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A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Global Health".

Deadline for manuscript submissions: closed (15 December 2018) | Viewed by 107088

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Special Issue Editor

Dr. Jennifer M. Grossman

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Guest Editor

Wellesley Centers for Women, Wellesley College, Wellesley, MA 02481, USA
Interests: adolescent development; sexual risk and prevention; family sexuality communication; teen-family relationships; evaluation of preventive programs; qualitative and mixed-methods approaches

Special Issue Information

Dear Colleagues,

Risky sexual behaviors leave teens vulnerable to sexually transmitted infections (STIs) and unplanned pregnancy, which impact sexual and reproductive health worldwide. Many teen parents drop out of school, incurring educational and economic setbacks for themselves and their children. Individual and systemic supports, such as school and community-based programs, healthcare services, and family and peer-based interventions can mitigate the potential for risky sexual behavior. Studies that address teens’ contexts, such as race and culture, gender, sexual orientation and family backgrounds can be used to develop and inform interventions that are sustainable, relevant, and context-specific. This Special Issue will focus on the genesis and implications of teens’ sexual risk behaviors and delineate contextually-relevant supports for teens’ reproductive health.

This Special Issue is open to any subject related to barriers to and supports for teenage reproductive health. The listed keywords suggest a few of the many possibilities.

Dr. Jennifer M. Grossman
Guest Editor

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Keywords

Teen pregnancy
Teen parenting
Social contexts of teen health and relationships
Family and peer supports for teen sexual health
STIs
Social media and teen sexual health
Prevention and intervention programs
Educational impacts of teen pregnancy
Economic impacts of teen pregnancy/STIs

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Published Papers (10 papers)

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Research

Jump to: Review, Other

16 pages, 299 KiB

Open AccessArticle

“You’ve Gotta be Careful”: Familial Messages Regarding Sexual Behavior and Sexual Relationships among African American Adolescents

by Gary W. Harper, Darnell N. Motley, April Timmons Tyler, Donald H. Tyler, Joseph A. Catania and M. Margaret Dolcini

Int. J. Environ. Res. Public Health 2019, 16(7), 1146; https://doi.org/10.3390/ijerph16071146 - 30 Mar 2019

Cited by 4 | Viewed by 3668

Abstract

Background: Research on the sexual behaviors of African American youth has primarily focused on associated risks, with a dearth of studies examining a fuller representation of African American adolescents’ sexual lives. This study explored the range of messages African American adolescents receive from family members regarding sexual behavior and sexual relationships. Methods: Participants were 52 sexually experienced African American youth (male = 32, female = 20) between the ages of 15 and 17 recruited from community-based organizations in the United States. Youth participated in individual in-depth qualitative interviews, and data were analyzed using a phenomenological framework. Results: Participants received a variety of messages about sexual behavior and sexual relationships from a range of family members including parents, siblings, grandmothers, aunts/uncles, and cousins. Types of messages clustered into three domains: sexual decision-making, quantity and quality of sexual activity, and sexual health promotion; with themes and sub-themes emerging within each area. Conclusion: Gender differences in the types of messages received are explored, and applications of the findings to the development of family-involved community interventions that promote sexual and reproductive health are discussed. Full article

(This article belongs to the Special Issue Teenage Reproductive Health)

15 pages, 1126 KiB

Open AccessArticle

Sociodemographic Factors Associated with the Knowledge and Use of Birth Control Methods in Adolescents before and after Pregnancy

by Reyna Sámano, Hugo Martínez-Rojano, Gabriela Chico-Barba, Bernarda Sánchez-Jiménez, Selene Sam-Soto, Ana Lilia Rodríguez-Ventura, Laura Mejía-Luna and Sylvia Sclavo-Melo

Int. J. Environ. Res. Public Health 2019, 16(6), 1022; https://doi.org/10.3390/ijerph16061022 - 20 Mar 2019

Cited by 9 | Viewed by 6837

Abstract

Adolescent pregnancy rates are high worldwide. However, insufficient information exists regarding the frequency of birth control methods used before the first pregnancy and postpartum. In the current study, we analyzed the association of sociodemographic factors with the knowledge of birth control methods and their use before and after pregnancy in a sample of adolescents in Mexico City. A cohort study was conducted on 600 pregnant adolescents in Mexico City, from 2013 to 2017, at a health care institution providing prenatal care. Participants were assessed during the second trimester and four months postpartum. The questionnaire explored the knowledge of birth control methods, their use, and other associated factors. Two logistic regression models were implemented to identify potential variables associated with the lack of birth control method use before and after pregnancy. The mean age of participants was 15.4 + 1 years, of which, 48% and 65.2% used a birth control method before pregnancy and postpartum, respectively. We found that the main factors associated with increased risk of not using any birth control method before pregnancy included being under the age of 15 years, school dropout, having an educational lag, initiation of sexual life before the age of 15, and having a mother who did not inform their child about contraceptives. By contrast, variables associated with a higher risk of not using any contraceptive methods after pregnancy included educational lag, lower level of education, and the fact that the adolescent had not used any birth control prior to the pregnancy. Full article

(This article belongs to the Special Issue Teenage Reproductive Health)

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15 pages, 687 KiB

Open AccessArticle

Parent-Teen Communication about Sexual and Reproductive Health: Cohort Differences by Race/Ethnicity and Nativity

by Hannah Lantos, Jennifer Manlove, Elizabeth Wildsmith, Bianca Faccio, Lina Guzman and Kristin A. Moore

Int. J. Environ. Res. Public Health 2019, 16(5), 833; https://doi.org/10.3390/ijerph16050833 - 7 Mar 2019

Cited by 30 | Viewed by 7067

Abstract

Parent-teen discussions about sexual and reproductive health (SRH) are associated with delayed sex and higher contraceptive use among teens. Using the National Survey of Family Growth, we conducted bivariate and multivariate analyses of different types of parent-teen SRH discussions among two cohorts of teens. We describe differences in patterns for males and females by race/ethnicity and nativity, and test for racial/ethnic interactions within each cohort. Analyses found that the prevalence of parent-teen discussions about SRH increased across cohorts. For males and females, there were increases in parent-teen discussions about condoms, and for males only, there were increases in any SRH discussions and discussions about contraception and STIs. Based on interactions, parent-teen discussions and STI discussions increased most for Hispanic females, and among Hispanics, increased most for the foreign-born. These data indicate increases in different types of parent-teen SRH discussions, particularly for males and foreign-born teens overall, and for Hispanic teen females regarding condom use. Future research should examine what factors are driving these changes, including changes in the structure of U.S. Hispanic communities and expansion of evidence-based teen pregnancy prevention programs. Full article

(This article belongs to the Special Issue Teenage Reproductive Health)

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14 pages, 317 KiB

Open AccessArticle

‘Know that You are not Alone.’ Influences of Social Support on Youth Newly Diagnosed with HIV in Kibera, Kenya: A Qualitative Study Informing Intervention Development

by Nicole M. Lockwood, Kathryn Lypen, Firas Shalabi, Manasi Kumar, Elizabeth Ngugi and Gary W. Harper

Int. J. Environ. Res. Public Health 2019, 16(5), 775; https://doi.org/10.3390/ijerph16050775 - 4 Mar 2019

Cited by 16 | Viewed by 3875

Abstract

The role of social support in assisting youth in developed countries cope with their HIV diagnosis has been examined through a vast body of research; yet, there remains a gap in research around the effects of social support among youth living in sub-Saharan African countries including Kenya. This study aimed to examine the role of social support among Kenyan youth living with HIV, specifically with regard to the variations in influences of this social support. We conducted semi-structured focus group discussions with youth (ages 18 to 27) living in the informal urban settlement of Kibera in Nairobi, Kenya (n = 53). Data analysis followed a phenomenological inquiry framework, and seven major categories of perceived social support influences were identified: (1) linkage to services, (2) antiretroviral (ARV) adherence, (3) self-acceptance of HIV status, (4) healthy and positive living, (5) understanding of what it means to be living with HIV, (6) HIV status disclosure, and (7) family and occupational strengthening. The findings from this study suggest that Kenyan youth living with HIV can benefit from social support in a multitude of ways and can occur across several socio-ecological levels. Future research should further examine these influences, specifically regarding intervention development across socio-ecological levels. Full article

(This article belongs to the Special Issue Teenage Reproductive Health)

13 pages, 1041 KiB

Open AccessArticle

Extended-Family Talk about Sex and Teen Sexual Behavior

by Jennifer M. Grossman, Alicia D. Lynch, Amanda M. Richer, Lisette M. DeSouza and Ineke Ceder

Int. J. Environ. Res. Public Health 2019, 16(3), 480; https://doi.org/10.3390/ijerph16030480 - 6 Feb 2019

Cited by 14 | Viewed by 10118

Abstract

Research shows that family communication about sexuality can protect against teens’ risky sexual behavior. However, few studies assess talk with extended family about sex or how this communication relates to teens’ sexual behavior. The current study includes cross-sectional survey data from 952 adolescents. Structural equation modeling (SEM) was used to assess associations between teens’ sexual risk behaviors and communication with extended family about protection methods, risks of sex and relational approaches to sex, defined as talk about sex within a close relationship. For sexually active teens, talk about protection methods was associated with fewer sexual partners and talk about risks of sex was associated with more sexual partners regardless of teen gender and the generation of extended family with whom teens talk. Results suggest that extended-family talk about sex may influence teens’ sexual behavior independent of effects of teen–parent communication. However, the direction of the effect depends on the content of the conversations. These findings suggest the need to explore whether and how extended family could be included in health prevention and intervention programs, because programs which include family largely focus on parents. Full article

(This article belongs to the Special Issue Teenage Reproductive Health)

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24 pages, 5646 KiB

Open AccessArticle

My Journey: Development and Practice-Based Evidence of a Culturally Attuned Teen Pregnancy Prevention Program for Native Youth

by DenYelle Baete Kenyon, Tracey R. McMahon, Anna Simonson, Char Green-Maximo, Ashley Schwab, Melissa Huff and Renee E. Sieving

Int. J. Environ. Res. Public Health 2019, 16(3), 470; https://doi.org/10.3390/ijerph16030470 - 6 Feb 2019

Cited by 9 | Viewed by 6204

Abstract

A clear need exists for teen pregnancy prevention programs that are responsive to the specific needs and cultural contexts of Native American communities. Recent data indicates that the birth rate for Native teens is nearly two and a half times the rate for White teens (32.9 versus 13.2). To address this disparity, we conducted formative research with Northern Plains Native American community members, resulting in My Journey, a culturally attuned curriculum for 6–8^th graders. My Journey is grounded in traditional values and teachings to promote self-efficacy in sexual health decision-making and engagement in prosocial behaviors. We conducted a pilot study with 6–8^th grade students (n = 45), aged 11–14 years (22 females, 23 males). Pilot study findings confirm program feasibility and acceptability. The process evaluation revealed that teachers liked the curriculum, particularly its adaptability of cultural components and ease of student engagement. The outcome evaluation demonstrated that My Journey provided an avenue for NA youth to increase their sex refusal self-efficacy. Application of the culture cube framework revealed My Journey has made a meaningful practice-based evidence contribution as a community-defined, culturally integrated curriculum that is effective. Future directions include broader implementation of My Journey, including adaption for additional populations. Full article

(This article belongs to the Special Issue Teenage Reproductive Health)

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16 pages, 647 KiB

Open AccessArticle

Identifying Sexual and Labor Exploitation among Sheltered Youth Experiencing Homelessness: A Comparison of Screening Methods

by Salina Mostajabian, Diane Santa Maria, Constance Wiemann, Elizabeth Newlin and Claire Bocchini

Int. J. Environ. Res. Public Health 2019, 16(3), 363; https://doi.org/10.3390/ijerph16030363 - 28 Jan 2019

Cited by 30 | Viewed by 11694

Abstract

Human trafficking is a significant and growing public health concern. Subgroups of adolescents and young adults are particularly vulnerable to human trafficking, especially youth who are unstably housed or homeless. While youth experiencing trafficking come into contact with the healthcare system, they are often not identified during routine assessment due to lack of specific inquiry and low disclosure. Therefore, we utilized a mixed-methods study design to assess the differences in the identification of human trafficking among youth experiencing homelessness (n = 129) between a standard psychosocial assessment tool and a human trafficking specific assessment tool. Findings indicate that the tool developed to specifically assess for human trafficking was more likely to identify youth experiencing sexual and labor exploitation, as well as the risk factors for human trafficking. Secondly, youth reported that mistrust of the system, fear of involving the police if reported, not wanting to interact with the mental healthcare system, and stigma are barriers to disclosing human trafficking. In conclusion, healthcare providers caring for youth experiencing homelessness should adopt improved screening tools for human trafficking to reduce the risk of missed opportunities for prevention and treatment among this high-risk population of youth. Full article

(This article belongs to the Special Issue Teenage Reproductive Health)

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15 pages, 362 KiB

Open AccessArticle

Socio-Demographic, Health and Lifestyle Factors Influencing Age of Sexual Initiation among Adolescents

by Lorraine Burke, Saoirse Nic Gabhainn and Colette Kelly

Int. J. Environ. Res. Public Health 2018, 15(9), 1851; https://doi.org/10.3390/ijerph15091851 - 27 Aug 2018

Cited by 17 | Viewed by 6556

Abstract

Behavioural and developmental factors mean that adolescents who initiate sexual intercourse early may be at an increased risk of adverse sexual health outcomes at the time of first sex and later in life. In an Irish context, there is insufficient knowledge about the specific correlates of early sexual initiation. This research explores relationships between contextual socio-demographic, health and lifestyle factors and the timing of first sexual intercourse among 15–17-year-olds in Ireland. Multiple regression analysis was carried out in conjunction with Multiple Imputation using data collected through the 2014 Health Behaviour in School-Aged Children Ireland study on a sample of 879 sexually active adolescents. The socio-demographic and lifestyle factors measured were a stronger predictor of age of sexual initiation among girls than boys. Risk behaviour initiation was significantly related to age of sexual initiation for adolescents, while alcohol use/drunkenness and unhealthy food consumption was significant among girls only. Family support and number of male friends were significant predictors for boys only. The study highlights the need for holistic approaches to sexual health promotion and provides a foundation for the development of alternative strategies and policies aimed at reducing negative health, well-being, educational and economic outcomes. Full article

(This article belongs to the Special Issue Teenage Reproductive Health)

Review

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24 pages, 342 KiB

Open AccessReview

Development of Contextually-relevant Sexuality Education: Lessons from a Comprehensive Review of Adolescent Sexuality Education Across Cultures

by Hildie Leung, Daniel T. L. Shek, Edvina Leung and Esther Y. W. Shek

Int. J. Environ. Res. Public Health 2019, 16(4), 621; https://doi.org/10.3390/ijerph16040621 - 20 Feb 2019

Cited by 111 | Viewed by 45456

Abstract

As reported by the World Health Organization in 2017, there are 2 million+ young people living with HIV worldwide. The World Health Organization also reported that a third of all new HIV infections around the world are estimated to occur among youths (aged 15–25). and teen pregnancy rates are on the rise in many places. These worrying trends suggest that existing sexuality education programs and interventions may be inadequate and/or ineffective. Although the 1994 International Conference on Population and Development’s (ICPD) Programme of Action highlighted the roles of Governments to offer sex education to young people to promote teenage reproductive health, yet inconsistency exists in the related initiatives in the global context. The present article aims to provide a comprehensive literature review of the existing sexuality programs in selected places in both English-speaking (i.e., the United States of America, the United Kingdom) and Chinese-speaking contexts (i.e., Hong Kong, Mainland China, and Taiwan). Based on the review, observations and implications for sexuality education policy and practice, as well as recommendations for future research for youths are outlined. Full article

(This article belongs to the Special Issue Teenage Reproductive Health)

Other

Jump to: Research, Review

10 pages, 265 KiB

Open AccessProject Report

An Examination of Twitter Data to Identify Risky Sexual Practices Among Youth and Young Adults in Botswana

by Judith Cornelius, Anna Kennedy and Ryan Wesslen

Int. J. Environ. Res. Public Health 2019, 16(4), 656; https://doi.org/10.3390/ijerph16040656 - 23 Feb 2019

Cited by 5 | Viewed by 4262

Abstract

Botswana has the third highest rate of HIV infection, as well as one of the highest mobile phone density rates in the world. The rate of mobile cell phone adoption has increased three-fold over the past 10 years. Due to HIV infection rates, youth and young adults are the primary target for prevention efforts. One way to improve prevention efforts is to examine how risk reduction messages are disseminated on social media platforms such as Twitter. Thus, to identify key words related to safer sex practices and HIV prevention, we examined three months of Twitter data in Botswana. 1 December 2015, was our kick off date, and we ended data collection on 29 February 2016. To gather the tweets, we searched for HIV-related terms in English and in Setswana. From the 140,240 tweets collected from 251 unique users, 576 contained HIV-related terms. A representative sample of 25 active Twitter users comprised individuals, one government site and 2 organizations. Data revealed that tweets related to HIV prevention and AIDS did not occur more frequently during the month of December when compared to January and February (t = 3.62, p > 0.05). There was no significant difference between the numbers of HIV related tweets that occurred from 1 December 2015 to 29 February 2016 (F = 32.1, p > 0.05). The tweets occurred primarily during the morning and evening hours and on Tuesdays followed by Thursdays and Fridays. The least number of tweets occurred on Sunday. The highest number of followers was associated with the Botswana government Twitter site. Twitter analytics was found to be useful in providing insight into information being tweeted regarding risky sexual behaviors. Full article

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