Young Minority Women Research Articles

Expanding Research on the Role of Alcohol Consumption and Related Risks in the Prevention and Treatment of HIV_AIDS

This article is a review of some of the major epidemiological, behavioral, biological, and integrative prevention research issues and priorities in the area of HIV_AIDS and alcohol consumption. Drinking alcohol increases both the risk for infection with HIV and related illnesses and the morbidity and mortality of patients who progress to AIDS. New and improved measurement procedures have helped in assessment of the complex patterns of alcohol use, identification of intervening explanatory mechanisms for risk behaviors and contexts, and determination of intervention outcomes. Both the direct and indirect effects of alcohol misuse appear to be major contributors to both the risk for infection with HIV and the transmission of HIV_AIDS at the individual and population levels. There is increasing evidence that perhaps no level of alcohol consumption is “safe” for those who are HIV infected and receiving antiretroviral treatment. Interdisciplinary basic behavioral and biomedical research is needed to develop comprehensive culturally appropriate strategies for programs that can be effectively delivered in community contexts in the United States and abroad and that focus on the integration of our understanding of individual behaviors, high-risk group membership, biological mechanisms, and the social and physical environments that place individuals at risk for HIV infection. High-priority topics include improving adherence to antiretroviral medications, prevention of infection in young minority women in the United States, and treatment of HIV+ pregnant women who are alcohol abusers to prevent adverse fetal outcomes, which is an international focus in under-resourced settings in Africa.

The Role of Postsecondary Education in Welfare Recipients' Paths to Self-Sufficiency

The effectiveness of higher education as a route into self-sustaining employment has been demonstrated by decades of educational and economic research. Despite this, recent policy changes at the federal level have led to a widespread denial of access to postsecondary education for welfare recipients, arguably one of the most economically disadvantaged groups in society. Participants in the recently created Temporary Assistance for Needy Families (TANF) program--implemented as part of the 1996 Personal Responsibility and Work Opportunity Act--are strongly discouraged by requirements set out in federal law from pursuing postsecondary education as a route out of poverty. Instead, shorter-term options such as immediate job search, vocational training that lasts a year or less, and subsidized or unsubsidized employment are among the activities available to assist low-income parents transition to self-sufficiency. In limiting postsecondary educational options to welfare recipients. TANF legislates some of the biases already inherent in societal institutions that steer disadvantaged and minority young women away from higher education. Research has shown that young people with lower socioeconomic status have worse educational outcomes, including lower rates of college attendance and graduation (Bainbridge & Lesley, 2002; Haycock, 2001; Sewell & Shah, 1967). Among those with low socioeconomic status, minority students in particular tend to have lower aspirations for college (Kao & Tienda, 1998). This may disproportionately affect young women, whose socioeconomic status has been shown to be even more important in their college-going decisions than intelligence (Sewell & Shah, 1967). Higher socioeconomic status students' comparatively better educational outcomes are due, in part, to both their more highly educated parents (Haveman, Wolfe, & Spaulding, 1991; Sewell & Shah, 1968) and the higher per-pupil expenditures in their schools (Elliott, 1998). Practices within schools themselves, such as tracking, dissuade some high school students, particularly those with low socioeconomic status and minority backgrounds, from attending college (Rosenbaum, 1976, 1980). Even efforts to de-track schools face hurdles in overcoming long-held attitudes about racial differences, social stratification, and intelligence (Oakes & Wells, 1998). Because welfare recipients disproportionately stem from low socioeconomic status families and minority backgrounds, they would face considerable challenges in pursuing postsecondary degrees, even in the absence of TANF regulations. TANF's anti-higher education stance has the potential to affect both welfare recipients and their children. Research has shown that mother's educational attainment is strongly linked to children's educational achievement (Haveman et al., 1991; Sewell & Shah, 1968). The effects of this policy may reverberate for generations to come. Welfare recipients are not all equally prepared for higher education and, as has been discussed for high school students (Rosenbaum & Person, 2003), should not be universally encouraged to attend. Barriers to employment such as mental health and substance abuse problems, low literacy, and learning disabilities are pervasive among the welfare population (Turner, Danziger & Seefeldt, 2004) and may place postsecondary education out of the immediate reach of a sizeable proportion of welfare recipients. Still, access to higher education can provide a second chance for some women on welfare, particularly the 44% of recipients who had their first child as a teenager (Wertheimer & Moore, 1998). Early parenthood has been shown to have negative effects on educational attainment for women (Ahituv & Tienda, 2004; Marini, 1984) and TANF provides another layer of discouragement for welfare recipients. Research is suggestive of improved outcomes for welfare recipients who attend college while on aid, but few studies have addressed this issue specifically. …

One-year outcomes of a randomized clinical trial treating depression in low-income minority women.

This study examines 1-year depressive symptom and functional outcomes of 267 predominantly lowincome, young minority women randomly assigned to antidepressant medication, group or individual cognitive- behavioral therapy (CBT), or community referral. Seventy-six percent assigned to medications received 9 or more weeks of guideline-concordant doses of medications; 36% assigned to psychotherapy received 6 or more CBT sessions. Intent-to-treat, repeated measures analyses revealed that medication (p=.001) and CBT (p=.02) were superior to community referral in lowering depressive symptoms across 1-year follow-up. At Month 12, 50.9% assigned to antidepressants, 56.9% assigned to CBT, and 37.1% assigned to community referral were no longer clinically depressed. These findings suggest that both antidepressant medications and CBT result in clinically significant decreases in depression for low-income minority women.

Enhancing Recruitment and Retention of Minority Young Women in Community-Based Clinical Research

Women are disproportionately affected by the sexually transmitted infections (STI) epidemic, with African-Americans and Latinos at significantly higher risk for STIs than Caucasians. Successful recruitment and retention strategies used with young minority women in community-based STI prevention or intervention research have not been previously reported. This communication presents eight key strategies learned in the recruitment and retention of 16- to 21-year-old urban women participating in a 12-month randomized clinical trial designed to promote STI screening to decrease the duration of untreated chlamydia and gonorrhea infection. Strategies learned include: (1) Educate clinic staff on the rigors of study design; (2) Facilitate a team effort between clinical and research staff; modify recruitment procedures, as needed; (3) Provide prospective participants the option of enrolling by return appointment; (4) Anticipate a diminishing recruitment pool over time; (5) Set positive recruitment tone at the beginning of each clinic session; (6) Consider participants' mothers as important points of contact; (7) Match communication styles to participant contacts; and (8) Consider a variety of retention techniques. Together, these strategies helped to reinforce participant's commitment to the project, facilitated their attendance at interviews, and encouraged them to adhere to the treatment protocol.

Role-Based Policing: Restraining Police Conduct 'Outside the Legitimate Investigative Sphere'

The last quarter of a century has produced a growing legitimacy crisis in the criminal justice system arising from profound and familiar differences in race and class. The same tactics used to win the War on Crime also harassed and intimidated the very people policing was supposed to protect, sending disproportionate numbers of young minority men and women to prison as part of War On Drugs. In this article, I take up challenge of social norms theorists who advocate empowering police and local communities through a variety of traditional and newly minted public order offenses. My claim is that the sort of preventative policing they advocate, singling out quality of life issues, can and should be separated from reactive investigative policing directed at apprehending criminals. The police, as currently constituted, are simply the wrong people to engage in preventative policing. My proposal is to radically restructure the manner in which we think about the legitimacy of various policing practices and the type of authority wielded by the police. The rule-based attempt to limit police authority through prospective constitutional (and other) norms limiting their ability to search, seize, and interrogate suspects does not work to constrain their ability to police public order and engage in crime prevention. Instead, I propose a series of role-based constraints of the scope of police authority. Much like the separation-of-powers limitation upon the various branches of government, role-based constraints suggest that municipalities should match the authority conferred upon particular government officials to the specific problems to be addressed through public order policing. The appropriate local authorities include bus drivers and crossing guards: municipal officials with no power to engage in investigation but who have the authority to enforce norms of public order. Such officials possess limited institutional legitimacy outside of their various spheres of operation and no role-based authority to engage in the invasive, investigative policing practices currently utilized in predominantly urban areas.

Chlamydia and gonorrhea screening in asymptomatic young women

BackgroundAdolescent and young adult minority women are at high risk for chlamydia (CT) and gonorrhea (NGC) cervical infections, which are significant causes of pelvic inflammatory disease, impaired fertility, ectopic pregnancy and chronic pain. The purpose of this article is to review among young women in the United States: (1) the epidemiology of CT and NGC cervical infection and their medical complications; (2) current public health recommendations to promote asymptomatic CT and NGC screening; (3) current screening practices and challenges of implementing public health recommendations; (4) testing and cost issues; and (5) future directions in promoting asymptomatic CT and NGC screening. MethodsWe conducted a MEDLINE search for articles published over the last two decades relating to CT and NGC screening in young women and then systematically reviewed all relevant articles. ResultsThe data indicate that CT and NGC infection are geographically widespread in the U.S. and asymptomatic infection is highly prevalent among economically disadvantaged young females. Public health recommendations promoting CT and NGC screening in asymptomatic young women are directed to both health care providers and clients. However, strategies to promote screening efforts have been primarily directed toward health care providers; there are no published studies on client-initiated screening strategies. Challenges of implementing public health recommendations and future directions for CT and NGC screening are discussed. ConclusionsYoung sexually active women continue to be at high risk for CT and NGC infection. The data indicate that implementation of health provider-based and client-initiated screening in private and public health care settings is a challenge. However, there is a great need to develop strategies to understand and promote client-initiated screening.

Neural tube defects: knowledge and preconceptional prevention practices in minority young women.

To assess 1) knowledge of neural tube defect (NTD) prevention by folic acid, 2) frequency of intake of multivitamins and folate- and folic acid-fortified food, and 3) factors associated with knowledge and prevention practices among sexually active minority adolescent and young adult women. Young minority women were enrolled in a folic acid program at 3 urban Houston, Texas, reproductive health clinics and assessed for NTD knowledge and preventive practices. A 3-month supply of multivitamins was also dispensed at enrollment. A 3-month program follow-up survey of a randomly selected sample at 2 sites was conducted. Of 387 women (mean age: 18 +/- 1.9 years), 72% were black and 28% were Hispanic. At enrollment, clinics were a major source of information of NTD prevention (44%); 52% had heard of folic acid, 45% had heard of NTDs, and 50% had heard of birth defects prevention by multivitamins. Significantly more Hispanic than black young women had heard of NTDs (59% vs 39%). Pregnancy history, regular birth control use, and education level for age were independently associated with knowledge. In young women with low education level for age, regular birth control use was significantly associated with knowledge. At enrollment, daily multivitamin intake was very low (9%) and folate-rich foods were consumed in inadequate amounts. Adequate folate diet was not associated with knowledge. The program follow-up survey indicated that 88% to 92% had knowledge of NTDs and folic acid, and 67% reported taking a daily multivitamin. Publicly funded clinics may be the only source of information on NTD prevention for many minority young women. Preliminary evidence suggests that a promotion program improves knowledge, and dispensing of multivitamins increases multivitamin use. However, clinicians in such programs need to reinforce daily adherence to multivitamins in young women.

Date and acquaintance rape among urban female teens

Conclusions: The most striking feature among these minority young women was that drinking by the victim or perpetrator was unrelated to rape or attempted rape. Rather past physical aggression was associated with completed or attempted date/acquaintance rape. Among those experiencing sexual coercion the context of their relationship suggests a pattern of coercion including pressure to use alcohol and verbal aggression. (excerpt)

The knowledge and use of birth control in the year 2000: the future needs of minority women

Objective: To assess the knowledge, main complaints, side effects, and satisfaction of minority women using various methods of birth control (BC). Methods: Three hundred thirty randomly selected charts of women using various BC methods were reviewed retrospectively. The study population consisted mainly of African-American (AA) and Hispanic (HP) women. Results: The most common methods of BC used by AA and HP women were condomS (28%), BC pills (19%), and Depo-Provera (13%). Main complaints were weight gain, breakthrough bleeding, nausea, and vomiting. The side effects and other complications were comparable between the two groups. Significant numbers (65%) of younger AA and HP women (median age: 24 years) expressed a strong desire to learn more about BC compared with older women (median age: 29 years). The abortion rate was significantly ( P = 0.01) higher in younger (<30 years) AA and HP women compared with older groups who used BC methods. Conclusion: The findings demonstrate that young minority women have insufficient knowledge about BC methods and the health benefits and relative risks of BC. To reduce the high rate of abortions and the risk of unplanned or unwanted and ectopic pregnancies, as well as future fertility, more counseling is needed for minority women.

Periodontal infections and pre-term birth: early findings from a cohort of young minority women in New York.

The aim of this report is to provide early data from an ongoing study examining (i) the relationship between periodontal infections and pre-term low birth weight (PLBW) in a cohort of young, minority, pregnant and post-partum women; and (ii) the effect of periodontal interventions on pregnancy outcome. During the first 2 yr of the study, 213 women were enrolled and examined clinically for dental plaque, calculus, bleeding on probing, and probing depth. Birth outcome data were available for 164 women, including one group (n = 74) subjected to oral prophylaxis during pregnancy, and a second group (n=90) who received no prenatal periodontal treatment. Subgingival plaque samples were available from 145 subjects (4 samples/subject) and were analyzed by checkerboard DNA hybridization with respect to 12 bacterial species. The prevalence of PLBW was 16.5% (27 cases) in this cohort. No differences in clinical periodontal status were observed between PLBW cases and women with normal birth outcome. However, PLBW mothers had significantly higher levels of Bacteroides forsythus and Campylobacter rectus, and consistently elevated counts for the other species examined. PLBW occurred in 18.9% of the women who did not receive periodontal intervention (17 cases), and in 13.5% (10 cases) of those who received such therapy.

Pap smear screening practices in newcomer women

world.‘r2 incidence and mortality rates in Canada and other parts of the However, many women are still at risk for this disease. These women include sexually active young females3 and minority women with language and cultural barriers to health services.4 The Canadian Task Force for Cervical Cancer Screening’ recommends that all women have a Pap test when they first become sexually active and be retested within 1 year. Rescreening should be done every 3 years until age 69, if the first two tests are normal. Women who are sexually active at an early age and those with multiple sexual partners should have an annual Pap test. Despite these guidelines, many Canadian women never have a smear test or are not tested regularly. The 1990 Canada’s Health Promotion Survey5 revealed that 30% of women had not had a Pap test within 3 years of the survey, and 21% of sexually active women reported never being screened. The few available studies on Pap smear screening patterns among ethnic minority women show that although blacks are screened at similar or higher rates than whites, women of ethnic minority groups are least likely to have received a Pap test6j7 and have lower cancer survival rates when compared with whites8 Disparity in health status thus exists between ethnic-minority groups and the larger population. Recent immigrants in Canada are more diverse than those of the last immigration surge in terms of national, linguistic, religious, racial, and cultural backgrounds.’ They are more at risk for diseases than is mainstream society because of their curative rather than preventive health practices. During their immigration process, newcomers are often preoccupied with stresses from unemployment, isolation, misplacement, or discrimination. They do not view preI,entive health care such as cancer prevention as a priority.rO Thus, an understanding of the patterns of cancer screening practices among ethnic minority women should enable health care providers to better assess and respond to their health needs. The author examines newcomer women’s Pap smear

Injuries among inner-city minority women: a population-based longitudinal study.

Active emergency department-based surveillance was conducted to determine the incidence of fatal and nonfatal injuries in an urban, female African American population from 1987 through 1990. Nearly 40% of the women studied sustained one or more injuries that required emergency care or resulted in death. By 1989, violence had surpassed falls as the leading cause of injuries, the rate increased by 55% over the study period. Injury rates were highest among young women for nearly every major cause of injury. The rate of death due to injuries was also highest among young women, for whom violence was the leading cause of death. In summary, injuries to women in this inner-city minority community were extremely common and increased significantly from 1987 to 1990. Injuries in young inner-city minority women should be considered a priority health problem in the United States.

Attracting young minority women to engineering and science: necessary characteristics for exemplary programs

A national educational imperative has been issued to reverse the trend of declining numbers of students choosing to study engineering and science. Minority women are particularly underrepresented in engineering and science, but in order to reach this pool of talent, the special concerns that affect young minority women must be recognized and programs that deal with these concerns must be developed. One such program offered at The George Washington University (GW) and funded by the National Science Foundation (NSF) from 1989 through 1993, utilizes computer technology and cooperative learning in a university setting to interest young minority women in engineering and science careers. As a result of the success of the GW/NSF program, a two-day working conference of experts was convened to determine the characteristics of exemplary programs that focus on this population. Outcomes from the conference included a criteria checklist, a program planning and self-evaluation guide, and suggestions for a national clearinghouse of information about exemplary programs designed to attract young minority women to engineering and science.< <ETX xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">&gt;</ETX>

Linkages Between Sexual Activity and Alcohol and Drug Use Among American Adolescents

Among a nationally representative cohort of young men and women reaching maturity in the late 1970s and early 1980s, over three-fourths of males and half of females had sexual intercourse by age 19, and a substantial minority used marijuana prior to their 16th birthday. However, in most cases, much smaller proportions began weekly alcohol consumption, tried drugs besides marijuana or experienced sexual intercourse before age 16. Males are generally more likely to have begun participating in these activities, at all ages, than are females. Only modest percentages of youths participated in more than one activity at early ages or engaged in them in close proximity to one another. Indeed, only by age 19 did even one-third of the young women engage in sexual intercourse and use both marijuana and alcohol. In fact, the norm for girls under 17 and for boys under 16 is either abstention or participation in just one activity. Although younger blacks are more likely to have initiated sexual activity than are their white or Hispanic counterparts, young minority women are less likely than white women to have begun using alcohol or marijuana. Young people who use one or more substances by a given age are more likely than those who do not to become sexually active within a year. However, marijuana use at a young age appears to be more strongly linked to subsequent sexual initiation than is regular monthly alcohol use.(ABSTRACT TRUNCATED AT 250 WORDS)