Abstract:Purpose To examine, from a youth's perspective, adolescent pregnancy and parenting in Baltimore, Maryland, a city with high rates of adolescent pregnancy. MethodsSix gender-stratified focus groups with 13-to 19-year-olds (4 female and 2 male groups; n = 47). We recorded focus groups, transcribed them verbatim, and analyzed them using the constant comparison method. Participants completed questionnaires to collect demographic and behavioral information. ResultsResults fit into a social-ecological framework. Individual (e.g., contraceptive use behaviors, religion), interpersonal (e.g., peer norms, maintaining male partners), and community (e.g., clinic factors, perceptions of community) level influences on adolescent pregnancy emerged. Participants discussed contradictory messages that were often gendered in their expectations; for instance, women were responsible for not getting pregnant and raising children. Adolescents expressed beliefs both against (e.g., challenging to complete school) and supporting early childrearing (e.g., religion). Recommendations for addressing the different influences included mentors, education, and community resources.

Given debate about the existence of a digital divide in the United States, the question remains: If individuals are in situations where all have access to the Internet (e.g., a university), will aspects of a digital divide still exist? The authors examine whether a racial digital divide exists among college students in the odds of their using the Internet and the different levels and types of usage. Data are from a random sample of full-time, residential college freshmen. Results indicate that aspects of a digital divide exist in terms of whether one uses the Internet for specific purposes; however, once individuals begin using the Internet, few racial differences exist. Internet experience and gender affect particular types of Internet usage, suggesting that the digital divide is multilayered. A policy implication from this study is that bringing individuals into structured environments with assured access may help to decrease aspects of the digital divide.

sicians should assess sexual histories in symptomatic patients as this may increase STI testing and subsequent detection. Future studies should evaluate factors affecting physicians' willingness to assess sexual history in the adolescent ED patient. Sources of Support: None. 183. REPRODUCTIVE HEALTH NAIVETY AND PERCEIVED GENDER INEQUITIES AMONG TIBETAN REFUGEE ADOLESCENT GIRLS IN INDIATenzin Dechen, BA, Leslie Jaffe, MD. Smith College Purpose: Over 188,000 Tibetan refugees, including many children separated from their families in Tibet, live in over 36 large settlements scattered across India. Girls living in foster homes at refugee Tibetan schools have sparse contact with female relatives. Cultural shyness about discussing women's reproductive health needs and absence of adult female relatives raises the question of what is learned and from whom. Inadequate or erroneous information about menstruation can lead to inordinate fear in young women at the onset of menarche. Ignorance of hygiene, sexual reproduction and sexually transmitted diseases (STDs) may lead to future adverse health outcomes. Concerns for the reproductive health of ethnic Tibetan refugee adolescent girls living in India, led us to design an assessment tool to determine the level of knowledge within this cohort. Methods: Following informed consent and guardian consent, 223 participants (7 th to 12 th grade) at the Tibetan Children's Village school in Bylakuppe, India took part in a group-administered survey. An anonymous questionnaire containing 22 closed-ended and 5 open-ended questions probed knowledge of and attitudes toward female reproductive health topics including menstruation and STDs. Descriptive statistical analyses were done to the close-ended questions. From the 22 close-ended questions, 9 were scale questions that were subjected to analysis of variance and post hoc tests. Results: Highlights of our results follow. Participants ranged in age from 13 to 19 with a mean age of 16. Menarche ranged from age 11 to 16, with age 13 being the most common (43.2%). The majority (59.2%) learned about menstruation from their friends, followed by their mother/foster mother (27.4%), sister (11.2) or no one (2.2%). The majority (58.5%) said men are at advantage because they do not menstruate; reasons included that men do not need to spend money for pads and underwear. One way ANOVA showed significant differences between age groups in terms of the menstruation being viewed as a nuisance, how menstruation occurs, family/friend/community support during menstruation and knowledge regarding menstruation and STDs. Only 57.8% participants said yes, they had heard of STDs, primarily listing HIV/AIDS, with a few listing Hepatitis (3.8%), cancer (0.8%), Tuberculosis (2.4%), Syphilis (1.5%), Warts (3.1%) The remaining 42.4% participants said they had not heard about STDs. Only 55.6% responded to the question on how STDs are contracted and how they can be prevented. The remaining 44.4% provided no response. A majority (83.4%) expressed a desire for school-based ...