Predictors of HIV-preventive sexual behavior in a high-risk adolescent population: The influence of perceived peer norms and sexual communication on incarcerated adolescents' consistent use of condoms

doi:10.1016/0197-0070(91)90052-N

Journal of Adolescent Health

Volume 12, Issue 5, July 1991, Pages 385-390

https://doi.org/10.1016/0197-0070(91)90052-N Get rights and content

Abstract

Data were collected from 112 sexually active adolescents incarcerated in a juvenile detention facility to identify predictors of consistent use of condoms during sexual intercourse. Adolescents completed an anonymous epidemiologic survey instrument developed by the Centers for Disease Control. The self-report survey assessed, demographic, psychosocial, and behavioral factors. Three factors were identified as associated with consistent condom use. These significant bivariate factors were entered into a multivariate logistic regression model to identify the independent contribution of each factor. Non-Black adolescents, adolescents who communicate with their sex partners about AIDS, and those who perceive peer norms as supporting condom use were significantly more likely to be consistent condom users. The findings suggest that Human Immunodeficiency Virus (HIV) prevention programs for incarcerated adolescents that emphasize training in communication skills and modifying perceptions off peer normative behavior may be more effective in increasing the adoption and maintenance of condom use.

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Peer norms moderate the association between mental health and sexual risk behaviors among young men living in Dar es Salaam, Tanzania
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Citation Excerpt :
While we found numerous associations between changes in perceived norms and men's behavior, we found no support for the association between men's behavior and changes in the self-reported behaviors of men's closest friends or in their larger camp friendship networks. These results were surprising given previous studies which have found that individuals' sexual behaviors, including partner concurrency (Catania et al., 1989) and condom use (DiClemente, 1991; Romer et al., 1994; Zapka et al., 1993), reflect their peers' behavior. It is possible that men have other important friendships outside of their camps which may be more relevant to their sexual behavior than camp friendships.
Young men living in Dar es Salaam's informal settlements face environmental stressors that may expose them to multiple determinants of HIV risk including poor mental health and risky sexual behavior norms. We aimed to understand how these co-occurring risk factors not only independently affect men's condom use and sexual partner concurrency, but also how they interact to shape these risk behaviors.
Participants in the study were male members of 59 social groups known as “camps” in Dar es Salaam, Tanzania. We assessed moderation by changes in peer norms of the association between changes in symptoms of anxiety and depression and sexual risk behaviors (condom use and sexual partner concurrency) among 1113 sexually active men. Participants nominated their three closest friends in their camp and reported their perceptions of these friends' behaviors, attitudes, and encouragement of condom use and concurrency. Anxiety and depression were measured using the HSCL-25, and condom use and sexual partner concurrency were assessed through self-report.
Perceptions of decreasing condom use among friends (descriptive norms) and decreasing encouragement of condom use were associated with lower levels of condom use. Perceptions of increasing partner concurrency and acceptability of partner concurrency (injunctive norms) among friends were associated with higher odds of concurrency. Changes in perceived condom use norms (descriptive norms and encouragement) interacted with changes in anxiety symptoms in association with condom use such that the negative relationship was amplified by norms less favorable for condom use, and attenuated by more favorable norms for condom use.
These results provide novel evidence of the interacting effects of poor mental health and risky sexual behavior norms among a hard to reach population of marginalized young men in Dar es Salaam. Our findings provide important information for future norms-based and mental health promotion interventions targeting HIV prevention in this key population.
What factors influence uptake of retinal screening among young adults with type 2 diabetes? A qualitative study informed by the theoretical domains framework
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Within those domains, we identified component constructs that were of greater salience to the young adult cohort, and which are consistent with constructs identified in the broader qualitative literature on healthcare engagement for youth and young adults. For example, social normative factors (which include social influence, an important screening facilitator in the current study), have been demonstrated to be more strongly correlated with health promoting behaviors than knowledge-based factors for young people.40,41 Similarly, screening barriers identified to be of greater salience to young adults with T2D in this study, such as stage of life constraints, low perceived personal risk and unrealistic optimism have previously been reported to impact perception of T2D risk and utilization of eye care services.26,32,42
Young adults with type 2 diabetes (T2D, 18–39 years) face increased risk of vision loss from diabetic retinopathy (DR). Retinal screening is essential to detect DR, yet screening rates for this group are low and little is known about the underlying factors influencing this important behavior. Using the theoretical domains framework (TDF) to guide data collection and analysis, we explored screening barriers and facilitator, contrasting them with a comparator group of older adults with T2D (40 + years).
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This study demonstrated that young adult retinal screening behavior was influenced by additional social cognitive factors compared to older adults, providing a first-step evidence base for clinicians and other health professionals, and potential targets for future eye health and retinal screening interventions.
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Citation Excerpt :
Our model also has a low-resource requirement and reciprocally benefits the student teachers who seek exposure to at-risk adolescent counseling. It is also possible that the relatively close age difference between the youth and student teachers might have helped modify peer norms with respect to safer sexual behavior, which is a known behavioral predictor in this population.17,18 Finally, we created an educational setting in which the benefits and necessity of interprofessional collaboration was readily perceived by the student teachers.
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We performed a prospective cohort study involving 134 incarcerated youth and an interprofessional team of 23 medical, nursing, and social work students, who participated in a comprehensive reproductive health curriculum over the course of 3 days.
Basic reproductive health knowledge, confidence in condom use with a new partner, and self-efficacy with regard to contraception use and sexual autonomy were assessed before and after completion of the curriculum. We also assessed the student teachers' level of comfort with teaching reproductive health to adolescents and their perception of interprofessionalism.
Incarcerated youth showed a statistically significant increase in knowledge regarding sexually transmitted infections as well as self-reported confidence in condom use (P = .002). Self-efficacy in contraception use and sexual autonomy did not show significant improvement. Qualitative analysis of student teachers' surveys revealed theme categories regarding perception of youth, perception of self in teaching youth, perception of interacting with youth, and perception of working in interprofessional teams.
Our program might represent a mutually beneficial community relationship to improve reproductive health literacy in this high-risk youth population.
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Looking forward: Future directions for prevention of HIV among adolescents
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Analytic Advances in Social Networks and Health in the Twenty-First Century
2022, Journal of Health and Social Behavior

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Original articlePredictors of HIV-preventive sexual behavior in a high-risk adolescent population: The influence of perceived peer norms and sexual communication on incarcerated adolescents' consistent use of condoms

Abstract

J Pediatr

Criminal Justice

J Adolesc Health Care

J Adolesc Health Care

The emergence of adolescents as a risk group for human immunodeficiency virus infection

Journal of Adol Research

AIDS in adolescence

J Adolesc Health Care

Adolescents and HIV infection: Struggling not to be forgotten

Pediatric AIDS and HIV Infection

Adolescents and AIDS: Current research, prevention strategies and public policy

Establishing a system of complementary school-based surveys to annually assess HIV-related knowledge, beliefs, and behaviors among adolescents

J Sch Health

Health status of detained and incarcerated youths

JAMA

Gonorrhea and syphilis in incarcerated urban adolescents: Prevalence and physical signs

Pediatrics

Sexually transmitted diseases in females in a juvenile detention center

Sex Transm Dis

Comparison of AIDS knowledge, attitudes, and behaviors among adolescents in a juvenile detention facility and public schools in San Francisco

Am J Public Health

AIDS awareness and the impact of AIDS education in juvenile corrections

Criminal Justice

Sex in the age of AIDS calls for common sense and “condom sense”

JAMA

Original article
Predictors of HIV-preventive sexual behavior in a high-risk adolescent population: The influence of perceived peer norms and sexual communication on incarcerated adolescents' consistent use of condoms