among Asian American Pacific Islander Undergraduates: Implications for Cancer Health Equity

Abstract

Purpose: Low rates of human papillomavirus (HPV) vaccination among young Asian American and Pacific Islander (AAPI) women need to be addressed, particularly given the high incidence of cervical cancer in this population. The current study aims to investigate predictors of HPV vaccination in young AAPI and non-Latina white (NLW) women. Methods: A secondary data analysis was conducted of a health survey administered to college-aged women (N = 2,270) at a large public university in the Midwest. Andersen's behavioral model of health services utilization guided the study theoretically, and hierarchical logistic regression analysis was conducted to investigate research aim. Results: NLW women had a significantly higher rate of vaccine completion than AAPI women (NLW = 60.7%; AAPI = 38.6%). NLW women also scored higher on all 5 measures of HPV vaccine literacy than AAPI women. Both groups of undergraduate women reported that increasing age, knowledge about HPV, greater use of gynecological services, and knowing someone who had cancer were significant factors related to HPV vaccination completion. In the NLW group, father's income was also found to be a predictor of HPV vaccination completion. Conclusions: Rate and predictors of HPV vaccination completion vary between NLW and AAPI women. Greater promotion of HPV literacy and gynecological service use should be made to young AAPI women to increase their HPV uptake. Further research should examine sociocultural factors that could hinder or promote HPV vaccination in young AAPI women.     

A Review of Human Papillomavirus (HPV) Infection and HPV Vaccine-Related Attitudes and Sexual Behaviors Among College-Aged Women in the United States

Abstract Objective: To identify human papillomavirus (HPV) infection and HPV vaccine-related attitudes among college-aged women and the relationship between HPV vaccine uptake and subsequent sexual behaviors. Methods: PubMed, MEDLINE, CINAHL, and Google Scholar searches were performed from 2006, the date after the first HPV vaccine became available, to present. Results: Of the 13 studies identified, most were cross-sectional. College-aged women saw HPV infection as serious and had positive attitudes toward the HPV vaccine. Barriers (ie, cost, lack of insurance coverage) existed that prevented women from obtaining the vaccine and many women did not see themselves at risk for HPV. The vaccine uptake rate, although increasing, has been slow. Conclusion: College-aged women in the United States may need unbiased information about HPV and HPV vaccine. Studies that focus on risk perception and the relationship between knowledge, attitudes, vaccine uptake, and sexual behaviors are needed to inform interventions and public health programs.     

Race Differences in Family Experience and Early Sexual Initiation: Dynamic Models of Family Structure and Family Change

We examine the effects of family structure on age at first sexual intercourse before marriage for a recent cohort of women. Previous research on the linkage between family structure and sexual initiation has employed relatively crude measures of family structure—typically a snapshot of the respondent's family structure at age 14. We use retrospective parent histories from the 1979–1987 National Longitudinal Survey of Youth to construct dynamic measures of family structure, using information on the number and types of parents in the respondent's household between birth and age 18. We use these measures in proportional hazard models to test the effects of prolonged exposure to a single‐mother family, prolonged absence of a biological father, parental presence during adolescence, and family turbulence. For White women, age‐specific rates of first sexual intercourse are significantly and positively associated with the number of family transitions; for Black women, age‐specific rates are significantly and positively associated with having resided in a mother‐only or father‐only family during adolescence. Net of other effects of family structure, we find no significant effects for White or Black women of being born out of wedlock, prolonged exposure to a single‐mother family, or prolonged absence of a biological father. Our results for White women are consistent with a turbulence hypothesis, whereas for Black women our results suggest the importance of family structure during adolescence. For neither White nor Black women are our results consistent with hypotheses positing earlier initiation of sexual activity for women with prolonged exposure to a single‐mother or father‐absent family.     

Adult daughter aging mother relationship over the life cycle: The Turkish case

Effects of mothers and daughters life cycle changes on mother–daughter relationships in the present study. The life cycle transitions focused on in this study are daughters' marriage and parenthood and mothers' widowhood and declining health. In-depth interviews were conducted with thirty Turkish adult daughter–aging mother pairs. Analyses of interviews with mothers and daughters revealed that age related changes reported by Turkish mothers and daughters were similar to those reported by western participants. Mother–daughter relationships were transformed when daughters got married, had children, and when mothers became widows. Relationships generally improved over the life cycle. Shared sense of femaleness increased and was reinforced by daughters' experience of wife and mother roles and resulted in greater empathy for mothers. Mothers' widowhood and declining health were associated with role reversal. Certain culture specific themes emerged. These were transfer of the responsibility for the daughter's honor from the family to the husband, stress on filial obligations, view of care giving and care taking as cyclic over the life cycle, explanations of conflicts by external norms and/or circumstances, association of women with places and/or relationships. Ambivalence voiced by daughters was interpreted as renegotiation of roles within a society in transition from traditional to more individualist norms.     

Language matters: effects of linguistic agency assignment on HPV prevention advocacy in Chinese public health education materials

This study was conducted to examine the effects of linguistic agency assignment on human papillomavirus (HPV) prevention advocacy in Chinese public health education materials. The participants (N?=?481) were asked to read one of four versions of an article about the HPV infection. The results indicated that the linguistic agency assignment of threat used in the context of health education in the English language functioned similarly in the Chinese context with only minor differences. In the Chinese language context, the respondents tended to report higher levels of personal susceptibility when the linguistic agency was assigned to the HPV vaccine and not human factors. Minor cross-cultural issues are discussed. The findings of this study contribute to the health communication literature by explicating the persuasive power of language and demonstrating that the concept of linguistic agency assignment is applicable across cultures for the effective promotion of public health education.     

Virginity Lost,Satisfaction Gained? Physiological and Psychological Sexual Satisfaction at Heterosexual Debut

Despite the literature's focus on (hetero)sexual initiation, little is known about the degree to which young people are satisfied by their first vaginal intercourse experience, let alone the factors that predict satisfaction. This study analyzed data from a cross-sectional survey of 1,986 non-Hispanic White and Black 18- to 25-year-old respondents from four university campuses. Respondents were asked to rate the degree to which their first vaginal intercourse was physiologically and psychologically satisfying. Both Black and White women were significantly less likely than Black and White men to experience considerable or extreme satisfaction at first vaginal intercourse, particularly physiological satisfaction. Among all four gender–race groups, being in a committed relationship with one's sexual partner greatly increased psychological satisfaction, particularly among women. Experiencing less guilt at first sexual intercourse was also strongly associated with psychological satisfaction for women. Developing sexual relationships with partners they care for and trust will foster satisfaction among young people at first vaginal intercourse. These findings highlight strong gender asymmetry in affective sexual experience.     

Parent‐Adolescent Communication About Sex: Retrospective Reports by Latino College Students

Latina female (n= 97) and Latino male (n= 69) college students (M age = 21.4 years) completed self‐report surveys regarding family of origin experiences, including sexual communication with parents while growing up. Latino parents of this comparatively highly educated sample tended to use direct rather than indirect strategies for communicating about sexuality with their children. Young women reported higher levels of sexual communication with mothers while growing up than did young men, and respondents reported less communication with fathers than mothers. Among young women, sexual communication with mother was positively associated with non‐Mexican origin and negatively associated with having older brothers living at home. In contrast, maternal education was positively associated with mother‐son communication about sex. Paternal education and the absence of older brothers positively predicted communication with both sons and daughters. The analyses provide novel information regarding sexual communication in Latino families and suggest directions for future research.     

Intent to receive an HPV vaccine among university men and women and implications for vaccine administration

OBJECTIVE AND PARTICIPANTS: In 2006, the authors examined intention to receive an HPV vaccine among 340 college students. METHODS: A total of 138 men and 202 women completed questionnaires. The authors measured intention by asking participants how likely they would be to accept an HPV vaccine that prevented against (1) all HPV, (2) cervical cancer but not genital warts, (3) genital warts but not cervical cancer, and (4) both genital warts and cervical cancer. RESULTS: Men and women reported high intent to receive an HPV vaccine, although women did so at a significantly higher rate (77.5% vs 88.6%, respectively; p < .01). Men were less willing to receive a vaccine that prevents cervical cancer alone than they were to receive one that prevents cervical cancer and genital warts (34.1% vs 77.5%, p < .001). Intent to receive the vaccine was significantly greater among participants who reported more than 5 sex partners and correctly answered 2 or 3 HPV knowledge questions. CONCLUSIONS: Interest varied according to sexual history, according to knowledge about HPV, and (in men) according to vaccine target.     

The co-occurrence of depression and alcohol dependence symptoms in a community sample of lesbians

Numerous studies have found an association between depression and alcohol use disorders in women. Little is known, however, about the relationship between depression and alcohol use among lesbians. We examined the prevalence of depression and alcohol dependence symptoms as well as the co-occurrence of these two health problems in a large community-based sample of women who self-identified as lesbian. Past year alcohol dependence symptoms were significantly associated with both past year and lifetime depression. Lifetime depression was higher among White and Latina lesbians than among African American lesbians. Younger women and those not currently in a committed relationship more commonly reported past year depression. Younger age was the strongest predictor of the co-occurrence of depression and alcohol dependence symptoms.     

Vaginal douching among university women in the southeastern United States

OBJECTIVE: The authors assessed the knowledge, beliefs about, and practices of vaginal douching among women attending 2 universities in the southeastern United States. PARTICIPANTS: There were 416 participants in this study; 46.9% were black and 44.5% were white. METHODS: The authors administered a 30-item questionnaire to women enrolled in health-related and social science courses at 2 southeastern universities. RESULTS: Approximately 38% of participants reported vaginal douching, mostly for hygienic reasons (70.7%). Most women first learned about douching from their mother. Douching was more common and more frequent among black women (48%) than among white women (27%). Age of first douche correlated positively with age of first sexual intercourse and age of first period. CONCLUSION: Women who had been informed not to douche by a healthcare professional were less likely to have douched within the past 6 months than were women who were not given this information. Misconceptions about douching are common and should be addressed by healthcare professionals.     

Adolescent Sexual Debut: A Multi-System Perspective of Ethnic and Racial Differences

Data from the 1997 cohort of the National Longitudinal Survey of Youth were used to assess the association between family, self, proximate extra-familial, and distal extra-familial system factors and abstinence/virginity and age of first sexual intercourse by ethnicity and race (N = 1,854). Findings show how and in what circumstances measures associated with these four factors vary for Black, White, and Hispanic youth. Findings point to the robustness of class and gender for each ethnic-racial group on timing of sexual initiation and of delinquency and negative peer relations on abstinence among Black and White youth and of religious affiliation among Hispanic youth.     

Heterosexual Women’s and Men’s Labeling of Anal Behaviors as Having “Had Sex”

This study explored labeling of penile–anal intercourse (PAI), manual–anal (MA), and oral–anal (OA) behaviors as having “had sex” among heterosexual men and women with such experience residing in the United States (n = 3,218). Adult men and women completed an online questionnaire assessing sexual behaviors and whether each counted as having had sex. With the exception of anal intercourse, there was high variation in whether a behavior was labeled having had sex. There was not consensus on which anal sexual behaviors constituted having had sex, with attitudes varying across age, gender, and behavioral experience. Those who were older, male, and had the specific behavioral experience were more likely to label it as having had sex. Behaviorally specific assessments of the various anal behaviors as part of the sexual repertoire is critical to more accurate evaluation of sexual histories and assessment of risks to sexual health.     

Sex Differences Among College Students in Awareness of the Human Papillomavirus Vaccine and Vaccine Options

Abstract

Objectives: To explore awareness of human papillomavirus (HPV) and use of HPV vaccines (Gardasil and Cervarix) by college students. Participants: The sample was composed of 817 undergraduates at 2 northeastern US universities; they participated between February and May 2010. Methods: Students were provided with a link to an anonymous, self-administered, Web-based survey comprised of 76 questions. The survey included questions about health behaviors, awareness, and knowledge of HPV and the 2 HPV vaccines, and vaccine uptake. Results: Results indicate high levels of awareness of HPV as well as marked sex differences related to vaccine awareness and uptake. Both sexes are largely unaware of Cervarix and the differences between Cervarix and Gardasil. Conclusion: The study affirms the importance of a clinician's recommendation for HPV vaccination. Public health messaging should become more inclusive of adolescent and young adult males. College students’ awareness of HPV vaccine options mirrors Gardasil's market dominance in the United States.     

White Mothers Negotiating Race and Ethnicity in the Mothering of Biracial,Black-White Adolescents

Abstract

Eleven White mothers of biracial, Black/White adolescents were interviewed in a qualitative study to determine whether and how these mothers socialize their children to issues of race and ethnicity. The majority of the women were raising their children with a focus exclusively on an African American culture and not including elements of an ethnicity germane to the mother. Their children identified as biracial privately and Black publicly. The specific strategies utilized by the women to foster ecological competence are discussed.     

Vaginal Dryness and Beyond: The Sexual Health Needs of Women Diagnosed With Metastatic Breast Cancer

While research on the sexual health of women with early stage cancer has grown extensively over the past decade, markedly less information is available to support the sexual health needs of women diagnosed with advanced breast cancer. Semistructured interviews were conducted with 32 women diagnosed with metastatic breast cancer (ages 35 to 77) about questions they had concerning their sexual health and intimate relationships. All participants were recruited from a comprehensive cancer center at a large Midwestern university. Three themes were examined: the role of sexual activity and intimate touch in participants' lives, unmet information needs about sexual health, and communication with medical providers about sexual concerns. Findings indicated that sexual activities with partners were important; however, participants worried about their own physical limitations and reported frequent physical (e.g., bone pains) and vaginal pain associated with intercourse. When women raised concerns about these issues in clinical settings, medical providers often focused exclusively on vaginal lubricants, which did not address the entirety of women's problems or concerns. In addition, women diagnosed with metastatic breast cancer reported needing additional resources about specialized vaginal lubricants, nonpenetrative and nongenitally focused sex, and sexual positions that did not compromise their physical health yet still provided pleasure.     

Evaluation of targeted human papillomavirus vaccination education among undergraduate college students

Abstract

Objective: To design and evaluate pharmacy student-led educational sessions to improve health beliefs about the HPV vaccine in college-aged students. Participants: Students aged 18–26 attending a large, urban university, including 545 respondents to a December 2014 needs assessment survey about HPV-related health beliefs, 131 students participating in educational sessions during 2015–2016 (intervention group), and 369 undergraduate respondents completing the needs assessment survey (control group). Methods: A needs assessment survey was conducted to inform design and implementation of pharmacy student-led educational sessions. A similar survey was administered to students after attending educational sessions. Health beliefs were compared for the intervention versus control group. Results: The intervention group was less likely to report high perceived barriers to HPV vaccination and more likely to report high perceived benefits and intention to vaccinate (if previously unvaccinated). Conclusions: Pharmacy student-led, health belief-based educational sessions were associated with improved health beliefs about HPV vaccination.