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PubMed1990

The determinants of sexuality among adolescent school girls in Kenya.

One thousand seven hundred and fifty one Secondary school girls aged 12 to 19 years were interviewed by means of a self-administered questionnaire. 416 (23.8%), of them reported to have been sexually experienced at the time of the study. 4.1% of the sexually experienced girls had started sex below the age of 10 years, some of whom had been raped. The low and middle class private schools in the city centre had higher incidence of sexually experienced girls. The same was observed in those girls staying away from their parents. Majority of the sexually experienced girls had started coitus within one to two years of attaining menarche or having a boyfriend. Some of these girls may have been forced to indulge in sex by the men/boys or circumstances. Lack of factual knowledge, parental guidance and lust for material gains are some of the factors the girls felt may be responsible for the upsurge in adolescent sexual behaviour. The role played by these factors in adolescent sexuality is discussed, and possible remedial measures are suggested.

Adolescent↗
PubMedDate not supplied

Teenage pregnancy in the United States.

One out of every 10 women aged 15-19 becomes pregnant each year in the United States. Of these pregnancies, five out of every six are unintended--92 percent of those conceived premaritally, and half of those conceived in marriage. The teenage pregnancy rate is high because only a minority (one in three) of sexually active young women always use contraceptives, and only one in two of these women rely on the most effective methods. The two most common reasons given by adolescents for not using contraceptives are believing that the risk of pregnancy is small, and failing to anticipate intercourse. Experience in other developed countries clearly shows that the incidence of adolescent pregnancy can be reduced if effective contraceptives are made widely available. Although high quality sex education programs that include information about contraception, reproductive biology and responsible sexual behavior can enhance the effectiveness of contraceptive delivery systems, they are not a substitute for the actual provision of services and supplies. However, there is formidable political opposition to the provision of such services by a vocal minority who believe that the crux of the problem is premarital sexual activity, and that lowering the cost of such behavior by reducing the risk of pregnancy will both legitimize adolescent sex and increase its prevalence. Consequently, there is a political impasse that guarantees a continuing large number of adolescent pregnancies. Further, even if contraceptives and sex education were readily available to all adolescents, there would still be a pool of teenagers who would see little benefit in postponing parenthood. This pool would be composed overwhelmingly of the poor and of blacks and Hispanics. Increasing the demand for pregnancy prevention among young women and men in this hard-core, high-risk group will be extremely hard to achieve without a fundamental restructuring of society.

Adolescent↗
PubMed1988

Parents' behavioral norms as predictors of adolescent sexual activity and contraceptive use.

The influence of parental factors on adolescent sexual behavior and contraceptive use has been examined previously, and findings have been contradictory. Previous studies, which found little relationship between parental norms and adolescent sexual activity, have been limited by their failure to recognize developmental differences in the relative weight of parent and peer influences between younger and older teens and by use of selected samples, resulting in a restriction of range. The current study differs in that it utilizes a clustered sample household survey of 329 males and females, aged 14 to 17, and 470 of their parents. Using multiple regression analysis, it was found that parents' reported behavioral norms account for 5% of the variance in whether adolescents have had intercourse, and for 33% of the variance in use of contraception at last intercourse. The study suggests that while parents' normative beliefs have limited effect in the decision to become sexually active, they have considerable impact on later contraceptive use.

Adolescent↗
PubMed1995

The relational determinants of condom use with commercial sex partners in Thailand.

OBJECTIVE: To analyze the extent and determinants of condom use with commercial sex partners among lower socioeconomic status groups in the Thai population. DESIGN: Respondents were sampled in Udon Thani, Saraburi and Bangkok in 1992. Completed sample size was 678 women in brothels, 330 male truck drivers and 1,075 men aged 17-45 years. Behavioral data and local sexual network information were collected using structured questionnaires (face-to-face interviews), focus groups and in-depth unstructured interviews. METHODS: Data were analyzed using univariate and multivariate logistic regression. RESULTS: Condom use with commercial partners remains inconsistent. Consistent use was reported by 61% of women in brothels, 25% of truck drivers, and 29% of men in the low-income population. The single strongest predictor of consistent condom use for all groups is type of partnership. Consistent use drops significantly with regular (multivisit) commercial sex partners compared with casual (single visit) commercial partners; adjusted odds of consistent use are 0.22 for women and 0.25 for men. Brothel women report that one in five of their commercial partners is a 'regular', and 20% of the young men who report a commercial partner report a 'regular'. DISCUSSION: The strongest determinant of consistent condom use is the nature of the relational bond between the partners, rather than their individual characteristics, knowledge or attitudes. To raise condom use further, programs will have to move beyond the standard knowledge-attitudes-practices paradigm focus on individual attributes to address the contextual determinants of behavior.

Adolescent↗
PubMed1994

HIV-infected women and sexual risk reduction: the relevance of existing models of behavior change.

This article utilizes constructs of the AIDS Risk Reduction Model (ARRM) to examine condom use in a sample of 215 HIV-infected women in New Jersey. We find evidence that processes affecting condom use in HIV-infected individuals are similar to those found in HIV-negative individuals. Results suggest that partner-related factors are important to consistent condom use in HIV-infected women. Women are more likely to use condoms consistently if they have high perceived power to influence their partner's condom use, have partners who are HIV seronegative, and have partners who do not want more children. Conflicts with the partner decrease the probability of consistent condom use. Also negatively associated with condom use are the woman's use of drugs and/or alcohol and her belief that condoms reduce sexual enjoyment. Implications of these findings for designing interventions for HIV-infected women are considered.

Adult↗
PubMed1994

Prevalence and correlates of AIDS-related behavioral intentions among urban minority high school students.

Using data from a cross-sectional survey of 926 predominantly black and Hispanic ninth through twelfth graders in three New York City public high schools, the explanatory power of theoretically and empirically derived predictors (i.e., demographic, contextual, and cognitive) of intentions to engage in sexual intercourse, to be sexually monogamous, to use condoms during intercourse, and to ascertain intercourse partners' sexual and drug-use histories was compared. One-third of sampled students "definitely" intended to have sexual intercourse in the next year, one-half "definitely" intended to be sexually monogamous, two-thirds "definitely" intended to use condoms during intercourse, and three-quarters "definitely" intended to ascertain intercourse partners' sexual and drug-use histories. In a predictive model including all investigated variables, those variables derived from the cognitive set (i.e., beliefs about susceptibility to getting AIDS, and beliefs about barriers, self-efficacy, norms, and values pertaining to AIDS-preventive actions) were most strongly associated with the four investigated behavioral intentions. However, certain variables derived from the demographic set (i.e., age, gender, race/ethnicity) and contextual set (i.e., previous behavioral involvement, cues, academic failure, substance use) also contributed explained variance to all four intentions.

Acquired Immunodeficiency Syndrome↗
PubMed1993

Condom knowledge, attitudes and use among patients attending the public STD clinic in Singapore.

Three hundred patients (255 males and 45 females) attending the public STD clinic in Singapore were interviewed regarding their frequency of condom use, attitudes towards condoms, problems related to condom use and places of purchase of the condoms. Among respondents with regular partners, 55.2% of males and 48.8% of females never used condoms, only 12.4% of males and 16.3% of females used condoms consistently. Among respondents with non-regular partners, only 2.2% of males used condoms consistently. The commonest reasons why male respondents did not use condoms consistently were that condoms decreased sensation, condoms made sex mechanical, the use of other forms of contraception, no condoms were available, and the perception that there was no risk of contracting STD/AIDS. Condoms were most commonly obtained from sex partners, supermarkets, roadside sundry shops and the Maternal & Child Health Clinics (MCHCs). About 8% of both males and females had experienced some problems with condoms before. Greater efforts to promote the practice of protected intercourse among the STD patient population as well as in the general population are required in order to control the spread of STD and AIDS in Singapore.

Adult↗
PubMedDate not supplied

Parent and peer communication effects on AIDS-related behavior among U.S. high school students.

Data from a 1989 national probability sample of 8,098 high school students in the United States indicate that young people's discussions about the human immunodeficiency virus (HIV) with parents and with peers are highly correlated and have opposite effects on behavior. Students who discussed HIV with their parents were less likely than those who did not to have had multiple sex partners, to have had unprotected sexual intercourse and to have ever injected drugs; on the other hand, students who discussed HIV with their peers were more likely than those who did not to have had multiple partners and to have had unprotected sexual intercourse. Subgroup analyses show that young women were influenced more by HIV discussions with parents, while young men were influenced more by discussions with peers; some communication effects differed by race and ethnicity. Students who received HIV instruction in school were more likely to have talked about HIV with both parents and peers.

Adolescent↗
PubMed1995

Condom awareness and use in the Arusha and Kilimanjaro regions, Tanzania: a population-based study.

A cross-sectional study of condom awareness, perceived availability, and use was conducted using a questionnaire in the Arusha and Kilimanjaro regions in northern Tanzania. The questionnaire was administered to a random sample (n = 1,081) of males and females (15-54 years of age) from four localities in the Arusha, Babati, Moshi, and Same districts. Of the 1,081 respondents, 69.9% knew what condoms are and, of these, 31.7% reported having ever used a condom, while 20.7% stated that they used condoms regularly. Furthermore, of the 756 respondents who knew what condoms are, 62.2% stated that condoms were available in their localities and, of these, 44.1% reported having used condoms regularly. The results suggested that, while the majority of the respondents knew about condoms and stated that condoms were available in their localities, reported regular condom use was low. Age, gender, marital status, occupation, and place of residence appeared to be significant determinants of condom awareness and use, while educational status was not. Although barmaids and professional drivers have been shown to practice high-risk sexual behavior, reported condom use among them was low.

Adolescent↗
PubMedDate not supplied

A cross-sectional study on factors including HIV testing and counselling determining unsafe injecting practices among injecting drug users of Manipur.

In India, a steep increase in the prevalence of HIV (0% to 50% within six months) among the IDUs has been reported in Manipur, a north eastern state in 1990. In spite of large scale intervention program like educational campaign and widespread voluntary HIV testing in this state, the infection has quickly spread to the heterosexual population at large. The determinants of risk taking behaviors like sharing of unclean needle among the IDU population has been explored in this paper. A cross sectional study has been carried out among all of the 488 IDUs who attended any detoxification centers and prison during last two years at Imphal, the capital city of this state. Self reported behaviors based on the pre-scheduled interview were recorded and participation rate was satisfactory. The data was compared to a similar survey carried out by us in 1990. Although there has been decline in risk behavior among the IDUs, a logistic regression analysis reveals that unsafe needle sharing behavior is not influenced by the knowledge on HIV transmission, educational status or history of HIV testing or serostatus of the individual. The limitation of cross sectional nature of the study, bias due to collection of data in prison, self reported behavior, possible differences with street samples of the addict are discussed.

AIDS Serodiagnosis↗
PubMed1996

Understanding why heterosexual adults do not practice safer sex: a comparison of two samples.

We assessed why heterosexually active adults did not have "safer sex" with their last sexual partner. Subjects enrolled in HIV education and testing trials at a sexually transmitted disease (STD) clinic and a university student health service (SHS) completed questionnaires about their last sexual partner's risk factors for HIV and whether they had safer sex with this partner. Of the 652 sexually active subjects, 61% reported not having safer sex with their last sexual partner and explained why. Low perceived risk of HIV infection was the most common reason, indicated by 62%, though most knew too little about their partner to ensure the encounter was low risk. Other reasons included condom unavailability (20%), the subject "didn't want to" use a condom (19%), "couldn't stop ourselves" (15%), the partner's influence (14%), and alcohol or drug use (11%). Thirty-one percent of subjects indicated more than one reason for not having safer sex. SHS subjects more often reported that the encounter was low risk for HIV transmission (p = 0.0001), while STD subjects more often reported condom unavailability (p = 0.002) and drug and alcohol use (p = 0.003). We conclude that there are many different factors promoting sexual behavior at risk of infection, combinations of which are important, and that these factors differ between samples. Preventive interventions must focus on the factors most important to the targeted population and may need to consider multiple factors simultaneously.

Acquired Immunodeficiency Syndrome↗
PubMed1996

HIV-related concerns and behaviors among Hispanic women.

Hispanic women whose sexual partners have other sexual partners may be at risk for HIV. A structured interview was administered to 106 Dominican and Puerto Rican women who reported that they knew or suspected that their partner had other partners. A subsample participated in qualitative interviews. The study assessed concern about HIV and predictors of condom use. The majority of women reported that they worried about getting HIV and almost half had been HIV-tested. Most of the women discussed HIV/AIDS concerns with their partners, and one-third reported some condom use. Predictors of condom use were: born in the Dominican Republic/Puerto Rico, having talked with their partner about being tested, and belief that he used condoms with others. Although the women were concerned about HIV, condom use was infrequent. Results suggested methods to address this discrepancy: introducing condoms early in the relationship, developing women-controlled methods, and directly influencing men's behavior.

Adult↗
PubMed1996

AIDS-relevant condom use by gay and bisexual men: the role of person variables and the interpersonal situation.

This study examined the relative ability of selected person variables (interpersonal self-efficacy, self-control, attitudes about the effect of condoms on sex, normative beliefs) and interpersonal-situational variables (partner preference, partner serostatus) to explain gay and bisexual males' (N = 267) condom use during insertive and receptive intercourse. Partner preference accounted for a large amount of variance in condom use by itself and when controlling for the effects of the remaining variables. Exploratory hierarchical regression analyses suggested that the receptive partner's preference influenced condom use decisions to a greater extent than did the insertive partner's. Partner serostatus alone explained little variance in condom use. However, partners serostatus interacted with subject serostatus such that dyads with concordance serostatus (i.e., both partners HIV positive or both HIV negative) used condoms the least, and dyads with discordant serostatus used condoms the most. Results suggest that the interpersonal situation plays an important role in condom use decisions.

Acquired Immunodeficiency Syndrome↗
PubMed1995

Factors related to condom use with casual partners among urban African-American and Hispanic males.

Constructs from the Health Belief Model and the Theory of Reasoned Action were tested for their relationship to condom use with casual partners in a probability sample of urban African-American and Hispanic males aged 15-24. The results indicate the importance of 1) promoting a sense of male responsibility regarding condom use; 2) promoting the belief that condoms should be used with all partners; 3) developing skills for condom use and partner communication; and 4) increasing perceived susceptibility to HIV infection in design of intervention programs.

Adolescent↗
PubMed1996

Non-condom use among female nurses in Zambia.

OBJECTIVES: To estimate non-condom user rate and to characterize non-condom users among female nurses. DESIGN: Cross sectional. SETTING: Health institutions. SUBJECTS: Data from 640 (86.5pc) out of 740 consenting female nurses were available for analyses. MAIN OUTCOME MEASURE: Non-condom user rate. RESULTS: Non-condom user rate (per 100) among the female nurses was 73.1pc (95pc CI69.7 to 76.5). Non-condom users tended to be aged above 30 years (OR 1.57; 95pc CI 1.02 to 2.40), midwives (OR 1.56; 95pc CI 1.03 to 2.37), married (OR 2.70; 95pc CI 1.73 to 4.21), not to think that spouse/partner has had sex with other partners (OR 1.72; 95pc CI 1.11 to 2.68) and to have had a sexually transmitted disease (OR 2.61; 95pc CI 1.25 to 5.43). CONCLUSION: There was a surprising high level of non-condom users among female nurses, probably due to the inability for females to initiate or negotiate condom use.

Adult↗
PubMedDate not supplied

Sexual activity and contraceptive use among children entering out-of-home care.

This study explored the prevalence of reported sexual activity of a cohort of children entering out-of-home care and the ability of selected factors to explain reported sexual activity and use or nonuse of contraceptives. It found that children as young as age 8 reported sexual activity, and that more than one-third of the children age 8 to 18 reported being sexually active. Of those who were sexually active, more than one-third were not using contraceptives. Using logistic regression, five variables are identified as having importance in explaining sexual activity. Two variables had some limited ability to explain contraceptive use. Implications of these findings are discussed and suggestions for policy and practice are made.

Adolescent↗
PubMedDate not supplied

Sexual initiation with older male partners and subsequent HIV risk behavior among female adolescents.

Data from a 1993-1994 survey of 150 black and Hispanic teenagers were used to examine differences in HIV risk-related behavior between young women who have a first sexual partner three or more years older than themselves and those whose first partner is their age. Compared with teenagers whose first partner had been roughly their age, the 35% of adolescents with an older partner had been younger at first intercourse (13.8 years vs. 14.6) and less likely to use a condom at first intercourse (63% vs. 82%). They also were less likely to report having used a condom at last intercourse (29% vs. 44%) or having used condoms consistently over their lifetime (37% vs. 56%) or in the previous six months (44% vs. 66%). Some 38% of teenagers with an older first partner had ever been pregnant, compared with 12% of those with a peer-age first partner. The mean number of partners and history of sexually transmitted diseases did not differ between the two groups.

Adolescent↗