Under our new Early View feature articles in Perspectives on Sexual and Reproductive Health are now 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.
Thanks to Early View, many of you have already seen the first article in our September issue: "Obstacles to the Integration of Abortion into Obstetrics and Gynecology Practice," (click here for the news release), by Lori Freedman et al., of the University of California, San Francisco.
HERE’S WHAT ELSE YOU CAN FIND IN THIS ISSUE OF PERSPECTIVES:
Working at Least Part-Time Is Negatively Linked To Teen Fathers’ High School Completion
For teen fathers (but not for teen mothers), having primary caregiving responsibilities is associated with increased odds of graduating from high school, while working at least half-time for pay is linked to reduced odds of finishing high school, according to "Exploring Variation in Teenage Mothers’ and Fathers’ Educational Attainment," by Stefanie Mollborn of the University of Colorado. The author analyzed data from 317 teenage mothers and fathers who participated in the 1988–2000 National Education Longitudinal Study, to explore the question of why some teenage parents finish high school and others do not. This issue is of particular importance given the body of evidence suggesting that curtailed education is an important explanation for the relationship between teenage parenthood and compromised socioeconomic outcomes later in life. Many programs aimed at keeping teen parents in school target primarily mothers. However, the study found that the likelihood of graduating did not differ between teen mothers and fathers, and the author concludes that teen fathers might benefit equally from interventions.
Improvements in Parent-Teen Communication About Contraception Are Needed to Counter High Pregnancy Rates Among Young Blacks
Good parent-teen communication about contraception can encourage young people’s consistent, effective use of birth control, which may be particularly important in black families, given black teens’ relatively early initiation of sex, low rates of contraceptive use and high pregnancy rates. In "Family Discussions About Contraception and Family Planning: A Qualitative Exploration of Black Parent and Adolescent Perspectives," Aletha Y. Akers, of the University of Pittsburgh, et al. explore a range of issues on this topic, using data collected in focus groups with 53 black families in Pennsylvania in 2007 and 2008. In separate focus groups for parents and teens, participants said that birth control is one of the most important sexual health topics for families to discuss, but many reported that they had not explicitly discussed contraception. Additionally, knowledge about available contraceptives, their risks and their side effects was generally lacking. Parents’ approaches to issues of contraception with their teens reinforced societal biases that sanction sexual activity among teen males while dictating chastity for females. Many parent-teen discussions emphasized planning for the future—including the importance of educational goals and becoming self-sufficient through gainful employment—rather than focusing on contraceptive use. And despite universal disapproval of teen pregnancy, negative attitudes toward abortion were prevalent. The authors suggest that parents need interventions that will improve their contraceptive knowledge, help them to understand the harmful effects of gender bias in information dissemination and provide them with communication skills tailored to enhance the role they play in their teens’ sexual development.
Change in Arkansas Law from Parental Notification to Consent Did Not Affect Incidence or Timing of Minors’ Abortions
Converting a statute requiring parental notification for minors’ abortions to one requiring consent and including a judicial bypass option is unlikely to contribute to a decline in abortion rates among minors, according to "Parental Consent for Abortion and the Judicial Bypass Option in Arkansas: Effects and Correlates," by Ted Joyce of Baruch College. Using Arkansas Department of Health data on abortions obtained by 15–19-year-olds between 2001 and 2007, Joyce evaluated the influence of a 2005 change in the Arkansas parental involvement law on minors’ abortion rates and timing of abortions by comparing them with those of older teens. Contrary to expectations, Joyce found no association between the change in the law and the rate of abortions among minors, suggesting that the consent statute is not associated with a differential change in the incidence or timing of abortions among minors. The author concludes that it is the imposition of a parental involvement requirement in itself, not whether the requirement calls for notification or consent, which may alter minors’ outcomes. Abortions obtained earlier in pregnancy are safer than those obtained at later gestations. Given that 34 states now have parental involvement laws that include a judicial bypass option, Joyce recommends bypass procedures that are clear, expedient and confidential to ensure that teens are able to obtain abortions in a timely manner.
Intersections Between Relationship Status and Race and Ethnicity Are Important to Women’s Childbearing Intentions
Racial and ethnic differences in childbearing intentions are frequently contingent on the relationship context in which they occur, according to "Unintended Births: Patterns by Race and Ethnicity and Relationship Type," by Lina Guzman, of Child Trends, et al. The authors analyzed data from the Early Childhood Longitudinal Study to examine childbearing intentions as reported by 9,100 mothers of children born in 2001. The analysis found that childbearing intentions vary by relationship type within racial and ethnic groups. For example, black women are more likely than whites to have an unintended birth, but the difference is evident only among those who are married. In contrast, the likelihood of having an unintended birth does not differ between foreign- or native-born Hispanics and whites; however, among married women, both groups of Hispanics are more likely than whites to have an unintended birth. Among cohabiting women, foreign-born Hispanics are less likely than whites to experience an unintended pregnancy. The authors suggest a need to improve access to family planning to help prevent unwanted and mistimed births, and stress that interventions should be "tailored to a woman’s relationship type" and recognize how relationship status may affect her childbearing intentions.
Interventions Needed to Address Sexual Activity Among Middle School–Age Adolescents
In "Sexual Intercourse and Oral Sex Among Public Middle School Students: Prevalence and Correlates," Christine J. De Rosa, of Health Research Association, et al. analyze data from a 2005 survey of sixth, seventh and eighth graders at 14 urban schools in Southern California. The authors report that 9% of surveyed youth had ever had sexual intercourse, and 8% had had oral sex. Among those who reported intercourse, 69% had used a condom at last intercourse, and 43% had had multiple partners. Because some middle school students are having sexual intercourse and oral sex, the authors suggest that preventive interventions need to begin before middle school. They suggest that interventions addressing relationship skills begin prior to sixth grade, and that middle school programs address the entire range of adolescent sexual activity and make it a priority to reduce the number of partners among young sexually experienced adolescents.
Pregnancy Intention Is an Important Risk Factor for Latina Teen Pregnancy
Latina teens surveyed in 2001–2004 who expressed any degree of wanting to become pregnant in the next six months were more likely to do so than were teens who definitely did not want a pregnancy, according to "Pregnancy Intentions and Teenage Pregnancy Among Latinas: A Mediation Analysis," by Corinne H. Rocca of the University of California, San Francisco, et al. The authors examined data from 213 Latina teens participating in the Mission Teen Health Project to determine whether pregnancy intentions mediated associations between risk factors and pregnancy. They found that pregnancy intentions were important not as mediators, but rather as independent risk factors for pregnancy. The survey results showed that wanting to become pregnant was strongly associated with actually becoming pregnant, and that teens who reported having a main partner or who had low sexual relationship power with a main partner had an increased likelihood of becoming pregnant. However, the degree to which teenagers thought a pregnancy would make them happy, another measure of intention, was not associated with becoming pregnant. Rocca and colleagues estimate that an intervention that could eliminate teens’ intentions to become pregnant, even without modifying other risk factors, could yield a 16% reduction in pregnancy rates. However, they do not suggest that it is desirable or feasible to remove pregnancy wantedness. They do suggest a need for increased focus in research and programs on factors that hinder effective contraceptive use among teens who want to avoid pregnancy.
In Assessing Teen Women’s Sexual Risk, Educational Context May Be More Important Than Age Differences Between Partners
Teenage women with male partners three or more years their senior are more likely to engage in sexual intercourse than are those with partners closer to their age. However, that difference is not significant after young women pass the age of 16, and it does not hold once the partner’s educational status is introduced into the analysis, according to "Partner Age Differences, Educational Contexts and Adolescent Female Sexual Activity," by Sarah Koon-Magnin et al., of Pennsylvania State University. The authors used data from the National Longitudinal Study of Adolescent Health to examine the social contexts of teen relationships and sexual behavior. They found that young women who date someone who is out of school are at higher risk of sexual intercourse than female teens dating men who attend the same middle or high school, regardless of the males’ ages. When a partner’s school context is taken into account, having an older partner is no longer associated with an increased risk of sexual intercourse. The authors recommend that when defining sexual risk in laws designed to protect young women, policymakers shift their focus from age differences between teen women and their male partners to the social contexts in which sexual relationships occur.
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