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The developmental association of relationship quality, hormonal contraceptive choice and condom non-use among adolescent women
Abstracts / 36 (2005) 95-110
ethnic groups with one exception: a slightly higher percent of African Americans reported MSDS at 48 (20.0%) than at 24 months (16.9%). Logistic regression analysis used to calculate the relative odds of experiencing MSDS adjusted for covariates, and using Africans Americans as the reference group, revealed higher odds of MSDS for Caucasians (Adjusted Odds Ratio [AOR]⫽2.0; 95% Confidence Interval [CI]⫽1.2-3.2) and Mexican Americans (AOR⫽1.6; 95% CI⫽1.04-2.6) at 3 months, and for Mexican Americans at both 12 (AOR⫽2.4; 95% CI⫽1.4-4.0) and 24 (AOR⫽1.9; 95% CI⫽1.04-3.33) months. MSDS at 3 months were significantly related to MSDS at 48 months for all race/ethnic groups (p⬍.001). However, 48.3% of African Americans who reported MSDS at 3 months also reported MSDS at 48 months, versus 39.4% of Mexican Americans and 27.9% of Caucasians (p⬍.01). Fifty-five percent of the entire sample reported MSDS on 2 or more surveys, while 15% reported these symptoms at all 4 points of contact. These findings did not differ by race/ethnicity. Conclusions: More than 50% of adolescent mothers experience MSDS during the first postpartum year, placing them at risk for major depressive disorder. As a group, African American adolescent mothers appear to have the lowest rates of MSDS when compared to Mexican Americans and Caucasians. While MSDS appear to resolve for many young mothers, a significant subgroup, particularly African Americans, reports recurring symptoms. Thus, health care providers serving adolescent mothers should screen for depressive symptoms at every encounter for early detection and intervention. Support: Supported by the National Institute on Drug Abuse (DA09636 and DA08404) and The Hogg Foundation for Mental Health.
PII: S1054-139X(04)00277-0
97
using HLM 5. The level 1 predictor was time, to test the hypothesis that condom non use increases over time. Level 2 predictors assessed relationship quality and coital frequency across all partners to assess hypotheses that participants’ condom non use increases over time as a function of relationship quality and coital frequency. Level 3 predictors assessed the participant level influence of recent OCP or DMPA use on time-related changes in condom non use. Results: 175 women contributed 732 visits. A total 275 sex partners were reported but the median number at any given follow-up visit was 1. Both average coital frequency and average condom non-use linearly increased during the 27 month follow-up. Average partner-specific relationship quality also increased over time. At any given follow-up, about 35% reported recent OCP use, and 65% reported DMPA use. HLM analyses showed that condom non-use increased as a function of time (beta⫽2.84; p⫽0.00, Level 1 analysis). Increased condom non-use over time was primarily a function of increased relationship quality (beta⫽0.39; p⫽0.00) although higher levels of coital frequency was associated with increased condom non-use at enrollment (beta⫽0.86; p⫽0.00, Level 2 analysis). The temporal increase in condom non-use was significantly reduced among DMPA users (beta⫽⫺2.28; p⫽0.01) but not OCP users (Level 3 analysis) (beta⫽ 1.39; p⫽0.90). Conclusions: Developmentally, relationship characteristics appear to have increasing weight in decisions about condom use. Hormonal contraceptive methods are not equivalently associated with the overall temporal decline in condom use. Future research associated with dual contraceptive/condom use should address differential factors associated condom use in combination with different hormonal methods. Support: NAIAD, U19 AI31494.
PII: S1054-139X(04)00278-2 5.
THE DEVELOPMENTAL ASSOCIATION OF RELATIONSHIP QUALITY, HORMONAL CONTRACEPTIVE CHOICE AND CONDOM NON-USE AMONG ADOLESCENT WOMEN M Aaron Sayegh, PhD MPH, J Dennis Fortenberry, MD MS, Marcia Shew, MD MPH, Donald P Orr, MD. Dept. of Peds, Indiana Univ. Sch. Med., Indianapolis IN. Purpose: Consistent condom use is critical to efforts to prevent sexually transmitted infections among adolescents but condom use may decline as relationships and contraceptive needs change. The purpose of this research is to longitudinally assess condom non-use in the context of changes in relationship quality and hormonal contraceptive choice. Methods: Participants were women (ages 14 –17 years at enrollment) at 1 of 3 urban adolescent medicine clinics. Data were collected at quarterly intervals (up to 10 interviews per participant) over 27-months using a structured interview. Independent variables assessed partner-specific relationship quality (5 items; scale range 5 - 20; ␣⫽0.92) e.g., this partner is a very important person to me); and, number of coital events with a specific partner. Additional items assessed oral contraceptive pills (OCP) use and injected depot medroxy-progesterone acetate (DMPA) use in the previous 3 months. The outcome variable was number of coital events without condom use) during the past 3 months. Analyses were conducted as a 3-level hierarchical linear growth curve model
PLATFORM RESEARCH PRESENTATIONS: SESSION II Health Care Needs of Older Adolescents and Young Adults 1.
RESULT-SEEKING BEHAVIOR IN WAVE III ADD HEALTH: DO YOUNG ADULTS WANT TO KNOW IF THEY ARE INFECTED WITH CHLAMYDIA OR GONORRHEA? Carol A. Ford, M.D, James Jaccard, Ph.D, Susan G. Millstein, Ph.D. Philip E. Bardsley, Ph.D., and William C. Miller, M.D., Ph.D. Univ. North Carolina, Chapel Hill, NC; State Univ. New York, Albany, NY; Univ. California, San Francisco, CA. Purpose: It is feasible to initiate testing programs for Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (GC) outside of clinic settings. Within this context, it is important to understand factors that predict actively seeking test results when testing is initiated in non-clinic settings. Methods: This is a prospective study. All participants in Wave III of the National Longitudinal Study of Adolescent Health (Add Health) conducted in 2001-02 were asked to provide a urine specimen in their home or another non-clinic setting for anonymous CT/GC testing. Those who provided a specimen were
ethnic groups with one exception: a slightly higher percent of African Americans reported MSDS at 48 (20.0%) than at 24 months (16.9%). Logistic regression analysis used to calculate the relative odds of experiencing MSDS adjusted for covariates, and using Africans Americans as the reference group, revealed higher odds of MSDS for Caucasians (Adjusted Odds Ratio [AOR]⫽2.0; 95% Confidence Interval [CI]⫽1.2-3.2) and Mexican Americans (AOR⫽1.6; 95% CI⫽1.04-2.6) at 3 months, and for Mexican Americans at both 12 (AOR⫽2.4; 95% CI⫽1.4-4.0) and 24 (AOR⫽1.9; 95% CI⫽1.04-3.33) months. MSDS at 3 months were significantly related to MSDS at 48 months for all race/ethnic groups (p⬍.001). However, 48.3% of African Americans who reported MSDS at 3 months also reported MSDS at 48 months, versus 39.4% of Mexican Americans and 27.9% of Caucasians (p⬍.01). Fifty-five percent of the entire sample reported MSDS on 2 or more surveys, while 15% reported these symptoms at all 4 points of contact. These findings did not differ by race/ethnicity. Conclusions: More than 50% of adolescent mothers experience MSDS during the first postpartum year, placing them at risk for major depressive disorder. As a group, African American adolescent mothers appear to have the lowest rates of MSDS when compared to Mexican Americans and Caucasians. While MSDS appear to resolve for many young mothers, a significant subgroup, particularly African Americans, reports recurring symptoms. Thus, health care providers serving adolescent mothers should screen for depressive symptoms at every encounter for early detection and intervention. Support: Supported by the National Institute on Drug Abuse (DA09636 and DA08404) and The Hogg Foundation for Mental Health.
PII: S1054-139X(04)00277-0
97
using HLM 5. The level 1 predictor was time, to test the hypothesis that condom non use increases over time. Level 2 predictors assessed relationship quality and coital frequency across all partners to assess hypotheses that participants’ condom non use increases over time as a function of relationship quality and coital frequency. Level 3 predictors assessed the participant level influence of recent OCP or DMPA use on time-related changes in condom non use. Results: 175 women contributed 732 visits. A total 275 sex partners were reported but the median number at any given follow-up visit was 1. Both average coital frequency and average condom non-use linearly increased during the 27 month follow-up. Average partner-specific relationship quality also increased over time. At any given follow-up, about 35% reported recent OCP use, and 65% reported DMPA use. HLM analyses showed that condom non-use increased as a function of time (beta⫽2.84; p⫽0.00, Level 1 analysis). Increased condom non-use over time was primarily a function of increased relationship quality (beta⫽0.39; p⫽0.00) although higher levels of coital frequency was associated with increased condom non-use at enrollment (beta⫽0.86; p⫽0.00, Level 2 analysis). The temporal increase in condom non-use was significantly reduced among DMPA users (beta⫽⫺2.28; p⫽0.01) but not OCP users (Level 3 analysis) (beta⫽ 1.39; p⫽0.90). Conclusions: Developmentally, relationship characteristics appear to have increasing weight in decisions about condom use. Hormonal contraceptive methods are not equivalently associated with the overall temporal decline in condom use. Future research associated with dual contraceptive/condom use should address differential factors associated condom use in combination with different hormonal methods. Support: NAIAD, U19 AI31494.
PII: S1054-139X(04)00278-2 5.
THE DEVELOPMENTAL ASSOCIATION OF RELATIONSHIP QUALITY, HORMONAL CONTRACEPTIVE CHOICE AND CONDOM NON-USE AMONG ADOLESCENT WOMEN M Aaron Sayegh, PhD MPH, J Dennis Fortenberry, MD MS, Marcia Shew, MD MPH, Donald P Orr, MD. Dept. of Peds, Indiana Univ. Sch. Med., Indianapolis IN. Purpose: Consistent condom use is critical to efforts to prevent sexually transmitted infections among adolescents but condom use may decline as relationships and contraceptive needs change. The purpose of this research is to longitudinally assess condom non-use in the context of changes in relationship quality and hormonal contraceptive choice. Methods: Participants were women (ages 14 –17 years at enrollment) at 1 of 3 urban adolescent medicine clinics. Data were collected at quarterly intervals (up to 10 interviews per participant) over 27-months using a structured interview. Independent variables assessed partner-specific relationship quality (5 items; scale range 5 - 20; ␣⫽0.92) e.g., this partner is a very important person to me); and, number of coital events with a specific partner. Additional items assessed oral contraceptive pills (OCP) use and injected depot medroxy-progesterone acetate (DMPA) use in the previous 3 months. The outcome variable was number of coital events without condom use) during the past 3 months. Analyses were conducted as a 3-level hierarchical linear growth curve model
PLATFORM RESEARCH PRESENTATIONS: SESSION II Health Care Needs of Older Adolescents and Young Adults 1.
RESULT-SEEKING BEHAVIOR IN WAVE III ADD HEALTH: DO YOUNG ADULTS WANT TO KNOW IF THEY ARE INFECTED WITH CHLAMYDIA OR GONORRHEA? Carol A. Ford, M.D, James Jaccard, Ph.D, Susan G. Millstein, Ph.D. Philip E. Bardsley, Ph.D., and William C. Miller, M.D., Ph.D. Univ. North Carolina, Chapel Hill, NC; State Univ. New York, Albany, NY; Univ. California, San Francisco, CA. Purpose: It is feasible to initiate testing programs for Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (GC) outside of clinic settings. Within this context, it is important to understand factors that predict actively seeking test results when testing is initiated in non-clinic settings. Methods: This is a prospective study. All participants in Wave III of the National Longitudinal Study of Adolescent Health (Add Health) conducted in 2001-02 were asked to provide a urine specimen in their home or another non-clinic setting for anonymous CT/GC testing. Those who provided a specimen were