| 1. Title: Contraceptive use among postpartum women - 12 states and New York City, 2004-2006. Author: Centers for Disease Control and Prevention (CDC) Source: MMWR. Morbidity and Mortality Weekly Report. 2009 Aug 7;58(30):821-6. Abstract: Postpartum use of highly effective contraceptive methods can prevent unintended pregnancies and ensure adequate birth spacing. Unintended pregnancies and short interpregnancy intervals are associated with adverse maternal and infant outcomes. In 2001, the year for which the most recent data are available, 49% of all pregnancies were unintended, and 21% of women gave birth within 24 months of a previous birth. Two Healthy People 2010 goals are to increase the percentage of intended pregnancies to 70% (objective 9-1) and to reduce the percentage of births occurring within 24 months of a previous birth to 6% (objective 9-2). To estimate the prevalence and types of contraception being used by women 2-9 months postpartum, CDC analyzed data from the 2004-2006 Pregnancy Risk Assessment Monitoring System (PRAMS) from 12 states and New York City. This report summarizes those results, which indicated that 88.0% of postpartum women reported current use of at least one contraceptive method; 61.7% reported using a method defined as highly effective, 20.0% used a method defined as moderately effective, and 6.4% used less effective methods. Rates of using highly effective contraceptive methods postpartum were lowest among Asian/Pacific Islanders (35.3%), women who had wanted to get pregnant sooner (49.9%), women aged >or=35 years (53.0%), and women who had no prenatal care (54.5%). State policy makers and health-care providers can use these results to promote use of highly effective contraception among postpartum women and target interventions for those with particularly low rates of usage, including women with no prenatal care. Language: English Keywords: UNITED STATES OF AMERICA | RESEARCH REPORT | DATA ANALYSIS | POSTPARTUM WOMEN | ETHNIC GROUPS | CDC | CONTRACEPTIVE USAGE | CONTRACEPTIVE METHODS CHOSEN | CONTRACEPTIVE EFFECTIVENESS | PREGNANCY, UNPLANNED | AGE FACTORS | TITLE 19 MEDICAL ASSISTANCE | Developed Countries | North America | Americas | Research Methodology | Puerperium | Reproduction | Cultural Background | Population Characteristics | Demographic Factors | Population | USPHS | Government Agencies | Organizations | Political Factors | Sociocultural Factors | Contraception | Family Planning | Reproductive Behavior | Fertility | Population Dynamics | Public Assistance | Grants | Financial Activities | Economic Factors Document Number: 342395 |
| 2. Title: Incidence and diagnoses of HIV infection - Puerto Rico, 2006. Author: Centers for Disease Control and Prevention (CDC) Source: MMWR. Morbidity and Mortality Weekly Report. 2009 Jun 5;58(21):589-91. Abstract: In 2006, 33 U.S. states and five territories had confidential, name-based, human immunodeficiency virus (HIV) infection reporting; among territories, Puerto Rico had the second highest rate of HIV infection. To characterize the HIV epidemic in Puerto Rico in 2006 (the year with the most recent available data), the Puerto Rico Department of Health and CDC analyzed data on diagnoses of HIV infection (including infections that occurred in 2006 and in previous years) and used a stratified extrapolation approach developed by CDC to generate HIV incidence estimates (the number of persons newly infected with HIV in 2006). The results indicated that, in 2006, an estimated 1,440 persons aged >or=13 years were newly infected with HIV in Puerto Rico, resulting in an estimated incidence rate of 45.0 cases per 100,000 population, twice the rate for the 50 U.S. states and District of Columbia (DC). Males accounted for 65% of new HIV infections in Puerto Rico, and 38% of new HIV infections occurred among persons aged 30-39 years; 39% of new infections were associated with injection-drug use, and 37% with high-risk heterosexual contact. The results provide insight into HIV transmission patterns in Puerto Rico that can help guide allocation of resources and the planning, implementation, and evaluation of HIV prevention programs and other services. Language: English Keywords: PUERTO RICO | SUMMARY REPORT | INCIDENCE | MEN | HISPANICS | IV DRUG USERS | MEN HAVING SEX WITH MEN | HIV INFECTIONS | PROGRAM EVALUATION | Caribbean | Americas | Developed Countries | Measurement | Research Methodology | Demographic Factors | Population | Ethnic Groups | Cultural Background | Population Characteristics | Drug Use and Abuse | Behavior | Sex Behavior | Viral Diseases | Diseases | Programs | Organization and Administration Document Number: 341589 |
3.  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 |
| 4. Peer Reviewed Title: Intentional condomless anal intercourse among Latino MSM who meet sexual partners on the Internet. Author: Balan IC; Carballo-Dieguez A; Ventuneac A; Remien RH Source: AIDS Education and Prevention. 2009 Feb;21(1):14-24. Abstract: Data on intentional condomless anal intercourse in risky contexts, also known as "barebacking," among ethnic minority MSM, whose rates of HIV infection continue to rise, are extremely limited. In this study, 31 Latino MSM who seek barebacking partners via the Internet underwent in-depth interviews about bareback sex and its association to pleasure, substance use, HIV concerns, and cultural identity. Participants reported engaging in bareback sex owing to the physical and emotional pleasure they experience. They expressed concern about HIV infection and took steps to reduce risk of infection. Although a majority of participants reported using alcohol or drugs in the context of bareback sex, substance use did not appear to propel the behavior. Crystal methamphetamine use, prevalent only among our HIV-positive participants, was related to very high HIV risk behavior. In this sample, culture did not seem to play a large role in barebacking. Language: English Keywords: NEW YORK | RESEARCH REPORT | KAP SURVEYS | MEN HAVING SEX WITH MEN | SEXUAL PARTNERS | ETHNIC GROUPS | ANAL SEX | CONDOM USE | INTERNET | RISK BEHAVIOR | SEX BEHAVIOR | PARTNER COMMUNICATION | DRUG USE AND ABUSE | HIV TRANSMISSION | PERCEPTION | Developed Countries | United States of America | North America | Americas | Surveys | Sampling Studies | Studies | Research Methodology | Behavior | Cultural Background | Population Characteristics | Demographic Factors | Population | Risk Reduction Behavior | Information Networks | Communication | Interpersonal Relations | HIV Infections | Viral Diseases | Diseases | Psychological Factors Document Number: 330344 |
| 5. Title: Sexual behavior and perceived peer norms: comparing perinatally HIV-infected and HIV-affected youth. Author: Bauermeister JA; Elkington K; Brackis-Cott E; Dolezal C; Mellins CA Source: Journal of Youth and Adolescence. 2009 Sep;38(8):1110-22. Abstract: A large proportion of perinatally HIV-infected (PHIV) children are becoming adolescents and exploring their sexuality. This study explored the prevalence of sexual behaviors (kissing, touching, engaging in oral sex, or having vaginal/anal intercourse) in a sample of predominantly ethnic minority youths (N = 339; 54.1% Black and 30.4% Latino; 51% female; ages 9-16) perinatally exposed to HIV (61% HIV+). Using logistic regression, we tested the association between sexual behavior and HIV status, demographic characteristics, and peer influences regarding sexual behavior. PHIV youth were less likely to be sexually active. Among sexually active youth, PHIV youth were more likely to engage in touching behavior than HIV-negative youth and were less likely to engage in penetrative sex. Youths reporting that a greater number of their peers believed that sexually active boys were "cool" or "popular" were more likely to report sexual behavior. The association between sexual behavior and peers believing sexually active girls were "cool" or "popular" varied by age, gender, and HIV status. Furthermore, friends' sexual activity was associated with sexual intercourse. Prevention programs should strengthen messages addressing peer norms regarding sexuality, as well as address specific issues related to adolescent HIV. Language: English Keywords: UNITED STATES OF AMERICA | NEW YORK | RESEARCH REPORT | COMPARATIVE STUDIES | ETHNIC GROUPS | PERSONS LIVING WITH HIV/AIDS | ADOLESCENTS | PEER GROUPS | VALUE ORIENTATION | HIV INFECTIONS | SEX BEHAVIOR | Developed Countries | North America | Americas | Studies | Research Methodology | Cultural Background | Population Characteristics | Demographic Factors | Population | Viral Diseases | Diseases | Youth | Age Factors | Knowledge Sources | Communication | Psychological Factors | Behavior Document Number: 342389 |
| 6. Peer Reviewed Title: Women's perspectives on family planning service quality: an exploration of differences by race, ethnicity and language. Author: Becker D; Klassen AC; Koenig MA; LaVeist TA; Sonenstein FL; Tsui AO Source: Perspectives On Sexual and Reproductive Health. 2009 Sep;41(3):158-65. Abstract: CONTEXT: Despite calls to make family planning services more responsive to the values, needs and preferences of clients, few studies have asked clients about their experiences or values, and most have used surveys framed by researchers', rather than clients', perspectives. METHODS: Forty in-depth interviews exploring lifetime experiences with and values regarding services were conducted with 18-36-year-old women who visited family planning clinics in the San Francisco Bay Area in 2007. Women were categorized as black, white, English- or Spanish-speaking Latina, or of mixed ethnicity to allow examination of differences by racial, ethnic and language group. Interviews were audiotaped, transcribed and coded thematically; matrices were then used to compare the themes that emerged across the subgroups. RESULTS: Eight themes emerged as important to women's views of services: service accessibility, information provision, attention to client comfort, providers' personalization of care, service organization, providers' empathy, technical quality of care and providers' respect for women's autonomy. Women reported that it was important to feel comfortable during visits, to feel that their decision-making autonomy was respected, to have providers show empathy and be nonjudgmental, and to see the same provider across visits. The only notable difference among racial, ethnic and language groups was that Spanish-speaking Latinas wanted to receive language-appropriate care and contraceptive information. CONCLUSIONS: Future surveys of family planning service quality should include measures of the factors that women value in such care, and efforts to improve providers' communication and counseling skills should emphasize the personalization of services and respect for clients' autonomy. Language: English Keywords: UNITED STATES OF AMERICA | CALIFORNIA | RESEARCH REPORT | INTERVIEWS | FAMILY PLANNING SURVEYS | WOMEN | CLIENTS | ETHNIC GROUPS | FAMILY PLANNING | LANGUAGE | HEALTH SERVICES | QUALITY OF HEALTH CARE | COMMUNICATION | COUNSELING | Developed Countries | North America | Americas | Data Collection | Research Methodology | Demographic Factors | Population | Program Activities | Programs | Organization and Administration | Cultural Background | Population Characteristics | Delivery of Health Care | Health | Health Services Evaluation | Program Evaluation | Clinic Activities Document Number: 342713 |
| 7. Peer Reviewed Title: Barriers to research and capacity building at Hispanic-serving institutions: the case of HIV/AIDS research at the University of Puerto Rico. Author: Bernal G; Ortiz-Torres B Source: American Journal of Public Health. 2009 Apr;99 Suppl 1:S60-5. Abstract: Substantive barriers to research, such as cultural, language, and methodological variables, exist in Hispanic-serving institutions. Historical and contextual variables account for the differences between academic settings with research-intensive centers and those with limited infrastructure for competitive research. We provide a case example to serve as a model for developing and strengthening the research infrastructure in Hispanic-serving institutions and for providing the mentorship Latino investigators may need to compete with other investigators in research-intensive centers. We present recommendations to reduce these barriers. Language: English Keywords: PUERTO RICO | CRITIQUE | RECOMMENDATIONS | CASE STUDIES | EXPERIMENTAL MODELS | HISPANICS | HEALTH PERSONNEL | UNIVERSITIES | RESEARCH ACTIVITIES | HIV | AIDS | CAPACITY BUILDING | CULTURE | LANGUAGE | PARTICIPATION | Caribbean | Americas | Developed Countries | Studies | Research Methodology | Ethnic Groups | Cultural Background | Population Characteristics | Demographic Factors | Population | Delivery of Health Care | Health | Schools | Education | HIV Infections | Viral Diseases | Diseases | Program Sustainability | Programs | Organization and Administration | Sociocultural Factors | Communication | Social Behavior | Behavior Document Number: 330955 |
| 8. 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 |
| 9. 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 |
| 10. Peer Reviewed Title: Infidelity, Trust, and Condom Use Among Latino Youth in Dating Relationships. Author: Brady SS; Tschann JM; Ellen JM; Flores E Source: Sexually Transmitted Diseases. 2009 Apr;36(4):227-231. Abstract: BACKGROUND:: Latino youth in the United States are at greater risk for contracting sexually transmitted infections (STIs) in comparison with non-Hispanic white youth. METHODS:: Sexually active heterosexual Latino youth aged 16 to 22 years (N = 647) were recruited for interviews through a large health maintenance organization or community clinics. RESULTS:: Adjusting for gender, age, ethnic heritage, and recruitment method, woman's consistent use of hormonal contraceptives, ambivalence about avoiding pregnancy, longer length of sexual relationship, and greater overall trust in main partner were independently associated with inconsistent condom use and engagement in a greater number of sexual intercourse acts that were unprotected by condom use. Perception that one's main partner had potentially been unfaithful, but not one's own sexual concurrency, was associated with consistent condom use and fewer acts of unprotected sexual intercourse. Sexually concurrent youth who engaged in inconsistent condomuse with other partners were more likely to engage in inconsistent condom use and a greater number of unprotected sexual intercourse acts with main partners. CONCLUSIONS:: Increasing attachment between youth may be a risk factor for the transmission of STIs via normative declines in condom use. Perception that one's partner has potentially been unfaithful may result in greater condom use. However, many Latino adolescents and young adults who engage in sexual concurrency may not take adequate steps to protect their partners from contracting STIs. Some youth may be more focused on the emotional and social repercussions of potentially revealing infidelity by advocating condom use than the physical repercussions of unsafe sex. Language: English Keywords: UNITED STATES OF AMERICA | RESEARCH REPORT | COMPARATIVE STUDIES | ETHNIC GROUPS | WOMEN | WHITES | YOUTH | HETEROSEXUALS | SEXUALLY TRANSMITTED DISEASES | RISK BEHAVIOR | CONDOM USE | Developed Countries | North America | Americas | Studies | Research Methodology | Cultural Background | Population Characteristics | Demographic Factors | Population | Age Factors | Sex Behavior | Behavior | Reproductive Tract Infections | Infections | Diseases | Risk Reduction Behavior Document Number: 330495 |
| 11. 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 |
| 12. Title: [Assessment of factors associated with patients' comprehension of treatment at the start of antiretroviral therapy] Evaluacion de factores asociados a la comprension del tratamiento en pacientes Author: Braga Ceccato MG; Acurcio Fde A; Vallano A; Comini Cesar C; Crosland Guimaraes MD Source: Enfermedades Infecciosas Y Microbiologia Clinica. 2009 Jan;27(1):7-13. Abstract: OBJECTIVE: The aim of this study was to evaluate factors associated with patients' comprehension of antiretroviral therapy (ART). METHOD: Cross-sectional analysis in which patients at 2 HIV/AIDS public referral centers (Belo Horizonte, Brazil) were interviewed after initiating ART. Information was recorded on variables related to the patient's characteristics, the treatment prescribed, and the healthcare professional involved. A score indicating the patients' level of comprehension regarding the medications prescribed was obtained using a latent trait model estimated by the item response theory. RESULTS: A total of 406 patients were interviewed. Mean (SD) age was 35 (10) years, 227 were men (56%), 302 of Afro-American ethnicity (77%), and 213 had <8 years of education (53%). The regression model determined that 52.25% of the variability of comprehension was explained by the individual's characteristics. Variables associated (P<0.05) with poorest understanding about ART were lower education (<8 years), lack of knowledge about treatment duration and clinical severity, inadequate information provided by physicians, inability to understand pharmaceutical information, daily number of tablets, and the ART regimen prescribed. CONCLUSION: Comprehension of information about the ART regimen prescribed varies considerably between individuals. Nonetheless, several factors were found to be associated with the level of understanding: characteristics of the patient (education, clinical severity), characteristics of treatment (daily number of tablets, ART regimen prescribed), and contribution of healthcare professionals (information from physicians and pharmacists). Strategies to reinforce information about ART should be a priority for patients with a low level of understanding. Language: Spanish Keywords: BRAZIL | RESEARCH REPORT | CROSS SECTIONAL ANALYSIS | INTERVIEWS | CLIENTS | ETHNIC GROUPS | PRESCRIPTIONS | EDUCATIONAL STATUS | KNOWLEDGE | TREATMENT | INFORMATION | PHYSICIAN-PATIENT RELATIONS | South America, Eastern | South America | Latin America | Americas | Developing Countries | Research Methodology | Data Collection | Program Activities | Programs | Organization and Administration | Cultural Background | Population Characteristics | Demographic Factors | Population | Distributional Activities | Socioeconomic Status | Socioeconomic Factors | Economic Factors | Sociocultural Factors | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Interpersonal Relations | Behavior Document Number: 341238 |
| 13. 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 |
| 14. 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 |
| 15. Title: Parental communication as a protective factor in increasing condom use among minority adolescents. Author: Buzi RS; Smith PB; Weinman ML Source: International Journal of Adolescent Medicine and Health. 2009 Jan-Mar;21(1):51-9. Abstract: The purpose of this study was to examine ethnic differences in risk behaviors among adolescents who attended family planning clinics and to evaluate the impact of parental communication regarding sexual topics on adolescent condom use. The sample for this study included 697 black and Hispanic female adolescents ranging in age from 13-22 years. Ethnic differences were found in sexually transmitted infection rates, number of sexual partners, and condom use. Although black adolescents were more likely than Hispanic adolescents to report recent condom use, Black adolescents reported higher rates of sexually transmitted infections and more sexual partners. Black adolescents reported more parental communication about sexual topics than Hispanic adolescents. Parental communication was associated with increased condom use. The results of this study emphasize the importance of parental communication in risk reduction among adolescents. As ethnicity emerged in the study as a significant factor, interventions aimed at increasing parent-adolescent communication will have to be tailored to address the needs of specific ethnic groups. Language: English Keywords: UNITED STATES OF AMERICA | RESEARCH REPORT | ETHNIC GROUPS | ADOLESCENTS | PARENTS | CONDOM USE | COMMUNICATION | RISK BEHAVIOR | PARENTAL INVOLVEMENT | Developed Countries | North America | Americas | Cultural Background | Population Characteristics | Demographic Factors | Population | Youth | Age Factors | Family Relationships | Family Characteristics | Family and Household | Sociocultural Factors | Risk Reduction Behavior | Behavior | Child Rearing Document Number: 341666 |
| 16. Title: Prenatal origins of undernutrition. Author: Christian P Source: Nestle Nutrition Workshop Series. Paediatric Programme. 2009;63:59-73; discussion 74-7, 259-68. Abstract: Undernutrition continues to be high in many regions of the developing world. Birthweight, a common proxy measure of intrauterine growth, is influenced by nutritional, environmental and lifestyle factors during pregnancy and, in turn, affects immediate survival and function, and is a determinant of later life risk of chronic diseases. Maternal pre-pregnancy weight and height are independently associated with birthweight and also modify the effects of pregnancy weight gain and interventions during pregnancy on birthweight and perinatal mortality. Other prenatal factors commonly known to impact birthweight include maternal age, parity, sex, and birth interval, whereas lifestyle factors such as physical activity and maternal stress, as well as environmental toxicants have variable influences. Tobacco and other substance use and infections, specifically ascending reproductive tract infections, malaria, and HIV, can cause intrauterine growth restriction (IUGR). Few studies have examined the contribution of prenatal factors including low birthweight to childhood wasting and stunting. Studies that have examined this, with adequate adjustment for confounders, have generally found odds ratios associated with low birthweight ranging between 2 and 5. Even fewer studies have examined birth length or maternal nutritional status as risk factors. More research is needed to determine the proportion of childhood under-nutrition attributable to IUGR so that interventions can be targeted to the appropriate life stages. Language: English Keywords: UNITED STATES OF AMERICA | RESEARCH REPORT | ADOLESCENTS, FEMALE | YOUTH | WOMEN | ETHNIC GROUPS | PARITY | REPRODUCTIVE AGE | MALNUTRITION | HEALTH STATUS INDEXES | INTRAUTERINE GROWTH RETARDATION | REPRODUCTIVE TRACT INFECTIONS | MALARIA | HIV INFECTIONS | INTERVENTIONS | Developed Countries | North America | Americas | Adolescents | Age Factors | Population Characteristics | Demographic Factors | Population | Cultural Background | Fertility Measurements | Fertility | Population Dynamics | Reproduction | Nutrition Disorders | Diseases | Health | Congenital Abnormalities | Neonatal Diseases and Abnormalities | Infections | Parasitic Diseases | Viral Diseases | Programs | Organization and Administration Document Number: 341348 |
| 17. Peer Reviewed Title: Trends in prenatal care settings: Association with medical liability. Author: Coco AS; Cohen D; Horst MA; Gambler AS Source: BMC Public Health. 2009 Jul 22;9(1):257. Abstract: ABSTRACT: BACKGROUND: Medical liability concerns centered around maternity care have widespread public health implications, as restrictions in physician scope of practice may threaten quality of and access to care in the current climate. The purpose of this study was to examine national trends in prenatal care settings based on medical liability climate. METHODS: Analysis of prenatal visits in the National Ambulatory Medical Care Survey and National Hospital Ambulatory Medical Care Survey, 1997 to 2004 (N = 21,454). To assess changes in rates of prenatal visits over time, we used the linear trend test. Multivariate logistic regression modeling was developed to determine characteristics associated with visits made to hospital outpatient departments. RESULTS: In regions of the country with high medical liability (N = 11,673), the relative number, or proportion, of all prenatal visits occurring in hospital outpatient departments increased from 11.8% in 1997-1998 to 19.4% in 2003-2004 (p < .001 for trend); the trend for complicated obstetrical visits (N = 3,275) was more pronounced, where the proportion of prenatal visits occurring in hospital outpatient departments almost doubled from 22.7% in 1997-1998 to 41.6% in 2003-2004 (p = .004 for trend). This increase did not occur in regions of the country with low medical liability (N = 9,781) where the proportion of visits occurring in hospital outpatient departments decreased from 13.3% in 1997-1998 to 9.0% in 2003-2004. CONCLUSIONS: There has been a shift in prenatal care from obstetrician's offices to safety net settings in regions of the country with high medical liability. These findings provide strong indirect evidence that the medical liability crisis is affecting patterns of obstetric practice and ultimately patient access to care. Language: English Keywords: UNITED STATES OF AMERICA | RESEARCH REPORT | STATISTICAL REGRESSION | PHYSICIANS | HIGH RISK WOMEN | ETHNIC GROUPS | ANTENATAL CARE | MEDICAL LIABILITY | OBSTETRICS | PHYSICIAN'S OFFICE | HOSPITALS | PROGRAM ACCESSIBILITY | HEALTH INSURANCE | TITLE 19 MEDICAL ASSISTANCE | Developed Countries | North America | Americas | Data Analysis | Research Methodology | Health Personnel | Delivery of Health Care | Health | Reproduction | Cultural Background | Population Characteristics | Demographic Factors | Population | Maternal Health Services | Maternal-Child Health Services | Primary Health Care | Health Services | Medicine | Health Facilities | Program Evaluation | Programs | Organization and Administration | Financial Activities | Economic Factors | Public Assistance | Grants Document Number: 342287 |
| 18. 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 |
| 19. Peer Reviewed Title: Group a Streptococcus causing necrotizing fasciitis and toxic shock syndrome after medical termination of pregnancy. Author: Daif JL; Levie M; Chudnoff S; Kaiser B; Shahabi S Source: Obstetrics and Gynecology. 2009 Feb;113(2 Pt 2):504-6. Abstract: BACKGROUND: Group A Streptococcus is an aerobic gram-positive bacteria known to cause cutaneous infections. Invasive infections can lead to toxic shock syndrome with multiorgan failure and mortality rates of 25-48%. CASE: A healthy, young woman developed necrotizing fasciitis, myonecrosis, and toxic shock syndrome after an elective medical termination of pregnancy. This patient had confirmed group A Streptococcus on blood cultures and underwent surgical debridement. After aggressive surgical treatment, below-the-knee amputation, and antibiotic therapy, the patient survived. CONCLUSION: This case demonstrates the need for prompt recognition and treatment of necrotizing fasciitis/toxic shock syndrome. Language: English Keywords: NEW YORK | RESEARCH REPORT | CLINICAL RESEARCH | CASE STUDIES | HISPANICS | WOMEN | BACTERIAL AND FUNGAL DISEASES | DERMATITIS | TOXIC SHOCK SYNDROME | ABORTION | GYNECOLOGIC SURGERY | SURGERY | ANTIBIOTICS | Developed Countries | United States of America | North America | Americas | Research Methodology | Studies | Ethnic Groups | Cultural Background | Population Characteristics | Demographic Factors | Population | Infections | Diseases | Fertility Control, Postconception | Family Planning | Urogenital Surgery | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Drugs Document Number: 330358 Notification |
| 20. Title: Determinants of condom use: results of the Canadian Community Health Survey 3.1. Author: Dhalla S; Poole G Source: Canadian Journal of Public Health / Revue Canadienne De Sante Publique. 2009 Jul-Aug;100(4):299-303. Abstract: OBJECTIVES: To examine the independent effects of mood disorder, age, race/ethnicity, personal income, being a current student, having a regular medical doctor and substance use in relationship to condom use at last intercourse in a Canadian population stratified by sex. METHODS: We used Cycle 3.1 of the 2006 Canadian Community Health Survey (CCHS 3.1), a population-based, voluntary, cross-sectional survey of subjects ages 12-85 years. Data collection took place between January and December 2005. From the survey, a study sample of 20,975 people was drawn, consisting of individuals providing valid responses (yes/no) to mood disorder and last-time condom use. The question of sexual behaviours was asked only of those ages 15-49 years. Logistic regression was used to examine individual variables as potential determinants of last-time condom use stratified by sex. RESULTS: The relationship between mood disorder and condom use was non-significant in both males (AOR = 0.85, 95% CI = 0.70-1.04) and females (AOR = 0.90, 95% CI = 0.78-1.03). Increasing age was found to be inversely associated with last-time condom use in both males and females. Male factors significantly associated with last-time condom use were being of white ethnicity (AOR = 0.71, 95% CI = 0.64-0.79) and being a current student (AOR = 1.28, 95% CI =1.16-1.42). Female factors associated with last-time condom use were being of white ethnicity (AOR = 0.71, 95% CI = 0.63-0.79) and being a former drinker (AOR = 2.25, 95% CI = 1.63-3.11). CONCLUSION: Our results identify important determinants of last-time condom use in both males and females in the CCHS 3.1. These findings may have important implications for the devising and implementation of safe sex programs in a Canadian population ages 15-49 years. Language: English Keywords: CANADA | RESEARCH REPORT | HEALTH SURVEYS | STATISTICAL REGRESSION | ETHNIC GROUPS | SEXUALLY TRANSMITTED DISEASES | CONDOM USE | MENTAL DISORDERS | SEX FACTORS | AGE FACTORS | ALCOHOL USE AND ABUSE | Developed Countries | North America, Northern | Americas | Health | Data Analysis | Research Methodology | Cultural Background | Population Characteristics | Demographic Factors | Population | Reproductive Tract Infections | Infections | Diseases | Risk Reduction Behavior | Behavior Document Number: 342618 |
| 21. Peer Reviewed Title: The influence of changes in women's religious affiliation on contraceptive use and fertility among the Kassena-Nankana of Northern Ghana. Author: Doctor HV; Phillips JF; Sakeah E Source: Studies in Family Planning. 2009 Jun;40(2):113-122. Abstract: Religious affiliation is undergoing major changes in rural Sahelian Africa, with profound consequences for customs that are grounded in traditional belief systems. This study examines the influence of women's religious affiliation on contraceptive use and fertility among the Kassena-Nankana of northern Ghana. Analysis of longitudinal data for women in 1995 and 2003 shows that 61 percent of women changed their religion, with shifts from traditional beliefs to Christianity being dominant. Moreover, women were more likely than men to make such a change. Regression results show that, compared with those who did not change, switching from traditional religion to Christianity or Islam is associated with increased contraceptive use and decreased fertility. The more rapid change in religious affiliation among women than men may have social consequences for the status of women, signaling a trend toward greater autonomy in the family and new aspirations, values, and behavior as evidenced by the proportion of people adopting contraceptives. Language: English Keywords: GHANA | RESEARCH REPORT | LONGITUDINAL STUDIES | SAMPLING STUDIES | ETHNIC GROUPS | WOMEN | RELIGIOUS ASPECTS | CONTRACEPTIVE USAGE | REPRODUCTIVE BEHAVIOR | BELIEFS | CHRISTIANITY | ISLAM | SOCIAL CHANGE | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Studies | Research Methodology | Cultural Background | Population Characteristics | Demographic Factors | Population | Religion | Sociocultural Factors | Contraception | Family Planning | Fertility | Population Dynamics | Culture Document Number: 341895 |
| 22. Title: Epidemiology of non-alcoholic fatty liver disease in China. Author: Fan JG; Farrell GC Source: Journal of Hepatology. 2009 Jan;50(1):204-10. Abstract: Fatty liver (steatosis) is highly prevalent in China and is more often linked to obesity than to alcoholism. Among more affluent regions of China, the community prevalence of non-alcoholic fatty liver disease (NAFLD) is approximately 15%. With the increasing pandemic of obesity, the prevalence of NAFLD has approximately doubled in the past decade. The risk factors resemble those in other ethnic populations, but it is important to note that ethnic-specific definitions of central obesity, obesity and metabolic syndrome are more useful in assessment of Chinese people. The full range of histological manifestations of NAFLD has been demonstrated in Chinese patients, but to date hepatic severity is generally mild. In contrast to chronic hepatitis C, steatosis is less common in patients with chronic hepatitis B; it is associated with metabolic, and not viral factors and does not appear to affect disease severity. Although long-term outcomes of NAFLD in Chinese populations remain unclear, it may be a predictor of metabolic disorders, diabetes and cardiovascular disease. Public health interventions are therefore indicated to halt or reverse the national trend of obesity in China so as to improve liver as well as metabolic health. Language: English Keywords: CHINA | RESEARCH REPORT | EPIDEMIOLOGIC METHODS | ETHNIC GROUPS | PREVALENCE | HEPATIC EFFECTS | OBESITY | RISK FACTORS | CULTURE | LIPID METABOLIC EFFECTS | HEPATITIS | METABOLIC EFFECTS | LONGTERM EFFECTS | DIABETES | CARDIOVASCULAR EFFECTS | Asia, Eastern | Asia | Developing Countries | Research Methodology | Cultural Background | Population Characteristics | Demographic Factors | Population | Measurement | Physiology | Biology | Body Weight | Sociocultural Factors | Lipids | Viral Diseases | Diseases | Time Factors | Population Dynamics Document Number: 330390 |
| 23. Title: Knowledge, attitudes, and use of emergency contraception among Hispanic women of North Carolina. Author: Galvin SL; Fagan EB Source: Southern Medical Journal. 2009 Jan;102(1):17-20. Abstract: INTRODUCTION: This project was designed to determine the knowledge, attitudes and self-reported use of emergency contraception (EC) of Spanish-speaking women of western North Carolina. MATERIALS AND METHODS: Using a cross-sectional survey, a convenience sample of patients completed the survey in exam or interview rooms of an obstetric and gynecology residency program in western North Carolina. Participants included 213 Spanish-speaking women of childbearing age (18 to 44-years-old) presenting for routine care between August 2004 and October 2006. RESULTS: Seventy percent of the sexually active respondents (N = 196) reported inconsistent use of birth control. Only 22% reporting knowing about EC; an additional 26% knew about the morning after pill. Overall, 12% reported previous use of EC. Very few (15%) reported a moral or religious objection to EC. Only 21% reported having discussed EC with a care provider. DISCUSSION: Considerable opportunity exists to expand patient education about all contraceptive options, including EC with Hispanic women of western North Carolina. Language: English Keywords: UNITED STATES OF AMERICA | NORTH CAROLINA | RESEARCH REPORT | CROSS SECTIONAL ANALYSIS | WOMEN | HISPANICS | EMERGENCY CONTRACEPTION | ATTITUDES | USER COMPLIANCE | Developed Countries | North America | Americas | Research Methodology | Demographic Factors | Population | Ethnic Groups | Cultural Background | Population Characteristics | Contraception | Family Planning | Psychological Factors | Behavior Document Number: 330064 |
| 24. Peer Reviewed Title: Opportunity for natural selection among the Indian population: secular trend, covariates and implications. Author: Gautam RK Source: Journal of Biosocial Science. 2009 Jul 23;:1-41. Abstract: Crow's index is widely used for indirect quantitative estimation of natural selection using birth and death rates. The present investigation is based on 179 studies among 144 different endogamous communities belonging to nineteen states and six geographical regions of India, categorized into six social groups. These studies appeared in 33 different years over six decades (1956 to 2007). The secular trend in Crow's index (It) and its mortality and fertility components (Im and If) shows a gradual decline in It and radical shift in the relative contributions of Im and If. Before 1990 the opportunity for natural selection was mainly determined by differential pre-reproductive mortality (Im), whereas after 1990 it has been determined by differential fertility (If). To find out the covariates of It, Im and If sixteen socio-demographic variables were considered, and nine were found to be significantly correlated with It: total dependency ratio, decadal growth rate 1991-2001, young age dependency ratio, crude death rate, total fertility rate, child mortality rate, under-5 mortality rate, old age dependency ratio and decadal growth rate 1981-1991. On the basis of multivariate stepwise regression analysis, female literacy emerged as one of the most important predictors of It. The declining trend of It, Im and If shows that the Indian population is passing through the demographic transition. Language: English Keywords: INDIA | ADMINISTRATIVE DISTRICTS | RESEARCH REPORT | DATA COLLECTION | STATISTICAL REGRESSION | TRIBES | MOTHERS | CASTE | POPULATION GENETICS | FERTILITY | MORTALITY | DEPENDENCY BURDEN | SOCIOCULTURAL FACTORS | DEMOGRAPHIC TRANSITION | Asia, Southern | Asia | Developing Countries | Geographic Factors | Population | Research Methodology | Data Analysis | Cultural Background | Population Characteristics | Demographic Factors | Parents | Family Relationships | Family Characteristics | Family and Household | Social Class | Socioeconomic Status | Socioeconomic Factors | Economic Factors | Genetics | Biology | Population Dynamics | Microeconomic Factors Document Number: 342293 |
| 25. Title: Sexual and reproductive health of persons aged 10-24 years - United States, 2002-2007. Author: Gavin L; MacKay AP; Brown K; Harrier S; Ventura SJ; Kann L; Rangel M; Berman S; Dittus P; Liddon N; Markowitz L; Sternberg M; Weinstock H; David-Ferdon C; Ryan G Author: Centers for Disease Control and Prevention (CDC) Source: MMWR. Surveillance Summaries. 2009 Jul 17;58(6):1-58. Abstract: This report presents data for 2002-2007 concerning the sexual and reproductive health of persons aged 10-24 years in the United States. Data were compiled from the National Vital Statistics System and multiple surveys and surveillance systems that monitor sexual and reproductive health outcomes into a single reference report that makes this information more easily accessible to policy makers, researchers, and program providers who are working to improve the reproductive health of young persons in the United States. The report addresses three primary topics: 1) current levels of risk behavior and health outcomes; 2) disparities by sex, age, race/ethnicity, and geographic residence; and 3) trends over time. The data presented in this report indicate that many young persons in the United States engage in sexual risk behavior and experience negative reproductive health outcomes. In 2004, approximately 745,000 pregnancies occurred among U.S. females aged <20 years. In 2006, approximately 22,000 adolescents and young adults aged 10-24 years in 33 states were living with human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS), and approximately 1 million adolescents and young adults aged 10-24 years were reported to have chlamydia, gonorrhea, or syphilis. One-quarter of females aged 15-19 years and 45% of those aged 20-24 years had evidence of infection with human papillomavirus during 2003-2004, and approximately 105,000 females aged 10--24 years visited a hospital emergency department (ED) for a nonfatal sexual assault injury during 2004-2006. Although risks tend to increase with age, persons in the youngest age group (youths aged 10--14 years) also are affected. For example, among persons aged 10-14 years, 16,000 females became pregnant in 2004, nearly 18,000 males and females were reported to have sexually transmitted diseases (STDs) in 2006, and 27,500 females visited a hospital ED because of a nonfatal sexual assault injury during 2004-2006. Noticeable disparities exist in the sexual and reproductive health of young persons in the United States. For example, pregnancy rates for female Hispanic and non-Hispanic black adolescents aged 15-19 years are much higher (132.8 and 128.0 per 1,000 population) than their non-Hispanic white peers (45.2 per 1,000 population). Non-Hispanic black young persons are more likely to be affected by AIDS: for example, black female adolescents aged 15-19 years were more likely to be living with AIDS (49.6 per 100,000 population) than Hispanic (12.2 per 100,000 population), American Indian/Alaska Native (2.6 per 100,000 population), non-Hispanic white (2.5 per 100,000 population) and Asian/Pacific Islander (1.3 per 100,000 population) adolescents. In 2006, among young persons aged 10-24 years, rates for chlamydia, gonorrhea, and syphilis were highest among non-Hispanic blacks for all age groups. The southern states tend to have the highest rates of negative sexual and reproductive health outcomes, including early pregnancy and STDs. Although the majority of negative outcomes have been declining for the past decade, the most recent data suggest that progress might be slowing, and certain negative sexual health outcomes are increasing. For example, birth rates among adolescents aged 15-19 years decreased annually during 1991-2005 but increased during 2005-2007, from 40.5 live births per 1,000 females in 2005 to 42.5 in 2007 (preliminary data). The annual rate of AIDS diagnoses reported among males aged 15-19 years has nearly doubled in the past 10 years, from 1.3 cases per 100,000 population in 1997 to 2.5 cases in 2006. Similarly, after decreasing for >20 years, gonorrhea infection rates among adolescents and young adults have leveled off or had modest fluctuations (e.g., rates among males aged 15-19 years ranged from 285.7 cases per 100,000 population in 2002 to 250.2 cases per 100,000 population in 2004 and then increased to 275.4 cases per 100,000 population in 2006), and rates for syphilis have been increasing (e.g., rates among females aged 15-19 years increased from 1.5 cases per 100,000 population in 2004 to 2.2 cases per 100,000 population in 2006) after a significant decrease during 1997-2005. Language: English Keywords: UNITED STATES OF AMERICA | SUMMARY REPORT | HEALTH SURVEYS | YOUTH | ETHNIC GROUPS | REPRODUCTIVE HEALTH | SEX BEHAVIOR | RISK BEHAVIOR | ADOLESCENT PREGNANCY | SEXUALLY TRANSMITTED DISEASES | HIV INFECTIONS | AIDS | ABORTION | VIOLENCE | Developed Countries | North America | Americas | Health | Age Factors | Population Characteristics | Demographic Factors | Population | Cultural Background | Behavior | Reproductive Behavior | Fertility | Population Dynamics | Reproductive Tract Infections | Infections | Diseases | Viral Diseases | Fertility Control, Postconception | Family Planning Document Number: 342146 Notification |
| 26. 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 |
| 27. Title: Circumcision and sexual behavior: factors independently associated with human papillomavirus detection among men in the HIM study. Author: Giuliano AR; Lazcano E; Villa LL; Flores R; Salmeron J; Lee JH; Papenfuss M; Abrahamsen M; Baggio ML; Silva R; Quiterio M Source: International Journal of Cancer. 2009 Mar 15;124(6):1251-7. Abstract: There is growing interest in understanding human papillomavirus (HPV) infection and related disease among men. To date there have been numerous studies reporting HPV DNA prevalence among men from several different countries, however, few have incorporated multivariable analyses to determine factors independently associated with male HPV detection. The purpose of this study was to assess the factors independently associated with HPV detection in men ages 18-70 years residing in Brazil (n = 343), Mexico (n = 312), and the United States (US) (n = 333). In samples combined from the coronal sulcus, glans penis, shaft, and scrotum, we evaluated factors associated with any, oncogenic, and nononcogenic HPV infections. In multivariable analyses, detection of any HPV infection was significantly associated with reported race of Asian/Pacific Islander, lifetime and recent number of sexual partners, and having sex in the past 3 months. Oncogenic HPV detection was independently associated with lifetime and recent number of sexual partners, and having sex in the past 3 months. NonOncogenic HPV infection was independently associated with lifetime number of sexual partners. Circumcision, assessed by clinical examination, was associated with reduced risk of HPV detection across all categories of HPV evaluated. HPV detection in men in the current study was strongly related to sexual behavior and circumcision status. Interventions such as circumcision may provide a low-cost method to reduce HPV infection. Language: English Keywords: LATIN AMERICA | UNITED STATES OF AMERICA | RESEARCH REPORT | KAP SURVEYS | MULTIVARIATE ANALYSIS | CLINICAL RESEARCH | EPIDEMIOLOGIC METHODS | MEN | ASIANS | MALE CIRCUMCISION | SEX BEHAVIOR | PREVALENCE | RISK BEHAVIOR | RISK FACTORS | HPV | Americas | Developing Countries | Developed Countries | North America | Surveys | Sampling Studies | Studies | Research Methodology | Data Analysis | Demographic Factors | Population | Ethnic Groups | Cultural Background | Population Characteristics | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Behavior | Measurement | Biology | Viral Diseases | Diseases Document Number: 330377 |
| 28. Peer Reviewed Title: [Sexuality, bodily experiences, and gender: an ethnographic study of persons living with HIV in Greater Metropolitan Buenos Aires, Argentina] Sexualidad, experiencias corporales y género: un estudio etnográfi co entre personas viviendo con VIH en el Área Metropolitana de Buenos Aires, Argentina. Author: Grimberg M Source: Cadernos de Saude Publica. 2009 Jan;25(1):133-141. Abstract: Based on the results of an ethnographic study on daily experience with HIV in Greater Metropolitan Buenos Aires, Argentina, the article discusses behavioral approaches that reduce the sexuality of persons living with HIV to an issue of safety and protection. By articulating a social construction perspective and the notion of hegemony, the author proposes that sexuality can be understood as a process of individual and social construction shaped by power relations and social regulations. The analysis of the experiences of living with HIV in marginalized populations shows how chronic social inequality, violence, discrimination, and stigmatization generate particular characteristics of sexual issues. These social processes become driving forces that shape sexual experience as a field of danger, repression, and restriction rather than pleasure and exploration. Finally, daily confrontation with social metaphors places strain on gender relations, practices, and identities. Language: Portuguese Keywords: ARGENTINA | RESEARCH REPORT | PERSONS LIVING WITH HIV/AIDS | ETHNIC GROUPS | SEXUALITY | SEX BEHAVIOR | SAFETY | INEQUALITIES | South America, Southern | South America | Latin America | Americas | Developing Countries | HIV Infections | Viral Diseases | Diseases | Cultural Background | Population Characteristics | Demographic Factors | Population | Personality | Psychological Factors | Behavior | Public Health | Health | Socioeconomic Factors | Economic Factors Document Number: 341871 |
| 29. 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 |
| 30. Title: The Contraceptive Needs of Incarcerated Women. Author: Hale GJ; Oswalt KL; Cropsey KL; Villalobos GC; Ivey SE; Matthews CA Source: Journal of Women's Health. 2009 Jul 24; Abstract: Abstract Objectives: We assessed the contraceptive needs of women incarcerated in jails in the southeastern United States to determine feasible and effective birth control interventions based on the needs of this population. Methods: Participants were recruited from local jails around a medium-sized metro area. Participants completed a survey of demographics, sexual health, contraceptive use, and preferred method of contraception. Results: The survey was completed by 188 women in jail. Participants reported high rates of sexually transmitted diseases (STDs) (50.5%), inconsistent use of birth control (36.5%), and use of unreliable and user-dependent methods of birth control. The majority did not desire to become pregnant in the future (61.5%) but intended to have sex after release from jail (76.9%). Women who were able to bear children were more likely to report intentions to use birth control or STD protection after release (77.9%). Additionally, significant racial differences were found. Specifically, nonwhites were more likely to be single and have more STDs and less use of a variety of birth control methods than whites. Conclusions: Women in this sample were at high risk for unplanned pregnancies. Therefore, a primary contraceptive need for this population appeared to be education about longer lasting, user-independent forms of contraception. Many of these women would be ideal candidates for such forms of contraception, especially if it was provided prior to release. Language: English Keywords: UNITED STATES OF AMERICA | RESEARCH REPORT | SAMPLING STUDIES | PRISONERS | WOMEN | ETHNIC GROUPS | CONTRACEPTIVE USAGE | NEEDS ASSESSMENT | SEXUALLY TRANSMITTED DISEASES | CONTRACEPTIVE METHODS CHOSEN | Developed Countries | North America | Americas | Studies | Research Methodology | Crime | Social Problems | Sociocultural Factors | |