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Sexual activity and contraceptive use among children entering out-of-home care.

This study explored the prevalence of reported sexual activity of a cohort of children entering out-of-home care and the ability of selected factors to explain reported sexual activity and use or nonuse of contraceptives. It found that children as young as age 8 reported sexual activity, and that more than one-third of the children age 8 to 18 reported being sexually active. Of those who were sexually active, more than one-third were not using contraceptives. Using logistic regression, five variables are identified as having importance in explaining sexual activity. Two variables had some limited ability to explain contraceptive use. Implications of these findings are discussed and suggestions for policy and practice are made.

Adolescent↗

Sexual initiation with older male partners and subsequent HIV risk behavior among female adolescents.

Data from a 1993-1994 survey of 150 black and Hispanic teenagers were used to examine differences in HIV risk-related behavior between young women who have a first sexual partner three or more years older than themselves and those whose first partner is their age. Compared with teenagers whose first partner had been roughly their age, the 35% of adolescents with an older partner had been younger at first intercourse (13.8 years vs. 14.6) and less likely to use a condom at first intercourse (63% vs. 82%). They also were less likely to report having used a condom at last intercourse (29% vs. 44%) or having used condoms consistently over their lifetime (37% vs. 56%) or in the previous six months (44% vs. 66%). Some 38% of teenagers with an older first partner had ever been pregnant, compared with 12% of those with a peer-age first partner. The mean number of partners and history of sexually transmitted diseases did not differ between the two groups.

Adolescent↗

Young women's degree of control over first intercourse: an exploratory analysis.

CONTEXT: While policymakers and researchers alike often seem to believe that young women's decision to initiate sexual intercourse is conscious and free of ambiguity, the actual degree of control that such young women exert over first intercourse has rarely been explicitly examined. METHODS: The 1995 National Survey of Family Growth asked all women who had experienced intercourse to rate, on a 1-10 scale, the wantedness of their first intercourse; they were then asked whether the experience was voluntary. Logistic regression analysis of data for women aged 15-24 who had experienced first premarital intercourse was performed to test the effect of background factors and wantedness scores on contraceptive use at voluntary first intercourse. RESULTS: Twenty-four percent of women aged 13 or younger at the time of their first premarital intercourse report the experience to have been nonvoluntary, compared with 10% of those aged 19-24 at first premarital intercourse. About one-quarter of respondents who reported their first intercourse as voluntary chose a low value (1-4) on the wantedness scale. Women whose first partner was seven or more years older than themselves were more than twice as likely as those whose first partner was the same age or younger to choose a low value (36% vs. 17%). Women whose partner had been seven or more years older were also less likely than other women to have used contraceptives at first intercourse. After the introduction of controls for demographic and background factors, partner age discrepancy and relationship status, wantedness of voluntary first intercourse was not independently related to the odds of contraceptive use at that intercourse. CONCLUSION: Characterizing women's first intercourse as simply voluntary or nonvoluntary is inadequate. Measures that take into account degrees of wantedness may help elucidate relationships between sexual initiation, contraceptive use and teenage pregnancy. The fact that substantial numbers of young women voluntarily participated in a first sexual experience about which they felt ambivalent or negative deserves the attention of program planners and service providers.

Adolescent↗

Factors related to condom use among four groups of female sex workers in Bali, Indonesia.

This article tests a behavioral model of condom use for four groups of female commercial sex workers. Data were drawn from a study of 614 female sex workers conducted in Bali, Indonesia. AIDS knowledge, risk behaviors, and factors related to condom use varied substantially among the four groups of women and reflect the social context of their work. Interventions for each group need to reflect these differences. Important factors to consider include the level of AIDS and STD knowledge in their environment, the characteristics of the clients served, and the degree of supervision that they receive.

Acquired Immunodeficiency Syndrome↗

Sexual activity and contraceptive use: the components of the decisionmaking process.

In light of the social consequences of early childbearing, unplanned pregnancy, and the transmission of AIDS, a great need exists to understand how adolescents make sexual and reproductive decisions. Drawing primarily on literature from sub-Saharan Africa, this article focuses on three behavioral outcomes: nonmarital sexual activity, contraceptive use, and condom use. It explores adolescent's perceptions of the costs and benefits of engaging in these behaviors, their assessment of their susceptibility to the potential consequences of their actions, and the role of family, peer, and dyadic factors in shaping their reproductive decisions. The literature reveals that cultural values regarding sexuality and gender roles, the power dimensions of adolescents' lives, and economic disadvantage exert powerful influences on the decisionmaking process. Decisions to engage in unprotected sex may also be based on insufficient knowledge and distorted judgements of the risks of becoming pregnant and acquiring sexually transmitted infections. Nondecisionmaking is found to be fairly common in some contexts.

Adolescent↗

Dual-method use among an ethnically diverse group of women at risk of HIV infection.

CONTEXT: Few U.S. women protect themselves against both pregnancy and sexually transmitted diseases (STDs) by using an efficient contraceptive method and a condom. Understanding the factors that influence dual-method use could help improve interventions aimed at encouraging protective behaviors. METHODS: Interviews were conducted with 552 low-income women at risk of HIV who attended public health or economic assistance facilities in Miami in 1994 and 1995. Multinomial logit analyses were used to determine the influence of women's background characteristics, perceived vulnerability to pregnancy and AIDS, and relationship characteristics on the odds of dual-method use. RESULTS: Overall, 20% of the women used dual methods. Women who were not married, who worried about both pregnancy and AIDS, who had ever had an STD, who were confident they could refuse a sexual encounter in the absence of a condom and who made family planning decisions jointly with their partner were the most likely to use dual methods rather than a single method (odds ratios, 2.0-3.5); those who considered the condom only somewhat effective in preventing AIDS or who shared economic decision-making with their partner were the least likely to use dual methods rather than a single method (0.5-0.6). The results were generally similar in analyses examining the odds of dual-method use involving an efficient contraceptive, except that black and Hispanic women were significantly more likely than whites to use condoms in conjunction with efficient contraceptives (3.3-7.1). CONCLUSIONS: Both women's individual characteristics and the context of their sexual relationships influence whether they simultaneously protect themselves from pregnancy and HIV. The involvement of male partners in family planning decision-making and women's control over economic decision-making ensure greater protection against HIV infection.

Adolescent↗