March 2011 Issue of Perspectives on Sexual and Reproductive Health

Under our Early View feature, articles in Perspectives on Sexual and Reproductive Health are published online as they complete the production process, which allows us to get material to you weeks before the printed journal arrives in your mailbox. Sign up at this link to receive an alert when new articles become available

Many of you have already seen this widely circulated article from our March issue: "Abortion Incidence and Services in the United States, 2008" (click here for the news release), by Rachel K. Jones and Kathryn Kooistra of the Guttmacher Institute.

HERE’S WHAT ELSE YOU CAN FIND IN THIS ISSUE OF PERSPECTIVES:

Overweight Teen Females More Likely than Their Normal-Weight Peers to Delay First Sex

Overweight teen females are likely to have their first sexual experience later than normal-weight teens, in part because they encounter social exclusion from peer groups, according to a study by Yen-hsin Alice Cheng, of the Academia Sinica in Taipei, and Nancy S. Landale, of Pennsylvania State University. The findings suggest that overweight teens have fewer opposite-sex friends and romantic relationships than their normal-weight peers, reflecting social alienation, which impacts their age at first sex. The analysis, using data from the National Longitudinal Study of Adolescent Health, showed that 87% of normal-weight adolescents made the transition to first sex by young adulthood, compared with 83% of those who were overweight and 76% of those who were underweight. Although being overweight was associated with delayed onset of sexual experience among white teens, it exhibited no such relationship among blacks, Hispanics and adolescents of other races. The authors suggest that efforts to address childhood obesity consider not just the negative long-term impact on health, but also the impact on teens’ social development and long-term healthy sexual development.

"Adolescent Overweight, Social Relationships and the Transition to First Sex: Gender and Racial Variations" is currently available online and appears in the March 2011 issue of Perspectives on Sexual and Reproductive Health.

Childhood Maltreatment May Be Linked to Increased STD Risk in Young Adulthood

Young women who experienced physical neglect by parents or other adult caregivers during childhood and adolescence are at increased risk of testing positive for an STD in young adulthood, according to a new study by Abigail A. Haydon et al., of the University of North Carolina at Chapel Hill. Furthermore, those who experienced any of four types of maltreatment have an elevated risk of reporting that they recently had an STD. The analysis, based on data from the National Longitudinal Study of Adolescent Health, reveals a positive relationship among young women between maltreatment and both self-reported and test-identified STDs, even after adjustment for socioeconomic and demographic characteristics, but no association among young males once these characteristics are accounted for. Increased sexual risk-taking did not explain the elevated risk of current STD. Given that all types of reported maltreatment are associated with self-reported STD but only physical neglect is associated with test-identified STDs, the authors suggest that exclusive use of self-reported STD data—the measure most frequently used in studies—may overstate the relationship between childhood maltreatment and adult STD risk. They recommend that future research examine the factors underlying the association between childhood maltreatment and STD acquisition in adulthood, to help health professionals and program planners tailor interventions that will effectively promote sexual and reproductive health among maltreated youth.

"Childhood Abuse and Neglect and the Risk of STDs in Early Adulthood" is currently available online and appears in the March 2011 issue of Perspectives on Sexual and Reproductive Health.

Pill Users’ Perceptions of the Method’s Advantages May Influence Whether They Continue to Use It

In a sample of family planning clinic clients, women who were confident in their ability to use the pill and who considered both its advantages and disadvantages important were more likely to continue use for six months than were those who undervalued the method’s advantages and lacked confidence in their ability to use it correctly. Angela R. Dempsey, of the Medical University of South Carolina, et al., analyzed data collected in 2003–2005 from young women who sought oral contraceptives at three publicly subsidized clinics in New York, Dallas and Atlanta. The authors found that women who had little confidence and gave low scores to the advantages of the pill made up the greatest proportion of those who discontinued oral contraceptive use (59%). Women’s perceptions of the pill’s disadvantages were not linked to continuation. The authors suggest that counseling should therefore emphasize the advantages of pill use and explore situations in which women may be tempted to discontinue use—such as relationship changes and breakups—in order to increase their confidence about continuing use even in those situations. They say that their findings are promising, because an individual’s perceptions of the advantages of pill use and self-confidence can be modified with counseling, whereas demographic characteristics (which did not predict pill continuation in this study, although they have done so in earlier work) cannot.

"Predicting Oral Contraceptive Continuation Using the Transtheoretical Model of Health Behavior Change" is currently available online and appears in the March 2011 issue of Perspectives on Sexual and Reproductive Health.

Supportive Parenting May Be Linked to Positive Teen Sexual Development

A new analysis of data collected from nearly 2,000 teens in Scotland in 2007 identifies both general and sex-focused parenting behaviors that are linked to teenagers’ sexual values, attitudes and behaviors, including delayed first sex and condom use and the development of healthy sexual relationships. Alison Parkes et al., of the Medical Research Council in Glasgow, found that parental communication about sex was not associated with any sexual outcomes except delayed intercourse, yet parental values were associated with a wide range of outcomes. For example, the more parents’ values opposed intercourse, the more likely teens were to delay first sex, or to expect it to occur when they were in love or in a relationship rather than just sexually attracted to someone. Additionally, parental monitoring was positively associated with delayed intercourse and condom use. However, the more strongly students agreed that their parents endorsed contraceptive use, the less likely they were to delay intercourse and the more likely they were to expect first sex when they were sexually attracted, rather than when in love or in a relationship. Although the authors acknowledge that this study does not identify direct causal relationships, they consider their findings to be in line with the body of evidence that suggests that the benefits of parenting extend beyond just helping teenagers avoid sexual risk: parents may shape teenagers’ social skills and attitudes toward sexual relationships. The authors recommend that interventions for teens focus on the importance of a supportive parent-teen relationship, beginning at least several years before teens are likely to start sexual activity.

"Is Parenting Associated with Teenagers’ Early Sexual Risk-Taking, Autonomy and Relationship with Sexual Partners?" is currently available online and appears in the March 2011 issue of Perspectives on Sexual and Reproductive Health.

Young Black Men Have Higher Rates of Risky Sexual Behavior and STDs Than Their White Counterparts

Young black men report higher rates of risky sexual behavior and of STDs than their white and Hispanic peers; black men and Hispanics are more likely than whites to maintain a high level of sexual risk and to increase their level of sexual risk over time. Using data from three waves of the National Survey of Adolescent Males, Jacinda K. Dariotis, of the Johns Hopkins Bloomberg School of Public Health, et al. found that black men were more likely than white men to have a history of STDs; the analyses controlled for level of risky sexual behavior and for individual and family background characteristics. Moreover, large disparities persisted between black and white youth even among those with low levels of risky behavior. The authors suggest that racial and ethnic differences in levels of sexual risk behavior may account for some portion of the disparities in STD prevalence and incidence, but that individual behaviors alone do not account for the relatively high STD rates among black men. They recommend that future research examine the romantic and sexual networks of young men to determine if factors such as concurrent sexual partnerships and sexual mixing patterns explain the observed disparities. They also suggest that interventions take into account network factors and address not just individual risk but also the risk of partners.

"Racial and Ethnic Disparities in Sexual Risk Behaviors and STDs During Young Men’s Transition to Adulthood" is currently available online and appears in the March 2011 issue of Perspectives on Sexual and Reproductive Health.

Intimate Partner Violence Among Teens Is Linked to an Increased Likelihood Of Risky Sexual Behavior and Coercion or Deception by a Partner

Teens who reported intimate partner violence in a 2006 survey were more likely than other teens to have engaged in risky sexual behaviors and to report sexual risk stemming from partners’ coercive or deceptive behaviors. A survey of more than 350 females aged 14–20 was conducted by Jay G. Silverman, of Harvard School of Public Health, et al. at four adolescent health centers in the Boston area. Two-fifths of teens surveyed reported intimate partner violence, and those who did had 3–5 times the odds of other teens of having experienced partner infidelity, fear of requesting condom use, negative consequences after requesting condom use and coercion to not use a condom during sex. In light of the findings, the authors suggest a need for health care providers’ assessment of women’s STD risk to include behaviors not under women’s control, particularly for those who have been exposed to partner violence. The authors recommend future studies to better understand how risk factors for STDs differ between teens who have experienced partner violence and those who have not.

"Coercive Forms of Sexual Risk and Associated Violence Perpetrated by Male Partners of Female Adolescents" is currently available online and appears in the March 2011 issue of Perspectives on Sexual and Reproductive Health.

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