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Jonathan M Ellen

Publications and source records attributed to Jonathan M Ellen.

At least 37 records · Page 2Linked to original sources
PubMed2005

Adolescent partner-type experience: psychosocial and behavioral differences.

CONTEXT: Adolescents behave differently with main and casual sexual partners. These differences in behavior may be due to how adolescents perceive main and casual partners, but may also be informed by which types of partners adolescents have had experience with. METHODS: Data were collected in interviews with 276 sexually experienced STD clinic attendees in 1996-1998. Chi square tests and one-way analyses of variance were conducted to compare risk and protective variables among groups with different types of partner experience (main only, casual only, main and casual). Post hoc analyses determined differences between pairs of groups. RESULTS: Adolescents with different partner-type experiences evidenced different risk and protective factors. For example, adolescents who had had only main partners perceived a greater risk of contracting STDs from both main and casual partners than those who had had both partner types. Women in the casual-only group were the least likely to have been pregnant. Adolescents who had had main and casual partners intended a significantly shorter delay in initiating sex with a new main partner than did those in the main-only group; they also more strongly intended to have a side partner than did those who had had only main partners. CONCLUSIONS: The design of risk reduction and prevention interventions for at-risk sexually experienced adolescents ought to consider adolescents' sexual partner-type experiences and tailor messages to capitalize on associated protective factors and address or minimize associated risk factors.

Adolescent↗
PubMed2005

Psychosocial correlates of adolescent males' pregnancy intention.

OBJECTIVE: To identify psychosocial differences between sexually experienced male adolescents who indicate intentions to get someone pregnant and those who do not. METHODOLOGY: Cross-sectional study of 101 sexually experienced adolescent males recruited from a sexually transmitted disease clinic in northern California. We used Student's t tests and regressions to examine psychosocial differences between males who reported any intention versus no intention to get someone pregnant in the next 6 months, and we used analyses of variance to examine differences among different combinations of pregnancy plans/likelihood. RESULTS: Adolescents' reports of their plans for getting someone pregnant differed from their assessments of the likelihood that they would do so (chi2 = 24.33; df = 1). Attitudes toward pregnancy and participants' mothers' educational attainment differentiated those with clear pregnancy intentions (planning and likely) from those with clear intentions to avoid pregnancy (not planning and not likely) CONCLUSIONS: To reduce the rates of adolescent childbearing, males' pregnancy intentions must be assessed and asked about in multiple ways.

Adolescent↗
PubMed2004

Does parental involvement predict new sexually transmitted diseases in female adolescents?

BACKGROUND: African American female adolescents living in low-income urban areas are at increased risk for sexually transmitted diseases. OBJECTIVE: To determine if high levels of perceived parental supervision and communication were associated with reduced gonorrhea (GC) and chlamydia (CT) incidence in low-income, African American, sexually experienced female adolescents, aged 14 to 19 years, attending urban health clinics. DESIGN: A prospective cohort study was used to determine the predictive value for high levels of parental supervision and communication on GC and CT infection in 158 adolescent females. Multiple logistic regression analysis explored the association between incident infection and perceived parental supervision and perceived parental communication while controlling for relevant demographic and behavioral factors (age, religious involvement, school enrollment, a 2-parent household, having a main sex partner, and having concurrent sex partners). RESULTS: When adjusted for age and baseline GC and CT infection, high levels of perceived parental supervision were associated with reduced GC and CT incidence (adjusted odds ratio, 0.06; 95% confidence interval, 0.01-0.31). High levels of perceived parental communication were not associated with reduced GC and CT incidence (adjusted odds ratio, 0.55; 95% confidence interval, 0.21-1.42). CONCLUSIONS: The link between parental supervision and disease acquisition is particularly valuable because it provides evidence that parental supervision can result in lower sexually transmitted disease rates in urban high-prevalence populations. This is important for interventions designed to increase parental involvement as a strategy for promoting protective sexual behaviors in female adolescents because it indicates that increased parental involvement can also influence subsequent disease acquisition.

Adolescent↗
PubMed2004

Adolescent pregnancy intentions and pregnancy outcomes: a longitudinal examination.

PURPOSE: (a) To examine different methods of assessing pregnancy intention; (b) to identify psychosocial differences between those who indicate pregnancy intentions and those who do not; and (c) to examine the relationship between pregnancy intentions and subsequent pregnancy at 6-month follow-up in nonpregnant (at baseline), sexually experienced adolescent females. METHODS: Longitudinal cohort study of 354 sexually experienced female adolescents attending either a STD clinic or HMO adolescent medicine clinic in northern California. Student's t-tests and regressions examined psychosocial differences between females who reported "any" and "no" pregnancy intentions. ANOVAs examined differences among different combinations of pregnancy plans/likelihood. Chi-square analyses assessed associations between baseline pregnancy intentions and subsequent pregnancy. RESULTS: Adolescents' reports of their pregnancy plans and their assessments of pregnancy likelihood differed from one another (chi2 = 50.39, df = 1, p < .001). Pregnancy attitudes and baseline contraceptive use differentiated those with inconsistent pregnancy intentions (Not Planning, but Likely) from those with clear pregnancy intentions (Planning and Likely, and Not Planning and Not Likely) (Pregnancy Attitudes: F [2,338] = 68.96, p < .0001; Contraceptive Use: F [2,308] = 14.87, p < .0001). Suspected pregnancies and positive pregnancy test results were associated with baseline pregnancy intentions (Suspected: chi2 = 19.08, df = 2, p < .01; Positive Results: chi2 = 8.84, df = 2, p = .015). CONCLUSIONS: To reduce adolescent childbearing we must assess pregnancy intentions in multiple ways. Information/education might benefit those female adolescents with inconsistent reports of pregnancy intentions.

Adolescent↗
PubMed2004

The intention of adolescents to carry a knife or a gun: a study of low-income African-American adolescents.

PURPOSE: To examine whether African-American inner-city adolescents are independently motivated by a fear of victimization or by delinquency to carry a knife or gun. METHODS: A household sample of 130 female and 93 male African-American adolescents, aged 13-19 years old, were queried about their fear of victimization, history of delinquency, and intention to carry a knife or a gun in the next 3 months. RESULTS: A high intention to carry a knife was reported by 27% of the males and 35% of the females. A high intention to carry a gun was reported by 25% of the males and 9% of the females. The intention to carry a knife was independently associated with a history of delinquency in females (odds ratio [OR] = 3.0; 95% confidence interval [CI] = 1.4-6.2) and males (OR = 4.7; 95% CI = 1.7-13.3). It was not associated with a fear of victimization. The intention to carry a gun was independently associated with fear of victimization in females (OR = 4.5; 95% CI = 1.1-17.7) and males (OR = 3.3; 95% CI = 1.1-9.9). It was also independently associated with a history of delinquency in females (OR = 4.1; 95% CI = 1.1-16.3) and males (OR = 11.7; 95% CI = 3.1-44.7). CONCLUSIONS: Delinquency may play a role in motivating inner-city African-American adolescents to carry a knife, whereas both delinquency and fear of victimization may influence adolescents' motivation to carry a gun.

Adolescent↗
PubMed2004

The clinic and elsewhere: illness, sexuality, and social experience among young African American men in Baltimore, Maryland.

This paper is concerned with how disclosure becomes self-production for young adults within the setting of the sexually transmitted disease (STD) clinic. The STD clinic is a special medical environment where the process of disclosure is not just a way of accessing treatment; it is also a process through which illness, sexuality, and social experience become entangled in telling. Illness according to medical categories is reshaped in the social world, bringing a different set of criteria to bear on the definition of illness. The concern we raise regards how meaning is secured simultaneously through the experience of illness and social relations. Using data from a series of clinic-based ethnographic interviews, we examine the narratives of three young men. Together, the narratives demonstrate the interrelatedness of illness and self-production in various forms. In one case the tension between interpersonal violence and self-preservation is central. In another, the place of knowledge in family relationships renders the entire picture of the social unstable. The paper signals a number of issues absent in clinical and epidemiological depictions of vulnerability, particularly in the context of the urban United States.

Adolescent↗
PubMed2004

Perceived social cohesion and prevalence of sexually transmitted diseases.

BACKGROUND: Although physical attributes have been shown to be associated with sexually transmitted disease (SD) rates, there is little information about the association between social attributes and STD rates. GOAL: The objective of this study was to determine the association between gonorrhea prevalence and perceptions of social cohesion in impoverished, urban neighborhoods. STUDY DESIGN: We conducted a street-based survey of 18- to 24-year-olds residing in selected census block groups in Baltimore City, Maryland. Census block groups eligible for selection were defined as impoverished (greater than 20% in poverty) and unstable (lowest 25th percentile for stability). From the eligible census block groups, 5 from high gonorrhea rate (greater than the 75th percentile) census block groups and 5 from the lower gonorrhea rate (lowest 25th percentile to equal or greater than the 75th percentile) census block groups were randomly selected. Participants within the 10 selected census block groups were recruited using a street-intercept method. Participants were asked about perceived social cohesion and control. RESULTS: Results showed that for young adults 18 to 24 years of age residing in high gonorrhea census block groups, the mean social cohesion index scores were 1.7 points lower than mean social cohesion index scores of the participants residing in the low gonorrhea census block groups (P <0.01). CONCLUSION: Future research needs to be conducted to determine the temporal association between gonorrhea prevalence and local social cohesion dynamics.

Adolescent↗
PubMed2004

Risk perceptions, condom use, and sexually transmitted diseases among adolescent females according to social network position.

BACKGROUND AND OBJECTIVES: Adolescent females are frequently treated as a homogenous group but could differ on their sexually transmitted disease (STD) risk because of individual attitudes and exposure through sexual networks. GOAL: The goal of this study was to determine if risk perceptions, condom use, and STD prevalence differs within sexual networks. STUDY DESIGN: Three hundred three adolescent females participating in a longitudinal study of adolescent STD risk perceptions and condom use were categorized as "core," "bridge," and "periphery" in a sexual network according to their and their main sex partner's risk information. Regression analysis determined differences in risk perceptions by network location. RESULTS: We demonstrated an inverse relationship between STD risk perceptions and network location. Adolescents with higher risk perceptions were more likely to use condoms, irrespective of network location. CONCLUSION: Female adolescents are a heterogeneous group exhibiting different risk perceptions. Different intervention strategies for adolescents at higher risk could be necessary. Interventions designed to raise risk perceptions could be associated with condom use, even for those adolescents at greatest risk.

Adolescent↗
PubMed2004

Phase-specific network differences associated with the syphilis epidemic in Baltimore city, 1996-2000.

OBJECTIVES: The objective of this study was to determine whether the syphilis epidemic in Baltimore City during the mid-1990s was associated with changes in sexual networks. METHODS: Data on index cases of syphilis and their partners were collected from 1996 to 2000 and entered into CDC STD*MIS software. Unique pairs of dyads were used to create networks using SAS Interactive Matrix Language. PAJEK and UCINET were used to analyze the largest component from all years (1996-2000), during the epidemic (1997-1998), and after the epidemic (1999-2000). RESULTS: Between 1996 and 2000, there were 3343 components containing 18,709 nodes. The 2 largest components were comprised of 1103 nodes and 125 nodes, respectively. From the period during the epidemic to after the epidemic, the average distance among reachable pairs, network centralization, number of n-cliques (n = 2, size = 3), and number of k-plexes (k = 2, n = 3) declined, whereas the block densities increased. CONCLUSIONS: Important differences exist between the sexual networks during and after the syphilis epidemic.

Baltimore↗
PubMed2004

Sex partner concurrency, geographic context, and adolescent sexually transmitted infections.

BACKGROUND: Geographic areas characterized by a high prevalence of sexually transmitted infections (STIs) are critical to the maintenance and persistence of STIs within populations. Sex partner concurrency has been shown to be associated with increased risk for individual-level STIs. OBJECTIVES: The objectives of this study were to determine whether gonorrhea rate per census block group and sex partner concurrency independently and interactively are associated with a current bacterial STI among adolescents. STUDY: Face-to-face interviews and urine testing for Chlamydia trachomatis and Neisseria gonorrhoeae were conducted among female, sexually active, 14- to 19-year-olds presenting for reproductive clinic care between August 2000 and June 2002. RESULTS: Gonorrhea rate per census block group and sex partner concurrency were not independently but were interactively associated with a current bacterial STI. Among participants with a main sex partner who practiced concurrency, living in high-prevalence geographic areas was significantly associated with a current bacterial STI. CONCLUSIONS: The results suggest that geographic context may moderate an adolescent sex partner's behaviors. The research adds to the basic understanding of sexually transmitted disease transmission and acquisition in a high-prevalence inner-city setting.

Adolescent↗
PubMed2004

Post-HIV test counselling of clients of a mobile STD/HIV clinic.

The objective of the study was to determine the post-test counselling (PTC) rates for HIV-infected and uninfected individuals receiving HIV counselling and testing on a mobile STD/HIV screening clinic and to determine whether individuals at highest risk for transmitting their infection were less likely to receive PTC than those at lower risk for transmitting. Clients presenting for HIV counselling and testing were asked about their demographic characteristics, clinical history, personal risk behaviours, and partner risk factors and told to return after 14 days for results. Disease intervention specialists (DIS) attempted to locate and counsel positive clients. The PTC rate among infected and uninfected clients was 66% and 46%, respectively. There were significant differences in demographics and risk factors for those who were post-test counselled versus those who were not. Among HIV-uninfected clients, there was a positive association between PTC and drug treatment in the past three months and having engaged in sex work within the last three months. Being female was negatively associated with PTC. Among HIV-infected clients, there was a positive association between PTC and current enrollment in drug treatment. These data suggest that mobile STD/HIV screening clinics may be limited in their effectiveness by low rates of PTC.

AIDS Serodiagnosis↗
PubMed2004

Adolescents' self-efficacy to communicate about sex: its role in condom attitudes, commitment, and use.

This study examined whether and how self-efficacy to communicate with parents and peers about sex relate to sexually experienced adolescent males' and females' (N= 144, 112) condom attitudes, intentions, and use. Results showed that males who reported greater self-efficacy to communicate with parents used condoms more frequently; and both males and females who can communicate with peers used condoms more frequently. Self-efficacy to communicate with peers was related to more positive condom attitudes, which in turn were associated with greater condom commitment and use. Greater ability to communicate with parents was also related to greater condom commitment and use among males. These results suggest the importance of designing interventions that give adolescents the skills they need to feel efficacious in their ability to communicate about sex and contraception.

Adolescent↗
PubMed2003

Comparison of clients of a mobile health van and a traditional STD clinic.

The objective of this study was to determine if there were any demographic, behavioral, and clinical differences between clients seen aboard a mobile sexually transmitted disease (STD)/HIV clinic compared with those seen in a traditional municipal STD/HIV health clinic for receipt of STD/HIV services. Clients seen in the two different settings were interviewed about demographic characteristics, reasons for their visit, STD history, their HIV/STD risk factors, and the risk factors of their sex partners. Clients in both settings were also offered testing for syphilis, gonorrhea, chlamydia, and HIV. Results suggested that clients seen at the mobile clinic were older, more likely to be injecting drug users themselves and/or to have sex partners who were, or had engaged in prostitution for money or drugs. Over half (54.4%) of the mobile clinic clients sought testing for HIV, and they were far less likely to be seeking care for symptoms of an STD. In contrast, only 7.1% of municipal clinic clients indicated HIV testing as the reason for their visit, whereas nearly two thirds (64.5%) reported symptoms of disease. Two percent of municipal clinic clients and 5.4% of mobile clinic clients had a positive HIV test ( p<.001), and 17.8% of STD clinic clients and 5.6% of mobile van clients had a positive gonorrhea and/or test ( p<.001). These data suggest that a mobile STD/HIV clinic may be an effective strategy to reach individuals at high risk for HIV who are not being served by traditional municipal STD/HIV health clinics.

Adult↗
PubMed2003

Environmental-structural factors significantly associated with consistent condom use among female sex workers in the Dominican Republic.

OBJECTIVE: To examine the influence of environmental-structural factors in promoting consistent condom use (CCU) among female sex workers (FSW) and their regular paying partners in the Dominican Republic. METHODS: A cross-sectional survey was conducted with 288 FSW recruited from 41 sex establishments in Santo Domingo from March to June 1998. Sex workers were asked about their sexual behavior, self-efficacy at negotiating safe sex, perceived intimacy with their most recent regular paying partner, and the physical, social and policy environment of the establishment where they worked. Factor and reliability analysis were utilized to develop aggregate measures for self-efficacy (Cronbach's Alpha 0.60), intimacy (Cronbach's Alpha 0.80), and environmental-structural support (Cronbach's Alpha 0.72). RESULTS: Controlling for sociodemographic characteristics of participants in multivariate analyses, environmental-structural support for condom use and HIV/sexually transmitted infection (STI) prevention was a significant predictor of CCU (OR 2.16; CI 1.18-3.97) among FSW and their regular paying partners. Safe sex self-efficacy (OR 2.80; CI 1.31-5.97) and low perceived intimacy with the most recent regular paying partner (OR 7.20; CI 3.49-14.83) were also significantly associated with CCU in multivariate analysis. CONCLUSION: Environmental-structural support for condom use and HIV/STI prevention is a significant predictor of CCU among FSW in the context of regular paying partnerships. Environmental-structural factors, in addition to relational and individual cognitive factors, should be assessed and addressed by behaviorally guided theory, research and interventions related to HIV/STI prevention and female sex work.

Adolescent↗
PubMed2003

The next generation of HIV prevention for adolescent females in the United States: linking behavioral and epidemiologic sciences to reduce incidence of HIV.

Given the increasing numbers of new HIV infections among adolescent females and limitations of the current generation of HIV interventions, a new generation of interventions is needed to prevent HIV and other infections in this population. Interventions available today are limited by their focus on single behaviors that have little epidemiologic significance, such as condom use, and their failure to be tested among the highest risk females. Recent advances in epidemiologic sciences suggest that the next generation of interventions should focus on parenting and parenting skills, sexual risk networks in which drug use and other high-risk behaviors are prevalent, and neighborhoods where these networks exist. Future research should include formative and observational studies to inform new intervention trials that reach the highest risk female youth.

Adolescent↗
PubMed2003

Discordant sexual partnering: a study of high-risk adolescents in San Francisco.

BACKGROUND: In sexual networks, bridge members engaging in discordant partnering play key roles in maintaining and transmitting sexually transmitted infections (STIs) within a population. GOAL: The goal was to characterize adolescents likely to engage in discordant sexual relationships with main and casual sex partners. STUDY DESIGN: Egocentric data about adolescents and their most recent sex partner(s) collected over 6 months were analyzed with use of logistic regression. RESULTS: History of STI, drug use, and meeting venue were significantly associated with discordant sexual partnering among high-risk adolescents. Participants with histories of high-risk behavior, e.g., hard drug use or STI, were more likely to have had a recent, dissimilar partner than those with lower-risk profiles. Particular meeting venues, such as clubs and street locations, were more likely to be associated with age-discordant, race-discordant, and drug use-discordant partnerships for females. CONCLUSION: Bridge members of adolescent sexual networks were more likely to have a history of STI, hard drug use, or meeting their sex partner through particular venues.

Adolescent↗
PubMed2002

A randomized comparison of A-CASI and phone interviews to assess STD/HIV-related risk behaviors in teens.

PURPOSE: To compare response bias associated with a telephone survey of sexually transmitted disease/human immunodeficiency virus (STD/HIV)-related risk behaviors and an in-home self-administered audio computer assisted self interview (A-CASI). METHODS: We randomly assigned an urban household sample of 223 African-American adolescents to a telephone interview or an A-CASI in their home. The sample was previously recruited by telephone for an earlier study regarding STDs and sexual behavior. We queried participants about their STD/HIV-related risk behaviors. We also assessed their perceived comfort, honesty, and accuracy in answering questions in the different modes through a telephone computer-assisted self-interview (T-CASI). RESULTS: There were no significant differences by mode in percentages of participants reporting STD/HIV-related risk behaviors, except more A-CASI participants reported having engaged in sexual intercourse in past 3 months (43.8% vs. 33.3%). There were no differences in perceived comfort, honesty, and accuracy in answering questions in the different modes. These results also did not change after we adjusted for age, household structure, and current school enrollment. CONCLUSIONS: Telephone interviews, a more economical mode, can be employed without much risk of increasing the response bias in the data assessing crude measures of risk.

Adolescent↗