IN THIS ISSUE
The transition from adolescence to adulthood is an important time of life; among the “firsts” that many people experience during this period are serious romantic attachments, long-term sexual relationships and marriage. Yet, the specific sexual and reproductive health needs of young adults—among whom STDs are fairly common—are unknown. The study by Christine Elizabeth Kaestle and Carolyn Tucker Halpern in this issue of Perspectives on Sexual and Reproductive Health (see article) explores the sexual behavior of a nationally representative sample of young adults with a long-term partner of the opposite sex and the emotional context of their sexual activity.
Among Kaestle and Halpern’s most striking findings are that most young adults in a long-term relationship engage in a range of sexual activities and that this range is closely linked to whether they love, and feel loved by, their partner. Although the data, which come from the third wave of the National Longitudinal Study of Adolescent Health (Add Health), do not permit analysis of causality, the researchers speculate that “the association between sexual variety and higher levels of love may contribute to building stable, rewarding relationships among young adults.” On the other hand, they point out that young adults in long-term, loving relationships may underestimate the risks associated with some sexual behaviors. Thus, while acknowledging the need for a great deal more research in this area, Kaestle and Halpern emphasize that it is important for health professionals and programs to “balance an appreciation for the potentially positive roles of sexuality in relationships with effective approaches to help individuals express their sexuality safely.”
Also in This Issue
•Trace S. Kershaw and colleagues (see article) demonstrate how classification tree analysis can be used to identify women at risk of acquiring an STD during pregnancy. The classification tree resulting from their analyses showed that individual, dyad, family and community characteristics all were associated with STD risk in a population of urban clinic patients; notably, it captured several risk factors that clinicians do not typically assess when screening women for STDs. The authors suggest that tools based on similar analyses could be used to integrate STD services into prenatal care settings.
•Teenagers’ ability to talk with their first partner about contraception and STDs before having sex is strongly associated with later protective behaviors, so understanding the factors associated with such communication is key to designing pregnancy and STD prevention programs that will help adolescents develop their communication skills. Using two waves of Add Health data, Suzanne Ryan and colleagues find that those factors include teenagers’ perceived level of knowledge about condoms, the number of dating activities the couple have engaged in and the level of parent-teenager communication, even when that communication is not specifically about sexuality-related issues (see article).
•In a study conducted among clients of Title X–supported clinics in two regions of Pennsylvania (see article), Paul G. Whittaker and colleagues found that the odds of emergency contraception use were higher among those attending clinics with a policy of offering the method to all eligible women in advance of need than among those whose clinics’ policy was to provide it only on an emergent basis. Women’s familiarity with the method was among the other characteristics predicting use, which leads the authors to recommend that women receive education about emergency contraception “in all clinic environments and during every clinic visit.”
•Across diverse geographic regions and demographic subgroups, California parents overwhelmingly support school-based comprehensive sex education, according to survey results reported by Norman A. Constantine and coauthors (see article). Even among groups who might be expected to oppose comprehensive sex education—evangelical or born- again Christians, regular churchgoers and self-described conservatives— at least seven in 10 favor it. Parents who prefer an abstinence-only approach most often cite moral or religious reasons for their preference, while those who would rather see comprehensive sex education in the schools have more pragmatic reasons.
•When a needs assessment determined that the family planning materials available through a California county’s health department were inappropriate for its clientele—most of whom are Spanish-speaking and have less than a high school education—the agency developed a project aimed at creating a new set of family planning brochures. In a special report (see article, Colleen Denny-Garamendi and coauthors describe the development and assessment of the new materials, and reflect on the lessons learned—which likely will be instructive to other agencies designing educational materials for targeted populations.