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Biomedical subjects

G Remafedi

Publications and source records attributed to G Remafedi.

33 records · Page 2Linked to original sources
PubMed1994

Predictors of unprotected intercourse among gay and bisexual youth: knowledge, beliefs, and behavior.

OBJECTIVE: To examine human immunodeficiency virus (HIV)-related knowledge, attitudes, and behaviors and predictors of unprotected anal intercourse. DESIGN: Structured interviews and paper-and-pencil instruments. SETTING: Community sites in Minnesota during 1989 to 1991. SUBJECTS: Two hundred thirty-nine gay and bisexual male adolescent volunteers. OUTCOME MEASURES: AIDS knowledge and beliefs, self-reported substance use, and sexual behavior. RESULTS: Subjects demonstrated accurate knowledge and beliefs about HIV; but 63% were found to be at "extreme risk" for prior HIV exposure, based on histories of unprotected anal intercourse and/or intravenous drug use. Thirty-four percent of subjects reported unprotected anal sex with at least one of the last three partners in the previous year. Perceived likelihood of HIV acquisition, substance abuse, having a steady partner, noncommunication with partners about risk reduction, and frequent intercourse were found to be significantly associated (P < .05) with unprotected anal sex in the previous year. CONCLUSIONS: Programs for gay and bisexual youth should focus on preventing unprotected anal intercourse. Other goals are to promote: communication with sexual partners, consistent condom use during oral and vaginal sex, low risk sexual practices, avoidance of substance use in sexual situations, and developmentally appropriate HIV antibody counseling and testing services.

Adolescent↗
PubMed1993

The impact of training on school professionals' knowledge, beliefs, and behaviors regarding HIV/AIDS and adolescent homosexuality.

The impact of training on secondary school professionals' knowledge, beliefs, and behaviors regarding HIV/AIDS and adolescent homosexuality was examined. Subjects (79 introductory and 50 advanced trainees) and 58 controls (no prior training) were systematically sampled from professionals in a statewide demonstration program to prevent HIV transmission among gay and bisexual youth. Subjects completed mailed, self-administered surveys based on the curriculum. The overall response rate was 79%. Trainees scored significantly higher than controls on knowledge pertaining to HIV and adolescent homosexuality. They also reported using greater numbers of strategies to teach students about homosexuality and to improve the mileu for homosexual students. Training at any level was independently associated with constructive behaviors, while controlling for demographic characteristics. Advanced learners were most knowledgeable and least reliant on informal sources of information. They were more likely than others to teach about homosexuality and to refer homosexual students to community services. Findings supported the hypothesized benefits of the intervention. Schools that mandate AIDS education should help staff confront the difficult issue of adolescent homosexuality.

Acquired Immunodeficiency Syndrome↗
PubMed1993

Youth coping with sexual orientation issues.

Youth who are struggling with the issue of sexual orientation often are aware of hostile attitudes within their families, schools, communities and among their peers, but are unable to find help. These young people are subject to humiliation, rejection, social isolation, and physical assaults, as well as life-threatening STDs and HIV. Resultant emotional and behavioral symptoms may bring them to the attention of the school nurse, who is often perceived as the most accepting and accessible resource within the school setting. This article provides background information on homosexuality, suggestions for leadership in providing intervention, and resources to help the school nurse reach out to these unserved youth.

Acquired Immunodeficiency Syndrome↗
PubMed1992

Special Health Needs of Homosexual Youth.

The authors provide a developmental framework for understanding the psychosocial and medical problems that threaten the health of homosexual adolescents. Their special health needs are described and the role of health professionals in reaching and caring for them is outlined.

Journal Article↗
PubMed1992

Demography of sexual orientation in adolescents.

This study was undertaken to explore patterns of sexual orientation in a representative sample of Minnesota junior and senior high school students. The sample included 34,706 students (grades 7 through 12) from diverse ethnic, geographic, and socioeconomic strata. Five items pertaining to sexual attraction, fantasy, behavior, and affiliation were embedded in a self-administered survey of adolescent health. Overall, 10.7% of students were "unsure" of their sexual orientation; 88.2% described themselves as predominantly heterosexual; and 1.1% described themselves as bisexual or predominantly homosexual. The reported prevalence of homosexual attractions (4.5%) exceeded homosexual fantasies (2.6%), sexual behavior (1%), or affiliation (0.4%). Gender differences were minor; but responses to individual sexual orientation items varied with age, religiosity, ethnicity, and socioeconomic status. Uncertainty about sexual orientation diminished in successively older age groups, with corresponding increases in heterosexual and homosexual affiliation. The findings suggest an unfolding of sexual identity during adolescence, influenced by sexual experience and demographic factors.

Adolescent↗
PubMed1991

Risk factors for attempted suicide in gay and bisexual youth.

Studies of human sexuality have noted high rates of suicidality among homosexual youth, but the problem has not been systematically examined. This work was undertaken to identify risk factors for suicide attempts among bisexual and homosexual male youth. Subjects were 137 gay and bisexual males, 14 through 21 years of age, from the upper Midwest and Pacific Northwest. Forty-one subjects (41/137) reported a suicide attempt; and almost half of them described multiple attempts. Twenty-one percent of all attempts resulted in medical or psychiatric admissions. Compared with non-attempters, attempters had more feminine gender roles and adopted a bisexual or homosexual identity at younger ages. Attempters were more likely than peers to report sexual abuse, drug abuse, and arrests for misconduct. The findings parallel previous studies' results and also introduce novel suicide risk factors related to gender nonconformity and sexual milestones.

Adolescent↗
PubMed1990

Fundamental issues in the care of homosexual youth.

The development of a homosexual identity spans the entire life cycle, but adolescence is a critical period in the lives of gay and lesbian persons. Various pre- and postnatal biologic and environmental factors are thought to determine sexual orientation early in life. An emerging homosexual identity may be reflected in youths' sexual attractions, fantasies, and cultural affiliations, as well as their behaviors. The adolescent experiences of homosexual persons profoundly affect health outcomes. The goals of care are to promote normal adolescent development, social and emotional well-being, and physical health. Comprehensive and coordinated educational, mental health, social, and medical services are recommended.

Adolescent↗
PubMed1990

Sexually Transmitted Diseases in Homosexual Youth.

The prevalence of sexually transmitted diseases (STDs) in homosexual populations is due to a complex interrelationship of host and pathogen factors. This chapter explores the risk factors, epidemiology, microbiology, clinical aspects, and prevention of STDs in homosexual youth. This discussion focuses on male adolescents, because STDs are uncommon among exclusively homosexual women.

Journal Article↗
PubMed1989

Clinical predictors of Chlamydia trachomatis endocervicitis in adolescent women. Looking for the right combination.

Chlamydial disease in adolescent women is a serious public health problem, but secondary preventive efforts through early detection and treatment are encumbered by the cost and complexity of mass screening. This study was undertaken to identify clinical predictors of infection that might narrow the scope of screening adolescent populations. Demographic/clinical data and endocervical smears for the direct-specimen fluorescein-conjugated monoclonal antibody test for Chlamydia trachomatis were collected from 244 consecutive women, 21 years of age or less, attending an adolescent health clinic. Positive direct-specimen fluorescein-conjugated monoclonal antibody test for C trachomatis results were associated with a past history of chlamydial infection, multiple sexual partners, sexual contact with men with urethritis, nonuse of condoms, metrorrhagia, exocervicitis, mucopurulent endocervical discharge, abnormal cervical cytologic features, and isolation of Neisseria gonorrhoeae from the endocervix. These variables were entered into a discriminant analysis to predict direct-specimen fluorescein-conjugated monoclonal antibody test for C trachomatis results. The discriminant function was statistically significant but explained only 17% of between-group variance. Two variables alone, exocervicitis and partners with urethritis, correctly predicted direct-specimen fluorescein-conjugated monoclonal antibody test for C trachomatis results in 79% of all cases (negative predictive value 90%; positive predictive value 35%). When routine screening with reliable laboratory tests is not feasible, selective testing or empirical treatment of adolescent women with either risk factor may be cost-effective alternatives.

Adolescent↗
PubMed1987

Male homosexuality: the adolescent's perspective.

Although homosexual activity is prevalent among US teenagers, adolescent homosexuality per se has been a poorly understood phenomenon. The purpose of this investigation is to describe the meaning and experience of homosexuality from the adolescent's perspective. Twenty-nine male teenagers, self-described as gay (79%) or bisexual (21%), volunteered to participate in a structured interview, the purpose of which was to examine the definition of homosexuality, the acquisition of a gay identity, and the impact of sexuality on family, peers, and community. The youths demonstrated well-established sexual identities by the consistency of their sexual fantasies, interests, and behaviors over time. Homosexuality was more frequently described as a general attraction to men (48%) and an indicator of positive personal attributes (33%) than as an isolated sexual behavior. The subjects reported strong negative attitudes from parents (43%) and friends (41%) toward their sexualities. Discrimination (37%), verbal abuse from peers (55%), and physical assaults (30%) were frequently cited problems. These stressors may place the boys at high risk for physical and psychosocial dysfunction.

Adaptation, Psychological↗
PubMed1987

Adolescent homosexuality: psychosocial and medical implications.

Despite a widespread interest in the health of the gay community, the psychosocial and medical problems of gay and bisexual adolescents have not been adequately investigated. In this study, 29 gay and bisexual male teenagers participated in anonymous and confidential interviews regarding the impact of sexuality on family, employment, education, peers, intimate relationships, and physical and mental health. The majority of subjects experienced school problems related to sexuality, substance abuse, and/or emotional difficulties warranting mental health interventions. In addition, nearly half of the subjects reported a history of sexually transmitted diseases, running away from home, or conflict with the law. A minority had been victims of sexual assaults or involved in prostitution. Those less than 18 years of age experienced higher rates of psychiatric hospitalization, substance abuse, high school drop-out, and conflict with the law than did older participants. Various explanations for the prevalence of these problems and their implications for health professionals are discussed.

Adolescent↗