African American Adolescent Females Research Articles

Barriers to HPV immunization for African American adolescent females

PurposeThe objective of this study was to identify motivations and barriers to HPV vaccination and culturally relevant and meaningful opportunities for vaccine promotion among African American mothers and adolescent daughters. Qualitative methods were employed to identify barriers to HPV immunization and understand mothers motivations to vaccinate their daughters. We conducted in-depth interviews with 19 mother–daughter pairs focused on 5 key areas: health history, prior vaccine experience, knowledge of HPV and HPV vaccine, relationship with physician, and experience of cervical dysplasia and cervical cancer (CD/CC). ResultsFour key factors drive HPV immunization among African-American mothers of adolescent daughters. First, mothers’ CD/CC disease experiences motivated a strong commitment to protect daughters from the trauma of CD/CC. Second, limited understanding of HPV and its connection to CD/CC made it difficult for mothers to assess the risk of infection or explain the medical benefits of the vaccine to their daughters. Third, mothers anticipate the sexual debut of adolescent daughters and advocate for healthcare interventions to protect them. Mothers were not deterred by multiple visits to complete the vaccine series; they likened HPV immunization to injectable contraceptives that require a series of injections and offer protection from the unintended consequences of sexual activity. Finally, mothers trusted physicians to initiate discussion of HPV immunization. Physicians who failed to initiate discussion and offer unconditional endorsement generated doubt about the vaccine among mothers and missed opportunities for immunization. ConclusionsOur initial results indicate that physicians can engage in culturally relevant vaccine promotion in urban, underserved African American communities by initiating discussions of HPV immunization that (1) acknowledge mothers’ own CD/CC experiences, (2) support parenting strategies that aim to protect daughters from the unintended consequences of sexual activity, and (3) make explicit the connection between CD/CC and HPV infection, and between prevention of HPV infection and HPV immunization.

Does making meaning make it better? Narrative meaning making and well-being in at-risk African-American adolescent females

It has been argued that, for certain people, attempts at making meaning about past life events, especially challenging events, might be detrimental to well-being. In this study we explored the association between narrative indicators of meaning making and psychological well-being, while also considering the role of individual level factors such as life history, personality characteristics, and locus of control, among an at-risk sample of low socioeconomic status inner-city African-American adolescent females with challenging lives. We found that having a more external locus of control and including more cognitive processing language in narratives about a highly negative past experience were associated with increased depressive symptoms. Our findings suggest that certain types of narrative meaning-making language may reflect ongoing and unsuccessful efforts after meaning, and may be more similar to rumination than to resolution. Additionally they support claims that for certain individuals from challenging backgrounds, efforts after meaning might not be psychologically healthy.

Examining interest in secondary abstinence among young African American females at risk for HIV or STIs.

Sexually active African American females are at increased risk for acquiring HIV or STIs. However, some reduce their risk by abstaining from sex for various periods of time following initiation, a practice known as secondary abstinence. Although this may be a valuable mechanism for reducing HIV or STI rates in this population, little is known about those interested in secondary abstinence. Baseline data were obtained from a sample of African American adolescent females, ages 14-20 years, prior to participation in an HIV-risk reduction intervention trial (N = 701). Differences in individual-level and interpersonal-level factors, as well as sociodemographic variables were examined between participants who reported strong interest in secondary abstinence and those who did not. 144 (20.5%) participants reported strong interest in secondary abstinence. Young women with strong interest in abstinence had higher odds of reporting a history of STIs and feeling negative emotions following sex because of their religious beliefs. They also had higher odds of believing their partner may be interested in abstaining and being less invested in their relationship with their main partner. Additionally, adolescents reported less interpersonal stress and more social support. African American females who are interested in practicing secondary abstinence and those who are not differ in their sexual health education needs. Findings from this study characterizing young women interested in secondary abstinence can help researchers provide more targeted health education by identifying those who may be more responsive to abstinence-promoting messages.

The role of feelings of intimacy on perceptions of risk for a sexually transmitted disease and condom use in the sexual relationships of adolescent African–American females

ObjectivesA core construct targeted by behavioural interventions is the perception that one is at risk for acquiring a sexually transmitted disease (STD). The objective of this analysis was to examine...

Factors Associated with Weight Resilience in Obesogenic Environments in Female African-American Adolescents

This study used a descriptive, cross-sectional analysis to examine a social ecological model of obesity among African-American female adolescents residing in obesogenic environments. The goal was to identify factors that promote weight resilience, defined as maintaining a healthy body weight despite living in an environment that encourages inactivity and undermines healthy weight behaviors. During 2005 to 2008, weight-resilient (n=32) and obese (n=35) African-American female adolescents (12 to 17 years) living in Detroit, MI, and their caregivers completed measures of individual, family, and extrafamilial weight-resilience factors. Variables related to weight resilience in bivariate analyses were subjected to multivariate analysis using logistic regression to test the hypothesis that these factors independently predicted adolescent membership into the weight-resilient or obese group. As hypothesized, the odds of an adolescent being weight resilient were predicted by lower caregiver body mass index (calculated as kg/m2) (odds ratio [OR]=0.790; 95% confidence interval [CI]: 0.642 to 0.973), lower caregiver distress (OR=0.796; 95% CI: 0.635 to 0.998), higher caregiver monitoring and supervision of exercise (OR=5.746; 95% CI: 1.435 to 23.004), more frequent full-service grocery store shopping (OR=5.147; 95% CI: 1.137 to 23.298), and more peer support for eating (OR=0.656; 95% CI: 0.445 to 0.969). Contrary to prediction, lower eating self-efficacy (OR=0.597; 95% CI: 0.369 to 0.965) also predicted weight resilience. The model correctly classified 92.5% of all cases. Findings suggest that increasing psychosocial weight-resilience factors across multiple systems might be an important intervention strategy for obese African-American female adolescents residing in obesogenic environments.

Household income and spiritual well‐being but not body mass index as determinants of poor self‐rated health among African American adolescents

Very little is known about predictors of subjective health status among African American adolescents. This study was designed to determine whether selected anthropometric, psychological, lifestyle behavioral, and structural variables predicted poor self-rated general health in a cross-sectional nonclinical sample of 310 female African American adolescents, 14-18 years old. The odds of reporting poor self-rated health were 2-3 times greater for African American teens from lower socioeconomic households when compared to teens residing in higher socioeconomic households and for those reporting infrequent participation in activities that promote spiritual well-being compared to those who participate more frequently in activities that enhance spiritual health. Findings indicate that socioeconomic level and engagement in behaviors that enhance healthy spirituality appear to be the most salient predictors of self-rated health. In addition to biodiversity considerations that influence perceptions of health status, culturally focused interventions should integrate variables shown to influence self-rated health among African American teens. These inclusions may inform a more integrated understanding of health, health outcomes, and health disparities in this vulnerable population.

Sexually Transmitted Infections, Sexual Risk Behavior, and Intimate Partner Violence Among African American Adolescent Females With a Male Sex Partner Recently Released from Incarceration

Social networks directly and indirectly influence sexually transmitted infections (STIs) risk. The objective was to explore associations between sex with a male recently released from incarceration and sexual risk and intimate partner violence (IPV) among African American adolescent females. Sociodemographic, psychosocial, and sexual behavior data were collected at baseline, 6, and 12 months from African American females, aged 15-21 years, participating in an HIV/STI prevention trial. Among 653 participants with ≥1 follow-up assessments, generalized estimating equations tested associations during follow-up between having a recently released partner and STI acquisition, sexual risk behaviors, and IPV, adjusting for age, treatment assignment, and corresponding baseline measure. Eighty-three (13.6%) participants had a recently released partner at 6 months and 56 (9.3%) at 12 months. Participants with a recently released partner were more likely to have the following: vaginal (adjusted odds ratio [AOR]: 5.48), anal (AOR: 2.43), and oral (AOR: 1.51) sex, a casual partner (AOR: 1.66), sex while high/drunk (AOR: 1.57) or with a high/drunk partner (AOR: 2.27); use condoms inconsistently (AOR: .58); acquire Chlamydia (AOR: 1.80), and experience emotional (AOR: 4.09), physical (AOR: 2.59), or sexual abuse (AOR: 4.10) by a boyfriend. They had a greater number of sex partners, lower partner communication and refusal self-efficacy, were high/drunk during sex more frequently, and used condoms during oral sex less frequently. A recently released sex partner is associated with sexual risk and IPV among African American adolescent females. Prevention programs should inform adolescents about potential risks associated with recently released partners as well as provide adolescents with skills to establish and maintain healthy sexual relationships.

Predicting Discordance Between Self-reports of Sexual Behavior and Incident Sexually Transmitted Infections with African American Female Adolescents: Results from a 4-city Study

This study examined correlates of the discordance between sexual behavior self-reports and Incident Sexually Transmitted Infections. African American adolescent females (N = 964) from four U.S. cities were recruited for an HIV/STI prevention trial. Self-reported sexual behaviors, demographics, and hypothesized psychosocial antecedents of sexual risk behavior were collected at baseline, 6-, 12-, and 18-month follow-up assessments. Urine specimens were collected and tested for three prevalent STIs (chlamydia, gonorrhea, trichomonas) at each assessment. Seventeen percent of participants with a laboratory-confirmed STI reported either lifetime abstinence or recent abstinence from vaginal sex (discordant self-report). Lower STI knowledge, belief that fewer peers were engaging in sex, and belief that more peers will wait until marriage to have sex were associated with discordant reports. Discordance between self-reported abstinence and incident STIs was marked among African American female adolescents. Lack of STI knowledge and sexual behavior peer norms may result in underreporting of sexual behaviors.

Clinical depression and HIV risk-related sexual behaviors among African-American adolescent females: Unmasking the numbers

Clinically depressed and nondepressed African-American adolescent females aged 13–19 years (N=131) were interviewed and surveyed to determine the relationship between depression and HIV risk-related sexual behaviors. Narratives indicate that the psychopathology of depression may create situations where the target population could become exposed to HIV. Specifically, depressed participants described feelings of loneliness, isolation, and wanting somebody to “comfort them” as aspects of depression that affect the decisions they make about sex and relationships. In essence, sex was viewed as a stress reliever, an anti-depressant and a way to increase self-esteem. They shared that even if they did not feel like having sex, they might just “git it over wit” so their partners would stop asking. Some also discussed financial and emotional stability offered by older, more sexually experienced partners. These age-discordant relationships often translated into trusting that their partners knew what was best for their sexual relationships (i.e., having unprotected sex). Sixty-nine percent (n=88) of the sample reported engaging in sexual activity. Given their mean age (16±1.9 years) participants had been sexually active for 2±1.8 years. The adolescents reported an average of 2±1.8 sexual partners within the past three months. Depressed participants reported a higher frequency of having ever had sex (78% vs. 59%, χ2=5.236, p=0.022), and had a higher mean number of sexual partners (2 vs. 1, t=–2.023, p= 0.048) and sexual encounters under the influence of drugs and alcohol (8 vs. 2, t=–3.078, p=0.005) in the past three months. The results of this study can guide the modification and/or development of tailored HIV/sexually transmitted infection (STI) prevention programs. The findings provide explicit, psychologically and culturally relevant information regarding the interaction between depression, self-medicating behaviors and risk for HIV/STIs among clinically depressed African-American adolescent females.

The mediating role of partner communication frequency on condom use among African American adolescent females participating in an HIV prevention intervention.

Although effective HIV prevention interventions have been developed for adolescents, few interventions have explored whether components of the intervention are responsible for the observed changes in behaviors postintervention. This study examined the mediating role of partner communication frequency on African American adolescent females' condom use postparticipation in a demonstrated efficacious HIV risk-reduction intervention. As part of a randomized controlled trial, African American adolescent females (N = 715), 15-21 years, seeking sexual health services, completed a computerized interview at baseline (prior to intervention) and again 6 and 12 months follow-up post-intervention participation. The interview assessed adolescents' sexual behavior and partner communication skills, among other variables, at each time point. Using generalized estimating equation (GEE) techniques, both logistic and linear regression models were employed to test mediation over the 12-month follow-up period. Additional tests were conducted to assess the significance of the mediated models. Mediation analyses observed that partner communication frequency was a significant partial mediator of both proportion of condom-protected sex acts (p = .001) and consistent condom use (p = .001). Partner communication frequency, an integral component of this HIV intervention, significantly increased as a function of participating in the intervention, partially explaining the change in condom use observed 12 months postintervention. Understanding what intervention components are associated with behavior change is important for future intervention development.

African American Adolescent Females' Perceptions of Neighborhood Safety, Familial Strategies, and Sexual Debut

Sexual debut represents a developmental transition that holds possibility for growth and for risk. Family and neighborhood may impact timing of debut. This qualitative study examined family strategies (e.g., moving, parental monitoring), perceptions of neighborhood, and attitudes about sex and sexual debut among sexually experienced and inexperienced African American adolescent females living in disadvantaged urban neighborhoods. Findings show that more familial strategies were reported by sexually inexperienced females, suggesting that strategies may delay sexual debut. Furthermore, experiences with neighborhood violence related to attitudes about sex and sexual debut, suggesting a linkage between death anxiety and sexual debut among female youth.

Exploring Factors Associated with Nonchange in Condom Use Behavior following Participation in an STI/HIV Prevention Intervention for African-American Adolescent Females.

To enhance future STI/HIV prevention efforts, this study examined factors associated with adolescents' failure to improve their condom use behaviors after participating in an STI/HIV prevention intervention. African-American adolescent females (N = 205; M age = 17.9) in an STI/HIV prevention intervention trial completed ACASI interviews and provided self-collected vaginal swabs to assess two prevalent STIs at baseline and 6 months after intervention. Analyses compared those who increased condom use after intervention (change group) to those whose condom use did not increase (nonchange group). 43.4% did not increase their condom use after the intervention and were more likely to have an STI at followup (χ 2 = 4.64, P = .03). In a multivariate logistic regression model, the nonchange group was more likely to have (a) higher sensation seeking (AOR = .91, P = .023), (b) a boyfriend (AOR = .32, P = .046), and/or (c) a physical abuse history (AOR = .56, P = .057). There were also differences in the extent to which psychosocial mediators changed between the two groups. Findings highlight the need to tailor STI/HIV interventions to adolescents with a greater degree of sensation seeking and address key relationship characteristics and trauma histories to bolster intervention efficacy.

The Relations of Stressful Events and Nonacademic Future Expectations in African American Adolescents: Gender Differences in Parental Monitoring

Urban African American high school students (N = 206) completed a study to examine gender differences in parental monitoring and the effect on the relationship between exposure to stressful life events and nonacademic future expectations. Participant's ages range from 13 to 18 (M = 15.78, SD = 1.19). Participants reported high exposure to stressful life events, but also high future expectations. Older girls reported the highest levels of parental monitoring. Parental monitoring showed a moderating effect on the future expectations only for African American adolescent males, who were exposed to a high number of stressful life events. This finding seems to suggest that while older African American adolescent females report the highest levels of parental monitoring, the construct has more of an impact on outcomes for males.Keywords: gender differences, stressful events, parental monitoring, future expectations, African American adolescentsAdolescence is a difficult and stressful time in the lives of youths regardless of gender, race, and background. Along with the normal trials associated with puberty, adolescence may be more challenging for ethnic and minority youth (Garcia Coll et al., 1996). Racial and ethnic minority families tend to reside in urban neighborhoods, which are often characterized by many challenges to academic success and good psychological, cognitive, social, and physical development (Leventhal & Brooks-Gunn, 2000). However, living in an urban environment does not automatically lead to negative outcomes. Parents often buffer adolescents' experiences. In particular, parental monitoring plays significant roles for most adolescents (Spencer, Dupree, Swanson, & Cunningham, 1996, 1998).PARENTAL MONITORINGParents play important roles in the lives of adolescents, and it is no secret that parents hold very different views about sons and daughters. It has also been shown that as early as 3 -years old, parents pressure their children into appropriate sex-typed play (Eisenberg, Wolchik, Hernandez, & Pasternack, 1985). Studies reveal that parents use rewards and punishments differently for boys and girls for appropriate play (Eisenberg et al, 1985). It is important to understand this gender-based differential treatment of boys and girls in early childhood to have a more holistic view of its consequences in adolescence. This point is especially true for African American adolescents. Mandara, Murray, and Joyner (2005) demonstrated in one study how a father's absence or presence differentially affects African American girls and boys. In particular, they found that African American father-absent boys reported lower levels of masculinity (e.g., self-defined traditional notions of maleness as assessed on a scale of Adjective Q-sort of ideal masculine to ideal feminine) than African American father-present boys. The same study showed that lower income African American father-absent girls reported the highest levels of current masculinity of all African American girl participants (Mandara et al., 2005). These findings demonstrate how fathers differentially socialize boys and girls based on gender, and that girls are encouraged by dads to be more feminine and boys to be more masculine. Therefore, this study demonstrates how parenting strategies, and parental monitoring in particular, becomes more salient and meaningful for African American adolescents.In adolescence, one area where gender-based differences become important is in the levels of parental monitoring (Hamza & Willoughby, 2011; Spencer et al., 1996, 1998). Parental monitoring is defined as parents' knowledge, supervision, and control of their children's daily activities and peer relationships in an attempt to minimize the potential risks to which their children are exposed (Cottrell et al., 2003; Hamza & Willoughby, 2011; Spencer et al., 1996, 1998). For example, families that show moderate to high parental monitoring may include parents that are familiar with their children's friends, extracurricular activities, and express concern about where their children spend time away from home and school (Spencer et al. …

Dating Violence Perpetration and/or Victimization and Associated Sexual Risk Behaviors Among a Sample of Inner-City African American and Hispanic Adolescent Females

The purpose of this study is to examine the prevalence of physical and psychological dating violence victimization and perpetration reported by inner-city African American and Hispanic adolescent girls as well as associated risky sexual behaviors among this population. Participants in this study were 10th- and 11th-grade female students from seven inner-city Chicago public high schools. Participants were administered with the Safe Dates measures of physical violence victimization, physical violence perpetration, psychological abuse victimization, and psychological perpetration. Approximately half of the sample reported some psychological dating violence victimization and perpetration, and approximately one third reported some physical victimization and perpetration. Hispanic adolescents were significantly more likely to report psychological victimization, whereas African American adolescents were significantly more likely to report physical dating violence perpetration. Victimization was found to predict perpetration in this population, and adolescents who acknowledged being both victims and perpetrators of dating violence were more likely to report having had vaginal sex and a higher number of past-year sexual partners. Inner-city African American and Hispanic adolescent girls may be particularly vulnerable to dating violence victimization and perpetration, which may be due to a number of other social factors not explored within this study. Furthermore, African American adolescent girls continue to engage in behaviors that increase their risk for negative health outcomes, predominantly STIs, highlighting the need for effective interventions with this population.

Deficiencies in the Management of Iron Deficiency Anemia During Childhood

Abstract 3154 Background:Iron deficiency anemia (IDA) is a common hematologic problem worldwide, potentially leading to cognitive delays, fatigue, seizures, and, when severe, high output heart failure. While IDA frequently is encountered in both the primary care setting and specialty clinics, its management is not evidence based. As a result, the diagnosis and treatment of IDA is often suboptimal. To help inform future clinical trials, we retrospectively characterized the clinical course of IDA in young patients (pts) referred to our center. Methods:Using our comprehensive hematology database, the records of children ≤ 18 years (yrs) of age with IDA seen in our outpatient clinic between January 1, 2006 and June 30, 2010 were identified and carefully reviewed. Results:Of 217 IDA pts in the database, 215 had evaluable records, 20 of whom were determined to have an alternative diagnosis. Of 195 evaluable pts, 64% were ≤4 yrs old at their first clinic visit and 31% were age 11–18 yrs. Pts ≤ age 4 yrs were 63% male and 60% Hispanic, whereas those age 11–18 yrs were 83% female and 37% Hispanic, 35% African-American, and 15% Caucasian.Causes of IDA in 128 pts ≤ 4 yrs were excessive consumption of cow milk (68%), breast feeding without iron supplementation (13%), overall iron-poor diet beyond 12 months (16%), prematurity (5%), and suspected malabsorption (6%). Causes of IDA in 60 pts aged 11–18 yrs were menorrhagia (43%), other blood loss (20%), iron-poor diet (22%), and poor iron absorption (7%). Some pts in both age groups had multiple causes of IDA, and in 17 the cause of the anemia was not clear.129 pts (66%) were referred to us directly by their primary care physician (PCP), and 49 (25%) by the emergency department (ED), 37 of whom had been sent there by their PCP for evaluation of anemia. Prior to their first visit to our center, 115 pts (59%) had received at least one trial of iron therapy, 62 with ferrous sulfate, 27 with carbonyl iron, 5 with iron polysaccharide, and 15 with an iron-containing multivitamin. For the pts ≤ 4 yrs of age where the precise dose of elemental iron prescribed by the PCP was known (n=59), greater than half of the pts were prescribed doses of iron outside of the accepted therapeutic range (3–6 mg/kg/day) (see figure). The pts’ mean Hb concentration before referral to our clinic (last recorded Hb measured either by the PCP or the ED) was 7.8 g/dl (n=170). [Display omitted] Following evaluation in our hematology clinic, 86% of patients were treated with ferrous sulfate. However, 17% of such pts ≤ 4 yrs of age still received iron doses outside of the accepted therapeutic range. At the time of their first and last visits to the hematology clinic the mean Hb values were 9.0 g/dl and 11.3 g/dl respectively. One third of pts had documented poor adherence with iron therapy, due to poor tolerability (19%), gastrointestinal upset (11%), misunderstanding of prescribed dose (14%), and use of a lower dose than prescribed due to parental discretion (41%). 40% of pts were lost to follow up. Summary and Conclusions:Among pts referred for IDA to our academic specialty clinic, Hispanic male toddlers and Hispanic or African-American female adolescents were disproportionately represented. Most toddlers had nutritional IDA while most adolescents had menorrhagia. Pts often received sub-therapeutic doses of iron before referral. After hematology clinic evaluation, most children demonstrated improvement of IDA; however, inappropriate dosing and non-adherence with oral iron therapy were high, and many pts were lost to follow up.Insufficient screening and prevention of IDA remains problematic. Additionally, when IDA is suspected it is often inadequately treated or inappropriately referred to the ED or the hematology clinic, where treatment is associated with poor adherence and high attrition rates. Future research must focus on all of these deficiencies to prevent the many immediate and long-term sequelae of IDA. Disclosures:No relevant conflicts of interest to declare.

Prevalence and Correlates of Recent Vaginal Douching among African American Adolescent Females

Study Objective To describe the prevalence and correlates of vaginal douching among urban African American adolescents and to examine the association between douching and sexually transmitted infection (STI) status. Design Demographic, psychosocial, and behavioral data were collected through cross-sectional, self-administered surveys. Self-collected vaginal swabs were assayed using nucleic acid amplification tests for trichomoniasis, chlamydia, and gonorrhea. Setting Sexual health clinic in a large metropolitan area of the southeastern United States. Participants African American females (N = 701), ages 14–20, participating in a human immunodeficiency virus prevention intervention. Main Outcome Measure The outcome of interest was the association between vaginal douching (lifetime, past 90 days, and past 7 days) with demographic characteristics (eg, age, education, and socioeconomic status), physical and mental health status, STI status, sexual behavior (eg, number of vaginal sexual partners, age of sex partners, consistent condom use in the past 90 days, sex while self/partner was high on drugs or alcohol), and psychosocial characteristics (eg, sexual adventurism, social support, peer norms, sexual satisfaction, self-efficacy for sex refusal, self-esteem, relationship power, risk avoidance). Results Forty-three percent reported ever douching, and 29% reported douching in the past 90 days. In bivariate analyses, recent douching was associated with demographic, behavioral, and psychosocial variables, but not current STI status. In multivariate analyses, recent douching was associated with age (odds ratio [AOR] = 1.13, confidence interval [CI] = 1.02–1.25), lower socioeconomic status (AOR = 1.25, CI = 1.05–1.47), and having sex with much older partners (AOR = 1.87, CI = 1.22–2.86). Conclusion Increased age, lower socioeconomic status, and older partners may be salient risk factors for douching behavior among African American young women.

Characteristics of African American adolescent females who perceive their current boyfriends have concurrent sexual partners.

Perceived partner concurrency, reporting that a current sexual partner has other sexual partners, may pose sexual health risks to adolescents. We examined the contextual characteristics of African American female adolescents who reported their current boyfriend was having concurrent sexual relationships. Participants were African American adolescent females (N = 511; mean age = 17.6) recruited from sexual health clinics. Before participating in an STD/HIV prevention trial, the participants completed audio computer-assisted self-interviews with measures of perceived partner concurrency and individual- (e.g., depression, substance use), interpersonal- (e.g., social support, interpersonal stress), and community-level factors (i.e., neighborhood quality). Twenty-seven percent of participants reported their belief that their current boyfriend had concurrent sexual partners during their relationship. In a logistic regression analysis, participants endorsing perceived partner concurrency reported less relational power (adjusted odds ratio [AOR] = .94, 95% confidence interval [CI] = .89-.98, p < .01), decreased relationship commitment (AOR = .88, 95% CI = .80-.96, p < .01), elevated perceived interpersonal stress (AOR = 1.02, 95% CI = 1.003-1.04, p < .05), and previous STD diagnoses (AOR = 2.07, 95% CI = 1.31-3.28, p < .01; overall model: χ(2) = 67.25; p < .001). Results suggest that the efficacy of sexual risk reduction interventions may be improved by emphasizing the increased HIV/STD risks associated with having a boyfriend with concurrent sex partners. In addition, interventions may benefit from incorporating stress management training and addressing key relationship dynamics, particularly among adolescents with a history of STDs.

Age Differences in STDs, Sexual Behaviors, and Correlates of Risky Sex Among Sexually Experienced Adolescent African-American Females

To explore age differences in factors associated with positive sexually transmitted diseases (STD) status among a sample of African-American adolescent females. Data were collected via ACASI from 701 African-American adolescent females (14-20 years) seeking services at reproductive health clinics. Adolescents provided self-collected vaginal swabs assayed using NAAT to assess the prevalence of three STDs. Younger adolescents (14-17 years) had significantly higher rates of STDs than older adolescents (18-20 years), but older adolescents had significantly higher levels of STD-associated risk behavior. In controlled analysis, having a casual sex partner was the only variable significantly associated with a positive STD test for younger adolescents, and prior history of STD and higher impulsivity were significantly associated with testing STD positive among older adolescents. These findings suggest that developmentally tailored STD/HIV prevention interventions are needed for younger and older subgroups of adolescent females to help reduce their risk of infection.

Constructing dressing rooms in urban schools: Understanding family through book clubs with Latino and African American female adolescents

Because adolescence is a difficult transition where teenagers work to establish autonomy, an understanding of family becomes essential when exploring students' social contexts. The purpose of this article is to examine the space of book club as a metaphorical and actualized “dressing room,” where for one year 12 urban Latina and African American females used adolescent literature and conversations to understand their lives, communities, and families. These discussions were essential in that families function as part of their identities and as systems of both support and conflict. Ultimately, the girls used textual family relationships and each other as guides for their present situations and future potentialities.

Ethnic differences in food sources of vitamin D in adolescent American girls: the National Heart, Lung, and Blood Institute Growth and Health Study

The National Heart, Lung, and Blood Institute Growth and Health Study was a 10-year longitudinal study of the development of obesity and cardiovascular disease risk factors (including dietary, psychosocial, environmental, and others) in 2379 African American and white girls who were 9 or 10 years old at study entry. Current studies have documented a high prevalence of vitamin D insufficiency among healthy children, adolescents, and young adults in the United States, especially among low-income, black, and Hispanic children (defined as serum 25-hydroxyvitamin D concentrations of <20 ng/mL). Although the main source of vitamin D is direct exposure of the skin to ultraviolet rays from sunlight, certain foods contribute vitamin D including fortified milk, meat, eggs, oils, and fortified cereals. Vulnerable subgroups that are especially at risk for inadequate intakes of vitamin D include teenage girls and women. Research providing the prevalent food sources of vitamin D, especially in the diets of both white and African American female adolescents is limited. The purpose of this study is to document food sources of vitamin D reported by this biracial young cohort and compare potential ethnic or other differences that could enhance tailored dietary interventions that are particularly relevant to this vulnerable population subgroup.