Advancing Sexual and Reproductive Health and Rights
 
Perspectives on Sexual and Reproductive Health
Volume 41, Number 4, December 2009

IN THIS ISSUE

Foreign birth appeared to have an "enduring" relationship with sexual behavior among a sample of Hispanic young women living in South Florida described by Ursula Keller Weiss and Kathryn Harker Tillman in this issue of Perspectives on Sexual and Reproductive Health (see article). Both women who had immigrated before age six and those who had done so later in childhood or in adolescence reported less risky behavior when interviewed at ages 18–23 than did U.S.-born Hispanic women; the two immigrant groups, however, reported similar levels of risky behavior. Immigrant men, on the other hand, did not differ from their U.S.-born peers in participation in risky behavior. One behavior that was not related to these young adults' place of birth was condom use: Levels of consistent use and use at last sex were low across the board.

Although the diversity of the U.S. Hispanic population is well recognized, associations between nativity and risky sexual behavior have not been explored in detail. Weiss and Tillman encourage large-scale research "to examine the familial and community contexts" that may underlie these associations.

Also in This Issue

•The dynamics within families that include a teenage mother may encourage younger siblings to steer clear of early parenthood or may enhance their risk, Patricia L. East and colleagues report (see article). More than half of 12–18-year-old Mexican Americans who participated in in-depth interviews said that their sisters' situation had motivated them to avoid pregnancy involvement, given them a greater appreciation of the hardships of early parenthood and made their parents more protective of them. More than one-quarter, however, said that it had given them the impression that early parenthood is not difficult and that they wanted a baby, too. "Efforts that encourage family involvement and discussion," the researchers observe, "may be a worthwhile prevention approach."

•Love, it turns out, may have lots to do with it, A. Michelle Corbett and coauthors learned through in-depth interviews with 25 couples at high risk of HIV (see article). Condom use was rare in this sample, often because the need for love, security and acceptance trumped recognized risks. The authors argue that research questions and the interpretations of resulting data betray a "disconnect" between conceptualizations of sex from a public health perspective and from the perspective of "high-risk" individuals. "Greater attention," they urge, "must be paid to developing interventions that…do not contradict people's beliefs about their relationships to the point where they reject those interventions as irrelevant."

•Young people who think that having an STD would be stigmatizing (but not those who would consider it shameful) have reduced odds of undergoing testing, according to findings from a survey of sexually active 15–24-year-olds conducted by Shayna D. Cunningham and colleagues (see article). Among the roughly half of participants who had had an STD test in the year before the study, the most common reason for doing so was that it had been part of a routine medical checkup—not that the youth had had symptoms of infection or concern about exposure. Cunningham and her coauthors encourage providers to deliver STD-related messages to teenagers "in a supportive manner that promotes future positive sexual experiences."

•Despite media reports to the contrary, Marla E. Eisenberg and coinvestigators, using data from a survey conducted in Minnesota, find little evidence that casual sexual relationships are psychologically harmful to young adults (see article). Results were similar whether relationship type was categorized simply as casual versus committed or whether it was more finely tuned. Furthermore, the few differences that emerged in the analysis did not indicate that psychological well-being grew steadily worse with increasingly casual relationships. The researchers caution that their findings, "while reassuring, should not suggest that interventions aimed at promoting safer-sex behaviors are unnecessary." Such initiatives, they stress, remain appropriate for young adults and adolescents.

•Megan L. Kavanaugh and Eleanor Bimla Schwarz take on the challenge of improving the assessment of pregnancy intentions by measuring women's feelings about a possible pregnancy prospectively, using measures that go beyond traditional dichotomous indicators (see article). Their measures—a single question with multiple response options and a series of five questions that tap different dimensions of fertility—yielded generally consistent results in a sample of Pittsburgh women. However, the multi-item measure appeared to capture some aspects of ambivalence toward pregnancy that the single question could not, suggesting to the authors that while the single-item measure is a good screening tool, use of the more detailed one could help providers tailor contraceptive and preconception counseling to women's individual needs.

•In an analysis of data from the National Educational Longitudinal Study, Nicole R. Steward and colleagues find that women who first have sex before age 15 have sharply reduced odds of graduating from high school and from college (see article). Marriage and childbearing explain a portion of these associations, but early academic achievement, behavioral and socioeconomic characteristics, and educational expectations contribute little. Further investigation into the mechanisms underlying the link between early sex and educational attainment clearly is a priority, as the researchers note. Meanwhile, the authors recommend that prevention interventions target youth early and provide "hope for future educational and employment opportunities."

—The Editors