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Repeated exposure to childhood adversity (abuse, neglect and other traumas experienced before age 18) can have lifelong impacts on health. For HIV-infected adolescents and youth, such impacts may include onward transmission of HIV. To evaluate this possibility, the current study measured the burden of childhood adversity and its influence on risky health behaviors among perinatally-infected adolescents and youth. We surveyed 250 perinatally-infected adolescents and youth (13–24 years) receiving care in Soweto, South Africa. Both male and female participants reported on childhood adversity (using the ACE-IQ), sexual behavior, and psychosocial state. Viral load was also abstracted from their charts. We used logistic regressions to test the association between cumulative adversity and behavioral outcomes. Half the sample reported eight or more adversities. Overall, 72% experienced emotional abuse, 59% experienced physical abuse, 34% experienced sexual abuse, 82% witnessed domestic violence, and 91% saw someone being attacked in their community. A clear gradient emerged between cumulative adversities and behavioral risk. Having experienced one additional childhood adversity raised the odds of risky sexual behavior by almost 30% (OR 1.27, 95% CI 1.09–1.48). Viral suppression was poor overall (31% had viral loads >400 copies/ml), but was not related to adversity. Adversity showed a robust relationship to depression and substance abuse. Childhood adversity is common, influences the current health of HIV-positive adolescents and youth, and puts their sexual partners at risk for HIV infection. Greater primary prevention of childhood adversity and increased access to support services (e.g., mental health) could reduce risk taking among HIV-positive adolescents and youth. 相似文献
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Antisocial behavior exhibited by children and youth has been an issue of concern for societies throughout history. Events of recent years in the United States (e.g., school shootings, increases in criminal adjudication among children and youth, escalation in violent behavior within this age group) have galvanized public concern and raised antisocial behavior among children and youth to a national health care issue. The purpose of this article is to briefly review the social skills training knowledge base and describe social skills training considerations for at-risk and antisocial children and youth at 3 grade levels: (a) preschool and elementary, (b) middle school, and (c) high school. Characteristics of students, composition of model social skills interventions, and, where possible, efficacy data are reviewed and discussed. We conclude the article by discussing recommendations for future research in this area. 相似文献
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Jeffery Sprague Hill M. Walker Steve Stieber Brandi Simonsen Vicki Nishioka Linda Wagner 《Psychology in the schools》2001,38(2):197-206
There is a growing concern about violent and destructive behaviors of youth that require intervention by juvenile justice and youth‐serving agencies. This concern has led many to conclude that schools and community agencies must increase efforts to prevent juvenile delinquency and to provide programs that will facilitate rehabilitation, education, and vocational training for youth already involved. A clear understanding of the nature and range of behaviors that result in juvenile crime is needed in order to develop programs and interventions that can be expected to lead to beneficial changes for youth and for society as a whole. The purpose of this article is to describe the relationship between school behaviors and youth characteristics in school (e.g., discipline referrals, teacher nominations, nomothetic ratings) and referrals to juvenile authorities (e.g., illegal behaviors). We describe a strategy of using teacher nominations, school discipline referrals, and community arrest data to predict delinquent and violent behavior in youth. We outline data from a group of socially maladjusted middle school youth to illustrate the relationship between the two data sources and recommendations for identification and treatment of youth at risk for delinquency and antisocial behavior. © 2001 John Wiley & Sons, Inc. 相似文献
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Mandy J. Hill Camden J. Hallmark Marlene McNeese Nike Blue Michael W. Ross 《Sex education》2014,14(2):128-143
The goal of this paper was to determine the effectiveness of the HIP HOP for HIV Awareness intervention, an innovative model utilising an exchange of an HIV test for a hip hop concert ticket, in a metropolitan city among African American youth and young adults. A subset of intervention participants participated in standardised testing, sex education and pre/post test administration. Data were analysed to identify changes in knowledge and attitudes with respect to HIV and sexually transmitted infections pre/post the educational session. An analysis of knowledge revealed variance in the pre- and post-assessment findings among participants receiving the intervention. Level of education and gender significantly influenced the variance in knowledge discerned from the pre- and post-assessment among participants. Two three-level significant interactions emerged from the analysis of variance: knowledge, education and gender; and knowledge, education and race/ethnicity. Programme findings suggest that an increase in knowledge and improved self-perceptions related to attitudes are the result of a brief, HIV-focused community-based intervention among young adults. 相似文献
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OBJECTIVE: To examine family risk factors associated with dissociative symptoms among homeless and runaway youth. METHOD: Three hundred and twenty-eight homeless and runaway youth were interviewed using a systematic sampling strategy in metropolitan Seattle. Homeless young people were interviewed on the streets and in shelters by outreach workers in youth service agencies. RESULTS: The current study revealed widespread prevalence of dissociative symptoms among these young people. Multivariate analyses revealed that sexual abuse, physical abuse, and family mental health problems were all positively associated with dissociative symptoms. No gender differences were found for any of the models. CONCLUSIONS: Dissociative behavior is widespread among these youth and may pose a serious mental health concern. Some young people experience numerous stressors, and with few resources and little support available, many may invoke maladaptive strategies such as dissociative behavior to handle such situations, which may in turn be detrimental to their mental health. Unless youth are provided with programs and intervention, the cycle of abuse that they have experienced at home is likely to continue on the street. 相似文献
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This paper takes up the concern that sexual health programs targeting adolescents may actually increase HIV risk among youth by reinforcing dominant versions of masculinity that portray males as sexually irresponsible and unconcerned about their health. If a key aim in HIV prevention education is a renegotiation of high‐risk behavioral norms, an important consideration is the ways young people resist stereotypical gender norms that can lead to risky sexual practices. From this perspective, opening up spaces for the expression of counter‐hegemonic masculinities may be an important health prevention strategy. In a study conducted in three urban Toronto high schools, we explore the ways students in mixed‐sex groups supported or challenged dominant discourses of masculinity expressed through three themes: notions of male sexuality as unrestrained and unrestrainable; narrow definitions of sex; and concepts of ‘risk’ and resistance to condom use. We argue that designing HIV prevention programs that begin with the exploration of alternative masculinities may be one way to fashion a framework for gender relations that can offer youth more effective prevention strategies. 相似文献
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The disappearance of traditional sex education during rites of passage in African societies has left many youth uncertain of where to look for information. Against this backcloth, the objectives of this study were to identify knowledge gaps amongst adolescents in Kenya regarding sexuality, HIV/AIDS and reproductive health. A thematic analysis was conducted of questions posed by 735 school youth aged 12–18 years from Meru and Kajiado Districts. Results show that many questions showed curiosity and anxiousness. Knowledge appeared to be fragmented and sometimes revealed misconceptions, which may put youth at risk. The raised themes differed by gender and age. Questions on saying no to sex, sexual violence and female circumcision were a great concern for girls. Boys were more concerned with managing boy–girl relationships, preventing STI/HIV infection, and condoms. Concern about transition to adulthood, sexuality, STI and HIV/AIDS, myths and misconceptions, and intergenerational communication cut across both genders. Older teens were more concerned with questions on boy–girl relationships, norms and values regarding sexuality, and STI. Younger teens ( < 15 years) wanted to know about reproduction, saying no to sex, HIV/AIDS, condoms, sexual violence and female circumcision. Compounding these challenges was the lack of intergenerational communication. The study identified important knowledge and communication gaps in sexual and reproductive health among in-school adolescents in Kenya. There is a need for sex education interventions for different age groups and genders. These interventions should work with parents, teachers and health professionals. 相似文献
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Gary W. Harper Laura Jadwin-Cakmak Emily Cherenak Patrick Wilson 《American journal of sexuality education》2019,14(1):109-133
Black gay/bisexual male youth are one of the groups most affected by HIV in the United States, but few behavioral interventions have been created specifically to address this health inequity. Oppression related to these youths’ multiple social identities—including racism, heterosexism, and HIV stigma—contribute to increased health risks. Primary and secondary HIV prevention interventions created specifically for Black gay/bisexual male youth that address the negative impact of oppression are urgently needed. We present empowerment as a framework for understanding how oppression affects health, and critical consciousness as a tool to be utilized in behavioral interventions. This approach helps to move Black gay/bisexual male youth from a place of oppression and powerlessness that leads to elevated health risks to a position of empowerment that promotes feelings of control and participation in healthy behaviors. Finally, we present a case example of our own critical consciousness-based secondary HIV prevention intervention created specifically for Black gay/bisexual male youth. 相似文献
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《Adolescence education newsletter》1998,1(1):8
Involvement of Youths in Population and Family Welfare Activities through Youth Clubs, a project supported by the United Nations Population Fund, has developed innovative ways of reaching Bangladeshi youth with reproductive health messages. One such project, executed by the Ministry of Youth and Sports, provided training in family life education to 74 youth training centers and launched population activities through 200 youth clubs in 98 thanas. Benchmark surveys were conducted in priority areas identified by individual clubs. A primary health care intervention reached 23,000 women and children with health card and sanitation programs. Follow-up surveys have revealed significant improvements in youth's knowledge of health, nutrition, maternal-child health, sanitation, and environmental conservation. In another Bangladeshi program, girls 9-19 years old received education through the Population Services and Training Center on topics such as the advantages of delayed marriage, family planning methods, and maternal-child health. 相似文献
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OBJECTIVE: To research the correlation between physical and sexual abuse by family members and AIDS-related knowledge, attitudes, self-efficacy and behavior among urban and rural adolescents in Zambia. SAMPLE: The sample comprises 3,360 adolescents, aged 10-19, from urban and rural Zambia; 2,160 of them attended school, while 1,200 of them did not. MEASURES: Standardized scales were utilized to assess AIDS-related knowledge, attitudes, and self-efficacy. In addition, the adolescents reported the extent of their engagement in various high-risk behaviors and their lifetime experience of being sexually or physically abused. RESULTS: As the level of abuse experienced by the adolescents increased, their level of knowledge about HIV/AIDS, tendency to hold positive attitudes toward prevention, and level of self-efficacy regarding HIV/AIDS prevention decreased. Most importantly, when controlling for socio-demographic variables, findings indicate that past abuse was a key factor predicting participation in high-risk behaviors associated with HIV infection. CONCLUSION: Physical and sexual abuse of adolescents in Zambia is significantly related to HIV risk behaviors. Future studies should investigate which factors mediate between the experience of abuse and the tendency to engage in risky behaviors. 相似文献
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OBJECTIVE: Much research has been done to examine the long-term effects of being victimized by sexual, physical, and/or emotional abuse in childhood, but much less research has focused on the impact of childhood neglect experiences. This study examines the role that childhood neglect has on adult women's involvement in HIV-related risky behaviors. METHODS: The data come from a study of 250 "at risk" women living in the Atlanta, GA metropolitan area, most of whom were African American. Data were collected in face-to-face interviews between 1997 and 2000. Multiple regression was used to explore the relationship between childhood neglect experiences, self-esteem, attitudes toward condom use, and involvement in HIV-related risky behaviors. RESULTS: Overall, the model tested received strong support by the study data. Childhood neglect led to reduced self-esteem. Neglect was associated with worsened attitudes toward condom use and women who experienced childhood neglect also reported more involvement in HIV risk behaviors. CONCLUSIONS: HIV intervention programs ought to target women who have experienced childhood neglect, as neglect experiences have adverse impacts upon their self-esteem, condom-related attitudes, and HIV risk behavior practices in adulthood. 相似文献
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Dionne P. Stephens Tami L. Thomas Asia Eaton 《American journal of sexuality education》2016,11(4):267-286
This study identifies health beliefs influencing Hispanic college men's human papillomavirus (HPV) vaccine uptake decision making processes. Hispanic college men were interviewed about their HPV vaccine knowledge, and information seeking behaviors. Overall, participants did not view HPV infection or vaccination as an immediate concern or priority; belief that it was a virus that only affected women, and a sense of invulnerability informed their positions. Despite these issues, most men were willing to consider getting the HPV vaccine if they received more education from health care providers, and cost concerns were addressed. These findings pointed to gaps in our understandings of Hispanic college men's HPV vaccination beliefs and provided insight into the importance of integrating this population's unique beliefs into campus health providers efforts aimed at increasing vaccination rates. 相似文献
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This article examines the structure of several HIV risk behaviors in an ethnically and geographically diverse sample of 8,251 clients from 10 innovative demonstration projects intended for adolescents living with, or at risk for, HIV. Exploratory and confirmatory factor analyses identified 2 risk factors for men (sexual intercourse with men and a general risk factor) and 3 factors for women (sexual intercourse with men, substance abuse, and a high risky sex behavior factor). All factors except women engaging in risky sex with men strongly predicted known HIV status of clients for men and women. The findings from this investigation highlight the use of structural equation modeling for applied problems involving overlapping and complex sets of risk behaviors in youth who present at community health programs. 相似文献
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OBJECTIVE: Using data from a nationally representative panel study, the National Survey of Child and Adolescent Well-Being (NSCAW), we address the following questions: (a) What are the youth, family, community, and child welfare system risk factors that place youth (ages 11-14 years) living at home, who are referred for maltreatment, at increased risk of delinquent behaviors over time? and (b) What promotive factors at the youth, family, community, and child welfare system levels appear to minimize the risk of delinquent behaviors for these youth over time? METHODS: The study uses the NSCAW data collected at baseline (Wave 1) and 18 months later (Wave 3). The multivariate analyses were conducted using a tobit model adjusted for longitudinal data and a complex survey sample. RESULTS: Several significant risk and promotive factors were found to influence the risk of delinquent behaviors over time. Older youth were more likely to engage in delinquent behaviors than younger youth. Girls were less likely to engage in delinquent behaviors than boys. Race or ethnicity did not have a statistically significant relationship with engaging in delinquent behaviors. Compared with neglected youth, youth who were physically abused were more likely to engage in delinquent behaviors. Increases in caregiver monitoring and in the quality of relationship with caregivers were associated with decreases in delinquent behaviors. Youth at greatest risk and those who engaged in more delinquent behaviors received more child welfare services then youth who did not engage in delinquent behaviors. CONCLUSIONS: The current child welfare delivery system emphasizes provision of services to youth experiencing the more serious problems and less on preventive services. The study findings suggest that preventive services when youth first enter the child welfare system that focus on enhancing caregiver skills in building positive relationships with their youth and increased monitoring of the youth's activity may alter the pathway to delinquent behaviors for these youth. 相似文献
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《Structural equation modeling》2013,20(4):609-621
This article examines the structure of several HIV risk behaviors in an ethnically and geographically diverse sample of 8,251 clients from 10 innovative demonstration projects intended for adolescents living with, or at risk for, HIV. Exploratory and confirmatory factor analyses identified 2 risk factors for men (sexual intercourse with men and a general risk factor) and 3 factors for women (sexual intercourse with men, substance abuse, and a high risky sex behavior factor). All factors except women engaging in risky sex with men strongly predicted known HIV status of clients for men and women. The findings from this investigation highlight the use of structural equation modeling for applied problems involving overlapping and complex sets of risk behaviors in youth who present at community health programs. 相似文献
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Alexandra F. Lightfoot Arianna Taboada Tamara Taggart Trang Tran Amy Burtaine 《Sex education》2013,13(4):348-363
Adolescents are at increased risk of HIV and sexually transmitted infections (STIs) in the Southern states of the USA, where rates among youth are higher than in the rest of the nation. This paper reports on findings from a pilot study of an HIV prevention intervention that uses interactive theatre to educate young people about sexual health. The intervention was developed in Los Angeles and adapted for testing in the Southern USA, with its legacy of abstinence-based approaches to sexual health education. This study assessed intervention effects among a sample of young people in two public high schools in North Carolina. We used a pre-test, post-test quasi-experimental evaluation design to assess changes in 317 ninth-grade participants' knowledge and attitudes about HIV. At post-test, we found statistically significant increases in participants' HIV knowledge (t = 60.14; p = 0.001), as well as changes in attitudes (χ2 = 8.23; p = 0.042) and awareness (χ2 = 4.94; p = 0.026). Focus group data corroborated an increase in HIV knowledge and a reduction in HIV stigma as successful outcomes of intervention participation. The findings make an important contribution to the literature on theatre-based interventions for sexual health education. Furthermore, they highlight the importance of considering sociocultural and political context in implementing HIV prevention interventions in schools. 相似文献
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Stefani A. Butts Annette Kayukwa Jake Langlie Violeta J. Rodriguez Maria L. Alcaide Ndashi Chitalu 《Sex education》2018,18(1):1-13
In sub-Saharan Africa, young women are at the highest risk of HIV infection. Comprehensive sexuality education and open parent–child communication about sex have been shown to mitigate risky sexual practices associated with HIV. This study aimed to identify sources of HIV prevention knowledge among young women aged 10–14 years and community-based strategies to enhance HIV prevention in Zambia. Focus group discussions were conducted with 114 young women in Zambian provinces with the highest rates (~20%) of HIV. Discussions were recorded, transcribed and coded, and addressed perceived HIV risk, knowledge and access to information. Participants reported that limited school-based sexuality education reduced opportunities to gain HIV prevention knowledge, and that cultural and traditional practices promoted negative attitudes regarding condom use. Parent–child communication about sex was perceived to be limited; parents were described as feeling it improper to discuss sex with their children. Initiatives to increase comprehensive sexuality education and stimulate parental communication about sexual behaviour were suggested by participants. Culturally tailored programmes to increase parent–child communication appear warranted. Community-based strategies aimed at enhancing protective sexual behaviour among those most at risk are essential. 相似文献
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