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Descriptors:
Acquired Immunodeficiency Syndrome (AIDS); Prevention; Sexually Transmitted Diseases; Young Adults; Adolescents; Incidence; At Risk Persons; Sexuality; Health Promotion; Access to Health Care; Family Programs; Social Influences; Social Bias; Minority Groups; African Americans; Hispanic Americans; Homosexuality; Models; Telecommunications; Educational Technology

Abstract:
The World Health Organization estimates that 50% of the 30 million HIV infections worldwide occurred in young people between the ages of 15 and 24 years. In the United States, national statistics estimate that almost 40% of new HIV cases occur in youth ages 13-29 (Centers for Disease Control and Prevention, 2011). Therefore, a focus on preventing HIV/AIDS among adolescents and young adults is warranted. There has been success in developing efficacious interventions for adolescents that reduce HIV sexual risk behaviors; however, the HIV incidence rates among adolescents remain alarming. This article identifies four areas of intervention development that remain underdeveloped and may guide the next generation of HIV prevention interventions. Family-based interventions, addressing health disparities and understanding the social determinants of health for adolescents, expanding the theoretical models that are relied on in developing interventions, and utilization of new technologies each have promise for successfully assisting adolescents to reduce their risk behaviors and enhance protective factors. Note:The following two links are not-applicable for text-based browsers or screen-reading software. Show Hide Full Abstract

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Descriptors:
Acquired Immunodeficiency Syndrome (AIDS); Scripts; Disease Control; Prevention; Sexually Transmitted Diseases; Friendship; Young Adults; Interviews; Homosexuality; Gender Differences; Interpersonal Communication; Safety; Health Behavior; Risk

Abstract:
Young adults, particularly young gay men (YGM), are vulnerable to human immunodeficiency virus (HIV). Yet, little is known about how YGM discuss sexual health issues with their friends ("gay boy talk"). We conducted semi-structured interviews with YGM and their best friends (11 YGM/YGM dyads and 13 YGM/heterosexual female dyads). In this paper, we examine risk assessment assumptions conveyed within YGM's communication about sexual health with their friends and how, if at all, the sexual scripts guiding these assumptions may differ between YGM and young women. Findings demonstrated that, while these young adults clearly intended to support their friends and promote safer sex, they also conveyed assumptions about HIV risk assessment, especially regarding sexual partner selection, that may actually increase their friends' risk for HIV infection. Since inaccurate HIV risk assessment assumptions were transmitted via sexual health communication between peers, it is suggested that such assumptions may need to be addressed in HIV prevention programs working with YGM and their friends. Further, gender differences were identified within the sexual scripts shared between YGM and their friends, suggesting that such interventions should be tailored to the specific needs of different friendship networks. Note:The following two links are not-applicable for text-based browsers or screen-reading software. Show Hide Full Abstract

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Descriptors:
Acquired Immunodeficiency Syndrome (AIDS); Prevention; Sexually Transmitted Diseases; African Americans; Young Adults; Males; Sexual Identity; Homosexuality; Sexual Orientation; Subcultures; Mixed Methods Research; Holistic Approach; Urban Areas; Health Programs; Program Effectiveness; Poverty; Housing; Job Training

Abstract:
African-American young men who have sex with men and transgender persons are at elevated risk for HIV infection. House and Ball communities, networks of mostly African-American gay, bisexual, and transgender individuals who compete in modeling and dance, represent a prime venue for HIV prevention with these difficult-to-reach populations; however, little research exists on effective approaches to HIV prevention within these communities. Using a mixed-methods approach, the present study sought to document participation in HIV prevention activities of a sample from the Los Angeles House and Ball communities (n = 263) in order to inform future service development. While 80% of participants were tested for HIV within the past 6 months, only 26% report HIV prevention program attendance. House leaders recommend a holistic approach to HIV prevention, one that incorporates attention to social problems beyond HIV, including poverty, housing difficulties, and lack of job training. Note:The following two links are not-applicable for text-based browsers or screen-reading software. Show Hide Full Abstract

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Descriptors:
Youth; Caregivers; Children; Adolescents; Young Adults; Experience; Decision Making; Aspiration; Barriers; Comparative Analysis; Education; Employment; Social Life; Health; Well Being; Social Services; Interviews; Questionnaires; Foreign Countries

Abstract:
This paper presents the findings from a project investigating the circumstances, experiences, perspectives and service needs of young people caring for a family member with a disability or long-term illness. Using qualitative methods, our research explored the experiences of two cohorts of young carers--younger carers aged 7 to 17 years and young adult carers aged 18 to 25 years. The concept of "bounded agency" offers an explanation for the way that younger carers' and young adult carers' decisions and aspirations can be shaped by the barriers and contexts in which they find themselves. The study compares the impacts of caring on the participants' education, employment, health and social life. Important differences are identified, particularly relating to young adult carers' future aspirations as they approach key normative transitions into young adulthood. The paper concludes with implications for services and policy for young carers. (Contains 1 table.) Note:The following two links are not-applicable for text-based browsers or screen-reading software. Show Hide Full Abstract

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Descriptors:
Psychopathology; Child Abuse; Smoking; Adolescents; Alcohol Abuse; Drug Abuse; Homosexuality; Depression (Psychology); Suicide; Housing; Sexual Orientation; Mental Disorders; Psychiatry; Victims; At Risk Persons; Homeless People; Family Violence; Young Adults; Incidence; Correlation; Psychological Patterns

Abstract:
Objectives: Lesbian, gay, and bisexual (LGB) populations exhibit elevated rates of psychiatric disorders compared to heterosexuals, and these disparities emerge early in the life course. We examined the role of exposure to early-life victimization and adversity--including physical and sexual abuse, homelessness, and intimate partner violence--in explaining sexual orientation disparities in mental health among adolescents and young adults. Methods: Data were drawn from the National Longitudinal Study of Adolescent Health, Wave 3 (2001-2002), a nationally representative survey of adolescents. Participants included gay/lesbian (n=227), bisexual (n=245), and heterosexual (n=13,490) youths, ages 18-27. We examined differences in the prevalence of exposure to child physical or sexual abuse, homelessness or expulsion from one's home by caregivers, and physical and sexual intimate partner violence according to sexual orientation. Next we examined the associations of these exposures with symptoms of psychopathology including suicidal ideation and attempts, depression, binge drinking, illicit drug use, tobacco use, alcohol abuse, and drug abuse. Finally, we determined whether exposure to victimization and adversity explained the association between sexual orientation and psychopathology. Results: Gay/lesbian and bisexual respondents had higher levels of psychopathology than heterosexuals across all outcomes. Gay/lesbian respondents had higher odds of exposure to child abuse and housing adversity, and bisexual respondents had higher odds of exposure to child abuse, housing adversity, and intimate partner violence, than heterosexuals. Greater exposure to these adversities explained between 10 and 20% of the relative excess of suicidality, depression, tobacco use, and symptoms of alcohol and drug abuse among LGB youths compared to heterosexuals. Exposure to victimization and adversity experiences in childhood and adolescence significantly mediated the association of both gay/lesbian and bisexual orientation with suicidality, depressive symptoms, tobacco use, and alcohol abuse. Conclusions: Exposure to victimization in early-life family and romantic relationships explains, in part, sexual orientation disparities in a wide range of mental health and substance use outcomes, highlighting novel targets for preventive interventions aimed at reducing these disparities. (Contains 4 tables.) Note:The following two links are not-applicable for text-based browsers or screen-reading software. Show Hide Full Abstract

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Descriptors:
Acquired Immunodeficiency Syndrome (AIDS); Health Promotion; Mothers; Prevention; Sexually Transmitted Diseases; Pregnancy; Parent Child Relationship; Sexuality; Child Health; Adolescents; Age Differences; Health Behavior; Access to Information; Self Esteem; Interpersonal Communication; Disease Control

Abstract:
Mothers play an important role in promoting the sexual health of their adolescent children. Fifty-seven HIV-positive mothers with adolescent children participated in an in-depth, qualitative interview regarding whether they have talked to their children about safer sex and sexually transmitted disease (STD) prevention, including at what age they began such discussions and what messages they gave to their children. The majority of mothers (95%) had talked with their child about safer sex; some began such discussions when the children were as young as 6 years old, but most began when the children were around 12 years old. Mothers' messages fell into the following areas: (a) protecting oneself from STDs; (b) giving factual information regarding STDs, including HIV; (c) avoiding pregnancy; (d) empowering and respecting oneself; and (e) communicating with sexual partners. The mothers' own HIV status affected the discussions with their children. Content of mothers' messages, child reactions, and child outcomes are discussed. Note:The following two links are not-applicable for text-based browsers or screen-reading software. Show Hide Full Abstract

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Descriptors:
Medical Services; Age; Mental Disorders; Health Insurance; Suicide; Young Adults; Adolescents; Patients; Foreign Countries; Health Services; Gender Differences; Prevention; Prediction

Abstract:
The characteristics of health care utilization during the last year of life by Taiwanese who died by suicide were analyzed. The degree of health services utilization was evaluated by extracting the data of National Health Insurance (NHI) outpatient cohort records in 2006. A total of 4,406 fatal suicide cases were matched with the 17,587,901 subjects in the NHI beneficiary registry file. Rate of visit of the suicide decedents for all NHI outpatient services during their last year before death was 85%, and that for mental disorders service only was 30.2%. Average number of visits per person-year of the suicide decedents was 24.5 visits per year, two times higher than that of the survivors. The average numbers of visits (ANV) of male suicide decedents who used the mental disorders services was increased 6.8 times compared to that for all survivors. The increase in female decedents, in contrast, was 2.7 times. The increase in ANV for 15-24 age group was 14.6 times, significantly higher than that for the other age groups (less than 4 times). Effective prediction or prevention of potential suicides through increased awareness and surveillance of medical care resource utilization is possible, especially for male and young adult patients under mental disorder health care. (Contains 2 tables and 1 figure.) Note:The following two links are not-applicable for text-based browsers or screen-reading software. Show Hide Full Abstract

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Descriptors:
Pregnancy; Sexuality; Females; Evidence; Sexually Transmitted Diseases; Sex Education; Foreign Countries; Hidden Curriculum; History; Adolescents; Prevention; Birth; Educational Attainment; Role; Personal Autonomy; Age; Well Being; Health

Abstract:
Historical studies have shown that, since its beginnings, sex education in England has mostly focused on "damage limitation", emphasising only the dangerous inevitability of pregnancy and childbirth after unprotected sex and the hazards of sexually transmitted diseases. This approach is largely based on restrictive notions of teenage sexuality, characterising teenagers as hypersexual beings for whom sexual drives continuously threaten to produce unwanted babies unless preventive action is taken. Analysis of current materials from many curricular areas reveals that this is still the case. Yet, recent demographic evidence shows that educated women in Europe continue to delay first childbirth for a number of reasons. At the same time they are also subject to seductive and deceptive media messages about the possibilities of conception at late reproductive age through reporting on "older" celebrity mothers, and the role that reproductive technologies play in conquering infertility. In the light of these demographic trends, and the misleading hidden curriculum, this paper contends that discourses of damage limitation are no longer appropriate in sex education. Instead, if educated women are to gain full reproductive autonomy then new, more balanced conceptualisations of sex education that also incorporate appropriate messages about the finite nature of the reproductive lifespan are needed. Not only will this help schools provide comprehensive, quality, progressive sex education, it will also ultimately contribute to future national health and well-being. (Contains 2 notes.) Note:The following two links are not-applicable for text-based browsers or screen-reading software. Show Hide Full Abstract

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Descriptors:
Drug Use; Suicide; Drinking; Sexual Orientation; Young Adults; Homosexuality; Adolescents; Longitudinal Studies; Family Relationship; Parent Child Relationship; Gender Differences; Depression (Psychology); Symptoms (Individual Disorders); Alcohol Abuse; Correlation; Health; Mental Health; Intervention

Abstract:
Some recent studies suggest that sexual minorities may have worse health-related outcomes during adolescence because they report lower levels of family connectedness, a key protective resource. Using data from wave 3 of the National Longitudinal Study of Adolescent Health (n = 11,153; 50.6% female; mean age = 21.8 years), this study extends prior research on adolescents to young adults. We examine whether lesbian, gay, and bisexual (LGB) young adults report lower levels of parental support than their heterosexual peers and whether differences in parental support help explain why LGB young adults tend to have worse health-related outcomes. We find that lesbian and bisexual women report lower levels of parental support than heterosexual women and that gay men report lower levels of parental support than bisexual and heterosexual men. Compared to heterosexual women, lesbian and bisexual women have higher odds of suicidal thoughts and recent drug use; bisexual women also have higher odds of elevated depressive symptomatology and heavy drinking. Gay men have higher odds of suicidal thoughts than heterosexual men. With the exception of heavy drinking, parental support either partially or fully mediates each of the observed associations. Even though the transition from adolescence to young adulthood is characterized by increased independence from parents, parental support remains an important correlate of health-related outcomes during this stage of life. Sexual minorities report lower levels of parental support during young adulthood, which helps explain why they have worse health-related outcomes. Interventions designed to strengthen relationships between LGB young adults and their parents could lead to a reduction in health disparities related to sexual orientation. Note:The following two links are not-applicable for text-based browsers or screen-reading software. Show Hide Full Abstract

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Descriptors:
Secondary School Students; Marijuana; Mental Health; Suicide; Drinking; Sexual Orientation; Sexuality; Substance Abuse; Adolescents; Young Adults; Comparative Analysis; Homosexuality; Depression (Psychology); Psychological Patterns; Smoking; Alcohol Abuse; Gender Differences

Abstract:
Previous research suggests that sexual minority youth have poorer health-related outcomes than their heterosexual peers. The purpose of this study is to determine whether sexual orientation disparities in mental health and substance use increase, decrease, or remain the same during the transition from adolescence to adulthood. Data are from Waves 1-4 of the National Longitudinal Study of Adolescent Health (n = 8,322; 55% female). Respondents were in grades 7-12 at Wave 1 and aged 24-32 at Wave 4. Latent growth curve modeling is used to compare the mental health and substance use trajectories of youth who consistently report heterosexual attraction versus those who consistently report lesbian, gay, or bisexual (LGB) attraction, those who report a transition to LGB attraction, and those who report a transition to heterosexual attraction. Among women and men, sexual orientation disparities in depressive symptoms and suicidal thoughts persist, but do not increase, during the transition from adolescence to adulthood. The same pattern is observed for disparities in smoking, heavy drinking, and marijuana use among women. Among men, disparities in substance use are only observed between those who report consistent heterosexual attraction and those who transition to heterosexual attraction. Disparities between these groups persist over time for heavy drinking and marijuana use but decrease over time for smoking. While this study finds evidence of numerous disparities in mental health and substance use outcomes during adolescence and young adulthood, particularly among young women, there is no indication that these disparities get larger over time. Note:The following two links are not-applicable for text-based browsers or screen-reading software. Show Hide Full Abstract

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