Biomedical subjects

William L Yarber

Publications and source records attributed to William L Yarber.

18 recordsLinked to original sources

PubMed2006

Family influences and biologically confirmed sexually transmitted infections among detained adolescents.

Data from a convenience sample of 476 detained adolescents were used to examine the relationship between family influences and biologically confirmed sexually transmitted diseases (STDs). Results indicated that frequent parental monitoring was negatively associated with STD infection and that this relationship was modified by age, gender, and race. Findings suggest that STD prevention efforts for detained adolescents (particularly high-risk minority females older than age 16) might focus on increasing monitoring by a parent or parental figure.

Adolescent↗

PubMed2006

Erection loss in association with condom use among young men attending a public STI clinic: potential correlates and implications for risk behaviour.

BACKGROUND: To assess prevalence of condom-associated erection loss and to identify correlates of erection loss among men attending a sexually transmissible infections (STI) clinic. METHODS: Men (n = 278) attending an STI clinic responded to an anonymous questionnaire aided by a CD recording of the questions. The sample was screened to include only men who had used a condom during penile-vaginal sex at least three times in the past 3 months. Erection loss was assessed for 'the last three times a condom was used'. RESULTS: The mean age of the participants was 23.7 years (s.d. = 4.1); 37.1% of the men reported condom-associated erection loss on at least one occasion. Men who had reported condom-associated erection loss were also reported having more frequent unprotected vaginal sex (P = 0.04) and were less likely to use condoms consistently (P = 0.014) than men without erection loss. Men with erection loss were also more likely to remove condoms before sex was over (P = 0.001). Age and race/ethnicity were not associated with erection loss. In multivariate analysis, three significant statistical predictors were identified: low self-efficacy to use condoms (P = 0.001); problems with 'fit or feel' of condoms (P = 0.005); and having more than three sex partners during the previous 3 months (P = 0.02). CONCLUSIONS: Condom-associated erection loss may be common among men at risk for STIs. This problem may lead to incomplete or inconsistent condom use. Men may be more likely to experience condom-associated erection loss if they lack confidence to use condoms correctly, if they experience problems with the way condoms fit or feel, and if they have sex with multiple partners.

Adult↗

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↗

PubMed2005

Teacher connectedness and health-related outcomes among detained adolescents.

PURPOSE: Data were collected from a convenience sample of 550 detained adolescents (ages 14-18 years) to explore the association between adolescents' perception of teacher connectedness and a range of health risk behaviors, such as gang membership, use of in alcohol, drugs, and tobacco, and engagement in sexual risk behaviors prior to detainment. METHODS: Participants answered survey questions using audio-computer assisted self-interviewing procedures that assessed demographic, pro-social, problem, and drug and sexual risk behaviors. RESULTS: Multiple logistic regression analyses controlling for demographic and socioeconomic status, truancy, number of days in the detention center, and family factors indicated that adolescents who reported low teacher connectedness, relative to their peers reporting high teacher connectedness, were twice as likely to use marijuana and amphetamines, and twice as likely to be sexually active, have sex while high on alcohol or drugs, have a partner who was high on alcohol or other drugs during sex, and have multiple sexual partners. CONCLUSIONS: The association between teacher connectedness and adolescents' health risk behaviors prior to detainment suggests that school-based interventions that enhance the school environment, particularly teachers' skills and training to enhance and maximize the effectiveness of their student interactions, may be one strategy for reducing health risk behaviors and their associated adverse health outcomes among youth at high risk.

Adolescent↗

PubMed2005

Accounting for failures may improve precision: evidence supporting improved validity of self-reported condom use.

OBJECTIVES: To determine whether a measure of unprotected vaginal sex that is adjusted for condom failures would produce improved accuracy in predicting biologically confirmed STDs (chlamydia and gonorrhea) among female teens. METHODS: Self-reported measures were collected using audio-computer-assisted self-interviewing. DNA amplification for the presence of Chlamydia trachomatis and Neisseria gonorrhoeae was conducted. RESULTS: The unadjusted measure of unprotected vaginal sex was not significantly associated with biologically confirmed prevalence of STDs (prevalence ratio [PR] = 1.51; 95% CI = 0.71-3.21; P = 0.28). Alternatively, the adjusted measure achieved significance (PR = 3.59; 95% CI = 1.13-11.38; P = 0.014). More than one quarter (25.6%) of teens using condoms inconsistently and/or incorrectly tested positive for an STD compared to 7.1% among those reporting the consistent and correct use of condoms. CONCLUSION: Findings demonstrate that studies of condom effectiveness should use an adjusted measure of condom use to achieve precision and rigor.

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↗

PubMed2004

Health risk factors among detained adolescent females.

OBJECTIVES: To identify the prevalence of health risk factors among a sample of detained adolescent females and determine whether there are racial/ethnic differences. DESIGN AND SETTING: A cross-sectional survey of 197 adolescent females (aged 14 to 18 years) recruited within eight detention facilities. OUTCOME MEASURES: Thirty-five measures, comprising four domains, were assessed. Domains were sex-related risk factors, violence-related risk factors, selected mental health issues, and substance abuse behaviors. Measures were collected using audio-computer-assisted self-interviewing. A biological assessment for the presence of Chlamydia trachomatis, Neisseria gonorrhoeae, and Trichomonas vaginalis was also conducted. RESULTS: Several health risk factors were especially prominent. Mean age of sexual debut was 13 years. The mean number of sex partners (lifetime) was 8.8. Twenty percent tested positive for an STD, and 32.2% had ever been pregnant. Of those reporting sexual activity, 33.9% had not used any form of contraception in the past 2 months and about 40% reported having recent sex with a casual partner. More than 40% reported that a friend had been beaten, attacked, or hurt by others in the past year. More than one half had witnessed violence (past year) and nearly 30% had ever belonged to a gang. Forty percent had thought about committing suicide in the past 2 months, with 35% informing someone of their intent, and 25% attempting suicide. Recent use of illegal substances was common. Correlations between the four domains were significant (p < 0.03), but weak. With some notable exceptions (STD prevalence, trading sex for money, witnessing violence), no difference was found between minority and nonminority adolescents with respect to risk factors. After creating an index of all the risk factors, a normal distribution was obtained (mean number of factors, 10.3; standard deviation, 5.0). CONCLUSIONS: Preventive medicine programs for adolescent females within detention facilities are warranted. Our evidence suggests that health risk behaviors in this population may be quite diverse; therefore, these programs should be broad in scope and that depth of the programs should vary as a function of risk level.

Adolescent↗

PubMed2004

Condom use as a dependent variable: a brief commentary about classification of inconsistent users.

Transformation of nonnormally distributed measures of condom use frequency can be problematic for researchers. Distributions are typically dichotomized. We used data collected from 483 university undergraduates in an anonymous, cross-sectional survey to illustrate the value of a screening analysis before dichotomization. Inconsistent condom users were compared to consistent users with respect to 14 measures. Subsequently, inconsistent users were compared to those who never used condoms with regard to the same 14 measures. Findings suggest that a screening analysis is a potentially important aspect of analyzing distributions that assess frequency of condom use.

Adolescent↗

PubMed2004

Correlates of having unprotected vaginal sex among detained adolescent females: an exploratory study of sexual factors.

BACKGROUND: Erotophilia, motivations for engaging in sex, and pleasure-related barriers to using condoms may all be important determinants of whether high-risk adolescent females have sex unprotected by a condom. This exploratory study identified associations between these factors and engaging in unprotected vaginal sex (UVS) among a sample of adolescent females recruited from short-term detention facilities in the USA. METHODS: A cross-sectional survey of 211 adolescent females (14-18 years of age) was conducted. Only those indicating they had sex within the past 2 months were included in the analysis. Adolescents were recruited within eight detention facilities. Measures were assessed using audio-computer assisted self-interviewing (A-CASI). RESULTS: In race-adjusted analyses, adolescents indicating greater pleasure-associated barriers to using condoms were more than 4.3 times more likely than those indicating fewer barriers to report having UVS in the past 2 months (AOR = 4.36; 95% CI = 2.15-8.86). Similarly, those scoring higher in erotophilia (compared with those scoring lower) were more than twice as likely to report UVS (AOR = 2.08; 95% CI = 1.02-4.24). Finally, adolescents who had ever been pregnant were approximately 2.5 times more likely to report having recent UVS (AOR = 2.48; 95% CI = 1.1-5.34). With the exception of having five or more sex partners in the past 2 months (P = 0.08), none of the remaining correlates approached multivariate significance. CONCLUSIONS: Constructs such as erotophilia and pleasure-related barriers to condom use may be important correlates of UVS among this population of high-risk adolescents.

Adolescent↗

PubMed2004

Correlates of condom breakage and slippage among university undergraduates.

An anonymous questionnaire was used to explore relationships between condom breakage, slippage and possible correlates in a sample of 428 single, never married college men and women. Specific condom use errors and problems that could lead to breakage and slippage were also examined. A three-month recall period was used. Breakage/slippage was found to be associated with never receiving instruction on correct condom use (P = 0.001), more than one sex partner (P = 0.001), more frequent use of condoms (P = 0.001), and partner(s) being less than highly motivated to use condoms (P = 0.02). Those reporting that condoms had contacted a sharp object were three times as likely to report breakage (P = 0.001). Those using condoms without proper lubrication (P = 0.006) and those experiencing loss of erection during sex (P = 0.001) were more likely to report slippage. Further research should investigate the efficacy of instruction addressing specific factors that may reduce the incidence of breakage/slippage, thereby enhancing condom effectiveness.

Adolescent↗

PubMed2003

Condom-use errors and problems: a neglected aspect of studies assessing condom effectiveness.

OBJECTIVE: To assess and compare condom-use errors and problems among condom-using university males and females. METHODS: A convenience sample of 260 undergraduates was utilized. Males (n=118) and females (n=142) reported using condoms in the past 3 months for at least one episode of sex (penis in the mouth, vagina, or rectum) with a partner of the other sex. A questionnaire assessed 15 errors and problems associated with condom use that could be observed or experienced by females as well as males. RESULTS: About 44% reported lack of condom availability. Errors that could contribute to failure included using sharp instruments to open condom packages (11%), storing condoms in wallets (19%), and not using a new condom when switching from one form of sex to another (83%). Thirty-eight percent reported that condoms were applied after sex had begun, and nearly 14% indicated they removed condoms before sex was concluded. Problems included loss of erection during condom application (15%) or during sex (10%). About 28% reported that condoms had either slipped off or broken. Nearly 19% perceived, at least once, that their condom problems necessitated the use of a new condom. Few differences were observed in errors and problems between males and females. CONCLUSIONS: Findings suggest that condom-use errors and problems may be quite common and that assessment of errors and problems do not necessarily need to be gender specific. Findings also suggest that correcting "user failure" may represent an important challenge in the practice of preventive medicine.

Adult↗

PubMed2003

Condom use errors and problems among young women who put condoms on their male partners.

OBJECTIVES: To comprehensively assess condom use errors and problems reported by women who apply condoms, given the lack of data on this aspect of condom use. METHODS: Data from a questionnaire survey, using a 3-month recall period, was analyzed for a convenience sample of 102 college women who put condoms on their male partner(s) for sex (vaginal, anal, or oral). The percentage of the sample reporting that an error or problem occurred at least once is presented. RESULTS: Fifty-one percent put the condom on after starting sex, and 15% took the condom off before ending sex. Forty-eight percent wanted a condom but didn't have one, 46% did not leave space at the tip, 30% put the condom on wrong side up and had to flip the condom over, 26% did not use a lubricant, and 15% wanted a water-based lubricant and did not have any available. Twenty-five percent reported that their partners lost erections in association with condom use. Twenty-eight percent reported breakage, slippage, or both. Higher error scores were found for those who reported: 1) breakage or slippage, 2) partner erection problems, 3) use of another form of contraception, and 4) not having received instruction in correct condom use. CONCLUSION: Educating women as well as men about correct condom use, in addition to promoting consistent condom use, may be an important public health strategy.

Adult↗

PubMed2002

Condom use errors and problems among college men.

BACKGROUND: An essential yet understudied aspect of condom use is whether they are used correctly. GOAL: The goal of the study was to comprehensively evaluate condom use errors and problems reported by heterosexual college men (N = 158). STUDY DESIGN: A cross-sectional survey, involving a 3-month recall period, was conducted. RESULTS: Of the 158 participants, 60% did not discuss condom use with their partner before sex; 42% reported they wanted to use condoms but did not have any available; 43% put condoms on after starting sex; 15% removed condoms before ending sex; 40% did not leave space at the tip; 30% placed the condom upside down on the penis and had to flip it over; and 32% reported losing erections in association with condom use. Nearly one-third reported breakage or slippage during sex. Few participants reported errors related to lubrication, storage, and reusing condoms. Higher error scores were associated with breakage/slippage rather than with consistency of condom use. CONCLUSION: Condom use errors were common, and error scores were associated with breakage and slippage. Increasing the focus on correcting potential user failures may be an important public health strategy.

Condoms↗

PubMed2002

HIV-associated histories, perceptions, and practices among low-income African American women: does rural residence matter?

OBJECTIVES: This study compared HIV-associated sexual health history, risk perceptions, and sexual risk behaviors of low-income rural and nonrural African American women. METHODS: A cross-sectional statewide survey of African American women (n = 571) attending federally funded Special Supplemental Nutrition Program for Women, Infants, and Children clinics was conducted. RESULTS: Adjusted analyses indicated that rural women were more likely to report not being counseled about HIV during pregnancy (P =.001), that a sex partner had not been tested for HIV (P =.005), no preferred method of prevention because they did not worry about sexually transmitted diseases (P =.02), not using condoms (P =.009), and a belief that their partner was HIV negative, despite lack of testing (P =.04). CONCLUSIONS: This study provided initial evidence that low-income rural African American women are an important population for HIV prevention programs.

AIDS Serodiagnosis↗

PubMedDate not supplied

Condom discomfort and associated problems with their use among university students.

In addition to consistent use, condoms must be used correctly. The purpose of this study was to identify prevalence and types of condom-associated discomfort among university students, the outcomes of this discomfort, and the role of discomfort in condom breakage. We conducted a cross-sectional study of 206 students attending a private university in the southern United States. We assessed 3 potential outcomes: breakage, not using condoms throughout sex, and low condom-use motivation. Nearly one third reported discomfort, including tightly fitting condoms, vaginal irritation, and loss of sensation. Discomfort was associated with breakage (p = .0001), incomplete use (p = .0001), and less motivation to use condoms (p = .018). Gender moderated the latter 2 findings. Adjusted findings indicate that students reporting discomfort were 3.6 times more likely to also report breakage (p = .0009). Continued investigation of this topic is warranted. Prevention education may benefit university students by promoting several key practices, such as adding lubricant to condoms before they dry out and acquiring condoms that fit properly.

Adolescent↗

PubMedDate not supplied

Women who put condoms on male partners: correlates of condom application.

OBJECTIVE: To identify correlates of women applying condoms. METHODS: Cross-sectional survey of 533 sexually-active women; questionnaire. RESULTS: Of the condom users (n = 322), 31.7% reported applying condoms at least once--an average on 59.7% of the occasions. Compared to nonappliers, appliers had more positive affect toward sexually related situations (erotophilia, P = .004) and a higher frequency of sex (P = .003). Condom users, compared to nonusers, were significantly younger (P = .001), were less likely to be in sexually exclusive relationships (P = .001) or married (P = .01), and reported more partners in the past 3 months (P = .001). CONCLUSIONS: Condom-applying women may have more positive attitudes toward sexuality and engage in a higher frequency of sexual activity.

Adolescent↗

PubMedDate not supplied

Rural and nonrural African American high school students and STD/HIV sexual-risk behaviors.

OBJECTIVE: To determine differences between African American adolescents on STD/HIV sexual-risk behaviors and precursors to these risk behaviors. METHODS: Six hundred sixty-three rural and 3313 nonrural adolescents who completed the 1999 YRBS Survey were selected. RESULTS: Rural females and males were more likely to report ever having coitus and not using a condom during last coitus. Rural females were also more likely to report early coistus, having 3 or more lifetime coital partners, and having more than 1 coital partner in the last 3 months. CONCLUSIONS: African American rural adolescents, particularly females, may have greater risk for STD/HIV infection than do their nonrural counterparts.

Adolescent↗

PubMedDate not supplied

Sexual health among male college students in the United States and the Netherlands.

OBJECTIVES: To assess differences in sexual health behaviors, outcomes, and potential sociocultural determinants among male college students in the United States and the Netherlands. METHODS: Survey data were collected from random samples of students from both national cultures. RESULTS: American men were more likely to report inadequate contraception, HIV/STD infection, and unintended pregnancy than were Dutch men. Religiosity and sexuality education were able to explain national differences in these sexual health outcomes. CONCLUSIONS: Findings suggest that sexuality education seems to decrease, rather than increase, sexual risk in heterosexually active male college students.

Abortion, Induced↗