Risk Factors for Chlamydia Trachomatis Infection in a California Collegiate Population

Abstract

Chlamydia trachomatis infection in college students has not undergone a detailed large-scale evaluation. The authors undertook a cross-sectional study of 4,086 students enrolled on the campuses of California State University, Sacramento, and 3 local community colleges from fall 2000 through spring 2002. They used an outreach screening model to determine the presence of infection by testing urine for chlamydial DNA by polymerase chain reaction. Participants completed demographic and behavioral risk questionnaires and a chlamydia knowledge assessment. Overall, 3.4% of participants tested positive for infection. Screening of male and female students was evenly distributed and incidence rates for males (3.03%) and females (3.78%) were similar. Variables associated with significantly increased risk were younger than 25 years, ethnicity other than White, more than one sexual partner in the preceding year or a new partner in the preceding 2 months, and current symptoms. Innovative outreach programs to screen a majority of at-risk college students should be developed.     

Food: Sustenance and Symbol

Abstract

College students often delay or avoid seeking testing for sexually transmitted infections (STIs), even if the services are readily available. We used in-depth, semistructured interviews to survey 41 college students aged 18 to 23 years about factors that influence decisions about STI testing. We grouped statements into 9 themes that represent influences on the decision. The most frequently mentioned factors were negative consequences of testing and perceived vulnerability to infection; other issues that influenced decision making included perceived benefits, perceived severity of diseases, public knowledge and opinion, social norms, provider characteristics, test-site characteristics, and personal considerations. Social stigmas and negative consequences appear to represent significant barriers to college students' being tested, which could increase the risk of spreading infections to others. Clinicians and health educators should raise students' awareness of the need for screening and should work to reduce the barriers to screening, including social stigmas and negative consequences.     

Difference in Condom Use Among Sexually Active Males at Historically Black Colleges and Universities

Black men who have sex with men (MSM) and black men who have sex with both men and women (MSMW) may not perceive themselves to be part of the larger gay community and hence may not heed prevention messages aimed at the community. Objective and Participants: To better understand the participants behaviors, the authors examined differences in condom use between black MSM/W (including MSM and MSMW) and men who have sex with women (MSW) at historically black colleges and universities (HBCUs). Methods: A paper-and-pencil questionnaire survey investigated sexual behaviors of 1,865 freshmen from 35 HBCUs during the 2001-2002 school year. Results: MSM/W were about 0.37 times less likely to always use condoms compared with MSW (adjusted odds ratio = 0.63, 95% confidence interval = 0.42-0.95). Sexual behavior, age at survey, total family income, and religion were also associated with condom use. Conclusions: These findings offer new directions for sexually transmitted disease and HIV prevention aimed at a highly marginalized population that remains at high risk for infection.     

American College Health Association Annual Pap Test and Sexually Transmitted Infection Survey: 2006

Objective: The authors describe the cervical cytology and sexually transmitted infection (STI) testing patterns of US college health centers. Participants and Methods: A total of 128 self-selected US college health centers—representing more than 2 million college students—completed an online survey during February and March 2007. Results: Almost 13% of cervical cytology results were abnormal; most of these were atypical squamous cells of undetermined significance and low-grade squamous intraepithelial lesions. In women, 2.9% of chlamydia tests and 0.4% of gonorrhea tests were positive. Human immunodeficiency virus (HIV) and syphilis tests were positive in 0.1% and 0.3% of students tested, respectively. Herpes simplex virus type 1 (HSV-1) accounted for 59.9% of genital herpes infections. Conclusions: College health centers are important sources for Pap and STI test data. Pap tests frequently yield low-grade abnormalities, and screening tests for chlamydia and especially gonorrhea are infrequently positive. Rates of HIV and syphilis in this population are low, raising concerns about positive predictive value when screening low-risk students. A majority of genital herpes infections are caused by HSV-1.     

Men’s condom use in higher-risk sex: Trends in five sub-Saharan African countries

This paper analyses trends in men’s condom use at last higher-risk sex (i.e., with a non-marital, non-cohabiting partner) using the two most recent Demographic and Health Surveys (DHS) in five sub-Saharan African countries: Cameroon, Kenya, Tanzania, Zambia and Burkina Faso. Condom use is an important method of preventing HIV transmission. Encouragingly, higher-risk sex has declined in four of the five countries, while condom use rose substantially in Cameroon, Tanzania and Burkina Faso but only had a minor increase in Kenya and Zambia, where use at last higher-risk sex remains below 50 per cent. There are no clear patterns of change across countries in the predictive strength of the explanatory variables between the two most recent surveys, although evidence of a widening gap in use by education in Cameroon is identified. In each country, lack of education remains a strong barrier to condom use in higher-risk sex.     

Relative Efficacy of a Pregnancy,Sexually Transmitted Infection,or Human Immunodeficiency Virus Prevention–Focused Intervention on Changing Sexual Risk Behavior Among Young Adults

Abstract

Objectives: Despite findings suggesting that young adults are more concerned about experiencing an unplanned pregnancy or contracting a sexually transmitted infection (STI) than becoming human immunodeficiency virus (HIV) infected, no empirical work has investigated whether the specific focus of an intervention may be more or less efficacious at changing sexual behavior. Participants: Participants were 198 college students randomized to 1 of 4 conditions: pregnancy intervention, STI intervention, HIV intervention, or a control condition during 2008–2009. Methods: The authors compared the efficacy of 3 theory-based, sexual risk–reduction interventions that were exactly the same except for an exclusive focus on preventing pregnancy, STI, or HIV. Condom use and risky sexual behavior were assessed at baseline and 4-week and 8-week follow-up. Results: Participants exposed to the pregnancy or STI interventions reported greater condom use and less risky sexual behavior than those exposed to the HIV intervention. Conclusions: The focus of sexual risk–reduction interventions may lead to differential behavior change among young adults.     

Group Treatment of Latency-Age Male Victims of Sexual Abuse

Researchers and clinicians across the country have documented increases in reports of sexual victimization of males. Awareness of the immediate and long-term needs of young male victims has highlighted the need for specialized, multi-modal treatment programs for these youngsters. Group therapy can be an important adjunct to individual and family unit therapy with this population. This article provides concrete suggestions for developing, implementing and evaluating a group therapy program for young male victims of sexual abuse. Specific areas addressed include: selection and preparation of group members; structure, phases, and salient tasks of the group; therapeutic group activities; co-leadership issues; managing transference and countertransference in the context of group; and, methods for evaluating the group's effectiveness.     

Predicting Human Papillomavirus Vaccine Intentions of College-Aged Males: An Examination of Parents’ and Son's Perceptions

Abstract

Objective: To examine male students’ and their parents’ human papillomavirus (HPV) vaccine communication in relation to males’ willingness to discuss the vaccine with their health care provider and the likelihood of being vaccinated. Participants: Dyads (n = 111) of students and parents. Methods: Participants completed a HPV vaccine survey based on the risk perception attitude framework in 2009. Results: Male students’ perceived susceptibility for HPV and self-efficacy to talk to their provider were directly related to their intention to discuss the HPV vaccine, and their intention was directly related to their likelihood of being vaccinated. Parents’ perceived self-efficacy to talk to their son and response efficacy of the vaccine were directly related to their intention to talk to their son; however, parents’ intention was not related to the likelihood of their son being vaccinated. Conclusions: College males may benefit from HPV vaccine educational programs that include communication skills training to discuss the HPV vaccine with their parents.     

Vaginal Douching Practices Among Women Attending a University in the Southern United States

Abstract

The authors assessed the frequency, characteristics, and motivational antecedents of vaginal douching practices among 125 White and 155 Black female college students. Overall, 40% of the students had ever douched and half of those women currently douche. Black women were most likely to be encouraged to douche by their mothers, whereas White women were more influenced by television advertisements. Among the sexually active women, being Black, using oral contraceptives, using spermicides, and being encouraged to douche by their mothers or by the media were independently associated with ever having douched. These associations were present among both Black and White women and were stronger when current douching was compared with never having douched. Women who were discouraged from douching by a physician or nurse were more likely to have stopped the practice. Douching is common, even among educated young women; nurses' and physicians' advice to stop douching appears to have a salutary effect.     

Policy Interventions Designed to Combat Sexual Violence: Community Notification and Civil Commitment

SUMMARY

Much attention has been given to the problem of sexual predators and the struggles of the legal-justice system to contain them. In response to public outcry over high-profile sex crimes, federal and state legislators have responded in the past decade with innovative but controversial public policy initiatives, called “sexually violent predator statutes.” In 1996 President Clinton signed “Megan's Law,” mandating all 50 states to develop requirements for convicted sex offenders to register with local law enforcement agencies and to notify communities when a sex offender lives in close proximity. Less publicized have been the civil commitment statutes introduced by 16 states which allow convicted sex offenders to be evaluated for involuntary and indefinite confinement in a psychiatric hospital following their release from prison. This article will review the literature regarding community notification and civil commitment as interventions designed to combat sexual violence. The history and context of each policy will be discussed, as will a review of available research evaluating the impact of each policy. Implications for future research and social policy will be examined.