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1.
Adverse childhood experiences (ACEs) have been linked to early sexual debut, which has been found to be associated with multiple adverse health outcomes. Sexual minorities and men tend to have earlier sexual debut compared to heterosexual populations and women, respectively. However, studies examining the association between ACEs and early sexual debut among men and sexual minorities are lacking. The aim of this study was to examine the sex and sexual orientation disparities in the association between ACEs and age at sexual debut. Data were obtained from Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions. Logistic and linear regression models were used to obtain crude and adjusted estimates and 95% confidence intervals adjusting for age, race/ethnicity, income, education, insurance and marital status for the association between ACEs (neglect, physical/psychological abuse, sexual abuse, parental violence, and parental incarceration and psychopathology) and early sexual debut. Analyses were stratified by sex and sexual orientation. Larger effect estimates depicting the association between ACEs and sexual debut were seen for women compared to men, and among sexual minorities, particularly among men who have sex with men (MSM) and women who have sex with women (WSW), compared to heterosexuals. Sexual health education programs with a focus on delaying sexual debut among children and adolescents should also consider addressing ACEs, such as neglect, physical, psychological and sexual abuse, witnessing parental violence, and parental incarceration and psychopathology. Public health practitioners, researchers and sexual health education curriculum coordinators should consider these differences by sex and sexual orientation when designing these programs.  相似文献   

2.
The objective of this study was to describe prevalent informal sources of information about sex and examine associations between informal sources of information about sex and sexual risk outcomes among sexually experienced adolescents. Work involved the secondary analysis of data from the Minnesota Student Survey, a statewide survey to monitor priority risk and protective health behaviors. The study sample included 22,828 sexually experienced adolescents aged 13–20 years. Multivariate logistic regression analyses examined associations between adolescents' informal sources of information about sex and three sexual risk outcomes. Peers and siblings were the most commonly reported source of information about sex. Ninth-graders who reported parents or parents plus peers/siblings as a source of information about sex had significantly lower odds of having multiple sex partners in the past year. Ninth-graders who reported any informal source of information about sex had significantly lower odds of unprotected intercourse at last sex. Ninth-graders and 12th-graders who reported any informal source of information about sex had significantly lower odds of lifetime pregnancy involvement. Findings suggest information about sex from people in adolescents' everyday lives has the potential to diminish the likelihood of involvement in sexual risk behaviors. To maximize effectiveness, formal sex education programs should engage informal sources of information about sex in adolescents' everyday lives.  相似文献   

3.
ABSTRACT

Using data from 2002 to 2013 collections of the National Survey of Family Growth, we explored how exposure and timing of sex education were associated with sexual health outcomes of 5,141 women between the ages of 15 and 20 years. Consistent with previous literature, sexual minority (e.g., lesbian and bisexual) women reported engaging in sexual intercourse with a male partner earlier than their heterosexual peers. Sexual minority women were also more likely to receive sex education after already engaging in sexual intercourse. Exposure to sex education was associated with poorer outcomes—such as an increased number of male sexual partners and higher reports of pregnancy—for sexual minority women but not for their heterosexual peers. Receiving sex education before engaging in intercourse was associated with an increase in birth control use among bisexual participants. Therefore, school psychologists and counselors should promote inclusive sex education programs that fully address the needs of sexual minority youth.  相似文献   

4.
From its beginning in 1885, the Hull House was beacon for social progress and urban reform. Founders Jane Addams and Ellen Gates Starr recruited talented, passionate partners from diverse fields to address issues from street sanitation to education in Chicago’s immigrant communities. Among residents’ many projects, their involvement in the “social hygiene” movement for sex education and contraception is perhaps the least recognised, in part because the Hull House did not save materials directly related to these services. As a result, the professional activities of Hull House residents Drs Rachelle Yarros and Alice Hamilton reveal a productive relationship between the Hull House and the social hygiene movement. Part of their critical work was to dismantle the cultural association of contraceptives and sex education with “fallen women” and reframe these services as necessities for maternal health. The papers of their professional organisations chronicle their delicate efforts to challenge assumptions about reproductive healthcare while preserving Victorian ideals about sex as a private, procreative endeavour strictly between married, monogamous people. Rachelle Yarros was particularly active, producing a dearth of literature on sexual health, teaching classes on the subject, and overseeing the opening of Chicago’s first public birth control clinics. Each of these advancements, including the birth control clinic, was available on Hull House grounds. By capitalising on the financial and medical resources available to them as physicians and reformers, Yarros and Hamilton achieved significant gains in women’s healthcare and initiated a national conversation about sexual health as a human right.  相似文献   

5.
This study sought to investigate the association between nativity status and Hispanic young women’s formal sex education and parental sex education in the USA. We used data from a cross-sectional sample of 310 Hispanic young women aged 18–24 years old from the 2013–2015 US National Survey of Family Growth. We assessed 11 outcomes: four formal sex education topics; receiving any formal sex education; a formal sex education scale; four parental sex education topics; and receiving any parental sex education. The majority of our sample was US-born Hispanic versus foreign born (72.6% and 27.4% respectively). Foreign-born Hispanics were less likely to have received any type of formal sex education than US-born Hispanics (adjusted odds ratio = 0.81; 95% confidence interval: 0.24, 0.68, p < 0.01). Foreign-born Hispanics were less likely to have received parental HIV sex education than U.S.-born Hispanics (aOR = 0.36; 95% CI: 0.14, 0.97, p < 0.05). Nativity status did not have a significant effect on each unit increase on the scale (aB = –0.07, SE = 0.16; aβ = –0.42, p > 0.05). Our results indicate that having appropriate sex education knowledge is better than not being cognisant. Future studies should however examine the quality and content of sex education programmes so policymakers can better understand these young women’s sexual behaviours and decisions.  相似文献   

6.
Parents play an important role in the promotion of adolescent sexual health, but little is known about parents’ attitudes and beliefs in immigrant families. We examine Hmong American parents’ attitudes about adolescent sexual health using survey data from 202 parents of adolescents with attention to parental gender differences. Breaking from traditional views, Hmong American parents most often viewed teen pregnancy as challenging, not beneficial, and advocated the involvement of parents and community leaders in its prevention. The parents also strongly endorsed addressing comprehensive sex education topics for adolescents. Findings encourage proactive efforts to involve Hmong American parents in the promotion of adolescent sexual health, both directly by enhancing parental knowledge and communication with youth and indirectly through parents’ support of comprehensive sex education.  相似文献   

7.
This study examined parental monitoring (PM) as a potential moderator of the relation between parent–child communication (PCC) and pre-coital sexual behaviours (PCSB) in an urban, minority, early adolescent population. Seventh-grade students (n = 1609) reported PCC, PM and PCSB. Multivariable logistic regression was conducted to assess for moderation. PM moderated the association between PCC and PCSB. Specifically, young people reporting both high PCC and high PM had the lowest odds of PCSB. Findings suggest that PCC is more protective in combination with high PM. However, young people reporting low levels of PM had an increased probability of PCSB with higher levels of PCC. No moderating effect between PCC, PM and PCSB was found by race/ethnicity or gender. However, race/ethnicity was found to moderate the effect of PCC on PCSB. This knowledge highlights the protective role of parental factors on PCSB and may inform the development of more effective parent-based adolescent sexual health interventions that address both PCC and PM.  相似文献   

8.
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9.
This study aimed to assess associations between school HIV education and protective sexual behaviors and sexually transmitted disease (STD)/HIV diagnosis with a representative sample of male and female high school students. Data from male and female adolescent participants in the 1999, 2001 and 2003 Massachusetts Youth Risk Behavior Survey (n = 12,243) were analyzed. Adjusted regression analyses stratified by gender were conducted to assess relationships between school HIV education exposure and the following outcomes: no sexual initiation, condom use at last sex, no multiple sex partners in the past three months and no history of STD/HIV diagnosis. Participants were mostly White (75%) and were 51% male; the subsample of sexually active students was younger than the total sample but was otherwise similar in demographics. School HIV education was reported by 93% of our sample and was significantly related to sexual initiation among boys (odds ratio = 1.9, 95% confidence interval = 1.4–2.7) but not girls. Among sexually experienced students (n = 4752), boys reporting exposure to school HIV education were significantly more likely to report condom use (odds ratio = 2.2, 95% confidence interval = 1.6–3.1), no multiple sex partners (odds ratio = 3.2, 95% confidence interval = 2.3–4.4) and no STD/HIV diagnosis (odds ratio = 3.2, 95% confidence interval = 2.0–5.0); girls reporting such exposure were significantly more likely to report no multiple sex partners (odds ratio = 2.2, 95% confidence interval = 1.3–3.6). In conclusion, exposure to school HIV education is associated with sexual protective behaviors and reduced likelihood of STD/HIV diagnosis for boys but less so for girls, suggesting the need for more gender‐tailored approaches to school HIV education.  相似文献   

10.
OBJECTIVE: To examine relationships between childhood autobiographical memory disturbance (CAMD) and adverse childhood experiences (ACEs) which are defined as common forms of child maltreatment and related traumatic stressors. METHODS: We use the ACE score (an integer count of eight different categories of ACEs) as a measure of cumulative exposure to traumatic stress during childhood. In a cross sectional analysis we assess the relationship of the ACE score to the prevalence of CAMD in a sample of 9,460 relatively healthy adults evaluated for wellness care at a southern California health maintenance organization between August 1995 and March 1996. In addition, we examined possible secular influences by examining association among each of four birth cohorts. Logistic regression was used to obtain the adjusted relative odds of CAMD associated with increasing ACE score. RESULTS: Overall, the age-standardized prevalence of CAMD was 18% (men: 15%; women: 19%). As the ACE score increased, the prevalence of CAMD increased in a graded fashion for both men and women (p for trend <.0001). After adjustment for age, sex, race/ethnicity, and education, adults with an ACE score >or=6 were 5.9 (95% CI, 4.4-7.9) times more likely to have CAMD compared to adults with an ACE score of 0. The prevalence of CAMD increased with each successive birth cohort, and graded relationships between the ACE score and CAMD were observed among each of the four birth cohorts though no statistical difference in the association was found across birth cohorts. CONCLUSIONS: The accumulation of ACEs across several domains is associated CAMD among men and women and in each of four birth cohorts. Further research is needed that describes the prevalence of CAMD in population-based samples and that examines whether impaired memory is a marker for persons neurobiologically affected by multiple forms of child maltreatment and related traumatic stressors.  相似文献   

11.

Most people in Bangladesh are rural, poor and underprivileged. The incidence of sexual disease has increased, but little has been done to educate rural people about sexual and reproductive health. In 1997, a sexual and reproductive health project was initiated within a collaborative research agreement between the International Centre for Diarrhoeal Disease Research (ICDDR,B) and the Bangladesh Rural Advancement Committee (BRAC), an indigenous non-governmental organization which pursues integrated rural development strategies. Qualitative in-depth interviews with 65 different women, men, boys and girls revealed significant sexual health problems and a lack of knowledge of sexual and reproductive health. The interviews were transformed into composite problem-solving picture stories and information about sexual and reproductive health. Stories mirrored respondents' interpretations of sexual behavior. Those who had achieved or ascribed legitimacy to talk about sex, e.g. traditional health providers, were trained to utilize the methods and materials. Qualitative evaluations revealed important changes in health providers' self-confidence, business and personal interactions as well as changes in clients' behavior. This project found that sexual and reproductive health education can be integrated into indigenous health activities if the sociocultural context in which sex, relationships, risks, diseases and communication occur is reflected in a program's content and methods. Unquestionably, there is a great need for sex education in rural Bangladesh.  相似文献   

12.
In sub-Saharan Africa, young women are at the highest risk of HIV infection. Comprehensive sexuality education and open parent–child communication about sex have been shown to mitigate risky sexual practices associated with HIV. This study aimed to identify sources of HIV prevention knowledge among young women aged 10–14 years and community-based strategies to enhance HIV prevention in Zambia. Focus group discussions were conducted with 114 young women in Zambian provinces with the highest rates (~20%) of HIV. Discussions were recorded, transcribed and coded, and addressed perceived HIV risk, knowledge and access to information. Participants reported that limited school-based sexuality education reduced opportunities to gain HIV prevention knowledge, and that cultural and traditional practices promoted negative attitudes regarding condom use. Parent–child communication about sex was perceived to be limited; parents were described as feeling it improper to discuss sex with their children. Initiatives to increase comprehensive sexuality education and stimulate parental communication about sexual behaviour were suggested by participants. Culturally tailored programmes to increase parent–child communication appear warranted. Community-based strategies aimed at enhancing protective sexual behaviour among those most at risk are essential.  相似文献   

13.
This paper examines the preferred sexuality education sources of older Australian adults in later life. Drawing on findings from qualitative interviews with 30 men and 23 women aged 60 years and older, we consider the sources that participants currently use, or would like to use, in seeking information about sex. Where relevant, we examine participants’ experiences of learning about sex in later life using different sources, and the impact these had on their sexual expression, pleasure and well-being. Preferred sources of information include the Internet, the media, health care providers, books and workshops or discussion groups. A substantial number of participants did not actively seek information on sex. For those who had, these educational endeavours could profoundly shape their sexual practices. As such, learning about sex should be viewed as a lifelong endeavour. Our findings carry important implications for the development and delivery of sexuality education for older adults.  相似文献   

14.
Sexual harassment has been studies as a mechanism reproducing inequality between sexes, as gender based discrimination, and more recently, as a public health problem. The role of family-related factors for subjection to sexual harassment in adolescent has been little studied. Our aim was to study the role of socio-demographic family factors and parental involvement in adolescent's persona life for experiences of sexual harassment among 14–18-year-old population girls and boys. An anonymous cross-sectional classroom survey was carried out in comprehensive and secondary schools in Finland. 90 953 boys and 91 746 girls aged 14–18 participated. Sexual harassment was elicited with five questions. Family structure, parental education, parental unemployment and parental involvement as perceived by the adolescent were elicited. The data were analyzed using cross-tabulations with chi-square statistics and logistic regressions. All types of sexual harassment experiences elicited were more common among girls than among boys. Parental unemployment, not living with both parents and low parental education were associated with higher likelihood of reporting experiences of sexual harassment, and parental involvement in the adolescent's personal life was associated with less reported sexual harassment. Parental involvement in an adolescent's life may be protective of perceived sexual harassment. Adolescents from socio-economically disadvantaged families are more vulnerable to sexual harassment than their more advantaged peers.  相似文献   

15.
The relationship between childhood adversity and adult depression is well-established but less is known about the association between childhood adversity and adult depression among the incarcerated. In this paper, we examine differential exposure and vulnerability to childhood adversity by race/ethnicity and gender on adult depression among the incarcerated in the United States. We address three research questions: does exposure to childhood adverse experiences vary by race/ethnicity and gender? Is there an association between these childhood adverse events and depression and does the strength of the association vary by the specific adverse experiences? And does vulnerability to childhood adversity vary by gender and race/ethnicity? Using the 2004 Survey of Inmates in State and Federal Correctional Facilities (SI-SFCF), we measure four key childhood adverse events – parental/caretaker substance abuse, physical assault, having been placed in foster care, and sexual assault. We use ordinary least squares regression and a series of interaction effect analyses to examine differential exposure and vulnerability to the four childhood adverse experiences by race/ethnicity and gender. Incarcerated women are more likely to report parental substance abuse, but all inmates/prisoners are similarly vulnerable to this experience. For the other three adverse experiences measured, we find that there are important racial/ethnic and gender differences in both exposure and vulnerability. African American men and women are more vulnerable to the effects of physical and sexual victimization than White and Hispanic men and women. Women are much more likely to be exposed to sexual victimization, but men who report this experience are significantly more depressed. Hispanic women and White men and women are more likely to report foster care, but all inmates/prisoners who report foster care experiences are significantly more depressed than other inmates/prisoners, with the exception of white men. The findings indicate that there are significant differences in exposure and vulnerability to childhood adversity by race/ethnicity and gender. We conclude that in order to effectively design and implement programs to decrease the probability that childhood adversity is a risk factor for adult depression interventions must be targeted toward specific, vulnerable groups according to race/ethnicity and gender.  相似文献   

16.
OBJECTIVE: The study's goal was to examine the relationship between a history of parental psychiatric disorder and a history of child abuse in a general population sample of Ontario residents. METHOD: A representative community sample of 8548 respondents who participated in the Ontario Mental Health Supplement (OHSUP) were interviewed about parental psychiatric history and completed a self-report measure of childhood physical and sexual abuse. RESULTS: The lifetime prevalence of either parent with a psychiatric disorder was as follows: 14.1% for depression, 3.7% for manic depression, 2.4% for schizophrenia, 2.4% for antisocial behavior, and 17.3% for any parental psychiatric disorder. Respondents reporting a parental history of depression, mania, or schizophrenia had a two to threefold increase in the rates of physical, sexual, or any abuse. Parental history of antisocial disorder increased the risk of exposure to physical abuse (adjusted odds ratios [OR 6.1] and any abuse [OR 7.5]). There was no statistically significant difference between parental psychiatric disorder and childhood physical or sexual abuse by gender of the respondent. There was a trend for increasing risk associated with father only, mother only, and both parents having any psychiatric disorder. CONCLUSIONS: The elevated risk for physical and sexual abuse among respondents reporting a parental history of psychiatric illness highlights the need to examine the mechanism for this association. Such information is important in developing approaches to assist families where the risk of child maltreatment is increased.  相似文献   

17.
OBJECTIVE: The prevalence of childhood sexual abuse among Latino adult men who have sex with men who live in the US was estimated because a history of childhood sexual abuse increases HIV sexual risk behaviors and other negative health outcomes in adulthood. METHOD: The Urban Men's Health Study is a random-digit telephone probability survey of 2881 adult men who have sex with men (MSM) aged 18 years or older residing in San Francisco, New York, Los Angeles, and Chicago. Self-reported history of childhood sexual abuse was the main outcome measure gathered from 2692 MSM. RESULTS: A significantly higher proportion of Latino MSM reported sexual abuse before age 13 (22%) than did non-Latino MSM (11%). CONCLUSIONS: Latino MSM are twice as likely to report a history of childhood sexual abuse than are non-Latino MSM. Given the association between childhood sexual abuse and increased risk for HIV and other negative health outcomes, health providers must remain vigilant to the possibility of childhood sexual abuse histories among their Latino patients.  相似文献   

18.
Child maltreatment has well-documented long-term, adverse effects on mental health, but it is not clear whether there are gender differences in these effects. We conducted a systematic review to investigate whether there are gender differences in the effects of maltreatment on adult depression and anxiety. Medline, PsycINFO, Web of Science, and Lilacs were searched for relevant studies published up to May 2016. Eligible studies included population-based studies (with a cohort, case-control or cross-sectional design) which assessed maltreatment during childhood or adolescence (≤18 years) and its association with major depression or generalized anxiety disorder (DSM/ICD diagnostic criteria) in adulthood (>18 years) separately for females and males. Meta-analysis was performed to estimate the association between each exposure and outcome using fixed and random effects models. Pooled odds ratios (OR) were estimated separately for women and men and compared. Five studies of physical and sexual abuse were included in the meta-analyses. These provided twenty-two effects sizes estimates (11 for men, 11 for women) for associations between physical/sexual abuse and depression/anxiety. Exposure to each kind of abuse increased the odds of depression/anxiety. Associations were larger for women than for men, however, these gender differences were not statistically significant. Physical and sexual abuse in childhood/adolescence are risk factors for depression/anxiety in adulthood and the effect could be larger for women; however, currently there is insufficient evidence to definitively identify gender differences in the effects of maltreatment.  相似文献   

19.
Massage therapy program directors completed an online survey to explore sexual education in massage therapy programs. The overall data suggest that program directors are supportive of sexual health education in the training of massage therapists and that such education is integrated into several aspects of their training programs. To enhance sexual health education, massage therapy programs could collaborate with specialists in sex therapy or sexuality education. Massage therapy training may need to include the following topics: working with clients who have been sexually abused, working with transsexual clients, understanding sexual arousal processes, and understanding dynamics between men and women.  相似文献   

20.
OBJECTIVE: To investigate the relationships between risk and protective factors and health outcome in a sample of adult females who had been victims of child sexual abuse. METHOD: Both person- and variable-oriented analyses were applied to questionnaire data from a non-clinical group of women (n = 152) reporting sexual abuse during childhood. RESULTS: Six groups with different patterns of risk and protective factors were found by cluster analysis. Two groups (Good Coping and Support Compensation) had significantly better health than expected in spite of severe abuse. Self-esteem and social support were strong predictors of health in the regression models. CONCLUSION: The relationships between risk and protective factors and health may be different in different groups of victims of child sexual abuse. Self-esteem was closely related to health outcome displaying the importance of this concept in clinical practice. Availability of resources seems to be more important for health outcomes than the amount of risk factors.  相似文献   

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