Biomedical subjects

Richard A Crosby

Publications and source records attributed to Richard A Crosby.

At least 19 recordsLinked to original sources

PubMed2006

Validation of a Parent-Adolescent Communication Scale for use in STD/HIV prevention interventions.

This study reports on the validation of a scale to assess adolescent girls' frequency of sexual communication with their parents. The Parent-Adolescent Communication Scale (PACS) was administered to 522 African American female adolescents ranging in age from 14 to 18. The PACS demonstrated satisfactory internal consistency (across multiple administrations) and acceptable test-retest reliability over a 12-month follow-up period. Concurrently, scores on the PACS were correlated with frequency of sexual communication with partner, sexual communication self-efficacy (boyfriend), perceived parental knowledge, family support, depression, and condom use with steady male sex partners. Prospectively, baseline PACS scores were correlated with frequency of sexual communication with partner and condom use. The present investigation indicates that the PACS is a reliable and valid measure of frequency of sexual communication between female adolescents and their parents. Utility of the PACS for researchers and practitioners is discussed.

Adolescent↗

PubMed2006

Brief report: sexual sensation seeking and its relationship to risky sexual behaviour among African-American adolescent females.

The relationship between sexual sensation seeking and sexual risk taking has been investigated among adult populations. There are limited data, however, regarding this relationship for adolescents. Since African-American adolescent females continue to be disproportionately diagnosed with STDs, including HIV, we examined this association among a clinic-based sample of African-American adolescent females (N=715) enrolled in an STD/HIV prevention intervention. Participants (ages 15-21) endorsing higher levels of sexual sensation seeking reported higher levels of sexual risk-taking behaviours (e.g. frequency of vaginal intercourse, number of sexual partners, and poorer condom use). Results remained significant after controlling for known covariates associated with sexual risk-taking behaviours. Results are consistent with the adult literature and highlight the need for future investigations examining sexual sensation seeking among adolescents. These results, though preliminary, could be used to better inform prevention interventions and clinicians/health educators who provide direct services to adolescents.

Adolescent↗

PubMed2006

The protective value of social capital against teen pregnancy: a state-level analysis.

PURPOSE: To investigate whether social capital may explain differences in teen pregnancy rates in the contiguous United States. METHOD: State-level correlational analyses were conducted. Predictor variables included social capital, income inequality, and poverty. MAIN OUTCOME MEASURE: State-level rates of pregnancy for girls 15-19 years old. RESULTS: In bivariate analyses, social capital was inversely correlated with teen pregnancy rates. The obtained correlation was strong (r = -.78) and achieved significance (p < .001). Poverty and income inequality were also significantly correlated with teen pregnancy rates, but the magnitude of these correlations was lower. In a linear regression model, poverty failed to retain significance; however, income inequality achieved significance and produced a Beta value of .24 (p = .017). Social capital was nonetheless a much stronger multivariate predictor of teen pregnancy rates (producing a Beta value of -.672). CONCLUSION: Findings from this state-level analysis suggest that social capital may explain differences between states with respect to teen pregnancy rates. Thus, social capital may play an important role in the prevention of teen pregnancy. This initial finding warrants subsequent empirical investigations designed to identify strategies that can be employed to foster the creation of social capital in communities and entire states.

Adolescent↗

PubMed2006

Predictors of inconsistent contraceptive use among adolescent girls: findings from a prospective study.

PURPOSE: To assess the independent effects of various behavioral and psychosocial antecedents on contraceptive use among a sample of low-income African-American adolescent females. METHODS: Stepwise logistic regression was used to calculate odds ratios for baseline predictors of inconsistent contraceptive use six months later. Study participants include 375 nonpregnant African-American girls aged 14-18 years who reported sexual activity in the previous six months. Data were collected using a self-administered survey, individual interview and urine pregnancy test. RESULTS: Adolescents who were inconsistent contraceptive users at follow-up were more likely to have reported a desire for pregnancy, previous inconsistent contraceptive use, less frequent communication with their partners about prevention issues, and an increased number of lifetime sexual partners at the baseline assessment. Of equal importance was the finding that a previous pregnancy or sexually transmitted infection did not influence future contraceptive behaviors. CONCLUSIONS: Clinicians can play an important role in counseling adolescents about sexual health and dispelling misperceptions that hinder consistent contraceptive use. Findings from this research could have significant implications for the development of effective sexually transmitted infection (STI) and pregnancy prevention programs for adolescents and can help in guiding clinicians toward relevant treatment practices.

Adolescent↗

PubMed2006

Ecological factors associated with STD risk behaviors among detained female adolescents.

The authors used Bronfenbrenner's conceptual framework of an ecological systems model to examine factors that are independently associated with sexually transmitted disease (STD) risk behaviors among 280 sexually active detained female adolescents. Using computer-assisted self-interviewing procedures, the authors assessed individual characteristics, peer relations, community factors, and media influences and their association to STD risk behaviors. Findings indicated that factors such as greater substance use, stronger risk-taking attitudes, lower perceived parental monitoring and familial support, gender roles supporting male dominance, risky peer norms, and lower student-teacher connectedness, were independently associated with increased STD risk behaviors. Findings suggest a multisystemic approach to STD prevention among this population.

Adolescent↗

PubMed2006

Preventing sexually transmitted infections among adolescents: 'the glass is half full'.

PURPOSE OF REVIEW: Given the disproportionate burden of sexually transmitted infections for adolescents, there is an urgent need to identify effective prevention programs. RECENT FINDINGS: This review documents the efficacy of recent sexually transmitted infection-prevention programs. Overall, the review identified few sexually transmitted infection-prevention trials published since 2000. Moreover, considerable variability in program efficacy was observed across studies. Some studies observed changes in sexually transmitted infection-associated risk behaviors, while only a few identified reductions in biologically confirmed sexually transmitted infections. In general, few programs demonstrated consistency of effects and a significant magnitude of effects across a broad range of outcomes. SUMMARY: New and innovative approaches are needed to amplify sexually transmitted infection intervention effects. Program development and evaluation needs to continue in a coordinated, scientifically rigorous fashion to optimize impact and, as important, to sustain effects over protracted periods. Furthermore, for interventions with demonstrated efficacy, a critical challenge is to translate them into sustainable programs that are widely disseminated. Ultimately, preventing sexually transmitted infections in adolescents does not only depend on the development of effective interventions alone, but on how effectively these interventions can be translated and integrated into self-sustaining components of clinic, school or community programs, particularly in those areas and among adolescent populations most adversely impacted by the epidemic of sexually transmitted infection.

Adolescent↗

PubMed2006

Will sexual risk behaviour increase after being vaccinated for AIDS?

The question of whether people will engage in greater levels of HIV-associated risk behaviour after receiving an AIDS vaccine has not been sufficiently investigated. Three objectives were: (1) assess the likelihood that people will engage in greater levels of HIV-risk behaviour after receiving an AIDS vaccine; (2) determine the association of increases with vaccination intent; and (3) identify differences between people who would and would not increase their HIV-risk behaviour after vaccination.A cross-sectional survey was conducted of 278 adults from three populations: gay men, African-American women, and persons who used illicit drugs. Nearly one-quarter of the sample indicated a likelihood that their HIV-risk behaviour would increase after vaccination. This increase was positively associated (r = 0.24) with increased intent to be vaccinated. Previous worry about having HIV (adjusted odds ratio [AOR] = 3.4, P = 0.004), being 32 years of age or older (AOR = 2.9, P = 0.0007), and having less than a high school education (AOR = 2.3, P = 0.027) were each associated with a post-vaccination increase in HIV risk. With the seemingly real potential for increased HIV-risk behaviours after being vaccinated against AIDS, intervention studies are warranted to identify strategies with potential to minimize this phenomenon.

AIDS Vaccines↗

PubMed2005

Correlates of condom failure among adolescent males: an exploratory study.

OBJECTIVE: To identify the prevalence and correlates of condom failure (defined as breakage or slipping off in the past 90 days) among a sample of adolescent males (15 to 21 years of age). DESIGN: A cross-sectional study of 481 condom-using males residing in three US cities (Atlanta, GA, Providence RI, Miami FL). Data were collected, in the years 2000 and 2001, using audio computer-assisted self-interviewing technology. Prevalence ratios were used to determine the strength and significance of bivariate associations between ten assessed correlates and condom failure. Correlates achieving a screening level of significance were entered into a multivariate model that was used to calculate adjusted odds ratios (AOR). RESULTS: Recent condom failure was reported by 34.1%. Younger adolescents were about one-third less likely to report condom failure (AOR = 0.66; P = 0.4). Adolescents reporting multiple sex partners were about 80% more likely to report failure (AOR = 1.84; P = 0.09). Adolescents indicating they had sex with someone on the same day they met the person were about 80% more likely to report failure (AOR = 1.77; P = 0.02). Finally, adolescents indicating recent problems obtaining condoms were about 70% more likely to report failure (AOR = 1.69; P = 0.1). Failure was not less common among those reporting a history of STD infection or those ever impregnating a partner. CONCLUSION: Because adolescent males may commonly experience condom failure, targeted clinic- and community-based programs designed to reduce user error could be an important aspect of preventing pregnancy and the spread of STDs.

Adolescent↗

PubMed2005

Condom failure among adolescents: implications for STD prevention.

This study of 921 adolescents found condom failure (past 90 days) was experienced by at least one-third of the sample, regardless of gender. Frequency of condom failure was positively associated with STD diagnosis (AOR = 1.22, 95% CI = 1.01-1.48), with the odds of testing positive increasing 22% for each added event of failure.

Adolescent↗

PubMed2005

A programmatic and methodologic review and synthesis of clinic-based risk-reduction interventions for sexually transmitted infections: research and practice implications.

The over-arching goal of this article is to systematically review and synthesize empirical findings for sexually transmitted disease risk-reduction programs that were developed and implemented specifically for adolescents seeking health care services at clinical venues. The objective is to examine the reported efficacy of these programs in reducing adolescents' sexually transmitted infection (STI)-associated behavior, in enhancing theoretically and empirically important psychosocial mediators associated with the adoption of STI-preventive behaviors, and, most important, in reducing adolescents' risk of acquiring an STI. In addition, our review assesses program and methodologic characteristics of the studies, determines compliance with standardized reporting guidelines, identifies a subset of program characteristics that are related to efficacy in terms of modifying adolescents' sexual risk behaviors, and examines the research and practice implications of these findings for implementing evidence-based STI risk-reduction programs in clinics.

Adolescent↗

PubMed2005

Prevalence and correlates of HIV testing among college students: an exploratory study.

OBJECTIVES: Whether college students who are most at-risk of HIV infection are being tested is unknown. This exploratory study identified the prevalence and correlates of ever having an HIV test among college students. METHODS: A cross-sectional survey was conducted among a probability sample of 903 college students. Measures of sexual risk behaviour were assessed. RESULTS: Of the students surveyed, 22.5% reported they had been tested for HIV. Testing was more likely among those 20 years of age or older (27.8% v. 14.7%; P = 0.0001), females (25.4% v. 17.8%; P = 0.01), and members of racial/ethnic minorities (42.7% v. 20.3%; P = 0.0001). After adjusting for these covariates, those who reported ever having vaginal sex (AOR = 5.5; 95% CI = 3.1-9.6); anal sex (AOR = 2.4; 95% CI = 1.6-3.6), and oral sex (AOR = 6.3; 95% CI = 3.0-13.3) were significantly more likely to report being tested. Students having vaginal sex in the past 12 months were significantly more likely to report testing (AOR = 5.3; 95% CI = 3.1-9.1). Those reporting vaginal sexual debut (AOR = 1.9; 95% CI = 1.2-3.1) or oral sexual debut (AOR= 1.7; 95% CI = 1.1-2.5) < or = age 15 were significantly more likely to be tested. Students reporting four or more sex partners were significantly more likely to be tested than sexually experienced students reporting fewer partners (AOR = 3.2; 95% CI = 2.2-4.6). Finally, those reporting at least one episode of forced vaginal sex (AOR = 3.9; 95% CI = 2.1-7.2) and reporting at least one episode of any forced sex (vaginal, anal, oral) (AOR = 3.0; 95% CI = 1.8-5.0) were significantly more likely to report being tested. CONCLUSIONS: Within this population, demographically controlled findings suggest that those most at-risk of HIV infection are indeed being tested for the virus.

Adult↗

PubMed2005

Self-esteem and theoretical mediators of safer sex among African American female adolescents: implications for sexual risk reduction interventions.

Theories of health behavior posit that change is accomplished by modifying factors deemed as mediators. A set of mediators from several theoretical models used in sexual risk reduction programs was assessed among a sample of 522 African American female adolescents. The goal was to determine whether self-esteem was associated with sexually transmitted disease (STD), pregnancy, and the set of theoretical mediators controlling for covariates. Bivariate analyses showed no relationship between self-esteem and STD or pregnancy; multivariate regression analysis revealed a significant relation between self-esteem and the set of mediators. Girls higher in self-esteem were more likely to hold positive condom attitudes, felt more efficacious in negotiating condom use, had more frequent communication with sex partners and parents, perceived fewer barriers to using condoms, and were less fearful of negotiating condom use. Self-esteem should be considered when designing and evaluating sexual risk reduction programs for this population.

Adolescent↗

PubMed2005

Issues related to gay and bisexual men's acceptance of a future AIDS vaccine.

The purpose of this study was to identify the salient issues related to getting a future AIDS vaccine among a high-risk group. In-depth interviews were conducted with 24 White and Black men who have sex with men (MSM). Participants reported that they would need information regarding the vaccine strategy, the clinical trials research, and vaccine attributes. A prerequisite for Black participants was the prior inclusion of Blacks in clinical trials. A high degree of safety and effectiveness, minimal side-effects, high-perceived risk, and affordable cost would promote vaccine acceptance. Barriers were low degree of safety and effectiveness, harsh side-effects, low-perceived risk, perception of a backlash effect, cost, and inconvenience. MSM may not readily get an AIDS vaccine unless they are provided with specific details and the benefits outweigh the costs. Researchers conducting HIV vaccine trials should provide information about the research and insure that samples represent Black men.

AIDS Vaccines↗

PubMed2005

Reducing risk exposures to zero and not having multiple partners: findings that inform evidence-based practices designed to prevent STD acquisition.

Our objective was to assess prospectively the relative contribution of reducing penile-vaginal risk exposure to zero and limiting the number of sex partners to one, on the acquisition of biologically confirmed sexually transmitted disease (STD) among African American women adolescents. Data from a prospective cohort of 522 African American women adolescents enrolled in an HIV prevention trial were used. Baseline STD testing and single-dose directly observable treatment provided an infection-free cohort, who were followed and assessed at six-month intervals. Self-administered vaginal swab specimens were tested for Chlamydia trachomatis, Neisseria gonorrhoeae, and Trichomonas vaginalis at baseline, six, 12, and 18 months. Frequency of having multiple sex partners and unprotected vaginal sex over each six-month assessment interval was measured. Adolescents who reported multiple sex partners, relative to only one partner, were more likely to test positive for an STD (adjusted odds ratio (AOR) = 2.9; P = 0.0001). Adolescents who reported unprotected vaginal sex relative to those reporting protected vaginal sex also had greater odds of testing positive for an STD (AOR = 1.5; P = 0.0001). Prospective findings suggest that having multiple sex partners and engaging in unprotected vaginal sex both remain significant risk factors for STD acquisition among African American adolescent women. STD prevention programmmes need to target both risk factors to achieve optimal risk-reduction effectiveness.

Adolescent↗

PubMed2005

Public opinion about condoms for HIV and STD prevention: a Midwestern state telephone survey.

CONTEXT: Public opinion is important in determining condom and condom education policies in public high schools. METHODS: A random telephone survey of 517 Indiana residents was conducted from July through October 2003 to assess public opinion about education on correct condom use for HIV and STD prevention; condom availability in Indiana public high schools; and issues related to condom use, effectiveness and promotion. Data were analyzed using bivariate and linear regression techniques. RESULTS: A majority of respondents strongly or somewhat agreed that instruction on correct condom use for HIV and STD prevention should be provided in public high schools (77%), classroom instruction should include condoms (71%), only medically accurate information about condoms should being given (94%) and the federal government should promote condoms (70%). Fewer than half (48%) strongly or somewhat agreed that condoms should be made available to teenagers in public high schools without parental permission. Nearly all (92%) considered condoms at least somewhat effective in preventing HIV and other STDs. Non-Republican party affiliation, younger age and condom use within the previous five years were each significantly associated with having positive opinions on many of the condom-related statements. CONCLUSIONS: Public opinion appears to support the provision of correct condom use information in Indiana public schools. Schools should consider providing only medically accurate information about condoms and including condoms in instruction so students can see and touch them.

Adolescent↗

PubMed2005

Adverse health consequences that co-occur with depression: a longitudinal study of black adolescent females.

OBJECTIVE: The purpose of this study was to identify adverse health consequences that may co-occur with depression among black female adolescents. METHODS: Adolescents were recruited from high-risk neighborhoods in Birmingham, Alabama. The sample comprised 460 black female adolescents (aged 14-18 years) who completed assessments at baseline and at 6 and 12 months. Only adolescents who consistently scored above the threshold for depression at all 3 assessments (n = 76) or below the threshold at all 3 assessments (n = 174) were included (N = 250) in the data analysis. Within this sample, adolescents who were depressed were compared with those who were not depressed with respect to the following health consequences: low self-esteem, emotional abuse, physical abuse, verbal abuse, poor body image, and antisocial behavior. RESULTS: Using generalized estimating equations and controlling for covariates, depressed adolescents were 5.3 times more likely to report low self-esteem, 4.3 times more likely to report emotional abuse, 3.7 times more likely to report being physically abused, and almost 3 times as likely to report being verbally abused. Furthermore, depressed adolescents were more than twice as likely to report poor body image and nearly twice as likely to report engaging in antisocial behaviors. CONCLUSIONS: The findings suggest that a broad range of adverse health consequences may accompany depression among black female adolescents. Physicians need to be alert to the co-occurrence of depression and low self-esteem; emotional, physical, and verbal abuse; poor body image; and antisocial behaviors among this population.

Adolescent↗

PubMed2005

Environmental barriers to HIV prevention among incarcerated adolescents: a qualitative assessment.

The purpose of this research was to identify environmental factors that influence incarcerated adolescents' risk for HIV/STDs. Based on data from six gender-stratified focus groups consisting of 28 incarcerated adolescents from three detention centers in Georgia, the following salient environments emerged: schools, families, peer groups, neighborhoods, malls, and detention centers. These environments represent places in which factors related to sexual decision-making are embedded for this high-risk population. Within these environments, five factors influence their risk for HIV/STDs: (1) hierarchical messages that promote abstinence and risk reduction, (2) availability and accessibility of condoms, (3) acceptability of condoms, (4) availability of comprehensive sex education, and (5) parental communication about sex and risk reduction. Increased understanding of the role of these factors may contribute to the development of integrated interventions designed to prevent HIV/STDs among incarcerated adolescents.

Adolescent↗

PubMed2004

Efficacy of an HIV prevention intervention for African American adolescent girls: a randomized controlled trial.

CONTEXT: African American adolescent girls are at high risk for human immunodeficiency virus (HIV) infection, but interventions specifically designed for this population have not reduced HIV risk behaviors. OBJECTIVE: To evaluate the efficacy of an intervention to reduce sexual risk behaviors, sexually transmitted diseases (STDs), and pregnancy and enhance mediators of HIV-preventive behaviors. DESIGN, SETTING, AND PARTICIPANTS: Randomized controlled trial of 522 sexually experienced African American girls aged 14 to 18 years screened from December 1996 through April 1999 at 4 community health agencies. Participants completed a self-administered questionnaire and an interview, demonstrated condom application skills, and provided specimens for STD testing. Outcome assessments were made at 6- and 12-month follow-up. INTERVENTION: All participants received four 4-hour group sessions. The intervention emphasized ethnic and gender pride, HIV knowledge, communication, condom use skills, and healthy relationships. The comparison condition emphasized exercise and nutrition. MAIN OUTCOME MEASURES: The primary outcome measure was consistent condom use, defined as condom use during every episode of vaginal intercourse; other outcome measures were sexual behaviors, observed condom application skills, incident STD infection, self-reported pregnancy, and mediators of HIV-preventive behaviors. RESULTS: Relative to the comparison condition, participants in the intervention reported using condoms more consistently in the 30 days preceding the 6-month assessment (unadjusted analysis, intervention, 75.3% vs comparison, 58.2%) and the 12-month assessment (unadjusted analysis, intervention, 73.3% vs comparison, 56.5%) and over the entire 12-month period (adjusted odds ratio, 2.01; 95% confidence interval [CI], 1.28-3.17; P =.003). Participants in the intervention reported using condoms more consistently in the 6 months preceding the 6-month assessment (unadjusted analysis, intervention, 61.3% vs comparison, 42.6%), at the 12-month assessment (unadjusted analysis, intervention, 58.1% vs comparison, 45.3%), and over the entire 12-month period (adjusted odds ratio, 2.30; 95% CI, 1.51-3.50; P<.001). Using generalized estimating equation analyses over the 12-month follow-up, adolescents in the intervention were more likely to use a condom at last intercourse, less likely to have a new vaginal sex partner in the past 30 days, and more likely to apply condoms to sex partners and had better condom application skills, a higher percentage of condom-protected sex acts, fewer unprotected vaginal sex acts, and higher scores on measures of mediators. Promising effects were also observed for chlamydia infections and self-reported pregnancy. CONCLUSION: Interventions for African American adolescent girls that are gender-tailored and culturally congruent can enhance HIV-preventive behaviors, skills, and mediators and may reduce pregnancy and chlamydia infection.

Adolescent↗