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I. PROGRAM RESOURCES
1. Are Adolescents and Young Adults More Likely Than Older Women to Choose Commercial and Private Sector Providers of Modern Contraception?
2. Building Assets for Safe, Productive Lives: A Report on a Workshop on Adolescent Girls' Livelihoods
3. The Case for Investing in Young People as Part of a National Poverty Reduction Strategy
4. Cyber Cafés: A How-To Manual (Including Designing a Web Site and Implementing an Online Peer Education Program)
5. Dying to be Men: Youth and Masculinity and Social Exclusion
6. The Economic Returns to Investing in Youth in Developing Countries: A Review of the Literature
7. Forgotten Casualties of War: Girls in Armed Conflict
8. HIV Counseling and Testing for Youth: A Manual for Providers
9. Improving the Reproductive Health of Adolescents in Senegal
10. The Policy Environment for Male Youth in Jamaica: Findings from a Pilot of the Gender Equitable Male Involvement (GEMI) Tool
11. Research In Brief — Adolescent Sexual and Reproductive Health
12. Sexually Transmitted Infections among Adolescents — The Need for Adequate Health Services
13. State of the World's Mothers 2005: The Power and Promise of Girls' Education
14. Strategies to Improve Reproductive Health Services for Adolescents in Bangladesh: A Community-based Study
15. World Youth Report
16. Young Men and the Construction of Masculinity in Sub-Saharan Africa: Implications for HIV/AIDS, Conflict, and Violence
17. Youth and the Millennium Development Goals — Challenges and Opportunities for Implementation
18. Youth Participation Guide: Assessment, Planning, and Implementation
19. YouthNet Briefs
II. RESEARCH SUMMARIES
Contraception
1. Condom use in African adolescents: the role of individual and group factors
2. Predictors of contraception knowledge and use among postpartum adolescents in El Salvador
Education
3. Perceived sufficiency and usefulness of IEC materials and methods related to HIV/AIDS among high school youth in Addis Ababa, Ethiopia
4. The potential of comprehensive sex education in China: findings from suburban Shanghai
Gender
5. Gender double standards in young people attending sexual health services in Northern Thailand
6. Siblings' premarital childbearing and the timing of first sex in three major cities of Cote d'Ivoire
HIV/AIDS
7. AIDS-related knowledge, attitudes and behavior among adolescents in Zambia
8. A controlled-study of preventive effects of peer education and single-session lectures on HIV/AIDS knowledge and attitudes among university students in Turkey
9. Written parental consent in school-based HIV/AIDS prevention research
Reproductive Health
10. An assessment of the awareness of sexual and reproductive rights among adolescents in Southwestern Nigeria
11. Attitudes about sex and marital sexual behavior in Hai Duong Province, Vietnam
12. Knowledge of personal and sexual development amongst young people in Pakistan
13. Reproductive tract infections among young married women in Tamil Nadu, India
14. The sexual and reproductive health of young people in the Arab countries and Iran
Sexual Risks
15. Does Audio-CASI improve reports of risky behavior? Evidence from a randomized field trial among young urban men in India
16. Early sexual debut among young men in rural South Africa: heightened vulnerability to sexual risk?
17. Effectiveness of a theory-based risk reduction HIV prevention program for rural Vietnamese adolescents
18. Parental factors and sexual risk-taking among young people in Cote d'Ivoire
19. Risk factors for HIV-AIDS among youth in Cape Town, South Africa
20. Vulnerability and sexual risks: vagos and vaguitas in a low income town in Peru
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I. PROGRAM RESOURCES
1. Are Adolescents and Young Adults More Likely Than Older Women to Choose Commercial and Private Sector Providers of Modern Contraception? (2005, PDF, 86 KB)
This study uses Demographic and Health Survey (DHS) data from 29 countries to examine if adolescents prefer private providers for contraception. It also explores patterns of sexual activity, and use and source of contraception by several variables. Results indicated strong regional differences in selection of contraceptive providers.
Contact: www.policyproject.com/contact.cfm
2. Building Assets for Safe, Productive Lives: A Report on a Workshop on Adolescent Girls' Livelihoods (2005, PDF, 744 KB)
This report summarizes a two-day workshop on adolescent girls' livelihoods held in April 2004. It discusses the meaning of livelihoods as applied to adolescent girls and reviews field-based interventions and research. It examines the interaction between work, school, and marriage on girls, particularly as they relate to decision-making and social and economic skills.
Contact: pubinfo@popcouncil.org
3. The Case for Investing in Young People as Part of a National Poverty Reduction Strategy (2005, PDF, 3.26 MB)
This paper from UNFPA highlights the benefit that focusing on youth will have on education, health, economic development, and civil society. It discusses the demographic rationale for focusing on youth, as well as short-term and long-term benefits.
Contact: martinez@unfpa.org
4. Cyber Cafés: A How-To Manual (Including Designing a Web Site and Implementing an Online Peer Education Program) (2005, PDF, 1.23 MB)
This easy-to-read manual includes step-by-step directions for setting up a youth-centered cyber café with access to sexual and reproductive health information. Designed for NGOs and other youth-serving organizations, the manual discusses the benefits of a cyber café and the project phases including planning, set-up, and implementation. The manual provides descriptions of computers, the Internet, and the development of an online peer education.
Contact: information@advocatesforyouth.org
Spanish (PDF, 1.27 MB)
Portuguese (PDF, 1.22 MB)
5. Dying to be Men: Youth and Masculinity and Social Exclusion (2005)
This book uses data from the United States and Brazil to examine manhood among young, poor, urban men and how social exclusion and other factors often result in violent behavior. It identifies why some young men do not become involved in violence and discusses relationships with women and sexuality.
Contact: cserve@routledge-ny.com
6. The Economic Returns to Investing in Youth in Developing Countries: A Review of the Literature (2005, PDF, 1.92 MB)
This 180-page report is an expanded companion to Assessing the Economic Returns to Investing in Youth in Developing Countries (2003). It explores the economic case for investing in youth in education, training, employment, reproductive health, school-based health, and community-based programs, with benefit cost analyses from several countries.
Contact: JKinUSA@aol.com; jberhman@econ.sas.upenn.edu
7. Forgotten Casualties of War: Girls in Armed Conflict (2005, PDF, 774 KB)
Save the Children UK prepared this report, which discusses with girls their involvement in armed conflict — how they became involved and the impact on them, particularly in terms of gender-based violence. Girls' needs for re-integration into communities are highlighted, including recommendations from the girls and for the international community.
Contact: publications@savechildren.org
8. HIV Counseling and Testing for Youth: A Manual for Providers (2005)
This HIV counseling and testing manual is designed for service providers and counselors working with youth. Approximately one-third of clients who seek HIV testing are youth, and these young people often have different needs than adults. With this easy-to-use, spiral-bound booklet, service providers and counselors can improve their skills and assist youth with the difficult issue of HIV counseling and testing.
Contact: youthnetpubs@fhi.org
9. Improving the Reproductive Health of Adolescents in Senegal (2004, PDF, 464 KB)
This report describes a three-year operations research study testing community-based interventions to improve youth reproductive health. Interventions included sensitization on adolescent reproductive health, outreach to parents, peer education, clinic-based activities designed to make services more youth friendly, and school-based education.
Contact: publications@popcouncil.org
10. The Policy Environment for Male Youth in Jamaica: Findings from a Pilot of the Gender Equitable Male Involvement (GEMI) Tool (2005, PDF, 140 KB)
This report from the Policy Project presents findings of an assessment of the policy environment for male involvement in Jamaica. The assessment piloted the use of the GEMI tool to gain perspectives from key stakeholders and programmatic information. The report outlines policy challenges, opportunities, and implications.
Contact: www.policyproject.com/contact.cfm
11. Research In Brief — Adolescent Sexual and Reproductive Health
These four-page documents summarize the status of sexual and reproductive health in Malawi and Uganda, covering sexual activity, contraception, marriage, childbearing, abortion, and STIs. They also examine HIV issues, identifying those at risk, information sources, how youth protect themselves, and policies and programs.
Contact: info@guttmacher.org
12. Sexually Transmitted Infections among Adolescents — The Need for Adequate Health Services (2005, PDF, 626 KB)
This literature review from WHO and GTZ examines different service delivery models for detection and treatment of sexually transmitted infections (STIs) in young people. The paper also looks at policies related to STIs as well as strategies to reach the most vulnerable youth.
Contact: cah@who.int
13. State of the World's Mothers 2005: The Power and Promise of Girls' Education (2005, PDF, 1.10 MB)
This annual report from Save the Children provides a compelling description of the power of education to improve the lives of girls in terms of health, economic productivity, and civic participation. The report highlights countries that have made significant progress in girls' education both in absolute terms and with respect to income, and profiles 11 countries most likely to succeed in girls' education.
Contact: publications@savechildren.org
14. Strategies to Improve Reproductive Health Services for Adolescents in Bangladesh: A Community-based Study (2005, PDF, 245 KB)
This document reports on a study by the Center for Health and Population Research on a community-based method to improve adolescent reproductive health. The quasi-experimental study targeted adolescent boys and girls, both in- and out-of-school, married and unmarried, and living in urban and rural sites. It examined the relative benefits of a program providing reproductive health education, community sensitization, livelihood training, and savings and credit schemes.
Contact: msik@icddrb.org
15. World Youth Report (2005)
This short report from the United Nations provides an overview of the global status of young people; an expanded version is scheduled later in 2005. It discusses youth in the global economy, youth in civil society, and youth at risk, and includes policy recommendations. An annex discusses five priority areas: globalization, information and communication technologies, HIV/AIDS, youth and conflict, and intergenerational relations. French, Spanish, Russian, Arabic, and Chinese versions of the report are also provided.
Contact: youth@un.org
16. Young Men and the Construction of Masculinity in Sub-Saharan Africa: Implications for HIV/AIDS, Conflict, and Violence (2005, PDF, 1,002 KB)
This working paper from the World Bank examines the role of gender on young men in Africa, particularly as it relates to HIV/AIDS, conflict, and violence. It includes a literature review, promising programs, data from key informant interviews and focus group discussions, key challenges, and protective factors.
Contact: cpr@worldbank.org
17. Youth and the Millennium Development Goals — Challenges and Opportunities for Implementation (2005, PDF, 1.01 MB)
This 80-page report, prepared by youth, describes young people's involvement in each of the eight Millennium Development Goals (MDGs). It describes how youth are affected by each goal and how they are currently participating in achieving each goal. It includes "opportunities for action" that governments, donors, and NGOs can use to involve youth more effectively.
Contact: comments@mdgyouthpaper.org
18. Youth Participation Guide: Assessment, Planning, and Implementation (2005)
The Youth Participation Guide seeks to increase the level of meaningful youth participation in reproductive health (RH) and HIV/AIDS programming at an institutional and programmatic level. The target audience includes senior and middle management, program managers, staff involved in implementing activities, and youth who may be engaged at all levels of an organization's work.
Contact: youthnetpubs@fhi.org
19. YouthNet Briefs (2005)
This series of two-page summaries highlights YouthNet's global impact by focusing on YouthNet research results, country projects, and technical leadership. The first nine briefs cover maternal health services, HIV counseling, working with sports teams, faith-based interventions, using participatory methods with youth, using radio to keep young people in school, and more.
Contact: youthnetpubs@fhi.org
II. RESEARCH SUMMARIES
Contraception
1. Condom use in African adolescents: the role of individual and group factors. Giles M, Liddell C, Bydawell M. AIDS Care 2005;17(6).
This study set out to assess the ability of the Theory of Planned Behavior (TPB) to predict and explain condom use in a traditional African context, and in particular to assess the relative contributions of individual and normative constructs. Researchers administered a questionnaire survey to 152 young adults (48 percent male, 52 percent female) at two points in time. Key constructs contained within the TPB were measured at Time 1. A short follow-up set of items was administered one week later at Time 2, thereby allowing for the measurement of actual behavior. The results not only provide strong support for the predictive power of the TPB, since 67 percent of the variance in intention was explained, but also highlight the extent to which sexual behavior in a rural location is governed by family/social influences. Subjective norms not only proved to be one of the most significant elements of the TPB model, together with self-efficacy (neither attitude nor perceived control were significantly involved), but 'my family' emerged as the most significant other. As such, the findings offer empirical evidence to support interventions that penetrate community networks.
2. Predictors of contraception knowledge and use among postpartum adolescents in El Salvador. Newmann SJ, Goldberg AB, Aviles R, et al. Am J Obstet Gynecol 2005;192(5).
Researchers conducted questionnaire-guided interviews in Spanish with 50 postpartum adolescents at an urban, public hospital in El Salvador. Open-ended questions included assessments of education, partnership status, and contraceptive knowledge and use patterns. The median age of subjects was 17 years. Eighty-four percent of the women reported contraception knowledge and 18 percent reported contraception use. Knowledge of contraceptives was related to educational experience and literacy, but use of contraceptives was not. After delivery and postpartum contraception education, 58 percent of the subjects stated intention to use contraception. Having a partner and living with him were predictors of intent to use contraception; however, being single negatively predicted intention to use contraception.
Education
3. Perceived sufficiency and usefulness of IEC materials and methods related to HIV/AIDS among high school youth in Addis Ababa, Ethiopia. Cherie A, Mitkie G, Ismail S, Berhane Y. Afr J Reprod Health 2005;9(1).
This study was conducted to assess the perceived sufficiency and usefulness of HIV/AIDS information, education, and communication (IEC) messages and materials as well as to identify preferences for IEC sources and methods. Data was collected from 901 students in Addis Ababa, Ethiopia, using a self-administered questionnaire and focus group discussions. IEC materials were perceived to be useful in increasing knowledge about HIV/AIDS by 51 percent of respondents, to influence attitude by 40 percent, and to acquire safer sexual practices by 42 percent of the respondents. None of the information sources and messages available for high school students highly satisfied the sufficiency indicators. Even though no single information source was highly preferred, radio and television ranked on top. Life skills training was the most desired intervention by the students.
4. The potential of comprehensive sex education in China: findings from suburban Shanghai. Wang B, Hertog S, Meier A, et al. Int Fam Plan Perspect 2005;31(2).
The numbers of unplanned pregnancies and sexually transmitted infections (STIs) among Chinese young adults have increased markedly. In response, a comprehensive sex education program, including information on abstinence, contraception, and healthy sexual behaviors was carried out in a suburb of Shanghai. The program used six methods for providing information and services to unmarried 15 to 24-year-olds over a period of 20 months. Sexual behavior surveys were conducted among intervention participants and among controls in a comparable town, who did not receive a similar intervention. While participation in the intervention was not associated with delayed sexual initiation, it was associated with reduced odds that youth coerced a partner into having sex and with increased odds of contraceptive use and condom use during the intervention period.
Gender
5. Gender double standards in young people attending sexual health services in Northern Thailand. Tangmunkongvorakul A, Kane R, Wellings K. Cult Health Sex 2005;7(4).
Concern about the sexual and reproductive health of young people has been mounting recently in Thailand. Unequal gender relations have a considerable influence on the lives of young people, especially young women, yet few studies have explored the ways in which they have impacted on provision of sexual health care. Drawing upon data from a qualitative study in Northern Thailand, this paper explores the views and experiences of young people in seeking health care, highlighting the kinds of gender double standards and power imbalances that may pose obstacles to their use of sexual and reproductive health services. Findings reveal the vulnerability of sexually active young women in seeking support and care from partners, parents, and service providers. Those who experience adverse outcomes of sexual activity, such as unwanted pregnancy or infection, report facing indifference, victim blaming, or the threat of abandonment by their partners.
6. Siblings' premarital childbearing and the timing of first sex in three major cities of Cote d'Ivoire. Diop-Sidibe N. Int Fam Plan Perspect 2005;31(2).
Information on siblings' influence on young people's sexual and reproductive health is scarce, especially for developing countries. Researchers analyzed data from 1,395 female and 1,242 male survey respondents ages 15 to 24 from three cities in Cote d'Ivoire; this analysis revealed that the probability of remaining sexually inexperienced was lower among persons who had at least one sibling with a premarital birth than among those who had no such sibling. Gender also plays a role: in general, among those with at least one sibling who had a premarital birth, the probability of sexual inexperience was lower if the sibling or siblings and the respondent were of the same gender rather than opposite genders. Finally, the probability of sexual inexperience was lowest among those who had a brother and a sister with a history of premarital childbearing. In the multivariate analysis for males, having one or more brothers only, or having at least one brother and at least one sister with a history of premarital childbearing, was associated with increased risks of being sexually experienced by ages 17 and 24. No such association was found for females.
HIV/AIDS
7. AIDS-related knowledge, attitudes and behavior among adolescents in Zambia. Slonim-Nevo V, Mukuka L. AIDS Behav
2005;9(2).
AIDS-related knowledge, attitudes, self-efficacy, and behavior were examined among 3,360 adolescents aged 10 to 19 years old in Zambia, including in-school and out-of-school, rural and urban, and married and unmarried adolescents. The adolescents reported a moderate to high AIDS knowledge, positive attitudes towards prevention, and low to moderate self-efficacy about AIDS prevention. Although these factors were significantly related to adolescents' engagement in high-risk behavior, the results indicated that these variables add only three percent of explained variance beyond the socio-demographic variables, which explains 14 percent of the variance. Three groups were identified as at most risk for HIV: out-of-school adolescents, adolescents from rural areas, and married adolescents.
8. A controlled-study of preventive effects of peer education and single-session lectures on HIV/AIDS knowledge and attitudes among university students in Turkey. Ergene T, Cok F, Tumer A, Unal S. AIDS Educ Prev 2005;17(3).
The goal of this study was to assess the impact of peer education and single-session educational lectures on HIV/AIDS knowledge and attitude change among university students (n = 157 male, n = 230 female; mean age = 20) on the campuses of two metropolitan state universities in Ankara, Turkey. The students were randomly selected to participate in peer education (n = 204), single-session lecture (n = 74) or wait-list control (n = 109) groups. Statistical analyses revealed significant differences in knowledge and attitudes, personal behavior, and awareness of HIV/AIDS. Both the peer education and HIV/AIDS lecture strategies were more effective in eliciting change in student's knowledge and attitudes than the control condition. Male and female students in both experimental groups showed higher attitude scores compared with all students in the control group.
9. Written parental consent in school-based HIV/AIDS prevention research. Mathews C, Guttmacher SJ, Flisher AJ, et al. Am J Public Health 2005;95(7).
By investigating parental consent form return rates, parents' recall and knowledge of the research, and the extent to which this consent procedure represented parents' wishes about their child's involvement in research, this study examined the process of obtaining "active" written parental consent for a school-based HIV/AIDS prevention project in a South African high school. This cross-sectional, descriptive study comprised interviews with parents of children in grades eight and nine in a poor, periurban settlement in Cape Town. Within two weeks, 94 percent of 258 parents responded to a letter requesting written consent and, of those, 93 percent consented. However, subsequent interviews showed that only 65 percent remembered seeing the consent form. At the end of the interview, 99 percent of parents consented to their child's participation. These findings challenge many of the assumptions underlying active written parental consent; researchers together with the communities in which the research is undertaken need to decide on appropriate informed consent strategies.
Reproductive Health
10. An assessment of the awareness of sexual and reproductive rights among adolescents in Southwestern Nigeria. Ogunlayi MA. Afr J Reprod Health 2005;9(1).
This study, conducted in Ikeja and Ikorodu Local Government Areas of Lagos State, examined the awareness of sexual and reproductive rights among adolescents in southwestern Nigeria. A total of 600 in-school and out-of-school adolescents were interviewed using quantitative and qualitative methods. The majority of the adolescents were aware of the existence of sexual and reproductive health rights but lacked knowledge of the content of those rights. The majority of respondents in various categories (by school condition and type of settlement) were not aware of sexual and reproductive health programs for adolescents. In addition, those who were aware of such intervention programs could not access or use the services due to certain sociocultural barriers.
11. Attitudes about sex and marital sexual behavior in Hai Duong Province, Vietnam. Ghuman S. Stud Fam Plann 2005;36(2).
This study examines attitudes concerning sexual relations outside marriage and levels of marital sexual activity using data from married individuals from Hai Duong Province collected in 2001. Among individuals who live in urban areas, have more schooling, and were married after the late 1980s, acceptance is growing concerning intimate behavior without marital commitment and having sex with a future spouse. Schooling, urban residence, and recent marriage have stronger associations with less conservative attitudes among men than among women. Even among younger and better-educated respondents, acceptance of premarital and extramarital sex generally remains below a majority. The reported level of premarital sex is higher among men than among women, and lower than available estimates from other parts of Asia and the developing world. The reported level of sexual activity within marriage in Hai Duong Province is similar to that observed elsewhere, including Thailand and the United States. The incidence of sexual activity declines with age, and at all ages men are more likely than women to report having sex with their spouse.
12. Knowledge of personal and sexual development amongst young people in Pakistan. Hennink M, Rana I, Iqbal R. Cult Health Sex
2005;7(4).
In this study, 24 focus group discussions were conducted to explore young people's experiences of gaining knowledge of personal and sexual development. Young women typically gained information from a limited number of sources within the home, while young men accessed a wide variety of information sources outside the home. Gaining information was frequently event-based, for example, at the onset of puberty or marriage. Overall, young people were critical of the quality of information they received, which often led to confusion and stress in understanding sexual development. Findings highlight a gap in formal systems of information provision. Although young people highlighted the merits of school-based information delivery, low school attendance and high drop-out rates amongst girls mean that alternative mechanisms of reaching young Pakistani women need to be identified.
13. Reproductive tract infections among young married women in Tamil Nadu, India. Abraham S, Prasad JH, Kurz KM, et al. Int Fam Plan Perspect 2005;31(2).
Studies of the prevalence of reproductive tract infections (RTIs) in South Asia have been hindered by low participation rates, and little is known about rates among the youngest married women. A community-based cross-sectional study of RTIs was conducted from 1996-1997 among married women 16-22 years of age in Tamil Nadu, India. Researchers questioned women about symptoms, and the women then received pelvic and speculum examinations and provided samples for laboratory tests. Results showed 53 percent of women reported gynecologic symptoms, 38 percent had laboratory findings of RTIs, and 14 percent had clinically diagnosed pelvic inflammatory disease or cervicitis. According to laboratory diagnoses, 15 percent had sexually transmitted infections and 28 percent had endogenous infections. Two-thirds of symptomatic women had not sought any treatment; the reasons cited were absence of a female provider in the nearby health care center, lack of privacy, distance from home, cost, and a perception that their symptoms were normal.
14. The sexual and reproductive health of young people in the Arab countries and Iran. DeJong J, Jawad R, Mortagy I, Shepard B. Reprod Health Matters 2005;13(25).
After reviewing published and unpublished literature and interviews with 51 key informants working mostly in NGOs and international agencies in the region, researchers determined there are few national government programs addressing young people's sexual and reproductive health, with the exceptions of Tunisia and Iran, and a lack of population-based data to guide such programs. Although a strong emphasis on the integrity and strength of the family unit has a protective effect, young people lack access to health information. Education curricula that include these topics are rare and, where they do exist, relevant sections are frequently skipped over by teachers. Health service providers neither recognize the needs of this age group nor make young people welcome, particularly those who are unmarried. Increased education and employment mean the age at marriage is rising, but unprotected forms of marriage are also reported. Taboos surrounding discussion of sexuality remain a key constraint, and data on unwanted pregnancy and abortion, violence against women, and STIs and HIV/AIDS are limited. Building on NGO models and existing efforts, there is a need for the development of national programs to support the well-being of young people in this region.
Sexual Risks
15. Does Audio-CASI improve reports of risky behavior? Evidence from a randomized field trial among young urban men in India. Potdar R, Koenig MA. Stud Fam Plann 2005;36(2).
This study compares the effectiveness of audio computer-assisted self-interviewing (Audio-CASI) with face-to-face interviews and self-administered questionnaires in collecting sensitive information on risky sexual and other behaviors among young men in urban India. A randomized study design compared data collected from 900 male college students using the three data collection approaches and from 600 young men residing in slums using Audio-CASI and face-to-face interviews. Among the college students, the reported prevalence of risky behaviors was generally higher for young men interviewed through the Audio-CASI approach than with face-to-face interviews; self-administered questionnaires failed to yield significantly higher estimates than face-to-face interviews. Among the slum residents, the results were more mixed; the Audio-CASI approach failed to yield consistently higher responses for many risky behaviors compared with the face-to-face interview mode. The results demonstrate that although Audio-CASI appears to yield higher estimates of risky behavior among college-educated, computer-literate populations of young men, the efficacy of this approach among less-educated and less computer-literate populations appears more doubtful.
16. Early sexual debut among young men in rural South Africa: heightened vulnerability to sexual risk? Harrison A, Cleland J, Gouws E, Frohlich J. Sex Transm Infect 2005;81(3).
This report examines early sexual debut (younger than age 15) among young men in rural South Africa, including risk behaviors at first sexual experience and age at first sex as a predictor of later sexual risk. Thirteen percent of 314 young men ages 15-24 years experienced sexual debut before age 15. Men with sexual debut at less than age 15 were more likely to report risk behaviors at first sexual experience including: no condom use (19 percent), a casual partner (27 percent), and not feeling they had been "ready and wanted to have sex" (20 percent).
17. Effectiveness of a theory-based risk reduction HIV prevention program for rural Vietnamese adolescents. Kaljee LM, Genberg B, Riel R, et al. AIDS Educ Prev 2005;17(3).
Researchers presented findings from a randomized controlled effectiveness trial of an HIV prevention program for adolescents ages 15 to 20 years in which 480 adolescents were randomized into control and intervention groups. Evaluation data were collected using the Vietnamese Youth Health Risk Behavior Instrument, including scales based on the protection motivation theory (PMT). Findings presented show significant differences in knowledge regarding severity of and vulnerability to HIV/AIDS, perceptions of self-efficacy, and response efficacy for condom use between control and intervention youth at immediate and six-month post-intervention. Reported engagement in vaginal sex or anal and/or oral sex was extremely low, and therefore changes in actual behaviors could not be accurately measured. However, intention to use condoms in possible future sexual encounters increased significantly for the intervention youth compared to control youth between baseline and both immediate post-intervention and six-month follow-up.
18. Parental factors and sexual risk-taking among young people in Cote d'Ivoire. Babalola S, Tambashe BO, Vondrasek C. Afr J Reprod Health 2005;9(1).
This study examines the relation between parental factors and sexual risk-taking among young people. Three parental factors (living in the same household as the father during childhood, perceived parental disapproval of early and premarital pregnancy, and parent-child communication about sexual abstinence) were positively associated with primary sexual abstinence (defined as yet-to-experience sexual debut), secondary sexual abstinence (defined as sexual abstinence subsequent to sexual debut), and reduced number of sex partners. The findings suggest that parental monitoring and control are important predictors of youth sexual behaviors and underscore the need to target parents and guardians in efforts to promote responsible sexual behaviors among adolescents.
19. Risk factors for HIV-AIDS among youth in Cape Town, South Africa. Simbayi LC, Kalichman SC, Jooste S, et al. AIDS Behav 2005;9(1).
This study examined risk behaviors and HIV risk factors among young people living in a black South African township. Researchers surveyed 113 men and 115 women ages 25 and younger; results showed that 68 percent of men and 56 percent of women reported HIV-related, high-risk sexual behaviors. Although knowledge about HIV transmission was generally high, there was evidence that misconceptions about AIDS persist, particularly myths related to HIV transmission. For young men, HIV risk factors were associated with fewer years of education, lower levels of AIDS-related knowledge, condom attitudes, and Dagga (marijuana) use. Among young women, HIV risk factors were associated with beliefs that condoms get in the way of sex and rates of unprotected vaginal intercourse.
20. Vulnerability and sexual risks: vagos and vaguitas in a low income town in Peru. Salazar X, Caceres C, Rosasco A, et al. Cult Health Sex 2005;7(4).
Many studies regard youth as a homogeneous group defined by developmental stages. This study provides strong evidence of the inappropriateness, in prevention interventions, of the concept of 'young people' as a group defined only by age and gender. When incorporating social resources and support into the analysis, specific segments of youth with diverse sexual practices and health seeking behaviors emerge. Thus, although most young people in urban areas show a similar level of HIV/STI knowledge, their exposure to risk varies according to their living conditions. Two population segments, "street guys" and "fast girls," identified as vulnerable for sexual risk, are characterized. Both groups spend time on the streets, and most are involved in using alcohol and drugs, and/or practicing transactional sex. This study provides evidence for the need of various approaches according to level of poverty and social vulnerability in order to develop more effective HIV/AIDS and STI prevention programs to meet the needs of young men and women in low-income areas.
