Bill de Blasio Mayor Oxiris Barbot, MD Commissioner nyc.gov/health
BACKGROUND. A greater understanding of the determinants of risky behaviors is an essential precursor to the development of successful AIDS prevention programs for adolescents. METHODS. A survey measuring AIDS-related behaviors, beliefs, and knowledge was administered to a sample of 531 10th-grade students residing in an AIDS epicenter. RESULTS. Of the 56.8% of students reporting past-year involvement in sexual intercourse, 67.3% reported unprotected intercourse with low-risk partners, 1.3% reported unprotected intercourse with high-risk partners, and 6.6% reported a past-year history of a sexually transmitted disease. Students whose friends had intercourse and never or inconsistently used condoms, who personally sanctioned intercourse involvement, who believed that the majority of their peers had intercourse, and who perceived low preventive action self-efficacy, were 5.1, 3.0, 2.1, 3.7, and 2.8 times more likely, respectively, to score in the riskier categories of an AIDS behavior index. CONCLUSIONS. These findings suggest that addressing socioenvironmental influences on risky and preventive behaviors may prove to be the most effective AIDS prevention strategy among adolescents.
During the COVID-19 pandemic in New York City, NewYork-Presbyterian Hospital provided HIV prevention patients with gonorrhea/chlamydia testing kits at home. This report describes the program implementation to provide other sexual health clinics with a roadmap in adapting to a “new normal” in providing comprehensive sexual health care virtually to patients.
Understanding the sexual risk behaviors of youths living with HIV/AIDS is critical to secondary prevention of HIV. As part of a larger qualitative study of youths living with HIV, in-depth interviews were conducted with 27 African American and Latino, HIV-infected young men who have sex with men, aged 16-24 years, living in New York City. The study explored the role of substance use, the social-sexual-environmental, and psychological contexts in which sexual risk behaviors occurred. Since learning of their HIV infection, the majority of participants had reduced their risky sexual behaviors; however, a subset (26%) of participants continued to have unprotected sex, in most cases with multiple partners. Substance use, the social environmental context of the sexual encounter, the psychological impact of HIV on sexual behavior, and partner characteristics were associated with high-risk sexual behaviors in this group. Among high-risk participants, factors associated with risky sexual behaviors clustered, with 57% reporting two or more factors. More intensive interventions are needed for this subset of youths living with HIV, including assessment and treatment for substance use and mental health issues, strategies for stress reduction, and partner interventions.
Recent trends in adolescent sexual behavior offer mixed messages. It is very encouraging that teenagers' overall rates of sexual activity, pregnancy and childbearing are decreasing, and that their rates of contraceptive and condom use are increasing. 1 However, the proportion of young people who have had sex at an early age has increased. 2 Moreover, while adolescent females' contraceptive use at first sex is rising, their use at most recent sex is falling. 3 There is general consensus that the proportion of teenagers who engage in behaviors that put them at risk of pregnancy and of HIV and other sexually transmitted infections (STIs) remains too high. Each year, approximately one million young women aged 15-19-or one-fifth of all sexually active females in this age-group-become pregnant; the vast majority of these pregnancies are unplanned. 4 In the United States, the risk of acquiring an STI is higher among teenagers than among adults. 5 Moreover, rates of unprotected sexual activity, STIs, pregnancy and childbearing continue to be substantially higher among U.S. adolescents than among young people in comparable industrialized countries. 6 Research has also begun to highlight an alarmingly high rate of involuntary sex among young people. In the 1995 National Survey of Family Growth, 13% of 15-19-year-old females reported that they had been forced to have sex. 7 When asked about their first sexual experience, 22% of 15-44-year-old women for whom it occurred before age 15 reported that the act was involuntary, as did 16% of those who first had sex before age 16. Involuntary sexual activity is typically unprotected and thus puts its victims at very high risk of pregnancy and STIs.Finally, recent research and clinical observations suggest that a substantial proportion of teenagers, including those who report having never had vaginal sex, are engaging in oral sex. 8 This trend has negative implications for teenagers' sexual health because many seem unaware that STIs can be acquired through unprotected oral sex.Adolescent health professionals are faced with the dilemma of how to refine programmatic and research efforts to maintain the progress that has been made while reducing those risk behaviors that remain too prevalent. The solution may lie, in part, in bridging the gap between research and programs. For more than 30 years, researchers have studied the antecedents of teenagers' high-risk sexual behaviors, and service providers have designed programs to prevent those behaviors. Their efforts have typically proceeded independently, however, and each professional community's work has not routinely informed that of the other.This lack of communication is understandable, given the differences in professional backgrounds and training, work settings and day-to-day activities. We believe, however, that this lack of communication inevitably compromises the quality of both research and programs related to teenage sexual health and behaviors.We are an interdisciplinary group of public health researchers and service provid...
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