1.  Peer Reviewed Title: Hormonal contraception, sickle cell trait, and risk for venous thromboembolism among African American women. Author: Austin H; Lally C; Benson JM; Whitsett C; Hooper WC; Key NS Source: American Journal of Obstetrics and Gynecology. 2009 Jun;200:620e1-620e3. Abstract: OBJECTIVE: We evaluated the effect of oral and other hormonal contraceptive (HC) use on venous thromboembolism risk among African American women and investigated whether the association was modified by the sickle cell trait. STUDY DESIGN: We report the findings of a case-control study that included 60 African American women with an idiopathic, first episode of venous thromboembolism and 196 African American controls. RESULTS: The odds of current HC use compared with noncurrent use contrasting cases and controls is 3.8 (95% confidence interval [CI], 1.7-8.1; P < .001). Among subjects with sickle cell trait, the odds ratio is higher (odds ratio [OR], 6.7; 95% CI, 1.0-43) than the odds ratio among subjects without sickle cell trait (OR, 2.6; 95% CI, 1.1-6.2), but the difference is not statistically significant. CONCLUSION: This study provides persuasive evidence that hormonal contraceptive use increases venous thromboembolism risk among African American women and that the increase in risk may be larger among women with sickle cell trait. Language: English Keywords: UNITED STATES OF AMERICA | RESEARCH REPORT | CASE STUDIES | BLACKS | WOMEN | CONTRACEPTION | CONTRACEPTIVE AGENTS | THROMBOEMBOLISM | DISEASES | RISK FACTORS | Developed Countries | North America | Americas | Studies | Research Methodology | Ethnic Groups | Cultural Background | Population Characteristics | Demographic Factors | Population | Family Planning | Embolism | Vascular Diseases | Health Document Number: 330853 |
| 2. Title: "Everything I know I learned from my mother...Or not": perspectives of African-American and white women on decisions about tubal sterilization. Author: Borrero S; Nikolajski C; Rodriguez KL; Creinin MD; Arnold RM; Ibrahim SA Source: Journal of General Internal Medicine. 2009 Mar;24(3):312-9. Abstract: BACKGROUND: African-American women have had higher rates of female sterilization compared to white women since its emergence as a contraceptive method. The reasons underlying this observed racial difference are unknown. OBJECTIVES: The goals of this study were to (1) explore what factors shape black and white women's decisions about tubal sterilization as a contraceptive method and (2) generate hypotheses about the relationship of race to the decision-making process. DESIGN: We conducted six focus groups stratified by tubal sterilization status and race. During each of the audio-recorded sessions, participants were asked to discuss reasons that women choose sterilization as a contraceptive method. PARTICIPANTS: The participants of the study were 24 African-American women and 14 white women. APPROACH: Transcripts of the sessions were qualitatively analyzed with particular attention to factors that might be unique to each of the two racial groups. RESULTS: Personal factors shaped black and white women's decisions regarding tubal sterilization. Preference for a convenient, highly effective contraceptive method was the main reason to get a tubal sterilization for women of both racial groups. We also identified socio-cultural differences that might explain why black women are more likely than white women to choose tubal sterilization over other contraceptive methods. An unanticipated, but clinically important, finding was that women often reported feeling that their doctors and the health-care system served as barriers to obtaining the desired procedure. CONCLUSION: Socio-cultural differences may help explain why black and white women choose different contraceptive methods. Language: English Keywords: UNITED STATES OF AMERICA | RESEARCH REPORT | QUALITATIVE RESEARCH | BLACKS | WHITES | WOMEN | TUBAL LIGATION | CONTRACEPTIVE METHODS CHOSEN | DECISION MAKING | SOCIOCULTURAL FACTORS | Developed Countries | North America | Americas | Research Methodology | Ethnic Groups | Cultural Background | Population Characteristics | Demographic Factors | Population | Female Sterilization | Sterilization, Sexual | Family Planning | Contraceptive Usage | Contraception | Behavior Document Number: 341434 |
| 3. Title: The impact of race and ethnicity on receipt of family planning services in the United States. Author: Borrero S; Schwarz EB; Creinin M; Ibrahim S Source: Journal of Women's Health. 2009 Jan-Feb;18(1):91-6. Abstract: OBJECTIVE: This study sought to examine the independent effect of patient race or ethnicity on the use of family planning services and on the likelihood of receiving counseling for sterilization and other birth control methods. METHODS: This study used national, cross-sectional data collected by the 2002 National Survey of Family Growth (NSFG). Our analysis included women aged 18-44 years who had heterosexual intercourse within the past 12 months, who were not actively seeking to get pregnant, and who had not undergone surgical sterilization. The primary outcome was receipt of family planning services within the past 12 months. Specific services we examined were (1) provision of or prescription for a method of birth control, (2) checkup related to using birth control, (3) counseling about sterilization, and (4) counseling about birth control. RESULTS: Although we found no racial/ethnic differences in the overall use of family planning services, there were racial/ethnic differences in the specific type of service received. Hispanic and black women were more likely than white women to receive counseling for birth control (adjusted OR 1.5, 95% confidence interval [CI] 1.2, 1.8, and adjusted OR 1.3, 95% CI 1.1, 1.7, respectively). Hispanic women were more likely than white women to report having been counseled about sterilization (adjusted OR 1.5, 95% CI 1.0, 2.3). CONCLUSIONS: Minority women were more likely to receive counseling about sterilization and other birth control methods. However, there were no differences in access to family planning services by race or ethnicity. Future studies are needed to examine the quality and content of contraceptive counseling received by minority compared with nonminority women. Language: English Keywords: UNITED STATES OF AMERICA | RESEARCH REPORT | CROSS SECTIONAL ANALYSIS | ETHNIC GROUPS | HISPANICS | BLACKS | SOCIOCULTURAL FACTORS | FAMILY PLANNING PROGRAMS | IMPACT | COUNSELING | QUALITY OF HEALTH CARE | Developed Countries | North America | Americas | Research Methodology | Cultural Background | Population Characteristics | Demographic Factors | Population | Family Planning | Communication | Clinic Activities | Program Activities | Programs | Organization and Administration | Health Services Evaluation | Program Evaluation Document Number: 331216 |
| 4. Title: Supportive friendships moderate the association between stressful life events and sexual risk taking among African American adolescents. Author: Brady SS; Dolcini MM; Harper GW; Pollack LM Source: Health Psychology. 2009 Mar;28(2):238-48. Abstract: OBJECTIVE: This study examined whether uncontrollable stressful life events were associated with sexual risk taking among adolescents across a 1-year period, and whether supportive friendships modified associations. DESIGN: Participants were 159 sexually active African American adolescents (57% male; mean age [SD] = 17.0 [1.5] years at baseline). Participants were recruited for in-person interviews through random digit dialing in one inner-city neighborhood characterized by high rates of poverty and crime relative to the surrounding city. MAIN OUTCOME MEASURES: Dependent variables included substance use before sexual activity and inconsistent condom use. RESULTS: Among adolescents who reported low levels of supportive friendships, uncontrollable stressors were associated with greater levels of sexual risk taking over time. In contrast, uncontrollable stressors were not associated with sexual risk taking among adolescents who reported high social support from friends; risk taking was typically moderate to high among these adolescents. CONCLUSION: Different processes may explain sexual risk taking among adolescents with varying levels of social support from friends. Adolescents with low support may be prone to engagement in health risk behavior as a stress response, while adolescents with high support may engage in risk behavior primarily due to peer socialization of risk. Language: English Keywords: UNITED STATES OF AMERICA | RESEARCH REPORT | KAP SURVEYS | FRIENDS AND RELATIVES | BLACKS | ADOLESCENTS | PEER GROUPS | URBAN POPULATION | STRESS | SEX BEHAVIOR | RISK BEHAVIOR | DRUG USE AND ABUSE | INTERPERSONAL RELATIONS | Developed Countries | North America | Americas | Surveys | Sampling Studies | Studies | Research Methodology | Family and Household | Sociocultural Factors | Ethnic Groups | Cultural Background | Population Characteristics | Demographic Factors | Population | Youth | Age Factors | Knowledge Sources | Communication | Psychological Factors | Behavior Document Number: 341117 |
| 5. Title: What do sexually active adolescent females say about relationship issues? Author: Bralock A; Koniak-Griffin D Source: Journal of Pediatric Nursing. 2009 Apr;24(2):131-40. Abstract: Many sexually active teenagers face risk for contracting sexually transmitted infections (STIs) including HIV. The purpose of our study was to gain an understanding about influences on condom use among sexually active adolescents in relationships. Data were collected through semi-structured openended interviews. The findings of this study suggest that many adolescents desired the love of a male partner, and were willing to concede to his request of practicing unprotected sex. Findings support the urgent need for interventions that will promote skill-building techniques to negotiate safer sex behaviors among youth who are most likely to be exposed to STIs through risky behaviors. Language: English Keywords: UNITED STATES OF AMERICA | RESEARCH REPORT | INTERVIEWS | ADOLESCENTS | COUPLES | BLACKS | SEX BEHAVIOR | SEXUALLY TRANSMITTED DISEASES | NEEDS | CONDOM USE | RISK REDUCTION BEHAVIOR | RISK BEHAVIOR | Developed Countries | North America | Americas | Data Collection | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Family Characteristics | Family and Household | Sociocultural Factors | Ethnic Groups | Cultural Background | Behavior | Reproductive Tract Infections | Infections | Diseases | Economic Factors Document Number: 342095 |
| 6. Title: Community characteristics, sexual initiation, and condom use among young Black South Africans. Author: Burgard SA; Lee-Rife SM Source: Journal of Health and Social Behavior. 2009 Sep;50(3):293-309. Abstract: Individual and household-level characteristics that influence sexual behavior have been extensively studied in South Africa, but community characteristics have received limited attention. We use multilevel discrete time hazard models and multilevel logistic regression models to analyze data from a representative sample of young people in KwaZulu Natal, and from several sources of community data. Results suggest that, net of individual and household characteristics, higher levels of community concentrated disadvantage are associated with increased hazard of sexual initiation and higher risk of unprotected sex. Social disorder increases the hazard of sexual initiation, while greater community social cohesion is associated with delayed sexual debut, although the latter association appears stronger for young men than for young women. We discuss these results and the ways they vary from predictions based on US. theory in light of conditions prevailing in contemporary South Africa. Language: English Keywords: SOUTH AFRICA | RESEARCH REPORT | DATA ANALYSIS | BLACKS | YOUTH | HOUSEHOLDS | SEX BEHAVIOR | AGE FACTORS | SOCIOECONOMIC FACTORS | RISK FACTORS | EXPOSURE | POPULATION CHARACTERISTICS | COMMUNITY | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Research Methodology | Ethnic Groups | Cultural Background | Demographic Factors | Population | Family and Household | Sociocultural Factors | Behavior | Economic Factors | Health | Residence Characteristics | Population Distribution | Geographic Factors Document Number: 342565 |
| 7. Peer Reviewed Title: Prevalence and risk factors for Hepatitis C and HIV-1 infections among pregnant women in Central Brazil. Author: Costa ZB; Machado GC; Avelino MM; Gomes Filho C; Macedo Filho JV; Minuzzi AL; Turchi MD; Stefani MM; de Souza WV; Martelli CM Source: BMC Infectious Diseases. 2009;9:116. Abstract: BACKGROUND: Hepatitis C (HCV) and human immunodeficiency virus (HIV) infections are a major burden to public health worldwide. Routine antenatal HIV-1 screening to prevent maternal-infant transmission is universally recommended. Our objectives were to evaluate the prevalence of and potential risk factors for HCV and HIV infection among pregnant women who attended prenatal care under the coverage of public health in Central Brazil. METHODS: Screening and counselling for HIV and HCV infections was offered free of charge to all pregnant women attending antenatal clinic (ANC) in the public health system, in Goiania city (~1.1 million inhabitants) during 2004-2005. Initial screening was performed on a dried blood spot collected onto standard filter paper; positive or indeterminate results were confirmed by a second blood sample. HCV infection was defined as a positive or indeterminate sample (EIA test) and confirmed HCV-RNA technique. HIV infection was defined according to standard criteria. Factors associated with HIV and HCV infections were identified with logistic regression. The number needed to screen (NNS) to prevent one case of infant HIV infection was calculated using the Monte Carlo simulation method. RESULTS: A total of 28,561 pregnant women were screened for HCV and HIV-1 in ANC. Mean maternal age was 23.9 years (SD = 5.6), with 45% of the women experiencing their first pregnancy. Prevalence of HCV infection was 0.15% (95% CI 0.11%-0.20%), and the risk increased with age (p < 0.01). The prevalence of anti-HIV infection was 0.09% (95% CI 0.06%-0.14%). Black women had a 4.9-fold (95% CI 1.42-16.95) greater risk of HIV-1 infection compared to non-black women. NNS to prevent one case of infant HIV infection ranged from 4,141 to 13,928. CONCLUSION: The prevalence of HIV and HCV infections were low among pregnant women, with high acceptability rates in the opt-in strategy in primary care. Older maternal age was a risk factor for HCV and antenatal HCV testing does not fulfill the requirements for screening recommendation. The finding of higher risk of HIV-1 infection among black women despite being in consonance with the HIV-1 ethnic pattern in some American regions cannot be ruled out to be a surrogate marker of socio-economic condition. Language: English Keywords: BRAZIL | RESEARCH REPORT | PREVALENCE | RISK FACTORS | PREGNANT WOMEN | BLACKS | ANTENATAL CARE | HIV TESTING | HIV INFECTIONS | SCREENING | COUNSELING | PRIMARY HEALTH CARE | AGE FACTORS | South America, Eastern | South America | Latin America | Americas | Developing Countries | Measurement | Research Methodology | Health | Population Characteristics | Demographic Factors | Population | Ethnic Groups | Cultural Background | Maternal Health Services | Maternal-Child Health Services | Health Services | Delivery of Health Care | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Viral Diseases | Diseases | Clinic Activities | Program Activities | Programs | Organization and Administration Document Number: 342683 |
| 8. Title: Contraceptive attitudes among inner-city African American female adolescents: Barriers to effective hormonal contraceptive use. Author: Gilliam ML; Davis SD; Neustadt AB; Levey EJ Source: Journal of Pediatric and Adolescent Gynecology. 2009 Apr;22(2):97-104. Abstract: STUDY OBJECTIVE: To better understand the contraceptive attitudes of low-income, inner-city African American female adolescents. DESIGN: We conducted four focus group sessions with African American female adolescents. SETTING: An urban, community health clinic serving low-income patients on Chicago's south side. PARTICIPANTS: African American female adolescents (n = 15) between 14 and 19 years of age. INTERVENTIONS: Focus group sessions lasting approximately 90 minutes in length were conducted using a pre-determined script with set probes and open-ended questions. MAIN OUTCOME MEASURES: Qualitative analysis was conducted to identify major themes related to adolescents' contraceptive attitudes. RESULTS: Six themes related to the contraceptive attitudes of these adolescents emerged: Concerns About Hormones, Concerns About Privacy, Concerns About Compliance, Limited Awareness of New Methods of Hormonal Contraception (HC), Preference for Condoms, and Acceptability of Emergency Contraception (EC). Overall, adolescents in these sessions expressed skepticism and unwillingness to use continuous methods of HC. For some adolescents, concerns about hormones, privacy, and compliance outweighed their concerns about pregnancy. CONCLUSION: Concerns about perceived side effects and long-term health risks associated HC and privacy in obtaining contraception and reproductive health care, as well as concerns about ability to comply with daily and weekly HC regimens are common among African American female adolescents and may deter consistent HC use. Although condoms and EC appear to be highly acceptable among this group, adolescents also report a number of barriers to their consistent use. Efforts to reduce early, unintended pregnancy among African American youth should focus on addressing adolescents' HC-related concerns, improving access to EC, and helping female adolescents effectively negotiate condom use. Language: English Keywords: UNITED STATES OF AMERICA | RESEARCH REPORT | FOCUS GROUPS | BLACKS | LOW INCOME POPULATION | ADOLESCENTS, FEMALE | URBAN POPULATION | ATTITUDES | CONTRACEPTIVE SAFETY | PRIVACY | CONTRACEPTION CONTINUATION | CONDOM USE | CONTRACEPTIVE METHODS | KNOWLEDGE | EMERGENCY CONTRACEPTION | Developed Countries | North America | Americas | Data Collection | Research Methodology | Ethnic Groups | Cultural Background | Population Characteristics | Demographic Factors | Population | Social Class | Socioeconomic Status | Socioeconomic Factors | Economic Factors | Adolescents | Youth | Age Factors | Psychological Factors | Behavior | Safety | Public Health | Health | Contraceptive Usage | Contraception | Family Planning | Risk Reduction Behavior | Sociocultural Factors Document Number: 330953 |
| 9. Peer Reviewed Title: A 15-Minute Interactive, Computerized Condom Use Intervention With Biological Endpoints. Author: Grimley DM; Hook EW 3rd Source: Sexually Transmitted Diseases. 2009 Feb;36(2):73-78. Abstract: BACKGROUND:: Brief face-to-face-behavioral interventions have been shown to be efficacious, but are costly to sustain and to widely disseminate. This study evaluated the efficacy of a 15-minute theory-based behavioral intervention designed to increase condom use and reduce new cases of Neisseria gonorrhoeae and Chlamydia trachomatis. METHODS:: Participants were randomly assigned via the computer to the intervention or the comparison group stratified by gender and their baseline stage of change (motivational readiness) for using condoms consistently (100%) with their main partners. Behavioral data and biologic specimens for testing of Neisseria gonorrhoeae and Chlamydia trachomatis were obtained at baseline and at 6 months post intervention. The intervention was delivered via an audio, multimedia, computerized application that provided individualized interventions to patients based on their responses to assessment items; comparison patients interacted with a 15-minute, computerized, multiple health risk assessment with no intervention. RESULTS:: The majority of the sample (N = 430) was black (88%); 54.5% women; with a mean age = 24.5. Assuming all participants who did not return to the clinic at 6 months were not using condoms consistently, 32% of the treatment group versus 23% in the comparison group reported consistent condom use (P = 0.03). The combined Neisseria gonorrhoeae and Chlamydia trachomatis incidence declined to 6% in the intervention group versus 13% in the comparison group (P = 0.04). Results from a regression analysis revealed that the only statically significant predictor of sexually transmitted diseases infection at the follow-up was group assignment (OR = 1.91, 95% confidence index = 1.09-3.34; P = 0.043). CONCLUSIONS:: These findings suggest that brief, interactive, computer-delivered interventions provided at the evaluation visit increase condom use and reduce sexually transmitted diseases without putting additional burden on clinicians or staff. Language: English Keywords: ALABAMA | RESEARCH REPORT | KAP SURVEYS | CASE CONTROL STUDIES | STATISTICAL REGRESSION | THEORETICAL MODELS | BLACKS | COMPUTER PROGRAMS AND PROGRAMMING | GONORRHEA | CHLAMYDIA | CONDOM USE | AUDIOVISUAL AIDS | TIME FACTORS | RISK ASSESSMENT | CONTRACEPTIVE PREVALENCE | Developed Countries | United States of America | North America | Americas | Surveys | Sampling Studies | Studies | Research Methodology | Data Analysis | Ethnic Groups | Cultural Background | Population Characteristics | Demographic Factors | Population | Information Processing | Information | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections | Diseases | Risk Reduction Behavior | Behavior | Educational Methods | Educational Activities | Education | Population Dynamics | Evaluation | Contraceptive Usage | Contraception | Family Planning Document Number: 329674 |
| 10. Peer Reviewed Title: HIV infection, stressful life events, and intimate relationship power: the moderating role of community resources for black South African women. Author: Ketchen B; Armistead L; Cook S Source: Women and Health. 2009 Mar-May;49(2-3):197-214. Abstract: BACKGROUND: Black women in South Africa are vulnerable with limited power in intimate relationships. This study explored whether stressful life events and/or HIV infection were associated with relationship power and whether the impact was moderated by community resources. METHOD: One hundred four women living with HIV and 152 women not living with HIV participated in individual interviews. RESULTS: Undesirable life changes were negatively associated with relationship control. HIV infection and women's knowledge of community resources were associated with mutual decision-making, while frequency of family use of community resources was negatively related to female dominated decisions. Women living with HIV perceived their male partners as less dominant when they perceived their community resources to be more helpful. CONCLUSIONS: Power in intimate relationships may enhance the quality and length of life for black South African women living with HIV. Knowledge of and perceived helpfulness of community resources are avenues for promoting relationship power. Language: English Keywords: SOUTH AFRICA | RESEARCH REPORT | BLACKS | WOMEN | PERSONS LIVING WITH HIV/AIDS | POWER | COMMUNITY-BASED DISTRIBUTION | SOCIAL WELFARE | STRESS | COUNSELING | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Ethnic Groups | Cultural Background | Population Characteristics | Demographic Factors | Population | HIV Infections | Viral Diseases | Diseases | Political Factors | Sociocultural Factors | Nonclinical Distribution | Distributional Activities | Program Activities | Programs | Organization and Administration | Economic Factors | Psychological Factors | Behavior | Clinic Activities Document Number: 342428 |
| 11. Title: Breastfeeding self-efficacy in women of African descent. Author: McCarter-Spaulding D; Gore R Source: Journal of Obstetric, Gynecologic, and Neonatal Nursing. 2009 Mar-Apr;38(2):230-43. Abstract: OBJECTIVE: To determine whether breastfeeding self-efficacy predicts the duration and pattern of breastfeeding in a sample of Black women of African descent. DESIGN: Descriptive, longitudinal, cohort study. Participants were recruited during the postpartum hospitalization and followed monthly for 6 months or until complete weaning. Breastfeeding self-efficacy was measured using the Breastfeeding Self-Efficacy Scale--Short Form (BSES-SF) (Dennis, 2003). SETTING: A large urban teaching hospital in New England. PATIENTS/PARTICIPANTS: Women who self-identified as being of African descent with full-term infants who were planning to breastfeed (N=125). MAIN OUTCOME MEASURES: Breastfeeding pattern was determined by the total number of feedings the infant received in the past 24 hours and how many of these were breast milk. Duration of breastfeeding was defined as the number of weeks until complete weaning. RESULTS: Higher levels of breastfeeding self-efficacy predicted longer duration and a more exclusive pattern of breastfeeding at 1 and 6 months postpartum, consistent with prior research (p<.01). Planned pattern of feeding predicted actual pattern of feeding at 1 month postpartum (p<.01). Returning to work after 12 weeks was protective of breastfeeding to 6 months postpartum (p<.01). CONCLUSION: Theory-based interventions to enhance self-efficacy will help improve breastfeeding outcomes. Language: English Keywords: UNITED STATES OF AMERICA | RESEARCH REPORT | LONGITUDINAL STUDIES | BLACKS | WOMEN | BREASTFEEDING | BREASTFEEDING, EXCLUSIVE | TIME FACTORS | WEANING | PSYCHOSOCIAL FACTORS | BELIEFS | EMPLOYMENT STATUS | INTERVENTIONS | Developed Countries | North America | Americas | Studies | Research Methodology | Ethnic Groups | Cultural Background | Population Characteristics | Demographic Factors | Population | Infant Nutrition | Nutrition | Health | Population Dynamics | Behavior | Culture | Sociocultural Factors | Socioeconomic Status | Socioeconomic Factors | Economic Factors | Programs | Organization and Administration Document Number: 341947 |
| 12. Peer Reviewed Title: Barriers and facilitators to maternal communication with preadolescents about age-relevant sexual topics. Author: Miller KS; Fasula AM; Dittus P; Wiegand RE; Wyckoff SC; McNair L Source: AIDS and Behavior. 2009 Apr;13(2):365-74. Abstract: The present study examined factors that promote parent-child discussions about sex topics. A sample of 1,066 dyads of African American mothers and their 9-12-year-old children participated completing computer-administered surveys. After controlling for all other covariates, mother's sexual communication responsiveness (i.e., knowledge, comfort, skills, and confidence) was the most consistent predictor of discussions. Mothers with higher responsiveness had significantly increased odds of discussions about abstinence, puberty, and reproduction, based on both mother and child reports. In addition, child's age, pubertal development, readiness to learn about sex, and being female were positively associated with an increase in the odds of discussions in most models. Findings indicate that encouraging parents to talk with their children early may not be sufficient to promote parent-child sex discussions. Parents also need the knowledge, comfort, skills, and confidence to communicate effectively and keep them from avoiding these often difficult and emotional conversations with their children. Language: English Keywords: UNITED STATES OF AMERICA | RESEARCH REPORT | BLACKS | MOTHERS | CHILDREN | SEXUALITY | INTERPERSONAL COMMUNICATION | OBSTACLES | SEX EDUCATION | PARENTAL INVOLVEMENT | ATTITUDES | SEX FACTORS | Developed Countries | North America | Americas | Ethnic Groups | Cultural Background | Population Characteristics | Demographic Factors | Population | Parents | Family Relationships | Family Characteristics | Family and Household | Sociocultural Factors | Youth | Age Factors | Personality | Psychological Factors | Behavior | Communication | Organization and Administration | Education | Child Rearing Document Number: 342862 |
| 13. Peer Reviewed Title: Ovarian cancer risk factors in African-American and white women. Author: Moorman PG; Palmieri RT; Akushevich L; Berchuck A; Schildkraut JM Source: American Journal of Epidemiology. 2009 Sep 1;170(5):598-606. Abstract: Ovarian cancer is the most lethal gynecologic malignancy in both African-American and white women. Although prevalences of many ovarian cancer risk factors differ markedly between African Americans and whites, there has been little research on how the relative contributions of risk factors may vary between racial/ethnic groups. Using data from a North Carolina case-control study (1999-2008), the authors conducted unconditional logistic regression analyses to calculate odds ratios and 95% confidence intervals for ovarian cancer risk factors in African-American (143 cases, 189 controls) and white (943 cases, 868 controls) women and to test for interactions by race/ethnicity. They also calculated attributable fractions within each racial/ethnic group for the modifiable factors of pregnancy, oral contraceptive use, tubal ligation, and body mass index. Many risk factors showed similar relations across racial/ethnic groups, but tubal ligation and family history of breast or ovarian cancer showed stronger associations among African Americans. Younger age at menarche was associated with risk only in white women. Attributable fractions associated with tubal ligation, oral contraceptive use, and obesity were markedly higher for African Americans. The relative importance of ovarian cancer risk factors may differ for African-American women, but conclusions were limited by the small sample. There is a clear need for further research on etiologic factors for ovarian cancer in African-American women. Language: English Keywords: UNITED STATES OF AMERICA | NORTH CAROLINA | RESEARCH REPORT | CONTROL GROUPS | WOMEN | BLACKS | WHITES | OVARIAN CANCER | RISK FACTORS | ORAL CONTRACEPTIVES | TUBAL LIGATION | OBESITY | BREASTFEEDING | GENETICS | Developed Countries | North America | Americas | Research Methodology | Demographic Factors | Population | Ethnic Groups | Cultural Background | Population Characteristics | Cancer | Neoplasms | Diseases | Health | Contraceptive Methods | Contraception | Family Planning | Female Sterilization | Sterilization, Sexual | Body Weight | Physiology | Biology | Infant Nutrition | Nutrition Document Number: 342784 |
| 14. Peer Reviewed Title: Increasing incidence of Kaposi's sarcoma in black South Africans in KwaZulu-Natal, South Africa (1983-2006). Author: Mosam A; Carrara H; Shaik F; Uldrick T; Berkman A; Aboobaker J; Coovadia HM Source: International Journal of STD and AIDS. 2009 Aug;20(8):553-6. Abstract: The aim of the study was to describe the temporal trends in the incidence of Kaposi's sarcoma (KS) in black South Africans in KwaZulu-Natal (KZN). The study was designed as a retrospective record review. The incidence of Kaposi's sarcoma was estimated using administrative records for patients receiving care for KS through public sector oncology clinics in KZN, 1983-2006. Annual age-standardized incidence rates were calculated using provincial census data for the denominator. Age-specific rates were calculated for the pre-AIDS (1983-1989) and for the generalized AIDS epidemic eras (2006). Age-standardized incidence of KS increased in KZN from <1:100,000 in 1990 to at least 15:100,000 in 2006; this increase was observed in both men and women. There was a shift in the peak age-specific incidence rates from the sixth decade of life in the pre-AIDS era to the fourth and fifth decades in the AIDS era. In conclusion, KS is a growing public health problem in KZN, South Africa. These data reinforce the need for comprehensive national access to and roll-out of antiretroviral drugs, given their success in prevention and treatment of KS in first-world settings. Language: English Keywords: SOUTH AFRICA | RESEARCH REPORT | INCIDENCE | EPIDEMIOLOGY | BLACKS | AIDS | SIGNS AND SYMPTOMS | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Measurement | Research Methodology | Public Health | Health | Ethnic Groups | Cultural Background | Population Characteristics | Demographic Factors | Population | HIV Infections | Viral Diseases | Diseases Document Number: 342265 |
| 15. Peer Reviewed Title: Application of the Attitude-Social Influence-Efficacy Model to Condom Use Among African-American STD Clinic Patients: Implications for Tailored Health Communication. Author: Noar SM; Crosby R; Benac C; Snow G; Troutman A Source: AIDS and Behavior. 2009 Aug 14; Abstract: The purpose of the current investigation was to apply the attitude-social influence-efficacy (ASE) model to achieve a theory-based understanding of condom use among low income, heterosexually active African-American STD clinic patients. N = 293 participants were recruited from a large, publicly-funded metropolitan STD clinic in the Southeastern United States and surveyed using an ACASI computer program. Results indicated that several ASE variables exhibited meaningful relationships with condom stages of change in univariate analyses, replicating patterns found in previous research. Fewer variables remained significant in multivariate analyses, however. There was also some support for the proposition that early stage movement (e.g., Precontemplation to Contemplation) is based more upon perceptions of condom use (e.g., pros, perceived norms), whereas later stage movement (e.g., Preparation to Action/Maintenance) is based more upon perceived and actual skills acquisition (e.g., condom self-efficacy, negotiation strategies). Results varied with regard to main and casual condom stage of change. Implications for developing tailored HIV prevention interventions with heterosexual African-Americans are discussed. Language: English Keywords: UNITED STATES OF AMERICA | RESEARCH REPORT | CLIENTS | BLACKS | CONDOM USE | BEHAVIOR CHANGE | HIV PREVENTION | COMMUNICATION PROGRAMS | Developed Countries | North America | Americas | Program Activities | Programs | Organization and Administration | Ethnic Groups | Cultural Background | Population Characteristics | Demographic Factors | Population | Risk Reduction Behavior | Behavior | HIV Infections | Viral Diseases | Diseases | Communication Document Number: 342545 |
| 16. Peer Reviewed Title: Stages of consistent condom use, partner intimacy, condom use attitude, and self-efficacy in African-American crack cocaine users. Author: Pallonen UE; Timpson SC; Williams ML; Ross MW Source: Archives of Sexual Behavior. 2009 Feb;38(1):149-58. Abstract: This study examined how condom use attitude, self-efficacy, and partner intimacy related to five stages of consistent condom use. Interview data were collected from sexually active, heterosexual, African-American crack cocaine smokers (N = 366). Dependent measures assessed both the participants' own responses and their perceptions about their last sex partner's own personal condom use attitude and participants' condom use self-efficacy expectations. Partner intimacy was assessed both as a continuous attitudinal and as a discrete relationship measure. Less than 10% were classified as consistent condom users. Two thirds of inconsistent users were in the Precontemplation (PC) stage. The contemplation (C) and preparation (P) stages were equal among the remainder of the inconsistent condom users. Higher partner intimacy reduced modestly readiness for consistent condom use. The stage but not the intimacy group was related to the condom use attitudes and self-efficacy measures. Last partners' perceived own negative attitudes were significantly related to the stages of consistent condom use and was especially low in the action (A) and maintenance (M) stages. Participants' own negative attitudes were unrelated to the stages. Of the self-efficacy measures, both participants' performance and situational condom use self-efficacies increased significantly after the PC stage and were highest in the P, A, and M stages. However, situational self-efficacy accounted for most of performance self-efficacy variance. In sum, consistent condom use was rare. A partner's attitudes and the participants' own situational self-efficacy expectations, rather than intimacy, determined the readiness to adopt consistent condom use. Language: English Keywords: UNITED STATES OF AMERICA | RESEARCH REPORT | DATA COLLECTION | INTERVIEWS | BLACKS | CONDOM USE | ATTITUDES | DRUG USE AND ABUSE | CHANGES | RISK REDUCTION BEHAVIOR | Developed Countries | North America | Americas | Research Methodology | Ethnic Groups | Cultural Background | Population Characteristics | Demographic Factors | Population | Behavior | Psychological Factors | Social Change | Sociocultural Factors Document Number: 330845 |
| 17. Peer Reviewed Title: Perceived condom norms and HIV risks among social and sexual networks of young African American men who have sex with men. Author: Peterson JL; Rothenberg R; Kraft JM; Beeker C; Trotter R Source: Health Education Research. 2009 Feb;24(1):119-127. Abstract: The association between condom norms and unprotected sexual intercourse was examined within social and sexual networks of young African American men who have sex with men (MSM) in an HIV epicenter of the southern United States. We used a chain-link design to recruit 158 young African American men: 95 initial participants, 56 contacts of participants (alters) and 7 contacts of alters. Men in the high-risk group, compared with those in the no-risk group, perceived significantly lower approval concerning condom use in their social and sexual networks. Also, 100 participants could be connected to each other in 86 dyads of social and sexual networks. Within these dyads, men perceived that their friends and acquaintances approved for them to use condoms but that their friends and acquaintances did not use condoms themselves. Low HIV risk behavior appears associated with perceived social norms that support one's use of condoms, even when perceived norms do not support condom use by network members themselves. Language: English Keywords: UNITED STATES OF AMERICA | RESEARCH REPORT | ETHNIC GROUPS | BLACKS | MEN HAVING SEX WITH MEN | RISK BEHAVIOR | SEX BEHAVIOR | CONDOM USE | HIV INFECTIONS | RISK FACTORS | SOCIAL NETWORKS | Developed Countries | North America | Americas | Cultural Background | Population Characteristics | Demographic Factors | Population | Behavior | Risk Reduction Behavior | Viral Diseases | Diseases | Biology | Friends and Relatives | Family and Household | Sociocultural Factors Document Number: 329525 |
| 18. Title: Building international research partnerships to develop HIV programs for women of color in the context of social inequalities and human rights. Author: Sanders-Phillips K; Pretorius L; Reddy P Source: Social Work In Public Health. 2009 Jan-Apr;24(1-2):60-75. Abstract: This article examines relationships among social inequality, drug use, and HIV risk for women of color in the United States and South Africa. In the first section, social and cultural factors that may place women of color at risk for drug use and exposure to HIV are identified. In the second section, lessons learned while developing HIV prevention research protocols for women of color in South Africa are presented and discussed. Experience suggests that to effectively address women's risks of drug use and AIDS requires specific theoretical models and methodological approaches that acknowledge the critical interface that may exist among social inequality, drug use, and AIDS risk for women worldwide. Successful HIV prevention and intervention programs for women of color worldwide also require international research partnerships that are based on mutual respect between partners and attention to the needs and priorities of the target populations. Language: English Keywords: SOUTH AFRICA | UNITED STATES OF AMERICA | CRITIQUE | RESEARCH ACTIVITIES | WOMEN | BLACKS | INEQUALITIES | HUMAN RIGHTS | DRUG USE AND ABUSE | HIV INFECTIONS | AIDS | SOCIOCULTURAL FACTORS | PROGRAM DEVELOPMENT | INTERNATIONAL COOPERATION | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Developed Countries | North America | Americas | Research Methodology | Demographic Factors | Population | Ethnic Groups | Cultural Background | Population Characteristics | Socioeconomic Factors | Economic Factors | Political Factors | Behavior | Viral Diseases | Diseases | Programs | Organization and Administration Document Number: 341953 |
| 19. Title: Condom failure: examining the objective and cultural meanings expressed in interviews with African American adolescents. Author: Sznitman SR; Horner J; Salazar LF; Romer D; Vanable PA Source: Journal of Sex Research. 2009 Jan 15;:1-10. Abstract: The purpose of this study was to explore the meaning and context of self-reported "condom failure" among sexually active African American adolescents. Semistructured interviews regarding methods of protection from pregnancy and sexually transmitted disease (STD) with 124 youth (ages 14-19 years) were content analyzed. The findings suggested three meanings of condom failure. First, condom failure represents a legitimate and important risk related to sexual activity. Second, it can serve as an excuse repertoire for adolescents who engaged in unprotected sex and later experienced either pregnancy or a STD. Third, it may serve as an explanation for males who deceive their partners into having unprotected sex. The findings are discussed with regard to their implications for HIV or STD prevention and research. Language: English Keywords: UNITED STATES OF AMERICA | MICHIGAN | RESEARCH REPORT | INTERVIEWS | YOUTH | BLACKS | CONDOM FAILURE | SEXUALLY TRANSMITTED DISEASE PREVENTION | PREGNANCY | CULTURE | PREVENTION AND CONTROL | Developed Countries | North America | Americas | Data Collection | Research Methodology | Age Factors | Population Characteristics | Demographic Factors | Population | Ethnic Groups | Cultural Background | Condoms | Barrier Methods | Contraceptive Methods | Contraception | Family Planning | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections | Diseases | Reproduction | Sociocultural Factors Document Number: 329664 |
| 20. Peer Reviewed Title: Prevalence, correlates, and sexually transmitted infection risk related to coitus interruptus among African-American adolescents. Author: Sznitman SR; Romer D; Brown LK; DiClemente RJ; Valois RF; Vanable PA; Carey MP; Stanton B Source: Sexually Transmitted Diseases. 2009 Apr;36(4):218-20. Abstract: "Coitus interruptus" or withdrawal that involves the male partner "pulling out" before ejaculation, has received relatively little research attention, particularly in adolescents. The limited data that exist suggest that it is practiced among adolescents, yet its prevalence remains unclear. In a research trial developed to test the efficacy of a sexually transmitted infection (STI)/HIV prevention program among black adolescents, we were surprised to see extensive use of withdrawal (60% prevalence). Because black adolescents are disproportionately affected by the intersecting epidemics of HIV and other STIs, the practice of withdrawal may pose a particular risk practice for this population. Therefore, we examined 3 questions: (1) what are the correlates of withdrawal use among black adolescents, (2) how widespread is the combined use of withdrawal and condoms, and (3) what is the contribution of withdrawal to STI acquisition? (excerpt) Language: English Keywords: UNITED STATES OF AMERICA | RESEARCH REPORT | EPIDEMIOLOGIC METHODS | CLINICAL RESEARCH | BLACKS | ADOLESCENTS | MULTIPLE PARTNERS | PREVALENCE | SEXUALLY TRANSMITTED DISEASES | WITHDRAWAL | SEX FACTORS | CONDOM USE | Developed Countries | North America | Americas | Research Methodology | Ethnic Groups | Cultural Background | Population Characteristics | Demographic Factors | Population | Youth | Age Factors | Sexual Partners | Sex Behavior | Behavior | Measurement | Reproductive Tract Infections | Infections | Diseases | Family Planning, Behavioral Methods | Family Planning | Risk Reduction Behavior Document Number: 341120 |
| 21. Peer Reviewed Title: Formative study to develop the Eban treatment and comparison interventions for couples. Author: NIMH Multisite HIV/STD Prevention Trial for African American Couples Group Source: JAIDS. Journal of Acquired Immune Deficiency Syndromes. 2008 Sep 1;49 Suppl 1:S42-51. Abstract: OBJECTIVE: To describe formative and pilot-testing research that generated themes and procedures, curricula, and critical measures for a randomized clinical trial testing a Risk Reduction Intervention for HIV-serodiscordant African American couples (Project Eban). DESIGN: This article describes the themes that emerged from discussions with African American serodiscordant couples about HIV-related risks from focus groups with 11 couples and pilot study results with 32 couples across 4 sites. METHODS: In step 1, focus groups examined the need for a Risk Reduction Intervention for HIV-serodiscordant African American couples and confirmed 4 themes that formed the basis for the intervention curriculum and study format. In step 2, a pilot study refined the clinical trial procedures for this population and tested critical measures and selected portions of the curriculum for both the treatment and the comparison interventions. RESULTS: Based on these findings, stigma and psychological distress, barriers to condom use, insufficient support from community and service organizations, and the lack of skills that emphasize individual and relationship protection were ultimately integrated into the Risk Reduction Intervention. CONCLUSIONS: Pilot study findings highlighted the importance of examining gender and ethnicity in HIV-impacted couples along with factors that heightened HIV-related risk behaviors that affect couples' skills and psychological adjustment. The goal was to ensure that a skill-based, culturally congruent, relationship-centered intervention could be understood and of interest to couples. Future analyses in the main trial will be discussed. Language: English Keywords: UNITED STATES OF AMERICA | RESEARCH REPORT | FOCUS GROUPS | PILOT PROJECTS | CLINICAL TRIALS | COUPLES | BLACKS | RISK REDUCTION BEHAVIOR | SEX BEHAVIOR | HIV INFECTIONS | TREATMENT | STIGMA | PSYCHOLOGICAL FACTORS | CONDOM USE | BEHAVIOR CHANGE | CULTURE | Developed Countries | North America | Americas | Data Collection | Research Methodology | Studies | Clinical Research | Family Characteristics | Family and Household | Sociocultural Factors | Ethnic Groups | Cultural Background | Population Characteristics | Demographic Factors | Population | Behavior | Viral Diseases | Diseases | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Social Problems Document Number: 328590 |
| 22. Peer Reviewed Title: Measure of HIV/STD risk-reduction: strategies for enhancing the utility of behavioral and biological outcome measures for African American couples. Author: NIMH Multisite HIV/STD Prevention Trial for African American Couples Group Source: JAIDS. Journal of Acquired Immune Deficiency Syndromes. 2008 Sep 1;49 Suppl 1:S35-41. Abstract: OBJECTIVE: Numerous studies have discussed the value of including biological outcome measures as a complement to behavioral outcome measures to assess the efficacy of HIV risk-reduction interventions. This article highlights strategies used to minimize the limitations of including both self-reported sexual behaviors and biologically confirmed sexually transmitted diseases as primary outcome measures in an HIV/sexually transmitted disease (STD) prevention program for African American serodiscordant couples (Eban). DESIGN: Couples receiving an HIV intervention condition (Eban) were compared with couples receiving a time-equivalent General Health Promotion condition on behavioral and biological outcomes. Both behavioral and biological data were collected at baseline, immediately postintervention, and at 6 and 12 months postintervention. METHODS: Literature reviews, consulting other researchers who conducted couples studies, our investigative team's experience in previous HIV interventions, and formative work were used to develop procedures to minimize potential limitations associated with the inclusion of behavioral and biological outcome measures for Eban. RESULTS: Given the strengths of including behavioral and biological outcome measures, the Eban study chose to have both measures serve as primary outcomes. The primary behavioral outcome for the trial is the proportion of protected vaginal and anal intercourse episodes that occurred within the index couple in 90 days before each follow-up assessment and over the 12-month postintervention follow-up period. The primary biological outcome is the proportion of participants (male or female study partners) with an incident STD (Chlamydia, gonorrhea, or trichomoniasis) over the 12-month postintervention follow-up period. CONCLUSIONS: Employing procedures to minimize limitations of using self-reported sexual behaviors and STDs as complementary primary outcomes enhances their utility as measures of the efficacy of HIV/STD prevention interventions. Language: English Keywords: UNITED STATES OF AMERICA | RESEARCH REPORT | LITERATURE REVIEW | MEASUREMENT | COUPLES | BLACKS | HETEROSEXUALS | SEXUALLY TRANSMITTED DISEASES | SEX BEHAVIOR | RISK REDUCTION BEHAVIOR | INTERVENTIONS | PROGRAM EFFECTIVENESS | Developed Countries | North America | Americas | Research Methodology | Family Characteristics | Family and Household | Sociocultural Factors | Ethnic Groups | Cultural Background | Population Characteristics | Demographic Factors | Population | Behavior | Reproductive Tract Infections | Infections | Diseases | Programs | Organization and Administration | Program Evaluation Document Number: 328591 |
| 23. Peer Reviewed Title: HIV/AIDS-related stigma and discrimination: accounts of HIV-positive Caribbean people in the United Kingdom. Author: Anderson M; Elam G; Gerver S; Solarin I; Fenton K; Easterbrook P Source: Social Science and Medicine. 2008 Sep;67(5):790-8. Abstract: This paper explores the effects of HIV/AIDS-related stigma and discrimination (HASD) on HIV-positive Caribbean people in the Caribbean and the UK. In-depth, semi-structured interviews were held with a purposively selected group of 25 HIV-positive people of Caribbean origin, using primary selection criteria of sex, age, sexuality and country of birth. Interviews with respondents revealed that they are keenly aware of the stigma surrounding HIV/AIDS, which some attribute to a particularly Caribbean combination of fear of contamination, homophobia, and ignorance, reinforced by religious beliefs. In fact, religion serves a double role: underpinning stigma and assisting in coping with HIV. HASD has usually occurred where respondents have lost or do not have control over disclosure. Compared to UK-born respondents, the accounts of Caribbean-born respondents, most of whom were born in Jamaica, include more reports of severe HASD, particularly violence and employment discrimination. All respondents mobilise a variety of strategies in order to avoid HASD, which have implications for their social interactions and emotional well being. While some manage to avoid the "spoiled identity" of the stigmatised, thereby creating their own understandings of HIV infection, these may remain individual-level negotiations. HASD affects HIV-positive Caribbean people at home and in the diaspora in a variety of ways: emotionally, mentally, financially, socially and physically. Interventions specifically addressing stigma and discrimination must be formulated for the UK's Caribbean population. Tackling stigma and discrimination requires more than education; it requires "cultural work" to address deeply entrenched notions of sexuality. Language: English Keywords: UNITED KINGDOM | CARIBBEAN | RESEARCH REPORT | INTERVIEWS | BLACKS | PERSONS LIVING WITH HIV/AIDS | STIGMA | SOCIAL DISCRIMINATION | HIV INFECTIONS | Developed Countries | Europe, Western | Europe | Developing Countries | Americas | Data Collection | Research Methodology | Ethnic Groups | Cultural Background | Population Characteristics | Demographic Factors | Population | Viral Diseases | Diseases | Social Problems | Sociocultural Factors Document Number: 330566 |
| 24. Title: Building protective factors to offset sexually risky behaviors among black youths: a randomized control trial. Author: Bell CC; Bhana A; Petersen I; McKay MM; Gibbons R; Bannon W; Amatya A Source: Journal of the National Medical Association. 2008 Aug;100(8):936-44. Abstract: OBJECTIVES: To test the effectiveness of the CHAMP among black South Africans in KwaZulu-Natal, South Africa. METHODS: A randomized control trial was conducted in KwaDedangendlale, South Africa, among youths (ages 9-13) and their families (245 intervention families rearing 281 children and 233 control families rearing 298 children). The CHAMPSA intervention targeted HIV risk behaviors by strengthening family relationship processes as well as targeting peer influences through enhancing social problem solving and peer negotiation skills for youths. RESULTS: Among caregivers in the control and experimental conditions, significant intervention group differences were revealed regarding HIV transmission knowledge, less stigma toward HIV-infected people, caregiver monitoring-family rules, caregiver communication comfort, caregiver communication frequency and social networks. Among youths, data revealed that control and experimental groups were significantly different for children in AIDS transmission knowledge and less stigma toward HIV-infected people. CONCLUSIONS: CHAMPSA enhances a significant number individual, family and community protective factors that can help youths avoid risky behaviors leading to HIV-positive status. Language: English Keywords: SOUTH AFRICA | RESEARCH REPORT | CONTROL GROUPS | YOUTH | ADOLESCENTS | BLACKS | HIV PREVENTION | AIDS PREVENTION | RISK BEHAVIOR | SEX BEHAVIOR | FAMILY RELATIONSHIPS | Africa, Southern | Africa, Sub Saharan | Africa | Developing Countries | Research Methodology | Age Factors | Population Characteristics | Demographic Factors | Population | Ethnic Groups | Cultural Background | HIV Infections | Viral Diseases | Diseases | AIDS | Behavior | Family Characteristics | Family and Household | Sociocultural Factors Document Number: 328413 |
| 25. Title: Preconception care and pregnancy planning: Voices of African American women. Author: Canady RB; Tiedje LB; Lauber C Source: MCN. American Journal of Maternal Child Nursing. 2008 Apr;33(2):90-97. Abstract: This study aimed to investigate the intersection of women's pregnancy planning beliefs with preconception care barriers. We assessed the meaning of "planned pregnancy" for African American women and explored its connection to preconception experiences. The role of race and economics as contextualizing women's experiences was considered. African American women (n = 168) recruited from health department sites discussed the following questions: "What does the term 'planned pregnancy' mean?" "Would you describe your most recent pregnancy as planned?" Substantive themes were extracted using phenomenological methodology. The following themes emerged: (1) Preconception care: An unfamiliar concept; (2) Planning for pregnancy: A continuum of responses; (3) The psychology of conception: Attitudes, beliefs, and behaviors; (4) The shared nature of pregnancy: It takes two to plan; (5) Birth control: The means to the end; and (6) The context of preconception care: The big picture. Nurses who care for women in the childbearing years should understand that planning for pregnancy is not a simple cognitive process, and that race and economics play a role in women's beliefs about pregnancy. Preconception care also encompasses the contexts of family, public health, and society. Linking preconception care with all medical encounters is an important but insufficient approach. Nurses should apply their understanding of the biopsychosocial dimensions of health in support of the goals of preconception healthcare. Holistic nursing and public health perspectives should be considered to broaden the scope of preconception interventions and more effectively address social factors that influence preconception care. (author's) Language: English Keywords: UNITED STATES OF AMERICA | RESEARCH REPORT | FOCUS GROUPS | WOMEN | BLACKS | FAMILY PLANNING | RACE RELATIONS | ECONOMIC FACTORS | ATTITUDES | BELIEFS | CULTURE | Developed Countries | North America | Americas | Data Collection | Research Methodology | Demographic Factors | Population | Ethnic Groups | Cultural Background | Population Characteristics | Political Factors | Sociocultural Factors | Psychological Factors | Behavior Document Number: 325222 |
| 26. Title: Young African American men having sex with multiple partners are more likely to use condoms incorrectly: a clinic-based study. Author: Crosby RA; DiClemente RJ; Yarber WL; Snow G; Troutman A Source: American Journal of Men's Health. 2008 Dec;2(4):340-3. Abstract: This study tested the research hypothesis that men's errors using condoms would be associated with having multiple sex partners. Specifically, men engaging in sex with three or more women were compared with those having sex with two or fewer women. Recruitment (N = 271) occurred in a publicly funded sexually transmitted disease (STD) clinic located in a metropolitan area of the Southern United States. All men were clinically diagnosed with an STD. They completed a self-reported questionnaire (using a 3-month recall period). Those reporting sex with men were excluded from the analysis. About one half of the men (48.5%) reported penetrative sex with three or more women. The authors found that among young African American men, newly diagnosed with an STD, reporting recent (past 3 months) sex with multiple partners may be emblematic of condom errors. These men may benefit from clinic-based, targeted counseling and education designed to foster improved quality of condom use. Language: English Keywords: UNITED STATES OF AMERICA | RESEARCH REPORT | MEN | BLACKS | SEXUAL PARTNERS | SEX BEHAVIOR | HIV INFECTIONS | SEXUALLY TRANSMITTED DISEASES | CONDOM USE | Developed Countries | North America | Americas | Demographic Factors | Population | Ethnic Groups | Cultural Background | Population Characteristics | Behavior | Viral Diseases | Diseases | Reproductive Tract Infections | Infections | Risk Reduction Behavior Document Number: 341309 |
| 27. Peer Reviewed Title: Sexual agency versus relational factors: a study of condom use antecedents among high-risk young African American women. Author: Croxby RA; DiClemente RJ; Wingood GM; Salazar LF; Head S; Rose E; McDermott-Sales J Source: Sexual Health. 2008 Feb;5(1):41-47. Abstract: The influence that female partners exert regarding condom use is not well known. In the present study, the relative roles of personal sexual agency and relational factors in determining whether young African American women engaged in unprotected vaginal sex (UVS) were studied. A cross sectional study of 713 young, African American women (aged 15-21 years) was conducted. Data were collected using an audio-computer assisted self-interview. Three measures of sexual agency were assessed and three relational factors were assessed. To help assure validity in the outcome measure, condom use was assessed in five different ways. Multivariate analyses were used to determine whether variables independently predicted UVS. Two of the six predictor variables achieved multivariate significance with all five measures of condom use: (1) fear of negotiating condom use with male partners, and (2) indicating that stopping to use condoms takes the fun out of sex. A relational factor (male-dominated power imbalances) achieved multivariate significance for four of the five measures of UVS. A sexual agency factor (whether young women greatly enjoyed sex) achieved multivariate significance for three of the five measures. The results suggest that young African American women at high-risk of sexually transmissible infections (STI)/HIV acquisition may experience male-dominated power imbalances and also fear the process of negotiating condom use with their male partners. Although these factors were independently associated with UVS, two factors pertaining to sexual agency of these young women were also important predictors of UVS. Intervention efforts designed to avert STI/HIV acquisition among young African American women should therefore include programs to address both sexual agency and relational factors. Language: English Keywords: UNITED STATES OF AMERICA | RESEARCH REPORT | CROSS SECTIONAL ANALYSIS | MULTIVARIATE ANALYSIS | KAP SURVEYS | BLACKS | WOMEN | SEXUAL PARTNERS | CONDOM USE | GENDER RELATIONS | FEAR | PARTNER COMMUNICATION | Developed Countries | North America | Americas | Research Methodology | Data Analysis | Surveys | Sampling Studies | Studies | Ethnic Groups | Cultural Background | Population Characteristics | Demographic Factors | Population | Sex Behavior | Behavior | Risk Reduction Behavior | Gender Issues | Sociocultural Factors | Emotions | Psychological Factors | Interpersonal Relations Document Number: 322846 |
| 28. Peer Reviewed Title: Prevalence, correlates, and efficacy of selective avoidance as a sexually transmitted disease prevention strategy among African American adolescent females. Author: DiClemente RJ; Wingood GM; Crosby RA; Salazar LF; Rose E Source: Archives of Pediatrics and Adolescent Medicine. 2008 Jan;162(1):60-65. Abstract: The objectives were to identify the prevalence and correlates of selective avoidance (SA) of sexual intercourse among African American adolescent females at risk for sexually transmitted disease (STD) acquisition and transmission. The design used was a cross-sectional study. The setting for the study was health clinics. The participants were African American females (N=715) between the ages of 15 and 21 years. The main outcome measures were self-reported sexual behaviors and laboratory-confirmed STDs. Among the participants, 35.4% used SA as a strategy to prevent STD acquisition; 25.7% used SA to prevent STD transmission. Use of SA was not associated with current STD status. In multivariable analyses, adolescents who had sexual intercourse with 2 or more partners in the past 60 days, those who had high fear related to condom use negotiation, and those who discussed STD prevention with their sexual partners were 2.05 times more likely (95% confidence interval [CI], 1.31-3.20), 1.55 times more likely (95% CI, 1.09-2.19), and 2.00 times more likely (95% CI, 1.38-2.90), respectively, to use SA to prevent STD acquisition, and the same groups were 2.62 times more likely (95% CI, 1.62-4.24), 1.60 times more likely (95% CI, 1.10-2.32), and 2.13 times more likely (95% CI, 1.39-3.26), respectively, to use SA to prevent STD transmission. This study provides initial evidence suggesting that SA as a risk-reduction strategy specifically used to prevent STD acquisition and/or transmission may be common among African American adolescent females. Based on a lack of differences in STD prevalence, we recommend that clinicians and prevention programs discourage the use of SA as an STD prevention strategy and encourage adolescent females to use condoms consistently and correctly with all male sexual partners. (author's) Language: English Keywords: UNITED STATES OF AMERICA | RESEARCH REPORT | CROSS SECTIONAL ANALYSIS | SURVEYS | BLACKS | ADOLESCENTS, FEMALE | SEXUALLY TRANSMITTED DISEASE PREVENTION | RISK REDUCTION BEHAVIOR | SEX BEHAVIOR | SEXUAL INTERCOURSE | RECOMMENDATIONS | Developed Countries | North America | Americas | Research Methodology | Sampling Studies | Studies | Ethnic Groups | Cultural Background | Population Characteristics | Demographic Factors | Population | Adolescents | Youth | Age Factors | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections | Diseases | Behavior | Reproduction Document Number: 323371 |
| 29. Peer Reviewed Title: Age at menarche and first pregnancy among psychosocially at-risk adolescents. Author: Dunbar J; Sheeder J; Lezotte D; Dabelea D; Stevens-Simon C Source: American Journal of Public Health. 2008 Oct;98(10):1822-4. Abstract: The author's sought to determine which factors influence the association between menarche and conception among adolescent study participants (n = 1030), who demonstrated an earlier age of menarche than did national samples. Age at first sexual intercourse (coitarche) mediated the relationship between age at menarche and first pregnancy among White girls, whereas gynecologic age at coitarche (age at coitarche minus age at menarche) and age at menarche explained the timing of the first pregnancy among Black and Hispanic girls. Pregnancy prevention interventions to delay coitarche should also include reproductive education and contraception. Language: English Keywords: UNITED STATES OF AMERICA | RESEARCH REPORT | EPIDEMIOLOGIC METHODS | KAP SURVEYS | PREGNANT WOMEN | ADOLESCENTS | BLACKS | HISPANICS | AGE FACTORS | MENARCHE | ADOLESCENT PREGNANCY | PSYCHOSOCIAL FACTORS | RISK FACTORS | MATERNAL AGE | FIRST INTERCOURSE | TIME FACTORS | Developed Countries | North America | Americas | Research Methodology | Surveys | Sampling Studies | Studies | Population Characteristics | Demographic Factors | Population | Youth | Ethnic Groups | Cultural Background | Menstruation | Reproduction | Reproductive Behavior | Fertility | Population Dynamics | Behavior | Biology | Parental Age | Sex Behavior Document Number: 328527 |
30.  Title: Age differences at sexual debut and subsequent reproductive health: Is there a link? Author: Gomez AM; Speizer IS; Reynolds H; Murray N; Beauvais H Source: Reproductive Health. 2008;5:8. Abstract: ABSTRACT: BACKGROUND: Experiences at sexual debut may be linked to reproductive health later in life. Additionally, young women with older sexual partners may be at greater risk for HIV and sexually transmitted infections. This study examines sexual debut with an older partner and subsequent reproductive health outcomes among 599 sexually experienced women aged 15-24 who utilized voluntary counseling and testing or reproductive health services in Port-au-Prince, Haiti. METHODS: Logistic regression models, controlling for socioeconomic and demographic factors, examined whether age differences at first sex were significantly associated with STI diagnosis in the previous 12 months and family planning method use at last intercourse. RESULTS: Sixty-five percent of women reported sexual initiation with a partner younger or less than 5 years older, 28% with a partner 5 to 10 years older, and 7% with a partner 10 or more years older. There was a trend towards decreased likelihood of recent use of family planning methods in women who had first sexual intercourse with a partner 5 to 9 years older compared to women with partners who were younger or less than 5 years older. Age differences were not linked to recent STI diagnosis. CONCLUSION: Programs focusing on delaying sexual debut should consider age and gender-based power differentials between younger women and older men. Future research should examine whether wide age differences at sexual debut are predictive of continued involvement in cross-generational relationships and risky sexual behaviors and explore the mechanisms by which cross-generational first sex and subsequent reproductive health may be connected. Language: English Keywords: HAITI | METHODOLOGICAL STUDIES | RESEARCH REPORT | KAP SURVEYS | BASELINE SURVEYS | INDIRECT ESTIMATION TECHNIQUES | ADOLESCENTS, FEMALE | BLACKS | CONDOM USE | VALIDITY | TIME FACTORS | RELIABILITY | Caribbean | Americas | Developing Countries | Surveys | Sampling Studies | Studies | Research Methodology | Estimation Techniques | Adolescents | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Ethnic Groups | Cultural Background | Risk Reduction Behavior | Behavior | Measurement | Population Dynamics Document Number: 328027 |
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