Longitudinal test of a multiple domain model of adolescent condom use

A comprehensive multiple domain model (MDM) to understand condom use in adolescents was proposed and tested using structural equation modeling of data at three time points. The proposed model integrates social psychological theory, demographic and personality factors, social environment, and situational/contextual variables. Adolescents who were sexually active at time 2 (6 months after baseline) and time 3 (1 year after time 2) and completed surveys at all three time points were included in the analyses (N = 511). An iterative process of model testing resulted in a structural equation model that provided a good fit to the data (CFI = .92, RMSEA = .04). Models comparing gender and race as moderators also were calculated and supported the generalizability of the model. Results provide support for an MDM that goes beyond traditional social psychological models for a broader understanding of condom use in adolescents. Implications for further theory testing and safer sexual interventions are discussed.     

Family Network,Workplace Network,and Their Influence on Condom Use: A Qualitative Study Among Older Female Sex Workers in China

The objective of this study was to qualitatively explore the components of social networks and their influence on condom use among female sex workers (FSWs) aged 35 years and older in China. In-depth interviews with 63 older FSWs and 6 focus group interviews with pimps and owners of roadside salons and hotels were conducted in 3 Chinese cities. The mean age of participants was 42.6 years old (SD = 6.9 years) and the mean age of starting sex work was 38.6 years old (SD = 6.6 years). Two types of networks that influenced condom use were identified: family networks (relationship with children and husbands) and workplace networks (relationship with peers, clients, pimps, and owners). Relationships between older FSWs and their children negatively influenced condom use. Low levels of network support and norms regarding condom use were observed in the relationship between older FSWs and their clients, whereas positive social support and norms were prevalent among older FSWs who had frequent contact with peers. Norms for condom use existed among pimps and owners but were counterbalanced by monetary gains. Future human immunodeficiency virus (HIV) interventions for older FSWs should take the different features of social network components into consideration.     

Preparing for Male Condom Use: The Importance of Volitional Predictors

Objectives: Intention is not sufficient to actually use condoms, as self-regulatory processes are needed to translate motivation into action. This study has focused on the role of preparatory behaviors as a proximal predictor of condom use and examined how they contribute to the self-regulatory processes proposed by the health action process approach model. Methods: An on-screen longitudinal study was conducted with 3 measurement points 2 weeks apart. The participants were young men aged 18 to 25 years old (N = 203) recruited from vocational training centers. Outcome expectancies, perceived self-efficacy, intention, action planning, coping planning, volitional self-efficacy, preparatory behaviors, and condom use were assessed by self-report. A structural equation analysis was used to test a series of 3 nested models, with all parameters estimated by bootstrapping. Results: The model proposed that the included preparatory behaviors provided the best fit to the data. Preparatory behaviors were the most proximal predictors of condom use, and mediation occurred in a sequential manner with preparatory behaviors preceding the volitional variables, action and coping planning, and volitional self-efficacy. Conclusions: To bridge the intention–behavior gap, preparatory behaviors play a mediating role, demonstrating how they work in conjunction with other volitional variables such as planning and self-efficacy in the translation of behavioral intentions into actual condom use.     

Psychosocial Correlates of Condom Use Intentions among Junior High School Students in the Bolgatanga Municipality of Ghana

ABSTRACT

Objectives: We explored sociodemographics, sexual experience, and psychosocial factors influencing condom use intentions of adolescents in Northern Ghana. Methods: Based on social cognitive theories and previous empirical studies investigating condom use, a cross-sectional survey was conducted among 2,018 adolescents (M age = 15.8 years) in Bolgatanga, Ghana. Correlations and multinomial logistic regressions were performed. Results: Findings showed that attitudes toward condom availability, injunctive norms toward condom use, sex experience, perceived susceptibility towards STIs, and perceived behavioral control toward buying as well as using condoms differentiated between people with different levels of intentions to use condoms. Conclusions: Implications for intervention development are discussed.     

Personal psychological resources,resilience and self-efficacy and their relationship with psychological distress in situations of unemployment / Los recursos psicológicos personales,resiliencia y autoeficacia,y su relación con el malestar psicológico en situaciones de desempleo

According to Hobfoll’s conservation of resources theory (1989), psychological resources such as resilience and self-efficacy could mediate the effects of unemployment on well-being. The objective of this study is to analyse the mediating role of self-efficacy and resilience on the relationship between the amount of time unemployed and psychological distress. A sample of unemployed persons from the Region of Murcia was used (N = 280). With a transversal design and using the macro PROCESS for SPSS (2013), a multiple mediation model is proposed which analyses the mediating role of psychological resources in relation to the amount of time unemployed and self-perceived health. The explained variance of this model is 23.79%. The results show that only self-efficacy partially mediates in the relationship between the two variables (β = .18, SD = 0.06, p < .01). The main contribution of this article is showing that personal psychological resources are an effective tool to cope with life stressors, such as, in this case, unemployment.     

Gender Nonconformity,Homophobic Peer Victimization,and Mental Health: How Same-Sex Attraction and Biological Sex Matter

We assessed whether homophobic name-calling accounts for the relationship between gender nonconformity and mental health (social anxiety and psychological distress) in a sample of 1,026 Dutch adolescents (boys: n = 517) ages 11 to 16 (M_age = 13.4). We also explored whether this hypothesized mediation differs by sexual attraction and biological sex. Data were collected by means of paper-and-pencil questionnaires at five secondary schools located in urban areas in the Netherlands. Mediation analysis indicated that gender nonconformity was related to both social anxiety and psychological distress partially via homophobic name-calling. Moderated mediation analysis further showed that the mediating role of homophobic name-calling varied according to levels of same-sex attraction (SSA) and biological sex. The mediation effects increased in magnitude when levels of SSA increased and were significant only for adolescents with mean and high levels of SSA. The mediation effects were significant for boys and girls in general, although the mediation effects were stronger for boys than for girls. Our findings emphasize the importance of research and school-level interventions to focus on factors that promote acceptance of cross-gender behavior among adolescents.     

Revisiting the Role of Impulsivity and Compulsivity in Problematic Sexual Behaviors

Impulsivity and compulsivity are transdiagnostic features associated with clinically relevant aspects of psychiatric disorders, including addictions. However, little research has investigated how impulsivity and compulsivity relate to hypersexuality and problematic pornography use. Thus, the aims of the present study were to investigate (a) self-reported impulsivity and compulsivity with respect to hypersexuality and problematic pornography use and (b) the similarities and possible differences between hypersexuality and problematic pornography use in these domains. Utilizing structural equation modeling (SEM) in a large community sample (N = 13,778 participants; female = 4,151, 30.1%), results indicated that impulsivity (β = .28, β = .26) and compulsivity (β = .23, β = .14) were weakly related to problematic pornography use among men and women, respectively. Impulsivity had a stronger relationship (β = .41, β = .42) with hypersexuality than did compulsivity (β = .21, β = .16) among men and women, respectively. Consequently, impulsivity and compulsivity may not contribute as substantially to problematic pornography use as some scholars have proposed. On the other hand, impulsivity might have a more prominent role in hypersexuality than in problematic pornography use. Future research should examine further social and situational factors associated with problematic pornography use.     

The Impact of Pre-Exposure Prophylaxis (PrEP) Use on Sexual Anxiety,Satisfaction, and Esteem Among Gay and Bisexual Men

Gay and bisexual men (GBM) with heightened fears of human immunodeficiency virus (HIV) acquisition have reported high levels of sexual anxiety and low sexual self-esteem. Similarly, sexual satisfaction has been reported to be lower among some GBM who rely solely on condom use as HIV prevention. We sought to explore whether pre-exposure prophylaxis (PrEP) had an impact on the sexual satisfaction, anxiety, and esteem of GBM. As part of a longitudinal cohort study of 1,071 GBM, participants reported at three time points on PrEP use and completed the Multidimensional Sexual Self-Concept Questionnaire (MSSCQ). A total of 137 GBM began taking PrEP in the 24 months following baseline. Comparing their responses during times before initiating PrEP and after, within adjusted multilevel models, there was a significant decrease in sexual anxiety (B = ?0.27, p = 0.03) but no significant changes in sexual esteem or satisfaction. Our findings indicate important psychological improvements resulting from PrEP initiation. Further research should explore the potential for other psychological benefits of PrEP use among GBM.     

Comparison of Adolescents' Reports of Sexual Behavior on a Survey and Sexual Health History Calendar

Assessing sexual risk is critical for human immunodeficiency virus (HIV) and sexually transmitted infection (STI) prevention with adolescents. This article compares sexual risk reports from two self-administered instruments, a standard survey and a sexual health history calendar (SHHC), among racially diverse youth (n = 232) ages 14 to 21 seeking services at a public health clinic. Agreement between methods was assessed using Lin's concordance correlation coefficients (CCC) and Bland-Altman plots. Lin's CCC showed poor to moderate agreement between instruments on reports of sexual partners in the past 3 (0.47), 6 (0.55), and 12 (0.49) months. While individual sexual partner questions were refused a total of 179 times on the survey, youth reported having sexual partners during the same time period on the SHHC in most (77.1%) of these instances. Poor agreement was also found for condom use frequency (CCC = 0.17), with youth's frequency of condom use on the SHHC differing from that reported on the survey for more than half (55.6%) of the months they were sexually active. While lack of objective sexual behavior measures limits conclusions about the accuracy of reports, the ways in which youth's responses varied across instruments may offer insight into the complexity of adolescent sexual risk taking as well as have important implications for development of HIV/STI preventive interventions.     

Emotional Intimacy Power Predicts Different Sexual Experiences for Men and Women

Those who are more emotionally invested in relationships have less power than their partners. Furthermore, less powerful individuals may attempt to equalize power imbalances by offering rewards to their partner and using sex and condom use as exchange resources. Australian young adults reported their condom use and pressured sex experiences in both romantic (n = 708) and casual (n = 118) relationships. Results showed that greater power (lower relative emotional investment) predicted more condom use among those wanting to use condoms. In casual relationships, an interaction with gender showed that women in particular used condoms more when they had more power. Power also interacted with gender for pressured sex and, unexpectedly, men who had more power experienced more pressured sex. The possibility that condom use and pressured sex have different meanings for men and women is explored.     

Modelling school participation based on the theory of planned behaviour / Modelamiento de la participación escolar basado en la teoría del comportamiento planificado

This study evaluated a predictive model of school participation based on Ajzen’s theory of planned behaviour. Attitudes towards social justice, perceived control and subjective norm on school participation were tested, mediated by the behavioural intention in favour of social justice in a sample of 443 secondary school students. The proposed model showed good fit (χ² = 597.740, df = 342; RMSEA = .041). The behavioural intentions towards social justice and perceived behavioural control were directly related to school participation. An indirect effect of perceived control on participation was detected, mediated by behavioural intention, but no evidence was found of the indirect effect of either attitude or norm on school participation.     

Early Age of First Sexual Intercourse and Depressive Symptomatology among Adolescents

Past literature has provided conflicting evidence for the association between adolescent sexual intercourse and depressive symptomatology. Whereas some studies conclude that sexually active youth may be at risk for depression, others provide contrary results. Thus, it is unclear as to whether depression results directly from coitus or if this relationship is explained by other factors—that is, there may be biological, psychological, or sociological predictors of both depressive symptomatology and early sexual intercourse. Using the National Longitudinal Study of Adolescent Health dataset, depressive symptomatology in adolescents over a seven-year time period was analyzed. The final sample (n = 6,510) was comprised of 49.35% male (n = 3,213) and 50.65% female (n = 3,297) participants. Although an earlier age of first coitus was predictive of future depressive symptoms, both variables appear to be concomitant outcomes of the biopsychosocial process. Thus, although one may be able to use early coitus as a marker for subsequent depressive symptomatology, it does not appear to occur because of early sexual intercourse. Furthermore, the reverse relationship was not found to be significant in this study—that is, higher levels of previous depressive symptomatology did not predict an earlier age of first sexual intercourse in adolescents.     

Relationships Between Social-Emotional Intelligence and Sexual Risk Behaviors in Adolescent Girls

Social-emotional intelligence (SEI) has been linked with a number of health behaviors in adolescent populations. However, little is known about the influence of SEI on sexual behavior. This study examined associations between three indicators of SEI (intrapersonal skills, interpersonal skills, stress management skills) and adolescent girls’ sexual risk behaviors. Data come from a cross-sectional sample of sexually active adolescent girls (ages 13 to 17 years) at high risk for pregnancy (N = 253), recruited from health care clinics in a Midwest metropolitan area during 2007 and 2008. Results of multivariable regression models controlling for participants’ age and race/ethnicity indicated that each aspect of SEI was related to distinct sexual risk behaviors. Specifically, girls with greater intrapersonal skills had significantly fewer male sex partners in the past six months (b = ?0.16). Participants with greater interpersonal skills reported earlier communication with their sexual partner about sexual risk (b = 0.14), and those with a better ability to manage stress reported more consistent condom use (b = 0.31). Study findings suggest that SEI may provide a protective buffer against sexual risk behaviors. Building adolescent girls’ social and emotional skills may be an effective strategy for reducing their risk for early pregnancy and sexually transmitted infections.     

Moderating Effects of Sexual Orientation and Gender Characteristic on Condom Use Intentions Among Boys’ Senior High School Students in Taiwan: An Exploration Based on the Theory of Planned Behavior

This study examined condom use intentions among adolescent boys in relation to the constructs of the Theory of Planned Behavior (TPB): attitude toward the behavior (ATB), subjective norm (SN), and perceived behavioral control (PBC). The potential moderating effects of sexual orientation and gender characteristic (masculine/feminine) were also explored. Anonymous survey data were collected from 929 students enrolled in a boys’ senior high school in Taiwan (response rate: 89.9%). Multivariate logistic regression analyses found higher condom use intentions linked to more positive ATB (adjusted odds ratio [AOR] = 8.09) and supportive SN (AOR = 2.73), as well as high PBC under facilitating conditions (AOR = 2.04). Notably, nonheterosexual boys perceiving supportive SN (AOR = 0.23) or high support for condom use from teachers and health educators (AOR = 0.10 and 0.26, respectively) had lower condom use intentions than their heterosexual peers. By contrast, relatively feminine boys perceiving supportive SN (AOR = 2.06) or high support from close friends (AOR = 2.18) had higher condom use intentions than their masculine counterparts. In conclusion, ATB and SN were strongly linked to condom use intentions; PBC was significant only under facilitating conditions. Sexual orientation and gender characteristic had important moderating effects. These empirical findings could inform tailored health education programs to increase condom use intentions in the male student population.     

Sexual Behavior With Noncommercial Partners: A Concurrent Partnership Study Among Middle-Aged Female Sex Workers in China

Female sex workers (FSWs) often engage in concurrent partnerships, meaning they have multiple sexual relationships at the same time. The objective of this study was to investigate sexual concurrency and its associations with condom use and syphilitic infections among FSWs over age 35. Respondent-driven sampling was used to recruit 1,245 FSWs in Nanning, Hefei, and Qingdao, China. FSWs were asked to report whether they had concurrent partners in the past six months. Concurrency was defined as engagement in sex with commercial clients and (1) husbands and boyfriends (n = 167); (2) husbands only (n = 301); or (3) boyfriends only (n = 469). FSWs with only commercial clients were used as the comparison group (n = 308). Across all groups, the percentage of FSWs with prevalent and active syphilis ranged from 19.6% to 25.6% and 9.1% to 11.5%, respectively. Condom use was low with noncommercial sexual partners and was more likely to be used when FSWs’ boyfriends had other partners. Three components of the theory of planned behavior were significantly associated with consistent condom use. Concurrent relationships may lead to increased transmission of syphilis at the workplace and family levels. Effective interventions should target concurrency with both commercial and noncommercial partners.     

Does Asking Adolescents About Pornography Make Them Use It? A Test of the Question–Behavior Effect

Longitudinal survey design is the preferred method for the robust assessment of outcomes associated with socially undesirable or potentially harmful sexual behaviors. However, repeated measurement may induce the question–behavior effect (QBE)—the phenomenon where asking about a behavior changes the probability of engaging in the behavior in the future. Using an online panel sample of Croatian adolescents (M_{age at baseline} = 15.8, SD = .50), the present study explored the QBE in the context of adolescent pornography use. To this end we compared the frequency of pornography use six months after the initial survey (T2) between adolescents who participated in both baseline (T1) and T2 survey assessments (n = 1,053; 41% of males) and those who began the study at T2 (n = 130; 42% of males). In line with the findings from a recent Dutch study, we found no evidence that surveying adolescent pornography consumption increased participants’ reports of subsequent use. Implications of the findings for studying pornography use in young people are discussed.     

The Advantages and Limitations of Seeking Sex Online: A Comparison of Reasons Given for Online and Offline Sexual Liaisons by Men Who Have Sex With Men

Australian young adults reported how often they wanted to use condoms in both romantic (n = 667) and casual relationship (n = 152) contexts and how often they thought their partners wanted to use condoms. Young adults wanted to use condoms more often than they perceived their partners to in both casual and romantic relationship contexts. Gender interactions showed that this pattern was especially strong among young women. Women seemed to underestimate the frequency at which their male partners wanted to use condoms. Furthermore, both the participants' condom use desires and perceptions of their partners' condom use desires predicted condom use behavior. Results suggest that gendered expectations may play a part in how often individuals perceive their partners to want to use condoms, which, in effect, may determine condom use behavior.     

Risky Business: Is There an Association between Casual Sex and Mental Health among Emerging Adults?

A multiethnic sample of single, heterosexual, emerging-adult college students (N = 3,907) ages 18 to 25, from 30 institutions across the United States, participated in a study about identity, culture, psychological well-being, and risky behaviors. Given ongoing debates about the connection between casual sex and psychological adjustment, in the current study we assessed the cross-sectional association of participation in casual sex with psychological well-being and distress. A greater proportion of men (18.6%) compared to women (7.4%) reported having had casual sex in the month prior to assessment. Structural equation modeling indicated that casual sex was negatively associated with well-being (ß = .20, p < .001) and positively associated with psychological distress (ß = .16, p < .001). Gender did not moderate these associations. For emerging-adult college students, engaging in casual sex may elevate risk for negative psychological outcomes.     

Research With Adolescent Victims of Child Sexual Abuse: Evaluation of Emotional Impact on Participants

The aim of this study was to evaluate the emotional impact on adolescent victims of sexual abuse from participating in a study addressing the consequences of their abuse. A total of 114 adolescents between 12 and 17 years old participated (54 sexually abused adolescents and 60 nonabused students). Both groups responded to a battery of scales to determine their coping strategies and some psychological consequences linked to stressful experiences and two questions about the emotional impact of participating in the study. Sexually abused adolescents reported fewer unpleasant emotions after participating than did nonvictim students (mean difference = .45, t[109] = ?2.934; p < .01). Adolescents who had more symptoms reported more discomfort (r_S scores between .35 and .49; p < .01). These results suggest that when ethical guidelines are followed, it is possible to survey adolescent victims of sexual abuse on aspects related to their experience without causing them significant distress.     

Associations of Alcohol and Marijuana Use With Condom Use Among Young Adults: The Moderating Role of Partner Type

This study used multiple levels of analysis to examine associations of alcohol and marijuana (AM) use with condom use, including the moderating role of partner type, in a general sample of 754 sexually active young adults (mean age = 18.6, SD = 0.63; 77% non-White). Multivariable models examined associations over the past 30 days (global) and at the most recent sexual event (event specific). Over the past 30 days, participants who had a recent casual partner and used both substances reported a higher proportion of condom-protected sexual events during this period compared to AM nonusers, whereas those who had a recent steady partner and used alcohol, marijuana, or both substances reported a lower proportion of condom-protected sexual events compared to AM nonusers. At the most recent sexual event, participants who used both substances were four times more likely than AM nonusers to have condom-protected sex if the event involved a casual partner; however, there were no significant associations if the event involved a steady partner. Marijuana use, particularly combined with alcohol use, deserves greater attention in the context of condom use. Future research should consider different levels of analysis and partner types to fully understand these complex associations.