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1.
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   

2.
Many adolescents are susceptible to negative outcomes associated with sexual behavior. This is particularly true for those who initiate sexual intercourse at an early age, have many sex partners, or engage in unprotected sex because these behaviors put one at risk for sexually transmitted infections (STIs), including HIV. This article reviews the various demographic, social‐contextual, and intrapersonal factors linked to sexual risk behaviors. Successful STI/HIV prevention programs must consider developmental and gender issues, as well as cultural norms and values, to effectively meet the prevention needs of all adolescents. We discuss the characteristics of effective intervention programs and provide the names and key features of empirically validated, school‐based STI/HIV prevention programs. In addition, we recommend specific roles for school psychologists in STI/HIV prevention efforts. Finally, other resources are provided to assist practitioners in their continuing review of STI/HIV prevention education. © 2007 Wiley Periodicals, Inc.  相似文献   

3.
OBJECTIVE: The prevalence and characteristics of childhood sexual abuse (CSA) among men who have sex with men (MSM), and links with sexual risk are explored. A model linking CSA and sexual risk among MSM is proposed. METHOD: A telephone probability sample of urban MSM (n = 2881) was recruited and interviewed between November 1996 and February 1998. The interview covered numerous health issues, including history of sexual victimization. RESULTS: One-fifth reported CSA, primarily by non-family perpetrators. Initial CSA experiences are characterized by high levels of force (43% involved physical force/weapons), and penetrative sex (78%; 46% reported attempted or actual anal intercourse). Such men are more likely than nevercoerced men to engage in high risk sex (unprotected anal intercourse with a non-primary partner or with a serodiscordant male). In multivariate analyses, the effect of childhood sexual coercion on sexual risk is mediated by substance use, patterns of sexual contacts, and partner violence, but not by adult sexual revictimization or by depression. CONCLUSIONS: Findings are interpreted within the context of social learning theory and prior research on sexual risk-taking. The high risk for CSA among MSM, which can predispose such men to patterns of HIV sexual risk, warrants new approaches in HIV prevention.  相似文献   

4.
OBJECTIVE: There were two aims in this research. First, to examine the relationships between childhood sexual abuse and HIV drug and sexual risk taking behaviors among female prisoners, and second, to examine the relationship between a marginal adult living context and HIV drug and sexual risk taking behavior among female prisoners. METHOD: The data were collected through face-to-face interviews with a random sample of 500 women at admission to prison in 1994. Differences between women who were sexually abused while growing up (n = 130) were compared to women who reported no sexual abuse (n = 370) along various demographic, and HIV drug and sexual risk taking dimensions. RESULTS: A history of sexual abuse while growing up was associated with increased sexual risk taking behaviors in adulthood. A marginal adult living situation also emerged as an important factor increasing the risk for HIV infection. Examining the co-occurrence of both childhood sexual abuse and adult marginal living context revealed a strong relationship between these two factors and HIV risk taking activities. CONCLUSIONS: The findings indicate that childhood sexual abuse may be a predictor for HIV sexual risk taking behaviors among incarcerated women. The marginal and chaotic adult living style of these women was also associated the extent of their HIV drug and sexual risk taking behaviors. Our research suggests that the co-occurrence of sexual victimization and marginality is a stronger predictor of HIV risk than each variable alone.  相似文献   

5.
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   

6.
A comprehensive survey of HIV/AIDS with middle-aged and older adults should include six domains (e.g., factual knowledge regarding the acquisition and transmission of HIV, traditionally-accepted behavioral risks for HIV infection). A sample of 23 women (54.8%) and 19 men (45.2%), ranging in age from 51 to 85 were surveyed across such domains. Although the majority of participants (92.2%) reported a good understanding of factual knowledge, strongly agreed with both their intention to engage in nonrisky sexual behaviors and their sense of internal self-control behaviors, they also reported high-risk behaviors (e.g., sexual intercourse without condoms).  相似文献   

7.
Structural equation modeling (SEM) techniques were used to compare 5 methods of assessing HIV/AIDS sexual risk in a large prediction model. These were: (a) multiple measures; (b) a single latent factor; (c) modifying the computation of the dependent variables used in Methods 1 and 2 to weight sexual encounters by specific partner risk; (d) use of risk composites, obtained by multiplying number of sexual partners by number of occasions of unprotected sex; and (e) use of risk indexes that assign a number based on responses to general questions about risk behaviors. Data from 452 at‐risk women from a New England community were analyzed in 5 versions of an HIV/AIDS sexual risk prediction model. Models were compared in terms of SEM empirical fit indexes (x2 [df], average absolute standardized residuals, and Comparative Fit Index); significant paths, explained variance, theoretical fit, and simplicity. Results indicate that: (a) multiple measures and latent factor models are preferable to all others by each of the standards of comparison, (b) in the composite dependent variable models, including information about the partners' number of partners provided little additional explained variance beyond knowing the number of occasions of unprotected sex, and (c) dependent measures that did not remain close to Centers for Disease Control criteria may not be adequately predicting HIV/AIDS sexual risk. Several recommendations are presented for selecting an appropriate conceptualization of HIV/AIDS sexual risk.  相似文献   

8.
OBJECTIVE: The prevalence of childhood sexual abuse among Latino adult men who have sex with men who live in the US was estimated because a history of childhood sexual abuse increases HIV sexual risk behaviors and other negative health outcomes in adulthood. METHOD: The Urban Men's Health Study is a random-digit telephone probability survey of 2881 adult men who have sex with men (MSM) aged 18 years or older residing in San Francisco, New York, Los Angeles, and Chicago. Self-reported history of childhood sexual abuse was the main outcome measure gathered from 2692 MSM. RESULTS: A significantly higher proportion of Latino MSM reported sexual abuse before age 13 (22%) than did non-Latino MSM (11%). CONCLUSIONS: Latino MSM are twice as likely to report a history of childhood sexual abuse than are non-Latino MSM. Given the association between childhood sexual abuse and increased risk for HIV and other negative health outcomes, health providers must remain vigilant to the possibility of childhood sexual abuse histories among their Latino patients.  相似文献   

9.
OBJECTIVE: There were two aims: first, to examine the relationship between prior sexual abuse and three types of adult risky sexual behaviors [(1) ever traded sex for drugs or money, (2) had unprotected sex in the past 6 months, and (3) frequency of unprotected sex in the past 6 months] among persons with severe mental illness (SMI), and second, to examine the potential mediating effects of adult rape, substance use, and PTSD. METHOD: Using a pooled sample of individuals with SMI (N=609), logistic and negative binomial regression analyses were used to investigate the impact of prior sexual abuse on these adult risky sexual behaviors. RESULTS: Childhood sexual abuse was associated with having ever traded sex for money and having engaged in unprotected sex in the past 6 months. However, childhood sexual abuse was inversely associated with the number of times males had unprotected sex in the past 6 months. Results differed between males and females and the impact of potential mediators also varied by gender and type of outcome studied. CONCLUSION: These findings suggest a complex link between childhood sexual abuse and adult risky sexual behaviors in persons with SMI. Clinical assessments of child abuse sequelae should include a variety of indicators and parameters of adult risky sexual behavior, as persons with SMI are at an increased risk of engaging in high-risk sexual behaviors and tend to have a higher exposure to childhood sexual abuse than does the general population.  相似文献   

10.
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   

11.
OBJECTIVE: The first purpose was to determine whether sexual abuse involving penetration that occurred in childhood only, adolescence only, or both childhood and adolescence differently impacted whether community-recruited women had ever traded sex for money or drugs, their number of recent sex partners, and the number of times they had engaged in recent unprotected sex. The second purpose was to assess the mediating effects of adulthood rape, recent drug use, and recent sex with an injection drug user on these three HIV-risky sexual behaviors. METHOD: Women (n = 1,490) recruited from three US sites were questioned about their childhood and/or adolescent sexual abuse histories, adulthood rape experiences, recent drug use, and adult HIV-risky sexual behaviors via structured interviews. RESULTS: One-third of the women reported having experienced sexual abuse involving penetration in childhood and/or adolescence. Overall, regression analyses indicated a significant relationship between early sexual abuse and adult risky behaviors; rape in adulthood mediated this relationship for all three HIV-risky behaviors. Abuse that occurred in childhood only and abuse that occurred in both childhood and adolescence had a stronger impact on later risky behaviors than did abuse that occurred in adolescence only. CONCLUSIONS: Because childhood constitutes a critical period in individuals' sexual, social, and personal development, sexual abuse precipitated during this time may distort women's constructions of sex and sexuality. Women abused in childhood may therefore engage in HIV-risky sexual behaviors to a greater extent than women abused in adolescence as a result of these disruptions to their development. Rape in adulthood appears to intensify the effects of early sexual abuse,  相似文献   

12.
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   

13.
The authors, of the University of Stellenbosch, South Africa, surveyed 60 male university students of mean age 21.37 years and 79 female students of mean age 20.13 years with the goal of gaining insight into their sex behavior and their attitudes toward sexuality. The home language of 83% of the women and 85% of the men was Afrikaans, while the remaining subjects had English as a home language. One student was married, three were engaged to be married, and two lived together with a person of the opposite sex. 51 students were in steady relationships and 82 were single. 82% of the men and 90% of the women choose to have sex with someone of the same race. The study found a relatively low occurrence of sexual intercourse and promiscuity, and a very high percentage of subjects regarded themselves as heterosexual and as morally and religiously conservative. 97% of the men and 99% of the women regarded themselves as being heterosexual, and 3% of men and 1% of women regarded themselves as being bisexual. 6.6% of men and 1.34% of women, however, reported having had sexual contact with someone of the same sex. 37% of the men and 32% of the women reported having ever had sexual intercourse with a person of the opposite sex. These percentages are notably lower than those found by other investigators and the authors believe that a higher proportion of students at the university are actually sexually active than that suggested by this survey's findings. Among those sexually active, 17% of men and 18% of women were involved in sexual relationships with more than one partner. 68% of the sexually active men and women report using condoms often, 14% of men and 8% of women use contraceptives on an irregular basis, and 18% of men and 25% of women never use contraceptives. The birth control pill and condom were the most widely used methods. 85% of men and 86% of women felt that both partners should be responsible for taking precautions against unwanted pregnancy. These findings indicate that the overwhelming majority of subjects in this study are not at high risk for contracting AIDS.  相似文献   

14.
OBJECTIVE: While research has supported associations between experiencing abuse and engaging in risky sexual behaviors during adolescence, research regarding these associations among adult women is much more equivocal. In addition, few studies have attempted to identify potential pathways from abuse experiences to sexual risk behaviors. The current study examined the associations between a history of physical or sexual abuse and recent sexual risk behaviors among adult women. Additionally, this study evaluated binge drinking and depressive symptomatology as potential mediators of any relationships between abuse history and sexual risk behaviors. METHODS: A total of 1,428 women between 18 and 40 years of age attending family planning clinic appointments completed a self-report survey regarding their recent sexual behaviors and sexual and physical abuse history. Logistic regressions using backward elimination were conducted to identify factors associated with sexual risk behavior. RESULTS: A history of physical abuse by a romantic partner was associated with several sexual risk behaviors. Few significant associations between intrafamilial physical or sexual abuse and recent sexual risk behaviors were found. Additionally, there was no evidence that these relationships were mediated by binge drinking or depressive symptomatology. CONCLUSIONS: Familial abuse experiences are not necessarily associated with recent sexual risk behaviors among adults. In contrast, physical abuse experiences, particularly those perpetrated by a romantic partner, are associated with engaging in adult sexual risk behaviors among women. However, these associations are not mediated by alcohol use or depressive symptomatology.  相似文献   

15.
HIV/AIDS prevalence in South Africa is one of the highest in the world with heterosexual, transmission predominantly promoting the epidemic. The goal of this study is to examine whether, marijuana use and problem drinking mediate the relationship between histories of childhood sexual, abuse (CSA) and HIV risk behaviors among heterosexual men. Participants were 1181 Black men aged, 18–45 from randomly selected neighborhoods in Eastern Cape Province, South Africa. Audio computer assisted, self-interviewing was used to assess self-reported childhood sexual abuse, problem drinking, and marijuana (dagga) use, and HIV sexual transmission behavior with steady and casual partners. Data were analyzed using multiple meditational modeling. There was more support for problem, drinking than marijuana use as a mediator. Findings suggest that problem drinking and marijuana use, mediate HIV sexual risk behaviors in men with histories of CSA. Focusing on men with histories of CSA, and their use of marijuana and alcohol may be particularly useful for designing strategies to reduce, HIV sexual transmission in South Africa.  相似文献   

16.
ABSTRACT

Using data from 2002 to 2013 collections of the National Survey of Family Growth, we explored how exposure and timing of sex education were associated with sexual health outcomes of 5,141 women between the ages of 15 and 20 years. Consistent with previous literature, sexual minority (e.g., lesbian and bisexual) women reported engaging in sexual intercourse with a male partner earlier than their heterosexual peers. Sexual minority women were also more likely to receive sex education after already engaging in sexual intercourse. Exposure to sex education was associated with poorer outcomes—such as an increased number of male sexual partners and higher reports of pregnancy—for sexual minority women but not for their heterosexual peers. Receiving sex education before engaging in intercourse was associated with an increase in birth control use among bisexual participants. Therefore, school psychologists and counselors should promote inclusive sex education programs that fully address the needs of sexual minority youth.  相似文献   

17.
Behavior change is the only available means of curtailing new HIV infections in South Africa. This study investigated the relationship between sexual risk taking and attitudes to AIDS precautions. The participants were about 25% white, about 30% colored/mixed blood and 45% black in their second year in polytechnics (413 females and 402 males). Participants responded to the 40-item HIV-related knowledge, attitudes and behaviors. Data indicated that young women showed more positive attitudes to AIDS precautions than young men (reflecting in part the stereotypic negative attitudes of young men toward condoms). In general, most males and females were found to have less knowledge about HIV transmission and less favorable attitudes toward safe sex behavior than their counterparts in the west. Also young men with more partners expressed more fatalistic attitudes toward AIDS. The possibility that a finergrained multivariate analysis of attitudes to AIDS and safe-sex behaviour is something that needs to be taken seriously in future research, however.  相似文献   

18.
This study aimed to examine the pathways from child sexual abuse to sexual assault victimization and perpetration in adolescence and early adulthood, considering risky sexual behavior and lowered sexual self-esteem as mediator variables. In a two-wave longitudinal study with 2251 college students in Germany, male and female participants provided reports of sexual aggression victimization and perpetration since age 14 (T1) and again a year later (T2), covering the last 12 months. In addition, child sexual abuse (CSA; before the age of 14), risky sexual behavior, and sexual self-esteem were assessed at T1, and risky sexual behavior and sexual-self-esteem were assessed again at T2. Experience of CSA was significantly associated with greater likelihood of sexual aggression victimization and perpetration, lower sexual self-esteem, and more risky sexual behavior in both gender groups at T1 and was directly related to victimization at T2 among male participants. In both gender groups, CSA indirectly contributed to a higher probability of sexual victimization at T2 via its impact on victimization T1. In males, the indirect path from CSA to T2 perpetration via T1 perpetration was also significant. Through its negative impact on sexual self-esteem, CSA indirectly increased the probability of sexual victimization among women and the probability of sexual aggression perpetration among men. Risky sexual behavior mediated the pathway from CSA to sexual victimization at T2 for men and women and the pathway from CSA to sexual aggression perpetration for women. The findings contribute to the understanding of gendered effects of CSA on revictimization and the victim-to-perpetrator cycle.  相似文献   

19.
In Tanzania, young women aged 15–24 are at high risk for HIV and nearly half (45%) of women experience pregnancy or childbirth before age 19. The HIV epidemic has motivated many parents to overcome cultural taboos and talk with their children about sexuality, but few studies in Tanzania have examined how young adults perceive these discussions. In-depth interviews with 31 Tanzanian college women (ages 18–25) reveal how they make sense of sexuality messages from mothers that are sometimes vague, admonishing and fear-based. Participants identified how mothers focused on the health, educational and social consequences of premarital sex and emphasised the avoidance of men as a strategy to maintain virginity. Mothers avoided providing specific information about safer-sex practices, or strategies to negotiate romantic relationships, sexual pressures or sexual desires. Findings offer insight into how relational and cultural contexts influence mothers’ sexual socialisation and can inform education and intervention approaches that consider the changing cultural landscape. Future qualitative research with mothers is recommended to develop programmes that are more responsive to mothers’ and daughters’ needs.  相似文献   

20.
This study investigated the association between sex stereotypes and the sexual behaviour of Nigerian school-going adolescents. It also ascertained the effects of age and sex on adolescents' beliefs about sex stereotypes. The study sample consisted of 658 (male = 287, female = 371) adolescents from nine randomly selected secondary schools in three urban towns in Osun State, Nigeria. A survey questionnaire consisting of items describing various misconceptions about sexuality to which respondents were to indicate their levels of agreement on a five-point Likert scale was used to collect data. The instrument measured the extent to which respondents engaged in risky sexual behaviour such as casual sex, multiple sexual partners and unprotected sexual intercourse. Data were analysed using simple percentages and chi-squared statistics. The results showed that Nigerian adolescent students strongly believed in sex stereotypes and demonstrate a tendency to engage in risky sexual behaviours. Results also indicated that respondents who reported a level of sex stereotypes showed a tendency to engage in risky sexual behaviour and that respondents' sex had a significant relationship with their belief in sex stereotypes. A large majority of respondents who reported a high level of stereotypes were males.  相似文献   

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