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PubMed2003

Older partners and STD prevalence among pregnant African American teens.

BACKGROUND: Several recent studies have addressed the question of whether adolescent females who have sex with older partners have a greater risk of sexually transmitted disease (STD) acquisition. GOAL: The goal was to identify differences in STD prevalence and selected measures of behavioral risk between unmarried pregnant African American adolescent females reporting sex with older partners and those reporting sex with similar-age partners. STUDY DESIGN: Adolescents (n = 169) were recruited during their first prenatal visit. Adolescents completed a self-administered survey and a face-to-face interview and provided urine specimens for nucleic acid amplification assays. RESULTS: Approximately 65% of adolescents reported that their male sex partners were >/=2 years older, while 35% reported having similar-age male sex partners. In age-adjusted analyses, adolescents with older partners were four times more likely to test positive for chlamydia (P < 0.04) and were more than twice as likely to report that their partner was also having sex with other women (P < 0.04). With use of a 30-day recall period, the mean number of unprotected vaginal sexual encounters among adolescents with older partners was 4.1, as compared to a mean of 6.9 among those reporting similar-age partners; this difference approached significance (P = 0.051). Prevalence of trichomoniasis as well as scale measures of adolescents' self-efficacy for condom negotiation and frequency of sexual communication with partners did not differ between those adolescents with older or similar-age male sex partners. CONCLUSION: In resource-constrained clinical settings, one implication of these findings is that pregnant adolescents reporting older partners may be a priority for targeted delivery of partner services. More frequent screening for chlamydia may also be cost-effective for pregnant adolescents with older partners.

Adolescent↗
PubMed1999

Demographic and attitudinal variables related to high-risk behaviors in Asian males who have sex with other men.

Although AIDS is spreading rapidly in minority communities, little is known about attitudes, knowledge, and behavior related to AIDS and HIV in the Asian community. The purpose of this study was to examine these variables in a sample of gay Asian males, as well as to investigate the relationship between knowledge, sources of information, culturally influenced attitudes and high-risk behaviors in this population. Results from a sample of 60 young Asian men who self-identified as "having sex with other men" indicated they were generally knowledgeable about methods of transmission and prevention, and appeared linked to a large information network that included informal sources such as peers and formal sources. However, significant percentages held culturally biased views of AIDS, such as believing race of partner or one's own gender role in the sexual encounter determined level of risk; and one third of the sample did not use condoms regularly. Having been tested for HIV was associated with holding less traditional cultural beliefs and a higher sexual activity level. Open communication about safer sexual practices was associated with monogamous as opposed to multiple relationships and with decreased tendency to engage in alcohol-related unprotected sex. Variance in overall risk was predicted by demographic variables such as education, age, and level of sexual activity, rather than by the attitudinal factors measured. Limitations of this exploratory study include a time-limited subject recruitment period and consequent small sample size, a homogeneous sample weighted toward young, well-educated, and middle-class respondents, and the exclusion of non-English speaking individuals. Nevertheless, study findings suggest that educational outreach targeting Asians who have sex with other men needs to address inaccurate cultural beliefs about HIV/AIDS, emphasize consistent condom use, and encourage models of open communication with partners about safer sexual practices.

Adolescent↗
PubMed1995

Demographic and sociocultural factors influencing contraceptive use in Uganda.

Bivariate and multivariate analyses of the influence of demographic and sociocultural factors on contraceptive knowledge, attitudes and practice among currently married respondents in Uganda show that: (1) contraceptive knowledge is widespread, even among women with no education; (ii) the majority of the respondents have favourable attitudes towards contraceptive use; (iii) the level of contraceptive use is low in comparison with knowledge and attitudes. Post-primary education, ethnicity, residence, the presence of the spouse in the household and discussion of family planning with spouse were strong predictors of knowledge and favourable attitudes towards contraception. Secondary or higher education, discussion of family planning with spouse and urban residence strongly influenced contraceptive use, but child mortality did not. The use of condoms as a behavioural change to avoid contracting HIV/AIDS was low. The results suggest that, particularly in rural areas, family planning services are not meeting the needs of potential clients.

Acquired Immunodeficiency Syndrome↗
PubMed2003

Contrasts in patients' and providers' explanations of rheumatoid arthritis.

PURPOSE: To investigate explanations of rheumatoid arthritis (RA) from young women's perceptions of the illness experience and providers' understanding of the disease. DESIGN AND METHODS: This ethnographic study included 17 women from age 26 to 40 years who were under medical care for RA, and five health care providers of these participants. FINDINGS: Two main themes were identified: (a) having RA "is a pain" and (b) it changed me. The first theme represented the participants' physical and emotional suffering, interferences in their everyday lives, and aggravations in receiving health care. The second theme represented the life and lifestyle changes the women experienced as a result of having RA. The providers' explanations included two themes: (a) functioning in a normal manner and (b) controlling the disease. The first theme was keeping the women's physical functioning as normal as possible. The second theme was the providers' goal to control the disease, which they believed would lead to the preservation of joint function and manageable pain levels. Regarding results of health care, the participants and providers had comparable beliefs about decreasing the physical pain and improving joint function but they had disparate notions about the participants' being active partners in communication and negotiation processes of their health care. CONCLUSIONS: The findings indicated the importance of discovering potential disparities in patients' and providers' explanations of RA, and revealed the participants' desire for clinical support in becoming partners in their own health care.

Activities of Daily Living↗
PubMed1985

Factors associated with married women's selection of tubal sterilization and vasectomy.

Multivariate analyses of data from 248 married women scheduled for tubal sterilization and 165 wives of men scheduled for vasectomy indicated that male and female sterilization methods were selected for different reasons and under different circumstances. More specifically, the woman who underwent tubal sterilization was more likely to have perceived that she had greater influence than her husband over the sterilization decision, to have had cesarean section or vaginal delivery in association with sterilization, to have chosen tubal ligation because her spouse refused to undergo the alternative procedure or because it was convenient to combine it with delivery or other surgery, and to have had a spouse who was unwilling to be sterilized because of possible side effects associated with vasectomy. The woman whose husband underwent vasectomy was more likely to have been very fearful of surgery in general or especially fearful of reproductive surgery, to have known many men who already had had a vasectomy, to have perceived that her husband was more strongly motivated than herself to terminate childbearing, to have had a spouse who participated in birth control, and to have chosen vasectomy because it was easier or less expensive or because her physician advised against tubal sterilization.

Adult↗
PubMed2004

Relational factors in understanding satisfaction in the lasting relationships of same sex and heterosexual couples.

Satisfying relationships are important to the well-being of individuals and families. Because of increased longevity, many couples are staying together for extended periods of time. Thus, it is valuable to understand the factors that contribute to a sense of satisfaction among partners in lasting relationships. Relatively little attention has been paid in the research literature to relationships among older couples who have remained together for many years. Even less attention has been paid to the lasting relationships of couples of color and to gay male and lesbian couples. This paper focuses on understanding the factors that contribute to satisfaction of partners in the long-term relationships of a purposive sample of heterosexual and same-sex couples. Data was collected through in-depth interviews with 216 partners in 108 relationships that had lasted an average of 30 years. Using logistic regression analysis, two factors were identified as predictive of satisfaction during the recent years of these relationships: containment of relational conflict and psychologically intimate communication between partners. Based on these findings, a theoretical model for understanding satisfaction in lasting relationships is discussed.

Communication↗
PubMed2006

Interspecific communicative and coordinated hunting between groupers and giant moray eels in the Red Sea.

Intraspecific group hunting has received considerable attention because of the close links between cooperative behaviour and its cognitive demands. Accordingly, comparisons between species have focused on behaviours that can potentially distinguish between the different levels of cognitive complexity involved, such as "intentional" communication between partners in order to initiate a joint hunt, the adoption of different roles during a joint hunt (whether consistently or alternately), and the level of food sharing following a successful hunt. Here we report field observations from the Red Sea on the highly coordinated and communicative interspecific hunting between the grouper, Plectropomus pessuliferus, and the giant moray eel, Gymnothorax javanicus. We provide evidence of the following: (1) associations are nonrandom, (2) groupers signal to moray eels in order to initiate joint searching and recruit moray eels to prey hiding places, (3) signalling is dependent on grouper hunger level, and (4) both partners benefit from the association. The benefits of joint hunting appear to be due to complementary hunting skills, reflecting the evolved strategies of each species, rather than individual role specialisation during joint hunts. In addition, the partner species that catches a prey item swallows it whole immediately, making aggressive monopolisation of a carcass impossible. We propose that the potential for monopolisation of carcasses by one partner species represents the main constraint on the evolution of interspecific cooperative hunting for most potentially suitable predator combinations.

Animal Communication↗
PubMed1994

Dimensions of self-efficacy among three distinct groups of condom users.

Condom use self-efficacy can be defined as expectations about one's ability to use condoms under a variety of circumstances. This investigation examined the factor structure of the Condom Use Self-Efficacy Scale (CUSES) in an 18- to 23-year-old college population (N = 339) and tested the ability of the factors to distinguish among three groups of condom users (nonusers, sporadic users, and ritualistic users). Emerging from a principal components analysis were four reliable factors labeled Mechanics, Partner's Disapproval, Assertive, and Intoxicants. Results from a discriminant analysis indicated that sporadic users were best distinguished from ritualistic users by number of sex partners, use of intoxicants, and intensity of alcohol use. The sporadic users had more sex partners, were less confident of their ability to use condoms when intoxicated, and were heavier drinkers than were the ritualistic users. Nonusers were best distinguished from ritualistic users by the factor labeled Assertive. Nonusers were significantly less confident in their ability to discuss condoms and to insist on their use with a sexual partner. Implications of the findings for improving campus-based programs to prevent the spread of human immunodeficiency virus infection and sexually transmitted diseases are discussed.

Acquired Immunodeficiency Syndrome↗
PubMed1997

A scale for Assessing Health Care Providers' Teaching and Communication Behavior regarding asthma.

Partnership between health care providers and patients is important for controlling illness. A limited number of studies show how to assess health professionals' communication and partnering behavior. The relationship between these aspects of professional behavior and enhanced management of disease by patients has received little empirical study. The research reported here developed a Health Care Providers' Teaching and Communication Behavior (TCB) scale for assessing the teaching and communication behavior of clinicians treating patients with asthma. Such a tool is needed for research related to provider-patient relationships and for evaluation of professionals' performance.

Adult↗
PubMed2001

Safer sex decision-making among men with haemophilia and HIV and their female partners.

An exploratory qualitative study of adult heterosexual men with haemophilia and HIV and women who were their sexual partners was conducted as formative research to better understand cognitive factors involved in behavioural intentions and practices which comprise HIV risk-reduction for sexual transmission. The study sought to generate hypotheses, uncover themes, and develop a broad perspective on possible determinants of behaviours related to HIV transmission risk reduction. Qualitative analysis of these data served as a basis for developing a subsequent quantitative, hypothesis-testing survey and an intervention. Face-to-face interviews were conducted with 23 single men and 28 married men with haemophilia and HIV infection, and 28 married women partners selected through stratified, purposeful sampling. The interviews identified beliefs, attitudes, and values underlying decisions regarding target behaviours related to preventing sexual transmission of HIV, including (1) using condoms consistently during vaginal intercourse and (2) talking to partners about risk reduction. The interviews elicited information about perceived advantages and disadvantages of performing each of the targeted behaviours, and factors that facilitate or prevent performing them. Qualitative analysis of coded responses yielded important themes regarding how choices are made about sexual activity and safer sex. Most notably, communication between partners (1) plays a direct, key role in facilitating condom use and (2) forms the basis for maintaining emotional intimacy in these relationships. The link between condom use and communicating about safer sex was viewed as pivotal in achieving HIV prevention for individuals in serodiscordant couples. Recommendations for risk reduction intervention development are discussed.

Adult↗
PubMedDate not supplied

A profile of the adolescent male family planning client.

CONTEXT: Family planning programs and policies increasingly focus on the male partner's roles and responsibilities in contraceptive decision-making and use. To effectively tailor services for males, policymakers and providers must refine their understanding of men's psychosocial and reproductive health needs. METHODS: Using self-administered questionnaires, 1,540 sexually active males aged 19 and younger who attended family planning clinics in California provided information about their sexual behavior, contraceptive use, pregnancy and parenting history, and psychosocial characteristics. Logistic regression was used to examine factors that contributed to effective contraceptive use. RESULTS: Although 73% of participants reported having used a birth control method at first intercourse, only 59% said that they or their partner had used an effective method at last intercourse, and 35% had used no method. If the client was uncomfortable with his method, the odds that he had used an effective method at last intercourse were reduced (odds ratio, 0.4). The likelihood of use at last intercourse was increased among males who agreed with their partner about their method and those who had never impregnated a partner (1.4 and 1.9, respectively). CONCLUSIONS: To adequately serve young males, clinics must take into account their sexual and contraceptive histories. But screening should go beyond traditional family planning techniques to discuss how to improve communication with partners and other lifestyle issues that may interfere with consistent use.

Adolescent↗
PubMed2001

Psychological predictors of sexual behaviors related to AIDS transmission.

This study was designed to assess the differential value of several psychological variables with regard to predicting safe-sex behavior. A sample of 94 male and 179 female undergraduate students, ranging in age from 16 to 66 years, were surveyed about sexual issues related to safe-sex practices. The survey included scales measuring participants' knowledge of transmission of AIDS, self-perception of safe-sex communication, fear and concern about AIDS, attitudes toward AIDS victims, and self-report of risky behavior. Several interesting relationships among predictor variables were found. For instance, favorable attitudes toward AIDS victims were positively correlated with knowledge about AIDS transmission, perceived communication with partners about safe sex, and fear of acquiring AIDS. However, only two predictor variables were independently predictive of self-reports of risky sexual behavior; specifically, fear about AIDS transmission was positively correlated with risky behavior, while communication was negatively correlated with risky behavior. These data suggest a need for a model that allows for complex, reciprocal relationships between the cognitive, emotional, and behavioral components of safe-sex practice. Implications are applied to research with college populations.

Acquired Immunodeficiency Syndrome↗