%0 Journal Article %J J Sex Res %D 2014 %T Sexual risk behavior in young adulthood: broadening the scope beyond early sexual initiation. %A Epstein, Marina %A Bailey, Jennifer A %A Manhart, Lisa E %A Hill, Karl G %A Hawkins, J D %K Adolescent %K Adolescent Behavior %K Adult %K Child %K Female %K Humans %K Longitudinal Studies %K Male %K Risk-Taking %K Sexual Behavior %K Time Factors %K Young Adult %X

A robust link between early sexual initiation and sexual risk-taking behavior is reported in previous studies. The relationship may not be causal, however, as the effect of common risk factors is often not considered. The current study examined whether early initiation was a key predictor of risky sexual behavior in the 20s and 30s, over and above co-occurring individual and environmental factors. Data were drawn from the Seattle Social Development Project, a longitudinal panel of 808 youth. Early predictors (ages 10 to 15) and sexual risk taking (ages 21 to 24 and 30 to 33) were assessed prospectively. Early sexual initiation (before age 15) was entered into a series of probit regressions that also included family, neighborhood, peer, and individual risk factors. Although a positive bivariate relation between early sexual initiation and sexual risk taking was observed at both ages, the link did not persist when co-occurring risk factors were included. Behavioral disinhibition and antisocial peer influences emerged as the strongest predictors of sexual risk over and above early sexual initiation. These results suggest that early sexual initiation must be considered in the context of common antecedents; public health policy aimed at delaying sexual intercourse alone is unlikely to substantially reduce sexual risk behavior in young adulthood.

%B J Sex Res %V 51 %P 721-30 %8 2014 %G eng %N 7 %R 10.1080/00224499.2013.849652 %0 Journal Article %J J Adolesc Health %D 2014 %T Understanding the link between early sexual initiation and later sexually transmitted infection: test and replication in two longitudinal studies. %A Epstein, Marina %A Bailey, Jennifer A %A Manhart, Lisa E %A Hill, Karl G %A Hawkins, J D %A Haggerty, Kevin P %A Catalano, Richard F %K Adolescent %K Adolescent Behavior %K Age Factors %K Alcohol Drinking %K Child %K Female %K Humans %K Longitudinal Studies %K Male %K Models, Theoretical %K Puberty %K Risk Factors %K Risk-Taking %K Sexual Abstinence %K Sexual Behavior %K Sexually Transmitted Diseases %X

PURPOSE: Age at sexual initiation is strongly associated with sexually transmitted infections (STI); yet, prevention programs aiming to delay sexual initiation have shown mixed results in reducing STI. This study tested three explanatory mechanisms for the relationship between early sexual debut and STI: number of sexual partners, individual characteristics, and environmental antecedents.

METHODS: A test-and-replicate strategy was employed using two longitudinal studies: the Seattle Social Development Project (SSDP) and Raising Healthy Children (RHC). Childhood measures included pubertal age, behavioral disinhibition, and family, school, and peer influences. Alcohol use and age of sexual debut were measured during adolescence. Lifetime number of sexual partners and having sex under the influence were measured during young adulthood. Sexually transmitted infection diagnosis was self-reported at age 24. Early sex was defined as debut at <15 years. Path models were developed in SSDP evaluating relationships between measures, and were then tested in RHC.

RESULTS: The relationship between early sex and STI was fully mediated by lifetime sex partners in SSDP, but only partially in RHC, after accounting for co-occurring factors. Behavioral disinhibition predicted early sex, early alcohol use, number of sexual partners, and sex under the influence, but had no direct effect on STI. Family management protected against early sex and early alcohol use, whereas antisocial peers exacerbated the risk.

CONCLUSIONS: Early sexual initiation, a key mediator of STI, is driven by antecedents that influence multiple risk behaviors. Targeting co-occurring individual and environmental factors may be more effective than discouraging early sexual debut and may concomitantly improve other risk behaviors.

%B J Adolesc Health %V 54 %P 435-441.e2 %8 2014 Apr %G eng %N 4 %R 10.1016/j.jadohealth.2013.09.016 %0 Journal Article %J Infect Dis Clin North Am %D 2013 %T Mycoplasma genitalium: An emergent sexually transmitted disease? %A Manhart, Lisa E %K Anti-Bacterial Agents %K Communicable Diseases, Emerging %K Female %K Humans %K Male %K Mycoplasma genitalium %K Mycoplasma Infections %K Sexually Transmitted Diseases, Bacterial %X

This article summarizes the epidemiologic evidence linking Mycoplasma genitalium to sexually transmitted disease syndromes, including male urethritis, and female cervicitis, pelvic inflammatory disease, infertility, and adverse birth outcomes. It discusses the relationship of this bacterium to human immunodeficiency virus infection and reviews the available literature on the efficacy of standard antimicrobial therapies against M genitalium.

%B Infect Dis Clin North Am %V 27 %P 779-92 %8 2013 Dec %G eng %N 4 %R 10.1016/j.idc.2013.08.003 %0 Journal Article %J Sex Transm Dis %D 2013 %T Mycoplasma Genitalium infection in sub-Saharan Africa: how big is the problem? %A Manhart, Lisa E %A McClelland, R Scott %K Africa South of the Sahara %K Cohort Studies %K Communicable Diseases, Emerging %K Cost-Benefit Analysis %K Female %K HIV Seropositivity %K Humans %K Mycoplasma genitalium %K Mycoplasma Infections %K Sentinel Surveillance %K Virus Shedding %B Sex Transm Dis %V 40 %P 428-30 %8 2013 May %G eng %N 5 %R 10.1097/OLQ.0b013e3182924b3b %0 Journal Article %J AIDS %D 2012 %T Another STI associated with HIV-1 acquisition: now what? %A Manhart, Lisa E %K Female %K HIV Infections %K HIV-1 %K Humans %K Mycoplasma genitalium %K Mycoplasma Infections %B AIDS %V 26 %P 635-7 %8 2012 Mar 13 %G eng %N 5 %R 10.1097/QAD.0b013e32834ff6ad %0 Journal Article %J J Adolesc Health %D 2012 %T Romantic relationship characteristics and alcohol use: longitudinal associations with dual method contraception use. %A Bailey, Jennifer A %A Fleming, Charles B %A Catalano, Richard F %A Haggerty, Kevin P %A Manhart, Lisa E %K Adult %K Age Factors %K Alcohol Drinking %K Contraception %K Contraception Behavior %K Female %K Humans %K Interpersonal Relations %K Linear Models %K Male %K Multivariate Analysis %K Sexual Behavior %K Sexually Transmitted Diseases %K Time Factors %K Young Adult %X

PURPOSE: Dual method contraception use, or the use of one type of contraceptive intended to prevent pregnancy combined with another type intended to reduce the risk of sexually transmitted infection, may be the most effective method to prevent both unintended pregnancy and sexually transmitted infection. This study tested the association between relationship length, relationship type (married, cohabiting, dating but not cohabiting), global alcohol use, and situational alcohol use and the probability of dual method contraception use from 20 to 23 years of age.

METHODS: Hierarchical linear modeling analyses were conducted using longitudinal data from 754 sexually active male and female young adults aged 20-23 years. Dependent variables included both any dual method contraception use and consistent dual method contraception use.

RESULTS: Between 15% and 20% of respondents reported consistent dual method contraception use at each time point. Longer relationship length and more committed relationship type were associated with a lower probability of both any and consistent dual method contraception use. Situational alcohol use (drinking before sex), but not global alcohol use, also was related to a lower probability of both any and consistent dual method contraception use. Increasing age was associated with a lower probability of any dual method contraception use, but was not related to consistent dual method use.

CONCLUSIONS: Efforts to promote dual method contraception among young adults should include messages discouraging drinking before sex and supporting dual method use even in the context of committed relationships.

%B J Adolesc Health %V 50 %P 450-5 %8 2012 May %G eng %N 5 %R 10.1016/j.jadohealth.2011.09.008 %0 Journal Article %J Vaccine %D 2011 %T HPV vaccination among a community sample of young adult women. %A Manhart, Lisa E %A Burgess-Hull, Albert J %A Fleming, Charles B %A Bailey, Jennifer A %A Haggerty, Kevin P %A Catalano, Richard F %K Adolescent %K Demography %K Educational Status %K Female %K Health Knowledge, Attitudes, Practice %K Humans %K Interviews as Topic %K Longitudinal Studies %K Male %K Papillomavirus Infections %K Papillomavirus Vaccines %K Patient Acceptance of Health Care %K Smoking %K United States %K Vaccination %K Washington %K Young Adult %X

OBJECTIVES: Despite the high efficacy of the human papillomavirus (HPV) vaccine, uptake has been slow and little data on psychosocial barriers to vaccination exist.

METHODS: A community sample of 428 women enrolled in a longitudinal study of social development in the Seattle WA metropolitan area were interviewed about HPV vaccine status, attitudes, and barriers to HPV vaccination in spring 2008 or 2009 at ∼age 22.

RESULTS: Nineteen percent of women had initiated vaccination, 10% had completed the series, and ∼40% of unvaccinated women intended to get vaccinated. Peer approval was associated with vaccine initiation (adjusted prevalence ratio (APR) 2.1; 95% confidence interval 1.4-3.2) and intention to vaccinate (APR 1.4; 1.1-1.9). Belief the vaccine is <75% effective was associated with less initiation (APR 0.6; 0.4-0.9) or intention to vaccinate (APR 0.5; 0.4-0.7). Vaccine initiation was also less likely among cigarette smokers and illegal drug users, whereas intention to vaccinate was more common among women currently attending school or with >5 lifetime sex partners, but less common among women perceiving low susceptibility to HPV (APR 0.6; 0.5-0.9).

CONCLUSIONS: HPV vaccination uptake was low in this community sample of young adult women. Increasing awareness of susceptibility to HPV and the high efficacy of the vaccine, along with peer interventions to increase acceptability, may be most effective.

%B Vaccine %V 29 %P 5238-44 %8 2011 Jul 18 %G eng %N 32 %R 10.1016/j.vaccine.2011.05.024