scholarly journals 596 Although teen pregnancy, defined by the US Centers for Disease Control and Prevention as pregnancies between the ages of 15 and 19, has declined in the US over recent years to 16.7 births per 1000 girls, it continues to represent an enormous risk factor for poorer economic, educational, and health outcomes, both for the teen and the baby.1 Sexually transmitted infections (STIs) also continue to be a concern among this age group, with nearly half of the 26 million new STIs reported each year occurring in young people aged 15 to 24.2 To mitigate this problem, the US Department of Health and Human Services (USDHHS) provides funding to organizations and communities to prevent teen pregnancy and sexually transmitted infections (STIs). Unfortunately, reviews of the evaluations of these programs show limited positive impacts on pregnancy, sexual delay, and STI prevention methods or contraceptive use.3,4 Juras et al4 conducted a meta-analysis of 34 of the 43 adolescent pregnancy prevention program evaluations funded by the USDHHS between 2010 and 2016. On average, the programs showed small, statistically non-significant improvements in sexual risk behaviors and in pregnancy and STI Kayla Knopp, University of California San Diego School of Medicine, San Diego, CA, United States. Galena K. Rhoades, Research Professor, Department of Psychology, University of Denver, Denver, CO, United States. Lisa A. Rue, Senior Advisor for Adolescent and Behavioral Health at cliexa, Denver, CO, United States. Michael A. Floren, Assistant Professor of Data Analytics, Department of Finance, Economics and Data Analytics, University of North Alabama, Florence, AL, United States. Kiley M. Floren, Director of Evaluation Services at Practical Statistics, Florence, AL, United States. Correspondence Dr Knopp; [email protected] Messaging Considerations in Teen Pregnancy and Sexually Transmitted Infection Prevention

2021 ◽  
pp. 596-608
Author(s):  
Kayla Knopp ◽  
Galena Rhoades ◽  
Lisa Rue ◽  
Michael Floren ◽  
Kiley Floren
Keyword(s):  
United States ◽  
Health Outcomes ◽  
Teen Pregnancy ◽  
Data Analytics ◽  
Future Research ◽  
Transmitted Infection ◽  
Sti Prevention ◽  
Sexually Transmitted ◽  
The Us ◽  
Multiple Messages

Objective: Teen pregnancy and sexually transmitted infection (STI) prevention are top public health goals. Despite decades of research, programs to prevent adverse sexual health outcomes among adolescents show limited effectiveness in broad dissemination. In the current study, we aimed to identify understudied factors that may impact effectiveness of teen pregnancy and STI prevention (TPP) programs, with goals of informing innovation in program development and outlining future research priorities. Methods: A panel of experts in TPP programs generated a list of understudied constructs in evaluation research, distilled to 3 considerations regarding messaging: single versus multiple messages, adverse effects of safety messages, and sociocultural context. We conducted an exploratory search of published literature in health promotion fields targeted toward messaging strategies, and we synthesized information from relevant empirical and review papers. Results: Limited evidence was found suggesting multiple messages or adverse message impacts are likely to impair TPP program effectiveness overall, although both may emerge in certain contexts and populations. In contrast, considerable evidence highlighted the importance of cultural context and individual differences. Conclusions: Effective TPP program messaging should be consistent, tailored, and systemic. Future research should evaluate these messaging strategies to determine whether they may enhance program impacts.

scholarly journals 1544. Sexually Transmitted Infection Laboratory Testing and Education Trends Among Physician Office Visits in the United States, 2009-2016

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S771-S771
Author(s):  
Amina R Zeidan ◽  
Kelly R Reveles
Keyword(s):  
United States ◽  
Laboratory Testing ◽  
The United States ◽  
Age Group ◽  
The South ◽  
Transmitted Infection ◽  
Sti Prevention ◽  
Prevention Education ◽  
Sexually Transmitted ◽  
Sti Testing

Abstract Background Rates of sexually transmitted infections (STIs) have been rising in the United States (US). Physician offices play an important role in providing both STI prevention and education, as well as STI laboratory testing options for patients who present at risk. However, few studies have documented the extent to which physician’s offices have contributed to prevention and testing efforts. We address this gap by evaluating STI testing and education provided in US physician offices from 2009 to 2016. Methods This was a cross-sectional study of the Centers for Disease Control and Prevention’s National Ambulatory Medical Care Survey (NAMCS) from 2009 to 2016. Data weights were applied to extrapolate sample data to national estimates. Testing for HIV, HPV, Chlamydia (2009 – 2016) and Hepatitis and Gonorrhea (2014 – 2016) were presented as testing visits per 1,000 total visits. Subgroup analyses were performed for age group, sex, and geographical region by individual STI test and receipt of STI prevention education. Results A total of 7.6 billion visits were included for analysis, of which 0.6% included an STI test. Testing rates increased over the study period for Chlamydia (R2=0.27), HPV (R2=0.28), and HIV (R2=0.51). Peak testing occurred in 2015 for all tests. STI prevention education was provided to 0.5% of patients. Females were tested at a higher rate for all STIs (4.2%) compared to males (0.4%). Females also received more STI prevention education overall (0.6% versus 0.4%, respectively). While the age group 25 – 24 accounted for highest Hepatitis (15.9%) and HPV (11.3%) testing rates, the 15 – 24 age group had the highest overall testing rate (9.4%). STI testing was highest in the South region (Figure 1). Conclusion STI testing in US physician offices increased in recent years. Females accounted for the majority of STI testing and STI prevention education. Testing was more frequent among patients 15 – 24 years old and those seen in the South region. Further research should be conducted to determine reasons for differences in testing and education amongst sex, age group, and geographic region. Disclosures All Authors: No reported disclosures

Perceived Discrimination and Health: Integrative Findings

2018 ◽  
pp. 442-456 ◽  
Author(s):  
Adolfo G. Cuevas ◽  
David R. Williams
Keyword(s):  
United States ◽  
Health Outcomes ◽  
National Health ◽  
Perceived Discrimination ◽  
Social Groups ◽  
The United States ◽  
Health Study ◽  
Future Research ◽  
Priority Areas

The Midlife in the United States (MIDUS) study was the first national health study to include a comprehensive battery to measure both major acute and chronic experiences of discrimination. Studies using MIDUS data have made significant contributions to the growing area of research on discrimination and health. This chapter provides an overview of research on discrimination and health, giving special attention to how findings from the MIDUS study have contributed to this literature. It provides a description of the discrimination instruments in MIDUS and summarizes key MIDUS findings that have examined discrimination in relation to health outcomes. This chapter outlines priority areas for future research. With growing recognition of the need to better understand the conditions under which specific aspects of discrimination are pathogenic for particular social groups, this chapter highlights the importance of using MIDUS to reach these goals.

scholarly journals Association between intensity of STI screening and development of antimicrobial resistance in N. gonorrhoeae in 12 cities in the USA: An ecological study

F1000Research ◽  
2018 ◽  
Vol 7 ◽  
pp. 1237
Author(s):  
Chris R. Kenyon
Keyword(s):  
United States ◽  
Antimicrobial Resistance ◽  
Ecological Study ◽  
Geometric Mean ◽  
The United States ◽  
Transmitted Infection ◽  
Sexually Transmitted ◽  
Antimicrobial Sensitivity ◽  
The Usa ◽  
Sex With Men

In this study, we assessed if there was a city-level association between sexually transmitted infection (STI) screening intensity in men who have sex with men and antimicrobial sensitivity in Neisseria gonorrhoeae in the United States, 2007 to 2013.  We found positive associations between STI screening intensity and increases in minimum inhibitory concentrations for cefixime and azithromycin, but not ceftriaxone when using change in city geometric mean N. gonorrhoeae MIC between 2005 and 2013.

Acceptability of a digital patient notification and linkage-to-care tool for French PrEPers (WeFLASH©): Key stakeholders' perspectives

2019 ◽  
Vol 30 (14) ◽  
pp. 1397-1407
Author(s):  
David Lessard ◽  
Alexandre Aslan ◽  
Jérémy Zeggagh ◽  
Stéphane Morel ◽  
David Michels ◽  
...  
Keyword(s):  
Linkage To Care ◽  
Epidemiological Data ◽  
Management Decision ◽  
Time Data ◽  
Transmitted Infection ◽  
Sti Prevention ◽  
Sexually Transmitted ◽  
Sex With Men ◽  
Access To Data ◽  
Exposure Prophylaxis

The objective of this study was to describe stakeholders’ perspectives on the acceptability of WeFLASH© (AADISS, Paris, France), a digital smartphone sexually transmitted infection (STI) patient notification (PN) tool to be launched among French HIV pre-exposure prophylaxis users (PrEPers). In Paris, Lyon, and Nice, we conducted 2-hour focus group discussions with PrEPers (n = 21) and community mediators (n = 10), and one-on-one interviews with PrEP-prescribing physicians (n = 5) and HIV/STI management decision-makers (n = 4). Recordings were transcribed. The analysis focused on perceived benefits and risks. Concerning benefits, participants mentioned that WeFLASH© could provide: improved PN and STI screening, by refining the notification of anonymous partners; customized linkage-to-care, by providing users with tailored information on care; and transferable epidemiological data, by filling a need for real-time data. Participants anticipated risks for: privacy and confidentiality and suggested specific security settings to protect users’ identity; sexual behavior and suggested game-like functions to improve the integration of the tool in sexual contexts; and fairness and emphasized the importance of making WeFLASH© accessible to all men who have sex with men. WeFLASH© could facilitate PN for an increasing proportion of anonymous partners met online, and empower users, including notified partners, on questions of confidentiality and consent, access to STI prevention and screening services, and access to data.

scholarly journals Demographics and health profile on precursors of non-communicable diseases in adults testing for HIV in Soweto, South Africa: a cross-sectional study

BMJ Open ◽  
2019 ◽  
Vol 9 (12) ◽  
pp. e030701 ◽  
Author(s):  
Kathryn L Hopkins ◽  
Khuthadzo Hlongwane ◽  
Kennedy Otwombe ◽  
Janan Dietrich ◽  
Mireille Cheyip ◽  
...  
Keyword(s):  
South Africa ◽  
Health Outcomes ◽  
Communicable Disease ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Transmitted Infection ◽  
Cross Sectional ◽  
Infected People ◽  
Sexually Transmitted ◽  
Group Sex

ObjectivesThis cross-sectional study investigated the burden of HIV-non-communicable disease (NCD) precursor comorbidity by age and sex. Policies stress integrated HIV-NCD screenings; however, NCD screening is poorly implemented in South African HIV testing services (HTS).SettingWalk-in HTS Centre in Soweto, South Africa.Participants325 voluntary adults, aged 18+ years, who provided written or verbal informed consent (with impartial witness) for screening procedures were enrolled.Primary and secondary outcomesData on sociodemographics, tuberculosis and sexually transmitted infection symptoms, blood pressure (BP) (≥140/90=elevated) and body mass index (<18.5 underweight; 18.5–25.0 normal; >25 overweight/obese) were stratified by age-group, sex and HIV status.ResultsOf the 325 participants, the largest proportions were female (51.1%; n=166/325), single (71.5%; n=231/323) and 25–34 years (33.8%; n=110/325). Overall, 20.9% (n=68/325) were HIV infected, 27.5% (n=89/324) had high BP and 33.5% (n=109/325) were overweight/obese. Among HIV-infected participants, 20.6% (14/68) had high BP and 30.9% (21/68) were overweight/obese, as compared with 29.3% (75/256) and 12.1% (31/256) of the HIV-uninfected participants, respectively. Females were more likely HIV-infected compared with males (26.5% (44/166) vs 15.1% (24/159); p=0.012). In both HIV-infected and uninfected groups, high BP was most prevalent in those aged 35–44 years (25% (6/24) vs 36% (25/70); p=0.3353) and >44 years (29% (4/14) vs 48% (26/54); p=0.1886). Males had higher BP than females (32.9% (52/158) vs 22.3% (37/166); p=0.0323); more females were overweight/obese relative to males (45.8% (76/166) vs 20.8% (33/159); p<0.0001). Females were more likely to be HIV infected and overweight/obese.ConclusionAmong HTS clients, NCD precursors rates and co-morbidities were high. Elevated BP occurred more in older participants. Targeted integrated interventions for HIV-infected females and HIV-infected people aged 18–24 and 35–44 years could improve HIV public health outcomes. Additional studies on whether integrated HTS will improve the uptake of NCD treatment and improve health outcomes are required.

Acculturative Stress and Bicultural Stress

2017 ◽  
Author(s):  
Andrea Romero ◽  
Brandy Piña-Watson
Keyword(s):  
Mental Health ◽  
United States ◽  
Acculturative Stress ◽  
Immigration Policy ◽  
The United States ◽  
Cultural Conflict ◽  
Future Research ◽  
Policy Context ◽  
The Us ◽  
Bicultural Stress

This chapter discusses the concepts of acculturative and bicultural stress, the theory and method behind the measurement, and the implications of the US immigration policy context for stress. The central sources of acculturative and bicultural stress are reviewed, including intergroup discrimination, language stress, intragroup marginalization, and family cultural conflict. In particular, literature is reviewed that examines the association between mental health and acculturative or bicultural stress. Extant research does demonstrate that degree of stress varies for individuals and that acculturative/bicultural stress is experienced not only by immigrants but also by minorities in the United States. Therefore, the present chapter reviews literature that connects the acculturative/bicultural stress process across generations. The immigration context is considered for future research in the area of acculturation and stress.

scholarly journals Polarization and the Judiciary

2019 ◽  
Vol 22 (1) ◽  
pp. 261-276 ◽  
Author(s):  
Richard L. Hasen
Keyword(s):  
United States ◽  
Supreme Court ◽  
Separation Of Powers ◽  
The United States ◽  
Future Research ◽  
Political Actors ◽  
The Us ◽  
Us Supreme Court ◽  
Selection Mechanisms ◽  
Federal Judges

The increased polarization in the United States among the political branches and citizenry affects the selection, work, perception, and relative power of state and federal judges, including justices of the US Supreme Court. Polarization in the United States over the last few decades matters to the American judicial system in at least four ways. First, polarization affects judicial selection, whether the selection method is (sometimes partisan-based) elections or appointment by political actors. In times of greater polarization, governors and presidents who nominate judges, legislators who confirm judges, and voters who vote on judicial candidates are more apt to support or oppose judges on the basis of partisan affiliation or cues. Second, driven in part by selection mechanisms, polarization may be reflected in the decisions that judges make, especially on issues that divide people politically, such as abortion, guns, or affirmative action. The Supreme Court, for example, often divides along party and ideological lines in the most prominent and highly contested cases. Those ideological lines now overlap with party as we enter a period in which all the Court liberals have been appointed by Democratic presidents and all the Court conservatives have been appointed by Republican presidents. Third, increasingly polarized judicial decisions appear to be causing the public to view judges and judicial decision making (at least on the US Supreme Court) through a more partisan lens. Fourth, polarization may affect the separation of powers, by empowering courts against polarized legislative bodies sometimes paralyzed by gridlock. The review concludes by considering how increased polarization may interact with the judiciary and judicial branch going forward and by suggesting areas for future research.

Association between number of sexual partners and utilization of family planning and sexually transmitted infection services by men aged 15–44 in the United States

2019 ◽  
Vol 52 (1) ◽  
pp. 14-26
Author(s):  
Mian B. Hossain ◽  
Yvonne Bronner ◽  
Ifeyinwa Udo ◽  
Sabriya Dennis
Keyword(s):  
United States ◽  
Family Planning ◽  
Health Services ◽  
Black Men ◽  
The United States ◽  
Sexual Partners ◽  
Family Planning Services ◽  
Sexually Transmitted ◽  
The Us ◽  
Number Of Sexual Partners

AbstractUnintended pregnancy and sexually transmitted infections (STIs) pose a huge public health problem in the United States. Efforts towards reducing unintended pregnancies have previously focused on women, but the role of men in family planning and preventing unwanted pregnancy is becoming clearer. The primary objective of the study was to fully examine the utilization of family planning services by men in the US, and to determine whether factors such as race, health insurance type and number of sexual partners influenced their utilization and receipt of family planning services and STI-related health services. Data were from the 2006–2010 National Survey on Family Growth (NSFG) study conducted in the US. The study sample comprised 7686 men aged 14–44 who ever had sex with women, and who had had at least one sexual partner in the 12 months before the survey. The receipt of family planning and STI-related health services by this group of men was estimated. The results showed that non-Hispanic Black men were more likely to receive family planning and STI-related services than Hispanic and non-Hispanic White males. Given that non-Hispanic Black men are disproportionately affected by STIs and are a high-risk group, the finding that this group received more family planning and STI services is a positive step towards reducing the disproportionately high prevalence of STIs in men in this under-privileged population.

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