When civil unrest broke out in Somalia in the 1990s, large numbers of Somalis immigrated to Western countries. It is unknown whether they maintain their cultural norms of low contraceptive use and high fertility after living in settings with different reproductive norms. To explore this issue, Carie Muntifering Cox and colleagues conducted interviews with Somalia‐born married men and women living in the Minneapolis metropolitan area (page 63). Some individuals, especially those with multiple children, said living in the United States had led to a reduction in their fertility desires, largely because of the struggle and cost of raising children. In discussing child spacing, nearly all emphasized the importance of information sharing, compromise and joint decision making with their spouse. Most husbands believed their wives had priority in making child‐spacing decisions, particularly men who had arrived in the United States before turning 20. The authors conclude that “understanding how Somalis may alter their views on these topics in their new countries is an important step in creating culturally specific and relevant programs and services.”
Also in This Issue
• In the first of this issue's two systematic reviews, Sara Vargas and colleagues examined the qualitative literature to identify barriers to and facilitators of the use of contraceptive vaginal rings (page 71). They assessed more than two dozen articles that presented findings from focus groups, interviews or other sources. Most women who had not used the ring were unfamiliar with it, and had concerns related to insertion and removal, cleanliness and discomfort with touching their vagina. However, women who had used the method said these concerns abated after a month or two. Other themes included ring‐related properties and characteristics, and considerations related to sexual partners and health care providers. The researchers believe these findings could aid in the design and promotion of rings—including the multipurpose devices currently under development to prevent both pregnancy and STDs—and could help yield products “that will fit into the real lives of the women who need them.”
• Many U.S. teenagers experience first sexual intercourse during high school, so understanding whether sexual behavior and academic performance are related is important. Research on sexual debut and grades, however, has produced inconsistent findings. To address this issue, Tanya Rouleau Whitworth and Anthony Paik analyzed data from the 1997–2000 waves of the National Longitudinal Survey of Youth (page 81). Overall, they found no relationship between sexual debut and grade point average (GPA), but did see differences for some groups. The predicted GPAs for black females aged 14 or 15 who reported first intercourse in a romantic relationship were significantly lower than those for their counterparts who had not had intercourse, whereas at 18 this relationship was reversed. Among 14–15‐year‐old Latinos, the GPAs of those who had had sex were lower than those who had not. the authors suggest “the need for a more contextual approach to the study of adolescent sexuality that accounts for age, race, ethnicity, gender and relationship context.”
• Although interventions that focus on adolescents’ knowledge, attitudes and behaviors can have positive effects on their sexual health, programs that address broader school‐related factors, such as academic climate, may also be beneficial. Amy Peterson and colleagues conducted a systematic review and meta‐analysis of randomized trials and quasi‐experimental studies to examine the impact on sexual health of interventions that address school environment (e.g., culture and safety) or student educational assets (e.g., academic goal setting; page 91). They identified 11 evaluations of a wide range of sexual health outcomes, though meta‐analysis was possible for only one: Pooled data from three trials indicated that school‐environment interventions may delay sexual debut. Findings for other outcomes were mixed, but suggest that addressing student‐level educational assets may reduce the risk of pregnancy and STDs. Future research, the authors recommend, should not only assess the extent to which school‐related factors are effective, but also “provide better understanding of the mechanisms by which they may work to improve adolescent sexual health.”
• One in seven men in the United States has experienced severe intimate partner violence, yet most research linking violence to condom use has examined female reports of male‐initiated violence. Moreover, recent research suggests that, in addition to the perpetrator's gender, the severity and frequency of violence should also be explored. Jennifer Manlove and colleagues included these variables in a latent class analysis to identify intimate partner violence classes among the dating relationships of 18–25‐year‐old men and women; they then assessed the associations between violence classes and condom use (page 109). Examination of data from Wave 3 (2001–2002) of the National Longitudinal Study of Adolescent to Adult Health revealed that although male‐perpetrated violence was reported less frequently than female‐perpetrated violence, it was more severe. The findings confirm that relationship violence is linked to reduced condom use, particularly in relationships with a higher frequency of violence or a higher rate of injury, regardless of the perpetrator's gender.