Non-parental adults in the social and risk behavior networks of sexual minority male youth

The presence of non-parental adults (NPAs), or adults outside of caregivers (e.g., extended family and natural mentors), in the lives of adolescents and emerging adults has received a rapidly expanding amount of empirical attention in the last decade. Compared to their heterosexual counterparts, sexual minority male youth (SMMY) experience disproportionate rates of abuse and victimization from parents and peers. Yet, despite the fact that this group, therefore, may be potentially vulnerable to negative interpersonal influences but also poised to benefit from additional relationships, NPA involvement in the lives of SMMY is currently not well understood in the extant literature. This study sought to examine and characterize the involvement of NPAs in the social and risk networks of SMMY (n = 175; 54% African American, 21% Hispanic/Latino, 14% Caucasian; ages: 17–23). Most SMMY identified at least one NPA, such as friends and grandparents, in their networks. Three categories of relationships were identified, Strictly Social, which only involved social interactions; Complex, which were both social and involved substance use and/or sexual activity; and Risky, which purely consisted of substance use or sexual activity. Relationships were rated as emotionally “closer” among ethnic minority SMMY, although, racial/ethnic similarity between SMMY and NPAs was not associated with relationship closeness. In addition, relationships involving female and heterosexual NPAs were also rated as stronger. These findings suggest the potential usefulness of considering multiple types of relationships between SMMY and NPAs when designing intervention and prevention efforts. Moreover, African American and Latino SMMY, who represent the most vulnerable sub-groups of SMMY in terms of HIV-risk, may be particularly poised to benefit from positive NPA relationships.     

Neighborhood structural inequality, collective efficacy, and sexual risk behavior among urban youth

We draw on collective efficacy theory to extend a contextual model of early adolescent sexual behavior. Specifically, we hypothesize that neighborhood structural disadvantage--as measured by levels of concentrated poverty, residential instability, and aspects of immigrant concentration--and diminished collective efficacy have consequences for the prevalence of early adolescent multiple sexual partnering. Findings from random effects multinomial logistic regression models of the number of sexual partners among a sample of youth, age 11 to 16, from the Project on Human Development in Chicago Neighborhoods (N = 768) reveal evidence of neighborhood effects on adolescent higher-risk sexual activity. Collective efficacy is negatively associated with having two or more sexual partners versus one (but not zero versus one) sexual partner. The effect of collective efficacy is dependent upon age: The regulatory effect of collective efficacy increases for older adolescents.     

The role of family interactions in HIV risk for gay and bisexual male youth: A pilot study

Despite ongoing prevention efforts, young gay and bisexual males continue to engage in sexual behaviors that place them at disproportionately high risk for HIV infection. Parental monitoring and parent–child communication have been found to be associated with low-risk sexual behavior among heterosexual youth, but the role of family interactions for gay and bisexual male youth remains largely unexplored. To help address this gap, an exploratory study of recorded and coded interactions among 35 gay and bisexual youth and their parents was done to begin to identify which types of family interactions were associated with youth high-risk sexual behavior. Parent–son communication that was mutual and low in conflict was found to be most prevalent among youth with the fewest reported high-risk sexual behaviors. These preliminary findings, along with a case example, demonstrate how social workers can coach families to engage in productive and potentially influential interactions that reduce HIV-related sexual behaviors among young gay and bisexual males.     

Peer-led interventions to reduce HIV risk of youth: A review

One approach in HIV prevention programming targeting youth is to use peer leaders in what is referred to as peer education programming. This paper critically reviews and synthesizes the results and lessons learned from 24 evaluated peer-led programs with an HIV/AIDS risk reduction component that target youth in the communities where they live and are delivered in low- and middle-income countries. Interventions were identified through a comprehensive search of the peer reviewed AIDS-related literature as well as publication lists of major organizations in the UN family that address HIV and AIDS. Our synthesis of study results finds that these programs have demonstrated success in effecting positive change in knowledge and condom use and have demonstrated some success in changing community attitudes and norms. Effects on other sexual behaviors and STI rates were equivocal. We include an overview of characteristics of successful programs, a review of program limitations, and recommendations for the development and implementation of successful community-based peer-led programs in low-income countries.     

“To be HIV positive is not the end of the world”: Resilience among perinatally infected HIV positive adolescents in Johannesburg

BackgroundResilience, or positive adaptation to challenging situations, has potential to improve health outcomes for high risk populations. Resilience may be particularly important for perinatally infected HIV positive adolescents, who are exposed to significant stigma, risks and stressors. Despite recognition that HIV positive adolescents show remarkable resilience in the face of adversity, little is known about how resilience occurs within this population.MethodsThe aim of this study was to identify elements of resilience in a group of perinatally infected HIV positive adolescents attending HIV clinics. In-depth interviews were conducted with 25 purposively selected HIV positive adolescents (15 female, 10 male) between the ages of 13–19 years in Johannesburg. Data were analysed in NVIVO 10 using a thematic approach to coding.ResultsDespite marked stressors in the lives of these adolescents, a high degree of resilience was described. Characteristics of resilience in this group included a pertinent set of beliefs, including a belief in fate and recognition of personal strength as a consequence of managing adversity. Character traits such as a pragmatic acceptance about one's life, actively taking responsibility, and a robust self-esteem were evident. Social behaviours included the ability to pursue and access adults and healthcare to meet developmental needs, having a desire to support and help others and challenging HIV related stigma. These characteristics were underscored by the capacity for self-reflection.ConclusionPerinatally infected adolescents, who face high levels of hardship and change, nevertheless exhibit strong resiliency beliefs, traits, and behaviours. Healthcare environments have the potential to be utilized as powerful resources in fostering resilience in HIV positive adolescents, if characteristics of adolescent resilience were integrated into current prevention and intervention programming. Resilience promotion could lead to improved health outcomes for HIV positive adolescents.     

A sexual assault primary prevention model with diverse urban youth

In this study, a nonprofit community mental health clinic developed a socioecological model of sexual abuse prevention that was implemented in a public school. The goal of the program was to promote and create community change within individuals and the school community by reducing tolerance of sexual violence and sexual harassment. Participants were 5th-12th graders at a school from a Midwest city. Completed measures were obtained from 202 students, and a quasiexperimental time series research design was developed to evaluate the effectiveness of the prevention program. The program was found to be effective at increasing participant's knowledge of sexual abuse, awareness of school and community sexual assault support resources, and identification of components of healthy and unhealthy relationships.     

HIV/AIDS among youth: A community needs assessment study

Adolescents remain at great risk for HIV transmission and contracting AIDS. Health education, preventive methods, and direct clinical intervention represent major strategies in combating this disease. In order to help increase the effectiveness of these activities, University faculty and a county health agency collaborated to conducted an extensive HIV/AIDS needs assessment of adolescents. The survey included high school, middle school, and community youth (N=1567). Results showed a relatively high level of knowledge about HIV/AIDS, yet participation in risk behavior which did not correlate with knowledge. Data suggested that parents and school were important sources of information about HIV/AIDS. Implications for social work practice and policy are discussed.The research was funded by the U.S. Conference of Mayors and done in collaboration with the Lucas County Health Department, Toledo, Ohio.     

Sexual self control as a mediator of high risk sexual behavior in a New York city cohort of HIV+ and HIV‐ gay men

This paper describes the development of the Perceived Sexual Control inventory (PSC) and a study investigating the relationship between an individual's perception of control over sexual behavior and actual sexual risk behavior in a New York City cohort of 108 HIV+ and 48 HIV‐ gay men. Correlational analysis indicated that reported difficulty controlling sexual behavior was associated with having more male sex partners and sex occasions over lifetime and in the 6 months prior to interview, with a greater number of one‐time partners and out‐of‐home partners, with less monogamy, and with being abstinent in the prior 6 months. Those who perceived difficulty with sexual control were significantly more likely to use cocaine or amyl nitrate (poppers) during sex, to do so on more occasions and to use more drugs overall. Additionally, perceptions of sexual control were found to relate to high risk sexual practices. Those lower in perceived sexual control reported more occasions of receiving anal ejaculation than those who reported greater sexual control. Two subscales (Perceived Control Over Sex Drive and Perceived Control Over Risk Behavior), derived via factor analysis from the 20‐item inventory used to assess perceived sexual control, were also examined in relation to the above variables, and differential findings are discussed. The overall pattern of findings supports the construct validity of the PSC.     

A prospective study of sexual assault and alcohol use among first-year college women

This study prospectively examined the relation between alcohol use and sexual assault in a sample (N = 319) of first-year college women. Both frequency of drinking and frequency of binge drinking were measured. Over the course of their freshman year, 19.3% reported experiencing at least one sexual assault. Frequent binge drinking and frequent drinking predicted a subsequent sexual assault; however, experiencing a sexual assault did not predict changes in alcohol use. Frequent binge drinking demonstrated a stronger association with sexual assault than did frequent drinking. Findings help clarify the relation between alcohol use and sexual assault in college women and call for continued differentiation in assessment of alcohol use.     

A treatment program for children with sexual behavior problems

This paper discusses the problems and treatment of children with sexual behavior problems. These children coerce, intimidate or force other children by threats of physical harm to comply with their sexual requests, frequently a reenactment of their own experiences. This paper describes a comprehensive therapeutic foster care approach to these children.     

Sex,lies, and videos in rural china: A qualitative study of women's sexual debut and risky sexual behavior

We studied the sexual behaviors of young, unmarried women living in rural China with a special focus on sexual debut, sexual risk‐taking behaviors, and reproductive health consequences. The analysis was based on 40 in‐depth interviews with young women who had undergone induced abortion, as well as information from focus group discussions. Study participants identified pornographic videos, parents’ tacit approval, and even encouragement as factors instigating their sexual debut. Reasons for unprotected intercourse included spontaneous sexual activity, misconceptions about fertility and the effective use of contraceptives, and the lack of negotiation skills. The results indicate the importance of making reproductive health education more accessible to rural populations in China, a group usually considered to be more traditional and less likely to engage in premarital sex.     

Residential mobility and the onset of adolescent sexual activity

Data from almost 5,000 adolescent respondents to the National Longitudinal Study of Adolescent Health (Add Health) are used to examine the mechanisms that transmit the facilitative effect of residential mobility on the timing of the transition to first premarital sexual intercourse. Adolescents who have recently moved are approximately one third more likely than nonmobile adolescents to experience first premarital intercourse between the first two waves of Add Health. We find that much of the difference between adolescent movers and stayers in the onset of sexual activity is attributable to the greater propensity for delinquency and the weaker academic performance among members of movers’ school‐based friendship networks. Adolescents’ own delinquent behavior and academic performance also help to mediate the association between residential mobility and the transition to first intercourse.     

Bullying and suicide in high school students: Findings from the 2015 California youth risk behavior survey

ABSTRACT

School bullying and cyberbullying have been linked to suicidal behaviors through depression and alcohol, tobacco, marijuana, and other drug use. However, how these associations may differ across racial/ethnic groups remains relatively unknown. Using data from the 2015 California Youth Risk Behavior Survey, this study aims to examine two questions in different racial/ethnic subgroups: (1) Does bullying affect suicide? and (2) Does bullying have an indirect effect on suicide through depression and use of alcohol, tobacco, marijuana and other drugs? The sample consisted of 1,765 Californian youth attending grades 9–12. Logistic regression analyses indicate that being bullied is associated with increased odds of suicide across all racial/ethnic groups; depression mediates the effect of bullying on suicide for all racial/ethnic groups; alcohol use mediates the effect only for Hispanic youth; other drug use mediates the effect only for White youth; marijuana and tobacco use have no mediating role. These findings suggest that bullying may lead to suicide through different risk behaviors for youths of different racial/ethnic groups. Professionals who work with bullied youths need to treat depression more effectively to prevent suicide in service planning and provision. They also need to be aware of the racial/ethnic differences in the risk behaviors intercorrelated with bullying and suicide and provide appropriate treatment to the youth of specific race/ethnicity.     

Prevalence of same‐gender sexual behavior and HIV in a probability household survey in Mexican men

The prevalence of male same‐gender sexual behavior in Mexico City in relation to HIV transmission was studied. A household probability survey of 8,068 adult men was conducted in 1992–93 using the Mexican National Health Survey sampling frame. The response rate was 59%. Differences between respondents and nonrespondents indicated no evidence for significant bias. A random subsample of 1,116 individuals provided serum or saliva for HIV testing. An estimated 2.5% of men practiced same‐gender sex in their lifetime: 2.1% (95% CI: 1.7 ‐ 2.4%) reported bisexual behavior and 0.4% (95% CI: 0.3 ‐ 0.6%) reported exclusively homosexual behavior. Among bisexuals, 70% reported sex only with women in the previous year, 7% reported sex only with men, 13% reported sex with both, and 10% were sexually inactive. A condom was used by 46% in their last homosexual encounter. An estimated 0.1% of married men were homosexually active in the previous year. The HTV prevalence estimate was 0.2% in the sample. The rate was 4% among homosexual/bisexual men and 0.09% in heterosexual men (p < 0.0001). Estimates of homosexual behavior and HTV infection from this population‐based sample are lower than results from nonprobability studies. The low prevalence of condom use anticipates future growth of the epidemic in the homosexual population. Bisexual behavior appeared to be infrequent and transitory, particularly among married men.     

Effects of parental monitoring on aggressive behavior among youth in the United States and South Korea: A cross-national study

ObjectiveThis cross-national study examined the direct and indirect effects of parental monitoring on aggressive behavior among separate samples of 10th grade youth in the US (N = 3784) and South Korea (N = 3079).MethodsData from two national probability studies—Monitoring the Future (MTF) for US youth and Korea Youth Panel Study (KYPS) for South Korean youth—were used. Both studies incorporated school-based, multi-stage, stratified, and randomized clustered sampling methods.ResultsPath analyses results indicated that while parental monitoring was directly and negatively related to aggressive behavior among US youth, it had no direct effect among South Korean youth. We also found significant indirect effects of parental monitoring on youth aggression through cigarette use, alcohol use, and self-esteem among both groups. Both US and South Korean youth who perceived increased monitoring from their parents reported less cigarette and alcohol use and higher self-esteem, which in turn reduced the likelihood of aggressive behavior.ConclusionsThis study serves as an example of conducting cross-national research using existing data to investigate significant issues related to youth well-being. Although there are cultural differences between US and South Korean youth, parental monitoring is still important in deterring both groups of youth from engaging in aggressive behavior.     

Linearity and nonlinearity in HIV/STI transmission: implications for the evaluation of sexual risk reduction interventions

A mathematical model of HIV/sexually transmitted infections (STI) transmission was used to examine how linearity or nonlinearity in the relationship between the number of unprotected sex acts (or the number of sex partners) and the risk of acquiring HIV or a highly infectious STI (such as gonorrhea or chlamydia) affects the utility of sexual behavior change measures as indicators of the effectiveness of HIV/STI risk-reduction interventions. Findings indicate that the risk of acquiring HIV through vaginal intercourse is essentially a linear function of the number of unprotected sex acts and is nearly independent of the number of sex partners. Consequently, the number of unprotected sex acts is an excellent marker for the risk of acquiring HIV through vaginal intercourse, whereas the number of sex partners is largely uninformative. In general, the number of unprotected sex acts is not an adequate marker for the risk of acquiring a highly infectious STI due to the highly nonlinear per act transmission dynamics of these STIs. The number of sex partners is a reasonable indicator of STI risk only under highly circumscribed conditions. A theoretical explanation for this pattern of results is provided. The contrasting extent to which HIV and highly infectious STIs deviate from the linearity assumption that underlies sexual behavior outcome measures has important implications for the use of these measures to assess the effectiveness of HIV/STI risk-reduction interventions.     

High-risk sexual behavior among students of a minority-serving university in a community with a high HIV/AIDS prevalence

OBJECTIVE: The authors used a stratified cluster sampling design to inform campus sexually transmitted diseases prevention programs. PARTICIPANTS AND METHODS: They conducted a cross-sectional study of students (N = 1,130) at a large, urban, minority-serving university in South Florida using the 2004 National College Health Assessment Survey instrument. RESULTS: Of the 1,130 participants, 14.0% reported risky sexual behavior (having more than 1 sexual partner in 1 year and not using a condom the last time they had vaginal intercourse), and 11.9% reported consistent risky sexual behavior (having more than 1 partner in 1 year and not using condoms most or all of the time during the past 30 days). In multivariable analysis, past-month alcohol use had the strongest independent association with both risky and consistent risky sexual behavior. Illicit drug use was marginally significant in both models. CONCLUSIONS: Administrators should address the use of alcohol and other drugs on campus in planning interventions to promote safe sexual behavior.     

Unplanned sexual activity as a consequence of alcohol use: a prospective study of risk perceptions and alcohol use among college freshmen

OBJECTIVE: The authors' goal was to show how risk perceptions regarding unplanned sexual activity following alcohol use are prospectively related to subsequent alcohol consumption. PARTICIPANTS: Undergraduate students (N = 380) completed questionnaires at 2 time points during their freshman year. METHODS: In the middle of the academic year (T1), students estimated their risk of engaging in unplanned sex and reported their alcohol use during the previous term. Four months later (T2), they again reported alcohol use and indicated whether they had engaged in unplanned sex since T1. RESULTS: Students who consumed more alcohol at T1 rated their risk of unplanned sex more highly, suggesting relative accuracy. Those with higher risk perceptions consumed more alcohol at T2 (controlling for T1 use), suggesting that they maintained the high-risk behavior. Last, those who were unrealistically optimistic (ie, estimated low risk at T1 yet had unplanned sex by T2) reported greater alcohol use at T2. CONCLUSIONS: These findings highlight the role that risk perceptions regarding sexual activity may play in college students' alcohol use.