Early Initiation Of Sexual Intercourse Research Articles

Prevalence and determinants of pregnancy termination in Ethiopia: a systematic review and meta-analysis

ObjectiveThis review aims to determine the prevalence of pregnancy termination and its determinant factors in Ethiopia.DesignSystematic review and meta-analysis.Data sourcesRelevant articles were retrieved from databases such as PubMed, EMBASE, Medline...

Prevalence and associated factors of early initiation of sexual intercourse among youth in Ethiopia: systematic review and meta-analysis

BackgroundEarly sexual initiation refers to engaging in sexual activity at a young age, typically before the age of 18. Even though many studies have been conducted in Ethiopia, the result is inconsistent between studies. In the study area, the pooled prevalence and associated factors of early initiation of sexual intercourse among youth were not done before. Therefore, this study aimed to determine the pooled prevalence and associated factors of early initiation of sexual intercourse among Youth in Ethiopia.MethodsThis study used a systematic review and meta-analysis of studies conducted from 2008 to 2022, in Ethiopia. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. PubMed, Cochrane Library, Hinari, and Google Scholar electronic databases were searched. The analysis was performed using STATA 17 software. Heterogeneity and publication bias were assessed using forest plots, I2, Cochran’s Q statistics and Funnel plots, Egger test, and Begg rank tests respectively. Duval and Tweedie’s ‘trim and fill’ method was also performed to adjust the pooled estimate. Pooled analysis was conducted using the inverse-variance fixed-effects model.ResultsA total of 10 articles were included in this systematic review and meta-analysis. The pooled prevalence of early initiation of sexual intercourse among youth in Ethiopia was 24.7% (95%CI: 10.4, 38.9). Being female (AOR = 3.57; 95% CI: 1.387, 5.743), having poor knowledge of HIV/AIDS prevention (AOR = 3.65; 95% CI: 1.981,5.309), alcohol use (AOR = 2.05; 95% CI: 1.415, 2.679), khat chewing (AOR = 3.03; 95% CI: 1.800, 4.254), Viewed pornographic film(AOR = 4.21, 95% CI: 2.135, 6.283), Cigarette smoking (AOR = 2.74; 95% CI: 2.102, 3.370) and Poor family controls (AOR = 4.39; 95% CI: 2.572, 6.199)were associated factors of early initiation of sexual intercourse.ConclusionsThe pooled prevalence of early initiation of sexual intercourse among Youth in Ethiopia was high. Being female, poor knowledge of HIV/AIDS prevention, alcohol use, khat chewing, Viewing pornographic films, Cigarette smoking, and poor family controls were associated factors of early initiation of sexual intercourse. It is recommended that targeted interventions be put in place to address the high prevalence of early initiation of sexual intercourse among youth in Ethiopia. These interventions should focus on addressing the associated factors such as poor knowledge of HIV/AIDS prevention, alcohol use, khat chewing, viewing pornographic films, cigarette smoking, and poor family controls. It is important that these interventions are gender-sensitive and take into consideration the unique challenges faced by females in accessing sexual and reproductive health services.

Longitudinal Patterns of Multidimensional Violence Exposure and Adolescent Early Sexual Initiation.

Early sexual intercourse is associated with sexually transmitted infections, pregnancy, and depressive symptoms, and delay of intercourse allows adolescents opportunities to practice relationship skills (Coker et al., 1994; Harden, 2012; Kugler et al., 2017; Spriggs & Halpern, 2008). Thus, understanding predictors of early sexual intercourse is crucial. Prior research has suggested that violence exposure is associated with early initiation of sexual intercourse in adolescence (Abajobir et al., 2018; Orihuela et al., 2020). However, most studies have looked only at a single type of violence exposure. In addition, little research has examined longitudinal patterns of violence exposure in order to determine whether there are particular periods when the violence exposure may have the strongest impact on sexual behavior. Guided by life history and cumulative disadvantage theories, we use longitudinal latent class analysis and data from the Future of Families and Child Well-being Study (N = 3,396; 51.1% female, 48.9% male) to examine how longitudinal patterns of multiple types of violence exposures across ages 3 to 15 are associated with early sexual initiation in adolescence. Findings suggest that experiencing persistent physical and emotional abuse across childhood was associated with the greatest prevalence of early sexual initiation. Early exposure to violence was not consistently associated with greater likelihood of sexual initiation; instead, early abuse was more strongly associated with sexual initiation for boys, while late childhood abuse was more strongly associated for girls. These findings suggest that gender-sensitive programs are highly needed to address unique risk factors for boys' and girls' sexual behaviors.

Association between childhood sexual abuse and early sexual debut among Chinese adolescents: The role of sexual and reproductive health education.

Despite accumulating evidence of the long-term impacts of childhood sexual abuse (CSA), few studies have investigated the association between CSA and early sexual debut among adolescents. In this study, we examine the relationship between CSA and early initiation of sexual intercourse among Chinese youth, and the role of school-based sex education in this association, based on a nationally representative survey. Data were collected from the Survey of Youth Access to Reproductive Health in China (YARHC) conducted in 2009. Multivariable logistic regression models were used to investigate the association between CSA experience and early sexual debut, and the interaction terms between sexual and reproductive health education and CSA were included to examine the role of education in the association between CSA and early sexual debut. Among 4,907 sexually experienced youth, 1,062 (21.6%) made their early sexual debut. After adjusting for sociodemographic characteristics, it was found that CSA experience was significantly associated with early sexual debut, with an adjusted odds ratio of 3.13 (95% CI: 1.67-5.87). Receiving any type of sexuality education (reproductive health, sexually transmitted disease (STD) and HIV prevention, or contraception use) was not associated with a decreased risk of early sexual debut. Our results indicate a greater risk of early sexual debut among Chinese adolescents with a history of CSA, and only 46.7% sexually experienced youth had received prior sex education, which suggested an inadequacy of school-based sexuality education. To reduce this risk, targeted intervention with timely and adequate sexuality education for both early starters of sexual intercourse and CSA victims is warranted in China.

Experience in the Management of Vaginal Cuff Dehiscence and Evisceration: A Retrospective 37-Year Single-Center Study.

PurposeVaginal cuff dehiscence (and evisceration) (VCD(E)) is an extremely rare and late-onset complication of total hysterectomy (TH). Limited evidence is available to guide clinicians in managing VCD(E). This study aimed to summarize the clinical characteristics of patients with VCD(E) treated in our center and share our experience in managing VCD(E).Patients and methodsFrom 1983 to 2020, a total of 14 cases of VCD(E), including 10 cases in our hospital and 4 cases in other hospitals, were included. Medical records were reviewed to summarize the clinical features and management of VCD(E).ResultsThe incidence of VCD(E) in our hospital was 10/46,993 (0.02%), and all 10 patients underwent laparoscopic hysterectomy. The median TH-to-VCD(E) interval was 3.13 months (8 days–27.43 months), and 11/14 (78.57%) patients experienced VCD(E) after coitus. The 3 major symptoms included abdominal pain in 11 patients, irregular vaginal bleeding in 8, and sensation of bulging or prolapsed organs in 4. Except for 2, most patients presented to our hospital within 72 h since the onset of the discomfort. All 14 cases were diagnosed through speculum examination: 3 had simple VCD, and 11 had VCDE. The protruding bowels of 4 patients were immediately manually repositioned in the emergency department without anesthesia. Regarding the surgical approach, 11 patients underwent simple transvaginal, 2 patients underwent laparoscopic-vaginal combined (transvaginal cuff closures), and 1 patient underwent laparoscopic. All but 1 patient did not undergo resection of the eviscerated organs. The median follow-up period was 39.33 (7.9–159.33) months. No patients showed any evidence of recurrence to date.ConclusionsLaparoscopic hysterectomy is a risk factor for VCD(E), and early initiation of sexual intercourse is the most common trigger of VCD(E). Clinicians should educate patients to postpone sexual intercourse for at least 3–6 months after TH. Immediate medical attention and patient-specific surgical management are crucial to avoid serious complications.

Estimating the Prevalence and Risk Factors of Obstetric Fistula in Ethiopia: Results from Demographic and Health Survey.

IntroductionObstetric fistula is the most common obstetric problem in low- and middle-income countries where maternal care is inaccessible. Obstetric fistula has serious social and economic consequences resulting in devastating health problems for women. There is a lack of national studies that show the burden of obstetric fistula and risk factors; as a result, this study aimed to estimate the prevalence of obstetric fistula, its symptoms, and risk factors in Ethiopia.MethodsA population-level cross-sectional study was conducted with a total of 7590 women who gave birth in the last 5 years, using data from the 2016 Ethiopian Demographic and Health Survey. Complex sample analysis and normalized weighting were used to compensate for the disproportionate sampling in the survey. A multivariable logistic regression model was fitted to find a significant association between obstetric fistula and covariates. Both odds ratios (crude and adjusted) with their corresponding 95% confidence intervals (CI) were reported.ResultsAmong the 7590 women having given birth in the last 5 years, 32 (0.42%) women with obstetric fistula were identified. Of these, 64% developed obstetric fistula after live birth and 23.1% developed obstetric fistula after stillbirth. More than 72.8% were associated with prolonged and very difficult labor. No history of contraceptive use (AOR = 3.43; 95% CI: 1.05–11.21), having a big problem of distance from the health facility (AOR = 3.7; 95% CI: 1.05–11.21), early marriage (AOR = 1.52; 95% CI: 1.12–3.5), and being a rural resident (AOR = 1.5; 95% CI:1.2–5.05) were risk factors associated with obstetric fistula.ConclusionThis study finding revealed that obstetric fistula is the most common devastating obstetric problem in Ethiopia. Early marriage, early initiation of sexual intercourse, distance from the health facility, no history of contraceptive use, and rural residence were the predisposing factors to develop an obstetric fistula. Thus, interventions should focus on creating community awareness regarding early marriage and its consequences, early seeking of health facility visiting, and avoiding unintended pregnancy to minimize the subsequent complications.

Prevalence of Cervical Cancer and Associated Factors Among Women Attended Cervical Cancer Screening Center at Gahandi Memorial Hospital, Ethiopia.

Background:Despite the fact that cervical cancer is preventable disease, it is the fourth most frequently diagnosed cancer and leading cause of cancer death in women. An estimated 604 000 women were diagnosed with cervical cancer worldwide and 342 000 women died from the disease. Therefore, the purpose of this study was to determine the prevalence and factors associated with cervical cancer among women attended cervical cancer screening center in Gahandi memorial Hospital.Methods:An institutional-based cross-sectional study was conducted at Gahandi Memorial Hospital in which simple random sampling technique was used to select 422 registration books of women who visited the hospital between May 2015 and May 2019. Texts, tables, and graph were used to present results. Binary logistic regression with a P-value of <.25 and multivariate logistic regression with a P-value of <.05 were used to determine the association between independent variables and outcome variable.Results:In this study, from the total of 422 women screened with visual inspection with acetic acid (VIA) screening test, 23.5% of them were found to be positive for VIA test. From those who were diagnosed positive with VIA screening test, about 10.1 % were identified with high grade lesions. Having multiple sexual partners (AOR = 1.83, 95% CI: 1.21-3.29), being HIV-positive (AOR = 2.22, 95% CI:1.10-4.69), having a history of Sexual Transmitted Infection (STI) (AOR = 6.76, 95% CI: 1.14-3.90), and beginning sexual intercourse at early age (AOR = 1.38, 95% CI: 1.20-5.13) were factors associated with cervical cancer.Conclusion:The study concluded that the high prevalence of cervical cancer. Having multiple sexual partners, being Human Immune Deficiency Virus (HIV) positive, having STI history and early initiation of sexual intercourse were factors associated with cervical cancer. Therefore, avoiding multiple sexual partners, delaying of early sexual contact, and self-protection from STI infections might help to prevent cervical cancer.

Precancerous lesions of the cervix and its determinants among Ethiopian women: Systematic review and meta-analysis.

IntroductionPrecancerous lesions of the cervix are changes in cervical cells that make them more likely to develop into cancer. Understanding the prevalence and determinants of the precancerous lesions of the cervix among women helps to take an action like vaccination programs, improving screening coverage, and close management and follow-up which could decrease the morbidity and mortality caused by cervical cancer.Materials and methodsThe international databases, PubMed/MEDLINE, Web of Science, EMBASE, CINAHL, Google Scholar, Science Direct and Cochrane Library and unpublished reports were systematically searched. Two authors independently extracted all necessary data using a standardized data extraction format. STATA 14 statistical software was employed to analyse the data. The Cochrane Q test statistics and I2 tests were used to assess the heterogeneity between the studies. A random-effect model was computed to estimate the pooled prevalence of precancerous lesions of the cervix in Ethiopia. Determinants of the precancerous lesion of cervix (early initiation of sexual intercourse, multiple sexual partners, and history of sexually transmitted infection) were analysed.ResultsThirteen studies fulfilled the inclusion criteria and included in the meta-analysis. The I2 test result showed high heterogeneity (I2, 93.2%, p = <0.001). Using the random effect analysis, the pooled prevalence of precancerous lesions of the cervix among women in Ethiopia was 14.21% (95% CI (10.49, 17.94). After adjusting of publication bias using trim-and-fill method, the pooled prevalence was 9.43% (95% CI (5.23, 13.62). Women who had multiple sexual partners in their lifetime (OR:2.67 CI: 1.49,4.79) and had a history of sexually transmitted infections (OR:6.22 CI: 2.99,12.92) were more likely to have a precancerous lesion of the cervix.ConclusionThe pooled prevalence of the precancerous lesions of the cervix among Ethiopian women was 9.43%. It was associated with having multiple sexual partners and a history of sexually transmitted infections.

Why Too Soon? Early Initiation of Sexual Intercourse Among Adolescent Females in Ethiopia: Evidence from 2016 Ethiopian Demographic and Health Survey.

BackgroundEarly sexual initiation – sexual activity that begun earlier than 18 years of age – is among risky sexual behaviors which may be associated with increased risks of adverse outcomes such as sexually transmitted infections (STIs), unwanted pregnancy and unsafe abortions. However, there is no nationally representative evidence on early initiation of sexual intercourse and its determinant factors among adolescent females in Ethiopia.MethodsData were extracted from the 2016 Ethiopian Demographic and Health Survey (EDHS) to assess early initiation of sexual intercourse and factors contributing to it in adolescent females. The analysis included a weighted sample of 3881 adolescent females aged 15–19 years. A multivariable logistic regression analysis was conducted and the results were presented as adjusted odds ratio (AOR) at 95% confidence interval (CI), declaring statistical significance at a p-value <0.05 in all analyses.ResultsAbout 1 in 5 (21.9%, 95% CI: 20.5%, 23.33%) adolescent females experienced early sexual debut. Administrative regions (Amhara, AOR = 2.3, 95% CI: 1.30, 4.09 and Gambella, AOR = 4.89, CI 95%: 1.08, 22.07), religion (Muslim, AOR = 1.76, 95% CI: 1.24, 2.49), substance use (e.g., ever chewed khat, AOR = 2.02, 95% CI: 1.47, 2.77, ever drunk alcohol, AOR = 1.83, 95% CI: 1.35, 2.48) and having no knowledge on family planning (AOR = 4.47, 95% CI: 2.22, 8.99) were found to have statistically significant association with early sexual debut in adolescent females. Whereas any levels of formal education decreased the odds of early sexual debut (primary, AOR = 0.44, 95% CI: 0.35, 0.56; secondary, AOR = 0.19, 95% CI: 0.13, 0.28, and higher, AOR= 0.31, 95% CI: 0.15, 0.63). Similarly, all categories of wealth indices as compared to the poorest were protective of early sexual initiation in adolescent females (AOR = 0.40–0.57) as was for education as compared to no education (AOR = 0.19–0.44).ConclusionA significant proportion of adolescent females initiate early sexual intercourse in Ethiopia and multifaceted factors appear to determine their early sexual experiences. Contextualized interventions including strengthening information, education and communication on adverse consequences of early sexual initiation in regions and improving contraceptive knowledge of teenagers will play a paramount role.

Pre-marital predictors of marital violence in the WHO World Mental Health (WMH) Surveys.

Intimate partner violence (IPV) is a pervasive public health problem. Existing research has focused on reports from victims and few studies have considered pre-marital factors. The main objective of this study was to identify pre-marital predictors of IPV in the current marriage using information obtained from husbands and wives. Data from were obtained from married heterosexual couples in six countries. Potential predictors included demographic and relationship characteristics, adverse childhood experiences, dating violence, and psychiatric disorders. Reports of IPV and other characteristics from husbands and wives were considered independently and in relation to spousal reports. Overall, 14.4% of women were victims of IPV in the current marriage. Analyses identified ten significant variables including age at first marriage (husband), education, relative number of previous marriages (wife), history of one or more categories of childhood adversity (husband or wife), history of dating violence (husband or wife), early initiation of sexual intercourse (husband or wife), and four combinations of internalizing and externalizing disorders. The final model was moderately predictive of marital violence, with the 5% of women accounting for 18.6% of all cases of marital IPV. Results from this study advance understanding of pre-marital predictors of IPV within current marriages, including the importance of considering differences in the experiences of partners prior to marriage and may provide a foundation for more targeted primary prevention efforts.

Psychosocial Syndemics and Sexual Risk Practices Among U.S. Adolescents: Findings from the 2017 U.S. Youth Behavioral Survey.

The present study aims to (1) identify classes of psychosocial syndemics among adolescents in the U.S. based on psychological factors, such as depression and suicidal ideation, and social factors, such as binge drinking, alcohol use, and drug use; (2) identify correlates of psychosocial syndemics; and (3) examine the independent associations between psychosocial syndemic factors and sexual risk practices. We used latent class analysis and a sample of 14,762 U.S. high school students who participated in the 2017 Youth Risk Behavior Surveillance System to examine youth population profiles based on shared characteristics of syndemics. Adjusting for sociodemographic factors, we conducted logistic regression to explore the connections between psychosocial syndemic factors and three sexual risk practices, namely, early initiation of sexual intercourse, condom use, and sex with multiple partners. The study results indicate that three classes of risk exist among the sample: substance misuse (class 1, n = 3872, 26.2%), normative (class 2, n = 8791, 59.6%), and mental health problems (class 3, n = 2099, 14.2%). Class membership of psychosocial syndemics was significantly different by gender, age group, and race. The odds of initiating sexual intercourse before age 13 were positively associated with participants belonging in the substance misuse class and the mental health problem class. The odds of using condoms during the last sexual intercourse for currently sexually active adolescents were lower for participants classified in the substance misuse class. The likelihood of reporting having sex with four or more partners in a lifetime was higher among participants belonging to the substance misuse class. The study advances our understanding of the heterogeneity of class membership associated with psychosocial syndemic risk factors among adolescents and extends our understanding of syndemics in the area of adolescent health. Thus, practitioners and policymakers can design multicomponent and multilevel school-based HIV/STI prevention programs that meet the needs of adolescents.

Adolescents Values Clarification and Development: A Model for Group Counseling

Youths involved with the juvenile justice and child welfare systems report higher rates of early initiation of sexual intercourse, more sexual partners, and lower rates of condom use compared with the general adolescent population. Such risky behaviors leave system-involved youths with volatile behavioral challenges and negative sexual health outcomes, such as unintended pregnancy. These effects can be attributed to detached support systems and a lack of early interventions, such as group therapy. This dynamic fosters further inquiry into asking, can delinquent teenagers who adopt a values clarification approach and understanding exhibit positive prosocial thoughts and behaviors? The intent of this paper is to discuss an alternative education program for pregnant, delinquent adolescents and young mothers allowed a social worker and his associates to implement a group counseling program. The counseling was intended to emphasize values clarification and values development. The counselors focused on attitudes, social views, and desired behaviors related to values. A unique aspect of the program was the development of a four-phase cognitive process related to values clarification and development. This process includes the discovery and awareness of values, the claiming and reclaiming of values, the acceptance of core values, and the appreciation and advocacy of the values phase. A content analysis methodology was used to analyze a self-report methods so that insights into cultural trends and experiences could be understood. Findings from the adoption of this program suggest a psychoeducation humanistic model can not only buffer teenage pregnancy risk and delinquency but also strengthen values and the moral development of troubled youth.

Prevalence and Risk Factors of Human Papillomavirus in Male Patients: A Systematic Review and Meta-Analysis.

Human papillomavirus (HPV) is one of the most prevalent sexually transmitted infections. Although the research focus has been on women, men are also affected. Thus, the aim was to estimate the prevalence of HPV in men and to analyse its risk factors. A systematic review with meta-analysis was performed. The main health science databases were consulted. The search terms were was: “papilloma virus AND (prevalence OR risk factors) AND men”. The final sample of studies was n = 16 and the men sample for the meta-analysis was n = 18,106. The meta-analysis revealed a prevalence of 49% (95% Confidence Interval (CI): 35–64%) of any type of human papillomavirus in men and 35% (95% CI: 26–45%) of high-risk human papillomavirus in men. The included studies showed that stable sexual habits, circumcision and condom use are protective factors against HPV. In addition, there is a certain positive association with tobacco use and the early initiation of sexual intercourse. In conclusion, the prevalence of HPV in men is high. The risk factors for HPV infection are sexual promiscuity, early sexual debut, absence of circumcision, lack of condom use and smoking. Further study in this field about the effectiveness of the vaccine and health education should be conducted.

Adherencia al seguimiento y evolución de la lesión en mujeres con Neoplasia intra epitelial cervical escamosa grado 1

ObjectiveTo determine adherence to follow-up and outcome of lesions in women diagnosed with grade 1 cervical intraepithelial neoplasia (CIN 1). MethodologyThe study included non-pregnant women aged 18 or older, referred for colposcopy, with a colposcopy directed biopsy diagnosis of CIN 1, with no history of prior CIN, hysterectomy or cervical ablative therapy. Participants answered a questionnaire on risk factors, and the outcome of previous cytology and colposcopy was documented. All women should have been followed up for 1 year with cytology and colposcopy every six months. Those who did not have cytology and colposcopy / colposcopy assessments or documented treatments after 15 months were considered as non-adherent. ResultsA total of 40 patients with CIN 1 were included. The loss to follow-up rate of loss was 17/40 (42.5%). The demographic and clinical variables most frequently associated with non-adherence to follow-up were null parity and early initiation of sexual intercourse. The progression of low-grade to high-grade lesion was observed in 4.3%. 22.5% failed Conservative treatment failed conservative treatment and moved to invasive therapy. ConclusionThe rate of loss to follow-up was high, with a considerable referral from conservative to invasive therapy. A large percentage of patients had regression of CIN 1. This study should help clarify the optimal strategies for the treatment of women with low-grade cervical abnormalities in populations of low sociocultural conditions and high risk of cervical cancer.

Prevalence and factors associated with VIA positive result among clients screened at Family Guidance Association of Ethiopia, south west area office, Jimma model clinic, Jimma, Ethiopia 2013: a cross-sectional study.

BackgroundCervical cancer is the 2nd most frequent and top killer cancer among women in Ethiopia. Prevalence and factors associated with visual inspection with acetic acid (VIA) positive result is not studied yet at the study area.MethodsA cross-sectional study was conducted at Jimma model clinic of Family Guidance Association of Ethiopia, from September 11, 2013 to October 11, 2013. Pertinent data of 334 screened clients were transferred to Epidata version3.1 using checklist, double data entry verification done and exported to SPSS version16.0. After cleaning the data, descriptive analysis was done and logistic regression model employed to identify predictors of VIA positive result. Statistical significance was declared at P < 0.05.ResultsOut of 334 screened clients, 43 (12.9 %) had VIA positive result. Initiation of sexual intercourse earlier than 16 years was found to be an independent predictor increasing the risk of VIA positive by 2.2 times as compared to clients who started at the age of 16 or more years (AOR [95 % CI] = 2.2 [1.1, 4.3]).ConclusionsEarly initiation of sexual intercourse was an independent predictor of VIA positive result in this study. Thus, any cervical cancer prevention and control effort at the study area should address the problem of early initiation of sexual intercourse.Electronic supplementary materialThe online version of this article (doi:10.1186/s13104-015-1594-x) contains supplementary material, which is available to authorized users.

Childhood Adversity Among Institutionalized Male Juvenile Offenders and Other High-Risk Groups Without Offense Records in Portugal.

The literature has shown that delinquent adolescents report high rates of childhood adversity and family dysfunction. However, it is important to know both the degree of adversity among delinquent adolescents in comparison with other high-risk samples and the contribution of each single form of adversity to this comparison. The purpose of this study was to evaluate childhood adversity, psychopathology, and risk behaviors among 4 high-risk groups, including incarcerated delinquent youths. The participants were 120 male youths between 13 and 19 years old (M = 16.18, SD = 1.26), including 30 youths who were arrested and held in detention centers as a consequence of violent crimes; 30 youths who were identified by Child Protective Services (CPS) and remained with their families; 30 youths who were identified by CPS, removed from their homes, and placed in child and youth residential care; and 30 youths who were randomly selected from schools. The incarcerated youths reported significantly more adversity, global psychopathology, and global index of risk behaviors. When considering each risk behavior, the incarcerated youths reported higher percentages of alcohol abuse, drug use, early smoking initiation, physical assault, carrying weapons, early initiation of sexual intercourse, sexual intercourse under the influence of drugs, and sexual intercourse without condom use. The logistic regression analyses showed that only emotional neglect was significantly associated with delinquency. This study suggests that delinquent youths are exposed to a great magnitude of adversities in childhood, with emotional neglect as an independent risk factor for delinquency. In addition, these youths have higher rates of psychopathology and risk behaviors compared to other high-risk samples.

Influence of Peers on Young Adolescent Females' Romantic Decisions

Background: Initiation of sexual intercourse during early adolescence is a known risk factor for teen pregnancy and sexually transmitted infections. Purpose: To examine young women's stories describing peer influences on their romantic and sexual decisions and behavior during early adolescence. Methods: Semistructured ethnographic interviews were conducted with 28 African American, American Indian, Euro-American, and Latina females ages 19 to 29 years. Results: Four common themes (patterns) emerged. First, most participants belonged to a same-sex peer group in early adolescence, many participated in mixed sex groups, and a small number had no peer group. Second, romantic relationships were discussed with peers more than with adults. Third, early adolescent romantic behavior commonly led to early initiation of sexual intercourse with negative emotional impacts. Fourth, participants cautioned teens about romantic involvement during early adolescence. Discussion: The findings suggest that mixed-sex peer group affiliation was associated with delayed dating. Older peers and social isolation were associated with riskier sexual behaviors. Early sexual initiation frequently led to negative experiences. Translation to Health Education Practice: Health educators and health care providers are encouraged to assess young adolescents' peer involvement, encourage prosocial mixed-sex peer activities, and provide guidance to parents about early adolescent development and the importance of monitoring their young adolescent children's activities to avoid potentially dangerous sexual situations.

School‐Related Assets and Youth Risk Behaviors: Alcohol Consumption and Sexual Activity

Two risk behaviors, alcohol consumption and early initiation of sexual intercourse (ISI), can have devastating consequences for youth. The purpose of this study was to determine the association of school connectedness and school-related behaviors (eg, academic performance, skipping school, getting into trouble at school) with these 2 risk behaviors. The Youth Asset Survey (YAS) was administered to 1117 youth/parent pairs in their homes using Computer-Assisted Personal/Self-Interviewing (CAPI/CASI). The YAS measures 17 youth assets and risk behaviors including alcohol consumption and sexual activity. The mean age of the sample was 14.3 years; 53% were female; and 70% were from 2-parent homes. Five school-related behaviors were positively associated with no ISI. Four school-related behaviors were positively associated with reporting no alcohol consumption in the past 30 days, including the School Connectedness asset (only among 12- to 13-year-olds), not skipping school (only among non-Hispanic Caucasians), staying out of trouble, and paying attention. School is very much a part of the lives of youth and therefore the relationship they have with their school experience is important and may influence their involvement in risk behaviors. Feeling connected to school is a positive asset that can protect youth from such risky behaviors as sexual initiation and alcohol consumption.

Latent Patterns of Risk Behavior in Urban African-American Middle School Students in Baltimore City

Students who engage in high-risk behaviors, including early initiation of sexual intercourse, alcohol use, marijuana use, tobacco use, and externalizing behavior are vulnerable to a broad range of adverse outcomes as adults. Latent class analysis was used to determine whether varying patterns of risk behavior existed for 212 urban African-American students from Baltimore public schools who were recruited as part of a study for the prevention of drug use. A two-class model was estimated. The proportion of the sample bearing a high probability of each of the five risk behaviors was 10.7%; in comparison, the proportion of students with a low probability of the risk behaviors was 89.3%. Controlling for other variables, older age and parental drug or alcohol use was associated with being in the high-risk class, whereas neighborhood was not predictive of latent class. Results from this study may be used to target early adolescents with co-occurring risk behaviors for prevention and treatment.

Sexual Intercourse Among Adolescents Maltreated Before Age 12: A Prospective Investigation

To examine whether child maltreatment (physical, emotional, and sexual abuse, and neglect) predicts adolescent sexual intercourse; whether associations between maltreatment and sexual intercourse are explained by children's emotional distress, and whether relations among maltreatment, emotional distress, and sexual intercourse differ according to gender. The Longitudinal Studies of Child Abuse and Neglect was a multisite, longitudinal investigation. Participants ranged from at-risk to substantiated maltreatment. Maltreatment history was assessed through Child Protective Service records and youth self-report at age 12. Youth reported emotional distress by using the Trauma Symptom Checklist at the age of 12 years and sexual intercourse at ages 14 and 16. Logistic and multiple regressions, adjusting for gender, race, and site, were used to test whether maltreatment predicts sexual intercourse, the explanatory effects of emotional distress, and gender differences. At ages 14 and 16, maltreatment rates were 79% and 81%, respectively, and sexual initiation rates were 21% and 51%. Maltreatment (all types) significantly predicted sexual intercourse. Maltreated youth reported significantly more emotional distress than non-maltreated youth; emotional distress mediated the relationship between maltreatment and intercourse by 14, but not 16. At 14, boys reported higher rates of sexual intercourse than girls and the association between physical abuse and sexual intercourse was not significant for boys. Maltreatment (regardless of type) predicts sexual intercourse by 14 and 16. Emotional distress explains the relationship by 14. By 16, other factors likely contribute to intercourse. Maltreated children are at risk for early initiation of sexual intercourse and sexually active adolescents should be evaluated for possible maltreatment.