%0 Journal Article %J Sex Transm Dis %D 2016 %T HIV/Sexually Transmitted Infection Prevention Messaging: Targeting Root Causes of Sexual Risk Behavior. %A Manhart, Lisa E %A Epstein, Marina %A Bailey, Jennifer A %A Hill, Karl G %A Haggerty, Kevin P %A Catalano, Richard F %X

INTRODUCTION: Sexual risk behaviors (SRBs) often lead to sexually transmitted infections (STI), yet little is known about what drives SRB and whether this differs by sex.

METHOD: Participants (n = 920; 75% white) were drawn from the Raising Healthy Children study, enrolled in 1993 and 1994 in grades 1 to 2, and followed up through age 24/25 years. Lifetime STI diagnosis was defined by self-report or seropositivity for Chlamydia trachomatis or herpes simplex virus 2. Multivariable models assessed individual (social skills, behavioral disinhibition) and environmental factors (family involvement, school bonding, antisocial friends) predictive of STI diagnosis as mediated by 3 proximal SRB (sex under the influence of drugs or alcohol, condom use, lifetime number of sex partners).

RESULTS: Twenty-five percent of participants had ever had an STI. All SRBs differed by sex (P < 0.001), and female participants were more likely to have had an STI (P < 0.001). Behavioral disinhibition and antisocial friends in adolescence were associated with more SRB for both sexes, whereas social skills were associated with less SRB in female but more in male participants. Considering SRB and individual and environmental factors together, lifetime number of sex partners (adjusted relative risk [ARR], 1.04per partner; 95% confidence interval [CI], 1.03-1.05) and inconsistent condom use (ARR, 1.10per year; 95% CI, 1.04-1.16) were associated with increased risk of STI, whereas social skills were associated with decreased risk of STI (ARR, 0.84; 95% CI, 0.75-0.93). Behavioral disinhibition seemed to drive SRB, but family involvement mitigated this in several cases.

CONCLUSIONS: Adolescent environmental influences and individual characteristics drive some SRB and may be more effective targets for STI/HIV prevention interventions than proximal risk behaviors.

%B Sex Transm Dis %V 43 %P 71-7 %8 2016 Feb %G eng %N 2 %1 http://www.ncbi.nlm.nih.gov/pubmed/26760178?dopt=Abstract %R 10.1097/OLQ.0000000000000402 %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